Heaven Knows We Need Them Here

Christina Taylor- Greene was one of the unfortunate victims of the Tucson massacre. We know so much about her already and she has touched so very many lives. For example we know that she was born on September 11, 2001. We know that when she was laid to rest that a special flag, one that flew over ground zero, was present at her interment.

We also know that she was the inspiration behind President Obama’s “We can be better” speech. We heard that this nine year old was eagerly on her way to meet her congresswoman when she was gunned down.

I recently learned that she wanted to be and was an organ donor. At nine, I don’t believe that I was even aware of organ donation- or when I was ten, eleven or twelve for that matter. It was reported tonight that her cornea were donated and as a result two children who were blind can now see. What an amazing gift and it demonstrates the power of selfless giving. The courage of her parents must be acknowledged too and I do so now.

Many years ago I saw a bumper sticker that read, “Don’t take your organs to Heaven, Heaven knows we need them here.” And perhaps, just perhaps a little bit of Christina stays behind in her inspiration, in her selflessness and in her courage. Check your driver’s license- are you a donor? Looking for a way to give?

‘And a child will lead the way.’

To Breastfeed for 6 Months or Not To Breastfeed for 6 Months…

…that is the question…

This week a small group of pediatric health experts from the UK published a report in the British Medical Journal questioning the 2001 World Health Organization’s recommendation to provide 6 months of exclusive breast feeding. The WHO and UNICEF recommend:

• Initiation of breastfeeding within the first hour of life
• Exclusive breastfeeding – that is the infant only receives breastmilk without any additional food or drink, not even water
• Breastfeeding on demand – that is as often as the child wants, day and night
• No use of bottles, teats or pacifiers

This is based on significant evidence that breast milk reduces the rate of pneumonia, ear infections, gastroenteritis and other infections.

Given however the much lower incidence rate of these illnesses in “developed countries” some medical professionals have voiced their concern about applying the 6 month restriction universally. They argue that while “exclusive breastfeeding for 6 months is readily defendable in resource-poor countries with high morbidity and mortality from infections, in developed countries, other concerns can take precedence”.

This aligns with the new report which suggests that babies who are breastfed exclusively for six months are at a higher risk for iron deficiency and food allergies including celiac disease, and may also lead to a delay in developing a taste for food products which could have a long term impact on diet. Among the questions asked – “will babies who aren’t introduced to bitter-tasting foods in the first 6 months continue to have an aversion to them for the rest of their lives??” If this does in fact occur, will it make it even more difficult to win the battle against obesity?

All of that being said, the current debate is not one which attempts to answer the question of whether or not a mother should breastfeed. That is a separate conversation with its own proponents for and against. But even for those moms who make the decision to breastfeed, many still struggle to continue for the recommended 6 months – especially if they return to work. (According to the CDC , although 75% of new moms in the U.S. start breastfeeding, only 13% are still breastfeeding exclusively at 6 months).

So what is the right answer? Can solid foods be introduced as early as 4 months? The WHO and UNICEF are continuing to support a 6 month guideline while a number of experts are now recommending the alternative. One area they both seem to agree is that each child is different, and watching for baby’s cues will be the best guideline of all.

So what about you?? How did you know when your little one was ready for solids?

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References:

• In Breastfeeding, What’s Best – Katie Moisse, ABC News Medical Unit – Jan 14, 2011
• Breast may not be best for the first six months of life, some experts say – Karen Kaplan, Los Angeles Times – Jan 14, 2011
• Exclusive breastfeeding – World Health Organization
• No solid answers on baby food – TVNZ – January 16, 2011

Facebook Now Provides Local AMBER Alerts for Missing Children

Thanks to a partnership between Facebook and NCMEC (the National Center for Missing and Exploited Children), Facebook users can now sign up to receive localized AMBER Alerts through their news feed.

The AMBER Alert™ Program is a voluntary partnership between law-enforcement agencies, broadcasters, transportation agencies, and the wireless industry, to activate an urgent bulletin in the most serious child-abduction cases. The goal of AMBER Alerts is to quickly involve the local community in helping to facilitate the safe return of the missing child. Since its birth, the AMBER Alert program has helped to save the lives of 525 children nationwide

Currently there are 56 new Facebook AMBER Alert pages that have been created – one for each U.S. state, Puerto Rico, U.S. Virgin Islands and the District of Columbia – as well as 3 pages for Canadian provinces Ontario, Newfoundland and Labrador, and New Brunswick. Additionally Australia, France, Malaysia, the Netherlands and Ireland all have AMBER alert systems in place, so it is hoped that Facebook pages will soon be available for these locations as well

Today, January 13th 2011 marks the 15th anniversary of the abduction and murder of 9 year old Amber Hagerman – the little girl who is the namesake of the AMBER Alert program. In her memory, I ask the Pediatric Safety readers who use Facebook to please sign up for these alerts.

