Back To School Health Concerns

It’s that time of year again!  Have you got kids going to school this fall?  Me too!  We’re shopping for school supplies and clothes and shoes just like everybody else.

Are your kids ready to go back?  There are a number of things you can do to set your kids up for success this school year!

Good Sleep

Did your kids get off their school sleep schedule this summer?  Don’t worry, if they did you should have plenty of time to get them back on-track before school starts.

Elementary school children need about 10 hours of sleep per night.  For instance, our kids’ bus came at 7:30 AM last year.  Since they got up between 6:30 and 7:00, that made our bedtime about 8:30 so that they were asleep by 9.

You will want to give plenty of time to adjust a child’s sleep schedule.  Move bedtime by no more than a half-hour per night, every few nights, to let your child adjust.  If they’ve become accustomed to sleeping in, start instituting a set wake-up time.  In the adjustment period if they seem tired let them take a short nap.

There are plenty of things to adjust to in the first few weeks of school.  Fatigue and sleepiness and battles over going to bed and waking up are things you just don’t need to deal with.

Doctor’s Visits

Are your kids playing sports this school year?  Summertime is a good time to get their sports physicals out of the way.  Don’t worry, the physical is good for a year and is covered by health insurance.  Make sure to bring along any medication administration forms (for asthma or other meds your child will need to take at school).

If your child will be heading into kindergarten or 7th grade, they will need vaccines prior to starting school.  You should have gotten paperwork from the school already if your child is affected.  Remember that although your rising 7th grader is required to have the DTaP, the meningitis and HPV vaccines are also recommended at this age.

I get a lot of questions about the HPV vaccine and dove a little deeper into that topic in this post.  Please discuss the vaccine recommendations with your child’s doctor in detail.

After the 7th grade shots, your child will be done with tetanus shots until after college (unless she hurts herself, gets bit by a dog, etc) but she will need a meningitis shot booster at age 16.  Other than annual flu shots those are all the shots your child will need.

Nutrition

My younger son participates in a summer day program every year that does not provide lunch.  We were a little concerned at the beginning that packing lunches would be a big hassle.  To our pleased surprise, it has been a very positive experience.

Our lunch planning guidelines have been that our child needs a sandwich (with deli meat and cheese) and a fruit, a vegetable, and a starch for his lunch.  We read labels and used a food scale to explore portions for the starch (often pretzels, corn chips or a granola bar).  Here’s a website with interesting school lunch ideas.

Now after several summers he makes his own lunches like a pro.  Even better, when we go to the market and our kids want to try a different food (like barbecue potato chips) we can look at ingredients and talk about what’s in there, portion sizes and how they’re manipulated, price versus value, and other good topics.  We’ve even gotten them to try some new vegetables!

From a health standpoint, heading back to school can be stressful from a health standpoint.  With a little planning your youngsters can transition into the school year happy and healthy.

QUESTION:  What back to school health concerns do you have that I didn’t discuss?  I can always talk about them next week, LOL!

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Teen Smoking And Alcohol Use Decreasing

When you talk to the teenagers in your life, do you feel like they don’t listen?  That your words go in one ear and out the other (or straight over their head altogether)? Don’t give up – there are positive signs that some kinds of substance use among our teens are on the decline.

FINALLY some good news about our teens!  There is evidence we are seeing teen smoking and alcohol use DECREASE in the USA!

There was a research article published last week in Pediatrics that found that high school seniors in 2014 were five times more likely to report they had never tried cigarettes or alcohol than they were in the mid-1970s.  Similar trends were seen for younger adolescents as well.

Why is this happening?  There are likely a lot of reasons.  First of all, it’s illegal for teens under 18 to buy or use tobacco products.  Granted, whether something is illegal isn’t a great deterrent for either teens or adults, but it does make it more difficult for teens to smoke cigarettes than it was in the 70s.

Same with alcohol.  Penalties for teenage drinking are increasing, as well as for parents who host parties where teens are drinking.

