Another Ear Infection…What Can I Do – Part II??

Since we now understand how ear infections occur (see Ear Infections – Part I), it’s time to deal with the child who seems to get repeated ear infections. Ear infections, particularly the middle ear type, are responsible for providers ordering more prescription antibiotics than any other childhood disease.

There are a certain number of children who just seem to get an outer ear infection (otitis externa) every time they get their ears under water, usually during the warmer months of the year. There are even some who get this when they do not get their ears under water, but usually these episodes are also in the warmer months. I spoke about the treatment of the sudden or acute ear infection, but what to do about the repeated episodes. The best answer to this is using either a prescription medication or better yet, one not costing you anything at all. Mix ½ to ½ mixture of white vinegar and rubbing alcohol and place a couple drops of this into your child’s ear as soon as they get out of the pool or lake or ocean and try to limit the time those ears remain submerged. This has a way of drying out the external ear canal and helping to change the acid content of the eardrum. Ear plugs may be effective under certain circumstances but in general if you force a plug into the ear it may just irritate the skin which is exactly what we wish to avoid.

Middle ear infections (otitis media) are a different matter entirely. Remember that these are primarily due to a blockage in the normal valve system of your middle ear, with resultant pressure, fluid and infectious results. (Please refer back to part I if this is confusing). These changes happen in a progression that can occur suddenly or can develop over time.

While the obvious answer would be to use a “cold medicine” early on in the process this does not seem to influence the course of events as outlined, when looked at in controlled studies. The other end of the spectrum for treating the occurrence of multiple recurrent middle ear infections is to alter the normal anatomy in such a way as to prevent buildup of pressure in that small space which can then lead to fluid accumulation and bacterial secondary infection. This is accomplished through the use of very small tubes that can be surgically inserted through the eardrum and will serve to equalize the pressure on both sides of the eardrum. The system will calm down and the incidence of new infections will drop tremendously.

But that is a surgical procedure under some type of anesthesia, and even with tubes in the proper place, there can still be fluid production which then drains out of the ear chronically. Also, the mere act of making a hole in the eardrum through which a tube can be put in place, can slightly damage and scar that eardrum. Depending on the type of tube implanted in the eardrum, it usually comes out by itself after six to twelve months and the eardrum heals. Occasionally, the ear drum fails to heal completely and there is a perforation that might need to be surgically repaired in the future.

We treat middle ear infections for one of several reasons: to control the pain, to prevent any further extension of the infection into sensitive areas, and to preserve speech and hearing in your child.

Fortunately there are other approaches to the treatment of recurrent middle ear infections. Each significant ear infection should recognized and treated appropriately and the fluid buildup behind the eardrum monitored for resolution.

• Fluid constantly in touch with the ear drum will dampen the usual vibrations and dull the hearing while it is there. Hearing testing can be run routinely to follow any changes in hearing.
• All types of medications have been tried at one time or another: preventative doses of antibiotics have and still are being used for several weeks to months in an effort to prevent the bacterial infections, but the increasing number of bacteria becoming resistant to common antibiotics have caused physicians to re –think the use of long term medication.
• Cortisone preparations by mouth have been tried to help with the middle ear inflammation, with varying results.
• Occasionally, when all forms of treatment fail it is up to the ENT surgeon to place those tubes and let the middle ear system calm down.

So, there are many things to consider in finding a course of action for your child with recurrent ear infections and your Doctor will be familiar with each of the methods and can discuss them with you.

How did my child get an ear infection – Part I ??

Ear infections come in two basic varieties; external, commonly occurring in the warm weather and referred to as “swimmer’s ear”, and internal or middle ear infections occurring mainly in the colder weather. The designation of external or middle is dependent on which side of the ear drum the infection is located. The outer ear canal, seen from the outside if you try to get a look in an ear, is a narrow bony channel covered with skin leading to the eardrum which is totally air tight and seals the chamber. On the other side of the ear drum lies the middle ear cavity containing specialized bones and small organs that allow sound frequencies entering the outer ear to be converted to impulses that eventually reach the brain and are interpreted as sound. This space would also be a closed space if it were not for the Eustachian tube which goes from the back of the nose to the middle ear cavity and keeps the pressure the same as the external canal.

