Archive for the 'Ask the Pediatrician' Category

Five tips for raising emotionally secure children

little girl hugging her dad and a teddy bear

If you read my post on Tuesday, you know I believe that a strong emotional security is one of the most important qualities you can instill in your child. Here are five tips to help you along your journey of bolstering that emotional security.

  1. Consistency. I can’t stress this one enough! Children thrive on routine and consistency because it makes them feel safe and secure in knowing what to expect. This starts in early infancy and carries through into adolescence.

    Consistency on the part of adults is of prime importance. When you act consistently, children know where they and their surroundings stand. Otherwise, children can feel confused and become unpredictable. Always do as you say. Be consistent in your actions and follow through with promises or consequences.

    Children sense chaos, so when things are getting chaotic, I often ask myself, “Am I staying consistent?” If not, I try to regroup and create a sense of routine in any way possible, this helps create a safer, more predictable environment, which in turn helps children feel more secure in the happenings of their lives.

  1. Encouragement. This is simple but very important! Try to let your children know that they are good at things, that they are nice people, and that you like them. It’s important that they know that we don’t just love them, but that we like them. We like being with them, we like spending time with them.

    We generally tell our children when they fail, when they annoy us, or when we feel let down by them, but we may forget to mention the good things. Thus, many children get the impression that they aren’t “getting it right” and can easily feel emotionally insecure and develop a poor self-concept. Remember, success breeds success. Children need to have successful experiences and have their achievements recognized to develop self-esteem and emotional security.

  1. Listen and explore their feelings. Try to accept your child’s reality. If a child is upset or scared about something (regardless of how irrelevant or trivial it may seem to you), accept that this is the real feeling of the child.

    Rather than brushing over the issue/feeling or trying to fix the problem (as we tend to do as parents), dig deeper. In other words, ask what the child is feeling and then help to go through these feelings to either accept or work around the worrying feeling. This can lead to your child’s better understanding of his feelings and teaches good coping techniques. The result: Your child feels more emotionally secure.

  1. Realistic expectations. Keep your level of expectation within the realms of the child’s ability. It is great to challenge our kids to be the best that they can, but keep it realistic. We shouldn’t expect kids to do more than they are capable of achieving. Success is a progression of small steps, not one giant leap.
  1. Lead by example. This is one of my favorites! Children are always watching and listening. It is extremely important to lead by example, in our daily interactions with our partners, our loved ones, our friends, our community. Be aware of how you interact with your children. Be aware of how you interact with others. Listen to yourself. Stay aware that children emulate us and use us as role models.

    Hey, I get it. We are all human and we lose it sometimes. But if you start focusing on what your children are doing or how they are feeling, you may start to see a mirror image of yourself in your children (like a *gasp* “I’ve become my mother” moment). Stay cognizant that we lead by example in our everyday interactions. When our children see us as confident, responsible, loving, mature, and secure parents, they will emulate the way we interact and sense the way we feel. Strive for your own emotional security and chances are your children will sense it and feel more secure themselves.

– Dr. Hannan Alsahlani is a Beaumont pediatrician and proud mother of four girls.

Let’s secure our children’s emotional security

four girls cuddled under blanket

I just kissed my four daughters good night and tucked them into bed. Surrounded by love, cuddles, giggles, and an immense sense of joy, it was a sweet ending to a rough day. I laid down and the first thing that came to mind was emotional security and feeling secure. I’m nowhere close to a perfect mom, I have my ups and downs. Life comes like a tornado at times and then settles down and we see the sun. Today I am seeing the sun and I am grateful for the sunny days.

Then the word security popped up again. I know my children feel secure; I am sure of it. Another thing I am absolutely sure of: As parents we must strive to make our children always feel secure. Not just by telling them they are safe and secure, but by our actions. Regardless of our children’s ages, it’s never too early to implement the sense of emotional security in their lives.

One of the most important qualities you can instill in your children is a deep sense of security in themselves and their world. Secure children grow up to be more confident, resilient, and empathetic, and they persevere in difficult situations.

There are a few things that help nurture my children’s developing sense of emotional security:

  • Security in one’s self. I am capable of taking care of myself. I am in control of who I am and what I want to be.
  • Security in the people around them. There are people in my world who will protect me and be there for me when needed.
  • The way they view the world. My world is a safe place that I can explore with confidence and free from fear.

