Category Archives: Teens

Good eating habits as a way of preventing obesity and eating disorders

Back-to-school time involves changes in just about everything: schedules, homework, sports, family time—even eating. Being rushed in the mornings makes having a decent, healthy breakfast a challenge. Families have to decide if kids will take lunch or buy the school lunch. Then comes the evening meal with people going in different directions, and often little time to prepare or eat a meal together. It’s no wonder that healthy eating and family time often take a back seat to homework, sports, and other activities.

As we all know by now, obesity among children and teens in our country is a widespread problem, and eating disorders (EDs) are also more common than before.

An article published last week on the website of the American Academy of Pediatrics (AAP) discusses how the same attitudes and habits can lead to both obesity and EDs. According to one study, dieting can actually be a precursor to obesity and EDs. Dieting “was associated with a twofold increased risk of becoming overweight and a 1.5-fold increased risk of binge eating…  Another study found that normal weight girls who dieted in ninth grade were three times more likely to be overweight in 12th grade compared with non-dieters.”

In addition to dieting as a cause, “weight talk”—no matter how well-intentioned—and “weight teasing” can lead to EDs and obesity.  “Weight talk, or comments made by family members about their own weight or to the child to encourage weight loss, has been linked to both overweight and EDs. Teasing children about their weight also has been associated with the development of overweight, binge eating and extreme weight-control behaviors in girls and overweight status in boys. Body dissatisfaction is a known risk factor for both obesity and EDs.”

So, how does a parent help a child be satisfied with her or his body? How do you encourage your teen toward a healthy relationship with food? “Adolescents who are more satisfied with their bodies report parental and peer attitudes that encourage healthful eating and exercise to be fit, rather than dieting.”

The article contains recommendations for pediatricians, and that guidance also applies to parents:

  • “Discourage dieting, skipping of meals or use of diet pills to lose weight. The focus should be on a healthy lifestyle rather than on weight.
  • Encourage more frequent family meals, which provide an opportunity to model healthy food choices and provide time for teenagers and parents to interact.
  • Promote a positive body image among adolescents. Body dissatisfaction should not be used as a reason to lose weight.
  • Encourage families not to talk about weight but rather to talk about healthy eating and being active to stay healthy.
  • Carefully monitor weight loss in an adolescent who is obese or overweight to ensure the teen does not develop the medical complications of semi-starvation.”

Don’t forget family meals. Though your children and teens may roll their eyes, the time spent together around the table is a time to connect over healthy food and discussions about topics great and small. Turn off the television and cell phones (including yours!) and enjoy each other’s company. It will make all of you healthier.

© 2016, MBS Writing Services

Drugs and young brains

According to the American Academy of Pediatrics (AAP), one in four young people (ages 12-17) who uses illicit drugs will also develop a dependency. This is a much higher rate than that for adults.

Why? No one is certain, but there are some known factors.

Heredity is one of those factors. Is there an addict or alcoholic (recovering or otherwise) in your family’s history? If so, be aware that this one factor can greatly increase your child’s chances of developing an addiction to drugs or alcohol. You should talk to your teen about this with the hoped-for effect that she will choose to be more careful.

Here are some other factors listed in an AAP web article:

  • “Untreated psychological conditions such as depression, anxiety, conduct disorder, oppositional defiant disorder and personality disorder. For these youngsters, as well as for those with untreated attention deficit hyperactivity disorder (ADHD) and other learning problems that interfere with academic and social success, taking illicit drugs may be their way of self-medicating.
  • Temperament: thrill-seeking behavior, inability to delay gratification and so forth.
  • An eating disorder.
  • Associating with known drug users.
  • Lack of parental supervision and setting of consistent limits.
  • Living in a family where substance abuse is accepted.
  • Living in a home scarred by recurrent conflicts, verbal abuse and physical abuse.”

Start the conversation about drugs and alcohol early on, in age-appropriate ways. And don’t assume that just because you’ve had this talk once, that’s good enough. Young people are confronted with opportunities on a regular basis, so make sure that you leave the door open to talking with you about it.

