On-Call with Editor-in Chief, Donna Thomas

It is thast time of the year when we can wait to spend as much time outdoors as possible! However, those lazy, hazy days of summer, can cause significant health issues if prevention is not in your beach bag!

I hope you will find this detailed article informative. Of course any questions you may have, consult with your doctor.

May is Skin Cancer Awareness Month

May is Skin Cancer Awareness Month and it is very important to have your dermatologists examine your skin for any unusual moles. Melanoma screening is vital, as it can diagnose cancer at the earliest stage.

·         Skin cancer is the most common form of cancer in the United States. More than 3.5 million skin cancers in over two million people are diagnosed annually.

·         Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.

·         Over the past three decades, more people have had skin cancer than all other cancers combined

·         Of the seven most common cancers in the US, melanoma is the only one whose incidence is increasing. Between 2000 and 2009, incidence climbed 1.9 percent annually.

The good news is that you can do a lot to protect yourself and your family from skin cancer, or to catch it early enough so that it can be treated effectively. Most skin cancers are caused by too much exposure to ultraviolet (UV) rays. Most of this exposure comes from the sun, but some may come from man-made sources, such as indoor tanning beds.

You don’t need any x-rays or blood tests to find skin cancer early, – just your eyes and a mirror. If you have skin cancer, finding it early is the best way to make sure it can be treated effectively.

Are some people more likely to get sun damage?

Everyone’s skin and eyes can be affected by the sun and other forms of UV rays. People with light skin are much more likely to have sun damage, but darker-skinned people, including African Americans and Hispanic Americans, also can be affected.

The skin tans when it absorbs UV radiation. The tan is caused by an increase in the activity and number of melanocytes, the cells that make the pigment melanin. Melanin helps to block out damaging UV rays up to a point, which is why people with naturally darker skin are less likely to get sunburned, while people with lighter skin are more likely to burn. Sunburns are thought to increase your risk of skin cancer, including melanoma. But UV exposure can raise skin cancer risk even without causing sunburn.Aside from skin tone, other factors can also affect your risk of damage from UV light.

You need to be especially careful in the sun if you:

· Had skin cancer before

· Have a family history of skin cancer, especially melanoma

· Have lots of moles, irregular moles, or large moles

· Have freckles and burn before tanning

· Have fair skin, blue or green eyes, or blond, red, or light brown hair

· Live or vacation at high altitudes (the strength of UV rays increases the higher up you are)

· Live or vacation in tropical or subtropical climates

· Work indoors all week and then get intense sun exposure on weekends

· Spend a lot of time outdoors

· Have certain autoimmune diseases, such as systemic lupus erythematosus (SLE, or “lupus”)

· Have had an organ transplant

· Take medicines that lower your immunity

· Take medicines that make your skin more sensitive to sunlight

Ask your doctor, nurse, or pharmacist if you are taking any medicines that could increase your sensitivity to sunlight.

How do I protect myself from UV rays?

You don’t have to avoid sunlight completely, and it would be unwise to reduce your level of

activity by avoiding the outdoors, because physical activity is important for good health. But too much sunlight can be harmful. There are some steps you can take to limit your exposure to UV rays.

Some people think about sun protection only when they spend a day at the lake, beach, or pool. But sun exposure adds up day after day, and it happens every time you are in the sun.

Simply staying in the shade is one of the best ways to limit your UV exposure. If you are going to be in the sun, “Slip! Slop! Slap! and Wrap” is a catch phrase that can help you remember some of the key steps you can take to protect yourself from UV rays:

· Slip on a shirt.

· Slop on sunscreen.

· Slap on a hat.

· Wrap on sunglasses to protect the eyes and sensitive skin around them.

Seek shade. An obvious but very important way to limit your exposure to UV light is to avoid being outdoors in direct sunlight too long. This is particularly important between the hours of 10 am and 4 pm, when UV light is strongest. If you are unsure about the strength of the sun’s rays, use the shadow test: if your shadow is shorter than you are, the sun’s rays are the strongest, and it is important to protect yourself.

