Good Fats Needed: Your Child’s Brain and Health

Could government guidelines for a diet low in healthy fats be making our children sick? The numbers and new research suggest this may just be the case. From 2003 to 2011, for instance, ADD/ADHD rates increased by 43%, and continue to rise. The number of kids on antidepressants jumped 50% from 2005 to 2012, with over 7 million children now taking psychoactive drugs.

In 2015, 6 million children in the U.S. were diagnosed with ADD/ADHD and treated with Ritalin, Adderall, and related drugs. While this means that only two out of three kids with diagnosed ADHD are treated, some experts feel that not enough children are being medicated. This is backwards reasoning that fails to look at the cause of ADHD. Over 2.1 million kids in the U.S., meanwhile, are taking anti-depressants, according to 2017 statistics.

There is no sign that trends in these ailments are reversing, but the good news is that there are practical steps you can take to prevent or alleviate these disorders. Adding vitamins and healthier food to your child’s diet will provide essential nutrients that are missing in the Standard American Diet.

SAD daily food plan
Standard American Diet (SAD) daily food plan

New research is discovering nutritional solutions to mental health issues, pointing to vitamin supplementation and better diet as the most effective solution for mental health issues. Studies show that certain fats make excellent antidepressants. Even severe depression and schizophrenia have been successfully treated with vitamins and diet.

The good news is that you can keep kids happy and healthy by changing their diet. Your children can benefit from proven research which is not yet widely known or accepted. The bad news is that you have to be willing to buck traditional nutritional and medical advice.

There are many plusses to treating mental health issues with diet instead of drugs. Let’s compare diet to Ritalin, the most common psychoactive drug given to kids:

Dietary Approach to ADHD:Ritalin:
No side effects.Long list of side effects including nervousness, tics, insomnia, weight loss, psychosis, etc.

 

Lower cost.The cheapest discounted Ritalin will cost about $400 per year for 30-40 mg per day. Full price and higher dosage could easily triple that amount to $1,200.
Long-lasting improvement: Mental health benefits from dietary supplements can last for at least one year after stopping supplements.Ritalin works only for as long as it is taken.

 

 

Before we discuss diet, let’s take a look at how started down this path of declining mental and physical health.

Replacing Fat with Sugar

In the 1970s, the nutrition advice of the U.S. government underwent a radical change in an effort to stem rising heart attack rates in men. Wanting a quick solution, politicians seized on the results of the earliest studies, ignoring researchers who cautioned them to wait until all the data was in. Worse yet, the new nutrition guidelines targeted adult men, ignoring children’s differing needs. The assumption that the new guidelines were safe for all has since been proven incorrect. The diet, moreover, did not prevent male heart attacks.

The new policy recommended eating a carbohydrate-loaded diet and restricting fats, especially saturated fats. People stopped eating animal fats, and ate more sugar, a simple carbohydrate. Manufacturers “improved” tasteless, boring, fat-free snack foods by adding sugar. The resulting products were sold as health food, while butter and fatty meats were said to be dangerous. Sugary foods were even marketed as low-fat and heart-healthy, despite being mostly devoid of nutrients.

Snackwell Devil's Food cookies were low in fats, high in sugar
The Snackwell Effect: high-carb, low-fat cookies touted as a health food

The new food items were a win for food companies because they were cheap to produce and had shelf lives stretching far into the future. Some breakfast cereals were over 50% sugar, while claiming to be good for children. Now that we have adult-onset diabetes in kids under ten, we’re beginning to see that sugar was never just a source of empty “fat-free” calories.

Inexpensive high-fructose corn syrup (HCFS) was first marketed in the late 1960s, and plugged as healthier than sugar, because fructose doesn’t raise blood sugar. But HFCS is 45% glucose, 55% fructose, while table sugar is 50% glucose, 50% fructose. There’s no great difference between the two. And while fructose doesn’t raise blood sugar, it does go straight to the liver, just like alcohol. Children who drink large quantities of sugary soda, use lots of sugar-laden ketchup, and eat sweet treats, may just end up developing non-alcoholic fatty liver disease (NAFLD).

Hidden Sugar

Today the CDC recommends limiting sugars, but other than recommending that kids under two avoid added sugar, fails to specify how much sugar is too much.  We’re used to a sweet edge on food, so manufacturers add sugar to commercial foods to make them taste better. As parents and consumers, we do however, have the right to check packaged foods for hidden sugar and to choose sugarless items.

Avoiding sugar except for rare treats makes sense. According to pediatric researchers, NAFLD is now common among children, affecting 3-12% of children, in general, and occurring in 70-80% of obese children. After 2020, NAFLD will become the most common reason for liver transplants. For kids, and especially teens, obesity creates its own world of mental anguish, as obese kids often face rejection and bullying.

Sugar may create behavior issues, too. Many parents note that children are more manageable on a low-sugar diet. Kids seem to have better focus and concentration without sugar. Sugar may be harming our children’s mental health. Mental health statistics suggest that lowering dietary fats and replacing them with sugar has only made things worse.

The Wrong Fats

Until 1990, McDonald’s used beef fat to make its crispy fries taste hearty. But a consumer advocate group believing the early, flawed research results, waged war on saturated fats. McDonald’s switched to a “heart-healthy” fat for its fries.

The food industry already had an inexpensive answer to the fat conundrum. Crisco and margarine had been around since the early 1900s. These hydrogenated trans fats made from vegetable sources replaced “unhealthful” animal fats. Trans fats were vegan and miraculous for food texture—until 2001, when we found out just how bad they are. Heart inflammation and brain issues such as memory loss are just two side effects of these solid fats.

The food industry switched to liquid vegetable oils. But when repeatedly heated to high temperatures these oils produce dangerous, cancer-causing acrylamides. Eating foods deep fried in these seed oils during pregnancy deters fetal brain development. That means that families eating lots of deep-fried foods are at risk for brain issues.

Because we traded bad fats for worse fats.

Most commercial vegetable oils, for instance canola oil, are unstable seed oils, and are best avoided. Such oils are high in unhealthy Omega 6 fats and low or without beneficial Omega 3 fats. As a rule, if an oil can’t be produced outside of a factory, it is inflammatory. Inflammation is responsible for many harmful disease processes throughout the body.

complicated canola oil production versus simple olive oil extraction puts olive oil in the family of good fats
Canola oil is extracted with multiple chemical processes; olives are simply pressed to release their oil.

Better Fats, Better Brains

If canola oil is bad for your child’s general health and brain health, what fats are good? For non-meat, non-dairy options, coconut oil, cold-pressed extra virgin olive oil, or avocado oil are all good choices. Coconut oil contains medium-chain triglycerides (MCTs) which are great for brain health and mental clarity. Avocadoes are a food source containing healthy fats.

We need healthy fats because the nervous system needs fat for proper function and because the human brain is 60% fat. Brain growth and development reach their full potential when we eat a traditional pre-industrial diet of home-cooked foods. In spite of what we now know, current CDC recommendations still advise a low-fat diet for children.

Cleveland dentist, Weston A. Price, demonstrated a number of the benefits of animal fats in the 1930s. Adding good grass-fed butter to the diet resolved nutrition and health issues in malnourished inner-city children, including tooth decay. These days, the CDC-recommended low-fat diet has left even affluent children malnourished.

Important: Fat-Soluble Vitamins D, A, and K

Parents once gave kids butter and cod liver oil rich in Vitamins D, A, and K, to keep them healthy. We ate fatty foods and foods fried in animal fats. The high-carb, low-fat trends of today’s Standard American Diet have left us literally SAD and reeling from depression. By putting nutritional fats back into the diet we can turn that frown upside down.

Vitamin D

Most people including children are, today, deficient in Vitamin D, a major cause of depression. The two sources of Vitamin D are sunshine and food. When kids play mostly indoors, they lose out on sun exposure. This means kids make less Vitamin D in their skin. Instead, they get their Vitamin D from milk with added Vitamin D2, which is inferior to the D3 we make in response to sunlight or consume from animal sources.

Animal sources are the most bio-available form of D. Bio-availability means that a nutrient source is eaten in the same form that our body uses directly. Non-bio-availability means that a chemical conversion is required, and this usually means a shortfall in that nutrient.

Why do we need Vitamin D3? Vitamin D3 acts as a hormone in the body. It helps us fight viral infections; absorb calcium for growth and maintenance; and regulate blood pressure. The mental wellness effects of D3 were well-known to traditional peoples who prized fatty fish.

