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Parenting in an age of personal devices

For decades parents have worried about the amount of time their children spend in front of electronic media.

Many of today’s parents grew up in the 1980’s and 90’s, when their parents worried about a per-child average of 3 hours a day spent watching network and cable TV.

Many of those kids have become parents to children growing up in a world of wireless media and limitless bandwidth. New channels of connectivity are literally reshaping our children, socially and developmentally and physically. The average total screen time for children today is an astonishing 7 hours per day, and of course there are many more types of screens.

From a health standpoint, there are significant concerns about children’s use of handhelds, whether these are smartphones or tablets.

Clinical concerns include:

Posture

A human head weighs about 12 pounds, and when standing up straight, it puts that amount of stress on the spine. But as we look down, the strain increases, to as much as 60 pounds as the chin nears the chest, which is the most common posture of texting and iPad use.

Repetitive Stress Injury

Holding a phone and tapping out words puts unnatural stress on the tendons and muscles of the thumb and forearm. Our powerful thumbs evolved for gripping – to put it simply, they are like the bottom half of a pair of pliers. They were never intended for hunting and pecking at tiny letters. Hours of daily texting can lead to tendonitis, carpal tunnel syndrome and other debilitating problems.

Accidents

Another real physical risk involving mobile media is accidents. More than 3,000 teens die each year in crashes caused by texting while driving. (By comparison, roughly approximately 2,700 teens are killed in drunk driving accidents.) More than 50 percent of teens admit to texting while driving.

Pedestrian injuries related to cell phones ranged from falling off walkways or bridges to walking in front of moving traffic. The study found that in 2010, 1,500 pedestrians were treated in emergency departments for cell-phone related incidents, as opposed to a mere 559 in 2004.

The attractions of mobile devices are an undeniable challenge to parents who want to limit their children’s screen time, yet there are strategies that can be employed to counter their attraction.

Enabling and Encouraging Immersive Experiences

You can make a positive impact in your child’s relationship with devices by encouraging them to join in on activities that are engaging and exciting.

  • Team sports
  • Martial arts
  • Yoga
  • Dance
  • Phone-free walks and bicycling
  • Artistic pursuits
  • Music lessons
  • Painting
  • Theater
  • Community based resources
  • Boys & Girls clubs
  • Social service opportunities

Additionally, most mobile devices have options for that will set time limits on session length. These controls are usually found in the “settings” area of the device.

Finally, engaging children in face-to-face conversation or games is a means of both building child-parent bonds and creating device-free time. Keep in mind that as adults we are far from immune from the distractions of our phones and iPads.

Leading by example is one of the best ways to ensure that our kids will develop media habits that are reasonable and balanced.

If you have any questions or concerns relating to these issues, speak with your doctor or pediatrician.

Communicating well with your child.

Conversations with your children are one of the most important ways you can keep them safe, resilient and loved. They can also be one of parenting’s most long-lasting satisfactions.

Real communication is easiest to establish when families are young, yet there are paths to openness that can be explored during any phase of family life.

Conversation tends to flow freely during ‘normal’ occasions, for example:

  • At the dinner table.

The benefits of families sitting down to eat together have been proven in study after study, as a means to build lifelong bonds, as well as social skills.

  • In the car.

Parental driving duties offer an opening for conversation.

Cell phones are a potential flashpoint, in cars and elsewhere.
Lead by example: tell them, firmly, that you are turning your cell phone off and they must do the same. This is particularly appropriate in the car, but cell-free time can be judiciously scheduled.

For example, at the dinner table, have everyone put their cell phones (muted) in a basket. Whoever uses their phone does the dishes.

  • At bedtime.

Opportunities to converse can also arise from other activities:

  • Working on a puzzle together.
  • Listening to a favorite song of theirs (and one you liked when you were their age.)
  • Sharing a poem.

Here are a few pointers:

  • True conversation takes place between equals.
  • Listen hard and with respect.
  • Engage your kids with leading, open-ended questions.
  • Address them by name.
    “Meghan – what was the best part of practice for you?”
    “Tony, what did Mrs. Summers have to say about her trip?”
    “Where would you like to go if we could go anywhere Brian? “
  • Avoid offering solutions or supplying answers.
  • When it’s your turn to talk, repeat a bit of what they’ve said and extend it with a leading question:
    “So, how do you think this will turn out? “
  • Speak infrequently, and be mindful of your tone of voice.
  • Be patient, especially during silence.
  • Avoid suggestive phrases that begin with “you should.”
  • Be thoughtful about topics, observant about your kids’ interests and concerns, and wait for the best time to raise them.
  • Time your topics for the right moments.

At some point, every child needs someone to turn to, and it is then that a well-established line of communication can literally be a lifesaver. It’s much harder to establish a rapport in the midst of a crisis.

