ADHD involves impairments in executive functioning. How can anything causing a broken executive functioning system be cherished?
Because they also have many positive traits that can be cultivated.
People with ADHD tend to think outside the box so are great problem solvers.
They have lots of energy so can work tirelessly.
They are often very creative so are gifted in the arts.
They often have a great sense of humor.
We all think of their inattention and poor focus, but they also hyperfocus on things they love. If they become passionate about something, they can sustain attention and work on it for long periods of time. If they use this hyperfocus wisely (with setting time limits so they can do other daily activities) they can become an expert in that area. For young children the hyper focus tends to be on “kid” things, like trains or video games, but as they get older, allowing kids to experience activities that interest them will give the opportunity to find a life passion that could turn into a fantastic career.
First, we must realize that everyone has gifts.
ADHD has many variables in the way it shows up, so people with it also have many variations in gifts. But they do have gifts.
I want parents, spouses, siblings, grandparents, aunts, uncle, neighbors, teachers, and more to understand the value of these gifts and help children (and adults) recognize the benefits that people with ADHD can have.
“ADD people are high-energy and incredibly good brainstormers. They will often happily work 12 to 15 hours by choice. The business community should not fear ADD. Instead, they should see that they have a potential gold mine here.” – Dr. Kathleen Nadeau, psychologist
Despite those positive qualities, It’s easy to lose sight of them
I’m not saying life for them is easy.
They struggle with many things other people can easily manage. But they still have gifts. I want kids to grow up building their confidence by using their gifts, not by measuring their failures when they don’t conform to norms.
Kids can lose their drive and ambition if they are not supported along the way. Depression and anxiety can easily develop when kids continuously fail to meet their potentials.
School is not favorable to kids with ADHD.
Kids must sit in a chair for prolonged periods of time and keep quiet.
They need to color in the lines. They need to do all the steps in the order the teacher wants. Doing things someone else’s way is not easy for kids with ADHD.
They need to solve the math problem the way the teacher did it and show their work. They lose points if they get to the right answer but didn’t show their work or if they get there a different way. The teacher might assume they cheated to get the answer, but some kids just skip steps. To me that might just show brilliance. They can skip steps. Their brain just “gets” to the right answer. I never could figure math out without being told how to do it, but there are kids out there who can. What a gift! Unfortunately they feel dumb if they can’t show the steps just like the teacher taught. And it would be quite typical for a child with ADHD to have a brain that thinks this way if math is that child’s gift. What a shame that our schools tend to make these kids feel inferior because in the end they might resist working on math and will never reach their potential.
role models and resources
If your child struggles with the diagnosis, consider finding a mentor who is successful but has the same diagnosis.
Have them read Percy Jackson (link to a book review). He’s a fictional character with ADHD and dyslexia that kids can look up to.
Throughout history many successful people have had ADHD. Your child with ADHD can also become a leader, an inventor, an artist, or an otherwise excellent contributor to society. Let them see this list and see how many athletes, celebrities, and other leaders have ADHD.
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.
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.
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.
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.
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:
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.
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.
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:
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.
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!
I remember long ago when I was a relatively new mom I still had insecurities about what I was doing (despite the fact that I was a pediatrician). Well, to be honest, I still have lots of great advice for parents, but with my own kids I often struggle to know what’s best. But my kids are way beyond the potty training years, so I feel like I have that hurdle down now…
A problem for many parents, even pediatrician moms…
My son’s baby book’s potty training page shows my naivety. He started showing interest in the potty and even telling me appropriately when he needed to go about 18 months of age.
I knew that he was on the early side of potty training (normally between 18 months and 3 years). This is especially unusual for boys, but he was a smart kid, was directing it all himself, and why not potty train him if he’s interested?
I was so excited for him (and me!) that he was interested.
We put out the potty chair.
We clapped and praised.
He was so happy to make pee in the potty.
Then he lost interest. Out of the blue. Done.
It is almost a year to the day later that the baby book says he was interested again. I actually tried to not let him train, since my 2nd baby was due soon, and I didn’t want him to regress.
One day the daycare teacher said, “He’s been in the same diaper all day for 3 days in a row, he needs underwear!” It was time to try again. I decided it was okay to break out the Buzz Lightyear underwear.
When he did it this time, he did it well. He easily mastered the skill and didn’t have accidents.
You’d think we know better for the 2nd kid…
When my daughter started using the potty early (at about 15 months) I thought it was a fleeting interest as well, but she continued to regularly use the toilet.
