Teens and Alcohol: A risky way to have fun

Most parents and even most teens are aware of the risks that come with drinking alcohol, yet many of us drink. Teens and alcohol use have long been problematic. The teen brain is known for being impulsive and seeking thrills, which increases the incidence for many types of risky behaviors. When teens drink alcohol, they risk many serious consequences.

Binge drinking

Teens who drink alcohol are more likely to binge drink than adults. Binge drinking is particularly dangerous because a lot of alcohol in a short amount of time doesn’t allow the liver to clear the alcohol as it’s consumed. This leads to higher blood alcohol content and more associated problems.

Binging can quickly lead to intoxication, which can lead to many of the problems to be discussed below.

A cycle often develops when teens start drinking. The more they drink, the more likely they are to drink again. This can lead to risks with each exposure, and to long-term problems with alcoholism. People who begin drinking before age 15 are 4 times more likely to develop alcohol dependence than those who begin drinking at age 21.

Consequences of teen alcohol use

It’s illegal in the US

Drugs and alcohol should be treated with respect and used only with good judgment. This judgment should take into consideration laws and safety.

Possession of alcohol by a minor is illegal, so teens in the area where others are drinking risk getting into legal trouble simply by being there. Each state’s laws are different, but all states have a minimum drinking age of 21 years.

You do not have to be driving to be convicted of violating a minor in possession (MIP) law. If you are holding an unopened beer and are under the state’s drinking age, you can still be convicted of a MIP offense.

Teens don’t have to be legally drunk under most state’s driving under the influence (DUI) laws to be found guilty of MIP.

While it’s true that the laws are not always enforced to the fullest extent, there are many states where possession can lead to mandatory suspension of a driver’s license. Jail time and fines are possible, especially for repeat offenders.

These charges also can impact sport team participation and college scholarships. They remain in government records forever, which can affect the job prospects of otherwise stellar candidates and cause major damage to their long-term career aspirations.

Adults who make the alcohol available to teens can also be held accountable.

Teens who drink are more likely to become abusive, commit a crime, or get into a fight. Each of these situations can increase legal troubles.

Brain development

Our brain does not fully develop until the early to mid 20s and early use of drugs or alcohol is impacted in two ways due to this. Teens fail to realize the full implication of their actions and alcohol can prevent proper brain development.

Teens often cannot understand the consequences of their actions due to brain immaturity, yet they are held accountable for their actions. They tend to be impulsive and crave thrills. Teens want to please peers and fit in. All of these typical teen traits can put them at risk to try known risks, including drugs and alcohol.

Not only does the underdeveloped brain put kids at risk to drink, but drinking impairs the way the brain grows.

Short-term or moderate drinking can impair learning and memory far more in teens than in adults in the mid 20s and beyond. Adolescents need to only drink half as much as adults to suffer the same negative effects.

Studies have shown physical changes in the brain in kids who drink, especially in the hippocampus and frontal lobe. Our hippocampus helps us learn and remember things and the prefrontal lobe is important for judgement, planning, impulse control and decision making.

Damage to the brain from alcohol during the teen and young adult years can be long-term and irreversible.

Injuries

When our brains are under the influence of alcohol, our bodies become uncoordinated. We lose judgement capabilities.

When drunk, one is more likely to fall, get into an accident, or get into a fight.

Many teens are hospitalized each year due to intoxication itself or the injuries resulting from being drunk.

Death

We all know the mantra to never drink and drive, but driving isn’t the only serious risk with drinking. Simply drinking too much alcohol can lead to coma and death.

If you choose to drink, you should ideally have food and water to help slow absorption. Unfortunately many teens drink excessive amounts of alcohol in a short amount of time without water or food. This might be due to the fact that they want to quickly drink before going to a school function, where no alcohol is permitted. Or maybe they are challenged to chug beer or down several shots. I’ve seen teens not eat during the day to “save calories” because they want to drink in the evening and not gain weight. These patterns are especially dangerous.

Drinking and driving is never safe, even if you feel you are still sober. Unfortunately alcohol impairs our ability to judge if we are sober or not. Underage drivers are more likely than adults to suffer impairment behind the wheel.

From the National Highway Traffic Safety Administration:

  • Car crashes are the leading cause of death for teens, and about a quarter of those crashes involve an underage drinking driver. In 2016, young drivers, 16-24 years old, made up 39 percent of drivers involved in fatal alcohol-impaired crashes.
  • To reduce alcohol-related fatal crashes among youth, all States have adopted a minimum legal drinking age of 21. NHTSA estimates that minimum-drinking-age laws have saved 31,417 lives between 1975 and 2016.

Despite the large numbers of people killed in alcohol related traffic accidents, the majority of underage drinking related deaths are not traffic related. Deaths occur from homicides, suicides, burns, falls, and drownings. Some kids drink to the point of alcohol poisoning and stop breathing.

Risky sex

Being under the influence of a substance can also put you at risk for being raped or having unprotected sex.

I don’t believe that anyone scan consent to sex if they’re under the influence of drugs or alcohol, yet we know that being intoxicated is associated with sexual activity.

My favorite example to help understand consent is the Cup of Tea video, which is nicely discussed in the linked blog from EducateEmpowerKids.org.

When under the influence, the chances of using proper protection from infections and pregnancy falls. Drinking is associated with sexually transmitted infections and unplanned pregnancy.

Do not drink from a container that has been left unsupervised – someone could slip something in it.

I encourage kids to stay with a group when they’re out. No one should be allowed to leave the group unless it is pre-arranged. You should not allow a friend to make this decision if they are under the influence.

Not cool

Drinking isn’t going to make you cool. In fact, it can lead to you saying and doing embarrassing things. You lose coordination, so can look very foolish. You might even get so drunk that you vomit on or pee on yourself.

No one wants to deal with a hangover the next day, but heavy drinking can easily lead to one. That’s definitely not cool.

And your “friends” have cameras with them at all times these days. One simple mistake or moment of poor judgement can be forever recorded… and potentially seen by parents, school administrators, your coach, or your boss. Even your future children could see your moment of disgrace if it’s uploaded or shared.

Depression

Depression is a risk factor to start drinking. People attempt to make themselves feel better with alcohol. Of course the alcohol leads to other problems, which tend to worsen the depression.

If you feel like you’re depressed, help is available! Talk to your parents, your school counselor, or your doctor.

If you feel like you want to hurt yourself, call the Suicide Hotline. Put a number in your phone now or search it in time of need.

  • Suicide Prevention Hotline 1-800-273-TALK (8255)
  • 1-800 –SUICIDE (784-2433)

Obesity

It’s no secret that alcoholic drinks can pack in a lot of calories. When people consume alcohol regularly, they are much more likely to become overweight or obese.

Increased weight is associated with many health conditions, including heart disease, diabetes, metabolic problems and liver disease.

Find a way to say no.

Just say no. (Only really confident people can be secure enough to not give a reason.)

Tell your friends that if your coach finds out, he’ll kick you off the team.

Say that your parents smell your breath when you get home. If you’re caught, your parents will probably tell other parents. (That will scare them into even asking you again!)

Offer to be a safe ride home if you have a car and are allowed to drive friends.

Say you don’t want the calories.

State that you want to be on top of your game for whatever you’re doing. For instance, if you’re playing cards you might not be able to strategize as well or keep a poker face if you’re under the influence. If you’re swimming you want to be safe. Since many people get tired when drinking alcohol, you can simply say that you don’t want to fall asleep at the party.

If you’ve already been in trouble for drinking, admit to that, and let them know that you don’t want to suffer consequences again.

Plan on doing things that keep people busy and are fun rather than just going somewhere to “hang out.” Go to a sporting event or a movie. Bring frisbees to a park. Go for a bike ride. Play a competitive card or board game.

Remember you can have fun without drinking!

For more information about teens and alcohol:

Impact of alcohol on the developing brain

Teen Drinking May Cause Irreversible Brain Damage

My child swallowed…

It happens all the time. Kids put things in their mouth that aren’t supposed to be eaten. Parents often call after their child swallowed a toy piece, a coin, and many other things. Most of the time things will just pass — though I’m not a fan of watching the stools for the swallowed object because it just worries parents if they miss it.

Who swallows non-food things?

my child swallowedThe biggest risk group is children between the ages of 6 months and 6 years, but anyone can be at risk.

I have seen an older school aged child swallow a magnet after putting 2 small strong magnets on either side of their tongue to look like a tongue piercing.

Even adults have been known to swallow things such as needles – sewers put the needle in their mouth if you think about it.

Be prepared

Learn CPR

If you are around kids it is a good idea to know child CPR and refresh your skills every couple years.

Classes are often held at local Red Cross stations, hospitals, or fire departments.

You can also find classes by searching “CPR” and your zip code.

Know warning signs

For great information on signs and symptoms of choking and general treatment of choking, visit this KidsHealth Choking link.

Of course, prevention is key

Store medicines and cleaning products where kids can’t reach them.

Be especially alert when visiting other people’s homes – especially if they don’t have young children.

Watch kids carefully when outside.

Throw away broken toys that could have pieces break off.

Keep young kids away from toys designed for older kids.

When to talk to your pediatrician

If your child seems to put more non-food items in his mouth than other kids, he is at risk of pica.

Pica is when a person compulsively puts non-foods in his mouth. For more see the KidsHealth Pica link.

Poison Control Number – use it!

