3 Don’t and 10 Do’s of Discipline

boy with baloon2-01So, you are Parenting: you have a structure of rules, and you have your focus lasered in on good behavior so that you can reward it appropriately. (If not, check out last month’s blogs on Rules and Rewards.)

But how do you deal with bad behavior? Of all the things we do as parents, this is the easiest to screw up. If we don’t believe in what we’re doing, we snicker and laugh—not convincing. If we’re not angry, we hate doing it; if we are angry, we sometimes go too far. We have to do it, or we will end up with spoiled children who, as adults, will have difficulty maintaining solid relationships and may never manage to have meaningful lives.

The American Academy of Pediatrics holds that discipline is a teaching opportunity, not a punishment. We will try for that, but we may not convince the kids.

Ahead of time, discuss discipline with your partner and have a structure in place. I can give you some guidelines, but you have think through your rules and decide how—given space and time for quiet reflection—you would like to react to some of the more interesting and creative behavior children will throw your way. When you are tired, stressed, and angry is not the time to decide what puni..—er—“teaching opportunity”—fits the crime.

(We never actually told our son not to cover the floor with water so he could slide across it in his bare feet. And as for cutting off all of his sister’s hair … Well, he has 2 year old twins now. Karma works.)

If you have trouble with authority roles, practice on each other. No smiling. Channel Smokey the Bear: serious, concerned, and confident.

You will make mistakes. Everyone does. Forgive yourself, apologize to your children, and move on. If you need to make it up to them, make your “learning opportunity” proportionate and relative to your mistake. Ask your kids what sort of punishment you deserve. Hopefully you fit in the time-out chair.

How Not to Discipline

There are a few dangers to avoid when discussing infractions with your children. The first is that if you allow the discussion to devolve into excuses, you risk turning your children into people who take no responsibility for their actions and believe they can talk their way out of anything.

Another is that the discussion can turn into an intimidating inquisition with the big people towering over the little ones. You want to improve their behavior, not destroy their confidence.

And don’t even consider giving a warning. They knew the rule, they broke it, and they know the consequences. What would a warning teach them? That they can get away with anything once? Craziness.

How to Discipline

When dealing with tiny people, of course, simple distraction and diversion will work. Pick them up, take them away from the neat burning candle, and hand them a book.

When they get old enough to understand rules, real consequences begin. No single consequence will work all the time; consequences vary with age, the personality style of the child, and the type of infraction.

Respect your children, get down to their level, and look them in the eye. Consider their points of view, but expect them to take responsibility for their actions. Explain why they are in trouble and what the consequences will be. Then do it. No exceptions, no waffling, no compromise. If they know that discipline is enforced every single time—and no amount of begging and crying will change that fact—soon you will have less begging and crying. I promise. If you sometimes let them talk their way out of things, you will have a battle each and every time, forever.

Time-outs

For little ones, usually a time-out is best. The standard belief is that time-outs work because they allow the child time to cool off and think about what they have done. Put the offending child in a chair in a corner alone and completely ignore him or her for as many minutes as they are old. The child can quietly contemplate their misdeeds. Hmm.

I think the truth is less pleasant and much more effective. Time-outs have more in common with traditional shunning than with quiet time. That little person has done something so unacceptable that he or she does not exist in your world for those few minutes. You are taking away the one thing that matters most to them in the world: your attention.

Time-outs: not so wimpy after all.

For a time-out to work, it has to be immediate (shocked looks help, especially for biting and hitting) and absolute. It does not have to be in a particular chair or corner. It can be on the floor right where they were when they decided to have a tantrum. You can even shut the door behind you as you leave. The point is to leave them alone, with no audience, no Mom or Dad, and no one who wants to be with them. The bad behavior will gradually go away because it gains them nothing and takes away something too important to risk.

Discipline by Karma

As they grow, some of their behaviors will have natural consequences. If your two-year-old breaks her toy by throwing it against the wall, she no longer has a toy. If your teenager doesn’t do his homework, he fails. If karma takes care of the punishment for you, your only job is to let it happen. No rescues! You don’t want them living in your basement at thirty!

Logical Consequences

Some consequences are logical. Your munchkin likes to slam their door? Take the door off the hinges and lean it against the wall. They won’t be able to close it for the duration. Horrors! Similarly, if they explore the wrong sites on the computer, they lose computer privileges. Forget their bike helmet? Walk.

