Rx For Parenting Today

Safety at Childcare Centers

Now that many childcare centers are opening, so parents can go back to work, there are some safety features to watch for. The most important thing is if the adults coming and going or staying are wearing masks. Are temperatures being taken on children and adults? Is a sick child sent home or just isolated at the center?  Do the children have naps and how is the food prepared? When are meals served and are there snacks? Do they know  if a child has allergies?

One little patient of mine wandered into  the kitchen at a childcare center and got into  detergent under the sink. She had to have surgery  on her esophagus or feeding tube because of severe scarring. No poisonous substances should ever be where a child can get into them. Is the center clean and is it licensed? It should not be in someone's home. Does it smell clean and do the children have plenty of room to play and also play outside? 

If your child is unhappy at the center is bullying going on? Can you just drop in and see what is going on or do you have to make an appointment?  Have the caretakers had recent medical examinations including a chest X-ray and TB skin test? How many adults are there per child? Have the adults had CPR training? How close is the nearest hospital and is there a pediatrician or GP on call?  It would be good also to talk to some  of the parents who have had experience with the center personnel. You can never be too careful, particularly at a time like this. 

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. 

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.  

Teenagers and the Virus Crisis

Now that schools are closed, I am told that most teenagers these days are spending their time on Social Media. I was delighted to have an e-mail from a neighbor I do not know. The the e-mail was sent to all the neighbors in the area where I live. The woman said her two 15-year-old twin girls wanted to help anyone who needed groceries. It said they would leave a list in the mailboxes and neighbors could check off what they needed. No contact would be  necessary because the groceries could be left by the front door and an invoice  put in the neighbor's mailbox. I sent back an e-mail saying how delighted I was by the offer, although I was O.K. for groceries. I added that the mother and her husband must have done a great job of raising the twins. 

I worry a lot these days about what is happening with so many of our teens. Many feel so entitled that they seem to grow up expecting the same treatment when they go to college or become doctors, lawyers etc. 

I have heard far too many stories of professionals who feel entitled to make all kinds of demands. If whose of us, who are older and professionals, had made those kinds of demands in college or professional schools we would have been quickly asked to leave. One woman medical resident demanded that she have a refrigerator to store her breast milk and be given special times off to nurse her new baby. I was amazed. I remembered when I was engaged during in my first year as a Stanford medical student  Our physiology professor saw my engagement ring  and tapped his fingers against it saying "If you had had that when you applied to  medical school, you would not have been accepted." I laugh now when I  realize that I probably practiced longer and saw more patients than most of my 62 classmates. 

My hope is that there are many parents like my good neighbor, who sent the e-mail, and are raising their children to do more than watch social media and feel entitled. 

 

 

Health Concerns in Children

I am sure parents are greatly concerned about their children's health these days with all the worries about the coronavirus. The most any parent can do,  particularly if the schools have to be closed is to keep in touch with their doctors and be sure basic medical care is given.. Children should have a  daily multi-vitamin and never be given herbal medicines. Deaths have occurred from these in children. Kids are not good about drinking enough water usually and drinking juice or soft drinks does not take the place of water. Kids should also do better about washing their hands, particularly after playing with pets. If you have a health concern about a child, you want to talk to the child's doctor not the receptionist or nurse. Retail clinics should not be used for children and urgent care clinics may also not be staffed by a physician.

If a child has a fever and is not eating it would be important to check in with the child's doctor. ER doctors would not be the ones you want to see your child, but a family doctor or pediatrician. you may have to be fairly assertive to get the medical care your child needs.  

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.

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!

What are We Doing to our American Kids?

I have been reading through several articles I have saved about parenting and they are depressing. The U.S. is ranked 37th in the well-being of children. Yet we are the richest nation in the world. What are we doing wrong? Europe is the top in the world. I have worked in England and visited France many times and been impressed with the concern parents have about their children. Family is very important to them and Sunday meals are a must in many of the families. That means meals without the TV on and no cell phones at the table. How many American families have these rules?

In the U.S., American infants are 76% more likely to die in their first year than in other advanced countries. Part of this may be that 425,000 kids are uninsured in the U.S. That is criminal.  Also 1/2 million kids suffer from lead poisoning and youth suicide in the U.S. is at the highest level on record.  25 % of  shooters have mental illness, yet many of these  have  identifiable signs of problems that are not treated. 

Now we are seeing a problem with vaping in teenagers and vaping appears to be targeting kids.  Six deaths have occurred and vaping is causing lung damage. Where are these children's parents? Do the parents have any idea what their children are doing? Yes, many of the parents are working two jobs to keep their family afloat and all Trump and his group can think of is getting a second term and taking care of themselves. It is embarrassing to be an American these days. My friends overseas can't understand what is happening to our country. Money and position have become all important and for many kids their goal is to find a way to  make a lot of money when they are adults. Instead of finding a job they love and are passionate about, money is the overriding goal. What a tragedy.