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7 Tips for Coping with Your Child’s Unexpected Diagnosis

Every parent imagines that their child will have a healthy life. When a child receives an unexpected medical diagnosis, parents begin the process of adjustment, which is often filled with emotions and an uncertainty about what to do next.

CHOC Children’s pediatric psychologist Dr. Sabrina A. Karczewski offers the following tips for parents to cope with unexpected news about their child’s health. The adjustment may take some time, but in most cases the stress does goes down, she says. “Most parents are able to find that equilibrium in their families again.”

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Dr. Sabrina A. Karczewski, a CHOC Children’s pediatric psychologist
  1. Absorb information at your own pace.

 When you receive unexpected news about your child, it can be hard to pay attention to what the doctor is sharing with you. It’s very common to be confused and to forget details.

Keep a list of ongoing questions. It’s okay to ask the same questions over again and to ask for clarification. When you meet with the doctor, have a family member or friend come with you and help write down the information you receive.

“The most important thing is to make sure you understand to the level that you need to,” Dr. Karczewski says. “It’s okay to not fully understand everything immediately.”

  1. Have permission to feel your feelings.

 Learning about your child’s medical condition can bring about feelings similar to the grieving process, such as shock, denial, anger and depression. These are all normal feelings and it’s okay to feel them.

A common reaction is to feel mad at your support people (medical team, family members, etc.). You can rest assured that relationships can be mended to move forward with your child’s medical care, Dr. Karczewski says. Some parents also might feel guilt, whether it’s due to concerns about their own genetics, not having an instinct that something was wrong sooner or attributing early symptoms to something more normal. “I would tell parents, it’s not your fault,” Dr. Karczewski says. “In fact, your child only got diagnosed because you did the right thing by bringing them to a medical doctor.”

Once you’re able to acknowledge your feelings, lean on positive coping skills to work through them. Think about a time that you have coped with another stressful situation and use those same skills that have worked for you, Dr. Karczewski says.

  1. Set limits on your online research.

 Most parents will turn to the Internet at some point during their child’s medical treatment. That’s understandable, but Dr. Karczewski recommends that you set some boundaries.

“The internet is a really wonderful place and it is also a terrifying place,” she says. “Use your medical team as a guide to direct you to reliable and trustworthy resources. I also recommend setting a healthy time limit for your online research so you can have time for other things and also not be consumed. The information will be there tomorrow, it’s okay to put it down for today.”

  1. Prioritize your relationships early.

 “What ends up happening for a lot of parents is they spend their energy on their child with a medical condition, and they neglect their relationship as a couple or with their other children,” Dr. Karczewski says. “Be sure to make time for activities outside of the medical experience, and nurture your other relationships, too.”

  1. Focus on self-care as best as you can.

 While it might feel wrong to focus on yourself instead of your child, you’ll be better able to help them if you take care of your own needs, even in small ways. Take a quick shower, go for a walk or schedule time to do an activity that you enjoy.

  1. Lean on family and friends.

 Dr. Karczewski recommends making a schedule for family and friends to be with you. “Family can be great, but I know they can add stress, and you may not have the space to manage that stress,” she says. “Come up with specific tasks for family members (like making meals or picking up your other kids from school); it helps them give you what you need and not feel like they are getting in the way.”

  1. Seek extra help for yourself if you need it.

 Pay special attention to any feelings that are interfering with your daily functioning and seek mental health services early if needed. Dr. Karczewski explains, “Nobody is born knowing how to handle this. Some of us need additional ideas on how to move forward, and that’s okay.”

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Eczema Treatment for Kids

By Dr. Eric Ball, a CHOC Children’s pediatrician

What is eczema? Atopic dermatitis, more commonly known as eczema, is a common skin condition that can plague everyone from babies to grown-ups. It can be as mild as a nuisance, or more serve with skin so dry it cracks, bleeds or gets infected. Most kids will get an itchy skin rash at some point in childhood, but about one out of every 10 kids will develop eczema.