Wow! Easy… she did it all on her own.
Her independent streak has its negatives, but I liked this aspect of it.
She never had accidents.
I stopped bringing extra clothes for her cubby at daycare, she was that good.
Then she lost interest. Out of the blue. Done. At 3 years!
One day she woke and said she was a baby and needed a diaper. By this time, we had no diapers. I told her she was a big girl, got her dressed, and sent her off to daycare as usual.
When I picked her up there was a bag of other kid’s wet clothes. She was on her 4th outfit of the day, but we had no extras at school because she was my never-has-accidents kid.
I knew she wasn’t sick (UTI’s can cause accidents.) She had simply decided that she wanted to be treated like a baby. And she’s always been stubborn.
I had to go out and buy diapers. We stocked her cubby with extra clothes. She LOVED being treated like a baby. The daycare even moved her back to the toddler room because the 3 year room didn’t allow diapers. She loved being with the babies, so it suited her just fine.
The problem was the teachers made such a big deal about how she was a big girl and didn’t need the diaper. When I finally convinced the teachers to just matter of factly change the diaper and ignore her behaviors, she decided it wasn’t fun any more to be a baby. Suddenly she was potty trained again.
No more accidents.
Kids develop at various stages.
My advice has always been to let them take the lead when to start potty training, which can happen anywhere from 15 months until 3 years of age.
Kids leading the way?
They are ready to take the lead and potty train when they show interest (wanting to sit on a potty chair, wanting a wet diaper off, telling you when they are wet).
If you push, they will resist. (Trust me.)
Teens and toddlers are one and the same: they both try to exert independence and do it their own way. The more you push, the more they pull.
If you think your child is aware of when he/she needs to urinate or have a bowel movement, put out a potty chair that is in full view when in the bathroom.
Buy potty training books geared toward toddlers.
Show excitement and give praise for interest and any steps in the right direction (sitting on potty, peeing in potty, washing hands, etc.).
You can do a potty dance, give stickers, call Grandma, and do whatever makes a big deal for each little step.
Praise others for using the bathroom.
Invite playdates who are similar ages and are potty trained over so your child can see them in action.
Praise older siblings for going to the bathroom.
You can put the idea in their head: “I’m going to the potty. Boy, do I feel good! I went on the potty, didn’t get my pants dirty, got to flush the toilet, got to use the foamy soap, etc.” but don’t tell them directly to go. They resist being told anything! Teenagers and toddlers are very similar in this aspect.
Scoop on Poop
Many kids are ready to go pee in the potty, but are afraid to poop there.
That is okay.
Offer a diaper at the time of day they often have a bowel movement.
It is not good to try to force stooling in the toilet if they don’t want to go there. They will hold it and end up constipated. Don’t go there!
You can take them to the bathroom after the bowel movement and drop the stool into the toilet, then have the child flush. Then they associate the stool going down the toilet, which sometimes helps. Encourage lots of fruits and water so the stool stays soft. If it hurts to poop, they hold it longer, which then hurts again, which reinforces holding and then constipation.
Don’t worry about setbacks
Many kids show a temporary interest in potty training, but then stop wanting to go completely. Return to diapers, but leave the potty chair visible. When the child starts to show interest again, give praises.
Remember: normal children do not go to kindergarten in diapers!
They will potty train some day.
If your child isn’t potty trained during the day by 3 1/2 years, talk to your doctor.
Many families travel when school’s out of session, which over the winter holiday season and spring break means traveling when illness is abound. I get a lot of questions this time of year about how to safely travel with kids. Traveling with kids can increase the level of difficulty, but it can be done safely and still be enjoyable!
Sleep deprivation can make everyone miserable, especially kids (and their parents). Make sure your kids are well rested prior to travel and try to keep them on a healthy sleep schedule during your trip.
Bring favorite comfort items, such as a stuffed animal or blankie, to help kids relax for sleep. If possible, travel with your own pillows.
If you’re staying at a hotel, ask for a quiet room, such as one away from the pool and the elevator.
Be sure to verify that there will be safe sleeping areas for every child, especially infants, before you travel.
Try to keep kids on their regular sleep schedule. It’s tempting to stay up late to enjoy the most of the vacation, but in reality that will only serve to make little monsters of your children if they’re sleep deprived.
If your kids nap well in the car, plan on doing long stretches on the road during nap time. If kids don’t sleep well in the car, be sure to plan to be at your hotel (or wherever you’re staying) at sleep times so they can stay in their usual routine.
