How To Pick Pediatrician

By Parents
August 27, 2009

Please speak for all doctors.

What is the most annoying thing we parents do?

Overreact to the little ills of childhood. American kids are the healthiest humans who have ever lived. But their parents often fear they’re one sniffle away from certain doom. So, please, have confidence that you can handle most of the little throat itches, earaches, goopy eyes, and low fevers your child has. You don’t need me; you just need a little chicken soup and love.

As much as you want a prescription to fix everything, your kid probably doesn’t need antibiotics. For example, 80 percent of ear infections go away without them. It’s a dirty little secret of pediatrics that ear infections pay our bills. Doctors are nice, and sometimes we write prescriptions because we want to feel like we’re doing something to help, even though you’ll be fine without it.

But what about medicine?

What’s another secret?

There’s a syndrome called “Sick enough to see the doctor, but well enough for baseball.” The kid absolutely must see me on Sunday, but just not until after his game. If your child is well enough for school or practice, he’s really not sick enough to see me. On the other hand, if your kid is sick enough to see me, he’s probably sick enough to have an adult stay home with him. I can’t magically make him well enough to get back to school or daycare.

P.S. The people pictured here are all models — we had to swear to protect our sources.

Source: Parents

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

Play, Paint, Think, Create

by Mimi Brodsky Chenfeld
August 18, 2009

Nurture a child’s creative expression to encourage learning and laughter.

The great artist Pablo Picasso always wanted to be able to paint like a child. He understood that children are the most original, unique, free-spirited members of our great family. Before they are taught anything, children see the world with fresh eyes. Their responses are honest and imaginative.

Recently, I took a trip to an apple orchard with a group of 3-year-olds. We celebrated afterward by dancing, making music, and recounting the adventure in story. We grew our bodies into trees, turned our arms into branches, and swayed as the wind blew our leaves. We sprouted apples and picked the fruit off our own limbs. I asked, “What color are your apples?” Without hesitation, the children called out, “My apple is pink!” “Mine is purple!” “Blue!” We had a rainbow of apples! There was no inhibition, no one saying, “This is silly!” or “That’s not right!”

Tap Into the Creative Spirit
We humans learn in a variety of ways. All of them have value. Some, however, are more valued than others. Creative expression could use more acknowledgement a lot more. It’s how children make meaning of the world, whether it’s through song, music, movement, play, painting, story, or poetry. In fact, many children are already singing, dancing, storytelling, and choreographing, before they start school. Why is that? Because we all come into this world with the need to create. It’s in our genes, and the arts are the basic way we express that need.

Our current fixation with standardized testing does a great disservice to our children. Putting labels on our children, ranking them on percentage charts, turns them into soulless commodities. They’re far more complex. They learn in their own ways, at their own speeds.

Creativity is the noble, delicious antidote for this stifling approach. It connects, clarifies, and enriches. But creativity is not a strategy or a technique. It’s not scheduled for Wednesdays after dinner if homework is finished. It’s a way of being and thinking, teaching and parenting.

Our greatest role in protecting the creative spirit within our children is to be open to their originality and questions, join in with their playful thinking, and appreciate their singing, building, and painting. To do that, we need to embody the qualities of the creative spirit that come naturally to our children: enthusiasm, excitement, spontaneity, playfulness, and imagination. But in the midst of our fragmented lives, how do we celebrate and exercise our creative spirit? My four “little nudges” can help. (See below.) Try them with your child. They’ll help you get into the moment alongside her.

Creativity is our birthright. The qualities we associate with creativity are gifts we all receive as we begin our amazing life journeys. Feel free to value it, honor it, and worship it.

Four Little Nudges

These simple tips can help stimulate the creative spirit in you and your child.

Ask, What else? The minute you hear or say the words, “what else?” your mind begins churning and whirling. What else can you add to a party, a trip, a painting, a song? The words help us expand our horizons and remind us that there is always more to discover, to learn, to ask, to wonder about. When a child comes to you with the words, “I’m done!” spark his creative juices with, “What else can you think of?”

Ask, What if? These are the key words of imagination. What if we changed the colors? What if we found buried treasure? What if we could understand the language of animals? The words open a world of possibilities. Listen to young children play, and you’ll hear what if in their imaginative games. Far too soon, this playful invitation often shrivels up in the wake of super-structured, highly programmed activities.

Show the idea! Sometimes, pictures speak louder than words. So demonstrate an idea in pictures, in music, in dance, sculpture, graphs, through an interview, using puppets in any way that communicates. Showing ideas gives validity to different ways of learning and comprehending. Plus, it’s fun and satisfying to experiment with different ways to convey ideas.

