Could a Baby Die Asleep in a Car Seat on the Floor?

Positional Asphyxia: Death Asleep in a Car Seat

Tragedy struck a North Dakota family when one of their twins died at daycare in his sleep.  The daycare workers usually took the babies out of their car seats.  At drop off, Linnea was taken out of her car seat.  But her twin brother, Anders Jungling fell asleep.  Just a few hours later, his mom, Rachel, got the phone call.  He died quietly in his sleep ... in his car seat.  Rachel didn't understand why he was still in his car seat.  The daycare workers didn't know that a baby could die in a car seat placed on the floor. So, they let him sleep.

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Why Does Any Mother or Caretaker Leave a Baby Asleep in the Car Seat? 

The reasons are many ... 

"I'm just so tired." 

"He finally fell asleep."

"He has such bad colic & has been crying all day. He needs the sleep."

"I'll leave him there for just 30 minutes."

"If I take him out, it'll take forever to get him back to sleep."

"I've always heard to let sleeping babies lie."

And many, many more.

How Many of Us Have Left Our Baby Asleep in a Car Seat? 

I've been guilty of that.  I remember constantly checking, every 2-5 minutes if my sleeping son was okay in the car seat.  Then, it finally dawned on me that the little bit of sleep he would get in his car seat was causing me extreme stress and additional mental unrest.  Why was I doing that to myself?  He had horrible colic.  He was only getting a maximum of 3 hours daily.  In the end, I couldn't reconcile his much-needed sleep with my ever-increasing madness.  I'm sure my sleep deprivation made me think unclearly.  Mentally, I just couldn't take the risk anymore.  And so, I took him out of his car seat.  And he cried.  A lot.  I hated it.  Praying he would just fall back asleep each time, but he didn't.  So, many a night, I would drive with him until he slept in the car.  I can understand why anyone would leave a baby in a car seat.  However, we just can't because they could die of positional asphyxia.

What is Positional Asphyxia?

Positional asphyxia happens when an infant stops breathing when they are either placed or fall asleep in an unsafe sleeping environment or an unsafe position.

How Can Positional Asphyxia Occur in a Car Seat?

A baby can sleep safely in a car seat placed in a car because the car seat is placed at an angle.  when the car seat is at an angle, a baby's heavy head remains backward and their airways remain open.  On the floor, the baby's head tilts forward and closes their airway.   The baby will not fight the asphyxiation.  They will die quietly in their sleep.  

What are Some Unsafe Environments for Baby's Sleep?

Car Seat

Bed-sharing

Objects in the bed, such as blankets, pillows, stuffed animals

Sofas

Waterbed

Beanbag Chair

What are Some Unsafe Positions for Baby's Sleep?

Side sleeping

Sleeping facedown

Sleeping with the head covered (in a car seat)

Face against a soft surface (bed bumpers, parent's chest)

What are the ABCs of Safe Sleep?

Alone – Babies need to sleep alone in a crib without anything that could suffocate them (bed bumpers, blankets, pillows, stuffed animals, pacifiers made with attached plushies).
Back – Babies need to sleep on their backs (no side sleeping or face down sleeping).
Crib – Babies need to sleep in a crib or a flat bassinet (not a car seat, swing, adult bed, etc).

Is This Rare?  Why Change if Nothing Bad Has Happened to Anyone I Know?

You may not hear or know someone whose baby died of positional asphyxia, but it's not worth taking the risk.  In my pediatric career, in over 20 years, I've had 3 children that I've cared for die from positional asphyxia.  If it happens to you or someone you know, it's life-changing.  You have to live with the pain and regret, forever wondering, if you had only changed, would life have been different?  It's just not worth it.  

Climbing Affirmation

On the ladder of difficulty,

I may be on the bottom,

But when I reach the top,

There's gonna be

One heck of a view!

Additional information about Children & Affirmations is available at this website where more detailed informations and applications of affirmations can be used and applied for you and your child.

There are also Daily Affirmations available where this affirmation and others have been adapted for both parent and child.

C

Lavender & Tea Tree Essential Oils | Abnormal Breast Growth in Girls & Boys

Lavender and Tea Tree Essential Oils - Use in Children

Lavender and tea tree oils may have negative side effects in children.  These oils may increase estrogen activity while inhibiting androgen activity.  Estrogen is the female sex hormone. Androgen is the male sex hormone.  Essentially, lavender and tea tree essential oils imitate estrogen and block testosterone.

