Rx For Parenting Today

Halloween Safety Tips

Halloween can be lots of fun for the whole family if some basic guidelines are followed. It is great fun for kids to create their own costumes, rather than buying expensive costumes. If a costume is purchased you want to be sure it is flame-proof. There should be a label on the costume stating this. It is best that the costume be light in color or you could put some special reflective tape on it. Masks are lots of fun, but can keep a child (or adult) from seeing obstacles or cars. The masks can be removed when crossing the street or taken off until a friend's house is approached. It is best for children to go with an adult to trick or treat and then just go to houses where you know the people. (My children always knew which neighbors gave out the best treats!)

Make-up can be used instead of a mask and a flashlight is always an important item to have with you. Going in a group is fun, as long as an adult goes with a group of children. Older kids will want to go by themselves, but should let their parents know where they will be and now with cell phones they can check in or be called. Walking on well-lighted streets is wise, as is crossing just at corners. 

When the goodie bags are emptied at home, be sure all the candies are wrapped and throw away anything that is not. Many dentists have a place where extra candy can be left and then sent overseas to the men and women in the military. Happy Halloween!

Checking for Deafness in Newborns and Infants

Many parents assume if their new baby has had a normal hearing test in the nursery before discharge that there is no problem. Even when there is a question about the hearing test, the American Academy of Pediatrics has reported that 40% of parents do not follow-up with a repeat hearing test. I know it is a very difficult time when a new baby comes home and I think part of the responsibility of having the test repeated lies with the baby's doctor. Now that some pediatricians don't  examine their new babies, but leave it to a hospital-based doctor  the information about the abnormal test may fall through the cracks. This is too serious a problem for this to happen. Some doctors do hearing tests in their offices, but this is not adequate. The hearing MUST be done in a pediatric hearing center. Otherwise there can be a false sense of security about the infant's hearing. 

An article in today's New York Times spoke about the incidence of hearing loss with cytomegalovirus or CMV. It stated that many more newborns are affected with CMV than Zika virus and yet doctors are not talking about this with their pregnant mothers. 

My other concern is that one in fifty-nine children with autism are also reported to be deaf. A hearing test should always be done when a child is autistic. I had one three-year-old little patient who was deaf from birth and her newborn brother was tested as normal in the hospital nursery.However, the mother soon realized that the baby was not reacting to sound as he should and testing in a pediatric hearing center proved that he too had congenital deafness. He was not autistic and with special help and cochlear implants he did well. What a smart mother!

 

Keeping Children Safe in Parking Lots and Public Garages

I was sitting in a busy parking lot yesterday drinking a cup of coffee. Looking out, I saw a mother and two beautiful twin girls, probably about three years old, coming out of a ballet studio. The little girls were dressed in cute pink ballet dresses and the mother was carrying a small child. The mother opened the back of her big van and started putting the little child in the car. One of the twins  hurried around to the back of the car and then to the other side. The mother was paying absolutely no attention to her when suddenly a car on the right started to back out. I was too far away to help in case the driver didn't see the little girl. Fortunately, the child then went to the left side of the car and was safe. I have been in this parking lot before and the last time kept a little child from wandering out into the busy driveway by blocking his way with my arms. Neither mother had any idea their children had been in danger.

Having cared for many post-accident children, I am always amazed when parents are completely unaware of a child in danger. How easy it would have been for the  driver to miss seeing the cute little girl and taking her life. He would have had a major tragedy and lawsuit on his hands, when the mother was the one at fault. Big garages and busy public driveways are hard places to watch children, but it just takes a few minutes for an accident to happen.

One grandmother had her three-year-old grandson by the hand in a parking lot going to her car when the little boy burst away and started running. Suddenly, a car came screeching toward the child, but the grandmother had had hip surgery and couldn't run. She yelled at her grandson, but he didn't listen. A man getting out of his car saw the danger and scooped up the child. The grandmother will never forget that almost terrible day.

Children and Food. Finding Ways To Give Kids Healthy Diets.

There here is an old saying that "We are what we eat". In this day of fast foods and many hard working, extremely busy parents, it is often difficult to provide healthy food. Also, the cost of good food seems to get higher and higher. The emphasis now on obesity in children is good, but trying to get the kids to eat foods without lots of fat in it, is often difficult. I was visiting a school the other day and saw a small, overweight child eating carrots, but putting thick salad dressing on each small carrot. I have never seen a child do that and wondered where he learned this or where he got the packet of dressing?

