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Stacy Beller Stryer, M.D.  
Female

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Important reminders for parents of newborns

Apr 24, 2009 - 1 comments
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newborns

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Immunizations

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parents

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Baby

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Babies

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newborn

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Pediatrics



A big part of pediatrics is what we call “anticipatory guidance” and preventive medicine.  This is where we get to impart our wisdom on parents, particularly the vulnerable, first-time ones.  For them, everything is new, exciting and, yes, anxiety provoking.  We hope that we can teach and guide them to raise medically and psychologically healthy children.  One of the first and most important things we can do is stress the importance of immunizing children on time.  I know – I have talked about this ad nauseum!!  But that is because when newborns, children and, yes, adults, are not adequately immunized, they are at risk of developing serious illnesses.  As you may recall, I blogged a couple of months ago about the haemophilus influenzae outbreak in Minnesota, where several children became ill and one died.  Well, guess what?  Now there are cases of measles in my hometown, Rockville.  It appears that an unimmunized adult contracted it and has infected several others, including an 8 month old child who is too young to have received the routine immunization.
But, believe it or not, I am not blogging about immunizations today.  It appears that this is just an example of what happens years after a successful plan has been implemented.  Because we don’t see many of these infections anymore, we aren’t routinely reminded of the importance of preventing them.   We seem to have forgotten that the reason we don’t see many of these deadly infections is precisely because children have been vaccinated.  So … the vaccination rate drops, and as the vaccine rate drops, the risk of contracting one of these illnesses rises.  I can guarantee that if we had an epidemic of measles here, with kids dying, parents would be lining up to ensure their kids were adequately immunized.
Well … it’s the same with ALWAYS putting your infant to bed on the back.  Multiple studies have demonstrated a significant increase in the risk of sudden infant death syndrome (SIDS) with placing your infant stomach-side down to sleep.  My recollection from when this recommendation first came out is that almost all parents put their infants on their backs to sleep.  Now, however, more and more parents are telling me that they are putting their infants on their stomachs to sleep because they sleep better.  Or, they are watched by a grandparent during the day, who puts them to sleep on their stomachs.  Well … it is even worse to put an infant on its stomach sometimes rather than always (not that I am EVER recommending stomach sleeping).
A study published in this month’s journal, Pediatrics, evaluated 333 infants in Germany over a 3 year period.  As noted in previous studies, those who were placed prone to sleep were at greater risk of dying from SIDS, particularly those who were not used to sleeping prone.  Other factors which increased the risk of SIDS were covers, sleeping at a friend or relative’s house, and sleeping in a living room.  The only factor which decreased the risk of SIDS was the use of a pacifier at night.   With such compelling evidence which supports many other studies on SIDS risk factors, there is no reason to place our infants on their stomachs to sleep – ever.    This includes when they are with any caretaker, including grandparents, nannies, and other relatives.
So let’s not become complacent about treatments that work.  Continue to immunize.  Continue to place infants on their backs to sleep.

Those Middle School Years …

Apr 17, 2009 - 3 comments
Tags:

Parenting

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children

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parents

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Pediatrics

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child development



As a parent, we often think these are years to be feared.  Years that we wish we could just blink away.  We hear horror stories from our friends and look at book titles, such as “Parenting 911,” and “The Roller Coaster Years,” with trepidation.  If only we could run away … just for awhile.
But, if we did run away we would be missing out on some of the most rewarding and exciting times we will have with our children.  Sure, I am not going to deny that middle-school age children(referred to as “middlers” by authors Charlene Giannetti and Margaret Sagarese) are emotional, moody and, at times, unreliable.  But, as someone once told me, almost every negative attribute can be turned into a positive one.  I guess that means that maybe, instead of being emotional and unreliable, our middlers are actually passionate and spontaneous.
Developmentally, they are expanding their horizons in many ways.  This is when they develop abstract reasoning, a complex sense of humor (beyond the potty jokes), and the knowledge that there is an entire world out there for them to conquer.  This is when they begin to develop strong interests, likes and dislikes, and when they begin to take greater risks – in a positive way.
Personally, I love being with my middler (8th grade) and my almost middler (5th grade) girls.  They are interesting, exciting, and a blast to be with.  When my 8th grader becomes passionate about something, particularly some social injustice, she can talk a mile a minute.  My 5th grader can be very intense when she practices viola or writes original music for her instrument.  She often performs for me while I am preparing dinner.  Both are becoming much more adventurous –  last month we went to an Asian supermarket and bought several  canned fruits we had never heard of so we could have taste tests.
I have been thinking about these middle years recently, not only because my children are this age, but also because I have been preparing for a lecture on this topic for parents at a local school.  Although I have been counseling patients for years, I have recently read several additional books on the topic in preparation for the talk.  They have been helpful, although my basic parenting principles remain unchanged.  They seem to be important for children and teens of all ages.  I think (“Parenting, according to Dr. Stacy”) that the six key elements of being a good parent of any age child include:
1.     Open communication
2.    Respect and consistent discipline
3.    Compassion
4.    Sensitivity
5.    Awareness
6.    Being a role model
Although the principles remain the same over time, the way we express them varies, depending on the child’s age.  For middlers, there should be a strong emphasis on sensitivity and awareness.  Children in this age range tend to be very emotional and sensitive, and we need to understand and respect this.  For example, they may not want to be kissed or hugged in public anymore.  Or, they may need some private time after school or in the evening.  We should allow them to retreat to their rooms for a certain time period before bombarding them with questions or making other demands.  Respecting their needs ultimately improves communication.  We should also be particularly aware of sudden or extreme changes in our middlers’ behavior, as depression, eating disorders and other problems can appear during these years.

Adapting these six basic parenting skills will certainly not ensure a problem-free middle school experience for you or your child, but it will make it much more likely that he or she will come to you in times of need and will strengthen the relationship that you have with each other.  Consequently, your middler will be less likely to engage in high risk behaviors or succumb to peer pressure which occurs during these years.