Category Archives: family

Back in School, Part 1: Staying Healthy

Now that your child is back in school, the sometimes easy-breezy days of summer have turned hectic with schedules, deadlines, homework, complex relationships. For the next few weeks we’ll be running a series about things to keep in mind during the school year ahead.

Today we start with how best to insure a healthy year at school.

You already know the best way to stay healthy, but it bears repeating: prevention is always the best medicine. Here are some pointers.

Checkups. Has your child had her annual well child checkup? If not, now is the time to schedule it. The doctor will look at health history, height and weight, and will discuss age-appropriate health topics with you and your child. If you have a specific concern (social behaviors, learning difficulties, chronic ear infections, etc.) to discuss, you’ll want to let the office know when you call for the appointment to make sure they schedule a longer visit for you.
Immunizations. Yes, we harp on this a lot, but it’s for good reason. Immunizations protect children, families, and even whole communities from dangerous diseases. The state requires that you keep certain ones up to date; we have others we recommend. Check with our office (or on the patient portal) for your records.
Exercise. Sitting all day at school, then coming home and sitting in front of the TV or at the computer and homework desk is not good for your kid. He needs to get moving. Don’t expect physical education classes to provide all the exercise he needs. Unstructured play is good for all children, and organized sports are a great way to learn things like discipline, teamwork and a sense of accomplishment.
Germs. Let’s be honest. There’s no way to avoid germs at school. Uncovered coughs and sneezes, shared desks and close quarters give viruses all sorts of opportunities to infect students. Some exposure is good to develop immunity, but keeping hands clean is a great way to stave off colds and flu. Send hand sanitizer to school in your children’s backpack, and remind them to clean their hands before eating and after they use the restroom. Every time. Don’t share drinks or eating utensils. And, while we’re at it, remind them not to share combs, brushes or hats, which is the most common way to spread head lice.
Sleep. A good night’s sleep is an essential ingredient in the learning process. Sleep also helps mood and strengthens the immune system. Set a regular bedtime and stick with it, making sure your child or teen has an age-appropriate amount of sleep.
Balanced diet. Eating right feeds both body and brain. This webpage at the American Academy of Pediatrics site lists several of their articles regarding diet. Don’t forget we have a dietician on staff who can help you come up with an action plan for your young athlete, picky eater, diabetic, or can help you plan easy lunches and snacks to pack for school.

Keep these things in mind throughout the school year and they will help your child have a successful and healthy school year.

Talking to your kids about alcohol and drugs

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Every parent worries about their child’s health, including whether or not that child will use drugs or alcohol.

It’s a valid concern. According to the Centers for Disease Control and Prevention, several studies in 2011 showed that:

“among high school students, during the past 30 days

39% drank some amount of alcohol.
22% binge drank.
8% drove after drinking alcohol.
24% rode with a driver who had been drinking alcohol.”

In addition, 40% of high school students have used marijuana at least once, and 25% have been offered, sold or given illegal drugs on school property.

What can parents do to prevent drug and alcohol use and abuse with their own children?

There is no single answer, and some children and teens will use or abuse substances no matter how hard parents try to keep them safe, but here are some things that may help.

Start young. Teach them how to say “no” when they don’t want something. Show them how to be strong in the face of peer pressure. Make sure they know the dangers and consequences of drugs and alcohol use.
Educate yourself. Don’t hide from statistics, but learn from them.
Be firm. Set rules and stick to them.
Be an example. Don’t abuse alcohol or consume illegal substances. If you drink, be responsible and don’t EVER drive intoxicated. Keep alcohol and prescription drugs inaccessible to your youngster. Never offer alcohol to an underage person.

If you think your child or teen is drinking or taking drugs, talk to your pediatrician or school counselor. They can find you the right kind of help.

Why narcotics are prescribed carefully

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You may have noticed that narcotic prescriptions are increasingly difficult to get for patients of any age these days. That includes children and teens.

Because of the common problems of prescription drug overuse and even abuse, narcotics are more tightly controlled than ever. Before anyone (even a child) can be prescribed narcotics in Kentucky, the physician’s office must run a KASPER report on that person’s prescription drug history. KASPER (Kentucky All Schedule Prescription Electronic Reporting) “tracks controlled substance prescriptions dispensed within the state. A KASPER report shows all scheduled prescriptions for an individual over a specified time period, the prescriber and the dispenser,” according the official website. The intent is not to prevent you from getting the medications you need, but to prevent overuse and provide a source of information for medical practitioners.