If you have any questions or a specific concerns consider speaking with your child’s pediatrician.

Talking with your kids about prescription drug abuse: Earlier is Better

Every day, teens are bombarded with conflicting messages about drug use that may leave them feeling confused and unsure of whom to ask for information. With 7.4% of teens reporting abuse of prescription drugs in the past year and 22.6% of 12th graders reporting using marijuana in the past month, it’s crucial to reach teens, and pre-teens, with the facts.

 

Did you know…

  • that 1 in 4 teens report they have taken a prescription medicine that was not prescribed to them?
  • 66% of teens who report abusing prescription medicines are getting them from friends or family members?
  • prescription medicines are now the most commonly abused drugs in kids 12-13 yr old?
  • after marijuana, prescription and over-the-counter medications (like cough medicines!) account for the most commonly abused drugs in teens?

 

Find out more from these websites:

teens.drugabuse.gov and medicineabuseproject.org to learn how to talk to your kids about drug use—and how important it is to make good choices!

Brain Power Snack Ideas for your Children

brainpowersnacks

With your busy schedule and active lifestyle, it can be difficult to pack healthy snacks for your children. While pre-packaged snacks are an easy choice, they are often loaded with processed ingredients that can be harmful for kids. Here are a few options for easy, healthy snacks that are kid-approved:

1. PB and fruit protein rolls

Peanut butter and jelly is always a hit when it comes to children. These no bake, PB and fruit protein balls taste like peanut butter and jelly, but they pack an extra protein punch. All you need is a cup of dried fruit, ½ cup of natural peanut butter, a cup of flake oats, two scoops of vanilla protein powder, ¼ cup ground flax and 3 tbsp of vanilla almond milk! Find out how to make them here.

2. Cheese and cucumber sandwiches

This healthy snack can be made in just a few minutes. It still has the great crunch of cheese and crackers and it gets your kids about ¼ of their recommended daily vegetable intake.

3. Apple sandwiches

Apple sandwiches are the perfect after-school snack. The combination of apples, almond butter and granola gives your children enough protein to stay full through after-school activities until dinner. All you need is five minutes to core and slice apples and mix almond butter with granola.

4. Banana bites

Banana bites are a great portable snack and are also perfect for an addition to lunches. All you need to do is spread natural peanut butter on a whole wheat tortilla, place a banana on the tortilla, roll the banana into the tortilla and cut it into bite-size pieces.

5. Veggies and hummus in a mason jar

Pack the bottom of a mason jar with hummus and place your favorite vegetables on top for an on-the-go snack. If your kids aren’t a fan of hummus, try adding peanut butter or homemade yogurt dip with natural peanut butter, Greek yogurt and honey.

Former Pediatric Patient Returns As Clinician

Briana Whalen, NP & Sherwood Lee, MD

 

Thinking back over four decades as a pediatrician, Dr. Sherwood Lee can only guess at the number of children who have been entrusted to his care. Some of the kids he saw in the early years of his practice are now grandparents of current patients.

On the whole, he reckons, the tally has to be in the tens of thousands. Yet of all those he has cared for, only one has returned as a clinician to work alongside him.

That former patient and current colleague is Briana Whalen, NP, now working with Dr. Lee and others in our busy Haverhill Pediatrics office, where she’s soaking up the art and science of caring for children.

Briana, who grew up in Haverhill, is the daughter of Bruce and Jennifer Franz. Following high school she attended Northeastern, earned her Master’s as a Family Nurse Practitioner, and before coming to Pentucket Medical in July of 2014 spent six years at a Mass General inpatient medical unit, where she cared for adults.

“Caring for the little guys,” Briana says, “is a big-time different world. It’s a lot different than working with adults. I am learning a lot from all of my colleagues.”

“I started my own schedule in February,” she adds. “I’m doing one physical an hour, and as I learn the ropes the pace is picking up. The support I’ve been getting here is amazing. It’s an ideal situation for someone like me.”

Dr. Lee sees a bright future for Briana.

“We’re hearing nothing but good things,” he says. “She has a good rapport with patients, and that’s very important in pediatrics where you have to develop a bond with not only the patients but the parents, in order to get information and to do the exam appropriately.

“It takes time,” he says. “I’ve always felt that 90 percent of what you need to know as a pediatrician you can learn in the first year or so of practice, but it takes 20 years more to learn the last 10 percent.”

Briana is focused, confident and hungry to learn. It’s clear she loves the challenge.

“Haverhill pediatrics is a big practice. It’s nice to see other people’s styles,” she says. “I come home at night and go online and read up on one thing that I’ve picked during the day to look into,” she says. “Harriet Lane, that’s the pediatric bible!”

