Managing the Meltdown: How to Handle Tantrums in Children

Monday, December 29, 2014 12:02 PM comments (0)

tantrumsEvery parent has been there at one point or another—at the mercy of his or her child’s tantrum in the checkout line at the grocery store, in a crowded restaurant or at home.  In a matter of minutes, your child goes from quiet and well-behaved to completely inconsolable. 

The good news is that temper tantrums are entirely normal, especially in toddlers. For toddlers, tantrums are often brought on by a young child’s inability to understand and cope with his/her emotions, emotions related to hunger, tiredness or feeling overwhelmed and over-stimulated. 

While it’s not possible to prevent every single emotional meltdown, there are ways to manage them. Leslie Deitch Noble, MD, Pediatrician at NorthShore, discusses some of the best techniques for approaching tantrums:

Don’t overschedule. Try not to overexert your child by packing too much into the daily schedule. This is not to say that every day needs to be the same, but when possible try not to push your child to the limits with errand running. A hungry or tired child is much more likely to act out. If you know you have a long day ahead, let your child know in advance so he or she will be better prepared for the change of pace.

Be consistent with your approach. Try your best to manage your child’s behavior during every tantrum. Encourage communication during a tantrum. Say, “Use your words” or ask clear questions to better understand what might be causing your child’s frustration. Lastly, do not give in. Letting your child have his or her way during a tantrum won’t help break the cycle, even if it ends the immediate tantrum. Ideally, you don’t want to give your child any attention—positive or negative—while he or she is having a tantrum. So, as long as you are not in public and your child is not going to hurt him or herself, the best approach is to completely ignore your child until the tantrum stops.

Distract. Distract. Distract. If you can, try to divert your child’s attention away from what may have prompted the tantrum in the first place. Be sure that you recognize that he or she maybe be upset by a situation, but then offer different options or new activities. For example, if your child has a tantrum over wanting a new toy or treat at the store, you can suggest that you find the “new” toy she got most recently when you go home. A similar approach can be tried with treats. If necessary, try to avoid going down aisles at stores that might prompt meltdowns.

Celebrate (and embrace) the good times. Let your children know when they are behaving well and encourage this type of behavior. Tell them how happy it makes you when they listen and follow the rules. Along with acknowledging good behavior (and even rewarding it), be sure your children know how much you love and care for them. Much of what triggers tantrums is children wanting to express their emotions and wanting attention.

Have questions about tantrums? Get answers from other parents and our team of experts in our new online community The Parent 'Hood. Find out more here: The Parent 'Hood

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Sick Days: What Are Hand, Foot and Mouth Disease and Herpangina?

Tuesday, November 11, 2014 12:56 PM comments (0)

hand foot and mouthHand, foot and mouth disease (HFMD) is a typically mild but highly contagious viral infection most common in children under seven years of age. The illness is characterized by mouth or throat pain (due to sores), fever and a rash (typically involving the hands, feet, buttocks, arms and legs). The infection is caused by enteroviruses—most often coxsackie virus A16—which are transmitted from person-to-person by oral contact with stool, saliva, fluid from skin lesions or respiratory fluids via coughs or sneezes. Herpangina, also caused by enteroviruses, is a cluster of symptoms characterized by fever and mouth lesions (but no rash).  These illnesses are particularly common in child-care settings because of the frequency of contact and germ sharing between children and inadequate handwashing—especially after diaper changes or toilet use. The viruses can also be transmitted by contact with contaminated surfaces or objects, like toys.

Outbreaks occur most often in summer and fall but can happen anytime, especially if your child is in daycare. Kenneth Fox, MD, Pediatrician at NorthShore, shares symptoms parents should watch for and outlines ways you can make your child more comfortable while the virus runs its course: 

Symptoms of Hand, Foot and Mouth Disease:

  • Small, painful sores in the throat or mouth, including cheeks, tongue and gums 
  • These lesions cause pain and difficulty swallowing
  • Small blisters or red spots classically located on hands, soles of the feet and between fingers and toes 
  • Fever
  • Decreased energy and appetite
  • Diarrhea and vomiting
  • Respiratory symptoms like congestion, cough and “pink eye” (conjunctivitis)

Symptoms of Herpangina:

  • Fever
  • Painful red sores in mouth/throat (as above)
  • Vomiting
  • Abdominal pain
  • Headache

Fever and mouth/throat pain usually last three to five days. Other symptoms, like mouth sores and rash (with HFMD) can last up to seven to ten days. The virus is shed orally for one to three weeks and in stool for two to three months after infection. While there are no cures for HFMD or herpangina, there are things you can do to make your child more comfortable during those first few days, as well as reduce the risk for dehydration which can occur because of pain and difficulty swallowing. 

