Elementary school kids Archives - Page 31 of 40

Myth: butter’s better on a burn

One of Dr. Lai’s patients burned his arm on a hot cookie sheet. The child stopped further injury by immediately running the area under cool water. However, his well-meaning great-aunt decided to then apply butter to the burn. Please, do NOT put butter immediately on a burn. It’s like putting butter on a hot skillet.

We’re not sure where the myth of putting butter on a burn comes from. A better idea for pain control, after applying cool water for a few minutes, is to offer the child a pain reliever such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

Burns caused by fire or burns covering large body areas are best treated at a hospital, but your first response, as you call 911, should be to get that burn in cool water. Run the water for several minutes. To avoid shock or extreme cold injury, do not use ice water. Don’t remove clothing stuck to skin but go ahead and put the burn and the stuck clothing in cool water.

Most burns sustained at home are mild or may cause blisters. Burns are easily infected because when you burn away skin, you burn away an excellent barrier to germs. Washing the affected area with soap and water and applying a topical antibiotic such as Bacitracin twice daily can prevent infection. Avoid popping blisters- you will take away a protective layer of skin.

Please remember that unlike for cookie batter, butter is not better for burns. Please pass this post on to anyone you know who cares for your children…it’s “hot off the press.”

Julie Kardos, MD and Naline Lai, MD
©2011 Two Peds in a Pod®

Revised 5/17/2015

The truth about lying: what to do when your child lies to you

Stunned, you find your child’s third quarter report card under his bed. Your child told you he got an A, but the teacher’s report shows a lower grade. A much lower grade. You are horrified, not about the grade, but about the lying. Refrain from running straight to school and yanking him out of class to confront him.

Lying is not uncommon in childhood. For very young children, “lying” is a normal part of developmental. Preschool children are at the developmental stage where they exaggerate and tell tall tales. Preschoolers rarely have a hidden agenda and truly believe in their fantasies.

Beyond the preschool age, there often is a hidden agenda. “There is a reason behind their lies,” says Pennsylvania based Buckingham Friends School teacher of over 25 years, Nancy Sandberg. Try to figure out your child’s underlying reason for lying. During elementary school children have developed a sense of right and wrong. They begin to lie to avoid disappointing a parent, to avoid a perceived punishment, or for attention. In their teens, kids protect their privacy and begin to separate their identity from their parents. Teens may lie because they are afraid of losing face with peers or in order to get something they want. A lying teen may also be covering up underlying problems such as alcoholism.

Before talking to your child about his lying, clear your head of anger. An emotionally charged confrontation will end up in a blow-up rather than a rational discussion. If he lies when you talk to him, state that you are not sure that he is telling the truth and plan a later time to discuss the issue. Also, do not ask your child questions to which you already know the answer and avoid giving him a reason to lie further. In the report card example, when your child comes home, do not ask him where his report card is or if he had seen his grades. Instead, start the conversation with facts: “I found your report card. I see that your grades are not what you said they would be. I am concerned because you hid the truth from me. Let’s talk about it.”

Sometimes anger may impede your ability or your child’s ability to have a rational discussion. Wait until things cool down or have an objective third party present during your conversation. In your discussion, give your child an alternative to lying. For instance, if she is concerned about your reaction to a grade, tell her to go to another adult first, such as a teacher, if the situation reoccurs and they can approach you together. Talk about how your child would feel if someone lied to her. Discussing a book with a protagonist who lied can give your child a way to indirectly discuss her own situation. And reassure, reassure, reassure her that in no way does the incident diminish your love for her.

Keep in mind, most episodes of lying are isolated incidents. However, a child who chronically lies and also shows negativity and hostility or defiance towards adults should be evaluated by a health care professional. For more information, click on the American Academy of Child and Adolescent Psychiatry’s site www.aacap.org.

Sandberg proudly recalls a child whom she worked with years ago. At the beginning of the school year, the child lied about his school work. Later, the child went on to play Hercules in the school play. Sandberg and the child talked about how like Hercules, he had struggled, but because he faced his challenges head-on, he turned into a hero.

Naline Lai, MD with Julie Kardos, MD

Tips to help the socially awkward child: guest blogger Amy King

“I am not asking for my child to be the life of the party, or a social butterfly. I just want her to be happy and have some friends of her own. She is a wonderful kid, and I hope someday others can see that.” -Scott Bellini, Ph.D.

