We think about childhood obesity as a problem facing our kids but, in fact, it’s become a global health problem. Whether you travel in your community or around the globe, it doesn’t take too long to notice just how major of a problem childhood obesity has become. This is likely the health issue that will be our kids’ downfalls if we don’t pay attention to it soon.

The Barilla Center for Food and Nutrition has been looking at this problem and has concluded that for kids to be truly healthy, there needs to be a coordinated effort between the family, schools and pediatricians.  One of the biggest hurdles is to address the fact that we are truly a melting pot of cultures, within the United States and throughout the world. So, educational efforts to combat eating habits and lifestyle changes have to take into account the many cultures that now co-exist in our communities.

One of the most fascinating area that the Barilla Center is working on is a concept called the “double food pyramid”. It’s the same food pyramid we’ve become familiar with juxtaposed next to a pyramid that takes into account the environmental impact of the foods we consume. It turns out the two pyramids are inverses of one another so that the foods we are told to eat the most of have the least impact on the environment:

Tomorrow, Tuesday October 11, 2011, at 11am EST, the Barilla Center will be hosting a webinar that will cover

1. WELL-BEING & ENVIRONMENT: NEXT GENERATIONS’ BEHAVIORS

2. SCHOOLS, FAMILY AND PEDIATRICIANS: ACTIONS & ROLES to promote healthy eating habits and lifestyles

3. DOUBLE PYRAMID FOR DEVELOPING COUNTRIES – what it really means and how to use it

Check out this video to learn more about the webinar:

It isn’t enough to have a “healthy home” because eventually our kids don’t spend their entire time at home. When at school, out in the community, at other people’s houses, they are exposed to the eating habits and ideas of many other people. So, unless we get everyone on more or less the same page, we’ll never get our kids to the healthy place we want them to be.

Tomorrow’s webinar is a great first step in a conversation that needs to happen. This is an issue that I feel strongly about which is why I agreed to partner with the Barilla center in promoting the webinar and sharing information about their work. I’ll be tuning into the webinar, and I hope you’ll tune in for a while, too.

Safety proofing. One of those necessary evils of parenting we love and hate all at once. We love the fact that we are protecting out infants and very young children, yet if only it were easier to accomplish at times…and if our tots had a bit less Houdini in them. Still, safety proofing measures do minimize injury and provide us with peace of mind during a very chaotic time in our kids’ lives.

Our danger antennas never stop beeping when our kids are young, even when visiting friends, relatives or on vacation. Those times can be overwhelming since you are out of your familiar home element but by paying attention to a few simple safety features any where you go, you can reclaim the same peace of mind you have at home.

Location, Location, Location

Whether staying at a hotel or a relatives house,  safety proofing is a must! The major areas to focus on are:

• Outlets: bring outlet covers with you and cover the easily accessible ones.
• Under bed areas: take a peek for dropped food and medication and toss out what you find.
• Window treatment cords: tie up high any that a child could reach as these are strangulation hazards.
• Furniture: check all for stability since young kids love to climb and pull. Watch TVs – they tend to slide!!
• Access to water areas: bathrooms and pools.  If you can bring a portable gate to gate off the bathroom, do so. For pools, direct supervision is always needed.
• Cribs: bring your own pack and play since hotel cribs are often not up to code.
• Windows: check to be sure they are locked. If a relative wants to open a window for air, ask that it be opened from the top so a child doesn’t fall through inadvertently.

Visiting Safety

Sometimes when grownups are together in a group, everyone makes a grand assumption someone else is watching all the kids. That is exactly when an accident will happen.  Try to create a rotation of adults so that no one feels they are being burdened as a baby sitter. But, be prepared that may be a task you end up doing yourself.

Cocktails, beer and wine look like juice to small children.  Encourage adults to place unfinished beverages out of reach of kids and toss any you find placed on coffee tables or even counters. It only takes a few sips of a cocktail for a child to become intoxicated so toss what you see often.

Restaurant Safety

Dining out with kids can molt from enjoyable to harrowing in the blink of an eye. Your success will be dependent upon a few simple things:

• Restaurant choice: Not all restaurants are kid-friendly so that is an important consideration. On vacation, after a full day of new things and sightseeing, this may not be the time to push the envelope on new food. If the restaurant doesn’t have choices your kids will do well with, find a different one.
• Time of Dinner: While you may be tempted to have everyone nap and eat later, your kids’ biological clocks won’t be so forgiving. Try to keep dinner time around what your kids are used to. Have snacks on hand to buffer wait times just in case.
• Past restaurant experience of your kids: some kids do great at restaurants and others don’t. If your kids are picky, stick to simple, family-oriented restaurants.

