Rx For Parenting Today

Successful Step-Parenting

Step-parenting can be a difficult task if the children are old enough to resent you and have strong ties with their other parent. Even if your partner has lost a spouse, the children may still remember enough about their mother or father that they don't want anyone to take his or her place. My daughter became a step-parent to two girls, four and eight. It took quite a while for the girls to love and respect her and as adults they greatly missed her after she died from breast cancer. Both of them told me how much she helped them and all the things she taught them that their own mother was too busy or uninterested to teach them. Jennifer had what she called her 1-800-Mom line that she used when she needed my help. It took quite a while for the children to follow her rules and realize  she truly loved and cared about them. Now both are married and I am sure will use many of the things Jennifer taught them when they  have children of their own.

Sometimes a step-parent finds that no matter what he or she does, there is just no way to make things better. Two step-mothers told me they finally had to get a divorce because each had a step-child who had their fathers completely under control. One step-son was a twenty-four-year old who slept on the couch, never looked for a job, and was probably using drugs. The step-mother finally gave up when her husband would not do anything about his son.

One sad case was a couple who were married in my garden and were much in love. Unfortunately, the woman had a very spoiled daughter who tried from day one to break up the marriage. It took her a year, but she succeeded. The couple are both dead now and I wonder what has happened to the girl and if she has any regrets?

Another woman told me she tried in every way she could to set limits for her step-daughter, but her husband would not back her up. The girl had two abortions and then after the couple were divorced decided to keep the baby after the third pregnancy. She relied on her former step-mother to help her and seemed to have matured quite a bit. So, all you can do is decide what yo will and will not accept and if the kids won't listen and your partner won't back you up,  you have to make a choice about whether there is any future for your marriage.

Muscle Weakness in Children and Malignant Hyperthermia

I recently spoke with parents who had a child with undiagnosed weakness of the muscles. The parents were intelligent, caring and had the money to seek doctors' opinions about their child in leading medical centers. They were concerned about the need for a muscle biopsy, which I told them needed to be done. One doctor had simply advised doing genetic tests and another didn't take a good  history or do a thorough examination. I emphasized the importance of having the muscle biopsy done using a local anesthetic, not under a general anesthetic. No physician had discussed a biopsy with them or the fact that Malignant Hyperthermia was a concern. The parents had not heard the words and were dismayed. I explained that in certain muscle disorders if a general anesthetic was given using specific drugs that high temperature, tightness of the jaw, and other dangerous symptoms could result. If an anesthesiologist is aware of the problem, the anesthetics that cause problems can be avoided. However, a general anesthetic is not necessary to do a muscle biopsy. It is a simple procedure and I have done or helped with many. In England, where I did some of my neuromuscular training, we did the biopsies with a special needle and were able to get adequate tissue. I remember one woman surgeon who  insisted on using a general anesthetic. When I said I would not be involved unless a local anesthetic was used, the woman  left in a huff. Fortunately, another surgeon was found who did the biopsy the way I had been trained, using a local anesthetic. Children with Duchenne muscular dystrophy and Central Core disease are particularly at risk if specific anesthetics are used. The anesthetics to avoid are: succinylcholine, halothane, enflurance, isoflurance and sevoflufrance. A board-certified anesthesiologist should always give the anesthesia if a general anesthetic is to be used on patients with muscle weakness.  A family history of anesthetic problems is always important for a doctor to take because the problem can run in families.

The Malignant Hyperthermia Hotline provides valuable information and a physician is always available to answer doctors' questions. Their number is 1-800-644-9737. Also, if a child is a risk for this disorder, it is wise to have him or her wear a Medic Alert Bracelet that notes the problem. Their number is 1-209-634-4917.

Children and Grandparents

Loving, stable grandparents can make a great difference in children's lives. Unfortunately, some daughters-in law or sons-in-law may feel threatened by their mate's parents and refuse to let the grandparents have any contact with the children. Grandparents' legal rights to see their grandchildren vary from state to state, so if the parents refuse to let them see the children, they have almost no recourse.  Of course, if they can prove the parents are abusive, drug users or have mental problems, they may have a case to see the grandchildren.

Grandparents, who are allowed to be involved in their grandchildren's lives can have a lasting impact. I have two friends who  were essentially raised by their grandmothers because their parents worked or were gone for varying periods. Grandparents can provide a sense of family, of traditions and if they are great cooks, lasting memories of delicious cookies and cakes.

