Category Archives: family

Good eating habits as a way of preventing obesity and eating disorders

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Back-to-school time involves changes in just about everything: schedules, homework, sports, family time—even eating. Being rushed in the mornings makes having a decent, healthy breakfast a challenge. Families have to decide if kids will take lunch or buy the school lunch. Then comes the evening meal with people going in different directions, and often little time to prepare or eat a meal together. It’s no wonder that healthy eating and family time often take a back seat to homework, sports, and other activities.

As we all know by now, obesity among children and teens in our country is a widespread problem, and eating disorders (EDs) are also more common than before.

An article published last week on the website of the American Academy of Pediatrics (AAP) discusses how the same attitudes and habits can lead to both obesity and EDs. According to one study, dieting can actually be a precursor to obesity and EDs. Dieting “was associated with a twofold increased risk of becoming overweight and a 1.5-fold increased risk of binge eating…  Another study found that normal weight girls who dieted in ninth grade were three times more likely to be overweight in 12th grade compared with non-dieters.”

In addition to dieting as a cause, “weight talk”—no matter how well-intentioned—and “weight teasing” can lead to EDs and obesity.  “Weight talk, or comments made by family members about their own weight or to the child to encourage weight loss, has been linked to both overweight and EDs. Teasing children about their weight also has been associated with the development of overweight, binge eating and extreme weight-control behaviors in girls and overweight status in boys. Body dissatisfaction is a known risk factor for both obesity and EDs.”

So, how does a parent help a child be satisfied with her or his body? How do you encourage your teen toward a healthy relationship with food? “Adolescents who are more satisfied with their bodies report parental and peer attitudes that encourage healthful eating and exercise to be fit, rather than dieting.”

The article contains recommendations for pediatricians, and that guidance also applies to parents:

  • “Discourage dieting, skipping of meals or use of diet pills to lose weight. The focus should be on a healthy lifestyle rather than on weight.
  • Encourage more frequent family meals, which provide an opportunity to model healthy food choices and provide time for teenagers and parents to interact.
  • Promote a positive body image among adolescents. Body dissatisfaction should not be used as a reason to lose weight.
  • Encourage families not to talk about weight but rather to talk about healthy eating and being active to stay healthy.
  • Carefully monitor weight loss in an adolescent who is obese or overweight to ensure the teen does not develop the medical complications of semi-starvation.”

Don’t forget family meals. Though your children and teens may roll their eyes, the time spent together around the table is a time to connect over healthy food and discussions about topics great and small. Turn off the television and cell phones (including yours!) and enjoy each other’s company. It will make all of you healthier.

© 2016, MBS Writing Services

Drugs and young brains

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According to the American Academy of Pediatrics (AAP), one in four young people (ages 12-17) who uses illicit drugs will also develop a dependency. This is a much higher rate than that for adults.

Why? No one is certain, but there are some known factors.

Heredity is one of those factors. Is there an addict or alcoholic (recovering or otherwise) in your family’s history? If so, be aware that this one factor can greatly increase your child’s chances of developing an addiction to drugs or alcohol. You should talk to your teen about this with the hoped-for effect that she will choose to be more careful.

Here are some other factors listed in an AAP web article:

  • “Untreated psychological conditions such as depression, anxiety, conduct disorder, oppositional defiant disorder and personality disorder. For these youngsters, as well as for those with untreated attention deficit hyperactivity disorder (ADHD) and other learning problems that interfere with academic and social success, taking illicit drugs may be their way of self-medicating.
  • Temperament: thrill-seeking behavior, inability to delay gratification and so forth.
  • An eating disorder.
  • Associating with known drug users.
  • Lack of parental supervision and setting of consistent limits.
  • Living in a family where substance abuse is accepted.
  • Living in a home scarred by recurrent conflicts, verbal abuse and physical abuse.”

Start the conversation about drugs and alcohol early on, in age-appropriate ways. And don’t assume that just because you’ve had this talk once, that’s good enough. Young people are confronted with opportunities on a regular basis, so make sure that you leave the door open to talking with you about it.

Not sure how to begin? Here’s another great AAP article entitled “Talking to Teens about Drugs and Alcohol.” It gives great advice about a conversation that is essential to your child’s health.

Educate yourself about drugs and alcohol. Have open conversation. Don’t abuse substances. Help your teen stay healthy and free from addiction.