I’m seeing in my office that fewer and fewer teenagers report smoking cigarettes.  Even better, they will often tell me that cigarettes are “gross.”  I love hearing that!  Cigarettes ARE gross!  The social pressure to smoke cigarettes is definitely decreasing among teens.

The downside to this is that smoking hookah (tobacco in a water pipe) and vaping are hugely on the rise.  Both of these are also illegal to sell or provide to minors, but the social pressure seems to favor these behaviors over smoking cigarettes.

What really concerns me is the recent sharp increase in marijuana smoking.  More and more of my teenage patients tell me they smoke pot, and they often don’t see any problem with it.  It seems like high school social pressures have moved away from cigarettes and towards behaviors that seem safer but really aren’t.

Those of us who are parenting or have leadership roles with teens need to be aware of these trends and continue to work to educate our kids.  There is danger in ALL tobacco products, marijuana, alcohol, other recreational drugs, and electronic cigarettes.

QUESTION: Do you spend time with teens?  Would you agree that drinking and smoking are decreasing?

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Injury Deaths Rise For Kids And Teens

What is the leading cause of death for children and teens?

If you said accidents, you’re right.  Injury is the leading cause of death for children over 1 year of age.  This includes accidents, homicide and suicide.  A recent troubling report from the CDC states that injury deaths are now on the rise among our kids and teens.

It used to be that kids mostly died from infections.  Pneumonia, measles, polio, influenza, strep throat, the list goes on.  As we got better at preventing and treating these illnesses, injury deaths became the leading killer of kids and teenagers.

We’ve been doing better with injury prevention.  Better automobile safety measures like seat belts and air bags have helped tremendously.  Injury deaths fell by 35% between 1999 and 2013.

Then they started to trend up again.  Injury deaths rose by over 15% from 2013 to 2016 (the last year for which data is available).

Why is this on the rise again?  All injury causes of death rose, including accidents, suicides and homicides.  Suicides are typically underreported and may be mistaken for accidental poisonings (especially opiate overdoses).

From reading this report, I have 3 takeaway points.

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES ARE CRITICAL

We have to help our kids cope with stress better.  I’ve written before about kids’ mental health issues.  Adolescence is hard no matter who you are or where you live, but some teens struggle more with it than others.

I’ve talked with more than one terrified parent desperate to protect their child and help them get and stay well.  I’ve wondered more than once if letting a teenager walk out of my office meant an unacceptable risk that I’d never see their face again except in an obituary photo.

It is critically important that we develop effective, easily accessed, and affordable mental health and substance abuse services that are designed for children and teenagers.  Our kids are killing themselves and each other, and we have to help them!

TEENAGE DRIVERS ARE A MENACE

My son is learning to drive right now, so I KNOW just how hair-raising it is to have an impulse-control-challenged video game player with a serious social media addiction behind the wheel!  (Just kidding, my son doesn’t do social media accounts.  Texting, yes.  Instagram or Snapchat, no.)

The death rate from motor vehicle accidents for teens 15-19 is almost 6 times that of kids 10-14.  In Ohio teens learning to drive must not only participate in extensive driver training but they must also spend 50 hours behind the wheel driving with their parent or guardian.

We very sadly had a traffic accident locally within the last few years where a teen driver had her car overloaded such that not every passenger had access to a seatbelt.  She was driving unsafely, lost control of the car and a teenage passenger was killed.  More laws would not have prevented this needless death, but it serves to illustrate that teens don’t always make the best decisions when it comes to behavior behind the wheel.

THOSE WHO OWN GUNS MUST KEEP THEM SECURE

Homicide and suicide by firearms are both on the rise.  Homicides of male children and teens increased by 25% from 2013 to 2016.  Homicides of female children and teens increased by a whopping 72%.  Suicides by firearms are overwhelmingly more common with boys, but rising in girls too.

