Is Your Child A Proud Member of The Picky Eaters Club?

Written by Melissa Arca, MD., FAAP – This post appeared originally on Dr. Arca’s blog Confessions of a Doctor Mom. Dr. Arca is a pediatrician. She works part-time while raising her two young children, Big Brother (age 6) and Little Sister (age 3). She is passionate about writing and writing about motherhood, parenting, and children’s health is what she does best. Dr. Arca blogs regularly at Confessions of a Dr. Mom

Having a picky eater seems to be the norm these days. I’d almost dare to say that children between the ages of 2-7 more often than not wind up in the picky eater category.

Why oh why the sharp jump in membership of The Picky Eaters Club during this time? Researchers believe it could be evolutionary. That way young “cave toddlers” wouldn’t walk around tasting every potentially dangerous thing in sight. Can you imagine? Still, there are far more factors involved here: genetics, personality, and family eating habits to name a few.

My son is no exception. He is a proud card carrying member of The Picky Eaters Club and I am a reluctant member by association, trying to sway my son in another direction.

It all began at the ripe old age of 2. Previously my baby boy would gobble anything placed before him: peas, squash, avocados, blueberries, you name it. I was proud as could be, snapping up pictures of his cherub face smothered in green bean puree.

Then at the age of 2, it was like a switch was turned off (or on, depending on how you look at it), and he was suddenly suspicious of everything that was placed before him.

Pancakes, orange juice, and chocolate milk seemed like the only foods acceptable to his new found sensitive taste buds.

This sent me in a crazy spin for awhile. I wondered what I had done. Certainly I must have caused this sudden disdain for all things considered healthy. I was convinced it was because I introduced bananas first. Or, that I failed to introduce the veggies in the proper order.

Worse yet, I figured I must be missing the magic mommy touch. You know, I didn’t have the finesse to cajole, coerce. or otherwise threaten bribe my child to eat well.

I know (now) that none of that is true. He is five now and I finally took a step back and realized there is only so much I can do. I can’t force feed the kid.

Although I admit, the thought had crossed my mind. I finally made a mental list of the things I could do and stuck to those. The rest is up to him and his discerning palate.

I continue to offer him his daily dose of veggies. All I ask is that he give them a try. It’s up to him whether or not he eats the rest. Did you know it can take up to 10-15 times of being offered a new food before a child will try it? Except, in my son’s case, it’s more like a 100 times…I’m still waiting.

He’s old enough to understand that his body requires a balanced diet. We talk to him about needing protein, fiber, and the good vitamins found in fruit and veggies.

He gets it. Hopefully one day it will sink in enough to not gag at the mere sight of broccoli.

Getting upset at him because he won’t eat the peas on his plate won’t make him want to eat those peas. He knows that he must taste them. Then, we move on. No long drawn out bribing session. We do encourage and praise his efforts though.

I have to admit I still do modify his meals somewhat. If we’re having spaghetti and meat sauce, he gets plain spaghetti with Parmesan cheese and a side of chicken. This is a kid who used to scarf down spaghetti and meat sauce at 18 months old…and yes we have a picture of that too!

Him being a picky eater has nothing to do with my mothering ability. Thankfully my daughter taught me this. At age 3, she is a much more adventurous eater and will gladly eat carrots, broccoli, edamame, and tomato soup. I can’t take credit for that either. Just the luck of the draw really.

I remind myself to look at the big picture. Instead of dissecting what he eats at each meal, I look at how he eats over the course of the week. Some days are better than others but overall, I am usually surprised to discover that he covers most of the dietary bases.

He continues to broaden his food horizons over time. It’s not overnight and I give him a multi vitamin to fill in the gaps. I hope someday he will allow a green vegetable past the obligatory “no thank you” bite. However, I am confident that his membership in The Picky Eaters Club is not lifelong.

So my fellow reluctant members of The Picky Eaters Club, take heart, it won’t last forever. I promise. One day you’ll wake up and find your formerly picky eater can’t get enough of your famous beef stew with peas and carrots.

Are you dealing with your own picky eater? Have you found ways to enjoy mealtime in spite of it?

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Pink Eye: Is it all the same?

Written by Melissa Arca MD

I get so many questions from parents about this, mostly it goes like this: “ewww…I hope it’s not pink eye!”

Pink eye is one of those afflictions that causes us to squirm, think “oh no!”, and inspire us to wash our hands a million times throughout the day. Most of us tend to hide away inside our homes until the icky looking discharge oozing from our child’s eyes disappears.

So, what exactly is pink eye, and what do we truly need to do about it? Not all pink eyes are created equal. Only half of the cases in children are truly bacterial.

Here are some quick facts about pink eye:

  •  Pink eye is a general term for what we pediatricians call conjunctivitis.
  • Conjunctivitis is the inflammation of the mucus membrane of the inner eyelids.
  • Conjunctivitis can be caused by viruses, bacteria, environmental allergies, or a topical irritant.
  • Viral conjunctivitis in young children is very common, especially during the summer.
  • Viral conjunctivitis will go away on it’s own, without antibiotic drops.
  • Only bacterial conjunctivitis needs to be treated with antibiotic eye drops.

How do we know if it’s bacterial conjunctivitis?

  • With bacterial conjunctivitis, the eye discharge is more likely to be yellow/green and “icky”.
  • Children with bacterial conjunctivitis often wake up with their eyes “sealed shut”.
  • Can be associated with an accompanying ear infection.
  • These cases need to be treated with antibiotic drops.
  • A child with bacterial conjunctivitis may return to school 24 hours after initiation of treatment and obvious signs of improvement.

Five factors pointing to a non-bacterial culprit for conjunctivitis:

  • The child is older than 6 years old
  • It’s summer time: viral conjunctivitis is more common during the late spring and summer months.
  • The discharge from your child’s eye is clear, watery, and may or may not be associated with allergy symptoms such as sneezing and eye itching.
  • No yellow/green eye discharge
  • Child does not wake with his eyes “sealed shut”.
  • If your child meets most of the criteria above, her conjunctivitis is more likely due to a virus or may be part of her allergy symptoms.

Tips for Treatment and Prevention:

  • Be vigilant about hand washing. Both viral and bacterial conjunctivitis are extremely contagious.
  • HAND WASHING. It’s worth repeating.
  • If it’s bacterial and your child is prescribed antibiotic drops, finish the designated days of treatment.
  • In most cases, treat both eyes even if only one appears to be infected at the time. Young children will inevitably spread it to the other eye. Avoid the ping pong effect.

Tip for antibiotic administration: have your child lie down, it’s okay if her eyes are closed. Place the drop in the inner eye, near the nose. Once your child starts blinking, the drops will enter the eye.

Look for the signs above, consult with your pediatrician, and above all…keep on washing those hands.

Dr. Arca is a pediatrician. She works part-time while raising her two young children, Big Brother (age 6) and Little Sister (age 3). She is passionate about writing and writing about motherhood, parenting, and children’s health is what she does best. Dr. Arca blogs regularly at Confessions of a Dr. Mom

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Parenting Advice, a Guide or How to Manual?

Written by Melissa Arca MD

Driving through narrow, winding roads on a wet and cold afternoon, I wonder (silently) if we are going the right way. After our second near miss of a head on collision, I speak up. “This doesn’t seem right”, I finally say, more than a little perturbed.

“I know, but the GPS says we’re almost there.”

I want to shout out about how dumb the GPS must be and that we could clearly have been there already if we had just looked out our window, used our common sense, and followed the signs. I know I don’t need to speak the obvious. He already knows what I’m thinking. I’m certain he is thinking the same thing.

Then it hits me, right there on that narrow, winding road, how much parenting advice is like this GPS. As parents we want to do things “right” by our children. We seek out advice from books, from experts, from google, and from friends. And, while that advice can be helpful and much needed at times, we have to remember that parenting advice is meant to be a guide, not a how to manual.

I’ve definitely been led astray myself when I felt compelled to do things by the book. I was certain that if I just followed the steps laid out before me, my child would be sleeping through the night, using the potty, and eating a variety of healthy foods.

In my quest for finding the “right way”, I got lost. I forgot to look at my child, use my common sense, and follow my motherly instincts. I forgot to read the signs that my child was giving me. Now, I know a little better. I know that there are many paths to take in this parenting journey. Some roads might be narrow and winding and perhaps not the best way for my child. Others may be smooth and straight, with only a few bumps along the way.

My job as mom is to figure out the best road to take for my own child. To remember to look up from my book, magazine, or computer and see the signs right in front of me. The ones that will ultimately lead me in the right direction because they are the ones given to me by my child.

Dr. Arca is a pediatrician. She works part-time while raising her two young children, Big Brother (age 6) and Little Sister (age 3). She is passionate about writing and writing about motherhood, parenting, and children’s health is what she does best. Dr. Arca blogs regularly at Confessions of a Dr. Mom

3

Should I Ditch the Pacifier?

Written by Melissa Arca, MD

My baby girl, who is on the verge of turning three, has three big loveys in her life: blankie, paci, and bear. And I, nor she, are in any rush to give them up. Still, the question creeps in from time to time…Should I ditch the paci?

With my firstborn, my son, I felt pressured to wean him by a certain age. Mostly because I was a first time Mom and Pediatrician and felt I should do things “right”. So I was all proud as could be when his paci was completely weaned by the time he was two. Even at that age I felt I waited too long.

Well guess what went along with the pacifier? Nap time. Now I would NOT call that a success story. I would call that a painful mistake. He never went back to his daytime naps after that. Why oh why did I hold firm? I should have just gone out and bought another one.

Now, here I am, a bit more experienced. More comfortable with my mothering and doctoring abilities. The Mom side of me knows the comfort it provides my daughter while the Doctor side still wants to make sure I’m not overlooking any potential harm.

So in my effort to answer my own question, I’ve decided to have a conversation about the paci…with myself. Yes you heard me right…Mom and Doctor discussing the whole pacifier issue. Bear with me, it should be good…

Melissa: Do you think it’s time to wean my daughter from the pacifier?

Dr.Mom: Why? Does her pacifier use bother you?

Melissa: No, not really.

Dr.Mom: Does it bother your daughter?

Melissa: No. Actually, it is a great comfort to her.

Dr.Mom: What is your concern about the pacifier?

Melissa: Well, I’ve read that it can interfere with speech development.

Dr.Mom: Does your daughter have her pacifier in her mouth all day?

Melissa: No, she only uses it for nap, bedtime, and car rides.

Dr.Mom: And, have you noticed any impairment of her speech?

Melissa: No, she’s quite the talker.

Dr.Mom: Okay then…

Melissa: Well, I’ve also heard that it can effect the development of her teeth, is she going to have crooked teeth?

Dr.Mom: Well, she might but then again, she might not. The changes are usually temporary and self correct once the pacifier is no longer in use.

Melissa: Okay then…I won’t worry about it anymore.

Dr.Mom: One last thought Melissa

Melissa: Yes, Dr.Mom?

Dr.Mom: Honestly, when is the last time you’ve seen a child walk in to kindergarten with a pacifier in her mouth?

So there you have it…no I’m not going to ditch the paci…not for now anyway. I’m sure the day she’ll have to give it up to the paci fairy is just around the corner. I’ll let her lead the way and we’ll see how things go. It’s one of her comforts and as far as I can see, there is no harm…only comfort.

I really love how Joey from Big Teeth & Clouds put it: “…hang onto whatever she needs. Life is tough, we should use what we can to get by”. Fantastic point Joey and I couldn’t agree more.

So, tell me, what do you think? Did you feel pressure to ditch the pacifier by a certain age? If so, what did you do?

Dr. Arca is a pediatrician. She works part-time while raising her two young children, Big Brother (age 6) and Little Sister (age 3). She is passionate about writing and writing about motherhood, parenting, and children’s health is what she does best. Dr. Arca blogs regularly at Confessions of a Dr. Mom

3

The Toddler Who Refuses to Nap

Written by Melissa Arca MD

Toddlers and not napping are three words that never go well together. And yet, right around the ripe old age of two, many children start to put up quite the fight when it comes to naptime.

Does this mean they don’t need a nap? Should I make my child take a nap? Help, my toddler doesn’t nap anymore!

These are questions and pleas I hear all the time from mothers in desperate need of that one to two hour window of reprieve. Sleep is important for all of us, this much we know.

But, how exactly do we make a toddler take a nap? As you and I both know, we really can’t make a two year old do anything.

The art comes in the form of gentle coercion and setting the magical scene that will translate into a solid and predictable nap-time.

Sounds simple right? Believe me; I know this can be quite the struggle. My son gave up his naps right before he turned three. This seemed way too early for me, especially since I had a newborn on my hands and rest at that point was not just a luxury, it was a necessity. Unfortunately, his naps never magically reappeared. I cursed the nap gods but realized he was catching all the zzz’s he needed at night.

So while trying to determine whether naps are gone from your life forever or whether you’ve simply hit a bump in the road, the two questions you should ask yourself are:

how many hours is my child sleeping at night and is this enough?

Children between the ages of 2 and 4 need about 11-15 hours of sleep within a 24 hour period. This is such a huge range and if you’re lucky enough to have a child that falls on the latter end of the spectrum, your child will most definitely still be taking a midday snooze.

I, however, had a wonderfully active toddler who clocked 11 hours at night and apparently that’s all he needed. If I was fortunate enough to lull him into a nap, it always came at a price, namely a super late bedtime. So, I no longer enforced his naptime.

He (and I) still needed some down time during the day, so I starting scheduling quiet time (for both of us). More on that later.

Now that you’ve figured out how much your child regularly sleeps at nighttime, how do you know if that is enough, or if he still needs a nap? If he regularly shows you signs that he’s sleepy, such as eye rubbing, yawning, zoning out, or is easy to meltdown, then in spite of his resistance, naps should still be part of his day.

Create a naptime routine that is a mini version of his bedtime ritual. Give him fair warning too. Tell him that after his snack and some coloring, it’s time for a nap. Children this age refuse naps because they can.

It’s an opportunity for them to exercise some control over their world. By letting him know what to expect and prepping him with a naptime routine, he can better accept what is to come.

Still won’t nap? Start instituting quiet time.

Even if he’s ready to kick those naps to the curb, he would still benefit from some down time. You will too. Tell your resistant napper that he may play quietly in his room with books, cars, or puzzles. Let him know that you will set a timer and that he can come out to play after an hour.

I have been doing this with my three year old daughter recently as she has started to resist naps. About half the time, she ends up dozing off and on her own terms. Quiet time is completely working in our favor.

As you can see, nap scenarios vary from one child to the next. Some will stop napping at age two, while others will be on the verge of entering kindergarten and still crave a midday nap. The key is determining your child’s sleep needs and making sure she gets it within a 24 hour period.

The bottom line is this: nap or no nap, children and parents need down time during the day. Whether this comes in the form of a nap or quiet time will depend on the needs of both you and your child.

When did your child give up napping altogether? Did you benefit from some quiet time?

Dr. Arca is a pediatrician. She works part-time while raising her two young children, Big Brother (age 6) and Little Sister (age 3). She is passionate about writing and writing about motherhood, parenting, and children’s health is what she does best. Dr. Arca blogs regularly at Confessions of a Dr. Mom

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Back to School Illnesses… Please Don’t Spread the Lovebugs

Written by Melissa Arca, MD

First of all, realize it’s inevitable: Children will get sick. I have yet to meet a child in school who went the whole school year without coming down with something. That being said, there are measures we can take to lessen the chances of our children falling prey to some of these viruses.

First, I will outline 5 of the most common culprits causing illness in the preschool and school age child during fall and winter. Then I will give you some practical tips on containing these viral bugs.

Hand Foot Mouth Disease: This is most commonly caused by the coxsackie virus and peaks in the summer and early Fall. This virus affects mostly young children (children under 10). The symptoms consist of a fever, decreased appetite, and sore throat. Usually painful mouth sores develop on the tongue, inside of cheeks and back of throat. This may or may not be accompanied by the non-itchy skin rash on palms and soles of feet.

The Common Cold: Your child may be afflicted with this a few times a year. The most common culprit here is the rhinovirus though there are several different viral strains producing symptoms of the common cold. Hence, several colds can be caught during one season. The symptoms vary but most commonly include: stuffy nose, sore throat, cough, mild fever, and sneezing.

The Flu: Ahh… the dreaded flu. Influenza and its various strains cause the dreaded flu symptoms. As opposed to the common cold, the flu gives more pronounced and severe symptoms: high fever (usually over 100.4), sudden onset of symptoms, profound body aches, headache, and general malaise with decreased appetite. With the common cold, respiratory symptoms such as sneezing, congestion and cough are more prominent than in the flu. So far, the only preventive medical defense we have against this is the seasonal flu shot.

Strep Throat: Unlike the above conditions, this one is caused by a bacteria (Group A Strep.) and not a virus. So, this must be treated with antibiotics. So how do you tell the difference from a common sore throat (viral pharyngitis) and strep throat? Here are the key differences: strep throat involves a higher fever (usually above 101 F), red and swollen throat with possible pus formation, absence of cough, and swollen lymph nodes in neck. Strep throat may also be accompanied by abdominal pain, possible vomiting, and a body rash.

Gastroenteritis, aka the “stomach flu,” is caused by several different types of viruses, most notably rotavirus and adenovirus. The most prominent symptoms are vomiting and diarrhea. Some children may only have the vomiting, some only the diarrhea, and the unlucky ones will have both. This may be accompanied by fever and stomach ache. Having the so-called “stomach flu” does not mean you have the “flu” as in influenza.

I picked the above 5 conditions because they are by far the most common this time of year and they are highly contagious. There is just no way around it. Okay, so having thrown all that at you, what can you do to help minimize and contain these nasty viruses?

  1. Frequent hand washing is the number one way to help prevent the spread of these bugs. Encourage and teach your child to wash their hands several times throughout the day. Before eating, after using the potty, after playing outside, etc. Have them sing a song while washing to make sure they wash long enough (ABC song is a good one).
  2. Carry sanitizer. I always wipe my kids’ hands as soon as they get into the car from school. This time of year, it’s just a good habit. Wipe down shopping cart handles too.
  3. Encourage children to sneeze and cough into their arms or a tissue.
  4. Keep children home if they have a fever, are vomiting, or have significant diarrhea. Of special note: keep them home if they have eye drainage, this could signify a conjunctivitis and should be evaluated by a doctor.
  5. Teach them not to share drinking cups or utensils with their friends.
  6. By all means, sanitize the toys and personal items in your house after a bout with any of the above.
  7. Make sure your children get enough sleep, eat well balanced meals, and exercise regularly. All of these will help insure that their immune systems stay in tip top shape.

Treatment: Since the above, with the exception of strep throat, are caused by viruses, antibiotics will not help. Keep your child comfortable by treating their fever with a fever reducer. Give plenty of fluids and rest. With the stomach flu, keep your child’s diet bland and make sure they stay hydrated with small and frequent amounts of liquids.

Possible Complications: Secondary infections can set in following colds or the flu. Ear infections and pneumonia are common secondary infections. Watch for fever recurrence, chest pain, difficulty breathing, or worsening cough. Dehydration can set in following a bout of gastroenteritis. Stay on top of your child’s liquid intake. These conditions should be evaluated by your child’s pediatrician.

Do not hesitate to contact your child’s pediatrician whenever you’re concerned or have questions regarding your child’s health.

Good luck to all of you this fall and winter season. Unfortunately, these bugs will make their way into our households — just make sure your child gets plenty of rest, fluids, and love.

We’ve already battled a short bout of gastroenteritis and a nagging cold. How about you? Have your children been afflicted by any of these back to school bugs yet?

Dr. Arca is a pediatrician, mom of two, writer, and blogger who works part time in a community clinic while raising her two young children. She has become passionate about writing and speaking about motherhood, parenting, and children’s health. She is author of the blog, Confessions of a Dr.Mom and writes a weekly column in her local newspaper, The Sacramento Bee.