Some families leave on long trips at the child’s bedtime to let them sleep through the drive. Just be sure the driver is well rested to make it a safe trip!
If you’re changing time zones significantly, plan ahead. Jet lag can be worse when traveling east than when going west. Jet lag is more than just being tired from a change in sleep routine, it also involves changes to the eating schedule. Kids will often wake when they’re used to eating because the body is hungry at that time. Try to feed everyone right before they go to sleep to try to prevent this. Breastfed infants might have a harder time adjusting because mother’s milk production is also off schedule.
Tired, sick, and hungry all make for bad moods, so try to stay on track on all accounts. Sunlight helps regulate our circadian rhythm, so try to get everyone up and outside in the morning to help reset their inner clocks. Keep everyone active during the day so they are tired at the new night-time.
Keeping track of littles
Toddlers and young kids love to run and roam. Be sure that they are always within sight. Use strollers if they’ll stay in them.
Consider toddler leashes. I know they seem awful at first thought, but they work and kids often love them! I never needed one for my first – he was attached to parents at the hip and never wandered. My second was fast. And fearless. She would run between people in crowds and it was impossible to keep up with her without pushing people out of the way. She hated holding hands. She always figured out ways to climb out of strollers – and once had a nasty bruise on her forehead when she fell face down climbing out as I pushed the stroller. She loved the leash. It had a cute monkey backpack. She loved the freedom of being able to wander around and I loved that she couldn’t get too far.
Parents have a number of ways to put phone numbers on their kids in case they get separated. Some simply put in on a piece of paper and trust that it will stay in a pocket until it’s needed. Others write it in sharpie inside a piece of clothing or even on a child’s arm. You can have jewelry engraved with name and phone number, much like a medical alert bracelet. Just look at Etsy or Pinterest and you’ll come up with ideas!
It’s a great idea to take pictures of everyone each morning in case someone gets separated from the group. Not only will you have a current picture for authorities to see what they look like, but you will also know what they were wearing at the time they were lost.
The great news is that air travel is much safer from an infection standpoint than it used to be. Newer airplanes have HEPA filters that make a complete air change approximately 15 to 30 times per hour, or once every 2-4 minutes. The filters are said to remove 99.9% of bacteria, fungi and larger viruses. These germs can live on surfaces though, so I still recommend using common sense and bringing along a small hand sanitizer bottle and disinfectant wipes to use as needed. Wipe down arm rests, tray tables, seat pockets, windows, and other surfaces your kids will touch. After they touch unclean items sanitize their hands. Interestingly, sitting in an aisle seat is considered more dangerous, since people touch those seats during boarding and when going to the restroom, so if you’re seated in the aisle pay attention to when surfaces need to be re-sanitized. Sitting next to a sick person increases your risk, so if there is an option to move if the person seated next to you is ill appearing, ask to be moved.
Most adults who have flown have experienced ear pain due to pressure changes when flying. Anyone with a cold, ear infection or congestion from allergies is more at risk of ear pain, so pre-medicating with a pain reliever (such as acetaminophen) might help. If you have allergies be sure to get control of them before air travel. The best allergy treatment is usually a nasal corticosteroid.
It has often been recommended to offer infants something to suck on (bottle, breast or a pacifier) during take off and landing to help with ear pressure. Start early in the landing – the higher you are, the more the pressure will change. Older toddlers and kids can be offered a drink since swallowing can help. Ask them to hold their nose closed and try to blow air out through the closed nostrils followed by a big yawn. If your kids can safely chew gum (usually only recommended for those over 4 years of age) you can allow them to chew during take off and landing.
Airplane cabin noise levels can range anywhere from 60 – 100 dB and tend to be louder during takeoff. (I’ve written about Hearing Loss from noise previously to help you understand what that means.) Use cotton balls or small earplugs to help decrease the exposure, especially if your kids are sensitive to loud noises.
Learn about cruise-specific opportunities for kids of various ages. Many will offer age-specific child care, “clubs” or areas to allow safe opportunities for everyone to hang out with people of their own age group. Cruises offer the opportunity for adventurous kids to be independent and separate from parents at times, allowing each to have a separate-yet-together vacation. Travel with another family with kids the same ages as yours so your child knows a friendly face, especially if siblings are in a different age group for the cruises “clubs”.