Dr. Jay Wortman, a Canadian M.D. and researcher, interviewed an older First Nations man about his traditional diet, which includes oil from the oolichan fish. High in D3 and other fat-soluble nutrients, oolichan oil was described by his grandfather as “your sun in the winter”. In the far north, the mood-boosting effects of the oil are important in the long, dark winter. Another key component of that northern diet is salmon, also a fatty fish. Traditional peoples did not avoid fats; they prized them as health-giving components of a proper diet.

Native American smelting process for oolichan or eulachon fish, a source of healthy fats
Oolichan or eulachon fish were a prized source of healthy fats for the indigenous population. Here they are rendered to extract the fat.

A diet deficient in D3 can mean poor mental and physical health. Correcting D3 deficiency may help fight autism. D3 acts to combat depression. Diagnosing and correcting a deficiency in Vitamin D3 levels should be the first line of treatment for depression. If your child suffers from depression, you will need to tackle the problem with sunshine and outdoor exercise, fatty fish, or D3 drops. You can check recommended sun exposure times for season and location here.

Vitamin A

Vitamin A is another important vitamin that fights infections, and long-term deficiency causes night blindness. A lack of Vitamin A leaves one prone to infectious diseases like pneumonia and measles. Enough Vitamin A means the ability to fight off serious infections. For school kids, that’s a big edge, especially in flu season.

Some think that a low-fat carrot muffin made with vegetable oil has enough beta carotene to provide Vitamin A. But the beta-carotene in carrots and yellow vegetables doesn’t readily convert to enough usable Vitamin A. That does not mean you shouldn’t eat yellow vegetables. It means you need to add a meat source, for instance liver, once a week, to get enough bio-available Vitamin A in your diet.

Start serving liver when children are young, and you won’t have to introduce it later. The secret is not to overcook liver, and to serve it with a smile. If kids won’t eat liver, try flavored cod liver oil for a balanced dose of A, D3 and other essential nutrients.

While Vitamin A is essential, you can get too much, so:

  • Always check dosage information for your child’s age and body weight.
  • Keep your pediatrician in the loop whenever you use supplements.
  • Remember it is always best to get nutrients from food.

Vitamin K2

Vitamin K2 is another key nutrient we are coming to appreciate for its many health benefits. Vitamin K2 has many important and distinct functions.

K2 Functions:

  • Supports brain function
  • Supports growth and development
  • Keeps skin healthy
  • Reduced inflammation
  • Prevents heart disease
  • Maintains bone strength
  • Prevents cancer

Eating foods with Vitamins K2, D3, and A will keep your child in good mental and physical health. We’re still learning about the best K2 food sources.

K2 Food Sources:

  • Fermented foods like natto and sauerkraut
  • Meats, including beef, chicken, and cured meats such as salami
  • Chicken liver
  • Butter and fatty cheeses
  • Egg yolks

Health and dietary trends show that the outmoded low-fat, high-carbohydrate diet recommendations aren’t working. Replacing fats with sugar, damages the health. Yet we stick with poor government advice. Mental health issues, childhood obesity, and diabetes are epidemic. Yet these urgent issues have not made a dent in the anti-fat CDC guidelines. Happily, parents have the power to make food choices for their children.

Real Food and Fats for Better Mental and Overall Health

Simple diet choices can have major impact. Serve kids real foods like eggs scrambled in grass-fed butter instead of breakfast cereal. Use full-fat cheese and olives on a lunch salad, and nourishing meats and fish for dinner. You don’t have to labor for hours, just plan ahead when shopping. Fish and hamburgers each take 20 minutes, tops. Frozen veggies like cauliflower, broccoli and spinach can be cooked with butter and full-fat cream or coconut cream. Blend veggies and cream with an immersion blender and a few seasonings for a hearty, filling soup. Add eggs instead and bake a casserole that can also be packed as tomorrow’s lunch along with a handful of nuts.

Cooking real food doesn’t have to be hard, and kids will find the fats so satisfying and filling that they won’t be looking for overpriced between-meal snacks.

This writer strongly believes that the evidence is sufficient and urgent enough for parents to make bold dietary decisions for their families. Our children’s mental and physical health are at stake. Our national institutions show little interest in revoking long-held and long-discredited nutritional advice. But there’s no time to wait. It’s up to us to protect our children.

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Single Parent Pros and Cons

Single parent households are now so common that more than a quarter of all U.S. children under the age of 21 are being raised by a single parent. Only one in six of these single parents are dads. But the very vast majority of single parents, be they moms or dads, work to put a roof over the heads of their children (and food in their mouths).

It’s a hard road to haul and it’s not always by choice. Some single parents are widowed. Others may have never found that special someone, but were lucky enough to have children. In short, every single parent has a story to tell and it’s bound to be an interesting story at that.

If you’re a single parent, or a parent contemplating the end of a marriage gone wrong, you likely worry about the effects of the single parent home on a child. By having only one parent, are you cheating your child of the stability of a two-parent home? Will your child suffer from having a mom with no dad or a dad with no mom? Or perhaps only part time influence from the other parent?

On bad days, the guilt can be crushing.

Single Parent Freedom

But on good days, perhaps you think how awesome it is to be free to make all the parenting decisions, to have no one undermining your authority, no one confusing your child with conflicting demands. By the same token, of course, when you’re absolutely exhausted from being up with a sick child all night and you still have to go to work in the morning, you may be green with envy of two-parent homes, where someone is available to pinch hit when the going gets rough. You may dream of someone who shares the burdens of cooking and housework and running errands. Someone who picks up the dry-cleaning or goes to that PTA meeting when you just can’t make it.

Melanie Oates can tell you all about both sides of the equation. A single mother to a set of special needs 6-year-old twins—one has autism, the other a rare genetic disorder called Chromosome 7 Terminal Deletion—Oates blogs about her experiences as TwinMomMel. The pros and cons of single parenthood are something Melanie has often contemplated.

Single parent Melanie Oates with her special needs twins Julius and Genell
Single parent Melanie Oates with her special needs twins Julius and Genell

On the pro side, Melanie says, “You don’t have to worry about daily input from the other parent nagging about how you changed a diaper or what you cooked the kids for dinner. You don’t need to worry about your child favoring one parent over the other. That doesn’t exist because you are the main (or only) parent! Also: you get to create all the rules.”

Single parent Melanie Oates with Genell and Julius

But being able to see the positive doesn’t mean that Melanie doesn’t see the downside of single parenthood. Her cons outweigh her pros. “You get burned out quicker because there is no time for you to take off your ‘parent hat’ while the other parent takes over. If you have more than one child, it can be difficult to give each child their own independence because you don’t have another parent to help take one child to soccer practice, while you take the other to dance practice.

The Single Parent: Dating? What’s That?

“Also, as a single parent, if your child is sick, there goes another sick day taken from work since there is no other parent to fall back on. Not to mention: dating (what’s that?), especially if you have special needs children like myself. Good luck with finding a childcare provider that can help while you try to explore the dating world. Even worse, try meeting a ‘Mr. Right’ who actually understands the circumstances at home!” says Oates.

Single parent Melanie Oates with Julius and Genell

For Becky Lockridge, the issue for her two sons was the absence in their lives of a positive male figure. A single mother to two sons, ages 11 and 23, Becky has always been on her own. The lack of a strong male in her sons’ lives is something Lockridge feels keenly. “I tried to fill the void with coaches, godfathers, and big brother types. In the end I do wish my sons had had their fathers actively involved.”

Kate Campion, who blogs at My Sweet Home Life, has experienced it all: shared custody, full custody, and with remarriage, step-parenthood, as well. Like Melanie, Kate loved that there was no one to compete with her parenting style and no one to undermine her parental authority. But Campion suggests some other perks we might not have suspected. “You get the ‘firsts.’ When your child gets home from school, they often tell their news to the first parent they see. By the time their second parent gets home, that report is condensed to ‘I had a good day,’” says Campion. “You are the one with whom they share all the details of their life as it unfolds. It makes your relationships closer.”

Campion also suggests that single parenthood can bring extended family members closer, since a single parent may be forced to rely on extended family for help. On the other hand, says Campion, “You will never be a family unit the way you once were. If you remarry, you will need to navigate the murky waters of step-parenting. When you have a child, you build up a bank of love over the years that you can withdraw from in challenging times. You don’t have that luxury with a stepchild and your new partner will not have that with your children.