Adults who own guns must keep them locked up and secure.  This is both a legal and moral responsibility and makes intuitive sense, but I think adults sometimes are as prone to impulse control problems and delusions of immortality as their teenage counterparts.

As a parent myself, and as a physician that cares for children and teens, the rise in injury deaths over the last few years is very concerning to me.  I will be keeping an eye on future reports and passing on recommendations to help keep my and your kids as safe as possible!

QUESTION:  Why do you think the injury deaths are on the rise for kids and teens over the last few years?

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Is It Love? Or Is It Limerence?

As the mother of a teenager, I think I speak for most parents when I say I worry about my child completely losing his head over a girl.  Whether your teen is male or female really isn’t relevant to this intensely visceral worry that keeps parents up at night.

Part of what steals parents’ peace of mind when their teen starts dating is that most of us have been there.  We’ve said and done things that make us cringe in thinking back, while praying desperately that our children will have more sense than we did.

A friend recently pointed me in the direction of an entirely new (to me) concept called limerence.  In reading about it, I immediately recognized elements of my teenaged patients’ first experiences with dating and, if I’m completely honest, with my own first dating experiences back when the dinosaurs roamed the Earth 😉

What is limerence?  The dictionary defines this word as “the state of being infatuated or obsessed with another person.”  Sounds like a crush, right?  There’s actually a bit more to it than that.

The concept of limerence was first explored by psychologist Dorothy Tennov in her book “Love And Limerence: The Experience Of Being In Love,” which was published in 1979.  She believed limerence was a disordered form of romantic love, closer to obsession.

Tennov’s limerence was characterized by

  • Idealization of the person – to the point that negative characteristics are minimized or not recognized at all.
  • Uncontrollable and intrusive thoughts about the person
  • Extreme shyness and awkwardness, nervousness and confusion around the person
  • Euphoria in response to real or imagined signs the person returns your feelings
  • Fantasizing about or searching for signs of reciprocation
  • Arranging one’s schedule to maximize encounters with the person
  • Being reminded of the person by everything around you
  • Fear of rejection and despair or thoughts of suicide if rejection occurs

Sounds very much like a teenage crush, right?  There’s actually something to that.  There is evidence that limerence, or infatuation if you like that word better, activates the same parts of the brain that addicts activate by using their drug of choice.  The intense euphoria and deep despair, the amount of time spent thinking about the person and the inability to think of anything else strikes a chord with those of us who treat addicts.  Substitute “heroin” for “Judy” and you would instantly recognize your lovesick teenage boy as an addict.

Limerence is much more likely to be seen in teenagers.  First of all, their brains aren’t done developing yet and they are much more susceptible to addictions of all sorts.  Smoking, alcohol, opiates and dating all light up the brain in similar ways, ways in which teenagers’ brains seem to be primed to behave.

If you’ve ever tried to tell a teenager they aren’t REALLY in love and the world won’t REALLY end if Judy doesn’t love him back, you know you might as well tell those things to the family dog for all the good it will do you.

It’s painful enough when one teen has a bad crush and the object of his crush doesn’t want anything to do with him.  What do you do when two teens experience the intensity of limerence for each other at the same time?

These times are when we earn our parenting badges.  Just like addicts, teens (and adults) in limerence are sneaky.  They lie to those who love them and take advantage of them.  Adults in limerence have extramarital affairs.  They do things that, were they in their right minds, they would never do.  Personalities change.  Formerly sensible people have sex in spite of knowing the risks and get pregnant and/or contract sexually transmitted diseases.  Good students ditch school or let their studies suffer.  Money that should be saved for college tuition or car insurance is spent impulsively on gifts and activities to impress the beloved person.

How do we keep our teens safe?  If your teen is dating and you notice a big change in behavior or personality, that should cause you to be very concerned.  Make sure you are talking to your teen about their activities and keep them appropriately chaperoned.