Be sparing when taking things away from your children as part of their “teaching opportunities.” If you do it too often and they don’t have the opportunity or ability to earn the things back, you get resentment and sullenness, not success. Never take away something they need—food comes to mind. And never threaten to take away something you know you won’t enforce. If they need the computer to do schoolwork, the punishment (yes, I said the “P” word) could be that they have to use the computer in the kitchen where they can be monitored. If they can’t miss soccer practice without hurting the team, the punishment could be not hanging out afterward with their friends.

Responsibility

Frequently, the punishment can be simply taking responsibility for what they have done and making it right. If they steal a candy bar, going back to the store, confessing to the clerk, and paying for the item out of their own hard-earned cash is very effective. Simply being made to apologize can be excruciating, but it is the honorable thing to do.

Psychiatric experts say you should enlist your children to help decide the consequences for their actions. This is sometimes enlightening and certainly worth listening to, but in the end, it is your decision.

The Big Picture (the 10 Do’s):

  • Never hit a child. That only teaches them that it’s ok for big people to hit little ones.
  • Take away your attention for a time out, never your love. Your love they keep, forever, no matter what they did.
  • Calm yourself first. If you act out of anger, you will regret it later, and you will need to be the one apologizing.
  • Whatever you choose to do, do it immediately.
  • The consequence should be relevant to the issue and proportionate.
  • Criticize the behavior, not the child. What they did was bad—they are not bad, and you expect better from them.
  • Don’t use guilt or shame; those tend to become internalized and suck all the joy out of life.
  • No shouting labels at your progeny; labels stick and follow them around forever. It is impossible to forget that your dad called you stupid or your mom told you that you were a bitch. Children will live up to the labels we place on them.
  • When possible, give them a way to earn back what they have lost. Rescue them joyfully from that time out, and put that toy where it can wait for them to settle down and do their homework.
  • Last, don’t make the punishment last too long. Less than a day is generally best for most infractions. Much longer can make them disconnect the punishment from the crime.

How to discipline a teenager? And what to do when discipline just doesn’t work? Come back next week, of course!

The Blogger's Pit Stop

How to Use Mindfulness to Help Your Child

boy with baloon2-01Mindfulness 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.

DomesticatedMomster
The Blogger's Pit Stop

Che, Che, Che, Changes… and Children

Change- just aheadBack-to-school season is the perfect time to think about how change impacts children, how to help them through it, and the positives that come when kids learn to be flexible and resilient.

Humanity is naturally comfortable with routine. We are confident in our ability to get through the day when we have done it all before. We are secure, and safe. We don’t have to particularly think about anything. To varying degrees, we all like to know what to expect–whole books are written about it!

This need for routine and stability is far more pronounced in a child. A toddler has no real sense of time–they live in the moment, and the future is a complete unknown. Older kids may have a better sense of time, but surprises can still incite strong emotion. Teens have so many changes going on already that seemingly small transitions can make them feel overwhelmed and out of control.

Yet change is inevitable, and the pace of change increases every day.  Parents today change jobs and geography more than did any previous generation; divorce is more common; the 24 hour cycle flings news at us continuously from around the planet.

Improvements in technology and rapid changes in our cultures remake our world the minute we turn our backs. So…

How to help children cope with change:

  • Be a good example. If you take things in stride and don’t appear worried or scared, they will imitate your reaction.
  • Build strong relationships. If they know they are loved and secure, a move or loss will not be so overwhelming.
  • Stay Healthy. Eat nutritious food, exercise, and get enough sleep. Everything is easier to deal with if you feel good and are not tired.
  • Warn them that change is coming. Imagine if even something as wonderful as Christmas happened without advance warning. There’s a tree in the living room, Dad is dressed up in a crazy suit, everyone is excited, and all the normal routines are suspended. Scary stuff! Let them know what is coming, and give them time to process.
  • Explain what is happening, and why it is happening, at their developmental level. Answer their questions. Give them information about the changes that are coming, and explore the possibilities. Imagine the good things that could happen as a result of the change as well as the bad and scary stuff.
  • Keep to routines when you can. Morning regimens, family meals, and bedtime routines are the foundation of a good day. Nothing feels safer than snuggling up with someone who loves you and a bedtime story.
  • Allow them their feelings. Don’t discount them. If the thing they are angry about the most with Grandma’s death is that no one will give them Tootsie Rolls anymore, nod solemnly and say you understand.
  • Expect bad behavior. Kids will regress with transitions, and will act out if they feel insecure. Discipline them in exactly the same way you would have before the change, because if they get away with bad behavior it will heighten their anxiety. If they still get a time out for saying that bad word, then things must not be that different. Bad behavior successfully disciplined establishes new borders and validates their security.
  • Let them have an impact on the change. Let them choose some flowers for an event, or the color of their new room for a move. Humans feel better when they have done something, no matter how small. Action shrinks fear.
  • Carve out time every day for a little one-on-one. ‘Nuf said.
  • Allow time for relaxation and fun. Laugh. Listen to music. Renee Jain, MAPP has a few excellent mindfulness activities for children here. I especially like her practice of “dissolving a thought.” Kids can devolve into what is called catastrophic thinking and spiral downward into a place where nothing is right with the world, and nothing ever will be. Mindfulness practice can stop that spiral and bring them back into the moment.
  • Avoid activities that increase stress, like competitive sports or games. This is not the time to play Monopoly. Simplify your schedule, and let things go.

Change is inevitable; learning to deal with it is a necessary skill. Kids who can adapt to new situations are better at everything from learning vocabulary to making friends to succeeding in the workplace.  Being able to manage your emotional responce to change is part of being a grownup. Knowing when to accept change and when to insist that you have an impact creates a fulfilling life. Last, seeing the good that can come from a transition is how you grab an opportunity.

The ability to adapt is one of the things that made humans special since we first started using that opposable thumb. Encourage your kids to learn it.

 

Domesticated Momster

 

The Blogger's Pit Stop

Summertime Rashes

little cute girl near the pool with a circle for swimmingWhen the days warm up, pediatric offices see a lot of summer skin problems. Kids aren’t often ill during the summer, but they do get sunburns, bites, jellyfish stings, and rashes.

Sunburn

No one thinks about sunscreen on that first glorious sunshiny day, so sunburns are usually our first evidence that summer is here. Remember to use sunscreen, of course, and don’t forget to reapply it every hour.

If your child does burn, give ibuprofen immediately – it helps with the inflammation and can actually reduce the depth of injury. Use aloe generously: it lessens the pain, moisturizes the skin, and helps heal the damage. If the burn is bad, call your doctor. Prescription steroids and burn creams will help.

Bug Bites

Bug bites are also very popular in the summer, from mosquitos, fire ants, yellow flies, and fleas. Insects inject toxins into children’s skin when they bite; how much a particular child reacts depends on how sensitive he or she is.

Cover up little arms and legs when you can, especially if you are going to be outdoors around twilight. There are excellent clothing treatments available that will keep bugs away and last through several washings, protecting your child indirectly.

If your child is older than 2 months, use insect repellant with DEET on exposed skin, even though it’s nasty. It works and it’s a whole lot better than getting insect borne encephalitis. 10% DEET lasts about 2 hours; 30% lasts about 5 hours. Don’t use anything stronger than 30% on a child. Don’t reapply in the same day, and do wash it off when you go back inside.

Creams with pramoxine or calamine will help with itchiness. Cortisone creams help itch and also swelling and redness, but can only be used a couple of times a day. If there are lots of bites, an antihistamine by mouth will also help with swelling and itch.

Never use antihistamine creams (benadryl is the most common), because children can react to the topical antihistamine and actually get worse instead of better.

Bee stings

Bee and wasp stings are treated much the same way, after making sure to remove the stinger and apply a cool compress (and yes, Grandma’s idea about the wet mud does help).

Poison ivy, oak, and sumac

If your child is a forest dweller, he or she will at some point get poison ivy, oak or sumac. These plants produce a poison called urushiol in their sap and leaves, causing redness, itch and blistering.

The severity of this reaction also varies depending on your munchkin’s sensitivity. My brother’s eyes would swell shut if someone burnt it a block away; I could pull it up and throw it away with no reaction.

Wash both the child and his or her clothes as soon as possible. No lounging on the furniture! The toxin can stay on surfaces for months. Once the toxin is either absorbed into the skin or washed off, the rash is no longer contagious. Blister fluid does not contain urushiol.

