Rx For Parenting Today

Handling a Childhood Emergency

Few children get through childhood without some kind of an accident or emergency. That is why it is wise to think about and know what to do if one occurs. I would suggest having the number of your child's doctor posted where a baby sitter or relative could easily find it. Adding the number of the poison center is also a good idea. As a parent if you know how to do CPR on a child, this should give you a feeling of comfort. Little children  often stick foreign bodies in different parts of their bodies. I  have taken them out of the nose, the ear canal, the rectum and the vagina. 

If a child is allergic to bees, particular foods or something else it is a good idea to  have an epi-pen on hand. I will never forget the mother  of a child who was quite allergic to bee stings. I had my nurse show her how to inject a syringe and  had her practice on a grapefruit. I also insisted she carry an epi-pen with her. However, when a bee sting occurred, she drove the child to my office for the nurse to give the epinephrine, Fortunately, she got to the office before there was a serious reaction. 

If a small child has a fever over 101 or 102, a doctor should be  called or the child seen. Remember that many ER doctors have little pediatric training. Also, urgent clinics and store clinics may be staffed by nurse practitioners who may also have had little  pediatric training. Eye injuries should be immediately seen, as should a child who has had a severe burn, a convulsion, or a head injury. Difficulty breathing, severe croup, severe abdominal pain, and a broken bone are all emergencies. If you are new to an area, it is wise to find out about the nearest hospital and be sure it is equipped to handle childhood emergencies. If a child needs surgery, it is important that a pediatric anesthesiologist be available. Hopefully, as a parent your child will sail through childhood without any serious problems, but it is a good idea to be prepared. 

 

Handling Fears in Childhood

Ir is quite common for children to have fears but it is important to be sure that there is not a good reason for the fears. If, for example, a child is being abused by a neighbor, a step-parent, or a close friend, the child may be afraid to say anything. If the fears are extreme then professional help from a child psychiatrist might be needed to find out the cause. I have two friends, who are both accomplished adults, but both had considerable abuse from their fathers. Many mothers are too afraid of the male to say anything. I had one parent who finally had to courage to leave her husband after he tried to drown their daughter in the bathtub. 

Sometimes asking a child to draw their fears can be helpful, I have found. If you make fun of fears  it can just increase them. When my grandson was a little boy he was afraid of fire engines and big noises. I took him to a fire station one day and the nice men let him climb up on the big fire engine and also showed him around the station. That took care of the fear. A night light can be helpful or there are stars that glow that can be put on the ceiling of a child's room. A dream catcher can also help if you have a little ceremony when putting it up in a child's room. 

Important Daycare Tips

Choosing the right daycare could make an important difference in a child's life. Any daycare you chose must be accredited. Some women care for a few children in their home and may not be accredited. It is important to visit several day cares and not be afraid to answer questions. Have the individuals had medical examinations, TB tests or chest X-rays? Are sick children sent home or isolated? Have the staff had CPR training? How long has the Center been in business?

I would want to drop in one or two times to the one you have chosen and see if the children are happy. Is the place clean and the children look well-cared for? If you can talk to a few parents that have children in the daycare , that would be a good idea. 

I  had one little patient who swallowed some dishwasher detergent that was under a kitchen sink and had to be hospitalized. All substances like this should be out of any child's reach. 

A good resource is the National Child Care Association at 1-800-543-7161. Another resource is The National Association of child Care and Referral Agencies at 1-202-393-5501.

 

 

Critical problems with Our American Education

It is astounding to me how poor schools have become in so many areas. Betsy Devos, the Secretary of Education, has done nothing to make any improvements. I recently found a statistic that "Americans spend more on beauty products that on education" Most inmates in the nation's prisons  are dropouts and yet I am sure there no help was given to see if there was a learning or other disability or social workers to find out if any family issues could be helped. We don't have the trade schools we had in the past and many students are not interested in going to college. College has become increasingly expensive and student debt is at an all time high. 

