Author: Kristin Cantu

There is no easy way to talk to children about the destructiveness caused by natural disasters. Thrive spoke with Children’s psychiatrist Stuart Goldman, MD, about how to talk to your children about Haiti’s devastating earthquake. Below are excerpts from that conversation and information from Children’s Psychiatry Department’s pamphlet “Helping Children Cope with Frightening Events without Frightening Them.”

Parents often don’t give children a chance to talk. In situations like this, kids feel helpless, which can lead to feeling very overwhelmed by the situation. Parents need to combat these feelings of helplessness by having conversations with their kids about the devastation in Haiti.

In general, you want to limit media exposure and set aside a quiet time to talk with your kids.  Start the conversation with an open-ended question: “What have you heard or seen on television about the earthquake in Haiti?”

Most adults have an easier time talking than they do listening, but it is important to let your children talk and for you, as a parent, to listen to what they have to say. Your child will then listen to your thoughtful and caring answers to their questions and be comforted by them.

For children under 8 years old, try to keep the conversation as simple as possible. Don’t go into details of the earthquake, but rather focus on the safety of your family and the people closest to you. Assure them that everything possible is being done to keep your child safe.

For children 8 to 12 years old, you can discuss more details of the earthquake. These are valuable pieces of information for children this age that help them understand the scope of the events.

For adolescents, ask what they know about the earthquake and explain the pieces that are missing or that they have wrong. Expect discussions of future implications. Adolescents have the ability to discuss events on a more sophisticated level but still need emotional support and reassurance about their safety.

Suggesting a way your children can help in Haiti’s time of need can be a very valuable way of empowering them during this scary time. Your children can run a clothing drive, raise funds for the Red Cross and write letters of support. If your family is religious, say a prayer of support.

Do you have any tips for how to talk to children about frightening events?

New studies indicate that after decades of Americans steadily gaining weight, they may have finally hit a plateau, reports an article in The Boston Globe.

Children’s obesity expert, David Ludwig, MD, PhD is quoted as saying that while it is a relief that these rates are not continuting to rise, it is certainly not cause for celebration. “If we continue those unhealthful habits, we just continue to maintain weights the way they are. It actually takes a marked improvement in lifestyles to start bringing weight down.”

Read a previous blog post where Ludwig discusses obesity rates leveling off for American children.

If your answer is no,there are two studies published this week to encourage more rest for your kids.

A recent study published in the Journal of Adolescent Health found that 69 percent of teens are getting less than seven hours of sleep a night when they should be getting at least nine. The study also noted that more girls are sleep deprived than boys.

If you have young children who average eight hours of sleep or less a night, researchers have found this may lead to higher blood sugar – a precursor to diabetes. The study, published in the Archives of Pediatrics & Adolescent Medicine, reports the risk is even higher if your child is obese.

You can read more about sleep and the effects it has on your child from Children’s sleep specialist, Dennis Rosen, MD. He blogs on whether sleeping late will keep your child slim and if later bedtimes increase the risk for depression and suicide in teens.

Are your children getting enough sleep?

A new study co-authored by Children’s obesity expert David Ludwig, MD, PhD, says that the majority of obese Americans will not lose a significant amount of weight unless there are serious societal changes concerning food. The article, published in JAMA, takes a look at the science involved in caloric intake versus physical activity and suggests that fundamental changes in America’s food supply and social infrastructure must take place in order to successfully take on the obesity epidemic.

Read more of what Ludwig has to say on trans-fats, taxing soda and junk food advertisements for kids.

Third on the list of the Huffington Post’s Top 10 Medical Research Trends to Watch in 2010, is “the Health Internet,” the brain child of Children’s Isaac Kohane and Ken Mandl.

Last fall, a group of leading thinkers and entrepreneurs from a variety of sectors gathered to discuss an idea that originated with Harvard’s Isaac Kohane and Ken Mandl — the development of an “iPhone-like platform” for health information technology (HIT), a more open and flexible approach than the architecture currently being contemplated, and one that holds greater promise for creating a consumer-oriented “Health Internet.” Obama Administration officials pledged at the meeting to have a pilot effort launched that could have real-time patient data accessible online this year.

The Children’s Hospital Informatics Program (CHIP) has been instrumental in connecting the public with health care issues through technology. CHIP created HealthMap, a website, blog and an iPhone app that tracks disease outbreaks in real-time. We featured their weekly H1N1 tracking updates over the last several months here on Thrive.

Here’s a quick look at what Thrive was up to last week.

Children’s obesity expert gives tips on how to change your eating habits for the better. Mark Alexander, MD explores the question of whether or not high school athletes should be screened for heart disease. Children’s injury prevention expert gives tips on how to avoid a winter sports injury. Claire McCarthy, MD lists great resolutions for your family to live by. Do later bedtimes increase risk of teenage suicide and depression? A group of doctors is pushing for routine circumcision. Our Mediatrician discusses teenage boys and first-person shooter video games.