Poison Control number 1-800-222-1222. For more: http://www.aapcc.org
Poison Control number 1-800-222-1222. For more: http://www.aapcc.org

Always keep the poison control number (1-800-222-1222) stored in all your phones!

If you call me about a potentially toxic substance, chances are I will refer to poison control. They have the best database of substance risks and their treatments.

Don’t delay treatment by calling the doctor!

Things kids swallow and what to do:

Balloons:

Balloons are statistically some of the most inhaled or ingested foreign bodies.

One reason is they are so popular with kids. Young kids often will try to bite them.

They often are found at parties or other large crowds, where toddlers and young children are often less directly supervised.

Balloons can suffocate a child quickly if they are inhaled.

Call 911 if there is any difficulty breathing, drooling, or other signs of distress. This can mean the balloon was inhaled into the lungs, not swallowed.

If swallowed, they will pass on their own.

Prevention

Keep balloons away from young children and supervise school aged kids when around balloons.

Batteries:

If you think your child has swallowed a battery, whether or not he appears distressed, immediately take him to an emergency room.

If there is distress, call 911.

Batteries can cause voltage burns or leak, causing acidic burns as soon as four hours after being swallowed.

X-rays will confirm if the battery is in the chest or abdomen.

Batteries usually need to be removed to prevent serious injury.

Prevention

Be sure to keep all of your batteries, especially the small button batteries, safely stored away from children.

Make sure battery-charged items have the battery securely secured. Most now have covers secured with screws. If the cover is easily removed, your child is at risk!

Bugs:

Most of us has swallowed a bug some time in our life. You might not even know if a small one hides in your soda can and you take a big gulp.

A little extra protein, right?

Unless your child chokes, or if it has a stinger (bee, wasp) there is nothing to worry about.

If he’s choking, follow choking instructions.

If you suspect a bee or wasp was swallowed, especially if your child seems to be reacting to a sting in the mouth, or there’s sudden difficulty breathing, drooling, or choking, call 911. Serious reactions to stings in the mouth can occur.

Prevention

Watch kids closely when outside, especially those under 3 years of age or kids who are known to put things in their mouth.

Buttons:

Buttons are generally harmless unless they get stuck or inhaled rather than swallowed.

Signs of breathing difficulty, choking, drooling, or generalized distress should alert you to bring your child to be evaluated.

Buttons are not easily seen on X-ray, which can make identification of a stuck button a little tricky, but if you suspect an issue, talk to your doctor.

Prevention

Keep unattached buttons (the ones in your sewing kit) stored away from kids.

Monitor your children’s clothing and repair any loose buttons.

Cinnamon

Cinnamon is technically a food, but the cinnamon challenge is leading kids and teens to take a spoonful, which can be very dangerous.

The challenge involves something along the lines of swallowing a tablespoon of cinnamon without water.

Ingestion of the cinnamon powder stimulates the gag reflex followed by inhalation of the powder. This causes excruciating pain due to the chemical properties of cinnamon.

It can also trigger airway narrowing and an asthma attack.

And there’s more.

Cinnamon is powdered bark. The cellulose matrix of tree bark acts like a sustained release medicine, slowly releasing a painful and damaging chemical in the lungs.

The body cannot metabolize cellulose. When it’s eaten, it gets passed into the toilet. But if it’s inhaled, our lungs can’t metabolize it.

Prevention

Talk to your kids about the risks of accepting a challenge. It’s not just the cinnamon challenge. Dr. Irene Tien discusses more Dangerous viral challenges you need to know about.

On the surface many things seem just silly and not really dangerous. But unless they know all the risks and consequences and know it is safe, they shouldn’t do the challenge.

Don’t limit this talk to just cinnamon. Use it as an example, but we never know what the next crazy challenge will be – the next category includes a more recent challenge.

Cleaning products, laundry detergent, and other chemicals:

These are highly dangerous and you should call poison control with any suspicion of ingestion. 1-800-222-1222

Call 911 if there are signs of distress.

Prevention

Cleaning products should always be stored away from children to prevent the possibility of swallowing in the first place.

Even the “green” products are usually not safe with ingestion.

And it’s not just toddlers… for whatever reason teens swallowing laundry pods has become a “thing” – talk to your teens about the risks. See the cinnamon challenge information above.

Coins:

Coins are some of the most frequently swallowed objects.

These usually pass through the body without any problems, but many parents never see it come out the other end.

Since it is so common you would think there would be a consensus as to how to manage it.

There isn’t.

When there’s distress

Of course if there is any distress, drooling, breathing difficulty or coughing, your child should be seen immediately, ideally in an ER so that an immediate surgical consult can be made if necessary.

If it was inhaled into the windpipe instead of swallowed into the esophagus or stuck high in the esophagus causing compression on the wind pipe, it may need to be removed.

When there’s no distress

As for kids who swallow coins and have no symptoms, it isn’t as clear cut what to do.

Some doctors get X-rays for all children who swallow a coin to be sure it isn’t stuck in the esophagus. About a third of those stuck eventually end up passing, but most need to be removed.

Some physicians only obtain an X-ray if there are symptoms.

Some physicians remove the ones in the esophagus immediately, others will wait up to 48 hours if there is no distress.

Generally once it reaches the stomach it will pass.

Prevention

Keep coins out of the hands of kids under 3 years old, and supervise young children closely with them.

Remind kids to never put them in their mouth. Not only for the small choking risk, but eeewww… coins have been handled by many and are full of germs!

Crayons or play doh:

I used to wonder why so many things were labeled “non-toxic” — at least until I had a child of my own.

They put everything in their mouth!

These are generally safe (again, unless they choke), although it is possible that these things contain lead or other contaminants.

Prevention

As with everything, supervise young children when they’re playing.

If your child frequently puts them in the mouth, it’s probably a good idea to not allow your child to play with them unless you’re consistently watching them.

Talk to your doctor about pica if they continue to put non-food items in their mouth after 3 years of age.

Dirt or rocks:

Unless your baby chokes or bites down on a rock and breaks a tooth, dirt and rocks are generally harmless.

Prevention

Supervise young children when playing outside.

If your child seems to crave these and eats dirt compulsively, be sure to talk to your doctor about pica.

Energy drinks:

Energy drinks are a popular choice for many, but they contain caffeine and other stimulants that can make them dangerous for children.

Many adults drink caffeine in various forms, so mistakenly think energy drinks are safe. Learn the risks!

Risks from energy drinks

They can lead to dehydration because caffeine is a diuretic.

Energy drinks also can increase heart rate and blood pressure.

They can increase shakiness, anxiety, insomnia, and headaches.

Routine energy drink consumption has been shown to increase the risk of obesity and Type 2 Diabetes, due to the high sugar content.

People build a tolerance to caffeine, leading to increased consumption over time.

Teens are more likely to take dangerous risks when high on caffeine. This could result in injury or legal trouble.

Ingredients in energy drinks can interact with other medications one is taking.

Call poison control if you suspect problems from energy drinks

Prevention

If you drink energy drinks, keep them away from your children.

Talk to teens about the risks of energy drinks. There are deaths reported in teens who drink energy drinks and then participate in sports or alternate alcohol with energy drinks.

Grass or plants:

Unless the grass was recently chemically treated or if the plant is poisonous, there is little to worry about here.

If you’re unsure about a plant being poisonous, contact poison control.

If there is choking, do CPR and call 911.

Gum:

Contrary to popular belief, the occasional swallowed gum does not stay in your gut for years.

It isn’t digested like other foods, but unless it gets stuck along the way, it finds its way out just like all your other food.

Hand sanitizer

Hand sanitizer in small amounts, such as putting fingers in the mouth after rubbing sanitizer on the hands, is generally safe.

Larger amounts can be dangerous and you should call poison control if you suspect ingestion.

Prevention

Keep hand sanitizer away from young children and talk to school aged kids about risks.

Be alert of the sanitizer hanging from your diaper bag or purse!

Magnets

A single magnet is not a worrisome as multiple magnets, but since it often is not known exactly what a child swallows, it is always recommended to take your child to be evaluated if there is a suspicion of swallowed magnets.

They will need X-rays and if there are multiple magnets, they must be removed to prevent perforation of the gut.

Prevention

Keep all magnets away from young children.

Talk to older kids about the risk of swallowed magnets and be sure they understand that they can never put one near their mouth!

Medicines, vitamins, supplements

If your child swallowed (or potentially swallowed) a medication or supplement, call the poison control number ASAP.

Have the bottle with you so you can answer their questions.

Prevention

Make sure medicines and other pills are kept away from kids.

Talk to Grandma about either removing them from her purse or putting her purse out of reach when she’s visiting.

Share this free online brochure with your kids: Medicine is not candy.

Use this interactive site from Scholastic to help kids learn medication safety.

Nicotine:

Sadly, ingested nicotine has been an increasing problem since e-cigarettes have been on the market, but even regular cigarettes, cigars, and their ashes pose problems.

Effects of nicotine poisoning include vomiting, sweating, lethargy and tremors in mild poisoning and confusion, paralysis, and seizures in severe poisoning.

If you even think your child has eaten a nicotine product, call poison control (or 911 if significant symptoms).

Prevention

Keep all nicotine products away from kids.

Talk to teens about the risks of smoking and vaping.

Pet food:

As disgusting as it smells to me, kids love to eat pet food.

The biggest risk here is choking.

If they choke, use your CPR skills. If you’re not confident with CPR, call 911 and they will walk you through it.