The frequency of sounds represents a pulsed pattern and each frequency has its own pulse pattern. As the sound, usually consisting of different frequencies, reach the ear drum they set the eardrum vibrating at different rates; these vibrations are transferred from the outer ear to the middle ear by way of the eardrum, and then picked up on the other side by a connected series of small bones or ossicles that transmit the information to the auditory nerve and then on to the brain.

Now that we know how the ear works as relates to the anatomy we can discuss more fully what ear infections are all about:

External otitis is caused by a damp, warm environment in the outer ear canal which breaks down the skin and causes irritation leading to possible mild bacterial infection. There is swelling in the skin lining that narrow canal and very little space to allow for that swelling. As a result there is more irritation and resultant pain which can be quite severe at times. As this occurs there is a change in acid content of the external ear leading to more discomfort.

The first thing to do is to prevent any further fluid or moisture from entering that ear canal, no swimming or diving for several days. If there is mild pain a ½ to ½ mixture of vinegar and alcohol can be used in that ear for several days, along with mild pain killers such as Tylenol or Advil. If the pain is severe go to see your Doctor who may prescribe further treatments. In general this is not a dangerous problem even though it can be very painful.

A middle ear infection starts with a pressure change in the middle ear cavity from congestion and narrowing or complete blockage of the Eustachian tube. AT this point the child may say he/she cannot hear well or the ear “feels full”, or even hear the sloshing of fluid. After some period of time there is a collection of clear fluid with more pressure buildup and resultant pain. As the fluid builds up, bacteria can migrate into that space and begin growing leading to more pressure, pain, discomfort and sometimes fever. Your Doctor will suggest treatment methods that will greatly decrease pain and help heal the infection.

Some children tend to get repeated episodes of ear infections and I will deal with that problem in Part II of this post.

Our Super-Successful Kids Are Struggling! How to Help Them Thrive

What if I told you that 1 out of every 3 kids age 6 to 11 is afraid that the Earth won’t exist when they grow up???

WHO are these children??? What if I told you that little kid you just kissed goodnight,,, who got an A on his test…who practiced her cello for hours… what if I told you they were the ones who said it. What if instead I told you they believed it and told NO ONE??? How is it possible this is happening??

Parents, meet the “Running on Empty” Generation – smart and dearly loved, inclusive and open-minded, well-educated with high aspirations for college and their future. From the outside everything you want and more for your child. But take a second look. These kids are less happy, more stressed, lonely, depressed, and suicidal than ANY other generation… and that was BEFORE COVID!

“We are college and career ready, but sure aren’t ‘human’ ready.” Erin, 16 years old

We are raising a generation of “strivers” – kids that are wonderful at reaching for the brass ring, but never feel good enough. We haven’t given them basic survival tools so when the real challenges hit, they often quit because they don’t have the inner reserve that helps them get through it…

“My parents do everything for me. My biggest worry when I leave home is that I’m going to flunk life.” 17-year-old straight-A student, headed for Yale

Surprisingly, despite today’s kids living through the most stressed time in known history – terrorism, lockdown drills, daily pandemic death counts, insurrections, food insecurity, failing power grids, climate crises and racial violence – some kids are not only surviving, but they’re also thriving.

They are bouncing back despite adversity. WHY?

In her new book THRIVERS, Dr. Michele Borba, Ed. D. shares with us the answer.

In the end, these kids – the Thrivers –manage adversity, develop healthy relationships, and embrace change. They are ready and deal proactively with whatever the world throws at them – even in uncertain times, not because of genes, GPA, IQ or a special skill or talent, but through reliance on a few character strengths they learned along the way that helped them steer their lives in a positive direction – helped them PICK THEMSELVES UP whenever their worlds came crashing down.

It is these seven essential Character Strengths that set Thrivers apart and set them up for happiness and greater accomplishment later in life. Self-confidence, empathy, self-control, integrity, curiosity, perseverance, and optimism – each of these helps safeguard our kids against the depression and anxiety that threatens to derail them. And best of all, these strengths are not something we are born with: from toddler to teen, these can be taught!

But where should you start?? THRIVERS is organized into three parts allowing parent to focus on strengths by category. It’s helpful to understand your child’s “superpowers” – what they’re already good at and can nurture – as well as areas that could use further development.

