Last updated 9 months ago
There is no question that bullying in schools has been on the increase in the last few years. The question is how to prevent it. Recently, an article was published that identified risk factors for bullying in grade school students. The risk factors identified were gender (being male had a higher risk), hostility, low parental involvement, exposure to media violence, physical victimization and prior physical fights. The article went on to say that having one or two risk factors didn't significantly increase a child's risk for violence, but 3 or more was associated a great increase in risk.
The article made headlines, because it mentioned exposure to media violence as a risk factor. It emphasized this finding, as this is a factor for bullying that can be manipulated, or changed. You cannot change whether or not a child was in a fight in the past, but you can limit his exposure to violence. I agree that this can and should be limited. However, several other risk factors can be manipulated. The other 2 risk factors that should be considered are low parental involvement and physical victimization. These 2 risk factors for bullying include such things as exposure to domestic violence, a history of child abuse and absent or disinterested parents. It may come as a shock to you that some parents are truly disinterested in the task of being a parent, but I have met many. I assure you, it shocks me every time I meet one.
The article on bullying came close on the heels of another article. This one demonstrated a link between spanking in childhood and adult mental disorders. You should note that this article does not refer to a little swat on the bottom, but to the routine use of force for discipline.
America must get control on the bullying epidemic that is plaguing our nation. I agree with the use of profiling to see which students are at risk for such behaviors, but only if it is used to get them counseling. I agree that our children see way too much violence in the media and their exposure should be limited. However, we as parents need to ban together and go even further. It is time that the bully, the bullied and the bystander and their parents sat down together. We cannot expect our children and their teachers to solve this alone. Parents have to get involved. Parents have to take a stand and set limits. Some parents may have to change their own behaviors. Research the problem and what you can do. Make a plan, then follow through. You'll be glad you did.
For the good of the children
~Dr. Nan N~
Last updated 10 months ago
When you need quick tips for healthy and safe summer activities, consult Dr. Nan’s Pediatric Solutions for telemedicine and general pediatric services. Contact us online or call (620) 330-8188. For more health information, see the recommended articles listed here:
Last updated 10 months ago
Weaning your baby from the bottle or breast is an important early developmental milestone. Hopefully, it will come somewhere after sleeping through the night and before potty training. Ideally, It is a process, and works best if you follow your baby's lead. Many parents dread weaning their infant to a cup. They envision temper tantrums, power struggles and sleepless nights. Breastfeeding moms may not want to give up the nurturing of nursing. Starting early and allowing your baby to lead the process will avoid much of this.
Many physicians, myself included, recommend introducing a sippy cup at 6 months of age. By 6 months of age your baby, even if breastfed, should be learning about solid foods, water and juice. A sippy cup is a natural part of this, and the first step toward weaning. Your baby is eager to try new things and will treat their sippy cup as a new toy. Experiment with different types of cups. Some infants want a sippy cup with a spout, others prefer straws. Some like handles and others don't. Most like bright colors and cartoon characters. Try a variety of sippy cups to see what your baby likes best. This will make weaning fun for both of you.
Initially, you may want to put only water in the sippy cup. As your baby becomes used to the cup, try juice as well as formula or breastmilk in the sippy cup. Your baby will be less anxious about weaning if they know the cup contains their usual formula or breastmilk. Many breastfeeding moms are reluctant to do this. That is understandable. This is not something you need to do daily. However, if you try this once every 2-3 days, you will find time to do other types of nurturing such as reading to your baby. Also, keep these colorful cups out where baby can see them. Keep bottles out of sight. This way, when baby is thirsty, she will ask for the sippy cup, rather than the bottle.
Eventually, the time will come to stop using the breast or bottle. Pediatricians and dentists recommend this occur between 12 and 18 months of age. I recommend trying to complete the process by 15 months. Waiting longer seems to make weaning more difficult for everyone involved. Start by using the sippy for all beverages except first thing in the morning and again at bedtime. This will be a gradual process for breastfeeding moms. Substitute one episode of nursing for one by sippy cup at the same time each day, the first week. The following week, substitute 2 feedings a day with the sippy cup, and so on. For bottle fed babies, you will eventually put nothing but water in the bottle. This makes in uninteresting and less desirable. Most babies will still need a little push to get rid of the nighttime breast or bottle feeding. A regular nighttime routine that includes a bath, a story and some snuggle time helps tremendously. You will need to let your baby lead you through the timing of this process. Don't make big changes when your child is ill or teething. Avoid doing these things when you are moving, traveling or changing jobs. Above all, remember that you are not alone: if you have problems or questions, contact your pediatrician.
Here are some other articles that might be helpful:
Let me know if there is anything I can do to assist you.
~Dr Nan N~
Last updated 10 months ago
When the weather heats up outside, it’s time to get in the pool and enjoy summer swimming! To help your child stay safe while in the pool, there are some important strategies to remember about reducing the risks posed by water. Drowning is among the most common adolescent injuries and is a leading cause of fatality in America’s younger population. Below are some ways in which you can ensure that drowning and other aquatic injuries don’t occur.
Know your child’s swimming ability: If your child is not a confident or strong swimmer, encourage her to stay away from the deep end of the pool. Young children should wear inflatable flotation gear to help them adjust to swimming. You might also consider swimming lessons to help your child move with more skill in the water.
Never let children swim unsupervised: An adult should always be actively engaged in monitoring children when they swim. Knowing CPR is beneficial in the event an emergency does occur, and courses are available to help you acquire the necessary training for CPR certification. Residential pools should be surrounded by fences with locked gates so that the water cannot be accessed when an adult is not present. Even the shallow end of the pool can pose a drowning risk, so don’t assume that kids in shallow water can swim unsupervised.
Set rules for all swimmers to follow: Make sure the rules for swimmers are clear to everyone, and include rules concerning the area surrounding the pool. Avoid falls and spills into the pool by discouraging rough play and running near the pool. Only swim when the area is well lit and the weather is clear so that the risk of an accident is minimal.
Understand more about summer safety and get tips to keep your kids healthy with Dr. Nan’s Pediatric Solutions. Schedule an appointment or get health information over the phone by calling (620) 330-8188.
Last updated 10 months ago
It is good to see so many physicians jumping into social media venues such as twitter, facebook, and LinkedIn. However, few medical schools or hospitalizations are offering education in how to use these tools. I'm no expert but, as a physician, I'd like to offer my thoughts on this issue, especially with respect to twitter.
Before you open an account on twitter, or any other social media venue, think about what you will and will not do. Set your own personal ground rules. Then, check with your institution. Read their social media policy and talk with their CIO about the institution ground rules. If your institution doesn't have a social media policy, consider helping them write one. I also suggest you read the blogger code of ethics. Check with your specialty's governing body to see their recommendations. For example, the AAP has a nice piece entitled "Making the Most of Social Media." Also, think about what you want to say. What is your voice? Do you want to be comical or educational? Are you reaching out primarily to patients or to colleagues? Will your tone be negative or positive? It is much easier to answer these questions before you start posting information.
There are some basic things you should learn about twitter. First and foremost, don't tweet anything until you have followed for awhile. Follow others in your field to get a feel for what is being discussed and how to use the site. To find people to follow, search #health, #FF and join chat rooms. Also search for specific topics that interest you by using hashtags. Read the twitter rules on how many people you can follow vs how many are following you. To get others to follow you, post information that is interesting, and be polite. Remember, social media is social. Use your manners. Thank others for following you, for mentioning you and for retweeting your posts. I don't recommend you use twitter to blast your colleagues, your institution or your patients. While controversy is good for getting attention, this practice will cause you to lose followers in the long run.
One dilemma is where to find content. Of course, you can write a blog and create all your own content. That would probably a full time job. Many people repost things that they have read on other venues, found in articles or seen on the news. Some use a combination of these types of sources. You should use what feels most comfortable to you. Don't invest any more time than you have. Again, do what is comfortable. If it starts to feel like work, then cut back.
Don't forget that there are many platforms for social media in medicine. They play off each other. A moderate amount of exposure on several different platforms can be more effective than high exposure on a single platform. Twitter, facebook fanpages and LinkedIn can all play off one another. Facebook fanpages and personal websites may allow for more dialogue with your patients. HealthTap gives you access to potential patients outside your practice. Doximity and Google + can be great ways to connect with colleagues. Explore your options.
There are many benefits to using social media. One is search engine optimization, or SEO. This leverages your social media presence to make you more visible to patients and potential patients. Today, more patients go to the internet to look for a physician, than to the yellow pages. Utilizing SEO can make your name show up on the first page of their search. It is also an excellent tool for patient education. This can be done without violating HIPAA by discussing disease entities rather than case studies or individual patients. Information about a specific disease, disorder, or commonly asked patient question can be answered once and posted to several platforms. Patients can then go to these platforms and search for this information at a later time or at their convenience. Social media is also a great way to find and interact with colleagues. Some platforms, such as Doximity, are specifically for interaction among colleagues. Several of the twitter chat rooms are for colleagues more than patients, such as #MDchat, #hcsm and #hcsmvac. I encourage you to familiarize yourself with some of these and find your best fit.
Social media is a smorgasboard. Don't shy away from it. Learn you and your institution's ground rules, then sample a few things and see what you like. We will all be better for your participation.
~Dr Nan N~