Friday, November 29, 2019

The Power of story telling 2019

My mom could go into a room full of chaos. “Once upon a time..” she would start in a steady calm voice.
It wouldn’t be long before everyone in the room was hanging on her every word; whatever they had been worrying about a moment ago was forgotten. She would then take her audience on a magical journey with a story that she often made up as she went. If it were a classic tale, you could count on her to take dramatic liberties. I don’t believe she told any story quite the same way twice. In her kindergarten classroom she would have her students shut their eyes as she told her tales. "Use your imagination", she would tell them. "I am thinking of a big black dog, he has 2 floppy ears. He also has 2 tails and 3 eyes!"
One distinct recollection of a time when mom’s storytelling saved the day comes to mind. My younger daughter Alana had several friends spending the night. In one of my bigger lapses in good “mommy judgement” I had rented a movie that I thought they would all enjoy. It turned out to be fairly dark and scary (always pre-screen, don’t rely on faulty memory of what may or may not be appropriate.) One of the girls started to cry and some of the other girls started to get sad and upset. A few of them wanted to stop the movie, but of course most of the others wanted to keep watching. The situation seemed like it could go downhill quickly. Fortunately my mom was visiting. She took control, turned off the movie and started to tell stories. These weren’t toddlers; they must have been about ten. They sat raptly listening to story after story. The evening was saved.
Books are wonderful too, but in truth, they are perhaps not quite the same as a story. A story is yours to tweak as you please. Stories are powerful mediums for working through issues. Folks who have asked me for parenting advice over the years know that using stories is a favorite tool. For as long as I can remember I have been counseling parents to create a fictional child with a similar name. Talk about what that parallel child has been going through. This tends to be a very non threatening way to talk about all sorts of issues.
Once upon a time there was a little girl who had an “owie” ear. The doctor had given her some medicine to make it better, but when she tried the medicine it tasted yucky.”....
Once upon a time there was a little boy who didn’t like to stay in bed……
Once upon a time there was a little girl who didn’t want to go to school...
Once upon a time there was a little boy who liked to put pieces of cheese in his nose….
These stories are great ways to launch into a dialogue about all sorts of positive and/or negative ways that the protagonist can deal with a variety of situations. This is an excellent problem solving technique.
When I was working on this post, I mentioned the storytelling theme to one of the wise mamas in my life. She immediately referred to these as “Annie Stories”. It turns out that back in 1988 this was quite the thing, and there was a book about how to use this method:

I use storytelling at work on a regular basis. I can’t even count how many times I used to be called into an exam room where a crying, or cowering child was terrified of a “dreaded shot”.... I would start my story:
“Once upon a time there was a patient who was so big. He played football for his high school. He was bigger than me, he was probably bigger than the grown up in your house, he was really big...and he was really scared of getting shots." At this point 90% of the kids had stopped thrashing about and were now listening to me talk. Yes, they might have been huddled on their parents' lap, or on the floor under the chair. They were probably not making eye contact, but I had their attention.
“He wasn’t afraid of getting bumped around on the football field but he hated shots. He was so scared of them that he would try to hide. He tried to hide inside the garbage can, but he wouldn't fit..” Now 99% were actively listening and some were almost laughing.
From here I was able to start a dialogue with them about why we were giving the shot. “It is magic protection so that if certain germs get inside of your body, you won’t get sick.” We talked about the fact that we wish there was a less yucky way to get the protection and that it is really normal for lots of people to be scared of shots. We talked about the fact that being brave is trying hard to hold still and it is still really okay to cry and yell if they need to. Before you knew it, they were ready and my wonderful assistant Josie had already gotten it done.
It all starts by engaging them with a story.
Not everything has to have a purpose. Sometimes stories are just for fun.
If I happen to be taking a walk outside and see something unusual such as a pair of shoes, sitting by themselves on a street corner, I can’t help to think to myself. Here is a story. How did those shoes get there? Take turns telling the same story. Families can have a wonderful time creating a collaborative tale. Another wise mama tells me that she used to have her kids give her three things that they wanted the story to include; perhaps a special name or a certain feeling.
Our kids these days are both blessed and cursed with the enormous choices of digital wonders. I am not opposed to limited use of regulated tech time, but it should not be in place of plain old imagination.
Recent studies show that books and stories started young have a real impact on brain development:
This Black Friday, as people run around to shop for all kinds of new technological marvels, don’t forget to “power down” and be thankful for the magic moments that you capture as you snuggle with your kids and simply tell a story. "Once upon a time......