The potential negative side effect in these lavender and tea tree essential oils are abnormal breast growth & breast growth before puberty.  Essential oils are being used widely, but not enough studies have been done to evaluate their negative side effects.  This is extremely important, as so many people are using essential oils due to the benefits of their antimicrobial properties, relaxation, and overall improvement and prevention of ailments.

Latest Study Published in Endocrine Journal

This groundbreaking study was published on August 8, 2019, in the Endocrine Society’s Journal of Clinical Endocrinology and Metabolism. The study also revealed that breast development resolved shortly after these lavender and tea tree essential oils were stopped.

Essential Oils in Many Children's Products?

Do you use these essential oils on your children?  Even if you don't use essential oils on your kids, you may be doing so without realizing it.  May common skin products, especially for babies contain lavender, such as lavender lotion or lavender baby bath products.

Should I Stop Using Essential Oils on My Children?

At this point, it's probably best to hold off on using these lavender and tea tree essential oils on children, at least until after puberty is complete.

Juice Recommendations for Children

Expert Panel: Milk, Water, & Juice Recommendations

for Children

Juice recommendations & recommendations for other drinks for children have been updated by a health experts panel. Under the leadership of nutrition research organization Healthy Eating Research, this panel formed to update parents, caregivers and health care providers on what should be provided with drink-wise for a healthy start for children from birth through age five (5) years old. The panel consisted of experts from the Academy of Nutrition and Dietetics, the American Academy of Pediatrics, the American Academy of Pediatric Dentistry and the American Heart Association. They reviewed current domestic and international policy statements and evidence-based recommendations.

Breat Milk, Milk, Water & Juice Recommendations:

Birth to Five Years Old:

0-6 Months Old:

Breast milk or infant formula.

No juice.

6-12 Months Old:

Breast milk or infant formula

Small amounts of plain drinking water introduced once solid foods become part of diet.

No juice.

12-24 Months Old:

Whole milk

Plain drinking water.

Maximum 100% juice 4 oz daily.

2-5 Years Old:

Skim or low-fat milk

Plain drinking water. Maximum 100% juice 4 oz daily.

What About Soy Milk?

The panel did not recommend plant-based milk or non-dairy beverages for "exclusive consumption in place of dairy milk," unless there is a medical necessity.  Non-dairy milks are missing of important nutrients that are typically obtained from dairy milk.

Fruit or Juice?

Are juice recomendations the same as for fruit?  Fresh fruit is always preserved over 100% fruit juice.  Furthmore, parents and children need to be educated about the benefits of the fruit as compared with juice.  Fruit has natural dietary fiber and less sugar than juice.  Juice has lots of sugar which has a tendency to add to excessive weight gain.

Fresh, Canned, or Dried Fruit?

Fruit recommendations are important.  While fresh fruit is best, it is not always practical, in that it doesn't work for everyone.  Fresh fruit is healthier, but it is more costly than canned or dried fruit.  In addition, fresh fruit also takes time to ripen.  Another thing to consider is that some young children have food texture issues that makes eating fresh fruit more difficult that eating softened canned fruit.  Reality is that fruit in any form is healthier and preferred over drinking juice.

What About Flavored Water and Flavored Drinks?

The panel did not recommend offering young children any caffeinated beverages, beverages with low-calorie sweeteners, sugar-sweetened beverages, toddler milk or flavored milk – such as strawberry or chocolate milk – at any stage during early childhood as part of a healthy diet. Personally, I do make one exception to the recommendation against flavored milk.  If your child has food issues, refusing  unflavored milk and other dairy (cheese, yogurt), then flavored milk an  acceptable alternative, so as to ensure your child has at least three calcium servings daily.

These sweetened drinks are the large daily source of added sugar for most children, resulting in excess calories and weight gain.

Other Times Not to Use Juice

In addition, unpasteurized juice products are not recommended for children as there is an increase of life threatening infections, such as E.coli O157 and O111, Salmonella, Cryptosporidium, norovirus, Vibrio cholerae, Clostridium botulinum, yeast, and hepatitis A.

Children who take specific forms of medication should not be given grapefruit juice, as it could make the medication less effective.  There are many medications that can be less effective with grapefruit juice, many are for cardiac conditions.  However, a common allergy medicine, Allegra (Fexofenadine) is weakend by grapefruit juice.  It's a good practice to ask the prescribing doctor your child's medication could be negatively affected by grapefruit juice.

