I always hoped that, since I’m a pediatrician, my children would have no qualms about anything that happens at the doctor’s office.  I was wrong.  My children get as upset about shots, as fearful of a blood draw, and as manic about opening their mouths for a strep swab as the next kid.  But shots don’t have to be a horrible experience for kids and parents alike.  There are simple things we can do to calm our child, no matter her age, to make everything go a bit smoother.

Leading up to the doctor’s visit, your toddler or school-aged child may ask if it will hurt.  Honesty is the best policy.  Let him know that yes, it will hurt for a second, but it won’t be bad and you’re right there with him.  Some kids like to role play beforehand, pretending to be the doctor giving shots to their parent or stuffed animal, which can make them more confident for the real thing.

At the doctor’s office, the first step in calming your child is checking in on your own mood.  If you are relaxed that will rub off on your little one; if you’re stressed, that will too. How would you feel about getting a shot yourself? Probably not exactly excited about it, but also not too worried or afraid. You should feel that way about your child getting a shot. And your child will notice how you feel, and will tend to feel that way herself. Children are perceptive – pretending won’t help. 

At the time of the shot, distraction can be very helpful.  An infant may want to nurse, suck on a pacifier, or be skin to skin on a parent, all of which have been shown to reduce the stress of painful procedures in babies.  An older child may want to hugged or cuddled, read a book, or even watch a favorite video on your phone.  Encouraging your child to cough loudly right before and right after the shot has also been shown to reduce painful reactions in school aged kids and even middle schoolers (yes, they get scared, too).

Congratulate your child on being cooperative and brave, but don’t make too big a deal out of it  Give her a high five, a hug or a cuddle to let her know you’re proud of her and then head out for a small reward. In our house we go for cake pops, and knowing there is a special treat waiting for my girls (and me!) at the end of a tough doctor’s visit puts everyone a little more at ease.  

How do you keep your child bundled up and warm in the car?  Dr. Jessica Long is here to help!

One of my favorite things about being a pediatrician is getting to work with new parents as they embark on this wild, crazy, amazing journey of raising a little human.  They often apologize for having so many questions but how could they not? There’s no all-inclusive manual on parenting and, even if there were, no parent would have the free time to read it.  Thankfully my schedule allows me to spend the time parents need to walk themthrough their questions and concerns,andtoassurethem that even as a pediatrician I had many of the same quandaries when I first became a parent.

This time of year one of the big things we talk about is how to keep kids safe and warm in the car. Multiple times a day a baby adorably bundled up in a snowsuit comes into our office looking like the Stay PuftMarshmallowMan. She’s clearly warm and toasty buckled in her car seat, but she’s not safe.  The parents are unaware that there is a better way to keep their baby snug and safe this time of year.

Due to the fluffiness of snowsuits and puffy jackets, it is impossible to get car seat straps tight enough to appropriately buckle your child.  Even when you have tightened the straps as snug as they can go, there is typically still four (!!!) inches of slack.  Though our muscles cannot squish down that extra air in the puffy clothes, the force of a car crash certainly can,and those four inches of slack can be enough to let your child slip out of the harness all together.

Save the snowsuits and puffy jackets for playtime outside or walks in the stroller. When you are buckling your child into the car, multiple thin layers are the way to go.  A long-sleeved shirt with a tight fitting fleece over it, a snug hat, and fleece leggings with pants on top is plenty warm in the car.  You can always add a blanket tucked in all around your little one.  There are also many products on the market that go around your baby or car seat for additional warmth without additional bulkiness.

What about when you’re putting your child in the car for a trip to go play in the snow? I know it’s a pain, but bring the snowsuit with you and put it on your child when you get there. If you dress your child as just described above, she’ll be warm enough for those few minutes. And the inconvenience is worth it to keep your child safe.

While most of these tips address infants, the same applies to bigger kids as well.  A bulky jacket will hinder the tightness and effectiveness of all car seat straps,so plan ahead with tight layers and add a jacket worn backwards (so that the fluffiness does not interfere with the straps) after your child’s buckled in.

Sleep (or lack thereof) is one of the biggest frustrations we deal with as parents. Here are Dr. Jessica Long’s tips on how many hours of sleep children need at each age and how to create a nighttime routine to achieve these sleep goals.

September is always a busy month in our household. School, homework, extracurriculars – there’s a lot to incorporate back into the daily routine, which is fun but also exhausting. By the end of the day our whole family is spent and everyone is exhausted. I know more sleep is the answer, but how exactly do we successfully get our children to sleep earlier, sounder and longer?

How much sleep your child needs depends a lot on her age. The American Academy of Sleep Medicine (AASM) recommends that preschoolers (3-5 years) get 10-13 hours of sleep, grade-schoolers (6-12 years) get 9-12 hours and teens (13-18 years) get 8-10 hours. Parents, as we know, routinely survive on 5 hours without problems (just kidding!).

So how do we meet these lofty sleep goals? Bedtime rituals are incredibly helpful in getting your child’s mind and body ready for sleep. A bath, brushing teeth, and a book may be the perfect routine for your 5 year old. Your middle-schooler might find it helpful to journal a bit before lights out. Whatever works for your family, make sure you plan for a sufficient amount of time to complete the bedtime ritual. Start the process 30-60 minutes prior to bedtime so that your child is sound asleep at an appropriate time.