To feel secure in themselves, children first need to feel secure in their world. If the family feels safe, then the child feels safe and secure. As a child grows up, this sense of security is internalized. We must show our children that unconditional love is unrelated to their actions, appearance, social standing, or achievements. With unconditional love comes emotional security.

I’m not sure I always felt secure growing up. Maybe it is for this reason I’ve been hypervigilant to make sure my daughters felt secure from infancy. I tell them, “You are safe, you are loved, you are special, you are strong, you are fierce, you are unstoppable, and you are capable,” before they sleep at night, when they wake up in the morning, and any chance I get.

I’ll be honest. Today was a rough day for me with lots of stressors and lots of very sick kids at work. When I came home and my daughters hugged me, immediately they could tell it was a rough day. My girls sat me down, asked me to take a deep breath, and together said, “Mommy,  you are safe, you are loved, you are special, you are strong, you are fierce, you are unstoppable, and you are capable,” and then they hugged me.

In that moment I knew I had done something right. Without question, I felt safe, emotionally secure and home again.

As I watch my 6-month-old sleep on her baby monitor, as I peek in on my 2-year-old hugging Mickey Mouse in her crib, and as I kiss my sleeping 8 and 9-year-olds’ sweet sleeping cheeks, I feel relieved knowing they feel secure. And for now, in this moment, I know I am helping them grow into emotionally secure human beings. I truly believe this is one of the greatest gifts I can give them.

You can give your child this amazing gift, too. Check back on Thursday for the second article in this series: Five tips for raising emotionally secure children.

– Dr. Hannan Alsahlani is a Beaumont pediatrician and proud mother of four girls.


We had a lice day

3 girls and a woman at a delousing boutique

Thanks to Elyse Kolender for helping us delouse.

The discovery

After a letter came home about a lice outbreak at the girls’ school, I immediately went to check them out. I stood in the elementary school office checking my girls’ hair, and sure enough, there were little crawling lice and eggs staring back at me. I embarrassingly and mortifyingly looked at the secretary and gave her “The Nod.”

As it turns out, it was a family affair; all six of us had lice! That includes my four daughters (even our 3 month old) and my 45-year-old physician husband. How could this happen to us?! I thought we were so clean! Of course as a pediatrician I knew it wasn’t because we weren’t clean, but as a mom I felt dirty and ashamed. As a mother, my battle with lice ensued, and it oddly, it was more empowering than I thought it would be. We faced it head on. (No pun intended!)

Oh no. We’re now a statistic.

Most people are ashamed of lice. But let’s face it, lice is highly contagious and it shouldn’t be taboo. Did you know that between six and 12 million American children between 3 and 11 years old get lice each year? My family just became part of that statistic. Eeeeew gross! But honestly, it can happen to anyone.

It’s critically important to be open, transparent and educated about all contagious diseases. With lice, it’s not a reflection of cleanliness but rather just how contagious lice is.

As a mom and a pediatrician, my public service announcement is: Please let your school, friends and contacts know if you have something contagious. It will help decrease the spread of the disease and save health, time and money!

Our response

The first step was knowing it was going around; it is fiercely going around in schools right now. The second step was accepting it, facing it, not being ashamed of it and treating it. The third step was very important: We had to tell everyone we had it — brave, I know — but extremely important. So off went the emails and texts advertising our family had head lice and anyone who had contact with us should get checked.

A little about lice

According to the Center for Disease Control (CDC), infestation with head lice is most common among preschool- and elementary school-age children, and their household members and caretakers. However, we are now seeing it in high schools and other places.

Head lice are mainly spread by direct contact with the hair of an infested person. The most common way to get lice is through head-to-head contact with a person who already has it. Some studies suggest that girls get head lice more often than boys, probably due to more frequent head-to-head contact. Common ways to get lice include:

  • playing with others at school or home.
  • activities where your child interacts with others (e.g., sports, playgrounds, camp, slumber parties, etc.).
  • wearing clothing (e.g., hats, scarves, coats, sports uniforms, hair ribbons, etc.) worn by an infested person.
  • using infested combs, brushes or towels.
  • lying on a bed, couch, pillow, carpet or stuffed animal that has recently been in contact with an infested person.

