Friday, December 27, 2019

The world can use a little bit more Mr Rogers

I met my husband Sandy in 1976; I was 17. Believe it or not, we were at Kennedy airport flying out on the same flight. Sandy was ahead of me in line and tells that he asked the agent to seat me next to him. In the 43 years that we have been together, we have missed a few birthdays and general holidays but we have NEVER been apart on New Years eve. Some years have been wild and crazy. Other years have been low key and we have looked at each other long before midnight and said…”somewhere it is already midnight, we don’t need to stay up”, but we have always been together. In those 43 years we have done many things, including raising two wonderful daughters and some epic travel adventures, but we have only been to a movie in the theater just about 43 times.

Sandy generally hates going to movies and agrees to go to one movie a year. If it was important to me, he would go more often. One of the reasons that we work so well together is that I simply go see movies without him. This year, to my surprise he opted to come with me to see the new Mr. Rogers movie with Tom Hanks. Sandy knew that I wanted to see it. I grew up in the real Mister Rogers Neighborhood of Squirrel Hill, in Pittsburgh Pennsylvania. I ran into Mister Rogers many times at Children’s Hospital of Pittsburgh where I worked my first job as a nurse. He was as genuine, kind and quirky in real life as he was on TV.  Spoiler alert, Sandy did not like the movie all that much (although he loves Mr. Rogers.) I loved it. No surprises there. It is not really directed at young kids, but I thought it told a lovely story about forgiveness, based on a true relationship that Mr. Rogers developed with a somewhat angry reporter many years ago. Tom Hanks was superb, and the Mister Roger’s message shined through.

Here is the post for several years ago. I added a few more worthy quotes.

****************************************************************************

I first ran this post several years ago when we had a week full of horrible headlines. Unfortunately we are so used to things like mass shootings that we are no longer shocked when awful things happen. 

In a previous post about talking to our children about scary situations, I actually quote Mr. Rogers. He shared a lesson that he learned from his own mother: “look for the helpers”. Those might be a person in uniform, or another parent with children. That remains great advice and is one of his more well known pearls of wisdom.
 
 A generation of children grew up better people because of the lessons he taught. Here are some of my favorite pieces of Mr Roger's wisdom:
 
"There are three ways to ultimate success: The first way is to be kind. The second way is to be kind. The third way is to be kind."
 
“There is only one thing evil cannot stand, and that is forgiveness.'"
 
"There's a part of all of us that longs to know that even what's weakest about us can ultimately count for something good." It is okay not to be perfect!
 
“Solitude is different from loneliness, and it doesn't have to be a lonely kind of thing.”
 
Accept people as they are.
 
Look and listen carefully.
 
We all have feelings.” Talking and acknowledging them is the first step towards finding ways to deal with them that don’t hurt anyone.
 
Anything that's human is mention-able, and anything that's mention-able can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we're not alone.
 
Wonder about things
 
“You can’t go down the drain in the bathtub.” Don’t be shy about sharing things that might be scary
 
“Be yourself.” It is not how you look, what you wear or what toys you have that make you special
 
What can you grow in the garden of your mind? Use your imagination.
 
You rarely have time for everything you want in this life, so you need to make choices. And hopefully your choices can come from a deep sense of who you are.
 
One of the most important things a person can learn to do is to make something out of whatever he or she happens to have at the moment.

"Often out of periods of losing come the greatest strivings toward a new winning streak."

"Often when you think you're at the end of something, you're at the beginning of something else."

"There are times when explanations, no matter how reasonable, just don't seem to help."

"Love isn't a state of perfect caring. It is an active noun like struggle. To love someone is to strive to accept that person exactly the way he or she is, right here and now."

 
Mr. Rogers was a gift to generations of kids but I wonder if any of my patients know who he is? I believe that Daniel Tiger is making sure that the whisper of his gentle message lives on!

Friday, December 20, 2019

Holiday Safety checklist 2019


This week's topic
Holiday safety list 2019

Have you thought of everything?

The lights are twinkling and the radios are playing the holiday tunes. People are putting up the holiday decorations. It is time for the holiday safety post.Take a moment to give this a careful read. There may be some things that hadn't occurred to you.

