Hot off the press! In an online study just released by the CDC, "70 percent of high school students are not getting the recommended hours of sleep on school nights". I could have done that study in my office on any given day of the week!!
Having raised 3 teenagers as well as thousands of teens in my practice, I know that sleep is one of the most important needs for teens. Having said that, they are the least likely group to believe/convince that lack of sleep causes a plethora of physical as well as psychological problems.
According to the study, which was just published online in Preventive Medicine, insufficient sleep is associated with numerous "risky" behaviors including drinking alcohol, smoking cigarettes, fighting, lack of physical activity and being sexually active.
The data on sleep was accumulated from the 2007 national Youth Risk Behavior Survey where students were asked, "On an average school night, how many hours of sleep do you get?" Insufficient sleep was defined as less than 8 hours, while sufficient sleep was 8 or more hours per night. On an average school night, almost 70% of responders reported insufficient sleep. In my practice I ask every child/adolescent about their sleep habits and routinely find teens are averaging between 5 - 7 hours of sleep per night. They also come in everyday with a chief complaint of FATIGUE!
I used to tell my own sons throughout their high school years that they needed to be in bed between 10:30 - 11 pm. They could not understand why I was up "prowling around their rooms" in the dark of night (when I was longing to go to bed!) suggesting, and then demanding, that they go to bed. "No one else has a bedtime in high school" was the common complaint. But I also told them that I made my living out of telling teens (and their parents) that the reason their child "felt badly" was not mono, or a dreaded disease, but lack of sleep. A good history and review of systems was far better than any blood test.
Now the latest study just confirms what we intuitively have already known, adequate sleep leads to other better habits as well. Those teens who did not have adequate sleep also drank more soft drinks (did not include diet), used computers for 3 or more hours every day, admitted to current alcohol, cigarette and marijuana use, were sexually active, and also expressed more feelings of being sad or hopeless or even of having suicidal thoughts. If we could improve these statistics and reduce so many teenage "health risk behaviors" by just having parents enforce bedtimes, it sure seems like an easy sell. So set a time, turn off the electronics and "put your teen to bed". I know they have homework and tests and papers to write.......but they also must be healthy, and rested to make good choices in both school and outside the home.
Oh, the study also found that watching 3 or more hours of television /day was not related to insufficient sleep. You might leave that part out!
That's your daily dose for today. I'm Dr. Sue Hubbard from The Kid's Doctor.
The surge in allergies this year has been due to a very wet winter and the weather this spring has brought erratic temperatures and lots of wind. The perfect storm for the "allergic cascade" to on a...
We are all saddened by the tragic devastation in Oklahoma and surrounding communities leveled by yesterday's tornadoes. There are numerous tragic and traumatic events which occur across our country...
You know there really isn't as they are both due to seborrheic dermatitis, an inflammatory condition of the skin in which the skin overproduces skin cells and sebum (the skins natural oil).
Cradle cap is the term used for the scaly dermatitis seen on the scalp in infants. It is also seen on the eyelids, eyebrows, and behind the ears. It is typically seen after about three months of age and will often resolve on its own by the time a baby is eight to 12 months old. It is usually simply a cosmetic problem for a baby as it looks like a yellowish plaque on a baby's scalp and is often not even noticed by anyone other than the parents.
Unlike seborrheic dermatitis in adults, cradle cap typically doesn't itch. It is thought that cradle cap may occur in infancy due to hormonal influences from the mother that were passed across the placenta to the baby.
These hormones cause the sebaceous glands to become over active. In some severe cases an infant's scalp becomes really scaly and inflamed and causes even more parental concern, as it appears that the infant is uncomfortable and may be trying to scratch their head by rubbing it on surfaces.
The treatment for cradle cap is to wash the baby's scalp daily with a mild shampoo and then to use a soft comb or brush to help remove the scales once they have been loosened with washing. When washing the head make sure to get the shampoo behind the ears and in the brows (keeping the soap out of baby's eyes).
This is usually sufficient treatment for most cradle cap. In situations where the greasy scales seem to be worsening it may help to put a small amount of mineral oil or olive oil on the baby's head and let it sit (I left a small amount on my children's heads overnight) and then to shampoo the following day. The oil will help the scales to loosen up and come off more easily.
For babies that have very inflamed irritated cradle cap a visit to your pediatrician may be warranted to confirm the diagnosis. In persistent cases I often recommend shampooing several times a week with a dandruff shampoo that has either selenium (Selsun) or zinc pyrithione (Head and Shoulders) making sure not to get any in the infant's eyes. I may then also use a hydrocortisone cream or foam on the scalp that will lessen the inflammation and itching. In these cases it may take several weeks to totally clear up the problem.
As children get older, especially during puberty, you may see a return of seborrhea as dandruff. Again you can use dandruff shampoos. It also seems that with the overproduction of sebum there is an overgrowth of a fungus called malessizia so using a shampoo for dandruff as well as a antifungal shampoo (Nizoral) often works.
I have teens alternate different shampoos, as sometimes it seems to work better than always using the same shampoo for months on end. Teens don't like white flakes falling from their scalp and unlike a baby, a teen is worried about the cosmetic issues of seborrhea!
