Rx For Parenting Today

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. 

 

 

Parenting Children of Affluence

It is hard work to be a parent but it can be  even harder if you live in a town where parenting is left to nannies or housekeepers. I was in pediatric practice in a town where many parents were extremely wealthy and was impressed with those who insisted their children have chores, did not have their own credit cards, and knew their parents were not ATM machines. I recently met a woman from an  affluent community who told me how hard it was to parent when many of the parents of her children's friends left the parenting to live-in help or let the children grow up without rules or much parental involvement. She had a friend who worked for a big law firm who said so many of the young women lawyers did not want to work more than a few hours a day and took time off when they pleased. The older partners did not know what to do with these young women. I told her that medical schools are encountering the same problems. Many of the young women medical students, interns, and residents don't understand why they can't take time off to have children and then they expect all kinds of adjustments to their schedules if they have children doing their training. 

I was in the office one day, a lot of years ago, of the chairman of the pediatric department at Stanford when his phone rang. He motioned for me to say seated and answered the call. I watched as his face got redder and redder. When the call ended, he slammed it down and said " I wish I never had to hire another woman resident." The caller was to start her residency in a month but said she was having a baby and would not be able to start for four months. He was wondering who he would be able to find to replace her at such a late date. When I was a Stanford medical student, we would have been told we  could either come by the expected date or not come at all. 

Back to School with Bullet-Proof Backpacks

We live in a sick country when 100 people die each day from guns and parents are buying bullet-proof backpacks for even little children. How stressful it must be to be a parent of a school-age child today. The Democrats have passed several bills to try and curb gun violence, but Mitch McConnell will not bring them  to a vote in the Senate. I do not understand how one man can  have so much power over the lives of Americans. I wish every parent would speak out and call or write to their legislators. 

There are several organizations that are trying to do something about gun violence, but until Trump and Mitch McConnell take the lead the deaths will continue. It must be difficult to be a teacher and have to worry about facing someone with a gun.  Having guns in the classroom is not an answer and I wonder if bullet-proof backpacks will help either. It is hard to watch the news or read the newspaper when killings are occurring every day. I am so glad I don't now have school-age children. I can understand why some parents decide on home schooling except I think that deprives children of socializing with others and always having to be with a parent  can  create problems. Children need to learn how to make friends and gradually become independent.   

Has American Childhood Been Ruined?

There was an important article in yesterday's  New York Times by Kim Brooks. The title is "We Have Ruined Childhood." I agree  that is true for many children. However, I believe there are still parents who don't push their children so hard they have no time to play or just "be." I feel sad and angry that many children are pushed so hard by their parents and schools they feel life is no longer worth living. The suicide rate has increased dramatically among teens, particularly those in high income families who have their children scheduled for tutors and every possible activity. Family fun and just sitting around the dinner table talking are for many families a thing of the past. Many individuals eat in their rooms and watch TV or talk on their cell phones. When I was a single, divorced parent, I tried to always have breakfast and dinner with my two children. Sometimes if there was an emergency this wasn't  possible. However, Friday night, the children chose the menu and special TV programs and we ate and watched together. We didn't watch any TV during the week.  Homework was not as  heavy then and the children had time to be outside, invite friends over and just have fun. Both children did very well in school with one getting a Master's degree and the other an M.D. We had lots of fun together and I enjoyed their friends who seemed to find our house a special place to be with no pressure and food always available. I still hear from several of them.

ER Care, Urgent Care and Retail Clinics

With the general decline in our American health care, it is important that parents know where to go  when a child needs medical care. Ideally, you have a good family doctor or pediatrician. However, since so many don't seem to offer weekend care, as I did, many parents are forced to find another resource for an ill or injured child. It is widely know that many hospital emergency rooms offer excellent care for an injured or sick child, while others do not have a doctor with the training to care for a sick child. The necessary pediatric equipment to care for children is also not available in many emergency rooms. I would check with your child's doctor whether or not this is true of your closest emergency room. 

Urgent clinics may or may not have an M.D. available because many of them use nurse practitioners. These individuals do not have the training to care for an ill child and I have seen some bad outcomes because of this. Retail clinics in drugstores and other places are staffed by nurse practitioners. The ones I have seen are closet size without an examining table. The American Academy of Pediatrics is generally not forceful about coming out against a specific type of medical care, but they very strongly advise parents not to take their children to retail clinics. 

One of my favorite patients, who had Duchenne muscular dystrophy, was traveling with his  parents across the country to see relatives. On the return trip, he became ill and was seen in an urgent care clinic. Diabetes was diagnosed. I'm not sure how this was done, but the parents called me and listening to the youth's symptoms, I suspected pneumonia,  which he had had before. The parents traveled all night and I met them on their arrival in our hospital ER. A chest X-ray revealed pneumonia and I hospitalized the boy. He did well and was able to go home in a few days. The parents were very grateful.

How Many More Children will die in the U.S. from Guns, Trump's Cages, Car Heat, and Abuse?

I almost hate to listen to the  news these days or read the New York Time. Children are so precious and yet we are seeing more and more deaths. Last night, it was a six-year-old in Gilroy killed by a shooter, today it was one-year-old twins the father forgot were in the back seat of the car. They died from excessive heat. How could any parent not remember a child was in the car? Nine children have died in Trump's border cages without medical care. Today, I read that 51 children died last year from being left in overheated cars. Two thousand died last year from severe domestic abuse. What is going on? Is there so  much anger in the U.S. today that defenceless children are the victims?

