Does Your Child Have “Affluenza?” Uh Oh.

Although this post was originally published four years ago, it bears another look. Why? Because recently, a 16 year old whose blood alcohol was almost three times over the legal limit, stole his dad’s car and plowed into four people, killing them all. His attorney pleaded that he should not be held accountable for their deaths. And the judge agreed. Why? Because the young man suffers from affluenza. Yep, that happened.

What on earth is affluenza? Is it contagious? Is it serious? Well according to PBS, which produced an hour-long television show about it, affluenza can be defined as: “1. The bloated, sluggish and unfulfilled feeling that results from efforts to keep up with the Joneses. 2. An epidemic of stress, overwork, waste and indebtedness caused by dogged pursuit of the American Dream.”

Basically, it’s an addiction to materialism — the overwhelming desire for more, more, more.

But what does that have to do with my kid, you might ask? He’s only three-years-old and more concerned with pursuing the household dog than dogmatically pursuing anything else. Career ambitions? Short-term, we’re shooting for total success in the potty training field and long-term, we’re possibly looking at something involving fire engines.

I know, but it actually does have a lot to do with your kid, and every kid, for that matter. It doesn’t just affect adults. Kids are suffering from it, too — in a big way — and yes, it is serious and highly contagious.

Just pair the affluenza idea with a recent study from San Diego State University and you’ll understand what I mean. Incredibly, they found that the number of teens suffering from anxiety and depression today is five times higher than it was during the Great Depression. Did you get that? And according to an article from Connect With Kids, the experts are pointing to affluenza as a major reason why.

That statistic took my breath away and it should get your attention too, because the trends that appear in the teen set today usually stick around for awhile and then eventually hit the pre-school set a few years later. The patterns and expectations you set up with your children now, while they are little, will last for a long time.

When we launched  this website, we promised to warn you about the inevitable potholes that appear when you least expect them, and hopefully save you some trouble. I know you’ve got a lot on your plate, with little ones running around but as a mom and a family therapist, I’m urging you to pay attention, because this is a big one.

So here’s the low-down on this prevalent and frightening virus: what it looks like like, how it gets passed around, and how you can prevent your child from becoming its next victim.


Many of the kids who were questioned in the study  (regardless of family income), said they needed the latest ipod, iphone, sports car, designer handbag, or $200.00 pair of jeans in order to feel comfortable and “good enough”  about themselves. Several reported buying something they wanted and then lying about its cost to a parent.

They knew they had crossed an important line regarding trust. But with affluenza, one’s sense of self worth gets linked to their possessions. What they own becomes the mark of who they are. Their accomplishments, ideals, families, talents or dreams for the future are not nearly as important as their “things” in determining how they see themselves.

The symptoms present as an obsession with shopping, or constantly comparing what they have with what their friends have. It’s a disease marked by competitiveness and their perception of “personal lack” can result in feelings of shame, anxiety, depression or unworthiness.

This is not, counter to what you might think, an exclusively upper-class disease. Kids from all racial and socioeconomic groups are affected.


This one gets passed around very easily and often gets its start at home. Parents beware! Take a step back and look at how you spend money and family resources. Do your purchases tend to be needs or wants? We all like to indulge ourselves once-in-awhile, but a picture is worth a thousand words and guess which one they’re looking at?

They are certainly going to pick up on the behaviors and norms of their buddies in the neighborhood and at school. But that makes it even more important to make sure that at home, you practice what you preach.


Affluenza can be successfully treated. The first step is to spot it and call it for what it is. The rest is based on good, old fashioned follow-through. So here’s the plan:

1. Slow down on all the presents. Save them for birthdays and Christmas or Hanukkah. And even then, keep it modest. In a previous article, I mentioned that a large research study had found that 73% (yes, 3 out of 4) of the stuff parents bought their kids were things that the children hadn’t even asked for. The parents bought the stuff simply because they thought their kid might like it. Don’t go there. It can create an addiction and the story of the overindulged child does not end well. The kids in that study grew up deeply resenting their parents, and vowed not to spoil their own children when they became parents.

2. Set limits. If your child does want something, help him figure out how to either wait for it (“Put it on your Christmas list”); save up for it (remember the lay-away plan?); work for it; or forget about it. Remind him that just because he wants something doesn’t mean he gets to have it. And then, stick to your guns.

