Wednesday, July 8, 2015

All health is collective

All health is collective.Every move you make, every food you eat, every substance you put on or in your body has a  collective effect on your health. It is never too early to start planning and implementing measures for good health and wellness. All food that has ever gone in your body has a positive or negative impact on your health. Heart disease starts early and the damage collects in the blood vessels throughout the rest of your body as well. As an example , look at all the recent evidence about concussions and head injuries . It is found to be from repeated injuries and sub clinical damage from youth sports on up, ( not just football) not only one massive concussion .  Our lifestyle affects our health in every way.  Radiation,  sun damage,  drugs, pesticides, bpas,most anything we do or put in our body has a collective effect. We are only recently understanding the cumulative effect of our diet and lifestyle from childhood all the way to adulthood.  Damage begins early in infancy. We used to think kids have time to enjoy their nutritional youth and not worry until middle age. Let teenagers be teenagers. Eat pizza , donuts, hot dogs. Enjoy the happy meal and happy times while we are young and naive, but we now know with certainty that what we eat starting in infancy collects in all of our organs and system impacting health at every stage of our youth, adulthood, and old age. Research has shown damage is done and visually documented by 1 year of age. Clogging of your child's arteries throughout their body starts almost immediately. Yes you can improve this as they grow and make amends at any age, but nothing is completely repairable. Start early , be relentless, make health - from the get go a priority. Not just a food or exercise fad,  but honest to goodness nutritional and movement excellence for your child. They might not thank you ever, but it will make over 80 % of the diseases they will be facing a lot less likely and push some of the most common life altering diseases off until old age. If you want to contribute to the most important part of your child's life, pay attention to their nutritional health. If you want them to be healthy, wealthy, and wise -encourage them to be fit, to exercise, to move , and find what moves them. Everything you put in their body leaves an imprint, leaves a trace, good or bad. Simple math , if it has negative nutritional content ,it will have a negative long lasting and collective impact on your body, your well being, and your health. Poor lifestyle will lead to early disease, and suffering. Is this the legacy you want to leave for your children? Your health and theirs, is at stake with these choices. This is where you make your stand, draw your line in the sand. This is the most important thing you can do for your children. If you leave them one thing, one legacy , leave then a healthy lifestyle.

Saturday, February 23, 2013

Parenting Peeves

“Parenting peeves”

Below are my top five 5 Parenting peeves from my personal collection. I have dozens more but I believe these represent universal frustrations we encounter on an all too frequent basis these days. Please share your stories of parenting woes you have witnessed along with any parenting peeves which have been grating on your nerves. Please include any comments or solutions.

Baby movie 
No matter what the rating of the movie- leave your baby or infant at home. Especially on a Saturday night.
Most movies PG-13 and R are loud, violent with inappropriate content for young children. Even if the child is sitting still I am uncomfortable with a young child in these movies. I find myself repeatedly studying the child to see if they are upset.
-There are a number of studies that show the effect of loud, violent tone on a baby does have a negative impact.
Story- With this particular “ Parenting Peeve” the stories are too numerous to tell. You get to the theater early to get a good comfortable seat the movie is about to start and a family with children enters the theater. You feel like a kid in grade school sliding down in your seat so the teacher does not call on you. But here they come moving up the aisle and sit right next to you with their baby on their lap , of course since there are only 2 seats. These parents try to watch the movie themselves and not be disturbed so they let their children bother everyone else by running back and forth up the aisles and in front of the screen.
Comment: This needs to be the movie theater’s responsibility. The rating should be absolute -not accompanied by an adult -R means no one under 17 and so on. I have heard recently of movie theaters like some malls have age restrictions after certain hours , possibly no babies allowed in movies after 7 PM. Unfortunately it seems as though we have to act as the force of common sense for these parents. And of course we always have the option of creating our own home theater and stay there.