The Single Parent: No One to Share the Delight

“Also, as a single parent, there is no one who will share with you the delight of their achievements. When your child performs in a school play, or has a killer time on the sports field, you won’t be able to share in those moments with their dad at the end of the day,” says Kate.

“Finally, you have half the time, half the money, half the energy. Even small things, like when your child is sick, or you have a late meeting at work, are so much harder to manage when you are on your own.”

A single mother of one child, Monique Battiste adds that as a single parent, “There’s not much time to yourself, no dating life (unless you have or can find a sitter), and you feel stretched thin both financially and mentally.  But the hardest part for me, perhaps, is having to answer the question of why the other parent isn’t in my child’s life, why that parent is simply unavailable.”

Single Parent Monique Battiste with her daughter Jianna
Single parent Monique Battiste with her daughter Jianna

Single Parent Blind Spots

Dr. Edward V. Haas, M.D., psychiatrist and author of Transformative Parenting: The Empathic, Empowering Approach to Optimal Parenting and Personal Growth, points out that for the single parent, there’s, “No one to catch you when you are becoming irrational/unreasonable: Sometimes we are irrational. We may have an unrealistic expectation of our child which is leading to frustration and anger. Having another adult with a second opinion can help us see these ‘blind spots’ which interfere with our understanding, communication and bonding with our child.”

Haas also speaks of the dilemma of the single parent in balancing work and home. “Even many couples have difficulty meeting their financial obligations and caring for their children at the same time. Being a single parent can create a severe conflict between being present to care for the emotional needs and wants of their children and working to provide for their needs for food and housing.”

While most single parents see it as a plus that their parenting styles hold sway with no one to undermine their authority, Haas sees this a different way. “A single parent can only teach their way of doing things. People have different strengths and perspectives, children who have two parents can learn different ways of resolving issues and seeing things.”

On the other hand, says Haas, “Single parents can teach their children their way of seeing the world and doing things without the stress of conflict with another parent who may want to teach their child differently. Parents who are inclined to provide more freedom of action to their child do not have to feel conflicted with the other parent who may be more comfortable restricting their child in certain ways, and vice-versa.”

Single Parent Attitude

There is no doubt that the life of the single parent has its hardships and much like any other parenting experience, its triumphs, too. Can single parenthood be better in some cases than the traditional two-parent home? It seems that in many cases, it may be, especially when there’s strife in the marital relationship. But what seems to matter most of all, is attitude. A single parent who makes the effort to see all that is good, while not turning a blind eye to the issues, is a strong single parent: one who is bound to raise a strong, independent and healthy child, no matter the obstacles that develop along the way.

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Underage Drinking: Having the Talk About Alcohol and Brain Health

Underage drinking can get in the way of the developing brain. And anything that gets in the way of the developing brain, for instance underage drinking, can interfere with academic performance. That means that kids who drink may grow up to be unemployed adults. If they don’t, for instance, get killed while driving under the influence of alcohol.

If you managed to follow that train of thought to its logical conclusion, your child can, too. It’s just that most parents haven’t thought to explain it to them, lay it all out on the table. Which is a shame, because doing so may just stop children from taking that first sip of alcohol.

That’s the conclusion of a new survey conducted by market research firm GfK on behalf of Ask, Listen, Learn, a program of Responsibility.org. More than 1,000 parents of children ages 10-17 took part in the November, 2017 survey, the results of which are in a report entitled, A Lifetime of Conversations: Kids, Alcohol, and the Developing Brain, issued just ahead of Alcohol Responsibility Month. The report also includes data culled from other research on the topic of underage drinking, along with important advice and perspectives from experts in the field.

Stunning details in the new report illustrate both how and when parents are having conversations with their children about underage drinking. This information helps us understand how we have managed to achieve a significant reduction in children’s alcohol consumption in the United States since 1991, when experts first began to track the point at which underage drinking begins.

Some conclusions from the report:

More Parents Are Talking the Talk.

The good news is that more parents are talking to their children about drinking alcohol. A majority (76 percent) of parents of children aged 10-17, have in fact, spoken to their children at least once during the past year about underage drinking. That represents an increase of 7 percent since 2003.[1]

Parents Wait Too Long to Have the Talk.

The report suggests that parents may be choosing to be reactive, rather than proactive in their conversations with their children about underage drinking and alcohol. Half of the parents surveyed wait until their children see something about drinking on television or social media, or until asked about underage drinking, before they begin the conversation about alcohol. They may be waiting too long at that: only 2 in 5 parents spoke to kids aged 10-14, though 23 percent of 8th graders (age 13 or so) have already tasted alcohol.

Too Many Parents Think: “My Kid Wouldn’t Drink.”

More than half the parents surveyed, 58 percent, or nearly 6 in 10 parents of children age 10-17, say their children won’t be needing to make any sort of decision about alcohol over the next three months. They think their children are too young to discuss drinking. This flies in the face of underage drinking statistics: 23 percent of 8th graders have drunk alcohol and 53 percent think it would be easy to get alcohol. These particular statistics only increase as children get to high school.

Parents Think Kids Are Too Young for the Talk.

Of parent participants of children aged 10-17 who have not yet spoken to their children about underage drinking, 46 percent say their children are too young to have a talk about drinking alcohol. This figure includes 60 percent of parents with children aged 10-14.

Parents Don’t Think About the Impact of Underage Drinking on Living a Healthy Lifestyle.

Only 15 percent of the parents surveyed listed avoiding underage drinking as a factor in children living a healthy lifestyle. Parents instead prioritized eating healthy foods, getting enough sleep, and staying away from smoking and drug use, as elements critical to living a healthy lifestyle.

Parents Don’t Talk About Underage Drinking and Brain Health.

Parents tend to speak to their children only about the immediate consequences of underage drinking, for instance alcohol poisoning or car crashes. Experts believe that parents should instead be discussing the impact of alcohol on brain development and the long-term effects of underage drinking, for example, memory issues and alcohol dependence. When asked to list reasons children shouldn’t drink, 4 out of 10 parents did not list brain health.

“Parents are the most powerful influence in kids’ decisions not to drink alcohol underage,” says Ralph Blackman, president and CEO of the Foundation for Advancing Alcohol Responsibility, the survey sponsor. “Past research demonstrates that when conversations between parents and kids about alcohol go up, underage drinking rates go down, but there is more that can be done to improve the effectiveness of these conversations.”

Experts like Blackman would like to see parents starting the conversation about underage drinking earlier, and they’d like them to continue the conversation as the child matures. Parents should begin the conversation before children are afforded an opportunity to drink alcohol, which means having that first conversation when a child is around 10 years old. By age 14, many children have already been offered a drink.

Does this mean that most children have been offered a drink by age 15? “No, not necessarily,” says Deborah Gilboa, MD, family physician and youth development expert, who serves on the Ask, Listen, Learn education advisory board. “In fact, the overwhelming majority of kids this age have not tried alcohol. but as kids transition from middle school to high school, their chances of participating in underage drinking increase. According to data from the National Institute on Drug Abuse’s 2017 Monitoring the Future survey, 23 percent of 8th graders have reported drinking alcohol in their lifetime, which increases to 42 percent in 10th grade and 62 percent in 12th grade.

“While there is still work to be done, these numbers have significantly decreased since 1991, partly due to an increase in parent/child conversations around underage drinking. Ideally, parents should discuss the dangers of alcohol, including the impact of alcohol on the developing brain, early and often with their kids, so they truly understand the risks and can feel confident in saying no if approached with an opportunity to drink,” says Gilboa.

But some parents aren’t speaking to their children about alcohol at all. One in four parents surveyed said they either didn’t speak to their children about underage drinking, or can’t recall whether or not they had that talk. That’s a shame: children need to know about these things, about alcohol and its effects. Children are open, moreover, to hearing about what underage drinking can do to them, not just in the short-term, but over time. Learning the facts of what alcohol can do to their developing brains, appears to deter them from ever wanting to try alcohol in the first place, according to the experts.

The upshot: It’s great that more parents are having conversations about underage drinking with their kids, but experts wish they’d put a different spin on these talks, and speak about brain health as being the most important reason to avoid alcohol. “Create a foundation for these conversations with kids by answering their questions simply and clearly at any age, and actively discuss this topic by age nine or ten. At this time, kids are becoming very curious about their growing bodies and brains and are open to learning about how alcohol can impact both.