Eczema causes are unknown, but it’s believed to be a combination between genetics and a trigger, which could be certain foods, seasonal or environmental allergies, stress, hormones and weather. Diagnosing eczema can be tricky because each child has a unique combination of symptoms that can vary in severity, and there is no test to diagnose it definitively. If you suspect your child has eczema, consult your pediatrician. They will conduct a physical examination, and help you identify things in your child’s environment that may be contributing to skin irritation.

Eczema is not contagious, so there is no need to keep a child with eczema home from daycare or school.

Eczema symptoms

Eczema symptoms typically appear within the first few months of life, and almost always before a child turns 5. More than half of all children who suffer from eczema will outgrow it by the time they’re teenagers.

Between 2 and 6 months of age, kids with eczema will have itchy, dry, red skin and small bumps. These eczema symptoms can appear on their cheeks, forehead or scalp. It may spread to the arms, legs and trunk; in the bends of the elbows; behind the knees; or on the backs of the wrists and ankles.

Eczema symptoms tend to worsen and improve over time. For many kids, it begins to improve by the age of 5 or 6; others may have flare-ups into adolescence and early adulthood. In many cases, eczema goes into remission and symptoms may disappear altogether for months or even years.

How to treat eczema

There is no known eczema cure. However, your child’s pediatrician may prescribe a topical corticosteroid, also known as cortisone or steroid creams or ointments, which are commonly used to treat eczema. These “eczema creams” are usually applied directly to the affected area twice a day. Continue using these corticosteroids for as long as your doctor suggests.

These creams and ointments vary in strength, so do not apply a topical corticosteroid intended for someone else.

Your doctor may suggest nonsteroidal medications instead of a topical steroid. These may also prescribe antihistamines to help control itching, or an oral or topical antibiotic to prevent or treat secondary infections common in kids with eczema.

How to help your child with eczema

  1. Avoid frequent hot baths or showers, which dry out the skin. Use warm waters and mild soaps during bath time. Gently pat their skin dry, instead of scrubbing or toweling.
  2. Avoid fabrics that may irritate their skin including wool or coarsely woven materials. Favor materials that “breathe” such as cotton.
  3. Apply moisturizing ointments like petroleum jelly, lotions or creams to their skin two to three times per day. Always apply within a few minutes of bathing after a gently pat dry, before the skin has fully dried. Do this in addition to using a cream prescribed by their pediatrician.
  4. Apply a cool compress to the skin to ease itching.
  5. Eliminate known allergens from your home, including certain foods, dust or pet dander.
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How to Deal With a Toddler Who is a Picky Eater

By Dr. Eric Ball, a CHOC Children’s pediatrician

Most babies are great eaters. The average twelve-month-old will eat most of what he is offered. At my son’s first birthday party, I remember that he happily ate broccoli and strawberries, and only nibbling on his birthday cake. Three months later, my wife and I were begging him to just try or lick a piece of broccoli. What happened?

Some studies suggest that over 90 percent of toddlers and preschoolers are described by their parents as picky. I have a few theories about what happens to these formerly stellar eaters:

  • Children’s growth velocity slows down dramatically after their first birthday. The average child gains 15 pounds in the first year of life and only 5 pounds in the second year. Most of the food your baby ate went to growth, whereas most of a toddler’s food will go to running around and playing. Therefore, a toddler’s hunger will be variable. There will be days when they are hungrier than other days. It is normal for toddlers to have meals― or even days― when they eat little. There are also days when a toddler might eat more during a meal than their parents.
  • The last thing a toddler wants to do is sit in a highchair for thirty minutes and eat a meal. They want to play and explore. The average toddler or preschooler will eat just enough to get the energy to play more. When their tank is refilled, off they go!
  • Kids get smarter as they get older. Eventually my son realized that chicken nuggets taste better than broccoli. Since toddlers have no knowledge of nutrition, they want to eat what they like the most. At this stage, the biggest pitfall parents can make is to start allowing their toddlers to decide what food will be served. They will obviously choose the junk food that tastes best to them.

