Health & Safety

Q: I worry that my son has ADHD. What should I do?

A: If your child fidgets a lot, has trouble sitting still, daydreams frequently or is easily distracted, he could have ADHD (otherwise known as Attention Deficit Hyperactivity Disorder). But then again, you probably exhibit those same symptoms on a daily basis yourself (most busy Moms do)! According to the National Institute of Mental Health, just 3 to 5 percent of kids actually have ADHD--a surprisingly low percentage, considering how often it seems to be diagnosed. (FYI: Contrary to popular belief, ADHD isn't a byproduct of the Information Age: It was first identified way back in 1845!)

The pediatrician says:
"Talk to your pediatrician. There are simple questionnaires you can fill out to see if there are symptoms of ADHD going on. Child psychologists can sometimes help with this, too, and if meds are needed, child psychiatrists are the folks to consult. (There are many choices of meds these days beyond Ritalin.) Keep in mind that if your child is doing fine in school and just shows signs of inattention or overactivity at home, ADHD is the wrong diagnosis to explore: True ADHD interferes with learning and school. If your child is having trouble learning, his school owes it to him--and you--to help sort out what's going on. Push them to test your kid!"
--Dr. Gwenn Schurgin O'Keeffe, MD, FAAP, is the CEO and Chief Editor of Pediatrics Now

For more information, check out these websites:

• http://www.nimh.nih.gov/health/publications/adhd/complete-publication.shtml
• http://www.cdc.gov/ncbddd/adhd

Mom•Logic Moms say:
"Talk to your pediatrician before self-diagnosing the problem," advises Julie, Mom of two. "I was worried about this with my own son, but the doctor said he's just 'spirited.'"

Other Moms say:

• Have a psychologist test your child.
• Make sure that whoever tests your child is reputable, whether they're a pediatrician, a family doctor, or a psychologist. Quacks are quick to give an ADHD diagnosis--and even quicker to medicate!
• Don't automatically put your child on prescription meds; they change children's brain chemistry before their brains are mature. Instead, try natural treatments--such as exercise--first. Yoga and sports that train kids to focus are especially effective.

Q: My first grader hasn't lost a tooth yet. Should I be worried?

A: Champing at the bit to play tooth fairy, are we? Too bad your kid's teeth aren't cooperating!

The doctor says:
"Don't worry...yet. Most children will have lost their first tooth by the end of first grade. That said, I recommend that every school-age child see a dentist every six months for regular followups. The dentist can help monitor for cavities, poor formation of enamel (the hard protective tooth covering) or growth problems that can cause lifelong trouble for children."
--Dr. Rachel Franklin, Mom of twins, Associate Professor of Family Medicine and author of "Expecting Twins, Triplets and More: a Doctor's Guide to a Healthy and Happy Multiple Pregnancy"

Mom•Logic Moms say:
"My son hasn't lost a tooth either, and he's in first grade," says Julie, Mom of two. "Our dentist said this isn't a problem. In fact, he said that the later you lose baby teeth, the better it is for your adult teeth."

Other Moms say:

• Worrying doesn't help. Ask the dentist!
• Seize the moment: Teach your child about proper tooth care (including flossing) now, so it will become second nature by the time his adult teeth come in.

Q: My son is a bed-wetter. Is he sick?
A: To a child, the worst thing about bedwetting isn't sleeping in wet, smelly sheets--it's the fear of being found out and ridiculed (or punished). Sleep-overs especially become something to dread, which is sad because they're one of the great joys of childhood!

