New Study Shows Exactly What I’m Seeing In My Own Pediatric ER, Rising Numbers Of Children Attempting Suicide

By Dr. Free N. Hess

It was an extremely busy night in my Pediatric Emergency Department. The kind of night where the wait to be seen is long, there are patients in the hallway because there are no more exam rooms, and it’s loud and chaotic. The typical organized chaos of the ER.

My Pediatric ER nurse walked over to me looking concerned and I excused myself to step away from the parent I was speaking with.

“Dr. Hess, the young boy in room 2 is here for a suicide attempt. An attempted overdose. He took multiple medications.”

“How old is he?”

She looked to the floor and sighed, “he’s seven”.

I’ve been an attending physician working in Pediatric Emergency Medicine for the past decade and this scenario still hurts my heart every time. I am seeing more and more children presenting with symptoms related to depression and anxiety, suffering from complications of self-harming behaviors such as cutting and disordered eating, and suicidal behaviors. It is not uncommon to have multiple children with one or more of these issues in a single shift, and some of these kids are extremely young, like my 7-year-old patient above. Many emergency medicine physicians around the country are reporting the same trend.

Suicide is now the second leading cause of death in children 10-18 years of age. A recent study published in JAMA Pediatrics that utilized data from the CDC’s National Hospital Ambulatory Medical Care Survey showed that the number of children presenting to Emergency Departments with a diagnosis of suicidal ideation or suicide attempt increased from 580,000 in 2007 to 1.12 million in 2015. That is a twofold increase in the number of children contemplating and/or attempting suicide in less than 10 years. The study population included all children under 18 years of age with an average age of 13. 43% of those seen for this complaint were between 5 and 11 years old.

Let me repeat that.

43% of the 1.12 million children who presented to the emergency department for suicidal ideation and/or suicide attempts in 2015 were under ELEVEN YEARS OLD. Some of these children we as young as FIVE YEARS OLD.

 

Why is this happening?

The increase in depression and suicidal behaviors in children is multifactorial and there are many researchers attempting to better understand the contributing factors. The fixed risk factors for suicidal behavior (family history of suicide attempts; male gender; adoption; parental mental health problems; personal mental health disorders; lesbian, gay, bisexual, or questioning sexual orientation; transgender identification; history of physical or sexual abuse; previous suicide attempts) remain relatively unchanged over time therefore most researchers are looking at social and environmental contributors such as bullying/cyberbullying and internet/social media use.

 

Bullying

According to the CDC 19% of high school students have been bullied at school and 15% have been cyberbullied. A recent survey done by the Pew Research Center found an even more alarming 59% of teens had been cyberbullied. It is well known that there is a strong link between bullying and suicide-related behaviors in children. A meta-analysis showed that students facing peer-victimization (i.e. bullying) were 2.2 times more likely to have suicidal ideation and 2.6 times more likely to attempt suicide than peers that were not victimized.

 

Internet and social media use

Research shows that internet and social media use, as well as excessive video game use, all contribute to an increase in mental health problems in children, including suicidality. The constant virtual connection that the internet and social media encourages can result in a child’s inability to escape the bullying that may be happening elsewhere. The idea of home being a child’s safe space is long gone. Bullying becomes cyberbullying and more often than not the child being bullied feels as if there is no escape.

Internet and social media access also increases the probability that a child will learn of other suicides which is a significant risk factor for child suicide. Exposure to this information is through online news sites (44%), social networking sites (25%), online discussion forums (15%), and video websites (15%). One study showed that increased media coverage can lead to teen suicide clusters, and this risk seemed to be closely related to specific story characteristics such as lead story placement, headlines using the word suicide or explaining the specific method used, and/or a detailed description of the suicidal person and/or the act itself.

Above are just a few of the contributing factors to this growing problem. We’re learning more everyday but it just doesn’t seem fast enough. The children I see in my ER, and those being seen in ERs all over the country, are counting on us. We need to gain a better understanding of the contributing factors, we need to become better equipped to mitigate those risks, we need to understand the urgency of identifying those children at greatest risk, and we need to be intervening in a productive and meaningful way.

#StartTheConversation #ItTakesAVillage

 

 

How Social Media Can Affect Your Child’s Self Esteem

pedimom-social-media

By Dr. Sean Paul

As a child psychiatrist who treats children, teens, and young adults, I have seen the impact of social media use. Because most people only present their “best selves” online, it can seem to your child that everyone has a perfect life but them. It is difficult to explain to a young person that what they are seeing online is not the full picture. I have coined the terms “visual UNreality” and “experiential Unreality” for the different ways this can manifest.

Visual UNreality occurs when photographs that are posted online are altered, modified, and even fabricated. A young person may see photos of a friend or influencer demonstrating a physical appearance, body type, or location that may not be realistic or even real at all.

With modern photo editing technology anyone can look like almost anything, anywhere. Their friend with what they deem to be the “perfect” body may be using software and other techniques to enhance their appearance in photographs. The influencer taking photos on a private beach may in fact not be on a beach at all. Reality can be distorted to great extents online, and we need to let our children know that they should not accept everything they see online as being real. I have seen first-hand how having unrealistic expectations of how to look, or where to be, can lead to many problems, such as eating disorders, depression, and social anxiety.

Experiential UNreality occurs when friends and influencers post only the best, and often exaggerated, experiences they have. Posts boasting about an exclusive event, travel experience, or the amazing things that someone’s significant other bought or did for them, can make those viewing those posts feel inadequate. Those people may, and likely do, in fact have daily struggles with finances, self-esteem, and relationship issues just like everyone else.

So what can we do as professionals and parents to help ease these pressures on our young people?

First and foremost, keeping an open dialogue with them about our own struggles and not talking and posting exclusively about only our “best selves” is critical. They need to know that they are not alone in feeling sad or inadequate or even jealous sometimes. These are normal emotions and we want them to feel comfortable not presenting a perfect front.

Other things we can do is reassure them that the images and posts they are seeing are one-sided and often meticulously planned and staged. Knowing the difference between reality and the front presented on social media will save many youth from getting down on themselves.

We can also and empower them to be the change and post something honest and real on social media, and hopefully others will then follow suit.

:::::

Sean Paul, MD is the founder at NowPsych and the Internet Addiction Center. He is a dual board-certified child/adolescent and adult psychiatrist who treats patients of all ages with anxiety, depression, ADHD, autism, behavioral issues, and OCD and also has an area of focus on Internet addiction and Video game addiction.

 

Kratom. Your kids likely know about it. Do you?

By Dr. Free N. Hess

More and more kids are using legal substances that have the ability to alter their brain and mood such as Kratom. Have you heard of this easily obtainable drug? You’re children likely have!

What is Kratom?

Kratom is a tropical tree (Mitragyna speciosa) that is native to Southeast Asia. It’s leaves contain mitragynine and 7-α-hydroxymitragynine which interact with opioid receptors in the brain resulting in an opioid effect. The mitragynine can also interact with brain receptors resulting in a stimulant effect.

It goes by many names such as Biak, Ketum, Kakuam, Ithang, and Thom. The leaves can be chewed, dried and used to make a tea, incorporated into various food recipes, smoked, or made into an extract. It is also available in pill and capsule form, sometimes sold as a dietary supplement, which is easy and convenient to buy. Despite FDA warnings, it is still legal in the US which has resulted in Kratom “bars” that serve this drug in tea form in states such as Colorado, New York, and North Carolina, just to name a few.

What is happening in the brain of Kratom users?

As mentioned above Kratom interacts with multiple receptors in the brain, including opioid receptors. At low doses (10 grams) the user will have increased energy, euphoria, increased talkativeness, and increased social interaction (stimulant effect). At higher doses (20-50 grams) the user will experience sedation, pleasure, and decreased pain. Kratom takes effect within 5-10 minutes after ingestion and its effects last 2-5 hours.

What are the negative effects of Kratom?

Kratom has multiple unpleasant and dangerous effects which include:

  • Nausea
  • Vomiting
  • Itching
  • Sweating
  • Dry mouth
  • Constipation
  • Increased urination
  • Loss of appetite
  • Seizures
  • Hallucinations
  • Psychosis

Over the past year the FDA has released multiple statements informing the public about these negative effects and their many concerns regarding Kratom use, including the potential for abuse and addiction. They have also released warnings regarding the contamination of Kratom-containing products being sold and used both recreationally and to self-medicate for pain or to treat opioid withdrawals. Tests of various products containing Kratom showed high levels of salmonella and heavy metals putting chronic users at risk of illness and heavy metal poisoning.

Thus far the FDA has identified up to 44 deaths related to the use of Kratom. It was noted that in many of these deaths individuals were using Kratom in combination with other drugs that affect the brain, such as illicit drugs, prescription opioids, alcohol, benzodiazepines and over-the-counter medications like cough syrups and the anti-diarrheal medicine, loperamide. There was, however,  a case report of a death with the use of only Kratom which is still being investigated. Another concern is that it is impossible to know what other ingredients may be mixed in with Kratom sold commercially as is is not regulated by the FDA.

Is Kratom addictive?

Like other drugs with opioid-like effects, Kratom can cause dependence and therefore users can experience withdrawal symptoms when stopped after frequent or chronic use. Some users have reported being addicted to Kratom. Withdrawal symptoms include:

  • Irritability
  • Hostility
  • Aggression
  • Emotional changes
  • Runny nose
  • Jerky movements.

Are kids really using Kratom?

Yes, kids are absolutely using Kratom and they are at high risk for abuse and dependency. It is easy to obtain, it’s legal, and it can have significant effects which make for a tempting substance to preteens and teens. It is important to include these less known substances when discussing the risks of drug use with your children.

Education is empowerment.

How Dangerous Is It To Text And Drive?

pedimom-texting-driving

By Dr. Alison Escalante

How dangerous is it to text and drive? Nikki Myles would tell you it’s extremely dangerous. When I asked her to tell me the story, she poured her heart out. This summer she was hit by a texting driver. This is her story:

“I was driving, and I looked up and I saw that there was a younger girl behind me. She looked like a newer driver with a friend in the passenger seat of her car. I saw in my rear view mirror that she was on her phone and it looked like she was either texting or trying to take a selfie of herself. I remember looking up and being like, “Wow, one day this girl is going to cause an accident!”

Probably ten seconds after that went through my head, I’m sitting in my car and I’m literally thinking, “Oh my gosh, why is my car moving? Why is my car moving? Why am I being pushed into the car in front of me?”

And it took a moment to click that “oh my gosh, this girl, she hit me!” So from that point, since I was stopped, she was able to hit the gas and push me. During their investigation, the police determined that she had to be driving over 55 miles per hour. So I essentially accordioned between the car in front of me and her car, hitting me from the back.

Nikki’s accident happened only four minutes from her home. “I think for a brief moment there, there was total confusion because I had been literally sitting there like, “Oh my god, I cannot wait to go home and get some water.” So I’m sitting there and it kind of took me a moment and I was like, “Why is my car moving, I have my foot on the brake?” So I then naturally started to pump my break because I was like, “Oh my gosh!” For a fleeting moment it didn’t quite register what happened with me.

After she hit me with such force, I hit my head on the headrest. My head flew back and hit the headrest and then flew forward. Thankfully, I did not hit the dash or anything of that nature. And then I was abruptly stopped by the car that was in front of me, so I then hit my head two more times during that incident.

I had no distractions, I didn’t even have a radio on. So I was very confused as to how my foot is on the brake and everyone in my lane is stopped. So I hit my head and I’m like, “Oh my gosh, I just got hit.” And then there was a sense of fear… I felt my body’s natural instinct, the whole fight or flight instinct.

At first, Nikki was able to get out of her car and talk to the police. It did not take long before she started to feel dizziness, nausea, neck and back pain. She found she was distracted by the worst headache she’d ever felt.

Later that day Nikki was diagnosed with a traumatic brain injury as well as back and neck injuries. She received months of physical and occupational therapy as she continued to have pain, dizziness, and difficulty concentrating and remembering things. She has seen neurologists, orthopedists, and undergone extensive neuropsychology testing. Her neuropsychologist was able to pull her records from high school and college, and show that there was a drop in motor skills, memory and most of her other abilities.

“Pretty much everything is different now,” Nikki told me. Even after almost a year, she is not fully recovered. She experiences motion sickness, often triggered by light or sound, and has to take anti-nausea medication to manage it. Like many people who have had significant traumatic brain injuries, she now requires medication treatment with Adderall, a stimulant typically used in ADHD, to manage her cognitive difficulties.

“At first I was pretty embarrassed about the fear,” Nikki confessed. “What fear?” I asked. “Well, the fear of driving. I guess it’s a natural instinct for anyone to be apprehensive of that activity after going through something so horrific.” She does drive now, but the apprehension remains.

I asked Nikki why she had shared her experience with me. “There needs to be more awareness,” she explained. “The more people can be educated about the dangers of texting and driving…well, it just doesn’t need to happen. There’s no need for it. All of this could have been prevented if she didn’t feel the need to be on her phone.”

How dangerous is it to text and drive?

How dangerous is it to text and drive? The National Safety Council reports that cell phone use while driving leads to 1.6 million crashes each year. Nearly 390,000 injuries occur each year from accidents caused by texting while driving.

1 out of every 4 car accidents in the United States is caused by texting and driving.

The NHTSA (the National Highway Traffic Safety Administration) wants us to know that distracted driving is a true danger. Distracted driving is anything that takes your attention away from driving. But of all of the things that distract us, texting is the worst. Sending or reading a text takes your eyes off the road for 5 seconds. At 55 mph, that’s like driving the length of an entire football field with your eyes closed.

You cannot drive safely unless the task of driving has your full attention. Any non-driving activity you engage in is a potential distraction and increases your risk of crashing.” (National Highway Traffic Safety Administration)

What can you do to help stop texting and driving?

  1. Parents can talk to their teens AND show them they mean it by never using their phones while driving themselves. If they see us using our phones, they will do it too.
  2. Teens can speak out to their friends and get the word out on social media. The more it’s not cool to text and drive in your social group, the less your friends will do it. Speak up if a friend is driving you while texting: this is your life they are playing with.
  3. Teachers can spread the word at school.
  4. Employers can educate at the workplace about distracted driving.
  5. All of us can be a voice in our community for safety, and we can vote for laws that discourage texting and driving.

:::::

Alison Escalante MD is a Pediatrician on a mission, with a clear, 3-step method to help parents raise kids skillfully AND enjoy doing it. She is a TEDx speaker and writes a column for Psychology Today. Find her at ThePrimaryCarer.com or watch her TEDx talk HERE

Reference: https://www.nhtsa.gov/risky-driving/distracted-driving

How to Talk to Your Teen When They Need You Most with Dr. Free Hess

dr-free-hess-imperfect-mom-life

In this interview, Lisa Chapman, host of the Imperfect Mom Life podcast and Dr. Free Hess get raw, real, and authentic about what teens and pre-teen’s are really facing in this digital world. From YouTube to SnapChat to Instagram…this is the first generation that our children are facing things that we never had to. The statistics are showing that our kids are more anxious, depressed, having self harm thoughts, suicidal thoughts…and worse than that, taking action and committing suicide. In so many ways, the online world is uncharted and new territory for us.

Dr. Hess is a Pediatrician who works in Pediatric Emergency Medicine, a Child Saftey expert, and founder of PediMom.com, but her most beloved job is being a mom to her 8 year old daughter. She has a crazy but beautiful life and is thankful for every day.
The most universal comment that kids are saying is:
People do not understand me.

 

Here is the blog post that went viral. Dr. Hess found a YouTube video that literally said, “Listen up kids, Side ways for attention, up and down for results.” while a male figure motioned on his arm.

Dr. Hess is taking a stand about protecting our kids and being active in their lives. We need to be having conversations with our kids and truly understanding what they are experiencing… What they are feeling…

And they need to know that we are relatable and they can trust us!

National Suicide Prevention Hotline (800) 273-8255
“We can all help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.”

Original podcast

Through The Eyes Of A Victim And A Bully

pedimom-little-girl-bullying

By Inaaya Firoz age 11


The Victim

Their mean words cutting through my skin
Their cackling laughs making it seem like they’ll win
Their taunting is haunting
Should I say
Or should I pray
To be saved
You’ll be sorry
They say
I am helpless you see
From the bullies
Who are filled with glee
For winning
While smirking and grinning
Others have been hurt
But their voices haven’t been heard
Big fat words
Like tears
Your fears
Escape
Your Brain whispers
But how
And right now
I can’t


The Bully

Why is she sad
It’s just some words
Come on we were just playing around
You can fly like a bird
Don’t act refined
We will try to be kind
You haven’t she says
I know but we try
Sure she sobs out
While starting to shout
Mean words come out of my mouth
I really just don’t know how
She’s such a baby
She needs to stop being crazy
It’s just a word
It can’t be that bad
Why is she always acting so sad
We are just having fun with her
But these past few days have gone by in a blur
Maybe I have been a bully
But it isn’t that worse
Then using a curse
Word
That is not what victims have said she uttered
Victims ? oh please
I roll my eyes
Oh what a surprise
Of course there’s a tattletale

YouTube Kids. There is still a HUGE problem.

YouTube Kids

YouTube Kids. There is still a HUGE problem.

By Dr. Free N. Hess

In the last several days there has been a lot of talk about videos on YouTube and YouTube Kids that are inappropriate for our children. One of those videos, the cartoon with the suicide clip, was brought to light right here on PediMom.com. I wish I could say that they are isolated incidents but unfortunately I cannot. My research has led me into a horrifying world where people create cartoons glorifying dangerous topics and scenarios such self-harm, suicide, sexual exploitation, trafficking, domestic violence, sexual abuse, and gun violence which includes a simulated school shooting. All of these videos were found on YouTube Kids, a platform that advertises itself to be a safe place for children 8 years old and under.

Below are just a few of the videos that I’ve found. All of the following videos and screenshots are from YouTube Kids specifically and all were found by me just today.

Here is a Minecraft video with multiple shooting scenes (one in a school) and swearing.

YouTube Kids Video

This is another Minecraft video with a shooting scene and swearing.

This next one is a cartoon suggesting human trafficking. An injured and abused female character disguised as a pet wolf is bought for $400 from a masked man with a simple phone call.

This on is a cartoon with a background song whose lyrics states “Oh she’s hot but she’s a psycho”. There is lots of shooting, violence, and threats to kill in this one.

In this next cartoon a young girl commits suicide with a knife after her father dies and her boyfriend breaks up with her.

In this zombie cartoon friends kill each other out of jealousy.

And finally, this cartoon has descriptive writing about a girl who is stopped from hanging herself. It speaks about standing on a chair and having a noose around her neck. 

There were just so many that I had to stop recording. I settled for screenshots of some other to give you all more of an idea of how significant this problem is. The following screenshots are of a Mario Brother cartoon where Mario goes into an all girls school and has lots of inappropriate comments and actions. There are also some screenshots of the descriptive explanation of the girl attempting to hang herself.

This is supposed to be a safe place for our children. Unlike YouTube itself, YouTube Kids is supposed to be specifically FOR kids. There has to be a better way to assure this type of content is not being seen by our children. We can not continue to risk this. Let’s come together and find a solution. #ItTakesAVillage. #YouTubeWakeUp

Use the arrow arrows to scroll through the screenshots:


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Talking to your Teen about Safe Sex

pedimom-sex-condom

By Dr. Monica Henning

Wow, how did we get here?  You go from rocking your little baby in your arms, then made it through the terrible two’s and three’s, and somehow you blinked, and now you have a teenager on your hands!

And along with teens, comes their moodiness, surliness, ability to cold-shoulder you or talk back to you. But they’re still your little baby, and it’s your job as a parent to protect them.  We protect them from physical harm… we bolt the furniture down so it won’t tip over, we put covers over the electrical outlets, we put locks on the cabinet doors, gates in front of the staircase.  But do we teach them how to protect themselves from infections that they can easily catch from sex?

Whoa, wait a second, you say.  My kid is not having sex. First of all, they’re just a kid, and second of all, they’re not even in a relationship with anyone. Well, unfortunately as an Ob/Gyn doctor, I have delivered many teen girls who barely knew the father of the baby. It’s happening.

Many teens have casual sex. They aren’t necessarily in a relationship with the person they sleep with. The fact of the matter is, that nearly 50-60% of high school students are sexually active, with the percentage increasing they older they get. Their hormones are raging, and they don’t necessarily have the maturity to handle themselves responsibly.  I hate to say it, but my youngest pregnant patient was 11 years old. Now when we were 11, we got giddy over “going steady” with someone and holding hands in front our classmates. But times have changed, and if we have to stay in the know if we want to protect our kids.

PediMom Sexual Activity

Proportion of high school students who have sex at least once, 1991–2009.

(From Eaton DK, et al. Youth risk behavior surveillance—United States, 2009. MMWR Surveill Summ 2010:59 [SS-5].)

Gonorrhea, Chlamydia, Syphillis, Herpes, genital warts, Hepatitis, HIV, Trichomonas, HPV…. These can all be caught through sex.  And we do NOT need our kids to be catching them.

There are so many infections, some cannot be treated by antibiotics because they aren’t even bacteria.  Some are viruses and will stay with a person throughout their whole lifetime. Some can cause chronic pain, meningitis, arthritis, blindness, infertility, or even cancer!

This is why it is sooooo important we talk to our kids about how to be safe. If they don’t know about safe sexual precautions, they could easily catch something that leads to much bigger medical problems.  Can you imagine, a preventable sexual infection being the cause of a cervical cancer or penile cancer? An ounce of prevention is definitely worth a pound of cure. We cannot afford to NOT have this conversation with our kids.

Not to mention, when you protect yourself against these STI’s (sexually transmitted infections)’s or STD’s (sexually transmitted diseases), you also add another layer of protection against unplanned pregnancy.

According to the national surveys conducted by the National Campaign to Prevent Teen & Unplanned Pregnancy, teens report that their parents have the greatest influence over their decisions about sex – more than friends, siblings, or the media.

Really?! Who knew, that they might actually be listening. Buuuuut, that’s only if you are talking to them about it.

But how? This is such a hard topic to try to approach a teen about. No parent likes to do it, but it definitely pays off. Most teens say they share their parents’ values about sex, and making decisions about delaying sex would be easier if they could talk openly and honestly with their parents.Studies have shown that teens who report talking with their parents about sex are more likely to delay having sex and to use condoms when they do have sex.2

Okay, so how do we parents broach this difficult awkward subject of sex and safe sex?

It’s important to talk about this frequently and in a way where they can converse with you. They don’t want to hear a lecture. They got that in sex ed class. It’s supposed to be a conversation.  You want them to feel like they can come to you with questions, and not have to turn to their friends or social media, who may not be a very accurate source of information.  And try not to be stiff and awkward about it. These teens can pick up on this. But the more frequently you talk to your teen about this subject, the less awkward it will become.

I find in the car to be an excellent time.  They are a captive audience, but you don’t have to awkwardly look each other in the eye during the whole conversation.  Dinner time works too. Or even if following watching something on a TV show or a movie. Let it be your segue onto the topic.  And remember, try to not sound judgmental or threatening.

“So Will and Heather are going out?  That’s good. They seem cute together.  Are there a lot of other couples in your grade? Where do they go on their dates?  Do they show a lot of PDA? What do you think of that? Do you think they’re having sex?   What do you think of that? You think they use protection? What do you know about protection? What about birth control?”

“Well that brings up a good topic… are you interested in anyone at school?  Have you gone on any dates with them? Do you think it will ever get to the point where you guys might have sex?”

It’s amazing, how scary the math can be on past sex partners… I like to give the analogy of it’s like all the past partners sharing an apple.  You initially have this delicious, fresh, crisp red apple. It’s so ripe, you have been saving this apple for a while, and have been looking forward to eating it all day.  Then Tiffany took a bite out of it. Then Tiffany slept with Brad. So Brad took a bite out of the apple. Then Brad slept with Jen, so Jen took a bite out of the apple too.  Jen slept with Will, who took another bite out of the apple. Will slept with Lisa, who took another bite out of the apple. By the time the apple makes it to you, so many people have taken a bite out of this apple, it’s not looking so delicious and crisp.  It’s now brown, and soft, and not looking appetizing at all.

This is how it can be more risky, the more partners you rack up.  Or even if it’s your very first partner, depending on who they slept with before you, you’re still at risk for an STD / STI.  Your chances of catching an infection increases with the more people you sleep with because they have most likely slept with others before you.  It all adds up, just like your chances of getting sick from that apple so many people have taken a bite out of and left their saliva on.

Important things to bring up to your teen:

  • Sometimes an STI can have symptoms of vaginal / penile discharge, burning when you pee, a blister in the genital region, etc.
    • But most STD’s don’t have any symptoms at all so you can’t tell if your partner has an STD just by looking at them.
    • A good way to be safe is to go with your partner and get tested before you ever start having sex with them.
  • An STI can get passed on from person to person through any type of sexual contact, whether it is through penile-vaginal “normal” sex, oral sex, or anal sex, and some just through skin-to-skin contact or what some of us refer to as “outercourse”.
  • The only way to surefire way to 100% protect yourself is to not have sex at all (abstinence).
  • The next best way, is of course by using a condom.  Now it isn’t 100% like abstinence, but it’s the only thing available.  Remember, a condom doesn’t cover the entire penis or vagina, so anywhere where there is direct skin to skin contact, you could catch something like genital warts or herpes.
  • It may seem safe to have oral sex and anal sex because one can’t get pregnant from it, but you can still get infections that way, including something as deadly as HIV.
    • Even with oral sex, you can get gonorrhea of the throat or syphilis.  I know it seems like overkill and unnecessary, but you need to use a condom even with oral sex.  And if someone doesn’t respect your wishes of wanting to use a condom, they don’t deserve to have sex with you.
  • Very important for you to understand NOT just to use a condom, but know HOW to use a condom.
    • There are male condoms to cover the penis, and there are female condoms to put inside the vagina. This link shows how to use a female condom.
    • There are condoms made of latex and non-latex (Polyurethane, polyisoprene, and lambskin). Latex tends to be more elastic and less likely to break.  Some of the non-latex are not as effective as preventing pregnancy and STI’s but are a suitable substitute for those with latex allergies.
  • Even if you and your partner are using a birth control medication of some sort, like pills, or a patch, or an implant, they don’t protect against infections.
  • If you don’t feel comfortable talking about these things with me, at least talk to your doctor about it.  They are health care professionals and are experts about this. Everything you speak to them about is confidential and won’t share it with the parents (unless doc believes you are going to harm yourself or others).  (Now parents do have the right to request a copy of medical records, and also may know some things through insurance billing)
    • Your healthcare provider can help you figure out how to keep safe as well as how to test for STD’s / STI’s.
  • And again, remember….The only fool proof 100% safest method of course is no sex at all!

Other Facts:

  • Even though 15-24 year olds are only ¼ of the sexually active population, they account for ½ of the 20 million new sexually transmitted infections that occur in the US each year per the CDC.  That’s 10 MILLION newly diagnosed infections in 15-24 year olds in the USA EACH YEAR!!!
  • Chlamydia 1.59 million cases in the USA per year  (CDC)
  • Gonorrhea 468,514 cases in the USA per year; 18.5% rate increase since 2015
  • Primary and Secondary Syphilis 27,814 cases; 17.6% rate increase since 2015
  • Congenital Syphilis 628 cases; 27.6% rate increase since 2015
  • 66% of sexually active US teens use contraception  (Guttmacher institute)
  • CDC recommends annual chlamydia testing for all sexually active women < 25 yo

Useful websites:

Other References:

  1. Albert B. (2012). With one voice: America’s adults and teens sound off about teen pregnancy. Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy. Retrieved February 11, 2014, from http://thenationalcampaign.org/ resource/one-voice-2012.
  2. Markham CM, Lormand D, Gloppen KM, et al. Connectedness as a predictor of sexual and reproductive health outcomes for youth. The Journal of Adolescent Health 2010;46:S23‒41.

:::::

Monica Henning, MD, is board certified in Obstetrics & Gynecology & a clinical assistant professor for the University of Oklahoma’s School of Community Medicine.  Dr. Henning has 2 young boys of her own.

 

An Open Letter To My Son’s Bully

By Sandy Lundy, Shane’s Mom

On Wednesday April 25, 2018 the unimaginable happened. Just two weeks before his 12th birthday, my son Shane took his own life. While tremendous effort was given to save him, there was no hope. We kept him on life support until organ recipients were located.

On April 28, 2018 Shane was gone forever.

Perhaps Shane kept his pain a secret because he was too embarrassed, too proud or too frightened to speak up. We will never know but there is no doubt that someone did. And they kept silent.

Shane was bullied.

He was bullied simply because he loved Broadway Theater. I can assure you that I will never stop being the best advocate for my son and I always have been. I pride myself in knowing that I have done, and will do whatever it takes to make sure my boys are happy, healthy and safe.

I have two choices now: fall into a dark place of which I know I won’t be able to come out of or do what Shane would have wanted me to do – make a positive change. I am working to create a foundation, Shane’s Imagine Nation, that will recognize and reward children who stand up and speak out against bullying.

I intend to activate the silent majority of kids who have either been bullied or have witnessed bullying. More importantly I will promote kindness and instill the concept that kindness is cool (because it is)! The foundation educates and empowers kids to be the heroes with the courage to stop the very bullying that ultimately killed Shane. Learn more at www.shanesimaginenation.org.

 

An open letter to the kid(s) who bullied my son Shane:

I know you are too young to grasp the impact that your words and actions had on my son, yet I still hold you responsible. You know what is right from what is wrong yet there is so much you didn’t know.

When you called him “gay” what you didn’t know is that he and I had a bond unlike any other. As a result, he tended to feel more comfortable with and trust women. He knew we were nurturing. He understood unconditional love because I would never hurt him. You and your posse of friends saw my son with a gaggle of girls…Perhaps you now can have a better understanding of why he decided to surround himself with people he trusted. Actually, your actions must have only reinforced to him that some people can’t be trusted or respected.

When you made fun of him for loving music and theater what you didn’t see was the light in my son’s eyes when he saw a play and the complete appreciation and passion he had for it. He only wanted to share his passion with others.

What you didn’t know is that he saved his birthday money to buy a ticket for one of his friends who had never seen a play. This selfless act is only a tiny example of the innate goodness that existed within that tiny body. Because of this passion and enthusiasm, you taunted him, ridiculed him and acted so cruelly. I very much doubt you have ever found something to become that passionate about. That is sad.

When you laughed at him, what you didn’t know is how hard he always tried to fit in and be liked. That all he wanted to do is be accepted for the amazing human being he was. He looked up to kids like you to determine his self-worth regardless of how many times I have told him how amazing he is and how other’s perceptions of him are meaningless.

When you called him “retarded”, what you didn’t know is that he was diagnosed with ADD when he was in kindergarten, which clearly only further outcasted him from people like you. What you didn’t know is how hard I fought to find a solution to why my son could not sit still or control his behavior.

What you didn’t know is how extraordinarily intelligent my son was. How his wit made me laugh every single day and how he knew more about most things than I do. How inherently proud I was of him for always turning a negative into a positive, which someday I hope you learn not many people can do.

When you made fun of his clothes and the way he dressed, what you didn’t know is that I am a single mother struggling to make ends meet. And while your clothes may come from the mall, my son’s came from the thrift stores and hand-me-downs. But…he appreciated all that he had because he knew how hard I worked for them.

When you made fun of the shirts he proudly wore from the Broadway shows he had seen, what you didn’t know is that underneath that shirt was a heart of gold. Which thanks to you is gone forever.

What you didn’t know is that he would never let you see him cry. He was smart enough to understand it would only add fuel to the fire. You didn’t know that he would wait until he came home, race upstairs to his room and suffer alone because he was too embarrassed to tell anyone.

What you didn’t know is that the words you have spoken are like weapons. But unlike a cut your words scarred him deep within his soul. Perhaps with time they would have faded. But this I will never know.

What you didn’t know is that I will forever be haunted by the humiliation and pain you caused my son. However, it will never compare to the humiliation and pain he must have felt. If I am being honest, I am not ready to know exactly how long he suffered because it will put me down a hole I don’t want to go down. I would most likely never come out of it either.

You didn’t know your words and actions had seeped into his brain and made him believe that what you said to him was true. He eventually shut down and gave up.

Perhaps with time I will forgive you. Perhaps not.

Perhaps my son could have forgotten the things you have said and done to him. Perhaps not. I will never know.

I fear that my son would have carried these scars with him for the rest of his life. For, someday in the future something will have triggered a memory of what you have done: a song, a smell, a voice…… and would have brought him right back to that moment where he was a vulnerable little boy who only wanted to fit in and be liked.

I will never again have the opportunity to hold him, kiss him and tell him that everything is going to be OK, because it won’t be.

What you don’t know is that Shane’s older brothers have had their childhoods stolen from them too. They will never be the same again because their brother is gone forever.

What you don’t know is that I cry myself to sleep every night. That I hide my pain from my boys because they need to know that I am OK, so that they can be OK.

What most don’t know is that this is the hardest thing I have ever had to do in my life. That this is not about being strong or courageous – it is surviving.

What you don’t know is the pain I feel when I walk past Shane’s empty room, still exactly the way he left it. His bed is still unmade and his water bottle is still on his nightstand.

I will not feel sorry for you. The fact that my son was a lesson for you to learn is something that I am not willing to forgive.

I cannot imagine how unhappy you must be with yourself. Kind people are kind. Happy people spread kindness. The fact that you were capable of saying such cruel things only exemplifies how you must feel about yourself. Oftentimes the most important lessons are learned the hard way.

You may have apologized for what you have done but you reap what you sow. I promise you that no matter what happens in your life – you will never know the love that I will always have for my sons.

– Shane’s Mom

***

Sandy Lundy is the Mom of Shane and his two older brothers Ryan and Griffin. She is honoring the life of her beautiful son by educating others about the devastating effects of bullying. She has created an amazing organization called Shane’s Imagine-Nation where children who stand up against bullying are recognized and rewarded. You can find more about Sandy and her important work here, here, and here.

#YouTubeWakeUp, #ProtectOurKids

#YouTubeWakeUp, #ProtectOurKids

By Dr. Free N. Hess

EDITED: Another win for the PediMom Village. We were successful in getting this cartoon pulled from YouTube just like the last one. My recording of it is still able to be viewed below. The second video is from YouTube Kids. It has been added to show that this exact cartoon was indeed found on the children’s app. 

Seven months ago a concerned mother alerted me to a cartoon on YouTube Kids that had a clip of a man spliced in showing how to properly slit their wrists. She noticed it while sitting with her young child trying to stop his nosebleed. This mother shared her story here. With a significant amount of effort we were able to get that cartoon pulled from YouTube Kids.

But there are more.

Just yesterday I was alerted to yet ANOTHER cartoon with the same clip spliced in at 4.44. This time the cartoon is on YouTube, not YouTube Kids. In looking back at the comments it appears that people began reporting this video approximately 8 months ago, yet it is still able to be viewed. 

This is not OK.

It was also found on YouTube Kids. Below is the recording from the children’s app.

YouTube Kids Video

Click on the video below to go directly to the video on YouTube and report. As of the time of this publication the video is still up despite hundreds of reports. The offending clip is at 4.44.NOTE: The video has been removed from YouTube!

Exposure to videos, photos, and other self-harm and suicidal promoting content is a huge problem that our children are facing today. Suicide is the SECOND leading cause of death in individuals between the ages of 10 and 34 and the numbers of children exhibiting some form of self-harm is growing rapidly. In a nationwide survey of high school students in the US 16% of students stated they had seriously considered suicide, 13% admitted to creating a plan, and 8% admitted to attempting suicide at some point in the 12 months prior to the survey. Every year 157,000 young people between the ages of 10 and 24 present to Emergency Departments for self-inflicted injuries and/or suicide attempts.

Many experts believe that access to self-harm and suicide promoting content is making the situation worse. There have been several recent reports of teens commiting suicide after viewing self-harm and suicide material online and on social media platforms. More and more researchers are starting to look into how access to this type of material is linked to self-harm and suicide in adolescents. One such study has just been commissioned and will hopefully give us some good insight into this issue.

But we have to start doing something NOW and we should start by educating ourselves, educating our children, and speaking up when we see something that is dangerous for our children. We also need to fight to have the developers of social media platforms held responsible when they do not assure that age restrictions are followed and when they do not remove inappropriate and/or dangerous material when reported. 

We need to all work together to #ProtectOurKids and let them know that #ParentsDemandAction!


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I Am Angry

pedimom-angry-apps

By Dr. Free N. Hess

WARNING: There are graphic photos following this article. They are included so that parents can become aware of what our children are viewing and experiencing on the social media apps they are using. All photos included have been taken by me directly from within the many apps I research for PediMom. All photos are taken from public accounts that our children have access to and they are included solely to educate the public, mainly parents, about what our children are being exposed to.

***

I am angry.

For about 6 months now I’ve been researching many of the apps that are most popular with our children: Snapchat, Instagram, LiveMe, TikTok, YouNow, Whisper, Twitch, Roblox, and plenty of others. I register for them using the youngest age allowed for each individual platform (usually 13 years old, but sometimes younger). I then use these apps in the same way our children use them, so I get to see what they see and hear what they hear. I watch them.

I am angry.

I watch as young girls are approached by anonymous predators asking them to perform sexually explicit acts live on camera for anyone from anywhere in the world to see.

I watch as these predators offer likes, virtual gifts (some of which can be exchanged for actual currency), and the “promise” of fame in exchange for photos, videos, or private chats with the intent to convince them to do even more.

I watch as these predators invite more of their disgusting “friends” into the live stream when they think they have a vulnerable child who will be easily convinced (i.e. tricked) into doing what they ask.

I watch as these predators ask the youngest of girls to dance seductively saying “you are such an amazing dancer” or to do handstands and cartwheels saying “you’re such a fantastic gymnast” hoping that their shirts will not stay in place giving them a peek at what is underneath.

I watch as these predators ask these girls to lift their shirts, stick their tongues out, pull down their pants, open their legs, touch themselves, or even to use the video controller they are holding while playing a game on a live stream as a vibrator…and these are the less explicit of the requests I see.

I watch as these predators use misspelled or alternate terms for these requests to avoid being flagged within the app. They know all sorts of tricks.

I watch as these children are bullied and insulted if they refuse to do as these predators request. They are called boring, chicken, loser, baby, ugly, fat, stupid, a waste of time because they are not willing to comply.

I watch as some of these girls do as they are asked because the attention, likes, increasing number of followers, and the desire to be noticed is too strong to resist.

I see the photos glorifying and promoting self-harm like cutting, burning, anorexia, and bulimia.

I see the posts encouraging our children to attempt suicide and I cringe when they give pointers on how to assure that they “complete” the act.

I watch as these people form underground societies with ever-changing hashtags so that they can continue to damage our children without being flagged or blocked by people like me who seek them out and attempt to have their account removed.

I am angry.

I report every inappropriate comment, user, photo, and video that I come across and I watch as nothing is done.

I try to type faster than the predators hoping these girls will heed my warnings and protect themselves and I watch as my comments are buried in the constant and overwhelming comments of those I’m trying to warn them about.

I email the app developers and I wait, and wait, and wait. Nothing.

I am angry.

You should be angry too.

The developers of these apps need to be doing more. They need to be held accountable for the dangerous and life-changing situations our children are placed in when using these apps.

We need to make them listen.

We need to be loud and clear that they must #ProtectOurKids.

And that #ParentsDemandAction.

Help me make them listen. Help me hold them accountable. Help me help our kids.

HELP ME START A MOVEMENT THAT THEY CAN’T IGNORE!!!

Post everywhere you can with the hashtags #ProtectOurKids and #ParentsDemandAction and tag as many of the apps as possible.

If we’re loud enough they will listen.

Our kids lives depend on it!

 

Use the arrow arrows to scroll through the screenshots:

Car Seat Safety 101

pedimom-carseat-safety

By Dr. Linda Abujaber

Why is it important to use a car seat?

When used properly, studies on car seat safety show that car seats lower the risk of death in car accidents by 71% in infants and by 54% in children between 1-4 years of age. They also lower the risk of serious injuries by 67%. One of the most important investments you will make in your child’s safety is in car seat safety.

Car seats are so important that hospitals in developed countries will not allow you to take your newborn home unless you have a car seat.

Remember: Car seats are made for transporting your baby in a car or other vehicle and not for use as a place for your baby to sleep. The risk of SIDS (sudden infant death syndrome) is higher in babies who sleep in their car seats rather than in their bed at night and at nap time.

How do I choose the right car seat for my baby?

Choosing the right car seat for your baby is only the first step toward keeping your baby safe in the car. It is just as important to make sure that the car seat is installed properly and that you use it correctly!