Remember my analogy about the lap bar on the roller coaster.  Everybody pushes the lap bar when they get into the seat on the roller coaster.  We are relieved when the restraint holds firm, NOT when it gives with a little pressure.  Our teens are the same way.  WE are their lap bar in the roller coaster of dating.  Expect them to push against us.  They will chafe against our restraint, but letting go, letting them get themselves in too deep, is not what they need from us.

Limerence, research has shown, does not last.  It generally does not deepen into an adult form of love that leads to happy marriages and families.  It is intense and overwhelming but does not stand the test of time and adversity.  Our teens need us to help them avoid making choices that will alter their life forever.

QUESTION:  Is this the first time you’ve heard of limerence?  Do you recognize the concept (if not the word) from your own adolescence or the experiences of friends and family?

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Social Media Makes Teen Girls Unhappy

There is a lot of controversy now about children’s access to electronic devices and, particularly, social media.  Many parents are understandably concerned about the effect social media may have on their kids.

Those of us adults who use Facebook, Twitter, Instagram and other social media know that people often choose to show only the happy, pretty, upbeat side of our lives.  Who wants to post about the fight you just had with your spouse, about the fact that you don’t like your daughter’s boyfriend, or the fear of losing your job that’s keeping you up at night?

Those whose only real exposure to others is through electronic media may not realize how inaccurate and misleading others’ social media profiles may be.

I know as a mom I worry that my teen is confining so much of his communication with peers to texting that he is not practicing valuable communication skills.  Gone are the days of teen girls spending hours holed up in their room chatting with friends on the phone.  Now they trade texts which are completely devoid of the tiny clues of tone of voice, facial expression, and uncomfortable pauses that can help interpret and layer meaning on spoken words.

Not to mention that it’s hard to create deep, long-lasting emotional relationships when all you can see is what another person purposely chooses to show.  It’s when things AREN’T pretty that you learn what someone is really like.  And tough times and real struggles build deep connections with others.

There was a study from the UK published recently that brought new focus to these pitfalls.  Researchers conducted a huge survey (almost 10,000 teens) which examined how much time the teens spent chatting on social media.  They also asked questions designed to evaluate the teens’ emotional and behavioral status and created a “happiness score.”

The researchers found that girls used social media more often than boys, although both genders’ use rose with age.  Also, use of social media in girls, particularly at a younger age, was associated with lower “happiness scores.  In boys it didn’t seem to have much if any effect.

Those of us who are parents of teens need to be careful to monitor our children’s use of social media.  Their happiness and well-being can be seriously impacted by spending too much time online, especially our daughters.

QUESTION: Do you have teens who use social media?  Do you notice it affecting their mood and well-being?

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What Parents Need To Know About E-Cigarettes

You see them everywhere.  Adults walking in no-smoking zones exhaling huge clouds of white with ball-point-pen-shaped devices in their hands.  My patients often tell me they’re switching to e-cigarettes when I remind them that they need to quit smoking.

Are e-cigarettes safer than regular cigarettes?  Do they help smokers quit?  What impact are they having on our teenagers?

As parents, we need to understand the appeal of e-cigarettes to our teenagers and what the health risks are.

E-cigarettes are electronic devices that provide a vapor that contains carrier chemicals, nicotine and flavorings.  They don’t contain tobacco and therefore don’t expose the user to the carcinogens and other harmful additives in traditional cigarettes.  They are seen as a safer alternative to traditional cigarettes.

But are they really safer?

According to the American Lung Association, the chemicals in e-cigarettes are largely untested.  Because they are usually marketed without drug claims, companies don’t have to disclose or test their ingredients for safety.  One chemical, called diacetyl, is associated with a lung condition called popcorn lung.

Nicotine itself is NOT safe.  It doesn’t matter whether a user gets nicotine from patches, gums, lozenges, e-cigs or traditional cigarettes, it is harmful to the brain and to the circulatory system.  Nicotine is harmful to developing fetuses and therefore pregnant women should NOT smoke or use e-cigarettes.

