How Using Mindfulness Can Help Your Kids Now

Mindfulness has become mainstream. The InnerKids Foundation in LA has been teaching mindfulness to inner city kids since 2001. The Goldie Hawn Foundation sponsors a program called MindUp that has trained thousands of teachers. In all likelihood, mindfulness is coming to a school near you, with very good reason. Mindfulness works.

MindUP has shown a 90% increase in children’s ability to get along with other children; an 80% increase in optimism; and a 75% improvement in planning, organizational skills, and  impulse control when kids practice. Several studies have shown that mindfulness practice brings a sense of well being and decrease in stress.

Our world has gone crazy, and our children are having problems with anxiety, stress, depression, and the resultant physical symptoms: stomach aches, headaches, and chronic tiredness. Anxious, stressed out kids build stories in their minds that circle, grow, and separate them from what is real and manageable. Mindfulness can help.

What is mindfulness?

Mindfulness is a meditation practice that we in the west have stolen from the Buddhists and warped to our own purposes. Through mindfulness practice a child can achieve a state of mind where they aware, focused on the present, and calmly accepting of  themselves and the world around them, without judgement.

Does this not sound like exactly what we want for our kids? Kids who learn to practice mindfulness have in their arsenal a tool that will help them deal with anxiety, stress, impulsiveness, and any number of damaging emotions–with no side effects and at the bargain price of free. No need to join a religion, and anyone can learn it.

How do we do it?

There are many internet sites that can lead you through mindfulness practice with your kids. I particularly like Renee Jain, MAPP, but there are many out there. There is even an iPhone app! The basics are really very simple:

  • First and most important, do it with your child.
  • Find a peaceful, quiet place, sit comfortably (the crossed leg/hands on knee thing is optional).
  • Focus on awareness of one thing.
  • Notice that thing–a sight, or sound, or feeling-any one thing.
  • Acknowledge that thing, then let the thought drift away, without judgement.

Babies are naturals at mindfulness. Stick mushed peaches in their mouths and they will taste them, look at them on their hands, rub them all over their faces, and smell them. They are in the moment and focused on those peaches. We can learn a lot from babies.

Older kids need to be brought back to that sort of focus. Sit with them in a quiet, comfortable place, and guide them to think about one thing. Use something they can hear (a bell or a shaker?) or taste, or smell. Teach them to notice that thing, then let that notice float away. Be aware and focused, but don’t try to conclude anything about what they are focused on and don’t pass judgement. Just hear, or see, or smell-and then let it go.

As kids get older, they can learn more traditional meditation techniques: breath coming into and going out, awareness of their bodies and of passing thoughts, and letting go so that they can be in the next moment, without attachment to what is passed and gone.

There is no one right way to meditate: the point is to be peaceful and live, for that time, in the present without attachment and without judgement. People meditate by arranging sand, by doing yoga, by coloring, by going fishing–whatever works for you and your child.

Why practice mindfulness?

Meditation can teach kids how to break the spiraling cycle of anxiety; how to develop a more positive and optimistic viewpoint; how to live without pronouncing judgement on everything they encounter, and on themselves. It can help them feel better about themselves and learn to regulate their emotions and impulses.

Imagine your child coming home stressed because someone was mean, they have too much homework, or they are last picked for a team. Imagine if they could find a quiet place, trace that stress to its origin, transform it into a color or a breeze in their minds– and let it go.

Better than sitting, stewing in the stress, and letting it spiral and grow until it takes over their evening, yes?

Create a habit of daily meditation.

Take a few minutes every evening and make meditation a routine–maybe right before homework or bed? Reward them for practicing with a hug or a few minutes more of your time, as you reward any behavior of which you want to see more.

Mindfulness is a skill, like riding a bike. If your child practices every day, when he or she needs it they won’t have to think about how to get their feet onto the pedals and make the bike roll forward. It will just be there for them.

Mindfulness works. Mindfulness practice has been shown to improve kids’ coping skills and their sense of well being. It can improve memory and learning by teaching them to pay attention and focus. It can teach them to be aware of their feelings, accept them, and then let them go, so that they can make wise decisions with their minds rather than poor ones based on overwhelming emotions. They can learn to self regulate and control their own emotions and actions.

Give it a try. Everyone can use a few minutes of peace in their day.