The restaurant as a playground
Parents who think it is fine for their children to act as though they are home when they are out at a restaurant. These families have no sense of disturbing others in a restaurant . I am sure everyone reading this has had the restaurant experience of children running around, screaming, throwing the food; ruining your meal .
Story:I was eating in one of the local popular chain restaurants recently. Everyone was enjoying their meal with their families and respecting the other patrons. But there was one little boy approximately 5 years old running around the restaurant by himself. I surmised his parents were in line getting his food. Finally this child’s dad  sat down across the restaurant from me and brought his son with him. I was relieved to see that this rambunctious little guy would now stop running around and eat his meal giving all of us a reprieve.. But much to my surprise and annoyance to everyone else the father and son began playing catch with a football in between the tables. Not surprisingly the ball landed on my table and knocked my water onto my food and fell to the floor.This dad came over to get the ball, but instead of the anticipated apology,  he commented that he was annoyed at my reluctance to throw the ball back. He was not happy he had to stop playing catch and get the ball himself. I would like to say I kept my thoughts to myself but I never turn down an opportunity to assist with parenting skills.
Comments: It is really up to the managers of the restaurant to have a no football policy . Start early by teaching your children the behavior expected in restaurants and public places and teach respect for others. Start with the expected behavior at home in the kitchen. You cannot expect children to behave in restaurants if they cannot during home meals. Make shorter outings initially. Be prepared to go outside to reinforce the behavior you want to teach. If you have to play football to keep your child’s interest then make a picnic in the park.

DVD/ I Pad movies in a restaurant with the sound on.
I am sure everyone has a story about this Parenting Peeve. You go to a restaurant for a night out from the TV, chores , after a long week . You want to be with your family and relax and have someone else do the work, and not be bothered by all the distractions of home and work. And there they are , people bringing the annoyances of home with them.
Story - pizza and a movie. This happens often, but recently we went to one of our local Italian restaurant a notch above a pizza joint . After we ordered, a family of six sat in the middle of the restaurant at large round table . The first thing they did after ordering was take out a DVD player and put on a children’s movie with the volume on high. After their pizza arrived the children took off running around the table with pizza flying everywhere, screaming while the movie was blasting. The parents and grandmother were blissfully enjoying their slices of pizza, while the restaurant staff essentially were baby sitting their children.  
Comment:The restaurants once again need to be proactive and institute policies if they want to stay in business. We all need to say something  in order to have an impact. Engage your child in educational games and conversation. Particularly in a restaurant. Pizza and a movie is for the home. Bring books, games, crayons and paper.

Leashes for children
OK, this is not what you think. While putting a leash on your child is probably a very contentious and controversial subject this story raises the bar on leash use.
Story: While at Disney World on one of our vacations, my family and I had noticed a mom walking around the park with her child on one of those kiddie leashes.Of course we had seen many children on leashes before whose parents were concerned about their child running off in a crowded place like Disney, but something this mom did made her legendary in the annals of our family parenting peeves. She apparently decided that it was vital to take a photo of her child next to one of the cut out wooden relief characters they have throughout the park.  With all the ingenuity she could muster , she tied her child like a dog, to the character ever so tightly so he could stay in the frame.
Comment:  Please hold your child”s hand.Teaching them public behavior and hand holding takes time and patience. Using a leash is not a short cut to the main lesson of staying near you and holding your hand. When necessary for safety sake and if you have multiple children under the age of six a leash may be useful. Tying them to anything is painful to watch, and what lesson are you teaching them?  

Time out in our favorite restaurant
I am all for consistency in parenting and teaching your children the proper restaurant behavior  But it is challenging to discipline  them in a restaurant, or public place without raising the ire of everyone around you. Common sense says you have to game plan, with a strategy to handle public situations.
Story: My family and I came into one of our favorite restaurants we frequent and could not understand why the manager could not sit us in the front room when the entire room was empty except for one family of four. After being convinced that we would be happier sitting in one of the smaller back rooms we sat down at our table reluctantly. While we were ordering we heard a lot of commotion coming from the direction of the front room. We asked the waiter what that was but he refused to tell us anything. Periodically the noise would stop and start up again for minutes on end. It became clear that there was a child crying and screaming. As we waited for our food more and more patrons were directed to our back room. Finally I got up and went to see what the noise was about. The room was still empty except for one family. Apparently these parents were practicing their book learned time out technique here in the main dining area of our restaurant. They would turn their 2 year old towards the wall when he would not cooperate or eat, and  they would turn back around to the table to give him another chance. This went on and on. Each time they turned the  chair around again facing the wall, he would then start kicking and screaming  at the top of his lungs. I asked the manager why no one would say anything to this family. And he told me that they had but these parents told them this is how they teach their child to behave in a restaurant.
Comment: We all have to express to restaurant owners our displeasure or these type of behaviors will continue. I do believe in using real world experiences to teach your children right from wrong and we should be able to go out as a family. Using the main dining room of a restaurant as a time out venue is not the best idea. Common sense parenting should trump by the numbers advice. Take your child outside or to the car. Have a logical plan to use time out consistently when you go out.