Does your child spend recess walking around by himself? Does he lack play dates with kids after school and on the weekends? Is it shyness or something more?

Possessing good social skills is important for our children. However, in today’s fast moving, highly technological society, we are seeing an increase in the number of children with social skill deficits. Children may be simply be shy or may have true difficulties relating and socializing with others. Experiencing some social pain from being teased or left out once in awhile can be normal. However, some children are at risk for serious psychological damage because of ongoing rejection or bullying. The “at risk” group may eventually suffer from a number of different problems including: anxiety, depression, loneliness, aggression, even suicide or homicide.

Social competence is the topic of conversation among parents and professionals around the country as more and more children are reported to be socially struggling and awkward. Good social skills have been shown in studies to be a better indicator of future success than straight ‘A’s. The socially awkward child is often regarded as the “misfit”: annoying, rejected and ridiculed by peers. Below are some tips to help children develop social skills

.Consider these techniques:

Listen to children with the “third ear,” i.e., active listening, not only to the words they say, but the feelings they are expressing.
- If your child is talking to a peer, watch for her non-verbal cues. Help her develop strong non-verbal cues (stand close but not too close, look person in the eye but don’t stare, act interested even when you aren’t)

Initiate and practice pro-social skills at home, including:

How to initiate, maintain, and end a conversation
The art of negotiation — how to get what you want appropriately
How to be appropriately assertive without being overly aggressive
How to give and receive compliments
How to respond to teasing by peers
How to accept constructive criticism

Here are other ways in helping children who may feel rejected or lonely:

Ask teachers, friends and other parents what they see when they observe your child interacting with peers or classmates.

Provide a variety of group opportunities.
Church groups, scouts, drama club, sports teams – these all provide an alternative to school as a place for a child to make friends and gain acceptance.

Don’t go back to school yourself!
Resist the temptation to march onto the playground and yell at the big kids for picking on your child. Resist the urge to gossip about other moms in the parking lot after school.

Always intervene if one child is made a scapegoat or is ostracized by the group.
Help that child learn how to fit in and, more importantly, help the group be more empathic and kind.

Give shy children a gentle push to try new social challenges.
They need lots of support and encouragement as they push out of their “comfort zone.” If a child is shy but would like to make a friend, it can help to invite over a classmate and the classmate’s parents; the kids will find the adults boring and, eventually, go off to play together.

Help the child find other children who have similar interests.

If your child likes to play chess or build with legos, sign them up for the chess club or look into camp programs that focus on your child’s interests. They are bound to meet other kids that share their interests.

Teach socially awkward children basic skills for getting along.

Examples include: how to guess what other people are feeling, how to join a group, and how to make friends.

Make sure the child pays attention to personal hygiene. This is so important because kids are big on first impressions. Why give another reason for others to make fun of them! If your child doesn’t wash or comb her hair, it will be noticed. Make sure your child bathes regularly and wears deodorant, if needed- kids are sensitive and often intolerant of body odor. Also make sure the child grooms those not-so-obvious areas, including cleaning her ears and clipping her fingernails and toenails. It may not seem so important to your child, but others will notice!

Children who have suffered repeated rejection and isolation are at risk for more serious difficulties. Please seek professional help for these children!

Amy King, MA, CCC/SLP; owner and facilitator of “Making Friends” A Social Communication Training Program, email makingfriendspa@yahoo.com

Sources:

Building Social Relationships: A Systematic Approach to Teaching Social Interaction Skills to Children and Adolescents with Autism Spectrum Disorders and Other Social Difficulties, by Scott Bellini.—1^st Edition, Shawnee Mission, KS: Autism Asperger Publishing Co. 2006.

Best Friends, Worst Enemies, by Michael Thompson, Catherine O’Neill Grace and Lawrence Cohen, Ballantine Books, 2001. Explores children’s social relationships and how to help kids deal with peer problems.

Mom, They’re Teasing Me, by Michael Thompson , Lawrence J. Cohen Ph.D., Catherine O’Neill Grace. The range of difficulties children face in social situations, from bullying and name-calling to rejection and socialization is the focus of this primer for parents, with specific tips on how to deal with these issues.

Allergy Meds- the quest for the best antihistamine

The antihistamine quandry

Junior’s nose is starting to twitch

His nose and his eyes are starting to itch.