Fake it! This nudge is for you if your child expects you to always have the right answer. Don’t know how to do something perfectly? Take a stab at it! Make believe you can do it. Faking it gives you courage. It moves you beyond “I can’t” or “I won’t.” It also invites participation and encourages involvement by granting permission to try something new or different. As role models for our children, we must be brave.

This article originally appeared on scholastic.com. Scholastic Inc.

Source: Grand Parents

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

Know Your Child’s Teacher

By AFT
August 18, 2009

By definition, a teacher is one who teaches.  Ya…so?  Let’s look at what it means to teach.   The dictionary defines the verb teach as:

• To impart, provide or instruct knowledge or skill
• To condition to a certain action or frame of mind
• To cause to learn by example or experience
• To advocate or preach
• To carry on instruction on a regular basis in

That last one, to carry on instruction on a regular basis, is a biggie…on a regular basis. On average teachers will spend 30 hours a week with your elementary age child. In contrast, let’s look at the amount of time you will spend, with your child during an average school week.   Between getting up, dressed, fed and teeth brushed, on average, a parent will spend 10 minutes actually with the child.

Then there’s after school – it’s probably at least 5:00 pm before you really spend time with your child; either due to your schedule or your child’s. (Note:  Seeing your child and spending time with – are not synonymous).   Then maybe you spend some time together preparing and eating dinner.   After school and after work you may have taken junior to practice or the store, or there was more homework.

If your child is like most, a bath or shower is probably needed. After that, perhaps a bedtime snack, a little TV and then it’s time to start the bedtime routine.  It’s safe to say, on average, parents will spend less than eight (8) hours a week interacting with their elementary age child.  Now do you see why it is vital to get to know your kid’s teachers?

Most schools have an Open House prior to the first day of school.  This gives the parent and child a chance to meet the teacher and vice versa.  Make every effort to attend this Open House.  If you have a schedule conflict you cannot rearrange, make an appointment before or after school to meet your child’s teacher.  It may only take a quick 10 minute visit initially, but don’t you want to know who will be imparting, providing and instructing knowledge and skills to your child?

Teachers will almost always provide phone numbers and emails where they can be reached.  Nearly all of them will give you their home number.  Use this contact information!  Many parents think, “Oh I don’t want to bother the teacher by calling him/her.”  Bother?  Staying informed about what is happening with your child thirty hours each week should by no means be considered, “bothering the teacher.”  Parents have a duty to know what is going on!

Source: Apples 4 Teacher

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

Ready for School in Tight Economy

By Apples 4 the Teacher
August 10, 2009

There’s no denying that the economy is having an effect on plans for back-to-school spending.
According to a recent report from the National Retail Federation, the average family is expected to spend 7.7 percent less this year for back-to-school purchases. On average, families with K-12 students will spend $548.72 on merchandise to begin the 2009-2010 school year, compared with spending $594.24 for school year 2008-2009. Overall, this year’s back-to-school spending is estimated to total $17.42 billion.

Here are a few ideas designed to help you get the biggest bang with fewer back-to-school bucks.

Make a Plan

First of all, develop a shopping list and a strategy. What would you like to purchase this year? What do you need to purchase this year? How do the two lists overlap? Is any trimming necessary?

Next—and most importantly—set a budget. Make certain it’s a realistic budget that can include all of the items on your list. Try not to overspend before school starts. There are plenty of unexpected expenses that are likely to crop up in the early months of the new school year.

Where to Shop

Discount stores, office supply superstores, online stores, and other retail outlets offer a variety of ways to stretch your school-bound spending.

According to the National Retail Federation, discount stores will be the preferred spending stop. Drugstores, however, will see a sizeable increase in back-to-school sales with 21.5 percent of families shopping there, an increase of 18 percent from 2008.

Keep an eye out for sales flyers for all of your area stores, especially the larger chain stores. Match the flyers and the prices to your shopping list and budget. Don’t let the flyers create a new—and even bigger—shopping list for you.

Note that some of the office superstores offer in-store specials or free shipping on Internet orders.

Online stores continue to offer new and innovative ways to explore the back-to-school market. Special pricing for lunchboxes, school uniforms, educational software, and electronics are just some of the bargains to be found online.

Lunchboxes.com provides access to what it claims is the largest online selection of new lunch boxes for children and adults. The entire inventory can be accessed by type (metal, plastic, insulated, thermoses, and accessories) or by use (school, work, or play). A Lunchbox Extras section provides access to a Girl Zone, Boy Zone, What’s New, Summertime, and The Lunch Room. The site features a banner proclaiming that the lunchboxes are tested to be lead safe. The lunchbox selections available when this article was written covered a variety of interests—from the U.S. Women’s Soccer Team to Kill Bill, Lord of the Rings, Snoopy, and even Junior Mints. The prices were reasonable; a $6.95 flat rate for U.S. shipping applies.

