Rx For Parenting Today

Neighbors' Children

Having great neighbors can be a wonderful gift, particularly if they have children who are pleasant and not spoiled. When parents have little control over their children or really don't care what they do, then you may have major problems. Children of all ages want and need limits and do respond to voices of authority. If you allow any child to be in control, trouble may loom. I was always glad to have kids play at my house when I was home because if there was a problem, I could take care of it right away. A good friend and I were talking the other night and she told me of the neighbors' son who she had next door. For the last few months he had started bouncing a ball at all times of the day and even late at night. He was  probably trying to score baskets and the patio was right behind her bedroom. She said she had been sleeping in another bedroom away from the neighbors' back yard, so she could not hear the bouncing. Then finally one night when she was tired, she went outside at 10:30 and said " You need to stop bouncing your ball now."Immediately, the youth said "O.K." and the bouncing stopped. She realized she should have done something like that several months before, but did not know the neighbors and hated to cause problems. I(t will be interesting to see what happens now, but I suspect the youth just needed an adult to say "Stop." Apparently his parents, were afraid to set limits or were just never home.

I remember a man telling me  his mother used to lock him out of the house after he had had breakfast and he had to entertain himself the rest of the day and forage for food from kind neighbors. Not all parents love their kids and many wish they had never had them. Lining next to neighbors like that can be a nightmare and even making a call to child protective services can cause terrible problems and may not result in helping a child. There are some great social workers in child protective services and there are some who just want their monthly check and don't care about the children they are supposed to protect.

So if you have problems with a neighbor's child, I would try to talk directly to the child or teenager and see if you can make them understand that certain behavior is just not acceptable.

Anxiety and Fear in Children and Teenagers

Fear and anxiety can be normal responses to dangerous situations and act as alerts. However, if a child or teen constantly feels anxious or fearful, then it is time to investigate the cause and take action.   Unfortunately, anxiety may be  a problem in about 25% of children with attention deficit hyperactive syndrome or ADHD. Children or teens with Asperger's Syndrome or Autism may also have anxiety and the statistics are that this occurs in  about 10% of kids.The National Institute of Mental Health has reported that about 19 million people in the U.S. have chronic anxiety. Some of this can be traced to early traumatic childhood experiences, such as some unbelievable accounts, as the child whose father tried to drown her in the bathtub, the girl whose father hit her repeatedly when she was in bed and trying to go to sleep and mothers, too, who were extremely cruel. How any parent could hurt a child is beyond my comprehension. 

If caring parents want to find an answer to anxiety in a child, then the place to start is with a good physical examination and basic blood work by the child's doctor. If no abnormalities are found, then the next step is an appointment with a well-qualified psychologist. Some testing will probably be needed to find out what is going on. If money is a problem and private testing is not possible the Regional Centers should be able to help, but this depends on the state and the help may be variable. If parents apply for testing by the school psychologist, this could be helpful, but sometimes school psychologists neither have the time, nor the training to do the necessary testing. An application would need to be made to the special education department in the child's school district.

Medication can make a great difference with some children and it would need to be prescribed either by a pediatrician or a psychiatrist. Social workers in large HMOs may be the ones asked to do this, but legally they should not be allowed to do so. There are some good community clinics that have doctors on the staff, so every child who needs help should receive it. Chronic anxiety can interfere with a child's life and well-being, so something needs to be done to help.

Overseas Travel with Children

Travel to other countries can be a wonderful experience, though it is a bit more risky now with all the problems with terrorists. Traveling as an adult is one thing, but traveling with a small child is quite different. I was recently in a New York City hotel waiting for a friend. A beautiful woman with a ten-month old was sitting near me and we started talking. She had just come from Dubai and I was interested in details about her country. While we were talking I noticed her little boy had considerable pus coming from one eye. That concerned me because the mother did not seem to be aware of this or if she was, she didn't seem too concerned. I told her I was a pediatrician and hoped she would ask the concierge at the hotel about finding a pediatrician. She promised that she would. If I was treating the child I would have wanted to get a culture of the pus to be sure I was prescribing the right medication. Children can become ill very quickly and traveling increases the risk, as they are exposed to many people and also can become extra tired. For overseas travel, you want to be absolutely sure your child's immunizations are up to date. Tuberculosis is still prevalent in many countries, so a TB test before you go, if your child has not had one, is a wise idea. Many doctors these days don't seem to worry about tuberculosis. If you know that the test is negative before you leave and a test later shows it is positive, you know treatment is needed. Polio is still a threat in some countries and in some countries malaria and parasitic diseases are common.

Remember if you are flying with a small baby or child, he or she needs to be swallowing or sucking on a pacifier when the plane is taking off or landing. A painful ear can result if a child is not sucking or swallowing. Having the name of a doctor in the place where you are going is always wise and often your child's doctor can give you advice about how to find one. Hotels usually have a doctor they trust who can be called. 

Body Piercing and Tattoos in Teens

I have never understood why kids and adults would want to have piercings done in various parts of the body. I realize that for some teens, in particular, it can be an act of rebellion against their parents or society in general. Tattoos have a long history and for some it is viewed as  body art. I am seeing more and more of both, particularly in adults. I saw a beautiful, young woman the other day who was professionally dressed and yet there was a tattoo on her leg and arm. I guess the culture now is that employers are afraid to say anything because it may not be politically correct. However, if the young woman were applying to law school, medical school or a Wall Street firm, I think it would reduce her chances of a job or acceptance. One of my former medical school classmates, who was an obstetrician, now volunteers in a clinic to remove tattoos. They can leave bad scars. Also, when receiving a tattoo if the place is not licensed and sterile technique is not used, the risk of infection is great. 

Body piercing is done even in small babies in some cultures. If a baby has an earring, the infant can rip out the earring and tear the ear lobe. I have seen too many torn ear lobes to ever allow someone to pierce my ears. Infection, too, can result and this is particularly risky with a small baby.  A baby could also get hold of the earring and swallow it or choke on it.  Almost every part of the body is pierced in some individuals. I remember a pretty young teen working at Starbucks who had her nose, her ear lobes and her lip with rings in them. I wondered where else she had piercings. Some teens ever have balls placed in their tongues.

The care of both tattoos and body piercings can be time consuming. Also, some people can be allergic to the dyes or the metal in the rings that are put in place after the piercing is done. For parents, I think it is important to talk with your teens, if this is something they would want to do. If there is mutual respect between parents and teens, I would expect that the teens to ask permission to have a tattoo or body piercing done. Both make a statement that may not be acceptable to your parents, your friends, your teachers, or other individuals. I think children want to be proud of how their parents look, just as parents want to be proud of their children.