Paranoid Parenting: Why Ignoring the Experts May Be Best for Your Child

"PF Riley" wrote in message
...
On Tue, 22 Jul 2003 19:56:00 GMT, "JG" wrote:

It's impossible, not to mention costly (time-wise, = inefficient) for
pediatricians to advise their patients' parents about every conceivable
hazard, the awareness of which often arises from freak, isolated
accidents. Wouldn't it be much, much better for them (pediatricians) to
simply encourage (advise) parents to keep a close eye on their young
kids at all times and to acquire some basic life-saving (e.g., CPR)
skills?

Give me a break. You've tried to make this ridiculous suggestion
before. Why you think it's condescending and/or insulting to parents
if I warn against specific hazards but somehow it's not even more so
if I simply "advise" them to "keep a close eye on their young kids" is
beyond me.

Imagine the howls we would read from JGer if the AAP came out with that
policy!

"Today the AAP announced a new recommendation admonishing pediatricians to
remind parents to keep a close eye on their childen. 'The list of specific
hazzards was growing just too darn long, so we are just saying to watch
them. It is much more time efficient that way,' said an AAP spokesperson who
wishes to remain anonymous. In a related story the NIH has decided to do
away with all classificcations of disease favoring the two term system of
'healthy' and 'not healthy' as much more practical........"

--
CBI, MD

"PF Riley" wrote in message
...
On Tue, 22 Jul 2003 19:56:00 GMT, "JG" wrote:

It's impossible, not to mention costly (time-wise, = inefficient) for
pediatricians to advise their patients' parents about every
conceivable
hazard, the awareness of which often arises from freak, isolated
accidents. Wouldn't it be much, much better for them (pediatricians)
to
simply encourage (advise) parents to keep a close eye on their young
kids at all times and to acquire some basic life-saving (e.g., CPR)
skills?

Give me a break. You've tried to make this ridiculous suggestion
before. Why you think it's condescending and/or insulting to parents
if I warn against specific hazards but somehow it's not even more so
if I simply "advise" them to "keep a close eye on their young kids" is
beyond me.

Sure, it's insulting. (*Equally*, not more so: At least you'd be
conveying that you think they're capable of monitoring their kids and
learning
CPR). Instead of "better," I should have simply said "more efficient,"
which is what I assumed people would infer after my statement that
specifying all conceivable hazards is *inefficient*.

It's like when you said I should tell people to avoid
choking hazards but not elaborate lest I insult someone, when what
would typically happen is that the ones who would want me to go into
more detail would be the ones least likely to ask me to for fear that
I would think they're stupid, as my initial failure to go into more
detail would be a tacit implication that they should know such details
already without having to ask.

Holy cow, Riley! First you make assumptions about what parents do and
don't KNOW, and now you make assumptions about what they FEEL (e.g.,
embarrassment). Do they know how utterly arrogant you are? (I suppose
not, huh, since they apparently have to have you do their thinking for
them...)

You think that parents would perceive your "initial failure to go into
more detail" as implying that they *should* know such details? Why
shouldn't/wouldn't they perceive it as your believing that they *DO*
know them, i.e., that you believe (and trust) that they're competent,
informed parents?

Here's an idea. Instead of trying to warn about every conceivable
hazard, which is impossible (except when it comes to obtaining
informed consent for vaccines, according to Roger), why not have
pediatricians glean from their experience the hazards that are
commonly overlooked by parents and frequently result in harm, and
advise selectively on those particular hazards? Oh wait, that's what I
do already.

Fine, go ahead and treat each set of parents differently (selectively),
based upon not only how much you think they need to be told, but also
upon how much you believe they want--even though they're too embarrassed
to ask for--your advice. Let's hope you're never sued for malpractice
by the parents of a deceased patient whose death would likely have been
prevented had they simply followed some piece of advice you *regularly
dispense* to others but didn't (neglected to?) convey to them because
you thought they were "smart enough" to know it. (It wouldn't matter if
you're right--i.e., if they did, in fact, know it--unless you could
prove they knew it.) Your failure to convey the advice to them, in
light of your dispensing it, UNSOLICITED, to others, probably wouldn't
sit well with jurors.

