Monthly Archives: September 2012

You Are Your Child’s Best Coach

family_walkingWhen was the last time you spent time with one or more of your children in an unplanned, unstructured activity? Do you feel anxious when you have time with your children alone? Do you feel that you should arrange play dates when your children “have nothing to do”? If you answered yes to any of these questions, you are not alone.

More often than not, parents in today’s society have never learned how to “be” with their children or to “play” with their children. In fact, I believe that many of them are afraid to be with their children. They want to do what’s best for them, and yet they don’t trust that unstructured time with them can be what is best. They have simply lost that instinct.

Many experts have come out and told parents that over-scheduling is not healthy for their children, but for many it is still a way of life for their family. They plan so many activities per child that a computerized scheduling system seems necessary to coordinate the carpools, coaching, games, dance recitals, etc. Some children are stressed; others seem to go with the flow. But I have never met a parent in this situation who is not stressed by the constant on the go schedule.

So why do parents get themselves and their children into this situation and seem unable and unwilling to change it? Somewhere over the past few decades, parents lost confidence in themselves as those that knew what was best for their children. At the same time, a proliferation of sports and activities for children developed along with the idea that early involvement was necessary for a child to be able to become competitive and successful when they were older.

A corresponding competitive spirit among parents emerged and seemed to match the growing industry of coaching, tutoring, and instructing young children in everything from soccer to computer science. Parents feared that their children would be at a disadvantage were they not included in these sorts of activities and so the idea that time spent with teachers, coaches, instructors and the like was “better” than time spent as a family arose. What’s more, for some parents, living vicariously through their children’s achievements, can become a powerful force of its own. With all of these competing factors, where does this leave the role of the family in a child’s life?

If you see signs of this kind of behavior in your own family and are tired of this lifestyle for yourself and for your child reflect on the following… Children do best when they are involved in sports or arts programs that stress enjoyment rather than intense competition. Children also avoid stress and the associated “burnout” when they have a variety of activities and are not pushed into “one” sport or activity to the exclusion of all others and of family time.

Children need time with you. Throwing a ball, shooting baskets, playing music, dancing in the living room – enjoying one another — are all very important ways to connect with your children. Sounds old fashion? Well it is! But try spending some unstructured time with your child and work through the anxiety you will feel that your child is “missing something”. Then follow some simple rules:

  • One team in one sport per child per season, and one non-sport activity such as in music, art, dance, creative writing, theater or computers.
  • Avoid very intense competitive leagues or traveling teams that require a child to practice more than one to two times a week or that demand play on holiday weekends and during vacation time.
  • Avoid intensive dance, gymnastic or music programs that require rehearsals more than two times per week.

If you follow these rules there will be plenty of “off time” for both parent and child. And you will hopefully see your anxiety decrease and your confidence increase as you spend more time with your child.

Lastly, remember — the chances of a child becoming a professional ball player, an Olympic gymnast, or a professional singer are really very small. But the chances that they will become a parent themselves who will have children who need them is really much greater. Try focusing on life lessons and developing skills that will help them meet those challenges and become better human beings. You will likely find far greater reward and satisfaction in these pursuits – and so will they.

Sore Throats

The winter months are a time of sharing germs in the classroom and at home and the season of sore throats and runny noses. How can a parent tell if they need to bring their child to the pediatrician for a sore throat. Here are some of the basic facts you will need to know…

What causes a sore throat ?
There are a variety of causes. Most are caused by viral or bacterial infections that invade the throat and cause redness and swelling of the tonsils and surrounding tissue, causing pain. A sore throat can also be caused by allergies with an associated post-nasal drip that irritates the throat. A bacterial sinus infection also can cause similar problems, as infected mucous drips into the throat. Other potential causes include irritation from cigarette smoke or dry air in a home.

What is “strep” throat?
Although most sore throats are viral and not caused by bacteria, strep throat is the exception. It is caused by the streptococcus bacteria and is the most common bacterial infection of this area. It requires treatment with antibiotics.

