Beaumont’s Certified Sitter Class

image credit: Lina Kivaka, Pexels

Beaumont’s Certified Sitter course is designed for boys and girls 10 years of age and older who are interested in babysitting or responsible for younger siblings at home.

This fun-filled course is taught by emergency room staff/American Heart Association instructors.

Over the course of two afternoons, students learn the basics of babysitting, how to advertise safely, and appropriate fees to charge clients. They will also receive five of their own business cards!

We discuss topics include babysitting as a business, growth and development, what to do in case of an emergency, and tips for playtime. 

Students learn that every child is different, and we talk about the needs and likes/dislikes of children from birth to six years of age. Topics include bottle feeding, diaper changing, common illnesses, and basic injuries. Calm and quick reactions to these situations are emphasized and tools to achieve them are discussed.

Playtime is a fun time and we discuss and demonstrate age appropriate toys for all age groups.  Meals and snacks ideas are discussed as well.

This course includes snacks for the students on both days, a starter survival bag, a certificate of completion, and the confidence to get started.

Enroll your child in a Certified Sitter class today.

– Cindy Miller, American Heart Association instructor, is the Training Center secretary with Beaumont Health Royal Oak.

Vegetarian, Keto and More! Your Teen and Dieting

image credit: Oleg Magni, Pexels

Teenagers who choose to diet fall into two categories: health conscious and weight conscious. Each has their own challenges for parents and kids, but recognizing the underlying motivation is important.

Health-conscious teens

Health-conscious teenagers tend to be near normal weight to begin with or may even be on the thin side. They are often athletic and high academic performers. Teenagers who are motivated to eat healthy while still in middle or high school often have high expectations for their own performance in every aspect of life and see changing their diet as another way to be in control of their body and health.

When done well, in a balanced and flexible way, these teenagers are choosing to change their eating habits for the better. Most aren’t primarily motivated to lose weight but rather are interested in becoming healthier.

Most health-conscious teens are opting for a vegetarian or plant-based diet. Healthy vegetarian diets are great when done well. Eating a plant-based diet is fantastic for all of us! Protein is in abundance in grains, veggies, and non-meat sources, so dairy is optional for vegetarians. Parents worry too much about the protein issue for vegetarian teens. I’ve yet to meet a grain-eating vegetarian who is protein deficient. The challenge for teenager vegetarians is to actually eat veggies! Most are just meat avoiders and replace meat with carbs. In order to do a vegetarian diet well, eating mostly veggies and fruits is a must. A multivitamin with iron is also a great idea as is a Vitamin D supplement (at least here in the cloudy Midwest).

Parents can support teenagers interested in a plant-based or vegetarian diet by sending them YouTube videos or getting them short books that are designed for teenagers. Content that is designed to show how easy it is and great the benefits of this way of eating are best. Avoid content that shows the hurdles. Encouragement is the way to go! Send just one or two, as too many will seem overbearing to your teenager who may want to do this on their own.

Health-conscious teenagers sometimes go a little off the deep end though. And because of their tendency to be high achievers, they can get caught up in the specifics of the program. Eating only certain foods, having no flexibility when few options exist, and going without food rather than bend.

If a health-conscious teen has a dual desire to lose weight, the rigidity can get even more extreme, especially if the teen has a compulsive personality. Food restriction and avoidance can result in a sense of control and power that fuels more of the same, especially if weight loss ensues. Behaviors like these are a slippery slope on the path to an eating disorder.

It’s tempting to “remind” teenagers to eat or to ask about protein sources or meal plans when your independent eater is preparing her own meals. Instead, try hard to ask what advice or help they need to succeed. Have your teenager give you a grocery list, prep food together, avoid giving opinions, and instead give praise. Reminders and advice will drive your teenager away and will not get them to eat differently.

Weight-conscious teens

Weight-conscious teens tend to consider other diets when they are in the mood to change their appearance. Like most adults, they wax and wane in their motivation to stick to a diet/eating plan. Most overweight kids have at least one parent who is overweight and it helps for the whole family to adjust their eating habits when an overweight teenager is ready to change their eating habits.

