All posts by Brian Orr

Scheduling Babies

So many parents with new babies are told, “get your baby on a schedule. Things will be a lot easier and you will get more rest.”

The problem with this advice is that it comes too early and without enough information. When babies are born, they schedule us and we do not schedule them. We need to follow their lead. For three months they should be spoiled. After three months children can learn some scheduling. But the first thing to work on is night sleep. After three to four months, children can learn to sleep for longer stretches. So parents can let up on their responsiveness to their children at night and see if they can learn to fall back to sleep again without cues from us.

After night sleep is accomplished, children develop into nappers over time. Napping is usuallly haphazard until closer to 9 months of age. By that time children start developing a natural schedule of two naps a day. By 15 to 18 months those two naps become one longer nap and then you have your child scheduled! But you didn’t do it. Children evolve into that schedule over time. Don’t let anyone tell you to push your child into a schedule before they are developmentally ready.

Tips for Managing Screen Time

Maybe I am harping on this a little too much. But I do not think so. I believe that screens are detrimental to the healthy development of human brains. It seems that the American Academy of Pediatrics agress with me. But too my surprise, it seems that a lot of parents agree too. In a recent article in the NY Times, Bruce Feiler surveyed parents about what they do about their kids screen time. He found that the majority of parents have rules governing their kids screens. Here sre some of the things he learned in his survey of parents and some of my suggestions added in.

 

  1. Parents need to be examples and put their phones down. More and more we are all becoming addicted to our screens.
  2. Delay getting a first phone until kids really need it. You may need your child to get a phone by the time they are in middle school for communication needs. But it does not have to be a smart phone. It can be a dumb phone to call and text only.
  3. When your child gets a phone or tablet, set up strict rules for them. No internet during the school week, and only 1 hour a day of screen time! Set up a contract and monitor use from the start. Yes, you will be a mean parent but you will be in the majority with other parents.
  4. Homework needs to be safeguarded. Yes, more homework is online. But other communication and apps need to be limited to decrease distraction. Have kids do homework in common areas. Check in on them. Your presence turns off cheating on rules. And no social media during homework time.
  5. No phone use 1 hour before bedtime. Screen use has been shown to hinder normal sleep patterns. Also communication through texting interrupts sleep. Check phones into a common charge area at night so phones are charged for daytime when you need to communicate.
  6. Make rules for teens that they must answer your calls or texts within three tries. The excuse about not having reception is no excuse. You need to be able to reach them.
  7. Meal times should be screen free times. Eat together and talk.
  8. Limit social media accounts. Younger kids do not need facebook, snapchat and other accounts. Each account drains time from your child. Use a common ipad for their accounts so you can monitor what is going on.
  9. Punish kids with device removal. Check in regularly. Adjust house rules as you need to. Read some random texts. Read them aloud to embarass them. These are ways to have some control of what they do in this open arena we call the internet.
  10. Family time is very important. Interaction is the only antidote to screen time. Have game nights. Cook together.  Get outdoors together. Have parent-child date nights. Any fun you can have without the screens is good fun and interactive fun.
  11. Don’t give up the fight. Screens are a privilege for kids to have not a right for them to have. You have control and pay for the screens. Turn off your router if you must.         Good luck!

Screen Time is Mean Time

Years ago a number of pediatricians and I spoke about kids getting heavier. After years of observing this trend, research showed that indeed there was an “obesity epidemic”as  if we needed research to prove that. Also years ago, I met with a number of child psychiatrists at a meeting and we discussed our respective literature to see if we had seen anything written about electronic media driving kids toward ADHD, anxiety, and depression. At the time we had not seen any such research even though we all felt that to be true. Now we have the research and the support and new guidelines.

 

Missed during the end of this raucous election cycle is the recent recommendations from the American Academy of Pediatrics for screen time for kids of all ages. The recommendations are more strict than before based on some scary information. There is little doubt that parents are not even close regarding the use of screens in rearing their children. And I find it an uphill battle whenever I talk about it. But there are important things to recognize before you lay your child in front of your phone or ipad.

 

First it is very important to think about our children’s brains and how they develop. Interaction with live three dimensional people is critical at any age even teenagers. Babies learn to smile in response to faces. Speech is taught by speaking and reading to children. Teenagers learn to read emotion in faces by the end of high school only through seeing actual faces! Children learn right, wrong, sorrow, joy, disappointment and resilience through personal experiences. Nobody can deny any of these statements. Yet we work against these important developmental stages through the overuse of screens – and yes they are being overused by everyone including parents!