First lesson of parenting; teaching your children decency and respect for others. Everything else is just behavior.

Share your stories and parenting peeves!

None of these stories represent any patient or any parent I have any personal knowledge. Any similarity is merely coincidental.

Saturday, May 28, 2011

Insect repellant guidelines and recommendations

Insect repellant guidelines.
1.       The ingredients proven the most effective and with the longest history of safety is Deet. Picardin has been studied for 15 years and has proven to be safe and is less irritating especially to children with sensitive skin. Oil of Eucalyptus has proven to be moderately effective as well.
2.       Children under 2 months of age should not receive any topical insect repellant. Oil of Eucalyptus should not be used on any children under 2 years of age due to the concerns regarding possible eye irritation.
3.       Apply it to your hands and then rub them on your child. Do not spray it anywhere near a child to avoid inhalation of fumes.
4.       Do not apply it to a child’s hand, they may put them in their mouth.
5.       Adults should do the applying for young children.
6.       Apply to clothing first and foremost to avoid unnecessary skin irritation. Do not apply it under clothing.
7.       Apply sunscreen first before adding insect repellant.
8.       Sunscreen and insect repellant mixture is absorbed in a higher degree and not recommended.
9.       The percentage of each ingredient correlates to the time spent outdoors. !0 % is usually sufficient.
10.   There has been no reported serious illness regarding the use of these ingredients in children.
11.   Natural products that have proven moderately successful include Avon “Skin so Soft”, California Baby, and Burt Bees. And some essential oils tend to be helpful including lemongrass and rosemary.
12.   Remember to reapply according to the instructions on the package .
13.   Pay attention to any skin irritation in areas where you apply the repellant.
Deet  products are the highest rated-for most effective by consumer reports.  I tend to add  smell and feel to the list of important criteria in selecting an insect repellant.
Consumer reports ranked Deep woods Off, Cutter Backwoods, and Off family care the most effective at 98% with Cutter Backwoods unscented and Off Family care smooth and dry much more tolerable for feel and smell to me. They all last up to 8 hours and keep mosquitoes away well.
Picardin- the product I use the most has a similar effectiveness. I tend to use the lower percentage of products by Off and Cutter advanced which contain 5-7 % Picardin. These two products have worked well for me in Florida as well as while hiking in Mosquito infested areas. Consumer reports ranked Natrapel which has 20% Picardin very highly at 97 %.
Avon skin so soft has a smell and feel that I have never been happy with. It is ranked as more effective than organic products at 73%.
Lemon Eucalyptus- ( Repel ) works well but the smell is generally intolerable to others. In my experiment I had to walk and jog by myself by at least 10 feet due to the annoying smell to other people in my party. This is not recommended for children under 2.
Organic products- based on plant oils generally are considerably less effective as a group .Bite Blocker  had a 56 % rating and Burt’s Bees had a 24 % rating compared to the recommended products effectiveness by Consumer reports.
Off " clip on repellant"- the off "fan" that clips on and distributes a fine mist of repellant by fan is moderately effective if you are still for long periods of time. It is not nearly as effective if you are moving or walking. There is a warning on it to not breathe in the fumes, which is not really possible especially for children. In addition to these findings by Consumer Reports it tends to not last nearly as long as it states on the package. I have used it for sitting in the backyard and it helps keep the mosquitoes away, but I would not recommend it for small children.

Monday, May 16, 2011

THE HEAT IS ON! Playing it safe in the hot sun.