Prevention

Keep pet food away from young children.

Pop-top from a can:

The flip top that opens a soft drink can is usually not a concern unless a child chokes on it.

It generally will pass through the intestines if swallowed, but if there are signs that it was inhaled or is stuck in the intestine, a child should be seen.

These do not show up on X-ray because they are made of aluminum.

Prevention

Kids should drink out of cups, not cans.

Keep cans away from young children.

Poop:

This one is gross, but happens more than any parent wants to know. Many babies stick their hand down their diaper and then the hand goes to his mouth.

While this is really gross, it does not cause any danger to the child. If it is his own poop, he will not be exposed to any new germs.

If your child finds someone else’s poop, usually animal poop, there is a little more concern for infection but still pretty low risk.

Symptoms of nausea, vomiting, diarrhea, and low grade fever usually happen within 30 minutes to 4 hours after the ingestion if they are affected. In this case, treat symptoms as you would any other stomach bug and call your doctor.

For specific information of various types of poop (even raccoon!) check out the Illinois Poison Control blog on poop. 

Salt, saltines, and baking soda:

These common kitchen items do not raise fear in many people, but if either is taken in large amounts, they can cause serious problems.

Salt

One tablespoon of salt in a toddler can cause seizures due to electrolyte imbalances. More can be deadly.

An aside: If your child seems to crave salt, talk to his physician. There are salt-wasting conditions that deserve immediate evaluation.

Another challenge

Kids and teens are challenged to eat several saltines without water.

The salt dries the mouth, allowing the cracker to form a powder that can be inhaled.

The coughing that occurs during the attempt encourages more inhalation.

Baking soda

One tablespoon of baking soda changes a body’s pH and can cause serious injury.

Treatment

If your child swallows significant amounts of salt or baking soda, call poison control immediately.

Prevention

Keep young children away from baking items.

Talk to older kids about using foods properly and not accepting challenges, as discussed above – see the Cinnamon section.

Sharp objects:

Any pointed object such as toothpicks, wire, chicken bones, open safety pins and hair pins can pierce the gut.

If you think or know your child has swallowed one of these, get the child to the emergency room immediately. If there’s distress, call 911.

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7 Ways to Keep Kids from Wandering and Getting Lost

Some kids never leave their parent’s side when out and about, but others wander without concern and are at risk of getting lost. I’ve had one of each, so I know first hand how scary it is to have a wanderer. Many parents worry that their kids will be abducted, but the large majority of lost kids leave on their own accord. Usually there’s no foul play and they can be found relatively quickly (though it seems like an eternity for a worried parent). What can you do to keep kids from wandering and getting lost?

Many times that parents realize their kids are missing, the child hasn’t made the same realization. Parents might be scared to death, but the child is fine – they are often enjoying an adventure and completely unaware of the problem.

Why do they wander?

Distraction and fun

Most of the time they have no clue what they’re doing, especially if they’re too young to really comprehend rules. They aren’t afraid if they’re focused on something else, which can be anything that gets their attention.

It doesn’t take much to get a child’s attention, especially if you’re at a new place.  The new place is also riskier because if they do get separated, they don’t know where they are or where to go for help.

Sometimes kids just want to do something fun because they’re bored. How many kids decide to play hide and seek while shopping? I’ve seen many crawl under clothing racks…

Small children can dart between people in large groups, making it hard to keep up with them without pushing and shoving others out of the way. They don’t realize when they’re focused on something that you’re not right there. Despite saying “excuse me,” I felt inconsiderate plowing through crowds to keep sight on my runner. (She was more than a wanderer…)

Parents get distracted too

Maybe you’re comparison shopping to decide which brand to buy. At some point you have to pay and talk to the cashier.

When your phone buzzes, it’s easy to answer a quick text. Studies show many parents spend a lot of time on their phones when they’re with their kids.

If you hear another child’s cry, do you look in their direction to be sure they’re okay?

And if you have more than one child, you can only really watch one at a time…

It only takes a second to look away from your own child for them to bolt and disappear.

A kid’s view

Kids don’t worry about wandering and getting lost. They get bored or get distracted.

I know one child who was lost at his brother’s sporting event. He decided he was tired and wanted to lay down, so he made it to the family vehicle and took a nap inside.

It all made sense to him, and he didn’t understand why all the parents (it was his brother’s game, so the whole team was looking for him) were upset.

We recognize that a small child roaming through a parking lot is dangerous, but he thought it was reasonable to nap in his familiar seat. He figured his parents would go to the car at the end of the game and find him.

Kids don’t think like adults. We need to talk to them about rules.

Stranger Danger

“Stranger danger” has a nice ring to it. It’s catchy to say. It’s commonly taught to kids.

But it isn’t effective or safe.

The large majority of strangers are good people. If a child is lost, they shouldn’t feel afraid to talk to the right stranger. I’ve heard of kids refusing to talk to caring adults, which delays reuniting them with their families.

The large majority of abducted (and abused) kids are victims of people they know – not strangers.

talk to kids about boundaries & rules

Kids should never be alone with an adult other than the “safe” people you’ve identified with them. This helps to protect them from predators they know.

They should know to never leave with a person unless that person knows a code word. Even if that person knows their name (it’s easy to listen and learn a kid’s name, or it might even be printed on their shirt or backpack) they shouldn’t leave with that person unless it was pre-arranged or they know a special code you’ve discussed.

All kids who are potty trained should know that there are places on their body that are private. Private mean no one should look or touch there unless you’ve given permission for that person. Permission should be given if they need help toileting (including wiping), bathing, or when it’s part of a medical check up. These private places include anything a swimsuit or underwear would cover.

See the bottom of the blog for resources on talking to kids about these big topics!

7 WAYS TO KEEP KIDS FROM WANDERING AND GETTING LOST
7 WAYS TO KEEP KIDS FROM WANDERING AND GETTING LOST

7 Ways to Keep Kids from Getting Lost

Preparation is key!

Talk to your kids about what they should do if they are separated from you.

A lot will depend on their age, maturity level and where you’re going.

If you know the place you’re going has a lot of distractions and crowds, such as an amusement park, you will need to plan differently than if you will be in a neighborhood park that is familiar or a family gathering where they know lots of people.

1. Supervision

When you’re out and about, it goes without saying that someone needs to be responsible for watching the kids.

This is especially true if you’re going with a group. Sometimes there are so many adults, it’s easy to think someone else is watching a child, but no one is. Make it clear who is responsible for watching each child.

If there are a lot of kids for each adult to watch, have the kids pair up with a buddy. They should not leave their buddy. Schools use this system for field trips and it helps keeps track of the kids.

Remind kids that they should never be alone with an adult, even one they know, unless it’s one of their safe adults. (A safe adult is someone you trust wholeheartedly.) There’s safety in numbers!

For your own safety and to avoid mistaken intentions, never be alone with a child who is not your own unless you have permission from their parent. Having two adults around in restrooms and other private areas is especially important!

2. Give kids identifying information

Until kids are old enough to know your phone number (and be able to tell it clearly to a stranger), have them carry it around in some manner. They should know that they can pull it out when needed.

You can make a bracelet with your number. Get number beads from a craft store and kids can help string them!

Put contact information on dog tags so they can wear it as a necklace. Even boys think this is pretty cool.

There are places to make customized temporary tattoos, or you can just use a permanent marker. This isn’t my first choice, but in a pinch, we all have markers.

3. Be ready to identify

I’m that parent who didn’t remember what I dressed my kids in most days. If they were appropriately dressed for the weather, I didn’t really care. But it does matter if you’re looking for a lost child.

If a child is lost and you’re stressed, it’s especially hard to recall what they were wearing.

In today’s world of everyone carrying a phone with photo capabilities, it’s easy to snap a picture.

Take a picture of your child before going to crowded areas. This photo will not only be recent, but will also show what clothing your child has on, which makes it easier to find your child.

4. Be prepared for boredom, hunger, and fatigue

When kids are tired, sick, hungry, or bored, they’re more likely to act up or try to make it fun.

Tired

Plan the trip around nap times as much as possible. Bring a stroller to let a tired child rest if needed.

Sick

Ideally we’d all stay home when sick. Bringing kids to public areas when they’re sick spreads germs.

Keep sick kids home whenever possible. It’s better for them and the community!

Hungry

If they will normally eat during the time of the outing, bring along something to eat.

Make sure the snacks are not going to leave a mess.

Don’t include nut products, since leaving residues around a public place could be life threatening to another child. (There are many other food allergies, so ideally you will wash their hands and wipe surfaces after any foods.)

Boredom

When you know the places you are going are not kid-friendly, try to make it into a game or at least get the kids involved.

The grocery store can be a place to talk to kids about choosing healthy foods. You can do simple math with them by figuring out how many apples you need for the family for the week or by choosing the better deal among differently sized packages.

If you know the kids will have to stay in one place for a while, such as waiting at the DMV, bring books, small toys or games to keep them occupied.

5. Practice

Practice with your kids what they can do if they’re separated. Their risks and abilities change as they get older, so you need to continue the conversation and adapt the plan over the years.

I sometimes would covertly watch my daughter when she ran ahead to see how long it took her to realize I wasn’t right behind her. I wanted to see what she would do when she did figure it out. By preschool she was a pro and knew what to do. She would yell my name or ask another child for help, but at least she stopped where she was and didn’t continue to run further away.

