Saved by the Dr. Bell

The overweight child

A-new-research-claims-the-logos-of-companies-like-McDonalds-Pizza-Hut-and-Burger-King-are-branded-on-the-youngsters-brains“How can my child be overweight?”

A lot of parents are surprised when I inform them that their children are overweight and are categorically obese. Many parents are shocked and defensive on this subject. This is a very touchy subject, and I understand the difficulties with self esteem and bullying regarding a child’s weight, but the fact remains, many of our children are overweight and it is up to us parents to accept this and move on to help.

Most grade school children need to gain roughly 6 lbs a year, but many are gaining 15, 20 even 30 lbs a year without signs of stopping. We are in an epidemic and it is your responsibility as parents to enforce changes for your child’s health.

I believe there are three main reasons why our children are overweight, and you will be surprised to hear what is the most important reason to me.

1. Our children are more sedentary.

Yes, our children are not running around outside anymore. As kids we of the 80’s and 90’s generation rode our bikes outside, played in the woods and had no iphones, ipads, computer games, etc. to keep us entertained during the afternoons, weekends, and summers. We didn’t have to be forced to exercise because that was all there was to do.

Parents are now in a position of having to force our children to go outside and play, to join a sport, do martial arts, or go to summer camps just to keep them active. I encourage making our children do this because they rarely will make this choice themselves, and, let’s face it, it’s good for them.

This is not the major reason for our overweight children. There is no amount of exercise that a grade schooler will perform that will burn off the calories for excessive weight gain. Running a child on a treadmill is unrealistic, and only the most motivated teen will exercise in amounts capable of creating significant calorie burn.

2. Our children are overeating.

This is true. Many children are snacking after they get home, and snack after dinner. Many children are taking extra helpings of food at dinner, and eating too fast to see that they are not hungry. Again, portion sizes in the 80s and 90s were much smaller. McDonald’s gave us a small burger, small fries and a small drink, and that was a meal for a truck driver. There is a culture nowadays of continually eating throughout the day, returning to the kitchen in the evening hours for more and more food because we are not feeling full and satiated.

But there is more to this problem than the amount, and here is the key:

3. Our children are eating the wrong foods.

You know this is true. Again, parents, as children of the 80’s and 90’s, we had better food. The fruits and vegetables were local, the meats were raised on grass not corn, and rarely was anything breaded.

This is my belief, that our children are eating unhealthy foods at every meal and gaining weight without nutrition. We forget that we eat for energy and growth, but instead our culture has turned eating into a form of entertainment and source of comfort.

Look at a typical day’s intake in a grade school child:

Breakfast:

Lunch:

Snack (home from school)

Dinner:

Add up a few of these items and you end up with more calories than a typical adult eats, more saturated fats and carbohydrates than any healthy individual needs in a day.

I believe that if you examine what your child is eating on a daily basis, then you will see why your child is gaining too much weight, why he has stomach pains, why is he tired every day, and why he has rapid mood changes.

Your child needs real nutrition, and it’s simple: fruits, vegetables, meats, eggs, fish, with minimal added sugars, preservatives, corn syrup and saturated fats.

Homo Sapiens have evolved over 2 million years of foraging and hunting. Agriculture was invented 10,000 years ago. Our bodies and intestines were adapted to eat fruits, vegetables, meat, eggs, and fish. Our bodies are not meant for high sugar diets, with breads and grains, high carbohydrate foods. If we can get back to a more natural diet, our children will thrive with less obesity, diabetes, hypertension, and cancer.

Is it too idealistic for this to be possible?

“But my child won’t eat those vegetables, and he refuses to eat fruits. He only eats those chicken nuggets from [insert brand here].”

Eating habits are hard to change. But first you must accept the fact that these habits have to change. Then we will move on in the next blog post.

ADHD – Guide for Home

adhdDr. Bell’s Guide for Homework Success for Children with ADHD:

I see many children who take ADHD stimulants to help with attention and school performance. Pills, however, are not the only answer. Once at home, a common problem for these children is the ease of distraction, flitting and flying from one stimulation to the next. Children with ADHD are often easily distracted, losing direction with homework, and lacking guidance for their evening hours.