Not sure how to begin? Here’s another great AAP article entitled “Talking to Teens about Drugs and Alcohol.” It gives great advice about a conversation that is essential to your child’s health.

Educate yourself about drugs and alcohol. Have open conversation. Don’t abuse substances. Help your teen stay healthy and free from addiction.

© 2016, MBS Writing Services, all rights reserved

Talking to children after a tragedy

The recent shooting in Orlando leaves every parent—and anyone who cares about children and teens—in the position of wondering what to say and how to say it. You are reeling from the news, and you want to protect the children you love from being hurt by it.

There is no perfect way to handle tragedy with youngsters, but here are a few basic guidelines. All of the quoted information below comes from an article you may want to read in its entirety, from the American Academy of Pediatrics (AAP).

  • “No matter what age or developmental stage the child is, parents can start by asking a child what they’ve already heard. Most children will have heard something, no matter how old they are. After you ask them what they’ve heard, ask what questions they have.”
  • “In general, it is best to share basic information with children, not graphic details, or unnecessary details about tragic circumstances. Children and adults alike want to be able to understand enough so they know what’s going on. Graphic information and images should be avoided.”
  • “Keep young children away from repetitive graphic images and sounds that may appear on television, radio, social media, computers, etc.”
  • “With older children, if you do want them to watch the news, record it ahead of time. That allows you to preview it and evaluate its contents before you sit down with them to watch it. Then, as you watch it with them, you can stop, pause, and have a discussion when you need to.”
  • “Today, most older children will have access to the news and graphic images through social media and other applications right from their cell phone. You need to be aware of what’s out there and take steps in advance to talk to children about what they might hear or see.”
  • “The reality is that even children as young as 4 years old will hear about major crisis events. It’s best that they hear about it from a parent or caregiver, as opposed to another child or in the media…

The underlying message for a parent to convey is, ‘It’s okay if these things bother you. We are here to support each other.’”

  • What if you have an older child or teen? “After asking your child what they have heard and if they have questions about what occurred during a school shooting, community bombing, natural disaster, or even a disaster in an international country, a parent can say something such as: ‘Yes. In [Orlando, Florida]’ (and here you might need to give some context, depending on whether it’s nearby or far away, for example, ‘That’s a city/state that’s pretty far from/close to here’), there was disaster and many people were hurt. The police and the government are doing their jobs so they can try to make sure that it doesn’t happen again.’”

If your child seems to be overwhelmed with anxiety after a tragedy, and that feeling doesn’t get better with time, talk to your pediatrician. You may also request our office to refer you to a counselor who specializes in working with children or teens. Signs that they are having trouble coping include problems with sleeping or eating (too much or too little); physical symptoms such as tiredness, headaches, digestive issues; or behavioral changes.

It is only natural to be upset when a tragedy occurs. Every adult feels that way, and so do children and youth. If you haven’t had a conversation with them about it, today is a good time for that discussion.

© 2016, MBS Writing Services, all rights reserved

Bullying is a serious matter

October is National Bullying Prevention Awareness Month. That means now is a good time for us to talk about this important subject.

Bullying can occur at school or on the bus, in the neighborhood, on the playground— anywhere. Cyber bullying is also on the rise, where people use the internet or phone apps to harm others.

At the very least, bullying lowers self-esteem. But as we know, continual bullying can cause children and teens to withdraw socially, may create depression or other mental health issues, and can even result in physical harm.

Parental awareness is essential. It’s almost certain that your child will, at some point, either be on the receiving end of bullying behavior, or will bully someone else, or both. An article on the American Academy of Pediatrics (AAP) website references a study from 1999, in which four out of five teens admitted to participating in bullying behavior at least once a month. Those who have been bullied often go on to mistreat others.

