Families

Here’s what your child’s pediatrician should do for you

PeaceHealth Medical Group pediatrician Dr. Jordana Hawkins gets her ear checked by Toby Ssendawula, 2, Aug. 10, 2016, in the pediatric clinic on Cordata Parkway in Bellingham. (The doctor’s name was corrected Aug. 30, 2016.)
PeaceHealth Medical Group pediatrician Dr. Jordana Hawkins gets her ear checked by Toby Ssendawula, 2, Aug. 10, 2016, in the pediatric clinic on Cordata Parkway in Bellingham. (The doctor’s name was corrected Aug. 30, 2016.) pdwyer@bhamherald.com

Back in the 1950s, greatest-generation parents turned to Dr. Benjamin Spock’s book for advice on raising their little baby-boomers. When those boomers grew up to have kids of their own, they often turned to Heidi Murkoff’s “What to Expect” books. Today, parents get their information online – and that can be a problem.

So says Dr. Jordana Hawkins, a pediatrician at PeaceHealth Medical Group in Bellingham.

There is tons of information out there, some of it good and some of it not even on the charts.

Dr. Jordana Hawkins, a pediatrician at PeaceHealth Medical Group in Bellingham

Misinformation about vaccines is a special concern for Whatcom County pediatricians.

“There is tons of information out there, some of it good and some of it not even on the charts,” Hawkins said. “I think parents are overwhelmed by that … It’s hard when they see us every couple months, but they are on Facebook every single day getting an onslaught.”

“We definitely have higher non-vaccination rates than some other parts of the country,” Hawkins said. “No, we’re not the worst.”

Parents with questions about vaccination safety should be able to get those questions answered in the doctor’s office, Hawkins said.

It’s not surprising that Hawkins advises parents to listen to their child’s pediatrician for reliable information. But she also hopes parents will find a pediatrician who listens to them, and eventually, to their children.

In today’s world, accidents, rather than disease, are among the biggest threats to a child’s health. Hawkins stresses some key safety tips in her own conversations with parents:

▪  Keep an eye on crawlers and toddlers at all times, especially around water. Make sure upstairs windows are latched, to prevent falls.

▪  Use car seats, every ride, every time. Get expert assistance in making sure your car seat is properly installed.

▪  As kids graduate from walking to bike riding, helmets are a must, every ride, every time.

As youngsters reach middle school and puberty, life gets a lot more complicated.

Both parents and doctor need to monitor the emotional and physical health of sons and daughters as the transition to adulthood: Are they doing well in school, making friends and keeping up with studies? Do they suffer from anxiety or depression? Do they have healthy eating and sleeping habits?

In today’s world, social media use has become something all parents confront, especially in the adolescent years. Hawkins said parents should encourage their sons and daughters to do their media surfing in a public part of the house. She also thinks parents should check up on exactly what their children are doing online: Phones and computers should be considered parental property that a child is allowed to use, but only with parental oversight.

Gaming can be especially addictive, and Hawkins says parents should set limits and require kids to take breaks.

Adolescence is also the time for sex education – the sooner the better, Hawkins said, even if it feels “too early.”

“If you don’t do it, society will,” Hawkins said. “It’s a hard topic to bring up.”

PeaceHealth sponsors a class in Bellingham called “Great Conversations” which Hawkins heartily recommends. It is designed for 10- to 12-year-olds, and the youngsters and parents take the class together. Boys and girls attend separate classes. Check with your pediatrician for information on when the class will be offered.

In her experience, some adolescents will tell the doctor things that they don’t feel comfortable sharing with parents. That’s another reason why Hawkins stresses the importance of finding a doctor who is a good listener.

“It’s amazing how much kids will hide,” Hawkins said.

It’s really important to just step back and let kids be kids.

Dr. Jordana Hawkins, a pediatrician at PeaceHealth Medical Group in Bellingham

In a society in which both parents often work, Hawkins – who has two little boys of her own – fears that many parents may be working too hard to be perfect parents when they are at home with their children. She stresses that parents need not feel obligated to spend all of their off-time with their children. Strive for balance.