Eleven million grandparents have either part or full-time care of their grandchildren. For these grandparents, it is important they are provided  legal documentation, so if emergency medical care is needed, the grandparents have permission  to do what is necessary, if the parents are not available.

I can remember seeing one grandmother when I was about four, but have no other memories of her. I do have many pieces of her furniture and dishes which I treasure.  I hope that parents today will make a place for their parents in the children's lives.Grandparents can bring a sense of belonging and comfort that is very important for today's children.

Helping Children Develop Good Self-Esteem

Children with poor self-esteem often become the target of bullies or they themselves may become bullies, in order to have some power. Those with disabilities are particularly the target of bullies. One of the hardest jobs parents have is to help each of their children develop a sense of who they are, so they will have good esteem. The current trend of parents constantly praising, even when it may not be warranted, is not the way for a child to develop the best self-esteem. Instead, finding a child's special ability or talent and helping it to develop will  give each child a feeling of confidence in  his or her own ability.

Giving kids chores seems to be almost lost today, as many parents offer very possible advantage: music, sports and  lessons of all kinds. Learning how to take care of  yourself; knowing how to cook, clean, iron, sew and do other household things gives kids a great feeling of confidence. I frequently talked with the parents in my pediatric practice about teaching children the steps of independence.  Of course, some parents try to hold onto their children and the kids may end up either hating their parents or leaving home, as soon as possible. The old saying of giving a child roots and wings is still a good one.

Spending one-to-one time with each child is important to find out what they want in life and his or her dreams. Giving lots of hugs and as much responsibility and independence as their age and maturity allows will also pay off. If a child has poor self-esteem, sometimes counseling  may be warranted.

Tips on Helping Picky Eaters

I was talking with the mother of a teenager the other day and was interested to hear her say  her daughter had always been a picky eater. I am sure the girl has ADHD, although her pediatrician has apparently never made that diagnosis. The next day I found an article in the journal, PediatricsConsultant that suggested picky eating could possibly "signify psychological health problems, such as anxiety, depression, ADHD and require medical intervention." The article was short and didn't go into other reasons why children become picky eaters. I think that is unfortunate, because before a doctor decides a picky eater has a "psychological problem", I hope he or she takes a good diet history and finds out about family eating patterns and what happened if a child from early on will only eat certain things. Allergic children may not eat things that bother them and a pediatric allergist should be able to help about  this.

If a child is just given the foods he or she likes when solid foods are started, a pattern will be set up.  My advice to parents has always been to expect a child to eat what is on the plate and for parents not to fix special meals unless there are allergies or something like Celiac disease. Yes, a child may start to throw things and have tantrums, but if he or she  is taken down from the table and not given food between meals, the child will soon become hungry enough to eat the food that is offered. I have seen this happen over and over again. It may take four or five days, but as long as the child is urinating and drinking plenty of juice and liquids, there should not be a problem.  Early eating habits can last a life-time.

It is true that children with autism and some on the Autism Spectrum or ASD may  have oral sensitivity, so this needs to be taken into account for these kids.

Fun Ideas to Keep Little Ones Away from Electornic Devices

I talked with a father at a recent book event and was delighted to see his beautiful, bright 13-month old. The father seemed worried that he and his wife were not giving their child enough intellectual stimulation and said they used flash cards and  a commercial product promising to make children bright. I told him his obviously bright little child just needed lots of hugs, books read to her, and some fun, creative toys. The next day I made a list of the things I used to keep my children busy and happy when they were little and I also looked at the list two famous child development experts had in the back of  their book.

My list was as follows: wood puzzles with big pieces, pull toys, pots and pans, cloth dolls, stuffed animals, a small plastic telephone, plastic rings that stack on a pole, plastic and small wood blocks, a toy xylophone, balls, a doll carriage, a small broom, and flour, salt and water to make dough. When my children were very small we lived in Rochester, New York where the winters were long and terrible. Thus, I had to be very creative about keeping the children busy. We had a black and white TV, but it was seldom turned on and fortunately this was before the days of so much marketing for children's products and so many technological devices. The American Academy of  Pediatrics has tried for years to keep little ones away from television. At this point, I think they realize that parents and baby sisters are still going to use the TV as a babysitter. It is reported that about 26% of two-year-olds have a TV in their room. I think that is appalling and harmful to the children. Kids need time to devise play that is not programmed and to be creative. Stifling their creativity  may have some long-term repercussions, I am afraid.