Conversations about appropriate behavior and language need to begin early between parent and child. Don’t hesitate to correct your child or teen when you hear name-calling or witness unkind behavior, even between siblings. They can learn early the boundaries between acceptable and unacceptable behavior. Teach them how to express themselves, especially when hurt or angry, by using language that doesn’t cross the line into disrespect. Don’t tolerate violent acts against people or animals.

Of course, your kids are not always near you, and you won’t be aware of everything that happens to them or everything they do. Continue the conversation about bullying; remind them to walk away from confrontations and to inform a responsible adult if they experience or witness bullying. Talk about kindness; role-play sticky situations. Monitor their internet and cell phone activity and discuss what you find there.

Teach your kids some nonviolent and non-confrontational ways to handle conflict. There are excellent resources for this in the article mentioned above, also here and here.

Remember that school counselors and other therapists can be really helpful if your child or teen is a victim or perpetrator of bullying, and our office can always make a referral.

As children get older, remind them that they help create a safe environment for others. They can be a positive force by refusing to contribute to an atmosphere of hatred.

As the school year continues, things can get very hectic. Don’t forget to pay attention to what’s going on with your youngsters. Ask questions, be supportive, get help when needed. Let’s keep our schools and community safe for everyone’s children.

© MBS Writing Services, 2015, all rights reserved

Artwork by Shawna

Artwork by Shawna

Sports physicals – it’s time

Your kids are on the move – literally, and all the time! If they are involved in a fall sport at school, then it’s time for their sports physical. Don’t forget that there is tremendous benefit to getting these physicals at your child’s pediatric office, rather than at a clinic or a school-sponsored physical day. The pediatrician has all your records including vaccinations, allergies, and your individualized and family medical history. He or she can discuss important sports information with you, including nutrition. And, of course, follow-up is always readily available, whether one week or six months from now. We are delighted to be working, with you as our partner, to make a medical home for your family here with us. If your child has a physical at a clinic or the school, that physical is not a part of our records, and we end up with an incomplete picture of his or her development and needs. Read our previous blog post for more reasons on why it’s wise to bring your child to the pediatrician when it’s time for a physical.

© MBS Writing Services, 2015, all rights reserved

Diabetes overview, type 1

Diabetes is a disease that can hit at any time of life from childhood to old age.  It can be a scary diagnosis, and it’s certainly not one a parent wants to hear.  Even so, new medical advances are constantly being made that can limit the bad effects of diabetes, and early diagnosis and treatment are always important.

Diabetes is not uncommon among children and teens.  According to the National Institutes of Health (and the National Diabetes Education Program—NDEP) article from which we have drawn much of the information for today’s blog, “About 208,000 young people in the US under age 20 had diabetes in 2012.”  Those numbers are growing.

The disease is classified into two categories, called type 1 and type 2.  Both types mean there is an elevated glucose (sugar) level in the blood, which is caused by problems with insulin production in the pancreas, and/or how that insulin acts on the body.

Type 1 diabetes, though only 5% of all diabetes cases, accounts for nearly all diagnoses in children under age 10.  It’s actually an autoimmune disease, in which the child’s own immune system destroys the beta cells of the pancreas that produce insulin.  (Insulin is the hormone that regulates the metabolism of carbohydrates, including sugars, and fats.)

Usually, symptoms of type 1 diabetes don’t appear until the disease has destroyed most of the beta cells.  According to the same article cited above, “Early symptoms, which are mainly due to hyperglycemia, include increased thirst and urination, constant hunger, weight loss, and blurred vision. Children also may feel very tired.”  If you are suspicious that your child has type 1 diabetes, seek medical attention immediately.

So far, there is no cure, but type 1 diabetes is managed through careful monitoring of blood sugar levels, and insulin administration by pump or injection.  The amount and timing of insulin doses is determined by taking into account food and beverage intake, physical activity, and the presence of any illness.  This management must be under the care of a physician who understands diabetes.

There are many ongoing studies into type 1 diabetes.  Perhaps in the not-too-distant future there will be a cure, or at least a way of pre-determining who is at risk and finding ways to treat the disease before it has destroyed the body’s ability to produce its own insulin.  The future is promising.