Why not follow Mark's example? Say to parents, "At his age he can eat
anything he isn't going to choke on." You can't possibly believe that
any conscientious-but-"uneducated" parent's curiosity wouldn't be
piqued, i.e., that he/she wouldn't ask, "Such as?" or "What kinds of
things do kids choke on?" At least you have, as Mark pointed out,
covered your ass.

JG

"Roger Schlafly" wrote in message
.. .

"PF Riley" wrote
pediatricians glean from their experience the hazards that are
commonly overlooked by parents and frequently result in harm, ...

When do you give all this advice, anyway? The only time I ever
take my kid to the ped is when she is sick, and then all I ask
about concerns the diagnosis and treatment of the problem.
I would never ask about choking. If I wanted parenting advice,
then I'd consult a parenting book. There are lots of good cheap
books that are a whole lot better than talking to a ped.

I agree. Perhaps PF should "gift" all his new patients' parents with
such a book. (Ooops! That would probably be insulting/embarrassing to
those who are illiterate and ashamed to admit it, huh? g)

JG

"PF Riley" wrote in message
...

So what about the educated, conscientious mom who simply didn't know
about the risk of hot dogs? Was her son's death "necessary" so that
people could learn from her?

(1) "Educated" (...what an utterly bogus word that has become; it means
nothing these days other than someone has completed a course of
training/instruction, whether it be in astronomy or astrology) does not
mean *thinking*.

(2) Merely because the woman never fixed on a (piece of) hot dog
*specifically* doesn't mean she wasn't capable of knowing, and probably
*would* have known, IF SHE'D GIVEN IT EVEN FIVE SECONDS OF THOUGHT, that
her son might choke.

(3) People--adults and kids alike (remember, this kid was *4*) can
choke on just about anything. If he'd choked on a chunk of peanut
butter, his mom would probably have said, "I didn't know you could choke
on peanut butter!" Is she going to insist that she didn't know, AT ALL,
what choking is? Let's say, over the course of her lifetime, she's
either witnessed or heard reports of three individuals who choked on (1)
a bite of steak, (2) some popcorn, and (3) a bite of apple. Is she such
a dolt that she'd think, "It's okay to give my son anything except
steak, popcorn, and apples."? C'mon! Furthermore, would you honestly
expect her to say either, "Yeah, I knew he could choke on a hot dog, but
I gave it to him anyway," or "I didn't think about whether he might
choke on a hot dog"? The latter statement would make her appear
negligent; the former could be interpreted as her being *more* than
negligent. Better, I guess (from a saving-face standpoint), to just
plead ignorance, with the veiled implication that the incident wasn't
your fault; i.e., that it was the fault of those--your son's
pediatrician? the gubmnt?--who didn't "educate" you about hot dogs, who
didn't look you directly in the eye and specifically state, "Your son
can choke on a piece of hot dog."

In answer to your question, no, it was not necessary for her son to die
in order to learn from her. The lesson, though, is to be careful with
any food at any age, not simply that a four-year-old can choke on a hot
dog. (Do you honestly think there are parents who would hear this story
and think, "I guess it's okay to give my kids hot dogs; this kid was
four, and
mine's five [or three]"?)

JG

PF Riley wrote:

And in my experience, the children who only come in when they are sick
and don't come in for check-ups certainly have a poorer outcome should
they develop health problems.

My two year old started throwing up on a Friday morning. No fever, no
rash, no reported pain, just throwing up. On Sunday morning I insisted
the ped x-ray his gut and get a WBC because, "something just isn't right."

I showed up at the doctor's office in grungy sweats, unwashed, worried
about things like obstructed bowel or perforated intestines with
peritonitis or acute appendicitis... the Doctor laughed and asked if had
been reading Robin Cook novels.

BUT HE TOOK ME SERIOUSLY BECAUSE HE KNEW ME WHEN I *WASN'T* INCOHERENT
WITH FEAR. Any other parent would have been told that it was
the stomach flu and sent home without expensive off-hour tests.

But after seeing the white blood count and the distended bowels in the
x-ray we were sent immediately for emergency surgery at regional medical
center. My previous relationship with that pediatric practice saved my
two year old's life.

He had several perforations in his small intestines with peritonitis. The
"something doesn't feel right" was an ileus, which I had never heard of
before and couldn't explain why it felt wrong, but I was correct that his
nausea was different than normal stomach flu. (In a normal stomach flu
you feel better after throwing up for a few minutes. With an ileus you do
not. Four ounces of ginger ale would go down and four ounces of ginger
ale would come back up and he would still be moaning.