The best prices on school uniforms can be found in the month of July. This is part of a conscious effort to stem the flood of last-minute uniform shopping that always occurs at the start of a new school year. July is also the best time to find uniforms in hard-to-fit sizes, since these are available in small quantities that tend to sell out first.

The school uniform shop at www.Sears.com is offering many uniform pieces at 40% off while they last. As this article was written, Old Navy—online at Oldnavy.gap.com—was offering free shipping with uniform purchases. Check your favorite web site to see what special offers you may be able to find.

A uniform-focused school may schedule days when students can dress out of uniform. Check with school administrators to find out if any special school clothing such as school logo t-shirts and sweatshirts can be worn. These items may be sold by the school’s P.T.A. or other fundraising organization; school staff members can tell you where they can be purchased. The staffers may even be able to tell you when these items will be on sale.

All is not quiet on the spending front, however. One area of back-to-school spending is slated to see an increase this year—electronics, including computer equipment and other items. This area is expected grow 11 percent over last year, or an average of $167.84 per family.

You can stretch your technology dollars a long way with a stop at online software and hardware retailers that offer special education discounts, such as www.JourneyEd.com and  www.AcademicSuperstore.com. These sites offer substantial discounts to students with the appropriate student identification. When this article was written, deeply discounted products on these sites included Microsoft Office Professional 2007, Adobe Acrobat 9 Professional, a VisTablet Graphics Tablet (12 x 10), and more.
Get Results

You can do more shopping with less money, even for back-to-school purchases. Simply do your research, make your plan, and keep yourself on track.

Source: Apples 4 Teacher

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

Books Rule!

By Billie Elias
August 10, 2009

Despite the onslaught of electronic toys and gadgets that “read” to your child (instead of books and games helping your child learn to read while they’re playing), learning to read will not be going out of fashion anytime soon. With most of America’s school children heading back to school next month, it’s time to dust off the books. Sadly, in our country 33% of all 4th graders cannot read at even a basic level, according to the 2007 National Center for Educational Statistics “Reading Report.”
 

What’s a parent to do?  Plenty!

In a read-aloud entry in  my parenting blog

I reported that the reading experts tell us that reading to your children is so important that even after they know how to read, we should still be reading to them!  Not only is it a cozy way to snuggle up and share precious moments with your child, but you’re sending the message that you value them:  they are important enough for you to break away from whatever adult task you were involved with to devote some time to just them.

It’s never too soon to get baby acclimated to sitting quietly for a few minutes, gradually building up to five or ten. Bedtime is another great time to read, but shouldn’t be the only time. You can start with fabric books or board books, textures that baby’s teething won’t instantly destroy. A couple suggestions for you to add to baby’s first library: Baby Bear’s Bedtime  Ladybug’s Lesson I also previously reported that since babies start learning language from birth, reading aloud exposes them to the sounds of human speech.  By the age of two, children know between 300-500 words. Children who are spoken to and read to frequently, have larger vocabularies and develop into better readers.

I have the fondest memories of a storybook that was read to me as a child.  My mother and father never seemed to tire of reading the same stories and poems over and over again.  The book happened to be an anthology of different writers, but the two-color illustrations that accompanied each story were indelibly written in my brain, along with some of my favorite stories.

I have yet to forget Mr. & Mrs. Apple naming their children after different types of apples (Jonathan, Winesap, Delicious, Baldwin) or of Mr. Apple going to the library to research the names as they added more and more children to their family.  There were Nina and Ted who looked forward each year to their winter vacation at their aunt and uncle’s home in Vermont where they tapped the trees for sap, turned it into maple syrup and ate it on their aunt’s delicious pancakes.  There was also Rosa-too-little, for that’s what they kept calling her until she could finally sign her name to get her very own library card.

These weren’t just stories; they were stories where I was learning something about my world.  Our local libraries have children’s librarians just waiting to help match you and your child with the ideal book, from picture book to non-fiction to chapter book.

For a beginning reader, you might choose an interactive book to encourage a love of reading.  “Ahoy, Pirate Pete” and “Once Upon a Time”  are almost magical, with picture pieces that are stored on each page that you change each time you read the story, creating a new tale with each re-reading.  “Dear Tooth Fairy” is another interactive book with small envelopes containing letters written by the Tooth Fairy to the little girl who refuses to leave her tooth under the pillow. Other early readers may experiment with word sounds like “bat, rat, cat, ratatattat” or “car, cat, cut, cot….bot, not, sot, rot, tot.”  I discuss this at length in banana-fana-fofana.