Tooth decay is common when anything other than water is kept in sippy cups, if they use them throughout the day.  Constant exposure to non-water drinks leads to the carbohydrates in them to cause tooth decay, as well.  Children should have their teetch brushed twice daily.  And especially before bedtime.  After brushing their teeth, they should only have water before bedtime to protect their teeth.

Lastly, it important to know that if your child is dehydrated, then juice will make it worse.  Rehydration needs to be done without all the sugar in juice. Apple sauce is the only fruit product that is recommended depending on the cause of dehydration.

More On Healthy Lifestyle Choices

Healthy Choices Affirmation, Healthy Dining, and Healthy Eating & Steps at the Holidays are also provides additional information about healthy eating and drinking.

Self-care Affirmation

Self-care is loving myself enough to not feel responsible for others.                          I am celebrating the person responsible for herself.

Additional information about Children & Affirmations is available at this website where more detailed informations and applications of affirmations can be used and applied for you and your child.

There are also Daily Affirmations available where this affirmation and others have been adapted for both parent and child.

Lastly, 101 Best Louise Hays Affirmations of All Time is an excellent resource.

Best Christmas TV Variety 2018

The best Christmas TV shows are a great time for family time. There are multiple opportunities to get together, share, and talk about family values and learn some valuable life lessons while watching them.  There are many options to choose from: Freeform's 25 Days of Christmas, ABC, NBC, Disney Channel, Hallmark channel's Countdown to Christmas, AMC, Lifetime & even Netflix has stunning Christmas original programming!  With so many options, where do you start?  Which are age appropriate?  Moreover, Common Sense Media does great review that includes their recommendations for age appropriate viewing.  Therefore, I've included those links for many of the best Christmas TV shows and movies below.  Here's my guide!       

Netflix

The Christmas Chronicles

Netflix

I'm going to start by telling you our first watched Christmas TV show for 2018.  I happened to see Netflix had a new Christmas show called The Christmas Chronicles starring a very entertaining Kurt Russel as Santa Claus.  I figured we'd take a chance with something new.   Plus it was an older brother & younger sister story.  Frankly, this was right up our alley as that is exactly our household sibling dynamic.  We LOVED it!  Why?  For instance, Santa rocks in the jailhouse while he has the brother-sister duo help save the very Christmas that they accidentally set on a course to be the Christmas that might not happen!  These siblings helping Santa while coming to some personal revelations about growing up & making us laugh along the way. 

Angela's Christmas

Then, there's Angela's Christmas.  It's a tear jerker about the family, loss, poverty & the chaos created when a little girl tries to warm the Baby Jesus, taking it from the church.  She had good intentions, but things go awry.  Above all, her family is there to help and support her.  My little girl really loved this one.  That is to say, she connected with special little Angela's her big heart and fierce determined personality.  

Other Netflix Christmas TV Originals

Likewise, some other entertaining Netflix originals include The Princess Switch and A Christmas Prince: The Royal Wedding.  

Freeform's 25 Days of Christmas

Above all, Freeform has the best Christmas TV show schedule that is includes Christmas movies too!  I really like that there is a great variety of non-Christmas shows & movies.  They are shown on the Freeform Channel, ABC & the Disney Channel.  What programming do they offer?  Here's a sampling with some of our family's favorites!  On December 11, 2018 they are showing Mickey's Once Upon a Christmas, Mickey's Twice Upon a Christmas, & Disney's A Christmas Carol.  On December 12, 2018, there are some repeats & a few different options such as Call Me Claus, Deck the Halls & The Santa Clause.  To sum it up, their schedule is great with a lot of variety aside from the Holidays, such as Disney's Finding Nemo, Brave & Tangled.  The whole family has an opportunity to pick a couple of favorites.  

