Willows Pediatrics Blog - We Know Kids

We Know Kids

The Willows Pediatrics Blog

Your Child and Social Media

Willows Reports: Your Child & Social Media

Adolescents and even children are spending more and more time on the Internet. Online activities can provide our kids with entertainment, technical skills and the ability to communicate with others. However, social interaction via the Internet—social media—can sometimes become unhealthy and unsafe, and Willows Pediatrics is here to help advise you of the Internet’s potential hazards.

The American Academy of Pediatrics recently issued a clinical report on “The Impact of Social Media on Children, Adolescents, and Families.” The report concludes that not all social media sites are healthy environments for children and adolescents and that parents should be urged to monitor for potential problems that can include cyberbullying, “Facebook depression,” sexting and exposure to inappropriate content. In addition, young people who spend too much time on the Internet have been found to have problems that include Internet addiction and sleep deprivation.

As pediatricians, we want to remind you that many of these online behaviors are extensions of issues that are affecting our children off-line in the real world, like bullying, popularity and status, depression, social anxiety and sexual development. Facebook, for example, can be difficult for kids already dealing with self-esteem issues, according to Dr. Gwenn O’Keeffe, a Boston-area pediatrician and lead author of new American Academy of Pediatrics social media guidelines. “With in-your-face friends’ tallies, status updates and photos of happy-looking people having great times, Facebook pages can make some kids feel even worse if they think they don’t measure up.”

With these issue in mind, we (and the AAP) advise parents to:

(1) talk to your children and adolescents about their online use;

(2) become better educated about the technologies your kids are using;

(3) develop a family online-use plan that includes family meetings and emphasizes citizenship and healthy behavior; and

(4) supervise online activity through active participation and communication.

Please note that age 13 is the minimum age for most social media sites. Falsifying ages so your child can participate on these sites can open the door to an unhealthy social media interaction, and it also sends mixed messages about lying. Online safety must always be the primary message being emphasized.

As with all aspects of adolescence, it’s important to find the right balance between giving your child freedom and autonomy and also maintaining a certain amount of control. As parents, it is our job to keep our children safe. Just as we would want to meet our child’s friends and their parents or do some background research on a school or summer program, we should take the time to understand the social networking they are involved in … and to monitor for potential problems.

If you have any specific questions in this regard, please let us know. As pediatricians and parents, we are doing our best to keep up to date on these technologies and their benefits, as well as their potential dangers.

Willows Talks About The Family Bed & Co-Sleeping

Willows Talks About The Family Bed & Co-Sleeping

Many families spend their days together. Others stay together at night too! The “family bed,” or co-sleeping is a common practice in many societies, and there are advocates for it here in the U.S. too. However, there are child safety concerns related to having adults and children share a bed. So, is it an acceptable practice?

A recent blog posted on CT Now (and written by former local mom Sarah Cody), asked the same question. She’d heard about the possible benefits of co-sleeping—better nursing and enhanced emotional security—but worried about the dangers to newborns and infants, including injury and suffocation.

She turned to Willows Pediatric Group physician Dr. Jeff Owens for his take on the issue. Dr. Owens rightly pointed out that ‘”The American Academy of Pediatrics still doesn’t recommend it.” He also noted that the dangers stem from two major concerns: soft bedding and impaired judgment. A baby should never sleep on a futon, couch or waterbed, and a parent should not drink, smoke or use drugs with the infant nearby.  Moreover, twenty-four hour bonding can challenge a couple’s need for a healthy physical relationship and leave a mother drained and exhausted.

However, Dr. Owens did allow for some wiggle room. “If it’s a stark, firm [bed] and the baby is on his back, the baby is probably safe.” Dr. Owens believes we should also respect different cultures, some of which believe “the family bed” is the answer to peaceful nights and strong attachments.

In other words, “do what works for your family as long as it’s a safe situation.”

Willows Pediatrics Offers The M-CHAT: A Tool For Early Autism Detection

Recently Time magazine featured a brief article about early detection of autism. The column correctly noted that because autism’s behavioral symptoms don’t become obvious until about age 3, pediatricians have been challenged to find ways to pick up indicators of the condition at an earlier age.

“But,” as the article stated, “researchers say it may be possible to detect subtle warnings of the developmental disorder as early as 12 months—and all it takes is a simple 24-item questionnaire that parents can complete in the pediatrician’s waiting room.”

Good news for patients at Willows Pediatric Group: we routinely offer the M-CHAT, a screening test like the one referred to above, to children at their 15-month checkup. M-CHAT, which stands for Modified Checklist for Autism in Toddlers, is widely recognized and recommended by the American Academy of Pediatrics. The M-CHAT does not provide a diagnosis, but it can indicate if a child is at risk and should receive further evaluation.