© 2016, MBS Writing Services, all rights reserved

Sun(ouch)burn

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Everyone now knows how important it is to limit sun exposure, especially in children. Being exposed to the sun’s rays can lead to skin damage and skin cancer later in life. It’s very important, then, to use sunscreen and to cover up while in the sun, and to limit exposure when possible.

Even so, just about every child will get sunburned at some point, and experience pain, blisters, or worse. When that happens, what should you do?

According to this article from the American Academy of Pediatrics (AAP):

“The signs of sunburn usually appear six to twelve hours after exposure, with the greatest discomfort during the first twenty- four hours. If your child’s burn is just red, warm, and painful, you can treat it yourself. Apply cool compresses to the burned areas or bathe the child in cool water. You also can give acetaminophen to help relieve the pain. (Check the package for appropriate dosage for her age and weight.)

“If the sunburn causes blisters, fever, chills, headache, or a general feeling of illness, call your pediatrician. Severe sunburn must be treated like any other serious burn, and if it’s very extensive, hospitalization sometimes is required. In addition, the blisters can become infected, requiring treatment with antibiotics. Sometimes extensive or severe sunburn also can lead to dehydration and, in some cases, fainting (heatstroke). Such cases need to be examined by your pediatrician or the nearest emergency facility.”

In our office we sometimes get requests for Silvadene (silver sulfadiazine) for sunburn or other burns, but we no longer use that topical medication. There are other products that are better, more effective, and easier to use at home.

Burns of any kind are no fun. Protect your child from the sun when possible. Use the AAP’s advice above when there’s a sunburn, and contact our office if necessary.

© 2016, MBS Writing Services, all rights reserved

The consequences of lead poisoning in children

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The tragic, preventable events in Flint, Michigan, have brought to the nation’s attention the results of lead poisoning, especially in children. It’s a good time to remember that lead poisoning can be a risk, no matter where you live.

 

How are children exposed to lead? Lead can be inhaled in polluted air (which is why lead was removed from gasoline decades ago). Children can be exposed through paint containing lead, either by eating paint chips or when lead paint is removed and is introduced into the air. They can also ingest lead through tainted drinking water, which is what has happened in Flint.

 

Children are at greater risk than adults because their bodies absorb higher percentages of lead. In addition, their developing bodies are more easily and irreversibly damaged.

 

Some of the worst and most obvious problems that result from lead poisoning occur in the central nervous system. Brain development can be greatly affected, especially in those under the age of two. Such problems are permanent.

 

Other severe effects can include anemia, kidney problems, endocrine issues (including the inhibiting of normal growth), and gastrointestinal concerns (like vomiting and constipation). Both small motor and large motor skills suffer from lead poisoning.

 

Because lead so severely affects the central nervous system, children often exhibit serious behavioral problems like aggression, impulsive behavior, and difficulty with attention—problems that don’t end with childhood. Later in life, these individuals experience a much higher than normal incidence of substance abuse.

 

The growing understanding of the severity of the consequences of lead poisoning has caused the Centers for Disease Control and prevention to modify its definition of toxic lead levels over the past several decades to one twelfth of its former measurement (from 60 micrograms/deciliter in 1970 to 5 mcg/dL in the current definition).

 

So, what can we and you do to prevent lead poisoning? First, make sure you limit your child’s exposure to lead. If you’re concerned because you live in an older home, you can have your water tested to be certain that no lead is leeching into the system from pipes. Make sure that any lead paint has been removed.

 

In our office, we assess lead levels at the one year checkup. In addition, we have increased our frequency of using a verbal questionnaire to screen for risks, starting at six months of age.

 

Together, we can reduce or eliminate your child’s risk of toxic lead exposure.

 

 

***Much of the information in today’s blog was gleaned from “Pediatric News,” Vol. 50, number 3, March 2016.

 

© 2016, MBS Writing Services, all rights reserved

 

Children with special needs and their parents

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If you are not the parent of a special needs child, you know someone who is. We encourage you to send them this link of a terrific article we’ve found, entitled, “10 Things I Wish My Parents Knew While Raising a Child With Special Needs.” Sally Ross Brown, a person with cerebral palsy, tells her own story and inspires the rest of us. Read it here

Learning CPR and how to use an AED

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We hope you never need to use CPR (cardiopulmonary resuscitation), but everyone should take a course so that you’re prepared in case the need ever arises.

Administering CPR is different with infants, children, and adults. Smaller bodies require different techniques and have different breathing and heart rates.

In a CPR course you will learn how to identify if someone needs CPR, how to be sure the airway is open, and how to administer CPR. Of course, calling 911 is essential if someone is not breathing.