Friday, November 22, 2019

Food Safety guidelines 2019

Here is my updated food safety guide, just in time for the turkey leftovers

I was recently back in Pittsburgh PA continuing the adventure of clearing out the family home. My long term readers know that this has not been a quick process (understatement!)

Horrifyingly, this trip I found some fairly disgusting food in the fridge that could have qualified as a science project in a high-school fair. Yuck. In some cases like this, it is clear that something has spoiled and no one in their right mind would even open the container, let alone put it in their mouth. Unfortunately, most of the time dangerous food isn’t quite so obvious.

It seems that stories in the news about nationwide recalls of contaminated foods are becoming more and more frequent. Many times safe handling and proper cooking can eliminate most of the risk. This post will give you some good knowledge and resources
Food Safety guidelines
Thanksgiving is a holiday associated with lots of yummy leftovers so it's usually a good time to update my food safety post. If you watch the news you know that food contamination issues can happen all year round. This post will give you some safe guidelines for foods that you buy and cook. If you do a lot of eating out, restaurants are supposed to have their cleanliness rating publicly displayed. Check the bottom of the article for some great links on food storage guidelines; everything from egg safety and turkey leftovers to breastmilk storage.

It is certainly not a sterile world. As soon as they are able, your baby will start putting anything that they can reach into their mouths. You can't even begin to imagine the phone calls I have gotten about icky things that some of my little patients have managed to get their hands and mouths on. Chap-stick, particles from an exploded hot pack, kitty litter, the little packet in shoe boxes that says do not eat. You name it, they lick it.

So yes, the world is full of germs, and while I don't generally get too concerned about a little dirt here or a big sloppy dog kiss there, foodborne bacteria can be nasty, and we need to minimize any exposure.There were over 300,000 reports of children under the age of five being impacted by tainted food last year alone.

Infants and young children are particularly vulnerable to foodborne illness because their immune systems are not developed enough to fight off infections. This is especially important for infants under 6 months of age. Extra care should be taken when handling and preparing their food and formula. Here are some basic food safety guidelines:

Wash hands for at least 20 seconds before food preparation. Soap is best. Hand sanitizer will do. Re-wash as needed after handling food that might carry germs. The most common offenders are poultry, meat, raw eggs.

Make sure kitchen towels and sponges are changed and cleaned frequently. Sponges can go through the dishwasher. Cloth can get easily contaminated and then spread germs. Watch out for potholders or other cloth items that come into contact with raw food.

Keep your refrigerator temperature at 40 degrees or colder. It is worth investing in an appliance thermometer so that you can keep track. All the science says that the 40 degree number is essential for keeping the bacteria from multiplying.

Your freezer should be below 0 degrees. To ensure the safety of your frozen food, you need to be sure that it has been actually kept constantly frozen. One clever trick to make sure of this is to keep a baggie filled with ice cubes in the freezer. If they remain cubes, you are in good shape; if they melt and refreeze as a block of ice that means that at some point your freezer was not cold enough. This can happen in a power outage or even if the door wasn't kept tightly closed. I am sad to say that if there was stored breast milk in there that has thawed and refrozen, I would no longer consider it safe. Label things in your freezer and rotate so that you are using up older stuff first.

Check the dates of baby food jars and make sure the lid pops when you open them.

Don't put baby food back in the refrigerator if your child doesn't finish it and you used the "used" spoon to take the food directly from the jar. Your best bet - simply don't feed your baby directly from the jar. Instead, put a small serving of food on a clean dish. Add more as needed with a clean spoon. Remember that once saliva has come into contact with the food it is no longer sterile and some bacteria can grow quickly.