Keep in mind that there are other people eating out, too. If your kids start to act up, ask for everything to go and eat it back at the hotel. Your kids just may be at their limit after a long day of stuff and we have to be realistic that they are just kids. What they may really need is downtime and bed.

When In Doubt, Count On Your Third Eye

The two rules of thumb I always find never fail us on the road are this. First, once we start trying to convince ourselves “how bad can it be”, we likely should not follow that plan. Those are the times we’ve found preventable accidents have happened in our family.

Second, trust the eye in the back of your head and never forget it is there.  You know that eye – it’s the one that tells you where your kids are when disaster looms? Easy to have it go to sleep on vacation but don’t let it! Have an extra espresso and keep it awake and on alert. You count on that third eye at home and you need to count on that even more when out of your element on the road.

(Originally posted June 2008; updated December 2009)

]]> http://www.pediatricsnow.com/2009/12/safety-proofing-when-away-from-home/feed/ 0 http://www.pediatricsnow.com/2009/12/common-questions-parents-ask-about-young-children/?utm_source=rss&utm_medium=rss&utm_campaign=common-questions-parents-ask-about-young-children http://www.pediatricsnow.com/2009/12/common-questions-parents-ask-about-young-children/#comments Wed, 16 Dec 2009 17:36:22 +0000 DrGwenn http://pediatricsnow.com/wptest/?p=155

Attending conferences and events, I’m always amazed by the new parenting devices and  gadgets that appear on the market. What’s timeless, however, are the questions parents have about the health of their young families.

Here’s a sampling of those common parents of new babies or of young children typically ask:

Can you really over bundle a baby?

Believe it or not, you can. Babies don’t have the best temperature control when very young so can get overheated very easily by being over swaddled or over-dressed. The best rule of thumb is to dress your baby as you dress yourself. Overheated babies can become fussy and clammy and may even run a low-grade temperature. If this occurs, try unbundling your baby a bit and if that doesn’t help calm your baby, call your pediatrician advice.

Should daycare centers and schools be nut free?

Nut allergies are very common and can be life threatening even from a simple touch or sip of water from someone who had recently eating peanut butter.  Schools vary in how they handle this but the only way to ensure the safety of the kids affected is to keep public places as nut free as possible.

How can I tell if my preschooler’s speech is normal?

The trouble with preschool speech is while there are guidelines for milestones there is a wide range for when kids are allowed to reach those milestones and still be “normal”. Here are the commonly accepted guidelines by the American Speech and Hearing Association (www.asha.org). If your child falls outside these guidelines, call your pediatrician or public school speech department to arrange for an evaluation.

3-4 Years:

Talks about their day at school or at a friend’s house

Understandable by people outside the family

Uses 4 or more words in a sentence

Usually talks easily

4-5 Years:

Sounds like other kids

Uses a lot of detail in sentences

Can stick to a topic when talking

Talks easily with kids and adults

Can say most sounds well except: l, s, r, v, z, ch, sh, th.

Uses the same grammar as other family members

Can I pamper myself while I’m pregnant? Get my hair colored or nails done?

The short answer: absolutely! You go girl! A pampered mom is a happy mom!

The longer explanation:

The cosmetic industry has come a long way in ensuring the safety of its products, and most OB/GYN doctors and salon stylists agree that the products on the market can be used during pregnancy without hesitation. The smells may bother you early on but a well ventilated room usually alleviates any nausea that may result.

Keep in mind, though, that hair does change during pregnancy and many women find they don’t need as much artificial color. Your stylist can guide you to what makes sense for your hair as your pregnancy progresses but many advocate waiting until second trimester to start any coloring during pregnancy to give the hair time to adjust.

Similarly, manicures and pedicures pose no risk at all during pregnancy. Nail color can’t penetrate the nails at all. The fumes are the only potential annoyance but, again, a well ventilated room can help with that.

Finally, while considering other spa services, massages are a wonderful way to pamper yourself and are very safe for you and your growing baby. However, avoid any activity in the spa that could cause you to overheat such as hot tubs and saunas. Increased body temperature is a risk factor for birth defects.

