Posts for tag: Pediatrics
When I first entered practice in 1985, the term “social media” wasn’t even a thing yet. Now, of course, its a major issue in the lives of virtually everyone and in particular adolescents. It is a frequent topic that I discuss with parents.
A recent study in a British public health journal demonstrated some very troubling patterns here. They enrolled almost 10,000 children and followed them from ages 10-15 to > 16 years. Initial surveys collected data on social media sites and amount of usage reported, then after several years standardized mental health questionnaires measuring both well being and negative emotions were completed by the now young adult subjects.
In girls they found a clear and quite strong association of increasing media usage with more negative feelings and greater emotional difficulties in late adolescence. Interestingly, they found no such correlation among boys. Greater prevalence was demonstrated in homes of lower economic or parental educational achievement. Unsurprisingly, more social media usage increased sedentary lifestyle. Racial differences were inconclusive. Another non-factor was type of usage–“passive”(reading only) vs “active”(posting and responding)–girls did worse either way.
There may be several reasons for this observation. Girls seemed to make a greater effort at online presence and often put greater emphasis comparing themselves to perceived online personality or situations. “Likes’ and “hits” are viewed very directly as popularity in ways similar to public opinion polls. Online, as opposed to in person, the conversation is more “indirect,” allowing less emotional commitment to the relationship, less effort at properly expressing oneself, and no opportunity to learn to judge facial expression, voice inflection, or body language which may result in a person with more limited social development. Needless to say, online interactions may increase risks of such negative interactions as stalking, bullying, or public shaming.
So–what’s a parent to do? As always, I say “you are your child’s best teacher and best toy.” Be a role model–don’t obsess with your phone and social media yourself. Use only at specific times and situations. Try not to walk into your home using the phone, no use of phone at meals or parent/child interactions interrupted(except true emergency, of course). Endeavor to develop ongoing activities of interest for your adolescent and take an interest in their participation. Spend time with them (a challenge– an important part of adolescent development is to establish autonomy from parents, so don’t overdo it here; try to do things with them on their terms). Also, I believe it is fine–almost essential— to place concrete time limits on phone/social media use, particularly in the evening when it can most commonly be an impediment to a good night’s sleep. I always counsel that cellphones NOT be kept in the teen’s bedroom overnight but rather in some fairly distant location in the house to avoid that frequent problem.
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As Kim and I are now blessed to have recently become grandparents, the forever pediatric issue of safe infant sleep now has renewed personal urgency for me. In a 2012 policy statement the American Academy of Pediatrics urged parents to avoid soft bedding objects like pillows or bumpers in the crib with young infants. In a study examining 1985-2012 researchers reported that infant suffocation in cribs, while rare(about 77 cases in that period), were almost always associated with bumpers: 2/3 caused by the bumpers themselves and the rest when the infant became tangled between the bumper and another object like a pillow or toy. There were an additional 146 nonlethal choking and near suffocations also all associated with bumpers in that time period.
Parents who use bumpers usually express concerns about avoiding head injury or limb entrapment. However, young infants lack both the strength and the coordination to slam their heads against the crib with enough force to cause any significant injury. And while it is rarely possible for a limb to get stuck between the slats, it is virtually impossible for this to result in a fracture or any other serious arm or leg injury–so the worst that could likely occur is an uncomfortable and upsetting, but ultimately essentially harmless, experience.
So the basic recommendations are:
• To prevent suffocation, never place pillows or thick quilts in a baby’s sleep environment.
• Make sure there are no gaps larger than two fingers between the sides of the crib and the mattress.
• Proper assembly of cribs is paramount – Follow the instructions provided and make sure that every part is installed correctly. If you are not sure, call the manufacturer for assistance.
• Do not use cribs older than 10 years or broken or modified cribs. Infants can strangle to death if their bodies pass through gaps between loose components or broken slats while their heads remain entrapped.
• Set up play yards properly according to manufacturers’ directions. Only use the mattress pad provided with the play yard; do not add extra padding.
• Never place a crib near a window with blind, curtain cords or baby monitor cords; babies can strangle on cords.
The consumer Product Safety Commission recently reviewed the data and added these additional concerns regarding the use of crib bumpers:
* They limit mattress space
* Cover key failure points in the crib
* are difficult to install
* frequently used in older infants beyond even the manufacturer’s recommended age
* used outside cribs
* sends mixed signals about padded objects in crib
So we pediatricians usually advise that “bare is best:” a flat, firm mattress without pillows or toys, no crib bumpers or thick quilts or blankets. Young infants can wear a head cap and be swaddled in a receiving blanket and older infants can just use warm pajamas for comfort.
For more information check out the following:
Safe to Sleep® Public Education Campaign<https://www.nichd.nih.gov/sts/Pages/default.aspx>
Nurses: A continuing education opportunity for you. Nurses are in a unique position to educate parents and caregivers about risk reduction of SIDS and other sleep ...
U.S. CONSUMER PRODUCT SAFETY COMMISSION 4330 EAST WEST ...<https://www.cpsc.gov/s3fs-public/CBStatement.pdf?dhFXWQNHUqQ2yV4xuY654JrJ3K0Towc>
u.s. consumer product safety commission 4330 east west highway bethesda, md 20814 statement of commissioner elliot f. kaye regarding release of policy paper on ...
Reduce the Risk of SIDS & Suffocation - HealthyChildren.org<https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Preventing-SIDS.aspx>
sleep~The American Academy of Pediatrics (AAP) explains ways to reduce your baby's risk of SIDS and suffocation.
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