Head lice are not known to transmit disease; however, secondary bacterial infection of the skin resulting from scratching can occur with any lice infestation.

Preventing and controlling the problem

Here are some simple things you can do to help prevent and control the spread of head lice.

  • Avoid head-to-head (hair-to-hair) contact during play and other activities.
  • Do not share clothing (including hats, scarves, coats) or things worn in the hair.
  • Do not share combs, brushes or towels. Disinfect combs and brushes by soaking them in hot water (at least 130° F) for 5 to 10 minutes.
  • Do not lie on soft objects that have recently been in contact with an infested person.
  • Wash things that an infested person wore or used for the two days before treatment. Simply machine wash and dry them using the hot water (130° F) laundry cycle and the high heat drying cycle. Clothing and items that aren’t washable can be dry cleaned or sealed in a plastic bag and stored for two weeks.
  • Vacuum the floor and furniture, particularly where the infested person sat or lay. Spending a lot of time and money on housecleaning isn’t necessary to avoid reinfestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing.
  • Do not use fumigant sprays or fogs. They aren’t necessary to control head lice and can be toxic if inhaled or absorbed through the skin.
  • To help control a head lice outbreak in a community, school or camp, teach your children how to avoid activities that may spread head lice.


Lice is not difficult to identify and there are many options for treatments out there. Talk to your pediatrician about different options for diagnoses and treatment. My family went to a local delousing boutique that kindly got rid of our little friends for us.

After the delousing, we went out to dinner as the cleanest, lice-free family in town. It was only partially embarrassing and peculiar to be out with our shower caps, a night to remember for sure!

After the delousing, we went out to dinner. It was only partially embarrassing and peculiar to be out with our shower caps, a night to remember for sure!

Moving forward

We are officially the cleanest, most lice-free family in our community now. As for you, stop itching (I know reading about it can bring on the itchiness!) and go make sure you don’t have it, too.

Dr. Hannan Alsahlani is a Beaumont pediatrician and proud mother of four officially lice-free girls (Sophia 9, Summer 8, Serene 2, and Solei 4 months).

A few important mottos for parents

Three young girls huddled together

First, I’d like to introduce myself and say I’m so honored to be writing for the Parenting Program blog. I have three girls (that’s them above) and am pregnant with my fourth! (Yes, someone pinch me — four girls!) After 13 years of marriage to an amazing man, rigorous medical training, four difficult pregnancies, and a brain tumor, I picked up a few goals along the way to help keep me healthy, sane and happy.

As a pediatrician for more than 10 years, I’m in awe of the amazing parents I see in my practice every day. They inspire me to strive to be a multitasking, loving, empathetic, energetic mother. All of us as parents are trying our best, and we all want what’s best for our children.

Sure that comes in many shapes and forms, many ups and downs, many trials and errors, but at the end of the day we are all doing our best. And our best is good enough, it really is!

Sometimes that means taking it one day at a time (or even one hour at a time). I’ve also learned that our happiest, most “successful” children aren’t always the smartest or most athletic, but instead they are confident, loved, and emotionally secure children who have healthy relationships with their peers and parents. Those are the ones who go on to do the best in school and life.

Now on to a few important mottos I’ve learned as a parent:

Don’t sweat the small stuff. Life happens, dishes pile up, and laundry never ends. But the special moments with your children are like a blink of an eye. Learn to let go, learn to ask for help, and not feel guilty about it. Why? Your children will remember the moments you played with them more than the spotless house.

Now that isn’t to say we should neglect our duties in the house, but instead, finding a balance will make you a happier, healthier family. Better yet, get the kids involved with the chores; you get help and it helps teach responsibility, pride and appreciation for all that you do in the home and outside the home.

Talk to your children. We often want to shield them from our emotions, forgetting to let them know about our good days and feelings. But sharing our feelings in kid terms (even when you’re overwhelmed) helps children learn empathy. They emulate us and when they see us open up about our feelings with open dialogue, they will tend to feel more comfortable and forthcoming with their feelings as well.