UV rays reach the ground all year, even on hazy days, but the strength of UV rays can be different based on the time of year and other factors. The UV rays become more intense in the spring, even before temperatures get warmer. People in some areas may get sunburned when the weather is still cool because they may not think about protecting themselves if it’s not hot out. Be especially careful on the beach or in areas with snow because sand, water, and snow reflect sunlight, increasing the amount of UV radiation you receive. UV rays can also reach below the water’s surface, so you can still get a burn even if you’re in the water and feeling cool.

Some UV rays can also pass through windows. Typical car, home, and office windows block most of the UVB rays but a smaller portion of UVA rays, so even if you don’t feel you’re getting burned your skin may still get some damage. Tinted windows help block more UVA rays, but this depends on the type of tinting. UV radiation that comes through windows probably doesn’t pose a great risk to most people unless they spend long periods of time close to a window that receives direct sunlight.

If you plan to be outdoors, you may want to check the UV Index for your area first. The UV Index usually can be found in local newspaper, TV, radio, and online forecasts. It is also available on the EPA’s web site at www.epa.gov/sunwise/uvindex.html and in a variety of smartphone apps.

Protect your skin with clothing when you are out in the sun, wear clothing to protect as much skin as possible. Clothes provide different levels of UV protection, depending on many factors. Long-sleeved shirts, long pants, or long skirts cover the most skin and are the most protective. Dark colors generally provide more protection than light colors. A tightly woven fabric protects better than loosely woven clothing. Dry fabric is generally more protective than wet fabric.

Be aware that covering up doesn’t block out all UV rays. If you can see light through a fabric, UV rays can get through, too. Some companies now make clothing that is lightweight, comfortable, and protects against UV exposure even when wet. It tends to be more tightly woven, and some have special coatings to help absorb UV rays. These sun-protective clothes may have a label listing the UV protection factor (UPF) value – the level of protection the garment provides from the sun’s UV rays (on a scale from 15 to 50+). The higher the UPF, the higher the protection from UV rays. Some children’s swim suits are now made from sun-protective fabric and are designed to cover the child from the neck to the knees.

 

Newer products, which are used in the washing machine like laundry detergents, can increase the UPF value of clothes you already own. They add a layer of UV protection to your clothes without changing the color or texture. This can be useful, but it’s not exactly clear how much it adds to protecting you from UV rays, so it is still important to follow the other steps listed here.

 

Use sunscreen

A sunscreen is a product that you apply to your skin for protection against the sun’s UV rays. But it’s important to know that sunscreen does not provide total protection against all UV rays. Therefore, a sunscreen should not be used as a way to prolong your time in the sun. Even with proper sunscreen use, some rays get through, which is why using other forms of sun protection, is also important. Sunscreens are available in many forms – lotions, creams, ointments, gels, sprays, wipes, and lip balms, to name a few.

Read the labels

When choosing a sunscreen product, be sure to read the label before you buy. Sunscreens with broad spectrum protection (against UVA and UVB rays) and with sun protection factor (SPF) values of 30 or higher are recommended. The SPF number is the level of protection the sunscreen provides against UVB rays − a higher number means more protection. When using an SPF 30 sunscreen and applying it thickly, you get the equivalent of 1 minute of UVB rays for each 30 minutes you spend in the sun. So, 1 hour in the sun wearing SPF 30 sunscreen is the same as spending 2 minutes totally unprotected. People often do not apply enough sunscreen, so the actual protection they get is less. 

Sunscreens labeled with SPFs as high as 100+ are now available. Higher numbers do mean more protection, but many people do not understand the SPF scale. SPF 15 sunscreens filter out about 93% of UVB rays, while SPF 30 sunscreens filter out about 97%, SPF 50 sunscreens about 98%, sunscreen protects you completely. Regardless of the SPF, sunscreen should be reapplied often for maximal protection.

The SPF number indicates protection against UVB rays only. Sunscreen products labeled “broadspectrum” provide some protection against both UVA and UVB rays, but at this time there is no standard system for measuring protection from UVA rays. Products that contain avobenzone (Parsol 1789), ecamsule, zinc oxide, or titanium dioxide can provide some protection from UVBand most UVA rays.

Check the expiration date on the sunscreen container to be sure it is still effective. Most sunscreen products are effective for at least 2 to 3 years, but after a long time in storage you may need to shake the bottle to remix the sunscreen ingredients.