Closing Thoughts

Our own experience is our best asset as a parent and one of the best gifts we can give each other is the benefit of that experience. At the Baby Faire last year, a mother of two, ages 4 years and 9 weeks, shared with me this snapshot of her family:

Me: How is your older daughter adjusting to having a new baby at home?

Mom: Great! I give her jobs which helps us all out.

Me: Jobs? How does that work?

Mom: Well, I figured by making her part of the baby stuff she’d feel more included. Her job is to get the diaper for every diaper change and help get the car seat ready. She loves this and it really helps us out! Besides, a child is never too young to learn to have responsibilities.

What a brilliant idea! I wish I had thought of it when my kids were young. Older siblings are often at a loss to figure out their place in the new family and giving them simple jobs around the baby helps them become more used to this new family entity. Of course, we all know the other show will drop at some point but no reason we can’t all enjoy some sibling harmony while it lasts.

(Originally posted March 2008; Updated December 2009)

Having “the talk” with our kids is never easy. Just getting through saying the various anatomic names can be daunting for even the most savvy or parents.  It used to be that we would talk about the basics, reproduction, and add sexuality, birth control and life issues like babies later on as our kids got older. The news of 17 pregnant teens in Gloucester, MA in 2008 rocked our beliefs to their core and there was a great deal of talk about how we can improve on reaching teens more effectively.

Given how many celebrity teen moms we now have and shows glamorizing teen pregnancy it’s clear we haven’t learned our lesson and are still not willing to see that teens need a different approach…one that takes into account the reality of what today’s teens are truly doing sexually and that goes beyond the basics to include:

• Accurate and honest information
• A discussion of consequences
• Problem solving ways to keep themselves safe – that is, an honest talk of birth control
• The knowledge they can turn to their parents if something goes wrong

Accurate and Honest Information

Accurate information is easy for parents, especially with the help of websites, books and basic reproductive health taught in 5th grade. Where parents have trouble is going the step further and being honest with their tweens and teens about the facts. The facts that need to be discussed are the basic facts of reproduction, the fact that sex leads to a baby, and the fact that something called birth control exists. To leave out any of those facts is not being honest with our kids about the full picture of reproduction and sexuality. In today’s society, kids need all this information, even in a basic form, our of the birds and bee talk gate.

A Discussion Of Consequences

Teens don’t problem solve well about sexual behavior so you have to do it for them and keep it simple.  My talk with teens about consequences of sex is simple: “If you have sex as a teen, you’ll either become a teenage parent, get a disease, or both.” Teens are very impulsive. They think sex is fun and babies are cute. If you start spelling out the reality of having a baby or getting a disease, most teens will begin to wake up and want to take steps to be more responsible.

Enlist your pediatrician’s help in talking to your teen about sexually transmitted diseases. Most teens become quite stunned when they learn the details of many of those STDs. To give your teen a reality check about life with a baby, don’t just tell them stories of your teen or other kids as cute babies – tell the tough stuff: hours of colic, sleepless nights, trips to the pediatrician, sick stuff, diapers, feeding, no social life, no money for anything but baby stuff. Don’t paint a pretty or overly glorious picture.

Problem Solving and Ways to Keep Them Safe

While many parents hope their kids will not have sex, clearly that is a pipe dream.  To truly keep your teens out of trouble if they have sex, birth control and the HPV shot for girls are the best methods at the moment. It is a huge myth that talking about birth control and the HPV shot will entice your kids into sexual activity.  Teens who have decided to have sex will do so with or without their parents “consent”. Think of it like this. You don’t have to approve or like your teen’s decision to have sex and you can let your teen know that. But, as a parent, you have a responsibility to help your teen not do something too stupid, either. Teens are impulsive and sometimes need rope to run with a gently tug back.

BTW, abstinence only programs don’t work. But, what does work is giving teens information and having parents who support them. What also works is keeping teens busy in other activities and helping keep their self-esteem high. Teens with high self-esteem who have lots of activities in their lives tend to not look for the “other” form of gratification too young.

The Knowledge They Can Turn To Their Parents

For problem solving to really work, our teens need to know they can talk to us. I know too many teens way too fearful of talking to their parents about issues of sex and sexuality for fear of being disowned. That’s very sad to me.  Our teens need to know we won’t always be happy with their choices but they also need to know we will unconditionally love and support them regardless of the outcome. If you haven’t seen the movie June, see it. The way those parents handled the news of Juno’s pregnancy is a model to us all.