Childhood Obesity: Consequences, Causes, and Prevention

This week I am happily building trellises in my new garden and I am feeling very lazy. Thankfully Kids Car Donations sent me this really cool infografic on childhood obesity, so I can pretend I did some work on the blog.

You can also check out Child Obesity: Why it Happens and How to Have an Impact for more information.

If you’d also like to join me in the garden, check out last week’s How to get Kids to Eat their Vegetables: Time to Garden!

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How to Get Kids to Eat Their Vegetables: Time to Garden!

little baby gardener lost in the moment with the sun shinning in

In Anna Karenina, Leo Tolstoy wrote “Spring is the time of plans and projects.” Plans and projects keep children out of trouble!

Not to mention that one of the best ways to coax kids into eating what is good for them is to involve them in its preparation. They are far more likely to eat the lunch they prepared with their own two hands than one you slaved over. If they help you peel and cut up carrots for dinner they will try them, and brag about their contribution while chewing.

Extend this a bit and you reap the miracle of children eating their vegetables because they grew them in their very own garden. They planted the seeds, watched over them, watered them, and cared for them. They will proudly eat the fruits of their labor and proclaim their tastiness.

Children need a variety of vitamins and minerals in order to function and grow, and the best place to get those nutrients, along with carbs for energy and fiber for bowel function, is in fruits and vegetables. Some, like beans and peas, are even excellent sources of protein. Many of them can be grown in small plots or in containers on a porch.

  • Carrots can be grown easily from seeds bought in your local garden store, and are very high in Vitamin A. Vitamin A helps with eyesight–especially night vision–which is why your mom always told you to eat lots. Watermelon, peas, peppers, beans, and tomatoes also have bunches of Vitamin A.
  • Tomatoes, peppers, and beans are high in B complex vitamins. B vitamins like riboflavin, niacin, thiamine and folic acid are tiny machines that allow your body to function. They help with everything from making blood cells, to generating energy from carbohydrates, to scavenging free radicles and protecting you from cancer.
  • Strawberries, raspberries, and blackberries are high in Vitamin C, which is necessary for collagen synthesis and wound healing and is an effective antioxidant. Without Vitamin C, people get scurvy.

Minerals are also easily come by on the plant side of your plate.

  • Calcium to build strong bones can be found in beans.
  • Potatoes, beans, corn, and mushrooms are high in iron, which helps carry oxygen around your body.
  • Potassium, necessary for muscle contraction and to maintain your heart rhythm, is present in potatoes, berries, peas, beans, and peppers.
  • Essential minerals like magnesium, phosphorus, copper, and zinc are all available in fruits and vegetables.

I’ve never seen a child turn down a pea fresh from the pod, or a strawberry plucked from the plant. Find a plant catalogue, pour through it with your child, pay attention to what will grow in your area and how much room the plants need to grow, and choose. Consider what you have room for: will these be container plants on the porch, or can you spare a patch of yard? Do you have space for a tree, or are we looking at a mushroom kit in the closet?

Some of my favorite kid friendly plants are peas, beans, peppers, tomatoes, and the ever popular carrot. Melons, pumpkins, and cucumbers are great if you have a little more room. Berries come in all sizes, from tiny strawberry plants fit for containers with pockets down the side, to raspberry vines best grown on trellises, to fat thorny blackberry bushes. Tires can be stacked up and filled with dirt in a tower as potato plants grow, then harvested by taking off one tire at a time.

Growing a few plants allows you to spend time with your children, get some exercise, and build some vitamin D of your own from all that sunshine. Have a conversation about science and nutrition while you are digging in the dirt. Money can be earned and financial lessons taught by naming the watering and weeding of those plants “chores.” Other lessons can be taught without any conversation: responsibility for life, the fruitfulness of hard work, and pride of accomplishment. Don’t miss this opportunity for spring plans and projects!

4th of July: 10 Tips to Stay out of the ER

Sunshine, water, and fireworks. What else could you need? To avoid the ER afterwards!

Oddly, most 4th of July injuries actually have nothing to do with fireworks, and everything to do with parents being so busy that they are not as watchful as usual. Sports are more dangerous when we want to impress cousins. Teenagers tend to get more reckless during a celebration, and young children sneak away quickly.

Most injuries are from everyday activities and household objects made dangerous by the craziness. So,…

Top Ten things that will land you in my office after the fireworks:

1.  Drowning: The 4th is all about water. Every year pediatricians see drownings and near drownings on the 4th. Never leave any child alone for even a moment near open water, whether it is an ocean, a bathtub, or a water bucket.

