Kid Doc — Good Job Being the Mom!: Recent Episodes
Jason Hoagland, M.D. and Emily Hoagland Gottfredson, J.D.--almost
RSV episode
WE ARE DOING THIS EPISODE AT THE START OF COLD AND FLU SEASON. WE THOUGHT IT WOULD BE TIMELY TO TALK ABOUT RSV.
What is RSV?
Why does it have such a bad reputation compared to other colds?
RSV isn’t just a disease for children but we mostly hear about it in children.
Should we be testing for this more in adults?
What are the symptoms of RSV in children?
How can parents differentiate between a regular cold and a potential RSV infection?
When should parents worry?
What makes RSV so hard for kids, especially under the age of 2?
And this is where the term “bronchiolitis” comes into play in connection with RSV. Why does RSV cause bronchiolitis?
How does RSV impact children differently across various age groups?
What symptoms do adults have?
People often say they are worried their child’s cold will “turn into RSV”—do you get that from your patients?
When should you see your doctor?
Are there specific groups of children more vulnerable to severe RSV complications? Which kids are at higher risk?
What is the significance of early detection and timely medical intervention? Is it helpful to come in early
What care can parents give for RSV at home?
What are the treatment options for RSV?
What are the potential complications from RSV?
What preventive measures can parents take to reduce the risk of RSV in their children?
There are two types of immunizations for RSV—one for mothers and one for babies.
AND IF THE MOTHER DOESN’T RECEIVE THE IMMUNIZATION THERE IS ANOTHER OPPORTUNITY FOR THE CHILD
Are there any misconceptions about RSV that you'd like to address?
DO YOU HAVE A FAVORITE RSV STORY?
AND YOU OFTEN SAY YOU ARE TOO THRIFTY TO BUY SALINE DROPS. WHAT IS THE RECIPE FOR MAKING SALINE AT HOME?
- It is 1/2 teaspoon of salt in 1 cup of warm water
NUTRITION PART 1 — GENERAL NUTRITIONFOR THE NEXT THREE EPISODES WE WILL TALK ABOUT NUTRITION.
IN THIS FIRST EPISODE WE WILL COVER GENERAL NUTRITION.
WHY ARE NUTRITION DISCUSSIONS SO IMPORTANT IN YOUR PREVENTION DISCUSSIONS?
NUTRITION IS SO FOUNDATIONAL WHETHER YOU ARE HELPING CHILDREN TO THRIVE IN SCHOOL OR IN SPORTS OR TO COMBAT FATIGUE AND HEADACHES
WHAT ARE THE FACTORS THAT CONTRIBUTE TO LOW BLOOD SUGAR?
KIDS HAVE A NEED TO EAT MORE FREQUENTLY THAN ADULTS DUE TO THEIR FASTER METABOLISM
HOW DOES THAT WORK WITH KIDS AT SCHOOL?
IS IT UNHEALTHY TO SCHEDULE EATING VS. WAITING UNTIL A CHILD IS HUNGRY?
SO WE TALKED ABOUT THE TIMING OF EATING
LET’S TALK ABOUT HOW THE KIND OF FOOD MAKES A HUGE DIFFERENCE WITH THEIR PHYSIOLOGY
AND WHEN YOU ADDRESS LOW BLOOD SUGAR YOU ALWAYS COUPLE THAT WITH GOOD HYDRATION--WHAT IS A GOOD WATER GOAL?
DO PARENTS NEED TO BUY GATORADE OR OTHER FLAVORINGS?
AND MAYBE ONE MORE PLUG IN FOR ADEQUATE SLEEP
IS THIS A HARD ASK FOR SOMEONE TO COMMIT TO?
A LOT OF KIDS COME IN WITH CONCERNS FOR FATIGUE AND DIZZINESS AND STOMACHACHES AND HEADACHES AND THE MEDICAL WORK-UP FOR THIS LIST OF PROBLEMS IS MASSIVE.
WHY DOES FOOD MATTER? WHY DOES NUTRITION MATTER?
AND THIS MAY MEAN SOME COMPROMISE ON FOOD CHOICES LIKE WE TALKED ABOUT WITH PICKY EATERS
WE SAY THIS OFTEN IN A COUPLE WAYS: PARENTS CHOOSE WHAT AND WHEN AND KIDS CHOOSE HOW MUCH; OR, SAID ANOTHER WAY THAT PARENTS CHOOSE THE CHOICES
LET’S TALK ABOUT THE BROAD STROKES THAT WE CAN PAINT NUTRITION WITH. WHAT IS ENERGY DENSITY AND NUTRITION DENSITY?