I learned many, many things during this kid's illness and recovery, but
one thing I realized for su well baby check-ups served to establish MY
relationship with the pediatrician so that they could believe me when I
told them about zebras.

-- Wendy

"JG" wrote in message t...
"Elizabeth Reid" wrote in message
om...

Though it makes me sound like a curmudgeonly fossil, I honestly
think
kids, *in general*, had it better in the '50s and '60s. I certainly
don't recall any angst-afflicted parents (now they're ubiquitous),
nor
do I recall kids manifesting the
conditions/behaviors--depression, hyperactivity (in
settings/situations
that demanded self-control, such as school or church), short
attention
spans, obesity, insolence--to anywhere near the extent they do
today.

It's sort of interesting; cnn.com's lead headline right now is
'Kids living better, but getting bigger.'

Humph. "Better" is entirely subjective.

I don't think anyone would argue with you that obesity is on the
rise, that's well documented. For the other problems, though, I
can't say for sure whether you're right or wrong, but my training
leads me to distrust recollection as a measure of social change.
For instance, one reason parents are so afraid right now is that
they're convinced that child abductions and molestations are much
more common now than they were during their own childhoods
a few decades ago. This is just plain demonstrably untrue, but
that perception is controlling a lot of parental behavior.

So before we discuss the causes of these perceived changes, I'd
want some evidence other than your memory that they actually
exist.

Look up stats for both legal (prescribed) and illegal drug usage. For
divorce. For teen sexual activity/STD rates. (Okay, so contraceptives
for kids
weren't as readily obtainable in the '50s and '60s...) While you're at
it, look up the stats (you might find some at the BLS; www.bls.gov) for
the number (and demand) for social workers and psychologists. Either
the
"need" (demand) for those in the "caring" professions has increased
exponentially OR individuals are going into these fields and
*creating*/maintaining a (false) demand for their services. (And, lest
anyone be tempted to trot out the tiresome "Well, we're simply better at
diagnosing problems," explanation, forget about it; it's a load
of--excuse
me--crap.)

I would look up stats for drug usage, divorce, and sexual activity
if you'd said anything about those issues in the portion of you
post I was referencing. You didn't. You mentioned increased
incidence of depression, hyperactivity, short attention spans,
and insolence.

Increased reliance on mental-health professionals *might* be
evidence of an increasing rate of mental health problems, but
it might not. The most obvious alternative explanation I can
think of is that there isn't nearly as much of a stigma attached
to getting that kind of help, so people seek it more often. If
you combine that with the decrease in church attendance
(which deprives people of one historic source of quasi-
profesional counseling) it makes reliance on psychologists a
pretty indirect measure.

Not at all! I'm assuming that virtually every parent (likely well in
advance of becoming a parent) is going to hear about a choking incident.
(Hard not to, of course, with 2500+ choking-related deaths a year!) And
who
hasn't, by adulthood, had a food-related choking incident *themselves*,
i.e., one in which the possibility of passing out, if not dying, didn't
briefly
cross his/her mind? I think the average parent can extrapolate; if
they'd stop to think about it, they'd realize that a bite of hot dog is
similar to a piece of carrot, a chunk of fruit, or a piece of popcorn.
(Fact is, people can and do choke on innumerable food and non-food
items.) Saying "I didn't know (a kid could choke on a bite of hot dog)"
is absurd; a believable statement would be, "I wasn't thinking (when I
gave my toddler a hot dog)."

I think the reason people make this mistake is that hot dogs are
soft, while hard candy, peanuts, chunks of raw fruit, etc. are
all hard. Generally, soft food is safer, so I don't think it's
obvious that hot dogs should be grouped in the choking
risk category. I agree that the statement "I didn't know a kid could
choke on a bite of hot dog" is probably not literally true, as
anyone could choke on a hot dog in a bad moment. I suspect what
the parent meant was, "I didn't know that hot dogs were known
to be a particular choking risk for toddlers," and that was
probably true.


which seems really unlikely.
I don't know anyone who strangled on a sweatshirt cord, and to
be honest, without the advice of professionals wouldn't have ever
given it a second thought. To an adult, sweatshirts, the
cords that hang from blinds, buckets with small amounts of
water in them, etc., just don't look all that dangerous. Hoping
that each parent will happen to read a story about a kid dying
from one of these hazards is really inefficient, aside from the
obvious defect that a kid has to die every once in a while to
serve as an object lesson for others to write articles and
tell stories about.