Some sunscreen products can irritate your skin. Many products claim to be hypoallergenic or dermatologist tested, but the only way to know for sure if a product will irritate your skin is to try it.

Be sure to apply the sunscreen properly

Always follow the label directions. Most recommend applying sunscreen generously. When putting it on, pay close attention to your face, ears, neck, arms, and any other areas not covered by clothing. If you’re going to wear insect repellent or makeup, put on the sunscreen first. Be generous Ideally, about 1 ounce of sunscreen (about a palmful) should be used to cover the arms, legs, neck, and face of the average adult. For best results, most sunscreens must be reapplied at least every 2 hours and even more often if you are swimming or sweating. Products labeled “waterproof” may provide protection for at least 80 minutes even when you are swimming or sweating. Products that are “water resistant” may protect for only 40 minutes.

Remember that sunscreen usually rubs off when you towel yourself dry, so you will need to put more on. Sunless tanning products, such as bronzers and extenders (described in the section, “What about tanning pills and other tanning products?”), give skin a tan or golden color. But unlike sunscreens, these products provide very little protection from UV damage.

Wear a hat. A hat with at least a 2- to 3-inch brim all around is ideal because it protects areas such as the ears, eyes, forehead, nose, and scalp that are often exposed to intense sun, such as the ears, eyes, forehead, nose, and scalp. A dark, non-reflective underside to the brim can also help lower the amount of UV rays reaching the face from reflective surfaces such as water. A shade cap (which looks like a baseball cap with about 7 inches of fabric draping down the sides and back) also is good, and will provide more protection for the neck. These are often sold in sports and outdoor supply stores.

 
Wear sunglasses that block UV rays UV-blocking sunglasses are important for protecting the delicate skin around the eyes, as well as the eyes themselves. Research has shown that long hours in the sun without protecting your eyes increase your chances of developing some eye diseases.

Children need smaller versions of real, protective adult sunglasses – not toy

sunglasses. Ideally, all types of eyewear, including prescription glasses and contact lenses, should absorb the entire UV spectrum.

Avoid tanning beds and sunlamps. Many people believe the UV rays of tanning beds are harmless. This is not true. Tanning lamps give out UVA and usually UVB rays as well. Both UVA and UVB rays can cause long-term skin damage, and can contribute to skin cancer.

Protect children from the sun Children need special attention, since they tend to spend more time outdoors, can burn more easily, and may not be aware of the dangers. Parents and other caregivers should protect children from excess sun exposure by using the steps above.

 Older children need to be cautioned about sun exposure as they become more independent. It is important, particularly in parts of the world where it is sunnier, to cover your children as fully as is reasonable. You should develop the habit of using sunscreen on exposed skin for yourself and your children whenever you go outdoors and may be exposed to large amounts of sunlight. If you or your child burns easily, be extra careful to cover up, limit exposure, and apply sunscreen.

Babies younger than 6 months should be kept out of direct sunlight and protected from the sun using hats and protective clothing. Sunscreen may be used on small areas of exposed skin only if adequate clothing and shade are not available.

 

Skin exams

Most skin cancers can be found early with skin exams. Both regular exams by your doctor and checking your own skin frequently can help find cancers early, when they are easier to treat. Get your skin checked by your doctor. As part of a routine cancer-related checkup, your doctor should check your skin carefully. They should be willing to discuss any concerns you might have about this exam.

Check your own skin. It’s important to check your own skin, preferably once a month. A skin self-exam is best done in a well-lit room in front of a full-length mirror. You can use a hand-held mirror to look at areas that are hard to see. A spouse or close friend or family member may be able to help you with these exams, especially for those hard-to-see areas like your back or scalp. The first time you examine your skin, spend time carefully going over the entire surface. Learn the pattern of moles, blemishes, freckles, and other marks on your skin so that you’ll notice any changes next time. Be sure to show your doctor any areas that concern you.

 *Copyright American cancer Society at cancer.org 2013

Additional resources

More information from your American Cancer Society. The following information may also be helpful to you. These materials may be ordered through their toll-free number, 1-800-227-2345.

