Rx For Parenting Today

Anger and Lack of Attention

I was sitting in a dentist's waiting room one morning when I noticed a cute little three-year-old.  His mother was expensively dressed and reading Vogue. The little boy kept asking his mother to read him a  story from a children's book he found.The mother said " In a while." The boy continued trying to get his mother's attention but to no avail.  He then started throwing toys from a toy basket.  His mother became angry and unpleasant. I would have loved to say something but decided she probably had a nanny to do most of the childcare and really wasn't interested in the child.  I love three-year-olds and think this is a wonderful age. How could any parent act like this mother? Why did she have children if she wasn't interested in her cute little boy?

No child can be good all the time. Children need one-to-one attention. One of my favorite memories, when my son was three-years-old and I was working part time was to pick him up at nursery school at lunchtime. We would go to the local Jack-In the Box and then down to the beach where we often saw "Limpy" our favorite sea gull. Geoffrey remembers those times also.  

If a child is ignored for a time, he or she will find a way to get a parent's attention. Taking along a favorite toy, crayons and paper can help if you have to do errands or sit in a waiting room. 

Betsy DeVos and Guns in Public Schools

Betsy DeVos, the inept Secretary of Education, is advocating that teachers in public schools all be given guns. This would be a disaster. It is a well known fact that when there are guns in a house, someone in the house is more likely to be killed than an intruder. There were guards with guns at some of the terrible college and school killings. It made no difference. 

I have several teacher friends and they shudder at the idea of having a gun in their classrooms.  They would retire before having a gun where they pupils might get hold of it. I wonder if Ms DeVos wants to  have guns in the private Christian schools  she and her family  attended? By taking money form school funds that should be used to educate our children, she is just helping the gun manufacturers. Does she have stock in these companies? She is worth, I understand about nine billion dollars. Perhaps she has a good friend in the NRA?

I  have no problem with hunters and people who store guns safely. I do have a problem with guns easily obtainable in a house, particularly where there are small children. Even if the guns are under lock and key, there must not be a way a child could find a way to get into the cabinet. If a child has some behavior problems or signs of mental illness, guns should not be available. One of my favorite doctors lost his doctor son and daughter-in-law to a grandson who got hold of a gun and killed his parents. I don't know how you recover from that. 

School Anxiety and Special Education

School will start in many places this coming week.  Children may be excited about either starting school for the first time or going  back to school. Parents are often relieved that the summer is over and someone else will be looking after their children. If a child is anxious about starting school or going back to school, there could be several reasons. Some children are too immature at even age five or six to start school and need to wait a little longer. Some worry about leaving home. Others who have real anxiety about school may have a reason to do so. Perhaps they  have been bullied or have some problems that has not been addressed. I had one little patient who rebelled about returning to school. His  parents thought it was because a beloved grandfather had recently died. However, the boy had some signs on physical examination that led me to believe he could have some learning disabilities. (There are some neurological signs that often go along with  these. I wonder if these are still being taught in medical schools?) Testing by a wonderful child psychologist proved this to be the case, so with some special help  the boy no longer fought going to school.

If a child needs special education help, parents need to contact their local school special education department and fill out the necessary forms. Then an IEP should be scheduled so the child's needs can be outlined and put in place. By law every child with special needs should receive whatever help he or she needs. An IEP outlined in one school must be transferred by law to any other school a student attends.This was not done in the case of the Parkland shooter and 17 students were killed. That was a terrible, unforgivable tragedy.

The Amazing Parkland Students

I was proud and delighted to read about the bus tour many of the Parkland school survivors are on. I applaud their parents also. The students give me hope that after this administration is gone  our country can again become a place where we are proud to live. Right now it is hard to be proud except for young people like the Parkland students. They are registering people across the U.S. and I am sure they are having an impact. I wish some of the  Republicans who believe everything Trump says could talk with some of these students.

According to an excellent article in today's New York Times "Since the shooting, states  have passed at least 50 gun regulations, largely because of pressure created by the Parkland movement." Not only must we do something about gun control in the U.S. but we also must help young people who are being bullied  or need special help in school. It is easier for a school to expel a troubled student rather than to be sure they get the special help they need. The Parkland shooter, Nikolas Cruz,needed special help which he  was not receiving. The school authorities wanted him to transfer to an alternative school for students with emotional problems, where he had had done well in the ninth grade. He had been found to be developmentally delayed at age three according to an article by Patrica Mazzei in the New York Times on August 4, 2018. Nikolas wanted to graduate from Marjory Stoneman Douglas high school. He was allowed to stay there but was not given any special help or apparently any psychiatric help. What were the school authorities thinking? They were not only breaking the law but certainly helped destroy the lives of 17 students. I wonder if the school will make any changes in how they handle troubled students?

Co-Sleeping and SIDS

The loss of an infant from sudden infant death or co-sleeping is a tragedy for the parents, the extended family, and the baby's doctor. Fortunately, now that most babies are being put to sleep on their backs, the incidence of SIDS has decreased. Sadly, the incidence of infant deaths from co-sleeping has not. A recent survey showed that " The percentage of babies sharing a sleep surface rose from 6.5% in 1993 to 13.5% in 2010." The first six months are when the highest incidence of deaths occur. Small babies under four months of age are at the greatest risk from co-sleeping.

