Two Peds in a Pod®

Introducing Lexi Logan

We are thrilled to introduce photographer Lexi Logan to the blogosphere. Look for her work in our upcoming posts. Busy mother of three, Lexi holds a Bachelor of Science degree in Fine Art and Art Education from New York University. After graduating with honors, she worked in Manhattan creating original window displays on Broadway, teaching elementary art, and exhibiting her contemporary paintings.

In 2000 Lexi moved to Bucks County Pennsylvania with her Australian husband Andrew Logan, an internationally recognized sculptor. Together they launched Canal Street Studios, LLC., a company that embodies architectural design, sculpture, and a full service bronze foundry. Lexi also serves as Associate Producer for Lunch Productions, a video and New Media production company. Her most recent project, aside from keeping up with our erratic requests, includes providing illustrations for an upcoming children’s book.

Sure beats our blurry iphone photography. Welcome Lexi!

Naline Lai, MD and Julie Kardos, MD
© 2010 Two Peds in a Pod℠

October 10, 2010 by twopedsinapod

Points about Periods: what you may have forgotten to explain about menstruation

She’s eyeing your lip gloss and won’t wear clothes with animals or hearts on them anymore. She’s begging you for a Facebook account, but still talks to her dolls and holds her dad’s hand in public. Yes, your daughter is on the edge of puberty and you’ve been talking to her about her upcoming body changes and getting her period. But your own memory of early adolescence from a couple of decades ago is a little fuzzy. Beyond the basic anatomical changes, did you cover everything? Here is a smattering of questions about menstruation which may not have occurred to you, but we hear in the office: first period

From the girls: Does a period hurt just like when I cut myself?

In a kid’s experience, blood is associated with an injury and therefore pain. Reassure your daughter that bleeding during a period is not like the bleeding of a cut. Yes, you can mention that she may feel cramps, but usually not initially.

From the moms: When can she wear a tampon?

At any point. Several manufacturers make tampons especially designed for teens. Do not worry; even for a virgin, a tampon will not cause any injury. Just like you’ve taught her everything, you may need to teach her how to insert and take out a tampon.Warning—do not teach her five minutes before she leaves for the beach during her period. For some girls, removing the tampon is more difficult than inserting it. Teach her/ talk it through when she is not menstruating. Remind her to change tampons frequently- young girls in particular are more vulnerable to Toxic Shock Syndrome.

From both: It’s been months, how long until her period is regular?

It can take around two years for periods to come regularly. Once they are regular, the average frequency is every 28 days, but can vary from 21 to 36 days.

From the girls: Will I know when I get my period?

Let your girls know that when they see their first period it may not be a bright red blotch of blood on their underpants. Explain that dried blood looks like brownish streaks; they may confuse it with stool.

From both: In this age of skinny jeans and jeggings, where to hide a pad or tampon during school?

If she doesn’t carry a purse, then have your daughter try inside the cuff of a sock or tucked in the waistband of pants. I have seen a thin pad hidden under the tongue of a sneaker.

From the girls: Do I go to the nurse’s office if I get my period for the first time during school?

Not necessarily, unless you are looking for pads. This is not an illness.

Remind your tween to let you know when she starts getting her period and that you will keep it private. One girl told me she did not tell her mother for months. The reason? Her neighbor’s mother had given her neighbor a “Red” party in honor of her neighbor’s first period. Everyone wore red to the party and there was even a red cake. My patient was appalled at the attention and avoided telling her own mother until well after her menstrual cycle was well established.

Also, you can help your tween track how heavy her flow is by checking her supply of pads and tampons. Excessively heavy periods cause anemia from blood loss and young girls can be unaware how much blood loss is normal. Remind her that if she has to change a pad once an hour, or if her period drags on over a week (average is three to seven days) she needs to tell you about it. Even without excessive blood loss, make sure she eats iron containing foods (eg. spinach, lean red meats) to help prevent anemia.

If you get overwhelmed by all the facts about menstruation which need to be explained, keep in mind this conversation I once had during a check-up. During the visit I gave a young teen a moment alone to ask questions privately. As the door closed behind her mother, I asked the girl if she had any questions about adolescence.

“No questions,” she declared.” I wear a bra… I bleed every month. There’s nothing else to know.”