Powdered formula is NOT sterile. Don't mix up more than you need in advance. If the infant is less than 4 months, I would mix it with boiling water and let it cool.

Don't leave open containers of liquid or pureed baby food out at room temperature for more than two hours. Bacteria thrive in temperatures between 40-140 degrees

Don't store opened baby food in the refrigerator for more than three days. If you are not sure that the food is still safe, remember this saying: "If in doubt, throw it out." See links below for guidelines on how long food stays safe.

Make sure that foods are properly cooked. A food thermometer is the best tool for this.

 Chicken ( white meat/ dark meat)...170/180
 Eggs....not runny

For all of you "older kids" who will be baking this holiday season, watch out for the batter (I am a notorious offender.), Even one lick from raw food containing a contaminated egg can get you ill.
Myth: Freezing food kills harmful bacteria that can cause food poisoning.

Fact: bacteria can survive freezing temperatures. When food is thawed, bacteria can still be present and can begin to multiply. Cooking food to the proper internal temperature is the best way to make sure any bacteria is killed.

Myth: vegetarians don't need to worry about food poisoning.

Fact: Fruits and vegetables are an important part of a healthy diet, but like other foods they may carry a risk of foodborne illness. Always rinse produce well under running tap water. Never eat the pre-washed 'ready to eat' greens if they are past their freshness date or if they appear slimy.

Myth: Plastic or glass cutting boards don't hold harmful bacteria on their surfaces like wooden cutting boards do
Fact: Any type of cutting board can hold harmful bacteria on its surface. Regardless of the type of cutting board you use, it should be washed and sanitized after each use. Solid plastic, tempered glass, sealed granite, and hardwood cutting boards are dishwasher safe. However, wood laminates don't hold up well in the dishwasher. Once cutting boards of any type become excessively worn or develop hard-to-clean grooves, they should be discarded.

Myth: Locally-grown, organic foods will never give you food poisoning.

Fact: Any food, whether organic or conventional, could become unsafe with illness-causing foodborne bacteria at any point during the chain from the farm to the table. Consumers in their homes can take action to keep their families safe. That is why it is important to reduce your risk of foodborne illness by practicing the four steps: Clean, Separate, Cook, and Chill.

Some excellent resources for food safety tips can be found at:  This site keeps track of any food recalls This is as great site for seeing how long food will last. I used it just this week to figure out if an open can of chickpeas was still good. (After a week, the answer was no)   This site has loads of kid friendly activities

Enjoy your Thanksgiving!

Friday, November 8, 2019

Car Seat Guidelines 2019

This week's topic
Car Seat Safety Guide 2019

Kids grow! Make sure they are strapped in properly!

The Rules

Car seats are an essential part of keeping your child safe. Countless children’s lives are saved annually by being properly installed in a car seat during a crash. Governor Jerry Brown signed a law that went into effect on January 1st, 2017. This law requires children be rear facing to a minimum of 2 years old:

It is recommended that they remain rear facing until as close to age 4 as possible! More and more studies are showing that rear facing is the safest place and position in the car. In fact, it is 5 times safer than forward facing.

In the case of an accident, a child's head and spine are better protected if the car seat is rear facing. One study shows that children ages two and under are 75 percent less likely to die or be severely injured in a collision if they face the back. I know kids might appear to be squished but most children are actually quite comfortable sitting criss-cross, or with their legs up the seat. For those parents/caregivers who are concerned about leg room, Graco has released the Extend2Fit, a new seat which has a 4-position extension panel that provides 5" of additional leg room.

Children who are 40 pounds or 40 inches are exempt from the law and can face forward, but while they may be exempt from the law, they are not exempt from the laws of physics. Rear facing is safer. Please take a moment to click the link below. This video is a good illustration about why rear facing is so important:

Toddlers who have outgrown the rear facing weight or height limit for their car seat should use a forward facing car seat with a harness for as long as possible, up to the highest weight or height allowed by the car seat manufacturer.