All it takes is one moment of inattention for a child to slip away. If there is open water, you need to be within touching distance and focused on your child. Pools should be fenced in and closed off with a self-latching gate at the end of the day, and all the toys should be put away. Life vests are fabulous for a parent’s mental health and relaxation (swimmies and floaties are not life jackets). Life preservers and a shepherd’s crook should be placed obviously nearby wherever kids are swimming. For more tips on water safety, check out my summer safety tips.

2.  Fireworks: I know, it’s obvious, but it had to be on the list. Please leave them to the professionals. It’s not worth months in the burn unit and doing physical therapy.  No-one thinks it will happen to their kid, until it does.

3.  Choking: Toddlers will put anything in their mouths. This means that everybody needs to pick up his or her stuff. Items over 1¼ inch in diameter are generally safe. Items smaller than 1¼ inch can go straight into their gut or lung. The most dangerous items to swallow are button batteries and magnets; the most dangerous to choke on are grape sized (older children’s toys, hard candy) or stretchy (balloons, plastic bags, marshmallows). Clean up!

4.  Allergic reactions: Holidays provide a banquet of things to irritate children’s allergies. Plants, foods, cigarette smoke, bonfires and other people’s homes and pets come to mind. Avoid them if your child has allergies.

5.  Fires and electrical injuries are especially common during holidays. Decorations can be flammable, candles and fires are commonly nearby. Frayed and loose wires easily start fires. I have had an astounding number of children run through banked campfires after dark. Block them off please!  Keep your eyes open for dangers.

6.  Poisonings: The one I see most is an overdose on Grandma’s meds. At Grandma’s home they are left on countertops; at your home they are in her purse. A left over drink is also a common way to poison children. A little alcohol can drop a child’s blood sugar and throw him or her into a coma.

7.  Alcohol inside the grown-up: does this really need explanation?

8.  Dehydration/Food poisoning: Watch their intake. It’s hot and the kids are running around in endless circles. Bring lots of water (the stuff mother nature made for you, not the stuff with caffeine and sugar added). Food left out in the heat for hours can grow things that cause vomiting and diarrhea. If you don’t know where it came from and how long it’s been there, don’t eat it.

9.  Scarce common sense: If it doesn’t seem safe, don’t let people pressure you into it. Make them wear that bike helmet! Trampolines and motorized vehicles (Sea Doos, dirt bikes) are never a good idea.  Feel free to let watching your kids take precedence over seeing Uncle Joe’s trophy or Aunt Mary’s vacation photos. “He’ll be fine” doesn’t make him fine. Keep an eye on him.

10.  Politeness: Feel free to be rude and head for home when the kids get tired, if a situation feels out of control, or if your child is being exposed to something you aren’t happy with. Use the munchkin’s youth or fatigue as the excuse for you to head home, relax and read a bedtime story.

The point of celebrations is to solidify relationships and give hope for the future. Focus on family, rejoice in the day and be careful.  Keep plans simple, pick fewer things to do, and do them together. Be safe and stay healthy.

The Weird and Interesting Life of a Flu Virus

shutterstock_87645001The first description we have of the influenza virus was from Hippocrates (my hero!) 2400 years ago. He dealt with it every winter, endlessly, just as we do now. Nowadays it makes between 3 and 5 million people sick each year, and kills 250 to 500 thousand people annually. In the US we average 200 thousand hospitalizations and 36 thousand deaths yearly. Persistent, nasty little bugger.

Influenza gets its name from the Italian word for influence, because people initially thought it was caused by the influence of the stars, and later by the influence of the cold. Now we know better.

The Anatomy of a Flu Virus:

The influenza  virus is a tiny spherical particle, only 80-120 nanometers in size. It would take a million of them standing in a row to make a 1 centimeter line. Its core is made of 8 separate segments of RNA (we humans have DNA). This core is surrounded by protective proteins and an envelop with 2 types of “glycoproteins”–the famous Hs and Ns you hear about when people talk about which type of flu is causing problems each year: Hemagglutinins and Neuraminidases.

NPR has a very cool video of the flu virus invading a cell here. The “key” in the video is the hemagglutinin.