Here are some rules of the road for children with ADHD that parents/guardians should enforce at home regarding homework and behavior.

1. Meals:

Start every morning with a good breakfast. Do not skip lunch.

2. Sugar Highs and Lows:

Give your child fruits, vegetables, and low sugar foods. Children become “hyper” on sugar. When they eat high sugar and/or processed foods, they get a sugar “high” for an hour, and then “crash” and become lethargic, tired, and/or cranky thereafter. Complex carbohydrates take longer to digest and provide a more even release of energy throughout the day. Provide them with lunches and snacks that contain complex carbohydrates like fruits, vegetables, low-fat dairy foods, breads, crackers, granola bars, etc.

3. Bed Time:

Your child should go to bed at the same time every night, even on weekends, getting 10 hours of sleep for grade schoolers, and at least 8 hours of sleep at night for teens. Have a “cool down” routine 1/2 hour to 1 hour before bed. Shower, brush teeth, read a book in bed. NO TV or video games during this time. Many kids are addicted to TV or video games “to help them sleep.” This is a poor choice. Break this routine; it only keeps the mind going and over-stimulated before sleep. If necessary, have a noise machine, fan, or soft music. (“But that’s boring!” That’s exactly the point.)

4. No TV in the Bedroom:

This is related to #3, but this is bigger than just sleep. The TV distracts the child, takes away your control of the child’s viewing habits, and further detaches the child from the family. This also increases the risk for overweight, out of shape children. Already have a TV in the bedroom? Have a discussion with your child about why it will be removed. This is not a punishment, only a change of habit.

5. Homework After School:

Do homework right after school when possible. Take a 1/2 hour break, but then get to it. Much longer that that, and any ADHD medicine your child is on will wear off, making it more difficult to accomplish homework.

6. Distraction-free Homework Space:

Have a quiet spot to do homework without distractions — no TV, no iPhone, iPad, Youtube or video games. This does not help a child concentrate despite what they say. It only distracts and causes careless errors. If they feel they need “something,” try a white-noise machine. Homework can be done in their bedroom if they have a desk or table, but the child can often be distracted by toys and other things in their room. Many children need to do their homework at the kitchen or dining room table to avoid distractions, but only if there are no other distractions.

7. Distraction-free Home:

When your child is doing homework, keep the rest of the house as quiet and free from distractions as possible. It feels unfair to the child to have to do homework at the kitchen table when a parent is in the next room watching TV.

8. Take Breaks:

Have the child take frequent breaks from homework (perhaps every 20 minutes for about 5 minutes). This does not mean video/screen breaks. Have them exercise, do jumping jacks, read a comic book or magazine, draw, play with a pet or sibling, or walk around, and then come back to the work. Use a timer and clock to keep track of time.

9. Check Assignments:

Parents should check homework assignments every night once homework is completed.

10. Organize:

Have your child put finished homework immediately into his/her backpack.

11. Limit Screen Time:

Limit video/screen media during the school week to one hour a day (or none at all). Save screen time for the weekends. This includes DS, tablets, smart phones and computers.

12. Discipline:

Discipline using the “1-2-3 Magic” rules for younger children: be consistent and persistent when enforcing rules.

  • Choose your rules appropriately and stick to them.
  • Give warnings to the child with each infraction of a rule and count it: “No back talk. That’s one.”
  • Use no emotion or lengthy explanation regarding rules and infractions; they know the rules.
  • When at 3, take them to a time out place, using 1minute/year of the child, set a timer. No talking.
  • When the time out is done, you do not need to explain yourself to child, or remind them of it. It’s over.
  • Repeat as necessary.

13. Plan Physical Activity:

For the “hyper” child, plan some physical activity in the afternoon. It could be sports, or even running around the house outside, jumping jacks, dancing to music, jumping rope. Make this mandatory even if it seems silly.

14. Parents/guardians need to contact the teachers:

Teachers want their students to succeed. They are available to parents/guardians by phone, email, or face to face. As parents/guardians, it is your responsibility to contact teachers about your struggling child. Find out what is going on in the class. Your child’s education is your responsibility as well.

Screen Entertainment and Our Children

2267178231 8174221ca7Your Child’s Internet Saturation – It’s Time to Engage!