Newer research shows that the brains of young people continue developing far longer than was previously thought.  (This is not a surprise to those of us raising teens, right?)   Use of nicotine is associated with problems of working memory and attention in adolescents.

Do e-cigarettes help smokers quit?

Credit ComplianceSigns.com

No, they don’t.  Evidence is pretty clear that using e-cigs actually REDUCES the likelihood of quitting smoking.

There was a survey done in North Carolina of middle- and high-school students about the use of cigarettes and e-cigarettes.  It found that use of e-cigs increased 4-fold between 2011 and 2013.  Those who used both cigarettes and e-cigarettes were actually LESS likely to quit (and less likely to try to quit) than those who smoked cigarettes alone.  Teens who use e-cigs are more likely to start smoking traditional cigarettes as well.

An study published in the American Journal of Preventive Medicine last month reported that those who use e-cigs are about half as likely to quit smoking cigarettes as those who don’t.  Using e-cigs keeps people from quitting smoking!

There has never been any evidence that e-cigarettes help smokers quit.  They cannot be marketed as a smoking cessation aid, but that doesn’t stop people from believing they will help.

As parents raising teenagers it is important we talk to our kids about e-cigs.  They will hear that e-cigs are safe, that they are just a fun, tasty way to get a little nicotine buzz.  E-cigs are heavily marketed to the adolescent age group.

The truth is that they are addictive, dangerous drugs that should be considered a gateway to traditional cigarettes.  They hurt teenagers’ ability to learn and process new information.  They are harmful to the lungs and circulatory system just as traditional cigarettes are.

When we’re talking to our kids about smoking, alcohol, drugs and sex, we can’t forget to cover the dangers of e-cigarettes because marketing messages and their friends certainly won’t give them the whole story.

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Tips For Getting Kids To Eat Veggies

If you’re a parent, this is all too familiar.  The eye rolls.  The gagging sounds.  The battles of wills where your child is still sitting at the table at bedtime glaring at the miniscule dab of sweet potato on their plate.

I know it.  The struggle is real.  (If your kid cheerfully eats salad and green beans and beets, keep it to yourself right now.)  Today I’m really motivated to write about kids and diet.  I found an interesting article with tips for getting kids to eat veggies.

Conventional mom wisdom suggests that kids like bland foods, right?  Chicken nuggets, corn, naked hamburgers, macaroni and cheese?  These are old stand-bys at the kids’ table and on children’s menus at restaurants.

What if this mom wisdom is actually wrong?  What if kids, like adults, are more likely to enjoy food that actually has some taste?

There was a small research paper published that got 100 teenagers in rural Pennsylvania to taste-test plain vegetables compared to vegetables seasoned with different spices.  The teenagers reported that they preferred the seasoned veggies over the plain ones.

This study has some limitations.  For instance the kids chose whether to participate, so more adventurous kids might have been more likely to do the tasting.  Also, it was funded in part by McCormick (the spice company).

But the beauty of this study is that it makes you think.  As a parent, do we change how we cook when we have kids?  (The resounding answer is YES.)  I hear it all the time – parents who want and desperately need to lose weight are resistant to doing what it takes to improve their diet.  They have to cook for their whole family, so they feel limited in their ability to add variety and be adventurous in different ways of cooking their foods.

What if this is based on a flawed premise that kids are little dictators and won’t EVER be willing to try new foods or established foods cooked in a different way?  What if, especially if it’s started early, kids actually will enjoy the foods that YOU enjoy?

There is an interesting book that sheds some light on getting kids to eat veggies.  It’s called “French Kids Eat Everything” by Karen Le Billon, and suggests that part of the blame for the childhood and adult obesity epidemic is due to bad parenting on our part.

French kids eat what their parents eat.  No children’s menus, no separate meals, no catering to childhood food jags.  They don’t snack between meals, in general.  I highly recommend this book for anyone dealing with a picky eater.

After all, getting kids to eat veggies is only a small part of the overall parenting job of helping our kids develop a healthy and adventurous relationship with food.  Food nourishes our bodies and keeps them healthy.  But food is also a pleasure, a feast of sights, sounds, smells, tastes and textures.