We know that children can understand books read aloud to them at several grade levels above their own reading level.  This serves to broaden their vocabulary at the same time as they are digesting more complex sentence structure.  A perfect book to read (and work on) together is “Puzzle Island.”  It’s a unique book that involves unscrambling letters to form the names of animals whose pictures are hidden deep within the book’s illustrations.  One important tip to having “quality time” together with your child is doing something that you also enjoy.

Sharon Duke Estroff writes some other suggestions for activities that will inspire kids to read:  help your child choose books appropriate to their reading level if they will be reading without you, bring books with you everywhere you go to reduce boredom, join a parent/child book club, read books of movies your child has seen, read from magazines written on topics of interest to your child, keep books in the car to use during traffic jams, listen to books on tape (and follow along).

 

Editor’s Note: Mrs. Elias, Independent Executive Manager of Discovery Toys contact: billietoy@gmail.com.

You can see some of educational toys at http://www.toysofdiscovery.com/.

You can see her blog at billiediscoverytoys.blogspot.com. Mrs is also follow her her Twitter, www.twitter.com/billietoy

We would like to know what you think? dan@youngchronicle.com

Source: Toys of Discovery

First Breast Feeding

By Michael K. Davis, MD
August  5, 2009

Some new mothers may be surprised that the newborn is prepared to eat within minutes of delivery.  The early breast milk (i.e., colostrum) is ready immediately after birth.  Once the placenta is expelled, progesterone levels in the mother drop, leading to increased breast milk production.  This so called, “let down” of the milk may take up to 5 days.

When should breastfeeding start?

Breastfeeding should begin within the first few hours after birth.  Some experts have shown that there is a benefit to allowing the infant to breast feed moments after birth.  Some potential benefits of breastfeeding in the first hour of life are:

Suckling stimulates release of the hormone oxytocin in the mother.  Oxytocin stimulates breast milk “let down” and also increases uterine contraction.  Contraction of the uterus helps with removal of the placenta and reduces bleeding from the uterus after birth.

• Infants have an intense suckling reflex after birth and this helps initiate the mother-infant bond.
• The early breastmilk (i.e., colostrum) contains important immune protection factors.
• Early breastfeeding stimulates the infants gut to move, which helps the infant pass any swallowed blood.  Digested blood can contribute to jaundice in the infant.
• The risk of breast engorgement is reduced.
• Early stimulation of the breasts encourages breastmilk production more quickly.
• The infant is more alert in the first 2 hours after delivery than later in the first day of life.

Will my baby get enough milk in the first few days before my milk “comes in?”

Newborn infants may lose up to 10% of their body weight in the first week of life.  This mostly occurs due to body water loss.  Newborns are born with extra fluid that helps prevent dehydration during this time.  While this is “natures expected path,” it is important to provide newborn infants with fluids and nutrition as early as possible to prevent excessive weight loss and dehydration.  It is important for newborn infants (especially breastfed infants) to see a pediatrician by 1 or 2 weeks of age to make sure feeding is adequate.

Some tips for breastfeeding in the first week of life.

• Breastfeeding should occur at least every 3 hours (day and night) in the first few weeks of life.
• Allow the infant to completely empty the breast on one side before switching to the other side.
• Avoiding the use of pacifiers in the first few weeks may encourage more effective breastfeeding.
• Do not supplement with baby milk formulas in the first few weeks unless directed by your doctor.
• The baby should urinate within about 8 hours of birth (babies often urinate during delivery or during the first bath).
• The baby should have a wet diaper at least every 4 hours.
• The baby should pass the first stool (i.e., meconium) within the first 24 hours of life.
• The baby should pass stool at least 4 times per day (about every 6 hours or less) in the first few weeks of life.  However, there is a lot of normal variation in the number of stools per day in breastfed infants.
• The baby should wake up and feed vigorously every 3 hours.
• Stools should turn yellow and “seedy” by about day 4 or 5 of life.
• The mother should be able to feel and hear her feeding infant swallow.
• Milk should be visible around the baby’s mouth and often leaks from the opposite breast when milk production is adequate.
• <>A feeding infant should latch onto the breast well without a lot of loud noise from air sucked into the baby’s mouth.

What are some clues that breastfeeding is not adequate?