You can take a course with the American Red Cross or, in Georgetown, through the fire department or health department.

Probably you have seen the proliferation of AEDs (automated external defibrillators) in public places. This article from the National Institutes of Health describes AEDs and the need for them this way:

“An automated external defibrillator (AED) is a portable device that checks the heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm. AEDs are used to treat sudden cardiac arrest (SCA).

SCA is a condition in which the heart suddenly and unexpectedly stops beating. When this happens, blood stops flowing to the brain and other vital organs.

SCA usually causes death if it’s not treated within minutes. In fact, each minute of SCA leads to a 10 percent reduction in survival. Using an AED on a person who is having SCA may save the person’s life.”

You don’t have to have a medical background to be able to use an AED, and the training isn’t difficult. The device itself is not terribly expensive to have in a workplace. For a few hundred dollars you can be prepared to save someone’s life.

© MBS Writing Services, 2015, all rights reserved

Bullying is a serious matter

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October is National Bullying Prevention Awareness Month. That means now is a good time for us to talk about this important subject.

Bullying can occur at school or on the bus, in the neighborhood, on the playground— anywhere. Cyber bullying is also on the rise, where people use the internet or phone apps to harm others.

At the very least, bullying lowers self-esteem. But as we know, continual bullying can cause children and teens to withdraw socially, may create depression or other mental health issues, and can even result in physical harm.

Parental awareness is essential. It’s almost certain that your child will, at some point, either be on the receiving end of bullying behavior, or will bully someone else, or both. An article on the American Academy of Pediatrics (AAP) website references a study from 1999, in which four out of five teens admitted to participating in bullying behavior at least once a month. Those who have been bullied often go on to mistreat others.

Conversations about appropriate behavior and language need to begin early between parent and child. Don’t hesitate to correct your child or teen when you hear name-calling or witness unkind behavior, even between siblings. They can learn early the boundaries between acceptable and unacceptable behavior. Teach them how to express themselves, especially when hurt or angry, by using language that doesn’t cross the line into disrespect. Don’t tolerate violent acts against people or animals.

Of course, your kids are not always near you, and you won’t be aware of everything that happens to them or everything they do. Continue the conversation about bullying; remind them to walk away from confrontations and to inform a responsible adult if they experience or witness bullying. Talk about kindness; role-play sticky situations. Monitor their internet and cell phone activity and discuss what you find there.

Teach your kids some nonviolent and non-confrontational ways to handle conflict. There are excellent resources for this in the article mentioned above, also here and here.

Remember that school counselors and other therapists can be really helpful if your child or teen is a victim or perpetrator of bullying, and our office can always make a referral.

As children get older, remind them that they help create a safe environment for others. They can be a positive force by refusing to contribute to an atmosphere of hatred.

As the school year continues, things can get very hectic. Don’t forget to pay attention to what’s going on with your youngsters. Ask questions, be supportive, get help when needed. Let’s keep our schools and community safe for everyone’s children.

© MBS Writing Services, 2015, all rights reserved

Artwork by Shawna

Artwork by Shawna

Spider bites

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Both spiders and ticks are common in our area. We’ll deal with ticks next time.

While most of their bites aren’t dangerous to most people, it’s good to be informed about different types of spiders, their bites, and diseases that might result from some of them.

Spiders use a venom to anesthetize and paralyze their tiny prey. The venom from most species is not dangerous to most humans (see below for exceptions). Watch for signs of infection and report those immediately to your pediatrician. If you are concerned that a bite is getting much larger, note the edges with a Sharpie marker so you can see if it’s continuing to grow.

The female black widow spider can be extremely poisonous to humans, sometimes even fatal. She has an hourglass shape and is dark colored with yellow or red on her abdomen. Symptoms can be severe muscle cramping and pain. Call EMS if you think someone has been bitten by a black widow spider.

The brown recluse spider is fairly common in Kentucky, and can also be fatal at times. People often don’t know they’ve been bitten until the bite starts to swell and get painful. Reactions greatly vary. Call EMS if you are concerned about a brown recluse bite.

According to this article by the American Academy of Pediatrics (AAP), here are things to watch for after a spider bite, and a signal to call your pediatrician or EMS:
• “Tiny fang marks
• Pain
• Pain begins as a dull ache at the bite site
• Pain spreads to the surrounding muscles
• Pain moves to the abdomen, back, chest, and legs
• Blister at the bite site
• Mild swelling and a blue-gray mark at the bite surrounded by lightening of skin color
• Progressive soft tissue damage; the skin becomes dark blue and then black (necrotic).”