The rash will develop first where the most toxin was deposited, in streaks and patches. It can spread for a week or so to the areas where less toxin landed, then take another two weeks to clear.

If the rash is mild, you can treat it at home with cool compresses, baking soda or oatmeal baths, the same creams you used for those pesky bug bites, and that antihistamine by mouth. See? Grandma was right again.

If the rash is not mild, or your child has it on their face, around their eyes, or on their genitals (and how did that plant get there?) call your doc. We can put them on steroids, which help enormously.

Jellyfish stings

If you harbor a small mermaid or man in your home, she or he may get stung by a jellyfish. There are some extremely dangerous jellyfish, so if your child has any trouble breathing, is weak or nauseated, has pain away from the sting, or has sweating, cramping, or diarrhea, call your doctor immediately.

If it is a simple sting, first remove the barbs by scraping it with a towel or a credit card. Don’t rub. Put suntan oil or salt water and hot sand on the sting; heat will deactivate the poison.

Do NOT wash the sting with fresh water – it will make the nematocysts (poison sacks) explode and release more poison into the skin. Your child will scream and not love you anymore. Put only fluids with lots of particles in them on the sting: sting-away, vinegar or steak sauce, for example. Ibuprofen will also help the pain and inflammation.

Allergic rashes

Last, we see allergic reactions to everything from sunscreen to henna tattoos to jewelry to pool chemicals from fun in the sun. Kids with sensitive skin or eczema will rash out in the summer from the heat, humidity and sweat.

By now you can probably sense a common theme (or you could just ask Grandma): give your itchy red bumpy child a cool bath with mild soap. Moisturize and apply topical steroids or give antihistamines by mouth.

If any of this doesn’t work, call me! It gets lonely in a pediatric office during the summer when all the kids are healthy.

DomesticatedMomster
The Blogger's Pit Stop

The Trickle Down Theory of Bigotry

kids with instruments-01Enough.

I  know it’s been an interesting ride. We’ve never seen a political candidate like Donald Trump before. He gives vent to the inner two year old, the child who knows he’s better than anyone else and doesn’t let logic, truth, or empathy get in his way. He wants what he wants, and he will say and do whatever it takes to get it – classic two year old behavior. Watching him is like spending a day at the circus.

The problem is that he is a bully, a liar, and a bigot – traits which spit in the face of American ideals like equality, opportunity, and freedom of speech – and our children are watching. When our children see us supporting him for the highest office in the land, they might reasonably believe that we think bullying, lying and bigotry are acceptable.

They are not.

In a speech on caucus day in Cedar Rapids, Iowa, Trump told his audience that he would pay the legal fees of followers who beat up protesters at his rallies.

After two brothers in Boston who beat up a homeless Latino man said that they were inspired by Trump’s anti-immigrant message, Trump suggested that the men were well-intentioned and had simply gotten carried away. A two on one well intentioned beating?

Last November, Trump supporters attacked an African-American protester who was chanting “Black lives matter.” They hit him, knocked him down, and continued to kick him after he was on the ground. Afterwards, Trump suggested that their behavior was justified. “Maybe he should have been roughed up,” he was quoted, “It was absolutely disgusting what he was doing.”

Hmm.

It reminds me of the sixth grade bully, gathering his friends behind him to beat up the unpopular kid, then trying to shift blame to the victim.

The Washington Post wrote that “Trump in this campaign has gone after African Americans, immigrants, Latinos, Asians, women, Muslims and now the disabled.” He physically mimicked Pulitzer Prize-winning journalist Serge Kovaleski, who suffers from arthrogryposis, a congenital joint condition that affects the movement in his arms.

Can you imagine sitting in the Principal’s office, hearing that your child had done such a thing?

How are we to explain to our daughters that brains, talent and hard work are more important than breast size when the man we are considering for president says that “it really doesn’t matter what the media write as long as you’ve got a young, and beautiful, piece of ass.”

Last, most of us agree that teaching our children not to lie is an important part of parenting. Mr. Trump’s truth rating on the Pulitzer prize winning site Politifact is 2%.

