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	<title>Ask Dr. Mama &#187; Parenting</title>
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	<link>http://askdrmama.com</link>
	<description>Parent Coaching &#38; Consultation with Rachel Zahn, MD</description>
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		<title>Hooker Barbie</title>
		<link>http://askdrmama.com/2011/02/hooker-barbie/</link>
		<comments>http://askdrmama.com/2011/02/hooker-barbie/#comments</comments>
		<pubDate>Thu, 10 Feb 2011 23:17:58 +0000</pubDate>
		<dc:creator>Rachel Zahn</dc:creator>
				<category><![CDATA[Parenting]]></category>

		<guid isPermaLink="false">http://askdrmama.com/?p=211</guid>
		<description><![CDATA[When my daughter was tiny, maybe three, she was madly in love with everything girly. The more lace, glitz and bling the better. An entire toy box was filled with feather boas of every color, plus princess dresses and plastic high heels. Her beloved Barbie dolls lived in the same toy box with their extensive [...]]]></description>
			<content:encoded><![CDATA[<p><a href="http://askdrmama.com/askdr/wp-content/uploads/2011/02/careerbarbie.jpeg"><img class="alignleft size-full wp-image-218" title="careerbarbie" src="http://askdrmama.com/askdr/wp-content/uploads/2011/02/careerbarbie.jpeg" alt="" width="253" height="217" /></a>When my daughter was tiny, maybe three, she was madly in love with everything girly. The more lace, glitz and bling the better. An entire toy box was filled with feather boas of every color, plus princess dresses and plastic high heels.</p>
<p>Her beloved Barbie dolls lived in the same toy box with their extensive wardrobes. Most were missing at least one body part, ’cause that’s what happens when you beg your older brothers to play Barbie with you.</p>
<p>It was around that time I decided if you can’t beat ‘em, join ‘em, and I started to collect non-traditional Career Barbies.</p>
<p>There was a period in the 90′s when Mattel attempted to expand its market by introducing several lines of unusual Barbies. There were international Barbies from around the globe. There were Barbies from history and literature, like Cleopatra Barbie and Heidi Barbie. And then there were my favorites — the Career Barbies.<br />
<span id="more-211"></span></p>
<p>One by one they lined up on her shelves. Pilot Barbie (long before I ever met a woman commercial pilot), Veterinarian Barbie, Dentist Barbie and Pediatrician Barbie (my fave), Photojournalist Barbie, Professor Barbie, Paleontologist Barbie, Barbie for President, and Firefighter Barbie. I may be forgetting a few, but you get the gist. My pre-schooler needed to know that even Barbie, that iconic man-pleaser, could be anything she wanted to be.</p>
<p>In spite of her feet, which were pre-formed to slide only into spike heels, that chick could climb mountains, fly jumbo jets and save lives. Somehow it felt important to neutralize the overt Barbie message with a woman power counter-narrative.</p>
<p>The problem was that my princess had little or no interest in Career Barbies. She never even wanted to take them out of the box, which was fine with me since I figured that once out of their perfect, strangled career poses they’d lose heads and arms too, and become just like all the other big-busted, tiny-waisted fashionistas in the toy chest.</p>
<p>So there they sat on the shelf; a perfectly frozen gallery of fantasy women’s lives. See, my darling girl? You CAN have it all. Wear your evening gown and strappy pumps to the prom tonight, and join the paratroopers tomorrow.</p>
<p>Who was I kidding?</p>
<p>Fast forward 13 years and I find myself in a different room – one full of toys destined to be distributed to children in hospitals and foster homes. My colleagues and I are sorting through mountains of playthings, deciding what might go to whom — what’s appropriate, and what’s not (you wouldn’t believe some of the things donated to toy drives).</p>
<p>I am floored. Out of a total 22 Barbies (by far the most represented of any single item), we will discard 11 because they’re too sexually explicit. California Barbie is sporting a bikini so tiny the top barely covers her nonexistent nipples — the bottom is a thong wedged into the plastic crack between thigh and pelvis. Disco Barbie wears a hot pink and silver halter dress so short she couldn’t sit down without displaying her Brazilian wax, and heels we used to call ‘f**k me shoes’.</p>
<p>Not a Career Barbie in sight … unless you consider hooking a career.</p>
<p>My younger colleagues, all smart women with big professional plans, aren’t too surprised. Once I point out the trend they’re suitably appalled, but it wouldn’t be a big deal otherwise. Their world is so saturated with this stuff they’ve been desensitized to it.</p>