Wish everything about the teenage years could be so simple.

Naline Lai, MD with Julie Kardos, MD

October 7, 2010 by twopedsinapod

Organic fruit and veggies: health or hype?

Two Peds in a Pod turns today to guest blogger Dr. Alan Woolf, Director of the Pediatric Environmental Health Center at Children’s Hospital Boston and president-elect of the American Academy of Clinical Toxicology, to tackle the question, “Should you feed your kids organic fruits and vegetables?”

Nutritionists are urging parents to feed kids one and one-half cups of fruit and two and one-half cups of vegetables daily and the American Academy of Pediatrics suggests whole fruit rather than juice to meet most of the daily fruit requirements.

OK, so that’s fine, but why spend a lot more money to buy those fruits and veggies labed organic? Are they worth it? Will non-organic produce harm your kid? No easy answers here. American consumers demand a bountiful supply of blemish-free, perfect fruits and vegetables. We want unspotted shiny red apples, brightly colored large oranges and arrow-straight asparagus. Farmers want to give us just that. Since pests attack crops causing blemishes, worms, blight, and other forms of costly crop damage, farmers have been using pesticides for years to increase crop yield, profit, and visual marketability.

The US Dept of Agriculture (USDA) regulates the agricultural procedures and labeling that use the buzz word organic. Obviously every business wants to put that word on their product if it means consumers will run out and buy it. The USDA will certify farms that use organic methods. But even the USDA’s definition of organic allows a percentage of synthetic chemicals to be added to products labeled organic. Also organic does not mean that the food contains increased amounts of essential minerals and vitamins or is more nutritious for you. And remember that organic produce doesn’t necessarily come from small, cuddly, local, family-run farms. Most large, international agribusinesses are touting organic foods for sale these days.

Well over one billion pounds of pesticides, according to the Department of Agriculture, are used on American crops annually. And pesticides tend to be nasty chemicals—otherwise they wouldn’t kill bugs. In large amounts, some types can cause seizures or coma in people. However, all foods , whether organic or non-organic, must contain pesticide residues well below the standard that the government considers safe. Not every piece of non organic fruit even contains a residue; it’s hit and miss.

But what about the long-term safety of pesticides in trace amounts, the amounts barely present as micro-grams or nano-grams? The fact is that no one knows the safety for sure. The science just isn’t there yet. Some dispute the government’s definitions; arguing that children don’t eat the same market basket as adults (they eat more fruit). They reason that using adult pesticide residue standards may not protect children. Recently some scientists did a study where they measured pesticide residue in the urine of school-aged children who were fed regular, market-basket produce, and then measured again after they switched them to organic-only fruits and vegetables. Guess what—kids fed organic foods excreted less pesticide residues in their urine. There’s a powerful argument for organic.

One thing that everyone agrees with—wash all of your fruits and vegetables after you buy them and before anybody in your family eats them. And that means soap and water, not just a quick rinse. Also keep in mind that infants and children are resilient even in this modern age filled with all sorts of hazards. Kids and adults are armed with marvelous defense mechanisms that prevent chemicals from doing bodily harm. Even if a chemical does cause some injury, the body has remarkable mechanisms that repair the damage in a hurry. No need to be “chemical phobic;” you can’t keep your kids in a bubble.

That being said, you still need to be cautious. In pediatrics we often invoke the “precautionary principle.” The idea is that if you don’t exactly know what a chemical will do to a child’s health because there aren’t enough scientific studies out there, then you assume that what it is capable of is bad and so, if possible, try not to expose them, just as a precaution.

When you can, buy from local farms or stands where you can ask them their growing practices, or else just grow your own. If you decide to buy organic foods, you should eat them right away. They may not stay edible as long without preservatives. Again, no matter what type of food you buy, wash, wash, wash.

Finally, alternative “greener” farming techniques, integrated pest management (IPM), and more resistant varieties of plants have increased crop yields, in many cases without using as much pesticide. That’s good news for all of us. Breeding of genetically-engineered plants require less use of pesticides, but they may not be acceptable to most consumers. That’s a whole column in itself!

The bottom line: My wife and I will try to buy organic foods when we think of it, but we don’t obsess over it when we forget.