Consider how you would rate your child on the following: 5 = always, 4 = frequently, 3 = sometimes, 2 = rarely, 1 = never

My Child:

1. Speaks mostly positively about herself, rarely negatively.
2. Displays concern and wants to help when someone is treated unfairly or unkindly.
3. Can be trusted to do the right thing and keep his word even when no one is looking.
4. Able to manage her own impulses and urges without adult help.
5. Intrigued or easy to motivate about trying something new, different, or surprising.
6. Does not become upset when something is difficult; rarely quits but keeps trying.
7. Can find the silver lining in a hardship or challenge.

As I’m sure you guessed each of these questions represents one of the 7 Character Strengths and is part of a longer assessment that will help you evaluate where your child is right now so you can determine which traits are their natural strengths and which traits need to be encouraged.

Know that these traits are cumulative: each character strength improves a child’s thriving potential as well as academic performance but is always more powerful when combined with another because they create a Multiplier Effect.

Self-Confidence + Curiosity increases self-knowledge and builds self-assuredness and creativity.

Self-Control + Perseverance boosts the chance of reaching a goal and achieving success.

Empathy + Curiosity helps find common ground and strengthens relationships.

At this point some of you may be thinking…yes this all sounds good, but bottom line, I’ve got to give my child every advantage so they can get into the right school because everything depends on that.

But does it? According to Dr. Borba these amazing, brilliant, talented kids are checking out – the urgency in writing this book came from an email from a distraught mom looking for help from her community:

“We have forty dead kids in two-and-a-half years to suicide within a twenty-mile radius. Most are white, affluent, high achieving males who did not use drugs but hung themselves. Most look like your kids and mine. The last seven have been females – two with guns.”

“It’s like we’re being produced to be test takers. We’re missing the pieces on how to be people.” Aaron, 12 years old

The epidemic of unhappy Strivers is real, but it’s not inevitable. We can do something about it. As Dr. Borba says “all our energy has gone into stretching kids’ cognitive abilities and neglecting their human side – the source of energy, joy, inspiration and meaning. The good news: focusing on character can flip that equation and teach your kids how to find happiness, calm and wonder in the world.“

But we NEED to pay attention… We SHOULD be worried… WE NEED to listen!!

“There’s an amazing amount of depression and anxiety. Seventy percent of my friends are in therapy; forty percent are on medication. We’re hurting but nobody does anything until another kid is suicidal.” Ava, 15 years old.

One last thought that I’d like to finish with. It is terrifying that our children – even the young ones – go to sleep worried about global warming, pandemics, racial violence, school shootings… the list goes on and on. It is even more terrifying that many of them don’t believe their generation will live to see the future. But there is something Dr. Borba’s book reminded me of that I’d like to share with you, and maybe you can share it with your kids.

Years ago a man named Fred Rogers brought optimism, love and hope to families across the country – and in these dark times we could all use a little of his outlook. With each new terror – each bombing, virus, terrorist attack, natural disaster, hate crime or mass shooting we wonder, “what shall we tell our children?” Fred Rogers had the perfect answer:

“When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.’ To this day, especially in times of disaster, I remember my mother’s words, and I am always comforted by realizing that there are still so many helpers, so many caring people in this world”.

My belief, and the reason I share this with all of you, is that this current generation of kids is in pain and they are struggling. Dr. Michele Borba (and THRIVERS) is one of the helpers.

Editors Note: all quotes included in this article, including those attributed to individual children and Fred Rogers can be found in THRIVERS: The Surprising Reasons Why Some Kids Struggle and Others Shine

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Across the nation, student mental health is plummeting, major depression rates among teens and young adults are rising faster than among the overall population, and younger children are being impacted. As a teacher, educational consultant, and parent for 40 years, Dr. Michele Borba has never been more worried than she is about this current generation of kids. In THRIVERS, Dr. Borba explains why the old markers of accomplishment (grades, test scores) are no longer reliable predictors of success in the 21st century – and offers 7 teachable traits that will safeguard our kids for the future. She offers practical, actionable ways to develop these Character Strengths (confidence, empathy, self-control, integrity, curiosity, perseverance, and optimism) in children from preschool through high school, showing how to teach kids how to cope today so they can thrive tomorrow. THRIVERS is now available at amazon.com.

Eating Issues and Kids with Special Needs

So many parents and caregivers struggle with issues surrounding food, with special needs kids and typical kids as well. For some kids the issues are medical so they require a specific diet, or they have a condition than includes low muscle tone. For others it’s a sensory thing, so they will only eat crunchy foods, or white foods, or the rules may change daily. For other kids it may be a control issue, and refusing food or demanding certain foods can be the only thing way they feel they can influence their world.