3. Hold off on giving them their own credit card until they are mature enough to handle it. Many of the kids in the San Diego study had them and spent over their limit on a regular basis. Unless you plan to fund them for the rest of their lives, you had best avoid that trap. That’s not to say they can’t have a credit card when they go to college for books, emergencies etc., but make sure you check it carefully each month and hold them accountable for any unauthorized purchases. And if they abuse it, cancel it.

4. Get them involved in giving back in one way or another. Volunteering in their community or school is a good way to start. This can start very young, with you!


There is no vaccine but there is hope. You are their best shot at prevention. And you can make all the difference. How?

1. Family dinnertime. Once again, it comes up as an antidote. Start right away with this habit and keep it going. Make it a priority to eat together at least 4 or 5 times per week. The research is crystal clear in demonstrating the positive effect on behavior, self-esteem, and overall happiness in children.

2. Spend time with your child playing, talking, and goofing around. Institute Family Game Night and “Special Time” and keep it going. The more quality time they spend with you away from the television and computer, the more confident they will feel about themselves.

3. Encourage them to develop their imaginations and become good at something creative that they enjoy. Something, not a hundred things. Maybe it’s music, or art, or fishing, or rock polishing. Just make sure it’s truly something that they like and don’t go overboard with lessons or teachers. Just give them encouragement and opportunity, and help them to develop their hobby or talent over time.

4. Make a pact with your friends to tone down the birthday parties and limit the excess when it comes to bigger and better. Work with your nursery school or P.T.A. to keep it simple when it comes to holiday parties or celebrations at school. And ask any well-meaning but notoriously overindulging grandparents, aunts, uncles or friends not to go overboard on a regular basis.

You can do this. I hope you’ll try. If you need a little more inspiration, keep in mind the wise words of Frank A. Clark: “A child, like your stomach, doesn’t need all you can afford to give it.” Now that’s something to chew on.

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Give, Not Gimme

HandPrints3+Painted+HandsAre you a bit stressed out about the whole holiday-present- buying thing? Short on time and, maybe, short on funds? We sure are, but the good news is that it’s easy to make the holidays less about material gifts, and more about the feelings behind them — especially for the littles in your life.

One of the most satisfying (and fun) ways to unite  the fam and replace some of the stuff-buying frenzy is volunteering. Volunteerism sets a good example for kids, shows them up-close that the world is much bigger than the small bubble they live in, and helps the community at the same time. A triple win! Start it early, and kids grow up expecting and wanting to participate.

And here’s the secret sauce that seals the deal …  how often do our smalls guys get to feel like they really make a difference in the world? The wonderful, empowering message for kids is that they’re important enough to have an impact on someone or something else. SHAZAM!

Next step … finding the right organization. Not always easy with small humans in tow, because many hands-on volunteer opportunities don’t exactly welcome the younger set. But a little creativity is in order here.

Even the smallest kiddo (with a bit of supervision) can pick up garbage at the park, playground, or beach. You don’t have to be part of a big effort to do this. Get yours together, find some garbage bags, and head out.

Or become involved in repair and renovation efforts for low-income residents. Younger kids might not be able to do the big jobs, but helping out by fetching a paintbrush or holding the nails involves them just the same.

Work at a community food bank or soup kitchen as a family. Find an organization that serves the elderly. Take food to people who are homebound and visit with them. Your kids can brighten a lonely senior’s day instantly. Offer your family’s help at the local animal shelter. Help plant flowers or trees.

Big kids (read tweens and teens) love to do for younger kids, so consider collecting baby clothes and toys for an organization that serves low income families. Who doesn’t love shopping for that adorable tiny stuff?!

Get your young’uns involved in choosing the activity and they’ll be more enthusiastic when the time comes. Approach it with excitement and anticipation — remember, they take their cues from you. You’re creating  lifetime habits here, Mama, and this is one to be proud of. Fight the holiday gimmes this year, show your family the true meaning of Christmas, and log less time fighting for a parking spot at the mall.




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Peer Pressure – It’s Not Just For Kids

The experts talk a lot about the power of peer pressure and how to help kids resist its pull as they enter adolescence. We are taught that the peer group has a remarkable and sometimes frightening ability to sway our kids away from the path they know to be right – the one we work so hard to keep front and center in their lives.

But what doesn’t get discussed nearly as much is how peer pressure and the tendency to go along with the crowd continues through life and can defeat us when we become moms and dads.

A case in point: Shannon, the mother of two boys from Portland, wrote that she was upset and confused by something that had happened with a couple moms in her son’s class. Billy, Shannon’s fourth grader, was invited to a sleepover party by a known troublemaker and overall bad influence. She said no to the invitation and her son accepted her answer without much of a fuss.