Adults look, kids stay put

I always suggest teaching kids to stay put if they realize they’re lost, unless they’re not in a safe place. If they’re in a street or other unsafe place, they should go to the closest safe location.

Kids should NEVER leave the building or area to look for you. You can teach older kids to go to the front of the store (or find a person in the uniform of the place you are) when you think they’re capable of doing this. Younger kids should just stay put.

Remind them that you will always look for them, and if they stay in one place it’s easier to find them. If they keep moving, they might go to a place you’ve already looked but left, so you won’t find them.

Get loud

Remind them that it’s okay to yell for you by name or whatever they usually call you, even if they’re in a place that’s usually quiet.

Safer Strangers

When lost, it’s okay to ask for help. This is why I don’t want kids to be taught stranger danger.

They should know that if an adult approaches them when they’re not lost, they should be cautious. If they’re at a park and an adult asks for a child’s help looking for their dog, that’s not right. Adults can ask other adults for help. They shouldn’t ask kids for help.

If an adult is offering to help when a child is lost, usually that’s okay. Yes, it’s possible that they’re taking advantage of the situation, but how likely would it be that a person of that caliber would be right there when your child is lost? Most people are good.

Kids should be told to give your phone number to a person who’s trying to help. It’s okay to give their name to a person who works at the place you are visiting. It’s confusing because kids are taught to not give their name and personal information to strangers, but it can help find parents names are shared.

Kids should be taught that they should not leave the area, especially with a strange adult. It’s okay if they help the child find the front of the store or a worker, but they should NOT take the child outside the building or park.

Ask another child for help

That child can then ask the adult they’re with to help your child.

Kids are generally safer to talk to and not as threatening to a child who’s already scared.

The other adult can call your phone if your child knows or is wearing your number. (Pay attention to your phone when looking for your child and answer calls from unknown callers!)

Ask a worker for help

Kids can also look for people wearing the uniform or nametag representing the place you are.

Point out what people wear when working at the location you’re visiting. Whatever it is, be sure your child knows what to look for.

We used to stop at the front of the store routinely so my daughter could be reminded what the cashiers wore. She could talk to someone with that uniform if she was lost.

6. Meeting place

Elementary school aged kids can learn where to meet you if they get separated when they show enough maturity and confidence.

Point out a customer service desk, a landmark at a park, or an easily found place where you are going. You can both go there if you get separated.

By middle school many kids like to be able to shop or play at a park with friends. If your child displays the maturity to do this, then it’s a great way for them to develop independence. Be sure that they know a time and place to meet and how to contact you if they need you before that time.

7. Restraints

I know “restraints” sounds so negative, but think about it.

It’s for safety, not punishment.

We restrain kids in the car because we know it can help to save their lives.

Not only can toddlers and preschoolers wander and get lost, but they can easily get injured when they’re not supervised.

Shopping carts and strollers

If your toddler or preschooler runs around, he’s not safe. If you strap him into a shopping cart or stroller, they’re safer.

Be sure to use the straps appropriately. They can keep kids from climbing or sliding out.

Our stroller just had a lap belt. The newer ones with shoulder straps would have prevented the time my daughter jimmied out of the lap belt and onto the concrete head first. I was pushing her in the stroller, trying to keep up with my son who was running ahead. I was unaware she was climbing out because I had my eyes on my son. She had quite the goose egg!

Leashes

I also have become a fan of leashes for young kids. I know many people think they’re cruel and only appropriate for animals, but I have had great experiences with them.

As mentioned above, my daughter was a runner. I lost her more times than I want to admit. She hated being strapped in a stroller – as I shared above. Of course she often refused to hold hands because she wanted freedom. Family outings that should have been fun quickly became miserable.

When I first got the leash my husband was horrified.

My kids loved it.

It was a cute monkey backpack with a leash. They loved taking each other for walks around the house and even fought about who would wear it. Since it was a backpack, they could carry favorite toys inside.

In public areas my daughter would wear it happily. When my husband saw how my daughter was so much happier having “freedom” while being leashed to us in public, he was sold on the idea.

Warning: if you use one, be ready for judging looks. That’s okay. If they have a runner, they’ll understand. If not, they have no idea.

Leash and book suggestions

I’m an Amazon Associates Member. I do get a small amount of money if you purchase from the following links, but there is no increased cost to you. As always, I only link to products that I recommend regardless of where you purchase them.

These wristband harnesses are great because they allow roaming while being safe, but do not look as much like a leash. There are two sizes, which can allow a child to go a bit farther than many of the backpack styles. It’s basically like holding hands from a distance!

I suspect you’d get fewer evil looks from strangers by using the wristband, but young kids might actually prefer the backpack styles because they’re cute and they can carry “stuff” in them.

I like these because they’re insulated for food storage in addition to having a strap for safety.

Going to Disney? I can see these popular there and for any Disney fan. I lost my 3 year old briefly several times on one Disney trip…

This monkey is similar to the one my kids loved. They’re also backpacks, so they can store a few of their favorite things inside. There are many cute designs.

Safety books



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Transitioning to The Big Kid Bed

Parents often try to keep the crib as long as possible to avoid the problem of their toddler/preschooler leaving the bed again and again at bedtime, but eventually they all need to take the plunge and get a big kid bed. How do you get a kid to stay in a bed?

Daycares do it

How do you know when your child's ready to move to the big kid bed?It always blows me away that daycares get 1 year olds to sleep on cots.

They stay there… how???

I suspect they are following what the older kids in the class are doing and they are never left alone. That makes it easier on many levels.  Parents don’t have that luxury at home when transitioning to the big kid bed.

When’s the right time?

Many parents are tempted to move their toddler to a bed before the child is really ready. Many experts advise continuing the crib until around 3 years of age.

Remember that the crib also is a place of security, so sleep problems can develop if kids are transitioned too soon.

Many kids that leave the crib before they can understand rules (around age 3) have a hard time staying in the bed.

Some kids are able to climb out of the crib, so parents think it’s safer to move to a bed. This is one solution, but you can also work on ways to keep your toddler in the crib.

Make sure the space is safe

Before you let kids sleep in a bed that they can easily get in and out of, make sure the room is safe.

This is a great time to check the smoke and carbon monoxide detectors. Change batteries when you change your clocks.

Furniture should be secured to walls so climbing kids won’t pull them down.

Don’t allow window cords to be reachable by kids. Too many kids get hurt from cords and window coverings.

Don’t put beds near windows.

Keep all medications and poisons out of your child’s room. This includes diaper rash cream and other “non-medicine” hazards.

If you have a bunk bed, be sure kids under 6 years of age don’t sleep on the top bunk. If your little ones won’t follow the rules, you should unbunk the beds.

Make sure kids can’t get out of their room without you hearing them. They could be at risk falling down the stairs or simply get into trouble helping themselves to junk food or extra tv time.

For more safety tips, check out Charlie’s House.

Build excitement

Parents can get the child excited about leaving the security of the crib by talking about the bed before it is used.

Have kids help pick out sheets or a pillow for the bed.

Remind them during the day how big they are when they ___ (fill in the blank with “use a spoon,” “pick up a toy,” etc). Warning:  This can backfire if they really are afraid of the bed and they do want to not be big, so they stop all the “big kid” behaviors.

Addressing fears

If kids are afraid of their new bed, lay together to read books at nap and bed time.

If you still have the crib available, ask if they want to sleep in the bed or the crib. Simply having the choice might empower them to want to stay in the bed.

Feel free to leave a light or night light on in the hall (or even in the room if they prefer).  Eventually they won’t need it, but it can really help if they want it!

Go through a routine of checking the closet (then closing the closet door), checking under the bed, and picking a favorite toy to be there while your child sleeps.

Use a comfort item. It’s amazing how much the power of suggestion that a stuffed toy will stay with them works!

Let them know you will check on them soon… and do, but wait a little longer each night until they are asleep when you check.

If your child has fears related to sleep, check out The Most Common Reasons Why Kids are Afraid to Sleep from AT Parenting’s Child Therapist & Author, Natasha Daniels.

Falling out

For kids who are prone to falling out of bed, decide what works best for that child.

Some parents put the mattress on the floor instead of on a bed frame, so if they roll off it’s no big deal.

Many parents use bed rails that keep kids in the bed.  Unfortunately if they roll hard enough, they can get trapped between the mattress and bed rail.  I know this from experience! My son would do that and it would FREAK him out. He usually went to sleep without much fuss, but after he would get stuck in the rails he was too scared to sleep. We finally just put the bed against one wall and moved everything away from the other side of the bed except a nice layer of pillows and blankets. When he fell out of bed (yes, most nights…) he landed on the pillow pile and kept sleeping.  Problem solved!

Pick a reasonable bedtime

Account for all the time it will take to do all the stall tactics when picking the bedtime.

If sleep time needs to be by 7:30, and you know they will resist brushing teeth, need to potty a 2nd time, get a drink, check the closet and under the bed, and read 3 books… get started in plenty of time to do all of that and still have them tucked in for the last time before 7:30.

Ironically as kids get more tired, they get more wired, so DO NOT allow this process to run too late! They will hit a 2nd wind and be up far too long.  We all know what kind of day tomorrow will be if they are up too late tonight… and it isn’t pretty!  Then they are overly tired for the routine the next night, which can lead to an earlier 2nd wind and more troubles!

Card trick

One trick I’ve learned that works well for older toddlers and preschoolers is the card trick.