A quote from an article by Bob Herbert sometime ago stated that "just two-thirds of all students and only half of all blacks and Latinos, who enter ninth grade actually graduate with diplomas four years later." I know of a senior in high school who gets mostly A's but only goes to school when she feels in the mood. The school sends e-mails to the divorced parents  but there is no penalty or follow-up about why she misses so many days. I had one patient who was doing this and his brother told me the youth had become involved with a gang. By working with the parents and the school I found that the youth was bored and also learning disabled. By getting him some  learning help, his life was changed and he was no longer involved with  the gang. 

An education is much more important now in getting many jobs and yet education is not a priority  for many students today. They would rather check their Facebook or other social media sites than open a book. Europeans are far ahead of us in education. Languages are taught in school and parents do not accept the poor education that many of our American kids are getting today.  We must do better and parents have a responsibility to see that their child's schools are giving the education their kids deserve.

My Favorite Parenting Tips and Remarks

A cartoon I saved from a 2014 New Yorker shows two little boys saying " I'm so over scheduled. If it weren't for timeouts, I'd have no free time at all." A remark I overheard: "Kids are being put in pressure cookers."  An  expert said "Let children be children."

A  woman told me about two professional parents who had a one-year-old who wouldn't go to sleep, so they made an appointment at a sleep clinic. The grandmother was a nurse and said she thought the baby was just hungry.  When the parents gave the child some food she slept all night!

I have a quote with no indication of the author. "A hundred years from now it will not matter what my bank account was, the type of house I lived in, or the kind of car I drive-but the world may be different because I was important in the life of a child"

Some of my favorite parenting tips: Children need time with their parents, not their credit cards. * Children born with money are handicapped unless they learn how to use the money wisely. *Not every child needs or should go to college. 

Serious Teenage Problems

Raising teenagers is more difficult now with all the social media craziness and many parents working two jobs. Even when I had my own pediatric practice I had teenagers who tried to commit suicide, took drugs,  and  some became pregnant. Now parents have to worry about the increase in anxiety, depression and  that some teens try to harm themselves by cutting or hurting themselves in other ways. Some experts say that self-harm has been on the rise since 2012 and occurs more in girls than in boys. 30% of girls suffer from an anxiety disorder and only 20% get treated. The need to be perfect, among girls, can cause terrible anxiety and some parents increase this anxiety. A friend, who is  quite beautiful, told me her father always told her how ugly she was. She has always fought a battle to stay slender and keep in good shape.

Another problem teenagers can have these days is needing to care for a family member. 22% of high school dropouts leave school to care for a family member. This can also be the cause of doing poorly in school or being absent. Many of these teens come from single parent or low income homes.  How fortunate are the teens with loving, caring parents who know when something is going wrong with one of their children and take steps to get the best help.

Why Medicare for All will Not Work

I certainly support the effort to give good medical care to everyone. However, I think the politicians supporting Medicare for All have no idea of the terrible mess it could be. The insurance and drug companies, as well as the hospitals and doctors, would fight very hard against all the rules and regulations and patients would suffer greatly. Great restrictions would be placed on what medical care could be received and people with cancer and disabilities, as well as those with chronic care, would get minimal or no care. Losing good insurance that you now have is a frightening concept. I cannot imagine letting the government tell me what doctors I could see or what procedures I could have. I am sure that things like kidney dialysis would be sharply curtailed and patients would  have to fight hard to get the procedures they need or to see the doctors they wanted to care for them. Many doctors would give up and retire or leave practice. In England where I have had some training, I know that if you can afford it, private care is available. The British system works well for most patients in that small country, but in a very large country like the U.S. I foresee nothing but major problems. Doctors would be soon replaced by nurse anesthetists and nurse practitioners. Their training is minimal compared with that of physicians. By expanding Obamacare or the Affordable Care Act and letting patients buy in if they chose we could have a system that works. Then we could have physicians and not minimally trained individuals caring for us. I hope voters do not vote for the candidates who want to take away our ability to chose our own health care. 

