Who Would Have Thought Jerry Seinfeld Could Be Such a Great Dad?

March 4th, 2010

I always considered Jerry Seinfeld a good comedian and a well-known TV personality but not much else. The last I heard of him was when his show ended and he got married. Naturally, I assumed that he had probably already divorced, like most celebrities, and perhaps had been in and out of relationships for the past decade. I mean, even us normal folk tend to witness the demise of our marriages more often than not.

But boy was I wrong. He even has kids!

A recent Parade article (”No Place Like Home,” by Harlan Coben) opened my eyes. Jerry Seinfeld sounds like a great dad! His insightful comments were a revelation to me, especially considering that his show was about a single male living in New York, seemingly without a clue regarding how to raise kids, let alone maintain a stable relationship. This is the guy who, on television, portrayed kids in a negative light or not at all throughout a decade of Seinfeld. As rich as he is, I thought that if he ever had kids, they would be spoiled like Paris Hilton, accomplishing nothing and living off the family name.

When I read his three rules of parenting, what he calls “The Poison Ps,” I became an instant post-Seinfeld Seinfeld fan.

His first P is Praise- “We tell our kids, ‘Great job!’ too much,” he says. Boy, do I agree. Parents come into my office (I am a pediatrician) and brag about their kids’ grades even though they are barely passing. They look pleased as they tell me that a “C” means that their children are eligible for athletics.

Seinfeld’s second P is problem-solving- “We refuse to let our children have problems. Problem solving is the most important skill to develop for success in life, and we for some reason cannot stand it if our kids have a situation that they need to ‘fix.’ Let them struggle – it’s a gift.”

Very well put. Countless times, I witness parents overstepping their bounds in an attempt to resolve a situation in which their children have placed themselves. A very common one, for instance, is not allowing children enough time to finish a school paper or project. The parents step in and finish the paper and the students get “A’s” that they did not deserve. Even in the more mundane aspects of life, however, parents still go over the top and prevent their children from attempting to resolve the mysteries of life without being spoon-fed the answers in advance.

Jerry’s third P- “Giving your child too much Pleasure,” is one that pretty much explains a key element in the childhood obesity epidemic. We feel guilty and will stop at nothing to make our children’s lives as perfect as possible. We interfere in their play activities in order to prevent them from getting hurt. We never allow them to experience physical or mental pain. We will wait in line for hours and pay top dollar for the latest toy or electronic gadget in order to avoid having our children face disappointment. We refuse to allow them to play outdoors and climb trees or rocks for fear they might hurt themselves, get wet, get cold, get sick, get into trouble, and instead we, in essence, encourage them to stay inside and play video games. We do not allow them to interact with strangers or other kids unless we vet them first. (Heaven forbid, the new neighbor might be a child molester, or the new kid might have germs and we certainly do not want our kids to get even the mildest cold.) We are wrapping our children in a cocoon of protection, and while we protect them from catastrophe, we lessen their experience of life.

Reading this article about Jerry Seinfeld made me realize that not all celebrities are bad role models for parents and children. Now, when we see countless cases of bad behavior in sports figures and movie stars, it is nice to have a major celebrity, worth hundreds of millions of dollars, emphasize the importance of not over-indulging your child and controlling every aspect of their lives.

So folks, learn the Three Poison Ps from Mr. Seinfeld. You will be a better parent for it, and your children will grow up appreciating the gift you grant them: freedom to experiment, freedom to fail, and freedom to succeed, all on their own.

Lack of Sleep is a Nightmare for Teens

February 18th, 2010

Girl Falls Asleep at the Library

Over the years, I have noticed an increasing problem in many of my teen patients: sleep deprivation. Sara, for one, is a very good student and active in extracurricular activities. Recently, she made an appointment because, of late, she had been feeling more tired then usual. The first inquiry I made was to ask her to run through her daily activities.

“I get up at 4:30am to be at water polo practice. After practice I have an early 7am AP class. After school, we practice until 7pm or have a game until 9pm. I have a quick dinner, go to my room, and do homework until midnight or 1am.”