ABC

Elsa & Anna

ABC has their Christmas TV show  schedule that includes some very special kid shows that are great to re-watch.  Here's a sampling are some of my family's favorites!  On December 19, 2018, the Disney geek in me is happy to see Olaf's Frozen Adventure!  There will also be Dreamworks' Shrek the Halls.  On December 20, 2018 there will be the classic A Charlie Brown Christmas.  On December 23, 2018, they will air Disney's Prep & Landing and Prep & Landing 2: Naughty vs. Nice.  To sum it up, I  can't resist those two elves.  One is funny & anxiety ridden & the other a bit of a daredevil in my opinion!                                                                          

NBC

It's a Wonderful Life

How the Grinch Stole Christmas is another absolute best Christmas TV show that NBC is scheduled to air on Christmas Day! To be honest, we own the cartoon original & the movie.  As a child, I was scared of the Grinch.  Then, my son came along.  As a result, I love the Grinch now.  Therefore, we plan to go see The Grinch movie soon too!  On December 24, 2018, NBC will also air It's a Wonderful Life.  This is the best Christmas show in Black & White.  And it never gets old!  It teaches so much about life, love, struggle, self-worth, self belief, community & that one person really makes a HUGE difference in so many unknown ways.  I grew up watching this one.  

Tampa Theatre

Ultimately, this year we're going to watch It's a Wonderful Life at the Tampa Theatre with showtimes are from Friday, December 14th through Thursday December 20th.  The Tampa Theatre is a wonderful experience is known as Tampa's Non-Profit Movie Palace & a National Historical Landmark.  My kids haven't been there yet, so this will be an extra special magical treat.   

AMC

Elf

This year, AMC has achieved a great trifecta!  They are exclusively showing Elf, National Lampoon's Christmas Vacation, & The Polar Express.  My family favorite filled with the magical ride to the North Pole is definitely The Polar Express.  Elf is one of the best Christmas TV movie comedies that makes me laugh and laugh!  AMC has a Christmas movie lineup of over 40 movies sure to satisfy the Christmas movie fan!                                                                                                                                                    

Hallmark & Lifetime Original Movies

Hallmark's Countdown to Christmas lineup does not disappoint either!  They have a Christmas movie lineup of 22 new original movies!  Lifetime's Christmas movie lineup has 14 new original movies!   While I wouldn't call these the best Christmas TV shows, I would say they have some ice entertainment value.  In addition, they are family friendly which is a plus!

The Original Christmas Specials

Rudolph the Red Nosed Reindeer

Three of the best Christmas TV shows are Rudolph the Red Nosed Reindeer, Santa Claus Is Comin' To Town (on Freeform Christmas lineup) & Frosty the Snowman.  A classic, Rudolph is the longest running Holiday special in TV history, broadcasting for 54 years!  I loved these every year since I was a little girl.  It was always special because I didn't get a chance to spend much time with my dad since he worked nights.  Christmas movies with my dad will never be forgotten!  They give my inner child a special warmth and a lifetime memories.      

FX

Jack Frost from Rise of the Guardians

Rise of the Guardians is another one of the best Christmas TV movies.  However, it seems the FX channel is the only one playing it.  Magic is in the air when Jack Frost, the Easter Bunny, the Tooth FAiry, the Sandman and Santa Claus need to save the world from Pitch Black, the Boogeyman, who is the nightmare maker.  Will the children still believe?  There are scary parts for the little ones.  Consider this before allowing to children to watch.  However, at the coreof the movie is Jack's search for his center  Santa's is his sense of wonder.  While watch, it made each of us think, 'What's my center?'

Family Time

In conclusion, what matters most about Christmas TV shows & movies is not just their content or quality.  Most importantly, too much TV is not a good thing.  Certainly, a few good shows is all it takes to have some memories & some good times.  The family time is the best part!  We have movie nights with popcorn, blankets, and all lights off, except for the Christmas tree. How do you create Christmas TV & movie memories?  Do you still believe?  While you're at it ... What's your center?  Please share it with yourself, your loved ones, and here as well.

Positive Talk with Children

Positive talk with children can be elusive.  Often, we get lost in the busy "to do list' of our lives.  When our children don't follow directions or listen to us, we fall into the usual negative talk.  "Stop that now."  "Don't touch that." "Leave me alone." Arguments, yelling, and fighting can take place. 

Positive Talk with Children
- Photo by Anna Kolosyuk

It's impossible to stop all the frustrating times with our children.  However, remembering that sometimes we can change our reaction or approach, can prevent us from feeling bad.  And positive talk prevents some of the negative feelings our children develop from constant negative talk.  In addition positive talk with children involves the crucially important skill of listening.  Other important aspects of positive talk with children include remembering that you're talking with a child, asking questions, acknowledging feelings, teaching alone time, giving praise, and making apologies.

Remember That You're Talking with a Child

Talk to children at eye level.  When children are always looking up, especially when they've done something wrong, this is intimidating to them.  Plus talking at eye level shows your children you have some respect for them.