According to the Southern Poverty Law Center, teens in Merrillville, Ind., at the predominantly white Andrean High School recently chanted “Build a wall” at their counterparts from predominantly Latino Bishop Noll Institute during a basketball game. Similarly, fans of Elkhorn High School in Wisconsin chanted “Donald Trump, build that wall!” at a girls’ soccer game against Beloit Memorial High School, whose team is largely Latina or black.

A survey of 2000 K through 12 teachers done by Teaching Tolerance reported an increased anxiety level and an upswing in bullying, harassment and intimidation among kids inspired by the appalling misbehavior throughout this campaign.

A kindergarten teacher in Tennessee wrote, “a Latino child—told by classmates that he will be deported and trapped behind a wall—asks every day, “Is the wall here yet?””

The “trickle down” theory of bigotry and bullying. If my parents admire this man, and this man says that Mexicans are rapists and women are disgusting animals, then it must be all right for me to think that also.

Most of us do not dream of our children growing up to be bullies and bigots.

Dr Martin Luther King said it better than I ever will:

The ultimate weakness of violence is that it is a descending spiral, begetting the very thing it seeks to destroy. Instead of diminishing evil, it multiplies it. Through violence you may murder the liar, but you cannot murder the lie, nor establish the truth. Through violence you may murder the hater, but you do not murder hate. In fact, violence merely increases hate. So it goes. Returning violence for violence multiplies violence, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that.

So, enough. Remember the basics: respect for our fellows, equality, honesty, justice…

Your children are watching.

Domesticated Momster

Top Ten Tips for Summer Vacation Success

skateboarder-01School’s out! Time for the Family Vacation. So how do you have fun without going insane? I, of course, have my top ten tips:

10. Pack a simple medicine kit: don’t waste a day of vacation at the doctor’s office, refilling the prescription you forgot at home. Take:

  • any prescription meds your child sometimes needs, even if they haven’t used them in a while (asthma and allergy meds come to mind)
  • frequently used over-the-counter stuff: acetaminophen or ibuprofen, an antihistamine, insect repellant with DEET (the other stuff really doesn’t work, and insect borne encephalitis is unpleasant), sunscreen, and hand sanitizer
  • basic first aid supplies (band aids, gauze pads, tape, antibiotic ointment, cortisone cream, alcohol, tweezers, scissors, thermometer)

9.  Write out a budget before you go. I know, I am a fun sucker, but it has to be done. Know how much money you have and where you plan to spend it. Give the kids an allowance for souvenirs. They will be more careful with money they consider their own, and they will not be constantly asking for things. “Can I have that?” can be answered with “Sure, it’s your money. But are you positive that is where you want to spend it? There might be something better later…” Also, knowing how much you yourself have to spend will save you stress and regret later.

8.  Keep to healthy foods most of the time. (Here I go, sucking out the fun again!) Kids will have more energy, feel better and have a better attitude if they are nourished. And it’s cheaper. Have a basket of fruit available, some whole grain crackers, cheese, peanut butter, popcorn – food with nutrients. Don’t waste valuable vacation time sitting in the drive thru line and arguing over food.

7.  Keep to established routines when you can. Bring along a book for that bedtime story, keep bed time the same, set aside time for their bath. Kids don’t always deal well with change, and vacations are all about change. A few familiar routines will help them feel less stressed. And a full night’s sleep is an absolute necessity if you don’t want an emotional wreck for a kid.

6.  Keep an eye on the little ones. You are in a different environment with new dangers. Distractions abound. Kids on vacation get lost, or get into Grandma’s meds or the local pool. Check out my summer safety tips.

5.  Find interesting things to keep their brains busy. Bored kids whine, and then they find their own version of interesting things. Have a stock of books, games and videos for the car. Bring a journal for them to write in, and art supplies. Explore the area you travel to – Google it before you go. See the sights, hit the museums, find the local artists and craftsmen. Check out ideas to abolish summer boredom.

4.  Keep your own mind open to new and different ways of doing things, so that your kids will do the same. Kids internalize their parent’s judgments, and they will close down their minds and wipe possibilities out of their lives if that is the example you set.

3.  Keep them physically active as well. A tired kid is less stressed, sleeps better, and is not sitting around thinking of ways to get into trouble.