The pediatrician says:
"This is a tough question to answer without knowing whether the child has ever been dry at night. Assuming the answer's no (which is the most common situation), it sounds like a simple case of 'nocturnal enuresis'--nighttime bedwetting caused by an immature urinary system. It's very normal in kids; in fact, 23 percent of 5-year-olds and 20 percent of 7-year-olds wet their beds on occasion. It's usually not caused by illness, but in rare cases it can indicate a plumbing problem in the urinary tract (such as a low-grade urinary infection), so you should take your child to a pediatric urologist. He or she will do some very simple outpatient tests and X-rays to make sure the bedwetting isn't the result of a medical issue."
--Dr. Gwenn Schurgin O'Keeffe, MD, FAAP, is the CEO and Chief Editor of Pediatrics Now

Coping with bedwetting

• Dr. O'Keeffe offers the following advice:
• Don't blame your child. "Bedwetting is 100 percent a developmental problem, and is therefore totally out of a child's control," she says.
• Don't let it keep your kid from enjoying sleep-overs. "There are medications that can help keep a child dry at night during sleep-overs, which is very reassuring for kids," she says.
• There's an entire industry built around manufacturing pull-ups that look like undies. Buy some!
• Give "potty alarms" a try--they effectively train some kids to wake up out of a deep sleep so they can make it to the toilet in time.
• Train your child to limit fluid intake after dinner.
• Wake your child before you turn in and have him or her go to the bathroom one final time before morning.
• Don't despair: Once your child's urinary system matures, his body will wake him up when he needs to potty.

Check out these websites for more info:

• http://www.urologychannel.com/pediatric/enuresis.shtml
• http://www.kidshealth.org/parent/general/sleep/enuresis.html.

Eating & Sleeping

Q: My daughter is chubby. How do I teach her better eating habits?

A: "Chubby" kids this age often aren't overweight--they're undertall. In other words, your daughter may experience a growth spurt in the next few years, shooting up several inches in height and becoming a relatively svelte teen. Still, this is a golden opportunity to begin teaching her positive lifelong lessons about food, exercise, and how important it is that she love her own body.

The dietician says:
"The best way to teach is by example! Show your daughter that moderation, variety, and balance are key. To help her understand the importance of eating well, get her involved in meal planning and preparation, and take her food shopping, too. Teach her to eat only when she's hungry, and help her identify the signs of hunger (i.e., grouchiness or a rumbling tummy). Tell her that her hunger should determine when and how much she eats--not the clock or the size of the plate. Also, get her moving!"
--Debi Silber, RD, Whole Health Coach and author of "The Lifestyle Fitness Program: A Six Part Plan So EVERY Mom Can Look, Feel and Live Her Best"

Mom•Logic Moms say:
"With kids this age, you pretty much have complete control over what they eat," says Julie, Mom of two. "Your daughter isn't old enough to drive to McDonald's, so don't you take her there, either! Similarly, I would start making your daughter's lunch every day. I'm disturbed by the fattening foods they serve in my son's school cafeteria!"

Other Moms say:

• Keep healthy snacks (such as raisins and fresh fruits and veggies) in easy-to-reach places; hide sweets and processed foods on upper shelves.
• Practice what you preach--limit your own portions, don't binge on sweets in front of her, etc.
• Start a new ritual: the family after-dinner walk. Stroll away from home for 15 minutes or more after dinner, then come back--good for her, good for you, and good for bonding, too!

Q: How much sleep should my grade-schooler get?

A: Children do need more sleep than adults (their bones, muscles, skin, and brains require lots of rest in order to grow!). The good news about big kids? They're more likely to take the guesswork out of it by flat-out telling you, "Mom, I'm sleepy."

The sleep expert says:
"Children between the ages of 5 and 8 need approximately 10-12 hours of sleep at night. You'll know your child's getting enough sleep when he or she is generally in a good mood during the day, shows good physical coordination, and is alert while learning and playing."
--Jill Spivack, MSW, is a psychotherapist and co-founder of Sleepy Planet, where she provides pediatric sleep consultations, leads general parenting groups for first and second time mothers

Mom•Logic Moms say
"It really bothers me when I see kids up and running around at 11 p.m.," says Krista, Mom of two. "I put my kids to bed at 8:30 sharp every night. Regular sleep is so important for health!"