What you need to know:

  • Infants and babies less than 2 years old should be in rear-facing car seats.
  • Different types of car seats are safe for different ages.
  • All car seats/booster seats for babies and children under 13 years of age should be in the back seat of the car.
  • Infant car seats are only safe for infants less than 20 pounds(10kg) and can only be used rear facing. They have a base you strap into the car and leave there, and a seat that you can remove from the car. Remember, it is not safe to use the seat as a place for your baby to sleep.
  • You can keep your baby in the infant car seat till he/she has outgrown the maximum height or weight rating of the car seat After this move your baby to a convertible car seat. Make sure the new seat is safe for your baby’s height and weight.
  • Convertible car seats can be used for infants (always note the minimum and the maximum weight and height ratings), older babies, toddlers, and preschoolers.
  • Either type of car seat should be backward facing until your baby is 2 years old after which they can be switched to forward-facing car seats.
  • After your child outgrows the convertible car seat s/he will still need to stay in a “belt-positioning booster seat”, booster seat, for short until the regular seat belt of the car fits properly. A properly fitting seat belt lays halfway across your child’s shoulder and very low on the lap under your child’s tummy and just above the thighs. A loose shoulder strap could hurt your child’s neck in the case of an accident and a loose lap strap could rupture an organ. Kids can usually move out of a booster seat when they are taller than 4 foot 9 inches tall and between 8-12 years old.

What are the most common car seat safety challenges parents face?

The three most common car seat challenges are :

  • Incorrect car seat for your baby’s age or weight or height.
  • Improper fit in the car.
  • Improper fit of your baby in the seat

How can I avoid these challenges?

Get the proper car seat for your baby’s age, weight, and height.

  • Check the information on the side of the seat to make sure it is appropriate for your child’s age, weight, and, height.
  • Look at both the minimum and maximum ratings if you have a small baby. If your baby is very small, make sure that the seat is safe down to your baby’s present weight.

Install the Car Seat Correctly:

  • Read the manual that comes with the car seat as well as your car manual
  • Make sure that the seat is safe to use in your car.
  • Install the seat properly in the back seat.
  • The car seat needs to face backward till your baby is at least 2 years old or he outgrows the height and weight limits on the seat.
  • The car seat needs to be strapped in so tightly that you cannot move it more than an inch (1.5 cm) from side to side and front to back. If it wiggles more than that amount, it’s not safe.
  • The car seat needs to be at the correct angle in the car so that the baby’s head does not flop forward and close the airway. There is a little level on the side of car seats to help you with this.
  • Here is a great resource for you to watch as you get ready to install your baby’s car seat.
  • If you’re not sure you’ve installed the car seat properly, many fire and police stations have specially trained people who can check that you have installed the car seat correctly and correct any problems they may find.

Make sure your baby fits snugly and safely in the Car Seat:

  • The slots for the shoulder straps should be at your baby’s shoulder level or just below.
  • The harness strap needs to be strapped snugly enough around your baby’s shoulders that you can’t put more than your thumb between baby’s chest and the strap and you can’t pinch any extra strap at the shoulders.
  • Make sure that the chest clip is at the center of your baby’s chest even with the armpits.
  • Do not add anything to the car seat to make it ‘fit better’ that is not approved by the manufacturer.
  • In the winter bulky snowsuits and clothing can actually make the fit of the straps too loose on your baby in case of an accident. Dress your baby in many thin layers rather than one bulky piece of clothing. If you’re not sure how many layers to use, a good rule of thumb is to dress your baby in one layer more than you have on.

What do I need to know when buying a used car seat?

  • Has the car seat been in an accident? If a car seat has been in a moderate or severe accident it may not be safe to use.
  • Does it have all its original parts? Any parts that are not original to the car seat should not be used or relied on as they are probably not safe.
  • What is the expiration date of the car seat? Plastic may lose strength over time, so you need to make sure the seat is not past its expiration date. Most car seats expire between 6-10 years after they are manufactured. You may find the information on the seat itself or in the manual. If you can’t find it – call the manufacturer or search online using the make and model number.

If you know that the car seat has not been in an accident and that it has all it’s original parts and is not past its expiration date, then it is safe to buy the car seat. If all three of these are not present, you are probably safer to buy a new one or a used one that meets all safety criteria.

What kind of car seat should I get for my preemie?

Choosing the right car seat for car seat safety for a small or preemie baby is very much like choosing one for a bigger baby with a few extra precautions:

  • Make sure you get a car seat rated as safe for babies down to 4 pounds(1.8kg). Check the label on the side of the car seat or read the manual to see the minimum weight rating of the car seat.
  • Make sure that the straps fit baby snugly and securely. Just like in bigger babies, the slots for the shoulder straps need to be low enough that they are at the level of your baby’s shoulders or right below. This way you know that the straps will be nice and tight on your baby’s shoulders which will hold him/her securely in place in case of an accident. If the straps are too loose baby won’t be safe!
  • It is not safe to use blankets or pillows to ‘fix’ the fit of the straps. Very small babies may slump over to the side and possibly close off their airways. Talk to the hospital staff about using very tightly wrapped receiving blankets on either side of the baby to hold them upright.
  • To secure the car seat in the car only use parts that came from the car seat manufacturer.
  • Bring the car seat to the hospital before discharge to check the fit of your baby and that your baby can tolerate the angle of the car seat
  • If your preemie can’t tolerate the angle of the car seat or your doctor tells you he/she needs to lie flat during travel, talk to your doctor about using a car bed. Make sure it meets the Federal Motor Vehicle Safety Standard 213. (It should say it does in the car bed’s manual). Before leaving the hospital ask the hospital staff to check your baby can lie safely in the car bed.

Remember:

  • Size does matter.
  • Fit matters.
  • Car seats should be backward facing for the first two years.
  • Babies and children need to be in the back seat until they are 13 years old.
  • Never leave your baby alone in the car, even if s/he is in their car seat.
  • Register your baby’s car seat so that you can be informed if there is a safety recall on the seat.

:::::

Dr. Linda Abujaber is a Holistic Pediatrician who has been working with children and their families for over 30 years. She is also the proud mom of two grown up kids who taught her to be a better pediatrician. Dr. Linda is passionate about offering new and experienced parents easy to use tips and skills so they can confidently and naturally keep their kids happy and healthy. You can learn more from Dr. Abujaber at AskDrLinda.com and connect on Facebook.

My Brother Owes His Life To His Bike Helmet

pedimom-bike-helmet

By Dr. Alison Escalante

Our culture can sometimes be a little crazy about safety. But every time a parent says, “We didn’t wear bike helmets when we were kids, and we were just fine,” I remember the summer day when my little brother was 9 years old.

That was the day my little brother was hit by a car.

My mother had been an early adopter of bike helmets, and we were the only kids in town who wore them. Then we moved to a new town and were the only kids who wore helmets in that town too. We were made fun of, and the older boys used to bang on the top of my helmet as I tried to escape the middle school bike racks.

We wore our helmets anyway, because our we were more scared of our mother than of the other kids. Logically, I understood the point of a bike helmet. After all, only half of people wore seatbelts then, but it felt really stupid to me not to just put the seatbelt on.

I remember seeing my brother’s friend run up to the side door of our house and start pounding, shouting that my brother was hit by a car. I watched my dad, the former college varsity runner, take off faster than I’d ever seen him run before. And suddenly I was out the door running after my dad, with an odd sense of watching myself as I ran.

When I caught up to my father he was pushing through a crowd of people shouting, “That’s my son.” The neighbors were in a circle, the first aid squad was on their knees at my brother’s feet. He was lying in a pool of blood and water.

The adults finally let me through, because I kept telling them I was his sister. But they wouldn’t let me touch him, and he was flailing as they tried to get him on a backboard. So I did the only thing I knew to do: I searched for his glasses, which I found several feet away and shattered.

The next thing I remember is the hours in the hospital waiting room, doing my best as an 11 year old girl to stay calm and comfort my 4 year old brother. We heard strange screams from the emergency room, screams that didn’t sound human, but I knew they were my brother. I tried to tell my youngest brother they were coming from somebody else.

Later, my parents updated me that he was technically in a coma, but they were hopeful he would survive. Eventually, he woke up and he wasn’t himself. He had suffered a significant traumatic brain injury. His path to recovery was long, but eventually he attended an Ivy League school.

He lived. The car had been at fault in the accident. The only thing that saved him was the bike helmet. There was no doubt in the doctors’ minds or anyone’s mind that he would have died or been neurologically devastated by that accident. Those early bike helmets were encased in thick hard plastic, and this one was cracked in half.

A year later my brother was featured on the local news in a feature on bike safety: a real life example of how bike helmets save lives. The kids in our town just made even more fun of us, and that was when I learned just how hard it is to get people to change unsafe habits.

Today I’m a mother, and my kids wear their helmets. So far, they are more scared of their mother than of being uncool.

The American Academy of Pediatrics recommends that all cyclists wear helmets that fit properly every time they ride, because evidence shows that helmets reduce the risk of injury and death. In fact, the evidence is so clear the AAP says it should be the law. “The bicycle helmet is a very effective device that can prevent the occurrence of up to 88% of serious brain injuries. Despite this, most children do not wear a helmet each time they ride a bicycle, and adolescents are particularly resistant to helmet use.” (AAP Policy statement 2001).

It starts with us. I urge parents to wear their own bike helmets every time they ride so that it becomes normal to their children. How can we hold them to a standard that we won’t maintain? If I want my kids to be wearing their helmets rather than hanging them off the handlebars as soon as their are out of sight like I see so many kids doing, then I need to wear mine.

I always advise parents that just like the rule is “no seatbelt, no car” the rule is “no helmet, no bike.” We don’t question the use of seatbelts anymore, wearing them just seems to be obvious. But we used to question seatbelts. I can’t wait until the day when we think of bike helmets the same way we think of seatbelts: essential. Why wouldn’t you wear a helmet?

References:
http://pediatrics.aappublications.org/content/108
GET A HEADS UP ON Bike Helmet Safety

:::::

Alison Escalante MD is a Pediatrician on a mission, with a clear, 3-step method to help parents raise kids skillfully AND enjoy doing it. She is a TEDx speaker and writes a column for Psychology Today. Find her at ThePrimaryCarer.com or watch her TEDx talk HERE.

What Parents Need to Know About Live-Streaming Apps

bark-livestreaming

In this video, I was talking to the Chief Parenting Officer of Bark about Live-streaming apps. We discussed what they are, how they work, why our kids use them, the dangers and risks, and how to talk to your kids about those danger. Check out the replay!

Sponsored Link

Sponsored Link
PediMom Bark bannerFor more information about the Bark Parental Monitoring App or to sign up for a FREE 1 week trial visit the Bark* website.

If you are interested in Bark, please feel free to use our PediMom promo code for a 10% discount for life*.  You can find Bark in the Google Play and IOS stores.

Click here to try the Bark App for free!*

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My Daughter Had A #MeToo Moment

pedimom-stop-metoo

By Natasha Sriraman, Mother

(NOTE: This Mother’s piece accompanies her daughter’s story which can be read here)

Srirman familySexual assault, sexual harassment, inappropriate touching, sexist remarks.

Celebrities, waitresses, housekeepers, nurses, physicians, lawyers.

There are so many instances. Women of all ages, all walks of life, and in all stages of life are affected by sexual violation. This has become known as the #MeToo movement.

While the celebrities brought these stories to light so many brave women, even those who would face adverse outcomes, told their stories. And luckily in most cases the outrage was swift, punishing the men who perpetrated these crimes. And while these brave women stood strong and told their stories loudly there were many men, so many supportive men, who had not realized how deep and pervasive this problem was (including my husband). Those men stood by, supported, and helped women speak their truth.

As an Indian woman who has lived in multiple countries and cities while I completed college, graduate school, medical school and residency, being approached by male peers, being catcalled/whistled at while walking down the street, or being inappropriately touched has been happening to me for as long as I can remember. Unfortunately, many in our generation of women were not necessarily taught by our mothers/aunts/grandmothers that this behavior is inappropriate. Yes, I was taught about outward sexual advances, such as don’t leave your drink unattended, don’t walk alone at night, etc., but the seemingly innocuous sexual advances, the innuendos, were never really addressed.

I remember the first time 2 years ago when multiple #MeToo stories were coming out, including the ‘grab the pussy’ news story by one of the presidential candidates. I had a visceral reaction. While thankfully I have not been a victim of sexual assault, I flashed back to my residency and remembered a time when an attending inappropriately touched me while I was on call with him one night. It just made me feel…nauseous. But I didn’t feel that it was a real #MeToo story.

As a mother of 3 I keep the lines of communication with my children open as best as I can. I talk to my daughters about the behavior of boys, how to remain safe, don’t go anywhere alone. I talk to my son about respecting a girls personal space, etc.

So when my daughter told me what happened during our Caribbean vacation, I was horrified, saddened, and so so mad. I felt terrible that I didn’t notice how the waiter was behaving towards my daughter. When she told me later that night in the hotel room I immediately hugged her and apologized. I literally wanted to march back to that restaurant to tell the owner and hold that waiter accountable.

While she said she was fine, I told her how sorry I was that she felt unsafe. I suggested to her that we have a code word/phrase (or maybe a Hindi word) so she can use it when she feels unsafe or worried and needs me to intervene. While she is such a brave and strong young lady, she was visibly shaken. I told her that it was NOT her fault, that some men unfortunately feel that it is their right. I then told my husband so that he would not only know but also so that he would be more cognizant of these situations as his daughter becomes a woman.

My advice for parents as a mother and pediatrician – please have these talks with your children, both boys and girls. Unfortunately it happens all the time, and while the #MeToo movement is ongoing there are still many people of both sexes that do not realize those ‘innocent’ comments or light brushes of the hand across a buttock or chest are not okay. It’s not ‘just an accident.’

My advice for kids/teens. Please, please, please tell someone you trust. Tell a parent, relative, teacher, counselor, family friend or peer. It will never be an inconvenience and you will be believed. Please don’t ever feel guilty or blame yourself. Just walk away and get to somewhere you feel safe and out of harm’s way.

When my daughter decided to write a #MeToo piece, I thought she was going to write about an incident that happened to her favorite singer, Arianna Grande. Arianna was grabbed by the pastor during the funeral service of Aretha Franklin. Instead, she wanted to tell her story, and I’m glad she did. After reading her piece we discussed the incident again. I told her about some of my experiences hoping to show her that while it can happen anytime and anywhere it is the fault of that person. I told her not to feel guilty about not yelling/standing up to that person in that situation.

I hope my daughter’s story can help young people out there; whether it is to trust someone enough to tell their story or by helping them feel strength as they stand up to prevent their #MeToo moment.

My #MeToo Story

PediMom #MeToo

By Sahara Sriraman, Age 16

(NOTE: This daughter’s piece accompanies her mother’s story which can be read here)

It is definitely not a secret that sexual harassment is a growing issue that is becoming more common every day. And all of us are familiar with the now-popular #metoo movement that has become bigger with every new story that comes out. Each one is different from the last but they have all been part of the movement that has brought people’s attention to the disrespect women are subjected to on a continuous basis.

Women, for centuries, have had to work twice as hard as men to even come close to reaching the same achievements. Women have automatically been deemed “less able” than men before they are even given a chance. This gender inequality has mostly shown itself through sexual harassment and sexual assault and now only recently has become an issue that people are really taking notice of and speaking out against it. With every new story, people become even more angered with the status quo and how men think they are allowed to touch women without their consent.

Regardless of this outrage, people, in my opinion, are not doing enough to prevent it. With all these stories coming to the surface, people have been telling women that they should dress more conservatively, not walk on their own, and not get too drunk, instead of taking action against these sexual predators. People are somehow getting away with giving the responsibility of self-protection to the women instead of doing what they can to help them. And as more women tell their stories, more men are being accused of this horrifying crime. Yet people are finding every possible way to twist it around on the woman and blame her for the unspeakable crime that was committed against her. It’s disgusting and is only getting worse as women become more vocal with the stories of sexual harassment/assault that they were too afraid to speak of before.

Regardless of the backlash we face as women for speaking our truth, we will still continue to fight for the justice we deserve to have. And as someone who has experienced sexual harassment once before, I want to add my voice to this movement.

I had thankfully never been inappropriately touched by a man before this event mostly because I never let a man get close enough to have the opportunity to do so. I knew what could happen if I did and I was always conscious and alert about this. I knew that as a 90-pound, 16-year-old girl, I was automatically vulnerable, so I was too smart to put myself in that position. However, I am still a kind person who doesn’t want to inconvenience anyone or be rude. This weakness, unfortunately, led to one of my biggest fears becoming a reality.

It was last summer when my family and I were vacationing in the Caribbean. We went to a restaurant in town for dinner and we were served by a male local. Throughout our dinner, he would entertain us with jokes and even convinced me to show him some dance moves. However, even though he was really nice, he made me feel extremely uncomfortable. Every time I would look at him, he would be intently staring at me and then look away as if I had caught him doing something bad and would even get uncomfortably close to me every chance he could get. By the end of the dinner, I was feeling really uncomfortable, but I didn’t want to ruin my family’s dinner by telling them what was happening. So I just put a smile on my face and continued to enjoy dinner the best I could.

After we finished dinner and were about to leave, my mom suggested that we take a picture with the owner of the restaurant. The waiter decided to get in the picture and positioned himself right next to me for the picture. When he did this, I knew that something wasn’t right and wanted to escape from underneath his arm. But I, again, didn’t want to arise suspicion from my family and upset them. So I just remained where I was and tried to fake a genuine smile. That’s when his hand slowly snaked down my back. I was silently praying that the man who was taking the picture would hurry up, as he was taking many different ones. I didn’t want our waiter to do what I thought he was doing. But, regardless of my personal thoughts, he did it anyway. His hand reached my butt and slightly squeezed it.

My biggest fear, the thing that I heard so much about on the news, was finally happening to me. And me, someone who vowed that if this ever happened to me I would stand up to the person doing it. Yet, here I was, frozen in my spot, letting this man I had known for all of 45 minutes, put his hand on my butt. And even though my mind was telling me to GET AWAY FROM HIM, I physically couldn’t.

After all the pictures were taken, the man pulled away before anyone could see where his hand has been and just smiled at me and acted as if nothing had happened. I felt violated. I didn’t know what to do. Should I confront him? Should I tell my parents? Should I inform the restaurant owner about his waiter’s behavior? But I did absolutely nothing instead. Looking back on it, I wish I had done something, anything. But that doesn’t change the fact that I didn’t do anything. It doesn’t change the fact that this waiter got away scot-free.

After we left the restaurant and began walking back to our hotel, my family was chatting about how it was such a good restaurant and how the owner/head chef was so nice and how we should go there for dinner again before we left. At this point, I felt like there was this huge weight on my shoulders that I just couldn’t get off and I knew why. I knew it meant that I should tell my parents about what happened, so I didn’t have to risk seeing that waiter again and going through that same traumatic experience. Yet, even though the thought of this made me want to break down, I still didn’t say anything. I didn’t want to disappoint my family and deprive them of having a good time, plus I was still in shock. I also felt like what happened wasn’t that serious and maybe I was just overreacting.

As we continued to walk, the weight started getting heavier. I just couldn’t keep it inside anymore. So I finally FINALLY told my mom about what happened and she automatically replied saying that we definitely would NOT be going back there. She wanted to talk to the owner, but I told her not to say anything. Even though I had told my parents about what happened and felt better knowing I had told the truth, I still wasn’t really the same for the rest of this trip. I was a little more hesitant about wearing revealing clothes and didn’t let myself get even close to a man I didn’t know. That one event affected the rest of my trip.

This event also changed me as a person and as a female. Even though it sucked and made me feel violated and insignificant, I finally understood partially what it was like for so many of the women who came out with their #metoo stories. I always imagined myself doing something that can only be described as heroic against a man like yelling at him in front of everyone, but I know that if it happened again, I would still do nothing. I think that just goes to show that you can train yourself to react a certain way to something you know may happen, but when it finally happens, you have no idea how you’ll react. I get really mad at myself knowing that my instinct to defend myself would never kick in if a situation like this ever happened again, but there’s nothing I can do to change that. And when I realized this, that’s when I realized that the only way to stop sexual harassment is to actually do something to prevent it. People can tell women what to do when faced with a sexual harassment situation like this all they want, but there’s no way to tell how she’s going to react when it actually happens. And that is why drastic measures need to be taken to punish sexual offenders and, therefore, protect women.

If you have been a victim of sexual assault or harassment, you need to tell someone immediately. Not telling someone is only hurting yourself in the end and it will make you feel so much better after you tell someone you trust. Sexual harassment should not be taken lightly and we can ensure that by communicating our experiences with others. In doing so, we will be on our way to justice for the thousands of victims who have been affected by this crime, along with ourselves. Telling someone the truth of what happened is only fair for yourself and your well-being and no one else should have an influence in your decision to tell someone.

Although my experience was fortunately only minor and I will never see that waiter again, this experience changed who I am and made me stronger, not only as a female but also as a human being. I waited so long to tell my story because I thought it was insignificant compared to all these other women’s’ stories, I didn’t think that mine would matter; I thought I was just overreacting. But then I realized that those women’s stories are what inspired me to finally speak up about mine and my story, albeit minor, was still an event that traumatized me and was still sexual harassment.

I hope that my story will inspire someone else to voice their story just as the other women inspired me to. I now know that if something like this ever happens again, I need to tell someone I trust, even if I feel like an inconvenience for doing so. Because my sense of security should always be top priority–and I finally realize this.

And now I can say #metoo.

There is a drug called Lean in school. Have you heard of it?

pedimom-lean-drug

By Dr. Melissa Welby

Truth be told, I read my daughters texts. I don’t feel great about it but 7th-graders aren’t “oversharers” (with their parents) and I want to have an idea of what is going on. Her texts were my source of learning about the drug called Lean. It wasn’t at a conference or in one of my 4,000 medical magazines that seem to come daily; it was embedded in a text to a friend about what their respective schools were like. She mentioned there were lots of kids who use Juul and some who use the Lean drug. What? Huh? Am I the last to know this is a thing? What is the drug Lean??!!

I couldn’t wait for her to get home from school so I could ask more. In the meantime, I did some research.

What is the drug Lean?

“Lean” is also known as Purple Drank, Sizzurp, Purple Lean, or Dirty Sprite.  The classic color of the drink is, not surprisingly, purple and it is nicknamed “Lean” because it literally makes you lean.

My daughter reported hearing a group of 6th-grade boys discussing “doing” Lean and how they mix it with Sprite. Lean is classically a mix of Sprite, prescription cough syrup, and a hard candy like Jolly Rancher.

Prescription cough syrups contain codeine, an opioid drug. They also can have an antihistamine, promethazine, that causes sedation and can impair motor functioning (hence causing the lean).

How common is the drug called Lean?
There isn’t good information about how prevalent using “Lean” is since the ingredients aren’t too trackable. But if my 7th grader knows about it, I take that as a sign that we should all be aware. Here is a study on prevalence in China.

In 2011, the Department of Justice wrote a Drug-Alert Watch on the resurgence of Purple Drank. It writes about some history on Lean:

“Used since the 1960s primarily in and around the Houston area, Purple Drank also has been prevalent in other areas of the south. The mixture enjoyed a revival in the 1990s. A 2007 music album and a song titled Purple Drank and other recordings and music videos by hip-hop and rap artists appeared to glamorize and promote the mixture.”

Is the drug Lean safe?
Well, of course, it isn’t. But let me say more. Given the national opiate crisis, we all know that taking opiates is dangerous and can lead to addiction, overdose, and death. It’s easy to imagine people who use lean don’t have a great idea of the amount of codeine they are ingesting since they are drinking a medicine that tastes like syrup, mixed with candy and soda. This puts them at higher risk of dangerous consequences.

Codeine:
Serious side effects of Codeine include slowed heartbeat, shallow breathing, blurred vision, agitation, and hallucinations. Read more from Medline about Codeine’s effects.

Promethazine:
Promethazine, a drug given for things like motion sickness, nausea and vomiting, or allergic reactions, is “anticholinergic”. When something is anticholinergic it has particular side effects that can be associated with it. In medical school, we learn lots of mnemonics to remember side effects:

What this means is that these side effects (which obviously increase with the amount taken) include blurry vision, inability to urinate (hence Lean’s association with urinary tract infections), and unsteadiness.

Blind as a bat (dilated pupils)

Dry as a bone (dry skin, mouth, eyes)

Red as a beet (flushing)

Mad as a hatter (delirium, confusion, agitation)

Hot as a hare (increased body temperature)

Here is more about promethazine side effects and overdose.

Celebrities spreading the word about the Lean drug:
Apparently, if I had read more celebrity news and not just medical journals I would have known about the Lean drug sooner. It’s sung about in rap lyrics and pictures of drinking out of a styrofoam cup (commonly the way to drink it. I don’t know why) are spread on social media.

The National Institute on Drug Abuse for Teens wrote a blog in 2013 about Lean:

In recent months, gossip magazines have reported on Justin Bieber’s erratic behavior, such as wearing a gas mask, fainting at a London concert, and traveling with a monkey. Mixed in with these reports is speculation about Bieber’s alleged use of a drug concoction called “Sizzurp.”

Bieber isn’t the only musician associated with the drink. Back in March and again at the beginning of May, rapper Lil Wayne was admitted to the hospital with seizures, allegedly from his use of Sizzurp (although he denied it)

The Lean drug
Well, there you go. Here’s my summary of a drug that I didn’t know existed prior to my daughter…ahem… “informing” me. Obviously, kids are using it (along with adults) and it is important for us all to know what to watch out for.

Someone, please tell me you also didn’t know about the Lean drug so I can feel I’m not the only one surprised! If you knew, how did you hear about it and what have you heard?

***

Dr. Welby is a Harvard-trained Psychiatrist passionate about empowering others to take charge of their mental health and destigmatizing mental illness. She writes about healthcare topics on her blog, spreading accurate and evidence-based mental health education to help people understand there is no true health without mental health.

This article was first published here.

Preventing Eye Injuries in Children

Eye and Vision Safety for kids

By Dr. Moran Roni Levin

“Didn’t your mother ever tell you not to run with scissors?”

While this may sound old-fashioned, as a pediatric ophthalmologist (eye physician and surgeon), I have unfortunately seen far too many eye injuries caused by everyday items or innocent play. I have seen serious and vision – threatening eye injuries not only from expected objects such as knives, pencils, and BB guns, but also from more unusual causes including tree ornaments, plastic dolls, and even a crab claw!

While I love helping to improve and preserve vision in my young patients, one the most disappointing challenges that I face is treating vision loss caused by preventable eye injuries. As a mother, my heart skips a beat when my daughter plays with rocks and sticks or runs around with certain objects. I immediately think of how I can protect and preserve her eyesight.

Eye trauma is the most common cause of preventable blindness in the United States. Children make up one-third of patients with serious eye injuries and this often occurs during innocent play. A research study I conducted of children who underwent surgery for eye trauma found that the four most common causes of eye injuries were BB guns, pencils, knives, and blunt trauma from a fist or object such as rock. Trauma to the eye can lead to devastating consequences. Not only can eye injury cause pain and loss of vision, but it can lead to lazy eye, with subsequent misalignment (strabismus), eyes not working together (loss of stereopsis), and even blindness, or loss of the eye. 

The best way to prevent eye injuries is to be cautious and aware of potential hazards. As a physician and a mom, I would like to share these tips on how to help prevent eye injuries in children:

Top 10 Tips for Eye Safety:

  1. Be aware of fly balls when attending a baseball game. Fly balls can not only cause injury to the eye, but also broken orbital bones.
  2. If your child has reduced vision in one eye for any reason including amblyopia (lazy eye), polycarbonate or protective glasses should always be worn. Children with vision loss in one eye often have reduced depth perception causing them to be at increased risk of falls or injury to the better eye. 
  3. Always wear protective eyewear (rec specs or sports goggles) when playing sports such as baseball, lacrosse, hockey, basketball, football, racquetball, or paintball. 
  4. Be especially cautious when using sharp objects including pencils, darts, and scissors.  Pencil injury was the number two cause of eye injuries requiring surgery in my study. 
  5. Do not let your child play with pellet guns or BB guns.  These types of guns can cause devastating eye injuries including complete loss of vision or even loss of the eye. 
  6. Avoid fireworks and bottle rockets. These can be extremely dangerous.
  7. Do not allow your child to play with laser pointers.  There are numerous reports of permanent damage to the retina caused by shining laser pointers directly into the eyes.
  8. Safety glasses should be worn when working with dust or tools. Dust can cause eye irritation and pain, and small objects such as metal or wood particles can get lodged in the cornea and cause potentially sight-threatening scarring.
  9. Use caution when cooking and keep children away from cooking areas.  Hot oil or grease from a stovetop can splash onto a child’s face cause eye injuries. 
  10. Keep bleach or household cleaners away from children’s reach. The most damaging solutions to the eyes included bases such as bleach and laundry detergents. In the event of an accidental chemical splash, immediately rinse the eyes and face for at least 10 minutes using either a sodium chloride solution (such as contact solution) or freshwater. After irrigating well, take your child to the nearest emergency room or urgent care center to check the pH of the ocular surface.

Eye injuries in children can be avoided if you use caution and are aware of potential risks. If an eye injury does occur, please immediately seek care from a pediatric ophthalmologist or go to the nearest emergency department with an on-call eye physician.

For more information please visit

AAO.org
AAPOS.org

:::

Dr. Moran Roni LevinDr. Roni Levin is a pediatric ophthalmologist in Baltimore, Maryland. She is a member of the American Academy of Pediatric Ophthalmology and Strabismus and has a particular interest in patient and medical student education.

 

Social media challenges. Why do our kids participate in such risky behaviors?

Social media challenges. Why do our kids participate in such risky behaviors?

By Dr. Free N. Hess

Netflix recently issued a plea to its viewers to stop participating in the most recent viral social media challenge dubbed The Bird Box Challenge. In this latest viral challenge, people are attempting to perform various tasks while blindfolded, mimicking the characters in the wildly popular Netflix movie Bird Box. While it is clearly obvious how dangerous this can be, many people on social media (mostly teens and young adults) are making videos of themselves and their friends attempting to navigate their surroundings with a blindfold; people running around their house, walking the streets of large and busy cities, and even driving cars. ALL WHILE BLINDFOLDED.

The Bird Box Challenge is just the newest among a growing list of risky internet challenges in this era of social media. Some of these viral challenges are extremely dangerous and have resulted in significant injury, and even death, of those participating. Here are just a few:

The Kiki Challenge

In this extremely popular challenge, people video themselves stepping out of a moving vehicle to dance to the song “In My Feelings” while the car continues to move forward with no driver in the driver’s seat. Since becoming popular, this challenge has resulted in multiple serious injuries. Eighteen-year-old Anna Wolden suffered a head injury resulting in bleeding in the brain requiring ICU care during her attempt of this challenge. Jaylen Norwood was struck by a car on video during his attempt at the same challenge. Although he was aware the second car would be coming (it was part of his prepared “act” where he was supposed to jump onto the hood of the car), he slipped and was struck by the passing vehicle.

The Fire Challenge

This is a outrageously dangerous challenge where people video themselves soaking themselves in flammable liquid and actually lighting themselves on fire. Sixteen-year-old Fernando Valencia lit himself on fire after dousing himself in nail polish remover, resulting in second and third degree burns to his abdomen, chest, and neck. Twelve-year-old Timiyah Landers attempt at the fire challenge resulted in second and third degree burns to 49 percent of her body, leaving her intubated and on a ventilator in critical condition after her her friends convinced her to mimic other posts on social media.

The Choking Game

In this challenge, “players” perform various maneuvers that cut off oxygen delivery to the brain in order to experience a brief period of euphoria. Unfortunately, many have actually lost consciousness and suffered serious brain damage or death. Although difficult to adequately assess given that many of the deaths due to this challenge may appear similar to suicide, the U.S. Center for Disease Control has accumulated enough evidence to report that there was at least 82 deaths between 1996 and 2008. Since 2008 there have been numerous additional deaths resulting from young people partaking in this risky act. Sixteen-year-old Jack Servi, 12-year-old Tua Muai, and Erik Robinson have all been victims of this dangerous challenge. Pedimom contributor Liz Calato shares how lucky she is that her son Ian survived this “game”. Unfortunately, many parents are not so lucky.

As parents, it can be difficult to understand why so many adolescents and young adults are so willing to risk serious injury or even death just to go “viral” on social media or to impress their peers. So why do adolescents and young adults take risks more often than any other age group? Several key factors have been identified by research studies that shed light on this puzzling behavior.

First, there is an increase in interest and the importance assigned to peer relationships, resulting in an increase in susceptibility to peer influence during the adolescent period. Several areas of the brain make teens more sensitive to the neurochemical rewards of peer acceptance and approval, resulting in a strong desire to impress friends and an increased willingness to take risks by performing risky and “exciting” behaviors. (Albert, Chein, & Steinberg, 2013).

Second, adolescents become more distressed when excluded by peers than adults due to the immaturity of a region of the brain called the right ventrolateral prefrontal cortex. Brain activity in this areas is associated with the ability to cope with the feelings associated with negative evaluation from peers. The immaturity of this region in adolescents results in a decreased ability to cope with social exclusion and an increased level of distress when exclusion occurs, thus they are willing to participate in dangerous situations to assure inclusion and to impress their peers. (Sebastian, et al., 2011).

Third, the area of the brain that is responsible for decision-making and mature self-regulation, the lateral prefrontal cortex, is also underdeveloped in the adolescent period. This leads to teens relying on areas of the brain that are more closely associated with reward than those which are involved in calculating risk. (Albert, et al., 2013).

For these reasons, teens and young adults are particularly susceptible peer pressure and more likely that younger children or mature adults to engage in reckless and risky behaviors, especially when participation in these activities is motivated by social media. 

What can parents do?

  1. Start the conversation. Talk to them about their relationships with their peers and what they see on social media. Let them know that their brains are wired to make risky situations seem pleasurable and less dangerous, and that you will be there to help them navigate particular situations, without judgment, when decision-making becomes difficult. Frequent discussions can help them identify risky situations and develop better strategies for dealing with tough situations. “What if” situations and discussions of cases of serious injury can help to introduce the topic to kids. 
  2. Organize safe adult-supervised activities to satisfy their natural sensation-seeking desires, including things they can post on social media. Zip-lining, rock-climbing (both with proper safety gear of course), roller coasters, water slides, and horror movies are just a few examples.
  3. RULES. Make it very clear that you expect them to be responsible for their actions and will hold them accountable for their behavior. Praise them when they make good decisions and talk about the unintended consequences that can occur from risk taking. Many teenagers have difficulty grasping their mortality and capacity to be injured, so honest discussion, encouragement, and praise can go a long way in keeping your children safe from injury related to social media inspired risk taking behavior.

Parenting in the social media era is hard. Let’s do it together.

It takes a village!

 

5 Tips For Setting Up Your Child’s Device For Safety From a Tech Mom

pedimom-child-digital-device

By Lisa Thee, CEO Minor Guard

When it comes to raising my kids, I often struggle with the challenge of keeping them safe, protecting their innocence, and preparing them to enter a technological workforce. I think about preparing them for the future, while helping them to live in the present.

As an engineer who has worked in the technology industry for 10+ years, I’m aware of the level of complexity technology introduces to the family. It’s important to provide children with access to devices so that they can connect with the world around them.

Establishing good guardrails sets you up for responsible parenting in the future. It’s important to take advantage of the tools that are available to keep our kids safer online.

Computers have gotten a lot better at filtering content, but only 5% of user-generated content is reviewed by actual humans, so plenty of age-inappropriate content slips through. This even applies to YouTube Kids. Here are some of my favorite tools I use in my house.

  1. Google’s FamilyLink app is free in the Google Play store and is both intuitive and user-friendly. It allows parents to manage parental controls, limit screen time, and restrict inappropriate content. You can always change the settings, so start conservatively and see how your family does. Apple offers similar options via IOS12 in the device settings.
  2. Having to spot-check devices is not only time intensive, but also ineffective, as many apps are designed to help your kids hide content. You need to confront technology problems with technology solutions. That’s why content monitoring software is really important once you let your child spend online time unsupervised. It also gets your child used to your role as their guardrail. I recommend Bark, which monitors texts, emails, YouTube, and more than 24 social platforms for issues that parents need to know about.
  3. We are in the infancy of artificial intelligence, and it will transform what work looks like in the future. Preparing your child for a skills-based career in technology means focusing their screen time on skill-building games like Nancy Drew Codes and Clues, Prodigy, and MIT’s coding game Scratch.
  4. My kids love the idea of becoming internet famous, and live streaming apps are really popular with young people. Pediatrician Dr. Free N. Hess of did a review video of Live.me here on this very website. It is important to know child predators know these sites are a great place to target kids.
  5. Give your child’s device a bedtime and charge it outside of their room.

This year, I got my 6- and 7-year-old kids child tablets for the holidays from Tanoshi. It took about 30 minutes to get them set up with the tips listed above, and they instantly started exploring the world on Google Maps, learning to code, and emailing me countless emojis.

I want my kids to make mistakes online. They will not always live under my roof, and I want them to take small risks and learn from the consequences. Kids need autonomy, but monitoring their online activities helps you know when risks go from minor to life-changing.

I would like them to be prepared for the world they live in, and I recognize that I am an important part of that journey, ensuring they get the right amount of exposure at the right time. Handing your child a device without guardrails is not responsible. These small hacks have made raising my kids easier in the digital age.

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Winter Weather Safety

By Dr. Jaime Friedman

Winter and cold weather brings back lots of memories for me. Sledding, hot chocolate, curling up on the couch with a cozy blanket, all fond memories from my childhood. Now as a parent and a pediatrician, all I see are the safety hazards. So I am here to pass on some tips to keep kids of all ages safe this winter.

AAP-winter-safety

Baby Safety

Babies and young children are at higher risk for getting cold related complications. They lose heat more easily and more quickly than adults. That means you want them to be in one more layer than what you are wearing. However, there are risks with bulking up baby.

  • Dress babies in thin layers if going out in the car. Make sure car seat straps fit normally and are right up against baby. Put blankets over the straps. Never put puffy coats or blankets under car seat straps as this loosens the straps and decreases the safety of the seat.
  • At night, put your baby in warm pajamas or a warm sleep sack. Do not put loose blankets in a crib with a baby. The safest sleep environment for a baby is a bare crib. Even toddlers can be at risk with heavy blankets in the crib because they can bundle them up, step on them and fall out.
  • Don’t forget that we lose heat from our heads and since a baby’s head is proportionately larger compared to the rest of their bodies, they are at greater risk for heat loss from the head. Make sure all babies wear hats when they go outside

Big Kids (let them go out and play!)

Playing in the snow is one of the most fun things for kids, and adults. Jumping in the snow, sledding, snowball fights, and building a snowman are all activities right outside the door if you live in a snowy location. Living in California I feel bad that my kids don’t get to grow up doing these things like I did. Besides fun, it’s also great exercise. But of course it is cold and wet out there so safety needs to be a top priority.

  • Put kids in layers. Thin layers keep them warm and keep them moving. Don’t forget hats and mittens too. Try to find insulated boots and jackets, preferably kinds that prevent snow or water from getting in.
  • Make sure to take breaks so they can warm up.
  • Avoid playing in temperatures colder than -15 degrees Fahrenheit.
  • Recognize the signs of hypothermia: shivering, slurred speech, slow movements and acting sleepy. If you are worried about hypothermia, go inside and warm up your child with warm blankets and warm fluids. Seek medical attention immediately if your child is not alert or does not appear to be improving.
  • Get wet clothes off as soon as possible as the wetness draws heat from the body.

Winter Sports

  • Everyone who will be skiing or snowboarding should wear helmets. Many parents also put helmets on young kids who are ice skating.
  • Keep up with hydration just like you would in the heat.
  • Put kids in layers so they can shed some if needed while they are active.
  • Again, go in and remove wet clothes as soon as possible.
  • Don’t forget sunscreen while out in the snow. The snow will reflect the sun’s rays.

Frostbite

Sometimes the air is so cold that the skin, and even the tissue below it, can freeze. This happens most often on the thin tissues at the ends of the body like fingers, toes, ears and noses. Frostbite will feel painful at first but then the skin will turn pale and the area will be numb. If your child complains of pain, go inside and warm them up with blankets or a warm (not hot) tub. Do not rub the area. As long as the child is alert and feeling better, give them warm fluids to drink. However, if the numbness continues or the skin blisters, seek medical attention.

Other pointers

If you live in an area where there is potential to get trapped in a snowstorm, keep warm blankets, water and snacks in the car. These storms can also shut down power so keep flashlights handy and cell phones charged. Don’t use candles if you can avoid it and never leave candles or a fire unattended. Similarly, don’t leave space heaters unattended and watch young children around anything that is a potential burn risk. If you use a wood-burning stove, be careful about carbon monoxide poisoning and make sure to always have a working carbon monoxide detector and smoke alarm in the home.

For more on winter safety, listen to Dr. Friedman on the RadioMD Podcast.

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Dr. Jaime Friedman is a Pediatrician in San Diego, California. You can see more from her on her blog DrJamieFriedman.com.