“It’s important to not put too much pressure on yourself,” she said.

While organized activities like sports, dance or music lessons are valuable, kids also need time to play on their own, Hawkins added.

“It’s really important to just step back and let kids be kids,” Hawkins said.

Dr. Julie Cheek, pediatrician at Unity Care NW in Bellingham, stressed that mental health and learning difficulties are now a key part of the job for her profession, in a time when infectious diseases have been curtailed by vaccination and other public health measures.

Doctors and parents should watch for trouble signs at an early age, Cheek said. Even in the first few months of life, there may be warning signs. Detailed information is available online, and pediatricians provide new parents with information handouts during checkups. Here are some examples, taken from the Centers for Disease Control checklist for two-month-old babies. The handout advises notifying the doctor if a baby:

▪  does not react to loud noises;

▪  doesn’t watch moving objects;

▪  doesn’t smile at people;

▪  doesn’t bring hands to mouth;

▪  can’t hold head up when lying on stomach and pushing up.

Similar checklists are available online for kids at four, six, nine, 12 and 18 months, and at 2, 3, 4 and 5 years.

There’s a range of normal. It’s hard for parents to know what’s normal.

Dr. Julie Cheek, pediatrician at Unity Care NW in Bellingham

Parents are often advised not to compare their own children to someone else’s. But Cheek said comparisons can be useful in identifying possible problems the doctor should know about. Is your child struggling with things that other kids the same age seem to do with ease? Talk to the doctor.

Cheek advises parents not to assume the worst if they notice potential problems.

“There’s a range of normal,” Cheek said. “It’s hard for parents to know what’s normal.”

Pediatricians also need to know if a child has had to endure traumatic events such as abuse, domestic violence or homelessness, Cheek said. Traumatic experiences affect a child’s emotional development, but later problems can be avoided if kids get the help they need.

Like Dr. Hawkins, Cheek is concerned about the impact of social media on young minds.

Excessive screen time is linked to physical inactivity, Cheek said. She recommends limiting that screen time – phone, television, video games – to no more than two hours a day.

Replace that excess screen time with physical activity: Cheek recommends an hour of it daily for youngsters. That means exercise strenuous enough to raise the heart rate.

Another social media pitfall is the tendency of young social media users to compare themselves to people they know online.

“They have so many expectations of what they should be doing,” Cheek said.

Kids who don’t fit in can find themselves bullied both at school and online, Cheek said. If kids show extreme reluctance to go to school, this is a possible explanation, she added.

Undiagnosed learning abilities may also make kids dread school.

“We rely on parents to tell us,” Cheek said. “Stay involved with your kid during the school year. If kids are avoiding school or say they don’t like school, stay on top of that right away … the most important thing for a kid’s outcome is a strong parent and an involved parent.”

CHOOSING A PEDIATRICIAN

Suggestions from the American Academy of Pediatrics, and local pediatricians:

  • Look for a doctor specially trained and certified in pediatrics.
  • Ask what kind of help is available outside normal business hours.
  • Ask if the medical practice has office hours in evenings or on weekends to make checkup scheduling easier for working parents.
  • Ask other parents to recommend a doctor.
  • Make sure your doctor does the recommended developmental screenings of your child during regular checkups.
  • The nurses and front desk staff, as well as the doctor, should be friendly, patient and courteous.
  • Look for a doctor who takes the time to listen and respond to the concerns expressed by you and your child.

ONLINE RESOURCES

Tips on finding a pediatrician, from the American Academy of Pediatrics:

https://www.healthychildren.org/English/family-life/health-management/Pages/How-To-Choose-A-Pediatrician.aspx

Immunization schedules:

http://here.doh.wa.gov/materials/immunizations-at-every-age/15_FamImm_E13L.pdf

Handouts for parents:

http://www.milestoneskids.com/patient-questionnaire-forms-bright-futures.html

Child development checklists from the Centers for Disease Control and Prevention:

http://www.cdc.gov/ncbddd/actearly/milestones/milestones-2mo.html

More information on Great Conversations sexual education classes:

http://www.greatconversations.com/?page_id=12

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