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Childhood Asthma: Part I

Asthma is the most common chronic disease in children and is responsible for more school absences than any other childhood disease in this country. It is a disease with a long history and is surrounded by much misconception and fear. Asthma is constantly being studied in the medical community which leads to new methods of diagnosis and treatment.

What is Asthma?

 Asthma is a disease characterized by repeated, mostly reversible episodes of wheezing. The symptoms of asthma are the end result of a series of reactions occurring in the body set off by a variety of causes. These causes vary from true allergy to specific substances in the air, to emotions, to exercise, to plain old colds. The tendency to develop asthma may very well be an inborn trait present from birth but the final common pathway of observable events remains child with inhalerthe same: the development of small airway narrowing (bronchioles) with a decreased ability to move air in and out of the lungs, slowing down the normal process of exchanging oxygen from the air for carbon dioxide from the body through the lungs. The reasons for this narrowing are related to inflammation in those airways with the production of mucus, and muscle spasm surrounding the airways: all have the effect of narrowing these airways. Oxygen is needed by every cell in the body in order to carry on the process of metabolizing various products that we use every minute of every day.

When the inability to properly exchange these gases is recognized by the body, a series of changes immediately takes place to make the system work better. Because each breath brings in less oxygen, the rate of breathing increases so as to equalize the gas exchange rate. We see that as breathing faster in the child with an asthmatic attack. Since the air that does get in and out must go though narrower airways, a person having an asthma attack must use accessory muscles (such as abdominal and even neck muscles) to help breath, and we see that as working harder to breath, and may even hear it as a whistling sound as the air is forced through narrow spaces (wheezing). Cough is produced as a reflex to the various changes in the airways. As the lack of gas exchange progresses there are further changes that can lead to failure of the lungs to do any of the work.

Needless to say, it is important to recognize the symptoms of asthma and treat vigorously.

How to recognize asthma

Many children will have wheezing during the first two years of life and this is usually part of a viral respiratory infection. This child will usually not have wheezing at any other times. A small percent of these children will develop true asthma over time but at this time it is difficult to tell who they will be. Many children outgrow this type of wheezing and therefore many physicians will withhold labeling a child with “asthma” until at least 2-3 years of age. There is also several other types of “asthma”. Some children with allergies develop wheezing secondary to exercise – or exercise induced asthma (especially in cold weather). Others might just have a persistent cough without wheezing for no apparent reason and might eventually be diagnosed with “cough variant asthma”.

What to do

If your child has already been diagnosed with asthma you will already know most of the information in this article. If your child has had a few previous episodes of “wheezing” or seems to be “wheezing” for the first time and your child’s breathing is not normal (remember the symptoms mentioned above), you will need to call your Doctor for further information and treatment.

What else can be done?

There are many ways to treat the symptoms of asthma and get these under control. There are also many ways to control and prevent the episodes of asthma and therefore the aim of treatment is to relieve and prevent the symptoms, allowing your child to be normally active and to enjoy all the activities of childhood without breathing problems. These treatments are very effective, and the well educated family unit blends with the medical home to produce excellent outcomes and many fewer episodes leading to sickness and missing school.

Note:  Childhood Asthma: Part II will deal more specifically with the diagnosis and treatment of asthma

What You Need to Know About Car Seat Safety? Ask a Fireman

Being a firefighter, I come across a lot of situations that make me shake my head in wonder. The one that my fellow firemen and I continually come across is installing and checking car seats and the many interesting and creative ways people have managed to improperly install a car seat. Whether you are the SUV with a few seats that have been installed for a while, or the new dad sweating on the way to the hospital stopping at the fire station asking the nice firemen to install your brand new seat, there are a few things that need to be taken into account when choosing your car seat and then installing your car seat.

What choice could matter more than that of the one your child is going to be sitting in as you motor around town? Choosing the correct car seat for your new baby or young child requires some homework and label reading.

First there is price. Car seats come in all price ranges, from free at some local fire stations and community organizations to very expensive with extra padding, lights and toys. Just because a seat costs more does not make it a better seat than the one next to it. Check online at places like www.consumerreports.com or www.safekids.org to find out how these seats compare to one another will give you better insight as to the correct choice for you and may even surprise you.

Next is the correct size seat for your child. This is the part about label reading that I mentioned before. Car seats are designed with a specific weight and height in mind for each seat and making sure the seat is the correct size for your specific child maximizes the safety of the seat for your child. Seats that are too big may allow for too much room for movement and seats that are too small may make your child uncomfortable and ultimately unsafe. Car seats should be securely snug but not a tourniquet.