As those boogies flow
You ask oh why, oh why can’t he learn to blow?

It’s nice to finally see the sun

But the influx of pollen is no fun.

Up at night, he’s had no rest,

But which antihistamine is the best?

It’s a riddle with a straight forward answer. The best antihistamine, or “allergy medicine” is the one which works best for your child with the fewest side effects. Overall, I don’t find much of a difference between how well one antihistamine works versus another for my patients. However, I do find a big difference in side effects.

Oral antihistamines differ mostly by how long they last, how well they help the itchiness and their side effect profile. During an allergic reaction, antihistamines block one of the agents responsible for producing swelling and secretions in your child’s body, called histamine.

Prescription antihistamines are not necessarily “stronger.” In fact, at this point there are very few prescription antihistamines. Most of what you see over-the-counter was by prescription only just a few years ago. And unlike some medications, the recommended dosage over-the-counter is the same as what we used to give when we wrote prescriptions for them.

The oldest category, the first generation antihistamines work well at drying up nasal secretions and stopping itchiness but don’t tend to last as long and often make kids very sleepy. Diphendydramine (brand name Benadryl) is the best known medicine in this category. It lasts only about six hours and can make people so tired that it is the main ingredient for many over-the-counter adult sleep aids. Occasionally, kids become “hyper” and are unable to sleep after taking this medicine. Other first generation antihistamines include Brompheniramine (eg. brand names Bromfed and Dimetapp) and Clemastine (eg.brand name Tavist).

The newer second generation antihistamines cause less sedation and are conveniently dosed only once a day. Loratadine (eg. brand name Alavert, Claritin) is biochemically more removed from diphenhydramine from than Cetirizine (eg. brand Zyrtec) and runs a slightly less risk of sleepiness. However, Cetirizine tends to be a better at stopping itchiness.

Now over-the-counter, fexofenadine (eg brand name Allegra) is a third generation antihistamine. Theoretically, because a third generation antihistamine is chemically the farthest removed from a first generation antihistamine, it causes the least amount of sedation. The jury is still out.

If you find your child’s allergies are breaking through oral antihistamines, discuss adding a different category of oral allergy medication, eye drops or nasal sprays with your pediatrician.

Because of decongestant side effects in children, avoid using an antihistamine and decongestant mix.

Back to our antihistamine poem:

Too many choices, some make kids tired,

While some, paradoxically, make them wired.

Maybe while watering flowers with a hose,

Just turn the nozzle onto his runny nose.

Naline Lai, MD with Julie Kardos, MD

Spring Break Surprises: preparing for illness

As spring break approaches, here are some ways to handle sickness while traveling with your children when you are far away from your children’s primary care provider.

If your child has a health condition that is intermittent, such as asthma, bring his inhaler, spacer, or any other medication. Even if he hasn’t had a flair up for months, it is much safer to travel prepared. Don’t forget your child’s epi-pen if she has a history of food allergies. If your child’s healthcare provider holds a United States license and you are not in the United States, your healthcare provider can not call in routine medications.
If your child has a complicated health history, bring a typed summary of his health history including current medications.
Decide beforehand where you will seek medical help if your child becomes ill . Maybe it is a pediatric or family medicine office that accepts new patients, a walk-in clinic, or an emergency room that sees children. Your child’s health care provider’s ability to diagnosis and treat your child is limited over the phone. Kids are much safer diagnosed in person with the benefit of a thorough physical exam.
Travel with the basics: 1) pain reducer such as ibuprofen or acetaminophen for headaches, minor injuries, or aches associated with fever, 2) a quick acting allergy medicine such as diphenhydramine (brand name Benedryl) in case of an allergic reaction such as hives, 3) anti-itch cream such as hydrocortisone in case of annoying bug bites or contact rashes such as poison ivy, 4) a topical over the counter antibiotic in case of skin scrapes, and 5) band aids. Remember to first wash any break in skin with soap and water.
Bring your child care provider’s telephone number. Even if she cannot provide a final diagnosis, she can provide advice and guidance as to whether or not you need to take your child to a local health care provider.
Make sure your child is fully vaccinated. You can’t vouch for the health of other people you encounter on your travels. It is much easier to prevent illness than chase it after it strikes. Likewise, practice good hand washing hygiene.
Travel outside of the United States may require specific vaccinations or preventative medications. Call a local travel clinic or check www.cdc.gov for advice on specific countries.

