Dear Mr. Dad: There are a lot of news items these days about how little parents know about what their kids are up to. Take the Florida girl who committed suicide after being bullied. How could the parents of the bullies be so ignorant?
A: In previous columns, I’ve written about the strange phenomenon of parents not recognizing (or admitting) when their children are obese. That willful blindness makes it impossible for those kids to get the help they need. We’ve also talked about how most parents believe that their children are smarter than they actually are. Why are we so in the dark? I think it’s because we want to see only the best in our children—and we ignore anything that challenges our fantasies. Let me give you a few more examples:
- Internet dangers. You’d think that with all the coverage of cyberbullied kids who commit suicide and others who use social media to post their intention to shoot up their school, parents would pay more attention to what their children are doing online. Sadly, the parents of those two Florida cyber-murderers (let’s be honest, that’s exactly what they are), are far from alone. A recent study published in the Journal of Computer-Mediated Communication found that parents often have no ideas of what their kids are doing online until it’s too late. For example, while 30% of young people say they’d been cyberbullied, only 10% of parents said they were aware. And while 15% of children admitted that they were the ones actually doing the cyberbullying, fewer than 5% of parents knew.
- Asthma medication. Most parents of young children who take inhaled asthma medication don’t know what to do to make sure their child takes the medication properly. There are 10 steps parents need to go through. In a recent study of 169 caregivers of children 2-9 who had been hospitalized for asthma and required ongoing asthma treatment, only one knew all of the steps. Out of those 10, five are considered essential, but only four caregivers knew those. Although asthma is quite common, it can be deadly when symptoms are severe enough. And not properly using asthma inhalers means that the child isn’t getting medication he or she needs.
- Infants must sleep on their back. In 1994, the government’s “Back to Sleep” campaign announced that parents should put their babies to sleep on their back, not on their stomach as the previous conventional wisdom dictated. In the years since, the incidence of Sudden Infant Death Syndrome (SIDS) has dropped by more than 50%.However, more than a quarter of parents are still not putting their babies down on their back. According to Eve Colson, lead author of a recent study tracking baby sleep positions, “African Americans still lag behind caregivers of other races by about 20 percent in following this practice.” One of the most important predictors of whether caregivers will put babies down to sleep on their back is whether he or she got a recommendation from a doctor.
- Pregnant women shouldn’t smoke. This one seems obvious, but a lot of women still haven’t gotten the message. Smoking during pregnancy has been shown to increase the pregnancy complications, risk of preterm delivery, smaller fetal and infant size, birth defects, and even infant death. Despite all that, the CDC estimates that the percentage of women who smoke during pregnancy has remained at about 13% for quite some time. The percentages vary greatly by state, ranging from a low of 5.1% in Utah and 6.8% in New Jersey, up to 19.7% in Tennessee and 28.7% in West Virginia. Unbelievable.
Several studies have documented earlier onset of puberty in girls over the past few decades. In a longitudinal study following more than 1,200 girls for seven years, researchers found those with higher BMI had earlier onset of puberty, as measured by breast development, and that white girls are entering puberty at younger ages than previously reported. The study, “Onset of Breast Development in a Longitudinal Cohort,” in the December 2013 Pediatrics (published online Nov. 4), tracked girls in San Francisco, Cincinnati and New York City. The age at onset of breast development varied by race, BMI, and geographic location. In white, non-Hispanic girls, breast development began at a median age of 9.7 years, which is earlier than previously documented, according to the study authors. Black girls continue to experience breast development earlier than white girls, at a median age of 8.8 years, compared to 9.3 years for Hispanic girls and 9.7 years for Asian girls. However, BMI was a stronger predictor of puberty onset than race or ethnicity. Study authors conclude the earlier onset of puberty in white girls is likely due to greater obesity.
Dear Mr. Dad: Last week you talked about some pregnancy myths and you mentioned that expectant mothers should be more worried about putting on too little weight than too much. That makes sense, but isn’t there a limit to how much weight a woman should put on? Before she got pregnant, my wife worked out and we tried to eat a healthy diet. But over the past couple of months, she’s completely let herself go, putting on about 30 pounds—and we’re only halfway through the pregnancy. I’ve tried to gently tell her that she should watch her diet a bit more, but she insists that she’s “eating for two.” How can I get through to her?
A: A woman whose pre-pregnancy weight was in the “normal” range, needs to eat about 300 more calories per day than she did before. That translates into 25-35 pounds, which is the range recommended by most OBs. (Women who were underweight before pregnancy should put on a little more, those who were overweight should put on less.)
Since your wife will get weighed at every OB visit, her doctor will probably be chatting with her about her weight pretty soon. And given that it’s rarely safe for a man to talk to a woman about her weight, that’s a good thing. Still, at the pace she’s bulking up, she’s putting herself and, more importantly, her baby at risk. Unfortunately, she’ll need more encouragement to start cutting calories than her OB alone can provide, which puts you directly in the line of fire.