Prepare your child’s room for sleep success as well. Keeping the temperature cool, the windows dark, and the bed free of too many toys/books/stuffed animals helps to set the scene for a good night’s sleep. My eldest daughter hoards dozens of books in her top bunk. We routinely have to declutter her bed to encourage her to close her books at an appropriate time to maximize her rest.

Probably the least popular advice I give to patients and their parents about improving sleep hygiene involves screen time. There is no wrath like a teenager who has been told she can’t charge her phone in her room overnight. Ideally, all screens should be turned off at least one hour prior to bedtime and all electronics should be charged outside of the bedroom. We are all guilty of checking our phones right before bedtime so make this a family goal to help improve everyone’s rest.

Sleep is a very important aspect of your child’s overall health. Poor sleep can affect mood, concentration and grades at school, behavior and more. If you are worried about your child’s sleep, discuss it with her pediatrician.

Happy zzzzz’s!

 

Anyone who has spent a second in DC during the Summer knows that the mosquitos can be especially brutal (we are on a swamp after all). Don’t let these pesky bugs keep you and your family from enjoying time outside with these tips from Dr. Jessica Long.

My kids are loving these long, sunny summer days and begging for some outdoor adventures.  However, if you are a true city girl like I am, the thought of leaving your concrete jungle and venturing into the grass and the trees may fill you with trepidation.  I do not like bugs and it greatly detracts from the nature time the rest of my family craves.  Plus, a new alert that West Nile positive mosquitos have been found in Ward 3 does little to calm my neurotic nature.  Obviously, I cannot prevent any and all insect encounters but there are many safe and effective ways to minimize my family’s exposure.

While complete avoidance of insects is not a realistic goal, we can be mindful of where we spend our time and what we wear.  Avoid areas with tall grass that ticks love to cling to as well as stagnant water that is a breeding ground for mosquitos.  When outside in the evenings when mosquitoes love to munch, choose long sleeves and pants that are light and breathable.  The same goes for hikes in the woods or tall grass to prevent ticks from attaching to your skin.  Be sure to do a “tick check” in the evenings when you’ve been outdoors (even your own backyard counts).  They especially like to hide in armpits, in and around ears, inside the belly button, back of the knees and between the legs, around the waist, and in your hair.

It is also a good idea to apply insect repellant to exposed skin and clothing. However, hitting the bug spray aisle of the store can be overwhelming.  There are so many options and ingredients!  Lotions, sprays, wipes, DEET, picardin – what should you choose?

The American Academy of Pediatrics and the Centers for Disease Control both give the thumbs up for 10-30% DEET in children as young as 2 months (keep the under 2 month babies away from insects completely). DEET has also been shown to be safe in pregnant and breastfeeding moms.  Another option is Picardin, a synthetic compound approved in the US in 2005 and protects about as well as 10% DEET.  There are also many repellants that contain essential oils such as citronella, cedar, soybean, and eucalyptus (the latter should be avoided in children under 3 years old).  While these are considered safe, they have to be reapplied frequently and long-term follow up studies are lacking.

Similar to sunscreen, whichever insect repellant you choose must be reapplied frequently.  10% DEET and products that function like it last about 2 hours while 30% DEET keeps you covered for up to 5 hours.  Choose the lowest concentration you need for adequate coverage; no need to go with 30% DEET if you are planning on playing in your backyard for an hour.

So now that you’re armed and ready to fight those insect bites, get out there and enjoy this gorgeous DC summer!  My family might even convince me to get out there, too.

It is heartbreaking to leave your child when he is upset. Read on for tips from Dr. Jessica Long on how to ease your child’s separation anxiety.

Nothing pulls at your heart strings like your child crying when you need to leave.  It makes you feel awful and, even if your little one recovers as soon as you are out of sight, makes you feel horribly guilty the entire time you are away.  Separation anxiety is a normal part of your child’s development but that does not make it any easier to endure.

Babies start to experience separation anxiety around the age of 4-7 months once they realize that you exist even when you are not right in front of them (this is known as “object permanence”).  They want you when you’re not there and are sad when you leave, even if it’s just to walk to the other room.  As our babies grow into toddlers, episodes of separation anxiety become less frequent but can be more intense (think crying, yelling, tantrums).  School-age children can even exhibit separation anxiety, especially with big changes like starting school or a new sibling in the house.  Thankfully though, it’s unusual for daily separation anxiety to continue in your school-age child. If it does, you should discuss it with your pediatrician.

So what’s a parent to do when you have to leave the house – now! – but you have a sobbing child clinging to your leg?  First off, no matter how tempting it is, don’t sneak out.  Your child needs to trust you and suddenly disappearing will only make her more fearful of your absences.  Instead, let her know that you are leaving and when you’ll be back in terms she’ll understand (“after you wake up from your nap” or “right before lunch”).  Just as importantly, keep that promise and be home when you say you will.  Develop a goodbye ritual that you use each time, to provide consistency, but keep it short.  Longer rituals may lead your child to fixate on the idea of you leaving.

Remember that practice makes perfect.  Being separated from a parent is important for your little one’s development, and it’s healthy for him to spend some time away from you.  Even having a friend, family member, or nanny provide child care for a few hours gives you the chance to practice your goodbye ritual and allows your child to experience special time with other trusted adults in his life.

Most importantly, separation anxiety is temporary.  Our children continue to grow, mature, and get used to new situations.  Stay loving and consistent in your goodbye routine and it will become easier and easier.