“Adolescence includes critical phases in brain development. The area of the brain that controls reasoning—helps us think before we act—matures later in the third decade of life. The sooner that parents speak with their children about the dangers of drinking alcohol underage, the better,” says Dr. Gilboa.

Survey Methodology

The Lifetime of Conversations study was conducted online with GfK’s Omnibus, using the web-enabled “KnowledgePanel,” a probability-based tool designed to represent the U.S. general population, not just the online population. The study consisted of 1,000 nationally representative interviews conducted between November 10 and 12, 2017 among adults aged 18+ with at least one child between ages 10 and 17. The margin of error is +/-3 percentage points for the full sample.

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[1] Responsibility.org, Wirthlin Worldwide National Quorum, May, 2003

After the Florida Mass Shooting: PTSD in Teens

Can just listening to the news and viewing disturbing images cause PTSD in teens? This is a question some parents are asking in the wake of the mass shooting at Stoneman Douglas High school, in Parkland Florida. These parents wonder if their teenagers’ sleeplessness, nightmares, and frightening thoughts are more than just strong but temporary reactions to the news. The answer is a definite yes: if your teen is experiencing such symptoms, it could be posttraumatic stress disorder (PTSD), and your child should be seen by a mental health professional.

Florida Mass Shooting

Perhaps thought you’d done as good a job as any parent might do in explaining the awful news coming out of Florida to your teen, but here it is, two weeks later, and your child still can’t get through the night without waking up drenched in sweat and shaking. Is this a genuine mental health issue or is it something that will pass with the healing qualities of time? What should you be doing to support your teen?

Dr. Robin Goodman of A Caring Hand, a nonprofit that specializes in helping children cope with bereavement, confirms that even teens outside of Florida can experience posttraumatic stress disorder as a result of the mass shooting, “We do know that direct physical exposure (witnessing the event or being there) or emotional exposure (knowing someone who was injured or who died) as well as indirect exposure (seeing and reading about the event in the news and on social media) can impact teens and lead to trauma reactions,” says Goodman.

Knowing that teens even far from Parkland can suffer emotional trauma from the fallout of the mass shooting is one thing. But what are the symptoms of PTSD in teens? What should parents be watching for?

Jessica Tappana, of the Aspiring trauma counseling center, says that teens can be impacted by PTSD every bit as much as adults. The difference is that teens may hesitate to reach out to the adults in their lives for help. That means that their parents may not even know their children are struggling. And not all of the complicated feelings teens may experience after a mass shooting like the one in Florida can be labeled as posttraumatic stress disorder.

Healthy Response

“In the immediate aftermath of the traumatic shooting, it is normal to expect youth to be shaken and more anxious. Certainly students returning to Stoneman Douglas this week are going to feel anxious, but youth across the country who have watched the news coverage of Stoneman Douglas and the many “copycat” threats since are experiencing anxiety as well. Some of this nervousness is a normal response to the trauma.

“In the weeks following the trauma, you can expect teens to be processing this anxiety and talking about the trauma; their personal experiences; and their reactions. This is their way of trying to make sense of the experience, and facing their emotions about the situation is actually a healthy response,” says Tappana.

Teens protest the Parkland, Florida mass shooting in TallahasseeSo when does a teenager’s reaction to the traumatic school shooting become an issue of concern?  When do you seek professional help? “If time goes on and your child’s anxiety about the shooting is impacting his or her ability to function, you may want to seek professional help. PTSD develops when the brain doesn’t heal from the trauma and instead sees danger around every corner,” explains Tappana.

“Teens developing PTSD might be avoiding situations that remind them of the school shooting (i.e. school, the news, etc). They may be thinking about the shooting constantly or even having nightmares.

“For teens who were at Stoneman Douglas or who have attended another school where there was a threat, there may be ‘flashbacks’ where it feels like they’re experiencing the threat all over again.  Withdrawing or reacting to everyday situations in an extreme manner can also indicate a problem.

Wait Three Months?

“Traditionally, mental health professionals wait until about three months after a trauma to diagnose PTSD. That said, it’s better to err on the side of caution. Speak to a mental health professional regarding whether counseling might help children process their reactions to the shooting. This is especially true if children’s concerns are interfering with their ability to feel safe at school, interact with peers, or otherwise function on a day-to-day basis,” says Tappana.

Dr. Sal Raichbach of the Ambrosia Treatment Center cautions parents that PTSD isn’t just something that happens to soldiers, “When we think of PTSD, we often think of active soldiers or veterans who have seen wartime and are plagued with flashbacks from the battlefield. But PTSD is a lot closer to home than we think. Any traumatic event can trigger PTSD, from abuse in the household to a school shooting, like the one we’ve witnessed in Florida,” says Raichbach.

But that doesn’t mean that teens are going to experience PTSD the same way as those in the military, or war veterans. “PTSD in children usually differs from that seen in adults, and teens fall somewhere in the middle. Kids tend to reenact their trauma during play or watch for signs that the trauma will recur and try to prevent that from happening. Teens, on the other hand, will often show more aggressive behavior and potentially engage in self-harm or use drugs and alcohol as coping mechanisms.”

Unprocessed Trauma

Why do teens experience symptoms of PTSD after incidents like the mass shooting in Florida? “PTSD is the body and mind’s response to unprocessed trauma. When trauma is processed properly, with enough expression either through shaking in the body, through crying, or through the expression of rage and fear, it becomes ‘resolved.’ This means the body and mind won’t be haunted by the experience forever, which might lead to nightmares, chronic and constant fear, and the feeling of being perpetually unsafe,” says psychoanalyst Claudia Luiz.

Why do teens outside of Florida experience PTSD? It may be because of the extensive and inescapable media coverage of the event. “Research from 9/11 has shown that people can develop PTSD just from watching a traumatic event on television over and over again. Teens have been fascinated by this school shooting more than others because the distressed students have continued to speak out,” explains Dr. Carole Lieberman, author of Lions and Tigers and Terrorists, Oh My! How To Protect Your Child in a Time of Terror, who adds that the most important thing parents can do to help kids with PTSD is to acknowledge their reactions to the event as understandable. “It is important to talk about what happened and to get them to express their feelings about what happened. Ask them if they’re worried that this will happen at their school. Ask if they know anyone who they think has angry feelings and might be ready to explode like Nikolas Cruz. Ask if they know any classmate who has guns. Ask if they themselves sometimes get angry feelings that make them fantasize about hurting people or hurting themselves.

“If they have feelings about hurting others or themselves, get them into therapy. Also, if their symptoms of PTSD don’t resolve on their own in a month, get them into therapy,” says Lieberman.

Practical Tips

Dr. Fran Walfish, a Beverly Hills family and relationship psychotherapist, author, The Self-Aware Parent, and regular expert child psychologist on The Doctors and CBS TV offers the following practical tips for parents:

  • Before injecting too much information into your teen, first ask “What did you hear?”
  • Listen not only to what your teens say, but also pay attention to what they do.
  • Emphasize to your teen “You are safe.” Explain details of the measures schools have already taken to reinforce safety, for instance locking school doors and practicing emergency lockdown drills.
  • A senseless school shooting at their school or anywhere else can make teens (and adults) feel powerless. Give your teen a sense of control by suggesting she write a letter send it to a surviving child or family affected by a school shooting. Or offer to help your teen have a bake sale so she might send the proceeds to the families. These actions are proactive and also offer your teen an opportunity to feel helpful and giving.
  • Limit exposure to TV news, online broadcasts, and social media. Repeated exposure to the violent stories and graphic pictures can re-traumatize your teen.

What if you can’t tell whether your teen is experiencing PTSD or just normal teenage angst? “In my opinion, parents are the first line of defense against mental illness in children. They interact with their children more than anyone else, so they are usually the first to observe signs and symptoms. If you know your child or teen has experienced a traumatic event, talk to them and keep an eye out for any further signs of PTSD,” says Raichbach.

Dr. Goodman adds that teens aren’t the only ones affected by the mass shooting at the school in Parkland, Florida. “Parents must take care of themselves and get their own support so they can best support their teens.”

Ban Best Friends in Schools??

At Prince George’s school, best friends are banned

Should schools ban best friends to encourage inclusivity? British parenting expert Liz Fraser thinks so, but the public wildly disagrees (and so does this author). Fraser cites four-year-old Prince George’s school, Thomas’s Battersea, as setting a positive example for its ban on best friends.  According to the Daily Mail, Fraser, a mother of four, told Good Morning Britain that having a best friend is too “territorial.” “It immediately [separates] this friend out as being different from all other friends, which immediately sets you into a mini group,” explains Fraser.

