Rx For Parenting Today

Does your Child's Doctor offer any Parenting Advice?

I remember taking my young second child to a pediatrician in Rochester, New York. He  was my usual pediatrician's partner because my doctor was ill or not able to be in the office. The man asked me a couple of questions, looked quickly at baby Geoffrey and that was that. He patted me on the back as said "You are doing a great job" and left the room.  It was snowing outside and I wondered why I had bothered to come. I will never forget that visit. When I  built my own office on starting my pediatric practice, I added a classroom to the back. It held about 30 people and there was always standing room only. I still hear from many of the parents and their children.  

A friend told me that when she goes to a doctor she types a list of questions and makes a copy. If a doctor does not answer the questions, she stands in front of the door and hands him or her the questions.  No parent should leave without having their questions answered. I must admit I am not seeing the quality of pediatrics  I saw formerly. Is making money so important that doctors have to push parents and kids out the door? That is unacceptable.

 

Mental Illness and Guns

I do not understand why a rich nation like the United States cannot do something about the terrible, ongoing violence that we have been and are having.  One of my worst memories as a Stanford medical student was having to care for a boy in the  ER at the big county hospital. He  had been shot by a playmate. The resident and two of us who were medical students did everything we could to save the child's life, but he died. I will never forget that day. Why any parent would buy a gun for an 18 year old, as just happened, is beyond my understanding. I think we must hold parents like that responsible. The  Buffalo shooter also had 2 other guns. It was reported that the school recognized the youth has major  problems and did some kind of an examination. In my experience with school administrators they do not like to spend the money to have  full  examinations done  by a qualified  psychologist. I have fought with several of these individuals and usually had to find  the money to pay for an examination with grant money.

One teacher told me  her principal said she could just refer three troubled students a year, for examinations. That is hard to believe.

Children on the Autism Spectrum

I was talking with an older couple recently and they told me of the terrible problems they had with their first child. Their pediatrician was of little help and  the couple  survived the first few years before she finally seemed to be a little more manageable. I am not sure they realize even now that she is autistic. They see little of her and she has pretty much  gone her own way. 

Sadly, I find that even though there now are a lot more  kids on the autism spectrum, most medical schools don't appear to offer their students help in making this diagnosis. I feel sad for parents who  know they have a child with problems, but don't where or know how to get help. A good child psychologist is often the place to start or an agency that care for kids on the spectrum. Some school districts insist on having a child tested and given a diagnosis, but others offer no help.  There are pediatricians who diagnose kids with autism but my experience is that this is rare. Parents who suspect their child has problems may have to go to several different doctors or agencies to get help.

Babies with Special Needs

It is heartbreaking for parents and family members when an infant is born with a problem, such as spina bifida or cerebral palsy. I have been impressed with the strength that some parents have shown and been dismayed at some who did not want anything to do with a child with a disability. 

One of the first two things that needs to be done is find a physician who is caring and and willing to take on the task of caring for a baby with problems. The doctor who delivers the baby could  have a good suggestion or an agency taht cares for similar babies. Other parents who  have a special needs child can be helpful also.

The second thing that is MOST important is to connect with your state's agency  that handles children with disabilities. Most states can help financially. You can find the state agency on the Internet or a good social worker at the hospital should know this resource.  Even if you have good insurance, you may need some financial help because hospital bills can be very large.

Another work of advice is taht mothers in particular should not spend most of their time at the hospital but be sure they take time for themselves and their own needs. Caring for a baby with a disability can take a great deal out of a person and if a parent does not take care of themselves.

Birthday Celebrations

I know several people who never had a birthday celebration as a child.  One had two parents who were professionals,  another came from a poor family. Others came from middle-class families. Even poor families can  have a celebration without spending a lot of money. Just having  a cupcake and lighting a candle can make a difference.

I think a birthday should be a special day, so the individual knows the family was or is glad they were born. I realize that many pregnancies are not planned, but if you have a child, I firmly believe the parents deserve to give that child the best parenting possible. Yes, there are lots of ways to parent, but a child being abused or ignored is  unacceptable. I have seen far too much abuse and the children being ignored. Also when parents have a great deal of money a birthday celebration can turn into an opportunity for the  parents to show how much money they have. The birthday child can feel the celebration is really not for them but for their parents' friends. Money can do very bad things for parents or it can offer great opportunities. 

Parenting and the Virus

It is amazing and painful to me that many parents will not get the vaccination  against the virus for their children when they are eligible. 700 plus children have already died and more sadly will. Religious scholars say there is nothing in any religion that prevents vaccination. If you have had to see children die as I  have from awful genetic diseases you would be first in line with your child as a parent.

I was certainly glad that Drs. Salk and Sabin had perfected the polio vaccine when my children were born. I was an interne when there was the polio epidemic and watching  children become paralyzed or die was terrible. Not only do children now end up in the hospital with the virus but they also infect others. It makes no sense not to get the vaccine.  If I had a parent when I was in practice that would not get a vaccine I would send a registered letter and ask them to find another pediatrician. Fortunately, that never happened. So please ALL parents get the vaccine when your children are eligible.