Why Teens Are Addicted to Social Media

Social media FOMO

By Suha Malik, age 15

As many parents probably already know, their teenage kids can be absolutely addicted to social media. And with the various websites and array of social media platforms, sometimes teens can spend all day glued to their screens. While I’m not exactly defending teens’ reasons to be stuck on social media all day, enlightening others is a good goal to have when trying to raise awareness about the potential negative impacts that social media can have.

One of the first reasons that comes to mind when talking about why our generation is addicted to social media is probably because of the Fear Of Missing Out, or FOMO. While some don’t care if they’re the first ones to see a new post by someone popular in their school, or even a celebrity, teens often give a lot of attention to their phones so they can see and understand what’s going on in the world in terms of pop culture.

Basically, it’s the fear that many teenagers have that if they don’t go on social media, they will miss out on a huge event, or something that they deem as important. Often in school, a student’s peers may be discussing a post or video that they all saw and shared the previous day, and if that student wasn’t on social media at the time, they feel left out of the conversation, and not as engaged in it as well.

In BBC’s article, titled, “FOMO: How the Fear of Missing Out drives social media ‘addiction’”, several high school students were challenged to not go on their phones or check their notifications for a week. One person said that the longer they didn’t go on any of their social media platforms, “the more disconnected and isolated from the world [she] felt”. FOMO is one of the main reasons why many teenagers feel the compulsive need to spend a decent chunk of their time on social media; to make sure they are up-to-date with all happenings in order to fit in.

Another reason why teenagers today obsess over social media is because their profiles really dictate how they appear to others. That is, the more likes and/or followers they have, the more popular and envious they come off as to others. Some teens may constantly be on social media platforms to hunt for more followers, make their posts the best that they can be, or find a way to get more likes on their posts.

Psychologist Emma Kenny states that likes on social media sites, such as Instagram, give you a physiological high, and is a reward cycle, prompting users to keep going back to and worrying about the amount of likes that they get. A lot of teenagers, myself included, have deleted posts if they didn’t get a high enough number of likes.

Getting a low number of likes and followers, in teenagers’ minds, equates to low status and ridicule, especially in a school environment, while having a high number of each equates to popularity.

An additional reason why teens may be addicted to social media is because of how quickly and easily they can communicate with their friends, no matter where either of them are. With the click of just a couple buttons, kids in my generation are able to send pictures to each other on Snapchat, as well as gossip and converse through DMs (direct messagings) or IMs (instant messaging). Teenagers can appear as if they are addicted to social media, even if they are not, because they devote a lot of their time to talking to their friends online through these social media platforms.

Social media can act as an escape from the real world. If a teenager is stressed, sad, or even depressed, they may turn to social media to forget their problems, even if it is only for a couple of hours. It’s also a lot easier to express yourself on social media, and teens who may be shy in real life are more likely to have a bolder online presence; they are able to think about their words, and come off as witty, even if in real life they are nothing like that at all. Additionally, if a teenager is feeling isolated or disconnected from their family or friends, they may turn to social media.

On these platforms, it’s easier to make friends, and more often than not, people are accepted wholeheartedly and right away, creating a sort of safe haven for those who feel this way. Most of the time, people post certain events in their lives, whether positive, like getting a job or getting into college, or negative, like failing a test or having a loved one pass away, in order for their online friends and followers to comment and give them praise, support, or reassurance.

A final reason why teenagers may spend an abundance of their time on social media, or on their phones in general, is to pass the time to avoid being bored. Too many times during dinner parties or get-togethers full of adults have my sister or I decide to pass the time going on our phones and scrolling through social media rather than just sit there and do nothing. It was not as if we wanted to avoid talking to people: it was just the fact that no one wanted to talk to us. Instead of doing absolutely nothing throughout the hours that these events took (and becoming wholly bored in the process), we take it upon ourselves to become engrossed in our phones to give us something to do.

So, with all of that in mind, it’s painfully clear that a good portion of the world’s teenagers are addicted to their phones. The impacts of this, though, are frighteningly negative. The “perfect” people that are showcased online tend to lower teenagers’ self-esteem. Without even thinking, we compare ourselves to others, especially those we see on social media platforms. When teens determine that they aren’t “good enough” because they don’t look a certain way, depression, anxiety, eating disorders, a hard time sleeping, disconnectivity, obsession with self-image, substance use, loneliness, and self-harm may manifest itself in teenagers.

Moreover, because teens spend a lot of their time on social media, they have less and less face-to-face conversations and connections because they are experiencing that all online. While this doesn’t seem like such a bad thing, the psychology website PsyCom reports that this results in a difficult time fine-tuning empathy and communication skills, attributes that need daily practice and experience.

For teens, it’s quite understandable and obvious, really, why they spend so much time on social media. Whether it’s to stay up-to-date with events, or just to pass the time because they have nothing else to do, social media is certainly a large part of a teen’s lifestyle. While there are some positive sides to social media, like being able to stay in touch easily, there are too many negative effects of social media which cannot simply be ignored. While it won’t go well if you tell your teen to completely cut out social media, it would be a good idea to limit their time on it, given all of the potential downsides.

SIDS prevention: How to get a good night of safe sleep

Pedimom-SIDS

By Dr. Natasha Agbai

Every day in my office I see loving moms and dads bring in their newborns for their first doctor’s visit with their pristinely clean car seat and a diaper bag filled with everything a newborn could possibly need, except maybe an extra pair of pants… you live and you learn. A few weeks later they come for the one month visit. The car seat might have a little dried spit up on it, the diaper bag has been thinned out, and it definitely has a second pair of pants.

One thing remains constant though no matter how seasoned a parent. It is the fear of SIDS, particularly in the first 6 months of age when SIDS is most likely to occur. So many of us parents can relate to waking up in a panic and checking to verify that the baby is still breathing.  Some families find that worry keeps them awake. Some families have been given well meaning gifts for their babies that are actually dangerous or have unknowingly purchased something that has been linked to an increased risk of SIDS. My goal as a pediatrician and a parent is to try to make sure that all parents can have easy access to current SIDS prevention recommendations.

The American Academy of Pediatrics (AAP) has a SIDS task force that reviews and summarizes new studies and forms SIDS prevention recommendations. These recommendations, along with practical tips, can be found at http://sidsrisk.org. The AAP comes out with updated recommendations every 5 years (the next update is in 2021). Here are some of their science-backed peer-reviewed SIDS prevention recommendations.

Prenatal:

✅ Pregnant women should obtain regular prenatal care.
✅ Avoid smoke exposure during pregnancy and after birth.
✅ Avoid alcohol and illicit drug use during pregnancy and after birth.

Setting up the nursery:

✅ It is recommended that infants sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for the first year of life, but at least for the first 6 months.
✅ Keep soft objects and loose bedding away from the infant’s sleep area to reduce the risk of SIDS, suffocation, entrapment, and strangulation.

Once baby is born:

✅ Infants should be placed for sleep on the back (face up) for every sleep until age 1
✅ Infants should be placed on a firm sleep surface (eg, mattress in a safety-approved crib)
✅ Aside from a fitted sheet, all other bedding should be avoided
✅ No soft objects in the sleep space
✅ If able, breastfeed exclusively until 6 months.
✅ Use a pacifier
✅ Avoid overheating and head covering/hats in infants.
✅ Infants should be immunized in accordance with recommendations of the AAP and Centers for Disease Control and Prevention.
✅ Avoid the use of commercial devices that are inconsistent with safe sleep recommendations.
✅ Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS

Setting up a safe sleep environment for your baby should be fun and rewarding. You can create a cozy, nurturing environment that is also safe.  Most people use a bassinet for the first 4 months of age and then change into a larger crib. If your baby needs a blanket I encourage the use of swaddles for newborns or sleep sacks (also called wearable blankets) for infants.

I urge you to ignore magazine ads showing babies sleeping peacefully with unnecessary (and unsafe) things like stuffed animals, bumpers (even mesh bumpers), quilts, positioners, and pillows. There are also a variety of “sleepers” that are sold regularly in stores that are unsafe sleep surfaces. Things like rockers, recliners, hammocks, and loungers often say “safe for supervised sleep”.  As a pediatrician and SIDS expert let me unequivocally translate this for you. “Safe for supervised sleep” means it is not safe for sleep. I hope in the future the labeling becomes more clear. Until that time we have to rely on savvy parents like you to outwit the marketers and remember the safe sleep principles.

Sometimes friends and family aren’t aware of the updated sleep recommendations. With the best of intentions people may tell you stories of how their child slept on X (insert an unsafe environment) and did just fine. Of course they did. Just like some of our ancestors kids rode in the car without a seatbelt and did just fine. But also some died. My response to this is simple, we make the best decisions we can to protect our children with the information we have at the time. As new information arises recommendations are updated. When it comes to SIDS we can’t yet predict who will end up just fine and who won’t wake up. For this reason, I recommend protecting all infants as best we can.

I also think it is important to recognize the level of sleep deprivation that comes with having a newborn. Sometimes parents need to make difficult choices. Some sleeping surfaces are riskier than others (the couch for example is one of the most dangerous places for an infant to sleep).  If you want to see how certain behaviors influence an infant’s risk for SIDS, check out my Risk Calculator available at http://sidsrisk.org/risk-calculator/  

Having an infant is exhausting, messy, and amazing all at once. Every parent that I have met wants the best possible future for their baby. My hope is that by adopting safe sleep practices our community as a whole will get to experience the joy that comes with more 1st birthdays!

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Natasha Agbai, MD, FAAP is a pediatrician at Palo Alto Medical Foundation and creator of SIDSRisk.org, a website dedicated to safe sleep and SIDS prevention.  She is the proud mom of two sons. You can follow her on twitter @AFitterFamily

Do You See Me? Do You Know Me??

pedimom-bullying-boy-928655_1920

By Dr. Uchenna Umeh

Do You See Me? Do You Know Me??

Do you see me?
Do you know me??

When you call me names
And pull at my hair
Drag my backpack
And mess up my books
Do you see me?

When you push me and punch me
And tell tall tales about me
When you jeer each time I pass by
Do you see my tears?

When my head pounds and my heart aches
My pulse races and my hands sweat
At the thought of waking up…
…to another school day,
Do you even care?

When my back hurts and my stomach cramps
My lips swell and my shins sting
And both eyes are black
From your punches and kicks
Do you feel my pain?

When I cry alone in my room
And refuse mom’s best meals,
When I cut my wrists and cut my thighs…
…in tiny slits by day and by night
So as not to feel the hurt you cause
Do you know that?

Have you known a pain so deep
From being left out and all alone
When y’all don’t look at me, play with me or even speak to me,
When y’all sneer at me and make fun of me,
Do you know what that’s like?

Did you know that my stomaches never go away,
My leg pains don’t get better
My sadness has led to depression
And now I want out?

Al have you know that
I won’t tell anyone,
I can’t tell anyone because
They don’t really care,
They don’t want to help
And they can’t really help.

I want to end it all

Do you know that I have thoughts?
Thoughts about killing myself,
Thoughts I’d be better off dead
Thoughts about getting a gun
Thoughts about using a knife?

I also have other thoughts
Thoughts about getting even
Thoughts about ending your life
Thoughts about getting it done
Ending your life and mine

Do you know that
When you tease me daily,
When you mock me and make me feel small…
…invisible and insignificant
I want badly to get even?

Do you know I have a plan?
I want to show you that
I am strong
I COULD hurt you
I CAN bounce back
And I WOULD hurt you
Like you hurt me

Yes, I want to hurt you
And ensure you are not here when I am done
You will have a hole in your heart
You will hurt, like I hurt
You will pay for all my pain
Yes, that’s my plan.

But you know don’t you?
That I will NOT carry out my plan
That I will NOT hurt you back.

But, one thing is for certain,
I will not let you hurt me again, EVER!
I will put an end to it
I will…
…today.

To all who have been hurt by bullies everywhere,
I see you.

BB

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Dr. Uchenna Umeh (oochaynnah oomay)  is a Pediatrician, a wife, a mom, a disabled veteran, a “doc-preneur” in the making, and an exercise enthusiast! She is passionate about teen depression and teen suicide which resulted in her launching TeenAlive.com. She also has a more personal blog with lots of great reads.

Guns and Kids: It’s About Child Safety

Gun safety

By Dr. Nerissa S. Bauer

One of the first issues I became passionate about was keeping kids safe from guns. Why? While I was a pediatric resident in San Diego, the school shootings at Santee, California occurred. This was just two years after the horrific events at Columbine. I saw kids coming to clinic, with non-specific complaints and in the end, not wanting to go to school. Parents had questions about how to best handle their kids’ (and their own) fears.

Why did this happen? How could it happen here? Should kids be allowed to stay home from school? What can we do from preventing this horrible thing from happening again?

This experience set me on the path towards advocating for children’s health within the context of public health. I saw just how this type of violence affects individual families but also its effects on the larger community. I started a project to simplify the screening for the presence of guns and other risks for childhood injury during clinic visits; passed out free gun locks to families who told me there were guns in the home; and distributed play date safety cards to families.

Over 75% of gun injuries and death are the result of children with easy access to guns that are improperly stored. When these types of events happen, it is usually at a friend’s house or their own. Now we see these headlines daily: a toddler who finds his mother’s handgun in her purse and accidentally shoots himself; school aged boys who come across a loaded gun during play and it accidentally discharges; a teenager with depression or is bullied who has easy access to a gun and commits suicide or decides to bring it to school as an act of revenge for perceived wrongdoings. The one thing that comes out of these events is that  they are brought to our attention.  The endless stories can cast no doubt that guns and kids are a public health epidemic. On the other hand, hearing these headlines daily can leave us feeling no longer shocked that these events happen. That somehow it is part of our daily fabric living in this country. Too many children’s lives lost, too many senseless events that could have been prevented. Too many families torn apart and affected by guns.

BUT DO NOT GET NUMB. Sometimes it can feel like there is nothing we can do as a society to change things because too many of these events happen EVERY DAY. However, we have a responsibility to do what we can for our own children, for those in our care, for those in our global community. No one is immune to these events.

We must remain vigilant and continue to do what we can as responsible adults, providers, parents, and community members. We can join organized groups that advocate for action  at the federal level to pass sensible gun safety laws and ensuring access to comprehensive mental health services. There are things we can do each day by knowing what safety risks might be present in the places our children are allowed to play. We cannot assume that children will know the right thing to do when they stumble upon a gun.

Playdate safety cards are meant to help parents ask each other about potential safety hazards in the environment in which children play. It is hard to ask someone if they have guns in the home, and even more so of friends or acquaintances you have known for a while but may have never thought to ask. These playdates cards can help start the conversation.

While this is a small measure and will not “cure” this epidemic, it can be a step towards prevention of another event.

When parents arrange a playdate for their children, they usually share information about their children including any food allergies and any fears of pets. Parents exchange phone numbers or emails in the process.  This is the ideal time to ask whether there are guns in the home. It is up to the individual parent what to do with that information if the answer is yes. However, if you don’t ask, you won’t know–and I would argue it is always better to know.

The cards can be printed on cardstock.  You can stick it on the refrigerator with a magnet or in an address book once completed. You can trade them when you meet another parent. The crucial part is that it has statistics and a section with questions to ask the other parent. If you cannot bring yourself to ask spontaneously, having these cards can give you ideas for how to start the conversation. The first few times may feel awkward, but after that it becomes easier.

 

 

 

 

 

*A special thanks to Heather Hunt Dugdale, Esq. for working with me in those early days in San Diego on this tool. Another heartfelt thanks to one of my first mentors, Dr. Bronwen Anders, whose clinic I worked at during residency, who supported and helped me gain the confidence to move this cause forward.

Educate yourself about this issue & what you can do to help this cause.

More information:

  1. American Academy of Pediatrics, HealthyChildren.org website has great parent friendly resources including: Gun Safety: Keeping Children Safe
  2. http://momsdemandaction.org
  3. http://everytown.org

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Nerissa S. Bauer, MD, MPH is a behavioral pediatrician, blogger, tweetiatrician, behavioral health care consultant and health services researcher. She most recently was an Associate Professor of Pediatrics at Indiana University School of Medicine until December 2018 when she decided to leave academia. She is now planning to spend time with her family, blogging, continuing with her tap class and launching a consulting business, NSB Consulting, LLC, which specializing in training, facilitation and implementation of best practices in behavioral healthcare in primary care settings. She is a media spokesperson for the American Academy of Pediatrics (AAP) on developmental-behavioral topics and an Executive Committee member of the AAP Council of Early Childhood. She resides with her family in Carmel, Indiana. Her blog is http://www.letstalkkidshealth.org.

What is JUUL?

pedimom-vape-3677971_1920

By Dr. Deborah Burton

What is JUUL?

JUUL is the most popular e-cigarette.
It is shaped to look like a USB drive, releases less smoke than other brands and has options to decorate them with colorful skins. Additionally, instead of pouring a liquid into a chamber, the JUUL has replaceable flavored pods…with names like Cool Cucumber, Mango, Creme Brulee, and Fruit Medley! These names encourage kids to consider the pods to be safe.

Oh my goodness. Check out this YouTube review of a JUUL pod called CoCo Mint. Can you imagine what your teenager would be thinking while watching this? Notice how he did not mention that they were vaping nicotine!

What is the difference between tobacco and nicotine?

Tobacco is a plant that contains nicotine. When it is smoked, nicotine leads to addiction, but the other harmful effects occur because of inhaling smoke. We understand the risks of tobacco in cigarettes, but children and parents both need more education about e-cigarettes and vaping.

Vaping nicotine is an increasingly popular activity, but many people do not fully understand that nicotine is still nicotine. Changing the delivery system does not change the chemical because the nicotine used in e-cigarettes comes from tobacco leaves!

Nevertheless, e-cigarettes (including JUUL) are often considered tobacco-free. Tobacco products are highly regulated by the government for health purposes; however few regulations in the United States exist for vaping.  Scientists and physicians aim to change that to avoid preventable health problems.

Both adults and kids incorrectly think that vaping is safe because you inhale and exhale vapor, not smoke like in regular cigarettes. But there are harmful chemicals in the vapor.

Long ago, regular cigarettes were found in vending machines in restaurants and stores; therefore, people did not realize the dangers associated with smoking. Now, e-cigarettes are sold in convenience stores while vaping and hookah stores are found in many shopping plazas and malls. Just because they are easy to find and purchase does not make them safe!

Many years of research has clearly shown the dangers of smoking tobacco; however, because e-cigarettes are new, they have only been studied for a few years.

Basic information about the difference between e-cigarettes and regular tobacco cigarettes can be found here.

Recently, at the Georgia Chapter of the American Academy of Pediatrics meeting, Dr. Susan Walley, a  pediatrician from the University of Alabama at Birmingham gave an incredible lecture. This presentation moved me to rush home and record a podcast about it.

Take home messages about vaping nicotine products

  • Vaping was initially created as a way for adults to wean off cigarette smoking
  • JUUL represents about 70% of e-cigarette sales
  • Nicotine is a powerfully habit-forming drug which is found in both tobacco and e-cigarettes
  • Vaping products are produced to resemble candy and food items which entice kids to buy them
  • Children become addicted to nicotine faster than adults due to immature brain development
  • Teens are using their JUUL in schools daily which is leading to more disciplinary problems
  • Teens who vape have an increased risk (4x) of becoming tobacco cigarette smokers
  • One JUUL pod contains as much nicotine as one pack of cigarettes
  • Second-hand vape smoke contains nicotine PLUS other toxic chemicals.
  • Parents should not vape around their young children
  • Cigarette smoking has decreased over the years but now a new generation is becoming addicted to nicotine>.

Additional sources of information on vaping nicotine

There is a lot of misinformation about e-cigarettes, but it is important to understand the 5 Truths You Need to Know About Vaping.> Physicians are working hard to lead the charge in educating people about the dangers of vaping. Dr. Kristen Stuppy, an extremely active social media pediatrician. has written a comprehensive post detailing the concerns of vaping in children and Dr. Jill Grimes, a well-known family physician has detailed her concerns about how JUUL is not cool!

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Dr. Burton is a board certified Pediatric Otolaryngologist, otherwise known as Ear Nose and Throat. Her blog, Dr. Momma Says, discusses timeless topics on parenting and healthcare. Check her out!

Nicotine/Nico-TEEN? Here’s Why NOT

nico-teen

By Dr. Jill Grimes

TEENS want to know: WHY are adults freaking out and taking away their “harmless” JUULs (the most popular e-cigarette) when teens have REAL problems (like active shooters, social media stress, and impossible college admissions?)

DON’T ROLL YOUR EYES, this is a legit question from our teens. Let’s talk nicoTEEN!

Last week, Austin high school SENIOR GIRLS shared with me that well over HALF of their peers are JUULing regularly at school. (Rapidly outdated/underestimated studies from 2016 show that over 9% of 8th graders and 16% of high school students Juul.)

These are the very kids who grew up professing “smoking is GROSS” to total strangers, complete with gagging motions, nose-holding and coughing dramatics. They KNOW smoking causes bad breath, yellow teeth and CANCERS (plus heart attacks and strokes).

WHY then, are they now carelessly JUULing, typically with no thought or concern of any connection with “real” cigs and REAL health hazards. A good chunk of JUUL-ers don’t have any idea what’s INSIDE these devices, and if they DO know nicotine is in there, they think it’s no big deal, because it’s SMOKING that’s, bad, not VAPING.

However, the adolescent brain is far more susceptible to nicotine addiction than more fully developed/more myelinated older brains, and we know that nearly a THIRD (30.7%, less I exaggerate) of teens who start using e-cigarettes begin smoking traditional cigarettes within six months. YES, a THIRD. Why? NICOTINE.

What does NICOTINE do? Smoking or VAPING nicotine zips it into the bloodstream (vs. slower absorption through the nose, gums or skin). Once in the bloodstream, nicotine races to the adrenal glands, releasing ADRENALINE for the physical “rush”: the racing pulse, faster breathing and raised blood pressure.

The BRAIN interprets these bodily changes as excitement or joy, while the nicotine inside the brain triggers the pleasure/reward circuits via DOPAMINE stimulation. All of this happens within about 10 seconds after inhalation, creating a very short-lived euphoria from each nicotine hit (puff of a cigarette or JUUL).

The key here is SHORT, which means the body immediate craves MORE. Fast forward to someone habitually recreating that burst of pleasure, when smoking/vaping/Juuling becomes a constant companion throughout the day. Soon this repeated exposure to nicotine goes beyond the short term buzz and begins adversely affecting higher level brain circuits like learning processes and impulse-control.

Continued usage requires more nicotine to get that same pleasure and bodily response, and soon simply LACK of nicotine creates withdrawal symptoms of cravings, agitation, sleep disturbance, poor concentration and irritability. Nicotine is WILDLY addictive, and although there are clearly individual sensitivities to that addiction, this is not a substance to casually “try out” for awhile.

E-Cig Abuse (beyond nicotine addiction) is quickly evolving. Many users feel a transient sharpening of their focus and attention that is less intense but similar to prescription stimulants used for ADD. College students who JUUL tell me not only do they use it as a stimulant “hit” before taking a test, but as a steady drip to keep them focused during studying.

Worse, some JUUL at the end of a party night (translation binge drinking) to “sober up” before driving home. News flash- stimulants do NOT “un-do” sedatives. Just as coffee doesn’t sober up a drunk; nicotine does not improve the reaction times and reflexes that alcohol (pot, or other sedatives) slow down- you simply become a more awake and agitated drunk.

Other young people use JUULing to suppress their appetite or to catch a “confidence buzz” without adding calories. Once again, the more you use nicotine, the less it works; the more you need, the more you use…lather, rinse, repeat.

Does nicotine cause cancer? No, not by itself. But nicotine doesn’t travel alone. In traditional cigs, nicotine travels with over 60 known carcinogens. In e-cigs, nicotine hooks up with metals like nickel, cadmium & chromium, plus other known carcinogens. E-cig vapor flavorings and volatile organic compounds can directly cause acute and chronic lung inflammation and disease.

Since we’ve only had a decade of e-cig experience (and most cancers take a couple decades to develop) we don’t have all the oncologic answers but CANCER is not the only concern.

Perhaps the worst thing nicotine does is GET YOU ADDICTED TO NICOTINE. You being to spend all day thinking about your next “hit” and get physically and mentally cranky without it. Nicotine is not FREE, so you are also steadily draining your wallet (~$4/pod/day or $6/pack of cig/day x one year is $1800!)

Ask ANY and EVERY adult you know that smokes how many times they have tried to quit…that answer alone will tell you why parents are beating their heads against walls watching their kids choose to “try” nicotine.

P.S. Please note that e-cigs sometimes EXPLODE– about 1000/year sending users to US emergency rooms. 80% of these random explosions happen during charging, which means 20% occur while vaping – exploding your tongue/mouth/face along with the device.

BOTTOM LINE: JUULs and other nicotine delivery systems like e-cigs are NOT “harmless” but they ARE a fantastic way to acquire a financially, physically and emotionally life-long addiction. E-cigs were designed to HELP ADDICTED SMOKERS STOP SMOKING- let’s LIMIT them to this use.

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Dr. Jill Grimes is a Board Certified Family Physician and an award-winning Author who is passionate about Preventative Medicine. You can see and learn more from her at www.jillgrimesmd.com

 

It Won’t Happen To My Kid!

Snapchat

By Anonymous, Mother

It can’t happen to me and my kids.  That is what I kept telling myself. Well it can happen and it did happen.

I would like to say that there has only been one instance that my daughter was propositioned for explicit images and videos via Instagram direct message, but that would be a lie.  Once I found the “finsta” account, I was put on high alert to monitor her social media accounts more closely and quickly realized Instagram was no friend of mine, or any parent. The parental controls are non-existent and the amount of inappropriate images and content are way too easy to innocently stumbleupon.

I became obsessed and researched some of the accounts that were following her account and discovered that there were multiple individuals that were 20, 30, 40 and even 50 yrs. old that were complete strangers. Why would adults want to follow a minor’s account? One guess. It was not because they are looking for an innocent friendship.  They were not trying to “save” my daughter from all the other perverts out there. No more Instagram.

After becoming a social media outcast from Instagram, my daughter pleaded with me to open a SnapChat account which I had been holding off on for as long as possible.  She sold SnapChat as a way for her to talk with her friends from school and make new friendships with people here locally. My husband felt sorry for her and thought she was mature enough to handle it.  I reluctantly let her create an account with what I thought was secure settings but I soon found out that secure settings don’t exist in SnapChat either.

She was recently propositioned by someone with the screen name Jack Smith.  Jack messaged her and asked if she wanted “to make a little or a lot of money”. Once she informed the person that she does not do that, he let her know that “he had messaged her under a fake account because he knew she was under age and he was not trying to get arrested”.  When she took a screenshot of the conversation, the Jack Smith account disappeared. SURPRISE!

As a concerned parent for all innocent kids on social media, I took the screenshot of the conversation and sent it along with a strongly worded letter to Snapchat (Snap, Inc.).  The response I received was less than impressive. There is no way to track a predator that uses fake accounts to solicit inappropriate information. They told me to block the account and send them the Snapchat Username for them to investigate.  We don’t have the Snapchat Username, because the person immediately deleted the fake account once they were notified she took a screenshot of the chat.

I currently use several parental control apps and services to keep her safe online, but none are perfect.  My advice for parents of tweens and teens who have social media accounts is to set up some parental controls (as best you can) before you hand over the phone, tablet or computer. Take the time to really have the conversation about online safety with your kid and have that conversation often.  My daughter admits that it does help to be reminded every so often about the dangers of the online world.

Reminder, you cannot unsee things and the internet is forever.

What Should You Do If You Think Your Child Is Depressed?

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By Dr. Catherine Larson

Depression is a medical illness with both genetic and environmental causes. In the United States about 2% of children and 4-8% of teens have Major Depressive Disorder at any given time. By the time youth reach age 18, about 20% will have had a Major Depressive Episode. Another 5-10% of children and teens have some symptoms of depression but do not meet the full criteria for diagnosis.

Untreated depression can lead to many problems in the child’s life: school, family and peer relationships. When severe, depression puts children and teens at risk for suicide. Suicide is the second leading cause of death in persons age 10-34 according to the Centers for Disease Control. The good news is that there are several forms of treatment which have been shown to be effective.

Early treatment of depression can improve long-term outcomes. As parents, we know our children best, so we are the first line for recognizing depression and getting our children the help they need. Children and teens often show different signs of depression than adults. Here are some of the possible signs of depression in children and teens.

  • No longer enjoying activities
  • Hopelessness
  • Low energy
  • Poor self-esteem
  • Isolation from friends or family
  • Irritability or anger
  • Mood swings
  • Frequent vague physical complaints
  • Changes in sleep
  • Changes in appetite
  • Discipline problems at home or school
  • Thoughts of suicide

What to do if you think your child may be depressed:

If you read this list and you recognize some symptoms that your child is exhibiting, it can be hard to know what to do next. Start by talking to your child with a loving, accepting and non-judgmental tone.

If you or your child feel that some of these symptoms are present and have persisted over an extended period of time, or if they are severe enough to interfere in their school functioning, their relationships (with parents, siblings, teachers or peers) or their activities, then it may be time to seek treatment.

If you feel your child may be struggling with depression, you may want to ask them about suicidal thoughts. Many parents fear that they will “cause” their child to have suicidal thoughts if they ask about them.

In reality, these questions may be what save your child. If your child is having suicidal thoughts, then it is better for you to know about them. If they are not having suicidal thoughts, you will not induce them by asking about them. Instead you will be showing your child that no matter how bad things get, there is nothing that is off limits for them to talk with you about.

It can be a difficult conversation. The way I often word this is, “It sounds like sometimes you feel pretty bad. Does it ever get so bad that you just wish you weren’t alive?” The answer to this question will help you to understand the severity of the depression. Suicidal thoughts occur in more severe depression and are cause for immediate evaluation.

Always err on the side of safety. Suicidal thoughts are considered a medical emergency. If your child is talking about suicide, has tried to hurt themselves or if at any time you feel they are unsafe, take them to an emergency room for evaluation and treatment. If you need immediate assistance, please dial 911. Another resource is the national suicide prevention line at 1-800-273-TALK (8255) which is available 24 hours per day, 7 days per week. There is also a crisis text line at 741741.

How to find help for your child:

If you notice some of the above symptoms, but do not feel they are in immediate danger from suicidal thoughts, then seeking outpatient treatment would be the first step. The best place to start is getting a comprehensive evaluation by a Board-Certified Psychiatrist (MD or DO).

Finding mental health care, especially when we are worried about our children’s welfare, can feel overwhelming. A good first step is contacting your pediatrician and asking for referrals. Another option is the website is psychologytoday.com which has a, “therapist finder” page. You can filter by your zip code and insurance. Search the list for an MD/DO near you.  The psychiatrist will evaluate your child and will recommend an individualized treatment plan that will include therapy, lifestyle changes and possibly medication.

Just by reading this article, you are supporting your child. Keeping the lines of communication open and being there for your child are the first steps toward helping your child to live a long, happy and healthy life.

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Catherine Larson, MD is a Board-Certified Child, Adolescent and Young Adult Psychiatrist. She is an Adjunct Professor at University of Texas School of Medicine at San Antonio and has a private Practice, Austin Child Psychiatry. Her blog at AustinChildPsychiatry.com/blog covers mental health and related topics. She can be followed on Instagram at @CatherineLarsonMD

References:

Dulcan, Mina K. (2016) Dulcan’s Textbook of Child and Adolescent Psychiatry. Second Edition. Arlington VA: American Psychiatric Association Publishing.

American Academy of Child and Adolescent Psychiatry (2018, March) Depression in Children and Teens.  

American Academy of Child and Adolescent Psychiatry (2017, October) Suicide in Children and Teens.

Centers for Disease Control and Prevention (2017, February) Leading Causes of Death Reports.

What Parents And Schools Need To Know About Cyberbullying

cyberbullying

By Daniel Grammer

Cyberbullying is one of the most persistent challenges facing kids today, and as more activities shift online it becomes harder to detect harmful behaviors. Cyberbullying may not reveal itself through scrapes and bruises, but it can have a detrimental impact on a child’s mental health. Knowing how to recognize the signs — and what to do when you see them — can protect kids from the worst of what a bully can do.

But perhaps even more important is to know when the standard steps are simply not enough. While most instances of cyberbullying can be managed with tactful discussions, some can cross the line into seriously dangerous conduct.

When that happens, parents and schools needs to contact other authorities — even law enforcement if necessary.

What’s at Stake

Digital technologies provide obvious benefits, but the same tools that increase productivity and foster connection can also provoke anxiety and isolation. The reality is that kids evolve alongside their devices, and new forms of cyberbullying are developed every day.

The result is an increasingly sophisticated set of tools that bullies use to target vulnerable kids, sometimes with fatal consequences.

Megan Meier, a 13-year-old in Missouri, fell victim to a sockpuppet scheme when a fake MySpace profile of a teenage boy was created to give her false hope of a relationship. Before long, the profile became a public forum for abuse that spread across platforms and into the halls of her middle school. She tried fighting back, but the onslaught led to her death by suicide.

A similar fate befell Phoebe Prince, a high schooler in New England. Six of her peers were convicted for their roles in a prolonged bullying campaign, in part consisting of the kind of harassment that is easy to perpetrate online. Later that year and only ten miles away, Happy Valley would mourn another suicide, this time of an 11-year-old boy.

Cyberbullying by the Numbers

In an ideal world, the internet would only be used to share wholesome memes in support of the soccer team. But since the Pew Research Center reports that “59% of teens have personally experienced at least one of six types of abusive online behaviors,” parents and schools should study up on how best to tackle the problem. Those behaviors are:

  • Name-calling (42%)
  • Spreading false rumors (32%)
  • Receiving explicit images (25%)
  • Near-constant badgering (21%)
  • Physical threats (16%)
  • Sharing of explicit images without consent (7%)

Parents are very concerned — especially with the spread of sexually explicit content. And while a majority of teens have a positive assessment of how parents handle cyberbullying, 58% give teachers a rating of only poor or fair.

Acting with Urgency

In some cases, victims of cyberbullying have standing in civil or criminal court. Laws vary between states, but charges of defamation, harassment, or even copyright infringement can provoke legal consequences that stop the behavior. By keeping a record of cyberbullying, schools can be an invaluable partner to parents who wish to appeal to the justice system.

Not everyone can wait on justice, however, and some threats are so urgent that they should be reported directly to law enforcement. Suicidal expressions, school shootings, and other acts of violence can be detected in advance with the right mechanisms in place. Many perpetrators — including the shooter at Marjory Stoneman Douglas High School — have alarming social media activity.

In concert with an inclusive campus culture, supportive counseling, parental involvement, and clear action plans, parents and schools can create conditions that reduce the likelihood of cyberbullying. The U.S. government’s website against bullying recommends the following actions for school officials:

  • Speak privately with students who show signs of being bullied online, and collect proof
  • Report cyberbullying to parents and facilitate discussion between them and their children
  • Develop activities that foster empathy, reflection, and self-regulation
  • Encourage peer involvement in prevention strategies

But even the closest partnerships have limits. Between home and school, kids produce so much content that it’s impossible to sift through it manually. This is where monitoring apps come in. Monitoring apps can reduce the dangers of cyberbullying both within schools and at home and are a must for families with children and teens in this digital era.

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Childhood Sexual Abuse

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By Dr. Yameika Head

What is childhood sexual abuse and who are the victims?

Unfortunately, Hannah’s story is a common occurrence.  Child sexual abuse is any sexual act between an adult and a minor or between 2 minors where one exerts power over the other.  Forcing and coercing a child into a sexual act or any non-contact acts such as exhibitionism, exposure to pornography, voyeurism, and communicating in a sexual manner via phone or internet all encompass the definition of child sexual abuse.  Child sexual abuse is more prevalent than what the public realizes. About 1 in 10 children will be sexually abused before their 18th birthday, that’s 1 in 7 girls and 1 in 25 boys before they turn 18.  It has been documented that there is a decline in the incidents of child sexual abuse but we are unsure of the exact cause for this.  The primary reason may be that only 38% of child victims disclose and we know from multiple studies that many never disclose. There are many privacy issues as well when it comes to reporting sexual abuse cases. News sources and public police reports do not disclose victims names and thus many not be included in the statistics. 

Who are the Perpetrators?

One of the many misconceptions about perpetrators of abuse are that individuals feel that they know what a “child molester” looks like, but they are often wrong. Perpetrators of abuse can be neighbors, friends, family members, coaches, priests, etc.  Abusers can be, and often are, other children. About 90% of children who are victims of sexual abuse know their abuser and only 10% are abused by a stranger. About 60% of children who are sexually abused are abused by the family they trust.  Also, many believe that all abusers are pedophiles, but not all are. Those that are not pedophiles are often offenders who offend during times of stress and later in life. Pedophilic offenders tend to offend at an early age and have multiple victims (frequently not family members).

How does sexual abuse occur?

Eighty one percent of child sexual abuse incidents for all ages occur in one-perpetrator/one-child circumstances and most occurs in the home, specifically the home of the victim or the perpetrator. Most abusers form close relationships with the child AND the family and often “groom” children prior to beginning the abuse. Grooming is the process where the offender gradually draws the victim into a sexual relationship and maintains the relationship in secrecy.  Grooming behaviors can include providing special attention to the child, special gifts, isolating the child from others, gradually crossing physical boundaries (touching, caressing) and using secrecy, blame or threats to maintain that relationship. No child is immune to sexual abuse.

Do all sexual abuse victims disclose their abuse?

Child sexual abuse victims are unique from adult sexual assault victims in that they often delay disclosing their sexual abuse. Multiple studies have found that disclosure rates for children range from 24% to 96%.  This includes immediate disclosure and delayed disclosure. Disclosure rates among adults who experienced sexual abuse during their childhood are more consistent and range from 31% to 42%. In a relevant retrospective adult study by Smith and colleagues (2000), they determined that 27% disclosed immediately, 58% waited more than a year, and 28% did not divulge until asked during the survey. There is overwhelming evidence that children who do disclose will disclose to a friend or peer. In one study by Priebe and Svedin (2008), 80% said that a “friend of my own age” was the only person that they told.  Many children disclose to a parent only when the abuser is not a family member. The next individuals noted in the study to which children disclosed were educators, but as mentioned above many children do not disclose at all. So why don’t children tell? In some studies, it was noted that many children did try to tell someone but they were not heard, not believed, or no action was taken by those they disclosed to. Those that choose not to disclose do so for a variety of reasons such as being threatened, fear of the perpetrator, lack of opportunity, a lack of understanding of child sexual abuse, or a close relationship with the perpetrator.  Other impediments would include, shame, fear of separation from the family, or fear of their parent’s reaction. Males are even less reluctant to report out of fear of being labeled homosexual or as a victim. Mental health difficulties also inhibit disclosure such as dissociative symptoms or PTSD.

What are the effects of childhood sexual abuse?

The immediate effects of child sexual abuse are emotional and mental health problems. These children will have major depressive episodes, symptoms of posttraumatic stress disorder, suicide ideation and attempts, self-blame, and guilt. This can lead to disruptions in normal development and can have a lasting impact leading to dysfunction and distress well into adulthood. Age-inappropriate behavior can be a very important and telling sign where abuse is concerned. Children who have been sexually abused have 3 times as many sexual behavior problems as children who have not been sexually abused.  Academic problems are common. Sexually abused children perform lower on psychometric testing when compared to non-abused cohorts. 39% of 7-12 year-old girls that have been sexually abused had some academic difficulties. Abused children have higher rates of high school absentee rates, more grade retention, increased need for special education services, and school adaptation. Substance abuse problems often occur in these children. Adolescents were 2-3 times more likely to have an alcohol use/dependence problem than non-victims. Stemming from substance abuse, they also often become more delinquent and exhibit more criminal behaviors. In addition, teen pregnancy is much higher in sexually abused girls, 2.2 times more likely than in their non-abused peers. The long term effects of sexual abuse are tremendous and it is daunting public health problem. Survivors of child sexual abuse are twice as likely to smoke, be physically inactive, and become severely obese. They are 30% more likely to develop serious conditions such as cancer, diabetes, high blood pressure, stroke and heart problems. Adult survivors of child sexual abuse have higher rates of healthcare utilization and report more health complaints than their non-abused peers.

How are sexual abuse cases investigated?

Only about a third of child sexual abuse cases are identified and even fewer are reported. Most disclosures are to friends and many do not result in reports.  Child protection agencies investigate 55% of child sexual abuse incidents. Some are “screened out” due to not enough information or other reasons. False reports of child sexual abuse are rare.  It is estimated that only 4-8% of child sexual abuse reports are fabricated and of those that are, they are fabricated by adults involved in custody disputes or adolescents. When disclosure does occur, the person should report to the police or child protective services or both. In every state, there are people that are willing to help victims and families. You can always contact your local Children’s Advocacy Center and they will gladly give you directions on what to do.

In closing, children and adults have lasting effects from the abuse they have suffered and we know that they often do not tell and suffer in silence. Hannah should be applauded for her bravery in telling her story. Her resilience after suffering so tremendously lets us know that bad things can happen in our lives, but with support we can overcome anything.