Some diets (e.g., keto, paleo, Mediterranean, vegetarian) focus solely on what a teen is eating. However, options like the Beaumont Healthy Kids Programs and Weight Watchers focus on teaching behaviors to promote and improve lifelong health.

So what is the best option for an overweight teen? To be frank, any of these will result in weight loss and are healthy enough for a teen to follow. Being able to stick to the plan is the biggest challenge. Let your teen choose the one that they think is the best fit for long term success. For example, keto and paleo may be difficult for teenagers to maintain due to the lack of carbs given the carb-laden foods they will be in constant contact with, but if that is the diet your teenager feels is the best fit then let him go for it.

One of the biggest challenges for parents is to support their teenager without managing the diet. Teens who express an interest in changing their eating habits need your help to grocery shop, learn to prepare foods, and to cheer them on when things are going well. Ask them what you can do to support them and then listen to what they say. Teenagers are not looking for advice, reminders or coaching. The more you do that, the more resentment and attitude you’ll get from your teen.

Until a teenager is self-motivated, your efforts to help will only breed resentment. Instead, prepare healthy foods at home and don’t mention eating habits with your teenager. They know what healthy eating looks like and know full well what they are doing isn’t healthy. Your reminders won’t change their behaviors, and if they are overweight, will only make them feel worse about themselves. Even if you are trying to approach the subject from a health perspective, teenagers who are overweight interpret this as another message about how fat they are and feel worse about who they are. When your teenager is finally ready, don’t go overboard, remember they are just like the rest of us — interested in dieting a week or two and then fall off the wagon. Stay patient, loving and let your teenager lead the way.

Parents who are concerned about their teens’ diet choices, behaviors around eating (like restrictive eating), or who recognize that a doctor would be a good person to discuss diet and eating choices, should make an appointment with their pediatrician. We are a great resource for parents and for teenagers who are changing their eating habits—hopefully for the better!

– Dr. Molly O’Shea, a board-certified Beaumont pediatrician, offers traditional medicine in non-traditional ways including newborn home visits and emailing parents directly. She has practiced pediatrics for nearly 30 years and was the “Ask the Pediatrician” columnist for the Detroit News for many years. A journal editor for the American Academy of Pediatrics, she also organized the AAP’s national continuing education programming for pediatricians. Dr. Molly loves cooking, traveling and spending time with her family.

The Hidden Dangers of Teen Dating

My 17-year-old son started dating this year, a lovely young woman who has been a friend since seventh grade. They are both nearly adults in age, but still adolescents in many ways. As parents we discuss everything from sexting to STDs to pregnancy with our son, and I know her mom does the same. We have planted books that contain answers to questions he may be embarrassed to ask. But it honestly never occurred to us to talk to him about domestic violence. He does not witness violence in his home, but he certainly sees plenty of it in the media, from games to YouTube to movies.

Domestic violence – specifically teen dating violence – is not a topic we should ignore simply because it is not part of our experience. Just because a child does not experience violence at home doesn’t mean they are not susceptible to violence – as victims or abusers. Here are some important facts from the Centers for Disease Control:

  • 1 in 11 female teens experienced physical dating violence in the last year
  • 1 in 15 male teens experienced physical dating violence in the last year
  • 1 in 9 female teens experienced sexual dating violence in the last year
  • 1 in 36 male teens experienced sexual dating violence in the last year
  • 26% of women and 15% of men who have experienced domestic violence had their first experience before the age of 18
  • LGBTQIA teens are more likely to experience dating violence than their heterosexual peers
image credit: CDC

Many parents are unaware of these statistics and may also be unaware of how teen dating violence is defined. There are four types:

  • Physical violence – when one partner harms another by hitting, kicking or otherwise physically assaulting them
  • Sexual violence – forcing or attempting to force a partner into performing a sexual act; includes sexual touching but also includes unsolicited non-physical sexual activity such as sexting
  • Psychological aggression – using verbal or non-verbal communication to exert control and/or inflict harm on another person mentally or emotionally
  • Stalking – unwanted attention and contact that is systematically repeated in order to cause fear and attempt to control the behavior and activity of the other person

Some of these behaviors, such as sexting, can start at a very early age. Children commonly get their first smart phone at age 10 and a discussion about sexting needs to happen before their personal phone is placed in their hands. Both boys and girls need to understand what kind of pictures are OK and which are not OK. They also need to understand that unsolicited sexual overtures cause the recipient to experience the same kind of distress and anxiety as if they had been physically sexually harassed.