There is no mistaking the pride in Dr. Lee’s voice as he talks about his former patient and new colleague, but when asked about it he deflects the question.

“My job as a pediatrician is to make sure they grow up healthy,” he says. “It’s really the parents that set the stage. “

Get Smart About Antibiotics

issues with antibiotics

 

WHY use antibiotics smartly??

Antibiotics, like amoxicillin or Zithromax, do not fight viral illnesses such as colds or URIs (upper respiratory tract infections). In fact, taking antibiotics for colds can be harmful and make future infections harder to treat. Here are some facts on antibiotics we all need to be aware of to keep us healthy!

  • Antibiotics are life saving — when used wisely to preserve their strength for future bacterial illnesses.
  • Antibiotics only treat bacterial infections — Colds, the flu, coughs, URIs, some ear infections DO NOT get better with an antibiotic. Saline nose sprays with nose blowing, fever reducers or pain medications can help but not antibiotics.
  • Most sore throats DO NOT need, or get better with an antibiotic — most sore throats are viruses, and not strep throat. Thus antibiotics do not help.
  • Green colored mucus is NOT a sign that an antibiotic is needed — Sinus infections are not a cold or nasal stuffiness that has only been for 3-5 days, even if the mucus is green. Antibiotics do not help this — saline nose sprays and good nose blowing help much more.
  • There are potential risks taking antibiotics — these medications can cause diarrhea, upset tummy and, rarely, a serious life threatening reaction. And, antibiotic use can cause bacteria to develop resistance (not work) to the antibiotic. These resistant bacteria multiply, can cause severe illnesses AND not respond to our current antibiotics.

Antibiotic Resistance — WHY the big deal?

Antibiotics kill bacteria, but not viruses, that can cause infection but bacteria can change and become resistant to antibiotics and thus not be killed but multiply and spread.

Every time a person takes an antibiotic, sensitive bacteria die but leave resistant bacteria to grow and multiply. This means infections caused in the future by these bacteria may not respond to antibiotics.

Almost every type of bacteria has become less responsive to antibiotic medication.

Use of antibiotics when not needed (such as for a cold, URI, cough, the flu, bronchitis, most sore throats—all usually viral infections) is one of the main causes of antibiotic resistance.

Antibiotic resistance means that our body may not get better with the antibiotic when we really need it—this can lead to more serious infection and even death.

Summer Safety Tips for Families

Summer is almost here! Playing outside, riding bikes, trips to the playground, beach, and/or pool should be fun and not cause for stress or worry! To keep your summer fun and safe, here are some tips from the American Academy of Pediatrics worth sharing.

Bugs

They are everywhere! Ticks, mosquitoes, black flies, wasps/bees- UGH! Avoiding them can be tricky but avoiding areas where they may be—such as stagnant pools of water, tall grassy areas near woods, and not being out in the early morning and early evening can limit our exposure. Not using scented soaps, perfumes, and hair sprays on your child and not dressing them with bright colors can limit bugs from being attracted to your kids. DEET containing bug repellent products can be used on children older than 2 months of age—including up to 30% DEET. 30% DEET protects for a longer period of time (5hr) than 10% DEET (2hr). DEET is safe as long as it is not put in the mouth or eyes and washed off when your child comes inside. It can protect your child from not only mosquito bites but ticks as well. Ticks can carry Lyme disease and mosquitoes can carry infections like Wet Nile, Dengue Fever and EEE. Never use the combined bug and sun products—as sunscreen should be reapplied every 2 hours, but bug repellents should not.

 

To prevent a trip to the Emergency Department, ensuring the playground is safe is a must!

  • Ideally, the playground area should have at least 9-inches of sand or wood chips/bark or 6-inches of shredded rubber underneath the equipment and 6 ft in all directions around the equipment.
  • Check for protruding bolts/nails or open “S” hooks which can lead to injuries.
  • Make sure your child cannot reach any moving part that might pinch or trap any body part.
  • Check to make sure the slide or bars or seats are not too hot—this can cause burns.
  • NEVER attach ropes, jump ropes, leashes or other similar items to playground equipment—children can get rope burns or strangle themselves.
  • Make sure your child wears shoes to prevent tripping or injuries to their feet!
  • ALWAYS supervise your child.
  • Many injuries occur when children play on a trampoline—if you have one ensure only one child jumps at a time and that the trampoline is enclosed.

Bike Safety

Always make sure your child—at any age and any place—wears a helmet! A helmet should have a sticker that says it meets the CPSC safety standard and fit properly—it should be snug on the head and worn level on the head to cover the forehead and not tipped backwards or forwards. The strap should be fastened with about 2 fingers able to fit between the chin and the strap. AND, if your child does fall and the helmet hits the ground, it needs to be replaced. Also the bike should fit the child—an over-sized bike can be dangerous and lead to injuries.

Skateboard, Scooter, Heelys Safety

Not only are helmets (that meet ASTM safety standards) needed but so are protective wrist, elbow, and knee pads. Children should use skateboarding parks and avoid riding in streets or using homemade ramps and jumps. Also, ensure your child rides alone on the skateboard/scooter/heelys and is not being pulled by someone—this can lead to falls and broken bones!

Fireworks

Can be beautiful to see, but can result in severe burns and scars—even sparklers! It is best to attend community firework displays run by professionals and NOT use fireworks at home.

Sun

Always ensure your child has sunscreen (even on cloudy days!) with an SPF 15 or greater that protects against both UVA and UVB rays. It should be applied liberally and reapplied every 2 hours OR after swimming or sweating. Eyes can also be “sunburned” so wearing sunglasses that protect against UVA and UBV rays—especially if at the beach or if your child is very light skinned- is a must!

Water Safety

NEVER leave your child alone near water (any pool, spa, beach, river, pond)—not even for a moment. NO ONE should swim alone—not even an experienced older teen. Inflatable swimming aids are not safe and should not be used as a substitute for an approved life vest. Swim lessons can help, but do not make your child “drown-proof”. If you have a pool of any kind, check out www.poolsafely.gov for tips to keep you and your child safe while enjoying the pool! If you go to a beach or public pool, never let your child swim unless there is a lifeguard (or an adult who knows about water rescue) present. For more water safety tips, visit www.healthychildren.org.

 

 

Kids in cars – THE SAFE WAY!

by Brenda Foley, MD

Motor vehicle related accidents are one of the leading causes of death in children in the U.S. It has been demonstrated that the appropriate use of car-seats can reduce traffic deaths of children by at least 80%. However, it is thought that as many as 80% of car-seats are not used correctly.

Tips using car-seats to keep your child safe

  • There is no “best” or “safest” car-seat. How much a car-seat cost does not determine how “good it is”!
  • New is better – Using a used car-seat bought at a yard sale or thrift store may not be safe, as car-seats wear over time and older seats might be missing parts, labels, and instructions on proper use. Also, they may have damage you cannot see or have been recalled.
  • Make sure the car-seat not only “fits” your child but fits properly in your car—in the backseat! The car-seat should be buckled tightly in the car and should not wiggle more than one inch side to side or front to back. Your child should fit “snugly” in the seat and you shouldn’t be able to pinch any of the harness straps between your fingers.

There are many types of car-seats:

  • Infant only carrier type car-seats
  • Convertible safety seats
  • Combination seats
  • Booster seats

Always follow the manufacturer guidelines of the car-seat. Ideally, children under 2 should be REAR-facing but many children will “outgrow” the infant carrier type car-seat. This is based on your child’s weight and height and they can still be rear-facing in a convertible car-seat. Continue using a 5-point harness type car-seat for as long as possible—until your child has reached the max height/weight limit. ALWAYS refer to the car-seat manufacturer’s instructions on proper use.

Children should not sit in the front seat until they are 13 years or older and should always where a seat belt with a shoulder strap. The lap belt should fit on the hips and NOT the belly and the shoulder strap should fit snugly across the center of your child’s shoulder, not the neck.

Check out this website for more information on picking out a car-seat and using it properly:

Protecting Our Children: VACCINATE!

Vaccines save lives

Diseases like tetanus, polio, H.Influenzae, smallpox and diphtheria often led not only to significant illness but to death or permanent injuries have essentially been eliminated here in the US because of vaccines.

Vaccines improve health

Pertussis, mumps, measles, chickenpox, pneumococcal, meningococcal, Hep A, Hep B, or rotavirus infections—all which often caused many acute illnesses/ED visits/hospitalizations, and occasionally death or severe injury, have also been significantly lessened because of vaccines.

Vaccines protect others and future generations

In 1960, there were 90 reported deaths from polio, 76 from pertussis/whooping cough, 68 from Diphtheria, and 380 from measles. In 2007, there were no deaths from any of these illnesses! We no longer need smallpox vaccination because the disease has been eliminated through vaccination. Polio hasn’t been seen in the US in decades because of vaccination. In the future some of the diseases we now vaccinate for today may be fully eliminated and the vaccines not needed—just like smallpox!

Vaccines can prevent cancer

HPV vaccine prevents cervical cancer in young women and penile cancer in young men.

Vaccines ARE safe

Although they may cause some pain and discomfort they have NOT been linked to autism or autoimmune disorders and serious side effects are extremely rare. The benefits provided from vaccines—prevention of serious illnesses—are much greater than the risk of serious side effects. And, they have been studied and reviewed by numerous scientists and doctors who have NO financial incentive in the vaccines.