So, what do you do with your newly picky eater? I was raised in a strict household where my brothers and I were forced into eating our food. My brothers and I all struggled with obesity as children and were all very picky eaters. My wife’s family had one rule for the table, “Eat what you want, leave the rest.” There was no arguing or bargaining around the dinner table in their home. My wife and her brother were always a healthy weight and ate a good variety of foods. Here are some tips that I learned from my wife’s family that I try to pass onto my patients and my own children:

As parents, we are in control of the quality of the food offered to our children, and they are almost 100 percent in control of the quantity that they eat.

Toddlers have a fierce independent streak and the more they are pushed, the more they push back. Do not bribe, coerce, or force your children to eat. Sit your toddler down for three well rounded meals per day and at least one healthy snack per day. Make sure that he is offered a variety of healthy foods at each meal. If he eats what is served, that is fantastic. If he does not eat what is served, that is okay, too, but do not offer him anything else. We parents are not short order cooks. If the family is eating chicken, rice and broccoli, then that is what the toddler should be served. If he is offered macaroni and cheese after he whines that he does not like chicken, then you have essentially taught him that in order to get macaroni and cheese, simply whine and refuse your food. This is the first step in the making of a picky eater. It is better to excuse him from the table if he does not want what he is served rather than give him something else. Children do not starve themselves to death. Place the dinner plate in the refrigerator, and he can have a second chance at eating his dinner later that evening if he decides he’s hungry.

Maximize your opportunities for successful meals by not filling up on liquid calories and snacks.

I do not serve milk or juice with meals, only water. When my son was a toddler, if he had milk with his dinner, he would chug the milk until he was almost completely full, and then eat little or no food A ten-ounce cup of whole milk has more calories than an equivalent sized soda. I would save milk or juice for snack time and limit my children to no more than 16 ounces of milk per day. In fact, I filled a 16-ounce measuring cup with milk each morning so that my children could see exactly how much milk would be allotted for the day. When the cup was empty, the milk for the day was over.

Give your toddler mutually acceptable choices for snack foods.

I will offer my children an apple or a pear for a snack. If they respond that they want Goldfish crackers, I will remind them again that their choices are between an apple and a pear.

Eat as a family whenever possible.

Children are much more likely to eat their food if they see others eating the same food. It is hard to expect a toddler to eat peas if he is the only one eating them. Even if work schedules make a true family meal impossible, try to have one parent sit with the children and eat small portions of what the children are served.

Allow children to participate in food preparation.

Most people are more willing to eat something of which they have ownership. Even something as simple as having your toddler stir the peas and corn may increase the odds that he will eat them.

If there are foods that you do not want your children to eat, do not buy those foods.

Good nutrition starts at the grocery store. If a child’s only options for snacks are fruits or vegetables, it is likely that he will eat them. Most toddlers and preschoolers eventually are smart enough and agile enough to find that stash of Oreos in the cabinet.

In medical school, I was repeatedly taught that parents should not make mealtime a battle. That lesson didn’t fully sink in until I had my own children and I realized how quickly a lovely family meal could degenerate into a stress-filled ordeal. By applying the simple family rule of “Eat what you want, leave the rest,” mealtime at our home is once again a pleasant experience.

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New Year’s Resolution Ideas from our Teen Advisers

It’s no secret that children often model their parents’ behavior and habits. As many adults make New Year’s resolutions in areas like health, productivity and self-care, it’s a good opportunity to talk to your kids about setting and sticking to good habits.

The American Academy of Pediatrics offers a list of new year’s resolutions ideas for preschoolers through teenagers.

Below, members of our Teen Advisory Council share their New Year’s resolutions, plus how they plan to stick to them. We’d love to hear your family’s resolutions—let us know in the comments below!

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Zoe Borchard, teen adviser

Zoe Borchard

To me, New Year’s resolutions are a fantastic idea, but most people don’t have time for the kinds of commitments they set.

Now this isn’t to say that all resolutions are unattainable, it’s simply necessary to start small when planning for the new year. Don’t bite off more than you can chew.