Later that week she got talking to a couple other moms in the school parking lot. Neither of them wanted their kids go to the party either. They all agreed that based on past experience, it would be poorly supervised and fertile ground for trouble.

Shannon told them that she had said no and encouraged them to do the same given their strong reservations. After some discussion, they were all on board. But the next thing she knew, the moms had changed their minds and their kids were going to the party. It wasn’t that they couldn’t say no to their kid, they couldn’t say no to their friend.

The two moms confessed that they were afraid of the upset and conflict that might arise if they declined the invitation. They decided to just go along with it and hope for the best.

When Shannon asked why they didn’t just bow out gracefully, claiming a previous commitment, they were aghast. “I won’t tell a lie!” was the response. Putting their kids in a situation they knew was neither safe nor healthy seemed like a better choice.

Even though Shannon had stuck to her guns and done what she felt was right, she ended up feeling isolated and “out.” Then she began to question whether she was being overly protective since all the other mothers seemed to be okay with it – even though in her gut, she knew she was right. Does any of this sound familiar to you?

In this situation there are actually two things going on: the pressure to follow along with our peers and the tendency to avoid conflict at all costs. Women in general often feel uncomfortable making waves, not because they are biologically wimpier than men but because they are socialized to be accommodating. Thankfully, this is changing and girls today are more comfortable being assertive. But many adult women still struggle with this.

Let’s face it: whether we are 16 or 70, we all want to fit in. We all want friends. But once those kiddies show up in our lives, the cost of not being able to fight the pressure to go along with the crowd skyrockets. It’s no longer just the effects on us that we have to worry about if we lower our standards and bow to the group. Now we have to consider how our actions will impact the safety and well-being of our kids.

Some of the more common parental-peer-pressure-traps that snare us every day include:

  • Letting kids go to parties or activities that are inappropriate or where supervision is questionable because our friends do.
  • Giving parties where rules are lax or non-existent because our friends do.
  • Letting teenagers drink or smoke pot at our homes because the other parents do.
  • Allowing girls to wear makeup or sexy clothing when they are too young because our friends do.
  • Letting kids have computers and T.V.’s in their rooms because our friends do.
  • Bending our own rules when we are around parents who have looser ones.

The thing to acknowledge is that we don’t always make bad parenting decisions simply because we have a hard time saying no to our kids. Sometimes it’s more that we don’t want to be odd (wo)man out with the other moms.

So how can you get more comfortable about following your own moral compass despite the influence of your peers? Start by paying attention to your feelings when you get into situations like this. If you begin to feel uncomfortable with what is being discussed, take notice. Check whether concerns about being different are causing you to question yourself and your values. Are they making it more likely that you will let others dictate what’s going to happen?

One of the best things to do is to take a good look at the other parents in your life and figure out which ones seem to be most on track and responsible when it comes to parenting. Wean out the ones who are constantly in crisis or who seem to make decisions that are inappropriate or irresponsible. A person who might have been a perfectly acceptable friend before you had kids might not be such a good fit now. Don’t forget: your peers matter! Surround yourself with good influences and depend on them for support.

In order to stand up for your own ideals, you don’t need to make a stink, you don’t need to shout, or to pass judgement. You must, however, learn to be discerning – to figure out what’s right for you and your family – and to stick to that truth calmly and courageously. You can definitely learn how to channel your “inner mama bear” and do what’s best for your children despite the potential social impact on you.

This is not a skill that can be learned overnight, but it can be practiced every day. And sometimes, if you follow your gut and do the unpopular thing, you are going to feel the sting of being the outsider. And that’s okay. You can do it anyway.

I would love to hear stories on this topic from you. Let us know how you’ve handled this kind of thing in your own life. Please share!


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A Sneaky Way To Get Them To Listen

Kids, kids, kids — wonderful, fabulous and absolute frikkin’ masters at the parental tune-out. Have you noticed? But WHY do their eyes glaze over and drift off to some faraway place whenever you offer that brilliant nugget of wisdom that would solve their lastest problem? Why dont they GET that you have oodles of hard-earned advice to share? Shouldn’t they be sitting at your feet, eagerly awaiting your next life lesson?

Well, not so much, if they are over 10. It’s a shock, I know, when the adorable little munchkin who has seen you as the smartest person in the world suddenly goes rogue and raises a suspicious eyebrow whenever you open your mouth to speak. It happens.