Thank you Hannah!

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Dr. Yameika Head is the Medical Director of the Crescent House, a service of The Children’s Hospital at The Medical Center Navicent Health. She is double boarded in General Pediatrics and Child Abuse Pediatrics and is the Program Director of the Pediatric Residency Program through MCNH/Mercer University School of Medicine.

Resources:

National Children’s Advocacy Center

Childhelp National Abuse Hotline: 1-800-4-A-CHILD (4454)- 24/7 (Trained volunteer to help you report a crime)

National Sexual Assault Hotline: 800-656-HOPE (4673)

Rape Abuse & Incest National Network

National Child Traumatic Stress Network

Safe Horizon:1-800-621-HOPE (4673)

Child Welfare Information Gateway

 

The Widespread Substance Use in High Schools

Vaping and drug abuse

By Suha Malik, age 15

It’s no secret that an abundance of kids in high school use drugs, alcohol, and other substances. There are a plethora of laws in place to prevent teenagers from getting their hands on these certain items: can’t drink until you’re 21, most drugs aren’t allowed to be in your possession at all, and in Wisconsin, you can’t purchase any nicotine products until you reach the age of 18 – in other states, in some cases, the age limit is lowered or raised from this particular number. However, these laws don’t really stop teenagers from getting their hands on these products: surprisingly, a lot of high schoolers somehow obtain them.

Many kids in my school use drugs and nicotine products, and they’re not shy about it: they post videos and pictures of the smoke they produce while vaping, or using their juul or cigarettes on social media platforms, especially on Snapchat and/or Instagram. If that isn’t bad enough, a lot of kids break into their parents’ alcohol storage, taking whatever they please, and drink constantly. While a lot of this may not surprise some parents and fellow teenagers, it certainly is appalling to me.

Not only is use of drugs, like cocaine, weed, or meth, illegal, but it creates lasting, awful side effects that may last for life. For example, young adults vaping or using e-cigarettes -or cigarettes themselves- gets them addicted to nicotine as such a young age, and it is fairly apparent what side effects of using it gets them: bad breath, yellow teeth, wrinkles, grayish skin, etc. And these effects aren’t even the worst of them.

According to The Real Cost, smoking as a teenager can lead to constant wheezing (and even asthma), weaker lungs, a weaker immune system, and on average, for every cigarette smoked, eleven minutes of your life comes off. Weed has negative effects on the lungs, heart, and brain. Meth negatively affects the central nervous system. Cocaine use can lead to strokes or heart attacks. Drinking alcohol at a young age can lead teens to become hooked on it, becoming an alcoholic in the process, before they’re even legally allowed to consume it. Not only that, but drinking excessive amounts of alcohol leads to dehydration, disrupts the production of hormones, and negatively affects metabolism.

But, many parents are probably aware of the potential negative health effects of using drugs and alcohol, especially at such a young age. The fact of the matter is, the kids who use these substances don’t limit their use outside of school; many kids bring these substances to and on school grounds.

Vaping is especially popular with high schoolers these days. Some claim that vaping isn’t as bad as smoking, but health experts say otherwise. To do this, many kids turn to the company JUUL, who claim to be a vaping alternative that is not addictive. Teens mostly use this company’s particular products because of its small, portable size: in fact, some use their JUUL out in the open, hiding the tiny, compact, USB-looking device in their hands. However, this company is being sued and investigated because underage kids have been caught using their products, and in Massachusetts, hooked kids on vaping when they claimed that they weren’t addictive.

However, it is a mystery how these kids can get their hands on these products in the first place. I’m not completely familiar with the aspects of this business, but I do have a couple ideas of how these age-restricting products end up in minors’ possession.

Firstly, a lot of high school kids are friends with people who are legally adults – that is, eighteen years old and over. Because of these connections, some kids are able to get illegal products that have been purchased legally by an adult.

Secondly, navigating the Internet comes in handy when buying products that you aren’t meant to come in contact with. Tons of kids use the app Tor or purchase Bitcoins in order to safely buy drugs and other illegal substances for their age; this is backed up by the website Thrillist. This part of the Internet is thus dubbed, “The Dark Web”, Thrillist explains. Going hand in hand with its name, the Dark Web seems to be sketchy, and definitely dangerous.

So, at the end of the day, it is critical and absolutely essential to know that many teenagers use and carry around drugs, especially at school. In my own school, the fire alarm went off a couple of months ago because someone was using an e-cigarette in the bathroom. Stopping the obtaining of these products is the best bet in order to ensure that these kids don’t fall into this dark world, or develop any health deficits.

Flu Vaccine 101: Fiction and Facts

Pedimom flu shot

By Dr. Gretchen LaSalle

It’s that time of year again. The kids are back in school, the weather is turning colder, and your healthcare providers and pharmacists are gearing up for flu season. This time of year can prove challenging for physicians and other medical providers. We feel like we spend hours every day trying to convince people of the very important reasons for getting the flu vaccine. We know of the devastation that the flu can cause. But some people mistakenly think that the flu is no big deal, or they’ve heard faulty information from friends, family or on the internet where untruths “go viral”, spreading rapidly and with ease, leading them to make the unfortunate decision not to vaccinate. If you are one of those folks considering not getting a flu vaccine this year, please read on. I’m about to let you in on some facts and fictions about the flu shot that may change your mind about this life-saving vaccine.

First, a little clarification about the influenza virus. Every day I get folks telling me that they got the flu shot but that they were “sicker that year than ever before”. The flu shot was never meant to be a one stop shop for preventing illness. There are numerous other viruses out there that can cause a flu-like illness that are not the flu.

Here is what true influenza looks like: It comes on suddenly. One day you’re fine. The next day it feels like you were hit by a truck. Your whole body hurts. You have a high fever, cough, headache, sore throat, and fatigue. It lasts, typically, a week. Unless, of course, you have complications of the flu that may linger longer.

Also, the “stomach flu” is NOT the flu. This is a viral stomach bug. Only occasionally does a person with the flu have vomiting (maybe a little more common in kids than adults) and diarrhea is not part of the picture. If you’ve got vomiting and diarrhea, you’ve got something else and the flu shot doesn’t help with that – I wish it did. I HATE vomiting!

Fictions:

  1. “The flu shot causes the flu.” This, my friends, is false. The flu shot is a killed virus vaccine and, as such, cannot cause the illness it is meant to protect against. It’s a different story for the influenza nasal spray vaccine. The nasal spray version uses a live-attenuated or weakened form of the flu virus. It should not be given to anyone with a suppressed immune system because it could give them influenza. “But I felt so cruddy after the shot”, you say. “It must have made me sick”. It is not uncommon to feel a bit under the weather after the flu shot – or any shot, for that matter. A bit of achiness, mild fatigue, even low grade fever is considered a normal response and is just your body’s immune system kicking into gear. It is NOT the flu. Trust me. The flu is much worse. Scenario #2: It takes 2 weeks before the flu shot even works and it is possible to be exposed to and contract the flu in that 2 weeks when you are not yet protected. This is why it is SO important to get your flu shot in the early fall. That way, by the time we see the flu in the winter months, your immune system is ready for the fight.
  2. “The flu shot is not that effective. It won’t help me anyway.” Au contraire, mon frere. Even though the flu shot is the “best guess” for what strains will be circulating that year and is not always spot on, it still protects you from serious complications of the flu. The Northern and Southern Hemisphere flu seasons are exactly opposite of each other. We look to the Southern Hemisphere’s flu season to try to predict what is heading our way. Some years’ guesses are better than others but that doesn’t mean the vaccine is not worth getting. We know this from looking at data regarding people who died from the flu. The CDC looked at all of the pediatric deaths during the 2012-2013 flu season and found that 90% of these deaths had been in children not vaccinated for the flu. And, since the flu vaccine was introduced in 1938, we have not seen a flu pandemic such as the 1918 Spanish Flu that killed nearly 50 million people. The flu vaccine works. Moving on.
  3. “I’m Healthy. I don’t need a flu shot. I’ll get over it.” Well, maybe. But even healthy people have serious complications from the flu like pneumonia, respiratory failure, and death. It is true that those with chronic illness, the elderly, babies, and pregnant women are at greatest risk. But remember those children who died in 2012-2013 from the flu? 40% of those kids had absolutely NO chronic illness or other risks for serious complications. And so what if you are healthy and you do get over it? What about all of those around you? What about those you come into contact with out in the world? Shouldn’t we try to protect each other and keep each other healthy as well? You. Yes, you. You are contagious for approximately 2 days before you even have one symptom. And there you are, out there in the world touching things, shaking people’s hands, and spreading germs that you don’t even know you have.
  4. “I prefer to get my immunity naturally.” Nope. Doesn’t work that way with the flu. The flu strains change each year. Having the flu one year does not prevent you from getting the flu the next year.
  5. “I can’t get the flu shot. I have an egg allergy.” Good news! Those recommendations have changed. As of 2016-17 flu season, the CDC now recommends the flu shot for everyone, even those allergic to eggs. If you can eat cooked eggs without difficulty or have a milder version of an egg allergy, you can get a flu shot at any location. If you have a serious egg allergy (stopping breathing, repeated vomiting, etc.), you can still get the flu vaccine but have to have it administered by a physician who can recognize and respond to a severe allergic reaction.
  6. “The nasal spray form of the vaccine isn’t available anymore.” While it’s true that the nasal spray flu immunization was not available for the last two years because of decreased effectiveness against the H1N1 strains of influenza, it has been revamped and will again be available for the 2018-2019 flu season. Check with your medical provider to see if they are offering this form.

Facts:

  1. You are more likely to have serious consequences from the flu than from the other infections for which we more readily vaccinate. In 2015 we had our first measles-related death in over a decade. By contrast, the Centers for Disease control and Prevention estimates between 9.2-35.6 million cases, 140,000-710,000 hospitalizations, and 12,000-56,000 deaths from the flu in the U.S. annually. In the 2017-18 flu season, 80,000 patients died, including 180 children. Statistically speaking, you should absolutely get your flu shot. PS – Please don’t use this as reason not to vaccinate for measles or other infections. Vaccination is the reason we don’t have the number of deaths from these illnesses that we used to have.
  2. There is NO mercury in the flu shot unless you are getting a vaccine drawn from a multi-dose vial. And if you are getting your vaccine from a multi-dose vial, the amount in one pediatric dose is equivalent to eating one 3 oz can of tuna fish. Not so scary, is it? Also, the type of mercury in that multi dose vial is Ethyl mercury (like my sweet aunt Ethyl, not dangerous at all) which is cleared much more rapidly and is less harmful than Methyl mercury (the kind found more commonly in that can of tuna).
  3. Everyone needs a flu shot to protect themselves and their loved ones and to protect those more vulnerable in our community. The flu shot can be given as early as 6 months of age (at which time the vaccine is actually given in two doses spread apart by a month, after that it is one dose per year).
  4. In an ideal world, everyone gets the flu shot by Halloween. Flu season typically lasts from November until April, some years running as late as May. Because it takes 2 weeks for the flu shot to work, we want to get it before flu season begins. But if you end up not being able to get the flu shot until later, don’t distress. It will still offer protection for the remainder of the flu season.

So, please protect yourself and those around you. Get your flu shot. And if you have more questions or concerns… ask your healthcare provider. Don’t let misinformation and misunderstandings keep you from being healthy and safe!

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Dr. Gretchen LaSalle is a board certified Family Physician practicing in Spokane, Washington.  She has a passion for public health and seeks to be a voice of truth and reason when it comes to doubts about vaccines.  You can follow her @GretchenLaSalle and on her website www.gretchenlasallemd.com

 

Don’t let concussions throw you for a loop

concussion symptoms

By Dr. Korin Hudson

With the start of the school year upon us, many of us (and many of our children) are gearing up for back-to-school and fall sports.  As many of our kids suit up for football, soccer, hockey and other sports, many parents worry about the risk of concussion. There have been a number of media stories lately about concussions and the long-term risk of chronic complications of injuries sustained in amateur and professional sports.  But what does this mean for our kids as they lace up their cleats this fall?

What is a concussion?

A concussion is an injury to the brain that results in a temporary loss of normal brain function, usually following a direct blow or a jostling of the head.  Loss of consciousness or “blacking out” is not required, and in fact- most patients do not report losing consciousness when they sustain their injury. Its best to think of a concussion as a functional injury to brain rather than a structural injury.  Unlike other structural brain injuries which cause bleeding, bruising, or swelling which can be seen on CT scans or MRI, concussions affect brain function, which means that even with a normal scan patients may have significant symptoms.

Concussion symptoms may vary from patient to patient and injury to injury. Some patient’s report symptoms that start immediately after the impact, while others don’t develop symptoms until later that day, or even the following day.  Symptoms usually fall into several categories: headache, neck pain, vision symptoms, balance symptoms and dizziness, sleep dysfunction, cognitive and memory deficits, and mood changes. Patients may suffer any or all of these, and they may improve at different rates.

Initial Evaluation:

If you or your child sustains and injury and you think they might have a concussion, the most important thing is to remove them from practice or competition immediately. If there is an athletic trainer or team physician on site they can do an evaluation for concussion and make a decision about the next step.  No athlete should be allowed to return to practice or competition without a thorough evaluation by a healthcare professional who is comfortable evaluating athletes with concussions.

Under some circumstances, athletes should be seen in the Emergency Department at the time of their injury (see Figure 1).  Athletes with any of these symptoms require an urgent evaluation by a physician and may need imaging to rule out more serious injury.

Figure 1

concussion-symptoms

 

 

 

 

 

Treatment:

Athletes should rest for the first 24-48 hours.  This may mean staying home from school and should certainly include avoiding television, computers, smartphones, and tablets.  Acetaminophen (brand name Tylenol) may be taken according to package instructions. If you or your child is prescribed any medication by your primary doctor or the ER, always check before using any over-the-counter medications at the same time as the prescription medication.  A follow-up appointment with your primary doctor or a sports medicine/concussion specialist should be scheduled as soon as possible to develop a plan for return to school and return to activity.

For years, injured athletes were told to stay in a dark room and do nothing until their symptoms resolve.  But in recent years we have realized that most student athletes are better served by an “active recovery”. In many cases, athletes can return to school with partial days, limited note-taking, and no homework or tests during their acute recovery period.   Getting back to school on even a limited basis helps the student athlete “ease” back into regular activity. During this time, audio books, short periods of reading and writing, and continued limitation on screen time may help limit symptoms. For prolonged symptoms, formal school accommodations (such as a 504 plan or an IEP) may be required, but in most cases, temporary accommodations will suffice while symptoms resolve.

In recent years we have also realized that moderate physical activity can help student athletes with concussion.  Moderate exercise, such as a brisk walk, light stationary biking, etc. can in fact help reduce symptoms and can actually get injured patients back to school/work faster and back to sports sooner than athletes who do no activity at all.  That said, any exercise plan should be guided by a physician, athletic trainer or physical therapist. Any light exercise should be limited to activities which do not exacerbate symptoms, and no vigorous activity (sprinting, plyometric exercises, weightlifting) or contact sports should be permitted during the acute recovery period.

Some patients will respond well to relative rest and a gradual return to exercise, but others will have protracted symptoms that may require additional treatments.  Though there is not a lot of high-quality research regarding the use of medications and specific therapies for concussions, many concussion specialists do feel that medications to prevent headaches are appropriate for some patients.  Some patients will also respond well to physical therapy, occupational therapy, and/or speech language therapy. Each of these therapies focuses on a different aspect of the concussion syndrome including the neck pain, dizziness and balance problems, as well as the vision symptoms and cognitive deficits.

Often, physicians are asked “how long will these symptoms last?” and the simple answer is: every patient and every concussion is different.  Most athletes with a first-time concussion, who doesn’t have pre-existing neurologic conditions (such as migraines, vertigo, or seizure disorder) will be symptom-free within a month.  However, patients who have had multiple prior concussions or with other medical conditions may tend towards longer recoveries. Each concussion much be approached individually.

Once symptom-free, athletes who wish to return to sports participation should go through a monitored, step-by-step return to play program.  The return-to-sport guidelines have been endorsed by international concussion experts, but may need to be modified for different sports and for different athletes. Many physicians and athletic trainers will couple the return-to-play protocol with repeat testing of vision, eye movements, balance and cognition (which may include certain computer testing modules) before final clearance for contact sports.

Long Term Consequences

Many athletes and parents will ask the question “how many concussions is too many?” and again, the answer is not always straightforward.  Most experts agree that any athlete that has 3 concussions in the same season should probably be held from further participation for the season.  In younger athletes, physicians may be even more conservative and may decline to clear an athlete to return to the same season after a second concussion.  However, for multi-sport athletes, year-round athletes, a frank discussion should occur between physician, athlete, and parent (for younger athletes) to decide the appropriate timing for return to full participation.

In recent years, there has been a lot of discussion about a condition known at Chronic Traumatic Encephalopathy or CTE.  Many patients and parents what to know what is the risk of developing this condition. For now, we think that the risk of CTE may not necessarily related to an absolute number of concussions, but rather that the condition may be related to multiple so-called “sub-concussion blows”.  These are multiple minor impacts sustained over an entire athletic career that may or may not cause acute concussion symptoms. A classic example is a boxer who is struck in the head multiple times during both practice and competition. Most of these impacts will not cause concussion symptoms, but over a lifetime the athlete may sustain thousands of impacts to the head.  The cumulative effect of this trauma is unknown. Its not clear why some former athletes seem to have no lasting symptoms while others develop severe and life altering symptoms that include dementia, movement disorders, and severe mood changes. The good news is that there is a lot of research ongoing that we hope will help us understand the risk of long term consequences of head injuries.

Prevention

The best way to prevent concussion is to follow good training guidelines.  This includes learning proper tackling and heading techniques. There is also good reason to think that certain activities such headers in soccer and tackling in football should be avoided in youth sports.  Even in high school, college, and pro sports, many experts recommend limiting the number of contact practices each week. In addition, we should also encourage the use of properly fitting helmets for bicycles, scooters, skateboards, snowboards, skiing, etc.  While there is no evidence that helmets actually reduce the frequency or severity of concussions- they can reduce the likelihood of more severe brain injuries.

Parting advice:

If you or your child has a head injury and you are concerned about a concussion- you should seek care from a physician who is very comfortable with the diagnosis and management of this complex condition.

:::

Korin Hudson, MD, FACEP, CAQ-SM works for MedStar Sports Medicine in Washington, DC.

 

Photo by Ben Hershey on Unsplash

Always Stand Up to a Bully

bullying

By Inaaya Firoz, Age 10

It all started in 1st grade…

I was what is called “the new kid” but the first graders treated me with respect. There was this boy I knew so, on the first day he excitedly said “Inaaya!” Some third graders heard my name and started calling me “Inaaya the Papaya” and other cruel names. I told a teacher about the name calling but she thought I was making it up.

The name calling stopped after the middle of the year but the third graders still would bully me. Now, the third graders would follow me at recess and say “Hi Inaaya!” in a rude, mocking tone.

There was one third grader who stood up for me and told my teacher, who actually cared. My teacher told my guidance counselor who called me, the bullies, and the witnesses. The witnesses did not watch a crime, but watched bullying happening which is worse than a crime. The witnesses told the counselor of my bullying problem and the counselor gave the rude older kids a stern talk. After that the bullies did not tease me.

When I went to second grade in a new school, I took the bus. Our bus driver assigned us spots and I was right next to the bully and one of her friends. This bully constantly called me “Ananya” even when I told her what my name was. She would also tease me and say “Here comes Ananya, everyone’s best friend.” You could hear her say NOT under her breath.

This year I told a teacher but, because the teacher did not care, I also told a safety patrol who cared and told her boss, our coach for PE. The coach gave my bully a stern talking and sent her with an SBR mark. An SBR mark is a Student Behavior Report to state a bad thing someone has done. If you get a certain number of SBR marks you get a principal visit, which obviously would not look good on your resume.

In third grade name teasing followed me everywhere. This second grader would call me “Anya” and when I asked her “You know my name is Inaaya right?” she would respond by saying “I know, I just don’t like saying your name.”

I never told a teacher in that situation and now I regret that because maybe if a teacher told her not to do it, someone else could have been saved from bullying. Luckily after 75% of the school year she left the school to be homeschooled for unknown reasons. Thankfully, I haven’t really been bullied, but if I had been bullied, I tell a teacher and the situation is solved. The lesson is to always stand up to a bully!

Diary of Pediatric ER Doctor: I Am Yours, Forever!

pedimom-pediatric-nurse

Diary of a Pediatric ER Doctor: I Am Yours, Forever.

By Dr. Free N. Hess

There you are in your father’s arms. He is practically running to keep up with the triage nurse. The nurse is walking quickly toward the room that we leave open for true emergencies and the sickest patients. Your father’s eyes are full of fear, and the nurse’s tone is worrisome.

I look down at you all snuggled up to your father’s chest. You are beautiful. So small and bright-eyed. You don’t recognize how hard your body is working, and you are just taking in all the sights and sounds around you as any baby would. The nurse takes you from your father’s arms, and she places you on the stretcher. I lean in and place my stethoscope on your chest. I’m sorry if it’s a bit cold. I lean in closer.

“Hey cutie, how are you?” I say, and I smile.

Your beautiful eyes look directly into mine, and you smile back. The nurses are buzzing around us. I look away from you for a second to talk to them. We need to gather up some things that we’ll need to make you better. When I look back, you smile again.

“I’m going to make you feel better,” I tell you. I say the same to your father, and he breathes a sigh of relief.

I’m sorry we have to put all these wires and stickers on you. I’m sorry about the mask and the pokes, but I’m going to make you feel better. I’ll be right here next to you until I make you better. You cry a little, but you also smile despite what is happening. I smile back and talk to you. You talk back. Cooing. You are beautiful.

We’ve been together for a while now. Are you feeling better? You are so much better! I too feel better. You are still smiling, cooing. You are such a happy baby. Your mommy is here now. She raced here as soon as your daddy called her. Would you like her to hold you? There is no better place to be than in Mommy’s arms. I have to step away for a minute. I have to make some phone calls to get you transferred to the PICU. I’ll be right over there, and I’ll be watching you every second.

This might take a bit longer than I had hoped. The PICU is full. It seems all you little cuties are keeping us doctors busy today. I’m working on it. You just hang in there. You’re doing a great job! Keep it up. I’m going to make a few more phone calls. I’ll be right over there, but I’ll be watching you closely as I have been since you were carried into my ER.

Oh, no, no, no. Wait. Hey, stop that. Why do you have that look? No, no, no. I lean in and say to you, “Hey cutie, I’m going to make you feel better.” I’m sorry I’m talking so loudly now.

No, no, no. Do not look at me like that. You are not allowed to have that look in your eyes. I know that look, and you cannot have that look. Do you see me? I’m right here, inches from your sweet face. I feel your breath on my face, do you feel mine? Do you see my eyes? Do you hear my voice?

“I’m going to make you feel better, sweet boy. I’m going to make you feel better.”

No, no, no. I do not like your color. You are still beautiful, but that color. I need to fix that. No, no, no. Your lungs, I need to fix them. I’m sorry sweet boy, but I’m going to have to put a tube into your lungs. You are tired. I’m going to make you feel better. One last look into those eyes. Sleep baby. Rest. I’m in. I feel better. Do you feel better? Don’t worry, I will breathe for you; rest sweet boy.

No, no, no. Talk to your heart sweet boy, tell it to be strong. No, no, no. What’s happening? What are you doing? I’m sorry sweet boy; I’ll need to squeeze your chest now. I’m sorry if it hurts. Your heart, I need to fix that. Be strong. I’m sorry it’s so loud in here. There are a lot of people that have come to help me. We are going to make you feel better. All of us. We are all here for you. But me, I am right here. Touching you, talking to you every moment. No, no, no. Please, sweet boy. I’ve tried everything. Be strong. Beat. Breathe. Please. Beat. Breathe. Please, sweet, beautiful boy.

It’s been an hour now sweet boy. I’ve been begging your heart to beat for an hour. I’ve been begging your lungs to breathe for an hour. Some are telling me it’s time. To call it. To call you. I can’t. Just a few more rounds. I told you I was going to make you feel better. I looked into those beautiful eyes and made you a promise. Please. Beat. Breathe.

Maybe this little probe will tell me that your beautiful little heart is moving beneath my hands and that I just can’t feel it. Maybe the monitors are wrong. Your heart is still. You are still sweet, beautiful boy. I’m so sorry. I told you that I was going to make you feel better. I looked into those bright, beautiful eyes while feeling your breath on my face and I told you that I was going to make you better. I’m so, so sorry. My heart is bleeding. I had to call out those awful words. The room was silent when I called it. Everyone was still. Having to say those words out loud took my breath away. I’ll remember that moment in time, that exact date, that exact minute. Forever.

That room. That awful room. I take a deep breath and close my eyes before I enter that room. My heart is oozing and threatening to explode. I open the door. Your lovely parents. They are sitting there in front of me holding hands. They look up at me with those eyes, your eyes. You have their eyes. Those words. Those awful words. “I’m so sorry. We did everything we could, but we could not save your sweet, beautiful boy.”

Those God awful words. Your mother fell to the floor and wrapped her arms around my legs. I nearly fell to the floor alongside her.

“Tell me you’re lying, please tell me you’re lying!” she screamed.

God, I wish I was. I sobbed uncontrollably. Your father cried too. He looked directly into me and said, “But you were just playing with him. He was smiling at you.”

Yes, you were. That smile. Those eyes. I’m so sorry. Everyone in the room is breaking. I brought them to you. Your mother held you in her arms, to her chest, near her heart almost begging yours to beat. I’m so sorry. I cried with them. My heart bled with theirs.

“Is there anything else I can say? Is there anything else I can explain? Do you have any other questions I can help answer?” I asked them.

Your mother looked at me with distant, empty eyes. Not your eyes anymore. She whispered sadly, “I just want you to give me my baby back.”

My heart paused. God, I wish I could. With every ounce of my being, I wish I could give that sweet, beautiful boy back to you. Instead, I give you me. You, your family, your beautiful boy, will have me. Every day. Every minute. You will have me. I am now yours. And his. Forever.

Struggling

sad teen girl

By “H”, Age 16

(To the reader: This is an emotional piece written by a brave and courageous young woman. Please know that she is now with people who love her beyond words and she is safe. “H”’s story is in her own words and has not been edited or altered in any way.)

When you think of father daughter relationship what comes to mind? Love? Strength? Kindness? Unwavering protection?

All those are good things, right?

Well when I think of a father daughter relationship I think of hatred, hurt, violated, disrespect, and most of all anger. Those feelings are normal for me. When I was 11 and 12 my biological father started looking at me in a different way. A way that most people would consider inappropriate.

For me I never had a relationship with a father figure, I was thrown from parent to parent growing up so never had a stable environment with parents and when my biological father came and got me from the town I was raised, I didn’t know what a father daughter relationship was, my biological father started doing things to me that were inappropriate, it went on for a while about five to six months, at first I didn’t tell anyone because I thought that no one would believe me.

I mean who would think that my own biological father could ever do such imaginable things.

It took me a while to tell my grandparents about what happened between my bio father and me, I was so confused and hurt by what he did to me he damaged all of the relationships with men I had in my life.

I don’t trust men anymore.

I feel hesitant every time I am approached by a male to this day, and I still deal with those struggles. I had to be strong for myself at such a young age.

I didn’t get to experience the things that kids should be able to do. I think I truly missed out on a lot of childhood memories because of me having to worry about those sick things that men could do to young girls.

When I finally told my grandma first, I told her before I told anyone else in the family mainly because she is a woman and I felt more secure talking to her, for me it was a moment of security for once I felt so safe that this person wouldn’t hurt me or not believe me I truly felt like I could tell her anything and she would do anything for me to help me through it.

Telling her but probably the hardest thing, I didn’t want her to look at me differently and I felt that maybe she won’t love me anymore, by telling her what is the step in trying to solve the problem that I had for such a long time, and it was a relief, being able to tell someone was probably the one thing the aloud me to conquer my emotions and issues about what happened.

Writing this is also probably the hardest thing you know I can’t get half of the page without crying, there are still a lot of emotions towards what happened. I think I’m getting to that age where I have to use it in a way that could help people.

I’ve lived with this for years I’ve been through all the emotions that come with it and I just hope that by me telling my story another girl or boy won’t be afraid to tell their story. this is not something to be ashamed of. it’s not your fault I’ve been told that so many times, and at the beginning I thought it was I thought that I was doing something that was causing these things to happen to me by my own biological father.

I think for me personally, at this point of the situation I don’t have anyone to really connect with on that level. you know I do have amazing parents’ grandparents, and my uncle they have helped me through so much.

But, I think I’m just looking for and outlet to speak about this and know that it’s reaching someone that is going through or has gone through the same thing that I’ve been through. I think one of the biggest things that are generation could do is to stick together through these things not to be so closed off about these issues that sadly are recurring problems in our society.

We are not these young kids anymore I turn 18 in less than two years and it’s time for me to be strong and get through these struggles, and try to make a difference in another young adults’ life’s

*If you or someone you know has been sexually abused or assaulted please know that IT IS NOT YOUR FAULT and TELL SOMEONE.

*In an emergency call 911 or contact your local police department.

*Childhelp National Abuse Hotline- 1-800-4-A-CHILD (1-800-422-4453)- this hotline is staffed 24 hours a day, 7 days a week, with professional crisis counselors who have access to a database of 55,000 emergency, social service, and support resources. All calls are anonymous.

*National Sexual Assault Hotline-800.656. HOPE (4673)

The Things We Carry

pedimom-forest-strong

By Kayla, Age 18

(Kayla is a Forest High School student and was present during the school shooting that occurred on April 20, 2018)

Everyone sees what you present
And most don’t care to see deeper –
To see the depression and the anxiety
That plagues everyday.

They only say
“Talk about mental health!”
In the aftermath of the tears,
In the aftermath of the blood.

Kids carry the issues without question,
Just like they carry backpacks,
The expensive bulletproof ones,
I guess.

We all fake it –
Fake being okay or whatever.
We’re all ready,
Ready for a return,
Ready for a repeat,
Ready for the end,
Ready for one last one.

Some kids carry backpacks,
Others carry guns.

We all carry fear.

*If you or a family member have experienced a traumatic event and need to speak with someone please reach out to to a trusted friend, family member, teacher, doctor, or contact the Crisis Call Center and/or the Crisis Text Line for help (Text: “ANSWER” to 839863).

(All contributions to Kids Speak are not edited or changed in any way and remain exactly as the the child submitted them.)

The Effects of Social Media on Self-Image In Girls

“Mama, I don’t like the way my thighs look when I’m sitting down. Look how wide they are. I don’t want them to look wide. I want them to look like this,” she says as she squishes her right thigh with one hand on either side.

She is 8 years old.

My daughter and I speak often about how every person is different and beautiful in his or her own unique way. We talk about having a healthy body and mind and how there is so much more to us than our appearance. I don’t speak poorly about myself in front of her and I’m always careful to say things like, “you’re so smart,” “you’re such a kind girl,” and “you’re so strong” instead of things like, “you’re so pretty,” or “you’re so cute.” Right now, I play the largest role in shaping her sense of self-image, self-esteem, and self-worth, but I worry about the future when others will begin to have a greater influence, especially with the widespread and obsessive use of social media.

The use of social media has increased dramatically in the past several years and has become an integral part of the social life of our children. According to the Pew Research Center,  95% of teens report that they have regular access to the use of a smartphone, and 45% report that they are online on a near constant basis, mostly on various social media platforms. These numbers continue to rise and have caused researchers to start taking a closer look at the effects of social media use on self-esteem and body image, particularly in young girls. Adolescent girls are more likely to use image-based social media platforms that may be more likely to negatively affect their self-confidence and body satisfaction. Girls are being bombarded on social media with filtered, altered, and staged images posted by their peers and strangers, in an attempt to gain likes, comments, and followers. The more likes and followers someone receives, the more likes and followers they want, and thus starts the cycle. This can often lead girls feeling pressured to seek an unrealistic image of perfection. Sixteen-year-old Sahara wrote, “I am now caught up in this madness of perfection. I find myself saying, “This is the perfect lighting for a picture.” She also writes, “social media was the main reason I had increasingly sinking self-esteem. Seeing beautiful girls with perfect bodies and even more perfect lives made me feel bad about myself, that I wasn’t enough and would never be enough. In school, I was already dealing with people who would make me feel badly about who I was, and social media made that issue even worse. I tried so hard to release an image out to the world that I was this perfect girl with a perfect life.”

This terrifies me. I worry that my daughter may be engulfed by this exaggerated world of false perfection and I struggle with finding ways to prevent this. I fear that it will negatively affect her in so many ways.

So, what do we as parents do? Social media is definitely here to stay. It has become an integral part of our children’s culture, and although I believe that we need to be paying closer attention to how early our children are introduced to social media and how much time they spend on it, we cannot keep them away from it forever. Here are some of my suggestions, as both a professional and as a mother, on how we can help to preserve our children’s self-esteem and positive body image as they struggle though the adolescent years on social media.

~Start nurturing a positive body image now. It’s never too early. Don’t speak poorly about yourself, your body, or other people’s bodies in front of you child. When they are young, use phrases like “You are so smart” or “You are so kind” more often than “You are so pretty.” When looking at photos of other people talk about how they appear confident, strong, sad, thoughtful, etc. instead of how they look physically. Discuss how no two people are the same and that being different makes us unique and beautiful. Talk about how there is amazingness in in being ourselves and not striving to be like others. As they get older and begin to confide in you that they don’t like certain things about their body, sympathize with them. We’ve all been there. Listen to their concerns and let them know that it’s normal to feel that way sometimes, and that you struggled with this too. Help them find the beauty in their imperfections and let them know that you needed help at times too.

~Emphasize that a healthy body is a beautiful body. Enlist ALL family members to eat healthy and exercise together, even when they are young. Discuss how strong healthy bodies can do amazing things. Be mindful of how you discuss the times you don’t eat healthy. We all love a cupcake or some other treat once in a while, but if you child hears you saying you are so “bad” for eating that, or that that cookie is going to “go straight to my butt,” they will start to think similar things when they eat cookies… and all kids should be happy when they’re eating a cookie!

~Build resilience. Life can be cruel and raw sometimes, and your child will indeed face some tough times, just as we all do. Prepare them as best you can by being honest with your struggles and the struggles of others. Help them understand that not everyone will like everything about them (and some might even be quite cruel in letting them know that), but they can be strong enough to move past negative criticism. Stand up for them when they feel defeated, but don’t fight their battles for them. Too much coddling can make children feel like you don’t think they are strong enough to fight their own battles. Let them lead the fight; just be there to fight beside them if necessary.

~Be honest about social media and your concerns. As our children get older and are introduced to social media, be honest about what you know regarding its effects. Admit that you understand and accept that social media plays a significant role in their lives. You do not want to be the parent that “just doesn’t understand” and gets shut out of their daily struggles. Learn about the social media platforms that your child and their friends are using and talk to them about it. Let them teach you the details (they will LOVE being the expert). Then guide them with regard to how to think about and process what they see. Discuss the fact that people often post filtered, altered, and staged photos and that frequently what they are seeing does not reflect reality. Adolescents will forget this when they are in the social media “trenches.” Remind them and remind them often. They WILL start feeling as if everyone is better, more beautiful, more perfect then they are. Acknowledge that what they are feeling is valid and understandable, but remind them of their true beauty. It’s going to be your job to keep them grounded in reality and appreciative of their strengths and talents.

Parenting is tough. Let’s do it together.

Start the conversation.

It takes a village.

A Thoughtful Approach to Moderating the Use of Video Games

Video games

By Mike McCarter, Director of Protection Services at Microsoft

Kids and video games can easily spiral into an out-of-control situation, and as a result some parents shun the consoles altogether. While certain games can drive great learning and development, the wrong games, or too much game time, can have adverse consequences.

As we know, kids can get really excited about video games, so considering their age and stage of development, it should come as no surprise when they struggle with self-moderation. Here is how I use my Xbox’s parental controls to let the system be the bad guy. It is continuously reinforcing what I view as healthy boundaries that reflect my family’s agreed upon values.

I set up my Xbox One console for my two kids, Blake (7) and Abby (9), in a manner that lets them easily log in and play Minecraft safely, without social connections to other players and without the risk of getting into other games that I don’t want them playing. Here’s how I did it.

First I set them up with child accounts and then I set myself up with a parent account with a secret button combo that lets me grant them advanced privileges later when needed. Then I set up face recognition for each of us using the Kinect so that there is no login required (just turn on the device and look at the screen to log into the correct account).

Next I configured their child accounts to have Minecraft be the only game they are allowed to play. Social connections with other Xbox players are set as ‘disallowed’ right now, although eventually we can add their friends on a case-by-case basis when they are ready for that stage of life.

At this point it is worth mentioning that my kids can occasionally play games other than Minecraft too, although this requires me to enter my secret button combo on the Xbox controller.

In my opinion, the secret button combo on the Xbox is so much better than the on-screen password approach used by other devices in our home. With those devices, our kids can instantly see and remember the passcode we enter, since it is shown right in front of them on the screen. I hope more consoles move to toward the secret button combo approach for overriding parental control.

When it comes to authorizing additional apps, I always have a robust conversation with my kids in advance. For example since they are both playing soccer in real life, I will sometimes approve them to play FIFA since it helps them understand the game better and teaches them about strategy and the roles of different positions on the field.

Right now however, I am currently limiting their access to this game. Eventually I will upgrade it to “first class status” once I get the newest FIFA, assuming it features playable versions of the amazing female athletes we see in real life. Instead of just seeing male players on the screen, how cool would it be for Abby or Blake to play Megan Rapinoe as she wins the FIFA Women’s World Cup? But I digress…

Once you’ve set up the permissions correctly on the Xbox, you have to operationalize your household’s gaming policy. This is where more parenting decisions come up.  Since your kids can now just turn on the TV and get themselves logged in, you have to decide how often you want them to do that. In our house, we have chosen to limit not only their game selection, but also their screen time.

Our current approach for this is to give them a choice of either 20 mins of reading or 20 mins of math problems (e.g. I have flash cards on my phone) and this will earn them 20 mins of screen time. The math facts can be done in a few mins, although these require some intellectual exertion, whereas the reading is more enjoyable but takes longer.

Once they have earned their screen time, they’ll typically yell “Alexa set the timer for 20 mins” and scamper away to the rec room to jump on the Xbox. Sometimes if I need my own screen time, I’ll let them earn more than 20 mins.

The screen in our rec room is highly visible to anyone who walks by, and it is audible throughout most of the house. So until Alexa’s timer goes off in the kitchen, they get no-hassle play time. I encourage them to play Minecraft in “creative mode” and sometimes I’ll have them show me the buildings they are creating.

In my opinion, Minecraft fosters learning, creativity, dexterity as well as a healthy satisfaction with the fruits of one’s hard work. With Creative Mode in Minecraft, players get to out pick the materials and designs that support the intended vision and function of what they are creating. I never cease to be amazed by what my kids come up with; their portfolio of virtual projects would make even the most famous architect envious.

Also worth mentioning, sometimes when we’ve had a discussion in advance, I will them play Minecraft in “survival mode”. This mode is the one where raw materials are limited and must be mined. Also zombies and spiders attack at night unless you build structures to protect yourself. Blake takes more interest in this mode than Abby. When he plays the game in survival mode, he has to play it with the volume turned down since the gurgling and groaning noises from the zombies can be a bit scary (and perhaps more psychologically impactful) when played loudly.

Blake’s older sister gets the same deal as him, although when earning her screen time her math problems are harder than his because she is older and more advanced.  In any case, she typically chooses to spend all of her time in creative mode.

In the current Minecraft world they’ve built, Blake and Maddy both have custom characters and they typically play together on the same device using a split screen while building structures on adjacent plots of land in their shared world.

Just as in life, this virtual world isn’t always a bed of roses. Sometimes they get restless or cranky and then harsh words get exchanged; sometimes tensions will escalate and Blake will damage or destroy Abby’s building, then harsh words are exchanged and the household equivalent of World War III begins.  In other words, it’s no different than their shared Lego project on a Saturday morning; all is harmonious, until it’s not.

That’s about it… not rocket science but hopefully helpful.

P.S.  Perhaps this is sketchy parenting, but earning game time can also offer great leverage when it comes to incentivizing positive choices in other difficult areas of their lives… like the checkout aisle at the supermarket. If they start to misbehave, I can just warn them that they may be jeopardizing their screen time, and they’ll typically shape up. If course this means that I need to actually follow through on the consequence if needed, and stick to my guns despite the wailing and objections.

Be Kind!

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By Hannah Welch, Age 9

Someone told me that kindness will never help anyone achieve something in life…well they might just be a little right, but unfortunately they were also wrong.

When you do something kind you get a little feeling inside, something that makes you feel good. When you do something rude, you most likely feel guilty.

Now I am going to tell you a story of someone who made a big mistake.