If you’re looking for a shortcut with cramming veggies into your diet, Shaklee JUST introduced Organic Greens Booster.  This new product provides one serving of green vegetables per scoop.  I had my first green smoothie this morning in honor of St. Patrick’s Day and it was tasty made with vanilla Life Shake mix 🙂

Organic Greens Booster from Shaklee

Organic Greens Booster can be added to smoothies, soups, muffins and other foods to get extra nutrition support.  Click this link to see more information!

Getting kids to eat veggies is tough, but these three things can help.  Vary the tastes and don’t be afraid to add spices and seasonings.  Start young by offering your kids the foods that you like, and be aware that cooking separate “kid meals” for them can backfire.  Add ninja veggies to fruit smoothies, soups and other kid-friendly foods with products like Shaklee’s new Organic Greens Booster.

QUESTION: Do your kids like veggies?  How do you get your kids to eat them?

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Rising Rates Of Babies Suffocating In Bed

As a mom (twice!) I understand all too well the lure of cuddling your new baby while they are sleeping.  There is nothing sweeter than holding that sleeping newborn and enjoying ever breath, every twitch, every murmur.

But I also remember the sleep deprivation, the effort it took just to shower and put on clean clothes, the middle-of-the-night feedings where I nearly fell asleep in the glider while nursing.  Shopping, laundry, cooking, relatively simple tasks were two or three times harder than they should be just because I was SO. BLOODY. TIRED!

I know I’m not alone.  All new moms and dads go through this.  That fatigue and sleep deprivation is one of the main reasons why doctors discourage the practice of parents bed-sharing with their newborn.  And when parents cosleep with newborns, we see rising rates of babies suffocating in bed.

A research paper published in JAMA Pediatrics this week reports that rates of babies suffocating in bed have more than doubled in the last 16 years.  Unfortunately the rate of rise is even higher among African-American babies and in babies living in rural areas.  Hispanic babies are less at risk.  The overall rate was about 28 per 100,000 people in 2015.  This means that in 2015 about 1100 babies died from being suffocated in bed.

SIDS deaths have fallen from about 70 per 100,000 to about 40 per 100,000 over the same period.  The reasons for SIDS deaths are not fully understood, but the reason why a baby would suffocate in bed is pretty clear.  A parent rolls on them, or a pillow falls on them, or they get stuck between the mattress and the wall.

Cases of babies suffocating in bed are entirely preventable.  The simple measure of NOT having a baby in bed with their parent(s) goes a long way towards prevention.  Pediatricians and family doctors have advised new parents for years to put their baby to sleep on their back in a crib or bassinet.  A separate bed is the safest place for a new baby to sleep.

Parents cosleep for many reasons.  More well-to-do parents may cosleep because they believe it will improve bonding and make breastfeeding easier to establish and more successful.  Lower-income parents may cosleep because there simply isn’t money to buy a separate crib or bed for the new baby.

Finland started a program in the 1930s for all mothers-to-be to receive a box of supplies for their new babies.  The cardboard “baby box” also contained a firm foam mattress with a tight-fitting sheet, making the box itself a bassinet for the new baby.

In 2017 Ohio became the second state to offer a similar program to expectant parents in our state.  By going to Baby Box Company’s website and watching a 10-15 minute video and taking a short quiz, Ohio expectant moms and dads will be able to receive their own baby box.

The video and quiz help to educate expectant parents on safe sleep practices.  The box gives the new baby a safe and portable place to sleep for the first few weeks of life.

If you or someone you know are expecting a baby, please educate yourself about safe sleep practices.  Grandparents and babysitters need to know the safest way to put a baby to sleep.  Even a short nap can be deadly.