 

Eating Disorders in Kids

I  have had far too many kids with eating disorders as patients.  These were not only mostly girls with anorexia, but kids who would eat only certain foods. These were not foods they were allergic to but foods they just did not like. Once in a while I had to ask for help from a psychologist, but generally I solved the problems in a simple way. I asked the parents just to give the patient the same food that everyone else had and not offer special foods the kids would eat. Snacks were not permitted, so of the patients got hungry enough they started eating what the family did.

I think these problems started when special foods were provided and then the problem  would get worse and worse. The family could not go out to dinner unless the particular foods were available. One mother was a physician and I think it was just easier for her to provide the special foods rather than call it a problem. That particular youth did need some counseling and for him I think a lot of it was attention-getting. He seldom saw his mother, never saw his father and was seeking attention. Gradually he became happier as the parents paid more attention to him. So for some food was certainly an attention-getting mechanism. 

Pediatric Care in the U.S.

I am often amazed at what parents tell me about the  pediatric care their children are receiving or not receiving in the U.S. One mother told me  her daughter's pediatrician had never looked below the child's waist. I was appalled. I have found many abnormal things by doing a complete physical exam once a year on kids. 

When I ask parents if yearly urinalysis are done, the answer is usually "no".  Every child, even little ones, should have a yearly urinalysis done. I have been amazed at the many problems I  have found by doing this. One teenager was not feeling well when I examined her, but I was unable to find anything wrong. I did check a urine, but it was O.K. I asked the girl's mother to bring her daughter back the next day.  Once again, there was nothing specific I could find wrong. I asked for another urine and the mother said, "but you did one yesterday." I told  her I would not charge for doing it, but did want another urine. The girl brought back a urine specimen that was brown. I knew immediately she had pyelonephritis. This can be extremely dangerous and I started her on antibiotics. The mother was very grateful and subsequently referred many other kids to me.  I saw the teenager many years later in San Francisco when I was doing a book signing and was delighted that she looked so happy and healthy. So parents please insist  a yearly urinalysis be checked on your children. A lot of problems could be found and helped.

Teenagers and Social Media

It is hard to watch the news and hear statistics about teens, who because they are active on social media,  may do harm to themselves. It  got me to thinking about what I would do if I was the parent of a teenager. I would certainly find a lot of fun activities the kids could become involved in, jobs they could do, or ways they could volunteer to help others. What are parents thinking if they allow a teen to spend hours on a computer being involved on social media sites? Don't parents have any  control of what their kids are doing these days? What about chores, helping around the house? Do teens these days learn to cook, sew, knit, iron, have music or art lessons, or have homework to do? I started working when I was 12 and later on worked as a waitress after school and on weekends. Money was tight for us as a family, even though my father was a college professor. 

Both of my children had sports activities and music lessons, and my son became very involved in theater.  My daughter volunteered at a school for children of  low income parents.  Then  later, after college she started a  program in San Francisco to help kids with disabilities find jobs and my son became a physician. If you are going to  be a parent, it is a hard job, but very rewarding if you take the job seriously. Are parents too involved with their social life, their jobs, shopping, or themselves? Something is very wrong if a child thinks suicide or hurting himself or herself is the answer. One of the reason I sold my much loved pediatric practice was  either I was going to  have to adopt some of the children who were in such pain or  open an orphanage.  

Raising Children with Manners and Morals

It must be hard to raise a child today with both good manners and good morals. With all the anger, division, and craziness in the world today, what can parents do? I think the answer is to go back to the basics of good  parenting. Children want and need to know their parents are in charge. Parents are also role models for their children. If you cheat, are unkind to people, and think money is the more important than anything else, how do your children know what is right?

I have seen all kinds of parents as a pediatrician. Some were wonderful parents, some were terrible parents, and some were essentially absent parents. When a child is raised by a nanny, a grandparent, or someone else, how do they know how to parent when they have children of their own? Some parents today just want to be friends with their children and are afraid if they ever say "No" that their child or children will not love them. I do not know where that concept came from or when it started, but it is just plain wrong. Children have much more respect for a parent who is in charge and from whom they can learn both good morals and good manners. It is a lucky child who has this kind of parent.

Keeping Babies Safe from Falling.

Now that the days are so difficult parents have to be particularly careful to not let their stress keep them from being vigilant about the safely of their children.

I remember one patient I had where the mother laid a baby on a bed while she did something else. It did not occur to her that the child might roll over onto the floor. But that is what happened. The baby did O.K. but we all worried for several hours. Now it has been reported by the CDC that there are about 2.8 emergency room visits a year because of falls by infants when the doorbell rings or a parent or caretaker needs to use a bathroom or do something else. Also remember that babies should always sleep alone and on their backs. I shudder when a grandparent tells me that a grandchild sleeps with the parents. Do the parents have any idea how risky that can be?  It is very tiring to care for infants  or little children, but a single mistake can  have a life-long effect.

With this awful pandemic, I worry about  all the babies being born and wonder if they will survive their parents' stress level. This is a particular problem if there are other children in the family and they have either not been  immunized or not yet able to go to school. I am certainly thankful that my children and grandchildren are adults. It is very important that parents find ways to take time off, have a little fun and relaxation. Parenting is  hard work and it never over, but the rewards are immense.