All Articles tagged ‘preschooler’

Concerns About Autism: Reasons To See The Pediatrician

When it comes to autism, we’ve all been rocked by the recent CDC data that found ongoing increases in the number of children diagnosed with autism annually; it’s estimated that 1 in 88 children has autism in the US. The rates are unfortunately higher for boys. The number is unsettling to say the least, particularly as the cause of autism is multifactorial and not entirely understood. Although we know genetics and family history plays a role, we don’t know what causes the majority of autism.

Read more about the science of autism from Autism Science Foundation.

We do know one thing: research proves the earlier you intervene to get a child additional services, the better their behavior, the better their outcome, and the better their chances for improved communication. You don’t need a diagnosis to access services for your child.

When you worry and can’t find resources online that reassure you, it’s time to check with your child’s clinician. That’s the point of a real partnership and a true pediatric home. Fight to find one if you don’t already have one. Fight to improve yours if it’s imperfect. The feedback I receive from families in my clinic allows me more leverage to make change. We’re all responsible for improved health communication…

Signs of Autism In Infants & Toddlers:

There is not one specific behavior, test, or milestone that diagnoses autism. More than any one behavior,

  • You should observe your infant demonstrating curiosity.
  • You should observe your baby expressing joy nearly every day after 4 months of age. Your child should smile when they are 2 months old, 4 months old, 6 months old and thereafter.
  • Your child should show you they know their name by 1 year of age.
  • You should see that your child tries to communicate thoughts more effectively with each month that unfolds during infancy and toddlerhood.

Here’s a list of specific Autism Warning SignsRead full post »

Carpooling Reduces Booster Seat Use

Survey results published this week found that the majority of parents report carpooling with their 4 to 8 year-old children. About three-quarters (76%) of those carpooling parents reported that their child used a booster seat when riding in the family car. But when carpooling–the seats were used far less often. For example, the survey found 1 out of 5 parents do not always ask other drivers to use a booster seat for their child. And only half of parents always have their child use a booster seat when riding with friends who do not have boosters. So what your friends do really may change what you do.

This makes sense. I guess. It’s clear people get tired of recommendations. Today, for example, when I sent out a link to the Washington State Booster Seat Law, someone replied on Twitter, “Oh come ON!” Read full post »

First Day of Preschool

He exceeded expectations. Our little boys do that, it seems. And like every parent, I glow and gleam and glitter when they do. Today little O exceeded. Today was O’s first day of school. And although I am the one who housed the separation anxiety this morning, I expected him to miss us at some point. Pick his head up and look for  me. Or look back over his shoulder. Or ask where we were. Or wonder about his role in the room. Or go looking for his brother.

Turns out, no. The note from the head teacher described a “duck to water” and “no moments of upset.” No accidents. No crying. No trouble. She ended the email with “watching him smile all over the place was a joy.” Are you kidding me? Yes, that’s my boy. My Our boy.

This is no guarantee for tomorrow, and I get that and I expect the tantrums and the imperfect moments, too. But this is a day to celebrate. 3 years ago today I was on bed rest. Wondering, worrying, wishing, and hoping for health. Today my little boy started school. It is jaw-dropping-roof-blow-off-mesmerizing moment for me. What these children can do. For themselves and for those of us privileged enough to witness their lives. Independence is an incredible gift.

O marched into his role as a preschool-student triumphantly. The only one in tears was me. And then his brother, at the end of the day. Sometimes this little boy lays out his scientific method for strength. Like a Marine, he’s always happy to be the first one through the door.

It’s love. I feel just.pure.love.

Pull Ups and Potty Training

My take on Pull Ups: get out of them as soon as possible! Easier said than done, of course.
Bed wetting is a common challenge for children (and their families). If your child is wetting the bed you certainly know that may be the understatement of the week. You’re not alone in your struggle to help your child stay dry at night, even if it feels that way at times. Know this, I talk about bed wetting every single week in clinic.

Bed wetting is familial and fortunately, often improves simply with time. Watch the video for more information, but the cliff notes: although Pull Ups are convenient, at times they may hinder and prolong bed wetting. If your child is potty trained but wears a Pulls Up/diaper at night, never having tried a night without them, there may be less incentive to potty train. Achieving nighttime dryness demands connecting their brain with their bladder. If there is a diaper on, there may be less motivation to form this connection.