<p>Woman power has taken on new meaning, at least in the media and mass market. From Jersey Shore’s Snooki to the endless parade of teen idol pop stars, and even our mega-movie stars, our center of power has been hijacked and relocated from our brains to those body parts most likely to benefit from cosmetic surgery.</p>
<p>When did women’s equality become about using our sexual power over men to its best advantage, instead of using our brain power to participate in all arenas as full partners? The truth is it didn’t, but you sure wouldn’t know it if you’ve been steeped in pop culture.</p>
<p>Sexual power is being confused with actual power, so that embracing cheap sex becomes a 21st century version of feminism. But take my word for it, lustful does not equal liberated.</p>
<p>Take a look at the Forbes Magazine Top 10 Powerful Women of 2010:</p>
<p>Michelle Obama (First Lady of the United States)</p>
<p>Irene Rosenfeld (Kraft Foods Chief Executive)</p>
<p>Oprah Winfrey  (talk show host)</p>
<p>Angela Merkel (German Chancellor)</p>
<p>Hillary Clinton (United States Secretary of State)</p>
<p>Indra Nooyi (Pepsico Chief Executive)</p>
<p>Lady Gaga (singer and performance artist)</p>
<p>Gail Kelly (Australian Westpac Chief Executive)</p>
<p>Beyonce Knowles (singer and fashion designer)</p>
<p>Ellen DeGeneres (talk show host)</p>
<p>All 10 got where they are by using brainpower, not sexual allure. Even the performers in the bunch — Oprah, Lady Gaga, Beyonce, and Ellen — are brilliant business women who crafted their brand carefully to propel them to the head of the class. They have much more in common with Career Barbie than Disco Barbie.</p>
<p>But try asking your ‘tween or teen chica to name 10 women who they think are important and powerful and I’ll bet you get a very different list. Come to think of it, that’s a great conversation starter for us and our daughters. AND for us and our sons.</p>
<p>Remember: the most important influence on our kids’ opinions and values isn’t their peers OR pop culture, it’s us. When we open up the conversation and talk about this stuff, they listen (just don’t ask them to admit it).</p>
<p>So tonight at dinner, ask your son or daughter to name a woman they admire, or one they’d like to be like, and take it from there. Try not to prompt or judge (“well how about fill-in-the-blank? Isn’t SHE the one?”). Just get information and start asking why.</p>
<p>Meanwhile, my Career Barbies are packed up in a big plastic bin on a shelf in the garage. They’re still frozen in those perfect poses, original packaging intact. I just know my someday granddaughter is going to love them.</p>
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		<title>Bad Parenting Trends (we can learn from)</title>
		<link>http://askdrmama.com/2010/12/bad-parenting-trends-we-can-learn-from/</link>
		<comments>http://askdrmama.com/2010/12/bad-parenting-trends-we-can-learn-from/#comments</comments>
		<pubDate>Wed, 08 Dec 2010 17:22:29 +0000</pubDate>
		<dc:creator>Rachel Zahn</dc:creator>
				<category><![CDATA[Parenting]]></category>
		<category><![CDATA[bad parenting]]></category>
		<category><![CDATA[parenting trends]]></category>

		<guid isPermaLink="false">http://askdrmama.com/?p=203</guid>
		<description><![CDATA[Let’s face it, there’s way too much advice for parents out there. One of the most confusing things for both advice givers and advice takers (and I place myself in both groups) is the sheer volume of … information … that exists, to put it kindly. On my first day of med school a wise [...]]]></description>
			<content:encoded><![CDATA[<p><img class="alignleft size-full wp-image-204" title="mistake" src="http://askdrmama.com/askdr/wp-content/uploads/2010/12/mistake.jpg" alt="" width="268" height="232" />Let’s face it, there’s way too much advice for parents out there. One of the most confusing things for both advice givers and advice takers (and I place myself in both groups) is the sheer volume of … information … that exists, to put it kindly. On my first day of med school a wise professor told us, “Half of what you learn here will turn out to be wrong. The problem is, we don’t know which half.”</p>
<p>If the past is prologue, it’s also full of all sorts of cautionary tales. So-called facts and accepted truths of all kinds that we absorb and include in our decision making about what is good and bad, and what we should and should not do.</p>
<p>Hormone replacement therapy for post-menopausal women is one example. Subprime mortgages is another. Then there’s the polyester leisure suit, which many of you don’t remember, and Latisse, the prescription product that grows longer eyelashes, which I predict will turn out to be a bad idea.</p>
<p>Life is full of trial and error, and so is the history of parenting trends. In case you’ve forgotten some of the seriously misguided concepts we used to take as gospel, here’s a partial list.</p>
<p><strong>Refusing vaccination because thimerosal causes autism</strong>. I know you don’t all agree, but I’m standing by this one. The research is on my side.</p>