How the Virus Works:

The Hemagglutinins (Hs) bind to target cells in your body and inject the virus particle into your cells. How contagious the flu is, what symptoms it gives you, and how sick it can make you depends on the Hs. An H that can bind to cells in your eyes, nose, and mouth is more contagious than one that can only bind to your throat. An H that can bind to a cell deep in your lung is much more serious than one that can only bind to a cell in your throat.

The Neuraminidases (Ns) release the progeny of that prolific particle from that cell so that the little critters can spread further through your body.

How we Fight it:

The Hs and Ns are the molecules our immune systems build antibodies against, whether we catch the flu or just get exposed to the dead virus in the annual vaccine. The Hs and Ns are also the targets for antiviral drugs. There are 16 different Hs and 9 different Ns. Humans are usually infected with H 1, 2, or 3 and N 1 and 2.

There are three groups (genera) of flu viruses in the family Orthomyxoviridae. (I love that word: Ortho-myxo-vir-i-dae.) The three groups are simply labeled A, B, and C. We frequently call the flu by which animal is its main host. Human, bird, and swine are the most common strains we humans catch.

Flu A has the most serogroups (Hs and Ns), infects the most different animals, and is the most virulent. It also mutates 2-3 times faster than B. The critters it infects are mostly aquatic birds, but it can infect many other species.

Flu B has only one serogroup and is almost exclusive to humans. It tends to be less severe and less common. Since it only has one serogroup and mutates slowly, many people develop a degree of immunity to it.

Flu C is even less common and less severe.

What makes Flu unique among viruses:

Viruses enter cells so that they can make copies of themselves and spread. As they make those copies they sometimes make mistakes, creating mutations. They average one mistake per copy, so mutation is constant– what we call antigenic drift. That’s why we never get immune to Flu A–it changes every year.

There is one really cool thing about the flu virus that makes it different from most viruses: its RNA is split into 8 segments. (Most viruses have one long piece of RNA.)

This means that if your local pig catches 2 different strains of flu at the same time, these strains can trade segments. When that happens we get antigenic shifts– much larger changes for which people have no immunity. These larger shifts can create a pandemic, like the Spanish flu in 1918 that killed an estimated 21 million people. We average 3 pandemics each century. We worry a lot about pandemics.

So, those are the ABCs of the flu virus. If you crave something more useful, like what you can do about it, check out my post on colds and flu or info on fever.

Now wash those little hands with soap, keep them away from noses and mouths, break out the bleach, and go get those flu shots! The shots cover an H1N1 and H3N2 Flu A, and two strains of B.

The X’s and Y’s of Sex: What Makes a Boy or a Girl

Infant feet-01Remember high school biology? You were taught that humans had forty-six chromosomes. There were two each of twenty-two pairs, and then there were your sex chromosomes, the Xs and Ys. If you had two X chromosomes (XX), you were a girl. An X and a Y (XY) made you a boy.

It’s not actually that simple. That is the most common arrangement, but there are many variations. When you have a variation on any other chromosome, it causes physical issues that are unfortunate and sometimes deadly. If you have three number twenty-one chromosomes you have Down’s syndrome, and your life will be different.

We don’t ever blame the child, right? Nobody asked them if they wanted the usual forty-six chromosomes or if they would mind having an extra. It’s not their fault.

When the extra or missing chromosomes are the Xs or Ys, suddenly we involve social judgment and religion. Why? I can only assume that we are all so uncomfortable with sexuality that we would rather judge than understand.

You’re reading the wrong blog if you wanted to get away with that.

Variations

One in 840 male births are an XYY. We used to think that this made the men more violent because the tests were all done on men in prisons. Once we started testing men who were not in prison, it turned out that there weren’t actually many differences. Most are completely normal. There is a mild tendency toward tallness, poor fine motor control, weakness, and some speech and language issues. Most of these guys never know they aren’t the typical XY.

One in 500 males have XXY, or Klinefelter’s disease. These kids do have some physical issues, such as a tendency toward long limbs, smaller genitals, and slightly less intelligence than they would have had without that extra chromosome.

When you get into larger numbers of chromosomes, you see more problems. XXYY and XXXY kids tend to need testosterone replacement. XXXY and XXXXY kids tend to be short with small genitals, mental defciency, and elbow issues.

Without any Y chromosome, we get girl babies. XXX girls are usually tall and sometimes uncoordinated. Rather like the XYY males, most won’t ever know they have it. Girls with as many as five X chromosomes have been found. The more X chromosomes they have, the more problems: they tend to become shorter, with mental defciency and behavior issues.