 

Starting with early childhood, parents with good intentions use electronics to try to teach their children. Many products have come out to support this parental desire. One problem exists with these products and TV shows. Under age two, there is no evidence that supports the notion that electronic games or TV shows help children under two develop. In fact, it is clear that young kids can operate an ipad, or sing along with a show theme, or even learn a word. However, it is not clear if this improves a child’s ability to interact. Even new words learned from a device may not be learned enough to use that word in their world. Ability to use an ipad is not a sign of improved intelligence at 20 months of age! This is why the AAP recommends no screens for children under 2.

 

Over age two, children may derive some benefit from educational TV, and educational computer programs. But that benefit is only realized if parents are involved with those shows and programs in order to reinforce the learning through ( you guessed it ) interaction. When parents reinforce the learning from a program by explaining what the child saw, and using what they learned, children actually learn the material. Without the follow through with interaction, children learn less of the material. Kids who learn through electronics and interaction together receive a benefit that can be recognized in kindergarten and first grade. Aside from that narrow perspective, TV shows and computer games have no benefit and can have detrimental effects. One of the key effects is teaching distractability and disturbing their ability to follow instructions. Both of those things are problems for school.  So the recommendation from the AAP is very limited ( 1 hour a day ) use of screen time for kids 2 to 5 years old and that screen time should be of educational content, and be supervised and reinforced by parents in order to be beneficial.

 

Now to the real fly in the soup. Parents that I know believe that school age and teenager screen use has gotten out of control. The American Academy of Pediatrics would agree. Being realistic, even schools are putting homework onto ipads and computer systems. So some screen time may be necessary. Some screen time is important to young adults in order to stay connected with friends. But there are extremes of use that are not good. We see more obesity that is tied to screen use. Our kids are sleeping less and are more tired. Social isolation is increasing with screen use. We even have a new psychiatric diagnosis called Internet Gaming Disorder where children and teens are addicted to gaming! And that is not all, we have more ADHD, anxiety, and depression that can be associated with screen overuse. I am convinced that fewer boys are going to college because of their screen use. The ratio of boys to girls in college has been steadily increasing in favor of girls for years and the boys that are going to college have lower scores than boys did in the past. We have not even talked about the antisocial behavior that is taught in games and online. Could our boys be taught attitudes about women in the games they play or sites they visit online? You bet! And should I even mention sexting? Or sex predators? If you want more information about how boys are affected by screen time among other issues check out the documentary “The Mask You Live In” on Netflix.

 

 

Screens are a new necessity in our lives. Parents can hardly put them down so how can we expect kids to? But we all need to put the screens down more. Every home should have some basic rules in place. Limit the time for non academic screen use. Turn off televisions when not in use. Avoid using media to calm your child. Monitor the content of your child’s TV and screen viewing. Keep TVs and other screens out of bedrooms. No screens  during meals one hour before bed. Develop your own Family Media Plan by checking out www.healthy children.org/MediaUsePlan . Children at all ages need to have their faces seeing other faces and interacting in order to develop and learn normally. This is so important and we are seeing the effects!  Screen time is mean time because it is bad for the development of our children. So please try and improve on your media use plans today. Thank you!

Three “NO-NO Battlegrounds for Parents

From the time that I became a pediatrician, thirty some odd years ago, I have been counseling parents to stay a way from three battles. We all know we “have to pick our battles”.  Early on in my career I saw an article that explained the three areas that I am talking about as “no-no’s” to battle with your kids.

As we engage with kids we often try to take control in areas where we do not have control. The result is a battle we cannot win.  I intend on doing a podcast on this issue too. Perhaps I can elaborate more there. So what are the three areas to NOT battle with your kids over?

  1. How much they eat! They have ultimate control of how much they put in their mouth and how much they swallow. You cannot make a child eat. REPEAT…you cannot make a child eat. Nor should you worry about how much they eat. You can control what choices they have for food. And you should take control of that!
  2. You should not battle over sleep. You cannot make your child sleep. But you do have control of bedtime, where they are to go to sleep, and the total hours of bedtime.
  3. You cannot make a child poop in the potty. They have control over where they put their poop. You have control of incentives and discouragements. In other words you have control over your responses after they go to the bathroom. You can act disappointed and cold if they are not pleasing you about their choice of going in their pants. And you can be pleased about when they succeed in the potty.                                                                                                                So there are the three no battle areas. Good luck! Actually this takes a lot of stress away when you realize what you have control over and what you do not. More details of approaches are in other articles on this website and in podcasts to come.   Check them out….thanks

Food Rules

Every family should have some rules around food and eating. From the time I was trained as a pediatrician until today, I have been taught that food should not be a battleground. As parents, we think we need to get kids to eat. But we DO NOT. They will eat what they need to grow on from the balance of food we present. Here are some rules every house should apply.

Do not pressure kids to eat.

Do not worry about how much your child eats at any age!

Make them eat from your choices , not theirs.

Their choice should be to eat or not eat.

Do not play around to “get them to eat”.