In terms of insurance coverage, we submit this service to your insurance company, but as is with all services provided in this office, we do not know or guarantee that your insurance company will pay for the service. At Willows we strive to provide the best care to your child without regard to reimbursement. If you have any questions about reimbursement please feel free to call us and we will help to guide you through the insurance maze.

At Willows, we are always available to discuss your child’s health and any behavioral issues that may be of concern. Child development is an integral part of child health and we are here to answer any questions you have about your child’s speech and language or social skills. If you have any questions about M-CHAT or other child development issues, please don’t hesitate to contact us!

Connecticut Magazine Recognizes Dr. Czuczka and Dr. Owens

Willows Pediatric Group is proud and excited to announce that Connecticut Magazine has included two of our physicians, Dr. Peter Czuczka and Dr. Jeffrey Owens, on their list of “Top Doctors” for 2011. This is Dr. Czuczka’s fifth year as a “Top Doc,” and this is Dr. Owens’ first year to receive the honor. (Dr. Czuczka was previously recognized in 2001, 2008, 2009 and 2010.)

The April 2011 issue of Connecticut Magazine includes its annual “Top Docs” feature, a listing of specialists in a variety of medical fields who have been selected based on the results of a survey of Connecticut physicians. Five thousand questionnaires were sent throughout the state asking doctors to recommend a physician (other than themselves) “to whom they would send a loved one for expert medical care.”

We congratulate Dr. Czuczka and Dr. Owens for being recognized by their peers. Willows Pediatrics takes pride in knowing that all six of our physicians—and our entire medical team—are at the top of their field and are providing compassionate, expert pediatric care to hundreds of local families.

New Car Seat Recommendations Released

Last fall, we blogged about the importance of correctly using car seats and booster seats to keep babies and older children safe while driving. Just a few weeks ago, however, the AAP released new recommendations relating to car safety, and we wanted to share them with you.

The AAP issued two important revised recommendations:

(1) Parents are now advised to keep toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat.

(2) The AAP now recommends that children ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.

More detailed information on these guidelines can be found at the AAP’s website.

According to the CDC, in 2008, an average of 4 children ages 14 or younger were killed in motor vehicle crashes every day, and many more were injured. Willows Pediatrics is here to answer questions about car seats or child safety in general. In addition, most of our local communities offer car seat check services.

We hope you will take these new recommendations into consideration when putting your children in the car. Use your best judgment and try to adhere to the weight/height guidelines, even if the age guidelines might not be appropriate for your child. For example, as Dr. Czuzcka notes, “The new 4’9” advice to stay in the back booster seat would mean that my wife’s grandmother would be a in a booster seat until she died in her 80s!” In other words, while these are important safety recommendations, each child is unique and there are times when exceptions may be made. (Feel free to ask us about your own child and your specific concerns at your next appointment.)

Thanks for checking in today … and, please, drive safely!

Sports-Related Head Injuries … and How Willows Can Help Manage Them

pa_heatherHeather Buccigross, PA-C

Lately, concussions and head injuries have been making national headlines; the NFL has even changed some of its rules regarding permissible tackles to address the issue. On a more local level, concussions during sports—and the impact they have on the brain—are something we take very seriously here at Willows Pediatric Group.

With that in mind, we offer ImPACT testing, a computer-based testing program specifically designed for the management of sports-related concussion. ImPACT testing is widely used in concussion management and has been implemented in many high school and college athletic programs.

The test measures attention, memory, processing speed, and reaction time. In addition, it asks for the individual taking the test to indicate the presence and level of concussion symptoms, if they exist. One of our Physician’s Assistants, Heather Buccigross, has been specially trained in this area and can help manage and treat children ages 12 years and up. (Some schools perform baseline ImPACT testing on students playing contact sports.  Results of the testing can guide when it is safe for an athlete to return to sports.  If your child does not have a baseline test done at school, we can perform one-please speak to your physician or PA about scheduling one.)

Recently, Heather spoke to parents and coaches in Fairfield about concussions and sports, and we thought we would share some of the highlights of her speech. If you would like more information, please let us know.

A concussion, known in the medical world as MBTI (mild traumatic brain injury), is a disturbance in brain function that occurs following either a blow to the head, or as a result of the violent shaking of the head. The CDC reports 300,000 sports related concussions occur annually in the U.S, and it is believed that sports concussions are under reported and this does not reflect the true incidence.

