Rx For Parenting Today

Where Were the Parents of the Teenagers?

As I watched the Ford/Kavanaugh TV spectacle, I kept wondering about the parents at the houses where the teens had their drinking parties. I cannot imagine allowing teenagers to  have a drinking party with no adults in the house. A doctor friend's son saved a friend's life at a similar party. The youth had been drinking heavily and became blue and unconscious. My friend's son was raised by two doctor parents and began CPR while someone called for an ambulance and the police. Unfortunately, most teens would not know how to do CPR.  So once again where were the parents? 

Teenagers think they are very mature and want to act like adults. Sadly, most still have a lot of  growing up to do before they can handle emergencies.  I was fortunate to be raised in a dry college town. I don't think I had anything with alcohol in it until I was in my junior year at Stanford. Yes, there were beer parties in the fraternity houses, but I didn't date anyone who attended them. Later on I remember a date bringing me two or three glasses of wine that I poured into a nearby plant. I have always tried to convince the parents of patients I cared for to know where their teens were going in the evening and also check  that the parents would be there. Getting to know the parents of your children's friends and checking with them is wise. A party with little or no food, lots of alcohol, teenagers  and no adults present is a recipe for disaster. 

 

Finding the Best Childcare

It is hard to be a working parent when you have children. If they are small and not in school, how can you find someone to care for them who  you  can sure will keep them safe? Even though you check references, the references could be written by friends. I found this out the hard way and had an unpleasant experience. Fortunately, I always knew to have a neighbor stop by to see how things were going, so I was able to handle the problems that arose. 

If you are going to put your child in a commercial childcare facility, you will want to check it out thoroughly. I  have visited some that were pretty bad. The facility should be licensed and it is always a good idea to talk to some of the mothers who  have children there. Stopping by at different times of the day can show you if the children are happy and clean. I would ask what the policy is about sick children. Do they send them home or have a separate room where they can go? I had one patient who was always sick a few days after he had been in a childcare facility. I had another one who got into dishwasher detergent under the kitchen sink and ended up with surgery on the esophagus or feeding tube. 

It is important that you know the medical history of any childcare worker either in your home or in a childcare facility. Have the workers had recent chest X-ray, had their fingerprints taken and are they smokers? Did they give a letter from their physician?

Some good resources to find help are college employment agencies, au pair agencies, your child's doctor, and parent newsletters. Networking with others  parents can be helpful.  My son found two different good nannies from the agency, Nanny Care. Both women were college educated and were great. 

Having Fun with Your Children

I see far too many stressed parents these days who don't seem to be enjoying their children or having any fun with them. The parents' focus seems to be getting the children to excel in school, sports and several outside activities. Yes, their children may get into prestigious Eastern colleges, but at what cost?  Will the children remember their childhood as a time of fun or just stress? Will some of these college kids find ways to end their lives by suicide or get into drugs or alcohol? This is happening far too often. I remember the girlfriend of one of my grandson's friends. She was beautiful, smart and wanted to be a doctor.  I was told she  came from a dysfunctional family  and ended her life when she was still in college. What a terrible tragedy and waste. 

Even though I worked full-time, I loved spending time with my two children and their friends. There were always soft drinks and food for them in our refrigerator and over the years we had two different, wonderful housekeepers. One had been a teacher and the other a business owner. Because I was divorced and often at the hospital in the evening, the women took over when I could not be home. I  have special  memories of picking the children  up at noon on Friday, a half school day, and taking them ice skating. At noon on Saturdays, they came by my office and we went to a favorite place for lunch. I didn't  have a lot of money, but we found ways to do things that didn't cost a lot. (Pediatricians are the bottom of  incomes for doctors.) I visited both when they were in college and later we had some special trips. Yes, there were days when I was exhausted, but I feel very fortunate that I was able to enjoy my children and remember many, many good times together. I hope other parents will think about the memories their children will have about childhood and their later lives.

 

Safety Concerns for Children with Autism

Children with autism are at very much risk for getting into dangerous situations. Those who like to escape are particularly at risk. The first precaution to take is to be sure the child is well known in the neighborhood and by the local police. A Medic Alert bracelet with the 800 number and the child's name can be an important step. Being sure there are strong locks or bolts on doors and windows is important also. If a child is riding in a car, you want to check that  there is no way he or she can suddenly open the door when the car is moving. Yes, this does happen. If necessary the inside door handle on the child's side can be removed.

If you are in a rental home or apartment, it is your right to  have the necessary locks placed on the doors and windows. Not only do many of the children like to escape, but some enjoy throwing things out of the windows. You could lose some valuable possessions that way.

Because a percentage of children with autism  have partial or complete hearing loss, this should be looked for and extra  precautions taken. Some children with autism  have increased sensitivity  to sound. If the child suddenly covers his or her ears, removal to a quiet place is needed.

If developmental delay is present, a child may not be able to realize dangerous situations or people. This can be an ongoing worry for parents. Siblings should not be put in the position of always having to be sure the child is safe. This puts a huge burden on a sibling who does not  have autism. As the children get older, they will hopefully  be more aware of potential dangers. Special help by professionals can make a difference.