Kids have a knack for knowing just which week of the year their family will travel and then get sick during that one planned-for week. I remember the spring vacation that our twins awoke with fevers on our first day away from home. Fortunately, my children travel with their pediatrician. Families who leave their pediatrician behind when they go on vacation can empower themselves with the knowledge of how to handle illness away from their medical home.

Or, there’s the option of inviting the pediatrician along… especially if you’re headed somewhere warm…

Julie Kardos, MD with Naline Lai, MD

Social media: the stats, risks and benefits

The American Academy of Pediatrics issued a clinical report today on the impact of social media on our children and teens. Ironically, Dr. Lai heard about it first on her Facebook.

Car safety update

The American Academy of Pediatrics issued an updated policy on car child restraints earlier this week.

The highlights:

– babies/toddlers ride backwards in a rearfacing carseat until two years old

– kids ride in booster seats until the car’s seat belt fits correctly- usually at 4’9″ and between ages 8-12 years of age

– kids ride in the backseat until at least 13 years of age

Please see the complete policy and the reasons behind it on the AAP website.

Explaining tragedy to children

When the first news of the earthquake and subsequent tsunami rolled in from Japan last week, my family started to track down news of my cousin who resides in Tokyo with her husband and two sons. We were relieved to hear of shaken china and toppled bookshelves but no injuries. My nephew was on a school field trip that day and the bus was delayed, but he got home safely the next day. They were physically safe, but mentally shaken.

Even though the event may be half a world away, explaining a large scale tragedy such as what happened in Japan to children is tough; especially in this case when the uncertainty of a nuclear meltdown still looms and images of a struggling Haiti still fill the newsfeeds.

Understand that kids sense your emotions even if you don’t tell them. Not telling them about an event may make them concerned that they are the cause for your worried hushed conversations. Break away from your discussion with adults to say, “ Do you know what we are talking about? We are not talking about you.”

Tell the facts in a straight forward, age appropriate manner. Answer questions and don’t be afraid to answer with an “I don’t know.” Preschoolers are concrete in their thinking—dragons are real and live under their bed, so don’t put any there that do not exist. For a preschooler a simple “Mom is sad because a lot of people got hurt,” will suffice. Young school age kids will want to know more details. And be prepared to grapple with more high level questions from teens.

If the kids ask,” Will that happen here?” or “Why did that happen?” Again, reassure in a simple straight forward manner. For instance you can say, “Many people are working hard to prevent something like that here.” Consider answering the question with a question. Asking “What do you think?” will give you an idea of exactly what your child fears. You can also reach out to other family supports for help with answers. Say to your child, ”I wonder what our minister or school counselor has to say about this, let’s ask.”

Routine is reassuring to children, so turn off the background 24 hour television coverage and make dinner, take them to sports activities, and get the homework done.

Give your kids something tangible to do to be helpful. Help them set up a coin donation jar at school or put aside part of their allowance for a donation.

If your child seems overly anxious and fearful, and her worries are interfering with her ability to conduct her daily activities, such as performing at school, sleeping, eating, and maintaining strong relationships with family and friends, then seek professional help.

You may not hold the answers to why a large scale tragedy strikes, but you do hold the ability to comfort and reassure your children.

Naline Lai, MD with Julie Kardos, MD

Teaching kids a culture of over eating- parts 2&3 of Pediatric Childhood Obesity

In Part 1 of our talk, we presented the problems with pediatric obesity and provided six seemingly simple rules to follow that can help encourage your kids to become or maintain a healthy weight. But why is it so hard to follow these rules? In Parts two and three of our talk, we play out several common scenarios that illustrate our culture of over eating and suggest ways to change this culture.

As always, we welcome your comments and suggestions.

What to do about childhood obesity-part 1

Worried about your overweight child? Last week we gave a talk in which we outlined six simple rules which you can use as a starting point for getting your child to a healthy weight. We also discussed ways to change our “culture of overeating” which unfortunately teaches our children to eat even if they are not hungry.

While the copy of the video recorded on the auditorium equipment did not turn out, the good news is that the presentation was captured on a different camera. It’s a little blurry, and the recording starts after the introduction slide (pictured here), but the audio is fine… think of it as an augmented pod cast.

We wish to thank our attendees for their many questions and for engaging in thought- provoking dialogue at the end of the session. Stay tuned for part 2.