What can parents do?

Keep little ones hydrated. Try Pedialyte or Gatorade to keep their electrolytes up. Also popsicles, ice chips and other frozen treats can replenish fluids while also helping with pain. 

Reduce pain or fever. Use Acetaminophen or Ibuprofen but check age-appropriate dosages before administering. 

Make swallowing easier. Eliminate salty, spicy or acidic foods to avoid further irritating mouth sores. Consider providing a variety of soft foods, like yogurt, pudding and rice. And always rinse mouth after meals. 

While it is not always possible to prevent your child from contracting hand, foot and mouth disease, you can reduce his or her risk, and your own. Here are some ways to keep your kids healthy and prevent the spread of HFMD in your home:

  • Wash hands with soap and water for 15-30 seconds and dry with disposable towel after using the toilet, changing diapers; after touching another child, the floor or contaminated surfaces; before eating meals or snacks; after coming in from outdoor play; after sneezing, coughing or wiping nose or eyes 
  • Clean and disinfect contaminated surfaces and toys more than once a day
  • Avoid or prevent close contact like kissing, hugging, sharing utensils or cups 

If your child does get hand, foot and mouth disease, watch for these signs of complications:

  • Dehydration (dry mouth, pale skin and nails, no tears or urine, lethargy)
  • Breathing difficulty
  • Chest pain
  • Stiff neck
  • Mental status changes (inconsolable crying, confusion, poor balance, difficulty walking)

Have questions about hand, foot and mouth disease or any other pediatric illness? NorthShore's new online community, The Parent 'Hood, has answers. Join today to connect with other parents in the community as well as our expert physicans.  Click here to start now

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The Benefits of Breastfeeding for Mom and Baby

Friday, July 05, 2013 1:00 PM comments (0)

breastfeedingIn return for sweet smiles and abundant cuteness, babies ask only for love, affection, the right to be awake when you want to sleep and nourishment. What form that nourishment takes is up to you.

New mothers who are unable to breastfeed should not feel guilty because formula is an effective way to feed your baby and ensure he or she receives proper nutrition.  But, the health benefits of breastfeeding for both mother and baby are many and exclusive breastfeeding for the first few months of a baby’s life is recommended. New moms should take note that many of the same benefits of breastfeeding can be achieved through a combination of breastfeeding and supplementing with formula.  

Ann Borders, MD, and Emmet Hirsch, MD, obsectrics/gynecology at NorthShore, share some of the valuable health benefits of breastfeeding:

  • Breast milk is nutritious and easy to digest. It’s the perfect combination of vitamins, fat and protein. It’s easy for a baby’s sensitive digestive system to break down, reducing constipation and gas.
  • Breast milk is an infection and disease fighter. It provides antibodies that help combat infection. Breastfed babies have fewer ear and respiratory infections. Breastfed babies have less risk of Sudden Infant Death Syndrome (SIDS). Babies breastfed for at least six months are less likely to become obese as children and adults. It’s believed that breastfeeding is linked to lower rates of asthma, type 2 diabetes and some forms of cancer later in life. 
  • Breastfeeding is a bonding experience. It is extremely important for a mother and child to establish a secure bond in the first months of a child’s life. The physical closeness and contact of breastfeeding is an important opportunity for bonding. 
  • Breastfeeding saves money. Formula comes with a heavy price tag. Breastfeeding can save thousands of dollars a year. Add to that sum the potential long-term costs of healthcare for issues breastfeeding might help prevent. The Centers for Disease Control and Prevention (CDC) reports that families that follow breastfeeding guidelines save $1,200 - $1,500 in formula costs alone in the first year.
  • Breastfeeding burns calories. A woman who breastfeeds burns approximately 500 extra calories per day, making it easier to shift those extra pounds from pregnancy. That’s the equivalent of jogging for one hour. It also helps her uterus return to the size it was before pregnancy.
  • Breastfeeding is healthy for mom too. Breastfeeding lowers a woman’s risk of developing type 2 diabetes, and breast and ovarian cancers. Breastfeeding has been linked to lower risk of postpartum depression. Some studies show that it could also lower her risk for osteoporosis. 

Did you breastfeed? What were the advantages/disadvantages for you? For more advice on breastfeeding from Ann Borders, MD, click here

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The Importance of Regular Pediatric Doctor Visits

Tuesday, January 08, 2013 8:31 AM comments (0)

Pediatric-AppointmentsDoes it seem like you make a lot of trips to see your pediatrician? Regardless of the reason—the sniffles, a high fever, an infection or something else—it is a good idea to make regular visits to the doctor. These appointments, along with any “back-to-school” check-ups, are not only important to your child’s well being, but also can help physicians identify health risks and preventive measures.