Talk to kids about safety issues on the ship and make sure they follow your rules. They should always stay where they are supposed to be and not wander around. There’s safety in numbers, so have them use a buddy system and stick with their buddy. Find out how you can get a hold of them and they can get a hold of you during the cruise.
Of course sunscreen is a must. Reapply often!
Be sure kids are properly supervised near water. That means an adult who is responsible for watching the kids should not be under the influence of alcohol, shouldn’t read a book, or have other distractions.
Car seats (for planes, trains and automobiles)
I know it’s tempting to save money and not get a seat for your child under 2 years of age on a plane, but it is recommended that all children are seated in a proper child safety restraint system (CRS). It must be approved for flight, but then you can then use the seat for land travel.
I always recommend age and size appropriate car seats or boosters when traveling, even if you’re in a country that does not require them. Allowing kids to ride without a proper seat will probably lead to problems getting them back in their safe seat when they get back home. Besides, we use car seats and booster seats to protect our kids, not just to satisfy the law.
So… my section header was meant to be cute. Trains don’t have seatbelts, so car seats won’t work. But they are a safe way to travel. Car Seat for the Littles has a great explanation on Travel by Train.
When should pregnant women and new babies avoid travel by air?
A surprising number of families either must travel (due to a job transfer, death in the family, out of state adoption, or other important occasion) or choose to travel during pregnancy or with young infants.
Newborns need constant attention, which can be difficult if the seatbelt sign is on and needed items are in the overhead bin. New parents are already sleep deprived and sleeping on planes isn’t easy. New moms might still have swollen feet and need to keep their feet up, which is difficult in flight. Newborns are at high risk of infection and the close contact with other travelers can be a concern. And traveling is hard on everyone. But the good news is that overall young infants tend to travel well.
It is advisable to not travel after 36 weeks of pregnancy because of concerns of preterm labor. Pregnant women should talk with their OB about travel plans.
Some airlines allow term babies as young as 48 hours of age to fly, but others require infants to be two weeks – so check with your airline if you’ll be traveling in the first days of your newborn’s life. There is no standard guideline, but my preference would be to wait until term babies are over 2 weeks of age due to heart circulation changes that occur the first two weeks. Waiting until after 6 weeks allows for newborns to get the first set of vaccines (other than the Hepatitis B vaccine) prior to flight would be even better. Infants ideally have their own seat so they can be placed in a car seat that is FAA approved.
Babies born before 36 weeks and those with special health issues should get clearance from their physicians before traveling.
Overall traveling with an infant is not as difficult as many parents fear. Toddlers are another story… they don’t like to sit still for any amount of time and flights make that difficult. They also touch everything and put fingers in their mouth, so they are more likely to get exposed to germs.
Who wants to be sick on vacation? No one. It’s easy to get exposed anywhere during the cold and flu season, so protect yourself and your family.
Teach kids (and remind yourself) to not touch faces – your own or others. Our eyes, nose, and mouth are the portals of entry and exit for germs.
Wash hands before and after eating, after blowing your nose, before and after touching eyes/nose/mouth, before and after putting in contacts, after toileting or changing a diaper, and when they’re obviously soiled.
Cover sneezes and coughs with your elbow unless you’re cradling an infant in your arms. Infants have their head and face in your elbow, so you should use your hands to cover, then wash your hands well.
Make sure all family members are up to date on vaccines.
Everyone over 6 months should have a flu shot if it’s flu season (fall-winter).
Take pictures of your passport, vaccine record, medicines, insurance cards, and other important items to use if the originals are lost. Store the images so you have access to them from any computer in addition to your phone in case your phone is lost.
Have everyone, including young children, carry a form of identification that includes emergency contact information.
Create a medical history form that includes the following information for every member of your family that is travelling. Save a copy so you can easily find it on any computer in case of emergency.
your name, address, and phone number
emergency contact name(s) and phone number(s)
your doctor’s name, address, and office and emergency phone numbers
the name, address, and phone number of your health insurance carrier, including your policy number
a list of any known health problems or recent illnesses
a list of current medications and supplements you are taking and pharmacy name and phone number
a list of allergies to medications, food, insects, and animals
a prescription for glasses or contact lenses
Last, but not least: Enjoy your vacation!
Don’t overschedule. Your kids will remember the experience, so make moments count – don’t worry if you don’t accomplish all there is to do!
Take a look at some of the Holiday Health Hazards that come up at vacation times from Dr Christina at PMPediatrics so you can prevent accidents along the way.
Take pictures, but don’t make the vacation about the pictures. Try to stay off your phone and enjoy the moments!