  • Go to Baby Box University and complete the short educational program to qualify for your free Baby Box.
  • Always put your baby down alone, on their back, on a firm sleep surface.  Babies should sleep without blankets, pillows, comforters or stuffed animals.
  • Do not cosleep.  Do not nap on a couch or recliner with your baby.  If you’re breastfeeding and up frequently at night, do not breastfeed a newborn while lying down.  Sit up in a chair to breastfeed then put your baby back in his or her bassinet, crib or Pack-n-Play (or bed box!) before lying down again.

After all, one baby suffocated in bed with their parents is too many.  1100 babies suffocating in bed per year is a horrible tragedy that can be prevented with proper sleep practices.

QUESTION: Did you cosleep with your baby?  Why or why not?

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Should Everyone Wear Sunglasses (Even Kids)?

A friend of mine mentioned recently that he’s been spending a lot of time at Cedar Point and mentioned he was surprised how few kids wear sunglasses.  All the parents wear sunglasses, especially at the waterpark, but very few of the kids are wearing sunglasses.

Does it matter?  Well, it turns out my friend is right to be concerned.  (And kudos to him, in his pics his absolutely adorable son is always wearing shades!)  According to the Vision Council (an eye care industry group), eye health depends on protecting the eyes from UV radiation.  Many people either are unaware or don’t believe that protecting the eyes from UV radiation from the sun is a critical, year-round concern.

There are 3 types of UV radiation – UVA, UVB and UVC.  UVC is filtered by the earth’s atmosphere and not a concern.  UVB is the type of UV radiation that stimulates vitamin D production in the skin, and is partially filtered by the atmosphere.  This is why those of us in northern Ohio can’t get vitamin D from the sun for the wintry half of the year, the sun is too low in the sky and the rays pass through too much air on the way to us.

The type of UV radiation that is most dangerous to the eye is UVA.  The earth’s atmosphere does NOT filter UVA.  If the sun is in the sky your eyes are being exposed to UVC radiation, no matter what season or time of day it is.  Wearing sunglasses as much as possible is important to protect your eyes when you are outdoors.

Here are 3 common misconceptions about sunglasses and sunglass use.

Kids don’t need sunglasses

Children receive about 3 times as much UV exposure per year as adults.  This is because they generally spend more time outdoors than adults do.  However, only 7.4% of adults report their children always wear sunglasses.

UV radiation damage is cumulative which means it builds up over time.  Damage can lead to aging of the skin, skin cancer, cataracts and damage to the retina.  Beginning in childhood, daily sunglass use will decrease the damage and preserve children’s eye health.

The darker the lens, the better the protection

This is not true.  UVA radiation passes right through lenses no matter what their color.  They must be coated to block UV radiation.  Polarized lenses are even better at blocking the UV rays.

In fact, it could be argued that dark lenses without UV protective coatings are the worst option of all, because they cause the pupils to dilate and allow more UV light through to the retina.

When you go to buy sunglasses check for labels to indicate the protection they give.  Make sure you choose lenses that are labeled as protective against both harmful types of ultraviolet light.

Wearing a hat is good enough

Not true.  While wearing a hat protects somewhat against direct UV exposure, it does nothing to stop REFLECTED UV light.

Credit: visioncouncil.org

So how do we get our kids to keep sunglasses on their face?  Hats are hard enough, right?  First of all, having a child pick out their own sunglasses makes it more likely they will wear them.  Make sure to get good quality glasses that fit the child’s face and don’t pinch or rub.

In addition, polarized lenses are more comfortable from a vision standpoint because they reduce glare and block more light.  Kids are more likely to keep them on because they don’t squint as much and they can see better.

Teenagers typically don’t want to be told what to do.  Make sure they understand they will have less problems with red, irritated bloodshot eyes if they wear sunglasses regularly.  Just like with kids, letting them pick out a couple of pairs of cool sunglasses they like will go a long way towards getting them to wear them regularly.

Kids, teens and adults all need to protect their eyes from harmful ultraviolet radiation.  The fronts of the eyes, the lens and the retina are all susceptible to damage which accumulates over time.  You and your family only get two eyeballs and it’s up to us to protect them!

