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How to Nurture Self-confidence in Your Child

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skateboarder-01In the last several weeks I have seen a mother trying to make her daughter look prettier (she was beautiful without the make-up), a father pushing a son better built for track into football, and a parent making fun of a son’s drawings.

These parents might someday wonder why their children did not have the self-confidence to achieve more in life.

Let’s not do that.

So… top ten ways to nurture a confident child

  1. The most important single factor in building a child’s self esteem is unconditional love from their parents. Children need to be certain that no matter what dumb thing they do, or how badly they fail, you will love them. You may not always like what they’ve done, but you will always have their back. They will have the courage to try, when they are sure you will catch them if they fall.
  2. Give your child a chance at success by laying out clear expectations; they need to know what success is in order to achieve it. Nothing will destroy self-confidence more quickly than trying to shoot at a moving target. What do you hope to see in your child: honesty? hard work? creativity? Be consistent. If you want them to be honest, then you need to be stringently honest in your own life, and require it of them in every part of theirs. No telling your child not to lie, then suggesting a fib about their schoolwork! Expect hard work? Work alongside them, and let them know how much you appreciate their labor.  Exhibit, and reward, the behavior you want to see.
  3. Make your expectations something at which your individual child can succeed. Any child can give their best, work hard, be true to themselves, and be honest. Not every child can be a football star, brilliant musician, or great artist. If your expectation is that your child try new things and do his or her best, then they can succeed at putting paint on canvas, and they will feel pride in their accomplishment.
  4. Find activities in which your child will thrive. You may have to try a few new things; break out the ballet classes and art lessons. Learn to throw a ball. Read books, tour a museum, travel… Explore the world in which your child will live his or her life. Nothing will build self-esteem like success, so seek out and encourage activities they love or for which they have a talent.
  5. Be interested in what inspires them. It’s impossible not to be: you are interested in their hair color and their height, how could you not be interested in their minds and talents? In the end, if mom or dad is interested, they will know that their accomplishments – and they themselves – have value.
  6. Allow time for free play and creative activity. Children do amazing things when they are allowed access to their own imaginations. Freedom will allow them to get in touch with their innate abilities, so that they can discover their best future. Self-confidence thrives when we do work at which we excel.
  7. Examine your own mind. Any left over preconceptions that might injure your child? Your small human is new. He or she embodies a combination of mind, talent, and ability that has never existed before. If you think science is the most important subject, but gave birth to a poet, you need to make sure that small poet doesn’t get the idea that you would have been happier if he or she could grasp algebra.
  8. Expect them to fail: the only people who do not fail are those who do not try. Show them with your own behavior that failure is a learning opportunity, so they will not think that they have less worth when they, in turn, fail. Let them watch you try new things. When you fail, make sure they see you accept that failure and learn from it, so that you can succeed next time. When they fail, tell them it was great that they tried, and redirect them to what they can do differently next time, so that they will get better. No defeatist talk, for the entire duration of their childhood!
  9. Spend time with friends with like interests, and friends who are completely different. Friends who value the same things your child does will reinforce his or her worth; friends who are very different will teach your child that every person has equal grace, whether their talents lie in building an app, a home, or a business.
  10. Be true and honest. Your children know you, and will know when you are not being real. Children do amazing things every day: there is no need for fake, meaningless praise. You love this child, therefore you love and will value the things that he or she is good at, even if you never thought you would before you became a parent. True praise builds healthy self-confidence.

While you’re at it, work on your own confidence. The world has probably battered it a bit. Children will always follow our example. If that example is self-confidence, courage, and honesty, how far might they go?

What To Do When the Screen Goes Off

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girl with plantMedia addiction in children and the importance of limiting their screen time is a big topic in pediatrics this week.

The American Academy of Pediatrics has always recommended no more than two hours of screen time per day for children over 2 (none for those under 2), and they have lots of data to back that up. Adding to this was a recent study suggesting that toddlers who watched more TV than average were more likely to be bullied later in life: reported bullying went up 11% for each additional hour of TV viewing, over the average of 1 1/2 hours. Scary.

Time spent watching TV is not spent developing social and verbal skills, and not spent using and exercising young bodies.

Children sitting in front of a screen develop a disabling habit of being more passive in their interactions with others.

They put on weight because while they are sitting, with their metabolic rate near what it is when they sleep, they are frequently munching on snack food.

They are more likely to have attention problems because TV teaches them to experience the world in 5 minute pieces.

Last, their perceptions are significantly skewed because they take the behavior of characters and people on TV as normal. Which they are not.

