If It Were My Child

All Articles in the Category ‘If It Were My Child’

Using Melatonin To Help Children Fall Asleep

Melatonin Boy SleepingWhen I recently shared this article on my Mama Doc Facebook about a “magic” children’s bedtime story promising to make the going-to-sleep process easier, many parents inquired about melatonin.

No question that supplemental melatonin has a role in children’s sleep dysfunction but also no question that parents are turning to melatonin out of a need for convenience. I’ve had COUNTLESS curbside consults from parents asking me if melatonin is safe to use in the short-term but also for years on end. The short answer is we don’t entirely know because studies just haven’t been done. Often when I get the story of how families are using melatonin, I end up advising changes in the sleep schedule more than a need for meds. What we do know: melatonin can help children fall asleep with sleep dysfunction, sleep dysfunction and inadequate sleep have serious health consequences, and although melatonin only helps with sleep initiation (falling asleep) it can be hugely beneficial for children who lie awake at night for hours at bedtime. The other thing we know: melatonin is not regulated like medicines (it’s overseen as a food supplement) that has been studied in very few pediatric populations so it’s difficult to generalize safety for children everywhere. Lots of definitions, dosing info, and pediatric sleep expertise below.

If your child can fall asleep in about 30 minutes after the lights are out (especially when you have made sure no screen time for 1-2 hours prior, no caffeine in afternoon) then melatonin is unnecessary.

If it were my child I’d use melatonin if sleep dysfunction at bedtime was getting in the way of necessary sleep, but I’d also do everything I could to get them off of it as soon as I could. Many children respond to the hypnotic effect of higher doses of melatonin, but many children are also given it for family convenience, too. In my experience, sometimes families use it to treat anxiety (those kids whose mind spins and spins and spins and worries) at bedtime. Although sometimes melatonin helps kids fall asleep, it’s just a band-aid.

Children are sleeping less than ever before and there are mounting impediments to a good night’s sleep (screens, early school start times, stimulants in the food source, busy school days and activities keeping kids up late). However inconvenient, I think sleep hygiene (routine bed time, no screens before bed, bed used only for sleeping) and consistency with what we do as parents may be the only magic wand to wave for sleep throughout childhood. Awakenings typically rise from all sorts of developmental milestones and changes as children grow. Overnight awakenings will always be normal although how our children get back to sleep on their own changes our night of sleep dramatically. When it comes to challenges falling asleep, sometimes melatonin can really help, especially in children with underlying autism spectrum disorder, attention deficit disorders, or children with shifted sleep schedules.

Only a few long-term studies have looked at prolonged use and associated effects, but most sleep specialists consider melatonin safe, particularly for occasional short-term use. The bigger question is why parents feel the need to give their child melatonin.  –Dr. Maida Chen

What is Melatonin?

Read full post »

4 Things To Know If Your Son Is Off To College

male college prepYou may have already read yesterday’s blog on preparing your daughter for college. Much of my advice for girls, of course, also pertains to boys (and vice versa). I’m writing two separate posts only for the purpose of getting people to read this content, not to differentiate. I added one section here for boys (on alcohol and risks) not because it’s an issue for boys only. In fact, we know that 1 out of every 5 high school girls binge drinks (see below).

If you have a boy heading off to college this fall there are a few things to know to help improve his safety and success this year. Of anything I know from my experience being a previous school teacher, and now pediatrician and mom to boys (still 10 years away from college!) the transition from HS to college-age is one steeped in emotion for all. In addition to the tips I’ve provided for girls, alcohol and the HPV vaccine are topics to discuss to ensure it’s a better and safer year for your son (or daughter) this year.

ONE: Safe Sex & Birth Control – What Your Teen Son May Need To Know:

Read full post »

3 Things To Know If Your Daughter Is Off To College

Prepping for college - female.pngIf you have a daughter getting ready to head to college this fall, holy moly I’m excited for you. In clinic it’s clear to me that the huge transition from high school to college-age brings great joy but also a remarkable sense of unrest for everyone, too. Vaccines, birth control, and suicide prevention may not top your to-do list while packing the car but there’s no question these are 3 things you can check in on to ensure it’s a better and safer year for your daughter. Not only is a brand new meningitis vaccine available to college-age girls this fall, included here are reminders with ways to support your daughter and her health as she heads off to learn even more…

ONE: Birth Control Options For Your Teen Daughter

1. Amazing Resources To Prevent Unwanted Pregnancy

The CDC confirms that as girls head off to college we know over 40% of them have had sex. And although 4 in 5 of them used a form of birth control the last time they had sex, only about 5% are using the most effective forms to prevent pregnancy. Read full post »

If It Were My Child: A Turkey Without Antibiotics

turkey photoMy coffee arrived in a red cup today so I know the holidays are officially upon us; Thanksgiving will be here before you know it.  If you’re ordering a turkey (and/or you’re incredibly organized) you’ll likely be picking out your bird in the next few days. Who are you people? For you prepared and pre-paid types and even those of us who wait until the Thanksgiving week, we have some decisions to make and a great opportunity. What turkey we buy matters.