“Some children don’t have a best friend. I didn’t have a best friend. If I did have a best friend, I think it’s because no one wanted to be friends with us.”

The British expert also asserts that men don’t have best friends (which would appear to contradict the concept of “bros before hoes”).

“Boys don’t have best friends,” said Fraser. “They have mates, whereas girls have a best friend. It’s very territorial, it’s quite possessive, and for me there’s an element of it’s actually not to do with this friendship, it’s more about telling everybody else this is my best friend.

“I think it’s a good idea to try and keep things a bit more broad.”

Two good buddy-roos.
Boys can so too be best friends!

Fraser urges elementary school teachers to encourage children to be friends with groups of children, rather than with just one best friend. But psychologist Dr. Mark Rackley, appearing on the same segment, disagrees, stating that having a best friend teaches children how to form relationships. Moreover, said Rackley, best friends can be crucial for only children, who don’t have the benefit of long-term, supportive sibling relationships.

Viewers agreed with Rackley, with the backlash against Fraser, severe. Some called the idea of banning best friends “ridiculous,” while others called the concept “rubbish” (and worse). The controversy was so huge, it made its way over to the United States, where Dr. Barbara Greenberg weighed in in a column for U.S.News:

“The phrase best friend is inherently exclusionary. Among children and even teens, best friends shift rapidly. These shifts lead to emotional distress and would be significantly less likely if our kids spoke of close or even good friends rather than best friends. And, if kids have best friends, does that also imply that they have ‘worst friends?’ A focus on having best friends certainly indicates there’s an unspoken ranking system; and where there is a ranking system, there are problems. I see kids who are never labeled best friends, and sadly, they sit alone at lunch tables and often in their homes while others are with their best friends.”Two young girls lying on the grass in opposite directions, smiling best friends

Nonsense, says Bryan G. Stephens, in a reader op-ed he contributed to the conservative website Ricochet called, Ban Best Friends?

“Adults deciding who kids get to be friends with? That will not only breed resentment, it will reduce engagement in school. I have seen children without a best friend at school (in 6th grade I was one), and it hurt my performance in school. In 12th grade, when my then best friends and I broke up, I made it a point to find a new best friend, one whom I am still best friends with, so take that, social do-gooders.

“Think of all the friends I ‘excluded’ by having this one.

“To look at it another way, having someone force the kids in 6th grade who did not like me to be my ‘friend’ would have made things 100 times worse. I was already being bullied. Having teachers force apart cliques to include me would have [bred] resentment on their part, and guess who would have [borne] the brunt of their ire?” wrote Stephens.

Little boys, best friends, hugging, facing camera

 

Stephens’ brief defense of best friends had a positive response from readers. So positive that not a single reader disagreed with him. Readers at Ricochet, it seems, saw a nefarious political motive behind the drive to ban best friends in schools. One commenter described such bans as coming from “Big Brother,” with others suggesting the ban on best friends as a construct of the radical left, or in reality, a desire to ban the “free market.”

Like Stephens, this author has been on both sides of the equation. Bullied and excluded in the early years of primary education, then quite popular for a time, with best friends coming and going from 6th grade through high school graduation and beyond into adulthood. To ban best friends would have meant grudging acceptance, which would have caused immense hurt. It would have hindered, not helped my self-esteem to be tolerated.

Best friends, on the other hand, are invested in keeping a relationship going, much as a married couple wants to keep a marriage healthy and strong. It takes work to build and maintain any long-term relationship. Through the months and years, best friends learn to listen to one another and grow. Best friends acquire experience in what makes things worse, and perhaps more important, they learn what makes things better.

Little girl best friends take a selfie

Is there a down side to best friends? Not if you’re teaching children to be kind and nice to everyone. Having a best friend doesn’t mean you have to be mean to, or exclude anyone who is not your best friend.

Children should be taught to include other children at play and in activities so their feelings won’t be hurt. They should either invite all their classmates to their birthday parties or give out invitations outside of school (so the one or two children not invited won’t find out they’ve been excluded). Children should be taught not to mention party invitations within hearing of children who might not have been invited. Empathy for less popular children should be stressed and inclusion encouraged. Children should be asked, “How would you feel if no one wanted to play with you?”

But that doesn’t mean that schools should ban best friends or that children should not form best friend relationships. Being nice to all and having a best friend are not mutually exclusive concepts. Think about it this way: you can be friendly to people and still be committed/married to a single partner/spouse. You can be inclusive and still be exclusive and this is not at all a contradictory idea.

Two teenage girls show joy in each others' company.

Yes. Teach these concepts to children: Be nice to all. Don’t bully or tease less popular kids. Try to include them in your parties, play, and other activities.

But say yes, as well, to BFFs. In allowing your child to have a best friend, you’re giving your child an opportunity. You’re allowing your child to learn how to have a close relationship. This is a crucial life skill.

By having a best friend, your child learns about commitment and trust; how to listen and get past disagreements; and yes, even how to be married and parent children. Long-term relationships—whether with a parent, a sibling, a spouse, or best friend—all involve the same critical skill sets.

Two young girlfriends eating treats on the beach, smiling at each other.

So schools, please don’t ban best friends. A ban on best friends would only keep children from acquiring the experience they need to cultivate and maintain life-partner relationships. A school ban on best friends would eliminate the possibility of experiencing what it means to be extra special to just one person. It would mean not having the chance of gifting that feeling of being extra special to someone else.

And finally, you’d be robbing students of the joy and pleasure of having someone who understands them better than anyone else in the world, in a world that is darned confusing.

Know this: a best friend is an anchor and a rock and a pleasure.

Now why would anyone want to take that away from our children?

Type 1 Diabetes in Children and Teens

Type 1 diabetes (T1D) is a disease that is marked by the body’s inability to manufacture insulin. Without insulin, the body cannot process the glucose from the food we eat. The result is that glucose levels rise dangerously high which can lead to a variety of serious health problems. There is currently no cure for run-of-the-mill diabetes with no complications, but the disease can be managed with daily doses of insulin. Type 1 diabetes affects some 450,000 U.S. children.

Type 1 diabetes is scary for parents of newly diagnosed children and their parents. The disease is unfortunately, all too common. Each year, some 13,000 children are diagnosed with type 1 diabetes in the United States, alone. There’s no magic wand to wave type 1 diabetes away, but the disease can be controlled and managed, with careful attention.

Diabetes affects the way the body uses glucose, which is a type of sugar in the blood. Glucose is a byproduct of the food we eat. Most people use this glucose as the main source of energy to fuel the various functions of the body.

After eating a meal, the body breaks down food into nutrients, such as glucose. These nutrients are released into your bloodstream by way of the gastrointestinal tract. This causes the level of glucose in the blood to rise after a meal. In healthy people, this rise in the level of glucose, or blood sugar, tells the pancreas to make a hormone called insulin, and to release this hormone into the bloodstream.

Type 1 Diabetes and Insulin

In people with type 1 diabetes, however, the body stops making insulin. This makes it impossible for the body to get energy from glucose-producing foods, without help. Since the body can’t use glucose without insulin, glucose remains in the bloodstream, with blood levels of glucose rising higher each time food is eaten.

An easy way to understand the role of insulin is to think of it as a key that unlocks the potential of the glucose we get from the food we eat. Insulin unlocks the “doors” of the blood cells, letting the glucose in. When there is no insulin, it’s like not having the key to the door: the glucose can’t enter the cells. That means the glucose remains in the bloodstream, unused. As blood glucose rises, a number of health problems can occur.

Type 1 diabetes used to be called juvenile diabetes, or insulin-dependent diabetes. This type of diabetes occurs when the body attacks itself, and the immune system destroys the cells in the pancreas responsible for producing insulin. Once these cells are destroyed, the body has no way of making insulin, ever again.

Type 1 Diabetes Causes

No one knows why this autoimmune response, of the body attacking the pancreatic cells that make insulin, occurs. Scientists think it may be partly genetic, running in families. There is probably at least one more factor that causes type 1 diabetes. It could be a virus or something like a virus that causes the body to attack itself.

As it stands, there is no practical way to prevent type 1 diabetes. There is also no way to know in advance who will contract the disease. This means that a child or adult can’t be said to have done something to cause the disease.