I know of one couple who the grandmother said not only had the baby sleeping with them but also one or two dogs. She and I were appalled. Fortunately, all survived, but the parents  were taking a great risk. A baby needs his or her own bed. It is important that cribs or bassinets should not have soft bedding, pillows, stuffed toys or anything a baby could come up against and smother. Crib slats should not be  more than 2 and 3/8 inches apart and  cribs should not  have sides that can fall or drop down. 

I know of  parents who give a baby a bottle in their crib at night and let it stay there. This, too can cause problems. A baby should be held when he or she is taking a bottle. Breast feeding a baby in  bed and then the parents falling asleep can also cause tragic problems. 

The answer is to use good common sense and realize that small babies can not easily move away from dangerous objects. So parents  have to be aware of problems that could occur and prevent them from happening.

Treatment of Unhappy, Difficult to Manage Children

I found a book the other day by a child psychiatrist that has been bothering me. The man described all the problems that he and his wife had with their own child. Then he made a career of caring for similar children. If I  had been asked to review the book before it was published, I would have wanted a chapter about what role the child's pediatrician or family doctor should play.  If I saw  a screaming, unhappy child, the first thing to be done  would be a medical workup. Is the child allergic, are there metabolic or thyroid problems? You don't suddenly either medicate a child or develop specific behavior control  guidelines. 

Babies who are allergic to cows milk are often unhappy, irritable children . If the mother is breast feeding, I would want her to eliminate cows milk in any form, wheat, fish, chocolate and eggs for at least a week to ten days and see if  this made any difference. A pediatric allergist would also be important to consult. I attended a talk by a pediatric allergist one day where he presented five children who had had a miserable childhood. All were very allergic  to milk. Once milk products were eliminated from their diet, they were different kids. No pediatrician had suggested eliminating milk. I was amazed.

A child should never be medicated for behavior problems without both a medical workup, including looking for allergies and psychological testing. The author of the book I was reading did not suggest either of these things. It takes time to take a good history, do a complete physical examination and talk with parents. If a doctor does not do this I would change to one who did. A three-day diet  record  of what a child eats is something I would also want. I have picked up some amazing diet patterns by asking for this record.

Eating Out with Children

These days with many parents both working outside the home, it is a treat to take children to a restaurant. If the kids develop restaurant manners early on, it can be pleasant, if not it can be a disaster. When my husband was overseas as a flight surgeon,  Jennifer, my first child, and I ate out quite often. She was always well-behaved, even as a six months old  because she had her favorite stuffed animal and I always took apple juice for her in a bottle. One time, a man at the next table kept staring at us and finally said " What are you giving that child to drink?"  I wanted to give him a bad time and say" Scotch"  but instead said  "apple juice." He looked embarrassed and stopped staring. As Jennifer and then her brother got older, I always took paper and crayons, tiny toys or favorite stuffed animals. Planning ahead can make a meal pleasant. Also, going to child-friendly restaurants and early before it gets full is a good idea.

I was eating by myself one day when the children were in college and was seated near a table with two children, probably about four and six. The parents were having wine and the children were beginning to get most unhappy. They didn't have any toys, crayons, or paper and were just expected to sit quietly.  Soon they began to get loud and  noisy and paid no attention to their parents when told to be quiet. The little boy soon got up from the table and went over to the balcony where he started climbing up and was about to go over. I was worried he wasn't safe and ask the parents if he could please go back to their table. I don't think they had even noticed he was gone! The couple were not pleased with me but did rescue the child.  I left soon after and was glad the little boy was O.K.

What Has Happened to Parents Saying "No"?

I found an interesting book in a used bookstore yesterday. It was about parenting  by Christie Mellor. She asked a question I have often wondered about.  The question was when and why did parents' ability to say "no" change so much? In the past, most parents were in charge and children didn't question their authority. Now many parents don't seem to feel they have the right to be in charge and say "No". All kids want and need their parents to do this. This makes them feel safe and secure. Christie Mellor notes that "Children really do want to be told "No" despite their protestations."  Then they have found an adult they can respect. For some reason many parents feel their children's self-esteem will suffer if they say "no". Boosting a child's self-esteem seems all important these days. There are lots of ways to do this. One is giving children responsibilities that make them feel good about themselves. Even little ones can pick up their toys, empty a waste basket and do simple chores. As they get older the chores and responsibilities should increase. I wonder how many children these days have chores? Do the parents keep chore charts, as I did? All children, both boys and girls, need to learn how to sew, iron, clean and cook a simple meal as they get older. It gives them a feeling of not only feeling good about themselves, but if they are in college or working they need to be able to take care of themselves. 

Children also need to be taught to respect others and have good manners. I am often amazed at the way I see children treating their parents and others.  If they are not taught to respect others, this can have long-term effects.