There was a girl named Katie she was having a hard time with school work and got a C- in algebra and was a little off the top with frustration when she sat down to eat lunch with her best friend, Madison, who was starting to brag about her grades and all her A’s.

Katie got mad so she yelled “Why do you always have to be so perfect in every way and have to have everyone know it? And if you can’t just say one word about me or my day, or even just don’t say a word about yourself…then maybe we could be friends!” Katie sat up and went to sit at a different table. Madison quietly said sorry and then started sobbing.

By the end of the day the ball of guilt inside Katie was so big that she just had to go say sorry, but it was too late, Madison was about to leave and already starting to make new friends.

The next day Katie went to Madison and she explained what was going on and said sorry, Madison forgave her and told her why she was hanging out with the other girls, because she needed a friend just as good as Katie, but no one was as funny.

In the end everyone was happy.

Now I hope you know what the word KIND means.

What I learned About Childproofing From Working in the ER

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By Dr. Archana Shrestha

As a new mother, working in an emergency department made me want to go home and childproof every nook and cranny of our house. On a daily basis at work I care for children, most often toddlers, injured at home in various ways. I learned of all the potential household dangers and how to keep my children safe.

I remember vividly caring for the 2-year-old girl who burnt her entire hand and arm with hot coffee after reaching up to grab mommy’s mug from the countertop. She screamed in pain and her mother felt so incredibly guilty for the honest mistake. After seeing that, I made sure to always keep hot liquids away from the edges of the countertop and never hold my children while drinking something hot.

I recall another toddler who climbed a TV stand and had the TV and stand fall on him. Luckily he had no major internal injuries and went home with only a few scrapes and bruises. Seeing that, I made sure to secure our TV and dressers to the wall so that they would never fall over on our kids. I also taught my children never to climb furniture as it could tip over and hurt them.

Another time there was a 2-year-old boy who fell down the stairs breaking his collar bone. The parents hadn’t installed a baby gate at the top of the stairs which could have prevented his fracture. They felt awful. We had a gate at the top of our stairs, but it was a reminder to always close the gate when my toddlers were upstairs.

On a different shift, there was the 3-year-old boy who touched a hot stove and burnt his hand. After seeing that, I made it a habit to always cook on the back burners of the stove and to teach my children that the stove is hot and never to touch it.

There were many children who would get into medicines that weren’t put away or pills that they would find at grandma’s house. From this I learned not only to put away medicines in locked cabinets at my own house but also at grandma’s house or any other home they might visit frequently. I also began teaching my kids that medicines are not candy and their potential danger. I made sure they knew that they should only take medicines when given to them by an adult. I also taught my kids about other household poisons such as cleaning solutions.

I can’t count the number of times I have seen small children with cuts to their foreheads or near their eyebrows after bumping into the sharp corners of a coffee table. Needless to say, we got rid of our wooden coffee table soon after my first child was born and replaced it with an ottoman. But putting foam bumpers on the table would have done the trick as well.

Once I remember being quickly called into a room for a one and half-year-old girl whose index finger was stuck in the sharp blade of a food processor. We were able to cut the food processor blade and pull it apart and off of her finger without lacerating it. I asked her grandmother, who was babysitting, how the little girl had gotten a hold of the food processor blade. Grandma explained that she was trying to make dinner and gave a box of kitchen utensils to the child to play with. She didn’t realize the food processor blade was in the box. It was a reminder to always keep sharp items locked up or on high shelves.

As much as we may wish we could, we can’t keep our children in protective bubbles. Accidents can happen so quickly. But we can have safeguards in place to minimize the risk of these accidents happening. Here are some things you can do to childproof your home:

  • Always place small objects or choking hazards (such as marbles and coins) in locked drawers.
  • Keep medicines in locked cabinets and use childproof medicine bottles.
  • Store sharp objects in locked drawers or cabinets or on high shelves that children cannot reach.
  • Get rid of blind cords and use cordless blinds.
  • Use childproof knobs on doors that lead to the exterior of the house.

We also have to get in the habit of following certain best practices all the time. Once they become a habit they are easy to follow and take no extra effort.

  • Always cook on the back burner of the stove.
  • Keep hot liquids, food or pots out of children’s reach.
  • Never hold children while drinking a hot beverage.
  • Be sure to close baby gates when children are at the top of the stairs.
  • Never leave a small child unattended in the bathtub.
  • Always pay close attention anytime children are near water, whether a pool or body of water.

Also as your children get older be sure to teach them about household dangers.

  • Teach them that the stove, oven and knives are only for adults to use.
  • Teach your children that medicines are not candy and about other poisons in the home.
  • Explain why they should not go outside the house without an adult.
  • Also enroll your children in swimming classes as soon as possible. Every child should learn to swim for their own safety.

Most important of all, always have a responsible adult supervising small children at all times. It can only take a second for something tragic to occur. And remember the more you childproof your home and teach children about potential household dangers, the more you can relax and just enjoy your kids.

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Archana Shrestha, MD is a practicing emergency physician in Chicago. She is coauthor of “The Chronicles of Women in White Coats” and Cofounder of WomenInWhiteCoats.com. She is also an online health and fitness coach. Her healthy living lifestyle blog can be found at MightyMomMD.com and she can be followed on Instagram @MightyMomMD.

Depression in Teens – What Parents Need to Know

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By Dr. Natasha K. Sriraman

Rates of anxiety and depression in children and adolescents continue to increase.  While these conditions are treatable with therapy and/or medications, 80% of kids with a diagnosable anxiety disorder and 60% of kids with diagnosable depression are not getting treatment. Surveys have shown that there has been a sudden increase in teens saying they were experiencing symptoms of depression–feeling hopeless, not enjoying life, believing they can’t do anything right.

The teen suicide rate has tripled among girls ages 12-14 and has increased by 50% in girls ages 15-19.

The number of children and teens hospitalized for suicidal thoughts or self-harm doubled between 2008 and 2015. Why? Why are today’s teens more stressed, more anxious than teens just 5, 10 years ago?

Social media is a large part of this puzzle.  More and more teens interact with friends, and other people electronically. How many times have we seen our teenagers and their friends sitting next to each other, not speaking, no excited chattering, but on their iPhones?  As my daughter writes in her post (The Pressure of Maintaining the Perfect Image), social media has also become a constant source of comparison, thereby eroding self-esteem. As a pediatrician, I see the constant posting to Facebook or Instagram, not only in my teen patients, but many times, the younger mothers in my practice.

Teen girls are expected to be hanging out with the right people, have the perfect figure while showing they are having the best time ever. Unfortunately this comparison doesn’t just occur among teenagers. As a middle-aged woman, I have seen other women, friends comment on how others are skinnier, prettier, have name-brand clothes, etc.

So what can parents do? First, if you have any concerns about your child/teenager, try talking to them.  Don’t minimize their feelings or tell them to ‘snap out of it.’ Although we, as parents, may be tempted to since we were raised in a different time, family-type, or culture, the approach has to be very different.

So what can you say? Validate their feelings, let them know that you are there for them—no matter what. ‘I know this is a very difficult time/situation, but I am here for you.’

And it may not need to be the primary parent (mother/father), but it may be another adult that is important in that child/teenager’s life (aunt/uncle/babysitter/close family friend).

Next, please contact your pediatrician.  As pediatricians, we are well-versed in adolescent mood and behavior. At every adolescent check-up, your child should receive a screening instrument assessing their mood/sleep patterns. This short questionnaire should be filled out by your teen by him/herself, without any parental input. 

The most common one is the Patient Health Questionnaire (PHQ-9). This screening survey will help the pediatrician guide the visit. Also, at this age, the pediatrician will ask the parent to leave the room so they can chat one-on-one with your teenager.  While the screening tool is important, this is extremely helpful since it not only opens up a dialogue between pediatrician and patient, but also pediatrician and parent. This allows the child/teenager the opportunity to either write or tell their doctor about what they’re feeling.

Many times, the teen may remain silent while we discuss the results, but discussing these topics not only lets the teen know that what they may be feeling is okay, but also that we, as adults, not only understand, but can help. I have not met anyone that WANTS to feel sad, anxious, or depressed, have you? Please note that while this depression screening tool is administered at the check-ups, it can also be given to the teenager at any visit (sick visit, sports physical), including if the parent brings their child in with concerns about mood disruptions in their child.

From here, the pediatrician will discuss the results with you both while helping to formulate a plan. First and foremost, the pediatrician will assess the severity of the condition before moving forward with the plan.  A teenager with active suicidal ideation will be treated differently than a child who has trouble completing daily activities. Once the patient is deemed to be safe, I encourage you, as the parent, to work closely with your pediatrician in formulating a plan with direct input from your teenager.  This usually starts with a referral to counseling/therapy with a licensed professional.  Cognitive-behavioral therapy is one form of therapy that is used to treat anxiety or depression, particularly in older children. It helps the child change negative thoughts into more positive, effective ways of thinking, leading to more positive thoughts and behaviors. Based on the needs of the patient, while ongoing therapy is important, medication to help your child may be necessary.  Often times, the child is open to medication therapy since they are tired of feeling so badly for so long. I have an in-depth discussion with both patient and parent about how the medication works, how long it will take before they notice a change along with the safety profile/side effects of the medication.  I encourage my parents to be in charge of the medication—giving the pill to their teenager every day.

Importance of sleep in any teenager cannot be minimized, good sleep habits are essential for our anxious/depressed teens.  Establish a consistent bedtime, remove all electronics from their room (TV, gaming systems, tablets). This also means their phone needs to be out of their room.  Pick a time that the phone goes to central area of the house for overnight charging. Instead, the teen can journal, read or sketch before bed to help them relax. Nutritious food, physical activity, predictable routines and social support will also help the child feel less stressed.

I frequently give my teenagers a blank journal for them once I start treatment.  I encourage them to write their feelings or even sketch. Deep breathing exercises (meditative breathing) to help minimize distractions and slow down the mind, is also beneficial.  Mindfulness is a practice that helps you become aware of your thoughts and can help them reflect on what is going on in your mind.

Continue to talk to your child. Keep the lines of communication open. Show them that they are not alone and that together, you and your child can find the treatment they deserve. 

Talk about suicide. Asking these questions in an objective way opens the door for your child to tell you something they might otherwise keep to themselves.   Make sure your child has the number of the National Suicide Hotline (1-800-273-TALK (8255)) to call if they do not want to tell you directly.  And most importantly, if you own them, remove all the guns from your home. Studies show that rates of suicide are higher in home with firearms.

For parents, confide in a close friend.  Find a parent network. Your child’s therapist may recommend family therapy and may help you find a parent support group. There are online support groups and books that may be helpful in your healing.  Contact The National Alliance on Mental Illness (NAMI) (www.nami.org) to find your closest chapter and for additional resources. Be sure to take some time for yourself. Remember, it is vital to take care of you!!

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Natasha K. Sriraman MD MPH FAAP FABM is an Academic Pediatrician and Associate Professor of Pediatrics at Children’s Hospital of the Kings’ Daughters/Eastern Virginia Medical School. She is a Co-author of The Chronicles of Women in White Coats and one of the Editors of the womeninwhitecoats.com blog. She enjoys running, yoga, reading and playing on the beach with her kids and puppy! Follow her on Instagram. 

 

The New Kid

By Ebrahim, Age 9

My bullying experience started when I moved from Pearland to Bellaire. I was actually excited going to a new school!!! But when I sat in the front office there was a bully gang. Lucky me, I didn’t go to their homeroom. So, when it was recess there was that bully gang over in the right corner they came right to me and said, “look at that stupid new kid”, said the leader of the gang. They all laughed and laughed. I got so angry. Then, the next day came. The bullies came again and I pushed them so they started telling on me. But, I told the teacher what they did yesterday. Then the teacher gave them study hall for one month. But they got better after one month. They threw a rock at my private part!! I told the teacher and then they got one month of study hall again.

This spring I told my mom if I could go to a summer camp. She signed me up for the soccer camp. I’m good at soccer but not as good as those kids at the soccer camp. Some kids said, “hey nice socks”. I thought it was not a bad thing at first. Then, practice started and the same kid said, “shut up you stupid idiot”. I got angry and told my mom that the kid said, “shut up you stupid idiot”. So, my mom asked him. He said, “I didn’t say shut up you stupid idiot”. Then I proved it. His nanny asked him to say sorry and he looked down and said, “sorry”. He did the worst thing ever and then I didn’t want to play soccer.

*** Ebrahim’s mother is hoping that children sharing their stories will help more moms of different backgrounds to feel OK to speak up and stand by their children. Have a story to share? Submit it here

Ebrahim letter

Ebrahim letter

The Pressure of Maintaining the Perfect Image

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By Sahara Sriraman, Age 16

As a teenager, you already have so much pressure put on you from school to applying to colleges to extracurricular activities. You are already expected to have everything figured out at such a young age, so it makes it harder for you to enjoy your teen years. This especially puts more pressure on the youth now because of how much pressure you have to be perfect all the time and how it affects you from such a young age. Unfortunately, the growth of social media has only worsened this issue.

Social media has been affecting this generation negatively as its effects continue to grow. There are so many social media apps out there and everyone nowadays is pressured to have all of them to keep up with their peers and everything going on. The more followers, likes, and comments you have, the more relevant you are to this generation and the more respect you get from it. The effect social media has on kids today is so terrible, not only what it does to them but how it affects them from a young age. If you’re taught that what people think of you on social media is one of the most important things, then naturally, you’re going to spend a lot of time and effort trying to maintain that ‘perfect’ image.

Social media is rarely used by teens for good anymore. It was made to update people on what you’re doing, where you are, etc. However, now it’s just used to get more likes on a picture than someone else or maintain Snap streaks with someone you haven’t talked to in 5 years. Social media, especially Instagram, is now about portraying yourself and your life as flawless. This perfection doesn’t come easy though. After awhile, you find yourself taking dozens of pictures for hours, desperate to find that one perfect one to post with a completely nonchalant caption that makes it seem like you took the photo completely by chance.

Of course, as being part of this generation brainwashed by social media, I am now caught up in this madness of perfection. I find myself saying, “This is the perfect lighting for a picture!” or “I only need one more like until I reach two hundred likes.” I used to constantly find myself obsessing over how many followers I had and followed more people in order to gain more. Once I had reached a social media goal I’d had for a while, it didn’t feel like enough and I felt like I needed to get more likes/followers. The only way to describe this feeling is: Obsession.

As someone who used to never know when to take a step back and analyze the situation before responding, social media was the main reason I had increasingly sinking self-esteem. Seeing beautiful girls with perfect bodies and even more perfect lives made me feel bad about myself, that I wasn’t enough and would never be enough. In school, I was already dealing with people who would make me feel badly about who I was and social media made that issue even worse. I tried so hard to release an image out to the world that I was this perfect girl with a perfect life. But then I became something else: boring and normal. Trying to imitate what every single other girl out there was made me exactly the same as them. I didn’t realize that social media made me a completely different person until it was too late and I had already become that person.

I have been through a lot in my life from being insecure about my skin color to trying to like what all the popular girls at my school liked, what they wore and to not eating when I was hungry because I didn’t think I needed to. I tried so hard to be a cookie cutter image of what society said I needed to be. Along the way, I lost touch with myself, my true self.

Even though I’ve had social media for years and it has done some good for me, it has also caused me to dislike myself at times.  It has made me constantly look at myself in the mirror and wonder why I couldn’t be beautiful like these other girls who had it so easy. Even though it had brought me to some really low points, I just couldn’t seem to turn away from it.

However, over the past year, I’ve learned self-control when it comes to social media. I’ve learned how to turn it off when I need to. I think that I’ve learned how to take a step back and say, “I’m better than this.” when I see how much it’s hurting me. Previously, I had allowed social media to take over my life and after seeing how negatively it affected me, I realized that I could no longer put myself through those feelings, not again.

Although I still spend more time on my phone than I probably should, I now know how to turn it off and do something else to get my mind off of it. I’ve now realized that those girls who portray their lives as perfect aren’t actually flawless. When people post on social media, they only show the good stuff and never the bad stuff. But I’ve realized that that is not real life. Pretending like you’re someone that you’re not to trick other people is only hurting yourself. My gradually decreasing social media obsession is something that I know that I had to learn to address on my own; no one else can help me with it. Only I know when I need to turn off my phone and take a break from it all.  

Now, I am a different person and know that I’m going to bring more people into my life by being my true self. And even though I am still figuring all of that out, I am discovering more parts of myself that social media has hidden from me. Social media has tried to change who I am plenty of times, but now I am learning to focus on the more important things that actually matter, such as my loved one, school and my future–and to be proud of who I am and who I am becoming. And as I figure all this out, I have learned to embrace who I am and realize I’d rather be myself than an exact replica of every other person out there.

As a parent, you want what’s best for your child and to protect them from the unforgiving cruelty of the world. However, social media has caused teenagers to lower their own self-esteem by realizing their own insecurities and over magnifying them to an unnecessary amount. Most parents may think that the safest and most reasonable thing to do would be to take away social media all together, so it cuts off any access their kids have with the online world. However, kids will most likely find another way to secretly get social media. If you’re a parent dealing with a teenager who is has an unhealthy attachment to social media, try taking the logical approach: TALK to them. Ask them why they need social media so much and why they need it to be their main focus every day. This will help them to come to terms with their own insecurities and encourage them to face them head on, not hide behind a social media account. Social media is an entity that is taking over this generation and kids today will do whatever they can to have it. It has become a crutch for teenagers today and they fall back on it when things in real life get difficult. They need to realize what’s best for them because, in the end, it’s their independent decision. As parents, you try to always protect them and catch them when they fall, but life isn’t always going to be that way. They need to learn how to make decisions for themselves because those tough decisions will benefit them in the end. Parents can also try talking with their kids about how social media will hurt them in the future, so the parents and kids can face the issue head on together and work on the appropriate solution. Help your teen identify their underlying self-esteem issues that may have originated from social media and help them address these issues together, as a family.  Help them address these issues because only then will they learn how to fix it and become a better version of themselves.

Emotional Protection: The Pressure’s On

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By Falon Canham, Blogger and Preschool/Gymnastics Instructor

Children are the most precious and valuable treasures to their parents. They are protected from harm at all costs. Physically protecting children is the easy part; keeping them fed, clothed, sheltered, and safe. But I’d like to touch on something I believe is more difficult than physical protection, and many parents miss: emotional protection.

The reason this is so much harder is because, even with the best of intentions, things adults do and say can be unknowingly harmful or traumatizing to our children; a blind spot, so to speak.

Countless facets of unintentional emotional harm exist, but the one that I see almost every day as a sports coach, is pressure. A vast majority of parents are putting too much pressure on their children to perform exceptionally well in sports, for numerous reasons. In my experience, the pressure comes in three main ways: direct comparison, subjective praise, and vicarious living.

Direct Comparison:

To explain the first type of pressure, “Direct Comparison,” I’d like to bring to mind the quote, “comparison is the thief of joy.” Some parents look at how other children are performing, then look at their own child and say things like, “Look at them! Why don’t you do it like that?” or “So-and-so won because they worked harder than you.”

Even if those things are true, saying this to your children only makes them compare themselves to others and not focus on their own progress. Some parents wear their comparison on their face. You know the look. The look of disappointment, of frustration. The look that sometimes says more than words.

I’ve witnessed this look on many a parent.

Comparing your child to others not only steals their joy, but yours as well. You are not allowing yourself to enjoy watching your child grow and excel individually. This pressure can cause feelings of insecurity, diminishing passion, and self-doubt.

To avoid this pitfall, try encouraging your children with positivity. For example, “If you continue to work hard, you will keep improving.” This type of phrase eliminates comparison, and acknowledges the hard work your child has already demonstrated.

Subjective Praise:

The second way parents pressure their children, is by only communicating praise in certain situations. For example, only applauding your children when they win 1st place, but not when they place 2nd. Or simply applauding their accomplishments while ignoring their efforts. Congratulations, you’ve now taught your child that it doesn’t matter how hard they try, the only thing that matters is succeeding and winning.

I once coached a 6 year old gymnast (we’ll call her Emma), whose parents were never happy with her performance at competitions. At the final competition of the year, she surpassed her personal best scores, but still didn’t win first place. Instead of being overjoyed at her massive improvement, mom gave her ‘the look,’ and squeezed out a begrudging “Good job.” Let me reiterate, Emma was 6 years old. The very real effect this kind of pressure had on Emma was displayed at every single practice. She was the most self-critical 6 year old I have ever met; constantly saying things like, “I’m terrible at this,” “I can’t do it,” or “you don’t have to tell me, I know that was bad.” Not a day went by that she didn’t cry over her inability to learn something new, on the first try, perfectly.

Perfection is an impossible standard, and if you hold your children to it, they will always fall short. As a result, you are left feeling disappointed and frustrated, causing your children to feel perpetually insufficient, and even lose all passion for whatever activity.

Living Vicariously:

Finally, some parents try to live vicariously through their children. This may be the biggest blind spot in existence on the subject of pressuring your kids. What I’ve found, is that many people played a specific sport throughout their youth, and want to push that same sport or athleticism on their own children. Or on the other hand, they were not athletic at all as a child, and were possibly teased, bullied, or made to feel worthless as a result. These parents have unspoken (and sometimes spoken!) personal goals for their children; whether it’s to get a college scholarship, play for the NFL, or become an Olympian. Or sometimes simply to brag to other parents about how talented their child is in a particular sport.

If you are this type of parent, I have two words for you: Stop it!

Your children’s performance, abilities, and natural talents have nothing to do with YOU. They are a unique gift from the creator of the universe, and your only job is to nurture these gifts. If you are having difficulty in this area, take some time to do a little soul searching, and figure out what it is you need to let go of so that your children can excel in something they are passionate about.

Comparing children to others is damaging and unfair. It inadvertently creates long-lasting feelings of insecurity and self-doubt, instead of a loving and supportive bond between parent and child. Only praising winning and perfection will lead to a child believing they will never be good enough, and they will lose all passion for something they might otherwise love.

When children are forced to participate in something that is not a natural talent of theirs, or isn’t something they have an innate passion for, their true self is being ignored. Instead of letting them be themselves, and fostering their unique gifts, they are being forced to be something that they are not.

These rules do not only apply to sports, but other areas of life as well, whether it be academics, arts, relationships, behavior, etc. We live in a society that preaches, “just be yourself,” but then are not creating the space for our children to do that. The solution is simple: let your children shine uniquely, praise individual achievement, nurture their passions and talents, and get out of the way.

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Falon Canham, Preschool/Gymnastics Instructor

Falon started gymnastics at age 4, and started competing at age 10. She competed up to level 9 and placed top 5 at level 9 Regionals! She started coaching at age 16 and has been coaching ever since! Check out Falon’s Blog

Bandage

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By Sheryl Recinos, Mother

She wears the crisp piece of flimsy plastic across her cheek like her battle cry; she has been through something profound and wants the world to know it. I rush across the room and lift her into my arms, ready to hug away the teeny tiny scratches that someone must have given her in a toddler battle over a favorite plaything.

But when I peek under the band-aid, looking for telltale signs of an injury, she giggles. “I okay, Mama,” she says as I kiss the bandage that covers unbroken skin.

Years later, I accidentally stumble across a notebook, while searching for a scrap of paper. A crisp eight-page note detailing how she will end her life, and why. I rush her to the emergency room, never telling her what I know.

How had I not noticed that her smile didn’t quite reach her eyes anymore?

How had I missed the pursing of her lips as she asked where she could find a tall enough building.

Tall enough for what, honey? No answer.

In the safety of the hospital, I confessed. “I found your note.”

Tears flow; a pain I didn’t know was lodged inside of her. I fully expect her to shout at me, to tell me I was wrong to go into her things, to tell me that she hates me. She doesn’t.

“I’m okay, Mom,” she whispers when I wrap her into my arms and hold her as she sobs. I wait for her to tell me the words I would’ve said to my own parents. No, the world has not been as cruel to her. Her childhood was wrapped with love. Love, and bandages.

Today, she wears no bandage. Her skin is unbroken. The pain was on the inside, all along.

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We can all help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. 1-800-273-8255

Protecting my teen online has been HARD!

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By Lisa Slusher, Mother

I recently learned that a large percentage of pre-teens and teens have a social medial account that parents are unaware of . . . honestly, I was kind of glad to read the statistic because up to that point, I thought I was the only one to uncover my daughters secret social media platform! Here is my story and my advice.

I have a 15-year-old daughter (I appreciate the empathetic sighs) – after much contemplation and prayer (as well as hours of discussion with my husband), I made the decision to purchase a laptop for our teen for Christmas. Her own personal laptop – she was thrilled! I had spent several years of sharing computers and watching over everything that she did on the computer. I felt that she had earned this tiny bit of freedom with a personal laptop. Now keep in mind that I didn’t just hand her over a computer with no parental oversight. I had carefully set up our Microsoft Family Sharing Account to set screen time limits, hours of the day for use, carefully blocked websites, restricted content based on her age, and was monitoring her activity on the computer. We had “the talk” again about internet safety – not sharing personal information, no chat rooms, etc. I disclosed to her that I had set up time limits and that certain sites had been blocked for her protection. We talked about all the dangers of such well deserved freedom.

She was thrilled! Her own laptop! She quickly set up her passwords (which I made her disclose to me) and went to town downloading apps for fun as well as for school. She is an avid reader so without hesitation we downloaded a reader where she would have access to thousands of books. She could do her own research without having to plan around my time on the computer! As the weeks went by, I got these lovely reports from Microsoft Family Sharing that told me how much time she spent on the computer, what sites she visited (as well as how much time she spent on them), if she attempted to go to any blocked sited, etc. Things were good! Or so it seemed . . .

As the months followed, so did my concerns. I started noticing that she was on the laptop more than what her time limits should have allowed. I checked my Microsoft Family Account – she had “timed out” several times during this week. I also started noticing that she was on the laptop during times that were blocked and several times I “caught” her with the laptop in the wee hours of the morning. Hmm . . parental gut check . . time to have another talk. What a relief, she was just reading books that she had downloaded to her reader! So I check the “reader” usage – and yes, she was spending a ton of time on the app and had several books checked off as completed. We mutually set some further restrictions – laptop on the table at night, no “overnight” reading sessions, etc. After all I wanted to protect her eyes! Even when she questioned the legitimacy of my concerns (as I am guilty of using my reader for hours upon hours) – I explained that I was old and my eyesight was already bad! Little did I know that this was just a tremble of the earthquake to come . . .

Life goes on beautifully – she is doing well in school. She is a delightful teen with lots to talk about. Computer on the table when she goes to bed, Microsoft Family Sharing reports all look good. Hmm . . maybe a little too good. This was my “whisper” – something’s not right, this doesn’t feel right, somethings up . . .

Since I was working a lot of overnight shifts, my husband was tasked with “computer monitoring” – and from all appearances was doing a fine job. Computer on the table most mornings when I came home. An occasional slip up with an “I forgot” or “I feel asleep” –Then the husband tells me that the other night he found her in her closet with the computer after he thought she was in bed. What? She tells me she was in the closet reading one of her books on the computer. OK that’s weird. I grill her about what book, why in the closet? Sure enough she had an answer for everything. She even had pillows and a blanket in the closet to bolster her story.

I started paying even more attention to the family sharing reports. No attempts to reach blocked sites but then I noticed something a little strange – she wasn’t using all of her computer time. She was no longer “timing out” on usage. Parental gut check and the whisper again. I checked the computer. Went through everything, or so I thought. Checked her internet history. Checked her “game time.” Everything seemed to be in order. Had a talk with her – gave her a chance to tell me if something was up. Nope. Everything was fine. She had just not been on the computer as much. Discussed with husband to learn that she is actually on it all the time when I am at work. Weird – right! How could that be as it should be “timing out.” I checked the reader again – yep, she was reading a ton of books! But why wouldn’t she just tell me that? Parental gut check . . . that dang whisper again – only it was louder this time – SOMETHING IS NOT RIGHT. DANGER AHEAD. TROUBLE. RED ALERT. RED ALERT.

The next day I was schedule to work overnight. I set my typical plan to prepare for a night shift in motion – stay up as late as I can to sleep the next day before my shift. At 10 pm the laptop was carefully placed on the table as my beautiful teenage daughter went to bed for the night. At 1 am, I checked on her – sound asleep, computer on the table. All is good. I settled in for a few more hours of Netflix – trying hard to keep my eyes open – I can typically make it until about 3:30 am and then I am out! But that parental gut check was haunting me and that whisper was now a loud voice telling me to get up and walk through the house just one more time.

Hmm . . computer not on the table. Was it really there before? Was I dreaming? Was I just so tired that I missed something? Quick sweep of the kitchen and then the den. Where was the computer? Glace at daughter’s room – her door is shut but the room appears dark. She doesn’t sleep with the door shut unless the dog is bugging her. Where is the dog – wait, the dog is asleep on my bed where she has been all night. I could feel my heart rate double – I don’t knock, I just open the door. A startled teenager is completely dressed, makeup and hair done – ON THE COMPUTER! She quickly closes the computer and without saying a word, I grab the computer and head toward the light of the breakfast nook. “Mamma I’m sorry, I was just reading, I will put it on the table now.” I still don’t utter a single word (I couldn’t get a word out of my mouth right now if I tried). “Mamma I wasn’t doing anything, I was just reading.” She reaches for the computer, still closed sitting in front of me. I am not about to let the computer go. I manage to utter “BED. NOW.” And fight the tears back to keep my stern voice in check. She is still trying to talk to me as I walk off, to my bedroom and close the door. She knocks. I don’t answer. I can’t even hear what she is saying at this moment. Mumblings from the other side of the door. Is she crying? I can’t tell, I can’t hear her right now. I don’t want to talk to her right now. I don’t want to see her right now. She must have given up and gone to bed – everything is silent – except my brain. All I can think about is what I am about to discover. And I had no idea how bad it was really going to be.

Full blown parent mode. Checked our Microsoft Family Sharing plan, checked and rechecked our security measures, read through every single email in her account (even recovered the deleted ones) – bam! Hit me like a ton of bricks! A “recovery” email in the trash folder from Gmail. She didn’t have access to Gmail, she didn’t have a Gmail account – or so I thought.

My 15-year-old daughter had created a whole separate online identity that I knew nothing about. First of all, she knew my Administrator password and when she was running out of time on the computer, she would just check the box “my parent is here” and type in my password – which then stopped the clock as well as the detail of sites visited (yes, the Microsoft Family Sharing is meant for monitoring children when the parent is not around, once the “my parent is here” box is checked and the correct password is entered, time limits and details of sites are no longer monitored). And then I learned that the Microsoft monitoring program only works for their supported web browsers! I did not realize that there were so many different web browsers that could simply be downloaded (Firefox, Mozilla, Chrome, Safari, Pale Moon, Opera – to name a few) for free and voilà – instant access to anything that was previously blocked. These browsers can also be hidden in either apps or toolbars.

I discovered that she had utilized these tools to build a strong social media platform on almost every social media site I had heard of – and some I had not heard of. She was using her Gmail account to set everything up and was communication with total strangers over the internet! And she wasn’t just surfing on these social media sites, she was actively posting things – such as pictures (carefully hiding her face on most of them), using a different name, communicating with total strangers, and even sexting! She was “video chatting” with people she had never met and that I would never in a million years approve of! On multiple sites! In my own home! Right under my nose! My heart sank, my dinner was making my stomach do flip-flops, I was nauseated, my head started pounding. I started crying uncontrollably. I didn’t know what to do. I didn’t know who to talk to. I didn’t understand how she could do this. I wanted answers. By this time the sun was peeking through the darkness.

I honestly thought I had my house under control. I had spent an enormous amount of time talking with my daughter about every topic – sex, boys, dating, safety, the internet, personal responsibility, body shaming, clothing choices – you name it, we talked about it. I couldn’t understand why she felt the need to be so “creative” on social media. And it was something that she could not explain to me. “I just wanted something of my own”; “I wanted people to like me”; “I wanted the attention”; “I wanted to see if I could get away with it”; – hours and hours of talking and these were the only answers I got. Does she not understand how dangerous these activities were? Did she truly not get it? Did she think I was just being overprotective by my approach? The honest answer is no, she didn’t understand. None of them do. They may tell you that they get it but they really don’t. They don’t have a “rational” brain at this age. I had to settle on the answer that it was just something to do when she was bored. There were a few other things that I discovered that we were able to talk about and hopefully open a line of communication for the future. I still deal with the thoughts of inadequacy as a parent. How could I let this happen? It is my job to protect her. Should I have not given her the computer for Christmas? How do I prevent this from happening again?

As my daughter nears her 16th birthday, I am forced to deal with the fact that in just a few short years she will be 18! An adult by legal standards. How do I prepare her for that? How do I use this experience to protect her? I still don’t have all the answers but I do have some words of wisdom for others. These “security measure” take a little bit of time to set up and they can be a little inconvenient for some but trust me, a moment of inconvenience could save your child! (These security measures are for any device that uses Microsoft as the operating system including cell phones and tablets).

  • Create your own Microsoft account first (if you have a Microsoft operating system you likely already have an account). DO NOT allow the teen to create their own Microsoft account. You will add them as part of your “family” once you set up their device.
  • Set up their device only after you have ensured that you have a Microsoft account. It is much easier than doing the device first and then trying to add to an existing account because you cannot merge accounts – so if they have somehow set up their own Microsoft account it needs to be deleted or closed. So if you are trying to set this up after weeks, months, or even years after they have had their own device where they are the Administrator or have their own Microsoft account (hand me down device, older device, etc), it is best to restore the device to factory settings and start over. This includes the X-Box!! Yes, X-Box has a Microsoft operating system and content, time limits, etc can be controlled by YOU if it is set up properly through your Microsoft account. Did you know that your child can surf the web with their X-Box??
  • Set yourself up as the “Administrator” on all of their devices! Set up your teen as an additional “user” with their own “username”. Make sure you check the box that prohibits adding an additional username with Admin privileges (this will prevent them from being able to obtain Admin privileges under their username). Log off your own personal devices every time – if they need to use your device, they can log in with their own username and password. Make them disclose their password (and test it frequently in case they change it). This is done on the device itself.
  • Add them to your Microsoft Family Sharing plan. This is done through your Microsoft account. Once they are on your Family Sharing plan, then you can set up the controls for screen time, block sites, block content based on age, etc. You can also put in specific websites that are “always blocked” such as other web browsers (these restrictions will also work on the X-Box device). I recommend blocking all web browsers except Explorer and Edge.
  • Don’t give them your password for any reason – and if there is an emergency where you have to disclose your password, change it as soon as you can. Anytime you have to give up your password in an “emergency” – check to ensure that no additional “usernames” were created (if you checked the box during setup prohibiting additional usernames with Admin privileges they can still create a username with no restrictions on website content, security, and monitoring). If an additional username was created, delete it immediately
  • Utilize the Microsoft Family Sharing account the way it was intended. Set up realistic time limits, time of day usage, website restrictions, as well as content restrictions. Realize that other web browsers are not monitored. Sign up for the weekly (or daily) report and read through it carefully. Make mental notes of things that don’t add up – are they “timing out” frequently? Has their usage time changed? Are there days where they “time out” followed by days that they barely have any time used? These are potential “red flags”
  • Block ALL downloads under their own username. This way, the “Administrator” password must be entered to download anything under their username – my daughter had managed to download a few things on my personal computer under my username because it was “always on” and then she could access it from her laptop because she had my password!
  • Log in to their user account and go for a test drive. Attempt to go to websites that should be blocked. Try to get to other web browsers that you think are blocked. Try to download a game or something from the App store.
  • Anytime you make a change to your settings in either your Microsoft Account or on the device – restart the device.
  • Technology is changing rapidly – keep an eye out for changes that could affect the security measures you have set up.

Dealing With Friends Who Use Profanity

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By Annika Nist, Age 12

When I began my 6th grade year, I was shocked at all of the foul language people were throwing around. On my first day, I heard someone cuss 7 times in a row. When I went home, I just threw myself onto my bed and thought, Why are people like this? In elementary school, if someone cussed, all of the yard duties would immediately be told and the offender would be sent to the principal’s office. In middle school, no one even was yelled at for cussing. If you are like me and feel that this is unnecessary, be prepared for all of the profanity that comes with middle school. Here are three methods for dealing with this annoyance:

Method #1: Avoidance

Avoidance can be the best strategy for some, but can be difficult for others. Middle schoolers are very loud, at least most of the profane ones. This is harder to block out than someone trying to get you to tell them the answers to a worksheet, which would be very quiet. You can try listening to music, and this helps me on the bus. However, it is very unlikely that you would be allowed to in class. Most experts in this skill just try to eat lunch in areas where there are not as many of the yellers. This is useful, as you can just talk with your friends and eat lunch in as much peace as you can get in middle school.

Method #2: Opposing

This method can be useful in some situations, such as if an innocent classmate is being verbally harassed by an older student. However, I strongly discourage this in less urgent situations, as if you do this, you will end up stopping someone constantly in the hallways(late to class!), and become a target for bullies. I wish this was a better world where people could be talked down by peers, however, that world has yet to come. I want to use this method constantly, but if I did, I would end up as a common target for bullies on the higher end of the middle school hierarchy and be useless anyway.

Method #3: A Combination

This method is the one I use. A balance, including both previous methods. I try to distance myself from the most profane students, but will still stand up to them if an urgent situation arises. I listen to music on the bus, but quietly rebel against my busmates who scream, cuss, and shriek constantly. This is also considered the best method among most of my friends, who feel the same way I do about this issue.

I hope this advice will do you well in your educational career, not just in middle school, but hopefully in high school and beyond. Just remember-safety is the most important thing here. Never willingly put yourself into a situation where you could be harmed in your efforts of dealing with profanity.

Stop using the word “strangers”

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Get the term “strangers” out of your discussions with your kids when discussing safety topics!

Caustic Ingestions

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By Dr. Tanaz Farzan Danialifar

What is a caustic ingestion?

Caustic substances are those that are capable of burning or eroding tissue by chemical effects. They can be either strongly acidic or strongly alkaline and they are in all of our homes. Common examples are household cleaning products (such as bleach, oven cleaner, and toilet bowl cleaner), laundry detergent, swimming pool products, cosmetic products like hair relaxer, and drain opener. When ingested these substances can cause injury to any part of the gastrointestinal tract including the mouth, throat, esophagus (food pipe), and the stomach as well as parts of the airway due to accidental inhalation.

What can happen after a caustic ingestion?

The type and severity of injury depends on the type, strength, and quantity of substance ingested. Generally, alkaline agents cause more severe injury, especially in the esophagus. Liquid cleaning products are generally less concentrated and due to bad taste children take smaller amounts. Concentrated and single use products like laundry “pods” are much more likely to cause severe injury. The effects can be immediate but in some situations delayed effects will be seen. In the gastrointestinal tract injury this can include mild burns, deeper burns resulting in scarring and long-term narrowing of the esophagus, and even perforations (tears) of the stomach or esophagus. Children with injury to the gastrointestinal tract will often experience pain or difficulty swallowing which can look like refusal to eat, drooling, or just fussiness. Some children may complain of chest or stomach pain, experience vomiting, or fevers.

How commonly do caustic ingestions and their complications happen?

In 2016 over 2 million accidental ingestions were reported by the American Association of Poison Control Centers. About 45% of these were in children under the age of 5 and more than half of those were children 2 and under. The most common ingestions were cosmetic/personal care products followed by household cleaning substances. In children 18-46% of ingestions may result in esophageal burns and injury. Stomach injury is less common.

What do I do if my child ingests a caustic substance?

Evaluation and management of caustic ingestion depends on the type and amount of substance ingested and the degree of symptoms the child is experiencing. If you suspect or know your child has ingested a substance that may be caustic first make sure the child has no problems breathing, if present seek immediate medical attention. If possible identify the exact type and brand of substance. Either keep the bottle or take a picture of the labels.

You can call Poison Control Centers of America (1-800-222-1222) 24 hours a day with this information and they will guide you on next steps. Medical evaluation may include a physical examination, x-ray imaging, and urgent endoscopy (camera evaluation of the inner lining of the intestinal tract). It is NOT recommend to induce vomiting after an ingestion as this will cause repeated contact of the caustic substance with delicate tissue.

  • How do I prevent caustic ingestions?
    At this point you may be panicking about all of the toxic products sitting in your home just waiting for your toddler to start playing with. Don’t worry; you don’t need to throw away every cleaning and cosmetic product. But there are some simple steps you can take to keep your children safe.
  • Keep all products in their original bottles/packaging. As discussed knowing the exact type of product is critical in determining the next steps. You can avoid unnecessary medical evaluation due to unknown ingestions
  • Keep all products in locked and if possible high cabinets. A home with young children can be difficult to navigate when full of childproofing. Consider putting locks on those cabinets with potentially harmful products. If locks are not a possibility keep potentially harmful products on the highest shelf.
  • Avoid purchasing gel packs, capsules, or pods. This type of single-use packaging contains the most concentrated forms of caustic products and the most likely to result in injury. Often due to the thicker consistency the can sit on tissues longer to cause more severe injury
  • Use child safety settings. Using products with child-proof lids or spray bottles with off position make it less likely that your child will actually ingest a substance they accidentally come in contact with.
  • Don’t leave children unattended around products. Ingestions can happen within just a few seconds. While it may not be possible to keep your children away when cleaning or working in the garage, don’t leave them unattended for even short periods of time. If you need to step away take either the products or the child with you.