2.  Keep stress to a minimum. Use a GPS if you’re driving: arguments with the navigator have ruined many a vacation. Keep your expectations in line with the actual possibilities, to avoid disapointment. Don’t overschedule – leave time for that relaxing hike and to have a conversation over dinner. Stay within your budget – your hindbrain will know you are overspending and your stress will mount. Stressed out people snap at each other and cannot enjoy time or family.

1.  Align your vacation with your priorities, then toss out the rest. What are the goals of this vacation? Relaxation, family time, memories, enrichment, joy? Plan the vacation and activities that will get you there, and don’t let exhaustion, stress, and fear get in your way. Don’t stop at Uncle Joe’s house if you know he will stress you out; don’t vacation with those friends who overspend or forget to pay their half of the bill. Don’t worry if the kids are getting dirty or if your Aunt Judy wouldn’t approve. Just say no, open up, and relax.

And have a fantastic vacation!

4th of July Safety: Tips from the Doc

safety signSunshine, 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.

Children in the Aftermath of Trauma

Sad child on black background. Portrait depression girlWe try to protect our children from as much as we can, but sometimes life has other plans.

The murders in Orlando have taken over our thoughts, our conversations at home and with friends, the internet, and the television waves. Our children are being bombarded by the nightmare in front of the TV at home, in conversations with friends, and with questions asked by their peers. It can be too much for a child to deal with.

Your child’s experience of an event will vary depending on their age,  personal style,  life experience, and  closeness to the disaster. A toddler will only care that his or her parents seem to be upset. Older children will hurt for the people involved, worry about friends and relatives that are not within their sight, and worry that it could happen to them sometime, at some other event. What seemed exciting to discuss with friends during the day becomes frightening after the lights go off.

Listen to them talk, and be patient when they ask you the same questions over and over. Reassure them, let them know that such things are extremely rare. Answer questions truthfully, at their own developmental level. Never lie.

Monitor what your child sees and hears – adult conversation and the media can magnify fear and confusion and increase their trauma. Repetition can intensify anxiety; pictures can get locked in their heads.

After the event symptoms of post-traumatic stress may appear, even in children not directly involved. They may be sad or moody, easily angered or irritable. They may be afraid to go to public venues. They may have trouble sleeping or sleep too much. Appetites may suffer. Your child may be anxious when his or her people are not all nearby, and wake from nightmares.

Children frequently have concentration problems after a trauma, and their grades will suffer. They may regress developmentally: your independent youngsters may become clingy, or need help doing things they had been able to do on their own. They may avoid activities they previously enjoyed, and withdraw into themselves. They may become anxious at the thought of going to school, or of being separated from mom or dad.

They can also develop physical symptoms like headaches and stomachaches. They may try to exercise more control on their environment, setting up their toys in a particular way, wanting their schedule to be predictable, or demanding activities they find reassuring. Teens may act out or try alcohol or drugs in an attempt to feel better.

Helping them may be as simple as listening. Be available and receptive but don’t push. A younger child may open up and tell you his story when you break out toys or art supplies; an older one may talk if you tell her a similar story about yourself, when you were scared or worried. Schedule time for just the two of you, and wait.

Children may try to hide their symptoms: they think they should be stronger, they don’t want to be a burden, or they think they are abnormal for having the problem. They may even feel that the disaster was their fault; children are not always logical. Allowing them to bury their symptoms will only erode their spirit from the inside.

Also, be a good example. Take care of yourself, eat healthy food, sleep, and discuss events calmly. Turn off the TV and stay off the web. Exercise. Take breaks to play, read a book, and do something unrelated to it.

Keep to recognizable routines– routine is reassuring and safe. Require reasonable behavior: if they still get in trouble for using that bad word, then everything must be OK. They may test you with bad behavior just to get that reassurance. Don’t spoil them with extra treats, because it will frighten them. Things must be really bad if The Parent gives me toys or lets me eat candy.

Lend a hand to other people. It will help to know that you have the power to help and comfort.

The traumatic symptoms may last quite a while. Triggers like parents going out at night or a security guard at a local festival may bring everything back. Fear of it happening again may linger. An anniversary will renew their anxiety.

If time passes and stress is affecting their lives, think about having them see a counselor or getting them into a peer group with similar concerns. We all need a little help sometimes.

My mom also used to say, “Time heals all wounds.” And with a little help from their guardians it always will.