• A Parent’s Guide to Skin Protection (also available in Spanish)
• Melanoma Skin Cancer (also available in Spanish)
• Skin Cancer: Basal and Squamous Cell (also available in Spanish)
• Sun Basics: Skin Protection Made Simple (brochure for children aged 8 to 14)
• Why You Should Know About Melanoma (also available in Spanish)
• National organizations and Web sites*

In addition to the American Cancer Society, other sources of information and support include:

American Academy of Dermatology

Toll-free number: 1-888-462-3376 (1-888-462-DERM)

Web site: www.aad.org

On-Call with... Editor, Donna Thomas

Even though the flu season is coming to a close, your children will still have to be careful in preventing the spread of germs in the months to come. Adopting these simple guidelines from and oral health perspective can become a good habit to adopt for next flu season. Donna shares with Pedimedica important tips recommended by Dr. Joe Kavitz on why...

A Healthier mouth = A Healthier You!

1.Each member of your family should use their own tube of toothpaste. Sharing the same tube spreads the virus as it can reside on the outside edge of the tube. Germs can sit on the outside surface of the toothpaste container and thereby spread to your toothbrush as well. *Toothbrushes should be changed every 3 months!

2.Wash your hands before brushing your mouth. The hands can carry germs that infect your mouth and spread throughout your body.

3.you do get sick, replace your toothbrush immediately. It is likely to host the virus. We find it useful to keep spare toothbrushes to supply to you and your family as needed.

4.Do not keep family toothbrushes together in a cup. The colds and viruses can spread to the other toothbrushes transferring the infection from one person to another.

5.Rinse with a mouthwash after brushing. Brushing your mouth only removes some of the bad germs. Rinsing with mouthwash has been shown to reduce bacterial and virus counts on the oral cavity.

6.Refrain from kissing others. As soon as you, your family, spouse, or friend can detect the a cold, do not kiss them or allow them to kiss others. The flu virus in particular is very contagious and can easily spread through mouth to mouth contact.

7.Do not share food or drink. Just as kissing is contagious, so is sharing food and drink.

8.Eat foods from the garden. Fruits and vegetables can boost your immune system naturally. There are nutrients in garden foods that help in resisting viruses.

For more information go to www.discoveryfit&health.com.
Dr. Joe Kravits, DDS,  2013

On-Call with… Martha Miqueo, DDS, Vizstara Dental

The importance of teaching your child good

oral hygiene from a young age!

Since Children’s Dental Health Month just passed, here are some important tips to keep in mind all year long! Dr. Miqueo, DDS, Pediatric Dentist and Orthodontist shares her recommendations with Pedimedica parents.

·         New parents should seek a pediatric dentist soon after their child’s birth.  A pediatric dentist

can show you how to care for your infants gums after every feeding and can discuss breast feeding, bottle feeding, pacifier use, suckling habits and their effects on the developing oral cavity.

·         Fluoride toothpaste should be introduced soon after the child has learned to rinse properly.

·         Toothbrushes should be replaced every two months or sooner if the bristles are worn out.

·         Remember, a child typically has the full primary dentition by the age of 3 and the permanent dentition begins to erupt by age 6.

·         Have your child evaluated for sealants when they turn 6 years old.

·         Bring your child to an orthodontist to evaluate the craniofacial growth by the age of 7.

Sometimes early orthodontic intervention can prevent extractions of permanent teeth and can yield better results preventing orthognathic surgery.

·         Make sure your children have a dental check up and cleaning every 6 months to maintain good oral health.

Early prevention practices help your child develop confidence in caring for their smile and avoids pain and suffering associated with dental emergencies.

 

Wishing you a beautiful Smile and lifelong savings! 

Dr. Miqueo is Co-Founder and VP of VIZSTARA, a Multispecialty Dental Facility. She is Director of Family Practice, Pediatric Dentistry, and Orthodontics. Dr. Miqueo is an expert in the management of pediatric patients with cleft lip and palate, as well as in the application of the laser technique for both soft and hard tissue. Dr. Miqueo graduated from New York University College of Dentistry where she also served on the faculty.

On-Call with Dr. Nyiri Grigorian, LCSW, Phd

College kids are back for the holidays!
This is the 3rd blog in a special series on sleep.