For most people, the holidays are a time for celebration. That means more cooking, home decorating, entertaining, and an increased risk of fire and accidents.

For every aspect of holiday celebrations, I can tell you the story of a patient who called with a related accident. It is not my intent to scare folks with my tales. As I tell parents who attend my safety class, if you know ahead of time what accidents can happen, you have a way better chance of avoiding them. I have seen some wild and improbable things over the years.

Baking cookies is just one example. A patient's mom called to tell me that her 10 month old had sustained a burn on his hand. She was holding him in the crook of one arm as she removed the cookie sheets from the oven. As she recounted, he turned into a cartoon character with a telescoping reach and he was able to stretch across her body and grab a hold of the piping hot tray. Simple solution: don't hold your child when you are working with hot stuff in the kitchen. Their arms are longer than you think. If even one accident has been prevented, this post was worth it.

Candles are another hazard. It was a winter evening many years ago in a cabin at Lake Tahoe. Dr. Jessica and family lit some holiday candles and went to sleep. Somehow one of the candles ended up burning a hole through a plastic mat that was on the table. Luckily the smell of burning plastic woke them up before any real damage was done, but it was a frightening lesson. This was a vacation rental. In this instance, there seemed to be no working smoke detector. She had no idea if and where there was a fire extinguisher. There are several obvious lessons here. Never go to sleep with candles or a fireplace still burning. Get acquainted with the safety features of any place your family is staying.  
 
Below are some safety considerations for dealing with the holiday season ahead. Some of these may seem like common sense but there might be a few tidbits in here that I am betting you haven't thought about.

Beware of button batteries. They are everywhere nowadays in all sorts of small electronics (and musical cards) and can be quite hazardous if swallowed. Take time in advance to do a mental inventory of items that you have around that may be powered by these. Put a piece of duct tape over the battery compartments to make sure they can't fall out.

Certain holiday plants like poinsettias can be mildly toxic (especially to someone with a latex allergy). You may not have them in your own house, but if you are visiting a friend or even a supermarket make sure little hands don't grab the pretty red leaves and put them in their mouths.

Be very careful transporting hot food to a holiday potluck. I have patients who have been burned from hot food spilling on them in a car.

WARNING TO PET OWNERS!

One of my patients had a tragedy several years. An eight year old healthy dog got into a wrapped package that was filled with chocolate. The amount ingested proved to be too toxic for this little dog to handle and they didn't make it. Please don't let this happen to you. Make sure that any mystery packages are nowhere near where a pet can get to them.

Christmas tree checklist:

  • When purchasing a live tree, check for freshness. A fresh tree is less of a fire hazard

  • Cut 1-2 inches from the base of the trunk immediately before placing the tree in the stand and filling with water to ensure absorption. Don’t add chemicals that might be toxic to kids or pets. A dash of plain 7 up can help keep the tree healthy.

  • check the water level daily to avoid the tree drying out

  • When purchasing an artificial tree, look for the label "Fire Resistant"

  • Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights and a person touching a branch could be electrocuted.

  • Place your tree at least 3 feet away from all heat sources, including fireplaces, radiators and space heaters

  • Make sure the tree is steady enough that it can't be pulled over by a toddler. You may need to attach it to something solid. Trust me, trees get knocked or pulled over. Older kids running around can cause this issue, it isn’t just toddlers.

  • Trim your tree with non-combustible or flame resistant materials.

  • Before using lights outdoors, check labels to make sure they have been certified for outdoor use.

  • Make sure all the bulbs work and that there are no frayed wires, broken sockets or loose connections.

  • Plug all outdoor electric decorations into circuits with ground-fault circuit interrupters to avoid potential shocks.

  • Strings of lights and garlands are a staple of holiday decorating, but they can also pose a strangulation hazard.

  • Avoid trimming the tree with things that look like candy which may pose a temptation to the kids.

  • Keep sharp, glass or breakable ornaments out of reach of small children.

  • Holly berries and other small decorations can be choking hazards.

  • Don't overload extension cords; make sure that your extension cords are high quality.