Sending Children to School with a Fever

It is always difficult to be a working mother and have a sick child. If you don't have household help or a good support system, the child can suffer. There was an article some time ago in the New York Times about a woman surgeon who sent her child to school with a fever, after having given the child tylenol. Later there were letters to the editor of the paper,  one in defense of the mother and one by the daughter of a woman surgeon who said she had had medical problems that were not given the care they needed. That writer also stated that one brother was homeless!

Sending a child to school with a fever not only could cause serious problems for the child but what about other children in the classroom?. When my daughter was in first grade in Rochester, New York a woman doctor sent her little boy to Jennifer's class when he had a fever. Of the twenty-two children in the class, twenty developed measles. Jennifer had such a severe case that I stayed home with her until she was well. I was directing the muscle disease program there at the time and doing some teaching. I later took a survey of the class, so I knew about the twenty children who developed measles. I was angry and appalled. No child should ever be sent to school with a fever. Not only is the child at risk for developing a serious illness such as meningitis, but what about the other children? As we are having more and more women doctors if they are going to have children, I strongly  believe a child's welfare should be their first priority. I loved practicing medicine but my two children were always more important than anything else. Their father was an excellent orthopedic surgeon who was rarely home, so it was my job to be sure the children were fine. I have never regretted the choices I made to always put them first. 

Parenting Twins/Multiple Births

Parenting  twins or triplets can be an enormous job without a lot of help. A good friend who is an identical twin has given me  considerable insight into the problems. Not only is she a twin, but she also has twin grandsons. The mother of the boys was very lucky to have her mother close by and has always been very grateful. You will need lots of extra supplies, as well as lots of help. If right from the beginning you can treat each baby as a separate individual, that is important. Dressing the babies alike defeats that. Twins in particular develop their own special codes, so they need to be with other children, as they grow up. Otherwise they can become just a unit of two and not really know how to interact with other children. 

When the children start school, if possible they should be in separate classrooms. One twin often becomes the dominant one, so you need to watch for this.  If you have other children, they should  receive as much attention as the twins. If not they can feel very left out. 

Many towns and cities have twin clubs and joining one can provide a lot of support and tips on how to handle different problems. If one twin has a medical problem or disability, this can be very time consuming and difficult. I know of one family that had a single child, then triplets and then a set of twins. The mother-in-law moved in and never left and eventually the parents were divorced. I am sure the strain and problems caring for so many small children put a tremendous burden on the marriage. So time spent taking care of your marriage is important and your self as parents. 

 

Eating Out with Children

I always enjoyed eating out with my two children. I would take a favorite toy when they were little and as they got older they could bring crayons or a small note pad. They knew it was a treat to go to a restaurant. I think teaching even small children what to do and  how to act in a restaurant or any place is important.  It is not fair to expect children to sit quietly throughout a  meal without having  things to keep them busy. I have seen parents in restaurants tell their children to be quiet while they were talking to each other and enjoying a glass of wine or cup of coffee. I would see no effort on the parents' part to talk with the children which always bothered me. Eating out with your children is a great way to have good conversations with them. They need to know how to act, how to dress, and how to treat waiters and waitresses. I was sad one morning when a friend and I were having coffee in a restaurant and saw two parents come in with a teenage boy. He was flapping his hands and fit the picture of a teen on the autism spectrum. The parents got drinks for all of them  and then totally ignored the youth. My friend and I desperately wanted to go over and talk to him but decided to stay seated. 

It is important to find a family friendly restaurant if you take your children and if you eat early, it is usually better. Having a conversation on the way to the restaurant about what you expect is a good idea. I always had office hours on Saturday mornings  when I had my own practice and would pick on my children at noon and go to our favorite restaurant. Those are good memories.