Rx For Parenting Today

Hearing Problems and Unhappy Children

I saw a new child in my office one day who the parents said always seemed miserable. They and the doctors they had seen thought the little girl was developmentally delayed. The little three-year-old did look miserable. I did a complete physical examination and could not find any problems except I could not see the ear drums. The ear canals were completely blocked by hard wax. I probably spent about 30 minutes cleaning out the ear canals and all of the sudden the child sat up, smiled and said" Thank you," She had not been able to hear and could not tell her parents why she was so miserable. She was not developmentally delayed but was hard of hearing because of all the build-up of wax in her ear canals. 

Sadly, I find that many doctors do not know how to clean out ear canals and also don't want to take the time. The otoscopes doctors use to look at the ear drums are often wrong for  them to be able to see and clean out an ear canal. I have tried hard to get two different medical school bookstores to order the necessary otoscopes. I was teaching at UC San Francisco Medical School one day and showing medical students how to clean out ear canals. Suddenly I was surrounded by a large group. The  chief resident was among them and said " Please come back. No one has ever shown us how to do that."

I  have taken beads, bugs and other foreign objects out of ear canals. I have also always done myringotomies when there was a full, red, bulging ear drum. That seems to be something that is not done these days. Of course the incidence of deafness in children goes up and up. We can do better.

 

More Travel Safety Tips for Parents

If you are planning to stay in motels or hotels on your travels, One problem I learned from experience was to check windows. Children are often eager to see what is outside and may try to climb up to look. Some even major hotel chains are not careful about putting protective screens over windows to be sure a child cannot slip through and fall out. Some serious injuries and even deaths have occurred as children fell from a window high up. I spent several weeks on the phone and writing letters after a wedding in Washington D.C. when I discovered there were no screens on the hotel windows. I finally reached the CEO in Florida who assured me he would take care of the problem. We had the same problem at the University Hospital when the UC San Diego Medical School first opened. Fortunately it didn't take too long for the windows to have screens.  

Another problem is with cribs. Some do not have adequate, stable outside rails, so I would check any hotel or motel crib you use. The mattresses need to be firm with no pillows or soft protective coverings around the bed rails. 

If you have a child with autism,  he or she should wear a Medic Alert bracelet  in case the child slips away. If you are staying with a relative you want to be sure the doors have adequate locks and the windows are shut. Autistic children are very clever about finding ways to get outside and run away. Travel can be lots of fun if  precautions are taken.

Traveling with Children

Now that summer is here, many families are traveling. I've had to travel with tiny babies, toddlers, and older children. Some of the things I've learned have been helpful to many of my parents. If you are flying with a baby or small children you want to be sure they are swallowing from a bottle of milk or water when the plane takes off and lands. Otherwise they may end up with a painful ear. If you are breast feeding that is fine too, as long as the baby is actively sucking.

Little children need lots of things to keep them distracted. A favorite toy is important for a child to have and I would discourage the use of electronic devices for them. It would be good if older children or teenagers could read or play a game rather than spending the entire flight looking at electronic devices.

If you are traveling by car, frequent stops are a good idea. I always had a bag at my feet with surprises and good nibbles. Be careful about hard objects that could cause swallowing problems. I would avoid nuts, cubes of cheese, raw vegetables or anything that could get stuck in a child's throat.

If a child develops medical problems along the way, I would first try to reach the child's pediatrician. Some of the urgent clinics may not be the best and ER's don't usually  have doctors with pediatric training. Playing car games is fun such as looking for license plates of all the states, playing "I spy" and singing. Old fashioned things make the time go more quickly and may leave some nice family memories. 

When Your Children Argue, Bicker or Fight

Being a parent,single, divorced, or widowed can be hard work but also very rewarding.  Parents often ask me what to do when their children don't get along. If the children just bicker that is one thing, but if they fight or hurt each other that is completely different. No child should be allowed to hurt a sibling or a friend. I've never understood the purpose of time-out and wonder if it really works. I once asked both of my grown children what was my best form of discipline. Both were in their late 20's and in different parts of the U.S. They both said" Just your voice, mother."  I was very lucky that right from the beginning the two children were friends. Yes, they had their disagreements, but if they sounded too loud I would ask them to spend some time in their rooms. I was fortunate becasue they knew how hard I worked as a pediatrician and they helped as much as they could. They had chores, allowances, and helped me often about how to handle particular problems with patients. Of  course, no names were used. As they got older they also had summer jobs. Teaching  politeness is best done by letting them see how you treat others. I've heard amazing stories from employees in three businesses telling me how they have been treated by customers.  Children see how their parents treat friends, people in stores, and employees. Role modeling is very important for children. If you lie, are rude, or unpleasant your children will quickly pick up on that way of treating others. If you have real problems with your children fighting or  having bad behavior, then sometimes some family or individual counseling for a child is needed. There could also be an underlying problem that some testing or a good physical examination could determine.

 

 

Does Trump Have any Concern or Compassion for Children?

The babies and children who have been separated from their parents at the Border are a daily painful concern for me. Many may never see their parents again. I admire the Judge who is demanding daily reports. Children are the future of our nation and what has been done to these babies and children may never be completely undone. 

Now an new indignity has been wrought by Trump. He has not gone along with the World Health Organization statement that breast milk is important and best for babies and little children. Instead the formula companies have lobbied him to say that formula is fine. If it is in a powered form and mixed with dirty water, as may happen in Africa and other third world countries, the babies can develop diarrhea and can die. What is the man thinking? Apparently no one in his inner circle can keep him from making these harmful and  dangerous statements. 

Our environment is under attack from the EPA, even though Scott Pruitt is now gone. Clean air and clean water are vital to all of us, but particularly for growing children. I  hope that  thinking parents will start protesting strongly. 

Then if the new Supreme Court nominee is chosen, teenagers who become pregnant will be forced to carry the babies to term and their lives will be forever changed.  Mothers who can not afford any more children will suffer greatly, as we go back to families with eleven and twelve or more children. I  have seen the great damage this can do to children who  get  little  parenting because their mothers were always pregnant, tired, and miserable. We all must speak up and not allow this to happen.

 

Keeping Children Safe in the Summer

Summer can be fun for parents and children if there is time to enjoy it and each other. Now that many parents both work outside the home, summer can be difficult. Hiring childcare workers can be a problem but is important if there is no one to supervise the kids in the summer. Summer camps  for older children can help if they are carefully researched. All children need to learn how to swim. Teaching babies to learn to swim is not something I am comfortable about. They need to be old enough to understand what they are being taught. If you have a swimming pool or access to one, kids need to learn what is safe and what is not. An adult needs to be on duty to be sure any child in a pool is safe. If a neighbor has a pool with a cover on it, be sure a little child can not find a way to get into the neighbor's yard and slip under the pool cover. All pools should be fenced if little children can access them. 

Spending time at the beach is something many families enjoy. Now that we have such severe climate change the days seem to get hotter and hotter. Sun screen is important to use for children after six months of age.  Otherwise hats for little  ones are very important. We always had a big umbrella when we took our two children to the beach. I don't do well in hot weather and the umbrella was a great help in keeping us cooler. Children can be hurt by sharp objects in the sand and hot coals from a barbecue can cause severe burns. 40% of the visits to emergency rooms in the  summer are by children.  So please have a safe, but fun summer with your family.