This year I’ll be making the choice to purchase a turkey raised without antibiotics –when you choose this type of turkey it doesn’t mean “organic” (even some organic meats come from animals fed antibiotics). Antibiotic resistance is a growing problem and I’m taking a new step to keep my kids away from excess antibiotics, like those found in many Thanksgiving turkeys. This is new for me and hasn’t been a priority until the last few years as I’ve tuned into information about the human microbiome and ways that antibiotics in our land, food, water and pharmacies really change our own habitat and potentially our family’s health.

The Problem With Unnecessary Antibiotics

I’ve written several posts on avoiding antibiotics when unnecessary, but here’s the cliff notes version: When you (or your child) take an antibiotic, most of the susceptible bacteria exposed to the drug will die. “Good bacteria” (naturally living on our skin or in your throat or GI tract) and “bad bacteria” (the ones causing the infection) will fail to survive. However, some bacteria will possess genes that allow survival amid the presence of antibiotics. Over time and without competition from other organisms, these bacteria can even thrive. This set-up creates different colonies of bacteria where some will be resistant ‘superbugs’ and changing the bacteria in our environment and our own bodies. Some of these colonies will eventually cause infections that are hard to treat. The more antibiotics are used anywhere, the more possibilities for these ‘superbugs’ to replicate with resistance over time. In fact 97% of doctors are extremely or fairly concerned about the growing problem of antibiotic resistant infections. Most parents are worried, too.

The Case For Antibiotic-Free Turkeys

Read full post »

If It Were My Child: No Football For Now

This is a position post where I take a stand that represents no one other than myself as a mom and a pediatrician. The reason I clarify this, is that my position is a strong one. No one wants to go up against someone like the NFL, it seems. But let me say this very clearly: It if it were my child, I’d never let them play football. No way. For my boys, the risks are too large, the sentiments too cruel, and the gains simply not worth it. There are plenty of other sports teams out there to grow, exercise, form friendships, and excel. I never want my children to be a part of any institution that houses intent to harm another human being. Although direct harm may not be a tenet in pee wee football, we all know that young sports teams are built to emulate the pros. If the NFL is the inspiration, for now, count my boys out. This isn’t just about the risk of concussion…

On my way into clinic on Saturday morning, I heard the alleged tape of Gregg Williams directing players to seriously harm opposing teammates. In the tape Mr Williams, the previous defensive coordinator for the New Orleans Saints, employed his players to inflict harm on multiple players–for example, attempt to tear the ACL of Michael Crabtree and work to re-concuss another player, Kyle Williams. Let me point out, some data finds the harms of concussions (particularly in adolescents) may be longstanding, and the risk of a second concussion may rarely be deadly.

In the tape you hear Gregg Williams repeatedly say, “Kill the head, the body will die” followed by, “We want his head sideways.” The tape goes on to capture more directives for harming additional players. It’s nauseating and provoking–got my fingers shaking during my drive. And really more than anything else, it was wholeheartedly disappointing. Particularly for me as a pediatrician. When parents now ask me about football, instead of talking about concussions as a significant risk, I’ll also be talking about ethics, sportsmanship, and integrity.

The great thing is that as parents we have lots of choices. Read full post »

If It Were My Child: No Television In The Bedroom

This morning as I was getting ready for the day, my 2 1/2 year old was watching Sesame Street. In the show, the segments change every few minutes or so and seem to weave old-school 1970’s content (familiar to me) with newly created vignettes that have a modern feel and construction. I like it nearly as much as the boys. One of the stories this morning was about tooth fairies. An animated group of fairies were detailing how they got to the tooth under a child’s pillow (lifting up the child) to replace it with a golden coin. Mind you, I was coming and going from the room and didn’t view the whole story. However at one point, the fairies accidentally turn on the child’s TV and worry it might wake the child, ultimately uncovering their work and secret magic.