The current California law also requires a car seat or booster seat until your child is 8 years or 4 ft 9 inches. Height parameters make more sense than the previous weight ones. For a child to safely transition into a booster, we look beyond the child's age/height/weight. There's another set of criteria to help determine if your child is ready to transition to a booster. There is a '4 Step Test', in which all criteria should be met; don’t dismiss the importance of Step 4!

1. Child is an absolute minimum of 40 lbs

2. Minimum of 4 yrs old

3. There is a lap & shoulder belt in child's seating position

4. The Child can be trusted to sit properly for the entire trip, every trip - even while asleep. This means no slouching (back straight up against seat), no leaning to either side, no playing with the belt, etc...even unsupervised.

Developmentally, most children don't meet all of these steps until somewhere between 5-7 years old, and generally closer to 6 or 7 than 5. A lot of this has to do not only with physical maturity, but emotional maturity.

This is one of those times in your parenting life where your child NOT graduating is actually a good thing. The longer your child is harnessed, the safer and more protected they'll be. Your child needs to be tall enough so that the seat belt goes across the chest, not across the neck. The purpose of a booster is to properly position a child in the adult-intended seat belt. What you’re looking for is proper belt fit across the lap and shoulders - the belt should be low and tight on the hip bones (not on the belly), and should be hitting the shoulder bone, not the child’s neck.

Be aware that most newer car and car seat models use the LATCH system ( Lower Anchors and Tethers for Children). The Latch system attaches the car seat to the vehicle through anchor points that are installed in the car and connectors on the car seat. This is supposed to make the installation easier as well as eliminating potential errors that can result from installing a car seat with a seat belt. The LATCH system has a 65 pound weight limit. What many parents are surprised to find out is that this limit includes the weight of your child as well as the weight of the car seat (some can weigh up to 25 pounds!).

When children are old enough and large enough to use the vehicle seat belt alone, they should always use Lap and Shoulder seat belts for optimal protection. To determine if your child is ready to sit unassisted, they must pass the 5-Step test:

The 5-Step Test:

  1. Does the child sit all the way back against the auto seat?
  2. Do the child's knees bend comfortably at the edge of the auto seat?
  3. Does the belt cross the shoulder between the neck and arm?
  4. Is the lap belt as low as possible, touching the thighs?
  5. Can the child stay seated like this for the whole trip?

If you’ve answered NO to any of the above, your child should remain safely boostered!

If your children complain about this rule, show them photos of race car drivers all bucked up in their restraint system. Be matter of fact about it and explain that there is no compromise for safety (there is also a mighty large fine if you are caught breaking this law.)

All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection. Airbags can actually be quite dangerous to a child so it is worth making sure that this isn't an issue with your car and the placement of your child's safety seat.

Picking the right car seat

If you are looking to buy a new car seat, check out these helpful links. The folks from sent me the following resource guides:

We recognize how difficult it can be to find the right information on car seats, so we evaluated both infant and convertible styles to help inform parents. To find the best, we consulted with child safety experts, dove into federal ease-of-use ratings, surveyed hundreds of parents, and then took a closer look at the top options. You can see our guides here:

If you are someone who doesn’t own a car and is popping the car seat in and out of car services, finding one of the cars that is easier to install in becomes even more important.

Making sure it is installed correctly!

The AAA states that 75% of car seats are installed or used improperly. As your child grows, there are services offered here in the San Francisco Bay Area that will check out your car seat or booster seat and make sure it properly installed. Have the infant car seat checked before the baby is born and then again with each transition to a larger seat.

Below are some local resources for making sure that not only is your car seat properly installed but that it is the right fit for your child's size and age. They can make sure that all the straps are where they need to be and that you pass the "pinch test", making sure that the seat's harness is tight enough

To be super safe, consider having the car seat fit and installation checked every 6 months. The reality is unless you are a certified child passenger safety technician, you’re not aware of some of the nuances of different kinds of seat belt systems, different features on different car seats.

When you go to get help with your car seat make sure you go to a certified car seat technician. Then you will know you are getting the best information available.

