wish list Archives - Happy Healthy Kids

E.R. Nurse’s Wish List

December 1, 2016 by Kelley Leave a Comment

This post is part of a “Wish List” series in which I ask experts in different pediatric fields—medicine, education, etc.—what they really want parents to know and do better. Interested in hearing from a certain type of expert? Please make a suggestion here.

If there’s one genuinely stressful experience common to pretty much any parent, it’s a trip to the emergency room. There are few circumstances when we feel less in control than headed into the E.R. with a sick child in arms, and yet, it ranks high among situations when we’d most like to have our wits about us. As we approach winter, when emergency department volume peaks, I asked Katie, a pediatric nurse who’s worked in a major children’s hospital E. R. and a neonatal intensive care unit, what she wishes every parent knew before heading to the hospital. Thanks for the tips, Katie!

1. Buy a thermometer—and use it. One of the most frequent statements parents make is, “he/she has a fever.” The nurse will always ask, “how high was the fever?” and the most frequent response is “well, I don’t know. He/she just felt warm.” You can save time and money by simply taking your child’s temperature before heading to the hospital. A fever below 101 typically does not merit a visit to your local E.R. on its own.

2. Before coming to the ER, call your pediatrician and give your child a proper dosage of Motrin or Tylenol.
Your pediatrician knows your child (hopefully) better than we do. Calling them and giving them a heads up, and explaining symptoms or injuries, will determine if you truly need to go to your local E.R. To be safe, they’ll often tell you to go to your E.R., but they will also give us a heads up that you are coming. This may expedite your process, and we’ll have a better idea of who you are when you come into the E.R. Also, give a dose of Tylenol or Motrin before coming in, if your child has a headache, fever, pain, or is uncomfortable. This will also expedite your visit and you’ll be one step ahead of the game once you arrive to the E.R.

3. If you have a child with a complicated medical history, write down their allergies, history and medications and bring it with you. Life is hectic. We get it. But, if your child has multiple conditions, medications, allergies, or any other specific medical concerns, write them down in a lucid moment and put it in a slip of paper in your wallet or save it on your phone. Parents who come to the E.R. even slightly organized will help nurses and doctors do their job better. There have been countless occasions where parents have failed to mention an important medication or symptoms that can be very key in the diagnostic or treatment process. We truly need all the information. You know your child best, so be prepared to share your knowledge.

4. Do not be afraid to ask questions, ask for help, or inquire about resources. One of the best parts of being in an E.R. is that we get a chance to educate patients about almost anything health-related. Don’t be afraid to ask your doctor or nurse questions even if it seems silly or you think it might be common sense. We have access to multiple resources, from child life specialists who can stop by during your visit to outside specialists we can refer you to. We’d rather take extra time with you than have you walk out confused.

5. Be prepared to wait. The busiest time to go to any E.R. is between 4pm-midnight. The reason: School and sports practices end, kids will admit around dinner time that they do not feel well, or they have been sick all day and it seems to get worse around bedtime. We wish this wasn’t the case, but it is. Patients receive treatment based on how sick they are, not in the order they arrive. Bring a book, iPad, games, coloring books or anything else that can help keep kids occupied for about an hour or more. We’ll do everything we can for your child, and if they seem to be doing worse as you’re waiting, tell us. We definitely do not want you waiting longer than you have to, and if your child needs more Tylenol, Motrin, an Ice Pack, Band-Aid, blanket or anything else, we are always happy to help.

Read more expert wish lists here.

Pediatric Sleep Doctor’s Wish List

May 26, 2015 by Kelley 2 Comments

This post is part of a “Wish List” series in which I ask experts in different kid-related fields—medicine, education, etc.—what they really want parents to know and do better. Interested in hearing from a certain type of expert? Please make a suggestion here.

Everyone has their own parenting challenges, but getting kids to bed seems to unite us all. From wakeful newborns to night-owl teens, sleep problems never seem to go away—they just change. For this reason, I’ve tapped Craig Canapari, M.D. for our latest installment of “Wish List.” Dr. Canapari is a pediatrician specializing in breathing and sleep problems at the Yale-New Haven Children’s Hospital. A dad of two, Dr. Canapari also has a website which provides real-world perspective on cutting-edge sleep research. (I should also add that I’ve been reporting on kids’ health for 15 years now, and think no expert beats Dr. Canapari when it comes to demystifying kids’ sleep issues and helping parents chill out about them.) Here, he tells us the five things he wishes every parent knew or did to help all kids of all ages have healthier, better, and more restful sleep.