Installation. Having your brand new car seat is wonderful and having it installed correctly is the most important factor of all. Where can I go to have my new car seat installed? There are many places that will correctly install your new car seat by using certified installation experts that have been trained on many different types of vehicles and the important points of each type of vehicle. You may want to call your local fire department or hospital for information on places to go for installation and you can also consult websites like www.safekids.org or the national highway traffic safety administration website http://www.nhtsa.gov to find installation centers in your area and may even find info on installation events going on in your area right now.

If you have any questions about a soon to be purchase of a car seat or the one that is in your car right now, please feel free to stop in at any fire station and ask for a check. We may shake our head but we love knowing your kids are safe.

God Bless!

Little One is on the move!!! Uhhhh….where’s the dog???

Baby Boy Playing with toy as puppy watchesThis is such an exciting time… and an exhausting one. You “safely introduced your dog to your new baby’ and established some guidelines to keep everyone safe (see ‘Your New Baby Safely Met Your Dog … Now What???) and so far everything has been going really well. Your baby is growing by leaps and bounds… and learning something new every day. But just as you started to get the new routine down pat, Mother Nature throws a monkey wrench into this perfect dynamic .Your child’s rate of development seems to be at warp speed, and before you know it, they have learned to crawl. In the blink of an eye they’ve gone from a very slow lobster crawl, to moving faster on hands and knees then you can on two feet! You just can’t seem to catch them! But there is a potential danger here…. The dog can… with ease!

As I did in my last article, I feel it is important to give you some insight into the dog’s mind, and also ask some very thought provoking questions to you, and then offer some ‘canine behavior’ awareness in more detail afterwards.

  1. What is the difference, in a dog’s mind, between a baby that ‘runs’ on all fours, and a pup that does the same thing, other than one has no fur or tail?
  2. How does the dog know the difference between baby’s toys and theirs? Both of their toys seem to be either hard plastic, soft plastic, or plush (stuffed).
  3. What sets off the ‘chase instinct’ in a dog?

So the answer to the first question is pretty obvious…. There is no difference in the dog’s mind. This is why it is so important that YOU teach them that there is a difference. When a pup wanders off, the mother dog picks them up by the scruff (the extra skin) on the back of their necks to bring them back to where they want them. So for this reason, it is important to still monitor their interactions, and make sure they are never alone together.

One of the things I teach my customers with infants is to really accentuate the “DOWN” command whenever they are around the baby. Now I do realize that some people say “DOWN” when a dog jumps on them, but I am referring to them physically lying down. (I often recommend to my customers to use the words “OFF” when a dog jumps, and “DOWN” to lie down, so they do not get confused.) This is especially important for two reasons: To make sure baby doesn’t get knocked over and hurt, but also, it helps to focus your dog. Dogs cannot multi-task; they can’t focus on your command and on the baby at the same time.

To teach “DOWN” first get your dog into a “SIT” position to start. Then, hold a treat between your thumb and pointer fingers, hold your palm facing the floor, and slowly lower your hand towards the floor, keeping the treat right in front of their nose. If they lose interest and look away, bring the treat back up to eye-level to re-capture their attention, and do it again, all the while saying, “DOWN” until they are fully lying down, and then tell them, “YES! GOOD DOWN!” and give them the treat.

I recommend that you practice this often, so when you give him the DOWN command and he is around the baby, he knows the command is not a suggestion or a request, but a direct order from his superior that must be obeyed immediately. To explain the importance of practicing this regularly, I ask my customers, “Why do they run fire drills in schools for the kids?” Because they don’t want to wait until a true emergency actually breaks out and ‘hope’ that the kids will know what to do! Think of how relaxed you will be if you know without a doubt that if you tell your dog ‘DOWN” he will do it immediately.

The second question is a bit trickier, but is important because for most of us, the saying “Possession is 9/10ths of the law” holds true. But to both dogs AND babies, possession is ten-tenths of the law. It can be potentially very dangerous for a baby to see a toy, assume it is theirs, and go to grab it… especially if it is in the dog’s mouth! The simplest solution would seem to be to keep the dog’s toys in one room, and the babies’ toys in another, but in reality, I have never found that to work. The baby goes through house with toys in their hand, and deposits them everywhere and anywhere, and the dog does the same in their mouths. At times, I arrive at a customer’s house, look around at the hundreds of toys scattered everywhere, and wonder if I myself could distinguish which toys belong to which species!