Alan Woolf, MD, MPH, FAACT, FAAP

Director, Pediatric Environmental Health Center, Children’s Hospital Boston

October 3, 2010 by twopedsinapod

HURRAY! National Public Radio

We were thrilled to record today with National Public Radio’s Robin Young on Here and Now about Two Peds in a Pod. Watch for the upcoming piece where we wax and wane philosophical about topics ranging from our thoughts on poop to our story of how we started.

The recording studio sure beat our kitchen table!

Naline Lai, MD with Julie Kardos, MD

September 28, 2010 by twopedsinapod

Fact or fiction? A flu vaccine quiz for all teachers, babysitters, parents, and anyone else who breathes on children

A few days ago, I spoke with the faculty of a local early childhood education center about flu vaccine myths. See how you do on the true and false quiz I gave them:

I can tell when I am getting the flu and will leave work before I infect anyone.

False. According to the CDC (US Center for Disease Control), you are infectious the day before symptoms show up.

I never get the flu so it’s not necessary to get the vaccine.

False. Saying I’ve never had the flu is like saying, “I’ve never a car accident so I won’t wear my seat belt.”

I hate shots. I hear I can get a flu vaccine in a different form.

True. One flu vaccine, brand name Flu Mist, provides immunity when squirted in the nose. Non-pregnant, healthy people aged 2-49 years of age qualify for this type of vaccine.

I got the flu shot so I was healthy all year.

False. Perhaps it was the half-hour a day you added to your workout, or the surgical mask you wore to birthday parties, but your entirely healthy winter was not secondary just to the flu vaccine. The United States flu vaccine protects against several strains of flu predicted to cause illness this winter. This year’s vaccine contain both seasonal and the 2009 H1N1 strains. Your body builds up a defense (immunity) only against the strains covered in the vaccine. Immunity will not be conferred to the thousands of other viruses which exist. On the other hand, the vaccine probably did protect you from some forms of the flu, and two fewer weeks of illness feels great.

My friend got the flu shot last year, therefore, she was sick all winter.

My condolences. True, your friend was sick. But the answer is False, because the illnesses were not caused by the flu vaccine. Vaccines are not real germs, so you can’t “get” a disease from the vaccine. But to your body, vaccine proteins appear very similar to real germs and your immune system will respond by making protection against the fake vaccine germ. When the real germ comes along, pow, your body already has the protection to fend off the real disease. Please know, however, there is a chance that for a couple days after a vaccine, you will ache and have a mild fever. The reason? Your immune system is simply revving up. But no, the flu vaccine does not give you an illness.

I got the flu vaccine every year for the past decade. I will still need to get one this year.

True. Unfortunately, the flu strains change from year to year. Previous vaccines may not protect you against current germs.

I am a healthy adult and not at high risk for complications from the flu, so I will forgo the flu vaccine this year.

False. The flu vaccine is now recommended for everyone greater than 6 months of age. When supply is limited, targeted groups at risk for flu complications include all children aged 6 months–18 years, all persons aged ≥50 years, and persons with medical conditions that put them at risk for medical complications. These persons, people living in their home, their close contacts, and their CARETAKERS are the focus of vaccination.

Even if I get the flu, I’ll just wash my hands a lot to keep the germ from spreading. I have to come back to work because I don’t have much time off.

False, According to the American Academy of Pediatrics Report of the Committee on Infectious Diseases, the influenza virus can spread from an infected person for about a week after infection.

Yes, kids get sick from others kids, but as a parent who comes in contact with two children, an early childhood educator who comes in contact with ten children, an elementary school teacher who comes in contact with twenty children or a high school teacher who comes into contact with one-hundred children daily, you may end up the one who seeds your community with a potentially deadly illness. Right now, flu vaccine clinics are as plentiful as Starbucks. Hit that CVS or Walgreens on the way home, wander into your doctor’s or grab a shot while you get groceries. By protecting yourself from the flu, you protect the children you care for.

Naline Lai, MD with Julie Kardos, MD

September 25, 2010 by twopedsinapod

Pump it up: breastfeeding and returning to work

Picture this: you are going back to work after a too-short maternity leave. Briefcase? Check. Lunch? Check. Breast pump? Check. Photo of your baby to put on your pump for inspiration? Check.