WHERE DO HIGHLY PROCESSED FOODS FIT INTO THIS DISCUSSION
WOULD YOU SAY THE SAME ABOUT ARTIFICIAL SWEETENERS?
AND MAYBE JUST A QUICK BASIC COMMENT ON ENERGY CONTENT OF EACH TYPE OF FOOD:
IS THERE A PLACE FOR FOCUSING ON PLANT-BASED FOOD?
LET’S SPEND SOME TIME TALKING ABOUT SPECIFIC NUTRITION COMPONENTS WE NEED TO WORK ON. THERE ARE SOME NUTRIENTS AND MICRONUTRIENTS THAT CAN BE CHALLENGES TO GET INTO KIDS.
FIBER FIRST. WHAT IS IT GOOD FOR AND WHO IS AT RISK FOR DEFICIENCY?
HOW IMPORTANT IS IT THAT PARENT’S MODEL BEHAVIOR?
CALCIUM
AND IF THEY WON’T DO MILK. CAN WE GET THIS ANY OTHER NATURAL WAY?
VITAMIN D—THIS HAPPENS NATURALLY WITH SUN EXPOSURE IS IT ENOUGH?
VITAMIN A
IRON
ZINC
WITH SUPPLEMENTS--WE ARE NOT TRYING TO REPLACE A WELL-BALANCED HEALTHY DIET, BUT SOME KIDS NEED THIS TO BE HEALTHY
LET’S TAKE THAT THOUGHT AND SEGUE TO OUR LAST SECTION ON HOW WE CAN HELP PARENTS ASSESS THEIR CHILD’S EATING. WHERE DO WE START THE EVALUATION?
IS THERE A DANGER TO SCREENING AND CATALYZING EATING DISORDERS?
WHAT IS A 30,000 FOOT LEVEL VERSION OF HOW YOU WANT TO HELP PATIENTS?
HOW ARE YOU TRYING TO COME AT THIS FROM THE PATIENT / PARENT OWNERSHIP INSTEAD OF A RIGHTING REFLEX
PARENTS WORRY MOST ABOUT THINGS THAT ARE THE HARDEST TO CONTROL: TOILET TRAINING, SLEEP, AND EATING
PORTION SIZES WITH UPSIZING THINGS AT FAST FOOD PLACES AND ENCOURAGING KIDS TO EAT ALL THEIR FOOD
SO TRUSTING KIDS HUNGER AND FULLNESS CUES AND LET THE GROWTH CHART TELL THE TALE IS A KEY
RESOURCES:
FIRST IS THE Website: myplate.gov WHICH HAS SOME GOOD GENERAL FOOD PRINCIPLES
Deceptively Delicious BY JESSICA SEINFELD
Sleep
THIS EPISODE IS HAPPENING THE WEEK BEFORE SCHOOL STARTS—A TIME WHEN ALL FAMILIES PLAN FOR A GRADUAL TRANSITION FROM SUMMER CHAOS TO A REGIMENTED SCHOOL SCHEDULE. INVARIABLY THOUGH FAMILIES THINK “OH NO, SCHOOL STARTS TOMORROW. WE HAD ALL SUMMER TO PREPARE FOR THIS. GOOD LUCK KIDS”
WHY DO WE NEED SLEEP?
Parents often want to know how to establish healthy sleep routines
WHAT DOES BEDTIME LOOK LIKE
IS THERE A BEST TIME FOR GOING TO BED?
SOUNDS GOOD. LET’S GET BACK TO: WHAT IS THE IDEAL ENVIRONMENT FOR BEDTIME?
SHOULD THEY HAVE A NIGHTLIGHT?
YOU TALKED ABOUT DOING THE MATH TO ESTABLISH BEDTIMES FOR CHILDREN.
How many hours of sleep are needed for children of different ages?
SOME SAY THEY NEED TO READ OR WATCH TV TO FALL ASLEEP. HOW MUCH OF THAT IS TRUE?
WHAT IS THE RELATIONSHIP BETWEEN BLUELIGHT AND MELATONIN PRODUCTION?
WHAT ABOUT EXERCISE BEFORE BED? AND SOMETIMES KIDS HAVE ACTIVITIES THAT RUN LATE AT NIGHT
WHAT ABOUT MUSIC AS A TOOL TO GO TO BED?
WHAT ABOUT NAPS AND DO NAPS DISRUPT NIGHTTIME SLEEP?