It's impossible, not to mention costly (time-wise, = inefficient) for
pediatricians to advise their patients' parents about every conceivable
hazard, the awareness of which often arises from freak, isolated
accidents. Wouldn't it be much, much better for them (pediatricians) to
simply encourage (advise) parents to keep a close eye on their young
kids at all times and to acquire some basic life-saving (e.g., CPR)
skills? Wendy's drawstring strangling death would have been averted
(had the family members present been keeping a closer eye on the girl),
as would, I daresay, virtually every (especially non-food-related)
choking death.

Of course it's not possible for a pediatrician to advise
parents of every conceivable hazard. That's a straw man, though,
because no one's saying they should. No, I don't think it would
be much, much better for peds to substitute advice to 'simply'
keep a close eye on kids at all times, because most parents do
this already, or think they do. I favor encouraging parents
to keep a close eye on their kids, AND alerting them to specific
common situations in which their kids may be in more danger than is
intuitively obvious.

It's really not practical for most parents to have their eyes
focused on their child for every waking moment of the child's
first few years. Unless one parent is willing to give up
eating, excreting, cooking, cleaning, etc. for four years, or
the child has two parents who don't work who can tag-team (and
of course no siblings, since they might require a moment of
attention), there will be times throughout the day when the
parent's attention is briefly on something else. That's why
virtually all advice to parents about this period stresses never
leaving the child unattended, but also eliminating as many
hazards as possible from the environment so that those
inevitable moments don't result in an injury or fatality.

Beth

"PF Riley" wrote in message
...
On Tue, 22 Jul 2003 19:56:37 GMT, "JG" wrote:

[Ray Bradbury-esque memoirs of a simpler time from JG omitted.]

You don't honestly expect us to accept your own childhood memories as
"proof" that the good ol' days really were better, now, do you?

Of course not. Based upon our memories, however, I think my childhood
was a heck of a lot more "typical" than Wendy's. (Was I shortchanged on
something, other than unpleasant memories, by NOT growing up in a
"dysfunctional" family?)

I offered, in a separate post,
(to which you haven't
responded), some indicators (drug usage, the prevalence of
psychologists/social workers, the rates of divorce and sexual activity
[including abortions and STDs], fitness [obesity]) of the quality of
life (for kids in general) now as compared to the '50s/'60s. Why don't
you address those?

JG

"Elizabeth Reid" wrote in message
om...
"JG" wrote in message
t...
"Elizabeth Reid" wrote in message
om...

Though it makes me sound like a curmudgeonly fossil, I honestly
think
kids, *in general*, had it better in the '50s and '60s. I
certainly
don't recall any angst-afflicted parents (now they're
ubiquitous),
nor
do I recall kids manifesting the
conditions/behaviors--depression, hyperactivity (in
settings/situations
that demanded self-control, such as school or church), short
attention
spans, obesity, insolence--to anywhere near the extent they do
today.

It's sort of interesting; cnn.com's lead headline right now is
'Kids living better, but getting bigger.'

Humph. "Better" is entirely subjective.

I don't think anyone would argue with you that obesity is on the
rise, that's well documented. For the other problems, though, I
can't say for sure whether you're right or wrong, but my training
leads me to distrust recollection as a measure of social change.
For instance, one reason parents are so afraid right now is that
they're convinced that child abductions and molestations are much
more common now than they were during their own childhoods
a few decades ago. This is just plain demonstrably untrue, but
that perception is controlling a lot of parental behavior.

So before we discuss the causes of these perceived changes, I'd
want some evidence other than your memory that they actually
exist.

Look up stats for both legal (prescribed) and illegal drug usage.
For
divorce. For teen sexual activity/STD rates. (Okay, so
contraceptives
for kids
weren't as readily obtainable in the '50s and '60s...) While you're
at
it, look up the stats (you might find some at the BLS; www.bls.gov)
for
the number (and demand) for social workers and psychologists.
Either
the
"need" (demand) for those in the "caring" professions has increased
exponentially OR individuals are going into these fields and
*creating*/maintaining a (false) demand for their services. (And,
lest
anyone be tempted to trot out the tiresome "Well, we're simply
better at
diagnosing problems," explanation, forget about it; it's a load
of--excuse
me--crap.)