AAA Appointments need to be made ahead of time. You do not need to be a AAA member to take advantage of this free service

CHP (California Highway Patrol) 415-557-1094 This is a very popular, and by appointment only. Please make an appointment as far in advance as possible. The current wait when I called to update this post was pretty short, but it varies and sometimes can be longer than a month. The inspections are done at 455 8th Street in San Francisco.

SFPD  415-575-6363 They try to have an officer at all of the local police stations who is trained to do the car seat safety inspections. Call the number above for more info.

The Colma police department 650-997-8321 does a car seat inspection for free. As with the other options, this is by appointment only.

Willing to pay to have someone come to you?


The following links can you assist you in finding the right car seat:

The National Highway Traffic Safety Administration website has a place to click to find updated local car seat inspection stations for those of you who are not in the Bay Area.

NHTSA/Get Your Car Seat Inspected has a page where you can plug in your child's age and size and they will tell you what type of seat they should be in.

Car Seats for the Littles - Car Seats for the Littles gives lots of great info about the specific brands of car seats on the market

Other considerations

Car safety doesn't end with being safely buckled. I know it is hard to avoid distraction with a baby fussing in the back seat. Consider getting one of the specially made mirrors so that you can keep an eye on your rear facing baby. Make certain that they can't reach anything that is a choking hazard.

Don't let them hold the keys; they can lock you out!!

If your child is asleep in the car seat and you have arrived at your destination, leaving them snooze for a few minutes is fine as long as they are supervised, but keep them tightly buckled. Having a baby in a car seat without being tightly strapped in not safe. The loose straps can be a safety hazard.

WINTER CAR SEAT TIP: The straps need to be tight up against your baby; puffy coats or blankets need to be OVER the straps!

Never leave your child unattended in a vehicle. Children can die from prolonged exposure to excessive temperatures in a hot car.

Most accidents happen within a few miles of your house. Even a short trip down the block requires the full "buckle up". Hey parents, model good behavior and always make sure you fasten your own seat-belt!

Did you know that car seats expire? Most of them have a 6-9 year life span. This date can usually be found underneath or behind the seat. Buckles and straps can wear out. Prolonged exposure to sunshine can weaken the plastic. Also, the technology is always changing and this ensures that nothing gets too out of date. Save the instructions/registration in a safe place. I know most of us never register the products we buy but make sure you register your car seat! If there is ever a recall, this will ensure that you are notified, and this is one of those products where you must know if there is an issue!

Let me close by confessing that I am NOT a car seat expert. The seats that my children grew up with were much simpler (but not nearly as safe!) When I see new parents struggling with all the straps and trying to figure things out, I am often as clueless as they are.

Here is the takeaway message. Putting your baby or older child in a car seat is an essential skill that you need to learn in order to travel with them safely. Find an expert to help you master this and make sure that you are using the car seat restraint properly. Safe travels

Friday, November 1, 2019

Election time/get your kids involved


This post is geared for families with kids who are no longer infants.

It is that time of year. Our mailboxes are filled with flyers telling us to vote yes on this and no on that. The phone is ringing and if it isn't the IRS, it is possibly the recorded voice of a celebrity telling you why to support a candidate.Television and radio spots are election related. Many give a collective sigh of relief when election day comes and goes. But take a moment and remember what it’s all about.

It was drilled into me at an early age that voting matters. I have early memories of going with my parents to their polling place. Knowing something about the issues and people running for office is our responsibility. Of course growing up in Pennsylvania was quite a bit different than the robust California ballots that we are faced with here. Having to figure out how to vote on all of the propositions can be overwhelming.

Let your kids see the process. Invite friends over to talk about the issues. It is a great way for them to to see that many of the ballot measures are multifaceted and often not black or white. How do you weigh all of the arguments? How do you sift through all of the information to find the points that sway you the most? How do you deal with friends and family who are of different opinions. How would they vote if they were eligible? Why? There are so many talking points and lessons to be learned.

