Saturday, September 18, 2010

Constipation – The Pain of Strain

Poop – a necessary part of life.  It’s amazing how traumatic it can be for kids and parents alike.  So, if your child has a problem with constipation.  Then here are some things that you can do to make it a little easier. 

Some of what you can do depends on the age of the child.  

Young Infants – Babies tend to strain when the poop, especially newborns.  This is normal as long as the poop is soft.  As doctors, we don’t consider it true constipation unless the stools are hard.  It really does not matter too much how often they poop, or how much they grunt and groan and turn purple when trying to go.  Parents often assume that it’s hard for the baby to poop (if we did what they did, we would feel constipated!).  Not true.  However, if they haven’t pooped for 5 days or more, or if they are having hard stools, then it’s constipation.  (If you have a brand new baby, your baby should poop at least once in the first two days of life.)  

So, if you think your baby is constipated, you can try giving 1-2 oz of water. or take your baby’s rectal temperature to see if you can stimulate a bowel movement.  If this fails to produce a prize, then some doctors recommend giving a teaspoon of karo syrup.   If your baby still cannot go, or seems like he is in pain, or has blood in the stool, call your child’s doctor.

Older Infants/Toddlers – Again, it’s the consistency of the poop (how hard it is) as opposed to the frequency (how often) of the poop that determines constipation.  For older infants and toddlers who are now eating foods, there are certain foods to avoid if your baby is having hard stools.  Bananas, Rice, Applesauce, and Toast (the infamous BRAT diet) are foods that cause constipation.  So, avoid giving your grunting groaning toddler these foods when they are having trouble.  Also, too much cheese or milk can sometimes constipate.  Your baby needs at least 16-20 oz of milk (formula, breastmilk or whole milk if older than age 1).  More than that may be adding to the hard poop problem.

What can help?  More water, fresh fruits and vegetables (other than bananas).  More  fiber – in the form of oats (oatmeal), bran, whole wheat, will help.  I like to say that white foods constipate (rice, white flour), and brown foods help (whole wheat, bran, etc).  Check the labels of your whole wheat products.  Sometimes the wheat is so processed, that the bread appears brown, but has almost no fiber content.   Prune, raisins and prune juice can also help.

Potty-trainers – This  group is notorious for holding poop.  Something about pooping into the freedom of a potty terrifies those who are learning.  Often, a child will hold his poop until someone puts him back into a diaper.  By holding it in, more water is absorbed from the poop… and voila, constipated, hard stools that hurt.  Then, they are not only worried about the potty, but they are afraid of the next painful poop.  So, they hold it in… and the vicious cycle continues.  

Give your potty-trainer the best chance to succeed.  People tend to poop about 20-30 minutes after eating.  So, if you can, try to put your child on the potty around that time.  Read a book, color, listen to music, watch a portable DVD… do something to help your child to relax and forget about the fact that they are sitting on a potty.  Then, if they happen to go – CELEBRATE!  If they don’t, no reason to make a fuss.  Just wait until the next time.

Some children need Miralax, an over-the-counter stool softener.  This is a flavorless powder that you mix into your child’s drink.  It helps to keep the stools soft and can help children get back into a regular pattern with soft, painless stools.  It is safe to use for a period of time.  Ask your doctor for guidance.  And don’t forget the diet changes (it’s the same as what I’ve written for toddlers above).

Big Kids (and Grownups) – it’s hard to tell sometimes that an older child or teenager has constipation since you no longer are involved in that process anymore (thank goodness).  However, if your child complains of intermittent mild stomachaches, it may be related to constipation.  Avoiding the BRAT diet (Bananas, Rice, Applesauce and Toast) and too much cheese and milk (make sure they get calcium from other sources) might help.  Increasing fiber and using fiber supplements such as Metamucil or Benefiber will help.  Drinking plenty of water makes a difference.  Prunes, raisins, prune juice will help a lot of people.  If your child has not had a bowel movement in 3-4 days, call your doctor to see other medications are needed.  If the stomach pain is severe, there is blood in the stool, or your child is vomiting, call your doctor immediately. 

For a cute video on constipation by DadLabs, see the link below:

Hope this helps those who are dealing with the pain of strain!  Thanks for reading!

Sunday, September 12, 2010

Silly Bandz and Being Cool

Silly Bandz… now why didn’t I invent those? Who would have thought that rubber bands could become so popular? What’s next … paper clips?

If your child isn’t collecting them, chances are you know a child who is. And certainly, you can see them all over the stores. Placed strategically at a child’s eye level at the checkout aisle – shiny packages of what look like a child’s dream come true worth of colorful Silly Bandz.

