Author Archives: My Two Hats

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About My Two Hats

Thoughts on child health from pediatrician/mom, Dr. Heidi Kloster.

A flood of (mis)information: parenting in the digital age

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photo by Heath Brandon

These days, when we have a question or doubt about our health or our child (or about anything really), our first thought is not likely to get out a book, or make a phone call. It is to search the web.  The internet brings answers to our questions within a few seconds.  This is an amazing thing- patients bring questions to clinic about things they have read, the patient/physician relationship becomes less paternalistic, e-patient communities are formed.  Patients and health care providers are more well-informed and empowered.

But what happens when the information we find is not correct? Continue reading →

The toddler, the toothbrush, and the timer: How does one keep a toddler’s teeth clean?

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The American Academy of Pediatric Dentistry is now recommending that infants see a dentist before their first birthday, or shortly after the first teeth erupt.  This may seem early, but it is for good reason.  Poor oral health and dental decay are all too prevalent in young children and can be cause of significant pain and suffering.  Baby teeth serve important functions in chewing, language development, and as place-holders for adult teeth. An early visit to the dentist can help catch any cavities and offers an opportunity to discuss dental care and fluoride needs. Practically speaking, I encourage parents to at least get to the dentist between the first and second birthday.

I took my son to his first dentist appointment around sixteen months of age.  Continue reading →

One bad burger: Is it food poisoning?

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Staph aureus: Cool to look at. . . not so cool to have.

Recently I’ve taken care of a few kids who came into the clinic with vomiting that suspiciously started soon after eating a hamburger (two at school and one at a fast food restaurant).  Is this food poisoning or a routine viral infection?  What is “food poisoning” and what causes it?  What should parents do if they suspect their child has food poisoning?  Read on to find out. Continue reading →

Feeding Toddlers, Part Two: The Picky Crowd

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Photo by Martin Cathrae

After a lovely holiday hiatus, I am back, as promised, with part two in the series on feeding toddlers.  Today I’ll focus on kids who are choosy.  For this post I lean on professional experience.  We have no shortage of patients in our practice whom one could describe as “picky eaters” or who are sometimes diagnosed with “feeding problems”.  I have trouble with the diagnosis “feeding problems or mismanagement”, as it comes up in our electronic medical record.  Why?  Well, and this hopefully serves as a bit of comfort, toddlers who are picky eaters are pretty much the norm.  It is, in fact, an expected developmental stage.  If you have a toddler who refuses dinner, but then begs for chicken nuggets, this post is for you.  If you have a toddler who only takes two bites at each meal, and then runs off to play, this is for you.  If your child seems to refuse all vegies, this is for you.  If, on the other hand, you have a child with true “failure to thrive” or difficulty gaining weight and growing well, please consult with your pediatrician, as I won’t be addressing those problems here. Continue reading →

Feeding Toddlers, Part One: The Cheese Stands Alone

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Photo by Christian Bauer

Our son has always loved to eat.  In the hospital after he was born, the lactation consultant called him the “barracuda” breastfeeder.  He ate vigorously and often.  While this made for some sleepless nights, it also meant we didn’t have to worry too much about early weight gain, which I was initially concerned about as a first time mom.

As a 21 month old he still loves to eat.  We haven’t found much that he doesn’t like, but he’s definitely starting to have favorites.  Early on my prescient husband nicknamed him “ratón” (spanish for little mouse), a name all too fitting as cheese now seems to stand alone at the top of the list of favorites for our little guy.  He recently has taken to standing in front of the refrigerator saying “cheese, cheese, cheese” and, if that doesn’t work he’ll switch to “queso, queso, queso”.    Perhaps this has something to do with being half-Wisconsinite.  We do love our cheese. Continue reading →

You say Phys Ed, I say Phy Ed, let’s not call the whole thing off

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In middle and high school I kind of hated phy ed. It all seemed so awkward. I mean, you come from class and change into awkward looking uniforms like this.

by Duke Yearlook, Duke University Archives

Okay, they weren’t quite that bad.  And then you stand around staring at your feet for awhile. Then you (if you are me) drag your 5 foot (on a good day with shoes) self out to the basketball court and kind of hope that no one throws you the ball or really expects you to make a basket. Twenty minutes or so later you head back to the locker room and face another awkward decision. Do you shower, or do you spend the rest of the day sweaty in order to preserve what’s left of the bangs that you had meticulously teased and sprayed that morning?  Now, to be fair, there were some great days in PE.  Archery was cool, badminton was fun, and the bowling unit was like getting a short field trip each day.  But, still, it was hard not to feel like PE was somehow a waste of time.  This, despite the fact that I was a kid that actually really liked being active and was part of various sports teams growing up.

Fast forward 20 years or so. That high school kid who wished she could get out of phy ed, is now a pediatrician who is a vigorous supporter of physical education for all children at all levels of education. Why the change? Well, the reasons are part anecdotal, and part data driven. Continue reading →

Step Away from the Cell Phone

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It happened again three times in clinic today.  In the middle of a patient visit, a parent picked up their cell phone.  To answer a call, to text a friend, to read their email.  The trend of being always connected and available has reached the exam room.  When this first started happening I was sort of incredulous.  I mean, I’m there, talking to you about your child’s health, and you’re taking a call? 

Then something interesting happened. I got a smart phone, and I started to get more connected myself.  I downloaded a few apps.  And, it was great.  I could read my email or the newspaper anytime.  I could use the phone during a clinic visit to check a drug dose or potential side effect.  Eventually, and here’s the confession part, I found myself start to be sort of drawn to the phone.  I pull it out while waiting in line at the post office.  I take it out of my pocket at work to use the calculator and suddenly find that my email is open and I am reading it.  This seems to happen as if all on its own. I have to close it, remember what I was doing, and move on.  I even sometimes have to consciously stop myself from grabbing the phone while driving.

Continue reading →

The Changing Face of Hunger

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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

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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 flawed.  Reiner 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 →