As a working mom myself, I have at times struggled with the guilt of not being around for every new milestone, class party, or other occasion. Working parents can make time to have time with their kids.
There are the stay-at-home vs working mom “Mommy Wars” that I don’t want to get into because these options are unique to every family.
I know that working is the right choice for me on many levels.
I like that my kids have two hard-working parent role models that also spend quality time with the family.
Do things always flow smoothly?
Of course not. We have a crazy, hectic life.
Every stage has had it’s own problems to conquer, and once we get into a routine it settles for a bit.
Then the life stage changes and we adapt.
At this point I thought my life would be less crazy (my oldest is away at college and my youngest drives), but it’s still crazy aligning schedules.
Life with little kids
When my children were younger, it was really hard to get home, get dinner on the table, and get them to bed on time for a good night’s sleep.
Young children need 11-12 hours of sleep, and when we get home at 6:30 pm, it’s really hard to do anything.
I became the queen of 15 minute meals and love my crock pot. My quick cooking is probably even healthier than fancy casseroles because it’s a basic heated frozen vegetable, stove top cooked chicken or a quick fish, and noodles or rice. No fancy cream sauces or cheesy goodness weeknights.
Sometimes my kids ate leftovers from the previous night so they could eat within minutes of getting home.
Whatever worked at the time to get dinner served quickly so the bedtime routine could start was what happened.
It takes a village
We only have two kids, and are fortunate to have two parents, but sometimes we still needed help from friends to get kids to scheduled activities on time.
I am a big believer in being there at games or shows, but it’s impossible with more than one child and overlapping schedules to be at everything.
We tried to alternate which child’s activity we do, though my husband went to more hockey games and I went to more dance activities because, well, we’re human and he can only watch so many dances and I had a hard time watching my son get thrown against the boards.
It is important that kids know parents are there for them, even if they aren’t physically able to be there all the time.
The best way to do that is to show kids. When you’re together, really be together. Don’t keep checking your phone. Make conversation. Make eye contact. Have fun.
Sneak in quality time any way you can, even if it’s just a minute or two.
Talk on car rides.
Make routine trips no-screen rides.
On longer trips consider an audiobook that you can all listen to and discuss along the way.
Make eye contact when your kids ask for your attention.
Even if you’re busy making dinner or doing the dishes, be considerate enough to look at them when you’re speaking to them.
So often we get upset by our children’s manners, but we forget who they’re modeling after.
Definitely at bedtime make the time to connect.
Those night time stories, back rubs, and cuddles are the perfect time to bond.
Even when your kids can read, take time to read to each other.
Find quick games to play after dinner.
Many games list the time it takes to play right on the box.
No one has time for Monopoly after dinner if they plan on getting the kids to bed on time, but family games are a great way to connect, and kids learn many skills from playing.
It sounds silly, but kill two birds with one stone. Have a family “clean time”- and make it fun.
The house needs to be cleaned or picked up regularly and if everyone pitches in with age-appropriate chores, it gets done more quickly.
Brag on your children’s effort and build their confidence.
Go to the games, recitals, and events
Try to be at activities as much as possible.
If they’re in a recital, they want you there. If they have a big game, they want you to see it. Even if they say, “it’s okay” when you can’t go, they want you there.
I know it’s not possible to be there for everything, especially if you have more than one child and you need to alternate between which activity you go to, but try to be at as many things as you can.
Even when it’s painful to watch the first season of kid-pitch baseball. And if you must take a pain reliever before going to the band concert for your 4th grader. Still go.
Make the time with them with them
Turn off your cell phone. Don’t check e-mail or social media.
Set a good example and talk with the people you’re with.
So many studies are being done that show parents ignoring their kids due to electronics.
You have time to check email after your kids go to bed when they’re young. When they’re older and their bedtime rivals yours, you can find time when they’re doing homework or when they’re at an activity.
No need to ruin family time with work, social media, or other things that can be done when you’re alone. I cannot stress the importance of this. Don’t miss your real life and your children’s lives by wasting time on screens.
Family meals are important
Study after study shows the benefits of eating together.
Take the time to talk.
Turn off the tv.
Keep the phones away from the table.
If your family gets stuck with conversation, try some conversation starters or the story game where someone starts with a sentence, then the next person takes it from there.
So often we have a list of tasks we know we must accomplish, but our kids can sense the rush. Take a deep breath and enjoy the moment with your kids.
Take 10 minutes to do whatever your child wants.