Final Thoughts

The biggest pill to swallow here is that teens are having sex, in all walks of life.  If we all become more honest about that perhaps we can cultivate a more open atmosphere in our own homes so our own teens make better choices than the Gloucester teens did (or Bristol Palin or Jamie Lynn Spears) – and one less baby born to a teen.

(Originally posted September 2008; Updated December 2009)

All families worry about whether their babies are developing “normally”. Concern is often more heightened when a baby’s head is on the small size. Here are two questions I received recently on this topic. As you’ll see, appearances can be deceiving and more times than not there is no reason for alarm:

Question #1
Dear Dr. Gwenn:

I had my son two weeks early due to IUG. We had an ultra sound at 38 weeks and his head measurement was not what they expected so I had a c section immediately. He was 5lbs 13 oz. and 19.5 inches long. He has grown on a normal curve but his head circumference has been just below the curve since he was born. He seems very content and has for the most part developed normally but I am concerned about his head size being too small.

His head at 8 months is about 42 cm. Am I worrying too much? I have read lots on the internet about microcephaly and it just scares me more!

CW

Question #2
Dear Dr. Gwenn:
Yesterday at my two month old baby’s well child exam, his doctor said his weight and length are good but his head size, 15 ¼” is a bit on the low side, in the 25th percentile. It was 14 ½” at his 2 week visit. She didn’t seem worried and said she’d keep an eye on it over time.

I have read that head growth equals brain growth. I am really worried that his brain might not be growing at a normal rate. I feel so bad that maybe we did something. Is there anything we can do to help? Have any of you had the same problem? Will he grow normally, intelligence wise? I don’t want my baby to be picked on. I am so scared that his body might keep growing but his head size might remain the same or very small. Is that likely to happen?

Thank you.
J.

*******************************************************************************
Even though these questions contain many differences, the most important fact they both share: both babies are developing normally and achieving their milestones. That is the best evidence that we have for realizing a baby’s brain is doing exactly what it is supposed to do.

Growth parameters can be difficult to evaluate and can cause alarm if you are not quite sure what to make of them. Growth curves represent the entire population so some kids will fall on the high end, some on the low end, and many in the middle. What we look for is the pattern over time and not just the isolated percentage. Also important is prenatal history and birth history. Many babies are born with IUGR and catch up nicely over time. CW, if you plot your baby’s head circumference from birth you may see that it is increasing along its own curve but since it started below it is just tracking there.

While we do worry about outliers, kids falling below or above the curves, we don’t worry so much about kids who are at the lower percentiles but grow along that curve. The Head Circumference Chart can be very helpful because we can see that a baby’s growth is progressing at whatever line it should be one.

Your baby will tell us his brain is developing normally by meeting his developmental milestones. Check out our Infant Development page for more information about what your baby should be doing today and what to expect in the coming months. As long as he is on track developmentally, you need not worry. One of the advantages of the frequent infant well child visits is to catch infants early who may need some early intervention and help with milestones. If you have any concerns about this, you should discuss it with your pediatrician. If she is not worried, you need not be worried.

Finally, as in these questions, parents often worry that they “did something” to cause this. If you took care of yourself during your pregnancy and had regular care, you did your job. All you can do now is love and nurture your son. That above all is what determines later success in life. Intelligence has a great deal to do not only with nurturing when young but genetics. All any of us can do is accept our kids for whatever learners they end up being and help them be the best they can be. Both these babies will look just like all the other kids when he is in school!

I would encourage both these families to talk to their pediatricians who know the facts of the pregnancy and the baby’s development better to get more reassurance. Both cases are different but the statistics are on the side of good outcome for both kids.

Puberty can be a confusiong time for kids and parents. You’ll feel a lot better about the process if you know what to expect. This section is really intended for teens and tweens but talk to your parents before reading too far. In fact, you’ll get more out of this page if you look at it with your parents!

Puberty Nuts and Bolts

Q) Dear Dr. Gwenn:

My grandson recently had his 9 months check up. At birth and 3rd month check up his head size was in the 55% range. His weight and height wereclose to the 90%.At the latest 9 months checkup, his head size was in the 90th% and his weight and height were lower than the earlier months, more like 75th percentile. His developmental milestones have been very normal or above. He’s smiley, happy, eye contact, verbal–lots of sounds including mama and dadada—. He crawls everywhere and up on everything. First child for my son and daughter.