There are a number of behaviors to look out for if you are concerned your child is experiencing or perpetrating dating violence (from the National Domestic Violence Hotline website):

  • Your child’s partner is extremely jealous or possessive to the point where your child stops spending time with other friends and family. When asked how they feel about this, your child might say something like: She thinks my friends don’t like her, so she doesn’t like spending time around them. Or, she thinks they’re a bad influence on me, and she’s just trying to help.
  • You notice unexplained marks or bruises.
  • You notice that your son or daughter is depressed or anxious.
  • Your child stops participating in extracurricular activities or other interests.
  • Your child begins to dress differently; for example, wearing loose clothing because their partner doesn’t like for them to show off their body or attract the attention of someone else.
  • Your child worries if they can’t text/call their partner back right away because their partner might get upset.
  • Your child expresses fear about how their partner will react in a given situation.

It’s important to stay tuned in to your teen as they make their way in the dating world. Teens who experience abuse or violence in their adolescent relationships are at much higher risk in college and adulthood. Teen victims may experience depression or anxiety; may use drugs to escape; may pass along the violence they experience in anti-social behaviors like lying, shoplifting, bullying, or physically abusing others (younger siblings can become a target); or may experience suicidal ideation or even attempt suicide.

Open a communication channel about healthy relationships with your children starting at a young age. Encourage them to think critically about the health of their friendships as those behaviors form the basis for their intimate relationships. Most of all, be that non-judgmental listening ear so they know that you will love and support them in all aspects of their lives.

For more information and resources, visit the CDC’s Dating Matters website.

– Kathy Henry is the adoptive mom to two amazing young men; a writer and business marketing consultant; and an active volunteer in her public school, Unitarian Universalist church, and community.

What Zit All About? Acne 101

image: Kjerstin Michaela Haraldsen, Pixabay

Blackheads, whiteheads, pimples, and oily skin are the hallmarks of acne. Most of us had our fair share of acne over the years and we heard a lot of advice about how to manage it. From basic advice of washing twice a day with soap to using expensive skin care products you can get delivered to your door every month to prescription medicines, acne remedies abound.

The reason there are so many strategies out there is that acne is embarrassing for teenagers and adults alike. Often the thought of going to the doctor to talk about skin issues (or even bringing up the topic with parents) is too difficult for most teenagers. Parents need to take the lead and ask teenagers if they are interested in doing something about their acne. Some teens are interested in working on their skin while others aren’t.

Before discussing the skin care regimes that work, it makes sense to understand the different components of acne.

  • Blackheads and whiteheads: These are pores that are blocked with debris (i.e., dead skin, oils, bacteria) but don’t have much inflammation (swelling or redness). What makes them black or white is whether the pore is still open (blackhead) or closed at the top (whitehead).
  • Pimples: These are blackheads or whiteheads that have gotten inflamed. Usually they are still close to the skin’s surface so the inflammation (i.e., swelling, redness and pus accumulation) come to a head quickly and resolves. Sometimes pimples will scar but if they are left alone and there are few of them scarring is less common.
  • Cystic acne: These are pimples deep under the skin as well as large inflamed pimples near the surface. What differentiates cystic acne from regular pimples is size of the swelling and depth of the inflammation. Because some of these acne lesions are so deep, they don’t come to a head and those that do are so large that they may leave scars.

Once parents have broached the subject with their tween or teen, what strategies work?

For mild acne that is made up of mostly blackheads and whiteheads and only a few pimples here and there, washing twice a day with a mild soap and using benzoyl peroxide 10% (available in a variety of over-the-counter preparations) once a day makes sense.

Once pimples are the main attraction, benzoyl peroxide probably won’t cut it. Talking to your pediatrician is the best first step. When pimples are the main issue, retinoids in the form of a cream used once-a-day (along with skin hygiene) is the best approach. Retinoids take about eight weeks to work and your teenager’s skin will actually look a little worse before it starts to look better. Once the improvement starts though, it’s a big improvement!

