The best way to attack the problem of bedwetting begins when you and your child have had a discussion about their feelings related to bedwetting. This often happens as they get older and continue to have problems with bedwetting and they are anxious or embarrassed. If you bring up the subject and they would rather just wear a pull up at night, and go back to playing outside rather than discuss strategies for staying dry, it is not time to tackle the issue. Timing is everything! As you start to discuss strategies to stop bedwetting, begin with having your child keep a calendar of their dry nights. This gets them involved and gives you an idea of their level of commitment. Then start setting their alarm clock to awake them in the morning and see if they can get up on their own. If the alarm doesn't wake them up for school it is probably not going to awaken them in the middle of the night. Remind them to recognize their need to go to the bathroom during the day too, and have them go every several hours to feel the sensation of their bladder filling throughout the day. Many of these kids are infrequent voiders during the day and have actually stretched their bladder wall and hypertrophied the bladder muscle. Lastly, make sure that they are not constipated and put them on something like Miralax to ensure that they do not have stool that also compresses the bladder (the colon sits right above the bladder and can push on the bladder). Talk about a reward system that they would like to use while working on the problem. It doesn't have to be a major reward, small things work equally well. I think the rewards should be given by the week, rather than the day. I also give rewards for effort, not just for dry nights. Trying is the whole idea. Sometimes the brain and bladder are just not ready and you do not want your child to feel defeated even though they have tried their hardest. If all of this is successful it is then time to set up a bedwetting alarm sy
What is that hissing noise in the air? Plenty of wheezing and coughing ushering in upper respiratory season. With all this noise, I'm on the lookout for respiratory distress. As I start to see more and more sick kids, my office becomes a cacophony of coughing. While many of the coughs sound horrible, fortunately most of the children I will see do not have any real respiratory distress.
It is the time of year when I start to get many patients asking me if they have a cold or is this flu, and how can you tell? Well, it is usually fairly easy as you are so much sicker with the flu! Currently we are seeing tons of colds and I have YET to diagnose a case of flu, although there is beginning to be sporadic cases reported around the country.
I recently saw a young teenager during her well-check visit and we were discussing whether she had a cell phone or a computer, and if so, did she have rules for their use? There was a giggle as she explained to me that she and her parents had discussed the rules prior to her getting a cell phone.
From the moment your baby is born until you send them off to college, your child will be seeing his/her pediatrician for "well child check-ups". These are regularly scheduled visits which occur quite frequently when you have a baby or toddler and become a yearly visit once your child is over the age of 3. The well child visit is an extremely important part of a pediatrician's job, and is also your child's medical home.
In fact, one of the most rewarding aspects of being a pediatrician is having the privilege to observe a child from birth through their teens, in a sense, "helping to raise them". Therein lays the reason for check-ups.
When you see your pediatrician for a check-up, I'm sure you get your child's weight, height, BMI, (and blood pressure once they are older), as well as their growth percentiles.
The doctor also does a physical exam on your child, which is hopefully all normal. But there is a lot more than that to your visit. This is the time for your doctor to discuss your child's milestones; whether that is sitting up for the first time, first words or how they are performing in first grade. These conversations continue for all of your child's school years as well.
It is also the time to discuss multiple other topics which should include sleep habits, nutrition and safety which is pertinent to all age groups. As your child gets older the conversation should include discussions about school performance, bullying, studying, screen time, family meals, exercise, and the child's interests.
For the teen patient I think it is important to discuss sexuality, peer pressures, driving, and the adolescent's long term goals. The list goes on and on, but certain topics should certainly be yearly discussions which are then tailored to the age of the child.
As a child gets older it is important to have some time where the doctor may be alone with the adolescent who may want some "private time" with the doctor. It