Speak simply.  A short sentence can go a long way.  Responding to questions or misbehavior with one simple sentence will help a child stay on task and understand more clearly.  Avoid a lecture.  Avoid going on and on.  At some point, they aren't listening.

Offer two choices, either of which you approve.  When children are given options, it encourages independence.  When you approve of either of the two choices that you offer, it creates an opportunity for happiness and not frustration.  For example, "Would you like to eat peaches or pears?"  They still may want chocolate chip cookies, but you have not asked them, "What do you want to eat?"  which incorrectly leads them to believe they can pick their meal or snack.

Ask questions only if you want your child's opinion/answer.  Asking, "Are you ready to go now?" gives a child the impression that if they are not easy, then you will wait.  If you are not willing to wait, then tell them, "It's time to go now," so that there is no confusion.  This allows them to know that there are times when their opinion matters.  Accordingly, it lets them know that other times you are the one in charge, making the decisions.

Listen To Your Child

Stop and listen.  We are often busy.  Day in day out, there's a lot to do.  There's laundry, meals, dishes, hosehold cleaning, work outside the home, family needs, and more keep us busy.  However, none of those tasks help us to listen.  Intentionally making the time to listen to our children can have a huge impact.  There are techniques on how to listen to your child that can be learned easily.  Our children can learn they are important by our interactions with them, not just what we do for them.

Set aside a time to listen.  When we don't have the time to talk, then it's good to be honest. We can let our children know that, "Right now is not a good time for me to talk with you.  I want to hear what you have to say.  I'll make some time to talk with you later."  Remember to tell your child a specific time when you will talk.  then stick to your word.  That way they will respect your time.  And they will still feel important.

Repeat or restate what you heard.  Often, we hear what our children said, but we interpret it incorrectly.  Other times, when we repeat it to them, and they realize that they misspoke.  This encourages our children to develop great communication skills.

Ask Questions

Ask open-ended questions.  "How are you feeling?" allows our children to express whatever is on their mind.  "You didn't like that, did you?" limits what they will say.  sometimes we need to hear all aspects of what their thinking, so that we can best help them.

Ask specific questions.  If there is a specific issue, open-ended questions may not give a parent the answer needed.  "What was your favorite part of today?"  "What upset you the most?" "Did you understand what you learned in math class today?"  These are some examples of questions that allow our children to narrow the conversation enough so that they know their specific positive or negative emotions and experiences are important.  You are less likely get short answers, such as "Good," "Okay,"  "Bad," which are conversation enders.

Feelings Are Important

Encourage all feelings.  It's okay to feel sad.  We often say, "Don't be sad," as if it's a bad thing.  This is hard to watch.  Sometimes children just need to be held until the emotion passes and/or they express their feelings.  Instead of pushing away unpleasant feelings, they will learn how to deal with their emotions, making them healthier children.  Encouraging our children to feel their emotions gives them mental strength as adults too.  

Share your feelings.  "You made me sad when you lied to me."  "I had a hard day at work today."  This teaches them to think of others.  It also shows them you are human too.  However, make sure you keep this simple, as a child can easily be overwhelmed by adult emotions and their wish to please their parents.  You want to share your feelings without making them feel responsible for your complete happiness.

Teach Alone Time

Teach our children to play by themselves. This will encourage independence which is essentially for their growth and development.  It will also allow parents to act independently while getting our own tasks done.

Teach children that parents need alone time too.  If you've ever been interrupted while on the toilet by your child, then you know the importance of your alone time.  Shouting, "Leave me alone!" is not pleasant.  Our children don't like it, sometimes getting their feeling hurt.  And we don't feel good about ourselves afterwards.  Explaining to our children that we need "alone time" for a certain amount of time and to carry out a specific task is important.  Our children will model after what we do, not just what we say.  They will learn from us that our time is valuable which will lead to the eventual realization that their time is valuable too.  It also teaches them that they are not the center of the universe.  We will not stop to fulfill their every need every moment of the day.  It teaches them that there is a time and place for everything.  Lastly, it also teaches them to appreciate everyone's need for alone time.  In addition, this helps teach them to be considerate of other people's time.  This form of positive talk with children explains actions and validating our children.

Praise Children

General praise is good.  "Good job!" is a form of positive talk.  However, it leaves some room for interpretation.  What exactly made it a good job?