Once someone has type 1 diabetes, that person will always have type 1 diabetes. The person with type 1 diabetes will need to treat the disease, every day, for his or her entire life. Children, teens, and adults with type 1 diabetes are dependent on daily doses of insulin to control their blood glucose levels. Insulin is given by injection or with a pump.

Sometimes the symptoms of type 1 diabetes are subtle. It can take a while for a parent to figure out that a child is sick, which means it can take time for the child to be diagnosed with type 1 diabetes. Type 1 diabetes can develop over time, or all of a sudden.

Type 1 Diabetes Symptoms

Here are some common early symptoms a parent might see in a child with type 1 diabetes:

  • Pees large amounts, often. When the body fails to make insulin, the kidneys try to flush out the excess glucose in the blood by causing the child to urinate (pee) frequently and in larger amounts than usual.
  • Extreme thirst. Because the child is peeing so much and so often, dehydration (loss of body fluids) becomes a problem. The child become very thirsty, to offset the drying effect of all that peeing. The child with type 1 diabetes will seem to constantly want drinks. This is an effort to keep body levels of fluids in balance.
  • Weight loss or lack of weight gain as the child grows. The child eats plenty, but is either losing weight, or not gaining as is normal in a growing child. Children and teenagers who develop type 1 diabetes seem to eat more than usual, yet stay the same or lose weight. This happens because the body can’t access the glucose in the body for fuel. The result is that the body begins to use its fat stores, and even breaks down muscle in its effort to feed its starving cells.
  • Tired much of the time. Since the body can’t access glucose for fuel, the child gets no energy from food, and feels tired.

Uncommon Symptoms

Less common early symptoms of type 1 diabetes include:

  • Bedwetting in a child who had been dry at night.
  • A vaginal yeast infection (Candida) in a girl who has not yet reached puberty.

Serious Symptoms

If these early symptoms of type 1 diabetes go unnoticed and untreated, more significant symptoms can occur. These symptoms are the result of a build-up in the blood of chemicals called ketones. When ketones build up in the bloodstream of a person with type 1 diabetes, this results in a serious condition called diabetic ketoacidosis (DKA). The symptoms of diabetic ketoacidosis can be mistaken for those of appendicitis, or the flu. Here are common symptoms of diabetic ketoacidosis:

  • Stomach pain
  • Nausea
  • Vomiting
  • Breath smells like fruit
  • Difficulty breathing
  • Loss of consciousness

Adult Complications

Type 1 diabetes can cause long-term health problems in adults, though not in children. These health issues come with having type 1 diabetes for a long time. Children and teens haven’t had diabetes long enough to have these issues.  The kinds of health problems that comes from having type 1 diabetes for many years, also tend to happen in cases where the person wasn’t doing a good job of managing the disease. Here are some of the common health problems that are associated with type 1 diabetes over the long-term:

  • Heart disease
  • Stroke
  • Kidney damage
  • Vision impairment
  • Various problems with the blood vessels, nerves, and gums

The important thing to know about type 1 diabetes is that it can be controlled, and the risk greatly reduced through proper treatment. It’s also easy to diagnose diabetes through a simple blood test that measures the level of glucose in the blood. Children, and especially teens with type 1 diabetes, may need lots of support and encouragement. They don’t like feeling different than their peers and may take risks with treatment. For this reason, researchers are always looking into new and easier ways of administering insulin, such as the insulin pump.

If your child’s doctor suspects or makes a diagnosis of type 1 diabetes, your child may be referred to a pediatric endocrinologist. A pediatric endocrinologist is a doctor who is a specialist in childhood diseases having to do with the endocrine system, for instance diabetes. The endocrine system is made up of the glands in the body, such as the pancreas. In type 1 diabetes, the pancreas sustains damage and stops producing insulin.

Girl Tests her glucose levels

Children and teens can find it painful or demanding to test their blood glucose. Testing blood glucose involves producing a drop of blood to test for glucose by means of a pin prick. Children can feel the same way about insulin injections as a way of replacing the body’s lack of insulin. It’s also awkward for teens and children to treat their disease when their friends are around. It can be a challenge to find privacy for treating type 1 diabetes, and (insensitive) peers might make them feel uncomfortable about their differences.

Type 1 Diabetes Medical Advances

Medical advances have been made to make treatment of type 1 diabetes easier on children and teens. There is now, for instance, the insulin pump, which mimics the natural way the pancreas reacts to glucose in the bloodstream in healthy people. The insulin pump is a portable device that attaches to the body. The pump delivers a continuous amount of short-acting insulin by way of a catheter that is placed under the skin. The device takes the place of multiple injections over the course of the day. The user also has more control over blood glucose levels because the insulin pump can be programmed to give faster or slower rates of insulin at specified times, such as while the user is asleep. The pump is slightly larger than a pack of cards.

Diabetic teen with insulin pump eating source of glucose

Another device in the works is the artificial pancreas. This device will be implanted or wearable and is an insulin pump that is connected to a device that automatically measures the blood glucose levels at all times.

Not relevant to most children and teens with type 1 diabetes is the major step of a pancreas transplant. While the transplant can cure diabetes, and remove the need for blood glucose monitoring and treatment, the transplant comes with the potential for a host of problems. In general, a person is only considered for a pancreas transplant when there are complications from diabetes, for instance, kidney damage necessitating dialysis. A pancreas transplant is often, in fact, done in conjunction with a kidney transplant. The child who would be considered for a pancreas transplant would be rare, indeed.

While no one thinks it a good thing for a child or teen to develop type 1 diabetes, it is not the worst thing in the world, and certainly not a death sentence. It helps to maintain a positive attitude as you guide your child through learning how to adapt to having a chronic disease. If your child sees you can cope, he or she will understand that everyone has challenges, and the main thing is to meet them face on, with bravery.

Does your child have type 1 diabetes?

How did you feel when you learned your child has type 1 diabetes?

Does your child with type 1 diabetes take risks with monitoring blood glucose levels and treatment? How have you coped with this situation?

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Croup Treatment: The Dreaded Barking Cough

Croup treatment is all about getting that child into a steamy bathroom; using a cool mist humidifier; or taking the child out into the cool night air. These are all effective ways to ease the dreaded barking cough of croup. Other than that, acetaminophen (or ibuprofen for older children) can make the child more comfortable, especially if there’s fever.

Croup Treatment: What is Croup?

Croup is an infection in a child’s upper airway. The infection causes swelling. The swelling makes it hard to breathe. The swelling of the airway also causes the barking cough.

Croup affects children between the ages of 3 months and 5 years. The most common age for a case of croup is at around 24 months. Croup occurs more often in the fall and in early winter. Boys are more likely to get croup than girls. Croup stays contagious for a few days or until the fever is gone.

Croup Treatment: The Barking Cough

Croup is caused by a virus. The virus causes the vocal cords (larynx), windpipe (trachea), and bronchial tubes (bronchi) to swell. It is the swelling of these parts of the upper airway that causes the barking cough, scratchy voice, and high, squeaky, breathing sounds. When the child coughs, air is pushed through passageways narrowed by swelling. The results are a cough that sounds like a seal barking, and breathing that sounds like a whistle (stridor).

Croup is frightening to parents and their children. The good news is that croup usually sounds worse than it is. Most of the time, croup is not serious. Croup can usually be managed at home. Kids with croup tend to recover within 3-5 days.

Croup Treatment: How Croup Begins

We parents know it’s croup when we’re awaked by that dreaded barking cough in the middle of the night. But when we look back on how it all began, a parent may recall that the child already had symptoms of a cold, for instance a stuffed-up or runny nose, and maybe some fever. Once the airways begin to swell, the child’s breathing becomes more difficult. In addition to the whistling noise made when the child breathes in (stridor), you might also see the child’s skin pulling in between the ribs (retractions). In more serious cases of croup, the child may seem pale or blue around the lips, which suggests the child may not be getting enough oxygen.

Croup Treatment: Symptoms of Croup

Croup symptoms tend to worsen at night. The symptoms also worsen when a child is crying and upset. Of course, when your cough sounds like a seal or a dog; you have a fever; and it’s hard to breathe, it’s natural to feel upset and to cry, which only makes things worse. This is why it’s important to appear calm to your child and to make an effort to calm the child down. If your child sees you are calm, he has less reason to be afraid or nervous.