Of course, achieving full potty training success is a huge milestone in every child’s life. It’s a big one for most parents, too. Remember, bed wetting is seen in up to 40% of 3 year-olds, 20% of 5 year-olds and even 10% of 6 year-olds. Watch the above video for my take on Pull Ups and ways to support your child, when ready, to ditch them.

Potty Training and Pull Ups, DO:

  • Try to get out of the Pull Up from time to time. Don’t force it, but if you child is interested in giving it a try without one, do it!
  • Set your child up for success: limit fluids after bedtime, consider waking them to pee at 10 or 11pm, and light the path to the potty so they know how to get there in a hurry.
  • Tell your child it’s not their fault for wetting the bed.
  • Tell your child if one of their parents was a bed wetter. Chances are, they were! Provide them support.
  • Celebrate success whenever it happens (any dry nap, dry night, less pee than usual, getting from the bed to the potty in the middle of the night).

Potty Training and Pull Ups: DON’T:

  • Don’t punish a child for wetting the bed. Even when you’re uber frustrated cleaning the sheets for the one hundredth time, to do your best to hide disappointment when your child wets the bed. This will only increase your child’s anxiety and frustration.
  • Don’t assume your child can’t make it through the night without a Pull Up. If they are dry during the day and dry during naps, I’d certainly give it a try without them.
  • Don’t force your child out of diapers or Pull-Ups if they resist. If resistance arises, back off and try again in a few weeks or month’s time.

Little Boy = Violent Play?

So parenting news is aflutter with research talking about little boys, their genetic make-up, and their aggressive and violent make believe play. New writing posits that this violent and aggressive play may be needed, that boys will process their aggression via this play. But the jury is still out for some educators and parents. The debate is timely for me after a recent weekend with my two little boys and their 4 year old cousin. I must say, I have the experience in observation part down pat. I’ve seen this behavior, yes.

Boys Need Aggressive Make Believe Play

From how I see it, boys may gravitate to aggressive play but as parents, we never have to condone their violent or aggressive actions. I really believe the lines between imagination, play, and the “real world” are often blurred. There are countless examples of children not understanding the consequences of their actions precisely because they are children. If I let my son pretend to kill/shoot/fight, aren’t I somehow complicit in equating a violent response as an okay one?

What do you think? Do you think aggressive, violent play is an essential part of boyhood?

Spanking: 65% Of Parents Say “Yes.” Do You?

Life is a blur this week. But something stopped me in my tracks. A study published in Pediatrics on Monday found that 65% of parents to 3 year-olds said they had spanked their child within the last month. Sixty five percent? The number surprised me. If you’d asked me to guess, I would have said 20-25%. Talk about way off. Another reminder of how much I have to learn.

The study evaluated risk factors, including domestic violence and intimate partner aggression & violence, on spanking and corporal punishment. The researchers are trying to understand/describe that while most child advocacy groups condemn spanking, in the US, the reality remains that nearly 2/3 of families continue to use spanking as a form of discipline. They found that parents who experienced aggression and violence between each other were twice as likely to be in the group that spanked their children. Having been spanked as a child increased the odds, too. Not surprising.

But the 65%; that was surprising.

I don’t talk about spanking in clinic (I can’t think of a time I did); no one asks my opinion about it. I talk about setting limits, behavior, tantrums, obedience, discipline, but no one asks me about spanking. I wonder, do parents feel it’s taboo? Do they feel I would judge them?

My position on spanking may be irrelevant, really. What I say as one mother or pediatrician doesn’t change the reality that more than half of the parents in this study are spanking children. I’ve always thought of spanking as illogical. If I’m trying to model behavior against aggression, why would I hit my child modeling just the opposite? But I’ll tell you this: I was spanked as a child and I certainly remember it. Clarity in fear. Further, there have been moments of desperation (think: major-tantrum-melt-down-disaster-ness) where I thought about it, too. So, I think the instinct to spank (particularly when you’ve seen it, or experienced it) in a moment of utter overwhelm may be the norm when raising kids. But 1/3 of us choose not to spank,and about 2/3 of us choose to spank our children. Why?

What pediatricians ultimately need to figure out for families is how to help parents improve their lives with their children. We need to support families in times of frustrations. Groups like the AAP discourage using spanking or corporal punishment of any kind. But their statement may not make much of a difference.