They start each night with 3 cards.

Every time they leave their bed for another hug, a drink, to potty, etc, they surrender a card to you.

Once all 3 cards are gone, they can’t leave the bed any more.

If they have cards left over in the morning, they get a sticker for each card.

They can earn up to 3 stickers (or make it special to get an extra sticker if they have all 3 cards!)

When they reach a set number of stickers they earn a prize.

Supplies:

Cards

You can use cards from a regular deck, or you can make it even more fun by having your child make his own cards.

Sticker chart

I also suggest making a simple sticker reward chart, keeping in mind how difficult you think it will be to earn stickers and set a realistic goal for all the needed stickers to be earned within a week.

If they don’t earn the prize fast enough at the beginning they might lose interest (but it needs to be enough time that they earn it). You can make it more difficult over time, as their bedtime routine gets better.

For ideas of reward charts, check out this fantastic free site!

Simple prizes

Prizes shouldn’t break the bank.

You can find trinket toys inexpensively or even pick an “event” as a prize. Maybe your child has been wanting to go to a new park. Maybe they want to have an extra book read at bedtime.

The most important thing is that the child will want to earn the prize.

Playing the game

Go over the rules of the cards and stickers during the day several times so they know the rules before you start the system.

At bedtime minimize the talking and just let them figure it out when you ask for cards or refuse to let them have a 4th resistance tactic.

Remember that each day is new, so they start with 3 cards and you can talk up how much you know they can keep them all!

Praise all the good choices.

If they struggle with it, find positives to praise… “You kept your cards a little longer last night. I can tell you’re working on keeping them all night!”

When kids leave their bed

If kids end up in your bed in the middle of the night and you don’t want them there, you must firmly but without much discussion bring them back to their room.

Too much snuggling, talking, or other interactions will only reinforce them coming to you again.

And again.

Night after night they get to spend more time with you– that’s what they see every time you give them attention when you need to limit the interaction.

Attempt to get them to walk themselves, but if they refuse, carry them with outstretched arms facing away from you to decrease body contact.

Family bed

If you don’t mind them in your bed, be sure you’re ready for a long term commitment to a family bed. Once the habit’s started it will be harder to break until the child wants to sleep independently.

Sleep deprivation makes parents do things they never thought they would…  you just want to get sleep.

Yes, I’m one of those parents who succumbed to being tired and let a little one stay in my bed. I realized I was kicked and punched often throughout the night by my lovely little angel who was not a great bedfellow. She affected my quality of sleep for quite awhile. She wasn’t sleeping well either. We all needed to have our own space. Her nightly visits didn’t stop until we made a firm decision to stop the behavior.

Weaning from a family bed

When we decided we simply couldn’t do the family bed anymore, we tried several methods to get our daughter back to her room. Many of these are discussed by Dr. Craig Canapari’s At Long Last: Sleep Training Tools For the Exhausted Parent.

The thing that finally worked was a slow wean.

We made a bed on the floor of our bedroom and let her sleep there. We slowly moved that bed further from our bed, then into the hall, and finally into her room. Eventually she even made it to her own bed.

If problems continue

If all else fails, talk to your child’s doctor about sleep problems.

Some sleep problems are due to real medical conditions and these should be evaluated.

If sleep problems continue, loss of sleep can affect growth, learning, behavior, and more… don’t let it get to that point!


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E-cigarette Use In Our Kids – Let’s Stop It!

For many years I didn’t see many patients using tobacco. I admit I’ve been lax in talking about risks because there seemed to be more pressing things to discuss in my limited time at appointments. Recently I’m seeing more kids who are trying nicotine due to e-cigarettes. These are marketed as a safer option, giving kids a false sense of safety while filling their desire to take risks. E-cigarette use is not safe or cool.

Tobacco is a problem

Tobacco use is the leading cause of preventable disease and death in the United States.

Nearly all tobacco use begins during adolescence, when developing brains are most at risk of developing addictions.

In 2016, e-cigarettes were the most commonly used tobacco product among high school (11.3%) and middle school (4.3%) students. In 2017, nearly a third of high school seniors report vaping.

About 3 million adolescents in the US vape. Those who start using nicotine by vaping are more likely to transition to traditional cigarettes.

Monitoring the Future 2017 Survey Results
Source: Monitoring the Future 2017 Survey Results

 

Vaping by many names and looks

There are many terms used to describe the use of e-cigarettes, so it can be easy for parents to miss that kids are talking about it. The devices themselves can look like other common items.

Electronic nicotine delivery systems (ENDS), e-cigarettes, personal vaporizers, vape pens, e-cigars, e-hookah, or vaping devices are all terms used to describe the device itself.

The devices themselves can be easily mistaken for other things. ENDS can look like traditional tobacco products like cigarettes, cigars, or pipes.  But they can also look like flashlights, flash drives, or pens, so easily hidden from adults.

ENDS liquid nicotine delivery systems
This image from the AAP shows the various types of ENDS.

Some of the more common terms for the behavior include vaping and juuling.

Dripping is similar to vaping, but uses the liquid nicotine directly on heated coils.

Liquid nicotine is called e-liquid or smoke juice.

E-cigarette use is a safer option? No!

One of the selling points for e-cigarettes is that they could be a safer option than regular cigarettes and a way for smokers to quit.

Kids are confusing the “safer than cigarettes” propaganda to mean safe. It’s NOT safer than not smoking. Period.

In fact, there are many studies showing that the amount of carcinogens (cancer causing agents) in e-cigarettes is substantial.

For parents who choose to vape in the home to help prevent their kids from inhaling secondhand smoke, you might want to even reconsider that. Vaping releases chemicals into the air that can cause problems.

Accidental ingestion of liquid nicotine is a growing problem. Common symptoms of ingestion include vomiting, rapid heartbeat, difficulty breathing, increased saliva, and feeling shaky. One teaspoon of concentrated liquid nicotine can be fatal for the average 26-pound toddler.

e-cigarettes, vaping
E-cigarettes are a threat to health. Source: Facts For Parents About E-Cigarettes & Electronic Nicotine Delivery Systems

Liquid nicotine is enticing and available

E-cigarette juices are sold in flavors like fruit, candy, coffee and chocolate.

Nicotine is addictive. The more kids vape or smoke, the more addicted they become.

Although legally most states prohibit the sale of nicotine products to adolescents, liquid nitrogen is easily available to kids online.

Sadly these products are highly marketed to our kids. Sellers know that if adolescents try it, they are likely to become long term customers of various nicotine products.

Teen and tween brains

Our frontal lobe helps us make healthy choices, but it’s not fully formed until our mid-twenties. This leaves teens at risk for making very unhealthy choices and increased risk of addictions. Teen brains crave stimulation. They take risks to fulfil this craving.

As their brains are growing, experiences and substances affect it. Developing brains can learn and remember things efficiently, but negative experiences and substances also get integrated efficiently. This means teens are more likely to develop addictions than adults.

Kids who vape just once are more likely to try other types of tobacco. Their developing brains make it easier for them to get hooked.

One in 4 teens who use an addictive substance will become addicted, compared to one in 25 who first use an addictive substance after the age of 21 years.

About 90% of adult smokers started before their 18th birthday.

Talk to your kids

E-cigarettes and liquid nicotine are a danger to our kids.

Our kids are bombarded daily with suggestions and choices.

They will see propaganda that encourage vaping online, on television, and in retail stores.

Talk to your kids about all risky behaviors.

Learn 6 ways you can help protect your kids from risky behaviors.

Help them understand the risk as well as what to do to avoid peer pressure.

Encourage them to come to you with questions and concerns by remaining non-judgemental and being present. Encourage family meals and activities. Spend time together without screens – turn off the phones!


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Teen Dating Violence Prevention & Treatment

As discussed earlier, teen dating violence is a relatively common problem that can occur in any socioeconomic circle. It’s important to recognize teen dating violence, but it’s even better to learn teen dating violence prevention and what to do if you recognize trouble!

Family relationships

How we raise our children from infancy and continuing throughout their lives helps set the expectations for relationships.

Abusive home increases the risk

Teen Dating Violence Prevention & Treatment.Children who are raised in homes with abusive behaviors are much more likely to grow up to be in an abusive relationship.

If your home is not safe make every attempt to make it so.

Stop the cycle!

SEcurity

We need children to feel loved and secure.

Children who feel unloved might look for love in all the wrong places, trying to please others and end up being taken advantage of.

Love unconditionally!

Parenting

Kids need defined limits, but an ability to learn and grow into independence with experience. Being firm and setting boundaries is an important part of being a loving parent.

Parents are NOT their child’s friend.

You don’t need to be a friend to be an effective, loving, parent who is well loved and respected.

As your child grows and matures, it is important that you allow them to take more responsibility for their plans and actions.

Be a role model

Kids need help learning to stand up for themselves and to deal with anger and disappointment in a healthy way. Set an example for this. Life typically presents many opportunities to model these behaviors.

Show healthy communication in your relationships. Use positive phrases, respectful words, and compliment one another.

Don’t let one partner dominate. Take equal share of responsibilities and decisions.

Do things with your significant other and with other people. Expect that your partner will also spend time with others. Don’t be overly jealous. Relationships need trust. Always spending time together isn’t healthy and doesn’t allow you to each follow your own interests.

Respect others in your life and be sure they also respect you.

If you have not learned to control your temper, learn.

Ensure enough sleep for everyone at home, as we are all more short-tempered when tired.