Many moms ask how to continue breastfeeding when they return to work. Because babies should receive breast milk or formula for at least their first year, here is how you can incorporate breastfeeding into your work routine:

Offer bottles by four weeks of age. Bottles can contain breast milk or formula, but you need to give your baby practice taking milk from a bottle by four weeks old. If you wait much longer, your baby will likely refuse the bottle. Have someone other than yourself give at least one bottle per day or every other day. In this way, your baby learns to accept nutrition from someone else.

Store breast milk using the simple and conservative “rule of twos.” Leave breast milk in a bottle at room temperature for no more than two hours, store breast milk in the refrigerator for no more than two days, and store in the freezer for no more than two months. If your baby has already sucked out of a breast milk bottle, that milk is only good for up to two hours. Remember to write the date on your milk storage bags and use the oldest ones first.

Now select from the following breast feeding menu, understanding that you might start with option 2 or 3 and then change to option 4. The best option is the one that works best for you and your baby.

Option 1: Continue to breast feed at work. This option works for moms who work from home, moms who have child care in their work setting, and moms close enough to dash home to breast feed during the day or who have caregivers willing to drive babies over to work for feedings.

Advantage: no pumping, no buying formula, no bottle washing. Disadvantage: may require some creative scheduling.

Option 2: Breast feed when home and pump and store breast milk at work. Have child care givers offer stored breast milk in bottles. This method allows moms to provide exclusively breast milk to their babies. Start pumping after the first morning feeding (or any other feeding that you feel you produce a bit more than your baby needs for that particular feeding) beginning when your baby is around four weeks old. Also pump if your baby happens to sleep through a feeding. Store this milk in two or three ounce amounts in your freezer. You can obtain breast milk freezer bags from lactation consultants and baby stores, or you can store milk in zip lock bags. As you continue to pump after the same feeding each day, your body will produce more milk at that feeding.

Once you have some breast milk stored and you are a few days out from returning to work, try pumping during the feedings you will miss while at work. Have someone else feed your baby breast milk bottles for these feedings. Finally, when you return to work, continue to pump at the same schedule and leave the stored breast milk for your child’s caregivers. Consider leaving some formula in case caregivers run out of breast milk. Remind them never to microwave the milk (this kills the antibodies in breast milk as well as creates a potential burn hazard) but rather to thaw the milk by placing in a hot water bath.

This method becomes easier as babies get older. Once babies start solid foods, they breast feed fewer times per day. Somewhere between six to nine months, your baby eats three solid food meals per day and breastfeeds four or five times per 24 hours. Thus, the number of times you need to pump decreases dramatically.

Advantage to this option: breast milk with its germ-fighting antibodies given through the first year and no expense of formula. Disadvantage: having to pump at work.

Option 3: Breast feed before and after work and give your baby formula while you are at work. If you do not pump while at work, your body will not produce milk at these times. If you work full time, then on weekends you might find it easiest on your body to continue your “work time” feeding schedule. If you choose this method, wean your baby from daytime breast feeding over that last week or so before returning to work. Suddenly going a long time without draining your breasts can lead to engorgement, subsequent plugged ducts, and mastitis.

Advantage: baby continues to receive breast milk. No need to pump at work. Disadvantage: you still have to wash bottles and have the added cost of formula.

Option 4: Breast feed until you return to work, then formula feed. Wean over the last week you are home with your baby to avoid engorgement and leaking while at work. Your baby still benefits from even a few weeks of breast milk.

Advantage: No need to incorporate pumping into your work schedule. Baby still gets adequate nutrition. Disadvantage: babies who are in childcare and exposed to many germs miss out on receiving extra antibodies in breast milk. However, weaning your baby off breast milk will not cause illness. Do what works for your family. Also, more expensive to buy formula and time-consuming to wash bottles.

Pumping should not take longer than 15 minutes if you’re pumping both breasts at the same time and can take as short as 7-10 minutes. Remember to wash your hands before pumping.

What kind of breast pump should you buy/rent? If you are in it for the long haul, we recommend the higher-end electric double pumps with adjustable suction. Ask the hospital nurses, your midwife, or your obstetrician for names of people who rent or sell pumps in your area.