A TV in the child’s bedroom? No way, Sesame. Read full post »

If It Were My Child: A Pediatric ER When Possible

A joint statement published in 2009 by the American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Emergency Physicians Pediatric Committee, and Emergency Nurses Association Pediatric Committee spelled out the need for reform in emergency care when it comes to caring for children.

The bottom line is this: if your child has an emergency and you have the luxury of time and choice of where to go, go to an ER at a Children’s Hospital or a pediatrician-staffed emergency room. Collect $200 and pass go. Learn from my mistakes.

Driving the joint statement was concern from both pediatricians and ER physicians about inconsistent care for children in Emergency Departments (EDs) that do not normally specialize in the care of children. The statement outlines strategies to prepare EDs around the country to care for children based on some sobering statistics… Read full post »

If It Were My Child: No Texting And Driving

Warning: this is a rant. Recently I was on my way to meet a physician for coffee to talk about my work in social media and health. While driving in front of Children’s Hospital, I saw a car going more slowly than I’d expect, changing the traffic patterns. We stopped at the light, it turned green, and she didn’t move. I looked over and saw her punching away at her phone, composing a text message. I laid on the horn. I pointed to her phone. I screamed! She looked surprised and confused that she’d done anything dangerous. I think she wondered why I was fanatical. You’re 23 times more likely to have a crash while texting and driving compared to someone who is simply driving. I wish I could have mentioned that, too.

No one was hurt, no one was injured that morning. Yet it appeared the last thing this driver was thinking about was the road, the traffic light, the children and their parents crossing at the walk while entering and leaving the hospital. Imagine.

Texting while driving was responsible for 16,000 deaths in a 6 year period. Over 5,000 lives were lost in 2009 alone and almost 1/2 million were injured in accidents related to distracted driving. Read full post »

Location, Location, Location: Where You Get A Pediatric CT Matters

After I saw reports of the 5-fold increase in CT scans in children, I asked for “The Husband’s” take. I worry about a rise in the use of pediatric CT scans in the US because when a child gets scanned, they are being exposed to radiation. A CT scan is a series of x-rays taken in quick succession that form a more composite view of the body. Although x-rays and CT scans save lives and improve diagnosis, the radiation given to children when obtaining these studies must be minimized. Children are more sensitive to radiation than adults; their bodies are still developing. And as the Society for Pediatric Radiology reminds, “What we do now lasts their lifetimes.” Here’s a post about why it may matter where your child gets a CT scan by Dr. Jonathan Swanson:


Pardon the interruption…I’m chiming in again on a similar topic as my last guest post (I am kind of a one trick pony) – radiation exposure in children. SMD has asked me to talk about a recent radiology-based study and what it might mean for how we take care of our children.  My take:

If it were my child, and F or O needed to go to an emergency room, I would go to the nearest children’s hospital…to spare my children unnecessarily high radiation exposure. Bias alert, I am a pediatric radiologist working at a children’s hospital. However, I think the literature supports my position. Read full post »

Read The Data On Bouncy Houses

I was forwarded a case series that captured a bit of data about injuries in bouncy houses and inflatables. It’s not a large study (only 21 families injured in a bouncy house were interviewed) but it sheds light on 2 things. One, orthopedists worried enough about bouncy houses that they set out to determine the risk, and two, bouncy houses do pose a real risk for fractures. Their suspicion alone doesn’t confer a problem, of course. But, validate my worry? Maybe. Change my decision? I don’t know…

The post I wrote last week about hating the bouncy house was more about negotiating my experience of parenthood than it was about the bouncer itself. What I mean is, I was writing about the internal wrestle I have with wanting to do things one way but feeling compelled (in my gut) to go in the opposite direction. You know what I mean, the parenting dynamic in which we set out to do one thing, then being tugged by instinct, we find ourselves in yet another spot. It feels typical, maybe expected, and entirely normal. For example, I set out not to use the pacifier with my first son. At hour 2 of crying, on about day of life 6, we grabbed onto that pacifier and gave it to F. Parents in my clinic will state that they meant to wait until 6 months to introduce solid foods, but once their darling 4 month-old started staring at their spoon with each bite, they gave in and grabbed the carrots. I set out not to use any television in our home. But after the second baby arrived, showing Sesame Street to the 2 year-old allowed me to take a shower. The list goes on and on and on. The ideas of how we’re going to parent and how we implement our choice are not always aligned much less overlapping. Like I said, this is normal. Being a parent helped me “get this.” Read full post »