There are many self-help books on this topic and counseling is available if you struggle in your own relationships.

Peer relationships

Friendships and dating relationships provide an opportunity for teens to learn and practice healthy communication, social skills, and managing strong feelings.

Teens need to develop independence while the trusted adults around them provide support and help them stay safe.

Talk to your kids about healthy choices and as they mature, allow them to make more decisions about what they do, when they do things, and who they are around. If you feel they aren’t making safe choices, let them know why.

Don’t be judgemental in how you approach things. There’s no faster way to turn a teen off to a conversation than putting him or her down or by making them feel like they’re being lectured.

Respect

Respect self

Kids should be taught to respect themselves in all they do: eat nutritionally, exercise, get enough sleep, wear helmets, buckle up, stay away from drugs, etc.

Respect others

Kids should be taught to respect others: say nice things, don’t ask others to do things that might cause them harm, respect their personal space and things, etc.

Demand respect

Teens should enforce that others treat them with respect.

If a friend does not treat them with respect, they can try first to talk with the friend about it if they feel safe doing so. If the friend does not change behaviors, they should take a break from the friendship.

Talking to teens

Start before they’re dating

It’s best to start talking about healthy relationships before your child starts dating.

Set expectations for how old they will be when they are allowed to go out in groups of boys and girls as well as when they will be allowed to go on an actual date. How well do you need to know the person they will date?

Talk about what they should do if they find themselves in a scary situation.

Discuss rules for friends coming to the house if you’re not home. Or if they’re allowed to go to a private area or if they must stay in the family room.

Talk about what to look for in a romantic partner, qualities that are important and not just superficial.

Ask how they would like to be treated and how they will treat their date.

Talk about sex. Kids who have sex at young ages are more likely to have multiple partners. Having multiple partners increases the risk of infections and dating violence.

Drugs and alcohol increase risk

Remind kids that alcohol and drugs impair our abilities to handle our emotions and actions. They do not excuse our actions, but we tend to not make good choices when we’re under the influence.

We also put ourselves at risk of a forced sexual encounter when we’re under the influence of drugs or alcohol.

Date rape can also occur if someone slips a substance into a drink, so they should always carry their drink or get a new one from a trusted source.

Starting the conversation

Use opportunities that present themselves to trigger conversations.

If you see people arguing in a television show, talk about what was and was not effective in how they handled the situation. Ask what your kids would have done differently.

If the news reports another #MeToo story, ask what your teen’s thoughts are on the subject. Talk about recognizing unhealthy relationships and how to get out of abusive situations.

Answering questions

If your child asks questions, don’t shy away. Don’t assume they’re too young to hear the answer because if they’re asking, there’s a reason.

You can certainly ask where they’re coming from to help guide your answer, but answer honestly.

If you don’t know what to say, offer to talk about it at a specified time in the near future, such as after dinner that night. That gives you time to think and plan what to say but let’s your child know you want to talk. Don’t forget!

Emotional support

Be there to just listen if your child needs an ear. Offer encouragement and advice. Do this routinely, not just if you’re concerned about a specific issue.

If you always offer an ear without harsh judgement or unsolicited advice, your kids are more likely to keep talking. (Note: Just because they want to talk doesn’t mean they’re ready to accept advice. Ask if you can offer advice and wait until they say yes.)

Remind teens that they are never to blame if someone forces them to do something sexually they don’t want to do. They need to feel open to share this pain with you or another trusted adult so they can get the help and support they need.

preventing teen violence
Preventing Teen Dating Violence. Source: VetoViolence

What if there is an unsafe relationship?

It can be frustrating if your child’s in an unhealthy relationship but isn’t ready or willing to leave.

It can be difficult to enforce ending a relationship. Be careful in how you approach the situation. Consider working with professionals at the school or in the community.

Advice to get out of a relationship will be better received if your teen understands how their relationship is not healthy. Help them understand the difference between healthy and unhealthy relationships.

They need to know it isn’t their fault and it isn’t under their control how another person acts. Ideally, your teen will be able to make the decision to leave the relationship.

I’ve actually seen a teen get pregnant on purpose because her parents refused to let her see her boyfriend. She decided that they’d have to allow him to see his baby (and by default, her). Of course it didn’t work as planned. She did get pregnant, but it didn’t help her relationship.

If you think they’re in immediate danger, you need to seek professional help.

There are many ways to get help

Abusers often monitor computer and phone use, so use caution.

SafeHome (KC Area)

From a safe computer, click here if you’re in the KC area.  From a safe phone call 913-262-2868. (Phones answered 24/7 confidentially at SafeHome).

Safety Plan (Love is respect)

Love Is Respect has a great safety plan for teens who are planning on leaving an abusive relationship.

DATING MATTERS®

Dating Matters is a free, online course available to educators, school personnel, youth mentors, and others dedicated to improving teen health. Learn what teen dating violence is and how to prevent it through graphic novel scenarios, interactive exercises, and information gathered from leading experts.

National Teen Dating Abuse Helpline

These resources are designed specifically for teens and young adults. It is managed by the National Domestic Violence Hotline (NDVH) and offers  support from trained Peer Advocates.

Call: 1-866-331-9474 Calls are answered 24 hours a day, 365 days a year.

Text: “loveis” to 22522

TTY: 1-866-331-8453

Web: www.loveisrespect.org

 

Teen dating infographic

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Teen Dating Violence: Recognition

Would you recognize signs of dating violence? Many teens don’t report it to friends or family. It can be difficult to recognize despite the significant prevalence. Victims might not say anything out of fear for their safety, embarrassment, low self-esteem, or not recognizing the abusive behaviors. Whatever the reason for the under-reporting, parents and other adults who interact with teens must recognize signs of dating violence to help protect our kids.

Relationships

Teen Dating Violence: RecognitionWe want our kids to develop healthy relationships where they can have fun, grow in their own identity, and be true to their own values. Healthy relationships are founded on honesty, trust, and communication. There is mutual respect.

Dating abuse can happen in any unhealthy relationship. It happens to smart people, rich people, girls, guys, LGBT, and can happen in any community. We see news stories of abusive relationships but it doesn’t always seem real. A new bride murdered.  A teen raped.  A sports figure accused.

Failed recognition

Unfortunately we don’t even know about most abusive relationships. People suffer silently.  How is a parent to know?

Can a teen see risk factors before becoming involved with a risky personality?

Abuser characteristics

Parents might look for the “type” of teen that they want their child to steer away from, but unfortunately, the abusers are not easily identified.

Abusers do not look like drug dealing, tattoo covered, pierced people in tattered clothing.

They are difficult to recognize on first glance because they tend to be popular, smart, good looking, and personable.

They are often good at reading people and responding to other’s desires, making them seem “perfect” initially.

Abusers manipulate others. Have you heard of gaslighting? It’s a common means to make the victim feel responsible.

They gain trust.

They weave deception.

Traits to watch for in an abuser:

  • Blames others for all problems
  • Jealous
  • Impulsive
  • Wants to move quickly into a relationship
  • Criticizes others
  • Does not respect personal boundaries
  • Denies responsibility for actions
  • Takes risks
  • Insulting (you’re fat, you’re stupid, no one else would love you like I do)
  • History of hitting or hurting others
  • Tries to monopolize your time and life – wants to control what you do, who you’re with, even what you’ll wear
  • Seems perfect initially (no one’s perfect!)
  • Mood swings or can’t manage anger or frustration well

What an abusive relationship might look like

Starting out – all seems great!

The relationship typically starts out well. A lot of laughs, good times.

If it didn’t, people would leave.

Power and Control cycle

Abusers have a power and control cycle that builds over time. They gain a little trust, then test with a little control.

Bit by bit they become more controlling and abusive. It builds so slowly many people miss the early warning signs and then are so swept by the cycle that it’s hard to leave.

Abusers want to know your every move, which at first might even seem flattering, but it is a control tactic. They might choose what you wear or where you go. Abusers monitor your phone calls to see who you talk to. They isolate you from your friends and even family so you lose your support group. They put you down so you feel no one else would like you or want you.  Abusers make you feel less of a person and they are “good” to put up with you.

They get jealous (again, flattering on the outset because they “care”). Abusers often apologize for hurting you, but then claim it is your fault that they behave that way.

In truth, they blame others for most of their behaviors and only take credit when things make them look good.

Cool tool

Breakthecycle.org has a really cool interactive wheel to see the relationship between words and actions. Move your cursor around the wheel to get more information on each topic in the orange part of the wheel.

Signs of an unhealthy relationship:

  • One or both people try to change the other
  • Control: one person makes most or all of the decisions
  • Isolation: one or both people drop friends and interests outside of the relationship
  • Fighting: one or both people yell, threaten, hit, or throw things during arguments
  • Verbal abuse: one or both people make fun of the other’s opinions or interests
  • Jealousy and control: one or both people keep track of the other all the time by calling, texting, or checking in with friends
  • Relationship moves quickly to “serious”
  • Mood swings, anxiety, depression, personality changes
  • Physical signs: bruises, cuts, scrapes, showering immediately when coming home
  • Abused feels guilty and “at fault” and makes excuses for their partner
  • Drug or alcohol use
  • Multiple sexual partners

Follow your instincts

If you suspect something is not right, act on your hunch and take action to address issues and leave the relationship early if problem behaviors persist.