This is not a safety issue, but it is worth mentioning. Is your child exhibiting any new allergy symptoms? Take a minute to consider whether or not they started during the holiday season. Trees, scented candles and other seasonal extras can trigger some allergies.

Hanukkah doesn’t fall on the same date every year since it is based on a lunar calendar. Many folks laughingly refer to it as coming either “early or late”. It also has more spelling variations than any other holiday. This season the first candle will be lit on the evening of December 22nd.

  • Make sure that all candles are safely out of harm's way.

  • The menorah should be on a glass tray or aluminum foil.

  • Make sure candles are not close to wrapping paper.

  • Don't go to sleep with candles still burning.

  • Don't leave the matches or lighters hanging around.

If you are frying latkes (fried potato pancakes that are a holiday tradition, yum) make sure that no one gets splattered by oil
Never leave the hot oil unattended

Remember that adding water to a grease fire will make it worse! Baking soda is okay, but a fire extinguisher is best. Make sure you know where it is and how to use it.

Kwanzaa may be the safest of the holidays, (no hot oil or stressing the electrical outlets) but there are still candles involved, so make sure they are placed in a safe place and toddlers don't have access.

If I missed any holidays, let me know! I will add them to this post in the future.

This is also a great time to test your smoke alarms and carbon monoxide detectors!!!

Stay safe and have a wonderful holiday season.

Friday, December 13, 2019

The Best Present is your Presence 2019

The best present is your presence

I saw a bumper sticker some years ago that said:

Good parenting requires twice as much time and half as much money.

So true!

This is the season for gift giving, but we all actually could do with a lot less stuff!! The best present I think that families can give to each other is the gift of self (otherwise known as time and attention.)

For kids who are old enough to understand, give a certificate that promises a special activity that you might do some time in the future. For older kids, escape rooms are a ton of fun. A membership to one of the local museums or the Exploratorium is another good gift to give to the family.

It is great for families to do outings altogether, but one-on-one time is so important if you can manage it. Mix and match so that you make sure that everyone gets special time with one other family member. This includes one on one time for you parents as well.

The list of Nurse Judy's inexpensive and creative activities has some old and new ideas.

  • Collect and decorate rocks with colorful paints and glitter for a rock garden.

  • This is a great one to use as a reward for good behavior. When they see the pretty rocks, they will remember that they earned them.

  • Make a collage. Old magazines and old photos are great for this activity.

  • Make a musical instrument. Use your imagination: a shoe box with rubber bands can be a guitar; glasses filled with different levels of water make different tones; tapping different surfaces with chopsticks makes different sounds.

  • Go on a 'use all your senses' walk. What do they see, smell, hear, and feel?

  • Make personalized place mats. Take some family photos, glue onto cardboard, and cover with clear contact paper. Kids will love to use these with meals.

  • Create a scavenger hunt walk. Plan a list ahead of time of thing to find...like a dog, an airplane, or even a girl with purple hair.

  • Go on an ABC walk. Find things that start with all the different letters...or find the actual letters on signs and license plates. This is a great game in a supermarket.

  • Download free coloring pages from the internet. With a little searching, you can get a picture of just about anything.

  • Draw with chalk. Make a hopscotch board.

  • Make your own play dough. You can find the recipe online.

  • Make a fort using the couch cushions,

  • For a really special occasion, set up the tent and have a backyard camp out (or as we once did, set it up in the house!)

  • Write a story and illustrate it together.

  • Decide on a recipe and bake or cook something. Kids will often try foods more eagerly if they helped with the cooking. Let them help sprinkle in different spices and be the taste-tester.

  • Have a tea party. Invite the dolls, and get out the good china that you never use.

  • Trace your hands and feet and color them in.

  • Have some down time while watching a video or a special TV program. There are some lovely educational TV programs and videos out there.

  • Play a computer game. Don't be afraid of controlled use. Children that don't learn how to be comfortable with computers at a young age are at a distinct disadvantage in this high tech culture.

  • Okay, now put that screen away and get some fresh air! Families can play some sports outside. Find a patch of grass, a basketball hoop or one of the city tennis courts and get active.

  • Blow bubbles.