For this reason, refills and usage of narcotics are scrutinized closely within our office and narcotic cough suppressants (such as codeine) are rarely prescribed or suggested.

This is a good time to remind adults to store medications out of reach and out of sight. A young child is curious, and differently colored and shaped pills can look like candy. Older children and teens may want to experiment with drugs, and the ones in your medicine cabinet are free and accessible. Serious consequences of overdose, addiction and even death can occur, so lock your medicines away so that your children and teens don’t have access to them. Remind grandparents and other homes where you child visits of these important safety guidelines.

Narcotics are sometimes important, even essential, tools in your family’s health. But they are to be used carefully and cautiously.

Back to school ALREADY???

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It seems as though summer just started, and we’re already talking about going back to school. That’s because now is the right time to be thinking about getting your child’s medical exams and immunizations covered.

Exams and physicals. Most sports (both school and community) will require that your child or teen have an annual physical. You’ll see ads for retail clinics in stores and also physicals being held at the schools, but keep these things in mind:

Those places don’t have your child’s medical records. Medical and immunization histories aren’t available to the person doing the physical or administering the immunizations.
They haven’t developed a relationship with you to know what is normal and appropriate for your family.
Follow up is minimal or altogether unavailable.
No nutritional counseling is available, which we believe to be extremely important.

For all those reasons and more, we highly recommend that you see your own pediatrician for back-to-school exams and immunizations. (Check out our 2013 blog on store-based clinics here.)

Immunizations. Many immunizations are required by the state, and there are some additional ones recommended by the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC). For example, Kentucky requires the meningitis vaccine for the 6^th grade; we also are doing a booster at the age of 16 which isn’t state required but is recommended by both the CDC and AAP. A printable immunization schedule for parents is available here from the CDC.

Concerned about immunizations? Read the article, “Why Immunize?” at the CDC website. Also, find here a series of articles from the AAP about a variety of immunizations.

Plan to arrange your pediatric appointments soon, so your teens and children will have everything they need before school starts.

In between your summer travel plans, pool days and sporting events, don’t forget to make room for health.

Sunburned!

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As the summer gets going into full swing with Independence Day weekend, days by the pool and in the backyard, and lots of sports, sun exposure is always a concern.

How do you keep your kids healthy, happy and sunburn-free while still giving them lots of time outdoors? And when sunburn does occur, how should you treat it?

Prevention. Check out our blog from last summer about sunscreens here. Bottom line: use sunscreen liberally and limit sun exposure. You don’t have to get a sunburn to cause long-term skin damage.

Babies and toddlers. See this detailed article from the American Academy of Pediatrics (AAP). Very young children are especially vulnerable to sunburn and heat stroke. Under 6 months they should be kept out of direct sunlight and in the shade as much as possible. Use the sun cover on the stroller. Take a canopy to the older kids’ soccer games—it’s not only a good place to put the infant, but the rest of the family can get out of the sun, too. Be aware that reflective surfaces, like sand or the concrete around pools, can still allow for sunburn even when you’re under an umbrella or other cover, no matter what your age.

In addition to limiting time outside in the hot part of the day, here are other considerations for the very young:

Dress them in lightweight, light colored clothing that covers arms, legs and the head.
Use sunscreen on any exposed skin. There are several types that are appropriate for tender baby skin. Don’t ever spray directly onto the face, but into your hand first.
Put a brimmed hat on babies and toddlers, or spray their scalps with sunscreen. A fully-brimmed hat can protect scalp, ears, and partially protect face and neck.

Possible skin damage. Don’t forget that everyone, even those with darker skin, are at risk of skin damage from the sun. Exposure over time can lead to skin cancers later.

Treatment. Sooner or later, most everyone will have a sunburn no matter how hard you try to prevent it. What to do? It depends on the severity.

Minor burns (red, warm to the touch) can be treated with cool compresses, acetaminophen and rest.
More serious burns can cause blisters, fever and chills, headache or other feelings of malaise, even infection. If the burn is very serious, call your pediatrician.

So, by all means enjoy the summer sun, just be careful of getting too much exposure!

Reading is fun, but what if your child has dyslexia?