About one in 2,000 live births are XO girls who are missing one X or Y chromosome. They have Turner’s syndrome. They have lymphedema (fluid swelling under the skin) before they are born and frequently have extra skin at the neck. They tend to be short, with wide chests and gonadal dysgenesis (sex organs that do not develop normally).

To add to all these variants, we have mosaics: two fertilized eggs fuse so that the resultant person has half a body with the typical XX or XY and half a body with a variation.

Variations with the Usual Chromosome Count

There are also variations that occur with the typical complement of chromosomes.

Girls with testicular feminization have 46XY. Their chromosomes say “boy,” but their bodies are insensitive to testosterone. They grow up as girls and don’t realize there is a problem until adolescence, when fertility issues arise.

Congenital Adrenal Hyperplasia (CAH) will give you a baby that has been virilized. On a girl, the clitoris will be enlarged, and the labia can become fused. It is difficult to tell when the baby is born if it is a boy or a girl until the chromosomes come back. Since the first question everyone asks is “Is it a boy or a girl?” this can be very traumatic to the families involved.

Adrenocortical tumors can also be virilizing, giving the child more masculine traits than they otherwise would have had.

Enough? There are many more. Biology is not as simple as they taught you in grade school, and throwing judgment and religion at it does not change it or help in any way. Ignorance is ugly.

The gender issues and sexual orientation parts of this blog got really long, so…

Come back next week please!

The Blogger's Pit Stop

Doc’s Top 10 New Years Resolutions for Moms and Dads

storkHappy New Year! Time for those resolutions.

This year, instead of resolving to lose that last ten pounds or eat more veggies (I really need to eat less chocolate…), resolve to do something that will actually make your life better. The reward for parenting well is amazing kids and sanity – definitely worth the effort. You may already be doing all these things (is that even possible?), but skim through if you are merely human and could use some help. So…

Dr. Lovlie’s Top 10 New Year’s Parenting Resolutions:

10.  Require chores. Equal participation is fundamental to receive the reward of being in a family. The pride your children feel serving the carrots they helped peel is well worth the time it takes to get them to do it. Every member of the family contributes, to the best of their ability. Family bonds and trust will form over the raking of leaves.

9.   Make rules, and enforce them consistently. Rules keep kids safe, teach them right from wrong, and civilize them. Make sure your child understands the rules, and every single adult in his life needs to enforce every rule each and every time. No “warnings,” because you made sure ahead of time that they understood the rule. Decide what the consequence will be for a broken rule long before you need to enforce it; make the punishment appropriate for the crime (timeout? loss of the toy? paying for the damage?). Read 5 Reasons Why Kids Need Rules.

8.   Feed the munchkin a healthy diet: whole foods that look like they either grew out of the ground or walked on it (I know, but not everyone is a vegetarian). Teach your children to eat when they’re hungry, and stop eating when they’re not hungry anymore. Aim for about 2/3 fruits, vegies and whole or enriched grains, and about 1/3 protein (meat, eggs, cheese, beans or nuts) and starch (potatoes, corn). Everything else will be easier if they are well nourished. Check out All the Right Foods.

7.   Keep a regular sleep schedule – both enough hours and at about the same time every day – as much as possible. Kids who are short on sleep are irritable, tired and have no attention span. Everything else will also be easier if he or she has had enough sleep.

6.   Keep them safe when possible. There are lots of surprises out there to keep life interesting; there is no need to risk preventable injuries. Use those seat belts and bike helmets, lock up the household poisons, guns and Grandma’s meds, and get those vaccines.

5.   Teach financial responsibility. Spend less than you make, stay out of debt, and save for the future. Do it where they can see you and explain what you are doing. Go through your budget with them in an age appropriate way, and feel free to say, “We can’t afford that.” Give them an allowance for those chores and require that they save some.

4.   Don’t wear blinders. Your primary job is to protect this child, even if it is sometimes from themselves. Children will lie, take things that are not theirs, and sneak out at night when they are 14. You need to catch them so that they learn that it doesn’t work. If they get caught stealing at 7, they have an embarrassing memory of having to go back and pay for what they took. If they get caught at 25, they land in jail and loose their job, partner, and children.