Let go of the guilt. As a full-time working mother married to a full-time working physician father, we constantly struggle with guilt. Seriously, I still cry when I drop my older girls off at elementary school. (Let’s keep that between us, OK?) Whether you work outside of the home or work at home as a full-time parent, we all suffer from guilt in one way or another.

There are days my girls are home sick, but I’m at work taking care of other sick children. I have a commitment to both my children and my patients. Finding the balance isn’t always easy, but I learned to deal with the feelings that come my way. I learned the various sacrifices that need to be made as a physician and mother.

Learn to be kind to yourself and realize none of us are perfect. Every day is delicate balancing act as a parent. We learn to prioritize — sometimes we get it right and sometimes we don’t — but at the end of the day, we survive, learn from mistakes, and celebrate the successes of the balancing act we call “parenting.”

Take care of yourself so you can take care of your family. Oh boy, this is one of my favorites! I’ve learned just how important over the years.

As a mother, I found myself getting burnt out with my children. I hated how I felt when I would snap at them or when they sensed I was short and unhappy simply because I was exhausted and overwhelmed. There were some days I would come home and have absolutely no energy left to interact and I was struggling to find joy with my children.

Then in October 2011, I was diagnosed with a benign brain tumor and temporary lost my vision. I endured spinal taps and treatments just to get back to being healthy. But my role as a parent never stopped; we can’t just “stop” being parents. So the show went on and — although difficult — we managed. This was my aha moment, when I knew I had to change my lifestyle and take time for myself or I wouldn’t be there for my family who needed me most.

A couple smiling

My husband, Ali, and me

I started running (well, at first it was a walk) and five years later, I’m an avid runner. Believe it or not, my husband and I ran over 10 marathons in the past five years together (raising money for pediatric cancer) and more than 40 half marathons. Before then, I never did a lick of running and it has been life changing! It is my “me” time, my thinking time, my healing time, my outlet for my stressors, and a source of joy. The end result: I’m a better mother and physician, emotionally stronger, and healthier mentally and physically.

Morale of that story: Parent burn out is a real thing. Find a hobby you like and run with it (no pun intended). Take moments for yourself, have date night with your significant other, get some fresh air on a walk, turn on some loud music and dance like nobody is watching, read a good book, color, whatever it is — make time for yourself. Your children will thank you in the long run for taking care of yourself. They will learn we become less stressed, less snippy and overwhelmed with them. And the time we spend with them becomes more precious, enjoyable and special.

Final thoughts

Well if you got this far, thank you for reading my very first blog article! I’m looking forward to writing more in the upcoming months. As a pediatrician and mother, I have much to share. Above all, thank you for being the parents that you are and for to raise emotionally happy and healthy children. Remember to be kind to yourselves, you are likely doing a million times better job than you think you are! Happy parenting!

– Dr. Hannan Alsahlani, is a pediatrician, Beaumont Children’s Hospital Residency Program faculty, and associate professor at Oakland University William Beaumont School of Medicine. But my greatest title of all is Mother!

Getting rid of those monsters under the bed

Scared little girl sitting up in bed

Unaltered image. Ben Francis, Flickr. CC License.

Halloween is fast approaching and can be a fun and exciting time, but for some kids it can be very scary. Lots of kids have fears about monsters under their bed or in their closet, and sometimes the shadows at night make frightening-looking creatures that seem alive. With Halloween nearby, there’s a possibility that your youngster may see someone dressed up as a ghost, goblin or zombie. What can you do when the Ghostbusters’ voicemail is full or hasn’t been set up yet? Below are some tips on how to ease your youngsters’ fears and have fun this Halloween.

The 411 on fears

  • Fear can be a good thing. It keeps us healthy by alerting us of dangers and keeping us safe. Without fear we might make poor choices.
  • It’s normal for toddlers and preschoolers to have nightmares and fears. Youngsters struggle with differentiating between what is real and imagined. School-age children are able to distinguish fact from fiction, but may have difficulty grasping the probability of an occurrence. Therefore keeping television and social media coverage of traumatic events to a minimum is helpful.
  • Your youngsters’ fears are real to them even though they may sound silly to you or not make any sense. It’s important to validate their fears and concerns.
  • Talking only to your youngster about their fears will not do the trick. Instead, you have to talk and treat. Kids’ fears can begin to subside when parents do something about those pesky monsters.
  • What if it’s more than fear? Some kids have anxiety, a mental illness that can involve both physical and emotional responses that are disproportionate to the situation. A key determinant if psychological intervention is needed is if there’s any impairment in functioning, such as resistance in going to school or inability to complete routine activities that previously weren’t difficult.