“You do this every night?” I exclaimed!

“No, I sleep in on Saturday’s and Sunday’s if I can.” She answered. “But too often I need the weekend to catch up on homework, or I have to study for a test, and I don’t get to bed until 4 or 5 am,” she concluded.

No wonder she is sick and feeling rundown. I would feel that way too.

After conducting a basic work-up, I reassured Sara that the only thing wrong with her was that she was burning the candle at both ends and not getting the proper amount of sleep.

This is a national problem with teens, as illustrated by a recent article by Marissa Cevallos of the San Jose Mercury News. Ms. Cevallos recounts research that shows teens do not do well on morning tests because their brains are not fully awake. She also states that Kansas teens involved in car crashes are attributed to being drowsy in over 15% of accidents.

Sleep deprivation can be deadly!

I revealed to Sara that sleep is one of the most important elements of staying healthy and that teenagers like her could require anywhere from 8 to 10 hours of sleep a night.

As with most teens, she said that this was impossible. With all of her activities and homework, she didn’t have the time to sleep.

She became more receptive to the importance of sleep, however, when I shared these insights with her:

People who get less sleep than their bodies require function poorly at work and school. They may think they are accomplishing a lot but, in reality, they are not. Without a good rest, they lack the ability to think clearly and avoid wandering thoughts.

Lack of this necessary rest makes one susceptible to illness or feelings of sluggishness throughout the day.

Irritability, mood swings, and even weight gain has been attributed to sleep deprivation.

Participation in competitive sports is hindered because the body does not receive the proper amount of time to refresh and re-energize.

Sara left my office with the knowledge that she could maximize not only her academics but also her performance in the pool by simply getting more sleep. This alleviated some of her unease. She craved more sleep but was under the false premise that getting the proper amount of sleep would cause her to perform poorly in her classes and be less competitive (due to lack of study time).

Many of us are under the same misguided notion as Sara. We assume that by spending more hours awake we are somehow more efficient and that by going to bed early, we would be wasting valuable time on a frivolous activity.

Quite the contrary! Thank goodness we are becoming more aware of the value of sleep and the effects of sleep deprivation. As mentioned by Ms. Cevallos, some people have attempted to remedy the problem.

School districts have taken under consideration the possibility of starting the school day thirty minutes to an hour later than now, but at the same time, they are also aware that this may lead to problems at the other end with extracurricular activities eating their way into the night.

Colleges have recently become aware of this phenomenon, noting that a young adult’s natural sleep cycle, or circadian rhythm, often calls for both more hours of sleep and later starts to the day. Administrators realized that many students were not showing up for early classes or they were too groggy to learn anything, so many universities have taken steps to limit the number of classes before 9am. (Of course, one of the major advantages of college over high school is the ability to pick courses to fit a particular sleep cycle.)

Now that she knows how important sleep is, I hope that Sara will schedule it into her daily routine.

With so many teenagers dealing with sleep deprivation, however, perhaps schools can take matters into their own hands to find ways to reduce the load for their students, and maybe parents and teenagers can decide among themselves to drop that extra activity, group, or club, as I’ve written about previously.

Is Breastfeeding Better Than Formula Feeding? What You Should Choose

February 18th, 2010

Is breastfeeding better than formula feeding? Every mother contemplates this question. Many instinctively “feel” that breastfeeding will lead to better infant health, and they hear countless media sources touting the many advantages of breastfeeding, from economics (you don’t have to pay for breast milk) to better immune health (see American Pregnancy Association ). Mothers who cannot breastfeed for health or personal reasons worry that they are depriving their children of essential nutrients that could affect their infants’ health levels. Therefore, they worry that they are placing their children at a disadvantage.

Perhaps they should worry no more. Professor Sven Carlsen, author of a recent study published through Acta Obstetricia and Gynecologica Scandinavica, claims that there is no difference between breastfeeding and formula feeding in regards to children’s health. (Read About It at the ) Carlsen, an expert in the hormonal changes of pregnancy, says instead that although studies show that breastfed babies are slightly healthier later in life, it is due to conditions in the womb and not due to later breast or formula feeding. Professor Carlsen suggests that higher levels of testosterone in the womb alter the infant’s development and the mother’s later ability to breast feed. Thus, the difference observed is actually an example of a correlation rather than an instance of causation.

This conclusion, however, goes against what experts have been saying for years. (Agency for Healthcare Research and Quality) And some researchers and physicians have fired back at Professor Carlsen’s conclusions. UNICEF in the UK even issued a direct retort of Carlsen’s statements, agreeing that he poses an interesting question, but hammering the point that numerous prior studies have supported the idea that breastfeeding leads to better infant health.

The makers of baby formula attempt to match the qualities of a mother’s milk by including ingredients that simulate breast milk in consistency and nutrition. One formula, Enfamil, advertises a Triple Health Guard formula that is “clinically proven to benefit your baby” in growth, brain development, and development of a healthy immune system. Yet no formula can match the natural immune benefits of breast milk because none contain the antibodies passed between mother and child (KidsHealth ).

Dr. Carlsen’s basic presumption, that breast feeding and formula feeding will be equally valuable to your baby, may or may not be entirely correct, but I do agree that there is not a great deal of difference between the two. If there were alarming differences, in all the years that formula has existed, then the FDA would have done something about it by now. Those studies that find one is better than the other haven’t found much of anything at all. If you choose formula, you are NOT hurting your child’s development.

Additionally, if you are a working mother who cannot always be available to breastfeed, or if you have medical issues which make breastfeeding more difficult, you might even be better off using a formula. Why? You will become stressed if you ignore the signals your body and mind give you, and when you are stressed, your body reacts by altering hormone levels and altering immune response. Your milk may not be as beneficial, and you may be better off feeding your baby formula rather than passing along hormonally altered milk. Do not fight your natural situation. If you are willing, able, and desire to breastfeed, then do it. If you are not, then you will be just fine using a formula. This small thing, feeding your baby breast milk or feeding it formula, will not cause any significant differences later in life.

There are other things that make a far greater difference.

Most important to me is infant nurturing. Forget the minuscule differences attributed to formula or breast feeding. Differences in infant nurturing will affect emotional and physical development far more than a few antibodies. Whether you do or do not breast feed, just be sure to present a warm and nurturing environment during feeding. Whether you breast or bottle feed, do not just force-feed your baby absent-mindedly according to your own schedule, but instead pay attention to your baby’s needs and maintain a strong bond between yourself and your child. Some parents ignore infant hunger levels and simply force bottles or nipples into their children’s mouths, as I have written about in the past. It should go without saying that this is not a good way to go about things.

In the great scheme of things, breast versus formula feeding makes far less of a difference than these personal interactions that can help your child grow into an emotionally healthy individual.

What is my final advice? Don’t worry about Dr. Carlsen’s findings. Don’t worry about the rebuttals. Being a good parent is about far more than protecting your child from the smallest imaginable threats, harped on by the media only because their ratings demand that they scare you. Just be the good parent that you are. Love and adore your child, and the little things will take care of themselves.

The Obesity Problem Starts At Birth: Parents Giving Children Too Much Food

January 26th, 2010

I was sitting in a booth at the local Chinese restaurant and doing what I do all the time: baby watching. I am a frustrated grandfather wanna-be. I love observing babies and listening to their babble and infectious laughter. I pay attention to the interplay between parents and baby, and I marvel at the naturalness of the encounters, even with new parents. Some interactions, however, cause me a great deal of concern.

For example, on this particular evening, I was watching a mother and her five-month-old baby, fascinated with the interaction and the obvious joy they felt with one another. The baby caught me watching and gave me a little smile that only an infant possesses. She then turned back toward her mother and started showing signs of boredom. She squirmed and emitted sounds of annoyance, reaching up with her hands and attempting to get her mother to take her out of her booster seat. Instead, her mother immediately shoved a bottle into her mouth. The baby took the bottle and sucked for a few seconds but clearly was not hungry. She turned her head, temporarily succeeding at dislodging the bottle, only to have her mother shove it straight back into her mouth. The baby was practically screaming, “I’m not hungry!” but her mother was so intent on simply keeping her daughter quiet that she totally ignored the message being sent to her.

Babies have only so many ways of letting us know about their needs, and crying is one of them. Indeed, it may be the best and surest way of getting our attention. Unfortunately, babies are then stuck with only one good signal for conveying many different messages. Many parents immediately think, “The baby is hungry. I need to feed it.” Some think, “The baby is crying. The last time I gave it food it stopped crying.”

Babies are not always hungry when they cry. They will let you know when they are, and they will let you know when they are not. If they are truly hungry, then eating will calm them down immediately. If they are not, then no amount of food will settle them down. They will eat when they need to, and when they are full, they will quit. Humans are born with a satiety center in the brain that controls hunger, and infants are much attuned to this natural instinct that prevents us from overeating. Perhaps they are even more attuned to it, not yet conditioned by society and culture.

Episodes like what I witnessed in the restaurant contribute to the obesity problem we face in this country. Parents do not pay attention to the actual needs of their children and are too eager to think food is the answer. As a consequence, their children do end up thinking food is the solution to all their problems. How often do you see someone overeating after a bad break-up, after getting fired, or perhaps just on a “bad day?” We use food to satisfy a need, even if that need is not hunger.

The baby I witnessed was trying as hard as she could to avoid that bottle. Her mother kept shoving the bottle at her, and the baby finally gave up and began drinking her formula. The infant came to the realization that her mother would not relent until she ate, so she did. She drank several ounces but refused to finish the bottle, and her mother finally got the message and picked her up, which was what the baby wanted in the first place.

Over time, this baby will equate eating with pleasing her mother, even when hunger is not an issue. She will no longer trust her instincts to sense hunger, but will be conditioned to eat when presented with food. As she grows older, her parents and grandparents will order her to finish her plate, to not waste. These days, society has dictated new eating norms. Restaurant portions are larger, plates are larger, and everything is super-sized. This baby will think that all of that is normal, even when exorbitantly over the top. If she does not see it coming, she might become another obese American.

While I was making my observations, I was eating my dinner, and the beef fried rice happened to be especially delicious. I had my fill, but there was some rice left on the serving plate, and not wanting to waste it, I began spooning the remains onto my plate. At that point, it dawned on me that I had not learned my lesson, even after my study of this infant’s eating behavior. I put my fork down and asked for a take-out container.

Please note, it is not necessary to finish everything on your plate even if someone is telling you to. Eat only when hungry and eat only as much as you need to satisfy your appetite.

Never make your children clean their plates. If they are unable to finish their portions, give them less next time. (Of course, do not let them get away with leaving only the vegetables!)

Pay attention to what you eat and how much you eat. Remember, you are the role model for your kids. Obese parents often have obese children, not just because of genetics, but also because of what they feed themselves and their children.

Do Not Bribe Children to Get Them to Do What You Want Them to Do

January 10th, 2010

A grandfather brought his little granddaughter into the office one morning. She was being uncooperative and refused to open her mouth. He tried coaxing her, but when this did not work, he resorted to bribing her: “If you open your mouth, I will buy you anything you want,” he said. Immediately, she smiled and opened her mouth. This was what she had been waiting for, a bribe.

Kids are not stupid. They quickly learn how to get the most from those around them and are very aware of which family members are most likely to give in and shower them with gifts, in many cases just to get their cooperation.

It always surprises me how much power parents or caretakers allow a little three-year-old to wield. Take this Associated Press article that discusses how parents overly reward their children, leading to a generation garnered with a “sense of entitlement.” Or how about a quick report that a significant number of parents bribe their children in order to get them to eat their vegetables. Another study found that many parents are utilizing bribery in promoting education.

Bribing a child is wrong, whether parents utilize it with the intention of gaining a child’s cooperation in my office exam room, in cleaning a room, or for better grades. Bribes rarely work in the long run. Children become too dependent on reward and never learn to accomplish a task on their own initiative. They perform a task because someone else wants them to do it, not because they want to do it themselves, and not because they themselves gain a reward from the mere act of completing the task.

For example, in promoting academics, a parent might reward a child with candy or money for receiving “A’s” on a report card. This, however, gives the child the idea that the incentive for working hard is the reward of cash or candy, not the grade itself.

Kids can and should do as told without parents resorting to bribery, anger, or punishment. If parents treat children with respect and teach them at an early age to respect the parent and the tasks given, bribery loses its necessity. A firm request, in a tone that warrants no argument, is all that is required in gaining the collaboration of any child.

Feel free to reward good behavior, but do not reward single instances of good behavior. Reward behavior that is always good.

Grandpa brought his little granddaughter into the office this morning. She was being uncooperative and refused to open her mouth. He tried coaxing her and when this didn’t work, he resorted to bribing her. “If you open your mouth I will buy you anything you want” he said to her. She smiled and opened her mouth readily. It seems this was what she was waiting for, a bribe.

Kids are not stupid. They pick up immediately on what will work. They also are very aware of which family member is more likely to give in and shower them with gifts just to get their cooperation.

It always surprises me how much power parents or family members will allow a little three year to have. I have seen family members do the most ridiculous antics because the allow a little person to have control.

Bribing a child is always wrong. I don’t care if it is to gain their cooperation in the exam room, to clean up their room, or for better grades.

Bribes never work in the long run. I have never seen a child, in a household where bribes were common, succeed. They become too dependent on a reward and never learn to accomplish a task on their own initiative.

Kids should be expected to do as told without the parent having to resort to bribing, yelling, or spanking. If the child is treated with respect and they are taught early on to respect the parent, this behavior is rarely necessary. A firm request, in a tone that warrants no argument, is all that is needed to gain the collaboration of any child.

Christmas and What to do about Presents for Children

December 7th, 2009

The holiday season is upon us, which is both a blessing and a curse. Often, it is a stressful time for parents, and more so with the current economic situation. What presents do you get for kids when times are tight but you still want to give them the feeling of Christmas? Well, I do not think you need to buy into the latest craze (especially if you have to drive 43 miles to do so!), give in to begging, or always take the easy way out, like some. Instead, here is some simple advice this holiday season.

First, never go into debt out of guilt. Only buy what you can afford. Never feel that you have to give your children everything on their Christmas lists. After all, these lists consist of wants, not demands. Beyond that, children cannot expect to receive everything they ask for. Fulfillment of this expectation will only give them a false sense of reality. Part of growing up is learning to live with disappointment, and giving in to your children’s whims does not teach them this important lesson in life.

Instead, be open and frank with your children. Let them know that times are tough and that you will be prioritizing that which allows you to pay the bills and keep putting food on the table. Kids are actually very understanding; they will surprise you with how little they really want.

Give more thought to the presents you buy. When you go shopping, keep a list of your favorite affordable items and the location with the best price. These days, finding unique games and toys is quite a bit easier than it was in the past. Through the internet, Amazon usually has items on sale, and eBay may just provide the perfect steal for a sold-out or otherwise unavailable item.

That said, consider making your own presents. Young kids will not think any less of your gift, and as they age, older children will realize how much love went into it. They may treasure it for years and even pass it on to their own children.

Additionally, children enjoy opening presents, so buy a number of small and inexpensive items rather than one pricey item. With the economy the way it is, bargains will be around throughout the holiday season. With forethought and patience, no child has to go without two or three presents for Christmas this year.

Finally, if you happen to be in a fortunate situation, remember all those kids who will not get presents this year and think about donating to Toys for Tots or similar organizations.

Best of luck, and Merry Christmas!

Food Stamps Can Make a Difference but Can Also Lead to a Reliance on Others

November 12th, 2009

I grew up in a poor household where, at times, my family struggled to put food on the table. To survive, we took advantage of all benevolent options offered, including the food stamp program, or what is now called the Supplemental Nutrition Assistance Program (SNAP).