I would look up stats for drug usage, divorce, and sexual activity
if you'd said anything about those issues in the portion of you
post I was referencing. You didn't. You mentioned increased
incidence of depression, hyperactivity, short attention spans,
and insolence.

I don't think many (any?) psychologists would argue that there isn't a
correlation between various behaviors--drug usage, promiscuous sexual
activity, insolence, even short attention spans--and depression.
(Indeed, in some persons these behaviors are undoubtedly induced by
depression, while, conversely, these same behaviors, with a different
etiology, might induce depression in others--rather a case of "Which
came first?".)

Increased reliance on mental-health professionals *might* be
evidence of an increasing rate of mental health problems, but
it might not. The most obvious alternative explanation I can
think of is that there isn't nearly as much of a stigma attached
to getting that kind of help, so people seek it more often.

I don't know where you are, but around here there's apparently still a
stigma attached to *kids* who receive counseling/therapy. Indeed, a
group of parents at one local school was so concerned about the
"post-lunch line up" (to receive various drugs, mostly psychotropics
such as Ritalin, I'd imagine) outside the school nurse's office that
they petitioned to have the practice changed. I'd argue that if the
stigma is abating, it's precisely because so many more are receiving
counseling these days; i.e., that the numbers--the increase--came first,
and it's only because so many are now "in therapy" that much of the
stigma is gone. Another factor accounting for some (hard to say how
much) of the increase might well the "pushing"--the marketing
(advertising) to potential users--of various mood-altering
(antidepressant) drugs by pharmaceutical companies. Their ads are
ubiquitous. [Surely I'm not the only one tired of seeing the
"moaning/groaning" UNhappy face--actually sort of an egg-shaped
blob--that turns happy (happy, HAPPY!) and bouncy once it's on whatever
drug (Zoloft, I believe) is being hyped. I wonder how many parents are
influenced by these ads: "You know, Mary just doesn't seem as merry
anymore. Maybe her moodiness is caused by depression. I'll make an
appointment for her to see her pediatrician; maybe he'll be able to give
her something like this Zoloft." (And concurrently recommend
counseling?)]

If
you combine that with the decrease in church attendance
(which deprives people of one historic source of quasi-
profesional counseling) it makes reliance on psychologists a
pretty indirect measure.

According to Barna (perhaps the most prominent surveyor of religious
trends), church attendance has been "on a roller coaster ride" since the
mid-'80s. (See
http://www.barna.org/cgi-bin/PageCat...?CategoryID=10.) It's hard
to say how much of an impact (reduced) church attendance has had on the
rate at which people seek/obtain counseling from social workers and
psychologists.

Other factors that might have led (and be leading) to increased numbers
of kids being counseled/guided include increased coverage of the cost by
third-party payers (Tipper's efforts have paid off) and the increased
accessibility (apart from simply the increase in number) of
psychologists/social workers. As recently as 35-40 years ago, I daresay
the only "counselors" high schools had were "guidance counselors" whose
primary function (apparently) was to "counsel" students regarding such
things as which "track"--college prep, business/secretarial, general HS
education, trade--best suited them and to provide information (e.g.,
college/university catalogs for those intending to further their
education and the names of prospective employers for others) to assist
them in making choices. There were no "on site" social workers and
psychologists (at elementary and junior high schools as well as high
schools); if anything, school districts might have had one of each
working out of the central administration offices.

[...]

It's impossible, not to mention costly (time-wise, = inefficient)
for
pediatricians to advise their patients' parents about every
conceivable
hazard, the awareness of which often arises from freak, isolated
accidents. Wouldn't it be much, much better for them
(pediatricians) to
simply encourage (advise) parents to keep a close eye on their young
kids at all times and to acquire some basic life-saving (e.g., CPR)
skills? Wendy's drawstring strangling death would have been averted
(had the family members present been keeping a closer eye on the
girl),
as would, I daresay, virtually every (especially non-food-related)
choking death.

Of course it's not possible for a pediatrician to advise
parents of every conceivable hazard. That's a straw man, though,
because no one's saying they should.