Last month Dr. Grigorian shared with our readers’ her insight to understanding sleep habits at college. In her final blog on sleep she focuses on the issues parents face when their children return for holiday break. Nyiri has been in private practice for twenty-five years treating children, adolescents, and adults, as well as families and couples. Dr. Grigorian not only specializes in anxiety and depression, but has treated couples in Parent Guidance for decades. She supervises a wide range of therapists professionally who are in the mental health field. Dr. Grigorian has lectured and conducted workshops on a wide range of topics, including sibling therapy, early intervention in childhood development, and prevention in mental health. She has also served as a consultant to many school districts and non-profit organizations identifying high-risk children and families. She has contributed to the body of research on treating siblings together as an alternative to traditional individual treatment. She has been part of long-term research group studying trauma.
They're Baaa-ack!

When the kids are home and living under your roof, life tends to be status quo. But what happens when they go off to college (or boarding school), and come home for winter break? For a month, they are back in your life. Be honest. You're happy, but not
that happy.

Relationship expert Nyiri Grigorian is here with some undercover insight on the bumpy days (and nights) ahead.

They're baa--ack.....

You think they're gone. You even cried; but dry those tears. Your college kid is home for a month.

Why is this so dramatic?

You are in a new rhythm, they are in a new rhythm and the music is out of tune.

They are still your babies, but functioning on their own.

You have experienced new found freedom and are thinking of reinventing yourself.

The lay of the land has been unearthed with boundaries taking on a new configuration.

This dynamic is played out in many ways.

They want to come and go as they please, but still have you, somehow, one hundred percent available.

Alone time with them is mutually desired, but often misfires and creates disappointment when it doesn't happen.

They need money; a lot of money.

Somehow, being home from college means eating in every restaurant, for every meal. Meanwhile you have stocked the house with all of their favourite foods.

Your new style is cramped. You have to reorganize your time and space.

It is a scene out of a movie: visitors coming and going as if they have been gone for years.

You tread lightly, as the parenting style has shifted.

You try to refrain from being overly intrusive or heavy-handed with advice.

They have formed a new life, with a new set of friends and a new self-identity.

You need to suspend judgment and it's difficult at best to hide your feelings.

And bedtime is disrupted.

The tenor of the whole house is changed when our college kids come home.

They seem to reset the tone of the bedtime atmosphere.

Simply put; you are up again, worried when they are out.

Siblings are ignited and think it is party time for them too.

And as if it's not disruptive enough you may now have strange kids sleeping in strange places in your home...get out the blankets and lock your bedroom door.

On-Call with Dr. Nyiri Grigorian, LCSW, Phd....

College and Sleep habits” 2^nd blog in a special series on sleep.

Last month Dr. Grigorian shared with our readers’ techniques to use with youngsters and bedtime stories. This month she offer insight to understanding sleep habits at college 

Nyiri has been in private practice for twenty-five years treating children, adolescents, and adults, as well as families and couples. Dr. Grigorian not only specializes in anxiety and depression, but has treated couples in Parent Guidance for decades. She supervises a wide range of therapists professionally who are in the mental health field. Dr. Grigorian has lectured and conducted workshops on a wide range of topics, including sibling therapy, early intervention in childhood development, and prevention in mental health. She has also served as a consultant to many school districts and non-profit organizations identifying high-risk children and families. She has contributed to the body of research on treating siblings together as an alternative to traditional individual treatment. She has been part of long-term research group studying trauma.

You just dropped your kid at college and are awake worrying if they will ever sleep again.

The college student faces many challenges when it comes to sleep. The first few months are the hardest adjustment.

Why?

The nocturnal environment of college life is not just stimulating; it’s also about not being isolated.

Distraction and noise are only the simple problems.

Sleeping in a room with a roommate/possible stranger presents an emotional as well as physical challenge.

The initial snap judgments made in the beginning of a roommate relationship take time to season.

But, your kid may not know this and will lose sleep over worrying about the stranger beside them. Balancing a schedule with this stranger is difficult at best.

Negotiating a shared bathroom or dormitory hallway bathroom will disrupt sleep with worry and confusion. Some kids plan this and will rise early to shower; some go in late at night for privacy, and some suffer over urinating in the middle of the night.

