Friday, February 12, 2016

Talking to your kids about "the birds and the bees"

While the majority of the calls we deal with are about little acute illnesses, we also field queries  about all aspects of growth and development. Recently I have had several folks ask me my two cents about answering the "Where do babies come from" question:so here goes.

Comes the time in every family when it is time to have the talk about sex, but how and when? It varies with every child.

There is a story about a young boy visiting his grandparents’ house one summer. He came rushing in from outside where he had been playing with some new friends from the neighborhood. “Grandma, what’s it called when two people are in bed, but one is on top of the other one?”

Grandma was taken aback for a moment but sat him down and gave him a matter of fact talk about the birds and the bees, so to speak. The little boy listened carefully with his eyes open wide and then ran back out to join his friends. It wasn’t long before he ran back into the house saying, “Grandma, it’s called BUNK BEDS and Mrs. Wilson wants to talk to you!"

The all important moral of this story is to make sure that when your child presents you with a question, that you understand what they are actually asking before you launch into any complex explanations. You could start with a statement such as “ I am so glad that you asked me. I am always happy to help you find answers to things. Tell me more about what you are wondering about”

Get yourself as comfortable as you can with the discussion. What do you call body parts? Does your family use a nickname (perfectly fine) or is your child able to rattle of the anatomical names for all of their “parts"? Of course having discussions about bodies usually comes long before discussions about sex.

Many parents are a little shocked and uncomfortable when infant boys have erections or they notice young boys and girls masturbating. This is incredibly common (the human race is quite fortunate that masturbation doesn’t actually cause blindness.) While it is usually quite normal, if you notice that your child is constantly touching themselves to excess, I want to make sure there is no irritation or external cause. Maybe their underwear is too tight. It could even be something like pin worms! If there is no obvious underlying issue, consider having a discussion about that fact that, yes it feels good, but our bodies are delicate and it is important not to touch so much that things can get sore. Some families have a talk about family rules and theirs might be that gentle touching is a private activity. Beware, a true story - One of my families who made a point of having accurate vocabulary was caught off guard one night when their 4 year old son made an announcement at a fairly formal dinner party with mom’s boss. “ I am going to go into my room now so that I can touch my penis in private.”

This is also an important time to have a discussion about body ownership. No one should be able to touch any part of your child’s body without permission. Exceptions are parents and doctors (with parent present)  and that should never be a secret! Empowering your child about their body early is important.

And then they get a little bit older….

I remember driving a van loaded with carpool kids to school many many years ago. I caught a piece of the conversation that was going on in the back seat and my ears perked up a bit as I tuned in.

“Yours have done it at least twice." “Yours have done it at least once” "Ours have done it at least twice...Oooh/Yuck”

As soon as you feel that your child is curious and is possibly going to be picking up odd or skewed information from their friends or classmates, it is important that you make an opportunity to have a chat. It is essential that your child sees you as the trusted source of correct information and is comfortable asking you questions. Unfortunately in this high tech world, it is becoming increasingly easy to kids to be exposed to all sorts of things with very adult content at a very young age.

You may want the help of a book. Amazon and libraries have an enormous amount of books that you can use as a resource. There are so many good ones out there. I would suggest that you read several until you find one that feels like it is the right comfort level for you. You may want to do this research a little ahead of time.

Liesel Harris-Boundy from the West Portal Branch of the San Francisco Public Library was kind enough to come up with a list of good books on the subject that she is familiar with. Liesel shared that an ObGyn friend recounted that her 7-year old son asked her, "Mom, what's a vagina?" and though she talks about vaginas all day, she was unprepared to tell her son and excused herself from answering!  That reserved part of her upbringing came through in spite of all her medical training!

The following books should all available through the library. Perhaps go in and leaf through a few until you pick one that you like.





Talking to Your Kids About Sex: From Toddlers to Preteens by Lauri Berkenkamp, Steven C. Atkins, Charlie Woglom

Sex Is a Funny Word: A Book about Bodies, Relationships, and YOU by Cory Silverberg


You want to make sure that the books are geared to the correct age. Some are guides for the parents and some are meant as a resource for the child.
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In our practice we are fortunate to have many different kinds of families, It isn’t always mommy plus daddy equals baby. I was happy to find out about the book below.

What Makes a Baby is a children’s picture book about where babies come from that is written and illustrated to include all kinds of kids, adults, and families. 

Geared to readers from preschool to about 8 years old, it teaches curious kids about conception, gestation, and birth in a way that works regardless of whether or not the child in question was adopted, conceived using reproductive technologies at home or in a clinic, through surrogacy, or the old fashioned way; and regardless of how many people were involved, their orientation, gender and other identity, or family composition. Just as important, the story doesn’t gender identify people or body parts, so most parents and families will find that it leaves room for them to educate their child without having to erase their own experience.

Once  you do pick your book that you feel comfortable using as a resource,go ahead and buy a copy so that there isn’t a time limit.

If your child is embarking on puberty and you are looking for something more interactive than a book, I recently learned about the Heart to Heart seminars hosted by Stanford. They hold these in multiple locations. The San Francisco class is held at CPMC on California street.     www.hearttoheart.stanfordchildrens.org

A list of other classes they offer are here:  http://www.stanfordchildrens.org/en/classes
One mom in our practice who went to the session thought it was very worthwhile, but she wished she had taken it earlier. She thought ten or eleven would have been perfect.

Bottom line, honesty and communication are essential. As awkward as this conversation may feel to some of you, you really don’t want your kids to be getting their sex education from the neighborhood kids (or even worse, the internet!) Don't force too much information on a younger child who isn't interested. Letting them know that you are always open and willing to talk about "grown up" stuff with them is a great start.

Happy Valentines day.


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