There is such a disparity today between those who have extremely large amounts of money (the top 1%) and the rest of the population that I understand  much of the anger. But why should children be the object of the anger? It would be better to use our anger to change what is going on in Washington D. C. Yet,Trump is threatening to take away food stamps, Medicaid, the Affordable Health Care Act and other sources of support for those who don't  have adequate incomes or good educations to obtain more. 

As a pediatrician, I think each of us, as caring parents,  have to get involved and do what we can to change what is going on in the U.S. If we don't get involved, I believe the changes  that have happened will change this country and our children's lives forever.

How Can Children Learn the Difference Between Right and Wrong?

We are living in such divisive times that I wonder how children today can learn the difference between right and wrong. I am seeing a lot of what is called situational ethics. This means that people do what is appropriate for them at the time, not what is moral or right. Our  leaders seem to be doing a lot of that right no just to ensure  their own positions and to keep their power, health care, and pensions. When children see this, how do they know what is right? I was very fortunate growing up that my college professor father made it clear that there was  a definite red line between right and wrong. He had no problem letting us know if he felt we were headed in  the wrong direction.I greatly appreciate that   and I think children want and need that. Otherwise they are left flying in the wind and don't  truly know how to lead their lives. I think drugs, alcohol and other teenage problems are a result of a lot of that. 

Sitting around the dining room table and talking about what is going on and teaching children your values is important. As parents rush around trying to perfect parents, talking to their children doesn't  occur often enough . Driving a child to a lesson, a medical appointment or something else is a good time to  talk. Having a child engrossed in his or her cell phone often prevents conversation. At the dining room,table,cell phones need to be left somewhere else. Conversation with parents is an important part of parenting.

Stress in Children and Teens

Stress in children and teens is increasing almost daily. This can be partly documented by the number of children being put on medications to modify their behavior or to increase their ability to focus, but also by the increasing number of teenage suicides. As parents, particularly affluent ones, enroll their children in more and more activities, the kids have almost no time to themselves to do what they want. Maybe they would like to lie in the sun or read a novel. Instead, they are signed up for karate or dance lessons, have tutoring or are involved in some other time consuming activity. The choice is often not theirs.

Schools are also to blame because the nonsense of giving even small children homework assignments started quite a few years ago. If a child has ADHD or is learning disabled, this can put a great deal of stress on them. Physicians may also be the ones to blame because it is  easier to write out a prescription for a medication than to do a complete physical examination, order lab tests. or make a referral to a psychologist for testing. The ten minutes often allotted for an office visit is ridiculous. I would never tolerated that. If money is the primary concern  for a physician, he or she certainly picked the wrong field if  they have chosen pediatrics or family practice. 

As a parent, if your child's physician does not take time to do a complete physical examination once a year and order a basic blood count and urinalysis, I hope you will look for another  doctor. There are still some who practice old-fashioned caring medicine. 

Guns, Guns, and More Guns

How many more students and others have to be killed before members of Congress have the courage to defy the NRA? How can parents send their children to  public schools in the United States and be sure they will ever see them alive again? I am horrified that the Governor of Florida just signed a bill allowing teachers and others in Florida schools to have guns?  Even with the 133 hours of training the bill suggests, a gun in a classroom is a very dangerous thing. I certainly would never send a child to a school where guns were allowed. It is a known fact that a gun in a house means it is more likely that a death or injury will occur to a member of the household rather than to an intruder. 

Rather than spend the money on guns and training, schools need more counselors, social workers, and nurses to identify at risk kids  and find help for them. Every school shooter has been an at-risk kid. Instead of getting help for them, they are generally expelled with no follow-up. I have a long list of these. Since 1970, 1.45 million Americans  have  died from guns. These include suicides, murders, and accidents. (New York Times 5/9/19). There are more guns in the U.S. than there are individuals. That is shocking!

If you have ever watched a child die from a gun shot wound, as I did as a Stanford medical student, you would fight for gun control as hard as you can. 

Manners, Morals and Ethics

It must be hard these days to know how to raise a child who has good manners, moral, and ethical values.  Children usually mimic what their parents do. If they see their parents being rude to a sales clerk or someone else, they suppose that is O.K.  If parents are unkind to someone, that too is noticed by their children. I was in a store one early morning when one of the workers told me how she  had been treated by a father the day before. This particular woman was a temporary employee because she was waiting to move to  another city where her husband had been sent. I had been impressed by the  woman when she told me she had a master's degree and written two novels. Apparently, this father was taking his child to school, but had stopped at the store to get something. He said to his daughter, "See that woman behind the counter, that  is why you have to get good grades so you don't have to do what she is doing." I was appalled and wished I had been there to tell the father what I thought. How rude can someone be? 

I have had several parents of children with disabilities tell me about some of the things said to them. One lovely mother and her daughter were leaving church when a woman came up to her and said " You have offended God because you have a disabled child."  Unbelievable when the woman had also  just come from the church. One of my favorite teenagers told me that he would love to have a girl friend but he had heard  one girl tell another  one that " He is probably funny in the head since he has to walk with crutches."  

Kids also copy the way  parents obey the law. If you never stop at stop signs, cheat in other ways and assume the law does not apply to you, how do your children learn what is right and what is wrong? My father was not a warm,  hugging man but he certainly taught us what was right and what was wrong.  As a college professor, I am sure his students quickly learned that cheating was unacceptable. He would  have been appalled at the college admissions scandal we are seeing today. What were these  parents thinking?