Whatever the underlying reason (and of course there may be more than one at the same time), the issues usually fall into two separate categories; getting kids to eat more, and getting kids to eat less.

All kids need to eat healthy foods and get all their vitamins, minerals and nutrients. Supplements and nutritional drinks can fill in the gaps for both kids who seem to exist on nothing as well as those who seem to only allow junk food to pass through their lips. My own child survived on Pediasure for years, but we never stopped encouraging actual food and expanding on her diet.

Both types of kids seem to be fairly picky about their eating. Pizza, chicken nuggets and hot dogs may be the only dinners that get their approval. Buying or making the healthiest versions is a good bet, so that each calorie will be full of nutrients and not just preservatives and chemicals – but something is always better than nothing, especially for the kids who need to eat more. For those who need to less, veggie-covered pizza is more filling than plain cheese pizza, and a salad eaten before the all white-meat chicken nuggets may keep the child from asking for seconds. At my house we have a strict veggies first policy. We also demand that a second helping of veggies is finished before a second helping of anything else. But we are mean at my house (LOL). Sometimes the veggies even appear as an appetizer while my ravenous children suffer through the torture of waiting for me preparing dinner. It’s amazing what will get eaten when a child is truly hungry.

All kids can benefit from a little undercover food. Fruits and veggies that might be refused (usually loudly) can be smuggled in undetected in many ways. Of course smoothies are a great way to slip in lots of ingredients, as well as protein powders. Pureed popsicles are also good, especially here in the hot weather. I got away with steamed, pureed cauliflower added to boxed mac and cheese and shredded zucchini in marinara sauce for years. Sadly, as my kids got older they also got wise to my tricks. Zucchini muffins, however, are still a big hit.

I grew up in a house with a VitaMix, which is a high-powered combination of a blender and a food processor. This workhorse is perfect for making your own nut betters or flours if you have specific dietary needs. It also makes killer smoothies and soups, and can even heat the soup. Check the customer reviews for great usage and cleaning tips. Nowadays we have a Magic Bullet, which is great for individual servings and smoothies as well as some chopping chores. The Nutri Bullet is an entire juicing system.

There are ways to sneak calories other than veggies into food for kids who need to bulk up. Try buttering bread before making a sandwich, or pair a favorite food with a new one to expand the child’s repertoire so it isn’t overwhelming – there is something familiar and comforting on the plate. Stick with whole milk, cheese and cottage cheese even if you swear by skim. I knew a mom who always served sandwiches with dip – salad dressing or veggie puree. Added calories and a bit of sensory fun, too! Food presented in a fun way or in fun shapes may also get gobbled up easier than the same old sandwich.

Both kids who need to eat more and kids who need to eat less should be involved in the food in the house. Take a trip to a local farm or a local farmers’ market so the child can see, feel, smell and taste the varieties. Getting to choose an item may make it seem more appealing on the table. Gardening is also great and lets the kids watch the growth and maturation of the fruits and veggies.

There are food and eating therapists who use exposure therapy and rewards. I heard of one that had a cute, friendly dog in the room – if the child licked the new food he or she got to pet the dog. Her patients made great progress and the dog got a lot of attention! There are also eating groups where kids come together to try new items in a fun atmosphere. If there is a control issue between you and the child then he or she may have more success with food away from you. My child is a social eater and is more likely to try something new if we are out at a restaurant or at a party. Then I can observe what she likes and try to make it for her at home. It takes about 6 exposures to a new food before a picky kid with actually try it, sort of how they naturally desensitize themselves, so try to be patient.

A nutritionist can also help. There may be a biochemical reason a child craves a certain food constantly. Get allergy tests done, too, especially if your child is avoiding an entire food group. Again, for older kids, it seems to help to hear advice from someone other than mom.

Food issues can be frustrating for everyone, whatever challenges they face. Try not to make mealtimes a battle; these kids have enough struggles in their daily lives.

Got a specific question about your child’s eating? Post it below!

Disclosure: this article contains affiliate links, fyi after all, a girl and her kids have to eat. Also, I am not a nutritionist so I am not giving anyone medical advice. Check with your pediatrician for any dietary questions.

Family Fitness: Stretches Everyone Will Love

During the winter, it can be difficult to get yourself, not to mention your family, to do any exercise. Now toss a PANDEMIC with social distancing and quarantines into the mix!!! My suggestion: Get everyone going with a gentle stretch session. Stretching will not only help relieve stress, but also energize your entire body. It’s also a great way to get kids moving in a focused manner.