  • Playing board games with the family is the stuff that great memories are made of.

  • There is little out there that is as much fun as a giant box to get inside of . If you buy a new appliance or see a neighbor buying one, ask for the box.

  • make a rain gauge and weather station

  • Play dress up. In my opinion, every house needs a good dress up box, (after Halloween is a great time to pick up costumes and things on sale)

  • Read!

  • If you can manage to make it work, try hard to have at least one meal of the day sitting down with the entire family. Have everyone say a little about their day. Having one child help with cooking a special dinner, including making and decorating a menu is a great way to have one on one time.

  • Take advantage of where we live; there are always fairs, festivals and museums that are going on.

  • Make a scrapbook with keepsakes and photos of all the fun activities

  • Unless you are using the phone or tablet as part of the activity make sure you put them down and be fully engaged in what you are doing (emails can wait)

For Those lucky enough to live in or near the Bay Area, here is my list of quirky, only in SF things to do.

  • Fort Funston: Bring some dog treats and take a walk. You are pretty much guaranteed to see lots of fuzzy friends to pet. If you are lucky you will see hang gliders. (Free)

  • Take a ferry ride. The route from the Ferry building to Jack London square is super easy, and there are snacks and a bathroom available!

  • Turrell Sky dome: For this you need an admission to the De Young museum. Many folks have no idea that this magical place exists. Go out to the garden by the cafe and follow the path and signs down to the sky dome. Once you are in there, make sure you sing and listen to the acoustics

  • The camera below the cliff house: Lots of folks don’t bother stepping in there, but it is worth it. The Camera Obscura gives a real time 360 view of the surrounding area. It is only open when the weather is clear. It isn’t free, but it is reasonably inexpensive

  • The Wave Organ: This is an old exploratorium exhibit that remains at the end of a jetty behind the St Francis Yacht club. When the tide is right (good luck, I have rarely been there are the right time) pipes will play music. It is an enchanting place regardless, especially if you are there when no one else is out there. It is free

  • Musee Mecanique - If they love it there...consider earning points for future play there

  • Labyrinth down at Land’s End is worth checking out.

  • Walking tours are free and plentiful. These are a fun way to get outside and learn a little history of the city.

  • The Gingerbread house in the lobby of the Fairmont Hotel is worth a trip. It is only there until the New Year. This is free unless you opt to splurge on the very expensive tea.

  • I love the Stairway walks of SF book. If you child is old enough that they don't start asking to be carried half way through the walk, these are a great family activity.


  • Sing-a-longs at the Castro Theatre (Thanks to JD and family for this addition)

  • Groupon and Goldstar and great ways to find the deals out there!

Happy Holidays...go out and make some wonderful memories!

If you have something that you think would be a good addition to this list, let me know!



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 1, 2019

Election time/get your kids involved


VOTE!!

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

Branching out from English only Language 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,

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.


ADULTS ONLY

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.

Friday, August 2, 2019

Kids and Pets

Kids and pets

Personally I think that most families are enriched by having a pet. Of course, as an advice nurse I have a bit of an unusual take on things. I get plenty of animal related calls. A little knowledge and planning can help keep the relationship between your pet and your child happy and safe, and can help avoid incidents with animals who don’t belong to you.

For those of you who already have pets living with you, I understand that animals are essential and much loved members of the family. In some cases they may actually feel like your first child, but here are a few things to consider:

Cats:
Many cats are quite happy to welcome a baby to the family, but cats are cats. Once your child has the ability to chase after them, the cat will usually establish dominance once or twice with a good swipe if someone is invading their space when they aren’t in the mood. Kids (and new puppies figuring out how to get along with the family cat) learn pretty quickly what the rules are. Watch out for cat scratches, they can get infected fairly easily. It is essential to clean them well and apply an antibiotic ointment. (Don't use peroxide, current thinking says to avoid it because it causes tissue irritation). If there is any increasing redness or red streaking appearing around the scratch site, that might be a sign that it is infected and it should be evaluated.
If your crawling child starts getting little red spots, consider that they might be flea bites. Fleas are rampant here in San Francisco year round. When not on your pet, fleas tend to hang out in the carpets and while they might not bother you, your child is spending more time on the rug and presents a tasty treat.
Please do your best to keep your kitties out of your baby's crib or bed. I know I sound like an old grandmother, but it is a safety hazard for a cat to snuggle around an infant's face.
Meow mix generally doesn't hurt anyone, but you want to make sure that the cat food is not left out where your toddler can get into it.
Now, getting a little more disgusting, make sure the litter box is somewhere where the child has no access. You don't want to be the parent who calls me horrified that their baby just had a snack of cat poop.
If any family members seem to be plagued with allergies, consider checking out Advanced Allergy Solutions. I have seen them make a huge difference for some people with allergies to cats and/or dogs
Dogs:
Make sure you closely supervise any interactions with your dog and your new baby to make sure the dog is not exhibiting any behaviors that you need to worry about. If the dog is at all growly, as heart wrenching as it may be, they might need to be placed in a home with no kids. 
Earlier signs of doggie stress can include:

  • Licking lips
  • Panting
  • Yawning when they are not tired
  • Pacing

By the time the dog is growling, it is possible that these other signs weren’t noticed.

There are some apps out there that can help you and your older children learn how to have appropriate interactions with dogs.



Puppy Prep’s Steph Miller, owner of Recess With Steph,shared the following excellent tips:

Dogs, Babies, and Expectations – Getting YouReady!
Here are some suggestions to help you prepare your dog for Baby’s arrival:
1. Practice basic manners and tricks so that your dog has plenty of cues he knows well and you can direct him to do. Examples: sit, touch, place, out, down, leave it, settle, target.
2. Socialize your dog around children in a positive and controlled environment. Observing kids while you give your dog treats or enjoy a game of fetch is a wonderful way to build a positive association. Short exposure is perfect!
3. Replace unwanted attention seeking behaviors with desired behaviors.
Example: sit to be petted instead of pawing you on the couch.

4. Practice short times of separation with a “success station” while you are home! Crates, gates, indoor tethers, or a doggie room are all great success station options.
5. Know your dog’s sensitivities. Research his breed or mixture of breeds. Observe whether the dog startles with fast motion, noises, or other sudden events.
6. Begin a “baby flexible schedule” vs. a rigid schedule. For example, if your dog always eats at 6 am, you may want to vary this time so that your dog gets used to changes and won’t wake you up early for breakfast!
7. Allow your dog to become familiar with the baby equipment. Focus on teaching him how you would like him to behave near this equipment. Doing this ahead makes a world of difference!
8. Place a baby doll or teddy bear in the baby’s carrier and move through the house and yard with it. Practice helps you to get the idea of what it will be like to use this equipment around your dog.
9. Walk your dog with an empty stroller, or put a heavy doll or a 10 lb weight in it for a more realistic feel, in order to learn more about the skills your dog needs to learn before a walk with a real baby.
10. Use a CD of baby noises to introduce new sounds and create a positive experience prior to the baby’s arrival. You can purchase dog expert Terry Ryan’s baby sounds as a CD or digital download by visitinghttp://www.legacycanine.com.
11. Have partner bring home a blanket with the baby’s scent on it (partner will smell like the baby, too). Let the dog become accustomed to the scent in positive ways.
12. If your dog is due for his yearly check-up and vaccinations, schedule your visit well ahead of time, and be sure to stock up on all necessary medications and supplies.
13. Familiarize your dog with the person that may care for them while you are away.
14. Find a good, safe spot for your diaper pail.
15. Find a licensed Family Paws Parent Education presenter in your local area: http://familypaws.com or contact me directly at recesswithsteph@gmail.com.
16. Have fun and enjoy your family!

Most dogs are perfectly wonderful with the children but even with the most loving dogs please make it a rule that your baby or toddler is not allowed near them at meal time. The innocuous infant might become more of a threat when they start getting more mobile. Let your doggy have a baby free zone where they can eat in peace. By far most of the bites that I get called about are food related.
I recall one situation where we had a toddler who got bitten by the family dog. One of those "treat balls" was unearthed under the sofa where it had been hiding for months. The dog got very territorial when the toddler tried to get it and the baby took the brunt of it.