I often tell medical students about the child who was referred to me from an excellent pediatrician. The child was showing signs of muscle weakness and was always tired. He was also quite irritable. I couldn't find anything, when I examined the child, that made me think of a muscle disorder. In talking to the mother and finding out about the family's life, I discovered she was an extremely hard  working single parent. I asked her to send me a three-day list of everything the boy ate and she did this right away. The list was primarily composed of fast foods with little fruits, vegetables, or salads. I talked to the mother at length and gave her some ideas about how she could shop on weekends and draw up a menu  plan for the week, as I did when my children were at home and not in college. After about two weeks, I had a call from the mother saying the life of the whole family had changed and the  little boy was full of energy, had no more signs of muscle weakness, and was no longer irritable. I wished I could cure other muscle diseases so easily.

 

 

Stomach Aches in Children

When a child has a stomach ache, it can be a simple thing like eating some spicy or other food that disagrees with the boy or girl or it can be more serious. I would first think about common things such as constipation. Little two-year-olds, who love milk to the exclusion of food, are particularly likely to get constipated. If the stomach ache is recurrent I would think about allergy. A friend, who was a physician, was having terrible headaches for which her doctors were not able to find a cause. She found it herself and discovered it was chocolate. A good pediatric allergist should be able to help find out if food is the cause for the stomach aches. 

One cause that is often not recognized is a urinary tract infection or abnormality. I find that doctors these days don't check urine specimens very often which is not wise, because the urinary system is the site of the most frequent congenital abnormalities. It took until my sibling's teenage years for a new doctor to discover a major kidney abnormality that required major surgery. 

If medical reasons can not be found for stomach aches then I would look for emotional reasons. Sometimes a child is being bullied and does not want to go to school, is learning disabled or having some other problem that a good psychologist or psychiatrist should be able to diagnose. Yes, cancer or tumors of some kind can cause problems, but I would first look for common everyday things. 

One of the most unusual things I found in a patient was an X-ray of the child's abdomen that showed he had swallowed a razor blade! I still have the X-ray. So I would insist the child's doctor keep looking if stomach aches are on-going. 

 

 

Why Some Little Babies and Children Cry and Cry

It often amazes me why even bright, well educated parents try to solve a medical problem and don't ask doctors for help. I have been reading an interesting, true account of young parents who took a fifteen-month-old and his three-year-old brother to Europe for a year. The younger brother was very difficult to handle because he was always in trouble and he cried or screamed day and night. This lasted until he was about two and a half when he suddenly stopped crying. At no time, was there any mention of a doctor or doctors being consulted, either in the U.S. or Europe. As I read the book, I thought about what I would have suggested or done if the little boy  had been a patient of mine. One of the first things I wondered was if the little boy was allergic? Allergic children can be very miserable and make the rest of the family very unhappy. If a pediatric allergist was not available, I would have given the parents a list of foods to eliminate from the child's diet, slowly one at a time. Cow's milk is the biggest offender, but sometimes even soy milk can cause problems. The other foods that can cause problems are eggs, citrus, wheat, chocolate, fish, and nuts. If the child had respiratory symptoms, he could be allergic  to dust, animal dander, pollens or other things in the environment. 

There can also be a physical reason why little children cry. I saw a little boy one day, as a patient, who not only cried, but he limped. I asked for an X-ray of his leg and foot and discovered  there was a needle embedded in the child's food. The little boy spent many days with his grandmother, who did a lot of sewing. Once a surgeon removed the needle, the child no longer cried. I had another child who had a bead in his nose, another had a bug in his ear and an older little girl had a safety pin in her vagina. I am always amazed at where children stick things. So there usually is a reason why children cry and cry and good medical care should be able to find an answer. It might take more than one doctor to do so.

 

Anorexia and Bulimia Are Treatable

All the ugly statements Mr. Trump made this past week about women and their weight have greatly increased the problems that both parents and doctors have in caring for girls with anorexia and bulimia. When I was in private pediatric practice, I cared for many teenage girls with the disorders and know how difficult they are to handle. Fortunately, I had a wonderful woman psychiatrist to help me with the patients and together we were able to keep all but one girl out of the hospital. I knew the families, made house calls and was available to help handle the on-going problems. I always insisted that both the girls and the parents have therapy. One father, who was a psychologist, insisted on weighing his chubby daughter every morning. Was there any wonder she developed anorexia? There are now big programs where girls with anorexia and bulimia are being sent when the local doctor is either unwilling or unable to  help. I attended a seminar one day at a well-known medical school where the speaker insisted that no patient with these disorders could be treated by local doctors. During the question and answer period, I raised my hand and said I had successfully treated many teens and had had to hospitalize just one girl. The speaker said in an arrogant voice, that she did not believe me. Well, she was wrong. We knew the families, worked closely with them, and the girls trusted us. I think a teen's doctor should be the first one to be called and hope the doctor will either take the appropriate action or make a referral to someone who has had considerable experience with the disorders and not send the girls to a big impersonal medical school program.