It seems reasonable that since I am one of those pediatricians constantly nagging people to turn off their screens, I have a responsibility to come up with some activities they can do instead. All those hours to fill, and all those useful skills to learn!

Our children need the abilities that excessive TV viewing destroys: social knowledge and the ability to interact with actual humans, verbal skills, an attention span adequate to complete a project, and physical exercise. Let’s throw in knowledge of the real world too, just to be complete.

So, ten things to do after you turn off the TV:

  1. Read a book. I know, it’s obvious, but that doesn’t make it any less important. The most rapid development in the brain’s language and learning centers occurs between 6 months and 3 years of age; we need to take advantage. Just 15 minutes of being read to each day between 6 months and 5 years adds up to 500 hours of reading before they even enter kindergarden, boosting development in these areas. Daily reading in older kids improves their comprehension and speed, in addition to adding to their store of knowledge. Hit that library!
  2. Experiment with science. My all time favorite science site is at Roots of Action. They have experiments in all kinds of science, organized by children’s age and type of science, from astronomy to zoology. There is enough there to keep your kids busy all summer long.
  3. Be creative. Break out the crayons or paints and draw. Make music. Write a story. Perform a theatrical: what kid doesn’t love performing in front of their most supportive audience? Creation exercises and stimulates the brain, making it more imaginative and receptive to new ideas.
  4. Garden. Not only does your munchkin get to play in water, dig in dirt and make a mess, but he or she will also have the pleasure of seeing their plants grow and flower. There is self confidence to be grown along with those beans for diner, and those flowers for the kitchen table. Also, they learn a little responsibility along the way, because they won’t want their precious plants to wither and wilt.
  5. Have a cooking class. Again, you get pride of accomplishment (they peeled those carrots!). They will eat better, because they won’t want their own hard work to go to waste, and they will learn an undeniably necessary skill.
  6. Make a chore list. Exercise, a sense of accomplishment, and lessons on responsibility all wrapped up in one. Give an allowance for completed chores and you can have financial lessons as well.
  7. Play a sport. With them please and have fun, so you have family time and everybody gets some exercise.
  8. Learn a new skill. Summer is the traditional time for classes and camps. Learn to draw, play an instrument, ride a horse… Anything your child has shown an interest in, someone is out there teaching, if you cannot teach it yourself
  9. Volunteer. Aiding others in need will help them appreciate what they have, and will feed their souls. The right sort of volunteer activity can also teach useful skills: Literacy promotion (reading), working with the elderly (communication, patience),  hospital work (medical knowledge), food banks and kitchens (cooking and nutrition), and Habitat (building and repair) are all enriching.
  10. After all this activity, take a backyard vacation. Put out the blow up pool and some beach towels, and drink things with tiny umbrellas. Have a trail hike through the neighborhood with a campout at the end. Have a day in Paris, with a home made Eiffel Tower and a French dictionary. Go to a Broadway show produced by your favorite tiny actors. Backyard vacations are limited only by your imagination, never your wallet.

Who has time for a screen? There is just too much to do! Turn that box off and put away that phone!

Your Daughter’s Vagina

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marilynThis week my amazing daughter handed my son-in-law a daughter. This brand new person has lots of silky dark hair, deep blue eyes and 2 dimples. She is a 7# 8oz miracle.

In the last few days my son-in-law has heard endless versions of “You’re in deep trouble, man,” “You’ll need a shotgun,” and “The boys will be after her!” My son-in-law is a deep thinker, so he gave it some deep thought and said, “Why?”

Assuming we want our daughters to have joy in life, fulfillment in their chosen work, family, and love: why then do we not want them to have sex? It seems an essential part of the picture.

When we actually consider why we feel this way, it comes down to the unfortunate fact that we equate a woman’s value with her sexual appeal, but devalue women when they actually have sex. No sex? Virginity and a pedestal. Sex with one man? Mother and Madonna. Sex with more? We have a direct line of descent into whoredom, where your daughter can be given a monetary value.

Then we confuse this scale by judging a woman’s value by how sexy she is. I once heard a med student say about the best kid cancer doc I knew, “What else could she do? She’s damned homely.” We want our daughters to be sexy, but not to have sex.

The valuation for men is perhaps equally harsh, but diametrically opposed. Virginity brings snickers and derision. Faithfulness to one women is sometimes thought to be gullible and foolish. Sex with many women is part of the admirable macho stereotype: men have conquests and “sew their wild oats,” admire James Bond, Casanova and Don Juan, and slap each other on the back as they carve notches into their belts or acquire trophy wives.