How can I tell if my child has strep throat or just a cold?
The signs and symptoms of strep throat infection are a painful throat, usually accompanied by fever and swollen, enlarged tonsils and lymph nodes that you often can feel on the side of the child’s neck. Other symptoms can include headache, abdominal pain, vomiting, pain in the back of the neck, joint pain, muscle pain or a fine red rash. Other rashes that strep can cause are hives and a very red swelling of the groin area.

Why does the doctor do a throat culture?
The strep test or throat culture is needed because even to the best examiner, many illnesses can look similar to strep throat. Many viruses-especially mononucleosis or adenovirus-can produce a red throat with swollen tonsils covered with a white coat of infected pus. Many more viruses can produce a red throat and fever. Not all of these illnesses require treatment with antibiotics, and in fact antibiotics may make things worse.

My children hate strep tests. Isn’t there an easier way?
The only way to test for strep is to obtain a swab of the secretions on the tonsils. The only way doctors can do that at present is to use a long Q-tip to obtain the material. Even with the best technique it can still cause your child to gag or even vomit after the procedure. Your support during the procedure can really help a child tolerate the swab.

What’s the difference between the short and long strep tests?
The quick strep or rapid strep test is a screening test. Using a reaction between the antigens taken from the throat swab and the antibodies for strep in the kit, we can find a positive strep infection 85% of the time. However, this method is not fool proof and should always be backed up by an overnight culture of the throat swab material.

How do I know if I need to bring my child in for a throat culture?
If your child has a sore throat with a fever and any of the symptoms listed above, she or he should be tested for strep. If your child has a cold, cough, laryngitis or hoarse voice, it is less likely that he or she has strep. However, if your child continues to complain for more than 3-4 days about the throat please call your doctor to discuss whether or not your child needs to be seen.

If it’s so obvious, why do we have to bring our children in for a strep test?
The strep test or throat culture is needed because even to the best examiner, many illnesses can look similar to strep throat. Many viruses-especially mononucleosis or adenovirus-can produce a red throat with swollen tonsils covered with a white coat of infected pus. Many more viruses can produce a red throat and fever. Not all of these illnesses require treatment with antibiotics, and in fact antibiotics may make things worse.

I have heard that babies can’t get strep. Is this true?
For unexplained reasons, babies and young toddlers rarely get strep. No one is exactly sure why this is so, however, there may be age differences in our immune systems. It is not impossible for infants to get strep infections, however, and your doctor may test for it, especially if there is a close family member with a strep infection or an outbreak in a day care center.

If my one child has strep, why not treat all my children?
It is not thought to be a good idea to treat asymptomatic children for strep. For one thing it may be unnecessary use of antibiotics, as not all children exposed will get the strep infection.

Why does my child get repeated strep infections?
The strep bacteria remain sensitive to most penicillin or erythromycin antibiotics. True resistance is rare. If treatment failures occur, it may not be that the antibiotics aren’t working, but rather because, after a strep infection is treated, the enlargement of the tonsils continues for some time. These enlarged tonsils are like “catcher’s mitts” for whenever the next child in class coughs the strep bacteria nearby. Some researchers also believe that other bacteria that live in our throats may act to decrease the strength of the antibiotic. If your child is having repeated strep infections, your pediatrician will discuss the treatment options with you.

What can I do to make my child feel better?
Regardless of the cause of the sore throat, the pain can be treated with acetaminophen (Tylenol) or ibuprofen (Motrin or Advil). Depending on the age of the child, lozenges or ice pops can also be helpful to ease the pain. Providing a humidifier or cool mist vaporizer in your child’s bedroom is also helpful in reducing the dry air which can aggravate any sore throat. If the doctor prescribes antibiotics, follow the directions completely. It’s important to treat strep infections for a full ten days to prevent rheumatic fever, a rare complication of strep infections.