© MBS Writing Services, 2015, all rights reserved

Younger children—don’t just focus on one sport

Summertime is just around the corner, and it’s time for kids to be outside enjoying themselves.  Organized sports are often a part of that.  Whether you have big dreams for your child’s sports future (college scholarship, pro career) or she has dreams for herself, it’s important not to push too hard too soon.  Doing so can cause injury and, perhaps more importantly, can decrease the all-important fun factor.

Most children love to play with a ball even before they can walk.  As their bodies mature, they’ll enjoy learning to swim, running short distances, playing physical games like tag in the backyard.  Activities like these are great for children’s physical health and for helping them grow into well-rounded people.  Staying active prevents obesity, gives a boost to the immune system, improves mental outlook, and fosters the development of social skills (learning to play fair, settling disputes, taking turns, sharing).

Parents should be cautious by not encouraging a child to play one sport to the exclusion of others.  Focusing on one sport, whether it’s swimming, soccer, baseball, gymnastics or something else, can lead to specific injuries.  Swimmers may develop shoulder problems; gymnasts can damage joints; runners might get shin splints.  Keeping a variety of physical activities in a young child’s life enables the whole body to develop, get stronger and more flexible, and decrease the risk for injury.

Eventually your child may decide to specialize in one sport, but doing so too early goes against the recommendations of the American Academy of Pediatrics (AAP) Council on Sports Medicine and Fitness.  There’s a great article on the subject here.  It’s best for your child’s physical, mental and social development to generalize, try a lot of different sports and activities, and to simply have fun.

 

© MBS Writing Services, 2015.  All rights reserved.

Batter up!

Baseball is here for the summer, for kids of all ages.  Grownups, too, for that matter.  If you’ve ever had a pitcher in the family, you know that shoulder injuries are common, and if you’ve ever watched a slow motion video of a pitcher’s action, you can see why.  It’s not an entirely natural motion, and done repetitively, it can cause injury.  Pain and swelling may occur and sometimes even surgery is required if the damage is severe.

Little League Baseball has guidelines in place, designed to prevent injury.  These rules govern both the number of pitches allowed per day, and the number of days rest required after pitching.  You can read their entire list of pitching rules here.

Both the number of pitches and the number of rest days are regulated by age.  Here is their list of pitching limits per day:

17-18         105 pitches per day

13-16         95 pitches per day

11-12                   85 pitches per day

9-10           75 pitches per day

7-8              50 pitches per day

 

And the rest day requirements, again quoting from their website:

Pitchers league age 14 and under

• If a player pitches 66 or more pitches in a day, four calendar days of rest must be observed.

• If a player pitches 51-65 pitches in a day, three calendar days of rest must be observed.

• If a player pitches 36-50 pitches in a day, two calendar days of rest must be observed.

• If a player pitches 21-35 pitches in a day, one calendar day of rest must be observed.

• If a player pitches 1-20 pitches in a day, no calendar day of rest is required.

Pitchers league age 15-18

• If a player pitches 76 or more pitches in a day, four calendar days of rest must be observed.

• If a player pitches 61-75 pitches in a day, three calendar days of rest must be observed.

• If a player pitches 46-60 pitches in a day, two calendar days of rest must be observed.

• If a player pitches 31-45 pitches in a day, one calendar day of rest must be observed.

• If a player pitches 1-30 pitches in a day, no calendar day of rest is required.

           A game official is required to keep the pitch counts for every pitcher in the game and to let the head umpire know when a pitcher has reached his/her limit.

For other notes on safety and required equipment for ALL baseball players at different positions, please read Little League’s equipment checklist here.

Fun and safety are the twins of any sport.  Insuring your child’s safety and health increases the fun quotient!

 

© MBS Writing Services, 2015, all rights reserved.

Breast development in boys?

As odd as it may sound, about three quarters of boys will develop some breast tissue early in their puberty.  This is a normal physical reaction to the increase of hormones, including estrogen, in the male body as it matures.