Read a book.
Color a picture together.
Just 10 minutes a day can make a difference. Make it a tradition, something your child looks forward to every day.
Don’t strive for perfection
And finally, remember that no one is perfect.
Some days just won’t work out as planned. That’s okay.
Just don’t let every day become that over-rushed day.
Stop the guilt
I see far too much guilt in parenting.
Guilt because you choose to give baby a bottle.
Guilt because you want your baby to sleep through the night.
It never ends.
I think one big driver of guilt is social media. We see into other people’s lives on Facebook, Pinterest, Instagram or Twitter and compare it to our own. The posts are usually the best parts of their life, but we forget that everyone has the parts they aren’t showing.
Everyone wants to be like someone else on some level. We all have dreams and aspirations to improve. Great. Keep bettering yourself. But don’t suffer from guilt of choices you’ve made. If they are working, great! Keep them.
If they aren’t working, investigate other options and make a positive change. In 4 S’s of Being a Confident Parent, Dr. Escalante discusses the trials parents face and errors parents make and why that’s okay.
I think that when people have such strong opinions about anything, it is a set up for failure.
Attachment Parenting can lead parents to feel guilty because they aren’t always there for a child.
You know what? It’s healthy to have alone time.
Parents need to do things with other adults and leave the kids with a trusted adult or mature teen babysitter. It’s just healthy. If you don’t take care of yourself, you won’t take as good of care of your family as you can if you are healthy in mind, body, and spirit.
Enjoy time with your kids.
They won’t be little forever. Make the time to be present in their lives.
One last thought… Here’s an old song that I always think of when I think of busy lives: Cats in the Cradle from Harry Chapin.
Area flags are at half mast today as we are mourning the loss of innocent lives from another mass shooting at a Texas church over the weekend. We are sad for grieving families once again. What we can do to protect ourselves and our loved ones from random violence and acts of hate?
My kids have been on lockdowns at their schools on several occasions over the years. Our kids are getting used to lockdown drills and even real events. Thankfully none of the local school lockdowns turned tragic. Being a parent who cannot do anything while a school is in lockdown is stressful. Not knowing what is happening during a lockdown when my children are most likely sitting on a floor of a crowded dark room is terrifying. My kids have never felt that scared, even when it’s a real lockdown, probably because they’ve practiced and feel prepared. For many kids this seems to be the case, but I’m sure there are some who start having separation anxiety or other manifestations of trauma-related stress.
Today my front office staff saw policemen with weapons in hand enter our building and run down the hall. They did not come into our office.
We locked our front door, closed the blinds, and kept patients in exam rooms. We saw several police cars in the parking lot for our building and those near ours.
Because I was only in the office for meetings on my “day off” I was able to help tell staff and patients what we knew. I helped bring some of the families into the office. I checked Facebook and Twitter repeatedly to find out what was going on. (But I didn’t grab these screenshots until hours later.)
I had planned on updating our social media, but couldn’t find any real information to post.
At one point we were told they apprehended someone in a creek area behind our building and got the all clear to open back up and let people leave.
A few minutes later we were told to put our building back on lockdown. No one knew what was going on.
Our receptionists covertly monitored the parking lot for patients so they could get the door for them – we didn’t want families stuck in a potentially dangerous parking lot. Several patients called that they would be late to their appointments because police had blocked one of the roads into our parking area.
I am very proud of my staff and the families that were in the building. Everyone remained calm. No one complained that they were told to not leave the building. I didn’t hear anyone complain when the rooms started to fill, which affected the flow of seeing patients. I must admit that I didn’t really feel scared during all of this, since it seemed like police were all over and our office felt secure. It was frustrating not knowing what was going on, but the anxiety was much worse when the potential shooter was near my children’s school and they were on lockdown.
It is sad that a false alarm like this must be taken seriously. I’ve heard that it was just a man with a stick. Or maybe it was just a prank. No one really knows at this time.
But what I do know is that there are many good people in this world. We can help each other in times of need. We can support one another. Mr. Rogers says:
When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.”
When you have to explain these things to your children, remember to keep it simple. Answer their questions, but don’t go deeper than they’re ready to go. Find out what they already know and help them to understand it in ways that mean something to them. Try to keep the news off when kids are in earshot and monitor their screen time online. It’s okay to share your feelings, but try to reassure their safety and list some positives, like Mr. Rodger’s mother did.
Resources for parents to talk to kids about tragic news, such as mass shootings: