Monday, June 23rd, 2014
A meeting of a sub-group of the American Academy of Pediatrics (AAP) that studies childhood resilience and the effects of toxic stress heard from a number of experts who all urged doctors to practice versions of the same advice–make understanding of the parent-child relationship a priority, and do that by modeling and teaching parents good listening skills. Too many doctors, the group heard, work with stressed out kids (on a rushed timetable, at that) without offering holistic support for the families, which includes understanding the mechanisms of how stress affects parents as well.
Toxic stress is chronic, unrelenting stress that can have serious and ongoing health effects on kids (and parents). More on the AAP’s prescribed “two generation approach” to helping families cope from The Boston Globe:
People need to feel safe to be able talk about what is important. This includes both the clinician and the parent. When the pediatrician feels stressed by a waiting room full of patients that the current system of care demands he must see, he is not able to be present with a parent in the way that careful listening requires.
It is like a set of Russian dolls. The society values the clinician’s time, offering the opportunity to listen to the parent, who listens to the child. And as many at the symposium recognized, it is not just pediatricians, but also child care workers, teachers, home visitors and others who have the opportunity to support stressed parents. All policy needs to be focused on protecting space and time to listen. Listening is not high tech. But it is this space and time, where parents feel safe and valued, that we have the opportunity to grow healthy brains and minds….
….when parents, who may be stressed and overwhelmed, feel heard, recognized and understood, they are better able to do the same for their child. When parents listen to their child, are fully present with their child, they offer the opportunity build resilience and the capacity to manage adversity. It is not about giving information, or even about teaching skills. It is about supporting parents’ efforts to connect with their most competent self.
Image: Stressed-out mother, via Shutterstock
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Tuesday, February 25th, 2014
The American Academy of Pediatrics has issued a policy statement urging parents not to use medical clinics at retail stores like CVS or Walgreens as their children’s primary care resource. More from Reuters:
Retail medical clinics, first opened in the U.S. in 2000, have popped up in grocery stores, drug store chains and “big box” stores. There were more than 6,000 such locations in the country as of 2012, according to the policy update published in the journal Pediatrics.
Representatives from Walgreens and CVS, both national drugstore chains with associated medical clinics at some locations, largely agree with the AAP guidelines and do not encourage people to use their services as primary care.
“We strongly encourage all patients to have a relationship with a primary care physician and medical home for ongoing medical needs and routine exams,” Walgreens spokesman Jim Cohn told Reuters Health.
The statement only refers to the types of clinics that are built into other businesses, not freestanding “urgent care” clinics, which have also grown in popularity and have some of the same drawbacks.
According to the authors of the statement, taking kids to retail clinics instead of primary care pediatricians fragments care, since the kids don’t always see the same medical provider. A child could have chronic ear infections or other long-term medical problems that seem to the providers at various retail clinics like unrelated single events.
Image: Mom and child at pharmacy, via Shutterstock
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Wednesday, December 18th, 2013
Raw milk–milk that has not been pasteurized–may carry serious health risks and should be avoided by pregnant women, infants and children, the American Academy of Pediatrics (AAP) is saying in a new policy statement. More from The New York Times:
Although the sale of unpasteurized milk products is legal in 30 states, the academy says that the evidence of the benefits of pasteurization to food safety is overwhelming, and that the benefits of any elements in raw milk that are inactivated by pasteurization have not been scientifically demonstrated.
The report, published Monday in Pediatrics, notes that many species of harmful bacteria have been found in unpasteurized milk products, including Listeria, Salmonella, Escherichia coli and Cryptosporidium, among others.
In a study published last week in Emerging Infectious Diseases, researchers estimated that over the past 10 years in Minnesota, where raw milk is legally sold, more than 17 percent of those who consumed it became ill.
“There are no proven nutritional advantages of raw milk,” said a lead author, Dr. Jatinder Bhatia, the chief of neonatology at Georgia Regent University in Augusta. “Further, raw milk and milk products account for a significant proportion of food borne illnesses in Americans. There is no reason to risk consuming raw milk.”
The AAP also advises avoiding raw milk cheeses for the same reasons.
Image: Cow, via Shutterstock
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Tuesday, October 29th, 2013
The American Academy of Pediatrics is recommending that kids who suffer a concussion, a common sports-related injury, shouldn’t return to school right away, lest they exacerbate the temporary symptoms of concussion that relate to learning and retaining information. More from Time.com:
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Although children may appear to be physically normal after having a concussion, they may actually have trouble learning new information and retaining it. Going back to school may exacerbate these symptoms, according to the American Academy of Pediatrics (AAP) in a new clinical report presented at the AAP National Conference & Exhibition in Orlando.
Research shows that it takes about three weeks for a child to fully recover from a concussion. If their symptoms are especially severe, they should stay home from school. Even though kids with concussions may appear asymptomatic, they often report difficulty focusing on schoolwork and taking tests, especially in math, science, and foreign-languages. Medical experts are worried that too much learning stimulation can overwhelm a brain that is still recovering, and make it even more difficult for a child to get back on track. If systems are mild, parents can consider sending their kids back to class, but should inform teachers about the concussion so adjustments can be made to the pace of the class if needed. The researchers call this necessary step, “cognitive rest.”
Wednesday, October 2nd, 2013
A growing number of families are bed-sharing, or having their infants and young children sleep in bed with their parents, despite warnings from health experts that the practice increases the chances that a baby could die of Sudden Infant Death Syndrome (SIDS), suffocation, or entanglement. A new government-funded study shows that bed-sharing has doubled over the past 17 years. More from USA Today:
The increase was most notable among African-American infants, according to the study reported Monday in the journal JAMA Pediatrics.
Overall, the percentage of nighttime caregivers who reported that an infant usually shared a bed rose from 7% in 1993 to 14% in 2010. Among black infants the proportion increased from 21% to 39%. Among white infants, it rose from 5% to 9%. Among Hispanic infants, it rose from 13% to 21%.
“The disparity in nighttime habits has increased in recent years,” said lead author Eve Colson of the Yale University School of Medicine in a statement. “Because African-American infants are already at increased risk for SIDS, this trend is a cause for concern.”
Advice from physicians could significantly reduce infant bed-sharing, also known as co-sleeping, for all families, finds the survey of nearly 20,000 caregivers conducted by researchers with the National Institutes of Health and others. Caregivers who perceived physicians’ attitude as against sharing a bed were about 34% less likely to report that the infant usually shared a bed than were caregivers who received no advice.
To reduce the risk of SIDS and other sleep-related dangers, the American Academy of Pediatrics recommends placing babies to sleep in the same room as the caregiver, but not in the same bed.
Image: Bed-sharing family, via Shutterstock
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