For those of you who don’t know what they are. They are essentially rubber bands shaped as various objects, such as animals, instruments, and so on. You wear them on your wrists and you can trade them, collect them, and just leave them all over the house (which is what my kids do with them). It’s the latest craze and amazingly appeals to preschoolers to teenagers. I’ve seen many adults walking around with them on their arms. The “cool” factor is high, the price is low, and they are something wearable. This is the ultimate combination of factors that makes a fad a success.

But then, add in the media… suddenly Silly Bandz were banned from several schools. It was on the news, on TV, and in papers. They were the topic of mommy-discussions everywhere. Children were getting injured from bands that were too tight and too small for their wrists. Suddenly, there was a danger factor or “badness” factor. That made it even cooler for the adolescent group as parents of preschoolers toned it down a notch.

I tried resisting the Silly Bandz craze. I knew that my kids would just toss them aside when they were bored with them. Just more clutter in my house. But, boy, was it difficult! The looks on their faces when they told me that so-and-so had MORE than twenty bands, and that their best friends had ones shaped as dinosaurs and cool sea creatures. The pleading “why nots?” from my five-year-old almost put me over the edge as I tried desperately to get him interested in buying a book at the bookstore as we stood next to the giant kiosk of Silly Bandz at the checkout line. And finally, it happened. Silly Bands were given out as goodies and they entered my home.

Now my kids were cool. They didn’t need many. Just one or two satisfied my oldest son. He was content that now he had some. And, of course, the little ones just pulled them until they broke. (My youngest even resorted to scissors.) Oh well. Four dollars down the drain. But they were happy.

If only all fads were so inexpensive. Those of you with teenagers know how pricey big kid fads can be. The best shoes, the coolest clothes, the right makeup or hairstyle, the best video game system, and of course… the car.

I guess I should be happy that few rubber bands are all that I need to buy for now!

Being popular is a high priority in children’s lives – especially as they reach their middle school and high school years, it’s important to teach them how to cope with the pressure of needing to be liked and popular.
As a parent, it is important not to minimize their need to be cool or to tell that those things are unimportant.

They are very important… to them and their sense of place in their world. The following link has some good advice on how to teach your child to cope and how you can help to give them skills that will last a lifetime.  It provides a nice outline how to help your child if they struggling with trying to fit in or if they are feeling left out.
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Wednesday, September 8, 2010

"Be A Sport" When Your Kid Plays Sports

Standing on the sidelines watching my son play football, I was chatting with some of the other parents.  One mom was talking about how the coaches had been fighting over her son when they picked kids for our teams last week.  Lots of heated arguments ensued and angry, hurtful comments were made during the discussions.  Her son was big, built, had experience, and was a natural for football.  It was no wonder that he was the ideal candidate.  The drama involved in building “super teams” and competing to get the best players is seen every year in sports – from college to professional teams.  Coaches are always trying to get the best players.  It makes sense. So, why was this mom upset that there was drama over her son?  He was only seven years old!  This was the local flag football team for kindergartners and first graders.

Another dad at the game shared that they had just left a league because of the politics involved as travel soccer team candidates were identified.  A friend told me recently how stressed she was because she had to tell her daughter’s field hockey coach that they were leaving because they wanted someone who was better and more driven.  She worried about how angry he'd be.  Stories have been published about parents have been banned from games because they were too abusive to the coaches and were overly zealous about referee calls. And everyone who has been to competitive sports games has seen “that dad” or “that mom” who is a little crazy when their child doesn’t shine that day.

Organized sports are great for kids.  It teaches them how to work on a team, how to follow instructions, follow through on commitments, as well as learn the skills for that sport in an controlled, safe environment.  The physical activity is great exercise, and can teach a lifetime love of exercise and staying in shape.

What we don’t want our kids to learn is how to be a poor sport, or how to yell when you don’t get your way, or that winning is the only goal.  Adults need to remember that the goals for children may be different than adult-oriented goals.  Kids are observant and many of our own behaviors come from what we learned from our parents.  I know that I’ve said things and thought with horror to myself, “Oh no!  That sounded like my dad!”  You can hear it from your own children when they say things back to you, and you realize that it sounded just like you.  (And, of course, it’s usually behaviors that you aren’t proud of!)

So, teach your kids that putting their best foot forward and trying their best is the key.  They may never play professional sports, or be a star athlete, but they will learn to love being on a team with their friends, be proud of achieving small personal goals (“You did a great job kicking the ball towards the goal today!”),  and feel good about completing a season. 