WE HEAR A LOT ABOUT SLEEP DEFICIT AND TEENS WANTING TO SLEEP IN UNTIL NOON FOR SLEEP DEFICIT PAYBACK ON THE WEEKEND?
WE HEAR A LOT ABOUT IT BEING EASIER TO HAVE THE CHILD SLEEP WITH A PARENT INSTEAD OF SOLVING THE PROBLEM OF HAVING THEM SLEEP IN THEIR OWN BED?
IT MAY SEEM MORE EXHAUSTING TO TACKLE THE PROBLEM THAN JUST PUTTING UP WITH HOW YOU ARE DOING.
LET’S TALK ABOUT How to deal with sleep disturbances—AND THERE ARE REALLY two kinds—difficulty falling asleep and difficulty staying asleep
LET’S FIRST ADDRESS DIFFICULTY GOING TO SLEEP
What are solutions for children who have a difficult time falling asleep
WHAT IF WE DO ALL THESE THINGS AND WE STILL ARE HAVING A HARD TIME GETTING THEM TO SLEEP?
HOW DO YOU HELP KIDS WITH INSOMNIA
WHAT IF ANXIETY IS THE OBSTACLE TO FALLING ASLEEP
ARE THERE ANY MEDICATION SLEEP AIDS THAT YOU USE?
LET’S MOVE THE SECOND CATEGORY OF SLEEP PROBLEMS—DIFFICULTY STAYING ASLEEP
So a key to manage sleep in the middle of the night is how we manage sleep at the start of the night?
WHAT DOES THAT LOOK LIKE IN THE MIDDLE OF THE NIGHT?
WOULD YOU TRY TO FIGURE OUT WHY THEY ARE WAKING UP?
COULD WE BE MISSING ANY MEDICAL REASONS OR MEDICAL PROBLEMS THAT ARE CAUSING THEM TO WAKE UP AT NIGHT?
WOULD YOU SAY THAT ONE OF THE MOST COMMON MEDICAL PROBLEMS AFFECTING SLEEP IS SLEEP APNEA?
HOW DO YOU EVALUATE SLEEP APNEA?
WHAT IS THE TREATMENT FOR SLEEP APNEA?
AND LET’S BRIEFLY MENTION RESTLESS LEGS SYNDROME AS AN UNCOMMON PROBLEM THAT KEEPS PEOPLE FROM FALLING ASLEEP AT NIGHT
IS THERE A TREATMENT FOR IT?
FOR THE LAST SEGMENT, LET’S TALK ABOUT SPECIFIC CONDITIONS THAT ARISE DURING SLEEP AND THEY ARE GROUPED INTO SEGMENTS—THE non-REM PARASOMNIAS AND REM PARASOMNIAS.
THE non-REM PARASOMNIAS ARE THE NIGHT TERRORS, SLEEP WALKING, AND SLEEP TALKING. THE REM PARASOMNIAS ARE NIGHTMARES
LET’S COVER NIGHT TERRORS, SLEEP WALKING AND SLEEP TALKING FIRST. WHAT IS THE BASIS BEHIND THESE CONDITIONS?
HOW DO WE BEST MANAGE THEM?
ARE THE
SUMMERTIME BUGS--GERMS AND INSECTS; PLUS THE ALLERGIES THAT WE KNOW AND LOVE!
IT’S A LITTLE LATE IN THE SPRING/SUMMER SEASON, BUT WE WANTED TO COVER PROBLEMS THAT ARISE WHEN THE WEATHER WARMS UP
WHAT DOES THE WARMER WEATHER BRING BESIDES AN INCREASE IN INJURIES?
LET’S COVER ALLERGIES AND INSECTS FIRST AND THEN MOVE INTO THE SEASONAL ILLNESSES LIKE INTESTINAL VIRUSES AND HAND-FOOT-AND MOUTH DISEASE.
ALLERGIES ARE THE BIGGEST ITEM WHEN IT GETS WARM AND THINGS START BLOOMING.
WHAT IS THE CYCLE OF ALLERGENS?
WHEN DO YOU RECOMMEND TESTING FOR ALLERGIES?
WHAT NON-MEDICATION STEPS CAN PARENTS TAKE TO PREVENT ALLERGIES?
WHAT IS FIRST-LINE MEDICATION HELP?
HOW DO YOU STEP UP TREATMENT IF NOSE OR EYE SYMPTOMS ARE ESPECIALLY BAD?
INSECT BITES AND STINGS ARE A BIG PART OF KID PROBLEMS IN THE WARMER MONTHS. HOW DO YOU MANAGE THESE?