Here are common symptoms of croup:

  • Barking cough (sounds like a seal or a dog)
  • High-pitched breathing (like a whistle)
  • Hoarse, raspy voice
  • Breathing fast
  • Labored breathing
  • Noisy breathing
  • Stuffy nose
  • Runny nose
  • Fever

Children under the age of 3 years have smaller airways. That means their symptoms are likely to be more severe. You can expect your child to have symptoms of croup for three to five days.

Croup Treatment: Causes of Croup

Croup comes in two varieties: viral croup and spasmodic croup. The symptoms of both are the same. Croup is caused by the same sort of viruses that bring on the common cold. The most common virus behind croup is the parainfluenza virus.

There seems to be a seasonal component to croup, since children are more likely to have croup in fall and early winter. Age and gender also play a factor in a bout of croup. Boys get croup more than girls. The peak age for a bout of croup is 24 months. Kids generally don’t get croup after the age of 5 years.

Croup is contagious. Your child may catch a virus by breathing near someone who sneezes. Sneezing can release droplets of virus into the air. That’s why it’s smart to sneeze into a tissue, instead of into the air.

Child sneezes into elbow
Sneezing into an elbow can help prevent others from getting sick.

When someone sneezes into air, the droplets of virus can fall onto toys or other surfaces that children handle. The virus can live on such surfaces for quite a while. If another child should touch a contaminated item or surface, and then touch his eyes, nose, or mouth, a virus may set in.

Even when children use tissues, some droplets of virus can escape. These droplets can end up on the hands or clothes. Teaching children to wash their hands after sneezing is one way to prevent the spread of viruses.

Croup Treatment: Diagnosing Croup

The doctor diagnoses croup by listening to the child’s barking cough, and the high whistling sound of the child’s breathing (stridor). You may be asked whether the child has had any recent cold symptoms such as a stuffy or runny nose, and/or a fever. The doctor may also want to know if the child has had past problems with croup or health issues of the upper airway.Doctor applies stethoscope to child's back.

If symptoms of croup are severe, and don’t respond quickly to treatment, the doctor may order a neck x-ray. If the child has croup, the x-ray will show the “steeple sign” in which the top of the airway narrows to a point.

Croup Treatment: Treating Croup

Croup sounds scary but children tend to quickly get better with home treatment. The main thing is to keep the child calm, since crying and being upset worsens the symptoms of croup. If the child has a fever, acetaminophen can help the child feel better. If the child is older than 6 months, you can offer ibuprofen. Your doctor can give you instructions on dosing: how much, how, and when to give acetaminophen, or for the older child, ibuprofen.

Children with croup feel better when they breathe moist air. You can offer moist air to your child through any of these methods:

  • Run a cool-mist humidifier in the child’s bedroom
  • Run a hot shower in the bathroom (with door closed) until the room fills with steam. Sit there with your child for ten minutes
  • Take your child outside in cooler weather
  • Go for a ride in the car with the windows open a bit to let in the cool breeze
  • Sit with the child near an open window

Make sure your child is drinking lots of liquids. Kids tend to dry out from the coughing, difficulty breathing, and fever. If your child resists drinking, try using a spoon, or even a medicine dropper to offer fluids. Your child should also rest as much as possible.

Some children need stronger measures to combat the symptoms of croup. These children may need to go to the hospital for more intensive croup treatment. Croup treatment in these cases may include a breathing treatment, or steroid medication to lessen the swelling in the upper airway. Sometimes kids with croup will need to spend a short stay in the hospital until their breathing improves.

Croup Treatment: When to Get Help

For most children, croup goes away quickly and everything is once again fine. Some children, however, are prone to complications from croup. Children who were born prematurely, or who have asthma or other lung problems, for example, are more susceptible to complications of croup and may need further croup treatment. Even so, only around 5 percent of children who go to the emergency room for croup need to be hospitalized.

If your child has any of the following symptoms with croup, call the doctor or get immediate medical attention:

  • Makes loud, high-pitched whistling sounds (stridor) both when breathing in and breathing out
  • Breathing sounds are becoming noisier
  • Has trouble swallowing, drools
  • Seems nervous and hyper
  • Is listless, lacks energy, hard to awaken
  • Child’s breathing is faster than usual
  • Child is struggling to breathe
  • The skin around the nose, mouth, or fingernails looks blue or gray (cyanosis)
  • The child is too short of breath to walk or talk
  • You can see the neck and chest muscles pulling in as the child breathes
  • The child is dehydrated (not peeing enough, pee is dark, eyes look sunken, few or no tears when child cries, dry or sticky mouth)

Croup Treatment: Preventing Croup

Defending your child against the viruses that cause croup means staying away from people with colds. It also means washing hands often and well. Teach your child to stay away from people who are sick. Have your child learn to sneeze into the elbow, when tissue is not available.

Has your child had croup?

What helped your child most?

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Spanking? The Jury is in: It’s BAD

Spanking was never proven to be a bad thing, at least not scientifically. That is until now. University of Michigan researchers have looked at the data and finally and absolutely concluded that being spanked as a child may lead to an assortment of mental health issues in adulthood.

This new study was undertaken by Andrew Grogan-Kaylor and Shawna Lee, both assistant professors of social work at the University of Michigan. The work they did in tandem with their colleagues points to spanking in childhood as a form of violence, which leads to mental health issues such as depression, attempts at suicide, and moderate-to-heavy levels of substance abuse, such as alcohol or illegal drug use, later in life.

“Placing spanking in a similar category to physical/emotional abuse experiences would increase our understanding of these adult mental health problems,” says Grogan-Kaylor.

Spanking and Physical Abuse

The researchers noted the similarities between spanking and physical abuse: both involve using force and inflicting pain. Both are linked to similar mental health outcomes. These similarities caused the researchers to wonder whether spanking should be categorized as an “adverse childhood experience.” That would place spanking in the same basket with, for instance, abuse, neglect, and household dysfunction. Household dysfunction would include, among other things, divorce, or a parent in prison.

To a layman, the questions that comes to mind are: are the scientists looking to label spanking as abuse? Could it be that parents who are likely to spank their children are also more likely to use physical abuse, neglect their children, or run dysfunctional households? Just how big a study was this?

Also: can we finally lay this to rest and rule, unequivocally, that spanking is bad? Or is this just some psychobabble being spouted? Must we, as parents, pay attention?

It bears noting here that the study is based on data pulled from the CDC-Kaiser ACE study. “ACE” stands for “adverse childhood experiences.” The ACE study definitely represents a large enough sample to be statistically relevant. The number of participants stands at over 8,300, with an age range of 19-97 years. As for the methodology, the data was gathered by having people answer questionnaires when visiting an outpatient clinic for routine checkups.

Clinic patients were asked how often they were spanked during the first 18 years of life. They were also asked to describe their childhood households and whether an adult had abused them. Physical abuse was defined for the participants as pushing, grabbing, slapping, or shoving. Emotional abuse was described as being insulted or cursed.

Almost 55 percent of those who filled out the questionnaires reported having been spanked as children. Men were more likely to have been spanked compared to women. Minorities, except for Asians, were more likely, compared to whites, to say they’d been spanked.

Spanking and mental health connection according to gender and color
(photo credit: Michigan News)

Participants who reported being spanked as children, were more likely to be suffering from depression and other mental health problems.

What constitutes “spanking” in this study? Is spanking any time the hand is applied to the bottom, whether or not the parent is angry at the time? The researchers came up with this definition: “spanking is defined as using physical force with the intention of causing a child to experience pain, but not injury, to correct or control the youth’s behavior.”

A fair enough definition. But how do we know it’s spanking that is causing the mental health issues later in life and not some other factor? This author put the question to researcher Grogan-Kaylor, who responded as follows: “The question is a great one. The key question is whether we are comparing children who are otherwise alike. That is to say, are we comparing families and children that are otherwise alike with the exception of spanking? Statistical techniques allow us to ensure that we are comparing like to like, and to rule out a number of other alternative factors as possible causes.”

Spanking as “Adverse Childhood Reaction”

Grogan-Kaylor shared with this author two other papers he’d co-authored, The Case Against Physical Punishment, and, Unpacking the impact of adverse childhood experiences on adult mental health. Both papers lend evidence to the theory that spanking can be seen as an “adverse childhood experience,” and therefore causes harm to the child, which may manifest only in adulthood, in the form of mental health issues. The former study illustrates this harm to the child through three theories: the attachment theory, the social learning theory, and finally, the coercion theory.