Finally, remember that the calorie count and nutritional content of breast milk and formula are the same. So do NOT feel guilty if pumping does not pan out and you and end up giving some formula. Your baby is almost always going to be more efficient than a breast pump and some breasts just don’t produce milk well during pumping sessions. In contrast, some of my patients never got the hang of breast feeding and their moms pumped breast milk and bottle fed them for the entire first year. Dr. Lai and I have each had patients who refused to take a bottle at childcare but just waited patiently for their moms to arrive. These babies got what they needed by nursing throughout the night. The babies didn’t mind what time of day they ate. Just like many aspects of parenting, sometimes with breast feeding, you just have to “go with the flow.”

Julie Kardos, MD with Naline Lai, MD
2010 Two Peds in a Pod®

September 22, 2010 by twopedsinapod

Don’t roll your eyes at strabismus (lazy eye)

My patient looked up at me. “Do you want to see what I can do?” she asked.

Her father mockingly moaned, ”Oh, no.”

“Pleeease,” persisted the girl, “just once.”

The dad just laughed.

“Watch,” she said proudly as she suddenly rolled her eyeballs back and flipped her eyelids inside out with her fingers.

“Very impressive,” I told her, and snapped a photo.

__________________________

Voluntary eye movements like the one in the photo may be ugly to look at but are not damaging. Nor will the child’s eyes be forever stuck in that position. On the other hand, any involuntary eye movement should be investigated.

In particular, be vigilant for lazy eye (strabismus). In this condition, the eyes are do not align correctly and drift. According to the most recent edition of Nelson Textbook of Pediatrics, lazy eye affects about four percent of children under six years of age and can manifest itself in infancy.

By two months old, your child’s eyes should be able to fix on your face and move together as she watches you. If you notice her eyes cross beyond this age, take her to her doctor. Lazy eyes tend to run in families. The child pictured immediately here has several relatives with lazy eyes.

The cause of most lazy eye is unclear; however some cases are due to a defect in the pathways of the brain and nerves which control eye movement. Occasionally, some types are associated with other medical problems.

Detection of a lazy eye is important because a “lazy” eye can lose vision (amblyopia) from underuse. Treatment for most kids involves covering the good eye and forcing the lazy eye to “do more work” in order to prevent amblyopia. Ophthalmologists (eye surgeons) use techniques such as covering an eye with a patch, prescribing special glasses, or using eye drops to encourage the use of the lazy eye. For some, surgery is needed to fully align the eyes. The earlier treatment starts, the more rapid the response. Unfortunately, after a child is eight years old, treatment is much less effective.

Shortly after the girl showed me her eye rolling talent, a boy in the office showed me another intriguing trick. By inhaling deeply, the boy sucked in one nostril until it flattened without pulling in the other one.

Didn’t take a picture of that one.

Naline Lai, MD with Julie Kardos, MD

September 18, 2010 by twopedsinapod

Of Bracelets and Breast Exams

Move over liveStrong bracelets, move over Silly Bandz. Just when you thought you threw away the your last Oriental Trading Company gadget, here come “I Love Boobies” bracelets. As I see the newest overpriced piece of fashionable rubber dangle from my daughter’s wrist, I sigh at the cost, but console myself that at least the money goes towards breast cancer research. Use the bracelets as a reminder to teach your girls to do monthly breast exams. The American Cancer Society recommends monthly self-breast exams starting at age twenty. However, most pediatricians recommend starting exams earlier. Breasts are full of normal lumps and bumps and your teen or young adult should know her baseline. For directions on conducting a breast exam refer to American College of Obstetrics and Gynecology’s online pamphlet . Yes, even a fashion accessory can turn into a parental teaching point. Now what do jeggings teach kids?

Naline Lai, MD with Julie Kardos, MD

September 14, 2010 by twopedsinapod

Beth

At this time of the Jewish High Holy Days, Dr. Kardos offers us a glimpse into lessons learned as a doctor in training. This is a true story she wrote years after meeting Beth and until now, had only shared with a few close friends.