1.       Dehydration- happens a lot faster in the summer sun- for most of us dehydration sneaks up on us after being in constant heat without drinking liquids for extended periods of time. Always hydrate before, during, and after all summer activities. This is especially true when we or our children are swimming. It is easy to forget to drink enough when you are in the pool feeling comfortable and cool. Make sure you give your children plenty of fluids before swimming and take “water breaks” like you would if they were playing a sport. Early signs of dehydration- general fatigue and weakness , tired, headache,  parched lips, thirsty, dry skin, skin flushing, chills, dark colored urine- Always keep water and electrolyte solution with you this time of year. Be sure to send an extra bottle of water with your child to school

2.       Eye protection- parents should educate their children regarding sun dangers particularly as it intensifies in the summer. This includes wearing a hat and sunglasses- sunglasses should have a large lens or wrap around frames. They should block 100% of UV rays and absorb most of HEV rays. Make sure they are inspected and are impact resistant. ( Be careful with inexpensive party favor glasses that may break while your child is wearing them)

3.       Skin care in the heat- besides sun tan lotion ( see article on sun awareness ) those with sensitive skin can get flushed and develop heat rashes –  In the summer we need to take care of our children’s skin especially with the increased humidity and drying effect of swimming. Everyone should, especially anyone with eczema, use moisturizer 2 x a day, and apply a generous coating after rinsing off from the pool or beach as well as the shower. Sweating, particularly in areas of contact with surfaces like car seats, makes skin more irritated. It also may cause preservatives and detergents to leach out from clothing. Be especially vigilant with angles of the body like behind the knees and elbows. Try to wear looser fitting clothing made out of cotton and washed with gentle allergy free detergent like those you used for your baby.

4.       Surface danger-any surface that has been out in the summer sun for extended period of time could cause burns and skin damage.
a.       Car surfaces are particularly susceptible since much of it is metal. From the door to the buckle on the seat belt, little hands can get burned easily. Be careful of things left in the car as well, like games and toys. Anything with metal components may burn your child when they go to play with it. Cover your car windows when you have to park your car directly in the sun.
b.       Pool and beach- the area around the pool particularly the edge is very hot and can cause burns on little hands and feet when a small child is holding onto the side of a pool and do not realize they are getting burned while they are cooling off in the water. Of course the sand on the beach is hot, but so is anything you bring with you and leave out in the sun before your child plays with it from cups to toys.
c.       Park and playground-benches, monkey bars and other park and sports equipment are always hot and can cause skin irritation and burns. Try to find parks with shade coverage unless you go in the early morning or late afternoon.

5.       Unattended in car-Never leave children in the car unattended even for short periods of time.  You will always underestimate the effect and may get delayed. Take the extra step- either spend time taking your child with you for the errand even if it is a brief outing. Plan ahead and think through your decision to bring your child with you in the first place.

Sunday, May 8, 2011

How to handle alcohol and your children?

How do you handle the issue of alcohol with your children as they grow up? 

          A recent study, found that the more permissive parenting approach to alcohol, the more likely teens would end up with drinking problems. 

This study ‘conducted jointly by the Centre for Adolescent Health in Melbourne, Australia, and the Social Development Research Group in Seattle, U.S. ,looked at more than 1,900 12 and 13 year olds , compared teens whose parents had more permissive drinking attitudes to those who did not.  “It found that young teens allowed to drink under parent supervision drank more overall than their peers, and were a third more likely to experience 'alcohol-related consequences' such as fighting or blackouts.”

Here are a few questions to consider when you are deciding your course of action regarding teenage drinking.

Is it ok for my kids to drink socially and what does that mean when they are at a party, one drink, two,three?
If you are proactive and involve yourself in their drinking will they handle it better?
Do you want to be the one introducing alcohol – using yourself as a guide- what message are you sending- is this your opinion or experience?
If you are introducing alcohol are you then condoning the use more than you are guiding and proposing restrictions?
What is the ultimate take away message for your children?
What side of this dilemma are you on?

