Rx For Parenting Today

Parenting in 2020

As a parent and pediatrician, I believe there are basic things children need and want from their parents. I worry with all the craziness in the world today, parents can get so caught up in just making it from day to day that their children may not be receiving important things. All children need to feel safe, to know they are loved and valued for who they are (not who their parents want them to be.) Yes, they need to be fed and clothed and receive good educations and health care, but above all they have to know they are treasured and even though they may make mistakes that their parents still love them.

I have cared for children of very wealthy parents, children of poor parents, and children with disabilities. I have also cared for children who disappointed their parents and children who had such a severe disability that their parents could hardly be in the same room with them. One mother of a spina bifida child said in the examining room, sitting next to her very sweet, but disabled child  "The day she was born was the worst day of my life!" 

Because the suicide rate is increasing among children and teens, something is very wrong. Are parents not telling their children how much they love and value them or are they expecting so much of the children, that the kids feel life is not worth living?

Children want and need lots of time with their parents, not just one parent, but both parents. Being a single parent is tough, but in many ways a single parent has an advantage because  he or she can parent the way they know is best without any problems with a partner. Family traditions and continuity are both extremely important. 

I have cared for children of some wonderful parents and I still hear from many of them. Their children are a true credit to the way they parented. I have long-term follow-ups of children  with parents who spent little time with them or pushed them to do things they were not capable of doing. Their lives have been tough and yes, some suicides have happened. 

So as parents starting the new year, please think about how you parent and let your children know often how much they mean to you. Happy New Year!

Toys for Children with Special Needs

With the frenzy of buying gifts for children, it is often hard to find toys for children with special needs. A list of ideas was given in a December issue of a pediatric newsletter. Their suggestions were to be sure and chose a toy for the child's developmental age, not real age. Watch always for any child to be sure there are no small parts that can come off or break off and be swallowed. Choking can easily occur. 

Staying away from electronic, difficult to handle toys is a good idea. Physical and occupational therapists may have some good ideas about appropriate toys, as can parents of older children who have a child with a disability. 

Books that parents can read to or with children are always good. There are so many beautiful children's books now that a book gift can long be treasured. My favorite cousin, Jean Bothwell, wrote 61 children's books and I still enjoy reading some of them. 

I hope small children will not be given smartphones or i phones. I think old fashion toys will mean a lot more in the long run. I still have my daughter's favorite stuffed animal that she dragged around when she was little and I have my grown granddaughter's big panda. A single stuffed animal may be a long-lasting friend. Happy gift buying!

Holiday Safety for Children

Holidays can be special and leave lasting memories. They can also be dangerous for children if a few safety precautions are not taken. Because entertaining happens more often at the holidays parents can get very stressed and not be as aware as usual of problems that can occur with the children. Holiday decorations can be a problem if holly and mistletoe are used, because both are dangerous for children. Lighted candles and toys that contain detachable pieces or magnets that can be swallowed  may also be a cause of harm.

Children with autism love to escape and can easily slip out a door as guests are arriving. Hiring a teenager to watch an autistic child during a party is a good idea and can even save a life. Guests may carry medicine in their purses, so these should be put up high if there are little children.  If glasses with alcohol are not cleared up after a party, a child may decide to  take a drink. I have cared for little children who were essentially drunk after a parents' party. Cigarettes should also be carefully disposed of because nicotine poisoning can occur. Kids will ingest almost anything when they are small. 

Why are Youth Suicides increasing?

A good article in the 12/3/19 New York Times stressed the importance of doing something about the marked increase in youth suicides. It stressed that from 2000 to 2007 the suicide rate of youths from ten years to twenty-four increased by 56 percent. That is startling. It is the second leading cause of death in this age group next to car accidents.  It also stated that "since 2011, there's been nearly a 400 percent increase nationally in suicide attempts by self-poisoning." 

What is going on? Are parents getting so busy that they are not recognizing a child in trouble? Perhaps they are in denial or just not paying attention to their children. School, too, are to blame when individuals in trouble are expelled rather than identified and helped. I've seen several articles about schools that send troubled kids to charter schools so their graduation rate stays high, rather than helping the students in trouble.  The charter schools don't seem to be helping these students either because many students do their school work online and no one pays much attention to them. 

Social media is terrible for the many students who spend a great deal of time online and their smartphones are their connection with the outside world. I would not allow any child of mine to constantly be on a smartphone. What about talking to your children, having family dinners, what about chores or doing things together? Has parenting turned into just feeding and clothing children? When I was in private pediatric practice, many kids would pretend to be ill just so they could come and talk to me. I still hear from patients I took care of many years ago. They are desperate for real communication and knowing an adult who cares. One of the reasons I sold my practice was I was either going to open a group home for the many lost kids I saw almost daily, adopt a bunch of them, or find an answer to their loneliness. 

Medical Care for College Students

Many parents have real concerns about letting their child or children go away to college. One of their fears is if the student becomes ill who will look after them. This is a very real concern, but there are ways to ensure your child will be safe. One way is to find an outside physician in the local community.The other is to teach your child what is acceptable and what is not acceptable in college medical care. When my daughter went to University of Colorado, I checked on the credentials of the health service doctors. I also found an outside internist she could see. She needed some medical advice, so made an appointment with the one doctor I  thought was the best. When she went for her appointment, she was told she would see a nurse practitioner. "No", Jennifer said, "My parents are both doctors and they researched Dr,. X. That is the doctor I want to see." Yes, she was taken to see Dr. X. 

One thing that is important to do when a child goes away to college is to check if he or she will be covered by your insurance. Some colleges require you have insurance under their specific health insurance. 

The child of a local doctor called me one day in San Francisco and told his daughter was very ill in Berkeley. She had seen someone at the local student health service who diagnosed tonsillitis and gave the girl antibiotics. She was alone in her dorm on a Friday night and was having a hard time swallowing. I got in my car and drove to the dorm in Berkeley. The girl had enormous tonsils and signs of infectious mononucleosis. I called an ambulance and arranged for her to be admitted to the local hospital. My diagnosis was correct and with good medical care the girl survived the night. Her big tonsils could have created a serious problem.

If a student has a chronic problem, such as asthma or diabetes, the health service should be  notified of this. An outside specialist would be particularly important  in this situation. 

Colleges and Students' Mental Health

I was delighted to see an article in today's New York Times  saying several colleges, including UCLA, are adding personnel to care for their students' mental health problems. This is long overdue. I hope some of the prestigious Eastern colleges will follow suit. Many parents these days are putting so much emphasis on their children going to prestigious colleges that I worry. I remember in my Stanford medical school class of 62 students that two of our class committed suicide. This is becoming more and more common in both undergraduate and medical school classes. What a tragedy to see the life  of bright, capable students end when mental health counselors should have been available. Sadly, as in the New York University case of suicide, the student was seen by a nurse practitioner in the health service and given medicine, but not referred to a physician, a psychologist, or a psychiatrist. 

Public schools in the past had a nurse on staff and some even had social workers. Now when a student is having  or creating problems, many schools simply get rid of the  student with no follow-up and no help. This is unforgivable. Several of the recent school and college  shootings have been by former students expelled from school with no help for their mental health problems. I have a long list of these. I wish we could  have an R.N. and social worker in every school, including charter and private schools. I think we would save many lives.