Tonight starts Yom Kippur and my two youngest children are asleep in their beds. As my oldest sits in the rocker next to my desk reading the last book in the Lord of the Rings series, my husband relaxes playing a computer adventure game. The Jewish High Holy Days are a time for reflection about the past year. But my mind goes back to a Yom Kippur Eve when I was working as a resident in the Pediatric Intensive Care Unit (PICU) as part of my pediatric training.

Residents work through most holidays, even ones they consider important. This night, I wished I had off, but I consoled myself with knowing that I would be off on Thanksgiving. Luckily I was partnered with Amy, the lead physician in the PICU.

The sickest patient that night was twelve-year-old Beth. She had leukemia and had just started chemotherapy. Because her immune system was weak, Beth was very ill with a bacterial infection in her blood. Despite powerful antibiotics, the infection raised havoc in her body. She developed such difficulty breathing that a tube from a mechanical ventilator was placed down her throat to force air into her lungs. Even the comfort of sleep escaped her. Beth was afraid of what was happening to her body. She refused to accept medicine that could help her sleep because she was so afraid that she would never wake up.

That night, despite her incredibly ill state, she got her period. Usually when a girl’s body is stressed, the body preserves all blood and the periods stop. But hers came, and because her blood cells were so abnormal from a toxic combination of infection, chemotherapy, and leukemia, she began bleeding to death. We transfused her with bag after bag of blood to keep her alive.

In the middle of the night, Beth’s blood pressure suddenly plummeted so we added even more medication. Because my mentor Amy was not certain that Beth would survive the night, we called her family at the hotel near the hospital where they were staying and told them come to Beth’s side. And through it all, Beth refused to sleep. Her eyes always opened in terror whenever we approached her bed. Her face was gray. Her chest rose and fell to the rhythm of the mechanical ventilator, and you could smell the fear all around her.

I stood with Amy just outside Beth’s room as Amy reviewed a checklist for Beth’s care. It went something like: “Ok, we just called blood bank for more blood; we called her family; we called the lab; we called the pharmacy. We are currently attending to all of her problems, we now just have to wait for her body to respond.” She paused,” But you know what?”

“What?” I asked her.

“We need to address her spiritual needs as well. Do we know what religion her family is? They may want a clergy member with them.”

I was startled. In the midst of all the tubes and wires of technology, Amy remembered to summon the human factor in medicine. We looked in her medical chart under “religious preference” and there it was: Jewish.

“Amy,” I said, “of all nights. Tonight is Yom Kippur…the holiest night of the Jewish year.”

I knew that the hospital had a Rabbi “on call” just like they had priests, nuns, ministers, and other spiritual leaders. But that night I was sure that every rabbi in Philadelphia would be at synagogue for Kol Nidre, the declaration chanted at the beginning of the Yom Kippur evening service. We were unlikely to track down a Rabbi.

Despite this, we asked her mother if they wanted us to call a Rabbi for them. She shook her head no. I remember feeling relieved, then guilty that I felt relieved. Amy left to check on another patient. Beth’s mom, dad, and older sister stood together watching Beth. Her sister’s hand lay on her mother’s arm. Her mother’s eyes darted from me to Beth to the mechanical ventilator next to the bed. Beth’s eyes were closed and it was difficult to know if she even knew we were there.

Her family walked out into the hall to talk. Beth at that moment opened her eyes and started tapping on the bed with her foot to get my attention. She couldn’t talk because of the tube down her throat and her hands were taped down with IVs. Yet she reached out with one hand as best she could.

I walked close to her bed so she could touch me and I asked, what is it, Beth?

Her lips formed the words around the breathing tube very deliberately, her body tensing. “Am I going to die?”

All in a split second I am thinking to myself: How do I know/it could very well happen/how can I lie to her/how can I tell her the truth of what I fear could very well happen/how am I going to answer this child?

What I answered was, “Not tonight, Beth.”

She relaxed into her pillow but kept her eyes on mine. I waited to see if she would say anything else, but the effort to ask that one question had exhausted her. I stood, holding her hand, until her family came back into the room. Her eyes followed them to her bed and I left so they could be together.

Beth did survive the night and in fact survived a month in the PICU. She became well enough to be transferred to a regular hospital floor. By this time I was working in a different part of the hospital, but one of the oncologists pointed her out to me.

I don’t know what happened to her in the long term.