CAN WE DO ANYTHING TO PREVENT THE SWELLING REACTIONS TO MOSQUITO BITES?
WHEN TO PARENTS NEED TO COME IN?
WHAT IS YOUR BUG SPRAY ADVICE?
ANY COMMENTS ABOUT BEE STINGS?
WHAT ARE THE MOST TYPICAL ILLNESSES WE SEE IN THE SPRING AND SUMMER?
SO A LOT MORE OF THE INTESTINAL VIRUSES THAT WE HEAR ABOUT ON CRUISE SHIPS ARE HAPPENING NOW?
HOW DO INTESTINAL ILLNESSES PRESENT?
WHAT MAKES DIARRHEA COMPLICATED IN KIDS?
WHAT PROBLEMS ARE CREATED BY NOT PROCESSING LACTOSE APPROPRIATELY?
HOW DO WE MANAGE THE TEMPORARY LACTOSE INTOLERANCE?
WHAT ABOUT HELPING THE GUT FLORA?
ARE THERE DEHYDRATION CONCERNS?
WHEN SHOULD PARENTS BE CALLING FOR HELP?
SPEAKING OF LONGER-LASTING INTESTINAL SYMPTOMS, AREN’T SOME OF THESE INTESTINAL ILLNESSES CAUSED BY OTHER PATHOGENS BESIDES VIRUSES? WE TALK ABOUT THE WEBER WATER HERE IN DAVIS COUNTY.
ARE THERE RASH COMPLICATIONS OF INTESTINAL ILLNESSES?
WHAT DO WE NOT WANT TO MISS?
LET’S TALK ABOUT HAND-FOOT-MOUTH DISEASE
WHAT DOES THE RASH LOOK LIKE WITH HAND FOOT AND MOUTH
HOW LONG IS IT CONTAGIOUS AND HOW DO WE CARE FOR THE KIDS?
YOU MENTIONED VIRAL MENINGITIS AS WELL
WITH PLAYING OUTSIDE, KIDS GET LOTS OF CUTS AND SCRAPES THAT GET INFECTED.
IS IT FINE TO USE NEOSPORIN INSTEAD OF A PRESCRIPTION TOPICAL ANTIBIOTIC?
AND LAST IS THE CLASSIC SWIMMER’S EAR.
HOW ABOUT PREVENTION FOR SWIMMER’S EAR?
THIS WRAPS UP OUR DISCUSSION OF WARM WEATHER INFECTIONS AND MEDICAL PROBLEMS. REMEMBER TO APPLY YOUR SUN BLOCK.
We start our problem-focused podcasts with ADHD.
What is ADHD?
What causes the gap between ability / potential and performance?
What are the specific elements of ADHD? Inattention, Hyperactivity, and Impulsivity
ADHD in boys vs. girls.
Nature and Nurture in ADHD
Are there mimics to ADHD?
Adult ADHD
How are children diagnosed? What is the evaluation process?
Treatment options for ADHD? Non-medication options?
Medication options for ADHD?
Side effects of medication?
Reasons for medication hesitancy?
Follow-up expectations.
We review our intro material--Jim and Jeanie Gaffigan, Winnie the Pooh, and Fred Rodgers. Here is parenting wisdom and humor for the ages that we love to share with you with each podcast.
We review the freestyle, parent-directed nature of this visit age.
Prevention is the key to this visit--consistent visits to prevent problems from growing.
We review the Plan for 9-10 year-olds to help them become independent adults.
For anticipatory guidance we cover the health, safety, and social development for children this age. We spend some time covering entitlement prevention.
We cover the preschool age along with starting Kindergarten. These kids now have FOMO which can lead to bladder and stooling problems along with headaches and stomachaches.
Prologue of Tactical Parenting taking kids out of their comfort zone to serve people in great need in Tijuana and other parts of the world. Get them out of their bubble and learn to see people in different circumstances--very valuable experience.
Hyperactive bladders along with voiding and stooling problems reviewed along with ruling out bladder infections and diabetes.
Management of bladder hyperactivity and voiding accidents.
Evaluation and management of the common stomachaches and headaches at this age.
Tactical parenting from the "Plan" on what skills to teach children at each age.
Age-appropriate Discipline, Safety, Diet and Health, and Social Skills reviewed
You now have 2 months under your belt. You have been through fussiness, gas, and colic. You passed the peak of fussiness and your baby will start getting fussy from here on out.
Now the questions begin with parents feeling the responsibility for this young child they have at home.