<p><strong>Birthday parties that cost as much as weddings</strong>. Maybe this is wishful thinking, but it looks like this values-crusher is on the way out.<br />
<span id="more-203"></span></p>
<p><strong>Baby Einstein videos, and their friends, the teach-your-newborn-to-read flashcards. </strong>Enough said.</p>
<p><strong>Put baby to sleep on his belly</strong>. The poster child for a hard and fast rule that we now know was entirely wrong. The rate of SIDS has dropped dramatically since we started laying infants down on their backs.</p>
<p><strong>Feed a cold and starve a fever</strong>. Children who are sick should be offered any healthy food that appeals to them and stays down, and more importantly, fluids, fluids, fluids.</p>
<p><strong>All ear infections need antibiotics</strong>. Not. See <a href="http://askdrmama.com/2010/11/the-pink-medicine-lie/" target="_blank">The Pink Medicine Lie</a>.</p>
<p><strong>Infants will sleep through the night if fed solids early and often</strong>. Breast milk or formula <em>only</em> before 4-6 months is the new rice cereal.</p>
<p><strong>Once a cesarean, always a cesarean</strong>. We applaud the rise of the VBAC. The routine risks of surgery are usually much greater.</p>
<p><strong>Kids don’t need a bedtime, they’ll go to sleep when they’re tired</strong>. Again, not true! This approach only leads to chronic sleep deprivation. Recent studies show that kids with bedtimes do better in school.</p>
<p><strong>Little girls dressed just like grown-ups</strong>. High heels for toddlers? Padded bikini tops for 1st graders? Is there any question why our ‘tweens are being sexualized way too soon?</p>
<p><strong>Chubby babies are healthy babies.</strong> This may be part of what got us into the childhood obesity mess in the first place. We now know how early the problem can start.</p>
<p><strong>Teething causes … fever, diarrhea, a rash, etc. etc</strong>. For years we blamed a slew of childhood afflictions on teething, probably because kids are teething more or less constantly between the ages of 5 months and 3 years. So anything else that pops up during that time must be due to … teething! Teething causes achy, throbbing gums and crabby, drooling kids. Nothing more.</p>
<p><strong>Taking health/parenting advice from celebrities</strong>. OK, this may seem a bit self-serving, but why do we hang on the opinions of Suzanne Somers and Jenny McCarthy, and ignore what the actual experts who’ve had years of education, training, and experience have to say? Just asking.</p>
<p>I could go on forever, but I won’t. Some of these are silly and some serious, but the point is that today’s parenting must-do, must-have, or must- emulate is just as likely to be tomorrow’s infant cold formula — something we now know is ineffective and may even be harmful. So don’t believe everything you read or everything you hear — even from us. Use your own judgement, do your own due diligence, and never ignore your own mommy gut.</p>
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		<title>The Pink Medicine Lie</title>
		<link>http://askdrmama.com/2010/11/the-pink-medicine-lie/</link>
		<comments>http://askdrmama.com/2010/11/the-pink-medicine-lie/#comments</comments>
		<pubDate>Fri, 05 Nov 2010 17:19:13 +0000</pubDate>
		<dc:creator>Rachel Zahn</dc:creator>
				<category><![CDATA[Parenting]]></category>

		<guid isPermaLink="false">http://askdrmama.com/?p=193</guid>
		<description><![CDATA[Common cold, flu, and ear infection season is upon us, and whether your kiddo is picking up stray germs in that perfect culture medium we call the classroom, or sharing microbe-laden chewy toys at playgroup, it&#8217;s likely you&#8217;ll have a childhood illness or two coming your way this fall. Before you can say back-to-school-night, your [...]]]></description>
			<content:encoded><![CDATA[<p><img class="alignleft size-full wp-image-196" title="nopink" src="http://askdrmama.com/askdr/wp-content/uploads/2010/11/nopink.jpeg" alt="" width="190" height="162" />Common cold, flu, and ear infection season is upon us, and whether your kiddo is picking up stray germs in that perfect culture medium we call the classroom, or sharing microbe-laden chewy toys at playgroup, it&#8217;s likely you&#8217;ll have a childhood illness or two coming your way this fall.</p>
<p>Before you can say back-to-school-night, your guy may start to look a little drippy. Next, come those three little words no mother ever wants to hear, &#8220;my ear hurts&#8221;. OH NO! It&#8217;s time to high-tail it to the pediatrician for some vitamin A, right?</p>
<p>Vitamin A, the magic elixir, the pink stuff, bubblegum medicine, fruit punch &#8212; all the nicknames you can think of mean the same thing. Amoxicillin. An antibiotic in the penicillin family that is used to treat a variety of bacterial infections (remember that word &#8212; bacterial &#8212; we&#8217;ll come back to it in a minute). Amoxicillin. Best friend and superhero of moms everywhere. It can fix anything AND kids actually ask for its pink, sticky goodness.</p>