• The baby should urinate within about 8 hours of birth (babies often urinate during delivery or during the first bath).
• The baby should have a wet diaper at least every 4 hours.
• The baby should pass the first stool (i.e., meconium) within the first 24 hours of life.
• The baby should pass stool at least 4 times per day (about every 6 hours or less) in the first few weeks of life.  However, there is a lot of normal variation in the number of stools per day in breastfed infants.
• The baby should wake up and feed vigorously every 3 hours.
• Stools should turn yellow and “seedy” by about day 4 or 5 of life.
• The mother should be able to feel and hear her feeding infant swallow.
• Milk should be visible around the baby’s mouth and often leaks from the opposite breast when milk production is adequate.
• A feeding infant should latch onto the breast well without a lot of loud noise from air sucked into the baby’s mouth.

Source: Dr Tummy

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

Sign of Sleeping Problems

By: Suzanne Dixon,
M.D., M.P.H.
Augus 6, 2009

Every parent has some degree of trouble getting a child to go to bed and stay in bed. Struggles over sleep are the most common concerns we hear about on the Web site and the ones I’m asked about most frequently in the clinic. Here we look at sleep from the child’s perspective and then explore some sleep problems and solutions for parents.

Routine Is Everything

Children behave the best around any issue when they see a pattern they can rely on. A regular bedtime and a standard routine for settling down for the night help kids understand what’s expected. If the time, the place, or the routine changes all the time, then anxiety, confusion, and room for negotiation may creep in. Although some kids rely on regularity more than others do, all children benefit from a bedtime routine.

A good bedtime routine for just about any young child lasts about 30 minutes. It can include a bath, a snuggle, a story, or a song. If the routine lasts longer than that or becomes too elaborate, kids wind up rather than settle down. But a routine under 30 minutes makes most young kids feel pushed to bed.

If weekend and weekday bedtimes vary by more than an hour, expect trouble on Monday. For best results, try to stick to a single schedule all week. This plan is tough for families who like to sleep in on the weekends, but my experience suggests that having at least one parent get up with the kids on Saturday and Sunday morning will make life go more smoothly overall.

Children should sleep in the same place every night if possible. Switching locations — sleeping in different beds, on the floor, on the couch — makes it difficult for kids to get into a good pattern. If kids are in a joint physical custody situation (which I don’t recommend for young children), do your best to be sure the routine and some of the physical features, such as the pillow or blanket, are the same in each place. Parents in different households need to coordinate bedtime routines so that they are providing pretty much the same structure.

From a child’s perspective, going to sleep is a separation: from parents, from siblings, from toys, from the exciting events of the day, and from whatever is continuing to go on in the household. Why would he readily give all this up — especially when it means going into a dark room where monsters may lie under the bed, ghosts could float outside the window, or snakes might slither under the sheets? No child goes to bed without some struggle and adjustment. And no child sleeps in his own bed by himself without a lot of prompts, learning, and firm rules that don’t change.

Sleep Is Separation

For parents, too, this is a separation. Although most parents say that they are ready to let go of their child at the end of a long day, many really struggle with this. They give their child mixed messages, only partially enforce the routine, and can’t handle the discipline needed to enable their child to sleep on his own. As parents, we have to recognize and deal with our own tough issues about separating and being apart before we can solve any of our children’s concerns.

Many cultures allow young children to always sleep with an adult next to them, and there is no harm in that. In fact, many families swear by the concept of the family bed. However, co-sleeping works only if everybody really agrees to the concept and everyone’s needs for some independence and privacy are met in other ways. Most families in Western societies think that children should sleep in their own bed from infancy onward. Either way, it’s best to discuss this issue openly with your partner. Most parents bring their kids into bed with them sometimes, when the kids are sick, scared, or under pressure. That’s fine, of course, but remember that your child won’t gladly go back to his own bed without clear direction and support from you, his parents.

Head Banging and Body Rocking

Many children will use these rhythmic, repetitive behaviors to settle themselves to sleep at bedtime or during the night to get back to sleep. This is most common in the first year of life and usually disappears before age 2. They hit hard, from a few minutes to half an hour or more, but they are extremely unlikely to hurt themselves. You can’t stop this behavior, but you can make things more quiet and comfortable:

• Move the crib away from the wall.
• Put rubber carpet protectors under the crib’s legs to cut down movement and noise. Put the crib on a thick carpet, too.
• Pad the crib up over the top. Secure the padding very well so it won’t slip and trap your child underneath or serve as a step stool out of the crib. Keep the ties less than six inches.
• Don’t go into your child’s room to check if you know she’s developed this habit. Your presence may reinforce this behavior as an attention-getter rather than a self-comforting habit.

Endless Drinks of Water

The toddler who bounces up like a ball after going to bed needs to be put back to bed with, at most, a single sentence of explanation. No discussions or negotiations, no more time watching TV. Silently put him back in bed, tuck him in, and leave. At first, you may repeat this process a hundred times before he stays put, especially if you’ve been loose about enforcing bedtime guidelines in the past. Be prepared for a struggle to establish this new routine. One drink of water is okay. One trip to the potty is enough.