Specific Positive Praise is better because it is an improved form of positive talk with children.  Let them know exactly what behavior or speech that did that you liked and why you like it.  This helps encourages positive behavior, and decreases negative behavior, improve self-esteem, and improves the parent-child relationship.  "I like how you sat quietly and completed your homework," is more likely to result in the child repeating the same specific behavior.  

Apologize

Admit when we are wrong.  There are times that we have gone too far.  We have said something that we shouldn't have said or did something we shouldn't have done.  Children seem to know exactly how to overwhelm us when we are already overwhelmed.  Simply saying, "I'm sorry.  I was wrong to say/do that specific behavior."  Then offer the change you'll make next time.  "I'm sorry I yelled at you.  Next time, I will tell you to stop playing video games or else I will turn off your device."  In addition, consider asking our children what consequence they would like for their behavior.  Usually kids know what they've done wrong.  They will come up with an appropriate consequence.  This is self empowering because they came up with the consequence.  This helps our children know what to expect and the consequences of their action if they don't listen.

Apologize simply.  "I'm sorry.  You were right and I was wrong.  And I'm so sorry."  This validates our children.  They learn that they have good behaviors.  Then learn their parents are human, make mistakes, and apologize when appropriate.  They also learn that it's okay to make mistakes.  No one is perfect.  In addition, parents are role models on how to apologize when we make a mistake.

Additional Resources

• Winning Ways to Talk with Young Children by Virginia State University, Cooperative Extension Service - Dr. Valia Vincell, Child Developmental Specialist.

• 25 Ways To Talk So Children Will Listen by Dr. Sears

• 20 Ways To Talk So Your Kids Will Listen by Robert Myers, PhD

• This blog also has information on Children & Affirmations and Daily Affirmations & Quotes that are helpful in general.

Coming Out To Your Doctor - Difficult & Private

Coming out to your doctor may be difficult, especially for if you are a teen.  Often, a teenager comes out with a million thoughts running

Coming Out To Your Doctor - Photo by Sharon McCutcheon

through their head.  Will my doctor accept me?  Will my doctor help me?  Does my doctor understand me?  Will my doctor tell my parents/keep my secret?  According to poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, 18% of all LGBTQ Americans refrain from seeing a physician for fear of discrimination. 

What If I'm Scared of Coming Out to My Doctor?

Coming out to you doctor may feel very scary and unsafe.  Consider asking your doctor if their office is a safe office where acceptance is commonplace.  Whenever the LGBTQ child is suffering, the most important thing I can say to them is, "You are safe.  You are safe here."  Because every child is special.  After all, one of the best gifts a pediatrician can give to any child, especially the LGBTQ child/teen is letting them know they are special and wonderful just as they are.  It is not my job to help the child/teen figure out their sexual orientation.  It is my job to make them feel comfortable enough so that I can help them with any health issues they may have to date. 

Come Out When You Are Ready

Coming out to your doctor can help you in many ways.  However, given the difficulty that this may involve, you may want to consider calling your/any doctor's office first to ask if they care for any LGBTQ patients.  Remember, you don't have to give your name out at the first call.  Ultimately, this may help you feel more comfortable and ready.  

How To Come Out To Your Doctor

There are many conversation starters you can use, such as "There's a conversation I need to have with you" or "How do you handle patient confidentiality?"  Consider telling the doctor in a matter-of-fact way.  Chances are, you are not the first LGBTQ patient they have ever had.  Follow up with a prepared list of questions that you have for your appointment.  There is a "Do Ask, Do Tell" brochure that may help answer questions about coming out to your doctor.  It is also important to know that there are laws that protect you and your doctor, so that your information is kept private.  Ask about confidentiality will make you feel safe as well.  In addition, you may consider bringing a friend, partner, or family member for support.

Doctors Can Offer Support in Many Ways

I've had teens come out to me as their doctor, some have been painful to witness.  Painful for me, because it incredibly hard to see someone suffer and be in such tremendous emotional turmoil and/or physical pain) for simply saying their sexual orientation and/or gender identity.  In the past, I reassured a transgender child in the midst of an immediate, intense, and severe panic attack by continually repeating, "You are safe.  It's okay.  You are safe here.  You don't have to talk about it, but if you do, I'm here for you."  I have had patients who became successful adults with great careers who thanked me for accepting them because I was the first person they came out to or that I cared for them and their issues with compassion and maybe even some tough love.  Most recently, I held and rocked a child that I cared for over 15 years until they stopped their uncontrollable shaking because they couldn't face themselves and their sexual orientation.   That child motivated me to write this blog.  I want to help other LGBTQ youths know that they don't have to suffer, that their doctor can help them.  Chances are your doctor cares and wants to help you in your journey to physical and mental health and peace.  