So I wonder, does 65% surprise you? Do you spank your children? Do you think it works? Do you feel spanking is corporal punishment? If you don’t spank your child, why not? So curious. Please share, even anonymously if need be.

If It Were My Child: No Feeding The Dog

“If it were my child: No kids feeding the dog.” Don’t allow kids to play, handle, or touch the dog bowls, dog treats, or supplements, either. You have to be vigilant and organized. I’m not always both, or either, for that matter. I have found my boys basically bathing in dog water, and dipping their hands/face/sippy cup into our dog food bin many times. News today informed me to change the rules around here.

Pet owners, be aware. Not, “beware.” I’m not trying to scare. A study published yesterday in Pediatrics found that a large number of salmonella infections between 2006-2008 were linked to contaminated dry dog/cat food.  Salmonella infections cause abdominal cramping, bloody stools, and in some (often the very young), more severe infections. I read about dog food as a possible cause of infection back in 2007 when my son (4 months at the time) came down with Salmonella gastroenteritis. Yes, it’s a real story. Bloody diarrhea, cramping pain, lots and lots of crying–poor little guy. I felt it was all my fault. He was an infant and I was controlling everything he ate, after all.

But F didn’t get Salmonella from dog food, he got it from a more predictable route. Read full post »

The Most Devastating Article: Fatal Distraction By Gene Weingarten

Happy July. In Seattle that usually means that summer is soon to arrive. For the rest of the US, I know, it has already begun. Ever since last week though, I have thought about July differently. I was midway through this post last Friday when I was forced to abandon it. Overwhelmed by the article I read, I wrote about sighing. I’ve now taken a big sigh… But this information has not left me. Today, we enter July, the month out of the year in which more US children die after being left (and trapped) in hot cars, than any other. Windows up and forgotten, these children die of hyperthermia and overheating. They overheat, cry for help, and are left unheard. It’s unthinkable, really. 18 children have already died this year, 8 of them in the first two weeks of June. Unfortunately, now that two weeks has passed, this statistic has likely changed.

This utterly alarming trend has caught the attention of safety experts. And mine. We all need to create systems in our life to prevent this from happening. Make a system to check the back seat of your car every single time you walk away from it. Kids in it or not.

You can read right over this stuff feeling like it’s irrelevant.

You’re thinking, this will never happen to me. No way would I forget my kid in the car. Before you convince yourself, read this 2010 Pultizer Prize winning article by Gene Weingarten published in March, 2009. It has changed my life; It is the most devastating article I’ve read all year. I’m not overstating this. The handful of others that I have had read this say the very same. Share it with anyone who will ever drive a child in a car seat or booster seat, anywhere. Read full post »

Anything for a Nap

My son climbing up a slideSo you know that thing you do when you’re desperate for your kid to sleep? That thing where you take your child to the park, run them into the ground, and force them to stay up a bit later than usual? Then when nearing complete destruction or implosion, you keep the windows down in the car and the music blaring so they won’t fall asleep on the way home? All this in the hopes that when you are home, they CRASH. CRASH HARD and sleep like a zombie. Instinct tells you that the physical fatigue they acquire will allow them to pound out an outrageous nap.

We do this. Most of us, at least. We think that the way we sleep is the same as the way our kids sleep. And after learning by experience that a hard day of weeding, running, or traveling increases our ability to crash asleep, we trust that tiring out our kids will get them to nap extra-hard, extra-soundly and extra-long.

Brutal reality: it may not. Read full post »

(Our) Doctor (To)day Keeps Those (Pull-ups) Away

F woke up with a wet bed. First time since the amazing transformation this past month where he decided to wear underwear. It felt like a miracle. New Year’s hopes and dreams come true. Wait until you hear how it happened.
I just couldn’t bring myself to write about toilet training until now. Didn’t want to jinx it. Now with the wet bed this morning, I’m safe. Can’t blame the blog for any future wetting-messiness. You’re off the hook, SeattleMamaDoc.

There is some new data suggesting there is an ideal time for initiation of toilet training. A recent study suggests half way between age 2 and 3 years is the golden age. Ditch the diapers between 27-32 months, the urologists say.

Finally, a data-driven answer to the question of “When should I toilet train little Jane?” Read full post »