If you vote by absentee ballot, have your kids help you fill them in and put them in the mail. If you go to the polls, take your kids with you. And wear your "I Voted" sticker proudly.

Friday, October 25, 2019

Branching out from English only


My husband and I have passed the halfway point of our European adventure. I am actually trying to write this on my little tablet on a high speed train from Milan to Rome. Sandy will give it a quick glance to make sure that there are no egregious grammatical errors, but do forgive any typos.

For the past few weeks we have been in cities where we have been surrounded by many foreign languages. It is easy and almost embarrassing to get along speaking nothing but English. Indeed, so far we have had zero issues. It was never my intent to be the entitled American who simply expected to be understood. In fact I have the Google translator at the ready on my phone. I have attempted to learn phrases such as, "Good morning", "Where is the nearest bathroom?" " Thank-you" and "I am a vegetarian" in multiple languages. The fact that everyone we have encountered thus far easily speaks multiple languages is striking.  The only trouble I have had so far ironically, is in Scotland where the thick brogue was sometimes tricky to decipher. I think that most of us have been in the awkward situation where we can't understand someone. Many times we can bluff through it. That wasn't the case when I was trying to figure out where exactly we needed to change trains on our way from Glasgow up to Inverness. After several attempts that I clearly wasn't understanding, the station agent patiently helped me out… "Stirling, like the castle" …."AhAh, got it, thank you". Trust me, what I had heard sounded nothing like Stirling. 

Now that we are in Italy, we are for the first time finding ourselves in situations where we have faced some very minor challenges when dealing with a foreign language. When we bought breakfast items at a little market, we weren't completely certain what we would end up pouring into our cereal. Fortunately it was actually the milk we were hoping for. Most folks do speak some English, but it is not as automatic or fluent as we found in the Netherlands or Belgium. 

The whole language thing got me thinking. People are people. We all have commonalities as well as differences. When folks find the things we have in common, bonds are formed. It is lovely. When instead we focus on our differences, history shows us how it is sadly human nature to become tribal, and often conflicts arise. 
In order to connect with others communication is essential. Language  differences can present a huge barrier. 

In Europe it is the norm for most people to be fluent in multiple languages. I am not talking about being simply bilingual. Easily being comfortable in four or more languages or dialects is not uncommon. How is this possible that the vast majority are multilingual? They simply make it a practice to teach kids more than one language from the start. The science is actually quite clear on this. When young children are learning to speak, their brains are in the most active phase that they will ever be in. Learning multiple languages at a young age opens up pathways in the brain that make it much easier to process all of the information. A recent MIT study found that  up until the age of 10, the developing brain has a much easier time with language. The ease with how most people learn a new language starts to slow as we age. Folks under 18 still have an easier time than adults. 

It is true that my patients who are exposed to more than one language might be a little slower with their initial speech, but who cares! What a gift. So what can we do to take advantage of this fertile brain? Does a parent, grandparent or nanny speak a different language? Expose the baby to more than one language as much as you can. Maybe take this opportunity to try to learn a new language yourself. There are amazing programs out there like Rosetta Stone (BTW, seeing the actual Rosetta stone in the British museum was amazing! Talk about history being brought to life!)
Communication and connecting to others is such a positive thing. Take advantage of the amazing young brains! As a bonus, kids can often learn to read music when you expose them to this skill young. Sign language is another thing to consider early. 

In the meantime, I will continue my adventure. We are only planning our trip just a few days in advance, so we are not quite sure where else we will end up. So far we have balanced gorgeous natural beauty including the Isle of skye in Scotland, and the amazing alps in Switzerland, with history and art in other amazing cities.

I hope this post finds you all enjoying a nice and healthy autumn. If I find myself feeling creative on another train ride I may try to do another post. If not I will be back in touch in early November with an updated class schedule. 

Ciao e stammi bene, 

Nurse Judy

Friday, August 23, 2019

Sleep tips through the ages/Insomina

This week's topic
Sleep tips through the ages/Insomina
Sleep deprivation is used as a torture device. A good night's sleep is essential for our health and happiness. I brushed up and updated my earlier sleep series.
The links are below.