Aren’t They Too Young to Enter Puberty??

American Academy of Pediatrics: Over a decade ago, Marcia Herman-Giddes, a pediatrician and now professor at the University of North Carolina School of Public Health, noticed many young girls in grades one to five were showing public hair and breast development,” In her words, “It seemed like there were too many, too young,” and launched a major national study involving 225 clinicians and over 17,0000 girls to prove her hypothesis.

Her famous paper published in Pediatrics found that our kids are growing up faster.

• The average age onset menstruation is hitting girls four years earlier
• 15 percent of seven years olds and almost half of eight years olds are now developing breasts or public hair

Comprehensive data is still not in for boys but studies show that they are reaching their adult heights at younger ages, suggesting they too are maturing earlier as well. There’s no doubt about it: our today’s kids are growing up faster in many ways. The key here is to beware of the trend and get educated so you can educate your child.

Start Those “Grown Up Talks” Earlier

But it isn’t just puberty that is hitting our kids earlier. Studies show that drinking, sexual promiscuity, engaging in oral sex, depression, eating disorders, stress, peer pressure, puberty, and even acne are all hitting our kids three to four years earlier than when we were growing up. So don’t deny your child’s fast-forward culture and wait to discuss those “grown up” subjects you planned for the teen years. If you’re not talking about these tougher issues believe me your child’s friends most likely are. Be the one who provides accurate facts that are laced with your moral beliefs and your values.

Also make sure your child’s doctor is someone your daughter or son feels comfortable speaking to as well. Puberty is striking kids at younger ages and your child does needs to feel comfortable speaking to someone—if not you–about menstruation or wet dreams.

What to Expect Age by Age

School Age: Puberty signs may begin in girls as seven or eight including public or underarm hair development, and acne.

Preteen: Feel physically and emotionally awkward with puberty.

Girls: onset of menstruation and breast development

Boys: puberty begins around age nine later than girls, with a sudden growth “spurt” or more “mature” body odor, enlargement of testes or penis as well as deepening voice, facial hair development.

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Resources

• Survey from AdAge; elementary-school set is one of fastest-growing markets for digital media players; 31 percent of U.S. kids 6 to 10 have some form of music player: Bryan Gardiner, “Technology for Kids,” nwa WorldTraveler, p. 74., 2008
• Too many too young: Marcia E. Herman-Giddens, et al, “Secondary Sexual Characteristics and Menses in Young Girls Seen in Office Practice: A Study from the Pediatric Research in Office Settings Network,” Pediatrics, 99, no 4(April 1997): 505-12.

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Dr Borba’s book The Big Book of Parenting Solutions: 101 Answers to Your Everyday Challenges and Wildest Worries, is one of the most comprehensive parenting book for kids 3 to 13. This down-to-earth guide offers advice for dealing with children’s difficult behavior and hot button issues including biting, tantrums, cheating, bad friends, inappropriate clothing, sex, drugs, peer pressure and much more. Each of the 101 challenging parenting issues includes specific step-by-step solutions and practical advice that is age appropriate based on the latest research. The Big Book of Parenting Solutions has been released and is now available at amazon.com

Tomorrow, AMC Sensory Friendly Screenings presents Yogi Bear

AMC and the Autism Society are again presenting first-run family movies in a supportive environment each month of the new year. This Saturday, January 8, 2011 the feature film will be Yogi Bear. All shows start at 10am. Admission prices are reduced for these showings. For a list of theaters nationwide, click here.

Although these showings began by the request of a parent of a child with autism, many kids who like to wander around, chat during the movie or dislike overly loud noises will appreciate the Sensory Friendly Screenings program.

Your Child’s Behavior: Willful Non-Compliance or Skills Deficit?

This might sound familiar, “I said, go to your room!” If that’s what happens in your home consider this. Many parents focus on punishment, calling it discipline. But discipline is something you teach your children not something you do to them. You may agree, but now you wonder, “Well how do I do it differently?”