TV, cable, movies, laptops, desktops, iPhones, iPads, iPods, XBox, WII, YouTube, texting!

World of Warcraft, Minecraft, Call of Duty – Black Ops, Halo, Grand Theft Auto, Assassin’s Creed…

etc., etc., etc.

I love video games. When I was a kid in Vermont, we would go to the “More Fun” arcade and drop quarter after quarter to play Galaga, Donkey Kong, and Dragon’s Lair. For Christmas in the early 80’s we got an Atari 2600. I remember the morning dad came downstairs to find me playing Space Invaders and said “Good morning,” when actually for me it should have been “Good night.” But that was rare, you can only stare at aliens on a screen moving back and forth for so long before you go crazy. The only other screen entertainment was TV and that included a few hours of Saturday morning cartoons, and then after 8 pm weekdays for Knight Rider and the A-Team.

For my own children, that time seems as foreign to them as my father’s youth when they first got a black and white tv when he was a grade schooler.

My boys are currently into Minecraft. If you have a boy, chances are he plays this too. Its a great fantasy world where you can create anything – buildings, mountains, volcanoes, ships, castles, you name it. The only problem I have is stopping them.

In the last decade our children have moved from simple tv watching to being saturated with instant media entertainment through video screens and devices, further detaching our children from the “here and now.”

Many children are allowed free reign of the internet and are being exposed to mature and violent images well beyond their comprehension and their maturity level.

Sitting in front of a screen, children are giving up opportunities for more active intellectual, emotional, artistic and physical growth:

Instead of hours surfing the internet, they should be reading a book, exercising, practicing talents like music or drawing, doing homework, or engaging in conversation with family and friends. They are missing meaningful interaction with people they respect and value.

They are being influenced by the thousands of commercials they see each year for alcohol, junk food, fast foods and toys and may be developing further unhealthy habits, and gaining weight.

The Kaiser Family Foundation found that 8 to 18 year olds spend an average of 7 hours and 38 minutes a day using entertainment media, as much time as they are in school.

And as parents, we can no longer be passive in the management of our children’s screen time. Here are some tips for parents to manage your kid’s media exposure:

  • Establish good habits early. Kids need guidelines and rules about what is a good amount of time to spend on the computer. A good rule of thumb for elementary kids is no more than an hour a day during the week. Allotting computer time in 15- or 30-minute increments gives you a chance to check in and suggest that it’s time for a break.

  • Be a role model. When kids are around, set an example by using media the way you want them to use it. Don’t bring your phone to the dinner table, and turn the television off when it’s not actively being watched. Record shows that may be inappropriate for your kids to watch — even the news — and watch them later, when kids aren’t around.

  • Stress homework before computer work. Make sure your kids know that homework must be finished before they look at YouTube videos or instant message the latest gossip.

  • Limit multitasking. Media multitasking is when kids are chatting online, watching TV, playing a game, checking out Facebook, or listening to music – and trying to do homework at the same time. It’s not really known what affect this has on how kids learn, but experts do know that it takes longer to do tasks like homework when other activities are going on at the same time. And that increases daily screen time.

  • Keep an eye on the clock. Keep an eye on how long kids spend online, in front of the television, watching movies, playing video games. The secret to healthy media use is to establish time limits and stick to them — before your kids turn on and tune in.

  • Determine if your child has an addiction or if he or she is simply spending too much time online. What happens when your children are away from the computer? Are they argumentative, depressed? Is there a marked change when they are online?

  • If you suspect a dependency, have a heart-to-heart. Have a real discussion with your kids about your concerns. This, plus some serious guidelines, may normalize the behavior. If the problem continues, or you think the computer time is masking depression or anxiety, see your child’s doctor for advice. Also, check in with the school counselor and see if there is something going on at school.

  • Have screen free days. A lot of parents have “no video games during the school week.” Sometimes the child spends his whole school day thinking about the half hour he is going to play that afternoon, and daydreams away his day. Having “no screen time” days frees the child to have other expectations during the day, forcing them to look for other forms of entertainment like reading books, playing games, drawing, hiking, or practicing sports.

For Starters

IMG 0010My wife keeps asking me, “Why do you want to write in a blog?”

