Topic #1

Four year old logic defies understanding – and, it can be irritatingly manipulative, to those of us over 4 years, a surprising amount of the time.  An adorable 4 year old came to the office, full of information, as is typical of 4’s, and so I listened as attentively as possible, waiting for the whole story.  At 4, sometimes the middle is told first, (cause it’s the neat part!), then the first part, then the ending.  But wait!  The middle has to be repeated (because it’s the neat part!).  So, I have to pay extra attention because, usually there is a test; some question that pops up out of nowhere, and I’m expected to answer correctly.  And if I don’t… well, it isn’t pretty.  Well, I had gotten through the test, and was feeling fat and sassy, as Mother and I were discussing why she brought him in today.  Alas, the 4 year old “star of the show” gets bored and after a few polite attempts to leave, the 4 year old logic kicks into play.  He deliberately turns to his mother and pops up with, “Mommy, why does my doctor talk so much?”  Game over, 4 yr old -1; blabbering pediatrician -nothing. … Now 4 year olds have an attention span of about 4 minutes when interested.  They ask a lot of questions, especially ‘why”, and they approach their world certainly from their own needs and wants, but with an eye to getting their own way.  They are starting to figure out manipulation and to know when you have manipulated them.  This all can be quite irritating, unless you realize that 4 year old logic is a wonderful phase, necessary for normal child development.  The secret is to spend time listening and sharing, listening some more, laughing and hugging, oh, and did I mention listening?  Give that kid a hug, and on that note, Dr. Greta will quit talking… for the moment, anyway… except to tell you to call the Ashley Clinic in Chanute, Ks.

Topic #2

Is it important how your kids spend their time?  Does what we think about affect our lives, short term and long term?  Well, the answer is yes, to all three, and a recent study in the November journal, Pediatrics, tells us this is true for teen pregnancy rates and how much sex on TV they watch.  Nearly 1 million young women, ages 15 to 19 years or 20% or all sexually active women in this age group become pregnant each year, the majority of these being unplanned.  Young mothers are more likely than others to drop out of school, to require public assistance, and to live in poverty.  Teen mothers have earnings that average less than one half of the poverty level.  Teen mothers are less likely to have effective parenting skills or to have adequate social support.  Teen fathers face similar challenges, with completing less education than those who wait to father a child until age 21.  Teen fathers earn less in their twenties than their peers.  Children born to adolescent mothers are at higher risk of low birth weight, limited fine motor skills, and low math and reading abilities, and are more likely to drop out of high school.  So is there something you can do to encourage your teens not to have sex and get pregnant?  In this study, of over 2000 teens, surveyed 3 times over a 3 year period, the girls who watched more shows with sexual content, including physical flirting, passionate kissing, intimate touch, implied or depicted intercourse, and sexual talk had a much greater chance of becoming pregnant.  We can’t and mostly don’t want our kids to live in an isolation bubble, but we do need to help them make wise decisions.  Who knows when a child should be exposed to some influence?  There is no easy answer, or one size-fits-all.  That’s why there are parents and loving caregivers to help choose activities, like watching sex on TV.  Give that kid a hug.  I’m Dr. Greta McFarland

Topic #3

When and how often do you give acetaminophen, also known as Tylenol?  Acetaminophen is the generic name for Tylenol, and it is a wonderful fever and pain reliever.  However, an international study from New Zealand, and published in the Lancet, suggests that if kids are given acetaminophen during the first year of life, they are more likely to develop asthma by 7 years of age.  The study was looking at 200,000 kids from 31 countries, and they gave acetaminophen for fever during the first year.  They didn’t say how high the fever, or how often it was given.  One of the problems with the study, was, it didn’t tell us if the kids given the Tylenol had high fever from conditions like that lung infection, RSV that causes the baby bronchitis.  RSV stands for Respiratory Synctial Virus and is one of the leading causes for young, especially premature infants, to develop asthma symptoms as they get older.  So, if they had RSV as an infant, they might have had a fever and gotten Tylenol, but the asthma could have been from the RSV and who knows about the Tylenol?  So there are some information holes here, but I did think this was worth discussing, as sometimes people think a fever is anything over 98.6, when many doctors don’t recommend giving any fever reducer unless the child has a temperature closer to 101F.  Ask your doctor what is right for your child.  Another real concern is giving Tylenol if kids are fussy, and the most common culprit is teething.  Teething gets blamed for lots of symptoms, some real and some maybe not.  This may be something we want to reconsider, if in deed, it is shown that asthma is more likely in kids who get a lot of Tylenol in their first year of life.  The bottom line is, don’t get in the habit of using a lot of pain or fever reducer, unless you check with your doctor, and know what you are treating.   Give that kid a hug.  I’m Dr. Greta McFarland.