Other Moms say:

• Likewise, have them get up at the same time every day (even on weekends). If they learn good sleep habits early, chances are they'll have fewer problems sleeping when they grow up.
• Twenty-minute naps in the afternoon are healthy for everyone--kids and adults!
• Check out the National Sleep Foundation's website for kids: http://www.sleepforkids.org.

Behavior

Q: My kid is being bullied. What should I do?

A: It's every Mom's nightmare: Your kid comes home with a fat lip, a tear-stained face, and a horror story about being pushed around regularly by a kid twice his size. But it's tricky: If you handle it the wrong way, you could actually make things worse for your kid at school. (Children have a twisted "code of honor" that makes parental involvement in cases like this practically verboten. You know, because you saw it in A Christmas Story.)

The safety expert says:
"Don't overreact, but do take action. Coping with bullying can be difficult, but your child has the right to feel safe and secure."
--Ross Ellis, founder and Chief Executive Officer of Love Our Children USA

Tips for your child
Ross Ellis suggests that he or she try the following defense tactics:

• If your child is fairly empowered/confident, have him or her face the bully, yell, "Stop!" and then walk away.
• If your child is shy/timid, tell him or her to ignore (or pretend to ignore) the bully and just walk away. "Bullies are looking for a reaction," notes Ellis. "If they don't get one from your child, they'll choose another victim." Sometimes silence is the best ammo!
• Encourage your child to use the buddy system (i.e., become joined at the hip with a friend or friends). "Bullies hardly ever pick on people if they're in a group," says Ellis.
• Tell your child that if the bullying persists, they should inform you or a trusted teacher.

Mom•Logic Moms say:
"Schools now have counselors and systems designed to deal with this very problem," says Pam, Mom of three. "They'll take a more professional, calm, objective approach. Tell them you're not going to tolerate this, and they shouldn't, either. Let them call the bully's parents. If you do it yourself, things might escalate!"

Other Moms say:

• Alert your child's regular teacher--he or she is the one adult most likely to witness the bullying and be able to directly intervene at the time.
• If the school's response doesn't satisfy you, call a conference with the bully's parents (but only as a last resort, unless you know them well).
• Remind your child of the axiom, "Do unto others as you would have them do unto you." Now's the time to practice it!
• Tell your kids, "You can't change others. You can only change yourself and how you react to the situation." It will empower them and help them regain their sense of control.
• Explain to your child that he or she isn't doing anything wrong; sometimes kids just do bad things because they want attention.

Q: My son is addicted to video games! How can I set limits that work?

A: He was so excited when he opened that Nintendo box on Christmas morning, he almost "Wii-d" himself. You felt like it was the best several-hundred-bucks you'd ever spent! But now he practically lives in front of the TV, and you think: "I've created a monster--a monster who totally kicks ass at Guitar Hero, but a monster nonetheless." What to do?

The parenting expert says:
"It's not difficult to set limits, but of course your child is going to be upset when you follow through. Empathize that and let him feel his feelings; don't try to argue him out of them. Also, if your child has a video-game obsession, chances are you contributed to it, and you should acknowledge that (even if just to yourself). Lots of parents have admitted to me that they've plunked their children down in front of the TV when it was convenient for them--whether they did it to keep siblings from fighting, keep a mischievous kid zombified, or just keep their kids out of their hair for a while so they could get something done. It makes you wonder how parents coped from the dawn of history until about 50 years ago. Well, I'll tell you how: They let their kids entertain themselves!"
--Noel Janis-Norton, founder and director of The New Learning Centre in London, is a learning and behavior specialist with over 30 years' experience in Britain and the United States

To wean your child from video games...
Janis-Norton suggests that you try these techniques:

• Teach him how to play by himself, sans TV/computer/cell phone. Start by assigning him a small amount of time each day to play solo. If you have more than one child, have each play alone in a different room. "Solitary play builds a child's inner resources and problem-solving skills," notes Janis-Norton. "Both of those things will help them in school and later on in life."
• Make clear rules. "Tell your child exactly when he can have screen time (i.e., when all his homework's done), what it will entail, and how long he will get."
• Be firm. "Don't ask him to limit his screen time, tell him," says Janis-Norton. "You're the parent!"
• Form a united front. "Make sure your husband's on the same page, because you have to be consistent when setting boundaries," says Janis-Norton. "If your child knows that his dad will play video games with him all night long, he won't take your new rule seriously."
• Feed your child's need for novelty in healthier ways. "The more things kids have to do, the happier they are," says Janis-Norton. "Also, the fewer toys they have, the happier they are--believe it or not! I tell parents to box up 4/5 of the toys in their child's room and rotate them every few months instead of buying new things. It works!"

Mom•Logic Moms say:

• Explains Julie, Mom of two: "We limit 'screen time' to one hour a day, and that includes computer, TV, and video games. When the hour is up, that's it! It's been working really well--our son's life seems pretty balanced."

Other Moms say:

• Make sure your kids go outside every day.
• Limit their exposure to screens of all types--including cell phones/texting.
• Make sure your child's face-to-face contact with friends is greater than his face-to-screen contact.
• Don't let your child play video games on school days.
• For every hour your child spends playing video games, have him or her spend an hour reading a book.

Q: I hate my kid's best friend. How do I deal?
A: Children may be pure and innocent and sweet when they're born, but as they grow up they tend to reflect their parents' attitudes. Which means that some of them can be real a**holes--er, little terrors. (It's true!)

The therapist says:
"'Hate' is a strong word to use on such a young child. Before taking action to limit the friendship, you should first ask yourself what it is about this child that bothers you so much. If your negative feelings really have nothing to do with the friend or your child, you might just want to leave it alone and find another way to work out the issue--one that won't impact their friendship. (That friend is making your kid very happy!) That said, you might have a good reason to dislike the child. While it's fun watching our little ones establish their own friendships, not all of them are going to be ones we approve of! When that occurs, you don't need to encourage the relationship. Just because your child has determined that this person will be his or her best friend, it doesn't mean that you must support the bond if you feel it isn't right."
--Rosanne Tobey, LPC, is a New Jersey-based therapist who specializes in individual, couples and family therapy.

What to do
Rosanne Tobey advises the following:

• Resist the temptation to "forbid" the relationship--that will only make your child want to see the friend more.
• Limit your child's exposure to the friend. "As the parent, you have the power to regulate how much and what kind of time the children spend together," notes Tobey. "Simply adjusting their ability to gain access to each other will have a significant impact. Your child won't be happy about it at first, but he or she will eventually adjust."
• Don't feel guilty. "Your job as a parent is to protect your child and choose appropriate situations for him or her," Tobey says. "Children need us to oversee situations and create ones that are safe and appropriate for them."

Mom•Logic Moms say
"If the friend is harming your child or influencing your kid do bad things--like dropping the F-bomb, shoplifting candy, or skipping school--that's one thing," says Rachel, Mom of three. "But if it's just his personality and nothing is truly wrong with the best friend, let them hang out."

Other Moms say:

• Ask your kid to tell you all the things he likes about this child and why he's his best friend. The answers may change your mind.
• If you have specific beefs, tell your child. "We explained exactly why the friend wasn't really such a nice person," says one mom. "Our kid cares about our opinion, so he took it to heart."
• Introduce your child to other people his age. "Friends many times are transient," says a mom of three. "If you just take it in stride, without a lot of intensity surrounding the relationship, then it will probably go away by itself."
• You can't control who your kids hang out with at school, but outside of school you have the right to not allow certain people over to your house.
• The worst thing you could do is make your son or daughter feel bad for liking someone.

Q: My son likes to "play doctor" with a neighborhood girl. Is this okay?

A: Sadly, "playing doctor" rarely involves a child pretending to have a successful career as a brain surgeon. (Sigh.) And this is one time you really don't want your child to "practice."