Wash the affected area with soap and water, and treat a bite with an ice pack (make sure you put a layer of cloth between the ice pack and the skin) Another resource for your questions about spider bites is the Poison Control Center.

As with anything, whenever you have a concern, call our office.

© MBS Writing Services, 2015, all rights reserved

Sports physicals – it’s time

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Your kids are on the move – literally, and all the time! If they are involved in a fall sport at school, then it’s time for their sports physical. Don’t forget that there is tremendous benefit to getting these physicals at your child’s pediatric office, rather than at a clinic or a school-sponsored physical day. The pediatrician has all your records including vaccinations, allergies, and your individualized and family medical history. He or she can discuss important sports information with you, including nutrition. And, of course, follow-up is always readily available, whether one week or six months from now. We are delighted to be working, with you as our partner, to make a medical home for your family here with us. If your child has a physical at a clinic or the school, that physical is not a part of our records, and we end up with an incomplete picture of his or her development and needs. Read our previous blog post for more reasons on why it’s wise to bring your child to the pediatrician when it’s time for a physical.

© MBS Writing Services, 2015, all rights reserved

Bug bites

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It’s summertime. Mosquitoes and other bugs are in hot pursuit of you and your family. What’s the best way to keep from being bitten? When should you be concerned about a bite?

If your kids spend any time at all outside— which they should, for the exercise and fresh air— they will be bitten from time to time. “Bugs,” of course, is not an accurate scientific term. Even so, we’re using it here as an all-inclusive word to refer to insects (mosquitoes, bees, wasps, chiggers, biting flies, etc.) and arachnids (spiders, ticks, etc.).

Most bites on most people are relatively harmless, causing irritation, itching, and redness. Different bug bites can result in different types of skin reactions, and not all people react the same. Rarely, even serious allergic reactions or illness can result.

The best medicine, as always, is prevention. Avoid times and places where mosquitoes and other biting bugs congregate.

Mosquitoes are most active around dawn and dusk. They love standing water in puddles and ponds. You are more likely to attract mosquitoes if you’re wearing dark clothing, including socks. They are attracted to your perspiration and sometimes to a scent to you may be wearing. Biting flies may be most common in wooded areas and around animals or garbage.

Repellents can be very helpful, especially against mosquitoes. However, you need to be cautious when choosing a repellent, especially for children. DEET is particularly effective against mosquitoes and some other bugs, but should be used with caution (see below). This is also true of permethrin, which is effective against ticks. Insect repellents should not be used at all on children younger than two months old.

There is terrific information in this article from the American Academy of Pediatrics. Here is their list of do’s and don’ts when you use insect repellents:

“Dos:

  • Read the label and follow all directions and precautions.
  • Only apply insect repellents on the outside of your child’s clothing and on exposed skin. Note: Permethrin-containing products should not be applied to skin.
  • Spray repellents in open areas to avoid breathing them in.
  • Use just enough repellent to cover your child’s clothing and exposed skin. Using more doesn’t make the repellent more effective. Avoid reapplying unless needed.
  • Help apply insect repellent on young children. Supervise older children when using these products.
  • Wash your children’s skin with soap and water to remove any repellent when they return indoors, and wash their clothing before they wear it again.

   “Dont’s:

  • Never apply insect repellent to children younger than 2 months.
  • Never spray insect repellent directly onto your child’s face. Instead, spray a little on your hands first and then rub it on your child’s face. Avoid the eyes and mouth.
  • Do not spray insect repellent on cuts, wounds, or irritated skin.
  • Do not use products that combine DEET with sunscreen. The DEET may make the sun protection factor (SPF) less effective. These products can overexpose your child to DEET because the sunscreen needs to be reapplied often.”

To treat a bug bite, you may apply ice for a few minutes every hour or two. Calamine lotion may be applied to stop the itching. Some people also find that baking soda mixed with water decreases their itching.

When should you seek medical attention for a bug bite? If anaphylaxis (a severe allergic reaction, which may include difficulty breathing – see definition from the Mayo Clinic here) occurs, get to an emergency room immediately.  Sudden hives are also a cause for concern and could be a sign of anaphylaxis. Otherwise, if the bite begins to look infected, or the reddened area around it is increasing in size larger than a quarter, keep an eye on it and check with your pediatrician’s office. You can use a Sharpie to mark the edges of the red area in order to note its progression.

Next time, more about stinging insects.

© MBS Writing Services, all rights reserved, 2015