For all of you new parents starting out, the above link has some essential tips to get you started out with good habits

The above link review some nap and bedtime strategies

The name of the post speaks for itself, Here are some strategies for keeping your kids to adjust to the new bed and the freedom that comes along with it

Now it is time for the post for the big kids and adults.

I had promised this post over the years, but somehow never got around to doing it.

If you or your child are having sleep issues, start playing detective to see if you can figure out an obvious source.

Here are some things to consider:

  • Is the insomnia every night or just once in a while?
  • Are there obvious triggers, such as anxiety? Starting school can certainly be a trigger. Are there any changes going on in the family?
  • Is the environment conducive to sleep?
  • Is it dark enough? Consider black out shades.
  • Are there noises around? Consider a white noise machine. Most folks have easier sleep in a cooler room, perhaps invest in a fan.
  • Are they snoring? It might be worth checking in with the Ear Nose and Throat specialist to see if their could be tonsils or adenoids getting in the way.

The basic sleep routine matters a lot. Sleep specialists often focus on something called sleep hygiene. This means getting to sleep and waking up at the same time every day. Yes, this means weekends.

Some teenagers get themselves sliding down the slippery slope by staying up late on the weekend nights and sleeping late on the weekend mornings. On Sunday evenings when it is bedtime, no one is particularly tired if they just woke up at noon. A week or so of rigid bedtime and wake up can make a huge difference.

Avoid screen time for several hours prior to going to sleep. I know this is hard for folks who are trying to finish up homework, but all the specialists are emphatic about this. Try to get your child to do any computer focused homework out of the way first. At the very least, try using a program such as f.lux or nightmode that adjusts the blue light, which is one of the issues shown to impact sleep.

Make sure there is no caffeine or too much sugar in the evening. This includes chocolate! Chamomile tea with a splash of warm milk has the combo of the tryptophan from the milk and chamomile in a nice soothing nightcap.

For the older kids, teens or adults that are having a tough night, don’t stay in bed tossing and turning any longer than thirty minutes or so. Instead, get out of bed and go sit in a chair or desk and do something boring. This is not the time to read Harry Potter or any book that is a page turner. After fifteen minutes get back in bed and try again. One way to ensure a teen gets back in bed is to limit their reading options to their textbooks (good luck!)

Consider meditation, acupuncture/ acupressure and or hypnosis. I have had many patients respond well to those.

Did you know that insomnia has a strong connection to anemia and vitamin D level? If you or your child are having chronic sleep issues, consider having your iron and vitamin D levels checked. There is no downside to making sure your diet is getting adequate iron, and that you are getting enough vitamin D, even if you don’t want to go to the lab.

While gentle yoga stretching can probably be relaxing, strenuous and heart-pumping exercise should be avoided at least two hours before bedtime. 

If none of the above remedies have helped you, occasional use of melatonin is fine. Especially if it is to get over jet lag or to help you get a good night's sleep before an important test or event.


CBD is very helpful for occasional sleepless adults. It is essential that you have these stashed carefully away so that your younger kids don’t have access.

Friday, August 16, 2019

When your child plays favorites

When your child plays favorites
I know that we are supposed to be the adults, but when your child seems to show a strong preference for the other parent, feelings get hurt.

You can be the head of a multi million dollar company or a world renowned heart surgeon, but when you become a parent, you had better protect that ego of yours. When a 2 year old says “Go away, I only want the other parent..” it feels rotten.

It should never be a competition. Ultimately your child will have a unique relationship with each parent. During the first couple of months, accept that if one of the partners is producing breast milk, it is developmentally appropriate for a baby to focus on her. It makes perfect sense. Even if mommy is pumping and the baby is fed from a bottle, mommy smells like milk. She is the sustenance. Being a nursing mom has its highs and lows. One of the benefits is the closeness that ensues. We need to give her this one. Mom has earned it from 9 months of pregnancy and then labor. It is not at all easy to be the primary supplier of your baby’s milk. 