 

If your teen is in a relationship with someone who is violent, your teen may:

  • Avoid friends, family, and school activities
  • Make excuses for a partner’s behavior
  • Look uncomfortable or fearful around a partner
  • Lose interest in favorite activities
  • Get lower grades in school
  • Have unexplained injuries, like bruises or scratches

If you think your teen might be an abusive person:

Teens who use physical, emotional, or sexual violence to control their partners need help to stop. Don’t make excuses if you think your child has a problem.

If your teen is abusive, he or she may have these characteristics:

  • Jealous and possessive
  • Blames other people for anything that goes wrong
  • Damages or ruins other people’s things
  • Wants to control a partner’s decisions
  • Constantly texts or calls a partner
  • Posts embarrassing information or pictures about a partner online

Next up:

How to prevent and seek help for teen abusive relationships.



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Teen Dating Violence: Stats to Know

Teen dating is an important way for kids to learn about themselves and others, but it can open them up to risky behaviors, heartache, and more. Violence in teen relationships is more common than you might realize, but recognizing warning signs can help protect our kids in their relationships.

Teen Dating Violence Awareness Month

teen dating violence statsFebruary is Teen Dating Violence Awareness Month, so it is a great time to learn about this all too common problem.

Today I’ll review the statistics to show just how prevalent it is.

Tomorrow I’ll cover how to recognize unhealthy relationships.

A third post will talk about what you can do to prevent abusive relationships and what to do if you recognize one.

What is teen dating violence and why should we care?

Definition

Teen dating violence is the physical, sexual, psychological, or emotional violence within a dating relationship, including stalking.

It can occur in person or electronically and can occur between a current or former dating partner.

Lasting effects

Youth who are victims are more likely to experience symptoms of depression and anxiety, engage in unhealthy behaviors (use of tobacco, drugs, and alcohol).

They often show antisocial behaviors and think about suicide.

Teens who are victims of dating violence in high school are at higher risk for victimization as an adult.

Dating apps

Dating apps isn’t what this post is about, but it deserves at least a mention. Certainly there’s a lot of teen dating violence with teens who meet in class or through a common friend, but this “service” opens up a Pandora’s Box of risky possibilities.

Teen dating apps?

Sadly, in researching this subject, the first many posts that showed up on my Google search for “teen dating” were teen dating apps. Not adults-only apps, or even apps that pretended to be adult-only.

Apps with “teen” and “dating” in the title.

One of the top search findings was a men’s website with an article about the “best” and “safest” teen dating apps. Yikes! This is on a website designed to attract adult men.

Another advertised that it was for kids 13-17 years of age. I’m not a fan of early teenage kids dating in general, but certainly a 13 year old is too young to safely navigate an online dating service!

As a mother of two teens, this is incomprehensible and scary to me. Why can’t kids meet the old fashioned ways ~ through friends, classmates, clubs, and activities?

On the other hand, I see the draw. So many teens of today haven’t mastered social skills. Kids of all ages today rely on texting to communicate with friends. They aren’t sure how to approach someone they don’t know. Teens find it hard to carry on a verbal conversation.

It’s easy to put your profile out there and search for someone with like-minded personalities. Easy, but not safe!

Thankfully, CommonSenseMedia.org had a high-ranking result to my search. Check out Tinder and 5 More Adult Dating Apps Teens Are Using, Too to see their stats and warnings. I highly recommend Common Sense Media in general for parents to help them moderate their children’s media intake: movies, games, apps, and more.

Dating violence: a very difficult and complex topic  

When teens find themselves in an abusive relationship, they often can’t find an easy way out. Sometimes they’re not even sure if the relationship is healthy or not.

How to separate?

Teens might share friends with their abusive partner. Their friends might think the abuser is wonderful, lending to peer pressure to stay together.

They typically go to school together, so it is difficult to avoid each other entirely.  

Teens might fear trying to leave the relationship safely.  

Victims often have feelings of love and attachment to the abuser, and hope that behaviors will change.

Drawing the line

If teens have lived with domestic abuse at home, they might think the abuse is normal.  

The abusive behaviors tend to lower the victim’s self esteem, making leaving feel less desirable since they feel no one else will ever care about them and a bad relationship is preferable to being alone.  

Guilt

Victims are often confused and made to feel like the abuse is their fault. They are told again and again that “if you didn’t do ___, I wouldn’t have had to ___.” They believe the abuser’s words.

Sometimes the abuse starts so gradually, it takes time to recognize that it’s there. By the time a victim realizes it, he or she may feel that if they say anything or get out of the relationship, others will think they’re stupid for not seeing it earlier. They continue to play the game of happy couple.

Bullying

Teens can experience cyberbullying even when not with their (ex-) partner.

There are no physical signs with verbal or online abuse, but the emotional scars can last a lifetime.

Even physical abuse (pinching, hitting, shoving, slapping, punching, or kicking) doesn’t always leave physical marks. If marks are visible, victims often make up stories to explain how they got there to cover for their partner.

Learn about abuse to help save someone you love from a dangerous relationship!

Stats- in other words, it’s a problem!

2015 National Youth Risk Behavior Survey

The CDC performs surveys of many risk factors on our children every other year. The 2015 National Youth Risk Behavior Survey is the latest reported. The 2017 report is expected to be published later this spring.

Nearly 70% of students nationwide dated or went out with someone during the 12 months before the survey. The statistics below represent a percentage of these 70% in the 12 months prior to the survey.

  • About 10% had been physically hurt on purpose (counting hit, slammed into something, or injured with an object or weapon) by their date or someone they had dated.
  • Over 10% of students had been forced to do sexual things they did not want to do by someone they were dating or going out with. These included being kissed, touched, or physically forced to have sexual intercourse.

The prevalence of physical teen dating violence did not change significantly from 2013 (10.3%) to 2015 (9.6%).

Other stats

Nearly 1.5 million high school students in the United States are physically abused by dating partners every year.

Females are more likely to be the victims (1 in 4 women have been assaulted by a partner).

Men are also at risk: 1 in 14 men report being victims.

Regardless of sex, it is likely that abusive relationships are underreported due to the nature of the problem.

Tomorrow: How to Recognize Teen Dating Violence 



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7 Vitamin K Myths Busted

Social media has allowed the sharing of misinformation about many things, especially medically related things. When the specifics of something are unknown to a person, pretty much anything that’s said can sound reasonable, so people believe what they hear. This happens with many things, such as vaccine risks, chelation, and vitamin K. I want to tackle 7 Vitamin K Myths.

Refusing Vitamin K

I am especially frustrated when parents refuse to give their newborns vitamin K after birth. Since 1961, the American Academy of Pediatrics has recommended giving every newborn a single shot of vitamin K given at birth. This is a life saving treatment to prevent bleeding.

Life saving.

Vitamin K works to help our blood clot. Insufficient levels can lead to bleeding in the brain or other vital organs. Vitamin K deficiency bleeding or VKDB, can occur any time in the first 6 months of life. There are three types of VKDB, based on the age of the baby when the bleeding problems start: early, classical and late. Unfortunately there are usually no warning signs that a baby will have significant bleeding, so when the bleeding happens, it’s too late to do anything about it. Why parents don’t want to give this preventative life saving treatment is usually based on incorrect information.

This is a matter of a fairly low risk of bleeding if you don’t give vitamin K: 250-1700 per 100,000 within the first week, and 4-7 per 100,000 between 2 and 12 weeks. You might notice that the number is variable – it’s hard to study since the large majority of babies have gotten vitamin K over the years and the risk is low even without vitamin K. However, when there is bleeding it has significant consequences: lifelong disability or death. And we also know that there’s very low risk from the vitamin K and it works very well to prevent bleeding. So why take the chance of not giving it?

Conspiracy Theories, Misunderstandings, and Science

This is not a governmental conspiracy to somehow kill children. It’s a world wide attempt to help children survive and thrive.

The World Health Organization (WHO) guidelines:

All newborns should be given 1 mg of vitamin K intramuscularly [IM] after birth [after the first hour during which the infant should be in skin-to-skin contact with the mother and breastfeeding should be initiated]. (Strong recommendation, moderate quality evidence)

Science is hard to understand

Most people look at scientific information and can’t make heads or tails of what it means.

Photo Source: Hemorrhagic Disease of the Newborn

That coupled with the fact that things we read that make us react emotionally (such as fear that something will harm our child) makes us remember and associate with the information that created the emotion, whether it is right or wrong. This can lead parents to make dangerous decisions for their children while trying to do the right thing.

Myth Busting

I’m going to attempt to de-bunk the most common concerns I’ve heard because the best way to combat misinformation is to help explain the facts as we know them.

1. If every baby’s born with too little vitamin K, that’s the way we’re supposed to be.

Babies are born with very little vitamin K in their body. If they don’t get it with a shot, they need to either eat it or make it. Breast milk has very little vitamin K and babies won’t be eating leafy greens for quite awhile. Formula does have it, but it takes several days for vitamin K to rise to protective levels with formula and the highest risk of bleeding is during that first week of life. (Of course if you’re using this argument because you want babies to be all natural, you probably won’t be giving formula at this point.)

Bacteria help us make vitamin K, but babies aren’t colonized at birth with these gut bacteria.

Just because they’re born that way doesn’t mean they’re supposed to stay that way. Inside the mother the baby is in a very different situation. They don’t breathe air. A fetus doesn’t eat. They don’t have gut bacteria. Their heart has a bypass tract to avoid pumping blood to the lungs. This all works well in utero, but must change once they leave the womb. Change takes time, and during this time they are at risk. Why not minimize the risk if we know a safe way to do it?