Top 10 Tips for Successful Summer Vacations

little cute girl near the pool with a circle for swimming

School’s out! Time for the Family Vacation. So how do you have fun without going insane? I, of course, have a top ten from the Doc:

10. Pack a simple medicine kit: don’t waste a day of vacation at my office, refilling the prescription you forgot at home. Take:

  • any prescription meds your child sometimes needs, even if they haven’t used them in a while (asthma and allergy meds come to mind)
  • frequently used over-the-counter stuff: acetaminophen or ibuprofen, an antihistamine, insect repellant with DEET (the other stuff really doesn’t work, and insect borne encephalitis is unpleasant), sunscreen, and hand sanitizer
  • basic first aid supplies (band aids, gauze pads, tape, antibiotic ointment, cortisone cream, alcohol, tweezers, scissors, thermometer)

9.  Write out a budget before you go. I know, I am a fun sucker, but it has to be done. Know how much money you have and where you plan to spend it. Give the kids an allowance for souvenirs. They will be more careful with money they consider their own, and they will not be constantly asking for things. “Can I have that?” can be answered with “Sure, it’s your money. But are you positive that is where you want to spend it? There might be something better later…” Also, knowing how much you yourself have to spend will save you stress and regret later.

8.  Keep to healthy foods most of the time. (Here I go, sucking out the fun again!) Kids will have more energy, feel better and have a better attitude if they are nourished. And it’s cheaper. Have a basket of fruit available, some whole grain crackers, cheese, peanut butter, popcorn – food with nutrients. Don’t waste valuable vacation time sitting in the drive thru line and arguing over food.

7.  Keep to established routines when you can. Bring along a book for that bedtime story, keep bed time the same, set aside time for their bath. Kids don’t always deal well with change, and vacations are all about change. A few familiar routines will help them feel less stressed. And a full night’s sleep is an absolute necessity if you don’t want an emotional wreck for a kid.

6.  Keep an eye on the little ones. You are in a different environment with new dangers. Distractions abound. Kids on vacation get lost, or get into Grandma’s meds or the local pool. Check out my summer safety tips.

5.  Find interesting things to keep their brains busy. Bored kids whine, and then they find their own version of interesting things. Have a stock of books, games and videos for the car. Bring a journal for them to write in, and art supplies. Explore the area you travel to – Google it before you go. See the sights, hit the museums, find the local artists and craftsmen. Check out ideas to abolish summer boredom.

4.  Keep your own mind open to new and different ways of doing things, so that your kids will do the same. Kids internalize their parent’s judgments, and they will close down their minds and wipe possibilities out of their lives if that is the example you set.

3.  Keep them physically active as well. A tired kid is less stressed, sleeps better, and is not sitting around thinking of ways to get into trouble.

2.  Keep stress to a minimum. Use a GPS if you’re driving: arguments with the navigator have ruined many a vacation. Keep your expectations in line with the actual possibilities, to avoid disapointment. Don’t overschedule – leave time for that relaxing hike and to have a conversation over dinner. Stay within your budget – your hindbrain will know you are overspending and your stress will mount. Stressed out people snap at each other and cannot enjoy time or family.

1.  Align your vacation with your priorities, then toss out the rest. What are the goals of this vacation? Relaxation, family time, memories, enrichment, joy? Plan the vacation and activities that will get you there, and don’t let exhaustion, stress, and fear get in your way. Don’t stop at Uncle Joe’s house if you know he will stress you out; don’t vacation with those friends who overspend or forget to pay their half of the bill. Don’t worry if the kids are getting dirty or if your Aunt Judy wouldn’t approve. Just say no, open up, and relax.

And have a fantastic vacation!

Why Did My Kid React to That Food?

Little chief-cook tasting the carrotKids can have reactions to food for many different reasons. They can be allergic, sensitive, intolerant, or have problems because the food contains poisons or has drug effects.

Food allergies are caused by a child’s immune system reacting to a food, similar to the way they can react to pollen or bug bites. Allergic reactions are usually to the protein in the food rather than the sugar or fat, and are usually immediate. The most common severe reactions are to tree nuts, peanuts, and shellfish. Less severe reactions are most common with cow’s milk, eggs, soy, wheat, and fish.

Celiac disease is in this category. People with celiac are allergic to the gluten protein in wheat and react with their immune system if they are exposed to even a tiny amount. Gluten allergy was worth a whole blog all by itself: A Gluten Free Blog.