Once the infant’s world expands beyond eating and sleeping, it is very common for babies to now make room for the other parents and caregivers in their hearts. It is normal for parents to come in and out of favor as the preferred parent as your child grows. While I hope that you can delight in the fact that your partner and your child have a solid bond, don’t minimize the input that you have over the relationship that you are forging with each child.

Do not allow your child to be the one in charge of how much time they spend with you. If your goal is a positive, deep and lasting relationship, then it is essential that each parent gets a slice of quality time with the kids. I know that many of us have busy lives. Make this happen if you can. Family time is great. The more the better, but it isn’t a substitute for one on one time. Take turns with reading, baths, bedtime.

Does this sound familiar?

“ I want daddy to read” 
“Tonight it is my turn”.

For kids that are old enough, get a calendar and show them. If something is stated as a rule it is sometimes more readily accepted.

"See today it is August 21.There is a big P for papa. That means it is my turn to do bedtime. Tomorrow is the D for daddy."

If they are old enough to articulate their demands, they are old enough to understand the concept of rules.

Acknowledge their displeasure.

“No..I only want daddy to put me to bed”

“I see that you are mad/sad that daddy isn’t doing bedtime tonight. How many ‘Phooeys’ are you feeling. Five? Okay, PHOOEY PHOOEY PHOOEY PHOOEY PHOOEY. Lets do an extra loud one together PHOOEY!!

Okay, Now, which story or song should we pick”

My husband brought his guitar in for some bedtime singing each night and earned the spot as the preferred parent for the final tucking in. Make an effort, figure out your gimmick and get that pendulum swinging back towards the center.

Truthfully, a 60/40 favorite parent is probably more normal than not. This tends to go in waves. If you feel like you are moving into a 70/30 then I think action is needed. Don’t get caught in the trap of spending less time with your child because they are playing favorites. Make an effort to adjust the balance. The answer is usually finding quality time. Even if you are a busy working parent, make the time that you have together count (put your phone away)! Find the common interests. Figure out a hobby that you can do together.

Many parents get caught in the trap of good cop/bad cop. If that is happening to you, it is time to step away and look hard at what is going on.

We often come from different upbringings and discipline style. It is imperative for the two parents to agree on common standards. Figure out the rules and then enforce them equally. 
If you are having trouble coming to agreement on the family rules, see if both parents can agree to have a third party to work with to help you find a compromise.

Even if you think you are on the same page as your partner it is a good habit that if older kids get into trouble, delay handing down a consequence until you have discussed the situation: 

Both of the parents will discuss this privately and will tell you what the consequence will be.”

This might avoid the out of proportion ridiculous punishment that you want to hand out simply because you are frustrated. “No play-dates or television for a month!” While that might be satisfying for a moment, giving a consequence that you know you can’t follow through with will just weaken your position.

Aside from discipline issues, some personalities are naturally easier together while some people clash. There is no reason to think this doesn’t happen with a parent/child relationship. Careful management now will reflect in the relationship that you carry over with your adult child. Learn how to communicate with each other. That can take work but it is worth the investment.

My bottom line suggestion is that time management is the key to solving a lot of issues. Kids playing favorites is just one of them.

  • Schedule family together time: Outings, game night, family meals...etc.

  • Make opportunities for one on one time with each kid: find a hobby that you enjoy working on together. My dad and I played piano and violin duets. Every time I hear one of the pieces we played I get full of positive emotions. For younger kids, put the bedtime routine on the calendar. Parents are in charge of this, not the kids.

  • Make opportunities for one on one time with your partner. Having an intact relationship with your partner is one of the best gifts you can give your kids. See if you can find another couple to swap babysitting with if it gets too pricey to have an evening out.

  • Carve out some sanctioned (no guilt) alone time. Everyone needs to put their own oxygen mask on first. It will make you function better. Maybe this is something as simple as going for a run, or taking a nap. Some people need this more than others. Identify your needs with your partner and see what can be done to allow you a bit of time.

Not everyone has the capacity to arrange these quality time opportunities as regularly as you like, but get your calendar out and see what you can figure out.