1. A good bedtime is critical for sleep success. Whether your child is 3 months, 3 years, or 13 years old, the most important area to focus on for good sleep is bedtime. A good bedtime occurs at a consistent time and is predictable and pleasant. In our home, my boys brush teeth, bathe, read stories, sing songs, and then have lights out. One trouble area for parents is that bedtime rituals can become too long and jumbled. For example, if the child is going upstairs then downstairs then outside then back to his or her bedroom, he or she is likely going to have some problems falling asleep. For older children and teens (and adults for that matter) it’s important to “power down” by turning off screens (and removing from the bedroom) and relaxing for 30–60 minutes prior to bedtime.

2. Sleep training doesn’t hurt your child, and may not even involve crying. Since Dr. Sears published The Baby Book in 1993 and started the attachment parenting movement, many parents have become leery of sleep training, which has become synonomous with “crying it out” (CIO). Both Dr. Sears and some more marginal sources have even suggested that sleep training is neglect, or even that it can brain damage your child. I would like to set the record straight. 1. There is no evidence that sleep training harms children, and good evidence that it improves sleep qualities and benefits families. 2. Crying may be necessary in some cases but can be minimized by a later bedtime (bedtime fading) and techniques like gradual withdrawal of parental presence, or “camping out”.

3. Some kids sleep better than others. When I was a baby, I slept for 18 hours a day, and my mother was really concerned about this. Other infants may sleep for 12 hours a day at first (and I guarantee that those hours are not occurring in a row). Differences can persist into childhood. So if your friend’s child is a perfect sleeper and yours is not, don’t stress too much. You can have good sleep but it may require a bit more diligence. (And her kid may be a picky eater, or like to eat dirt, etc).

4. Snoring is not normal and should be investigated. Some kids who snore may have a condition called obstructive sleep apnea, where the airway (the breathing tube from the nose and mouth to the voicebox) may narrow or close and open during the night. This problem can be associated with sleep disruption and drops in oxygen levels, as well as daytime problems with behavior and attention. Most (but not all) kids with OSA snore, and frequent or loud snoring should be discussed with your pediatrician, especially in the first year of life. The evaluation may include an overnight sleep test. Treatment options can include allergy medications, removal of the tonsils or adenoids, or orthodontic work.

5. Sleep deprivation is toxic, both for parents and adults. In children and teens, inadequate sleep is associated with a myriad of issues including behavioral and mood problems, weight gain, and difficulties in school. Most younger children will not be sleep deprived as they will go to sleep when tired and wake up when they are rested. However, if you routinely need to wake your school-age child in the morning, or if they easily fall asleep on short car trips, it is worth checking to see if they have had enought sleep. For more information on how much sleep kids and grownups need, here are the recommendations from the National Sleep Foundation. Teenagers are a different story; according to a recent survey by the CDC 90% of teens are sleep deprived, and the primary culprit is in appropriately early school start times. To learn more about this issue, go check out Start School Later. and start advocating in your community for this issue.

Environmental Health Doctor’s Wish List

January 28, 2015 by Kelley Leave a Comment

For this installment of the expert “Wish List” series, we’re honored to share the wisdom of Jerome Paulson, M.D., a professor of pediatrics at George Washington University School of Medicine and Health Sciences and chair of the executive committee of the Council of Environmental Health for the American Academy of Pediatrics. Here, he tells us the five things he wishes every parent knew or did to help all kids—your own and future generations’ —consume healthier air, water, and food.

1. Consuming a variety of fresh, whole foods is more important than eating organic. We know that produce is full of antioxidants and other nutrients that help protect kids from all sorts of problems. But many people will be surprised to learn there’s actually no documented long-term health benefit of eating organic foods. Eat organic if you want to, but don’t limit your child’s intake of fresh fruits and vegetables, calcium-containing foods, and whole grains if buying organic makes these choices too expensive. If you want to be choosy about organic purchases, look at the Environmental Working Group’s Dirty Dozen and the Clean 15, here. They have an app that will allow for quick reference at the grocery store.