Getting Into Parents’ Bed

If you really don’t want your child to share your bed, silently put him back into his own bed, a hundred times if necessary, with no talking and no discussion. If you let him climb into your bed in the morning and go back to sleep, he won’t understand what’s different about doing the same thing in the middle of the night. For a child who is stressed by separation or has been co-sleeping with his parents for a long time, I recommend placing a sleeping bag on the floor of your room and giving him rewards for moving closer and closer to his own room. This staged approach helps with the separation, which is hard for everyone.

Nightmares

Nightmares, or bad dreams, are a sign of an active mind putting life’s experiences in order. Although children can have a nightmare any time during the night, as a child gets older, he will dream toward morning, as adults do. We all use dreams and nightmares to handle stress, adjustments, and pressures. Children have the capacity to dream as soon as they learn to talk. Young children usually can’t remember their dreams, even the ones that awaken them. And since dream content isn’t that important, don’t push to get it. If a child is stuck with the same dream over and over for weeks, however, ask a health professional to help figure out the source of stress. Don’t go after the monsters in the closet; just provide simple reassurance. If you take the monsters too seriously, it’s hard for a kid to be sure they aren’t there, under the bed.

Night Terrors

These are abrupt partial awakenings that generally occur before midnight in children ages 2 to 6 years. Children are flushed, sweaty, and unresponsive to comfort. Night terrors are scary to parents because their child looks so wild-eyed and thrashes around. But they don’t mean anything, and a child will have no memory of the event in the morning. He won’t respond to your comfort measures, either. Keep him safe from injury as he moves around his bed and room. He’ll grow out of this. You or your spouse may have had night terrors when you were youngsters, as they run in families.

Dealing With Night Terrors

• Make the environment safe. Remove hazardous or breakable items around your child’s bed. Cover the floor with something soft — a rug or blanket if there isn’t any carpeting.
• Keep the atmosphere calm. Keep the light down, and turn off any radio or TV in the area.
• Don’t try to calm or soothe your child with words or hugs. She won’t respond, and restraining some children will only make it worse. Don’t shake or slap her.
• Wait until your child falls back asleep before you leave the area.
• Avoid overtiredness. Your child may need an earlier bedtime or even a brief afternoon nap.

Sleepwalking and Sleep Talking

Both of these conditions are partial awakenings and run in families, increase in frequency and degree during times of stress and overtiredness, and are more common in boys. Young children particularly may also have these when no special stress is present. Most kids outgrow these conditions by adolescence. Don’t take the nighttime talk too seriously, as the content won’t make much sense. And don’t tease a sleepwalker or talker too much, as self-conscious kids may worry that they are revealing secrets or be reluctant to stay over at another child’s house. Reassure your child that he’s normal and that his sharp mind and lively imagination are just keeping him going at night. He won’t remember a thing in the morning.

Dealing With Sleepwalking

• Clear the floor of all objects, including throw rugs, and remove breakables from the bedroom.
• Install a bell on the bedroom door so you know when your child leaves her room.
• Install gates at stair entrances.
• Move your child off the top bunk, if that’s where she sleeps. Consider a first-floor bedroom if she doesn’t already have one.
• Lock or block off the kitchen or other areas that have hazardous items available.
• Be sure all glass in windows, cabinets, and shower doors is shatterproof.

Source: Pampers

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

Juvenile Rheumatoid Arthritis

By Michael K. Davis, MD
July 31, 2009

Juvenile rheumatoid arthritis (JRA) is a disorder that causes chronic inflammation of the joints in children less than 16 years of age.  The cause of JRA is unknown, however it seems to be related to certain genes that disrupt the immune system, leading to inflammation (especially arthritis). 

Arthritis is defined as swelling or limitation of motion of the joint accompanied by heat, pain, and/or tenderness.  JRA is classified into 7 basic types depending on the number and location of joints involed and the involvement of other body parts.  The treatment of JRA in children involves limiting pain and the development of long-term damage. 

The first treatment for most children with JRA includes non-steroidal anti-inflammatory medicines (NSAID’s) such as ibuprofen.  Some children require treatment with corticosteroids or other medications that regulate or suppress the immune system.  Most children with JRA have symptems that are well-controlled with medications and have limited disability.

 

What is JRA?

Juvenile rheumatoid arthritis (JRA) is a disorder that causes inflammation of the joints that lasts more than 6 weeks.  While children and adults of all ages can develop arthritis, the term “JRA” is reserved for children that develop symptoms before 16 years of age.  Some children may have involvement of one joint (i.e., the knee) while others may have inflammation in several joints.  In some cases, JRA may lead to poor growth, eye inflammation and bone mineral loss.