In another instance, Grandma’s cosseted little dog didn’t like the fact that a visiting grandchild got on the bed. The child got a severe bite on the face. It wasn’t the first time that dog had bitten someone. Grandma should have been more wary of the interaction.

Just an FYI, A study of dog bites in Calgary finds no breed group can be singled out for serious bites. It has much more to do with the training, or lack thereof.

The Family Dog cites the chilling statistic from a study that was done of Philadelphia emergency room visits that found that 77% of dog bites are actually from a dog that belongs to a family or friend.


Always make sure your dog has a safe, kid free zone that they can retreat to if they need a break. If they have a crate, make sure that it is off limits for the kids.

If you are visiting a friend or relative's house and they have a pet ask them explicitly if the animal has any history at all of aggressive behavior with children. Some folks have a blind spot where their beloved pets are concerned and lose their common sense. If there is any doubt please ask that the pet be kept away from your child.

Never reach through a fence or into a car to pet a strange dog.
If you are walking down the street, teach your child that before you pet any unfamiliar animal you ask the owner for permission. Alisha Ardiana empawthy.com
who is a local dog trainer (she works with my grand dog Bowie) says that she believes that dogs deserve access to public spaces without being put in the position of having to interact with strangers. Some animals, walking on leash or tied up outside a store may be stressed and don't feel comfortable being approached. Don’t take it personally if the owner prefers that their dog be left alone.
If you do get the 'all clear' to say hello, demonstrate the safest and best way to meet any new animal. Show them how to hold out their hand first. Tuck the thumb inside the fist so that there are no fingers sticking out. Respect the animal’s personal bubble. Let the animal come to them to give them a sniff. Even if the owner says its fine, but the doggie isn’t interested, move on. 

Here is a good article worth reading.
https://fox28spokane.com/your-children-and-dogs-they-dont-know/

After that initial sniff, for younger kids who are learning how to do gentle petting, consider teaching them the one finger petting technique - have them make a fist except for the pointer finger. Alternatively they can pet with the back of the hand. These methods can keep the kids from grabbing hunks of fur.

Even with the best training and intentions, my youngest Alana kept me on my toes. From the minute she could crawl, she was scampering across the park to say hello to anything with fur.

If you don't have a pet and are considering getting one:
I am a total animal lover and I think that having a pet is a wonderful thing. In our case, our family was adopted by a semi-stray Siamese cat when Lauren was still a baby. George (we didn’t name him) lived a very long life and I am sure never regretted choosing us as his family. A cat who comes to seek out ‘toddler love’ is indeed a cat starved for affection.
We also wanted a dog.

My mother-in-law had plenty of strong opinions. Among them were some pearls of wisdom that resonated with me. Her theory was:

All children need a dog, teenagers especially so. There is nothing quite like the unconditional love of a dog to get you through tough times. The last thing an adolescent needs is to lose their dog during those tumultuous years. Barring an unforeseen tragedy, the lifespan of a dog is roughly predictable, so plan accordingly.
When she first mentioned this to me I was actually a little horrified. It felt so callous and calculating, but I thought about it a little further and it made perfect sense. We ended up getting our beautiful golden Java when my girls were 9 and 12. We were blessed to have her with us for 12 wonderful years. Our family was much richer for it.

For an extra pet safety tip and a story, click this link to an old post:

Please accept ahead of time that as much as you bargain with your child and make agreements about how the dog responsibility will be shared, just give up right from the start. The dog is yours. You (in my case it was my husband) will be the one remembering to feed them, doing all the walks in the rain and probably 100% of the poop scooping. Trust me on this. Luckily the value of getting a family pet goes way beyond teaching your child responsibility.
Keep in mind that a dog bite impacts everyone involved. Let's do everything in our power to prevent them!

No offense to the fish, birds, snakes and other more unusual animals out there since most of the focus of this post was on the more popular furry cats and dogs.
Pets regardless of species, give us many life lessons. They teach us how to deal with loss, but also about unconditional love.

Big thank you to Stephanie Miller and Alisha Ardiana (Dog trainer extraordinaire) for their valuable input on this post