Not their fault, not your fault. It’s been that way forever. Part of it is that they have to learn how to work things out on their own and part of it is sheer stubbornness. Despite the fact that you do, in fact, have much to teach (and they have much to learn), once they hit those pre-teen years, they resist. Until they enter their twenties they will never again be fully convinced that you know what you’re talking about, regardless of the topic.

But take heart. I have a strategy that you can use to help get your all-important point across. Your message will be delivered quickly and easily and your kids will go away remembering it and quoting it themselves later to friends and siblings alike.

How does it work? The secret lies in keeping it short and sweet. Think for a minute. When some urgent piece of information needs to be communicated right away, what do we do? If you’re out to sea and run into trouble, you send an SOS. Not too long ago we got the word out with a telegram. Today we send text messages and receive urgent public news through bulletins that slide across the bottoms of our T.V. screens.

The thing they all have in common is that they are short and to the point. No long letters or 25 page reports. And that’s why adages, or old sayings, work so well with kids. They cut to the chase, stick in the mind, and get chewed on later. The wisdom, presented metaphorically, sinks in slowly and effectively. Plus, they have an air of authority to them and make you look like you know something your kid doesn’t.

Paul McCartney, famous for his work ethic, talks about how his dad doled out a favorite expression, “Do it now!” when he was growing up. It was later shortened to DIN and McCartney says that little saying was always working in the back of his mind and has stayed with him.

My parents had a few that they relied on to get their point across and I’ve passed them on to my kids, too. They can be surprisingly effective but must be used appropriately and repeated often. So next time you find yourself deep in the trenches, going head to head with an unreceptive child, try something a little different. Give your speech as usual but seal the deal by tacking on an old-time saying at the end. Next time, the adage alone may be sufficient.

There are hundreds to choose from. Here’s just a sampling:

If, for example, you typically try to get help and cooperation along these lines: “You guys need to get in here right now and help out with the dishes! Im sick of being the only one who….” You could substitute: “Many hands make light work.”

Or, if you want to get a professional procrastinator off his behind and on the job you could try, “The early bird catches the worm” instead of, “If you don’t get off that couch right now you are not going to be able to…..”

When junior comes to you proclaiming his innocence and blaming his brother/sister/friend for the fight/problem/whatever, you can listen sympathetically but then hit him with: “It takes two to tango.”

If you’ve got one who is forever making and breaking promises you can enlighten him with “Actions speak louder than words.”

A habitual complainer can be helped out of her rut with, “Better to light a candle than curse the darkness.”

For a teenager who doesn’t feel he needs to work too hard looking for summer employment because his best friend’s dad has a hardware store and will “definitely” give him a job try, “Don’t count your chickens before they’re hatched.”

When you’ve got one who’s in the dumps dealing with a tough disappointment try, “Every cloud has a silver lining” or “This too shall pass” or “When one door shuts, another one opens.”

In order to promote hard work and perseverance you can go with, “Genius is 1% inspiration and 99% perspiration.”

If your child is famous for pulling it off at the last minute you might throw out, “Failing to plan is planning to fail” when he tells you he’ll start the 10 page report that’s due Monday on Sunday morning.

I hope you will find a way to work these in to your Mom Talks. They do have a sticky quality to them and work their magic behind the scenes when no one’s watching.

Here are some more gems to contemplate. There’s at least one for every parenting situation you can imagine!

When the going gets tough the tough get going.

You can lead a horse to water but you can’t make him drink.

A poor workman always blames his tools.

A problem shared is a problem halved.

A stitch in time saves nine.

Don’t put off till tomorrow what can be done today.

You cant judge a book by its cover.

Better safe than sorry.

Charity begins at home.

Don’t burn your bridges behind you.

Don’t put all your eggs in one basket.

If a job is worth doing, it is worth doing well.

Into each life some rain must fall.

Little strokes fell great oaks.

Where there’s a will there’s a way.

You catch more flies with honey than with vinegar.

There’s a time and place for everything.