<p>I&#8217;m here to tell you it ain&#8217;t necessarily so &#8230; <span id="more-193"></span> Children’s ear infections, colds, and many other minor childhood illnesses don&#8217;t automatically need to be treated with antibiotics, amoxicillin or otherwise.</p>
<p>It has taken way too long for the American Academy of Pediatrics to change its recommendation, but based on serious research done in Europe we now agree that routinely treating all ear infections with antibiotics is not the best option.</p>
<p>Many ear infections are caused by viruses, and antibiotics won&#8217;t touch them because they&#8217;re only effective against bacteria. Colds and flu are caused by viruses, too, so antibiotics won&#8217;t help those either.</p>
<p>Ear infections are not contagious, although the associated cold that can trigger them is. The pain stems from the buildup of pressure in the middle ear. The degree of pain varies: some ear infections may go unnoticed, while others can be excruciating. The pain peaks in the first twenty-four hours, and rarely lasts for more than a couple of days.</p>
<p>For the longest time doctors believed antibiotics were the only way to treat the symptoms of ear infections. So almost every kid has ingested large amounts of that yummy pink stuff. But this widespread overuse has resulted in a serious problem: antibiotic resistance.</p>
<p>The more often bacteria are exposed to antibiotics, the more resistant they become. Because bacteria reproduce rapidly, these antibiotic-resistant bacteria spread like wild fire. Unlike higher organisms, bacteria can transfer DNA to other bacteria that are not their offspring, and even to members of completely unrelated bacterial species. In effect, bacteria can teach one another how to outwit antibiotics.</p>
<p>And lots of them have pulled an end-run on amoxicillin. In many communities the most common bugs laugh at our savior in pink. Doctors are forced to move on to bigger guns with more side effects and greater risk for resistance.</p>
<p>Increasingly, the standard of care for children with an ear infection is to soothe their pain with acetaminophen or ibuprofen and observe them carefully for signs of persistent  infection. Pain medications are magical (unlike the pink stuff), and give relief quickly. Your kid will go from crying to singing as soon as they take effect.</p>
<p>If the infection doesn&#8217;t resolve on its own in a few days an antibiotic may be called for, but giving your child&#8217;s own immune system a chance to do its thing first is the way to go. The reality is that most ear infections, whether caused by a virus or bacteria, will heal just fine without antibiotics.</p>
<p>Unfortunately, despite the scientific evidence and the new recommendations, many doctors are still heavy-handed with the prescription pad when it comes to ear infections, partly due to their habit of dispensing gallons of pink medicine, and partly due to the pressure they get from moms who just love the stuff.</p>
<p>So next time your little one complains about a painful ear have your pediatrician take a look, but don&#8217;t ask for vitamin A. And if your doctor offers some, ask whether your child really needs it, or if it might be better to wait a few days and see if it that hurting ear clears up without it. If it makes you feel more secure, another option is to take a prescription and hold on to it for 3-5 days to see if the infection heals naturally.</p>
<p>But that takes some willpower. It&#8217;s awfully tempting to grab for the pink stuff, even if it is a lie. The Centers for Disease Control and Prevention says that decreasing inappropriate antibiotic use is the best way to control resistant organisms. To do that, we have to educate patients, parents and physicians about the need to use antibiotics more sparingly. Be strong. Just say &#8216;no&#8217;.</p>
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		<title>Eat, Play, Sleep</title>
		<link>http://askdrmama.com/2010/09/eat-play-sleep/</link>
		<comments>http://askdrmama.com/2010/09/eat-play-sleep/#comments</comments>
		<pubDate>Mon, 27 Sep 2010 20:03:41 +0000</pubDate>
		<dc:creator>Rachel Zahn</dc:creator>
				<category><![CDATA[Parenting]]></category>

		<guid isPermaLink="false">http://askdrmama.com/?p=183</guid>
		<description><![CDATA[Newsflash! Just when we were getting terminally depressed about the rapidly expanding girth of American kiddos, there’s emerging information that offers hope, and lots of it. New research from Ohio State University published in the journal Pediatrics supports a simple, yet elegant prevention strategy for the national explosion of childhood obesity. The study suggests that [...]]]></description>