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How To Get Kids To Swallow Pills

It seems like more and more, I’m seeing older children and teenagers, fully adult-sized patients, who refuse to take medication in tablet form.  “I can’t swallow pills.”  “They make me gag.”  “I’m going to choke.”  I talk a lot with parents about how to get kids to swallow pills.

The problem with older kids and adults that won’t take pills is that a ten-day course of antibiotics for an adult can be quite a lot of liquid.  Some medications just aren’t made in a liquid because they aren’t meant for children, and sometimes they can’t be crushed or cut into pieces to make them easier to swallow.

Before we go into how to work with your kids to help them achieve this adult skill, I want to be very clear on how we use words.  I hear “I can’t” a lot, both from patients and parents.  If your child is eating solid food, he or she CAN swallow pills.  It is physically possible to do so.  A single bite of food is MUCH larger than any tablet that is made to be swallowed intact.

So what is the problem?  Your child (and maybe you as well) has bought into a self-limiting belief.  They BELIEVE that they are unable to swallow pills and if they try, something unpleasant will happen.  Maybe they half-swallowed a piece of hard candy once and had a choking sensation that scared them.  Maybe they DID swallow a piece of ice from their drink or a piece of hard food they didn’t chew well, and it hurt a little going down.  Whatever the reason, they firmly believe that swallowing something intact will hurt.

Your job as their parent is to help them prove to themselves that they CAN swallow it and it WON’T hurt.

How do we do that?  Candy to the rescue!  (Yes, you read that right, Dr. Jen is actually advocating you giving candy to your child.  In this instance, though, the candy isn’t candy but a training tool and a necessary evil, LOL!)

Start with a small package of really tiny candies.  Some examples are Tic-Tacs, M&M Minis, and Mini SweeTARTs.  You know your child, what would they like?  It just has to be really small.  Get one small package and tell your child if they are able to swallow the first (insert small number, like 3 or 5 or 10) whole, they can have the rest of the package to eat.  Use milk or juice to wash the candy piece down.  Watch them to make sure they don’t chew them first (and if they do, that’s OK, it just doesn’t count) and apply liberal amounts of praises and atta-boy/girl.

Gradually work up to larger and larger pieces of candy until they are able to swallow pieces as large as an average medicine tablet.  Examples are Skittles, plain M&Ms and Reese’s Pieces.  Once they are able to confidently swallow these, they should be ready for an ibuprofen or acetaminophen tablet in case of a headache or minor injury.  Be sure to use the correct weight-and-age-based dose for your child.

Also, since children’s supplements are usually formulated to be chewable and to taste good, they often contain sweeteners and flavors that really aren’t good for your child.  Not to mention that they are EXPENSIVE!  I recommend to parents that they move their child to a high-quality adult supplement as soon as they are able.

I started my children learning to swallow pills when they were five years old.  The first pill they took was Shaklee’s Optiflora probiotic, which is so tiny that if you drop it, you won’t find it again unless your flooring is really dark:

Shaklee OptiFlora

After the probiotic we moved on to Shaklee’s OmegaGuard which is also small.  (Plug for those of you who don’t like fish oil because they’re horse pills – OmegaGuard is little!)

Shaklee’s OmegaGuard

And now both my boys, at 15 and 10, take Shaklee’s Vitalizer Men.  I laugh when people ask me what I’m feeding my 6’2″ teenager who has sprouted up about 8 inches in the last 2 years.  He’s my Shaklee kid!

Shaklee’s Vitalizer Men

Your child CAN take pills, if he or she is able to swallow solid food.  It is physically possible.  It’s your job to help him or her past the fear and get the confidence to learn this adult skill.  Like so much of parenting, it just takes patience, persistence and lots of positive reinforcement.

They can do it!  And so can you 🙂

QUESTION: How did you help your kids learn to swallow pills?  Do you have a child that can’t or won’t do it yet?

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