The pediatrician says:
"'Playing doctor' is very normal for kids this age--they're very interested in their own bodies and want to know if other kids have similar parts. Comparing body parts is part of how kids normalize who they are and obtain a gender identity. Children this age are particularly interested in the opposite gender, because they know the parts they have but are curious to see what their friends have."
--Dr. Gwenn Schurgin O'Keeffe, MD, FAAP, is the CEO and Chief Editor of Pediatrics Now

The best way to address a child's healthy curiosity:
"Very calmly and matter-of-factly, explain that private parts are private and that it is not socially appropriate to show them in public," says Dr. O'Keeffe. "Then use age-appropriate books to help your child understand gender differences a bit better."

One book we like for kids this age
Amazing You: Getting Smart About Your Private Parts, by Gail Saltz. Check it out at Amazon

Mom•Logic Moms say:
"I looked out my kitchen window one day to see my 6-year-old daughter and the little neighbor boy standing there with their pants down, studying each other's genitals," says Jeannie, Mom of two. "I totally panicked, but as I rushed outside to stop them, all I could think was, 'Don't warp her mind. Don't warp her mind.' My solution was to pretend nothing unusual had occurred at all. I greeted them with a smile, pulled up their pants without comment, and told the little boy in a bright voice, 'Tommy, your Mom says it's time to come home.' Whew!"

Other Moms say:

• It happens--and it's always cringe-inducing! Notes one Mom, "I would not be happy about my first-grader doing this with a girl, and I doubt the other parent would be, either."
• Make sure your child knows that he or she can come to you with any and all body-related questions.
• If you catch your child and another kid "red-handed" (so to speak), discreetly let the other child's parents know what has occurred, so they can explain things to him or her.

Q: It takes my daughter so long to do her homework. How can I motivate her?

A: It's so heartbreaking to open a child's bedroom door at night and find that she's fallen asleep with her face in a schoolbook. What will happen when her classes get harder? Something's got to give!

The parenting expert says:
"This isn't necessarily a motivation issue. There's a reason your daughter is struggling--something about the work is difficult; she got too late of a start, so she's tired; her blood sugar is low.... Whatever the issue is, don't get sucked into helping her do it! That's the worst thing you could do, because it could turn homework into an attention-seeking tool."
--Noel Janis-Norton, founder and director of The New Learning Centre in London, is a learning and behavior specialist with over 30 years' experience in Britain and the United States.

What to do
Janis-Norton advises the following:

• Try to determine what the problem is. "Sit with your daughter while she does her homework a few times and watch what she's doing," says Janis-Norton. "Does she refuse to even pick up the pencil? Write down an answer that's almost right, and then stew over it? Write down something that's completely from a different planet? You may be able to offer constructive advice that will facilitate the process."
• Call the school and find out how long her homework is supposed to take. "It's often printed in the school's handbook," she says. "If it isn't, her teacher will know. The load doesn't vary widely from day to day, so that can be your guide.
• If the teacher says a certain assignment should take 20 minutes or whatever, don't let your child spend a minute longer than that on it, even if she's just staring at the paper. "Whether your child is doing the homework or not, you mustn't allow her to sit over it," says Janis-Norton. "That's not education, that's torment! It's totally soul-destroying."
• As soon as the time limit expires, say, "Well, time's up," and take your child's books away--even if she screams, "My teacher will kill me!" "The purpose of homework is to learn something, not to get the homework done," says Janis-Norton. "Don't buy into the 'you're supposed to finish it!' idea. If your child doesn't complete the assignment in the time allowed, write the teacher a note: 'We spent the right amount of time on this, and this is what my child achieved.'"

Mom•Logic Moms say:
"After spending some time being poky with homework, kids figure out that if they get done, they can go outside and play," says Krista, Mom of 2. "They figure out that it's their time that they're wasting. Eventually they 'get it.'"

Other Moms say:

• Set a timer for 45 minutes.
• Don't let your child play video games or watch TV until his or her homework is done.
• Give your child the adage that if something's unpleasant, it's better to get it over with quickly.