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Many people delight in reading a good book over the summer and families often take trips to the library or virtual trips to Amazon. But for some, reading is a chore or nearly impossible.

Dyslexia, also known as Developmental Reading Disorder (DRD), is a learning disability that starts with the brain, though it doesn’t at all mean that the affected person has lower intelligence. It’s simply the inability to process words properly and can involve auditory and oral issues as well as reading. A person with DRD might have trouble distinguishing letter and word sounds when someone is speaking, as well difficulty recognizing written words. DRD may sometimes be clustered with learning disabilities that inhibit writing and/or arithmetic skills.

If you’re concerned that your child may have dyslexia or another learning disability, speak with your pediatrician. She’ll ask questions about family history and the particular difficulties your child is having, and may schedule (or refer for) a neurological exam or other testing.

Treatment involves specific types of tutoring and coping skills, depending on the type and severity of the learning disability. The pediatrician or an educational psychologist can help you find the right program for your specific situation.

Learning disabilities often lead to boredom, behavior problems, and low self-esteem. The frustrations of not being able to read at grade level or perform schoolwork correctly and in a timely manner can be very stressful. For that reason you may want to arrange some counseling for your child as well. Psychological coping skills are just as important as educational coping skills.

For more information, this National Institutes of Health article is very helpful, and the source of much of the information in today’s blog.

Manners? Yes, please.

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Summertime is easy—so they say. It can also be an easier time to remind children and teens about good manners. Hopefully, you will have more times of relaxed conversation when you aren’t trying to juggle homework, school and extracurricular schedules all at once.

Manners are important because they remind us of the value of every human being. Saying please and thank you is respectful, whether those words are spoken to someone in the family, a teacher or coach, or a complete stranger. Being helpful ingrains kindness in the helper and encourages it in the recipient and observer.

What are age appropriate manners?

Ages 2—5. Teach children to say please and thank you at the right times. Children at this age usually love to help people, so encourage that tendency. At the playground, they can help a younger child, with supervision. At home, they can learn to pass the potatoes. When meeting someone, they can shake hands and learn to answer questions that are asked.
Ages 5—7. As the child develops physically and emotionally, so should their moral growth be progressing. Teach good phone manners by practicing in a game. Have a “manners night” once a week at the supper table, where everyone has to speak politely and initiate good conversation. Give a small reward at the end of the meal for the person who showed the best manners.
Older children. Learning to smile and maintain eye contact during a conversation is important as children grow. They can learn to ask people about themselves, and to distinguish between appropriate and inappropriate questions. Your suppertime conversations can engage their imaginations and teach them how to talk to other people.
Teens. When our children mature into teens, they often become less receptive to their parents’ helpful instructions on manners, but that doesn’t mean you can let them off the hook. By now they should know your standards, and you should be able to witness them using their manners at home and elsewhere. Teens who are mannerly, you may tell them, will likely advance at school and work because others respond positively to our good behavior.

Perhaps the main thing to remember about teaching manners to your children is this: be an example. Use please and thank you when you remind them about their chores. Treat your spouse and other adults and youngsters with respect.

If you are often cross with them, they will reflect that attitude back to you and to others. But if you treat them and others kindly, they will learn to mimic that behavior, both consciously and unconsciously.

Expect good manners from your children and that is likely what you will get.

E. coli and other nasty things: how to have good food safety for your cookout or picnic

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The holiday weekend approaches, with plans for picnics, cookouts, reunions, and fun! At the same time we’re hearing about a recall of nearly 2 million pounds of ground beef that is possibly contaminated with E. coli bacteria. How can you be sure about the safety of the food you’re serving your family?

You are right to be cautious. Foodborne illnesses can be very serious, even deadly. E. coli, in particular, can cause organ failure, and children may be especially vulnerable.

Here are some basic rules to keep in mind.

Cook ground meats ALL the way through. Pink interiors mean raw meat, and when that meat is ground, microbes that used to be on the surface of the meat can now be deep inside it. If the meat is fully cooked, any E. coli should be taken care of.
Cook poultry completely through. Chicken, in particular, can be contaminated with Salmonella.
Don’t reuse the plate that held raw meat or poultry. It must be washed before being used to hold cooked meat or other foods. The same goes with knives and other utensils.
Keep food separate. Fruits and vegetables shouldn’t be stored in the same container with uncooked meat and poultry, for example.
Chill leftovers soon. This is important when you’re at a picnic and far from your refrigerator. Take a cooler and ice packs.
Keep your hands clean. Wash them often. Take hand sanitizer on your picnic. Don’t change a baby’s diaper while preparing food.
Wash your fruits and vegetables. When you clean poultry in the sink, be sure to sanitize the sink afterwards so that you don’t contaminate food, dishes and utensils.