3.   Give them love without condition. Love the child you have, not the one you dreamed they would be. Love is not a prize you can give when your child is good, and take away when they do not live up to your expectations. Without the absolute faith that no matter what happens or what horrible thing they do you will still love them, the foundation on which they build their life will by shaky and unstable. You chose to have them – unconditional love was part of the deal.

2.   Nurture your child’s unique talents and abilities. Don’t try to fit the ones you want them to have on an unsuitable frame. This little person is an original – why would you want to shove him or her into a standard form? And what irreplaceable gifts would be forever lost because you did not value them? Respect the exceptional person that he or she is.

1.   Inspire them with your own life. Be what you hope for them. Find work you love, maintain a healthy relationship with your partner, eat a healthy diet, and exercise. Learn something new every day. Never lie. Give respect, and demand it for yourself. Keep an open mind, explore the world and grab opportunities when they happen by. Make your children proud.

The Blogger's Pit Stop

5 Truths: Why Rewards Work

Parent with Child, parenting
Without rewards, rules become guidelines that tell our children how to get our attention.

We must reward our children when they are good–chiefly with our time and praise–since there is otherwise no benefit to good behavior. Rewards are far more effective at shaping good behavior than punishments will ever be, because children desire their parents’ love and attention above all.

Rewards are not bribes. Rewards are earned, like a paycheck, for desired behavior. Bribes are given beforehand, when they have not been earned.

What Earns a Reward?

As with rules, what behavior is defined as rewardable depends on the particular child’s personality, age, abilities, and the environment in which they find themselves. (Last month’s blog How to Custom Fit Rules to Your Child outlined what children are capable of at different developmental ages.) Think about the behavior you want, look for it, notice it, and reward it. You will see more of it.

Try not to expect behavior that is improbable for the age of the child. Fifteen-month-olds will not be able to control their tempers. Two-year-olds can begin learning that temper tantrums do not get them what they want. A temper tantrum in a seven-year-old is not attractive.

Consider, also, your particular child’s style and ability. Everyone is better at some things than others, and ability changes with age. Think about where they are now compared to where you want them to be and aim in that direction, taking small, attainable steps.

It is far too easy to ignore good behavior–or just not notice. Your toddler shared his toy?Definitely worth noticing. Your five year old is looking through a book? Fabulous. Teenager being civil? Yay! Good behavior is easy to miss or dismiss with the thought He should act that way all the time. But would you go to work every day if there was no paycheck at the end of the week? Would you work as well if your boss did not appreciate you? The human mind is built to respond to approval. If you want to see more of a particular behavior, reward it.

Small Goal, Small Reward

It is vital that you keep your goals small and of short duration. A trip to Disney for straight As sounds good, but can be soul killing to a child who just can’t get there.

Frequent small rewards are more effective. The child can see the end point and know that it’s possible. “If you wash the dishes, we can read that book together” is immediate and obtainable. “If you clean the whole house, I’ll give you fifty dollars” is distant and improbable, as well as overwhelming.  Divide responsibilities into many short sprints rather than an inconceivably long marathon.

Instant Gratification

Rewards should be immediate. Children have short attention spans, and if too much time passes, they won’t be able to remember what they did or why they’re being rewarded for it.

Immediate rewards create an emotional connection to the behavior that will give them a good feeling when they repeat it. Reading that book made them feel happy, so they will grab another book. They probably won’t remember the hug and smile, but the feeling will be there.

Proportion

Rewards should also be proportionate. Small people receive small rewards for small actions. Putting away their toys receives a hug and a smile, not a new toy. Finishing their homework should be rewarded by going with Dad to walk the dog, not by getting a new puppy.

Older kids, who generally want larger things,  can work toward them by getting points for small acts of fabulousness. Working toward an A in history? Homework done? Points toward that bike can be prominently displayed for each small accomplishment.

Respect your children’s intelligence: if you go overboard, they won’t believe the approval is authentic. If the reward is grandiose, they will know they did not truly earn it and may feel manipulated. They might be insulted that you thought they were so dumb. You may want to jump up and down when you find your teenager doing homework, but a nod and a “Cool, good job,” will be more accepted.

He’s Never Good!