So now I tell my oldest child it’s time for him to stop reading and go to sleep, and I walk him to his room to say goodnight. My husband and I decide what time we’ll attend Yom Kippur services tomorrow. Part of me feels joined with Jews everywhere who will also be spending the next day reflecting, praying and celebrating a new year. But mostly, like every year at this time, I remember the sounds and the smells and the fear in the PICU where sickness doesn’t care who your God is or what your intentions are. I remember Amy caring enough to think about a dying child’s family religion, and always, I remember Beth.

September 11, 2010 by twopedsinapod

Stopping a bully: Talk, Walk, Squawk and Support

Can you identify your child in any of these scenarios?

-Your second grader comes off the school bus crying because another student was teasing him the entire ride home about his new glasses.

-Your fifth grader was punched on the school yard by a sixth grader and none of the playground teachers saw it happen. Your child’s friend shoved the older child off your child before more damage was done.

-Your ninth grader keeps missing the school bus so you have to drive her to school. When she comes home from school she uses the bathroom immediately. You find out she avoids the bus and the school bathroom because verbal abuse occurs in both places.

Whatever your child’s age, when you realize he or she is being bullied you will be outraged. In fact you might be tempted to retaliate against the bully yourself. However, here are more appropriate ways to help your child.

Bullying should never be tolerated. Teach your child how to directly deal with a bully, but be quick to talk also to the adult supervising your child when the bullying occurs. Your child should always feel safe in school, day camp, on a sports team, or any other adult-supervised activity.

Bullies are always in a position of power over their victims; either they are physically larger, older, or more socially popular. Teach your child first to try a strong verbal response (talk) such as “STOP talking to me that way!” or “Don’t DO that to me!” Speaking strongly and looking the bully in the eye may take away some of the bully’s power as well as attract attention of nearby peers or adults who can help your child.

Teach your child to walk away from a fight. Tell him to keep on walking toward a teacher, a classroom, a peer, or anyone else who can offer safety from a bully. Train him to breathe deeply/ignore/de-escalate situations to diffuse a bully’s anger.

Have your child tell a teacher, camp counselor, coach, or other supervising adult about the abuse (squawk) as soon as it occurs. Always encourage your children to talk to you as well. Remember at home to ask your child questions such as “How is school,” “How are your friends,” “Do you know any kids who are being bullied?,” and “Are YOU being bullied?”

If your child says he is angry at a friend or a classmate, be sure to ask questions that encourage your child to elaborate, such as “Oh, what happened?” or “Did something happen between you?” Listen carefully to his response. He may be taking out his anger at a bully on his own friends. This response is in retaliation for his friend’s failure to protect him from a bully. Also, is your child becoming more reluctant to attend school, “missing” the bus more often and thus requiring a ride, or acting angry or sad more often? Kids who are victims of bullying can act like this.

In school, once you are aware that your child is a victim, talk not only to your child about how she should handle a bully but also alert your child’s teacher and/or school principal about the situation (support). You should tell them in your child’s words what happened, what was said, and be clear that you are asking for more supervision so that the bully has less access to your child. Ask for more supervision during times when there is usually less adult presence such as in the lunchroom or on the schoolyard. Your school may already have a “no bullying” policy. Often, the aggressor gets the heavier consequence in the event of a conflict. Again, children have a right to feel safe in school.

Restore your child’s self-confidence. Bullies pick on kids who are smaller and weaker than they are, physically as well as psychologically. So your child has more positive experiences with kids who do not bully, encourage your child to invite friends over to your home or host a fun group activity (kickball game in your backyard, show a movie/supply popcorn, etc.). Do family activities and show your child that you enjoy spending time with him. Enroll your child in activities that increase his self esteem such as karate, sports, or music lessons. A child who feels good about himself “walks taller” and is less likely to attract a bully.

As a parent, you might read this post and think, “Yes, but I’d rather just teach my child to take revenge.” Unfortunately, escalating the situation only breeds anger and in fact may get your child into trouble. Rather than “hate” the bully, help your child see that a bully deep down feels insecure. A bully resorts to making himself feel better by making others feel bad. Teach your child to pity the bully. With your guidance, your child will project self-confidence and a bully will never, ever, be able to touch him.

September 7, 2010 by

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