A group of doctors from the National Institutes of Health and Johns Hopkins are pushing the case for neonatal circumcision. They argue that recent studies show that circumcision is an effective method for reducing the risk of catching certain sexually transmitted diseases.

The American Academy of Pediatrics’ stance has been that there isn’t enough evidence to recommend routine circumcision. However, they are reviewing evidence this year to determine if they should update their recommendations.

Children’s Hiep Nguyen, MD, co-director of the Center for Robotic Surgery and director of Robotic Surgery Research and Training, answers common questions about circumcision.

What are your reasons for choosing to or opting not to have your son circumcised?

The federal government’s annual report monitoring kids’ alcohol and drug abuse has been released. The 2009 Monitoring the Future Survey reports that while use of cigarettes, methamphetamines, cocaine and binge drinking is down the use of prescription drugs and smokeless tobacco is up. Marijuana use is holding steady.

John Knight, MD, director of The Center for Adolescent Substance Abuse Research (CeASER) at Children’s says those findings aren’t particularly surprising. What we do need to worry about, he says, is that the survey also reports that adolescents’ perceived harm of marijuana is way down.

What exactly does that mean? Knight says that when adolescents think a drug has little or no harm, they are much more likely to use it. So, be ready for marijuana use to jump along with other drugs. “Marijuana is a gateway drug that leads kids towards all kinds of other drugs,” Knight says.

Why do kids perceive marijuana less harmful now than in the past? The national debate over medical marijuana use is a big reason, says Knight. The decriminalization of marijuana in some parts of the country makes it seem less risky to kids.

“Marijuana as medication is just a smokescreen,” Knight says. “What other kinds of medications do you see being distributed at pharmacies in baggies?”

Knight says that the government’s version of medical marijuana, Marinol, has faced opposition from medical marijuana reform groups like NORML because it doesn’t make you feel high like other street versions of the drug. “It treats chronic pain without the high and that’s not what these groups want.”

If you think your child might be using drugs and alcohol, visit CeASAR’s website for helpful resources.

In this video clip, Knight talks about the signs of substance abuse.

The holidays are supposed to be a time full of joy. Unfortunately, they can also bring with them stress, sadness and unrealistic expectations. Kids are affected by this just as much as adults. We talked to Children’s psychiatrist Stuart Goldman, MD, about how to help your kids cope with the holiday blues and make this a memorable holiday for the whole family.

The holidays can be especially tough for children who have lost a family member. What are your suggestions for helping a child cope with the loss of a loved one during these times?

The holidays bring back memories of things missed and that might have been. Parents need to give children permission to be sad and reminisce over the loss of a loved one. It’s okay to look through photo albums and have a remembrance at church or over dinner. It’s important for kids to remember the past and not have it shut off. Tell children that it’s okay to miss that loved one, but that you can still have a good holiday. Have them write a letter to Grandma who’s in heaven and start a new holiday tradition that will help make this year’s celebrations memorable.

What are signs of sadness or depression that parents should be aware of?

Sadness and anxiety are a part of life. It when they’re disproportional or extend too long and disrupt functioning that they become a problem. We should expect everybody to be a bit somber around the holidays or upset if they’ve lost a loved one. It’s when your child is irritable, won’t get out of bed and refuses to open presents that you should be more concerned. Episodic sadness is nothing to worry over. Only sustained sadness should be concerned about.

A lot of families are experiencing a tough time economically. How can parents explain to their kids why they won’t be receiving as many gifts this year or going to The Nutcracker?

Parents think kids don’t know about family problems, but they always do. Not talking to your children makes them feel excluded. Parents should be direct about their financial situation, but don’t need to share all of the details. You should shield them from things like being worried about making the mortgage payment, but should talk about why you can’t have the Christmas you’d like to have. Have this talk early on because kids always know.

Parents have the idea that it’s all about gifts and it’s really shared memories that make the holidays, but it’s creative family time that makes a difference during the holidays. Rent The Nutcracker on DVD, make popcorn and buy candy for everyone to share.

Children have come to have high expectations of the types and amount of gifts that they receive around the holidays. What has contributed to these expectations and what can parents do help their kids not get caught up in the commercial aspects of the holidays?

Kids have learned to have high expectations for the holidays and very few things actually live up to one’s fantasies. Parents whose kids have unrealistic expectations have to examine whether they are contributing to that. They should begin to address the topic of gifts early on – not on Christmas morning. If parents are proactive, Christmas morning won’t be a disaster. Parents often feel guilty about not being able to get their kids everything they want, which can result in anger because their kids aren’t appreciative of the gifts.

Break this larger conversation down to a few smaller serious conversations. Everybody has a wish and feels like the holidays are a time when they can be gratified. Parents have to set the line for realistic versus unrealistic gifts, wherever that may be in your family. There might be jealousy and sadness because your children didn’t get a certain gift that their friends did, but there are lessons to be learned. This is an opportunity to say we learned things and that it’s okay to be jealous. Maybe things will be different next year.