Feeding Small Children

Having a child who is a picky eater is a real challenge. I had one child who loved to eat and was easy to feed. The other one was a  picky eater and yet grew up to be a great cook and one who liked to eat.

Some of the things I learned with my first child, who was the picky eater, were the following: 

• Simple, single foods are the best to offer.
• Mixtures are not well tolerated by most small children.
• Mixing a favorite food with one that is not particularly liked often works.
• Sitting down and eating with your child or children will help.
• Snacks between meals are not a good idea. Apple juice can be a good substitute.
• Graham crackers contain lots of sugar and should just be an occasional treat.
• Milk between meals will kill a child's appetite for a regular meal. 
• No child should be forced to eat everything on their plate.
• If a child greatly dislikes a food, he or she could be allergic to it.
• If there is a problem with constipation, avoid apples and bananas.
• For small children, start just one food at a time. That way  allergies can be detected.
• Small children or preemies may need small frequent meals.
• Vegetarian diets for small children can lack needed protein.
• Pre-packaged food for children may contain many  calories and not much nutrition.
• Catering to a child's food wishes can create eating problems.
• If a child refuses to eat what  is on his her  plate, I would take the plate away and not offer anything until the next meal.
• Good luck!

 

Health Concerns for Children

It is the vogue in some  communities to give herbal medicines to both adults and children. Children can die from herbal medicines, so it is not something to  be taken lightly. One step-mother gave her step-daughter 23 herbal medicines. The girl was greatly underweight and the 23 medications did terrible things to her appetite and her health. It was a bit of a fight to keep the step-mother to stop the practice, but it was either that or I could not be involved in her medical care.

Both babies and children should receive a multi-vitamin. Health store vitamins should be avoided. A yearly urinalysis and check on hemoglobin should be routine tests. I also advocate a yearly tuberculin skin test. Many children's doctors don't do this and it is of concern with caretakers, grandparents and others who may come from countries where TB is often seen. I  found two children in my private practice with early acute TB. They had grandparents from other countries and picked up the TB from them. With early treatment, they did well.

Pets can transmit diseases, so children should always wash their hands after playing with a pet. All pets should be seen regularly by a veterinarian and receive their necessary shots. 

Vision and hearing should be checked on a regular basis. Hearing loss can easily occur with repeated ear infections or in teens who listen to very loud music. When a child has repeated ear infections and the doctor keeps ordering antibiotics, I would urge that a  pediatric ear-nose-and throat doctor be seen. Because most doctors don't do myringotomies these days, as I did, the loss of hearing is on the rise among children. I was often amazed at the amount of pus that would come when I put a tiny slit in an ear drum. The children often thanked me because they could hear and feel better.

 

Emergencies in Childhood

If you are a well organized parent, I am sure you have thought about what you would do if an emergency occurred with one of your children or a child  at your house.  In many ways it was easier being medically trained as a parent when I had children, but harder because I knew all the problems that could occur. When we were renting a house and finally buying one of our own, I made the decision a pool was an absolute No-No. I love to swim but with both of us working, I would never have been sure the children were safe. One thing I always did when the  kids were small was to walk around the house before I went to bed to check on anything  they could get into and  to be sure all the windows and doors were locked. This is particularity important if you have a child with autism. Trying to escape can be one of their favorite games.

If you are a non-medical parent, taking a CPR course or looking for one on-line could be life-saving. Having the necessary items in your house in case of illness or an injury is important. You need a first-aid kit, a good rectal thermometer and basic information about emergencies, Posting the number of the poison center on your telephone or your refrigerator could save time if a child ingested a poison or took someone's medicine. Eye injuries should be treated immediately.  If a child has a convulsion or seizure,  be sure  he or she won't be able to come in contact with any sharp objects.  

If you need to take a child to an emergency room, remember all hospital emergency rooms don't have the necessary equipment to care for small children. If you are new to an area, I would check with your child's doctor to be sure the nearest hospital does have pedaitric equipment and a pediatric anesthesiologist. I give a long list of pediatric emergencies in my book, Your Personal Parenting Guide. 

Siblings and New Babies

When a new baby is brought home and there are one or more siblings in the house, problems can arise. It is usually easier if the brothers or sisters are older. Then they can get involved in helping with the new arrival. However, if a little child has been the center of attention for some time and suddenly is in second place. trouble can be ahead. Sometimes a little child can get so angry that he or she  will try to hurt the baby. One thing I did when my second child was born was to have the baby send one or two gifts to his sister. That way she looked forward to seeing  her new little brother and she was always very protective of him. We did put a latch up high on the baby's door  to be sure his sister didn't go into the room and try to kiss or hug him.  A latch also helps keep a dog or cat out of the room. Animals can also become jealous of a new arrival and I have seen babies with scratches from cats.

When there is a new baby in the house, it is important that parents spend extra time with  siblings. Taking them for ice  cream, a fun walk or some other treat can make a real difference.

If a new baby is a preemie or has some kind of problem, an extensive time in the nursery may be involved. Siblings can get very lonely if all the parents' attention is focused on the baby. This can cause  some long-lasting problems, so parents need to be sure the siblings receive lots of attention. Grandparents, other relatives, can often be of great help.