One trick I have given a few families that seems to work very well is to dip the toys belonging to the dog in some bullion soup. (For stuffed animals, just dip a small corner of it. That is sufficient for a dog’s sensitive nose.) This gives it an added flavor that they love, and they tend to play mostly with those. Just remember to wash and re-dip them weekly…. You don’t want them to get stinky or to attract bugs.  Another option is to get a wire rimmed basket for the dog’s toys and a toy chest for your child’s toys. Make sure the right toys go in each basket every night before bed, and get into that routine. When your child is a bit older, and can understand a bit better, (and no longer puts everything in their mouths) you can use a black magic marker to mark your child’s toy.

The final issue… baby moving at warp speed; crawling on all fours, can easily set off the ‘chase instinct’ in your dog. I have two cats. One of my cats is never bothered by the dogs… they never chase him. However, the other one is always being chased. Why is this? Because my male cat does not get nervous or scared by the dogs, and if they look or bark at him, he ignores them… so they leave him alone. My female on the other hand, gets scared and goes to run away… and the same dogs that ignored my male cat, go chasing after her. So how do we combat this? By reinforcing earlier commands with the dog… “GO TO YOUR PLACE” and “DOWN/STAY” are important ones to really enforce, but you can also add a new one: “IGNORE.”

To teach IGNORE, get your dog on a leash, put him in a down/stay position, and have someone roll a ball in front of him. If he goes to give chase, give a quick and firm tug on the leash and say, “IGNORE”. Do this a few times until he is completely non-reactive, and then either treat and praise, or play and praise with one of HIS toys. (I want to point out that at this point your baby is copying everything you do… so please remember, you’re “rolling the ball” to the dog… not throwing it. The last thing you want are items going airborne at your dog!)

In the end, adding a few new commands to your dog’s routine (and a few new tricks for you to try) is a great way to both make sure he behaves appropriately around your little one, and also make sure he continues to get the attention and mental stimulation he needs.  Happy dog…happy baby…safe home.

So I will wrap this post up a bit differently from my last ones… and ask your input. Apparently, I stumped some of the best trainers in the world by asking for their input on how they go about distinguishing a kid’s toy from a dog’s. So I would love to hear from those of you who have raised your kids (and your dogs) already through this stage…how did you successfully keep the toys separate???

Shy Doesn’t Have to Mean Alone: Help Your Shy Kid Join the Fun

If your child is shy, chances are he was born with a more introverted, sensitive personality. So this is not about trying to turn him into an shy girlextrovert. After all, you can’t change your child’s personality and natural temperament. But you can help your child learn the skills he needs (and deserves) to feel more comfortable and confident with other kids. And that is doable because of this fact: shyness doesn’t have to be debilitating. So let’s focus on what you can do to enhance your kid’s abilities to find, make, and keep friends. Here are secrets from THE BIG BOOK OF PARENTING SOLUTIONS to help a shy child fit in and feel more comfortable in social situations.

  1. Model eye contact. One of the most common traits of well-liked kids use is that they use eye contact. In fact the average person spends 30 to 60 percent of the time looking at the other person’s face. As you’re talking with your child say: “Look at me.” or “Put your eyes on my eyes.” or “I want to see your eyes.” If your kid is uncomfortable about using eye contact, tell her: “Look at the bridge of my nose.”
  2. Praise prior success. It’s natural for a shy child to focus on past failures. So help her recall previous experiences when things went really well. “Remember last year’s swimming lessons? You begged not to go, but did and met a new friend.” “Before you went to Sara’s birthday party last month you wanted to stay home. But when you agreed to stay at least a half an hour and you ended up one of the last ones to leave.”
  3. Reinforce smiling! One of the most common characteristics of confident, well-liked kids is that they smile and smile. So whenever your child displays a smile, reinforce it: “What a great smile!” or “That smile of yours always wins people over.” Also, point out how your child’s smile affects others: “Do see how kids smile back when you smile?” “That little boy saw your smile and came over to play. Your smile let him know you were friendly.”
  4. Debrief a stressful event. If your kid has had a really embarrassing attack of shyness find a time to discuss what happened and she could handle it better next time. “It sounds like you really didn’t like being with so many kids. What if you only invite one friend at a time?” “So what really bugged you was asking Kevin face to face. Why not ask him on the phone next time?”
  5. Reinforce any social efforts. Any and every effort your child makes to be even a tad more social deserves a pat on the back: “I saw how you walked up to that new boy today. Good for you!” “I noticed that you really made an effort to say hello to Sheila’s mom. She looked so pleased!”
  6. Schedule warm up time. Some kids take longer to warm up in a social setting, so give your child time to settle in. Be patient and don’t push too quickly. Let her watch a bit, figure out what’s up, and set her own time frame to join in.
  7. Help him fit in. All kids need to feel as comfortable as possible when they’re with their friends. So make sure your son or daughter has a cool hair cut, the “in” pair of sneakers, backpack, jacket, or pair of jeans. It can make a big difference in boosting a kid’s comfort level.
  8. Rehearse social situations. Prepare your kid for an upcoming social event by describing the setting, expectations, and other kids who will be there. Then help him practice how to meet others, table manners, making small talk, and even how to say good-bye. Doing so will decrease some of the anxiety he’s bound to have from being in a new setting. Hint: A shyer child often feels less threatened practicing social skill with a younger, more immature kids than children his own age.
  9. Create One-To-One Time. Many kids can be overwhelmed in groups, so limit the number of friends to one at a time. Then gradually increase the number as she gains confidence.