Math works, and these numbers do not add up.

There are of course other problems with these assumptions: not only are we devaluing our daughters, we are also making life difficult for our sons. We want our boys to have self respect, good long term relationships with their partners and the maturity to hang around to see their children grow up. Herpes, AIDs, and serial shallow relationships devoid of respect will not bring them this future.

So what is the solution?

We need to give our own values serious consideration, and then evenhandedly teach those values to both our sons and our daughters. We cannot tell our boys that it is OK to get a girl drunk so that she will have sex with them, and then tell our daughters that if they drink too much and have sex they are whores. We cannot tell our boys they are not manly if they choose to wait for love, and our girls that they must wait, or they are trash. It does not work to dress our seven year old daughters in spangles and teach them to hip thrust to sexy music, but then insist they remain innocent.

We need a coherent, honorable, human plan. Consider the future you want for your child, give thought to how sex fits into that future, be fair, be stringently honest, and build rules consistent with that future.

Some simple rules might be: we don’t want you to have sex until you are fully mature; we want you to be in a relationship built on love and mutual respect when you do; we want you to be safe and responsible.

Follow your own rules. Start when your babies are brand new, behave honorably, and be consistent throughout their childhoods. “Do as I say, not as I do” has never and will never work, because in the end your children will know you very well indeed.

  • Watch what you say, both to your own partner and about the other people in your life, because words and judgments will worm their way into your child’s mind and later poke holes in his or her self worth.
  • Keep conversation open, so that when they hear something at school or at a friend’s house they know they can ask you about it. They need to be able to come to you when they have questions. Give them knowledge so that they will be able to make good decisions.
  • Monitor what they see on the internet and on TV. Much of what is on screens these days will need explanation.
  • They will probably make mistakes. When they do, it is perfectly all right to discipline them, because they did break your rules (aren’t you glad you made those rules beforehand, and made sure he or she understood them?) Do not, however, add judgment to the mix. Give them time and space to think and consider the consequences of their actions. Allow them the chance to do better next time. Everyone makes mistakes, and it is hard enough to forgive yourself and go on, without the ones you love adding to the weight of regret in your heart.
  • Never throw labels at them, because labels will leach onto their brains forever. They will never forget that their parent, who should love them no matter what, called them trash, or a slut. They might even feel that they have to live up to the label.
  • Sex is a powerful weapon. If handled well it can bring joy, deepen a loving relationship, and create life. A parent’s example provides the model, good or bad, for their child to follow; thoughtless words from that same parent’s mouth can echo in their brains and make them bleed.
  • Society’s views, as seen in your neighborhood or church, and on the screen in everything from commercials to movies to music, have an impact.
  • How we think about sex, our behavior, and the inner judgments of our own actions effect everything from our relationships to our health, our self esteem to our future.

Sex can be a natural part of a fulfilled life, or it can injure your child’s mind, body and soul, up to the point of self-injury, depression, and death. It is important. It is deserving of respect and careful consideration, and an absolutely equal and consistent application of those conclusions to the parenting of both our sons and our daughters.

My son-in-law is brilliant, you know, and he was right.

Top Ten Summer Activities to Abolish Boredom

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2013-09-06 13.00.12A short gap-toothed person looked at me today, smiled, and said, “…only fourteen more days of school!”

Summer is on its way!

No need to run screaming to hide in a closet. Below are my top ten ideas to fill those sunny days with things that will engage their brains and bodies:

  1. Exercise. They have been cooped up all winter. Throw them outside with a ball, bike or roller skates.
  2. Be creative. All those regimented classes, begone! Break out the finger-paints, colored pencils, and charcoal and let them draw anything they want. Find some sticks and build a fort. Act out a drama. The world is their canvas! I mean that literally: they can draw on bark, rocks, the sidewalk…
  3. Listen to music, and make your own. Break out the kitchen utensils if you don’t have instruments. Write your own songs and play them on pots and pans. This is a two-fer, because you will also build reading skills as you play with the words. Listen to music from other cultures and styles and you will painlessly add on lessons in history and anthroology.
  4. Explore. Hit the museum, the library, and the internet, where the world awaits. If nothing comes to mind, ask them what they find interesting and start with that.
  5. Volunteer. Not only is a great way to spend their time, it also fosters an appreciation for what they already have.
  6. Do chores. Chores bind a family together, allow for pride of accomplishment, teach responsibility, and provide a source of money so you can…
  7. Teach financial lessons. What better way than with summer money? Decide before they have it in their grubby paws what they want to save for and how much of their earnings will go into savings. Then watch the pile grow. This works even better if you can match their savings for a little extra inspiration.
  8. Learn a new skill. Make sure it is something they want to learn, of course. Summer is the traditional time for classes, camps, and music lessons. Have a “we’re only speaking spanish” hour, learn to swim, make a tile mosaic – the options are endless.
  9. Introduce yourselves to strangers, especially those who look different than your usual friends. Compliment what they are wearing, ask about what they are doing – be interested and start a conversation. Seeing the world from another person’s point of view can up possibilities for your child.
  10. Get a modern sort of pen pal. These days it’s as easy as getting a twitter account, search #WhatYourChildFindsInteresting and see who pops up. Your child might end up with friends from all over the world. Umm, monitor that, OK?