I rather think PF *would*, if he could (i.e., if he didn't have time
constraints); I believe he has a terribly overblown sense of duty.

No, I don't think it would
be much, much better for peds to substitute advice to 'simply'
keep a close eye on kids at all times, ...

"Better" from the perspective of *efficiency*, not necessarily
effectiveness.

because most parents do
this already, or think they do. I favor encouraging parents
to keep a close eye on their kids, AND alerting them to specific
common situations in which their kids may be in more danger than is
intuitively obvious.

I think perhaps the ideal solution would be for pediatricians to
recommend (or, better yet, *give* to parents...passing on the cost, of
course g) a good, basic "how to raise an infant/child" book. (The AAP
itself even publishes such a book--"Caring for Your Baby and Young
Child:
Birth to Age 5"--as well as a number of other "guide" books (see
https://www.aap.org/sforms/parentresourceguide.htm#5). While there's
no guarantee parents would read them, such a practice would avoid both
stigmatizing "idiot" parents and being perceived as condescending by
"competent" parents.

[...]

JG

"JG" wrote in message t...
"Elizabeth Reid" wrote in message
om...

I would look up stats for drug usage, divorce, and sexual activity
if you'd said anything about those issues in the portion of you
post I was referencing. You didn't. You mentioned increased
incidence of depression, hyperactivity, short attention spans,
and insolence.

I don't think many (any?) psychologists would argue that there isn't a
correlation between various behaviors--drug usage, promiscuous sexual
activity, insolence, even short attention spans--and depression.
(Indeed, in some persons these behaviors are undoubtedly induced by
depression, while, conversely, these same behaviors, with a different
etiology, might induce depression in others--rather a case of "Which
came first?".)

Sure, there are correlations between these things. It's still
really poor evidence for your original assertions. Kids are more
insolent and hyperactive today - as proof, here are some
statistics on teen sexual activity!

Other factors that might have led (and be leading) to increased numbers
of kids being counseled/guided include...

Right. So how is increased counseling evidence of increasing
disorder incidence?

I think perhaps the ideal solution would be for pediatricians to
recommend (or, better yet, *give* to parents...passing on the cost, of
course g) a good, basic "how to raise an infant/child" book. (The AAP
itself even publishes such a book--"Caring for Your Baby and Young
Child:
Birth to Age 5"--as well as a number of other "guide" books (see
https://www.aap.org/sforms/parentresourceguide.htm#5). While there's
no guarantee parents would read them, such a practice would avoid both
stigmatizing "idiot" parents and being perceived as condescending by
"competent" parents.

Stop the presses: we agree!

I'd be fine with that, especialy if the ped also said, "... and feel
free to ask me about any safety concerns," leaving the door open
for parents to get more advice if they wanted it. I don't care
whether the doc speaks the words, I just want the parents to
get the information they need. It might be more effective to
distill the basic advice into a pamphlet (shorter than a book
easier to read) but that's just qa uibble.

I'm curious, though. Do you have any reason to think that anyone
besides you perceives orally delivered safety advice as condescending?
I'm hypereducated about some baby stuff (feeding practices for one
thing) and I've never been insulted when my son's doctor has told
me things I already know, even things I think are common knowlege.
He's not a mind reader, and he doesn't have any way of knowing
which factoids I've encountered and which I haven't. I'm able
to say, "Thanks, I'd heard that," without it ruining my whole
day.

And I don't get why giving a basic book is not insulting, while
giving basic advice is. It'd be a time-saver, sure, but you seem
to be wavering back and forth between objecting to advice because
it's inefficient and objecting to it because it's insulting.
Your solutions to the inefficiency problem seem to up the
insult factor, if anything.

Beth

"Elizabeth Reid" wrote
I'm curious, though. Do you have any reason to think that anyone
besides you perceives orally delivered safety advice as condescending?
I'm hypereducated about some baby stuff (feeding practices ...
And I don't get why giving a basic book is not insulting, while
giving basic advice is. ...

Peds are trained in medicine, not safety. You probably know more
about safety than your local ped. If I take my kid to a ped, then I
am looking for medical advice, not safety advice. Safety advice
is more reliably obtained from books and other sources. The safety
advice from a ped is apt to be silly, wrong, and unwanted.