What makes the holidays great is that it’s shared time with parents. Building new experiences doesn’t cost anything. One thing my family does is make “surprise balls.” It’s a paper mache ball or hollow Christmas ornament where you hide a note about where someone’s present is in house and what it might be. Do something that contributes to fun family memories.

While you’re here, check out these other holiday-related blog posts:

• Pediatrician Claire McCarthy, MD, talks about why you should put downtime on your holiday calendar this season.
• Tynaya, a Youth Advisor in the Center for Young Women’s Health, recently wrote a blog about what the holidays mean to her.
• Michael Rich, MD, MPH, our Mediatrician, offers a great guide to holiday gifts this year. Plus find out how to shop for safe toys.
• Read some tips on how to balance your holiday eating this year.
• Don’t let glass holiday ornaments injure your child.

It was another Sunday soccer game for 15-year-old goalie Glen Martin. He was ready to do anything to protect his team’s goal. While trying to block a shot, the opposing team’s player accidentally kneed him in the stomach.

When Glen was hit, his organs were pushed against his spine, lacerating his liver, puncturing his small intestine and severing his pancreas. He was flown to Children’s that night and operated on the next day. Glen spent the next 70 days recovering in the hospital.

Knowing first-hand that having activities to do during your hospital stay is important, Glen joined Children’s Teen Advisory Committee (TAC) after his long inpatient stay. Patient boredom can be avoided by planning activities where you interact with other patients. The TAC meets once a month and organizes activities that will enhance the hospital environment for other teen patients. That way, instead of only being able to think about getting out of the hospital, patients actually have something to look forward to during their hospital stay.

TAC has two carts filled with “teen only” activities that they bring to the bedside of hospitalized teens. They also host three parties each year for teen patients and their families, educates patients on how to make educated decisions about their own health care and hosts an annual education fair.

Jessica Strzelecki, a Child Life Specialist and TAC facilitator, remembers Glen talking about wanting to give back to the hospital during his stay. “I thought TAC would be a great place for Glen to share his ideas from his own experience and to help with the many projects that were underway within the committee,” she said.

This spring Glen also helped raise $2,500 for Children’s through Miles for Miracles, where patients sponsor runners in the Boston Marathon. All the money raised is then donated to Children’s.

You can read more about Glen’s patient experience here.

While volunteering is not a new idea, it may be to some of your children. Research has shown that “volunteering plays a valuable role in shaping how youth learn to interact with their community and develop the skills, values, and sense of empowerment necessary to become active citizens.”

Related posts:

1. Kids giving back to kids: Children in medical research #1
2. Health headlines: Mozart helps preemies, children’s allergies and teen brains really are different
3. Health headlines: Fearless toddlers, Viagra for kids and Santa wants his vaccine

Jennifer LeBovidge, PhD, a psychologist from Children’s Allergy and Immunology Program, was quoted this weekend in a Boston Globe Magazine article about the challenges of parenting a child with significant food allergies.

Although only about 4 percent of Americans are affected by food allergies, they seem more prevalent today than ever. We recently finished an eight-part milk allergy series where we followed Brett Nasuti, a Children’s patient who last summer became the first person ever to go through a milk exposure desensitization trial. Check out the first video in the series.

Related posts:

1. A cure for milk allergies? Part 1: Meet Brett, whose severe allergy to milk may be cured
2. A cure for milk allergies? Part 7: Cooking at home with the Nasutis
3. A cure for milk allergies? Part 2: Dr. Schneider explains the bold, new idea.

The fight for what our kids eat continues to rage on. The battle has moved from the home to  school lunch rooms, fast food restaurants and grocery store shelves. Fresh versus frozen. Organic and local versus imported produce. Natural versus artificially sweetened beverages.

There’s no denying that we all care about what our kids consume. Yesterday, Children’s director of the Optimal Weight for Life Program, David Ludwig, MD, PhD, wrote a piece expressing concern about the widespread use of artificial sweeteners in soft drinks. (The Washinton Post recently featured Dr. Ludwig on this topic. Also read more of Dr. Ludwig’s articles on children’s health here.)

This week there have been several news stories concerning the foods and beverages our children consume.

• Activists have persuaded many schools across the country to stop serving chocolate milk because of its sugar content. To fight the chocolate milk ban, the dairy industry has launched the “Raise Your Hand for Chocolate Milk” campaign that has on online petition and its own Facebook page and Twitter following.
• General Mills has made a public commitment to reduce the amount sugar in its cereal advertised to children. This will affect 10 products.
• A USA Today investigation has found that school lunches are worse than fast food. According to the investigation, “In the past three years, the government has provided the nation’s schools with millions of pounds of beef and chicken that wouldn’t meet the quality or safety standards of many fast-food restaurants, from Jack in the Box and other burger places to chicken chains such as KFC.” Watch this CNN interview with USA Today reporters.

As a parent, how do you balance your child’s diet? Any simple tips for getting your kids to eat well while not turning “junk food” into the forbidden fruit?

Related posts:

1. How local goverments can help kids be healthier
2. This week on Thrive: Dec. 7 – 11
3. Back to school: A new report card to measure if your child is obese?