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Pick Your Battles – A Ten Step Program

We hear that line all time, but have you thought about how it relates to your mommy style? Use it as a guide and you can shift your reactions to the ups and downs of raising your gang and help save precious energy for things that really matter. In no particular order …

  1. Let go of your inner mommy fashionista. Sure, your 2-year-old may have a different aesthetic than you, but who says that purple tutu doesn’t work with the mini-me football jersey she wears to watch Sunday NFL with Dad? And does anyone really care? Look at it as creative expression.
  2. Turn in your ‘food police’ badge. Avoid appetite-killing snacks, offer a wide choice of healthy foods at every meal, and then back off. Research shows that children need to be exposed to a new food several times before developing a taste for it (sugary stuff not included), so keep steaming that broccoli. Don’t cajole, bribe, beg, or force-feed — it sets you (and them) up for lasting food issues.
  3. Know their limits. If you spend an hour or 2 dressing everyone to the nines for the holiday photo shoot, chances are by the time you get to the studio your little one will be ready for a major meltdown. Short circuit it by letting him play happily ’til the last minute. Then do a quick 1 minute  clean-up for the camera and keep it low key.
  4. Stop comparing! This one is tough for most moms, but just because little Austin in play group loves pee-wee karate and is already working on his orange belt doesn’t mean there’s something wrong with your Charlie if he whines and sucks his thumb through the entire class. It’s just a sign that the martial arts are not his gig — not for now anyway.
  5. Skip the over-scheduled enrichment activities (see karate above). There’s nothing to be gained by forcing small kiddos to participate in structured groups they’re not drawn to, even if it’s called “play”. Wait until they show interest or try out a range of different options until something sticks. Always leave plenty of time for relaxed free play without rules. Children learn best when engaging their imaginations.
  6. Make it fun when you can. Want them to write a ‘Thank You’ to Aunt Susie for her birthday gift? Try providing a new set of cool markers for the project. Desperate for a thorough room clean-up? Offer to make it a race and set the kitchen timer. Any job that doesn’t have CHORE written all over it is less likely to be greeted with attitude. Channel your inner Mary Poppins.
  7. You can’t pick their friends. I know it’s hard to swallow, but if your daughter can’t stand the sight of your best friend’s child, even though you both always dreamed they’d be best friends, too, don’t force it. You can and should expect good manners, but you can’t make her like it.
  8. If they can do it themselves, they should. Even if the results are imperfect and it takes forever. From getting dressed to helping wash the dishes, and, yes, on to homework and the dreaded science projects, they learn competence by doing — not by watching you doing. Trust me … start this one early and you’ll avoid many future battles.
  9. Be the change you wish to see in your kids. I can’t say it enough. Children model the behavior they observe, not the words they hear. If you want them to be kind, treat others with kindness. If you want them to work hard, show them what hard work looks like. It’s hard to win the fight over video game time when you’re glued to your Blackberry 24/7.
  10. Reality check! Ask yourself: Will this be important in 5 minutes? 5 weeks? 5 years? If the answer is yes it may be worth fighting for. If not? Take a deep breath and walk away.
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5 Bad Habits That Can Harm Your Kids

We all have a few habits we could do without, but we’re not always aware of how they may influence our kids. The first step (of your 12 step program) is to recognize them:

1) Criticizing the way you look. Focusing on that extra 5 pounds, or other physical attributes you’re not happy with, teaches kids (especially girls) that appearance is all-important. It can make them dislike what they see in the mirror, leading to a lifetime of self-esteem issues and a tendency towards unhealthy habits, like yo-yo dieting. The way you talk about yourself matters, and they ARE listening.

2) Emotional Eating. If you use food to feel better when you’re sad or stressed, you could be passing on unhealthy messages to your kids. You’re showing them that overeating is the way to feel better. Instead, work on other ways to get an emotional boost when you’re having an off day. Let them see you talking it out with friends or going for a run to feel better. You probably don’t feel so great after scarfing down an entire box of Thin Mints, but you sure do after pounding five miles of pavement.

3) Emphasizing material things and superficial “girly” stuff. Sure, fashion is fun, but if you focus on the latest designer jeans and the importance of a great mani/pedi your daughter may tend to equate self-esteem with what she has rather than who she is. Instead of shopping, spend time together to learn a sport or a new hobby. Mother-daughter (and mother-son) book clubs are a great option. Tell her she’s smart or kind as often as you compliment her beauty.

4) Using coffee or alcohol to perk up and feel good. If you come home after a bad day at work and blurt out, “I need a drink,” you show your child that alcohol is a good way to relieve stress. Same goes for lunging at the coffee pot first thing in the morning. Instead, look for healthier ways to relax and recharge, like exercise or meditation. You can practice these with the kids, too.