Good resolutions to start with vary from person to person, so you should ask yourself the question: “What have I always wanted to improve in my life?” Loaded question, right? Just spend a minute reflecting on it. I’ll use myself as an example, I’ve always wanted to get more organized, so in the new year, I’d like to make that happen in all aspects of my life.

It’s a lot to ask of myself to organize everything in my life and then keep it as a habit, so I’ll start with small things and work up to it. I could say things like I’m going to organize my school binders with subject dividers, I’m going to write down my activities in a daily planner, etc.

It shouldn’t be too hard to keep up if you started small, but something I always remember is that it only takes one day to break a habit, and 21 days to make another one. It’s also important to remember that you will never regret doing something good for yourself. Keeping these things in mind, you have all the tools you need to make and keep your resolutions this year! Remember to dream big, plan small, and most importantly, believe in yourself!

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Layla Valenzuela, teen adviser

Layla Valenzuela

A new year is a time to go back and look over what we’ve accomplished, and in what areas we fell short. New Year’s resolutions are a great way to change little things that we would like to improve, and to add new things to improve our lives. However, we must be rational when making these goals. So, here are some ways that I brainstorm my own resolutions:

  • Be realistic. While making goals, we have to remember to outline practical ideas. Saying that we will be millionaires by the end of the year is not 100 percent realistic. Think about who you are, and if you can see yourself fulfilling your goal, then go for it!
  • Remember your goals. In order to keep your goals top of mind, try writing them down somewhere where they can be seen daily. Or, set a reminder on your smartphone. Just remind yourself of your goals and slowly incorporate them into your daily life.
  • Don’t push too hard. This is where New Year’s resolutions can get dangerous. Especially for teenagers, we cannot set goals that we know can be risky. For example, I know that many adults tend to set goals to lose a certain amount of weight. A healthier goal for teens could be incorporating healthy habits like exercise into your daily routine.
  • Think of what you want for yourself, not what other people want. Don’t let peer pressure affect your goal setting in a negative way.
  • On the less serious side of things, create a resolution that makes you happy. My New Year’s Resolution is to do things that will make me happy. I am not going to listen to music that I don’t like just because everyone else likes it. I am trying to set up a healthy, exciting, and positive lifestyle for the new coming year
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Heather Bisset, a teen adviser

Heather Bisset

I set goals for myself throughout the year, but have some trouble completing them because it’s hard to set a timeline or end date for something that will help me personally. I usually have better luck accomplishing my goals when I can hit refresh on a new year, with a clear roadway ahead of me.

Remember to break down larger goals into smaller steps. For example, say my goal was to do better in school. That’s a big goal, and I would break it down into smaller increments. For this goal, I would make a checklist that would have multiple steps including:

  • study for an hour every day for a week leading up to a test;
  • work on homework before practice instead of after;
  • put my phone away when doing homework or studying.

Setting big goals can feel overwhelming, and they are easier to accomplish if you break them down into smaller pieces. Plus, crossing off tasks—even small ones– on a checklist feels rewarding.

To stick to my goals, I tend to set reminders on my phone. I also tell my friends or peers about my goals, if they see me steering away from my resolution, they can kindly remind me to get back on track.

This year, my resolutions are to stop biting my nails, to be more consistent with completing my household chores, to stay off my phone more, and to stop drinking soda. These are all simple things that will make me happier with myself.

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Cameron Macedonio, a teen adviser

Cameron Macedonio

I see New Year’s resolutions as kind of obsolete, as they’re often times not followed. If you want to change something about yourself, you don’t have to wait for a new year.

To set realistic goals, know your limits. It’s totally acceptable to want to push your limits but be realistic. Try consulting a friend or loved one before setting a big goal so they can try to talk about a game plan with you.

Also, don’t stress if you cannot complete your goals! Life is full of trial and error; embrace your failure and learn from it. Don’t be afraid to fail. Failure is normal, and it doesn’t make you a loser or a complete failure; just persist past your misfortune and use it as fire to drive you to success.