2. Take steps to be more energy conscious. Climate change is one of the major health problems facing the globe. Any parent concerned about the future of their children and the planet should make an effort to use public transportation and carpools whenever possible, buy the most fuel efficient vehicle consistent with safety and their budget they can find; conserve energy at home; and encourage their elected officials to change local, state, and national policy so the U.S. can contribute to climate change mitigation where possible and adapt to climate change where it must.

3. Avoid toiletries and cosmetics that include endocrine disrupting chemicals. Certain chemicals common in household products are thought to possibly interfere with many chemical processes in growing bodies and are known to have adverse health effects in animals. Err on the side of caution and avoid buying soaps, lotions, and makeup for your kids that contain triclosan, phthalates, parabens and certain other ingredients (for a full and helpful list, check out the EWG’s Skin Deep page, here).

4. Keep indoor air free of pollutants. Polluted indoor air is a big asthma risk. Don’t allow people to smoke in your home—ever—and work with your local school district to take steps to keep the school’s indoor air clean by avoiding air fresheners and keeping humidity down to inhibit mold growth. Moms Clean Air Force and the American Lung Association have great tips on their websites.

5. Take your shoes off when you enter the house. You’d be amazed by how much bad stuff is tracked in on the soles of shoes—pesticides and harmful chemicals, just to name a couple. Make a designated spot by the door where everyone in the family can stow their boots and sneakers, and get everyone into the habit of removing their shoes when they come into the house.

Photo credit: Odin Thomas via Photo Pin, cc

Pediatric Dentists’ Wish List

October 20, 2014 by Kelley Leave a Comment

THE PEDIATRIC DENTISTS

This week, I consulted the pediatric dental team at Chestnut Dental Associates in Needham, MA about what they wish parents knew about taking care of kids’ teeth. At home, Dr. Keri Peterman, Dr. Jon Shusterman, Dr. Anne Hertzberg, Dr. Crissy Beard, Dr. Amy Regen, and Dr. Shelley McBride have eight children (ranging in age from 1 to 12) between them. Thanks, guys!

1. Young children might cry when you’re brushing or flossing their teeth. Don’t take that as license to rush the job. Lots of kids cry when their diapers are getting changed, too, but you aren’t likely to leave that task half-done as a result. Remember, you’re not hurting them; you’re helping them.

2. Children will need a hand with brushing well into grade school. Reaching the back teeth and the inside gum line properly requires a level of manual dexterity that a lot of kids simply don’t have. Monitor older children’s brushing and step in often to help them reach the tricky spots.

3. Cavities aren’t always just the result of lazy dental care at home. Some 60 percent of children have a cavity by age 5, making dental decay the most common chronic disease of childhood. A lot factors go in to the development of cavities (including genetics and water quality), so even model brushers need to keep regular appointments to see a pediatric dentist, who can help determine a child’s risk factors for cavities and help with their management.

4. Fluoride is your friend. Fluoride is an inorganic ion of fluorine which is in our periodic table of elements; it exists all over the earth. When used in moderation—recommended amounts when brushing with a fluoridated toothpaste, periodic dental treatments, fluoridated water— it’s very safe and effective at reducing the risk of tooth decay. Be sure to talk to your pediatric dentist to make sure you’re child is getting the right amounts.

5. A child is exposed to less radiation in today’s dental x-rays than in a cross country flight. Dental x-rays have changed over time, and digital technology reduces radiation exposure by 40-60%. When taken at appropriate time intervals they are essential to diagnosing and treating dental disease.

6. Sugar is everywhere. Yogurt, raisins, packaged snacks, and juice—even “organic” and “all-natural” kinds—are all very high in sugar. The best way to reduce overall sugar consumption is to limit snacks and cut out juice entirely between meals. The AAP recommends no more than 4-6 ounces of juice per day with meals, which reduces the possibility that a child will sip juice over a long period of time. When it comes to dental health, reducing the frequency your kids’ teeth are exposed to sugar is key.