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Tanaz Farzan Danialifar, MD is a board certified pediatric gastroenterologist practicing in Los Angeles, CA. She is the Medical Director of the Neurogastroenterology and Motility Program and Children’s Hospital Los Angeles and Assistant Professor of Pediatrics at Keck School of Medicine of USC. https://www.chla.org/profile/tanaz-farzan-danialifar-md

References
David D. Gummin, James B. Mowry, Daniel A. Spyker, Daniel E. Brooks, Michael O. Fraser & William Banner (2017) 2016 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th Annual Report, Clinical Toxicology, 55:10, 1072-1254

Fishman, D (2018). Caustic esophageal injury in children. In AG Hooin (Ed.) UpToDate. Retrieved June 4, 2018 from https://www.uptodate.com/contents/caustic-esophageal-injury-in-children#H1.

Byrne WJ. Foreign bodies, bezoars, and caustic ingestion. Gastrointest Endosc Clin N Am 1994; 4:99.

Wasserman RL, Ginsburg CM. Caustic substance injuries. J Pediatr 1985; 107:169.

Nuutinen M, Uhari M, Karvali T, Kouvalainen K. Consequences of caustic ingestions in children. Acta Paediatr 1994; 83:1200.

Gun Safety From a Doctor-Mom and Cop-Dad’s Point of View

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By Dr. Leigh Doane

Hi! I’m a mom of two little girls here, ages 28 months and 7 months. I’m also married to a police officer who’s been on the force for 12 years now. I’m also a fulltime working mom and an OBGYN. I never grew up around guns and didn’t have them in the home. I maybe shot a gun less than 5 times in my life before we started dating. So when my now husband and I started dating, and he owned FIVE guns, I knew I had to everything to educate myself, to make sure I was safe, and that I knew how to handle them. This was reiterated even more as I became pregnant with our oldest, because soon enough she would be crawling, walking, and exploring every inch of our home! And now she’s the tiny tyrant that runs our household.

Let me start off by telling you a somewhat funny story, but also honest too…. My husband and I had been dating for a few months and he had a pool at his apartment. After one afternoon at the pool, I decided to shower and get ready for a dinner out.

I went into the linen closet to grab a fresh towel and then his handgun fell from the top of the stack of towels and landed straight on my foot!

His fully loaded hand gun landed with a big THUD on my foot!

No, nothing bad happened. I wasn’t injured. But I was freaked out to the max. It COULD have. I was so scared that it came out as anger. How could he just leave it there and not tell me where it was? What if it would have misfired? What if the safety had come off? This was so dangerous I was beside myself. I can honestly say I’m very thankful that my husband and I rarely fight but this had me so upset it was worth fighting about. From that day forward, we set out to be safe, smart, and educated about gun safety. We had to come up with a plan for having guns in our home that provided comfort and reassurance. It has taken a bit of work and a small investment, but the piece of mind is well worth it. It’s funny now and we can look back and laugh about the time I almost shot my foot off (ok, maybe I’m being a drama queen, but it wasn’t funny then!)

The American Academy of Pediatrics (AAP) advises that the safest home for a child is one without guns. The most effective way to prevent unintentional gun injuries, suicide, and homicide to children and adolescents, research shows, is the absence of guns from homes and communities. With my husband’s job in law enforcement, that’s not happening anytime soon. I may be “old fashioned” but I still believe in the second amendment the right to bear arms and own a gun. However, I do support gun-control legislation. I believe that assault weapons and high-capacity ammunition magazines should be banned.

If you don’t have a gun in your home, congrats. Well done. That still doesn’t protect your kid from going to one of the 2 million homes in the United States that have a gun. Nearly a third of all children live in a home with a gun. So, when your child goes over for a sleep over this weekend, just keep that in mind. In 2017, 285 children got a hold of a gun and inadvertently shot themselves or someone else.

Studies show that teaching our kids about gun safety is not enough. Clearly there needs to be a dialogue so that if they find one they know what to do, but we must go further than that.

  1. All guns need to be stored safely.
    – We have a small gun safe that we keep under the bed that has a code that only my husband and I know. If there was an emergency in the house this is my “go to” gun.
    We also have a separate closet which also has the rest of my husband’s police gear in it that contain his guns and other hazardous items (taser, mase, etc). This again has a coded key pad that only he and I know.
    – There are various types of safes available (coded, fingerprint, fast entry) and others are designed for water/fire protection. The point is that its locked, out of reach. You can pick which one suits your family’s needs.
    – Do not keep loaded, unlocked guns in your car.
    – Ammo needs to be in a separate locked location. If your kid finds a way into one (which those clever sneaky kids can do!) hopefully they will not know where the other is stored and can’t have access that either.
  2. Know the guns in your house.
    – When we first moved in together I asked my husband to show me how to load, unload, and fire all the guns in our home. I wanted to know what I was doing. He also happens to think this is pretty hot. Bonus for me for being a hot wife!
    – We go and shoot the guns about every 6 months. Like I said we are both busy full-time working parents, but we make it a priority to keep our skills current. I feel like I learn something every time I shoot, and my confidence grows too. I always shoot my “go-to” gun but I practice with other ones too.
    – When are girls are a little older, we will teach them to shoot as well. But for now, its hands off.
    – When using a gun for hunting or target practice, keep the safety on until you are ready to fire it. Before setting the gun down, always unload it. As much as a child may want to take a turn shooting, this is not a good idea. No matter how much instruction you may give about how to safely shoot a gun, children are not capable or responsible enough to handle a potentially lethal weapon without complete supervision.
  3. Ask about guns when your child visits another friend’s or family member’s home.
    – Just because you practice gun safety, doesn’t mean other parents feel the same way.
    – More than a third of all unintentional shootings of children take place in the homes of their friends, neighbors, or relatives.
    – One idea is to create a playdate checklist so when you call to ask about what time you need to pick up/drop off, ask about what rules they have (pets, allergies, cursing, movies, video games, internet usage, bedtimes, gun safety etc). Just make this part of your normal parenting routine.
    – Did you know that there is a whole day dedicated to asking about guns in the home??? It’s June 21st. Check out: www.askingsaveskids.org
  4. When you do talk to your kids about guns….
    – Let them know that what they see on TV and in a movie is not REAL. There little minds have trouble discerning what is real and what is acting. (My toddler is convinced that Moana is real when went to the beach she thought she’d see her there).
    – If they come across a gun, don’t touch it and tell you immediately.
    – Remind them again and again. How many times do you have to remind your kid to brush their teeth? Enough said.

Some thoughts to dwell on…. Every day 78 children are killed or injured by guns in the United States. Children as young as 3 are stronger enough to pull a trigger. If you think you’ll wait until your kids are older. Don’t. Don’t put it off.

Not My Child. Not My School. Not My Home.

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By Dr. Mundeep K. Kainth

I write to you today not as a doctor or as a researcher. I write to you as a mother. My two boys attend daycare in a school that is housed 5 minute drive away from my home. My eldest’s future kindergarten class in a building that is a 5 minute walk away from my home. But in both of these cases, I feel that every day, I endanger my children every minute they are out of my sight. Why? Because we have a rampant problem in our country today: gun violence.

Gun violence takes many forms. It can occur in your community, in your home, in your workplace. Most frightening is when gun violence enters a school. Traditionally, one thinks of a tranquil schoolhouse sitting on a stretch of land with no metal detectors, no security guards, and no ‘shooter’ evacuation drills. But our children live in a different era, where there are teenagers who are taking to the streets after a high school shooting in Parkland, Florida. These young individuals are using their voices to call our legislators and leaders to action. The requests appear to be simple. Stricter gun laws. More background checks. Make it harder to obtain a weapon. Restrict access to assault rifles. However, these requests are met with chagrin from large lobby groups and investors in the production and use of firearms. These practical measures are thought to be a violation of basic inalienable rights of our country’s constitution. It is clear that this is no longer about the victims of gun violence. It is about who is best at making a point and winning a decades-old debate.

But why is my community any different from the others that have faced gun violence? Why is your school down the road any different? There are 45 reported instances of guns fired on school grounds in 2018 alone. The rapid rise of gun violence in schools over the last 5 years is eerily focused on towns and cities that are usually already known for violence. The number of children killed in one year by gun related injuries can fill 134 classrooms. But the schools that land on the front page of the newspaper are the ones from communities like Newtown, CT. Young children. Massive shootings with multiple casualties. The massive media coverage overcrowds the heart of the issue – why is this happening and how do we stop it?

Maybe we can teach our fellow parents how to keep their firearms locked and stored separately from their ammunition, as well as hiding the keys. 33% of households contain a gun, approximately HALF of them do not lock them in a safe place. Our fellow parents may seek out advice about how to handle a situation where a gun has been picked up by a child in a home. Approximately 7.4 people per day are killed unintentionally by a gun. As a concerned mother, I would suggest that within those households where this is the norm, a respect for the power and danger a weapon holds should be emphasized over and over again.

Perhaps the answer lies in the children themselves. Perhaps we ask too much of adults to provide laws and rules to follow. Perhaps what we really need to be doing is listening to our children. Providing mental health assistance to those facing depression and anxiety is as important as counseling those who have witnessed or experience gun violence. Finding out what their daily lives really feel like to them. Seek out and meet the people who spend 8 hours of their day with them, 5 days a week. Perhaps the answer to is create a community again. The atmosphere of a neighborhood. The freedom to walk down a block with no fear of gunshots or violence.

Are Cough and Cold Medicines Safe for Children?

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By Dr. Sarah Lazarus

Cough and cold medicines are commonly used, and can be dangerous. Per the FDA (Food and Drug Administration) website, these products include decongestants, expectorants, antihistamines, and antitussives. These medicines are often used in an attempt for parents to relieve their children’s coughs, colds, and allergies.

Multiple studies have shown that there is little clinical advantage between the use of placebos and cold and cough medicines in very young children. These studies have shown that cough and cold medicines do not improve sleep, or quiet cough. In fact, the dangerous side effects outweigh any benefits.

Thousands of children are treated in emergency departments every year due to secondary side effects from cough medicines. Ingredients such as pseudoephedrine, have even been linked to a number of deaths. Reasons children may experience side effects from these medications may include receiving too much medication, receiving medication too frequently, or receiving multiple cough medications containing the same ingredient.

The FDA recommends (also stated as warnings per their website) that over-the-counter cough and cold products not be used in infants or children under the age of two years. In 2008, manufacturers voluntarily re-labeled cough and cold products to state “do not use in children under four years of age”. Unfortunately, parents of children in this age range still report use of this medication. In a study done at Children’s Healthcare of Atlanta in conjunction with Emory University, the authors found that out of 65 caregivers of children under the age of six surveyed in an urban pediatric emergency department, 82% stated they would treat their children’s current symptoms with cough or cold medicines. In the demonstration portion of the study, 70% of caregivers chose medicines containing phenylephrine and 58% of caregivers would have dosed medications inappropriately per dosing recommendation labels in spite of having the bottles with associated instructions readily available. Interestingly, 20% of caregivers stated that they had previously received recommendations to give cough or cold medicines from health care providers (pediatricians, nurses and pharmacists). The majority of the potential dosing errors that were made involved giving these medications to children who were younger than the label’s recommended age for the product.

Parents and caregivers should follow the directions on labels closely regarding the indications, use and delivery of these medicines. It is important that parents and caregivers only use the measuring spoons or cups that come with the medicine. Often, parents will use a teaspoon, tablespoon or other household object to measure out these medications, and it is important to note that these are not calibrated measuring devices and may deliver inaccurate or inappropriate amounts of these medicines. These medications do not quiet cough, do not improve sleep, and are not any better than a placebo (non-active medicine) for children in the improvement of cough and cold symptoms. Per the American Academy of Pediatrics, other alternatives to cold and cough medicines include honey (2-5 ml as needed by mouth) for children over the age of twelve months. Under twelve months, honey is not considered safe (due to risk of botulism). Using a bulb suction with or without saline drops, may also help with congestion in children even younger than 12 months. Often, cold and cough symptoms are caused by viruses, so symptoms should improve in about 5-7 days without any medications.

Screening for Risky Behaviors

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By Dr. Alexis Hugelmeyer

We are losing our teenagers. We are losing them to drugs and alcohol, cigarette smoking, sexually transmitted diseases, motor vehicle accidents, suicide, homicide, depression, anxiety, eating disorders, unplanned pregnancy, gun violence, gang violence, bullying, peer pressure.

Adolescence is a difficult time for teens and parents alike. Our children are often dealing with very adult issues without your knowledge or input. The antagonism inherent in the parent-teen relationship often makes open communication difficult. Hopefully, your child has an adult, if not one of his or her parents, to confide in – perhaps a coach or teacher.

The yearly physical exam by your child’s pediatrician or family doctor is a unique opportunity for a trusted adult to capture the teen’s attention and screen for high risk behaviors. It is imperative that a physician build rapport with pediatric patients in their early childhood years so that by the time they are teens, they will trust the relationship as unbiased and non-judgmental.

My goal is that my teenage patients will see me not only as a doctor, but an advocate, a counselor, someone they can turn to with questions. My teenage patients must know that for the most part our discussions will remain confidential barring the idea of hurting themselves or others of course. This once-yearly encounter may be the only time anyone is asking about these behaviors. Most teens who display risky behaviors are afraid and desperately want someone to notice. Your child may be waiting for someone they trust to ask the tough questions. Make sure that you kid’s doctor is asking you to leave the room, so they can take the most honest appraisal. If they don’t ask you to leave, make sure you offer. Don’t be concerned about what your child might tell the doctor, be relieved that someone is asking the right questions. If the doc isn’t already, request that they spend time with anticipatory guidance.

Here is a list of questions I ask every adolescent starting around age 10. Of course, the questions depend on the child’s age and his or her risk factors…

  • Do you wear sunscreen?
  • Do you use a bike helmet?
  • Do you always wear your seatbelt?
  • Do you use drugs, alcohol or smoke cigarettes?
  • Do you ever drive under the influence of substances?
  • Do your friends ever pressure you to do things you don’t want to do?
  • Have you tried any other substances such as huffing or bath salts?
  • Are you or have you ever been abused – emotionally or physically? At school, at home or elsewhere?
  • Do you ever harm yourself? Have you ever thought about hurting yourself or others?
  • Are you sexually active? With men, women or both? Do you use protection every time? Do you use effective birth control every time?
  • Are you comfortable with your sexuality? 
  • Is there a gun in your home or in your friends’ homes?
  • Are you involved in gang activity?
  • Do you suffer from depression or anxiety?
  • How do you feel about your body image?
  • Do you binge and purge or go long periods without eating?
  • Is there an adult that you trust and confide in?
  • How are your grades?
  • Are you being bullied at school?

Don’t lose your teenager to high risk behaviors. Talk to your child’s doctor about screening and make sure he or she is asking the tough questions. Be aware that, depending on your state’s law, the physician may not be required to divulge conversations they’ve had with your teen especially as they relate to sexual activity, pregnancy, and STDs.

How Do We Keep Our Kids Safe When Dating?

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By Dr. Tiffany Rhodes

As a mother and an Ob-Gyn Physician this moment of #MeToo has struck a nerve with me. How do I raise my son to be respectful of women and navigate the minefield of dating in the teenage years? As an Ob-Gyn, how do I help my female patients to be safe in a dating world filled with some men and boys that feel entitled to their bodies and a culture that teaches girls they are responsible for inappropriate advances and sexual assault? In this article I will explore these questions and attempt to guide parents through raising boys and girls in the time of #MeToo. How do we keep our kids safe while dating?

In my opinion it starts early. When children begin to talk teach then the proper anatomical terms for their genitals. There are many reasons for this. Knowing the proper terms for penis, vagina and testicles may make children less vulnerable to sexual abuse because prospective offenders understand that these children’s parents are willing to discuss these subjects and inappropriate touching. If something bad does happen, children with proper terminology can tell what happened much easier than a child who is using terms like “cookie” or “boo boo.” While this security issue is certainly important, in my opinion, much bigger for future dating life is the effect that nicknames has on a child’s body image. Giving genitals a nickname gives the impression that it is dirty or bad and discourages questions. While it may be uncomfortable for you as a parent if you did not talk about genitals in your family, opening the line of communication at an early age will help you in the teenage years when things get much harder. Encourage questions about the penis and vagina. Always answer them open and honestly. Most importantly, do not make you child feel ashamed for asking a question. This open and honest dialogue will pay off in the teenage years when dating comes into play.

In elementary school teach your kids to say no. We are often focused on being everyone’s friend, sharing, helping others, but when it comes to our bodies we can say NO. Teach your children the following:

  1. Permission is important: this can be as simple as borrowing a toy at a young age to physical affection as they get older.
  2. It’s OK to change your mind: Even if they said Yes at first you can change your answer to No, this can be due to the experience, fear, etc. Answer of Yes is never a forever Yes.
  3. Allow Kids to say No: Don’t force affection. Allow kids to express affection of their own terms. “Don’t force a hug.” Expect others in their life to respect their decisions as well.
  4. Ask them for consent: Practice asking your children for consent. “May I have a hug?” “May I have a kiss?” This small gesture can show them that they have a say who touches them.
  5. Model the behavior: Let your children see you respecting other people’s No. Every time you respect others you are teaching your children about respect.

With this list, I am not saying that your kids can get away with saying No to you all the time to you. Believe me, my son would be out of control if I let him get away with that. I am just saying acknowledge you hear them, even though you can’t give them everything they want.

Teen Sexting Is On The Rise: How To Reduce The Risk For Phone Sextortion

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By Lisa Thee, CEO Minor Guard

Fact: 40% of child pornography reported to the National Center for Missing and Exploited Children(NCMEC) was generated by children themselves via sexting or sextortion.

In 2017, NCMEC received over 10M reports of explicit images of children

That is a 2000% growth rate from 2013.

The great news is that technology has come a long way since then.

We started in February with conducting market research.

We found some trends regarding teens, phones, social media, sexting, and sextortion.

Many of the explicit images being shared between teens were not something they were actively seeking.

They were sent directly to them via peers on social media or text.

Sexting

In schools everywhere, teens are forwarding explicit images of each other which were shared with them in private.

Typically after a breakup, they get sent to a small group and then from there they go viral.

These teens did not seem to understand that they are distributing child pornography which is a criminal offense.

We met a parent who had to cancel our interview because her 13 year old was still involved in a pending legal investigation.

She had spoken to her teen about risks of sexting weeks before he forwarded pics his friend had sent him.

Their family is still dealing with the fall out from law enforcement.

According to Human Rights Watch, children as young as 9 have been placed on the sex offender registry for sexually experimenting with their peers.[3][31]

In the US, Juvenile convicts account for as many as 25 percent of the sex offender registrants.[32]

Although many parents feel that “boys will be boys” that is not how the legal system is set up to deal with sextortion and sexting offenses.

We interviewed a single mom, who got her children cell phones when she got divorced.

She wanted to increase their safety and ability to communicate as they transitioned between her house and their Dad’s house.

While her 12 year old teen son was at camp, he left his 10 year old sister in charge of his phone.

During this time, she was exposed to explicit images for the first time because his friend sent photos of a naked teenage girl via the social media app snapchat.

One can only wonder ideas that gave her about how to be popular with boys.

She reported the issues to her mom who has further restricted his phone access and checks his content weekly.

Sextortion

We observed that teenage (11-14 year old) girls were receiving unsolicited penis pictures from their peers in school on their phones.

These sexts are from boys they have known since kindergarten.

One girl had never seen one before and responded by not talking to her “friend” for a few months.

After he apologized profusely and promised it would never happen again, she reestablished a friendship with him.

Eventually he convinced her to send a picture of herself without her shirt

He replied with lots of compliments and attention.

Then used sextortion to get her to send more explicit images

He then used them to blackmail her into performing sex acts at school against her will.

This only ended when she transferred into a home schooling program.

According to Thorn’s research only 1 in 3 victims of Sextortion report their experience to anyone.

We also spoke with parents whose 14 year old girl received an explicit image from a boy the first week of high school.

The family had known this boy since preschool.

When the victim decided to report the sexting incident on her phone to the school, the bullying began.

The boy involved was popular and told the girls that she was making his life hard.

They started calling her names and throwing food at her in the halls.

She has now transferred to an online high school.

This is the kind of bullying that can lead to teen suicide.

Call to Action

The current and future generations are digital natives and will always be ahead of adults on technology.

Especially on social media apps.

The current model that forces parents into the role of detective and technology trainer is not effective or efficient.

Among children, the average age in the US for a cell phone is 10 years old, and according the Ericsson’s mobility report that age will drop to 6 by 2020.

This will bring a new, younger wave of users into the phone market.

The adolescent brain is not completely developed until 24 to understand the long term implications of sharing explicit images.

I believe there is a large opportunity for start ups to proactivly help them to learn from their mistakes before content gets off the device.

There is an opportunity for parents and teens to support these businesses by buying products or sharing on social media.

The status quo is simply unacceptable.

Please let me know your thoughts on the issue of sexting and sextortion on phones.

 

Is Your Child Ready For Social Media? Helping Them Decide

Father And Teenage Daughter Looking At Laptop Together

By Jessica, Special Agent
Electronic Crimes, US Department of Justice, Mom, and Wife

The internet and social media are here to stay and they are always evolving, with new apps and information constantly being added.

The internet has changed how we gather and share information and how we interact with others.

Social media is just one aspect of the internet and a tool we all use to share with others.

Our children have grown up with the internet and social media apps, they don’t know a world once existed without it.

For our children, the internet is a way of life…social media is a way to communicate both positively and negatively with their peers.

As parents what can we do?

We can try to fight the inevitable, what we know is already out there or we can accept it as a tool.

We can educate ourselves and our children, about the upside and pitfalls of the internet and social media.

I believe as a parent, we know our children better than most.

As parents we know the dangers that lurk out there on the internet.

It is up to us to know whether or not our children are ready for social media and the internet.

It is our duty to inform our children and educate them on it.

Here are a few questions you can use with your child:

What is your understanding of social media?
Why do you want social media?
Account security? Do they know what that means? (For younger children this may not apply)
Do they agree to allow parents full access to accounts? If no, then child doesn’t get to sign up.
Here is how the conversation went in my house:

My son is 11 years old…my husband and I decided this past year that he was responsible enough to have a cell phone.

We went over the “rules and responsibilities” of owning said device, and installed parental apps to monitorhis usage and activities.

This included getting alerts whenever he tried to download a new app.

Fast forward to several months later after our son received his phone.

I was downstairs and my phone alerts me to a new email.

The email tells me that someone is trying to set up an Instagram and Facebook account on my son’s phone.

I call my son downstairs and ask him if he’s trying to set up these social media accounts.

I explain that he’s not in trouble but I need to know if he’s the one trying to set these up.

He looks sheepishly at me and says, “Yeah”.

I begin the discussion by asking him why he wants to establish these accounts and if he understands the responsibility of owning these social media accounts.

I can see the look of confusion about, “Responsibility? But it’s just Facebook and Instagram.”

He tells me that his friends have social media accounts so he wants to be like them.

We discuss his choice of a profile name and password….because I notice they are identical.

I explain to him that for account security they should not and cannot be the same.

He looks surprised and says, “Oh!”

I then go into the concerns about people that pose as others (you know the adult creeper that pretends to be a child), cyber bullying etc.

I’ve had these “talks” with my son before but he’s eleven and probably tuned me out the last time and forgot the rest.

I can see the wheels turning in his head, the look on his face changing from (“oh great, mom is going to say no again”) to….”I didn’t think about that”.

In a matter of minutes my son exhales a big sigh, looks at me and says, “I guess I’m not ready for social media yet”.

Bear in mind, these conversations should be age appropriate and they should be frequent.

I didn’t have to use that dreaded two letter word kids hate to hear (N-O), instead I gave my son the ability to think about it and decide.

But to be honest, if he hadn’t decided for himself, I would have said no because he’s not ready.

Teen on Social Media

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By Deputy Attorney Bruce Chang

Technology is advancing at unprecedented speeds, seemingly making the world smaller and connecting people in ways that appeared in the science fiction of the past. When I was a boy, I remember my mother writing to relatives in China on razor-thin airmail paper and waiting weeks for a reply. Now I can video tour my sister’s home in Europe in real time. Like all progress, there are consequences and problems that arise from making it so easy to connect with strangers around the globe on your social media and phones.

In my first career as a public school teacher, I watched many students grow from kids to teens to young men and women. One of the most difficult times is the middle school years. This is where many students faced the age-old conflict of trying to make decisions like independent people while also wanting to please/impress their peers and test their limits with parents and teachers. As a teen, I remember how my “nosy and annoying” parents drove me crazy by asking me questions about who I hung out with, what we were doing, and where. I was determined to live my own life and tune out many of their lectures. For me as a teen and many of my students, this would unfortunately lead to risky behavior and reluctance to tell supportive adults what happened after something bad happened.

In my current assignment as a cyber crimes prosecutor, I handle many cases where teens do not appreciate the potential results of using social media and digital technology from their phones. Many cases tend to fall into two categories:

  1. Sharing Digital Images: these can start off simply enough, sending semi-clothed or nude selfies to boyfriends/girlfriends, sexting. Often, a recipient of a sext promises not to share the image, but the images mind up being disseminated for a number of reasons — relationship ends, peers sharing with other peers, etc. — all of which may result in issues such as bullying, anxiety, depression, self harm, suicide, and sextortion.
  2. Meeting Strangers via Social Media: there are so many social media apps available on phones that it is hard for law enforcement to keep track of everything. Teens will start chatting with online strangers and in the best case scenario, they are communicating with someone they know absolutely nothing about (age, location, criminal record). In the worst case scenarios, I’ve handled cases where adult men posing as teens create a relationship with a child or teen and arranged for nude images, sexts, and midnight meetings, at times resulting in sextortion or sex trafficking.

As a parent, it drives me crazy to watch my kids taking gag videos of each other with their tablets or phones. I keep telling them to remember that once digital information is shared, it is almost impossible to unring that bell. I find myself lecturing that the best way to stop personal information from being available to the entire world is to use good judgment in not taking/posting at all.

From all of my experiences as a teen, teacher, prosecutor, and parent, I hope that technology will evolve that will help to protect our teens from themselves. Until then I intend to be the same “nosy and annoying” parent that my parents were!

 

Common Sense versus Common Senseless

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By Bailey Danielson, Age 19

After a lot of persistence accompanied by complaints of being the only one of my friends without a phone, my parents finally gave in. I got my first phone late compared to my peers. I was nearing the end of Middle School already. Why shouldn’t I have a phone at that point?

I didn’t have a real reason to need a phone. I merely wanted one because everyone else had one. “You want me to be the weird kid?” seemed to be a good selling point for me, and I ran with it.

The tech savvy world from a tech savvy teen

Being a teen immersed in one of the first generations that got phones at young ages, I’ve seen how it can be used for both good and evil.

I am a full believer in that teens without phones are unfairly, although not purposely, ostracized by their peers. Who’s all going to the sleepover? Everyone in the group chat for it. Sometimes it’s not even because teens don’t make the effort; it’s because “I forgot to tell my mom to call your mom” or “my mom forgot to call your mom” issues that all could have been avoided if the teen just had a phone.

Given that, it’s a shame that this is the case. The tech world is a scary place. I easily concede to that. Meeting and forming bonds with strangers is easy and becoming normal when it shouldn’t be. Stranger Danger is still very relevant.

I consider myself a bit abnormal as a teen. Part of me wants to make this distinction between myself and a lot of my peers merely because I see them do stupid, unsafe, and common senseless things with and even without their phones. Although, a majority of these actions take place on and because of phones.

Safety versus Success

When it comes to phones and social media, I bet every parent considers common sense to be in the premises of don’t post stupid content and don’t interact with strangers. Well, unlike parents, teens would consider tech common sense to be in the vicinity of post during prime traffic hours, post content that makes me look cool, and get as many followers, likes, and comments as possible. Beyond this, a lot of what is common sense for teens helps them outsmart their parents when it comes to restrictions and monitoring.

I’ve never had to outsmart my parents and I still can tell you a boatload of ways I could get around whatever monitoring or restrictions they could set in place. Vault apps, hiding apps, non-permanent deletions, using code words or emoji are all basic strategies that come to mind without any effort. With the tech savvy generation, there always seems to be a loophole.

In their endeavors, kids aren’t trying to be malicious; they just want to fit in and have freedom. The conflict between parents and teens about social media usage isn’t complicated. Common sense for parents means safety, but that safety hinders what common sense means for teens: success.

Bridging the Gap

As a teen, I would suggest not approaching the situation authoritatively, but instead with a willingness and eagerness to understand. If there is some underlying reason they hunger for social media success, other solutions may be more suitable.

Setting boundaries may be the best solution in general, but make sure to compromise. If you set boundaries that are too restrictive and obviously based on only or mainly your version of common sense, they’ll just use their common sense to get around them. When bridging the gap, compromises will be your best friend. When done right, it’ll be your teen’s best friend too, and the responsible one at that.

 

Are you a bully or an ally?

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By Diya Mittal, age 12

Bullying. It’s a word that we all know. It’s something that we have all probably experienced or participated in. Have you ever been a bystander? Or an ally? I have been both.

The victim in this story will be called Steve for his privacy.

At the beginning of sixth grade I noticed that people in our group made more jokes about Steve than any other person in our group. At first, I ignored it chalking it up to the fact that he wasn’t very friendly and sometimes insulted people.

As the year went on, I realized that people were targeting him. I really wasn’t sure what to do so I pretended I didn’t notice, after all, he was being mean back, right? Plus, the people bullying him were my friends and so I felt like I couldn’t tell on them or contradict them.

Then, one of my best friends said that Steve had insulted her because she was black and he had said something racist. Everyone was horrified that he would do that and the complaints were finally made to teachers.  It blew up into a big thing, nobody would talk to him or sit with him. Then we found out that Jenny had been lying, Steve had never said that stuff and the few witnesses had just played along with Jenny’s lie.

I was furious. She had basically ruined his social life for no reason, he had never been mean to her! All my friends forgave Steve but pretended that Jenny had done nothing wrong. Still, when we went on our class trip, everyone bullied him as usual.

Finally I decided to do something, I talked to a trusted teacher, and started hanging out with Steve. In doing so, I realized Steve was really nice and funny. This made me feel much better about the situation and i’m sure it made him feel better too.

My biggest worry was that my friends would be mad at me but they got over it – though they didn’t really change their behavior. By becoming an ally I felt much better about myself and was able to improve Steve’s situation.

 

Trampoline injuries. When jumping isn’t fun anymore.

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By Dr. Derya Caglar

Trampolines provide huge fun for kids and adults of all ages. Initially engineered as a tool for gymnasts and subsequently used in military training, these days many families enjoy jumping in the backyard while others spend the afternoon at a trampoline park. You get exercise and it’s a great outlet for high energy kids. So why are health experts increasingly recommending families avoid recreational trampoline use[1]? And is avoiding trampoline use altogether the only way to keep your family safe?

Injuries from trampolines accounted for approximately 100,000 emergency department visits per year between 2002 and 2014, costing $1 billion. [2] Children are the most frequent users of trampolines, and thus suffer the bulk of all injuries. Most injuries tend to happen when more than one person jumps together, with the risk of an injury increasing exponentially as the number of simultaneous jumpers increases. The youngest jumpers, under the age of 6 years, are at the highest risk of injury, though older jumpers tend to have more serious injuries. More than 95% of all injuries occur at home, despite an AAP warning against home trampoline use in 2012[1].

The vast majority of injuries are musculoskeletal, mainly involve the upper and lower extremities, with bruises, broken bones, and ankle and knee sprains being the most common. While this accounts for most injuries, serious injuries can also occur. Spine and neck injuries can lead to paralysis, weakness, and even death. 0.5% of all trampoline injuries (and while that sounds small, that’s 1 in 200) lead to permanent neurologic damage. In many cases, jumpers were doing somersaults or flips and landed poorly. Any neck or back pain after a trampoline injury should be immediately evaluated for possible neurologic damage. This is particularly important if jumpers are experiencing any weakness or sensory changes in their arms or hands.

In an effort to make trampolines safer, manufacturers have encouraged the use of netting to enclose jumpers, and padding to cover springs and other hard structures. Studies, however, have not shown any decrease in injuries with these measures [2]. Some argue that these measures may, in fact, lead to riskier behavior due to a false sense of security. They may also be improperly installed or less helpful as they are worn down through use.

Despite recommendations to avoid trampoline use, many families choose to jump. If children are going to use trampolines, there are things you can do to decrease the risk of injury.

  • Make sure jumpers are age 6 and older. 
  • The equipment should be dry.
  • Trampolines should be regularly inspected for evidence of wear and tear and should have adequate, properly installed protective padding.
  • Equipment should be placed on level ground away from trees or other overhanging structures, and shouldn’t be placed on hard surfaces like concrete or asphalt.
  • Any damaged parts should be repaired or replaced before use.
  • Children should only jump one at a time and always under constant adult supervision.
  • Jumpers should avoid flips and somersaults, and should never jump off or use other equipment ( ie ride bicycles) on the trampoline.

In addition to these safety measures, as an added precaution, families should also review home insurance policies as most do not cover injuries related to trampoline use. A separate rider may be needed to provide adequate coverage.

Though trampolines can provide endless entertainment for children, families should consider the risks and benefits of their use and if they choose to keep jumping, use every measure available to decrease the likelihood of injury.

References

[1] Briskin S, LaBotz M; Council on Sports Medicine and Fitness, American Academy of Pediatrics. Trampoline safety in childhood and adolescence. Pediatrics. 2012;130(4):774–779pmid:23008455

[2] Loder RT, Schultz W, Sabatino M. Fractures from trampolines: results from a national database, 2002 to 2011. J Pediatr Orthop. 2014;34(7):683–690pmid:24686299

 

Water Safety

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By Dr. Crystal Sparling

Just when you thought it was safe…

Early last summer I found myself in one of those slow-motion time warps that every mother knows and dreads. I stepped outside and saw my daughter struggling in the deep end of our friend’s pool. She floundered and gasped for less than ten seconds before she was scooped to safety by a nearby adult but we were both shaken up. This minor close-call was a reminder of how tragedy can strike in an instant.

As a pediatrician, water related injury is very high on my worst-case scenario list. Ask any Pedi Mom about water safety and they’ll have a heartbreaking story to share. And it’s no wonder. The numbers on water related injury and death are startling. According to the CDC, about ten Americans die from unintentional drowning every day. On average, two of those are children younger than 14. In addition, for every child that dies from drowning, another five children visit the emergency room for nonfatal submersion injuries. Those kids often have devastating brain injuries that result in permanent disability.1

So how do we keep our kids safe around the water? The key is not to take your kids’ safety for granted. Every second counts. Check out these simple interventions to reduce the risk of water-related injury.

  1. Pool Fences and Other Barriers: Most drownings in children under the age of four occur in home swimming pools. Strong, four-sided pool fences are most effective at reducing the risk of injury. The fence should completely surround the pool, not have footholds for climbing, and be equipped with a self-latching gate. Don’t forget to secure hot tubs, garden ponds, and other water features. Above ground pools should also be protected by a fence because kids can fall over or through the pool wall.2
  2. Swim Lessons: Children over the age of one that have had formal swim lessons are at lower risk of drowning. Make sure your kids are strong swimmers and teach them about water safety.
  3. Equipment Safety: Suction from pool and spa drains can trap kids underwater. Make sure all drain covers and pool equipment are functioning appropriately. It’s a good idea to keep a rescue hook near home pools. If your child will be using a life vest in any body of water, make sure it fits properly.
  4. Eyes on the Water: Nothing takes the place of close supervision. Never leave a child unattended in or near the water under any circumstances. Don’t assume that any floatie or life vest will keep your kids out of trouble, and remember that even good swimmers can drown. Many injuries take place when a lot of adults are around and everyone assumes someone else is watching out for the kids. Designate a responsible adult to watch the water at all times and consider hiring a lifeguard for parties.

It doesn’t get much better than the pool or beach in the summertime and swimming is a great physical activity for the whole family. Take the proper precautions to protect your family so you can continue having fun in the sun. For more information, you can check out healthychildren.org and safekids.org. Stay alert and have a great summer!

:::

Crystal Sparling, MD, MPH

Dr. Sparling is a mother and a board-certified pediatrician with experience in outpatient pediatrics, hospital pediatrics, and public health. She is a co-founder of Scissortail Pediatrics in Blanchard, OK. www.scissortailpediatrics.com

References

  1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. [cited 2012 May 3]. Available from: URL: http://www.cdc.gov/injury/wisqars.
  2. Thompson DC, Rivara FP. Pool fencing for preventing drowning in children. Cochrane Database of Systematic Reviews 2000; 2.

 

Firearm Safety at Home

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By Dr. Kati Eisenhuth

Let’s do a thought experiment about our kids’ safety. Let’s send our kids on a hypothetical playdate to a friend’s house. I have boys, so in this scenario, I’ll send my oldest son. Here’s how my drop-off goes: I let the other parent know my son has tummy trouble. He shouldn’t have too much junk food. Fruit is OK. I hand over a bag with sunscreen, extra clothes, and a helmet, just in case wheels are involved. “Be good,” I tell my son. I flash that Mom look and give him a hug before he wiggles away. I make sure the parent has my number for emergencies and I thank them.

Did your drop-off go like mine? What did we miss? We left them with good people and we’ve sent them there before. They should be fine, right?

But how safe are they if there are guns in the house? What if the guns are unlocked and loaded?

I never asked about guns until something happened. It was one recent day when my son followed his friend into his family’s garage. My son had just arrived and, when they spotted each other, the boys were struck with an overwhelming burst of energy and excitement. While I spoke with the parents, the boys thundered into the garage, my son right on the heels of his friend, to find the balls that were kept in a mesh bag just inside the door. They dumped the bag and balls bounced all around, some coming to rest beside a duffel bag strewn a few feet away. Suddenly, the friend’s attention shifted. He raced to the bag, picked it up, pulled on the zipper and held out a rifle. The rifle had been left outside the lock box after a weekend trip to the hunting camp and, to this day, I have no idea if it was loaded or not.

There were three parents watching that day, laughing at the motor-like activity of young boys, when the rifle emerged from the bag. It got snatched away immediately and there was no harm done. But how often do we look away? How often are we in the next room? It doesn’t take long.

My son didn’t touch the gun that day. He barely got a peek before it was slammed into a locked cabinet and my heart palpitations slowed to a steady rhythm. I walked away feeling confident. My son would never have laid a finger on a gun. Right?

What would your child do?

I talk to my son about guns. He is dutiful in his response when I ask him, “What do you do if you see a gun?”

He knows to say, “I don’t touch it, Mom.” This lets me breathe a mini-sigh of relief. I smile and feel proud and safe. But truthfully, I shouldn’t. My son is about to turn six and there is good evidence that my heart should keep skipping beats. Enough to remind me to ask questions every time I leave him in another house.

A 2001 study at Emory looked at the behaviors of 8-12-year old boys. They were sent with a friend or a sibling into a room, where a gun was hidden in a drawer. Seventy-two percent of the groups found the gun and, when found, 70% of the boys handled the gun. Gut-wrenchingly, 48% pulled the trigger.

When I read this study, I thought to myself, but my son would remember what we talked about. He would remember what to do. He would hear our voices echoing through his mind at the crucial time and never touch that gun.

That’s what other parents thought as well. Seventy-four percent of gun-owning parents believe their child would leave a gun alone if found. Because they talk to their kids about guns and safety. But 90% of the boys in the above study who handled the gun had received gun safety instruction beforehand.

So, I asked my son again what he would do if he found a gun just lying around. He gave me that look and recited the magic words that used to make me feel better. Then I asked him, “What if you thought it might be a toy?”

And this is when my heart started up again: He said, “If I think it’s a toy, then it’s ok, Mom. Right?”

In the above study, half of the boys thought the real gun was a toy.

Let’s do another experiment. This one’s harder. Let’s say our kids are a little older. Maybe early adolescents. They’re moody and when you ask them questions about their day, they offer one-word answers. They no longer want to play basketball like they used to love and instead prefer to spend their time sprawled on their bed alone, browsing Facebook. You can’t remember the last time you saw a smile.

As parents, what action should we take?

No one wants to think about their own child and suicide with the same neuron. Yet, suicide rates are rising in the US, particularly in kids. From 1999 to 2014, suicide tripled in 10-14-year old’s and increased by 50% in 15-24 year old’s. According to the CDC, suicide is the third leading cause of death in kids age 15-19 and guns are the most common method in this age group. Fifteen percent of US adolescents in 9-12th grades seriously consider suicide. The risk of suicide in a teen is increased by simply having guns in the home. This increased risk occurs even in teens without a previous psychiatric diagnosis.