MY opinion based on experience with all sorts of children and parenting styles – I believe no matter how you introduce it, if you act as the bartender then you are condoning drinking and increasing the opportunities for abuse. “Children allowed to drink by liberal parents are more likely to abuse alcohol”, is the overriding take home message from this study. “A separate Dutch study claimed that it was the amount of alcohol available at home, and not how much parents drank, that influenced how much children drunk themselves.”‘According to the findings from this study researchers stated that Middle class parents who let their children have the odd glass of wine or beer in an effort to take away the 'illicit thrill' of booze are actually doing more harm than good, they say’ undermining what many parents believe to be a good way of alcohol introduction; this study found that‘ ‘Allowing teenagers to drink small amounts at home while underage has long been considered a good way of demystifying alcohol and encouraging responsible drinking - but the new study shows that it sends out 'mixed signals' to youngsters.’ “ do as I say not as I do” Once again the biggest resource and influence for your children is you are and how you live - sanctioning drinking “ letting them have a sip or try it” at any age does not seem to help.
       As a Pediatrician in communication with thousands of parents and teenagers -I found that you cannot protect your children enough or prepare them adequately by trying to be cool or their friend by offering drinking tips. The only take home message they get is that it is OK to drink,– what they really want from their parents is real guidance and boundaries . The lead author of the study  Dr Barbara McMorris, from the University of Minnesota, said: 'Both studies show that parents matter.  The study proves that “parents still have a big impact” even if they are away and with their friends. She went on to say: 'Kids need parents to be parents and not drinking buddies”, a clear role without any second guessing. 'Kids need black and white messages early on. -'Adults need to be clear about what messages they are sending. 'Such messages will help reinforce limits as teens get older and opportunities to drink increase.'
They need you as an absolute reference point. In other similar studies it has been found that even though teens in general can be challenging and want their own space and move towards peers and away from the family; they tend to associate and gravitate to groups or other teens that are in their comfort zone. In other words they find like people who had similar home experiences who had parents who instilled similar values- people who make them feel good about their choices and values, people who were given the same instructions and guidance. When teens go out in the world they compare notes, they either reinforce the positive messages or negative ones.

Please feel free to post your response!

Wednesday, May 4, 2011

Sun protection:

"Fun in the Sun"

Now that there is no relief from the hot days, and all the snow birds are gone, it is time to get out and enjoy the best part of living here.  The secret is to take advantage of the many fun things to do down here while following a few essential rules.  
An important outdoor precaution we will take for our children and ourselves this summer is sun protection. Living in South Florida requires daily vigilance to protect our skin and our children’s from sun damage. Dermatologists recommend that we use sun protection every day. That consideration is especially true as the summer sun intensifies.
Sun protection: Sunscreen lotion alert!!!!!
1.       Sunscreen  lotion- our most important ally if used correctly. However, new government studies have raised concerns regarding ingredients found in the most common sunscreen lotion protection products. The most commonly used sun protection ingredients might be having a dangerous effect on our skin by causing an acceleration of skin damage. These harmful ingredients include Vitamin A ( retinyl Palmitate), and Oxybenzone. It is also not recommended to use sun protection products that include insect repellant. These are commonly found in the most marketed and widely accepted products available. Also Sprays, Powders, and any designation of a SPF above 50 are not recommended. Creams and lotions are the most reliable and safest form to apply suntan protection
 Ingredients to look for that are safe and valuable as sun protection include Zinc, Titanium Diaoxide, and Avobenzone or Mexoryl Sx .Some of the products that have been rated the highest and are considered to be safe include Jasons Natural Cosmetics, Organic Desert essence, California Baby, Badger, and All Terrain. Since I first wrote this newsletter I have been using Water babies Pure and Simple 50, it seems to be one of the realistically priced products that is reliable.
 Other factors to consider include water and sweat resistance. An SPF of 30+ is recommended. Anything above that is not considered reliable.
2.       Clothing- The best protection is by covering as much exposed skin from the sun as possible. Light weight, sun shielding clothing is recommended. In addition a hat and sun glasses are a must for everyone at all ages.
3.       Timing- Try to stay out of direct sunlight as much as possible, but if you do go in the sun go during the cooler part of the day; generally before 11 AM and after 4 PM. 
       Share your thoughts and favorite sun products