5)  Too much screen time. It doesn’t make sense to tell the kids not to text at the dinner table if you’re sitting there checking your work email. What you do sends a stronger message than what you say. Set family rules about electronics and everyone, including parents, needs to stick to them. Here’s an idea: keep a tech basket in a central location where all mobile devices get deposited during dinner time, homework time, and at a sensible bedtime. Because you know if your cell is within arm’s reach you’ll be itching to use it.

If you find yourself behaving in a negative way around your kids, don’t ignore it and hope they didn’t notice. Point out your mistake and use it as a teachable moment. When you’re able to share your human frailties with them, they’re much more likely to be open with you.

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Don’t Let Their Size Fool You!

If you think you’re too small to make a difference, you’ve obviously never been in bed with a mosquito.

How true! And it goes double for your kids and the impact they can and do have in your life. When you think about it for a moment it’s absolutely mind blowing how such little beings can so easily begin to rule the roost that used to have your name on it.

Within just a couple of years many parents find themselves taking orders from someone who can’t even put together a complete and coherent sentence or wipe their own behind. How crazy is that?

But before I go any further, let me make one thing clear: I am an absolute sucker when it comes to kids. I adore them. I’m not one of those “Children should be seen and not heard,” types at all. In fact, I love to hear what the little munchkins have to say and find myself marveling over their perceptiveness or clear and direct honesty pretty regularly.

But … I am also a firm believer in the notion that they have a place in the family hierarchy and it’s not at the top. That spot needs to be reserved for you and you alone (well okay, you and your spouse). If you want your home to be the kind of place where everyone (including you) feels comfortable, then start early to make sure that your child’s voice doesn’t get too big!

Even though it seems easier to just give him his way when he’s little, it will backfire on you very quickly. I can give you a money-back-guarantee on that one. Once they see themselves as capable of pushing you around it will be hard for them to give it up. Power is intoxicating! And down the road it will get even uglier. If you were humbled by the terrible two’s, I’ve got some bad news for you — adolescents are kind of like huge two-year-olds on steroids.

So yes, of course, feel free to ask for his opinions. Listen to her requests and suggestions. Take their ideas into account when planning an outing or deciding what to have for dinner or when they should go to bed.

But make it clear from the get-go that although you appreciate and will consider their input, YOU will be the one making the decision. This will be an enormous relief to them although they may kick and scream about it at the time. They will probably never tell you how wonderful it is to be able to put in their two cents worth (when appropriate) but not have to take on the burden of knowing what to do.

And as they get older and the stakes get higher, you will be relieved to know that the precedent has been set and you won’t have to spend all weekend long arguing about whether your 15-year-old can go to an all-night hip-hop concert two hours away. You will only have spend part of the weekend arguing about that — and that, my friends, will seem like a frikkin’ gift at the time.

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5 Things Your Pediatrician Won’t Tell You

In the unlikely event that you don’t already know it, let me clear something up.

Medicine IS more art than science.

Sure, we know a gazillion times more about the physiology of illness than we did a generation ago, and every scientific advance makes us better able to understand and cure disease.  But the truth is that everything we learn in school, every new medical gadget invented to measure physical function, and every imaging test developed to scan every millimeter of your innards is being interpreted and applied by a human being.

That human being has opinions, points of view and life experiences that color how they see what’s going on with patients.  That’s why we say that if you put 5 doctors in a room you’ll get 6 opinions. And nowhere is that more true than in pediatrics, where our patients often can’t speak for themselves, and their ‘interpreters’ (parents) may be scared, upset, and vulnerable.

How kid doctors look at a problem when they walk into an exam room has everything to do with what happens next. Your pediatrician won’t tell you this stuff, but it matters.  Big time.

1)  What we think of you DOES make a difference. We all have impressions of people. You think that mother down the block yells too much, so you don’t encourage your kids to hang out over there. You’d rather have her kids at your house.  I think my neighbor across the street is too nosy and intrusive, so when I drive into my driveway and see her at her mailbox I quickly wave and scoot inside before she can stop me.

Your child’s doctor is no different. She has an impression of you as a parent. And that impression may come from her view that your parenting style matches hers.  Or doesn’t. It’s not good or bad, it’s a question of fit.  If she assumes you think the way she does, she may share more of the power in the relationship. She may tell you to watch and wait rather than fill that prescription right away.  Or she may rely more on your description of how that injury happened, and feel comfortable skipping the x-ray.  The result is more collaboration.

Do you feel like the two of you have  a meeting of the minds?

2)  We often depend on YOU for answers. You know your child way better than we do.  You notice subtle changes in behavior and activity that we couldn’t possible catch.  A good pediatrician listens carefully to your description of the problem because it often makes the diagnosis.  You are our patient, too.  If you feel ignored that’s a BIG red flag.

