Rx For Parenting Today

Urinary Infections in Kids

I have always done a  yearly urine check when I did a complete physical examination. Sadly, I am not sure many family doctors or pediatricians do that today. I  have been amazed at the various problems I have found. The most important one was on a teenage girl. She complained of not feeling well, but her physical examination was negative.  I still wasn't satisfied, so I asked her mother to bring her back the next day. I then requested another urine specimen. "But you just checked one", her mother said. "I won't charge you," I said, "but I would  like another one." When they returned and the girl gave me a urine specimen it was brown. She had glomerulonephritis that can be very serious. Once she was started on medication she did well. I then referred her to a urologist  to be sure there was not other problems. 

 Girls are more likely to  have urinary infections because of having stool get into the bladder. Usually girls can have one treated urinary infection and not have a urological workup until they get a second one. If a boy  has a urinary infection, he should have a workup after the first one is cured. As a parent, if your child's doctor does not request or order a urine specimen, I would ask for one. I remember taking my grandson to a pediatrician and the doctor not only did a poor examination, but did not request a urine specimen. When I said I wanted one she said "We don't do those!" I pushed and did get one. Of course, she never saw my grandson again. 

I  have picked up enlarged kidneys, problems at  the junction at the pelvis and ureter and several other problems. The most likely congenital anomaly is of the kidney, ureters or bladder, so it is important that doctors look for problems of the urinary system.

Constipation in Children

Constipation in children can be a real problem if they have a rectal fissure or spina bifida. Diet can also play a major part in a child being constipated. If a child lives primarily on milk or drinks a lot of milk between meals that can lead to hard stools. The foods that are most constipating are cheese, bananas, and apples. In general, most children do not like vegetables, which can help prevent hard stools. Most children also do not like salads and fruits. Drinking water between meals or apple juice, as I used to give my children, helps prevent constipation. 

If a child as a rectal tear or fissure, it can hurt to  have a bowel movement, so a child will try to keep from having a bowel movement. Sadly, I find these days that many medical students are not taught to do rectal examinations, so they would not be able to find a rectal fissure if they become pediatricians or family doctors. I can remember patients telling me I was the only doctor who ever did a rectal exam. Unbelievable! I have picked up a great many problems by routinely doing a rectal exam  when I did a complete physical examination or if I thought there could be a problem. Children with spina bifida may not have bowel or bladder control, so should be watched closely for constipation. Sometimes there will be stool expelled around a large stool mass, so this needs to be considered if there is abdominal pain or difficulty with bowel movements. Also children with celiac disease may have either diarrhea or constipation, so this disorder should always be considered. 

Will it be Safe for Your Child to go back to School?

Some states are planning to have children go back to school the first week in  August. I am so glad not to be a parent of a young child during this awful pandemic. If parents refuse to get vaccinated themselves, they put everyone they come in contact with, including their children, at risk. Now the experts are saying that not only can children die from the Covid 19 virus but if they become ill and live they may have long-term neurological or brain malfunctions. How can any parent, grandparent, or relative of a child not be vaccinated? That to me is a very selfish and totally unbelievable act. 

I am miss practicing pediatrics greatly, but I would not be able to take care of  children whose family members, and particularly parents, refused to be vaccinated.  I remember a child who had very bad asthma and when allergy tests were done, smoke seems to be a major problem. His mother was a chain smoker and when she learned the results of the test, she said, "Well Mathew  can have his asthma, I am not going to stop smoking." I immediately sent the mother a registered letter stating she would need to seek pediatric care elsewhere.  I could not tolerate that treatment of a child. 

Now some of the governors who  spoken against the vaccine are changing their tune, as are some parents who have lost a family member to the virus. Also it has now been been deemed legal that businesses can require their employees to be vaccinated. So I'm glad we are making a little progress. 

Unvaccinated Adults are Infecting Children

I do not understand why so many adults refuse to get the vaccine. Trump and his family, Tucker Carlson, and the group at Fox have all been vaccinated. I had to change dentists because the dentist refused to get vaccinated. Dentists are putting their patients at risk if they do not get the vaccine.

More and more children are becoming ill from the virus and many are dying or having bad side effects. What is wrong with these adults? Have we become such a callous nation that we don't care about other people and particularly children? One of the things I miss greatly is the feeling of community I had growing up and the feeling of neighbors caring for each other that I found in San Francisco and some other communities. I  have not found that in San Diego. Money and keeping up with the wealthy seems much more important. Greed has become the outstanding characteristic of far too many Americans. Children are being given their own credit cards and designer clothes are important to many teenagers. Morals are not being taught to  a lot of kids and getting away with whatever they can seems to be the focus of many adults and  children.

If you had ever had to care for a dying child, as I have, you would rethink what you are doing each day. Lets hope we get better as a nation.   

 

Parenting and the Covid Vaccine

I am appalled that a public health  doctor in Tennessee could be fired because she quoted a state law that teens of a certain age could get the Covid and other vaccines without their parents' consent. Don't parents care whether their teens could die from the virus or diseases like meningitis?  I realize that many in some states still live in the dark ages and are against the teaching of evolution, receiving vaccines and other subjects. I cannot imagine that if there was anything you could do to save your child's life that you would not allow it. I wonder what the pediatricians and family doctors do in states like Tennessee. I could not be a pediatrician in those states.

The majority of those who have died during this pandemic had not received the vaccine.  Tucker Carlson,  who is spewing the lies about the vaccine grew up in the small town where I now live. He also apparently went to the same school, not at the same time, that my two children went to. It was a wonderful school and I was the pediatrician for the headmaster's children. I also taught several sex education classes there. These are not allowed in some of the same states that do not allow facts about vaccines, evolution etc. to be taught.

I have great fears for what is ahead for both the children and adults in the U.S. today. There is such terrible division and even educated people seem to care more about their bank accounts or their power in Congress than about the country.  It is hard not to feel angry.

Parent Do's and Don't

As a practicing pediatrician for 50 years, I have seen some wonderful parents, some that were doing the best they could and a few  who were just plain awful.

What children want most is not lots of toys and gifts, but time, attention, and  love from their parents. I see many parents these days who want their children to get attention from nannies or childcare workers, but little attention from themselves. I had one mother who never brought her child to my office, instead  the child was always brought by her nannie. Several  years later when I had relocated to the Bay area, I saw the mother at a book party and asked about the child. "Oh, the woman said, "she committed suicide several years ago!" I was appalled.

I have had an opportunity to talk with quite a few nannies and the stories they  have told me gave me chills. I don't understand why a mother would  have a child unless the child's interest were foremost in her mind. Often fathers end up doing a lot of the parenting. A caring father is so very important, but I have also seen both abusive fathers and abusive mothers. They certainly should not  have had children.