Do I Have to Tell My Doctor I'm LGBTQ?

It's best if you do tell your doctor.  Your doctor can't give you the best medical care if he/she doesn't know that you are a LBGTQ person.  A doctor needs to know a patient's sexual orientation, gender identity, and sexual activity history, to best help that patient and their medical and psychological needs. 

Medical Help & Disease Prevention Available

Sexual history will help me test for, diagnose and treat STDs.  Also, a pediatrician or internist will be able to teach you how to prevent HPV and offer the HPV vaccine to prevent this cancer and wart causing disease.  In addition, if you are HIV negative, but at high risk for developing HIV, then your doctor may start PrEP medication.  What is PrEP?  Pre-Exposure Prophylaxis (PrEP) is Truvada, which is a daily pill that when taken helps prevent HIV in people who are high-risk by up to 92%.  Your doctor may start this medication, if you agree to take it every day and follow-up with appointments every three (3) months.  Consider bringing a List of Top Ten Issues LGBTQ People Can Discuss with Their Doctor with you to your appointment.  In addition, if you are a transgender youth or adult, your doctor, yes, even your pediatrician, can refer you to a specialist for hormonal treatment.

Psychological Help Available

A doctor will also be able to make some psychological recommendations, if needed.  LGBTQ teens are more likely to suffer from anxiety, depression, have increased risk of suicide, abuse, may need referral to a psychologist, a psychiatrist, and/or a support group, like the Gay Straight Alliance (GSA), and GSA Network.  GSA is a student-led or community based organization.  GSA is an important resource on social media on Twitter (@GLSEN)  and Facebook.  GSA Network is also a resource available on Twitter (@GSANetwork) and Facebook.  Local support groups area usual available for GSA and GSA Network on social media and in as clubs many schools.  Lastly, your doctor is a source of support, simply be accepting you and caring for you.

Doctors Willing to Learn LGBTQ Issues & Needs

Your doctor may be comfortable with caring for you as a LGBTQ patient.  However, we are not classically trained to care for LGBTQ patients, so there usually is a learning curve.  However, if your doctor says, "I don't know how to care for that issue, but let me do my research; I'll get back with you on that particular issue," then you have a great doctor indeed.  A doctor that's willing to learn, cares for you, and is honest is the best kind of doctor.

Additional Resources for LGBTQ Teens & Parents

• Coming Out: Information for Parents of LGBTQ Teens is a helpful resource from the American Academy of Pediatrics. 

• How To Support Your Child Who is Questioning Their Sexual Orientation by Everyday Feminism which includes definitions of many LGBTQ+ terms.

• Transgender Children & Youth: Understanding the Basics by the Human Rights Campaign.

• Teens & Gender from an NPR interview which includes many gender terms, such as gender questioning, gender queer, gender fluid, agender, etc.

• Sexual Attraction & Orientation by Kids Health.

• This blog also has information on Children & Affirmations and Daily Affirmations & Quotes that are helpful in general.

Are There Test Anxiety Strategies That Can Help?

Test Anxiety Strategies - Photo by Tim Gouw

Yes!  There are many test anxiety strategies on how to deal with test anxiety.  First, I'm going to review the causes, the symptoms,  and who gets it before I discuss what test anxiety strategies to use for managing test anxiety.

What is Test Anxiety?

Test anxiety is a feeling someone gets before or during test taking.  It is a type of performance anxiety, that occurs when someone is typically concerned about getting a good outcome.  The result is physical and psychological symptoms that occur before or during tests.  Test anxiety can negatively affect learning and performance.  The good news is there are test anxiety strategies on how to deal with it.  

What Causes Test Anxiety?

It is caused by fear of failure, poor test preparation and/or problematic test taking history.  There is pressure to perform at your best level.  This can motivate the test taker.  However, it may also create fear of failure.  Good test preparation is important for a good test result.  It is also important to prevent test anxiety.  A calm test taker tends to know they've studied to the best of their ability.  They also tend to have studied over time, and not in just a few days or at the last-minute.  If the test taker has had a history of negative experiences with test or poor grades on test, this can also cause anxiety on future tests.

