Good afternoon! Thanks for joining us. We've got a bunch of excellent questions in the queue.
First, I'm going to start by asking our expert a few questions about something that happened to my family yesterday. We were rear-ended at a red light by an inattentive driver. Both my kids were in the backseat with their belts on. We called the police and filed a report. It didn't seem like anyone was seriously hurt. But, that night and especially today we are all pretty sore. Should I have gone to the ER right away, even though it didn't look like anything was broken?
This is a hard question to answer from a medical-legal standpoint. There are many reasons to go to the ER after any car accident, both medical and legal. If you have any concern regarding heath, I would go right away. Not only does this ensure your medical safety, but it also helps make the other party responsible for medical bills if the injury was due to the accident.
On the other hand, if you are a healthy person and you were all wearing seat belts, and there were no apparent injuries at the time of the accident, and there is no dizziness, headache, or loss of consciousness, it can be quite normal to be a bit sore the next day. It may be appropriate to see your primary care physician in the office, rather than go to the ER. If you are not sure what to do, I would call your own pediatrician's exchange and ask for guidance. a
As always, if you have any immediate concerns, or if you still have concerns after seeing your pediatrician, go to the ER.
Interesting. That's good to know. We did go to the doctor this morning, who wants me to get an MRI and x-rays. Our pediatrician's office said they wanted the kids to have xrays done before we even made an appointment because it involved a car accident. I worry about unnecessary exposure to radiation, so this was a really tough call for me. I'm definitely following up today.
The problem is that any motor vehicle accident is what we call a serious "mechanism of injury." So doctors feel obligated to be cautious in their evaluation of these patients.
And to be honest, I'm surprised at how sore I feel given that it wasn't a major accident. Thanks for the info, Dr. B.
Thanks for that tidbit, Erin. Good to know!
Great question! I've been borderline anemic since I was child, and iron supplements have always been difficult for me to take, so I look for iron-rich food options. Let me find a good list online and post a link for you.
Mild anemia can be associated with a host of problems, including minor learning difficulties and exercise intolerance. It is important to address anemia in children. Your doctor has made the correct recommendation to add iron supplements. High iron foods such as meats are also a good idea. But actually, it's more important to be sure that your toddler is not drinking too much milk. "Milk drinking anemia" is very common in toddlers, because milk does not naturally contain iron. Toddlers will consume too many of their calories through milk and not eat enough iron-containing foods.
Yes, the flu can cause healthy kids to die. And it does. Every year. Even in St. Louis. Influenza can cause death through a variety of mechanisms, but the most common are influenza pneumonia, and influenza meningitis. Influenza also weakens the body's natural defenses against bacterial infections, especially bacterial pneumonia. So many kids who die first get influenza and then get a secondary bacterial pneumonia and/or bacterial blood stream infection.
So, to be clear: A child who doesn't have underlying health issues or a compromised immune system, can still die from complications of the flu?
YES! Otherwise healthy children (and adults) can die from influenza.
That is scary and a very good reason to get a flu vaccination.
It's not too late to get your flu vaccine!
For children who may be a little older, you can start having the conversations to prepare them a little in advance. It's important to realize how significantly a pet's death can affect a child, even a much older child, who may not be willing or able to express how upset he or she is. Give them time to grieve. It's very normal to cry and feel sad for a while.
Another thing to consider is how much information your child really needs to know. In the case of my editor, they decided not to tell their children that they had their dog put to sleep. That may be confusing for a young child.
Hi Stephanie, Dr. B. and I have both been in this same situation. My first child missed the cut-off date by a month-and-a-half, and I really struggled with whether to push her ahead or have her "waste" another year in preschool. I did tons of research and talked to dozens of other parents who had faced the same question. I literally lost sleep over this. What I found out is that in Missouri, boys who are near the cut-off date are routinely held back an extra year before kindergarten. This gives them a chance to mature socially and emotionally..and that's even if they MAKE the cut-off date. So, a boy who misses the date will definitely be the youngest in the class. Sometimes by quite a bit.
In the case of a girl, which was my situation, as well, it's less clear-cut. While my daughter seemed mature enough at the moment and was reading pretty well by age 4, I wondered how she would fare as the youngest in middle school and high school when those social pressures become so much more intense.
One of the parents I talked to gave me this advice: I've never regretted giving my child an extra year of preschool even though he was capable and academically ready for kindergarten.
I also struggled with kindergarten cut-off issues. My daughter was born in mid-August.
It can be very challenging to know how to handle a child who was born right around the kindergarten cut-off date, which is August 1st in Missouri. There is no one right answer about how to handle this—it depends on the specific needs of the child and the family.
We chose to push our daughter ahead, and sent her to a private school for kindergarten with the intent of then transferring her into our public school (which our older child already attended). After kindergarten we ended up making an unexpected switch to homeschooling, for many reasons. So she never actually went to public school.
I did a huge amount of research on this issue. The public schools are required to take your child if they have completed an accredited kindergarten. They will accept her into first grade if she passed kindergarten. Many private schools will not accommodate these kinds of transfers.
Almost everyone I spoke with discouraged us from pushing our daughter ahead. They wanted us to hold her until she could legally start kindergarten in Missouri. She would have been 6 years old BEFORE starting kindergarten. It just didn’t seem right. She was socially and emotionally and academically prepared for kindergarten.
Of note, Missouri has one of the earliest kindergarten cut-off dates in the United States. Many states, especially on the East Coast use December or January cut-off dates. So, if I had held my child until she was six-years-old to enter kindergarten, and then we moved to a state with a later cut-off date, she would have been more than a year older than the other kids in her class.
That said, being the youngest has had its challenges. She learned to swim after most of the other kids in her class, and swim parties were hard. She wishes she were one of the older kids, for no apparent reason. I do feel she has been at a slight disadvantage with sports.
A huge benefit, though, is that she will have another year of her life as a young adult. It’s up to her how she uses this time. She can easily choose to take a year off from school and travel, do volunteer work, etc. I’m happy to give this gift to her.
Homeschooling has turned out to be an excellent solution to this kindergarten cut-off issue. I’ll post my article on homeschooling, too.
What I ended up doing was enrolling in a Montessori preschool and kindergarten, which has much smaller class sizes and teaches to the individual level of each child. So, she was still challenged and not bored at school. When she joined her peers in public school in first grade, she may not have learned as much academically, but she had a lot to learn socially. A lot. And, honestly, I don't regret giving her that extra time.
So, as you can see, both Dr. B and I did a ton of research and choose a different path for our girls. And both of us feel as though they've done fine.
It's totally normal for babies to cut teeth at different times and in different patterns. Normal first tooth eruption times can vary from 4 months-8 months. It is also normal to cut different teeth first. Most babies start with the lower central incisors, but others start with lateral incisors or upper incisors. It's all normal. :)
I had not heard about this before, but I just read that some twins do develop language later: Late onset of speech, and speech and language difficulties, including stuttering, are more common in twins than in singletons. This is because twins are frequently premature or low birth weight babies, and their parents may have less time to attend to them individually and to help them develop verbal skills.
That same site, written by a speech language pathologist, suggests that "a child is considered to be a "late talker" if they have a spoken vocabulary of less than 50 words at 24 months. This does not mean that the 50 words have to be pronounced perfectly - two year olds are supposed to talk baby talk."
So called "twin speak" is common in twins-- it just means that they learn to communicate with each other and can even invent their own words. It is normal. It can cause twins to learn regular language later.