If we have a teenager, what should we do with respect to firearms in our home?
This is a bit like preaching abstinence. Obviously, the most reliable way to keep our teens safe from firearm injuries at home is to not have firearms. But one third of households do. There are other measures.

Simply locking a gun reduces the risk of death or injury by 73%.

I am often told that keeping a gun locked and unloaded defeats the purpose of having one. Seventy-five percent of gun owners do so for self-protection. But here are some scary facts:

  • A gun is 43 times more likely to be used against a family member or friend than a criminal.
  • In the event of an assault, a person in possession of a gun is 4 times more likely to be shot than someone without a gun.

Given these numbers, it could be argued that protection is better achieved with safe storage of the gun.

Guns kill 1,300 children per year. Half of these are homicides, 38% suicides, and 6% are unintentional. What can we do to keep our kids safe? Here are three strategies:

  • Safe gun storage. Forty-three percent of firearms are stored in an unsafe manner, including 13% stored unlocked and loaded. Locking a gun reduces injury risk by 73%.
  • Education. Talk to kids about guns, about steering clear and alerting an adult if they spot one. This is important but we need to realize that in our youngest children, these conversations are merely planting safety seeds. We need to aim our largest efforts at parents because research shows that even well-informed children handle guns when confronted with them.
  • Ask about guns. Don’t let your kids visit another house without finding out the gun status first. If there is a concern, invite the kids to play at your house.

Welcome Home Baby!

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By Dr. Jennifer Kurtz

You’ve waited about nine months for this, and perhaps you’ve been waiting for this your whole life. You’re a mommy. No matter how you arrived to mommyhood, someone is handing over this tiny little person into your care, and you are about to take him/her home. Well, now what?

As a mom of two, and a pediatrician, I have some insight into how those first few days are going to go, and allow me to give you some do’s and don’ts that may alleviate some of the anxiety surrounding welcoming your darling baby home from the hospital.

Before you leave the hospital parking lot:

    • DO make sure you car seat is installed correctly. There is a great article about car seat safety HERE. If you are confused about installation, and YouTube videos aren’t cutting it for you, you can likely head to a fire station for some assistance. (And I know in some areas, there is an actual “Carseat Lady” who is an expert on installation.)
    • DON’T forget to add your newborn to yours (or your partner’s) insurance plan. This is something you will probably forget the moment you get home, so take care of this before you leave the hospital.
    • DO have an appointment with the infant’s pediatrician set up before you leave the hospital. That first newborn visit is a big deal, and it may just be a comfort knowing in 2-3 days that you will be seeing your baby’s doctor.
    • DO make sure you have the basics at home. Diapers, formula (if you are using it), baby wipes, bottles (if you are using them), and clothes. Everything else can be purchased once you are home from the hospital!

Once You Arrive Home:

  • DO give yourself a moment. There may be thirty family members that can’t wait to squeeze your bundle of joy, but a quiet entrance to home is ideal. A complete stranger is moving into your house FOREVER, and you may not even be sure where to put him/her. Give yourself and your partner a few hours to adjust to having your new family member without having to act as host to family and friends.
  • But DON’T be afraid to ask for help. Having a family member, friend, or baby nurse stay with you for the first few days home (or weeks) is incredibly helpful. Having someone around to help cook, with laundry, or allow you a few minutes to shower, use the bathroom, and take a nap will mean the world to you.
  • DO designate safe sleeping areas for the baby. The SAFEST place for an infant to sleep is in his/her crib, on his/her back, on a firm mattress. However, your baby will not be spending the entire day in his/her crib. Other appropriate sleeping surfaces are a bassinette or moses basket, rock-and-play, swing, pack-and-play, amaroo…well, the list goes on and on. However, make sure that all of these items are bought from trusted manufacturers, have no recalls, and that all safety precautions (seatbelts, etc) are followed. Additionally, make sure you are watching your infant, at least every few minutes while they are sleeping in something other than their crib.
  • DON’T freak out about a feeding schedule. You may have read tons of baby books, many of which schedules for your baby with the goal of getting a full night’s sleep. This is great, but entirely not appropriate for a newborn. Your infant may want to eat every three to four hours. Or every two. Or every 45 minutes. All of this is NORMAL. Breastfed babies tend to eat more frequently, and again, this is normal. Do not panic if for the first few weeks it seems like all you are doing is feeding your baby. As the weeks go by, you may want to consider sticking to a feeding schedule, but do not consider doing so in the first few days. Just go with it!
  • But DO attempt some normalcy. Keep the shades open during the day to allow sunshine into you house, and keep your home at a normal (ie, one where you are not sweating) temperature. Try to keep you infant around during daytime to hear normal conversation, and background noise so he/she gets used to it. Designate a time for bath, “bed”, and drawing the curtains. This sets your baby up for a normal circadian rhythm, and helps he/she adjust to day and night.
  • DON’T be afraid of the outside world. Unless it’s freezing, snowing, or raining, there is no reason you cannot strap your newborn into his/her stroller and go for walks. Or for a drive in the car. The fresh air is good for you and your baby, and is definitely something I recommend for all new moms! But on that note, DO avoid crowded spaces (indoor shopping malls), and sick contacts.
  • DO take time for yourself. This can mean anything from a long shower, a walk outside, or a manicure. It can mean a dinner or a movie with your significant other. You are still the YOU that you were before your baby entered this world, and that is nothing to feel guilty about. When your baby sees you calm and happy, then he/she will be calm and happy.
  • Lastly, DON’T forget to enjoy this time. Having a newborn is exhausting, and for most, this time goes by in an absolute blur. Take pictures, savor the snuggling, the nursing, and that yummy newborn smell. Before you know it, you will be chasing after a muddy toddler!

:::

Dr. Jennifer Kurtz is a Attending Neonatologist.

A Tough Pill to Swallow: Teens and Prescription Drug Abuse

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By Dr. Jacqueline Winkelmann

Teens don’t have it easy these days…social media, celebrity influence, school pressure. It’s no surprise they’re looking for ways to reduce stress or anxiety, help with school or athletic performance or just take a break from reality. Teens are vulnerable, and biologically predisposed to taking risks. Unfortunately, they have a much higher predisposition to addiction later in life. As a parent to a 12-year old boy and a 17-year old girl, I’m right there, living it day to day. As a hospital-based pediatrician working in the ICU, I see the tragic consequences of not dealing with this issue head on. So let’s talk about the facts, the warning signs and the action plan.

The Painful Truth

  • About 2,500 teens abuse prescription drugs for the first time EVERY DAY in America.
  • More Americans die from prescription drug abuse than from cocaine, heroin, ecstasy and methamphetamines COMBINED.
  • Prescription painkillers are the drugs of choice among 12- and 13-year olds.
  • Almost 70% of those who abuse prescription medications report they get them easily from family and friends.
  • The most abused prescription drugs among teens are opioids (Oxycodone/hydrocodone, Oxycontin and Vicodin), central nervous system depressants (Valium, Xanax), and ADD/ADHD meds (Concerta, Adderall, Ritalin).

We can all agree that prescription and over-the-counter drugs can lead to addiction, serious health problems or overdose and even death. Despite this knowledge, less than half of teens see these medications as dangerous and most do not believe they can be harmful; after all, they are legal, prescribed by a doctor and used by their own parents for pain or anxiety. Teens believe prescription drugs are MUCH safer than illegal “street” drugs.

The Warning Signs

As parents, staying informed and vigilant can literally save our child’s life. What do we look for? Here are a few signs that something might be going on. Keep in mind that some of these changes can be a normal part of adolescence-why can’t we catch a break? We have to be providers and role models and now detectives. But believe me, this one is one not to skip.

Behavioral changes

  • Has changed relationships with family members or new friends
  • Avoids eye contact or even conversation with parents
  • Locks bedroom/bathroom doors
  • Sudden increase in appetite at home
  • Disappears for long periods of time
  • Loss of interest in extracurricular activities, hobbies or sports
  • Declining grades in school or trouble with work

Mood personality shifts

  • Mood changes or emotional instability
  • Sad, withdrawn, depressed
  • Silent, uncommunicative
  • Hostile, defensive, angry, uncooperative
  • Less motivated
  • Unable to focus

Health & Hygiene Issues

  • Unusually tired, slow to move
  • Runny nose, not caused by allergies or illness
  • Changes in weight (weight gain or loss)
  • Excessive thirst
  • Poor hygiene, messy appearance
  • Red, flushed cheeks or face

Don’t Panic! When I read this list, I said to myself: “check, check, holy cow check!” Yes, teens can be moody and more tired and sometimes unable to focus (thank you IG and Snapchat), but only YOU know your child, and only YOU as a parent can know if these changes are more than just a “teen phase.” If your teen checks more than the usual boxes, get help! Start with your child’s pediatrician or family doctor and voice your concerns.

The Action Plan

What can we do as parents? The first challenge is to become aware of the problem, educate yourself about the issue and remain vigilant. Sadly, on a recent survey, only 24% of teens reported that their parents had talked to them about the dangers of abusing prescription drugs. The Partnership for Drug-Free Kids (https://drugfree.org)
recommends a 3-step approach for parents: (1) educate, (2) communicate, and (3) safeguard.

Educate

  • Educate yourself on the dangers of medication misuse among teens and be aware of the statistics for your area.
  • Learn about the signs of drug abuse in teens.
  • Encourage schools to include prescription and over the counter drugs when discussing drug abuse in middle schools and high schools.

Communicate

  • Talk to you child, over and over, about this dangerous and potentially deadly problem.
  • Make your child aware of the fact that even legal medications prescribed by doctors can have SEVERE consequences when misused and abused.
  • Communication needs to start early! Early middle school is a great time to have open and honest discussions with your child and remember the message will need to be reinforced over the years.
  • There are some great documentaries to start a conversation with your child.
    Behind the Orange Curtain
    Overtaken
    The Other Side

Safeguard

If your child/teen has been prescribed an opioid for pain control after an injury or surgery, make sure you discuss with him/her the dangers of taking more than has been prescribed, the potential for addiction, and take charge of dispensing the medication. Keep all pills in a secure location.

Dispose with care! Prescription drugs should be disposed of properly. NEVER flush them down the toilet! Pills should be crushed, mixed with coffee grounds or cat litter, and placed in a can or bag before throwing them in the trash.

There are prescription medication drop-off boxes in many police departments and even some pharmacies nationwide. Check with your local pharmacy or go the Drug Enforcement Agency website.

Jacqueline Winkelmann, M.D., known as Doctor Jacq, has been a hospital-based pediatrician at CHOC Children’s Hospital in Orange County since 2001 and most recent Chief of Staff at CHOC Children’s at Mission Hospital. Doctor Jacq has a special interest in sports nutrition for young athletes, teen issues and the drug epidemic, and baby/infant/child product safety. You can learn more at www.doctorjacq.com or contact her at jacq@doctorjacq.com.

Laundry Detergent Pods: Convenient and Dangerous

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By Dr. Amanda Valdez

laundry-detergent-podWhen my son started crawling, I approached child-proofing our home like most everyone does. Outlet covers, cabinet locks, a few foam covers on especially fierce edges and corners. I moved anything that could potentially be dangerous if played with or ingested up high or into locked cabinets. I was feeling pretty on top of it.

One afternoon, my son was on my hip as a threw in a casual load of laundry. In a millisecond, his ninja-like hand reached over and dumped over my bag of Tide Pods, sending them scattered about the dryer’s surface and the floor. Had I already taken one out of the bag and set it down before use, he likely would have grabbed the pod itself. “Oh my gosh!” I thought, scrambling to get them put away. It was a reminder of how quick a six month old can be. I had always used detergent pods, despite having a specific interest pediatric injury prevention even before I became a mom. I fell into the mindset of “It will never happen to me.”

The Problem

Laundry detergent pods are single use packets of very concentrated laundry detergent encapsulated in a thin membrane designed to burst when they become wet. They are extremely convenient compared to a clunky, messy jug of traditional liquid detergent, making starting a quick load of laundry much simpler. They are also colorful, and to a small child, look a lot like a really tasty treat. They are more toxic than regular old laundry detergent due to some ingredient differences as well as the dense concentration of the soap. When one is placed inside the mouth, it only takes a few seconds for the liquid to release and be either swallowed or aspirated into the lungs. The concentrated material is extremely irritating to the oropharyngeal tissues and membranes (the tissues in the mouth and throat) and can cause them to swell, narrowing the airway. This is especially problematic in babies and small children as their airways are already small. While the most common effects with oral exposure are vomiting, coughing/choking, and drowsiness, additional serious effects that have been documented include coma, seizures, pulmonary edema (water on the lungs), abnormal heart rhythm, and respiratory arrest. Exposure of the pod contents to the eyes is an additional danger, which can cause abrasions to the corneas. Needless to say, these products work wonders for easing our laundry burdens, but are extremely dangerous to children.

The Stats

Laundry detergent pods have received a considerable amount of press in recent years. That is because thousands of exposures in young children have occurred since the product’s release in the US marketplace around 2012. A study out of the Center for Injury Research and Policy and Nationwide Children’s Hospital in Columbus, OH reported over 17,000 detergent pod exposures in children ages 6 and under, over a two year time span (2012-2013). In 35% of cases, the child was seen in an urgent/emergency care setting, and of those, 12% of children who were exposed via oral ingestion were admitted to the hospital. There was one confirmed death in an infant. In the years following, the number of exposures (documented by calls to the Poison Control Center) increased by 17%. According to the Poison Control Center, over 2600 exposures have already been documented for a 4 month period in 2018.

Pod Safety at Home

Certainly utilizing traditional liquid detergent in your home would eliminate much of the risk to your children in regards to pods specifically. However, should you have children as well as choose to use laundry detergent pods in your home, it is vitally important to exercise extra diligence in preventing a pod related injury from happening to your child. Most of the large producers of detergent pods have developed special seals and lids for their products. Tide (who holds the largest share of the pod market), even has a new “Child-Guard” feature for both their tub and bag products.

Consider these scenarios and guidelines:

  • All household cleaning products, including pods, should be stored high-up and behind child-proof doors. After use, they should be replaced immediately after you are done using them. Don’t rely solely on packaging seals and locks to keep your child safe.
  • Purchase products with tightly sealing packaging features and use them correctly. Snap the lid shut or tightly seal the resealable bag products. Even though they are being stored out of reach, check and double check that they are closed tightly.
  • Never set a pod down on a countertop, on top of the laundry machines, or in a basket of laundry. The pod should go directly into the washer and the container should be closed immediately. Remember how persistent your child is to get to an object he or she is fixated on.
  • Even if your child is out of “everything in the mouth” phase, always keep in mind how exciting a detergent pod looks to a child. Think of this in comparison to a spray bottle of cleaner for instance, which even in the case of a child getting ahold of it, typically requires a larger grasp to operate. A pod fits perfectly in a little hand and looks delicious.

Dr. Amanda Valdez is an anesthesiology resident in Seattle, Washington. She plans to pursue pediatric anesthesiology.

References

American Assoiciation of Poison Control Centers. Laundry Detergent Packets and Children. Retrieved from http://www.aapcc.org/alerts/laudry-detergent-packets/. 2018.

Stromberg, P.E., Burt, M. H., Rose, S. R., Cumpston, K. L., Emswiler, M.P., & Wills, B. K. (2015). Airway compromise in children exposed to single-use laundry detergent pods: A poison center observational case series. The American Journal of Emergency Medicine. 33(3), 349-351.

Valdez, A. L., Casavant, M., Spiller, H., Chounthirath, T., Xiang, H., & Smith, G.A. (2014). Pediatric Exposure to Laundry Detergent Pods. Pediatrics, 134 (6).

The Alarming Increase in Nationwide Suicide

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By Suha Malik, Age 15

Not that long ago, the world was struck with the news that Katherine Noel Brosnahan, professionally known as Kate Valentine or Kate Spade, committed suicide by hanging herself with a scarf, on June 5th, 2018 in her Manhattan apartment. Only three days after this tragedy, famed and esteemed celebrity chef Anthony Bourdain also committed suicide, hanging himself with a bathrobe belt in his hotel in France. The deaths of these esteemed celebrities push the topic of suicide into the spotlight, both nationally and internationally. Obviously there’s a problem because people who we consider to have perfect lives are so depressed and anxiety-struck that they decide that they cannot bear it to continue their lives, coming to the decision to end them. While it is apparent that suicide rates continue to increase, what may startle some people is the fact that an increased number of teens are deciding to commit suicide.

Suicide is the second-leading cause of death in children, teenagers, and young adults. According to the American Academy of Child and Adolescent Psychiatry, or AACAP, suicide is often seen by teenagers as a way out of their overwhelming problems, and can be caused by, “feelings of stress, self-doubt, pressure to succeed, financial uncertainty, disappointment, and loss”. It’s important to note that all of these things are true, but some may argue that the majority of these things are caused by the stress, lifestyle, and livelihood of school.

The basis for this argument is the fact that teenagers spend most of their time in school, and their thoughts are often revolving around the concept, whether that be homework, exams, tests, or even the fellow students and teachers there. Students are often under pressure to succeed, as AACAP stated, to get good grades and do very well in high school because this is how they are going to shape their future; it’s the determining factor for if they can get into college, if they are deemed educated enough to get a job straight away, etc. Teenagers can also develop suicidal thoughts because of bullying: this may seem cliche, but it is very, very true.

Bullying can be verbal, physical, cyber…the list can go on. Repetitive acts of bullying can drive a student to depression, the factor that mostly causes suicide and is most associated with it. Depression, though, can be caused by large factors – or even just one – as well as a series of smaller factors built up over time. Many may simply ask why these students do not inform others of the bullying that they are experiencing, but again, the answer is startlingly simple and troublesome. Bullying goes on too much during school, and kids do not tell any adults or parents because then they are given a negative stigma for being a “snitch”, “crybaby”, or not being “man” enough to take some “teasing”. Sometimes, students are too embarrassed to tell anybody about the amount of bullying they’ve been the victim of. A more serious reason why teenagers do not express their concerns over bullying they may be receiving is because the adults that they would go to in school simply do not do anything. Teachers may brush severe bullying off as teasing, immaturity, or the result of bad attitudes. Principals may not want to take any action against the bully for fear of parent retribution. I am fortunate enough to say that my current school is not like this at all, that they action whenever necessary, and do not tolerate any forms of bullying, but other kids may not be so lucky.

Because of this reason, it is essential and critical that others around teenagers are able to recognize warning signs, as well as signs of depression. Depression is a treatable mental disorder, and getting someone the help they need may be just the thing that stops them from ending their life. One article, titled, “Schools one part of complicated response to teen suicide, experts say”, stresses the fact that, “…schools play a ‘huge role’ because students spend much of their time there, but getting families involved is crucial. [S]chools can educate the community about the warning signs of suicide — bullying, social withdrawal, expressing hopelessness, substance use — and families should engage in conversations with children and teens”. The article also mentions that in a report released by the U.S. Center for Disease Control and Prevention, or the CDC, it was found that suicide rates in the United States of America have risen in all of our states except for one; the reality is that while in the certain year the study was observed, the suicide rate went down in New Jersey, over a seventeen year period, it generally has increased.

So, at the end of it all, the recent celebrity suicides of Anthony Bourdain and Kate Spade show so much more than the fact that they were unhappy, depressed, and anxiety-ridden. They contribute to a larger, much more horrifying picture, that shows how more and more people, everyday, are ending their lives because they feel like they cannot live anymore. It is a truly sad thing that should not be brushed off as statistics or fact. Studies have shown that when people reach out for help if they are suicidal, they are less likely to commit suicide, and the overall suicide rates would go down. It seems that only one good thing has come out of the suicides of Anthony Bourdain and Kate Spade: there have been increased calls to the Suicide Prevention Lifeline, which you can reach at 1-800-273-8255.

 

How to Stop Bullies

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By Benjamin Norton, Age 10

Hi, my name is Benjamin and I just finished the fourth grade. This year has been very rough for me due to a bully in my class.  Tyler (not his actual name) made things miserable for me. He would tease me on a daily basis, calling me “stupid” and told me that I sounded “weird” when I talked.  At one point, he announced, “Oh no, I have to go to a party with Ben!” in front of other classmates. It got to the point where I wanted to do anything to get out of going to school, including getting hurt so that I could miss class.

One of the problems is that I didn’t tell anyone about Tyler until the end of the school year.  Eventually, things got worse and I told my Mom and she got the principal involved. I realized that I should have told an adult about Tyler much sooner.

Another issue is that bullying is not addressed much at my school.  This past year, bullying has only been mentioned once and that was when cyber-bullying was discussed in my technology class.

I have thought a lot about bullying and I came up with some “rules” that I think will help other kids:

Stand up for yourself. It is ok to verbally defend yourself if you feel comfortable doing so.

Tell someone. Tell a trusted adult about what is going on.

OK to walk away. If someone is giving you a hard time, it is also OK to just walk away.

Peaceful.If you stand up for yourself (or others), do it calmly and peacefully.

Overall, I am looking forward to the 5th grade.  I feel more prepared to deal with issues in the future if they occur.  I hope that my experience and set of “rules” can help others deal with their bullies.

My child played the choking game

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By Liz Calato, Mother

I was aware of the choking game. I saw it featured on Dr. Phil when I was pregnant with my son and his twin sister. I was properly horrified and made a mental note to have this discussion with my kids when the time came. At the end of their 5th grade year while going through the dare program, it was brought up. They came home horrified. Mom, did you know kids play this game? This was my opening. I told them yes, I’d heard about it, it’s dangerous,  never do it, tell someone if you see someone else doing it. Don’t worry they assured me…we won’t.

Fast forward to the summer after grade 6. A week before it happened, Ian came into the kitchen with marks on his neck. I asked him about it. He said it was from the chlorine at the pool. He said it was particularly bad that day. I straight up said…Ian, those look like ligature marks, are you playing the choking game? He said no way, that’s dumb. At night the marks were still there. He told me it was itchy. I put cortisone cream on his rope marks. I was so naive. If I had only checked his camera….I always monitored their texts and social media…I never thought to look at his pictures. Big mistake. The videos were there.

A week later it was a wonderful Friday night. We had neighbors over for a BBQ and to watch the opening ceremonies of the Rio Olympics.  He and his sister invited their 2 best friends over for a sleepover. They wore flag shirts, painted their faces and jumped around with glow sticks. The ceremony dragged on and the adults left before it was over. I wanted to see the end. I went up to bed and put it on my TV up there. The 4 kids were in the basement, and my other son Charles was on the main level watching a movie. It was getting late and I was having trouble staying up. I called both Ian and Charles on their phones and said come to bed by 11, I’m falling asleep.

Ian came in about 10 to 10 and said good night he’s going to bed. The girls decided to sleep in the basement, he wanted his bed. I said good night as I struggled to stay awake for the Olympic flame lighting. I must have dozed off….and then there was a crash. Charles barging into our room with such force the door broke from the hinge. He was white as a ghost, and was hysterical…all he could say was “Ian!!! What the f***!!!!” I knew it was bad if he used the F word. I knew they weren’t just fighting. My husband and I jumped up and went running towards his room. Charles stayed back in our room and as we raced towards the bedroom, he yelled “He hung himself”.  I couldn’t go in. Because I knew I had been right. He was playing the choking game.

My husband got there first and started screaming.  I forced myself to go in and there he was. Hanging by the neck from the foot board of his bunk bed his feet dangling.  He was purple and had foam coming out of his mouth. He wasn’t breathing. I lifted up his dead weight as my husband undid the tie. He crumpled to the floor, unresponsive.  I dialed 911 and they asked if he was breathing. No. Then they asked us to start CPR. We were so frozen. We couldn’t remember what to do. She started to walk my husband through it, and seconds later the first policeman was on the scene. He jumped in and took over. Seconds after that paramedics arrived. He was taken to the local hospital and then flown downtown via helicopter.

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He was in a coma for 5 days. We never left his side. We watched the Olympics to make our minds focus on something else. We played music, we talked to him. On the 5th day, he just woke up. We don’t know how long he was without oxygen that night.  Charlie said he came up right at 11 like we asked and the 911 call went in at 11:09. So 15 minutes would have been the max. He had a few days of physical,occupational and speech therapy and they dismissed him almost immediately. He was amazingly OK. He missed the first week of school, but other than that resumed right where he left off. We got him back. We became one of the luckiest of statistics for kids who play this game.

pedimom-choking-gameI knew about this game, I talked about the dangers of it to my kids, I did everything right. I checked their phones, for social media, and text dangers. They are good kids. But I didn’t think to check the pictures. Like I said, the videos were there. I got complacent.

I screwed up.

We learned a hard lesson and didn’t even have to pay the ultimate price like most do. We are beyond grateful and make every day count.

The bullying of Benjamin

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By Lisa Norton, Mother

Almost every morning, Benjamin, my 10-year old, would whine and complain about going to school.  He would often shout, “I hate school!”, but I just assumed it was because he didn’t want to get out of bed.  It was not until the end of the school year that Benjamin told me why he dreaded going to class. He told me about a boy in his class, “Tyler,” who would frequently tease him.  Besides lots of name-calling, Tyler would tell the other classmates not to be friends with Benjamin. On one particular day, Tyler notified the class that he would not attend a birthday party if Benjamin was invited as well.  As far as I know, Tyler never became physical with Benjamin, but the ongoing cruelty really affected Benjamin.

Once Benjamin told me about the bullying, I was filled with a mixture of emotions, ranging from anger to sadness to guilt.  I sent an email to the principal and requested that the 2 boys are not placed in the same class in 5th grade. Unfortunately, I do not feel that there was much of a resolution.

I often think back to my childhood and have very fond memories of elementary school.  For me, bullying didn’t start until middle school and we really didn’t talk about it, either at home or in school.  So, now I am left with a multitude of questions. How do we, as parents, prevent bullying? How do we teach our children to handle bullying?  What is the school’s responsibility? And, I can go on and on.

I want my boys to be as prepared as possible to handle difficult situations.  I want them to understand that it is OK to walk away. It is OK to ask an adult for help.  And, in my opinion, it is OK to defend yourself (without violence). We have also discussed that it is NOT OK to be a “bystander” to someone else who is being bullied.

My heart aches for all of the kids who are bullied, especially the ones who suffer in silence.  I think that we, as parents, need to open the lines of communication very early on with our children.  I also think that we need to engage our schools more. We should inquire about anti-bullying programs and school policies regarding bullying. Through this experience, I have learned that I need to ask more questions, both of my son and of the school.  I am hopeful that 5th grade will be a better year for Benjamin.

I locked my child in the car

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Lauren Rowe, Physician Mother

My 2 1/2 year old finished dance class and we went to the car on this hot June day. On the way to the car my friend called and we were chatting. This was before Bluetooth and hands free devices so instead of driving and talking I put my daughter in the front seat of the car and turned on the air while we sat there. She was having a great time messing around with buttons and everything.

After I finished the call I turned the car off but left the keys and phone on the seat so I could carry her around and put her into her car seat. I buckled her in then closed the door.

Then the sinking feeling set in and I tried the front door and it was locked!

She had locked the car doors while playing and I just locked her in the car! Of course, in this normally busy parking lot there wasn’t a sole. Panicking I didn’t want to go as far back as the building but as I walked towards it I saw a car pull in and chased after it yelling at the woman to give me her phone.

Long story short, I called 911 and while they were on the way I called OnStar and either the policeman or OnStar opened the door…they both took credit and I hardly cared! Scary though this was about 5 minutes and my daughter was already hot.

My lesson here was to always take pause and think when I’m with my kids before taking action. I also put a reminder in masking tape on her car seat to remind me to make sure I had my keys before I shut the door!

 

Photo by Nick Karvounis on Unsplash

 

Keep your eyes on your kids in the pool

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By Lauren Rowe, Physician Mother

We were at a neighborhood pool party and my Mother in law was “on duty” watching my 5 yo and 9 yo in the pool. Both swimmers, no life vests. I look over and she is talking to someone facing them and not the pool! I look in the pool and there are tons of floats and rafts and a dark bottom and I spot my 9 yo but not my 5 yo. In a matter of seconds I’m looking all over and she comes up in the shallow end sputtering and coughing. A bigger kid led her to the deep end on a raft and she fell in but panicked and didn’t just swim to the ledge. Apparently, the older girl tried to “help” her and swam to the shallow end dragging my daughter under water the whole way! The moral is obvious here but doesn’t happen as often as it should! My lesson is my kids my eyes need to be on them.

Kindergarten Bullying

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By Anonymous, Mother

My oldest started kindergarten last year. Her absolute favorite thing is art and she’s always said that she wants to be a famous artist when she grows up.  Within two weeks of school starting, she started saying that her “drawings are bad” and “I’ll never be a famous artist”. A little boy at her table in class had told her that she was “a terrible artist” and laughed at her pictures.  She didn’t want to draw anymore. It broke my heart. She was only 5 years old!!! I immediately talked to her about bullies and how some kids are mean and that she should ignore him. We also talked about how to reply to his comments in a positive way if she wanted to do that instead.  And I of course praised her art and pointed out specific things that I loved about her pictures. I also emailed the teacher who was absolutely amazing. She spoke to the whole class about bullying and spoke individually with the boy. She offered to move the other child somewhere else if any bad behavior occurred again and she made sure that the kids knew that they could tell her if someone was being mean (stressed that it wasn’t tattling.). Thankfully my daughter’s story had a good outcome and the boy actually became a friend of hers later on.  And she’s back to loving art and planning her very own art showcase now. I credit the teacher with taking prompt action. What amazed me was how early this behavior could start (in kindergarten!!) and how quickly a couple of mean comments could ruin my daughter’s dream. I know that will not be the last incident but I hope that it helped both of us learn how to deal with mean kids and how to come out on top.

 

Photo by pan xiaozhen on Unsplash

Tricky People

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By Physician Mother, Anonymous

My son had just turned 4 at the time and he remains just as socially flirtatious as he was then. An incident happened at the park and I thought I was being a watchful parent from a distance to allow my child the autonomy to play freely.

This world today is so different and difficult to navigate especially as a single mom, to sift through faces at a glance from a distance (while sleep deprived and overworked).

I call out to Kai at the 2 min warning as I watch him play from afar. He’s happily talking to a bigger kid that looks to be about 12-14 years old. I keep my distance and I keep watch.

While walking together back to the car Kai says momma that boy has a brand new puppy he wants me to see but I didn’t take his candy because we don’t take candy from strangers …and the hairs on my neck stood erect.

Bells and whistles went off in my head as I frantically scanned the crowd to find that face again. He was gone.

I’ve talked to Kai on several occasions about talking to strangers and yet he insists on waving, saying to everyone “hello my name is Kai what’s your name and I like sharks”

So my strategy was to teach him that that’s ok as long as you’re with a grownup

But what if there’s no grown up around-what then?

I taught him about what a “tricky grownup” would look like or act like.

We would go through scenarios and I’d role play with him at home.

I’d let him tell me why he thought a particular scenario was ‘silly’ or how the grownup was being/acting ‘tricky’.

A tricky grownup:

-will try to ask kiddos for help and that’s tricky because a grownup that really needs help would ask another grownup (one they know and not a kiddo)

-will try to ask you to do something (a naughty no no) in hiding places

-will tell you secrets that you can’t tell momma

I teach my child that the only good secret is the kind where everyone (and I mean EVERYONE) will find out real soon about the surprise

-will try to ask you to go with them (you never go with strangers anywhere even for a second)

-will offer you treats or candy (you never take food treats drinks toys from strangers)

I had prepared him for tricky grownups. We have a code:- to yell loud and louder still STRANGER DANGER at the top of your lungs when you feel unsafe around a tricky grownup

I always played the role of the tricky grownup in our role play at home but never had I EVER thought about the tricky bigger kid as a lure, in a public place in broad daylight at a park…and I was there! This shook me to my core. And now I’ve made revisions so to speak on the scenarios we role play-not just grownups any more.

 

Photo by Sandeep Swarnkar on Unsplash

YouTube Kids Scare

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Anonymous, Physician Mother

Today I was actually grateful for my son’s nosebleed.

We were sitting on the floor of the bathroom, watching YouTube Kids to distract him from the bleed, when I saw it.

It was a simple, innocent cartoon – until it happened.

Four minutes and forty-five seconds into the video, a man quickly walked onto the screen, held his arm out, and taught the children watching this video how to properly kill themselves. What did I just see? Did I really just see that? I immediately turned off the video. My son’s nose stopped bleeding, and I further investigated the video in private while he went to play.  I watched it again, certain that I had dreamt it up. I know YouTube had some sick videos, but I thought YouTube Kids was safe. They sure make it seem like it is.

But – no. There it was again. Four minutes and forty-five seconds into the video.  The man quickly walked in, held his arm out, and tracing his forearm, said, “Kids, remember, cut this way for attention, and this way for results,” and then quickly walked off.

Not much shocks me.  I’m a physician, I work in the emergency department. I’ve seen a lot.

But this did.

This video was intentionally planted on YouTube Kids to harm our children. He waited until parents’ guards were down, thinking their kids were just watching a harmless cartoon when he made his entrance four minutes and forty-five seconds into this video.

How can anyone do this?

How can YouTube Kids trick parents into thinking their content is safe?

What else do our children seen on these apps?

I reported the video and asked my friends and family to report.  Hours later though, it is still up, and I wonder how many children have seen this video since.  Those apps are all now deleted and will never return to our household.

I am disturbed, I am saddened, I am disgusted.  But I am also relieved that I was there to see this video with my own eyes, so that I could take the appropriate actions to protect my family.   I would recommend everyone reading this to take these same steps as well.

Today I was grateful for my son’s nosebleed.

UPDATE: PediMom was able to get this particular video removed from YouTube Kids therefore it is no longer able to be viewed. This is unfortunately not an isolated event. There are many more videos out there with inappropriate content but they can be hard to spot prior to being viewed. I will continue to get this kind of information out to parents as I become aware of it.


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That Time My Son Almost Drowned

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By Physician Mother, Anonymous

As the mom of two very energetic toddler boys, I would probably describe myself as fairly laid back. I don’t care if they jump on the couch, or play in the mud, or wrestle each other to the ground. If dinner ends up being turkey bologna and a cheese stick, I’m probably happy.

But as a Pediatrician, I’m always on heightened alert. Hot dogs, carrots, and grapes are cut into tiny pieces. Car seats and bicycle helmets are non-negotiable. Supervision at the pool is priority. Swim lessons start at age 2, despite the fact that pool season is pretty short in New York.

So how did my son, then age 2.5, almost drown? Well, let’s back up for a second…

It was a gorgeous summer day, and my husband and I decided to take our two sons to our community pool. We invited my brother and sister-in-law, and their kids. When we got to the pool it was fairly crowded with neighbors, and children.

I was post-call, and decided to take a nap in the shade. My older son, a strong swimmer already at age 4, was playing with his friends and cousins, supervised by another mom. My husband held and played with our two year old (Callum) in the pool. Although he was taking swim lessons, Callum was definitely not a “swimmer” yet. At one point, he got out of the pool to give me a kiss, and walked back towards the pool and sat on the steps.

I began to doze, and did a quick surveillance glance. I saw my older son, laughing with his friends as they jumped into the pool and swam back to the side. I saw my younger son…wait, WAIT, WAIT! My half-awake brain screamed. I didn’t see my younger son. I saw my husband standing in the pool near the steps talking to a neighbor. I jumped from my chair, scanned the pool, and I immediately saw a tiny blonde head submerged under water, arms and legs flailing as he tried to reach the surface. I jumped in, wearing my clothes and shoes, and pulled him out of the water.

Callum came out of the water clinging to me like a baby monkey, and crying. He was upset for approximately 3 minutes at which point he asked if he could go back in the pool.

I’ve been upset for approximately…well, it’s been nearly a year. And Callum is now, at age 3.5, a good swimmer. But for a few days after the incident the what-ifs ran through my mind. What if I had not looked up at that moment? What if I had not spotted Callum?

At this point, I have had many months to reflect on my youngest son nearly drowning, and instead of dwelling on the “what-ifs”, I would prefer to let this serve as a lesson and warning to every mama out there. As we enter the summer, I BEG you to keep a few things in mind when you bring your children to swim:

1. Assign a SPECIFIC person to watch your child.
My husband and I realized that this would have likely prevented this entire situation. At the time, I thought he was watching my son, but because Callum had stepped out of the pool (to give me a kiss), my husband stopped watching him, and didn’t see him come back to the pool. Since that day, anytime we go to a pool, we actually say who we are going to watch.

2. Don’t assume the lifeguard is watching. 
I know this sounds horrible to say, but there was a lifeguard at our pool that day. But it was so crowded, he just couldn’t see everyone.

3. Your kid can’t swim. 
I’m kidding, obviously, since many of our children CAN actually swim, but I think it’s important to remember that children (even pre-teens) should not be left unsupervised in pools and oceans. In terms of water, there can be so many variables. Crowds, horseplay, and water currents are just some things to keep in mind.

4. It can happen to you. 
Don’t judge other moms in this situation.  Despite our BEST intentions, mistakes happen. I know I’ve definitely questioned a mom who I felt wasn’t watching her kids. Instead of judging one another, let’s try to learn for ourselves.

5. Teach your kids to swim!
I think it’s so amazing that my son wanted to go right back into the water, and I have to say that on our recent trip to Florida, he didn’t want to get out of the pool. Part of this is luck, and part of this is sheer determination on my part (despite my fears) that he conquer the water.

Hug your babies tight tonight. And hopefully, take some of my advice this summer when you head to the pool or beach.

Smoking

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By Dhruv Pai, Age 13

Below the earthen floor Beyond the walls of stone Deep in the earth Past the place where spirits moan

Through the cobbled gates of hell Past the devils and demons Into the empty nether well Past the guardian daemon

Into the endless void of evil Through the wall of death Inside the prison of ultimate darkness There stirs of a memory of an unpaid debt

And as you cast your searching gaze Something catches your eye A glimmer of light in the darkness An insignificant fly

Yet something is odd about that little light The darkness around it is dark And no heat comes from the light A twisting turning spark

And it speaks of death And it speaks of a wanting It speaks of countless opportunities As if it was in a haunting

But beneath that sad surface of loss There is a rolling frothing fire Straining to get out from its prison An anger that will never tire

And as in still thought we stood

The orb pulsated and flamed Then burst in an explosion of light And a figure burst forth, untamed

With eyes of flame and claws of steel With wings of darkness and teeth of flame A mighty beast burst forth

A spirit incapable of shame

It was an incarnate of pure evil The apocalypse simply put A beast of death and emptiness A form of destruction in a body of soot

“I’m free, free at last!” The creature shouted And with a turn of its deep black head The pits in its head were focused on you And you were overcome with a sense of dread

Your hand searched your scabbard Feeling for your sword And with a flash you found your hilt All feelings of fear ignored

With a flash of steel and crimson gold Your weapon was by your side The only thing you had to fight this darkness Your single oafish pride

And with heart in your hands And hands on your weapon You faced off this mighty beast This creature of poisonous venom

And fro and away with a running start You leapt up to meet the beast And fought with all your heart And as you went through his energy decreased

Until finally you got a hit And you felt him shudder Then you struck again and finished him off with another

Victory you felt soaring through your wings And true joy came over you A feeling that had been long forgotten A feeling that would come to only a few

Don’t succumb to the beast, quit smoking!

Food Teasing

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By Suria Mehta, Age 11

As I was eating my bean and cheese burrito during lunch time, Sam, my 5th grade classmate, asked me why I never bring meat to lunch. I told him that I am a vegetarian and I didn’t eat meat. He was shocked, speechless, and couldn’t comprehend what that meant.

Next, he pointed his finger on his left temple and made it into a gun shape. He said that he would shoot himself if he was a vegetarian because he could not live without meat. Sam kept saying that I wasn’t physically strong enough, I didn’t have enough muscles, I wasn’t healthy, and I didn’t eat any kind of protein at all. He wouldn’t stop picking on me as this was the 3rd time at lunch that he came over and made these strong embarrassing remarks. Honestly, I was upset, devastated and crushed because Sam was making fun of me, my religion and my food choices.

Enough was enough. I took matters into my own hands and told my English teacher right away. I made it clear to my teacher, Ms. Smith, that I didn’t appreciate what Sam had said to me; all those horrible things about being a vegetarian. Ms. Smith spoke to Sam and was appalled by his behavior. Ms. Smith wanted to know why Sam reacted this way. Of course, Sam had no real reason why he chose to make fun of me.  Ms. Smith made it clear and spoke about kindness, respect, and loyalty among the fellow classmates. Sam was embarrassed and disappointed in himself; he realized he made a wrong choice. Sam decided to go the right thing and apologize to me. He wrote me a kind letter of how sorry he felt for teasing me. I felt as if Sam understood how he hurt me and fixed the issue.

Bullying is hurtful in any form. On the other hand, kindness brings joy, warmth, and happiness, like a mouth watering, hot fudge sundae! Getting over the feeling of sadness is tough and learning to forgive the mistakes is harder. You have to move on in life and look at the bright and happy sides of things, as this makes you a stronger person.