What if you don’t ever see the behavior you’re looking for? Sometimes you can create the behavior you want, and then quickly reward it before they figure out that they didn’t mean to do it. Sneaky, but it works. You are smarter than they are—for a while, at least.
If they’ve been in a timeout, grab that instant before they scowl and say, with a relieved smile, “Good, you’re back! I missed you so much when your evil twin took over! Let’s go do something fun.” Most of the time, they will grab that preemptive reward and run with it.

We do this in the pediatric office when we torture kids. Right after a throat swab, their faces will start to crumble. In that instant, we smile and say, “Wow, you were so brave! I think you were the bravest kid all day! Would you like a sticker?” They are so proud of their bravery that they try to live up to it.

If they are exploring and about to get into something they shouldn’t, stop them before they do and tell them they are wonderful for being so curious. It is so much more fun than yelling at them for breaking that lamp! Interpretation is everything.

If your toddlers are not great at eating veggies, give them the ones they like and will eat, then tell them how great it is that they ate their veggies and that they will make them big and strong. Set up the playing field in such a way that they will succeed and you will have something to reward.

But what rewards do you give for what behavior? Check out What rewards? When? How?

How to Keep Your Kid Alive and Still Have a Happy Halloween

Kids Carving Pumpkin At Halloween

A Safe and Happy Halloween

Time again for the annual “How to keep your kid alive and still have a happy Halloween” article. I know you’ve read this sort of thing before, but skim through – you might see something you forgot!

First, costumes:

From tiny ones who want to be lions to preteens dripping blood, costumes are the best part of Halloween. For a few hours we suspend boring reality and play at being something else. How better to encourage creativity and imagination?

Please try for bright, easy-to-see colors. Check to make sure the fabric is flame retardant and add reflective tape. Make sure the costume fits well so your little guy won’t trip. Stick your little gal’s feet into comfortable shoes. Pin a paper with their name, address and phone number inside their pockets in case you get separated.

Paint their faces so they don’t need to wear masks that can obstruct their vision.

Be careful about those accessories! Long scythes and pitchforks can be trip hazards. Accessories should be soft, short, fake and flexible. Guns that look real have caused problems when people were unsure they were toys. Arm them with a flashlight with fresh batteries instead.

Home décor:

I once put a big fat candle on a table decorated with straw. It took my next-door neighbor–a fireman–raising his brow sardonically for me to see that this was not a terribly bright idea. So. Be careful where you put flame. Fire inside a floor level pumpkin with costumes sweeping by–not so good. Try battery powered candles or glow sticks instead. The firemen will appreciate it.

Only the grown ups get to use sharp objects, so pumpkin carving is for big people only. Nothing ruins a holiday like a trip to the ER. Kids can design with markers or paint.

Last, inspect your yard and home for trip hazards such as bikes and hoses. Check for frayed wires, and poorly lit areas.

Trick-or-treating:

There are, I admit, children who may disagree with me about costumes being the best part of Halloween. There is that other thing they like a lot: running around neighborhoods screaming maniacally and getting free candy. I would frown upon such activity but I have fond memories of doing the same.

The number one way children are hurt on Halloween is by running in front of cars in the excitement of the moment. Teach them basic safety, know where your kids are, and know who they are with.

Kids under 12 walk with a grown-up (No, that is not up for debate; blame it on me.) Over 12, it depends on the maturity of the child and the safety of the neighborhood. If they are not with a grown-up, they need to travel in a group, on a preplanned path. If you can find a neighborhood where they close off the streets, enjoy! If not, hike through a familiar neighborhood (it can’t hurt to check the registered sex offender site and avoid those houses).

Trick-or-treaters need to stay in well-lit areas, avoiding short cuts, alleys and darkness. Use sidewalks and walk facing traffic. Be careful when crossing the street: even if the approaching car does see your child, the one behind him or her might not. Make sure they know to never approach parked cars and never enter a house. Have your big kid carry a cell phone and check in every hour. Agree on a curfew.

When they get home, go through their haul. Throw out anything that looks like it was tampered with, anything home made (if you don’t know the maker), choking hazards, and whatever else you can get away with. Freeze some for holiday cookies later.

Last, take care to keep your pets safe during the holiday. Keep chocolate and anything sweetened with xylitol away from your dog. Watch for choking hazards and yummy electric wires, and lock your four legged ones away from the front door so they won’t escape when the hoodlums knock.

Happy Haunting!