2. The package insert has a big warning at the top that it can kill.

There are many reasons why we should not use the package insert of a medicine or vaccine to make healthcare decisions. These have been discussed before so I won’t go into all the details but please see these great blogs on how to read and use package inserts:

It is true that there is a black box warning on the top of the vitamin K package insert. This has scared some parents from wanting to get the vitamin K shot for their newborn.

Screen Shot from Package Insert 

Reactions to IV (intravenous) vitamin K are much more common than IM (intramuscular) injections. The difference is anything given by IV goes directly into the bloodstream and back to the heart. But we don’t give vitamin K by IV to newborns.

IM injections go into the muscle, allowing very slow absorption of the medicine. This not only decreases reactions to the injected vitamin, but also helps the level of vitamin K stay elevated for a prolonged time after a single injection.

I only found one report of a newborn with a significant reaction to vitamin K. The authors of the paper did note that IM vitamin K has been given for many years to babies all over the world without significant reactions and could not explain why the one infant had such a significant reaction.

Since we must always look at risk vs benefit, the very, very low risk of a serious reaction from receiving vitamin K IM is preferable to the benefit of the prevention of VKDB.

Another great resource on this topic is Dr. Vincent Iannelli’s That Black Box Warning on Vitamin K Shots.

3. Vitamin K causes cancer.

Many years ago there was a small study that suggested vitamin K led to childhood cancers. This issue has been extensively studied since then and no link has been found.

Vitamin K does not cause cancer.

Rates of cancer have not increased in the years since vitamin K has been given to the large majority of newborns worldwide. This is reported in the Vitamin K Ad Hoc Task Force of the American Academy of Pediatrics report Controversies Concerning Vitamin K and the Newborn.

4. Bleeding from vitamin K deficiency is rare or mild.

In the US bleeding from vitamin K deficiency is rare because most babies get the vitamin K shot soon after birth. In countries where vitamin K is not used routinely, bleeding is not rare at all. Some communities of the US where vitamin K is being refused by parents are seeing an increase in newborn bleeding.

Early VKDB occurs within 24 hours of birth and is almost exclusively seen in infants of mothers taking drugs which inhibit vitamin K. These drugs include anticonvulsants, anti-tuberculosis drugs, some antibiotics (cephalosporins) and blood thinners to prevent clots. Early VKDB is typically severe bleeding in the brain or gut.

Classic VKDB typically occurs during the first week of life. The incidence of classic VKDB ranges from 0.25-1.7 cases per 100 births.

Late onset VKDB occurs between 2 and 12 weeks usually, but is possible up to 6 months after birth. Late VKDB has fallen from 4.4-7.2 cases per 100,000 births to 1.4-6.4 cases per 100,000 births in reports from Asia and Europe after routine prophylaxis was started.

One out of five babies with VKDB dies.

Of the infants who have late VKDB, about half have bleeding into their brains, which can lead to permanent brain damage if they survive. Others bleed in their stomach or intestines, or other vital organs. Many need blood transfusions or surgeries to help correct the problems from the bleeding.

5. It’s just as good to use oral vitamin K.

Early onset VKDB is prevented well with the oral vitamin K in countries that have oral vitamin K available, but late onset VKDB is an issue.

Children with liver or gall bladder problems will not absorb oral vitamin K well. These problems might be undiagnosed early in life, putting these kids at risk for VKDB if they are on an oral vitamin K regimen.

Getting the oral form isn’t easy

There is no liquid form of vitamin K that is proven to be effective for babies in the US.

That is a huge issue.

Some families will order vitamin K online, but it’s not guaranteed to be safe or even what it claims to be. This is an unregulated industry. It is possible to use the vitamin K solution that is typically given intramuscularly by mouth, but this requires a prescription and the taste is questionable, so baby might not take the full dose.

It would be an off-label use so physicians might not feel comfortable writing a prescription. The other issue that might worry physicians is with compliance in remembering to give the oral vitamin K as directed, since most studies include babies with late onset bleeding who had missed doses.

Vitamin K in food

Most of us get vitamin K from gut bacteria and eating leafy green vegetables.

Newborns don’t have the gut bacteria established yet so they won’t make any vitamin K themselves. They may get vitamin K through their diet, but breastmilk is very low in vitamin K. Unless baby is getting formula, they will not get enough vitamin K without a supplement.

It is possible for mothers who breastfeed to increase their vitamin K intake to increase the amount in breast milk, but not to sufficient levels to protect the baby without additional vitamin K.

What do other countries do?

Many countries that have used an oral vitamin K protocol, such as Denmark and Holland, have changed to an intramuscular regimen because the oral vitamin K that was previously used became no longer available.

There are various oral vitamin K dosing strategies that can be reviewed in the linked abstract.

  •  Australia and Germany: 3 oral doses of 1 mg vitamin K are less effective than a single IM vitamin K dose. (In 1994 Australia changed to a single IM dose and their rate went to zero after the change.)
  • Netherlands: A 1mg oral dose after birth followed by a daily oral dose of 25 mcg vitamin K1 may be as effective as parenteral vitamin K prophylaxis.
  • Sweden: (a later study) 2 mg of mixed micellar VK given orally at birth, 4 days, and 1 month has a failure rate of one case of early and four cases of late VKDB out of 458,184 babies. Of the failures, 4 had an undiagnosed liver issue, one baby’s parents forgot the last dose.
Oral Vitamin K vs injectable (IM) Vitamin K

When vitamin K is given IM, the chance of late VKDB is near zero.

Oral vitamin K simply doesn’t prevent both early and late bleeding as well. This is especially true if there is an unknown malabsorption disorder, regardless of which dosing regimen is used.

6. My baby’s birth was not traumatic, so he doesn’t need the vitamin K.

Birth trauma can certainly lead to bleeding, but the absence of trauma does not exclude it.

Late vitamin K deficient bleeding (VKDB) cannot be explained by any birth traumas since they can occur months later.

7. We’re delaying cord clamping to help prevent anemia and bleeding. Isn’t that enough?

Delayed cord clamping can have benefits, but decreasing the risk of bleeding is not one of them.

There is very little vitamin K in the placenta or newborn. Delaying the cord clamping cannot allow more vitamin K into the baby.

Still not convinced?

Read stories about babies whose parents chose to not give vitamin K:

For More Information:

Evidence on: The Vitamin K Shot in Newborns (Evidenced Based Birth)

Help! My Child Stuck ____ Up His Nose!

Help! My child stuck ___ up his nose!

If you’ve ever said these words, you know how awful it can be to know your little one has something stuck up there but cannot blow it out. The longer it has been there, the more chance there will be secondary complications, such as irritation to the nasal mucosa (“skin” in the nose) or infection.

If your kids stick something up their nose, try this trick before running to the ER.

How do you know there’s a problem?

Sometimes the first sign of  something in the nose is a foul smell to their breath and thick yellow or green discharge from only one side of the nose. This is due to infection from the body’s rejection of the object. (Usually a cold or allergies affects both nostrils, right?) These kids should be seen at the doctor’s office for further evaluation and treatment.

Sometimes you are lucky enough to find out about the foreign object soon after it is placed up the nose, before complications arise. But even then, how do you get it out?

Getting it out

Some parents feel most comfortable with a medical professional removing it. That’s fine. Call your doctor’s office and they’ll be happy to help.

Regardless of where you decide to get the thing out: keep calm! Try to keep your child calm because if they are crying they can suck the object in further. A common problem is parents get upset, and this just gets the child upset. Even if you’re going crazy on the inside, maintain your calm on the outside.

To actually get something out of the nose, sometimes doctors need to use their special equipment to get it out. But there’s a really good trick I learned from an ER doc friend long ago that can even work at home: blow it out for them.

What can you do at home?

It’s called the “Mother’s Kiss” but dads can give it a try too.

This is something you can try at home or in your doctor’s office if you’re nervous or unsure how to do it. Never try to reach up there with something to pull it out… you might push it in higher and get it stuck in a turbinate– see the picture below.

Kids need help

The basic problem is kids who put things up their nose don’t usually have the ability to blow hard enough to get it out. If you blow into their mouth you can often force the object out. (Think of CPR, only you don’t block the nose to force the air into the lungs- that would be bad!) 

It’s important to not block the exit from the other nostril and not to do this if something is up both nostrils.

There are those kids…

We don’t want to force the air into the lungs and cause problems there!

In my office we often put Neo-Synephrine in the nose to shrink the nasal passageways to make it easier for the object to be blown out, especially important if the object has been there awhile and there is mucosal swelling.

And then the kiss…

Blow into the mouth with a quick puff of air. This forces air up the back of the throat into the nose. Don’t block either nostril as you do this. The blow can be repeated several times if not successful at first. The parent usually ends up with a cheek full of mucus along with the object!

Of course, if this fails, you will need to bring your kiddo in to be evaluated. Sometimes with fancy tools we can remove the object. If it is deep into the nose or into the turbinates, an Ear Nose and Throat specialist might be required.

Don’t let there be a next time…

As always, prevention is the best cure. Keep small things away from kids and when they are working with craft beads, eating corn, playing on a gravel road, or otherwise in the vicinity of small objects, keep an eye on them!

nose picking, objects up nose
Kids will pick their nose and stick things up there…