There is a phenomenon that has been coined, “FOMO,” which means fear of missing out. Students are so afraid of missing opportunities to meet and greet friends and be part of what they believe is important to construct a social life. Like toddlers, they do not want to sleep and miss out on the fun.FOMO is especially prevalent amongst freshmen college students. This alone will change the sleep life of every college kid.

Erratic sleep schedules are created by class schedules as well as day-to-day changes of where and when to be at school.For example, if Wednesday and Friday contain a class that is held only in the afternoon, sleeping in might work for that morning but not for the others.

Sleep deprivation amongst college kids is an actual human experiment. Like sex and drugs, it is a time in life to push the limits of cognitive and emotional health standards and to learn self-regulation.

What can you do as a parent?

Well, try to remember that they are away at school for a reason. Perhaps in this instance, unless you receive an SOS or other smoke signal from the university’s powers that be, rest assured, your kid will figure out his/her new circumstances. Besides, you know they will not listen to your advice. What they need most now is the chance, just like a baby, to soothe himself or herself under duress and most importantly, as an autonomous person.

 As a relationship specialist for the Bedtime Network (www.bedtimenetwork.com) Nyiri contributes weekly stories providing advice on a variety of sleep topics. Pedimedica found the following published article to be beneficial to their readers and wanted to share her perspective on dealing with the difficulties of getting their youngsters to bed!

Dr. Nyiri Grigorian, LCSW, Phd.

Copyright Bedtimenetwork.com   published 9/1/12 issue

On-Call with Dr. Nyiri Grigorian, LCSW, Phd

"Can I Have One More Book Mom?” and other bedtime issues!

Nyiri has been in private practice for twenty-five years treating children, adolescents, and adults, as well as families and couples. Dr. Grigorian not only specializes in anxiety and depression, but has treated couples in Parent Guidance for decades. She supervises a wide range of therapists professionally who are in the mental health field. Dr. Grigorian has lectured and conducted workshops on a wide range of topics, including sibling therapy, early intervention in childhood development, and prevention in mental health. She has also served as a consultant to many school districts and non-profit organizations identifying high-risk children and families. She has contributed to the body of research on treating siblings together as an alternative to traditional individual treatment. She has been part of long-term research group studying trauma.

As a relationship specialist for the Bedtime Network (bedtimenetwork.com) Nyiri contributes weekly stories providing advice on a variety of sleep topics. Pedimedica found the following published article to be beneficial to their readers and wanted to share her perspective on dealing with the difficulties of getting their youngsters to bed!

“One of the most frequently asked questions in clinical practice with parents of young children revolve around BEDTIME strategies and difficulties. Sleep and how to get more of it is the number one question on parents’ minds! It can be at the root of parent fatigue, guilt, anger, and marital strife. Very often, for example, when treating couples in marital therapy, the theme of putting children to bed at night comes to the fore as a central focus. In some families, there is the dread over the impending bedtime and, it is often viewed as another chore at the end of a long day.

In the same way adults frequently feel it is never a good time to get married, get pregnant, buy a house, move, change jobs, or go back to school, they feel too, that there is never a good time to tackle a child’s bedtime issues. In a like manner to adult concerns, children are teething, sick, having separation anxiety, coping with the birth of a sibling; starting nursery school coping with a new babysitter etc…There never seems to be a good time.

One of the things most helpful to acknowledge before tackling bedtime problems is: always REMEMBER that when you are putting your child to sleep at the end of the day, you are at your most fatigued and vulnerable. Your mind could still be on the toys that are all over the floor downstairs, laundry that is undone, and…bills. Although it sounds simplistic, one of the most dramatic things a parent can do (if married or with a partner) is to be in AGREEMENT about the bedtime approach. For example, that means that one parent isn’t angry at the other while they are playing airplane and wrestling 20 minutes prior to bed or resentful that their partner jumps at every whimper, sound and move their child makes.

How can we create a stress-free bedtime? How young children sleep at night very often is connected inextricably to what goes on during the day. We need to remember that toddlers, preschoolers, and latency age children sleep dramatically better when they are tuckered out from plenty of exercise, fresh air, and activity during the day. Since children are consuming many hours of television a day and are involved with electronics at a VERY young age, they are exercising less and less. Passive activities have replaced playing at the park and playground, running and playing in the fresh air.

