Rx For Parenting Today

Safety Tips for Babies' Safe Sleeping

Having your first baby is a hard time unless you have been around little babies. When I was  a young intern, I loved spending time in the newborn nursery. However, when I had my first baby I had now idea about practical things.  Fortunately, our family G.P. recommended an old nurse to come and help. I called her "Minnie the Angel. She taught me to be sure Jennifer was in a small, snug bed with no soft toys, a firm mattress and no soft pillows or quilts. Babies must sleep on their backs and having a baby sleep in bed with  you is a recipe for disaster. The use of a pacifier and a smoke-free room also reduce the number of infant deaths. If or when a baby is put in a crib, it is important to check that the crib slats are no more than 3/8 inches apart. A warm bath before bedtime can be very soothing. Also, a music box placed near the crib can help a baby relax  and get sleepy. If a baby won't settle down sitting in a rocking chair while nursing can help. When a child is not dressed warmly enough or is in too many clothes, both will make a baby fussy. Anxious parents can make an anxious baby. Letting a infant fuss a little is usually a good idea. Most parents can soon distinguish between a hurt cry, the need for a diaper change or burping and just fussiness. When I was baby sitting for my first grandchild, Heather started crying la, la. I let her fuss for a few minutes and she soon quieted herself. Babies do have that ability and picking up an infant at their first cry does not give the baby the chance to calm down. 

Parenting the Siblings of a Child with a Disability

As a pediatrician with neuromuscular training, I have cared for countless children and teens with disabilities. I know the toll it takes on parents. It also can take a toll on the siblings. So much time and effort has to be given to the child with a disability that there may just not be enough time and attention left to give to any other children. I learned a great deal about this when I held special groups for the siblings of my patients.They felt a lot of compassion for their sibling, but also a sense of loss for the parenting they missed. I also held groups for the parents and I think it helped the  siblings a little by talking about how much time and attention many felt they were missing.

Many children with disabilities have learned how to manipulate the adults around them to get the most attention they can. I remember a patient with spinal atrophy, who while in the hospital would yell down the hall that she wanted various things. When I didn't immediately run down to her room, she finally learned  I was one adult she could not manipulate. She was bright and attractive and a great actress. When parents have one or more children with disabilities, a sibling who does not  have any medical problems, often gets completely left out. I had to hospitalize one boy in a psychiatric ward because he had 3 brothers with Duchenne muscular dystrophy and got minimal parenting. 

I asked one of my favorite mothers how she raised such an outstanding son.  Kenny had muscular dystrophy and the other  boy had no medical problems. Her reply was that she expected Kenny to do chores and other things just like his brother. Kenny was a wonderful teen and it was a great loss when he died at 21. 

When there are no Special Education Services with Schools Closed

Special Education services are so important for children with disabilities that when schools are closed parents need to take over. There is a lot that can be done at home with the guidance of the special ed professionals. If a child has something such as Duchenne muscular dystrophy or other forms of dystrophy, muscle stretching is important. Tightness of  the heel cords is a common problem and a therapist has probably shown you how to do the stretching. Many therapists are still available by telephone and can help you do a lot of what is needed. Having a boy stand in a stand table or in his AFO's or braces can be very helpful to keep his legs working. Putting his arms and legs through a range of motion can help also. 

I had one patient whose physical therapist kept him out of a wheel chair after a heel cord lengthening. The orthopedist did a good job surgically but did not arrange for any physical therapy afterwards, which was a glaring error. The boy's physical therapist called the parents and arranged to go to their house daily . She kept  the youth moving and also kept him from having to spend the rest of his days in a wheelchair. Occupational therapists, speech therapists, and learning disability specialists are key to the progress and development of many children. They can teach parents many things that can be done at home. Yes, it takes a lot of time, but with businesses and many other things now closed because of the corona virus  parents may have time on their hands. Once a child is allowed to slide back in learning, reading, walking, or speaking, it is hard to regain what is lost. Often parents can help each other by sending pictures of what to do or just by being supportive. We all have to help each other to get through this pandemic without losing a lot of ground. 