I’ve been reading online that rapidly increasing head size particularly towards the end of the first year may be an early indicator of autism. Should his parents and I be concerned?

-concerned grandma

A) Dear Concerned Grandma:
The first point I want to make is that your grandson is still on the growth chart so that is very reassuring. Plus, whenever there is a single jump in head circumference at a visit, measuring error always has to be considered. To have a truly “large” head, the kind we worry about when considering any sort of pathology, the head usually grows literally off the chart and there are often developmental issues. Neither of these situations are occurring with your grandson and that is very, very reassuring that he is A-OK!

Evaluating infants with expanding head size includes many possibilities with autism being on the list but much lower down than other, more common, nervous system conditions that also cause developmental issues. Pediatrician Ari Brown, MD, author of Baby 411 and Toddler 411 agrees. “Rapidly increasing head is just one finding with autism”, Dr. Brown told me via an email interview. “I worry more about (other issues) when I see this but certainly keep my eye on developmental milestones when the head is enlarging.”

So, my best advice would be to talk to your grandson’s pediatrician about his head growth to see if it is truly enlarging or has just jumped a size but not to worry too much. And, keep in mind that more times than not, big heads are just big heads – and often run in families!

By the way, the American Academy of Pediatrics is very interested in helping parents identify autism in their children as early as possible and in October, 2007, came out with some very important guidelines for diagnosis that help us now identify children in infancy and as toddlers. From their press release, they list the following as “subtle signs” that autism may be present in an infant or young toddler:

• “not turning when the parent says the baby’s name;
• not turning to look when the parent points says, “Look at…” and not pointing themselves to show parents an interesting object or event;
• lack of back and forth babbling;
• smiling late; and
• failure to make eye contact with people. “

Puberty – the final frontier.

These are the voyages of our tweens and teens*.

Their 5-ish year mission: to become independent while their body is changing inside and out,

to boldly go where every tween and teen in history has gone before!

Just like Captains Picard and Kirk on Star Trek, we encounter aliens daily as our kids evolve through puberty. Those aliens are none other than our teens and tweens, or Ts for short. I have to admit I was a nonbeliever that the alien force could start so young until my girls both entered the terrible Ts at the early age of 9. But, that is when it begins – tweendom and puberty.

When parenting Ts, we’d be wise to follow Star Fleet Academy’s Prime Directive.  The Prime Directive allows for healthy interaction without interference in a way that would alter the natural history of that alien culture, and prohibits introducing technology and information they have not advanced to.  Sounds like parenting maturing children to me. But, unlike in Star Trek, the lines of where to not intervene are not so clear cut. Our kids are still kids even as they enter and evolve through puberty.

Puberty, the process, changes everything about our Ts inside and out, similar to a purge and rebuild of a computer hard drive. Sometimes the transition is smooth and other times bumpy but in the end all systems return to normal.  Puberty occurs over 5-7 years in 5 stages starting with our prepubertal child in stage 1 and ending with an adult-like older teen in stage 5.  All Ts go through the same 5 stages but the timing can be very different from T to T.  Inside and out, the focal point of puberty is a maturing reproductive system and ability to reproduce. So, needless to say, our Ts sexual lives start to develop during this process. Whether they act on those feelings or not, the feelings are their and can be confusing.

Boys and girls experience puberty very differently.  Maria Olio, a mom of three teen boys and one tween girl and local columnist, found that all her Ts were similarly moody but her boys seemed to have an easier time accepting the physical changes. This makes sense since girls’ physical changes are quite obvious whereas a  boys’ are more subtle.

What can we do as parents during this chaotic time? Simple. Follow the Prime Directive of Parenting Ts:

1. Develop a good poker face. There will be some Tums moments, but the less you react, the quicker the emotional chaos will subside.
2. Expect RHMs for all kids, boys and girls: Random Hormonal Moments. There will be times your child appears possessed. To handle a RHM, listen – breathe – listen…exhale…then talk. When in doubt, say nothing. Once the RHM subsides, it will be easier to figure out if any real issue is at play.
3. Space is your friend. Ts need some alone time but they also very much struggle to stay connected to their family. True give and take work better then edicts.
4. Be open for conversation and accepting if they have emotional or sexual views different from your own. Work in tidbits and find teachable moments from the news or town and school events. Kids this age do better if the information isn’t too personal at first.  “Don’t wait for them to ask you”, notes Maria. “You ask them”.