Well, I’m still trying to explain it to her, but it boils down to my desire to connect further with my patients and their parents more than during our short conversations in the office. On this site I hope to continue discussions about discipline, ADHD, childhood development, obesity, healthy living, and more. Here I might be able to expand upon and better explain what I was rambling on about in the office. I will be writing mainly for my patients at Fairview Pediatrics, but hope that this site will help parents of other children, too.

I aim to give information about general health topics. My biggest goal, however, is to continue our endless quest to create that well-rounded, well-educated, well-developed, happy, healthy child. (And as soon as I figure it out, I will be posting that.)

First, a few disclaimers:

If you have seen me in the exam room with your child, you may have noticed my total disregard for formality. This is on purpose. All children deserve for their doctor to come to their level. Please realize that I have the highest regard and respect for your child, and my gentle teasing and playful attitude is meant simply to create an atmosphere of comfort and fun for the child, which allows my patients to open up and feel free to talk about whatever they feel. What I write here may be even more comical and irreverent than what I say during office visits. But please understand that I mean no disrespect to you or your child.

In addition, my ideas and opinions on this site are not necessarily the opinions of the American Academy of Pediatrics, nor should they be taken as direct medical advice.

My general philosophy of child rearing and the development of children is this: it’s all about moderation. This is true in matters of discipline and freedom, exercise and leisure, study and play, order and chaos. My job as a pediatrician is 10% medical and 90% telling parents, “you’re doing okay.” We parents must realize that despite our best intentions we are going to make mistakes, and that regardless of our attempts to mold our children, they are going to turn out who they are going to be, and that will be just fine.

I have been practicing medicine for 12 years now, and I’m still just practicing. I hope that I’ll get it right sometimes. As my oldest child said once when he was 3, “Sometimes you have to do the wrong thing, before you find out what the right thing is.” I hope that my writings are entertaining and enlightening, and that I can give you a fresh look on how to approach your children in their daily lives. That being said, let’s get started!

Juggling

jugglingI just thought I would put in a starter post regarding juggling. I first got interested in juggling when I was in grade school. I remember the moment wanted to juggle: I was in 8 years old and I was watching Mr. Rogers’ Neighborhood. Mr. Rogers was interviewing a 12 year old boy who taught himself how to juggle. He was performing a very basic 3 ball juggle pattern. I decided, for some reason, that I was going to teach myself.

I remember practicing with apples.

Why apples? I think because we had a lot of them in Vermont and we lived next to a farm with apple trees. I remember bruising a lot of apples. I would throw two apples in the air and drop them. Then I would throw them in the air and drop them. I would then throw them in the air and almost catch them and then drop them. This went on for a long time.

I do not know where my patience came from. I believe the answer lies in my environment. In 1978 I lived in Norwich Vermont, population under 4,000, in a house built in 1812. We had a black and white TV and got 2 stations, PBS and NBC. We lived on a dirt road surrounded by dairy farms and old folks. So you get the picture, there wasn’t much else to do. So I threw apples in the air and tried to catch them.

After many many months I remember I had established the ability to throw two balls and catch them, AND do that in a circular pattern. I came to school with two apples in my lunch bag and showed a few friends at lunch time. I distinctly remember Charles saying, “That’s not juggling. Juggling is with three balls.”

I went home dejected.

I went back to the orchard and got three apples.

It was another year before I could juggle in the standard three ball crossing pattern.

By 6th grade I could do other tricks: under the leg, behind the back, even catch a ball on the back of my neck.  Only after I went to college did I try doing machete knives and flaming torches.  (my mother would not have approved).

The point of this simple story is simple. Practice is an art of patience. It can be mind-bogglingly boring. It needs to be done with almost no expectations. It also needs to be done with no other distractions. No TV, no VCR, tape cassette, Walkman, CDs, DVDs, Blu-Ray, Atari, Colecovision, Sega, Playstation 3, or XBox.

As a parent, allow your child to be bored. When they say, “I’m bored!” Great! Remember that this is the first step towards creativity and accomplishment. Your job as parent is not to entertain them, but to push them from that point to do something different, and maybe even extraordinary.

Scroll to Top