If your child happens to have a talent, support them, and make sure that they are participating in a healthy way and not overdoing it.  Take them for regular check-ups with their doctor to make sure they are cleared to play.  If they have an injury, have it checked by a physician before they do any further damage by “playing through the pain.”  Children heal quickly, yes, but they have looser ligaments and tendons, and are still building their bones and muscle mass.  They can injure themselves more easily and can do more permanent damage if not treated early.

That being said, organized sports are much more common and can be great fun.  Keep your kids healthy and safe.  Make sure that they have the proper equipment and protective gear, and they will have a great time. 

Happy playing! (well, actually, happy driving and watching - you know what I mean!)

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Friday, September 3, 2010

Flu.... So soon? Time to vaccinate!

Flu is here!  We've seen several cases of flu in our office over the last few weeks.  Already!  While it's too soon to say if it's going to be significant and spread, it has caused us to start offering vaccinations for children now in our practice.

The flu vaccine is available at many places around the country at this time, and you should consider calling your child's doctor to see if you can get it soon.  This year, the H1N1 vaccine is included as a strain in the seasonal flu vaccine.  So, no need for two different types of vaccines this year.  (Thank goodness, last year was a nighttime trying to get all those shots!)

How many flu vaccines does your child need this year?   It's kind of confusing, so I'll try to outline it below for you.

If your child is over 9 years old, he/she only needs ONE flu vaccine this year.

If your child is under 9 years old, has had the seasonal (regular) flu vaccine before AND got the H1N1 vaccine last year, then your child only needs one flu vaccine this year.  Even if your child only got 1 H1N1 vaccine last year, then he/she only needs ONE flu vaccine this year.

If your child is under 9 years old, has had the seasonal (regular) flu vaccine before, but did NOT get any H1N1 vaccine last year, then your child needs TWO flu vaccines this year.  The vaccines need to be at least 1 month apart.

If your child is under 9 years old  but has never had the seasonal (regular) flu vaccine, then your child needs TWO flu vaccines this year.  The two vaccines need to be at least 1 month apart.  Even if your child got the H1N1 vaccine last year, if he/she has NEVER had the seasonal (regular) flu vaccine, then your child needs two flu vaccines this year.

If your child is under 9 years old and has never had any kind of flu vaccine, then your child needs TWO flu vaccines this year.  The two vaccines need to be at least 1 month apart.

Babies under 6 months of age cannot receive the vaccine.  However, it is highly recommend that everyone else in the house (parents, caregivers, siblings) get the vaccine if they can.   This way, hopefully they won't get the flu and bring it home to your baby.

Children who are allergic to eggs may or may not be able to receive the vaccine.  They may need to be tested before they are given the vaccine.  Check with your child's doctor.

The nasal spray version of the flu vaccine (FluMist) is very effective as well.  Children over age 2 may be eligible for the nasal flu vaccine.  If your child has asthma or significant wheezing or immune problems, he/she should not receive the nasal spray vaccine.  Check with your child's doctor to see which form of the vaccine your child should receive.

It's hard to believe that flu is here already.  But H1N1 was here all last summer, too... so I guess we shouldn't be surprised!  Take care, and stay healthy!

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Wednesday, September 1, 2010

Chronic cough? Sore throat? Sneezing? It might be allergies...

Over the last few weeks, my kids all sound like they are sick.  Coughing and sniffling from one.  Hoarseness and sneezing from another.  Another one keeps rubbing his eyes.  My own face and nose feel like someone has decided to fill my sinuses with wet tissues.  That's how I know that the Fall season must be on its way!

Hay fever or allergic rhinitis is very common and can develop at any time.  Most children do not develop allergies to environmental such as pollen, grasses, molds, and trees, until around 3-4 years of age.  Right now at the end of August/beginning of September, ragweed is abundant in our area as well as grasses.  Anyone who is allergic to these is likely to be feeling the effects of their allergies now. 

Common symptoms of allergies include sneezing, itchy eyes, runny nose, occasional cough or sore throat.  If you suspect that your child may have allergies, you could try some over-the-counter allergy remedies for children.  Children's Zyrtec and Children's Claritin are readily available at stores.  Recently there were some recalls of name brand versions of these, so you may have to get store-brand or generic versions.

If your child has frequent cough, trouble breathing, fevers, or appears sick, then it is less likely to be allergies and you should call your child's doctor immediately.  Also, if your child is very young (under age 2), it is less likely to be related to allergies and you should call your doctor.

A good place to check to see what the pollen and allergen levels are in your area is at the website:  On the "red zone" days, it's a good idea to avoid outdoor activities if your child is allergic to outdoor pollens.  Reducing exposure to whatever your child is allergic to is the best way to avoid feeling bad from allergies.