Napping can also be a major culprit when identifying difficulties at bedtime with young children. Parents can be reluctant to shorten naps or eliminate them altogether thereby enabling them to have more time to themselves. After all, who wants a cranky child on their hands? Phasing out naps slowly and shortening them can have a major impact on how easily and what time your child goes to sleep. One must work hard, for example, keeping your child awake in the car in the later afternoon so that he doesn’t go to sleep.

Consistent bedtime routines are KEY to a smooth transition at bedtime. Setting the same time every night is the single most helpful bedtime ritual and the addition of a soothing bath, brushing teeth with a special toothbrush, a small stack of books to choose from, or a short song can all make the pleasure and safety of bedtime better for children.

Since bedtime for children can summon up separation issues and fears, it is crucial for them to feel in CONTROL. For example, one can give them a choice of books to read, which stuffed animal to sleep next to and which “night-night” song to sing.

If children are frightened to be alone, one can sit in the room with them and leave for brief intervals, checking in every five, ten and fifteen minutes. Let them know you’ll be back to check on them. Don’t attempt any long-winded explanations of why they have to sleep. Keep everything loving, comforting, simple and short. Don’t forget to verbally and physically reward your child when for several nights in a row, they have gone to bed well. Three nights become one week, and one week becomes two weeks. Simple rewards and treats, for example, even a new colourful pack of markers or stickers, can show your appreciation. Before you know it, your child will be in the land of Nod.”

Dr. Nyiri Grigorian, LCSW, Phd.

Bedtimenetwork.com   published 10/1/11 issue

On Call with Dr. Lori Rosenberg

Dr. Rosenberg has all the answers to the questions you may have on what to expect when your newborn arrives and will provide you with prenatal advice as well, in her BABY PREP 101 seminar!
Are you having a baby?  Are you excited? Nervous?  Scared?  Have no idea what to expect?  Getting advice from your mother, mother-in-law, father, even father-in-law and from every friend who’s been pregnant?    Don’t know which book to buy, which friend to listen to and which side to sleep on (when you’re not waking up to use the bathroom every three hours)? 
To find the answers to all of your questions, come to BABY PREP 101.  Some of the questions that will be discussed are….

Q:  How do I choose a Pediatrician?

A:  Choosing the right pediatrician for your baby is very important.  You want to find a doctor that you can trust and feel comfortable with because for the first few years, the relationship will be between you and the doctor.  Most doctor practices will allow expectant parents to set up prenatal consults to find out more about the practice, hospital affiliations, on call hours, how appointments are scheduled and phone calls are handled, etc. 

Q:  What do I need to bring with me to the hospital for the baby?

A:  Not much initially.  All hospitals put your baby in diapers and t-shirts.  Some hospitals even provide pacifiers.  You can bring a pacifier from home if you desire.  Anything that you forget to bring, you will have at least a day or two to retrieve.  On the day of discharge, the baby will certainly need a fully assembled car seat and clothes to travel home (bring a few outfits, as one might get soiled prior to departure).

Q:  When does my baby get his or her first shot?

A:  Hepatitis B is offered in the hospital; however, it is not given without parental consent.  Some pediatricians choose to have the hospital administer it, others opt to self-administer at the first office visit.

Q:  How soon after birth will the pediatrician see my baby?

A:  Pediatricians come within twenty four hours to make rounds.  They typically arrive in the morning prior to office hours.  If there is a complicated delivery or emergency, there will always be a pediatrician at the scene (some hospitals have residents, some have house doctors and others will call in the private pediatrician).  Regardless whether the baby is seen at delivery or not, the pediatrician makes rounds daily as long as mom and the baby are in the hospital.
 
Q:  What can I do in my last trimester to prepare for my baby?

A:  Sleep as much as you can!  It might be difficult to do so with a newborn at home.  There are no books to buy or magic tricks to learn that can teach you as much as ‘on the job’ training will.

AND …come to my class:  Baby Prep 101, where you can find out the answers to all of your pre and postnatal questions.