Gynecomastia, as it’s called, is a source of concern for many boys because they are unprepared for it and think something may be wrong with their bodies.  And, of course, it comes at a time in their lives when they may already feel insecure about their physical and sexual development, when they may already be uncomfortable in the locker room at school

Gynecomastia can start as tenderness or soreness around the nipple and can manifest in one or both breasts.  Most of the time, the tissue will only grow a half inch or so, and often will be just around the nipple.  It can take a couple of years to go away, but normally it will go away.

You should also know that certain medications, both prescription meds and illegal drugs, can cause gynecomastia.  In particular, anabolic steroids, marijuana or heroin can lead to gynecomastia, as can insulin and other prescription drugs.

The information for this blog was gleaned from an article on the website for the American Academy of Pediatrics, an article which contains much more information about male puberty and what changes a boy may expect in his body.

If your son has gynecomastia, make sure he knows the condition is common and will resolve itself with time. Show him this article.  Encourage him to talk to his physician who can assure him that nothing is wrong with his body or his development.

 

© MBS Writing Services, 2015, all rights reserved

Halloween Safety Tips

Today’s entire blog below is quoted from the AAP, here.  Have a great Halloween!

Halloween is an exciting time of year for kids. Here are some tips from the American Academy of Pediatrics (AAP) to help ensure they have a safe holiday.

All Dressed Up:

  • Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
  • Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.
  • Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives. Hats should fit properly to prevent them from sliding over eyes.
  • When shopping for costumes, wigs and accessories look for and purchase those with a label clearly indicating they are flame resistant.
  • If a sword, cane, or stick is a part of your child’s costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.
  • Obtain flashlights with fresh batteries for all children and their escorts.
  • Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as “one size fits all,” or “no need to see an eye specialist,” obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss.
  • Teach children how to call 9-1-1 (or their local emergency number) if they have an emergency or become lost.

Carving a Niche:

  • Small children should never carve pumpkins. Children can draw a face with markers. Then parents can do the cutting.
  • Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.
  • Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and should never be left unattended.

Home Safe Home:

  • To keep homes safe for visiting trick-or-treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations.
  • Parents should check outdoor lights and replace burned-out bulbs.
  • Wet leaves should be swept from sidewalks and steps.
  • Restrain pets so they do not inadvertently jump on or bite a trick-or-treater.

On the Trick-or-Treat Trail:

  • A parent or responsible adult should always accompany young children on their neighborhood rounds.
  • If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.
  • Only go to homes with a porch light on and never enter a home or car for a treat.
  • Because pedestrian injuries are the most common injuries to children on Halloween, remind trick-or-treaters:
    • Stay in a group and communicate where they will be going.
    • Remember reflective tape for costumes and trick-or-treat bags.
    • Carry a cell phone for quick communication.
    • Remain on well-lit streets and always use the sidewalk.
    • If no sidewalk is available, walk at the far edge of the roadway facing traffic.
    • Never cut across yards or use alleys.
    • Only cross the street as a group in established crosswalks (as recognized by local custom). Never cross between parked cars or out driveways.
    • Don’t assume the right of way. Motorists may have trouble seeing trick-or-treaters. Just because one car stops, doesn’t mean others will!
  • Law enforcement authorities should be notified immediately of any suspicious or unlawful activity.

Healthy Halloween:

  • A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats.
  • Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
  • Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.
  • Try to ration treats for the days following Halloween.

Whether dressing up in costumes, trick-or-treating, or having parties with their friends, most kids love Halloween. But did you know that Halloween is also a time when more children than usual end up in the emergency room due to falls, traffic collisions and other injuries? All the sweets in the house (and at school) can also wreak havoc on a child’s teeth and healthy diet.

To help ensure your child’s Halloween is both safe and healthy, pediatrician Corinn Cross, MD, FAAP joins the Healthy Children show on RadioMD with some tips from the American Academy of Pediatrics. Listen here.