Keep them moving, reading, and doing, so they won’t turn into sloths.

Have they ever seen a sloth? Isn’t it amazing how slowly they move? Let’s go find a video on Google! Or hit the library! Or draw a picture of one, and make up a story! Or do the sloth dance!

School will start back in no time.

What Happens When It’s Homework Time?

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CinemaUsher-01There are more than 2000 school days in your child’s life, most of which will end with homework. Over time that means you need to inspire your children to do about 4000 hours of schoolwork at home, when video games are calling their names. Yipes.

How can you get that mountain of homework done with less argument and frustration? There are tricks.

The first trick is to establish the habit of homework long before they actually have any. When they are little, assign time in the evening when the TV is turned off, activities are done, and you as a family can sit and read, build things, or play games that involve a little brain work. Do this during the two hours before bed and the kids will also sleep better. A win-win!

Why do we need homework?

Consider the goal of homework: what do we want our child to gain from doing it? Of course, we want them to learn the material. More importantly, we want them to learn how to learn, and to love doing it. We want to furnish them with skills that will prove useful in real life. If homework can teach your children to examine facts, explore knowledge, organize and take personal responsibility for their work, and manage their time efficiently – what might he or she accomplish in life? These are the very skills that form a foundation for success.

Where?

Choose a place. There is no “right” place. If your child does better in a quiet environment, a desk in his room would work well. If he or she needs a little supervision, the kitchen table might work better. Wherever you choose, turn off the TV, videogame, and cell phone (quiet music is usually fine, and sometimes can even help children concentrate). Make sure they are comfortable and the lighting is good. Have the supplies they need – pencils, paper, calendar, dictionary? – nearby. Get rid of any distractions.

When?

Pick a time. Again, there is no “right” time. Some kids will do better right after school; some will need to blow off steam and may do better after dinner. Choose the time that works best for your individual children, involving them in the decision. Then make this schedule a routine, because children’s brains accommodate habits well. People don’t argue over something they have done every day for years; they argue endlessly over change and unpredictability.

Give your children a warning a few minutes before their free time is ending, so they can finish whatever they are doing before your drag them away.

Keep your expectations appropriate for your child’s age. As a general rule of thumb a child should have about 10 minutes of homework per grade level. Children in elementary school will need help organizing their work and staying on task; teenagers should be able to do their work without supervision. Somewhere in middle school they learn to take responsibility. Hopefully.

Start the hardest subjects first; position assignments which require memorization (spelling, math?) early and repeat after breaks.

Since you as parents won’t always be around to supervise, let your teenager fail in high school when they make poor choices. Summer school is cheaper and immensely less life altering than flunking out of college; repeating algebra is torture, but less traumatic than loosing a job. To paraphrase: give a child an organized notebook, and he will pass one test; teach him how to organize and he will have a skill for all of his life (sorry, couldn’t help myself).

Expect problems; they give you a subject of conversation to share with your child! Approach problems with diplomacy and respect for the person who is your child. Label the problem: “You get distracted by your cell phone.” Don’t label your child: never “You’re lazy.” Be wiling to compromise with your child to solve the problem. “If you will turn off the cell phone while you do your work, you can have 5 minute breaks between subjects to catch up, call and text.” Agree to the compromise; it is a contract with your progeny. If you need to, write it down and both of you sign it.

Rewrite this contract when the first one flops, until you find an arrangement that enables your child to learn and you to not run screaming from the room.

Allow the child’s input as much as possible. Let him decorate his workspace up to the point where he puts in distractions. Let her decide subject order, as long as it works. Let them choose their break activity, up to a time limit.