The flip side of this is that we can’t read minds. If you don’t tell us, we can’t know. We also don’t have x-ray vision. If you suspect that the pea Tyler stuck up his nose may be causing that green stuff that’s pouring out, PLEASE speak up.

3)  We CAN be bullied into prescribing antibiotics. Not all of us, not all the time, but many of us are occasionally vulnerable to begging and nagging.  So even though little Megan is on her third awful cold since school started and it’s not even Thanksgiving yet, and you just know the cough is going to linger for a week and keep the whole family up at night, please reconsider blocking the doorway until we give in and hand over that prescription for Zithromax. It won’t cure the viral cough and it’s bad for her.

Antibiotic resistance is a huge problem.  Help us curb it.

4)  Most medications in tablet or chewable form DO NOT go bad by the expiration date on the bottle. The pharmaceutical companies don’t want you to know this, but most meds in solid form are perfectly safe and effective for at least 6 months after the date printed.  There are a few notable exceptions, so ask your doctor or check a reputable reference site, but for the most part you’re just fine using that chewable Augmentin you never opened 6 months ago instead of refilling and re-paying.

NOTE: This isn’t true of most liquid meds, which tend to become unstable quickly.  And please don’t pour the old stuff (solid or liquid) down the sink where it can end up tainting our water supply.

5)  A lot of the time kids’ illnesses get better all by themselves (but we’re happy to take the credit). This is the beauty of pediatrics.  Children are amazing little beings who have incredible resilience and recuperative powers.  Their little bodies can take insults that would floor the average adult, and bounce right back.  This is not to say that you don’t need us — you do, but maybe not quite as much as you think.

I often tell parents that as long as your child will drink fluids, eat a little bit of the foods that appeal to him, and is fairly perky, it’s fine to wait 48 to 72 hours to see if Mother Nature will take care it. If things aren’t improving by then, come on in.

So there you have it — a few of our secrets revealed.  Stay tuned … there are plenty more.

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No Kids Yet. Should You Freeze Your Eggs?

Not that long ago single, young women worried a lot about getting pregnant. Abortion was illegal and out-of-wedlock pregnancy was characterized by shame and stigma. Then along came the birth control pill, and the Roe v. Wade Supreme Court decision that legalized abortion, and everything changed.

These days, many single, young women worry that they will NOT get pregnant – if and when they are ready to try. They worry that the lifestyle choices of their twenties and thirties (career, travel, casual dating) may have pushed them into the land where pregnancy may no longer be a given for them. And some of them are kind of freaking out.

Recently, we received a question from a reader that pretty much sums up how a lot of them are feeling. It really got to us and we wanted to respond:

Dear Mamas,

I turned 27 years old this year. At my annual exam, my doctor not-so-kindly reminded me that if I wanted to have children in the future, I should know that my reproductive health would start to decline at age 30. I don’t currently have a mate that I would consider having children with and I don’t know if I will before my reproductive health begins to decline. I don’t even know if I’ll ever want children in the future. Yet, I worry. Should I freeze my eggs? What are my options? My doctor wasn’t very friendly, and I will be looking for a new one, but I’m just seeking some guidance here.


First of all Stacy, I am so sorry about the way your doctor treated you. He blew it. He behaved in a less-than compassionate way and I can only imagine how alarmed you must have felt. But it’s always good to know the truth in a situation like this so that you can wrap your head around it, gain some perspective, and make a plan.

So here are the facts regarding fertility:

  • Girls are born with all the eggs they will ever have, unlike boys who will manufacture sperm from the time of puberty until they die. From puberty onward, an egg (sometimes more than 1) is released with each ovulation cycle, and it’s thought that the “ripest,” most viable eggs are released first.
  • It is true that once you hit your 30’s your fertility begins to decline. A healthy woman in her 20’s has an 87% chance of getting pregnant over the course of a year. By the time she is 35, her odds of getting pregnant in any given year decrease to 52%.
  • A recent study published by the University of St. Andrews and Edinburgh University in Scotland found that by age 30 women have already lost 90% of their eggs and by 40 have only only 3% left.
  • According to fertility specialist Sherman Silber, after age 30, a woman has about a 15% chance of getting pregnant in any single ovulation cycle. At 40, the chances that she will conceive on her own, without help, in any given ovulation cycle is about 10%.
  • As we age, so do our eggs. In an article for NPR, Dr. Allen Cooperman of Reproductive Medicine Associates of New York says that by 40, 90% of a woman’s eggs are abnormal. These abnormalities can make it more difficult to conceive and increase the likelihood of miscarriage.
  • Miscarriage risk also rises throughout the 30s, but slowly. From ages 30 to 34 it’s about 12%. From 35 to 39 it goes up to 18 percent.
  • At age 30, the risk of carrying a child with Down syndrome is one in 759. But by the time you hit 35, that risk has increased to one in 302.