Even though I don’t really have a New Year’s resolution this year, I am just working hard to keep my head in the right place and be ready for any extra challenges that may come my way.

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Sanam Sediqi, a teen adviser

Sanam Sediqi

New Year’s resolutions are a good way to set healthy and positive goals for the next chapter in your life. However, setting unrealistic goals that are hard to reach can give way to self-doubt and feeling like a failure

My best advice is to set easy-to-achieve resolutions that will make a positive change in your life.  When setting resolutions, don’t put too much pressure on yourself. For example, tell yourself you’re going to work hard and pass your classes. Or that you’re going to spend more time with your family, or you’re going to try and eat healthier. It’s always good to tell yourself to try. Even if you don’t succeed you know you tried at the least.

One way to stick to your goal, and something I plan on doing this year, is to make a vision board. Keep this in your bathroom or bedroom as a daily reminder why you’re doing what you’re doing. I believe that having a little reminder every day is what it takes to stick to your goal and to keep pushing.

My New Year’s resolution is definitely to try new things, and to get to know more people. I would also like to become a healthier version of myself, as well as go to college, get my license and spend more time with my family. To me, these are goals I believe I can reach and I can’t wait to accomplish them.

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Stomach Flu vs. Influenza

Many people talk about the “stomach flu” when they’re feeling sick to their stomachs. It isn’t the same as influenza or the flu. Stomach flu is an illness called gastroenteritis, which is usually caused by a virus. The seasonal flu, or influenza, is a virus in the upper respiratory system. Each year from October to May, millions of people all across the U.S. come down with the flu.

Stomach flu (gastroenteritis)

Someone with the stomach flu may have the following symptoms:

  • Stomach cramps
  • Diarrhea
  • Fever
  • Nausea
  • Vomiting

He or she will usually feel sick for a day or two and then feel better. Unfortunately, there is no vaccine or cure for the stomach flu or gastroenteritis. Here’s how you can make the stomach flu go away:

  • Get lots of rest
  • If you’re throwing up, avoid solid food. When you feel up for reintroducing food, start with bland items like bananas, rice, applesauce or toast.
  • Sip fluids, such as water, or try a popsicle.
  • To avoid dehydration, sip small amounts of beverages that contain electrolytes.

Seasonal flu (influenza)

When people have influenza, they usually feel worse than they do with a cold. Most people start to feel sick about two days after they come in contact with the flu virus. They might have:

  • Fever
  • Chills
  • Headache
  • Muscle aches
  • Dizziness
  • Loss of appetite
  • Tiredness
  • Cough
  • Sore throat
  • Runny nose
  • Nausea or vomiting
  • Weakness
  • Ear pain
  • Diarrhea

Sometimes, influenza can turn into pneumonia. This is especially dangerous for babies, or kids and adults with pre-existing health conditions. If you think your child has influenza, see a doctor.

How to treat the flu

Most kids with influenza will get better at home. Make sure your child:

  • Drinks plenty of fluids
  • Gets plenty of sleep
  • Takes acetaminophen or ibuprofen to relieve fever and aches.
  • Wears layers that are easy to remove. Children might feel cold one minute and hot the next.

Fever and most other flu symptoms often go away in about five days, but kids may experience a lingering cough or feel weak. Children should be kept home from school or daycare until they have been fever-free for 24 hours.

Tips for keeping your kids safe from the seasonal flu:

There are several things you can do to help your family avoid the seasonal flu.

  1. Get a flu shot. It’s better to get vaccinated later in the season than not at all. The Centers for Disease Control recommends annual influenza vaccinations for everyone 6 months and older.
  2. Practice proper hand washing. Besides getting a flu shot, proper hand-washing is the best way to prevent the spread of illness, including the seasonal flu.
  3. Stay away from people who have a fever. Ask friends, family and caregivers who have had a fever or chills within the past 24 hours to stay away from your child. Likewise, keep your little ones home from school or daycare for 24 hours after they’ve had the same symptoms.
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