What Are Symptoms of Test Anxiety?

Symptoms are physical, emotional, and/or behavioral.  They range from mild or very intense. 

The physical symptoms may include: headache, nausea, vomiting, diarrhea, fast heart rate, fast breathing rate, feeling like you can't breathe.  If the anxiety is severe enough, a panic attack may occur.  When someone is having a  panic attack, it is generally very debilitating.  A panic attack can make a person feel paralyzed internally or externally, like they can't move, can't talk, & they may feel like they're having a heart attack.

The emotional symptoms may include crying, feeling fear, feeling sadness, and helpless.

The behavioral symptoms may include negative self talk, inability to think clearly, and inability to function.

Who Gets Test Taking Anxiety?

• Worriers - If your child has a tendency to worry, he/she is more likely to suffer from test anxiety. Even if your child is prepared, your child's worrying could cause test taking anxiety.
• Perfectionists - If your child aims for self perfection, then he/she is more likely to suffer from test anxiety.  Even if your child does wll in school, the very thought of getting questions wrong, or getting less than an A, leads the perfectionist to have test taking anxiety.
• Unprepared People - If your child has not learned the subject matter, not practiced with classwork/homework, and/or studied the material, then he/she is more likely to suffer from test anxiety.

How To Manage or Prevent Test Anxiety ?

There are many ways to help your child manage, prevent, and/or minimize test anxiety.  

    Talk About It

• Ask your child what's making your child feel nervous.
  • Talking about their feelings make children have less anxiety.  Stay calm too as this helps your child stay calm as well
• Accept mistakes
  • This can be a part of you child's life lessons.  Teaching your child to handle things when the outcome is not what they expected will help them in life, not just in test taking.
• Boost your child's confidence.
  • Tell them how wonderful they are.  Ask them to give themselves compliments.  What do they like about themselves? About their great brains?
• Always offer support.
  • Remind your child that you are always there.  Sometimes, they don't want a solution.  Sometimes being a listener is all he/she needs.

    Review Studying Habits & Test Prep

• Have your child practice on sample tests.
  • Having experience with what the test will feel like will prevent anxiety.
• Focus on test preparation.
  • Establish a routine for studying and preparing for the upcoming test is very helpful.  Studying a little bit at a time, over a set time period.  It is usually better than craming it in the day before the test.  It also also for better retention of the facts.  
• Learn your child's best study habits.
  • When does he/she study best?  Is it morning, afternoon, or night?  
  • Does he/she need breaks? 
  • Could hunger be slowing his/her learning/studying? Consider snack breaks in between studying.
  • Does he/she need to do something physical or move around in between studying.
• Review test taking strategies.
  • Teach your child what to do if they are stuck on a test question.  If they can't answer one, then teach them to mark the question and move on.  They can get back to it later.  
• Help your child feel their best the day of an exam 
• Review all methods and test after the test is complete.
  • What were your child's strengths on the test?  Where are their weaknesses?  How could he/she have improved test prep?  What did he/she do that was just right?  What can he/she do again the next time?  Or do differently?  Ask them to evaluate this with you.

    Sleep & Screen Time

• Find your child's best number of sleep hours.
  • Does your child need eight (8) hours a night?  Ten (10)?  Twelve (12)? Try to make sure they get their best sleep before tests.
• Monitor your child's screen time.
  • If your child has too much screen time, especially at night, or the days or week before an important test can do more harm than good.

    Relaxation, Guided Meditation & Affirmations

• Practice relaxation techniques.
  • Deep breathing 
  • Taking a bath
  • Listening to relaxing music
  • Create art.  Drawing and/or coloring is fun and relaxing.
  • Play a board game that's fun with the family the day before the exam.
  • Watch a funny movie with your child.  Sometimes, laughter is the best medicine.
• Use Guided Meditation.
  • I recommend and use, I Am Peace, by Susan Verde.  This is a wonderful book.  It is geared for children.  I think it's a great book for any age.  The last page has a Guided Meditation.  I've read this out loud to my son while he is lying down with his eyes closed.  I must say that both he and I are relaxed at the end, every time.
  • The Balloon
  • Follow the Leader
• Use Affirmations
  • There is more information on Children & Affirmations on this website.
  • There are Daily Affirmations available as well.