If your child participates in sports, here is a list of some of the most common symptoms reported by athletes with head injuries:

  • Headache
  • Nausea
  • Balance problems or dizziness
  • Double or fuzzy vision
  • Sensitivity to light or noise
  • Feeling sluggish
  • Feeling “foggy”
  • Change in sleep pattern
  • Concentration or memory problems
  • Also, here is a list of the most common behaviors others have observed in athletes with head injuries:
  • Appears to be dazed or stunned
  • Is confused about assignments
  • Forgets plays
  • Is unsure of game, score, or opponent
  • Moves clumsily
  • Answers questions slowly
  • Loses consciousness (even momentarily)
  • Shows behavior or personality change
  • Forgets events prior to hit (retrograde amnesia)
  • Forgets events after hit (anterograde amnesia)

Even if you don’t think your child was hit in the head, if he or she is experiencing these symptoms, it is best to have him or her evaluated. Something called “Second Impact Syndrome” occurs in athletes with an unreported, prior concussion who return to play before resolution of the symptoms and can cause a very serious increase in intracranial pressure.

This is one of the reasons coaches are encouraged to remove athletes from the game after any head injury and to perform an on-field mental status evaluation. When in doubt, it’s best to keep an athlete out of the game and refer him or her for a full evaluation in a medical office.  With proper diagnosis and management, we can maximize recovery after a concussion and take steps to avoid risk from returning to play too soon.

Your child’s safety is very important to us, and the proper management of head injuries is crucial. Again, if you would like to schedule baseline ImPACT testing or have any concerns about your athlete, please contact us.

Take care, and enjoy the spring sports season!

Breakfast … and Why It’s Important for Children and Teens

Connecticut Kids Eat a Healthy Breakfast

photo via Wikimedia

When babies are little, we feed them first thing every morning. Yet somehow, as kids get older and the morning routine gets more rushed, children (and especially teenagers) are leaving the house without breakfast.

Breakfast has been touted for years as the “most important meal of the day,” and there’s actually a lot of truth in that statement. Not only does it get the body’s metabolism up and running in the morning, but it also affects school performance. (And a caffeinated soda or coffee on the way to Staples, Ludlow, Warde or Prep just doesn’t cut it!)

“Study after study shows that kids who eat breakfast function better,” says Dr. Marcie Beth Schneider, a member of the AAP’s Committee on Nutrition, in a recent article entitled The Case for Eating Breakfast. Not only does a morning meal improve behavior, but it also enhances memory and school performance in general.

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Iron: How Much is Enough for Your Infant or Toddler?

How much iron should my baby have?

Photo via Wikimedia.com

In November 2010, the AAP issued new age-based recommendations for iron intake in infants and toddlers. Because iron deficiency can have irreversible long-term effects on children’s cognitive and behavioral development, the AAP Committee on Nutrition stated that, “It is critical to children’s health that we improve their iron intake status starting in infancy.”

Babies born healthy at full term are born with sufficient iron stores for the first 4 months of life. Therefore, full-term babies do not need iron supplements prior to four months of age. However, if the infant is breast-fed, the AAP now recommends a 1-mg/kg daily dose of oral iron starting at four months, and continuing until an infant begins eating solid iron-rich foods – typically around six months of age. (Formula-fed infants will receive sufficient iron in their formula and do not need a supplement between four and six months of age.)

There is one caveat: Preterm infants do require iron during the first four months. If they are bottle-fed, the iron-fortified formula will provide the proper amount for these infants. However, according to the AAP, preterm infants who are breast-fed should take a 2-mg/kg daily dose of iron starting at one month of age.

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A Spoon is Great for Soup … Not Medicine!

medicine dosing

photo via flickr.com

We’ve been saying it for years: a teaspoon in your kitchen is not a “teaspoon” in medicine dosing terms. Same goes for the tablespoon. In other words, kitchen spoons are made for eating, not for measuring medicine!

A recent study found that when using household spoons, participant measured medicines highly inaccurately, with some pouring 8% less than recommended and others pouring 12% more. Read More

For New Parents: Using Older Cribs is Potentially Dangerous

Infant Safety - Cribs

photo via flickr.com

Though it may have been the crib you spent time in as a child—and you did just fine—your old crib is most likely not suitable for your new baby. It’s tempting to purchase a used crib from a tag sale or to accept one from kindhearted family or friends whose children have grown up, but Willows Pediatrics recommends avoiding cribs that are more than 10 years old. (This means avoiding them at home, and also at day care centers and grandma’s house too!)

Here are just some of the dangers of older cribs:

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