As our Ts go through puberty and become young adults,  we have to change our parenting styles. We have to become less hands-on and more observers while keeping a foot in the door to intervene and advise when needed. We have to help them find boundaries, learn from their mistakes and discover who they are as individuals. And, we have to be accepting if they develop different views from our own.

The key to success is being mindful of the stage they are at and not reading too much into everything. I was reminded of that recently with my own 9 year old daughter in this conversation:

Tween: “Mom, did I tell you that Loralei and Christopher are back together on the Gilmore girls. They’re sleeping together, too”

Mom:   “Oh? What exactly is ‘sleeping together’?” (very calm, I might add – practiced points 1 and 2 above!)

Tween: “You know, dating…and sleeping in the same bed. I don’t think they’ve had sex yet.”

Mom: “Sex?”

Tween: “Yea, You know, when you get naked and kiss a lot.”

She’s only 9 so I would not expect more detail, but it is coming and before I’ll be ready, or 5th grade, which ever comes first!  But, the clock is ticking!  I just hope I remember to follow the Prime Directive when the conversations get more in tense.

[*Teen: a child in the later stages of puberty, 13-18

Tween: a kid no longer a child but not yet a teen, early to mid puberty, ages 9-12]

(Originally posted January 2007; Updated December 2009)

Your pre-teenager’s school calendar has “scoliosis screening” scheduled for the following week. You take a quick look at your child’s spine which looks nice and straight to you so you put the issue out of your mind. Imagine your surprise when you receive a letter from the school informing you that your child’s back screen revealed some signs of scoliosis that should be investigated further by your pediatrician. But, you are not convinced – your child’s back looks fine to you. You can’t help but wonder if a lot is being made of nothing. Do you really need to pursue this?

It turns out that you are right – and wrong – all at once. Most scoliosis will not impact your child’s life at all; however, there are some cases of scoliosis that develop into something much more severe – and that’s why catching it early is so important.

Our spines are made to curve naturally front to back in the neck and lower back to help support our body on our pelvis and to keep us upright. But some backs develop curves sideways. Scoliosis is the term used to describe these abnormal curves. While scoliosis can run in families, it doesn’t have to. Scoliosis can develop at any age but the vast majority of scoliosis occurs just before puberty when growth begins to accelerate. 80% of scoliosis is “idiopathic”, which is medical short-hand for cause unknown. Rarely, some kids will have an underlying neurologic, muscular, or genetic disorder causing the scoliosis but those kids usually have other medical issues as well. The amount of boys and girls who are diagnosed with scoliosis is the same but girls tend to get the more progressive type.

Most idiopathic scoliosis is mild and requires little treatment beyond observation. But progressive scoliosis is a different story and left untreated can cause many problems in adult life such as deformity, chronic back pain, breathing difficulty and neurologic problems. School screening allows for early identification of scoliosis to intervene well before problems develop and when many treatments options still exist.

Most states now have school screening programs for scoliosis including Massachusetts and all target the preteen and early teen years. The school scoliosis examination most often used is the Adam’s Forward Bend Test which looks for unevenness in the back with one side being higher than the other. Kids backs are also looked at for other signs of possible scoliosis: uneven shoulder or hip heights or a shoulder blade looking prominent. Keep in mind that these findings are only suggestive of scoliosis. Only an xray can truly diagnose scoliosis and define the extent of the curve. The greater the curve, the more severe the scoliosis.

Should a school nurse detect a feature that may suggest scoliosis, you’ll be informed – usually by a letter. If this happens to one of your children, call your child’s pediatrician to arrange a more formal evaluation. In addition to a repeat physical examination of your child’s back, your child will likely obtain an xray to confirm if a curve is present and to what extent. If scoliosis is indeed present, your pediatrician can explain to you what sort of treatment is needed, if anything. Children with curves that require more than observation are usually referred to an orthopedist.

Luckily the vast majority of scoliosis is mild and without later consequences. Mild curves, less than 20degrees, are usual managed by observation and rechecks every 3-6 months until the child stops growing. This is the most common scenario picked up by school screens. For more serious curves or progressive curves, bracing and surgery may be needed. An orthopedist can help guide the treatment option best for your child should your child’s scoliosis fall into this category.