So it seems pretty clear that when we’re talking about starting a family, age does matter. But that has always been the case. People do get pregnant in their thirties! I had my first at 30, my second at 33 and my third at 37. How things might play out for anyone in particular will, of course, vary. But knowledge is power and knowing the facts can help you make the best plan for yourself.

But what if you, like Stacy, are already worried and wondering about your future? What are the facts regarding freezing your eggs? To be honest it’s a bit of a mixed bag:

  • Thanks to a new flash-freeze method called vitrification, frozen, unfertilized eggs have a much higher rate of survival than before. We have been freezing fertilized eggs for some time but freezing unfertilized eggs is fairly new.
  • Due to advances in in vitro fertilization and egg freezing, many women are now able to conceive at older ages. But the procedures are challenging, do not guarantee success, and can be very expensive.*
  • According to a report by Jennifer Ludden for NPR, “The whole process — a week of hormones, plus the procedure to collect the eggs — runs $12,000 to $14,000. And because it takes 10 to 20 eggs for a reasonable shot at success, some may need to do this several times. Plus, there are annual storage fees. Then, when you’re ready to use your eggs, you’ll need in vitro fertilization, another pricey procedure. All told, costs can easily exceed $40,000.”
  • Unless the freezing is being done because of upcoming cancer treatment, insurance will most likely NOT cover the costs.
  • We don’t yet know how long frozen eggs remain viable. The assumption is that those coming from younger women will be okay for years but we really do not know.
  • The Society for Assisted Reproductive Technology, which sets the guidelines for this new industry, still sees the whole business of freezing and harvesting eggs to be experimental. Not all eggs that are harvested will tolerate the freezing process. And of those that do, not all will fertilize later, when thawed and exposed to sperm.
  • They (SART) also say that as far as we know, the babies who have been born using frozen eggs (only 1,000 to 2,000 world-wide) seem to be fine. But they caution that it is still early and hard to tell what the long term effects may be.

So now that you have some of the facts, how do you plan? Well, even though there isn’t anything you can do to slow Father Time, there are things you can do to impact your fertility in a positive way. For example, if you smoke, stop. If you are overweight, lose the extra pounds. And do whatever you can to control stress in your life. All of these actions can slow the loss of fertility.

Try not to worry about whether you will get pregnant one day in the future but do what you can now to increase the likelihood that when you are ready, things can fall into place pretty quickly.

For example: If you know that you really want children someday, don’t waste your time in a relationship with a man (or woman) you would never want to have children with. If the thought of him as a spouse/life partner/father leaves you with questions and concerns, do yourself and him a favor and cut it off. Don’t wait for him to change. He probably won’t and when you start to dream about babies, you may well wish you had acted earlier and found someone more appropriate to be the daddy.

Think about the kind of life you want to have. Be realistic. If you know that you want children some day, work that wish into your plans, realizing that your ability to conceive will get harder as you get older. And if you aren’t sure, keep thinking. Don’t just stick your head in the sand. By the time you pull it out, you may be surprised by the facts that greet you.

If your dream is to be a surgeon/live on a mountaintop in Nepal for 5 years/climb Mt.Everest/run for president, then definitely go for it! Dream big and follow those dreams wherever they lead you.

But at the same time, remember that you are making choices here. And one choice may cancel out another choice. It’s all good as long as you are aware of this and are conscious about what you are choosing.

And don’t forget that if, one day in the future, you can’t get pregnant, adoption and in vitro fertilization are also options to consider.

At the end of the day though, you do the best you can and keep the faith. Live your life as fully as possible and try not to worry about the future. Things usually have a way of working themselves out, regardless of how they might look now.

*For more on the specifics of what’s involved check out this article from Forbes Woman.






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The Mama ButtonThe information provided by MamasOnCall is not intended as a substitute for professional advice, but is for information purposes only. You assume full responsibility for the health and well-being of your family. Talk with your healthcare provider about any questions you may have regarding a medical or psychiatric condition.