Reward success.

We as humans are hard wired to respond better to rewards than to punishment. How long would you go to work if you did not get a paycheck?

Sadly, it is not realistic to expect a better grade to be your child’s only reward. That grade is too far into the distant misty future, over a mountain of hard labor.

Rewards work best if they are small, and given for small increments of good behavior. A hug, a smile and pride in their accomplishment is all they need when they are small. When they are a little bigger, take time to read a book together or play a game. Keep rewards simple, small, and frequent.

Older children also need small, frequent rewards, though probably not as simple. They always have items that they want, but don’t need; these items make great rewards. Study time, completed homework and test grades can all earn them points toward a goal. There is no need for an argument when he or she doesn’t do their work before picking up the phone; they just won’t get that essential point.

They win, because even if they don’t get that A in History, they retain the points toward that skateboard or new game. And Science is coming!

Homework is training for life. Choose the place and time, working with your child to fit it to your family routines, your child’s personality, and his or her age. Endeavor to teach self-discipline, time management and responsibility equally with reading, writing, and arithmetic. Reward success. Keep in mind that the goal is not to learn how to spell that list of words, but rather to inspire a love of learning which will propel your child to succeed, now and into the future.

Growing Brains: Reading as the Anti-Zombie

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ROARlogo2-01In The Dead Poets Society, Robin Williams said, “No matter what anybody tells you, words and ideas can change the world.” They can, in particular, change your child’s world.

I am a book pusher. In my office we force free books on babies and children at every visit, compliments of the Reach out and Read program. They generally would prefer lollypops, but they put up with it.

With each book they get nagged about reading. We do this because a child’s brain develops most rapidly between 6 months and 3 years, and reading aloud stimulates the parts of the brain in which language skills reside. This is an opportunity we cannot afford to miss.

The problem is that only 48% of families read to their children every day; 1 in 6 read to their children only 3 days a week. One third of children enter kindergarten lacking basic language skills. These kids are typically 12-14 months behind; 88% will never catch up. These kids start the uphill journey of life at a tremendous disadvantage.

The solution is reading aloud. Reading aloud is the single most important thing a parent can do to prepare their child for school and beyond. Reading aloud develops literacy skills, including:

  • Vocabulary. The number of words with which children enter kindergarten directly predicts their later success.
  • Phonics. There is no other way to learn how words sound than by hearing them spoken.
  • Familiarity with the printed word. Opening a book should feel comfortable, warm, and welcoming, not intimidating.
  • Storytelling ability. There is no better way to stimulate your child’s imagination than allowing them to create their own story.
  • Comprehension. Children learn the actual meaning of the words by hearing them used.

Knowledge is power, and it is waiting to be gathered from the words in books. Love of reading is also waiting in those words, needing only to be nurtured by time shared reading. That love will become a mighty tool and support throughout their lives.

There are tricks to doing it better:

  • Ask questions. The traditional questions are what-when-why-where-how? What is the creature in that tree? Why is Clifford so big? Where did that mouse go? Get involved in the book.
  • Describe the book. Talk about the pictures: That dog is bigger than the house! Look how tall that beanstalk grew! Count objects, if there are several: One-two-three apples! Notice the actual letters: Look, there is an “N” – that’s the first letter in your name! Notice and point out colors and shapes.
  • Use funny voices: nothing will entertain your child like you sounding like a duck.
  • Emphasize rhymes; sing the words when you can. Kids love to imitate crazy words. Generations of people can say “supercalifragilisticexpialidocious’. What were the chances?  Is your Mama a Llama? There is a reason “One, two, buckle my shoe” is around long after the demise of shoe buckles. It rhymes, and you can sing it.
  • Relate the book to your own life. If you read “Clifford and the big storm,” talk about that storm you had last week.
  • Have fun. Your munchkin will see your happiness, and their joy in reading will grow.
  • Reward reading. Kids will do what they are rewarded for doing. If reading brings with it hugs, smiles, and time with mom or dad, they will want to do it again.

Bring reading into the rest of your life. Notice signs beside the road; mention the movie marque for the show they want to see. Visit libraries, museums, and parks and talk about what you see. Listen to music, and talk about the lyrics. When your child shows you the picture he or she drew, invite them to tell you a story about it. Where is that dinosaur going? Is he all alone? Show them how you use words through the day, writing your lists, or paying your bills.

