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Duke Children's Pediatric News Tips

Duke Children's Pediatric News Tips
Duke Children's Pediatric News Tips


Duke Health News Duke Health News

Your Katie is off to kindergarten and both you and she have to face
the fact that she isn't a baby anymore. Sure, she went to daycare and
pre-kindergarten, but boarding that big yellow school bus is different.
It's a milestone in life, a little hill Katie has climbed, akin to a
parent viewing the big downslope at 40... How do you reduce her
anxiety? And yours? Duke child psychologist Dr. John March suggests
parents prepare their child gracefully, without buckets of tears that
might make Katie think she's going straight to jail. In his words:
"Parents should be matter of fact in providing reassurance. Too much of
a good thing can actually make the child more anxious by communicating
that there is something to worry about. Assure them that school is an
OK place and the youngster is expected to go to school and to stay at
school." Very anxious children can be helped to make their time at
school predictable "by telling them what will happen and showing them
around in advance, so they have a feeling of control," March said.
"Give them things to do and suggestions on what will make their day go
better." Also, gently probe Katie for the meaning she might have
already attached to school, March suggests. "One youngster may be
anxious about friends; another about whether the teacher will like him
or her; still another about the bathroom." But when it appears things
aren't working - when Katie can't sleep, and gets a lot of physical
aches and pains or refuses to get on that bus again - consult your
teacher or your pediatrician. "Often, simple, common-sense adjustments
in how the child, parents and teacher approach this situation can turn
it around," March says. If all fails, a pediatrician experienced in the
treatment of pediatric anxiety disorders can help since children with
these conditions are easily treated with cognitive-behavioral
psychotherapy alone or in combination with medications. So, what about
you? Take it a day at a time. That way you won't slide down the hill.

Making pain plain

Katie did fine on the first day, but now she complains of bouts
of pain. More than one parent has noted that school can result in a lot
of stomachaches and headaches -- unspecific ailments that crop up the
first week of school or periodically. What is it - the school water,
the lousy lunches, asbestos-laden air, an ulcer, or, gasp, a brain
tumor? Could be any of those things, but more likely, it is anxiety,
the same stress parents feel but are more physically used to. But how
can you tell? Family nurse practitioner Jerri Oehler says parents
should monitor symptoms over the course of days, and after a week of
ongoing pain, a pediatrician should be consulted. But if the pain is
severe or if there are changes in a child's personality or gait or
vision, parents need to seek a doctor right away. That also goes for
tenderness in a child's lower quadrant, blood in the stool and fever
with abdominal pain. She adds that parents commonly worry about a brain
tumor, but that's rarely the problem.

Bright-eyed or bushed

There's nothing like first impressions. Which child would you
rather teach? One who is alert and bright-eyed, or one who has his
clothes on backward and uses his desk as a pillow? Kids who are used to
getting up and staying up late during summer vacation, who play outside
until they fall into their beds, aren't going to easily convert to
school times. Here's a few tips on how to "transition" children, from
Duke nurse clinician Nancy Murray: 1. To move a child's sleep schedule
back, begin by working on the wake-up times. Gradually move the wake-up
earlier by 15 to 30 minutes every few days. "This should naturally move
up bedtime," she says. "If not, move it back in the same way." 2. "No
Nintendo or TV late at night," she says. "Cut down on vigorous or
stimulating activities late in the evening. Try to institute quiet
activities such as reading or some games." 3. Try not to plan a
tiresome or stressful week just before school starts. Zooming in from
vacation the day before school starts "will make the adjustment
harder," Murray says. "The same goes for the first week or two of
school. The fewer the activities, the better." 4. Begin discussing
school routines with your child now, and ways you can both make them
efficient, she suggests. Some ideas are: pack bookbags at night;
establish homework routines; pack as much of a child's lunch as
possible the night before; have clean clothes ready; keep extra
equipment or school supplies packed; and institute a weekly family
calendar of activities for everyone to see. And keep it updated.

Cookie monster?

Okay, you like to sneak a little treat into your child's lunch
box once in a while, a reminder that nothing is sweeter than a parent's
love. But you worry about that so-called "sugar high," that rush of
energy that will surely result in some kind of spontaneous behavior,
followed by a nasty look from a teacher. Well, here's the scoop (yes,
of ice cream...). Duke researcher Keith Conners says it's just not true
that sugar, by itself, promotes hyperactive behavior in kids. In a
study of sugar's effects on performance, Conners found that eating a
sugar-rich food as a snack between meals does not affect a child's
physical or mental behavior. The catch, however, is if sugar is eaten
with other food, and what kind of meal that is. Conners found that
sugar impaired performance and mental alertness only if it was eaten
after a high-carbohydrate meal. But sugar consumed after a high-protein
meal enhanced alertness and performance. Conners noted these effects in
all kids, but the reactions were more pronounced in kids diagnosed with
attention-deficit/hyperactivity disorder (ADHD). "Hyperactive kids tend
to lose control over blood glucose levels," Conners said. "As blood
sugar levels rise in normal people, insulin is released and it restores
blood sugar level. That doesn't happen in the ADHD kids we studied.
Their functioning is decreased with a heavy sugar load." Conners says
that's because the body processes simple carbohydrates (sugar) and
complex carbohydrates (starches) in much the same manner.

Vitamins or veggies?

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