			<content:encoded><![CDATA[<p><img class="alignleft size-medium wp-image-185" title="FamilyDinner" src="http://askdrmama.com/askdr/wp-content/uploads/2010/09/FamilyDinner-300x235.jpg" alt="" width="300" height="235" />Newsflash! Just when we were getting terminally depressed about the rapidly expanding girth of American kiddos, there’s emerging information that offers hope, and lots of it.</p>
<p>New research from Ohio State University published in the journal<em> Pediatrics</em> supports a simple, yet elegant prevention strategy for the national explosion of childhood obesity. The study suggests that preschool-aged kids have a lower risk of obesity if they regularly engage in three specific household routines: eating dinner as a family, getting adequate sleep and limiting their weekday television viewing time </p>
<p>The study showed that 4-year-olds living in homes with all three routines &#8230; <span id="more-183"></span> had an almost 40 percent lower prevalence of obesity than children living in homes that practiced none of them. The routines were protective even among groups that typically have a high risk of obesity, including children who’s mother is obese, those living below the poverty line, and those growing up in single-parent homes.</p>
<p>This is huge, folks, and it backs up what we’ve been saying over and over. In just three easy steps (well, maybe not easy, but certainly do-able) we can turn this thing around. What does each of these mean to the life of your family, and how can we help make them a habit?</p>
<p><strong>Eat dinner as a family.</strong> For all you soccer, ballet, piano lesson, math tutoring and full-time-job moms out there …I feel your pain, and I know how hard it is to actually make this happen on a regular basis. It seems overwhelming and all but impossible. Sometimes all you can manage on the run is a few baby carrots, a Power Bar and a healthy bowl of my boyfriends, Ben &amp; Jerry, when you get home. I know where you live.</p>
<p>But let me offer a different angle on dinnertime. What if you decided to block out the hours between, say, 6:00 and 7:00 PM for family time? What if you just say “NO” to other activities that cut into that time? What if you start with 2 or 3 nights a week, grab a handful of quick ‘n healthy recipes (RachaelRay.com is a good starting place), and give it a try for a 2 week trial period? Start slow and make sure everyone shows up … you just might get hooked.</p>
<p><strong>Make bedtime count.</strong> We talk about this all the time, and by now you know that kids need plenty of sleep. But how much exactly? Here’s the breakdown, according to WebMD.</p>
<p>1-3 Years Old: 12 – 14 hours per day</p>
<p>3-6 Years Old: 10 – 12 hours per day</p>
<p>7-12 Years Old: 10 – 11 hours per day</p>
<p>12-18 Years Old: 8 – 9 hours per day</p>
<p>This is only going to happen if you set a reasonable bedtime for your guys and make it stick. That means if your 8-year-old 3rd grader needs to fit in, let’s say, 10 1/2 hours of zzz time before his alarm goes off at 7 AM, he’d better be well on his way to REM by 8:30. This may seem impossible if they’ve gotten used to staying up for American Idol and falling into bed exhausted right around the time you do, so don’t try the cold turkey approach.</p>
<p>Start moving school night bedtimes back by about 15 minutes at a time. Keep it there for a few days while they adjust and then take another step back. Repeat until you reach a time that works. If their favorite TV show is a roadblock, vow to tape it for family viewing later or on the weekend. Value added? You’ll find yourself with some alone time you didn’t have before. I say that’s a win-win.</p>
<p><strong>Limit TV time.</strong> I know, I just finished telling you to tape their favorite shows, but those need to be included in a sensible amount of time spent in front of the screen. The American Academy of Pediatrics recommends that kids under 2 years old not watch any TV (no, not even those Baby Einstein videos) and that those older than 2 watch no more than 1 to 2 hours a day.</p>
<p>If this is way out of line with what your kiddos are watching now, try the gradual approach described above for bedtime. Decrease viewing time in a step-wise way until your family goal is reached. Use that extra time for creative, active play — outdoors if possible. Some basic family rules that can help get you there …</p>
<p>Keep TVs out of bedrooms.Turn the TV off during meals. Don’t allow kids to watch TV while doing homework. Treat TV as a privilege to be earned — not a right, and set a good example by limiting your own TV viewing.</p>
<p>And what about video games? That’s screen time too, and ideally it should be included. As a compromise, try replacing some of those sedentary games with Wii Fit or other movement-based ones.</p>
<p>We can turn this crisis of obesity around. Transforming these three simple routines can make all the difference. Try it in your house.</p>
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