Alison Galanopoulos, MD, NorthShore-affiliated Pediatrician, identifies some of the common health concerns that a pediatrician can often identify during regular visits:

  • Behavioral Issues. Some behavioral issues may be hard for a parent to pinpoint. Something as simple as snoring, for example, can sometimes signal serious problems, such as sleep apnea, bedwetting and even ADHD.
  • Growth and Development. Your pediatrician can monitor patterns to help determine your child’s growth and development. He or she should also be able to ask the right questions during appointments to help identify any problems.
  • Obesity. Preventive health is key. With the rise of childhood obesity, having regular appointments that can track your child’s weight and height are essential to help determine a potential weight problem. Your pediatrician can work with you to establish healthy eating habits and promote exercise from a young age.
  • Nutritional Deficiencies. Many children have been found to be deficient in Vitamin D, which can lead to future health problems. The best way to combat this is to have your child (depending on age) eat 2-3 servings of calcium a day.
  • Vaccinations. There are many required immunizations, and it can be overwhelming for a parent to keep track of what is needed. You can work with your pediatrician to confirm your child is up to date.

How frequently do you take your child/children to the pediatrician?

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Guide to Buying and Giving Age-Appropriate Toys

Thursday, December 06, 2012 5:37 PM comments (0)

Now is the time when our shopping lists for holiday giving may include items for children of varying ages. While walking through the aisles, you’ll see plenty of new toys along with many of the tried-and-true classics (like building blocks and dolls). With all the options out there, how do you know which toys are best suited for what ages?

The most colorful or cute toy on the shelf doesn’t always make it the best choice. It’s worthwhile to recognize that children of varying ages have achieved different development milestones.  Just as you wouldn’t give an infant a LEGO® set, you also wouldn’t buy a four year old a teething rattle.

Kenneth Fox, MD, a pediatrician at NorthShore, gives the following recommendations when shopping for age-appropriate toys:

  • Safety first. Choose sturdy toys with washable surfaces. Watch out for small parts, sharp points or edges. Make sure attached pieces (eyes, buttons, etc.) cannot be torn or bitten off to create choking hazards. Avoid toys made of or decorated with toxic substances or chemicals (paints, dyes, glazes or other embellishments). As much as possible, try to understand where toys or other gifts are made and avoid untrustworthy sources even if they appear to be bargains. Make certain batteries are not accessible to curious and nimble little hands and mouths. Battery- or electric-powered toys should be  labeled “UL approved.” For more detailed information on specific toys consult Consumer Protection Safety Commission website (www.CPSC.gov).
  • Read the packaging information. Most toys include a recommended age on the packaging. These labels, based on a typical child’s abilities and skills at a particular age, should serve as guidelines. But remember, every child is different and develops at his own pace. Ask yourself the basic question: “Is this toy right for this particular child, given his particular developmental stage?”
  • Resist buying toys that a child can “grow into”. Age guidelines on toys exist for a reason. As nice as it may be to stock up on new toys for the growing child, it’s often hard to keep these toys out of reach until they are age appropriate.
  • Choose usefulness over fad, “must-have” toys. Every year there are countless new toy trends and gimmicks. It often is best to stick to options that have been around long enough to be dependable and tested. The best, most fun toys often have an unstructured aspect. They invite and engage the child’s imagination and creativity.
  • Kids learn a lot both by receiving and by giving. Basic capacities for empathy emerge in childhood through experiences with gift exchange and through symbolic play. Kids learn to be generous givers and gracious receivers of gifts through practice, guided by caring adults. From choosing, wrapping and presenting gifts to others, a capacity for empathy is nurtured, supported and reinforced. Also, modeling how to show one’s appreciation is a great gift in itself. “Thank you” goes a long way, even in today’s world of rampant consumerism.
  • Set limits on gifts and keep things simple. How often have you noticed that young children are often more entertained by gift wrapping and packages—like big empty boxes—for creative play? Art supplies are often the most treasured, enduring and useful gifts.
  • As much as possible, try to connect a gift with an experience. For example, handmade or homemade gifts or cards in which the child participates creatively make for heartfelt and memorable experiences. A book about or memento of a particular activity, thing or place that a child can then have direct experience with in a hands-on way, makes for a wonderful, cherished gift.

Play is essential to a child’s physical, cognitive, social and moral development. Toys, books and experiences that enrich creative play make wonderful gifts for the season and support healthy child development all year long.

Can you remember a time when one of your children received a toy not well suited for his or her age? What did you do?

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