Do not pay attention to their behavior around food.

These rules should make your house more peaceful around meals and dinnertime. To learn more join our discussion of these rules on Thursday October 30th at 11:30 at our parent coffee. Good luck.

Dr. Orr

What Worry Does

A recent report showed that ill people who know that many  people were worried about their illness actually did worse than  those who knew that few were worried about them.

All parents worry. But the extent that we worry may impact  our children negatively. When we worry we focus on the negative  and our children feel the focus. Subconsciously they gravitate  to actions that keep them as their parents’ preoccupation. We  can actually perpetuate problems in school or illness at home by  setting up that expectation. Worry is often based on irrational  unrealistic fears. But those fears may control our feelings  toward our children’s problem. If children don’t feel the  confidence from their parents that they will get better, they  tend not to heal as fast. Likewise, in school if kids don’t  feel their parent’s support and confidence they don’t succeed in  school as easily.

Our children respond to us from the attention we give and  the control we grant them. If their behavior (I stink at  spelling, or I have a headache) gets the parent’s attention and  controls the parent’s response it may become a behavior that is  fostered to continue. These behaviors may not be positive for  the child in any other way except for the subconscious attention  it draws to him. Headaches, stomachaches, emotional outbursts,  and even less than optimal school performance may pull us into  the same trap that temper tantrums do. (Certainly, many  illnesses, school problems, and emotional outbursts need serious  attention. Usually, in these cases, there are more objective  signs that teachers, doctors, or even parents can see that  support the need for addressing the child’s problem.)

So how can we avoid this negative spiral? Parents need to  always temper how much attention they are paying to a problem.  Too much attention may perpetuate any problem. We also have to  measure how much a problem is controlling the household – the  discussions, the actions, and, yes, even the worry a problem is  causing. Get an objective opinion whether the problem is worth  all the concern. Set a positive course to fix the problem and  then have faith and confidence in the resolution. The more we  can move away from preoccupation and worry to action and  confidence, the more we can get away from any traps that  attention and control can draw us into. If problems are real  and worth more concern, you will get another chance to reassess  your action.

Many of today’s parents tell me that their parents always  blew off their illnesses when they were kids. “Oh you’ll be  fine – just take some Tylenol. Your headache will go away.”  Some people criticize their parents for being too insensitive.  Maybe they had it partially correct – they didn’t get too  worried and we didn’t get too much attention for mild illnesses.

Why Yelling Doesn’t Work

I use to be a yeller. Yes, even pediatricians yell at their kids. But I have reformed and yell much less now  then in the beginning of my parenting career. Over time, I  saw what my yelling really was doing. It created fear. It  intimidated my children, even my kids who were not the  target of my yelling. It created tension between me and my  wife and my kids. I always felt bad after yelling. And,  most important, it didn’t work to convince my kids to my  point of view. In fact, it often backfired and made my  children back into the trenches of verbal warfare and work  hard to hold their positions. As I contemplated the issue  of yelling in context of my overall parenting philosophy, I  realized that there were good reasons why yelling wasn’t  working.

In my philosophy of parenting, children often behave  in ways that work toward two goals – getting attention from  their parents and controlling their parent’s response.  These two factors become more of a motivation for children  in moments of conflict with parents. Children know we have  more power in decision making especially regarding  purchases, transportation and finances. But that doesn’t  mean they cannot exert some power by controlling our  response by pushing us in arguments to the point of  yelling. How powerful is it for children to “push our  buttons” enough to see a parent have a temper tantrum? And  since they are the focus of the attention (even though it  is negative attention) they are receiving a second victory  especially over their siblings who are not the focus of  attention. So, when I was in a yelling fit with my child,  I was actually falling into a subtle trap set for me by my  child and feeding some subconscious need. So I needed to  change my tactics.

I set goals for myself to see how many days, weeks and  months I can go without yelling. It takes a lot of  practice. It is natural for our kids to want to argue with  us. And they do not want to end an argument. As a result,  if we become committed to the ending of arguments, then we  may avoid getting to the point of yelling. We can end  arguments sooner if we stick with our initial answer and  refuse to engage any further in discussion no matter what  else is said!!

The other time parents yell is when children won’t do  things we ask them to do. The same motivational factors  for children to push us to yelling exist in this situation.

So it is possible to create a life free of yelling.  You may come up with your own tricks. But now that you  know that yelling doesn’t work, you may want to try  something new. Hopefully, my tips will motivate you to try  a new approach before you let your kids see more of your  temper tantrums.

Why Ask Why?

Why do you always have temper fits when you don’t get your way? Why do you whine to me after school? Why do you  always complain about dinners? Why do you always fight with  your sister? Why do all parents ask these questions?

