I've previously reviewed the trial parents encounter if they have a "P.U.R.P.L.E." baby at home.
I've described how the young infant has to LEARN not to squeeze the anal sphincter muscle as they have a bowel movement.
But there are other reasons they become so distressed as they're about to have a bowel movement after they reach one month old:
Fetuses don't have any bowel movements while growing inside their moms. So that when they are born and begin to have BM's, the strength of the intestinal waves that push the waste along toward the rectum is naturally weak, sluggish. These are muscles that have never been used before. But as the weeks go by, the intensity of the intestines' squeezing increases. The muscles being used every day get stronger and stronger. The baby is bound to FEEL the stronger PUSH of the waste through the bowel, and since it is a NEW feeling of cramping, it is likely to be UNCOMFORTABLE and SCAREY.
At the same time, the baby's BRAIN is "putting two and two together", and the baby becomes more alert, and MORE AWARE of the feelings on and inside its body. So, while the two week old baby might have a vague sense of discomfort when his gut squeezes swallowed food along, the six week old FEELS the cramp MUCH MORE INTENSELY. But the baby has NO IDEA what is happening, or why. It has NO MEMORY of what happened an hour ago, let alone yesterday. So when the baby feels strong pressure in the rectum before a BM, it feels like IT'S GOING TO DIE. EXPLODE. WORSE than appendicitis! Gradually, over a month or two (or three), she begins to remember the daily pattern of slight belly ache followed by a pushing out of the stool; one always following the other, and she realizes it's not a big deal after all. And the hysterical panic crying begins to ease a bit at a time. Little by little, the "P.U.R.P.L.E." baby, starts to shade into pink.
The title of this entry sounds scary. But it isn't at all.
My wife and I were watching a "health" special on Public TV (Channel 21) and the topic was "Living longer and WELL". Naturally, one of THE worst health problems of our time is obesity. So the docs were telling how they help their patients get into better shape: There are two prongs to the attack:
1) Daily exercise (even 1/2 hour of moving is enough); In March of 2013, a lady named Jill Vento of Des Moines, Iowa weighed 370 and was diagnosed with diabetes. She began to walk, a lot. (ten or fifteen minutes, three times daily) and has lost over 200 pounds! Her diabetes and sleep apnea resolved. And everyone at the airport knew her as "the smiling lady" because she was beaming with joy as she made her daily rounds, 5 days a week! Check out her story online (NOT FAKE NEWS!)
2) Better nutrition. That's the tough one; to a large degree because we always focus on what you CAN NOT eat. But if you eat a lot of good stuff, you won't be as hungry for the bad.
G-Bombs is the memory jogger for some REALLY good stuff, with each letter standing for a good group/type of delicious food:
Seeds! Every day, try to pile these onto your plate. You should cook them,
add them to other dishes, or snack on them.
And drink at least 2 quarts of water every day.
Today, most people know that eating yogurt is good for their stomach because of the beneficial live bacteria that's a major ingredient. Now scientists have shown that the bacteria in yogurt also affect Emotions and Behavior in a powerfully positive way.
An experiment was performed in which mice were placed in a bucket of water. Although mice can swim, they hate water and try desperately to get out of it. The scientists split the mice into two groups: Half of the animals were treated with the various bacteria that are found in yogurt by being fed the germs and the other half were not. When the untreated mice were dropped in the water, they swam around continuously for approximately four minutes, trying unsuccessfully to escape from the bucket and the water. Then they "gave up", floating without moving (although they didn't drown).
The mice that had eaten the yogurt germs kept swimming beyond 4 minutes, and 5 minutes, and 6 minutes! They would NOT give up.
How do we explain the difference in the two groups' BEHAVIOR? There is no reason to think the mice in the untreated group just "got tired". To put it in human terms, it seems like they became hopeless and were despairing after four minutes. So they stopped trying. But the bacteria group were like "Energizer bunnies" who kept Going and Going and Going! They didn't seem stressed; they were resilient and "hopeful" and persisted in trying to swim out of the bucket. It didn't matter that the task was impossible.
The scientists even proved HOW the bacteria made the mice more determined: If the experimenters cut the vagus nerve (which runs from the stomach up to the brain) before the swim test, it didn't matter if the animals got the bacteria. They still gave up after only four minutes of trying. So the vagus is required to bring the helpful signal to the brain in order for the Reslience Persistence Effect to be seen.
Hearing this story has affected MY behavior: nowadays, I eat yogurt EVERY DAY! We live in an unpredictable world where "speed bumps" and "roadblocks" could always be waiting around the next curve. I want to be at my best every day, ready to face whatever surprising challenges could be coming. And I want to be hopeful, and not even think about giving up when difficult problems arise.
So, unless someone has SEVERE MILK ALLERGY, I advise eating yogurt every day. And, for those allergic people, there's a new food product on the market called "Co Co Yo", which is made from coconut fermented with the same bacteria germs that are in yogurt. But it has no milk in its ingredients.
Our first daughter spoke at a very early age and we were so proud of her that we frequently prodded her to repeat what she'd said earlier that day when she was with our relatives or friends. After a week or two of our showing her off, we noticed that she was having some trouble when she'd begin speaking. There was a hesitation, and soon it appeared that something was BLOCKING her from speaking. She was struggling to get the first sound out when she wanted to speak. I quickly realized that she was having the beginning of stuttering and I knew it was important to help her immediately so the problem didn't get worse, or permanent.
I found a guide for helping children with mild stuttering and followed its recommendations:
Try to model slow and relaxed speech when talking with your child, and encourage other family members to do the same. Don't speak so slowly that it sounds abnormal, but keep it unhurried, with many pauses. Children usually can't help from acting the way they see people close to them behaving. So they will tend to imitate the slower, relaxed pace.
Slow and relaxed speech can be the most effective when combined with some time each day for the child to have one parent's undivided attention. Set aside a few minutes at a regular time when all you plan is to listen to your child talk about whatever is on her mind.
When your child talks to you or asks you a question, try to pause a second or so before you answer. This will help make talking to your child less hurried, more relaxed. (And the child will see that she, too, can take her time speaking when YOU are done.)
Try not to be upset or annoyed when stuttering increases. Your child is doing his best as he copes with learning many new skills all at the same time. Your patient, accepting attitude will help him immensely.
DO NOT tell the child to "slow down" or "take your time". This will likely make him MORE upset by his trouble. You can SHOW the child that they can slow down by patiently waiting and listening to them and looking at their face with love.
Don't put the child on display where they must perform to show off under pressure. Don't question them in a way that they must answer under pressure.
Make certain that when your child speaks to you, your focus is ONLY ON HIM. The child should NOT have to compete with computers, phones, TV's, or newspapers for YOUR ATTENTION. SHOW the child how important he and his ideas are to you.
The first surprise I had in my Dermatology Course at Johns Hopkins was learning that the experts believed NO FOOD caused a worsening of acne in teens.
I had been raised to believe that eating greasy foods, chocolate, and pizza were damaging to the skin. That turned out to be untrue when controlled experiments were done with volunteers.
Now some good research has shown that SKIM MILK will aggravate acne. Patients drinking skim milk tended to have worse complexions than those who drink whole milk, or low fat milk (and the subjects drinking whole milk were actually a bit better off than the low fat group). Some people using skim milk still had good skin, but it's something to consider if a young person is having acne problems.
I also have a suspicion that eating A LOT of orange vegetables and broccoli can be helpful. The Vitamin A in carrots, sweet potatoes, and butternut squash is chemically similar to the active ingredient in THE MOST POWERFUL acne medicine around, Accutane. So eating a bunch of those foods every day seems like a good idea for healthy skin. Even if it doesn't improve your skin, you will be healthier because you are eating them!
In his incredibly informative book Why Zebras Don't Get Ulcers, Dr. Robert Sapolsky, the famed Stanford neuroscientist and primatologist, explains that as animals age, they tend to have higher levels of cortisol, the stress hormone, in their blood.
A while back I discussed some baby safety issues in bathrooms and kitchens.
But let's not forget bedrooms and living rooms. A young infant can't be left alone on a bed. Not even a 3 month old on a king sized bed. The child can choose that moment to try her first "roll over", and roll right off the bed! (It happened to my daughter over 30 years ago; we were lucky as the floor had a thick carpet and she only got a small bump on the scalp.)
Coffee tables have no place in a home with a toddler. They are an accident waiting to happen! Whether glass or wood, the hard, unforgiving edge is an invitation to severe cuts, bruises, or knocked out teeth.
Getting outside is an adventure with babies but safety must come first. With kids riding in an automobile, you HAVE TO worry about the closing of the car door. We played a compulsive game with our daughters to always have their hands on their head when we were about to close their door. That is a good ritual to develop. And always, always, always, in their car seat.
We don't want to frighten children unless there is a powerful justification. But walking with a toddler outside in the suburbs can be really dangerous. We made it a rule with our little ones that they would hold the hand of a grown up. And we taught them from an early age that stepping off the curb was SCARY. We WANTED them to have fear of the roadway, because a toddler running into the roadway can end in tragedy. Once they get older, the kids can learn to cross the street with care and without fear.
Next we'll discuss playgrounds.....
I previously presented the new recommendation to offer peanut butter to young infants as published last year in the New England Journal of Medicine. Babies who eat peanut early and on a regular basis are much less likely to become allergic than if they wait until after their birthday.
What does the above quote from the bible mean? It is almost always referred to as justification for striking a child to teach them moral behavior. But the reference is to a shepherd gently GUIDING his/her flock with a staff, to point out the best way for the sheep to go. Hitting isn't necessary at all. "Limit setting" is an important part of parenting. But it can and should be done without violence. In fact, kids who live in homes where limits are clear and understood are usually happier, and feel more secure and safe. Kids understand that parents know what's best for them and the family.
The American Academy of Pediatrics published a position statement in 2012 clearly discouraging corporal punishment. There is no good reason to cause physical pain to a child in order to improve his/her behavior. There are GOOD reasons not to use corporal punishment:
In the mid 1990's, the Varivax vaccine was introduced to put an end to chickenpox. But was this necessary? If a vaccine were offered to put an end to "dandruff", would it make sense? Dandruff is an annoyance, but would we want another expensive, uncomfortable shot to give our kids?
I recently heard a lecture on breastfeeding that gave me an "AHA!" moment.
Unfortunately, a dark sad story to report:
Exciting news on the science of FOOD ALLERGY was just published in the prestigious NEW ENGLAND JOURNAL OF MEDICINE last month.
It's been the conventional wisdom to avoid giving peanuts to babies until after they turn a year old. Now it's been proven that the risk of peanut allergy is reduced by WELL over 50% by introducing it to the diet at around six months of age.
Interestingly, one of the mothers in our Practice shared with me that that has been the tradition in Israel for YEARS. And very few people there have peanut allergy.
Begin with less than a teaspoon thinly spread on soft bread. Always start a new food before noon, at least three days after starting any other new food. And always have Benadryl liquid in the home, just in case you see a reaction to the new food. It's easy to remember how much to give if a child has hives:
a 22 pound baby gets 1 teaspoon 4 times a day;
a 33 pound baby gets 1 1/2 teaspoons 4 times a day;
a 44 pound baby gets 2 teaspoons 4 times a day;
a 66 pound child gets 3 teaspoons 4 times a day.
The science shows that early introduction reduces the risk of developing peanut allergy ESPECIALLY IN CHILDREN AT HIGH RISK OF FOOD ALLERGY. That would be kids who have close relatives with allergies, or if the child already shows signs of sensitive skin (eczema, atopic dermatitis), or asthma.
The study that was conducted only looked at peanuts, but we'll keep a look out for reports on early introduction of other "at risk" foods, such as eggs and tree nuts (almonds, walnuts, pistachios).
Children don't come with a "Manual" on how to get the most out of them, how to enjoy them the most, or how to "fix them when they're broken".
Not many years ago, people were advised to eat foods with a lot of starch, as many as 12 servings daily. The problem with this strategy is that our ancient ancestors did not eat this way. There was VERY LITTLE STARCH in their diet because until about 10,000 years ago, there was NO AGRICULTURE. That means no wheat, rice or potatoes. If you believe in evolution and natural selection, that means our ancestors had to grow and thrive for HUNDREDS OF THOUSANDS of years on a diet LOW in STARCH. Since the genetic make-up of animals changes very slowly, that means WE are genetically engineered to eat a diet low in starch. On the contrary, most Americans LIVE on STARCHY foods: bread, pasta, potato, rice, corn, and sugary sweets make up a huge part of what we eat.
The Paleolithic (or Old Stone Age) Diet is becoming popular today, as people attempt to use our ancient ancestors as role models for making healthy nutritional choices. This Diet avoids the starches, and also DAIRY products. Because humans only domesticated animals and began drinking cow milk and eating cheese or yogurt about 10,000 years ago.
What DID the "cavemen" eat? They were "hunters and gatherers". They picked fruit and nuts off the trees. (And those fruits WERE NOT NEARLY as sweet as ours are today!) Ate lots of meat as animals were plentiful. Took eggs from bird nests. Caught fish. May have dug up some WILD root vegetables. Eating these foods kept our species alive for hundreds of thousands of years. Without fruit juices or soda.
And everybody had THE SAME JOB: Looking for food. From rising at dawn, until lying down at dusk, we were usually hungry and searching for food to survive. (Just like the birds and squirrels do today.) AND we moved around. A lot. It's believed that when early humans searched for food, they didn't walk or stroll. They jogged or ran as much as five miles a day. Covering more ground in a day gave them a better chance to be successful in their hunt.
What did humans NOT HAVE before ten thousand years ago? NO ONE suffered from Celiac disease (also known as gluten sensitivity enteropathy). Because there was NO GLUTEN TO EAT. No bread. No pasta. Today there are communities with up to ONE PER CENT of the population with this dangerous disease.
Cow milk protein allergy affects up to 3% of my newborn patients. If the baby isn't changed to a "hypoallergenic" formula, they become seriously ill with violent vomiting and diarrhea, often becoming bloody. Simply changing the formula cures them almost without fail. It's wonderful that 97% of babies can tolerate cow milk. But it's not surprising that 3% become ill when exposed to a foreign protein, "intended" to be only consumed by calves.
So if you believe the old saying: "If it ain't broke, don't fix it!" has merit, consider changing your daily menu closer to the one that successfully kept us around for a very long time in the wilderness.
There are as many personalities in children as there are children. Some are very "mellow", easy-going and calm. A few children are VERY sensitive and become wildly emotional when they are frustrated or experience a sudden unpleasant shock/surprise.
It's very exciting to see your infant getting around by herself; but it should also be a bit anxiety-provoking. With the new mobility comes a degree of danger.
It's essential that you "baby-proof" your home to reduce the risk of injury to your baby. But you must remember that there is still no substitute for adult supervision. Almost every accident that happens (whether minimal or tragic in consequences) occurs DESPITE precautions in place. All swimming pools are fenced in; medicines have "child-proof" caps; electric sockets are plugged. But every year we hear horrible new reports of baby injuries.
Kitchens are the most dangerous place in the home. One should always use the back burner on a gas/electric range so baby can't pull a hot pot down. But more importantly, there should be a compulsive rule that baby is NOT ANYWHERE NEAR the range when food is cooking. When my baby was three years old, my wife was boiling spaghetti and dropped the pot on her arm, getting a severe burn. Thankfully, we had the baby sitting safely at the kitchen table where she belonged. Drawers with silverware and knives, as well as glass casserole dishes in cupboards need "kinder-locks". We had ONE cabinet in our kitchen without a lock. The pots and pans were stored there and our toddler spent hours at a time banging and playing with them. For her, there was only one cupboard in the room; for her, the locked doors didn't even exist!
All sockets need safety plugs so that baby can't stick a pin into live electricity. Electric wires must be kept away from babies. They explore by mouthing objects. If they bite into a live wire, the mouth burn injury can cause a permanent disfiguring scar.
Bathrooms are not safe for an unescorted baby. A fall on the hard tile is likely to cause a fracture or laceration. Family members' medicines could be poison to an overdosed baby who thinks that they are candy. A baby could fall into a toilet and drown. Drownings occur in bathtubs as well. The door should ALWAYS BE LOCKED.
to be continued.......
Allergy is a condition in which a generally harmless (or healthful) substance injures a person because of the way they react to being in contact with it.
More people suffer from allergy today than ever before. The exposure to the offending substance can be contact with the nasal lining, the eyes, the lungs (from inhaling it), the skin, or the mouth (when eating it).
The symptoms of food allergy can vary in people, and in the same person over time.
Many foods can be the cause of allergy. The eight most common culprits are
Peanuts (which are not "nuts" at all, but legumes like peas that grow in the ground)
Other foods commonly responsible include chocolate, berries, tomatoes, apples,
With a mild food allergy, the lips and gums may feel swollen and itch. This is called "oral food allergy syndrome" and should be taken seriously as it can progress to full blown severe symptoms. Frequently the feeling will leave on its own or with swallowing an anti-histamine allergy medicine such as Benadryl. It is wise and logical to AVOID any food that you can connect to such a reaction.
A severe food allergy reaction can be life threatening. The victim may later describe having the sense of "doom" upon them. The throat and upper airway may swell so that breathing is impossible. Blood pressure and circulation can fail sending the patient into "shock". Without immediate treatment, they can die. To buy time so the patient can get to a medical center for help, people who are known to have a severe food allergy are given an "epi-pen" to carry with them. If they have a severe reaction they inject themselves and the adrenalin it contains can give them relief for fifteen or twenty minutes. It is urgent that they head for a hospital after they've had the epi-pen injection. The attack can resume even more severely as the adrenalin wears off.
Again, AVOIDANCE is the main strategy to prevent the illness. Friends, relatives and restaurants must be notified of the patient's problem.
I'll review inhalant allergens in my next post.
When I was 18 years old, I taught a friend how to ride a bicycle. He was 19 and had not learned earlier because his mother was afraid he'd be injured riding. So she kept the family in their apartment across from a schoolyard his entire childhood. That way, he'd always have a place to play nearby and have no need to learn. But then our gang started playing tennis - at courts that were two miles from our homes. Mark had a choice of a forty minute walk or a bus ride to join us at tennis. It was a pain for him. So he decided to finally learn to ride a bike - and I got to teach him. I wasn't sure how it would go. I wasn't sure that I'd be able to teach him, or how long it would take. To my pleasure, it was easy and didn't take more than a half hour.
I taught my first daughter to ride at age nine. She wanted to learn because lots of kids on our block were riding every day and she wanted to be one of them. I can't remember actually teaching her because it was easy, uneventful.
My younger daughter was eight years younger. Although she enjoyed having a bike, she insisted on keeping her training wheels on until she was ten years old. There were no kids on our block now (so she had no motivation to keep up with her friends), and we lived on a hill. It's hard to learn on a hill: tough to go up, scary to go down! We decided that we'd seriously try to learn on the Fourth of July weekend. We went to a parking lot with plenty of empty spaces and began. I was in my late 40's. This is a problem because the teaching involves running alongside the child on the bike, one hand on the steering handlebar and one hand behind the child on the rear of the seat, to keep the bike steady and upright.
As we began "the learning" that day, I promised her that she would be successful. I guaranteed that she'd be riding a bike on her own before she went back to school in September. I had no idea how long it would take her to learn. I didn't want her to feel like a failure if she still hadn't learned to balance a week or more after we'd begun practicing. So I set the deadline target date way, way in the future.
So we started going around the parking lot: she was peddling and I was running alongside. I quickly sensed that she was tilting away from me. That didn't feel good. I felt as if she would tip over if I didn't pull hard to tilt the bike back toward me. But despite my strong pulling on the bike seat, the bike continued to angle away from me. It was a puzzle. Why was the bike leaning over away from me?
Suddenly, a light went on over my head: Juliette was leaning over to the right, away from me, because she felt the bike being pulled over (by me!) and she was compensating adjusting for that force. What should I do? We couldn't go on the way we were. I was really out of breath! Then I realized what I had to do: I had to stop pulling on her seat; I had to let go of the seat! A small weak part of me was terrified: "But if I let go, the bike will tip right over!" But my gut knew that wasn't true. If she stopped feeling my pulling her toward me, she could ride centered and straight up.
So I secretively removed my hand from the bike seat, continued to run alongside with my hand on the handlebar, and watched the bike straighten right up and balance evenly!! Juliette was riding a bike. She was successful. I was successful. WE were successful. Then she noticed from our shadow on the parking lot tarmac that my hand was not on the seat. "Daddy, you promised not to let go!!" I shouted back that I was sorry but had to let go or suffer a heart attack. She yelled with joy as she revelled in her flight, as she pedalled away from me. Then she screamed in panic that she didn't know how to stop! (But she did fine with a soft landing.)
What is the point of my little tale? It is this: For this father and daughter to agree to begin the project of "learning to ride", there had to be in place four testaments of faith. Juliette had to trust that her father was competent to teach her and that he would not let her get hurt. I had to trust that Juliette would be capable of learning to ride. Juliette had to trust herself; that she would be able to ride the bike alone. I had to trust in myself, that I was up to the task of helping her succeed in this "rite of passage". And life is filled with similar challenges that must be met head on: Learning to tie your shoes, to recite the alphabet; learning to swim; learning to skate and to cook and to go on a first date. A good portion of the joy of parenting is in the ushering of one's child along the road of achievement and growth.
The dreaded nightmare of the teen years: draining fatigue with a terrible sore throat, huge "kissing" tonsils coated in pus, so bad that the youngster can't swallow his/her own saliva(!), severe nausea/abdominal pain, with insomnia mixed in for good measure...