Remember: your role is not to try and change your child’s basic temperament and personality but instead to help him warm up, open up, and join the fun having friends can bring. Simple, little changes can reap big results.

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Dr Borba’s new book The Big Book of Parenting Solutions: 101 Answers to Your Everyday Challenges and Wildest Worries, is one of the most comprehensive parenting book for kids 3 to 13. This down-to-earth guide offers advice for dealing with children’s difficult behavior and hot button issues including biting, tantrums, cheating, bad friends, inappropriate clothing, sex, drugs, peer pressure and much more. Each of the 101 challenging parenting issues includes specific step-by-step solutions and practical advice that is age appropriate based on the latest research. The Big Book of Parenting Solutions is available at amazon.com

Special Siblings: How a Child Sees Special Needs

The other day my three children and I got into a discussion about special needs kids. They all go to a charter school with a mission statement of inclusion, and many special needs students are enrolled there. There are “paras” in each class – paraprofessionals who assist these special students. Each class has space for three special needs children. My 6-year-old son commented that his kindergarten class only has two of these kids.

I was shocked. His class does have three special needs kids – the third one is his twin sister!  I told him this gently, not wanting to make a big deal about it. But he argued with me, saying that his sister didn’t need any help like that. The other two students in his class can have extreme behavior even though they have completely different conditions.

Since they are twins my son came along to every therapy session, doctor’s appointment, assessment and specialist. He was right there beside her for the entire journey – special equipment, toys, bottles, shoes and more. People came in and out of our house to work with her. We went to an inclusion mommy and me program and preschool. But he doesn’t remember most of it since he was a baby. As he got older, I guess he didn’t question it. I know he and his older brother get a little jealous because the rules are sometimes different for her, but for the most part she is just their sister.

For more on siblings of special needs kids:

  • Check out the book by Holly Robinson Peete and her daughter at Amazon.com
  • Here is a great article from the University of Michigan on Siblings of Special Need Kids
  • Article from New York Times 2006
  • Also, most Counseling centers and Regional Centers have support groups for siblings

If you have a special needs child have you dealt with situations like this?

Flossing Your Kid’s Teeth – Just 3 Simple Steps

I have talked a lot about the importance of good oral hygiene and starting healthy habits with your kids at a young age. Hopefully you now know the importance of kids starting their daily routines at a young age. This includes not only tooth brushing but also flossing.

Flossing is a step that a lot of parents neglect because they don’t understand the importance or it feel like too much work. However, you should start flossing your kids teeth between 2 and 3 years of age. They will need your help for a few years but don’t even be surprised if they are 8 years old when they can finally floss without any assistance.

Why floss you ask? Flossing is very important for several reasons. First of all it removes plaque that builds up between your child’s teeth and secondly it removes plaque from the gum line. Neither of which a tooth brush will typically be able to reach.

Flossing should be done at least one time per day and shouldn’t take much longer than a couple of minutes. If you have detailed questions about what to do, consult your child’s dentist.

A few little tips that may make flossing more exciting for young children is to find flavored or colored floss and let them pick out their favorite. This will help them be anxious to use their floss.

3 Simple Steps:

  1. Use approximately an 18 inch strand of floss
  2. Let them wrap their floss around their middle fingers on both hands
  3. Gently guide the floss in between each tooth moving it around the tooth and on under the gum line on each side

This is also a great time to make sure Mom and Dad get their daily flossing in! As always, we teach best by setting an example. Make a few minutes at the end of your day to floss with your children for happier, healthier smiles!