More information is available here from the Centers for Disease Control and Prevention.

A fun holiday is a safe holiday. Enjoy the time together and have a great weekend!

Launching your senior

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Graduation quickly approaches. Is your senior (or junior who will be at this point a year from now) prepared for a life in the world? Are you prepared for such a big change?

“Launching,” as it’s called, can create feelings of excitement and dread, happiness and fear, joy and anxiety in both teens and their parents. You’ve all been aiming for this day her whole life, and now it’s right around the corner. What’s the best way to face this important time?

Actually, there may be no “best way.” Every graduate, every parent, every family is different. Pay attention to how your graduate is facing this important milestone, and pay attention to your own feelings.

Letting go. You’ve been practicing letting go for nearly two decades: the first day of school; the first sleepover at a friend’s house; the first solo car trip. Even if your graduate isn’t moving out, increasing independence should be his goal and yours. He’s an adult, or soon will be.
Holding on. You and your graduate both need to verbalize that she’s always going to be a part of the family; graduation doesn’t change that. Even if she is moving out, she will benefit from the knowledge that she will always have your love and support.

How to find the balance? Make time (if you haven’t already) to address a few important topics together, so your graduate will know your expectations, and you will know his.

Education. Is higher education after high school an expectation? A hope? If so, what type and when? Is taking time before further education an option?
Money. What are expectations regarding continuing parental financial support, whether school is an option or not? Who will pay for rent, food, cell phone, computer, books, etc.?
Living arrangements. Is the graduate moving out or continuing to live at home? If staying at home, is she expected to contribute to household expenses and chores?
Communication. How will you stay in touch if he moves out? How will you grant independence if he stays home?
Healthcare. Investigate health insurance options. Your young adult needs to be aware of what health care coverage she has – on or off campus. She should carry a copy of the insurance card, know her allergies and medications, her medical and family medical history. He needs to be up to date on Immunizations. The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend more vaccines than most campuses require, so check out the above links whether or not he’ll be continuing in school. Have a discussion about what to do in case of a health emergency. Here’s a good link from Rowan University about what college students need to bring for the best healthcare.
Help. When there are bumps in the road of growing independence, how will you help negotiate the difficulties together?

Create an environment for listening to your grown-up-child’s hopes and fears. It’s an important time for all of you, and you will navigate it together.

ADHD—diagnosis, treatment and your concerns

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You hear so much about ADHD these days. It’s in the news. You likely know children, teens or adults who’ve been diagnosed with it. Debates continue about under- and over-diagnosing, and about medicating.

First, just what is ADHD?

ADHD is Attention-Deficit Hyperactivity Disorder. Of course, nearly all children will sometimes be hyperactive and lack focus. How do you know when it’s a problem worth taking to your pediatrician?

The American Academy of Pediatrics has a great article covering the basics of ADHD in which they say, “Children with attention-deficit/hyperactivity disorder (ADHD) have behavior problems that are so frequent and severe that they interfere with their ability to live normal lives.” We might add that family life is also greatly affected by a child with ADHD. This same article deals with concerns about medications and why more children are now being diagnosed with ADHD than, say, 10 or 20 years ago.

Another fascinating article about the trend is here, from MacClean’s.

The bottom line is this: yes, it’s a real problem. And yes, it may also be over-diagnosed.

Families of children and teens who have ADHD find that the right medication in the right amount can profoundly help. Specific testing is needed up front, then some time is often required to pinpoint and adjust the proper medication. In addition, coping mechanisms for studying, chores and social skills can assist parents in dealing with ADHD.

At Georgetown Pediatrics, we are conscientious in making the right diagnosis for your child. Four of our physicians (Dr. Hambrick, Dr. Hoddy, Dr. Sweigart and Dr. Forster) are specially trained to diagnose and design a treatment plan specific to your child. With compassion we can help you find your way to a less stressful future with your family.

If you have concerns that your child may have ADHD, contact our office for an appointment.