The Changing Face of Hunger

As the fall-out of the recession lingers on, I am seeing more and more families in my clinic who are facing food insecurity and hunger. Many of these are families who used to be solidly middle class, but have been out of work for a year. They’ve already sold their car, their home, some of their belongings. They are running short each month. They are not sure where to turn, and they are often ashamed to talk about it. Continue reading

School-less in California

I recently became a fan of Rob Reiner.  No, it is not for his work on The Princess Bride (although I must say, “wuv tru wuv”).  I became a fan when I learned that he is a major advocate for early childhood development and helped to create First 5 California, a program that now provides critical services to young children.  And, then, I learned, he turned his energies toward making preschool available for all California children.  He backed Proposition 82 in 2006, a ballot initiative that would have provided access to free, voluntary, half-day preschool for all 4 year olds in California.    Some say the bill was well designed, some say flawedReiner took an incredible amount of heat for backing the bill, was forced to resign his position on the First 5 board, and the bill failed miserably at the polls.  What?  Well, it turns out that preschool is surprisingly controversial. Continue reading

Let’s Potty!

So, the time is approaching.  The time I’ve been dreading a bit.  The one developmental milestone, that, for some reason, I was kind of hoping my son would reach later rather than earlier.  It is almost time for toilet training.  How do I know?  Well, the little guy routinely sits on his little potty for a few minutes before bathtime.  We read some books, chat, and that is that.  But, lately, these nightly sits on the potty have occasionally become, shall we say, productive.

Why am I afraid of potty training?  Well,  this is one area of parenting for which I think practical life experience is probably a lot more useful than reading about it.  Perhaps the pediatrician in me is worried the mom won’t be able to do it “right”.  I also have visions of mapping out the shortest distance to the nearest bathroom during every errand, trip, and walk.  Diapers are just so easy right now.  Messy, occasionally, but easy.  But, as we say, toileting is one of the areas where the kids have much of the control, so if he’s getting ready, I better get on board.

The “app gap”: How parents obtain health information

The number of educational topics a pediatrician is trained to cover in a standard well child visit is a bit overwhelming.  Each topic could (and does) fill books.  A 2006 study published in Pediatrics found that there are 162 different verbal health advice directives that pediatricians are told to cover with each patient over time.  These important topics range from injury prevention to nutrition to sexual health to literacy promotion.  But, as the authors of the study point out, not only is there little time to cover these topics, there is scant evidence to suggest whether or not talking about these topics with families is actually effective.  It is often difficult to know exactly what to prioritize for discussion in a short clinic visit.  In order to ameliorate our own anxiety that we didn’t have time for everything, many pediatricians provide educational handouts.  But, does anyone read them?  What’s more, are they written in the language the parent speaks, at a level they can understand?

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Bilingual Bebé

“How many words do you think he can say?”, I asked, as I do for all 2 year olds, at a recent well child visit.  The mom’s eyes gleamed proudly, “at least 50 I think” and then her face dropped, “but they’re mostly in Spanish.”

In my diverse practice well over half of the families speak a language other than English at home.  And, the above is a common scenario- apparent disappointment or shame that their young child prefers that language to English, or speaks a mixture of both.  I have made it my mission to dispute the notion that speaking two or more languages at an early age is somehow a disadvantage, and I am really happy to see so many recent studies that back me up. Continue reading