 

What causes JRA?

The exact cause of JRA is unknown.  There seem to be several genes that make a child more likely to get JRA.  It is possible that a child with abnormal “JRA genes” may develop JRA after an infection or other environmental trigger.

 

Who gets JRA?

Up to 100,000 children in the United States have JRA.  Symptoms must begin before 16 years of age to be considered JRA.

 

 What are the symptoms of JRA?

• Arthritis (swelling, redness, pain, and warmth in a joint).  May affect a single joint or several joints.  The knee is the most common joint affected.  There may be mild or no pain.  Use of the joint may be avoided (i.e., limping) or the range of motion may be decreased.  Arthritis must last more than 6 weeks or more to be considered JRA.  Many viral infections may cause arthritis that looks like JRA, although arthritis due to viruses (i.e., toxic synovitis) lasts less than 6 weeks.
• Morning stiffness
•  Limping 

 

Sometimes present…

• Enthesitis (inflammation at the sites of attachment of ligament, tendon, or fascia to bone)
• Dactylitis (swelling of the fingers or toes)
• Lower back pain
• Nail pitting (small indentations in the finger or toe nails
• Psoriasis (large areas of skin scaling)
• Fever
• Rash
• Fatigue
• Malaise (a general sick feeling)
• Inflammation in or around other organs

 

How is JRA diagnosed?

There is no specific JRA test.  Your history and physical exam are key for the diagnosis.

 

Blood tests

• Erythrocyte sedimentation rate (ESR) – A general marker for inflammation.  Elevated in JRA.
• Hematocrit – Anemia may be present due to the effects of chronic inflammation.
• White blood count, platelets, ferritin – Other blood tests that may indirectly indicate inflammation.
• Anti-nuclear antibody (ANA) – A marker of an auto-immune process.  Often present in JRA.  Also present in some normal people.
• Rheumatoid factor – A marker for JRA.  May indicate a more aggrssive form of JRA.
• X-rays are often normal initially but may show bone damage in chronic or severe arthritis.

Imaging

How is JRA treated?

Different patients respond differently to different medications.  Some options include…

• Non-steroidal anti-inflammatory medicines (NSAID’s) such as ibuprofen or naproxen. 
• Corticosteroids taken as an oral medicine or injected into affected joints.
• Methotrexate is an immunomodulating medication.  Lab values must be monitored closely. 
• Anti-TNF therapy is given intraveneously or intramuscularly.
• Other medications are used to reduce inflammation, modulate or suppress the immune system.

 

A healthy diet with adequate calcium and vitamin D to minimize bone mineral loss.

 

Folate is given when methotrexate is used.

Physical therapy is often required to maintain good joint function and range of motion.

 

What happens with JRA long-term?

The future course of JRA depends on the type of JRA.  Many children with JRA will outgrow the disease.  Some forms of JRA persist into adulthood and some forms of JRA will be life-long.

 

What are the possible complications of JRA?

• Joint and cartilage damage
• Joint stiffness
• Poor growth
• Limb length differences
• Uveitis (a type of eye inflammation that can cause loss of vision if not detected early)
• Pericarditis (inflammation around the heart) in the systemic form of JRA
• Pleuritis (inflammation around the lungs) in the systemic form of JRA

 

Source: Dr. Tummy

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

Preparing Your First for a Sibling

By: Shalom Fisch, Ph.D.
July 27, 2009

 

When people think about relationships among siblings, the first word that often springs to mind is “rivalry.” To be honest, that conception isn’t entirely wrong; siblings can wind up competing for their parents’ attention. But it doesn’t have to be that way—or only that way.

As a parent, you can set the tone for the way your children relate, not only to you, but to each other as well. With a little effort, you can foster relationships that are loving, supportive, and cooperative instead of competitive.

Part of the secret is to start building a positive relationship among your children before problems arise. In fact, you can even start setting the stage before your second child is born!

 How?

 

Here are a few tips to try:

 

• Tell Your Child Before Telling the Neighbors: It’s best for your child to hear the news about a new baby from you, rather than from someone else. Telling your firstborn yourself shows her that you trust and value her, and also gives you control over how the information is framed. So make sure to share the news with your child before you go public. The best bet is probably to time your conversation for shortly before you tell your friends. That way, your child won’t accidentally spill the beans before you’re ready.