Spells and monster potion

  • Some parents swear by Monster Spray. Decorate an empty spray bottle and fill it with water. Mist your child’s room at night to protect from monsters. Another favorite is the Monster Swatter. Take a fly swatter and decorate it. At nighttime, swat the air a few times to make sure the room is empty. Kids can help with the decoration which can be empowering!
  • Create a spell with your child and say each night like “Hocus pocus, zoom zoom boom, no monsters allowed in David’s Room!”
  • Tie fairy dust (salt or sugar in a plastic bag) to the door knob. Monsters are allergic to fairy dust!

Mind tricks

  • Have your child draw happy pictures and put them all over his room to create a protective monster and all scary things barrier.
  • Pretend to give your child’s favorite stuffed animal magical powers that protects the entire bedroom and closet when your child snuggles close with that stuffed animal.
  • Pretend to tie a magic invisible cape around your child that protects them against all scary things.
  • Get a trash bag and pretend to put the monsters and all scary things in the trash bag while talking back to the monsters. “Get out monsters, you are not allowed in the house.” Then take the trash bag and place it outside the house. Your youngster can help too.
  • Use your pets! Sometimes it may help telling your child that your dog or cat helps protect the house at night and won’t let any monsters inside.

Other ideas

  • Read kid-friendly stories about monsters or watch a movie like Monsters, Inc. This will help prepare your child for Halloween and see that not all monsters are scary or bad.
  • Ask your child what will help make the monsters go away and then oblige. Sometimes your child will know what will work and you won’t have to spin your wheels so much of thinking what to do.
  • Using your religious affiliation may help as well. Reciting favorite scriptures or passages that empower and instill calmness can comfort your child.

Remember that your child’s fears are real and how you handle them is important. Helping your child to manage their fears can be a time to bond, teach great skills, be silly, and have fun all at the same time.

– Carnigee Truesdale-Howard, PsyD, ABPP, Pediatric Psychologist with Beaumont Children’s Hospital Divisions of Hematology/Oncology & Gastroenterology




March is Brain Injury Awareness Month

Model of a brain

Cropped image. Army Medicine, Flickr. CC License.

Concussion is a “hot topic” in the news, but did you know that a concussion is a traumatic brain injury? Traumatic brain injury, or TBI, can be classified anywhere from mild to severe and is often caused by a blow, bump or jolt to the head. There are many misconceptions about concussions, so to test your own (or your child’s) concussion knowledge, try taking this simple true and false quiz.

A concussion quiz for athletes, parents and coaches

How did you do? If either of you need a refresher, everything you need to know about concussion is on Beaumont’s neuroscience page. Don’t forget to watch the video; I make my acting debut!

You can reduce your risk for traumatic brain injuries. Here are 10 tips to get started:

  1. Prevent falls. Falls are the leading cause of TBI, accounting for about 32.5 percent. Safe Kids Worldwide offers some great tips on how to prevent childhood falls.
  1. Ensure your young children are properly secured and in the correct car seat. Recommendations have changed over the years based on research. To familiarize yourself with current recommendations, visit the CDC’s Child Passenger Safety page.

    Beaumont Children’s Hospital offers free car seat safety checks monthly (by appointment only). To have a certified child passenger safety technician check your car seat installation, click here for dates and information on how to make an appointment.

  1. Keep older kids in the rear seat until they are at least 13 years old. Did you know an airbag deploys at 140 mph? Airbags save lives but for younger kids, they can actually cause severe injury and even death.

    Also, never put a rear-facing car seat in front of an airbag. This video shows exactly what can happen to a rear-facing seat in the front. Bonus, you can show your tween how fast the airbag would come out at them if they give you any grief about riding in the back seat.