Because retinoids can be harsh on the skin, some doctors start with topical benzoyl peroxide and antibiotic combo creams or gels. These are not as effective but may be enough for mild acne.

Cystic acne is different. Because of its scarring nature and because many of the pimples are so deep, topical management doesn’t work well. Heading the dermatologist makes sense. Accutane is the best management strategy for cystic acne. Even with all of its challenges (including monthly lab tests, appointments, and side effects), this pill is by far the most effective approach. It is taken for nine months or so and then many people need a second course a year or two later for another three to six months. All in all it’s easier than years-long skin regimes and far more effective.

The biggest challenge though in any acne treatment plan is compliance. Many teenagers get frustrated or bored with the skin regime of washing twice a day and applying product. Because so few solutions are foolproof and all require continuous participation to gain continued results, teenagers are at risk for falling off the skin regime bandwagon when results aren’t as good as they had hoped, or when their skin is looking better for a week or so. Either way their lack of commitment is the Achilles’ heel of any approach parents and doctors put forth. That’s why opening the conversation with your teens and getting a real sense of how interested they are in addressing their skin health is key to moving forward.

Many families ask about commercially available skin regimes that they see engaging advertising for. Many of these products do work and if they teen is coming to you engaged by the sales pitch, he or she may be more committed to the regime which is really the “magic” that ensures the success of the product.

As a final comment, let’s cover some common myths and truths about what makes acne worse.

  • Myth: Never use moisturizer on your face.
    • Moisturizing acne-prone skin can get tricky. You want to be sure to choose an oil-free moisturizer. Many products now will even say “non-comedogenic” on the label, which is good sign it’s acne friendly.
  • Myth: Chocolate (or milk, or fatty foods) makes acne worse.
    • Eating a healthy diet and drinking plenty of water is great for your body and your skin. Eating certain foods though won’t make your acne worse. All kinds of old wives’ tales surround food and acne, but research shows that what you eat makes no real difference in how your acne progresses.
  • Truth: Hair products, like gels and hair oils, increase acne.
    • Any oils, gels or even your hair’s own natural oils (if on your forehead all the time) can worsen your acne. If your forehead is your main problem area, keep your hair off your face and keep hair care products far away!

– Dr. Molly O’Shea, a board-certified Beaumont pediatrician, offers traditional medicine in non-traditional ways including newborn home visits and emailing parents directly. She has practiced pediatrics for nearly 30 years and was the “Ask the Pediatrician” columnist for the Detroit News for many years. A journal editor for the American Academy of Pediatrics, she also organized the AAP’s national continuing education programming for pediatricians. Dr. Molly loves cooking, traveling and spending time with her family.