Did You Know? Truth, Tips, and Treatment for Warts.

girl-doc-01The common wart, or verruca vulgaris, appears as a small, rough-surfaced bump on your child’s skin, frequently on their hands or feet. Interestingly, kids can be infected for months before the warts actually get big enough to see. Warts are benign, causing little harm to their bearer (the exception being genital warts). They can, however, drive the parent of said bearer insane.

Warts are caused by a virus called Human Papillomavirus. They are contagious. Kids catch them by touching someone else’s wart, or by touching a surface that has come in contact with a wart. The virus prefers to invade through cuts, abrasions, and chewed bits of skin, so children are fertile ground for invasion.

There are about 130 strains of HPV. The type of wart you get depends on the strain and on where it appears.

Types of warts include:

  • Common warts. HPV types 2, 4 and 7, among others, cause the common wart. These warts can pop up anywhere, but they are most often seen on hands. “Periungal” warts are around the fingernails.
  • Plantar warts. Most commonly HPV 1, but can be caused by other strains ( 2, 3, 4, 27, 28, and 58) “Plantar” means on the sole of the foot, so that’s where you find plantar warts. They can be painful, because constant pressure on the sole of the foot forces them to grow inward rather than outward. They can feel like a pebble in a shoe.
  • Mosaic warts are a group of warts clustered together, usually on a foot.
  • Filiform warts. HPV strains 1, 2, 4, 27, and 29.These are rapidly growing long strings, frequently found on eyelids and noses. Luckily they are less common.
  • Flat warts. HPV 3, 10, 28 and 49. These warts are smaller, smooth, and more numerous. Kids will get between 20 and 100 separate warts all at once. They like to show up on the face.
  • Genital warts. There are lots of strains but the worst are 16 and 18, which cause cervical, skin, and anal cancers. This is the one we have a vaccine to prevent, given at age 11 or 12.

There are many therapies for warts, and many interesting traditional remedies. None of them work terribly well. My favorite dermatologist once said, “treating warts is treating a non-disease with a series of treatment failures.” Left alone, warts will resolve on their own, so doing nothing is probably the best option. Duct tape and rubbing with  potatoes are absolutely safe to try.

There are medical treatment options if the warts are driving you nuts. (check out the American Academy of Dermatology)

  • Chemical peels. Paint the wart with an acid every day after a good soak. Then abrade off the top layer of the wart with an emery board or pumice stone. (Don’t use the board or stone for anything else). You can buy salicylic acid over the counter, or a doctor can prescribe a stronger version. Some docs will also use tretinoin or glycolic acid, especially for flat warts.
  • Cryotherapy, or freezing.We use liquid nitrogen to form a burn blister under the wart, so that the wart will die and scab off. This frequently requires repeated treatments every two weeks or so.
  • Imiquimod (Aldara cream). This is a cream that encourages your body to make interferon, a part of your immune system that will fight off the virus.
  • Canthariden. This is a poison made from beetles injected into the wart–not FDA approved.
  • Electrosurgery and Curettage. Fancy words for burning it then scraping it off. Ouch.
  • Excision. Cutting it out.
  • Lasers (usually a pulse dye laser) and Infrared Coagulators. Painful and can leave a scar, both to your skin and your bank account.
  • Bleomycin. This is a cancer chemotherapy drug injected into the wart. Not ideal, as it is very painful and can cause you to lose pieces of fingernails, or fingers. Just say no.
  • DPCP, or diphencyprone. This is a potent contact allergen. The idea is that when your body reacts to the allergen it will attack the wart. Side effects include itching, welts, and blistering. Did I mention that common warts don’t have any side effects?
  • Cidofovir. The new thing, in trials now. It is an antiviral that actually kills off the virus with minimal side effects. Very cool, but still in the future.

So, all in all, my favorite wart therapy is: do nothing. They will usually go away on their own. Exceptions are if the wart changes color, bleeds without good reason, becomes painful, or interferes with your child’s activities. It is also important to see a doc if your child has a weak immune system caused by AID’s or things like cancer chemotherapy.

So, to end, Mark Twain’s advice, via Tom Sawyer:

Put your hand into water collecting in the hollow of a tree stump at midnight and say: “Barley-corn, barley-corn, injun-meal shorts…Spunk-water, spunk-water, swaller these warts.” Then “walk away quick, eleven steps, with your eyes shut, and then turn around three times and walk home without speaking to anybody. Because if you speak the charm’s busted.”

DomesticatedMomster
The Blogger's Pit Stop