It is best to consider discrete behaviors you hope your child will exhibit and what is in the way of your child’s achieving this behavior. OK, that seems like a tall order, but it’s simple once you learn to work your observation muscles a bit. When your efforts at parenting do not appear to be working, take a step back and look closely at what is going on. Observation leads to a better understanding of what poses difficulties for your child. Then you can put in place some strategies to better equip your child for success.

A really important concept I teach parents is the difference between behavior that stems from a child’s skill deficit and behavior that is from willful non-compliance. A later chapter will be devoted entirely to these two topics, but right now, we’ll be focusing on identifying skill deficits.

First, let’s give The Family Coach Method definition for these two terms:

The Family Coach Method Definition: Skill deficit

(n.) With a skill deficit you are dealing with a child’s inability to exhibit the expected behavior in this time-frame and under these circumstances.

The Family Coach Method Definition: Willful Non-compliance

(n.) When a child who possesses a necessary skill set, obstinately and deliberately chooses not to exhibit behaviors required within a specific social, work, cultural, academic or family setting.

Next, let’s see what that means in the real world where you and your child live:

Let’s learn about identifying skill deficits as opposed to willful non-compliance.

How to Identify a Skill Deficit (the short version).

Ask yourself these two questions:

1. What is the expected behavior? …and
2. Can he/she do it?

(If yes, expect it. If no, teach it.)

Many times we ask our children to exhibit behaviors for which they have not yet developed the skills. The process of examining your child’s ability to “do it” helps you to make sure you are fostering reasonable expectations of your child.

For Your Toolbox: “Can He/She Do It?”

This is an effective evaluation tool I use in my office and you can do at home. It works like this: Write down a specific behavior your child has had difficulty with in the past 48 hours. We’ll call this “the expected behavior.” Then, before enlisting your normal compliance strategies, ask yourself if your child possesses the skills necessary to complete the desired behavior. If the answer is yes, then expect it. If the answer is no, then teach it. It’s that easy.

Now, let’s look at one specific behavioral challenge. Behavior 1: Sharing Toys

Step #1: What is the expected behavior?

• “I expect my 5-year-old daughter to share her toys with her brother.”

Step #2: Can she do it?

Here are the kinds of things to look at as you consider the answer:

• Did I discretely define one behavior I am seeking my child to exhibit?
• Does my child have the requisite skills to exhibit this behavior?
• Are there any roadblocks that inhibit my child’s ability to exhibit the behavior? For example, did my child sleep well and eat well?
• Have I defined which toys are for sharing and which are personal and will not be played with by others?
• Have I told my child she may place special toys in a basket in her closet and those will be just her own, no sharing?
• If my child will share another toy, but not the requested toy, did I offer that alternative solution for the children?

Step #3: If yes, expect it.

If you determine that your child has the skills for the expected behavior, then expect it! You can ensure the behavior by clarifying expectations and establishing a time frame for sharing. It might look like this:

Parent: “Shiloh, James has asked to play your Nintendo. That is a toy we agreed we would share right now. You now have ten seconds to hand the toy to your brother.”

Step #4: If no, teach it.

If you determine that your child does not yet have the skills for the expected behavior, then teach it. Help the child to choose an alternate toy. Your child now has an opportunity to model sharing and practice sharing.

Parent: “Shiloh, James has asked to play your Nintendo. When will you be willing to let him play? In five minutes or in ten minutes?”

When we parent children 0-3 years of age, most of what we do is teach, guide, mentor and reinforce. We do not need to punish a child for not sharing, we need to teach the child how to share.

Take a peek at a behavioral challenge you have had with your child. Ask yourself, “Did my child have the skills to do as expected?” Most of the time, your child needs the cognitive skills, words and actions to make a different choice. When you understand the difference between skill deficits and willful non-compliance, the focus of your parenting shifts to teaching and away from frustration and anger. Give it a try, you can do it! Your child will thank you.

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This post reflects Dr Kenney’s “The Family Coach Method” used in practice for a number of years, and released for publication just this past September. The Family Coach Method is ‘rug-level,’ friendly and centered on the concept of families as a winning team – with dozens of age-appropriate sample conversations and problem solving scenarios to guide a family to the desired place of mutual respect, shared values and strengths. The goal is to help children to develop the life skills, judgment and independence that can help them navigate the challenges of an increasingly complex world. The Family Coach Method is also being taught as an Educational Series where parents can join with other moms and dads in live calls with Dr Kenney.