Talk about the words themselves:

  • Some words can sound the same, but have totally different meanings. You can bake cookies with flour, or pick a flower off a bush; Grandma’s hip might creak, but it’s not the same as the creek you fish in.
  • Different words can mean the same thing. That flower can also be called a blossom, if you are in the mood.
  • The exact same word can have very different meanings. A dog’s bark is very different than the bark on a tree, as a computer mouse is different than a live one.
  • Words can end the same, and rhyme! That mama llama is an enduring favorite.

Make reading a habit. Children’s brains are designed to form habits. Habits and routine are security to them; use this to your advantage. A habit of snuggling up to read every night before bed will make bedtime a much more enjoyable experience. Happy children sleep better. If you make a habit of reading to your child for 15 minutes each day, by the time they enter kindergarten you will have read to them for a whopping 500 hours. No wonder it makes such a difference!

Parents are a child’s first and best teachers. They are the most important people in their child’s universe. If a parent thinks that reading matters, then it does matter. If they think that reading is enjoyable, then it is.

With a routine of reading, a child will enter kindergarten with a larger vocabulary, a habit of reading and learning, and a habit of being interested. They will know that interest is always rewarded. They will be ready to excel.

Reading can open up the world for children. Anything they find interesting, they can explore. They can discover things they otherwise might never have known existed. They can search for the answer to any question, and be inspired to ask new ones of their own.

Reading lights up the dark corners of prejudice and bigotry, and will help your child become a better person. With reading, he or she can find their own magic, unlimited by their immediate surroundings. To paraphrase Robin Williams in Dead Poets: “… the powerful play goes on, and your child may contribute a verse. What will their verse be?”

Trendy Poisons for your Kids

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tidepod-01Kids always seem to find new and interesting ways to hurt themselves, intentionally or accidentally. Poisoning is the #1 or #2 cause of injury death annually, fighting for that honor with car accidents. The annual numbers on poisonings are out (thank you, Annals of Emergency Medicine). The new winners are opioids, laundry detergent packets, bath salts, synthetic cannabinoids, and energy drinks.

Opioids are the traditional first place winner for deadly poisonings, and they are in that spot again this year. 90% of poisoning deaths involve drugs, and opioids are involved almost half the time. Opioids include all of the narcotic painkillers. They are intentionally abused because of the euphoria they induce; they are also accidentally ingested because people keep them laying around the house on countertops and in purses. When taken in high enough doses, the kids who took them forget to breathe; when taken chronically they are addictive.

The new second place finisher is laundry detergent packets. They are a problem because they are more concentrated than traditional laundry detergent, and can cause nausea, vomiting and sedation when taken by mouth, and irritation when put in contact with skin and eyes.

“Bath salts” have been popular since 2010. They are substituted cathinones (stimulants) which cause disorientation, extreme paranoia, and violent behavior. In 2012 there were 994 reported exposures and 16 deaths. They are called bath salts because they resemble Epsom salts, but are also known as plant food, ivory wave, vanilla sky, and bliss.

Synthetic cannabinoids (man made marijuanas) are common now and have an added level of danger above Mother Nature’s version. Kids have anxiety attacks, psychosis (loss of contact with reality), rapid heart rates, and seizures. In 2012 there were 5225 reported exposures and 6 deaths. The kids call this stuff spice, genie, Yucatán fire, or aroma. Drug screens do not pick it up.

Energy drinks are on the upswing, causing about half of the 2.3 million calls to poison control centers in 2012. They cause seizures and heart rhythm abnormalities.

The new kids on the block are the liquid nicotine refills for  e-cigarettes, which come in vials without child resistant closures. One teaspoon is enough to kill a child. Liquid nicotine is unregulated, which means that in 10 states and DC a child can buy it; it can be advertised to children in all but 4 states. In 2014 poison control received 3353 calls for exposure to nicotine products, up from 1543 the prior year. Children can be exposed by inhaling the vapor, by swallowing the liquid, or by absorbing it through their skin. Children experience a racing heartbeat, vomiting, and grunting breaths, before they loose control of the muscles in their upper body and die.

So take a few minutes to clean out your medicine cabinet. Throw out meds you don’t take anymore. Lock up the ones you do take, vapor refills, and laundry detergent packets. Don’t buy energy drinks. Talk to your kids about the risks of  drug use, and learn the language they are using. While you’re at it, lock up the rest of your cleaning products and pesticides as well.

Poison control’s phone number is 1-800-222-1222 in the US; keep it posted on or in every phone. They are excellent in an emergency, and they have more in depth analysis of which age groups are taking what and why on their site, if you are interested.

Be safe. Safe is always better than sorry.