That's your daily dose, we'll chat again tomorrow.
Send your question to Dr. Sue!
Here is another one of the can't believe what I hear at the office! I was on call the other night and it was around bedtime when I walked in the exam room to see 2 little girls (actually they are part of a triplet set but their brother was home). Their dad had brought them in because they had rashes and bug bites. Nothing too serious. They are adorable 2 years old and very well behaved.
So, after examining the rashes and bites and determining that they could be dealt with a bit of cortisone cream, the dad and I were discussing a few more things. Of course the girls got bored, and as you know a bored 2 year old typically doesn't sit still, especially when it is time for bed. So as the girls jumped up and down off the table and picked out more stickers their Dad was getting tired as well. By the way, he is a great father and he and has wife have handled having triplets with such ease. They were meant to have multiples.
Well, before we could finish up the appointment the girls had gotten into the diaper bag, pulled out snacks and were enjoying themselves. As much as he was ready to go, they were not ready to pack up and leave and he was having a hard time getting them to listen.
Here comes the line of the night! He turns to the girls in a moment of what to do next and says,if you don't behave and listen to me, Dr. Sue is going to make you sick! LOL! I have heard a lot of Dr. Sue will give you a shot if you don't behave, but I have never heard this one. While I don't believe in threatening kids with shots at the doctors, this was a new one.
After I stopped laughing I told the girls that this was not true, doctors would and could not make them sick, but they did need to listen to their dad!!
I know that we all say things out of desperation, but please don't use the lines the doctor will give you a shot to try and change a child's behavior. We docs seem to give enough shots when needed and not for bad behavior. This also includes the doctor will make you sick! there's always a new one.
The surge in allergies this year has been due to a very wet winter and the weather this spring has brought erratic temperatures and lots of wind. The perfect storm for the "allergic cascade" to inflict itself on everyone's nasal mucosa.
The best preventative for nasal allergy symptoms (allergic rhinitis) has been the use of intranasal steroids. These steroid sprays have been used for the past 15 years and clinical studies have shown that intranasal steroids are superior to oral antihistamines.
Intranasal steroids function by inhibiting the production of chemical mediators such as histamine and prostaglandin that cause inflammation and mucous production. In other words they are more of a preventative medication, while an antihistamine is treating the histamine that was released once you inhaled the offending tree or grass pollen. Intranasal steroids may also help eye allergy symptoms too.
The problem is getting young kids to let you use a nose spray on them. The same holds true for the older tween and teen crowd who complain that they "just don't have the time to use it everyday" (it must take all of 15 seconds to use on yourself!) They have been shown to be effective within 3-12 hours, although will reach their maximum effectiveness after several days to weeks of use, so using it daily and throughout the allergy season is going to give you the maximum therapeutic effect.
There are many different brands available and everyone seems to have their favorite. If one spray seems to bother your child due to scent, or intensity of the spray ask your doctor to try another brand. Many times they will have a sample and give you several to try and then prescribe the one that is easiest to get your child to use. It may be trial and error, but finding the right nasal steroid may just change your allergy season.
That's your daily dose, we'll chat again tomorrow. Oh, God Bless You!
Send your question to Dr. Sue!
We are all saddened by the tragic devastation in Oklahoma and surrounding communities leveled by yesterday's tornadoes. There are numerous tragic and traumatic events which occur across our country (and around the world) and at times, children may be witnesses to these events. With that being said, how do you discuss these tragedies with a child? think the most important thing to remember when talking to a child about a trauma or tragedy is to use words that are appropriate for the child's age and vocabulary and to acknowledge your own feelings as well. They need to know that you too were scared, sad, upset or anxious about the event. Ask them how they felt and listen to the words that they use as you may use those words again when talking to your child. While every child is different you can often follow their cues as to how much and how detailed a discussion to have, and when and how to bring the topic up again. Some children are talkers and want to discuss things at length, while others may be quieter and take some time to absorb the information. Don't force the discussion. A parent knows their children and the discussion may/will be different for each child and will be further impacted by their ages. For young children, it is also important to let them know that "Mommy and Daddy" are there and will take care of them and protect them, but at the same time bad things sometimes happen. That is why parents take precautions and are responsible (like holding hands when crossing the street, or wearing a helmet etc).But, if something does happen it is so important to validate your child's feelings while at the same time teaching your child coping skills and resilience. If your child does view a traumatic event it is not unusual for them go through a period when they are afraid of separation, or have nightmares etc. They sometimes develop somatic complaints like tummy aches, headaches, and non specific complaints of "I just don't feel well". This is normal, but you should watch for a child who seems to "be stuck" with symptoms long after the event. In some cases a professional therapist may be helpful. Lastly, don't let them revisit the event. By that I mean keep the TV off for awhile, and monitor the internet so they are not watching constant images of the same event. With so many amateur videos of traumatic events being shown "on screen" 24/7 if your child sees these images over and over, it is as if they are reliving the experience each time. It sometimes may feel as if we become addicted to watching it. It was nice "in the olden days" when there were not constant images on screen to remind us of a picture that often fades in our own minds.