Chores for Kids Now with School Closures

Household chores for kids can be made fun with a little creativity. Now that schools are closed and may not open until fall, children have plenty of time to help around the house. Little children usually love to imitate their parents when chores are done. As  they get older, if chores are part of their everyday life, then there is usually not a problem. I always had a chore chart on the kitchen bulletin board where Jennifer and Geoffrey could check off chores as they did them.  An allowance was received each week when all their chores were completed. Both learned to cook, iron, clean, sew and take care of other household things. I was amazed to learn that some colleges now have classes to teach students how to do basic things, such as washing clothes, etc. I believe teaching the steps of independence are an important part of parenting. I was amazed as a young Stanford student to see the girls from affluent homes put their dirty clothes into a special suitcase and mail it home for the maids to wash and iron. Little children can dust, set the table, empty waste baskets and put away their toys. As they get older they can water plants, fold clothes, polish silver, make beds and help in lots of other ways.  Learning to make special dishes can be fun and a life-saver when they have their first house or apartment. Both of my children became excellent cooks. I don't like to cook so they laughingly said they both learned to cook because I disliked  it so.  Families who work together and help each other usually develop close bonds and are very fortunate. My friends who had wealthy parents often never had that closeness with their parents. 

When a Teenage Girl Is Pregnant

I was walking down Market Street in San Francisco one morning when I saw a teenager sitting in a doorway with a small baby. The girl looked scared, dirty, and depressed. I wanted so much for her to have a safe living place, medical care, and social work help. I wondered if she had been thrown   out of her home because of the pregnancy and what kind of home she had come from? I had a male friend who told me his mother was 15 when he was born and his older father was a bully. Some teenage girls run away from home because of abuse by a father, mother, or step-parent. Some are told to get out if the parents are against abortion. I was in Utah for a medical meeting a few years ago, when a doctor from Salt Lake City told me of the high number of runaway, pregnant teenage girls they had in Utah. The girls were not willing to abide by the strict restrictions of the Mormon Church and were unable to seek an abortion or were thrown out by their families.

When I was in private pediatric practice I had several girls from affluent families who became pregnant. Some of the parents were willing for their daughters have an abortion, but one mother insisted  her 14-year-old carry the baby to term because the mother wanted a baby to raise! I was  appalled. Some of the babies born to these teenage mothers are addicted to drugs and have terrible withdrawal symptoms. 

Teens from low-income families have an even harder time when they become pregnant. As the Republicans cut down on the number of abortion clinics, more and more pregnant teens are left with no medical care. I do not understand how anyone can insist a pregnancy be carried to term when the baby has little chance of a real education, a good home or loving parents. Many grandparents do take over the care of these babies but they are often in low-income families. I do not understand anyone can treat a pregnant teenager that way. The babies have little chance of a decent life unless a loving couple adopts them. 

Raising a Child on the Autism Spectrum

I cannot imagine having to worry about the corona virus these days and also having a child on the autism spectrum, who is no longer at school and not allowed to have special education. I have diagnosed several children with this disorder early on, when their general pediatricians seemed either unaware or didn't want to give a child such a diagnosis. Sadly, many medical schools these days are not teaching things like diagnosing the disorder, but seem more interested in teaching computer medicine or about rare disorders. Now that the diagnosis is said to occur in 1 in 59 children in the U.S. this is a very important diagnosis to make, so early therapy can be given. Some of the children are brilliant, but do have problems with eye contact and connecting with other children. One out of control four-year-old said to me, "I don't like to talk to people and I don't like to read." His mother has refused to accept there is any problem and the child is not getting any special help. This is a child from another state, so I hope the school will insist he  get help. 

There are lots of resources for parents and when I redid the book, Children with Autism for the publisher, Adams Media, I listed many in the back of the book. I also added a lot about practical matters, such as dental care,  special education etc. One excellent resource is Autism Speaks, www.autismspeaks.org. So if you have concerns about your child and the child's doctor does not share your concern, I would do some research, check with the local Autism group and change doctors.  Remember that little children with autism love to escape, so be sure door handles are up high, windows are kept locked and neighbors and local police are notified there could be a problem. 

Children and Viruses

Now that we are all seeing the terrible effects of the cororna virus, I hope parents who have not allowed their children to receive vaccinations will think differently when we get a vaccine against the corona virus. If a parent had seen, as I have, a teenager almost die from chickenpox encephalitis and a youth become deaf from mumps, they will change their minds.  I do not understand any parent refusing protection for their children against diseases. 

Dr. Andrew Wakefield did a terrible thing when he connected autism to vaccinations. His medical license was taken away from him in England and so he moved to Texas. Why he met with Trump in the Oval office bothers me greatly. He continues to defend his unscientific  beliefs that there is a connection between immunizations and autism, although many excellent studies have repeatedly shown this not to be true.

I spent the first two months of my pediatric internship at Children's Hospital in San Francisco.  Ir was the last year of the polio epidemic and having to put patients in iron lungs, when my resident was absent, was a frightening experience. We had an entire floor of the large hospital with beds filled with post-polio children.  Many never walked again.