These questions are an expression of frustration by  parents over behavior exhibited by our children. We as  parents all fall into the trap of asking these questions  whether they serve a purpose or not. Do these questions  ever get answered? No they do not. These questions can be  demeaning and labeling for children. That is how children  feel when they hear these questions. They are labeled as a  fighter, whiner, or complainer. Just in the asking of  these questions the child is criticized and treated as one  who is acting as a child should not act. Perhaps they  should not act that way but changing that behavior takes  time. When parents accept their children’s behavior as  natural, and accept their behavior as action that all  children try with their parents, then parents can forget  the “why” questions and move towards more appropriate  responses to the behavior. The “why” questions only expose  a parent who is not accepting their children acting as all  our children act.

How can we better deal with frustrating moments with  our children? How can we reach a place where we can be  more accepting of how our children act towards us?

First we need to be accepting of the fact that in our  role as parent we will face children acting in childish  ways. All parents face similar behaviors. All children  try the same behaviors on for size. As a parent we will  encounter whining, complaining, tantrums, accidents and  other childish acts that we cannot control. Many parents  spend valuable time asking “why do I have to face this  behavior in my child?” Why waste time asking “why”? If  we can function at a higher level by accepting our kids as  kids, their developmental level and their childish acts  then we are ready to respond better. Yes, all parents must  accept that their children will act in very embarrassing  and childish ways.

Don’t take me wrong. Acceptance of your child’s  behavior does not mean giving in to every whim. Part of  acceptance is educating yourself about your role and how  you can better respond to your kids. Acceptance gives you  a place from which you can act without fighting the reality  of your situation. Acceptance gets you over the why  questions and moves you towards “how do I respond”  questions. This is where you have control. This is where  you can decide how to act, ignore, or give fair consequence  to your children’s behaviors. Acceptance gets you over the  anger brought on with “why” questions and lets you treat  your children with greater kindness. You no longer act in  condemning ways but with a more fair response to your  child’s manner.

Why questions make a child question themselves. Your  acceptance of them gives them more leeway to accept  themselves. Children that grow up with less questioning  and less condemnation grow up liking themselves and turn  into confident people. It is purely for that reason that  acceptance of your children’s behaviors is important to you  in your life as a parent and to your children in their life  as a child. After acceptance, remember that it is your  responses to your child’s behavior that can make the  behavior better. From a place of acceptance a parent is in  a more peaceful position to choose a response that teaches  their child how they should or should not behave.

Where Are Our Heroes?

Children look up to heroes. Young children look at fairy tale or fictitious heroes. Harry Potter, Superman, and Batman –  we can name hundreds of heroes in fiction. But as children  grow, they graduate to real heroes. These could be sports stars  or people in the news. This is a sad time for children since we  have so many fallen stars. Barry Bonds, the biggest home run  hero of our time, cheated by using steroids. An American  cyclist, Floyd Landis, came back to victory in the Tour de  France only to have his victory clouded under doping  allegations. Our President is usually an obvious choice of a  hero yet our last two Presidents failed our children. Clinton  is famous for his cheating on his wife and Bush made up reasons  for war and has made America famous for torture. Hollywood  props up movie stars as heroes but then we hear about their  drunk driving or their prejudicial remarks or both.  Unfortunately, there are only a few Tom Brady’s around. We hope  that our newly elected officials live up to there promises and  reputations, though we are losing faith.

Kids need heroes. But more importantly, they need adults  that they can look up to and respect. I once heard in a  parenting conference that what children need is an “influential  adult” outside their family who becomes their local hero. These  “influential adults” can be teachers, coaches, or community  leaders. They aren’t famous heroes because over time kids turn  away from their infatuation with distant heroes and turn their  attention to real tangible, respectable adults who are involved  in their lives. To that end, adults in every community need to  respond to this era of poor examples of heroes at the top. We  have to become the heroes on the bottom. Every adult in every  community needs to evaluate how he or she is demonstrating him  or herself as an example to young adults. What child will look  up to you as an “influential adult” in their lives? At home,  are you there for them or do you disappear too often to ensure  you have your fun? Do you provide examples of good community  work? Do you volunteer or donate time or money? Do you expect  returns for your good works or is it truly given like real  heroes do? Do you simply act in kindness so children see and  live kindness around you?

You can’t ask “what is happening with kids today?” without  asking what is happening to heroes for kids today? We, the  adults, can make a difference inside and outside of our homes.  We need to start in our small communities. Do good work in your  community. Donate time to worthwhile projects. Work with food  pantries, or help the elderly. Don’t expect praise but let your  children and other kids witness your good acts. Be kind. Live  a well-valued life – especially those of us that work with  children. If we start at home and in our communities we can be  heroes for our children. They need them. We can build a  community of “heroes” pitching in and helping each other. Maybe  over time local heroism will filter up to where we need them for  our children the most in the high visible places of our country.