Scoliosis screening is a wonderful way to introduce our kids to the idea of screening in general and the importance of good health monitoring to catch potential issues before they become problems. We need our backs to do most everything in life. You can help your kids understand why back screens are so important by explaining to them that if they do truly have scoliosis, later in life they may have trouble doing the activities they love today. That to me is worth not only the disruption in our kids’ school day but the risk of a false alarm.

© 2005-2006 Pediatrics Now.
All rights reserved. PEDIATRICS NOW is a trademark of Pediatrics Now.

Our summer has had some interesting moments. Summer camp had barely begun before our 9 year old daughter threw us a curve ball. “Mom, J is going to sleep away camp this year. You HAVE to let me go next year – otherwise I’ll be the only 5th grader in the entire world not going.” I have to say, while she’s been somewhat of a pneumatic drill on the topic this summer, watching her try to convince us has been quite amusing. She’s tried everything from emailing us to leaving notes around the house to borrowing the overnight camp promotional DVD from here friend. In her mind, She is completely convinced life will stop if she does not go next summer – the first of many such situations we’re sure to face as her preteen years creep in. Somehow, we went from the cat’s meow to yesterday’s news in the blink of an eye. Just goes to show you that just when you think you have your child figured out, they change again….

Have you ever stopped to consider just how important peers our for our kids and at very young ages and with even ordinary events? We recently had a funny experience at a local restaurant with friends when we discovered that the 9 year olds and 7 year olds were conferencing about what to order and unwilling to order something the others did not like, want, or agree to. So, my friend’s 9 year old ended up eating prime rib because my daughter “had to have it”, and my 6 year old actually ate food she’s never eaten before because her 7 year old buddy was eating it! If only all peer experiences could be so positive – and so innocent….

Peers are good – we need them to develop and thrive. We influence them and they us. It’s really in all our wiring to want to be accepted by our peers and to want to seek out their opinions. Just watching kids in action for even simple, daily interactions you’ll be amazed at how pervasive kids sense the need to be like each other. Our kids get easily energized by what excites their friends – from books to sports to movies to food. And, just as easily, kids can be swayed to the “dark side” and try things that are not acceptable – shoplifting, drinking, drugs, skipping school, bullying, to name a few. The goal is to empower our children so much when they are young in feeling positive and good about their choices that when the stakes are higher they’ll know what to do. The little stuff in early childhood is practice for the big stuff in the teen years and beyond. And, in many ways, how we handle our kids’ mistakes and decisions when they are young will color whether they turn to us when the stakes are really high.

So, take a deep breath and consider these simple ideas to help you help your kids with their peer negotiations while keeping you in the wings the entire time:

1. Help your kids learn the language to get out of a situation or say “no” to something they are not comfortable with. Role play to give your kids scripts for what to say in different situations. Take turns being different types of people.
2. Many kids think they need to solve their own problems instead of turning to an adult. Help your kids understand this by explaining to them that even adults turn to others for advice when in a tough situation.
3. Kids who feel good about themselves and good about what they do are less likely to get into trouble or mix with the “wrong kids”. Praising our kids often and watching the tone of criticism will help our kids think about themselves positively.
4. If you are worried about the type of kids your child is hanging out with, redirect your kids towards kids and activities that are more positive. At the same time, explain to your child what made you worried or uncomfortable about a particular situation or person.
5. Try to find consistent time to talk with your kids each day – even if while driving to the next activity, just asking “how was your day? Anything you want to talk about?” will give your kids the message you are available.

You can never start too young or with too mundane an event to start reinforcing “good” vs. “bad” peer issues with your kids. In my mind, it’s the simple decisions when our kids are young that will arm them with solid self-esteems and well rehearsed strategies when they are older. For example, if your daughter wants to play the trombone and every other girl she knows is playing the flute, she may feel left out and the other kids may look at her odd for playing a “boy” instrument. Use humor – have her picture what that band would be like with 100 flutes!! Find some role models in the “real” world where girls play instruments that are not thought of as a “girl” choice.

So, find something wonderful that your kids have done today and tell them that you noticed. Find a decision they made that was good, and tell them how proud you are of that. And, if you get a strange look, just smile knowing you hit the nerve that will keep them coming home when it counts.

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