 

• Enjoy Your “Big Boy” or “Big Girl”: Even if you weren’t expecting a second child, it still would be important to celebrate all the ways your firstborn is growing. Moving from a bottle to solid food, from diapers to underpants… all of these milestones show your child is growing up. As children grow, it’s important to show them how proud you are that they’re growing into “big boys” or “big girls.” And it can prepare them for seeing themselves as “big brothers” or “big sisters,” too.

  

• Time Your Transitions: Depending on the age difference between your children, you may find that one or more of your firstborn’s milestones roughly coincides with the arrival of your new baby. In some cases, you might want to space your children’s transitions. For example, you may not want to move your older child into a new bedroom and the baby into the “old” room at the same time, so your firstborn doesn’t feel like she’s being replaced. However, other transitions may work well together—see if you can move your firstborn into a “big boy” bed as your baby starts to sleep in a crib. If the timing works out, it’s a great opportunity to show your pride in both children’s growth.

 

• Let Them Help: As you already know, babies require a lot of work and attention, and there are many ways in which a big brother or sister can help. Your firstborn can talk or sing to the baby, help with bottles or when you change diapers, and so on. When you find ways to let your firstborn help, you’re sending him several important messages: that you trust him, that he can take an active role, that part of being a big brother is taking care of a younger sibling, and that you’re all in this together. (As an added bonus, once your firstborn gets the hang of his new responsibilities, it can make your life a little easier, too.)

 

• Reassure Them: One common worry among firstborn children is that a new baby will replace them in your heart. From time to time (both before and after the baby arrives), make sure to tell your firstborn that you’ll always love her just the same. And be sure to show her, too, by making time for the two of you to have fun together and just snuggle.

 

• Set the Tone for Other Adults: Along with reassuring your firstborn, be careful that other well-meaning adults don’t accidentally undermine your efforts. Shortly before my own second child was born, a grown-up friend (who wasn’t an experienced parent) joked to my 3-year-old son, “Oh, the baby’s coming soon. Then you’ll come live with me, right?” But while he knew he was joking, my son didn’t. Seeing the worry on my son’s face, I immediately reassured him that my friend was just being silly—we’d all still be a family together, just like always. Then, I quietly explained to my friend the efforts we were making to prepare my son, to help my friend understand and avoid repeating the error in the future.

 

All of these techniques can be effective, but obviously, you know your firstborn better than anyone else does. So with some thought (and a bit of trial and error), you’ll find the strategies that work best for your family. Whatever methods you use, though, one point remains true: By putting in a little effort now, you can reap a big payoff later on… and your children can, too.

Source: Pampers 

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

Find Good Child Care

By: Erin Brownfield
Families and
Work Institute
July 22, 2009

 

“Stay rested.” That’s wonderful advice for your nine-month journey, but it’s easier said than done for some women. A growing belly, an active baby, and hormonal changes can make it tough to fall asleep and stay there. Here are some common pregnancy sleep disruptions and techniques for dealing with them.

 

Tossing and Turning

One of the most common sleep complaints during pregnancy, especially in the third trimester, is finding a comfortable position to sleep in. Try lying on your side with a pillow between your knees for lower-back support. You can also buy a body pillow, which can be molded along the length of your body, offering support where you need it most. Some women find relief by sleeping in a slightly reclined position with lots of pillows behind and around them.

Frequent Urination

The farther you get into your pregnancy, the more often you will have to urinate, and nighttime probably will be no exception. The need to urinate increases as your growing uterus compresses your bladder. You don’t want to cut back on fluids during the day, but you might try to limit drinking just before bedtime. 

In most cases, frequent urination is just a symptom of being pregnant. But you should be aware that urinary tract infections (UTIs) also have this effect. Frequency isn’t the only symptom of a UTI: You may feel that you must urinate right away (called “urgency”) and feel pain or burning during the process. If you experience symptoms other than frequency, contact your health care provider. He will probably test your urine to see if you have a bacterial infection.

Your Baby’s Activity

Some women are awakened by the baby’s movements during the night. There’s not really anything you can do about this, nor would you want to: A moving baby is usually a healthy baby. When babies stop moving or slow down, we become concerned about their health. So while this may be frustrating for you, it is actually a sign of your little one’s good health! If your baby is keeping you awake at night, you can try to get some sleep during the day. Even a short nap can help you feel refreshed.

Sleep-Easy Tips

Here are some other ways to get a good night’s sleep:

• Cut out all caffeine in your diet.
• Get some exercise each day. Studies show that regular exercise promotes better sleep. Walking is a great choice for pregnant women. For more information on exercising during pregnancy, see Get Moving!.
• Try drinking a glass of warm milk just before bedtime.
• Finally, do not take any over-the-counter medications or herbal preparations to help you sleep. Always check with your doctor before treating a symptom on your own.

Source: Pampers

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

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