  1. As a parent, don’t drive distracted! Distracted driving includes alcohol, drugs (including medication that may make you sleepy), texting, talking on the phone, eating and applying makeup.
  1. Have your child always wear a helmet. In addition to sports such as football and hockey, also wear a helmet while bicycling, skateboarding, on scooters (these can hit a rock and flip your child over the handlebars), snow sports, horseback riding, snowmobiles and all-terrain vehicles. Kids often are in a hurry to be more “grown up”, so don’t forget to have the adults always wear a helmet as well!
  1. Anchor your furniture and televisions to the wall with furniture straps. One child dies every two weeks due to tip-overs in the home. Read this article for more information about furniture and television tip-overs.
  1. Never prop an infant seat on top of a shopping cart. According to a report published by The U.S. Consumer Product Safety Commission (CPSC), more than 20,000 kids under the age of five are seen in Emergency Departments each year with shopping-cart-related injuries. The majority of the children, 84 percent, suffer from head and brain injuries. Read more about shopping cart injuries here.
  1. Show your kids the safe way to enter water. Brain and spinal cord injuries occur when diving into shallow or water with an unknown depth. Even far from shore in open water, there could be a large rock or sandbar that’s unknowingly close to the surface. The safest way to enter water is feet first!

    Remember that even simple water play can be dangerous and that it takes less than five minutes to drown. Heading to open water? Brush up on these additional open-water safety tips.

  1. Inspect playground equipment before use. More than 200,000 children are injured on America’s playgrounds each year. That’s one child injured every 2½ minutes! This article has more tips on how to give the playground a “once over” so you can relax and watch your kids play.Additionally the American Academy of Pediatrics (AAP) has a specific policy that advises pediatricians to discourage the use of recreational trampolines. The report shows that head and neck injuries account for approximately 10–17 percent of all trampoline-related injuries.
  1. Have your athletes take a baseline concussion screening before they are injured. Beaumont’s Concussion Health Awareness and Management Program (CHAMP) offers both pre- and post-concussion screenings for athletes and other individuals age 13 and older through ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). It’s important to have a baseline screening on file, so health care providers can determine the best concussion treatment plan.

– Erica Surman, RN, BSN, Pediatric Trauma Program Manager, Beaumont Health System

New Help For Children With Urinary Incontinence

photoIncontinence of any kind can be an embarrassing problem for children and their families. To help combat this condition, Beaumont Children’s Hospital has a new physical therapy program for kids affected by bladder or bowel incontinence.

The Get Rid of Wetness, or GROW, program is for children ages 5 to 17. It is being offered at three Beaumont outpatient facilities in Royal Oak, St. Clair Shores and West Bloomfield. The specialized program includes physical therapists trained in pediatric incontinence and is led by Kevin Feber, M.D., a pediatric urologist. This new program was developed by Rehabilitation Services and Beaumont Children’s Hospital.

About 5 to 7 million children in the United States are affected by pelvic floor dysfunction, which includes daytime urinary incontinence, recurrent urinary tract infections, constipation, bowel leakage and bed wetting.

Incontinence can affect boys and girls of any age, but it is not a normal part of everyday life. It may affect a child’s self-esteem and social interactions.

“We use the latest research and treatments to compassionately address each family’s concerns and symptoms,” Dr. Feber explains. “There is hope. We communicate with your child’s physician to ensure complete care, and we evaluate each child to develop an individualized, age appropriate program to deal with bowel or bladder dysfunction.”

The program involves patient and family education, and noninvasive biofeedback treatment, which focuses on contraction and relaxation of the child’s pelvic floor to learn control of muscles related to incontinence.

“Our program is unique to Southeastern Michigan,” says coordinator and physical therapist, Kristen Maike, adding that it is a collaboration between Beaumont’s pediatric rehabilitation and pelvic floor dysfunction programs.

The therapy requires a doctor’s prescription. The three facilities are open Monday through Friday. Treatment may be covered by health insurance. Social work and counseling services are also available.

For more information, call the location nearest you:
Beaumont Health Center in Royal Oak, at 248-655-5700
Beaumont Rehabilitation Services in St. Clair Shores, at 586-447-4070
Beaumont Medical Center, West Bloomfield, at 248-855-7411


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