Below are a few great stretches for you and your family to enjoy. All you need is comfortable clothing, a carpeted floor (or a yoga/exercise mat on hardwood), lighting that’s easy on the eyes and down- to mid-tempo music. On a last note, if you are going to help one another stretch, heed the advice of Dr. Timothy McCall in Yoga As Medicine: The Yogic Prescription for Health and Healing: Adjustments should be gentle, like the “laying on of hands” from biblical folklore. Never push too hard or tug too firmly. Remember: You are attempting to reduce, not aggravate, stress!

Cat/Cow Sequence: Moving Your Spine

Nothing feels as good as getting your spine moving, which is why many yoga classes begin with a simple cat/cow sequence. It loosens the muscles around your spine and gets blood flowing into your shoulders and intestines, which helps digestion.

• Begin on your hands and knees with your hands placed directly underneath your shoulders, and your knees placed directly below your hips.
• With your inhale, allow your midsection to relax while you draw your shoulders together on your back and gently gaze up. Try not to arch your neck too much; instead let your shoulder blades guide your gaze upward slightly. Let your tailbone lift and feel your sit bones widen.
• Begin to draw your belly button in and up as you exhale, tucking your chin into your chest and rounding your upper back, like you are pushing the floor away. Try not to cramp up around your neck; there should be a stretch, but you don’t want your collarbones to feel as if they are being pinched together. As your navel pulls up and in, your tailbone will lengthen, giving you a nice release in your lower back. Repeat for 10-15 breaths.

Cobra: Energize While Calming

After you finish your cat/cow stretches, lie flat on your stomach for Bhujangasana, or Cobra. If you’ve ever read Philip Roth’s American Pastoral, you might recall that “the Swede’s” father had no affiliation with yoga but did Cobra every day to alleviate stress. It’s also a wonderful pose to do if you’re feeing sluggish and tired, as it offers you a burst of energy.

• Place your hands next to your chest, with your thumbs just behind the level of your armpits. Allow your forehead or chin to rest on the ground.
• Keeping your hands on the ground, begin to draw your shoulder blades onto your back, like you were trying to squeeze your elbows together. Press the top of your feet firmly into the ground; this is important, as you don’t want to clench your butt and tighten your lower back.
• As you draw your elbows in, begin to gently straighten your arms. (They most likely won’t straighten fully; don’t force it.) Let the action of your shoulders begin to lift your chest and, lastly, your head. It’s important to keep your pelvis (around where you’d wear a belt) on the ground. Cobra pose is an energizing movement that really works your shoulders and upper back. When lifting your pelvis, you are relying on arm strength (and probably crunching your low back). After a few breaths, easily lower your head back to the ground. Repeat five to eight times.

Child’s Pose: Finding Strength in Relaxation

Perhaps the most relaxing pose is Child’s Pose. It stretches your lower back and hip flexors, as well as your ankles.

• After your Cobra sequence, place your hands underneath your shoulders and gently press your seat to your heels, allowing your upper body to rest on your thighs. Don’t worry if it does not reach, especially if your hips are tight; again, don’t force any of these movements. If this position bothers your knees, roll a towel or blanket up and place it behind the backs of your knees, as this will take pressure off the joints.
• Either rest your arms straight out in front of you or next to your hips, with your head on the ground (or a block or pillow, if this position bothers your upper back or neck).
• Take 10 deep breaths into your lower back. With every exhale, see if you can allow your hips to rest downward a little more.

Twisting out the Rest

Twisting will not only calm your nervous system, but also stimulate digestion, which can also be very helpful around this time of year!

• Slowly lift yourself out of Child’s Pose to sit on your heels. If this bothers your knees, you can sit cross-legged. If sitting on the ground doesn’t feel good, you can sit in a chair.
• Place your left hand outside of your right thigh and easily twist your upper body to the right. Try not to twist your hips; allow the twist to begin in your abdominal region, using your shoulders drawing together once again to accentuate the movement.
• Feel like you’re growing taller with each inhale, and as you exhale, draw your navel into your lower back and shoulders together a little more to enhance the twist. You can rest your right hand on the ground behind you, though you don’t want to feel like you’re leaning back at all.
• Take 8-10 long breaths here. Slowly return to center, take a breath and try the other side.