11 health concerns to discuss with your teen

doctor talking with mom and teen

Photo credit: Rhoda Baer, Wikimedia Commons

  1. Nutrition. As teens become more independent, their eating habits frequently change for the worse. Family dinners are replaced by pizza with friends or fast food between extracurricular activities. At the same time, increased social pressures can result in body image issues and eating disorders.
    What parents can do: Continue to stress the importance of fueling your body with good food, stock the refrigerator with healthy options, and model good eating habits. If the teen no longer drinks milk, introduce calcium and vitamin D supplements to strengthen their bones during this time of growth.
  2. Sleep. Teens are sleeping less and less. Between extracurricular activities, school, friends, and electronics, sleep becomes a teen’s last priority. Sleep is very important however and teens need nine hours of sleep a night on average. Not getting that amount is associated with everything from poor school performance to obesity to depression.
    What parents can do: Emphasize regular bedtimes, restrict phone use at night, limit activities, and talk to your schools about later start times.
  3. Exercise. There are kids who struggle with both too much and too little. Athletes who specialize in single sports at a young age suffer from overuse injuries and burnout. Kids who don’t have opportunities for regular exercise struggle with obesity.
    What parents can do: Encourage a goal of at least one hour of aerobic activity every day. For athletes, emphasizing cross-training and breaks can help with injuries.
  4. Vaping. E-cigarette use has been rising exponentially in teens over the past several years. Now, about 1/5 teens have used them! The chemicals in the vapor are toxic, but more importantly, the nicotine in e-cigarettes is highly addictive. It makes it much more likely that they will go on to use cigarettes. It also affects the developing teen brain.
    What parents can do: Talk to your teens early about the dangers of e-cigarettes. For more information on vaping and adolescents, check out this article.
  5. Marijuana. As many states are beginning to legalize marijuana, we are seeing increasing use in teens. They view it as the “safe and natural” drug since it is legal. However, marijuana has significant negative effects on the developing teen brain. It is not safe for kids to use! In addition, many teens are using their e-cigarettes to vape marijuana.
    What parents can do: As with vaping, talk to your teens early about the dangers of marijuana.
  6. Alcohol.Thirty percent of high school students drink so this is a topic you can’t skip. Of particular concern is that many teens are drinking hard alcohol rather than beer and they are much more likely to binge drink. This is particularly concerning because they are much more likely get alcohol poisoning; teens need to understand that drinking strong liquor quickly can be very dangerous. 
    What parents can do: Start discussing this important topic early and consciously model responsible behavior. Timing is crucial as you don’t want to bring it up for the first time as the teen is walking out the door to go to a party. Use a news story, movie or TV show to bring it up in a relaxed atmosphere like dinner. Luckily, teens now are generally much smarter about drinking and driving, but that is still something that should be discussed with every teenager before they get he or she gets a driver’s license.
  7. Acne. Acne is one of the most stressful parts of being a teen. So much of a teen’s identity revolves around his or her appearance. Luckily, there are many options for acne treatment now; they don’t need to suffer through it.
    What parents can do: Let your teen know that acne is not a hygiene issue and that over-scrubbing his or her face can actually make it worse. If over-the-counter medications don’t work, talk to your pediatrician.
  8. Sex. The “birds and the bees” talk is one of the big milestones that your child is growing up. Although it is awkward (for both the parent and the kid), it is critical for your teen to get accurate information from you rather than inaccurate information from friends.
    What parents can do: Giving your teens a book to read beforehand (or together) is a good way to start the conversation. Being open-minded and non-judgmental will go a long way to keeping the lines of communication open between you and your teen for years to come.
  9. Hygiene. Hygiene can be another awkward conversation but is vital to discuss. Some kids figure this out on their own; others need some guidance.
    What parents can do: Let teens know that the changes in their body make it important for them to care for themselves differently. They need to shower every day, use deodorant and wash their clothes regularly.
  10. Bullying. No matter how many educational sessions teens have, after-school movies they watch, rules that guide them, bullying continues to be a big problem. And now with social media, bullies have a whole new and particularly vicious way of tormenting their peers.
    What parents can do: Open the door to conversation by bringing up stories that you hear. Keep a watch out for signs that your teen is being bullied and get help early if you suspect bullying. Beaumont Health’s anti-bullying program, NoBLE, has resources.
  11. Mental health. Many mental health disorders such as depression, anxiety, and schizophrenia present during adolescence.
    What parents can do: Talk with your teen about mental health, especially if there is a family history. Like with bullying, look for signs such as mood swings, change in activity or sleep or appetite, loss interest in friends or activities, or substance abuse. Don’t assume these changes are “normal teen behaviors.”

Many of these topics don’t need a formal, sit-down discussion. In fact, those can make your teen uncomfortable and less likely to hear what you are saying. My favorite way to bring up many of these topics with my teens is in the car using a situation I had heard about. For example, when we were travelling near a college campus, I commented on all the vape shops I saw and mentioned that I was worried about e-cigarette use. My then-12-year-old son reassured me that e-cigarettes were perfectly safe – just water vapor – and that one of his friends got one for Christmas. What?! But that opened the door for conversation and I got a chance to have a really good discussion about vaping.

Good luck! The teen years are both wonderful and terrifying, but before you know it, they will be gone and you will miss them.

– Rita Patel, MD, MPH, is the associate director of the pediatric residency program at Beaumont Children’s Hospital. She is also an associate professor at OUWB School of Medicine.