I still remember, however, the shame of standing in line while my grandmother paid for our groceries with our embarrassing form of currency. I could see the disdain in the eyes of those behind us in line, and I could see their annoyance. After all, we could not surreptitiously hand the grocer our means of payment and move along. Instead, there was an inefficient and slow process to it, drawing even more attention. I vowed to do everything I could to avoid taking a handout again.

Recently, I learned through a forwarded news article that half of all American children will be on food stamps during this economic crisis.

I can tell you that this is not merely a temporary fluctuation in numbers, nor will most of these people utilize the program for only a short period of time. No, these types of things become a part of life. Generations grow up on food stamps.

The food stamp program, or SNAP, is quite useful in the short run. I only hope that families will learn not to depend on it indefinitely. Parents, and probably more importantly, children, lose self-respect, and perhaps some lose sight of the fact that these programs are meant to assist when down, not to supplement forever. I fear that this economic crisis will create a generation dependent on the government to bail it out whenever things go sour.

A Good Mother

October 20th, 2009

I had a unique experience recently. A mother brought in her teenage son for a routine sports physical. I plotted his height and weight and remarked how nice it was to see a slender young man.

The mother replied that she made an effort to give her kids nutritious meals. I found this quite refreshing. A parent who was making an active choice to feed her children well! Too often, I deal with childhood obesity and parents setting bad examples.

This parent impressed me in another manner. Years ago, she decided to become a stay-at-home mom in order to ensure that her kids grew up healthily and that she would have the time to cook wholesome meals for them each day.

She and her husband agreed to give up eating out or buying the latest gadgets or new clothes in order to afford this lifestyle. This is rare in today’s world. Most families need both spouses to work in order to make ends meet, and this particular mother said that it took a great deal of sacrifice. She added, however, that the payoff was well worthwhile.

Too many parents feel that providing things like the latest fashions or the newest electronic toys shows their kids that they care. Kids do want a lot of things, but what they desire most is quality time with their parents. Sometimes, the richest families are the ones with the least amount of money because they gain far more value for their limited resources.

Consider this. If you think you can get by on one salary, give it a try. You might be surprised at how enjoyable life will be for your kids and for your family.

Parental Concern Over Child’s Lack of Appetite

September 28th, 2009

A mother brought in her five year old and stated that her appetite had gone way down in the past several weeks. She was worried that her family would nag her, saying that her daughter was too skinny.

One of the problems in today’s world is that kids are expected to be slightly plump. If they are not, immediately the family worries that there has to be a problem.

Even when we are facing a crisis in childhood obesity, parents come in concerned about their children not eating enough. In many cases, it is an issue with the grandparent. The grandparent will always insist that the child is too thin.

New parents are sensitive to the remarks of others and often not confident enough in themselves to stand up for their children.

Many kids experience a lack of appetite at some point in their lives. This is a natural state for children. It is up to you, as a parent, to be aware of when this is a problem or a normal condition. If you cannot tell, then by all means ask a physician. But do not just listen to relatives and feed the growing problem of obesity in our world today.

If some relatives persist in pestering you about your child’s slenderness, invite them to the next office visit. Perhaps hearing it directly from your physician and speaking about their concerns, the issue may be resolved.

Side Effects from ADHD Overuse Not Surprising

September 22nd, 2009

I became annoyed when I read an article describing dangerous side effects caused by the misuse of ADHD medications. Why, in this case, are there substantial side effects? Simple, individuals are misusing the drugs. They are using them to get high or hoping they will be useful as study aids.

When we, as doctors, write a prescription, we give directions on how to take medicine. Pharmacists include detailed handouts describing possible side effects and precautions to take in case of a reaction to the medication.

Unfortunately, when medications are misused, the effects do not quite match the normal expectations. Ritalin, for example, carries side effects such as insomnia and nervousness, but when misused, increasingly serious effects such as high blood pressure, a racing heartbeat, hyperactivity, or even seizures can occur. In truth, any medication can cause severe illness or death, e.g., aspirin, Tylenol, or even too much water. Anything taken to an extreme or taken incorrectly can be dangerous. Follow the prescription, and do not abuse medication.