The Real World

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By Lyiba Malik, Age 17

I don’t blame him for the words he said, but I do blame him for repeating them to me, knowing that it would have a negative effect on me. I still don’t why he did it and it’ll always be a mystery to me. I didn’t understand then, the significance of those words. Where he heard those words, I don’t know. A first grader certainly can’t come up with such insults on their own.

It was just after my 7th birthday, and the snow had not yet fallen. It was storming frequently and tornado warnings and watches were issued often. Already, my move to Franklin was gloomy.

I loved my teacher, Mrs. Coats. She was obsessed with frogs and had turned her classroom into its own little forest, with frogs at every corner. I was one of the only “different” kids in my class, a fact that I was well aware of but didn’t think it mattered too much. But I moved, I was a new kid, and an easy target. And one person took advantage of that.

It started out as teasing, but that I could handle. Because of an unexpected accident that occurred six years earlier, I wore glasses, which was unusual for my age group. My glasses were taken away and I was asked to see how many fingers my classmate — let’s call him B — was holding up. I guess he thought I was completely blind without them, because he was surprised when I answered correctly. But then, it started to go further. B asked why my skin was a different color. My ethnicity is South Asian, but I didn’t understand why that merited inquiry. I simply said because my parents are Pakistani and Pakistanis have this color.

That was my first mistake. Exposing myself, my information. I made it easier for him. That was also when teasing turned into bullying.

I knew I was Muslim, as well. Telling this was my second mistake. Because I didn’t know what the world thought of Muslims. I didn’t know the details of 9/11 and who caused it and why the world seemed to think I was to blame. But he did.

For over three weeks, I heard thoughtless and nasty comments thrown my way. Eventually, more people joined B. I remember every word he said, to this day.

“Are you American?” B inquired. I didn’t know the significance of this question until way later on in my life.

“Yes.” I answered, already worn down by his relentless prying.

“You don’t look like me, so you’re not American.” I would be hearing this again throughout the course of my life.

“You’re Pakistani, and Americans chop off Pakistani’s heads.” B proclaimed. I took this as a threat; this was it for me. I went straight up to Mrs. Coats.

“B’s being mean to me.” I tattled.

“Just ignore it.” She dismissed me. I decided to do just that.

Three weeks. That’s how long it went on before I admitted everything to my mother. During those three weeks, B had recruited more people. More people told me I wasn’t American. And I started to believe it. I heard over and over again why I wasn’t American and what Americans do to Pakistanis like me. After about two weeks, I decided it was enough. It was too much to ignore and it was affecting my schoolwork.

“Mrs. Coats, B’s being mean to me.” I complained once again.

“You have to learn to ignore it.” She quickly spat out and turned.

My fondness of Mrs. Coats quickly diminished. Didn’t she understand? I can’t ignore it anymore! It became quickly apparent me to that I was not getting help from Mrs. Coats anytime soon. Almost a week later, a substitute teacher was standing in Mrs. Coats’ place.Finally, someone who could take care of this! Relief flooded me. That day is clear in my mind. We could quietly work in our journals or read. B sat across from me in our new assigned seating arrangement. I was drawing in my journal when B put his book down and hissed, “Americans poop on Pakistani’s heads!”

Ignoring the laughs emanating from the table and confident in the fact that a new adult was here, I waltzed right up to substitute and told her my problem. Her response crushed me.

“You’ll have to tell your regular teacher about it.” She directed. I delayed my walk back to the table, knowing what taunts awaited me, and sure enough, I was bombarded by another claim that I wasn’t American.

“Am I American?” I asked my mom the following day.

I sensed her suspicion when she confirmed, “Yes, you are. You were born here,” She paused before asking, “Who told you that?”

“B.” The truth was out. The torture that I had to endure was finally not only my burden. Not confiding in my mother was my third mistake. The relief I felt was indescribable. I knew for certain now someone was going to stop it. She would tell my teacher and she would put an end to it.

“What else has he said?” My mom started investigating. And so I repeated all the horrendous insults that I heard. At one point, my mom stopped me, and got out a paper and a pen and started writing. Her facial expressions changed from horror to disgust to determination throughout this little session. I didn’t understand why she was horrified at these words. They were just annoying to me, but they meant so much more to her.

When I stopped, she declared, “I’m going to the principal with this.”

“Noooo!” In first grade, going to the principal meant that someone was in for a tremendous amount of trouble. First graders rarely were called down to the principal’s office. Until now.

“Why?”

“Then he’ll tease me for being a tattletale!” I wailed.

“No, he won’t.” She firmly proclaimed.

Knowing this war was over and that I lost, I dreaded the next day. But the prolonged feeling of dread in my stomach was not enough for me to skip school.

Just before lunchtime, we had a small field trip to the library, where all I could think about was what was going to happen. B and his gang had been called down 5 minutes earlier and they still had not returned. I randomly picked out a book off the shelf to show Mrs. Coats that I cared when the secretary walked in towards Mrs. Coats.

She whispered, but I could still hear her. “Do you have Lyiba Malik?”

I turned around and Mrs. Coats was pointing at me.

“I need you to come with me.” The secretary ordered. I dropped the book and she escorted me over to the principal’s office.

Mr. Reinke (the principal) towered over the sniveling first graders who took up all the chairs in his office. He smiled warmly at me and gently comforted, “You can sit on my chair.”

I avoided eye contact with B as I shyly sat on the large cushioned chair. All eyes were on me. I then noticed that my mom wasn’t here.

“Now, tell me what they said to you.” I paused before spewing out all the hateful words that were once directed at me. Mr. Reinke’s expressions mimicked my mom’s.

B didn’t deny saying those words. But the rest of his crew did. They were downright scared of the principal and what their punishments will be. Though they repeatedly shook their heads desperately and urged, “No, no, no!” over and over again, Mr. Reinke believed me.

“All of you are getting detention!” He boomed, his finger pointing at everyone. “Except you,” He pointed at me, “But I am a little disappointed in you. You should have come to me sooner.” Mr. Reinke pointed out my fourth mistake: not going straight to authority for help.

Those snotty and superior spirits of B and his bunch that were present when they ridiculed me vanished.

But Mr. Reinke and my mom’s anger at hearing those words tugged at me for year after the incident. As I grew up, I finally understood. I learned and experienced discrimination much worse than what B had said to me. I’ve experienced danger and heard words that every Muslim, every South Asian, and every South Asian descendant will hear. I’ve experienced the real world. Bullying at this level cannot be stopped by ignoring it. Intervention from adults was the only thing that worked for me to stop the ignorant comments throughout elementary school. Comments such as the ones I heard come from a bigoted and ignorant environment, but these words should not be allowed to penetrate the learning environment of our schools.

Looking back, I realize that those words were just child’s play. That was just the door to what people like me would have to endure in American schools. What’s beyond the door is much worse.

The Safety of Good Company

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By Caroline Moledor, Age 13

I know that upon reading this title you are probably thinking that this is just another boring article stressing the already-stressed importance of good company. I know that most people are tired of hearing about it. But I also know that the good company is more important than most people presume!

Everyone has been told many times in their life that “You are who you hang out with.” A few years ago, I would just nod my head and pretended to agree while really thinking “That’s not true. As long as I don’t listen to bad influences or do what they do, I’ll be fine.” I didn’t know how wrong I was.

It is truly amazing how much we act like the people we are around. Children often inherit traits from their parents or caregivers because they are around them so much. My brother and I act so similar and are so in-sync that we have most of the same ideas at the same time. This is the same with anyone, even bad influences.

Often, you don’t even realize that the people who you are around may be bad influences. Sometimes you have to be around those people in school or other activities, and there is no way to avoid them. But remember that even if they are doing certain things or pressuring you into joining them, you are not forced to do anything! Be safe and make the right choice.

I feel that one easy habit to fall into is using profane language. Some people throw around certain words so casually and frequently that it makes it seem less offensive more innocent. If you spend enough time around those people, you may find yourself speaking a lot like them. Trust me, I know. In a lot of situations, profanity can get you into a god amount of trouble!

Another dangerous thing that is easy to fall into around bad company is bullying. If someone bullies you, especially more than once, it seems less harmful and ok to do it yourself. This is one of the main causes of bullying today, and it needs to be avoided now more than ever. It is okay to tell someone you are being bullied. It will keep you and others safe if you do!

If you start choosing the immoral and harmful actions of the bad influences around you, those influences might start to seem like your friends, and you could lose some of your real friends. Your real friends were friends with you, not this bad influence you’ve become. Remember to keep your good friends very close!

If you have to spend time with bad influences at activities and things, just try to ask yourself if your actions are moral and good. Perhaps you can be a good influence on the others!

I’m not suggesting that people who may be a bad influence on you in some ways are all bad and should be completely avoided. Every person has their struggles, and maybe those people don’t know what they’re doing is wrong. We still need to love them and respect them!

I hope this was helpful, and I hope you and all of us will go out into the world as influences for good.

Teen Stressors: Do we know when and how to help when we need it?

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By Sydney Powell, Age 13

School can be stressful. Anyone who has ever been through middle or high school knows that. In school I learnt that a good amount of stress is healthy. I agree that with the right amount of stress, it can help motivate you to do what you need to do. But I also learned that too much stress can be unhealthy. This line states a good point too. Too much of something good is bad. Up until 7th grade I didn’t even know high amounts of stress could affect you physically. I remember the long 3 day lecture where we learnt that too much stress can cause headaches, Insomnia, lack of energy and more. This was a whole new concept to me. I mean who knew something like stress can affect you physically. But then I wondered, what’s something that all teens stress about? What could be a leading factor in the stresses teens face? Then it came to me, School.

In Middle school you are expected to follow the rules of the classroom, school, and district. You must finish the projects, homework, and regular work on time as well for all of your classes. In high school it is even more stressful, you have even more work, higher risks, and has to be done on time. If it isn’t done on time some teachers won’t even accept it and you have to live with an F on whatever was late. But what really puts the pressure on in high school is College. Mainly people mentioning it since we were little kids. In school, the pressure to do well in high school starts with standardized tests. They’re supposed to tell you if you will succeed or not in life. From 3rd grade on, Standardized tests tell you if you’ll get into a good collage and basically if you’ll live a happy life. All of this leading up to 4 years which we are told will either be the greatest of worst years of our life. The 4 years which decide if we get into good college, get a good job, and are successful in life.

But that’s just the Classwork part of school. There is a whole other portion of school which is known for the drama and stress it brings. The dredded social life of a student. In Middle School, it’s like the stereotypical high school in the movies. You have the rude popular girls, nice popular girls, the jocks, the jokesters, the nerds and geeks, but you do have the mixtures of each. But everyone, for the most part fits into at least one of those categories. In High School they still have the cliques and stuff. Most people have their groups that would do anything for them. But I like to think of it like the weather, the cliques are constantly changing in unpredictable ways. One minute someone could be your best friend in the whole world and poof! The next minute they’re your worst enemy. So of course this would be a big factor in the stress of a person’s life.

But there is one more stress that comes with, not only school, but life, Bullies. Most people will have to deal with at least one bully in their lifetime. Most of the time you hear about bullying happening in middle and high school. There are many different reasons people get bullied in the first place. It might be that their nose is too big or they’re too tall or too short. Sometimes it’s because the person has ADHD, Anxiety, or Autism. Being told that you don’t belong or that you’re stupid is hard enough, but then if you tell, you’re a snitch and “Snitches get stitches.” This makes it so you feel alone and while you are trying to handle your social issues in whatever way, you are still expected to do all your classwork for all your classes on time just like everyone else. But it’s twice as hard for the victim to to do this as it is for anyone else. The worst part about the Bullying situation is that before high school it is handled with friendship circles or in school suspension (ISS) where the bullies get to play on their phone. So people think it’s ok to treat others like crap and bully them given the lack of real consequences.

Not only is stress a problem in schools these days, but mental illnesses too. Depression and anxiety have infected the halls of our schools like plagues. I think they are linked to the same thing as stresses especially the social stressor contribution.  With all the hormones, brains that are not fully developed, and world issues it seems like school is a breeding ground for anxiety and depression.

With all of the Stress, anxiety, and depression going around school, they must be doing a lot to help the students who need it. They have counselors and for as long as I can remember, they’ve been telling us to talk about what we’re feeling, not to hold it inside. Earlier this year I was thinking of more things they could to to help the students, and I didn’t think of an easy solution. When learning about these issues in health class we learned what they were and symptoms to look out for and to talk to someone. But then when learning about sex, we learnt about all these places that you could go to get free protection and hundreds of things to do instead of having sex. After that I better realized what was missing when we were taught about stress, anxiety, and depression.  The classes focused on what depression, anxiety and stress were including how to identify them, but very little on how to access help and actually teach us coping skills. I can now easily identify them and although I don’t know where one, single therapy office is, I know where I can go for free condoms?! I’ve never learnt coping mechanisms in health class, I learnt them on Pinterest and music class. It would take one day to teach us how to cope with the stuff we’re learning about and where we can get help if needed outside of school. But we don’t learn that stuff. It’s like giving someone who can’t cook the ingredients to a cake telling them what it tastes like and leaving them to cook something. Do you expect them to cook the cake? No, you don’t. So why do schools tell us what these things are but not how to deal with them? They just expect the cake to be cooked.

The stress that school gives and the depression and anxiety in kids won’t go away. That’s why schools need to do more. The person can’t bake the cake until you give them instructions, so give them instructions. The Student can’t handle the stresses well until you give them the resources that they need.  It’s not that hard, yet it could help hundreds of students out there. Whether they’re too stressed, getting bullied, or suffering from anxiety or depression. When we know what we can do to get help, it doesn’t seem like as big of a hole to climb out of.

Roller Skating and Safety

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By Freya Heyman, 7 years old

My favorite sport is roller skating.  I like to roller skate around my neighborhood. Remember it’s always important to be safe:

  • Before going roller skating, tell your parents where you are going and when you will be back. 
  • Be brain smart!  Wear a helmet. 
  • Also wear elbow and knee pads in case you fall. 
  • Always look for cars.
  • Stop at stop signs and look both ways before you cross the street. 
  • Always look for sticks and rocks in the road so you don’t run over them and fall. 
  • Learn how to make turns and how to stop.

I like to see how fast I can skate.  I like to skate with my friends.  We look at the gardens and the trees and flowers.  We know it is good exercise for us and we enjoy it.  Give roller skating a try today!

 

Don’t Smoke – It’s no Joke!

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By Bella Kalra, Age 9

Why should kids not smoke?

Smoking is a VERY bad habit and causes many terrible diseases. Cigarettes are filled with different disgusting things you probably don’t know much about.

What are the ingredients in cigarettes?

  • Acetone – found in nail polish remover
  • Ammonia – a common household cleaner
  • Arsenic – found in rat poison
  • Benzene – found in rubber cement
  • Carbon monoxide – released in car exhaust fumes

Now of course these aren’t ALL the ingredients. There are about 600 different chemicals in cigarettes!

What diseases can cigarette smoke cause?

Smoking can damage your whole body! Here are some of the illnesses caused by smoking:

  • Cancer – Cancer is an abnormal growth in your body which makes your organs stop working. Smoking can cause lung, throat, bladder and many more types of cancers.
  • Stroke – A stroke is a blood clot or a bleed in your brain which damages the way you think and move.
  • Pneumonia – Pneumonia is an infection in your lungs which causes you to have a fever or a bad cough.
  • Chronic lung diseases – These diseases damage the airways in your lungs and can make it hard to breathe.
  • Heart disease – Smoking damages the blood vessels in your heart. This can cause a heart attack.
  • Along with all the diseases above, smoking causes bad breath, stinky clothes and yellow teeth. YUCK!

Do you want to hear a personal story about how smoking affected my family? If yes, please keep reading!

My great-grandfather was a smoker. Back in the day, 100 years ago, people didn’t know smoking was bad for you. After years of smoking, he developed throat cancer. It made him stop breathing and pass away when he was 70 years old.

How can you stay away from smoking?

  • Avoid all contact with cigarettes.
  • If someone asks you, “Do you want a cigarette?” you can say, “No, smoking is bad for you”.
  • Try to keep away from people who smoke.

All you kids out there who smoke or are thinking about smoking, I hope this information convinces you to stay away from cigarettes and live a long, healthy life!

 

Parents, I Challenge You

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By Anonymous, 17 years old

Regardless of the common misconception that social media can help children to stay connected, in many ways it hinders a child’s development by disconnecting them from the reality that surrounds them. Some parents are now giving their children phones at ages as low as six or seven, which is causing numerous problems in how our society functions. Having phones at such a young age leads children to addiction; if you ever go out to eat I challenge you to look around and notice that almost every table has at least one family member on their phone — typically a child — using social media, watching videos to  prevent boredom, or playing games. While this may provide a temporary solution to prevent a fit, it hinders a child’s ability to learn communication and social skills. Trust me, I am guilty as charged, but as I have matured, I’ve realized that the importance society places on social media and phone usage is inherently ruining our ability to learn basic cognitive skills. 

To explain further, children are being exposed to more and more negativity on apps such as snapchat, instagram, or twitter. While the child my resent a parent’s resistance to them making a social media account, it does make a large difference in the long run. When kids start using their phones for things such as social media, they easily get addicted. Each time they get a snapchat or a like on instagram, their brains release dopamine, giving them the feeling that they constantly need to be using this apps to get a dopamine high. However, as they do this, they are surrounding themselves with negativity that will eventually start to make them a more negative person overall. To add on to the negativity thing, social media creates a false sense of reality that children perceive as the truth. Children will see fake pictures, fake news, and they see people who do not represent the average person. It starts to create confidence issues for children because they are constantly exposed to people who they think are prettier, have a better body, are nicer, etc. It has happened to me. Social media is one of the many reasons I have confidence issues at this point in time. 

To any parent that is reading this right now, I challenge you to stop your child from using social media at such a young age. Yes, you may get a few “I hate you” comments when you initially refuse to let them get social media, but it will be worth it in the long run. They will know how to communicate and not resort to using their phones in uncomfortable situations (I am guilty of this), they will know how to be more positive instead of focusing on things that are going wrong in life (I am guilty of this), and they will have a lot more confidence which will prevent them from always talking themselves down (I am once again guilty of this). Not giving your child a phone at such a young age can have short term drawbacks, but numerous long term benefits. All parents want to set their child up for success, and preventing phone usage is a large way a child can achieve their full potential.

 

My Bullying Story

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By Suha Malik, Age 15

My arm was thrust away violently as she hissed it to my face. With a look of disgust etched in her facial expression, she stomped away, leaving me frozen to the spot with confusion and surprise, close to tears. I clutched the water fountain, so tightly that my hand cramped, met with frigid, smooth metal. Thoughts raced through my head as I continued to walk with the rowdy pack of children, thoughts that questioned if what she uttered was true, thoughts there that should not have been in the mind of a nine-year-old.

~~~

Like any other kid, I was very glad that the school day was over, and was anxious to get home. I rushed to put on my gear, from my heavy coat to my thick gloves. I ran to the cluster of students, hoping to get a good spot. Impatiently, I leaned out of the line to catch a glimpse of how close the white halls were, determining how fast I could get to the bus lines, and was absolutely delighted to hear that we were finally dismissed.

As we rounded the corner, almost to the gym, I noticed someone trying to skip me and all kids hated when someone did that in elementary school, as did I. “No skipping!” I asserted, sticking my arm out to slow the girl, whom I had now recognized, down and stop her from crossing me. “You wouldn’t like it if I skipped you, and I don’t like it when you skip me,” I informed her, completely oblivious to her increasing annoyance. Until this point, my jacket-covered arm simply hovered in front of her, blocking her. But when she tried to power through, she made contact with it.

“Ew! You touched me! Now I’m dirty!”

I froze. “Wh-what?” I faltered. I took a shower this morning, so I’m not dirty! I quickened my pace, but she was already ahead of me. “I’m clean! You must be dirty too, then!” I called after her as a last resort, trying to defend myself.

She pivoted to face me and strung out more insults while walking backwards. “No, I’m not! Your face is dirty, too! All of you is dirty because you’re brown!” With that, she spun around and stalked away. My lip trembled, but I did not understand the extent of what she said. Then, I connected the dots.

Everything seemed to be slowing down, seemed to become distorted as the weight of her words hit me. Snapping back into reality moments later, I tried to brush away the tears that were still flowing, desperate to make sure that none of my classmates saw me. It was too embarrassing at this age to cry at school. Crying meant that you were a baby, and that was the last thing that I wanted to be labeled as.

I assimilated back into the crowd, which was now thinning, as almost all of the students had already made it to the gym. I trudged the rest of the way, almost tripping on the divides between the smaller, white tiles several times. After much effort in making it to the doors, I leaned on them, feeling a strip of coolness across my forehead from the metal as I did. I started to ponder about what had happened, but the tears started to flow again. Deciding I was drawing too much attention, I sat down in my line for my bus.

I hoisted my winter coat up and pulled my hat down so most of my face, stained with tears, could not be seen. I looked for my sister, who at the time was in sixth grade. She was at the front of the line, and I knew I wouldn’t be able to tell her what had happened just yet.

As we were finally ordered to go to our bus, I shot up, itching to get on it as rapidly as possible. Finally! I can’t wait to leave. It was too soon before we made it onto the familiar yellow vehicle. Ignoring the chatter of others behind me, I mounted the steps and grasped onto the metal rail, and was met with coolness. I sat next to my sister as usual, setting myself down on the hard, vinyl seat, weeping again at this point. In horror and disbelief, she asked, “What happened?”

I was now bawling openly, with no regards for those who were watching. Distressed, I tried to explain what happened, confused as to why it did. “Sh-she said that I was dir-dirty because I’m br-brown!” I sobbed, wiping my nose on my jacket’s sleeve.

~~~

I had to recount this awful experience several times, including to my parents, who were so appalled that they called the school’s principal. He promised to do something about it, and he did. I was brought into his office to explain what had happened yet again. I tried not to cry as I recounted what had happened. Whether or not the girl was punished is still unknown. When I see this girl in the halls of my school today, I am reminded of this incident and am horrified to realize that in fourth grade, she was able to say this to me.

Author’s Note: This was originally a school paper, but has been edited a great deal in order to make it easier to understand and read!

Social Media Addiction

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By Michaela Galarza, Age 17

Social media is a drug just as addictive as alcohol, nicotine and opioids. With technology spreading like wildfire, social media apps such as facebook, snapchat and instagram have gotten teens hooked.

At just thirteen, I first downloaded the app instagram oblivious of its side effects. At first it was cool scrolling for hours through people’s feeds and seeing their effortlessly beautiful pictures, however, in just a short time, I had become devoted to social media and its demands. What I soon discovered was that girls in my school had thousands of followers, hundreds of likes and comments on their pictures, whereas, my instagram feed consisted of a random assortment of old fuzzy selfies with the outdated duck face and only seventeen likes. It had become clear to me that if I wanted to be part of this online world, I would have to step up my game. At this point I was addicted, but I did not care. It was all about getting approval and impressing people with my lifestyle, friends and beauty. My parents would always say, “ you have to be private! No strangers!”, but the desire for more followers was a force stronger than my discernment. I followed random people to get my numbers to climb and posted perfectly edited pictures to follow the trends. Nevertheless, it still wasn’t enough.

What I realize now is that no amount of followers or likes can ever truly represent who I am. Social media is a facade. Whether you have fifty followers or fifty thousand, we are all driven by our craving for approval so we post what makes us look good or seem cool rather than what is true. It was not until I deleted instagram that I realized how addicted I truly was. As I approach two years of being free, I realize how consuming the pressure of living up to others expectations is because of social media.

Just like any other drug, the side effects of social media addiction result in immense damage to a teen’s confidence, self-worth and time. Social media has become the breeding ground for teen self loathing. With the ability to compare yourself to more alluring and picture perfect people, teens get themselves intertwined in an endless cycle for perfectionism. With models posting bikini pictures with flawlessly sculpted bodies and the wealthy showing off their extravagant lifestyles, ordinary teens feel obligated to resemble that ideal.

That is why I feel so free, I do not feel the pressure of living up to the ideal. I have accepted that I am never going to be as beautiful or rich as some, but I have other qualities that make me special.

 

Doubts and Fears – A Doctor-Mom’s Discussion of Vaccine Concerns 

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By Dr. Gretchen LaSalle

Doctors are not immune to the anxieties and fears of newbie parents.  Yes, we’ve gone through 4 years of medical school and pediatrics rotations (and some of us have had further training in family medicine or pediatrics residencies) and we’ve learned all of the appropriate developmental milestones and all of the common concerns of early childhood.  But that doesn’t necessarily protect us from worry, sometimes irrational, about why they sleep so much or why they are jaundiced or why they aren’t latching well or why their poop is that color. I could go on. So when it comes to vaccinating our tiny precious peanuts, we can begin to question all the pokes and exposing their immune systems to so many viral and bacterial proteins all at once.  And we, too, get those anti-vaccine feeds on our Facebook pages and doubt has this insidious way of working itself into one’s subconscious. Anti-vaccine assertions play on our fears as well.  After all, none of us would ever want to do anything to harm our little ones.  But those doubts and fears are unfounded, and I am here to tell you why! Let’s look at a few of these vaccine worries and break them down.

Worry #1 – That is so many pokes all at one time.  I don’t want them to hurt.

  • No one wants their child to hurt.  Wouldn’t it be awesome if we could invent a pain-free vaccine?  Let’s get to work on that drug companies! But we have to put this in perspective.  The pain of a shot is temporary (usually just a few seconds) but the consequences of vaccine-preventable disease can be life-long or even life-threatening.  And babies do not have long term memory. Thank goodness. If they did, they may have a lot more to hold against us when they get older. “Mom, remember that time when you set me on the bed and I rolled off and that time when you cut my nails too short and that time you gave me mashed up peas and I vomited.”  Also, we do things for our kids all the time that they don’t necessarily like (like strapping them into car seats, making them wear helmets when they ride their bikes, and making them eat their vegetables) but we do it because we know it is what is best for them. It’s no different for vaccines. And, these days, many of our vaccines come in combination, meaning multiple vaccines in only one poke.  So, the actual number of pokes is minimized. Honestly, I think this worry is a bigger deal for the parent than it is for the child. Come on Mom and Dad. You can do this! Get those vaccines and know that you are doing what’s best to keep your little one healthy and safe.

Worry #2 – Aren’t we going to overwhelm their immune system by exposing them to so many proteins all at once?

  • Let’s look at this realistically.  Kids are exposed to so many more proteins on a daily basis (what with sticking their hands in their mouths 24/7, and crawling around on the floor, and sharing germs with other little germ factories at daycare) than they are ever exposed to in a series of vaccines. Exposure to these proteins is good.  This is what helps build a stronger immune system. And, thanks to advances in vaccine science, the load on their immune system is even smaller than when we were kids! The 14 vaccines given today contain fewer than 200 viral and bacterial proteins or polysaccharides, compared to more than 3000 of these components in the 7 vaccines that were given in 1980.  We parents are more likely to have received exposure to those 3000 proteins and we turned out just fine, thank you very much! So, please, have no qualms about their immune health. Know that, in vaccinating, you are only helping their immune system to be stronger!

Worry #3 – I’ve heard that vaccines aren’t well tested or monitored.  I don’t want to give my child something that isn’t safe.

  • In reality, vaccines are some of the most well regulated interventions that we have in modern medicine.  Vaccines have to undergo 10-15 years of study before being brought to market.  They are tested and retested. There is oversight by both public and private organizations that help ensure that what is being given to our population is both safe and effective.  And after they are released for use, the monitoring doesn’t stop. The manufacturers often continue observation and testing and organizations like the Vaccine Adverse Event Reporting System (VAERS) constantly monitor for any trends that might suggest a significant adverse event related to a vaccine.  And, if they identify one, the vaccine is pulled from use and a safer alternative is developed. We a very robust system of checks and balances when it comes to vaccines and we should feel confident putting our faith in it.

vaccine concernsParenthood comes with a lifetime supply of worry and we medical parents share that worry with you.  We all, medical and non-medical parents alike, need periodic reassurances that we are making the right decisions for our children.  We trust our doctors to steer us in the right direction regarding issues of breastfeeding and treating diaper rash and how to get our child to sleep through the night.  We can trust their expertise in the area of vaccines as well. Our doctors only want what is best for us, for our children, and for our community and we should have total confidence that vaccinating our children and ourselves is the best choice we can make to keep us all healthy and safe!

Dr. Gretchen LaSalle is a board certified Family Physician practicing in Spokane, Washington.  She has a passion for public health and seeks to be a voice of truth and reason when it comes to doubts about vaccines.  You can follow her @GretchenLaSalle and on her blog at AdventuresofDoctorMom.com.

Don’t Share a Bed With Your Baby

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By Dr. Judy Melinek

It was one of the toughest phone conversations I have made in my 15 years as a forensic pathologist. I had just completed the autopsy of a three month-old infant. He had spent the night sharing an adult bed with his mother and six year-old brother. In the morning they found him prone, with his face against the pillow, dead. During the autopsy I found that blood had pooled under the skin of the baby’s face and abdomen after death, and I documented characteristic areas of pallor where the pillow had pressed against his nose and mouth. He had asphyxiated. After leaving the morgue I had to go pick up the phone and tell a mother she had accidentally smothered her son.

I investigate sudden infant deaths three or four times a year. Parents who lose a child to a bed-sharing accident inevitably ask me why the cause of death isn’t SIDS, sudden infant death syndrome. I have to explain that SIDS is a diagnosis of exclusion: the autopsy and scene investigation rule out injury, and we can’t find any fatal natural disease. A child who is found face-down with his nose and mouth covered has been injured. The cause of death in such a case is positional asphyxia, and the manner of death is accident. Accidents are avoidable, which makes that postmortem conversation all the harder. The parents blame themselves. I frequently end up in tears along with them. I have three children who were babies not that long ago, and though I’m a doctor I am not made of stone.

My medical colleagues and I were dismayed to read the Los Angeles Times Op-Ed of September 18, 2016 titled “It’s OK to sleep next to your infant child. In fact, it’s beneficial,” showing a photo of a smiling mom sharing an adult bed—with soft blankets and pillows—with her three month-old. The authors, two professors of human development, cite anthropological research while dismissing the recommendations for safe sleep promulgated by medical professionals, including those in the CDC and the American Academy of Pediatrics. This article operates under the fallacy that cross-cultural anecdotes trump hard scientific data. It conflates SIDS deaths with all sudden infant deaths, betraying an ignorance about asphyxial death in unsafe sleep environments. It also ignores differences in death investigation and certification between countries. For instance, the authors cite Japan’s low rate of reported infant mortality while ignoring the fact that fewer than 30% of infant deaths in Japan are autopsied. (Taylor BJ, et al. Arch Dis Child 2015;100:1018–1023. doi:10.1136/archdischild-2015-308239). They press the absurd and dangerous assertion that “the proven benefits of mother-infant co-sleeping far outweigh the largely imaginary risks.” These are not imaginary risks. They are real and they are tragic.  According to the CDC, infant asphyxia is the leading accidental cause of death in infants under one year of age. Parents who lose a child to a preventable death and parents whose children end up in a vegetative state after an anoxic brain injury suffer grievously. They have created support organizations like Charlie’s Kids and First Candle to educate others about safe sleeping, including co-sleeping without bed-sharing.

There are safe ways of sleeping next to your child in the same room without sharing the same bed, but most parenting websites and magazines do not distinguish between co-sleeping and bed-sharing. Self-appointed parenting experts who actively advocate for bed-sharing ought to recognize the recklessness of such a position. According to ICAN, the Inter-Agency Council on Child Abuse and Neglect, sudden infant deaths in unsafe sleep environments dropped from 69 per year to 35 after a 2013 safe-sleeping campaign in Los Angeles County. Public health outreach saves lives. Misleading parents about published death statistics in the interest of promoting unprovable life-balance benefits is irresponsible, and the endorsement of bed-sharing as a safe approach to co-sleeping is dangerous. Do not share a bed with your infant. It isn’t worth the risk of an autopsy.

:::

Dr. Judy Melinek is a forensic pathologist and does autopsies for the Alameda County Sheriff Coroner’s office in California. (http://www.pathologyexpert.com/drjudymelinek/) Her New York Times Bestselling memoir Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner, (http://www.drworkingstiff.com) co-authored with her husband, writer T.J. Mitchell, is now out in paperback. She is the CEO of PathologyExpert Inc. This article was originally published at her blog.

 

 

Are Dogs and Kids a Dangerous Combination?

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By Dr. Jennifer Greer

It only takes a second.

Dog bites can happen to anyone… We were on a long weekend at home, and I was brainstorming ideas from Pinterest to keep my toddlers busy, as the dreary weather kept us cooped up indoors. The kids were completely wound up, and repeatedly tearing their way through the indoor obstacle course we had created out of furniture. Our 13-pound MaltiPoo was getting wound up as well, chasing the kids around the room. I turned my back for just a minute… and heard a shriek from my 3-year-old.

Dog bites are very common.

Dogs bite an estimated 4.5 million people every year. And dog bites to the face are one of the more common reasons my Plastic surgery skills are need in the middle of the night. Preschool age children are more likely to be bitten in the face or neck because they are low to the ground. And as I know from watching my own toddlers, they love to get right up and personal with dogs for hugs and kisses. Older children and teens are bitten in the arms and legs as well as the face. Again, this makes sense. Older kids are taller, and don’t have that same tendency to lead with the face.

I’m usually on the other end of this story.

As a mom I’ve always been very sympathetic for the parents involved whenever I’m called to the ER in the middle of the night. The ER is an unsettling place, especially if you aren’t in the medical field. You’re worried about your child, and you have the added stress of keeping him occupied for several hours in a strange environment. And bites to the face are especially scary: they bleed, sometimes a lot, and of course you worry about how it’s going to heal. Now I understand firsthand the questions that run through your head: “Is my kid going to look okay? Will the scar be bad? Did I fail as a mom?”

As I mentioned, my dog is a MaltiPoo- a Maltese poodle mix that’s the exact opposite of threatening. Given her small size, I’ve always thought she’d be less likely to do significant damage. But it turns out small dogs (Shih-Tzus were specifically named in one study) are the most common culprits when it comes to biting young kids. There wasn’t any explanation of why this might be. But I would suspect it’s because little dogs are cute and approachable to young children.

Older kids, in contrast, are more likely to be bitten by larger dogs; pitbulls and pitbull mixes accounted for 50% of the bites to older kids in one. One other fact you may not be aware of: the dog is known to the victim 68% of the time.  I know I personally have a tendency to get complacent around dogs I know, thinking “he would never bite.”

But biting is natural behavior in dog; older dogs will give younger dogs a quick nip to let them know they need to back off. And it’s not uncommon for a dog to use this same method of communication on an over-exuberant toddler. The toddler, unfortunately, does not have a protective layer of fur. So even a small nip can result in a deep cut.

Wyatt’s bite was little more than a scratch.

We lucked out at my house. I don’t think my dog really meant to hurt my son. He’s a typical three-year-old: loud, boisterous, and low to the ground. And Maggie has a bit of a nervous disposition. This was probably her way of telling my son to back off and get out of her face. Although the bite broke the skin, it could have been much worse.  I’ve seen bites to the face that split the nostril completely or went all the way through the lip. Even these weren’t even true attacks – just a quick nip on the dog’s part. (If you’re wondering what an actual dog attack looks like, imagine multiple bites over multiple areas of the body. Absolutely gruesome, in other words).

Yes, Wyatt’s cut could have used a stitch or two.  If I had seen him as a patient in the ER, I absolutely would have sutured it closed to make the scar better. But when I mentally debated the benefit of a narrower scar vs. the trauma of going to the ER and needing sedation I chose to tape the wound shut with some steri-strips.

The wound healed well.

No infection developed, thankfully. And when the steri-strips fell off a week later the cut was completely healed. The scar is starting to fade, and from my experience as a Plastic surgeon I know it’s going to be a fine white line eventually. But when I recently saw a photo of Wyatt without the scar I was sad: I felt like I failed as a mom.

What if your child is bitten? If your child is bitten by a dog, have a low threshold for going to the ER. Anything more than a very superficial scratch should be seen by a doctor within the first 24 hours. Dog bites can become infected fairly easily, so having the wound evaluated right after the injury is important. You’ll likely be asked the following questions by the ER staff:

When was your child’s last tetanus shot? If it’s been more than five years, or if you can’t remember, then your child will need a tetanus booster shot.

Does your child have any allergies? The data aren’t clear-cut whether giving prophylactic antibiotics (i.e. to prevent infection) actually decreases the risk of infection. So don’t be alarmed if you get sent home without an antibiotic. (And this is why I felt comfortable not starting my own son on antibiotics, knowing I had the experience to recognize the early signs of an infection). But most doctors do error on the side of caution and routinely give antibiotics to anyone with a dog bite.  This is especially important if your child has diabetes, if the bite occurred in the hand, or if it’s been more than 12 hours since the bite occurred: both of these factors increase the risk for infection.

Is the dog up-to-date on vaccinations? Rabies is fortunately pretty rare in the United States – there are fewer than 100 cases per year in dogs. But once symptoms develop rabies is always fatal. If the dog isn’t up-to-date on vaccinations, animal control will observe the dog for 10 days. As long as the dog remains healthy, no further treatment is needed. But if the dog develops symptoms of rabies such as seizures, excessive drooling, or difficulty walking, then a series of shots can prevent rabies from developing. If the dog cannot be watched, i.e. in the case of a stray dog that ran away, your local health department can advise whether rabies prophylaxis is needed.

How bad will the scar be? How a scar heals depends on a few factors. First, how traumatic (physically, not emotionally) was the injury? The more trauma to the tissue, the worse the scar may be. Dog bites can range from a fairly clean scratch to torn or missing tissue.

Second, how is the wound closed? Contrary to common belief, closing a dog bite with sutures doesn’t always increase the risk of infection. The face is obviously a cosmetically sensitive area, and I always suture wounds on the face closed so that the scar is the best possible. Puncture wounds or wounds on the hand have a higher risk of infection, so these may be left open. Time from the injury affects the risk of infection as well. If it’s been more than 12 hours since the bite occurred (24 hours if the bite is to the face), then the wound may be left open as well.

The third factor that affects scarring is how quickly the wound heals. The more quickly the healing, the better the scar. While the dog bite is healing I advise my patients to apply Vaseline or bacitracin a couple times a day. This keeps the wound moist, and moist wounds heal more quickly. I do recommend cleansing the wound with mild soap and water once a day. Soaking in a bathtub isn’t recommended, but if your child is old enough to shower, it’s okay to let soapy water run over the wound.

Once the dog bite is fully healed, it can take 6-12 months for the scar to settle. During this period the scar will be pink or red, and may be slightly raised. Applying a silicone-based scar cream like Siligen or Biocorneum will help the scar fade more quickly. These scar creams are clear and dry quickly, so most kids tolerate them pretty well. If your child won’t let you apply the scar cream, try having him apply it himself. My son still likes to put scar cream on the fading scar on his cheek! Many of these scar creams already have SPF. But if yours does not, applying sunscreen daily is critical for the first year if the scar is in a sun-exposed area. This will prevent the scar from becoming permanently darker than the surrounding skin.

Some people do develop widened or thickened scars, despite our best efforts. And kids especially have a tendency to heal a little overenthusiastically, meaning they form excess scar tissue. If the scar does raise up or thicken, steroid injections or laser treatments can improve the appearance, even years down the road.

So what now?

Prevention is always the best treatment for a dog bite. Keep a close eye on children and pets. Even a well-tempered dog can get frustrated, and one good nip is all it takes to do damage.

My husband and I talked at length about the situation in our house. We agree that not keeping a closer eye on the dog with the kids was our failing as parents, so we’ve made a few changes. We’re teaching Wyatt not to get in the dog’s face. We’re also showing him how to give commands to Maggie, so that she respects him as a person, and doesn’t treat him like an unruly puppy. Most importantly. we’ve agreed not to leave the dog and the kids alone, even for the amount of time it takes to run to the bathroom.  Once the kids are 4 and 5, we’ll probably be able to relax a little. For now, if Maggie spends a lot of time in the bedroom during the day, that’s okay.

:::

Dr. Greer is a Plastic Surgeon who practices in Cleveland, OH. Her passion is helping moms regain self-confidence by getting rid of sagginess, wrinkles, and stubborn fat. Read more at her blog.

 

Sources:

Dog bites in a U.S. county: age, body part and breed in paediatric dog bites. Ramgopal SBrungo LBBykowski MRPitetti RDHickey RW. Acta Paediatr. 2018 May;107(5):893-899. doi: 10.1111/apa.14218. Epub 2018 Feb 5.

Pediatric Dog Bite Injuries: A 5-Year Review of the Experience at The Children’s Hospital of Philadelphia. Kaye, Alison E.; Belz, Jessica M.; Kirschner, Richard E.

Plastic and Reconstructive Surgery. 124(2):551-558, August 2009.

 

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