80-90% of the time, kids will outgrow allergies to eggs, wheat, milk, and soy by 5 years of age. They outgrow peanut allergies only 20% of the time. (Do NOT experiment with this!) Fewer will outgrow allergies to tree nuts and seafood.

Symptoms of an allergic reaction include:

  • Skin rashes. Hives, or whelps–itchy raised patches with pale centers and red rims. Hives move around, fading in one area to reappear in another. Antihistamines like Benadryl (diphenhydramine) help the symptoms.
  • Breathing problems. Food reactions can make kids wheeze, make their throats feel tight, and give them sneezing fits.
  • Gastrointestinal symptoms like nausea, vomiting, and  diarrhea.
  • Circulatory symptoms like paleness, lightheadedness, and loss of consciousness.
  • Severe reactions can involve several of these areas, and are called anaphylaxis.

Food sensitivities and intolerances are not allergies. Some children can be sensitive to the common effects of a food and react strongly. For example:

  • Apples, pears and bananas contain pectin and can be constipating (useful if your child has diarrhea). Some children can get stopped up if they eat too many.
  • Dairy products can also constipate–some kids will never poop again if they eat a lot of cheese. (This may be a slight exaggeration.)
  • Sugar can cause diarrhea, so children may have problems if they drink a lot of juice. (Interestingly, we have never been able to prove that sugar makes kids hyper.)
  • Kids can react to dyes and preservatives in foods–they will feel nauseated or tired, and we have proven that red dye can make them hyper.
  • Lactose intolerance is an reaction to the sugar in milk. People who are lactose intolerant are missing the enzyme (lactase) that breaks down the sugar in milk (lactose). They get bloating, gas, and diarrhea.

There are certainly plants that contain toxins (poisons) in themselves–poisonous mushrooms, apple seeds, and belladonna are examples–but most poisonings are accidental, usually from foods that have spoiled:

  • C. Botulinium bacteria grows in improperly canned food and in cans that have rusted through.When we used to give Karo syrup for constipation, the bacteria would grow in Karo left on a cupboard shelf and children would die, paralyzed by the neurotoxin (nerve poison) that the bacteria produced.
  • Staph Aureus can grow in spoiled food and produce a toxin that is usually self limited in its effect, giving kids cramping, diarrhea, and vomiting.
  • Clostridium perfringens produces a similar toxin, and is frequently the villain in cafeteria incidents and contaminations in soil and sewage.
  • Salmonella can grow in spoiled meat, eggs, and milk and give your child diarrhea, vomiting and fever.
  • E. coli is more likely to grow in beef, but can be found in mishandled produce. Same unpleasant symptoms.
  • Shigella is common in daycare outbreaks. It causes the same nausea, vomiting, diarrhea, and fever, but has the added risk of seizures from the toxin it produces.

Foods can also have drug effects. The best examples of this are drinks (coffee, tea, energy drinks) and food (chocolate) that contain caffeine. Caffeine makes kids restless, shaky, and interferes with their sleep. In large doses, as with energy drinks, it can produce a rapid heartbeat, muscle tremors and seizures. There were 20,783 emergency room visits from energy drinks in 2011; 5 people died after consuming them. The youngest was a 14 year old girl.

Foods can also be irritants. For example, babies can get rashes around their mouths or diaper rashes from acidic foods.

People do not react to a food solely because it is a GMO (genetically modified organism)–GMOs are not something you need to avoid unless you have a reaction to the particular item. GMO wheat produces the same allergens as non-GMO wheat; if you are allergic to one, you will be allergic to the other. Also the subject of an entire blog: What’s the Deal with GMOs?

In conclusion, not every food reaction is a food allergy. Avoidance or treatment of the food reaction varies with the actual cause. If a child has an anaphylactic allergic reaction to peanuts, he or she never needs to be around peanuts again. They may outgrow other allergies. If they get gassy from a lactose intolerance, they can take lactase tablets when they eat dairy. Kids who become constipated with apples or cheese need to limit the number they eat. It is always important for every child to not be fed spoiled food or energy drinks.

Knowing in what way your child reacted to a food determines what you do about it in the future. Knowledge rules.

Domesticated Momster
Rhyming with Wine
Rhyming with Wine