The attachment theory suggests that a child needs to feel absolutely sure of a parent’s love and care in order to flower. This sense of secure attachment to the parent is founded on parental empathy and sensitivity to children. Spanking then, is a way of responding to a child’s need for attention that erodes the child’s secure attachment to the parent by making the child feel degraded and rejected. Such children can develop feelings of being unworthy, which in turn can lead to depression and anxiety.

The social learning theory has children learning from example. The theory here is that when parents punish children for bad behavior by spanking them, children learn that violence is an acceptable method for correcting the misbehavior of others. Further complicating the message, is the fact that spanking stops the poor behavior, so that children learn that violence is an effective way to control and cope with interpersonal relations and for dealing with social interactions in general. In other words: violence is the way to work things out with people/relationships.

Coercion theory describes a cycle that occurs when the child rebels against the parent’s punishment. The parent may say, “If you don’t stop doing that, I’m going to spank you.”

Spanking: Vicious Cycle

The child may react with hostility to this situation, which causes the parent to “step up his game.” The intensification of the parent’s response comes with anger from the parent, which makes the child more rebellious. This “coercive cycle” continues to worsen until one side gives in. The parent may give up disciplining the child or the child may give in to his fear and pain and do as the parent wishes. In any event, one side “loses” and feels defeated. Defeated, one might emphasize, as opposed to feeling as though a problem has been resolved, or a lesson learned.

The latter paper shared with this author by Grogan-Kaylor does a fairly good job of showing that spanking in childhood is a risk factor for later mental illness independent of such adverse childhood experiences such as neglect; a parent in jail; or divorce. This suggests that spanking should also be included in an expanded understanding of the “adverse childhood experience.” This idea led to the current study, which concludes that spanking is absolutely an adverse childhood experience.

In terms of real life examples of how spanking is or isn’t used as a parent-rearing method, this author has often heard one mother say, “I don’t need to hit my children.”

The implication here is that there are other ways to make children behave, and they don’t involve violence.

Spanking as negative association

Another friend said she spanked her child just once, when her child ran out into traffic. This mother spanked her child out of equal measures of love and fear, out of a desire to preserve her child’s safety. It was a protective, knee-jerk reaction. In spanking her child this one single time, this mother meant to create an association: run into traffic=receive an unpleasant smack on the butt.

That child is today, what seems to be, to this author’s eyes, a well-adjusted adult, with no apparent mental illness. Also, that child never again ran into traffic. Thus, at least on a basic level, the parent achieved her aim: to create a negative association so the child would never repeat the behavior. Would that lesson have been driven home as effectively in any other manner?

There may be a generational factor in parents who did spank and parents who never do. Today, there is a greater awareness of abuse in all its forms. A parent may be reluctant to spank due to the perceived association between spanking and physical abuse. Back in the 1980’s, however, there was much less awareness of abuse and its effects. Even today, this is study is groundbreaking in that it suggests that spanking actually hurts children in terms of their future mental health.

Lead author of this study, Tracie Afifi, associate professor at the University of Manitoba, suggests we too often think about child abuse and its prevention, but not so much about harsh parenting. Afifi believes we need to put thought and effort into preventing this sort of parenting before it occurs. “This can be achieved by promoting evidence-based parenting programs and policies designed to prevent early adversities, and associated risk factors,” says co-author Shawna Lee, who is also a faculty associate at the U-M Institute for Social Research. “Prevention should be a critical direction for public health initiatives to take.”

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Energy Drinks and Bars: Deadly Teenage Treats?

Energy drinks and bars attract teenagers by holding out twin promises of increased strength and ability on the playing field, and better concentration in the classroom. These food products are especially appealing to teenagers, since they never get enough sleep. When teens wake up late for school, they don’t have time for breakfast.

Even when teens have the time to sit and eat breakfast, energy drinks and bars attract, because they need no preparation. Teens don’t even need to sit down to eat or drink them. You open them up and hold them in one hand. Teens can eat or drink them as  they walk to school.

Teens may know that energy drinks and bars are not as nutritious as a home cooked meal, and still, readily purchase these treats. They figure it’s better they use these products than starve. The problem is, energy drinks and bars may not be better than going hungry, because they may actually be dangerous.

Energy drinks, for instance, may contain large doses of caffeine. The caffeine may give teens a feeling of increased alertness. When that feeling wears off, the teen may drink another one. At a certain point, the teen is developing a dependence on caffeine. Caffeine can be dangerous to the health, and in large amounts, may even cause heart attacks.

Energy bars may be loaded with sugar. The result of eating sugar-laden energy bars is a sugar high, followed by a crash. The sugar high makes the teen think the energy bar is giving him energy. When the crash comes, the teen does the logical thing and eats another energy bar. Without realizing it, he’s using sugar like a drug.

But the convenience of energy drinks and bars is irresistible. They’re more nutritious than a bag of corn chips or a candy bar, and they’re so convenient. Not to mention: they taste good, too.

So how do the experts come out on energy drinks and bars for teens? Are they danger in a convenient package or are they safe as long as teens don’t overindulge? It seems the important thing to do is to become educated consumers. We need to read the labels and research the ingredients and educate our teenagers to do so, as well.

Here is some information about common ingredients in energy drinks and bars and some pros and cons for using these products:

Obesity and Energy Drinks and Bars

Energy drinks and bars are loaded with sugar and calories. The rate of obesity in teens, meanwhile, has more than doubled over the past three decades. Using energy products is only going to contribute toward excess weight gain, and may also lead to tooth decay. Teenagers who are heavy into high-intensity sports such as weight training or football, on the other hand, do burn more calories. For these teens, the occasional energy drink or bar does no harm and may even supply the extra energy they need to perform.

Caffeine and Energy Drinks

Energy drinks aren’t just loaded with sugar. They’re also filled with caffeine. Drinking one may give teens the jitters, tummy aches, headaches, and insomnia. But drinking more than one can be deadly.

On April 26, 2017, David Allen Cripe, a 16-year-old boy, died after drinking three caffeine-laden drinks within the space of two hours. He drank a cafe latte at 12:30 PM, followed by a large Diet Mountain Dew and an energy drink. Cripe collapsed at school at 2:30 PM and by 3:40, was pronounced dead.

David Cripe didn’t have a heart problem. He hadn’t been drinking alcohol or using drugs. What happened is as simple as this: the amount of caffeine in those three drinks, drunk within a short time span, made his heart give out.

At a press conference following the teenager’s untimely death, South Carolina’s Richland County Coroner Gary Watts said, “Parents, please talk to your kids about the dangers of these energy drinks.”

The caffeine in energy drinks can cause the heart to beat irregularly or too fast. Caffeine can cause the blood pressure to spike, and in large amounts, may even cause hallucinations or seizures. That’s in perfectly healthy teens with no preexisting medical conditions.

Now let’s say a teen starts out drinking one energy drink a day. Then it seems not to have the same effect. So he drinks one before lunch and another before football practice after school. This suggests the teen has begun to develop a tolerance to the effects of caffeine. The teen may drink more energy drinks to get the same boost in energy, until the point where, like Cripe, he’s taking in much too much caffeine within too short a span of time—to the point where his energy drink habit becomes life-threatening.

Do speak to your teen about the danger of energy drinks. If your child used to drink one energy drink and now drinks two, it’s time for him to change his habit. One way to do that is to add water to dilute the energy drink, rather than drink a second one.

Energy Drinks Vs. Sports Drinks

Teens should also be taught that energy drinks are not the same thing as sports drinks. Sports drinks hydrate the body. Energy drinks do the opposite. The caffeine in energy drinks acts as a diuretic, pulling moisture from the body. Put simply: energy drinks dry you out. If it’s hydration he needs, your teen would do better drinking from the water fountain at school.

Other Dubious Ingredients

Caffeine and sugar may be the culprits most familiar to teens when they’re reading the labels of energy drinks and bars (if they read them at all). But there are other substances that are found in these products. Substances like guarana, taurine, yerba mate, and ginseng have been found in energy drinks and bars. Guarana and yerba mate contain caffeine, taurine is an amino acid that may increase the effects of caffeine, and ginseng isn’t regulated by the U.S. Food and Drug Administration (USFDA). Research into ginseng is not conclusive, as there are many types of ginseng, and studies aren’t always clear about the type of ginseng investigated.

Teens should be wary of the food products they purchase. If a product contains an ingredient they haven’t heard of, they shouldn’t buy the item without further research. This warning is doubly important for teens who have chronic health issues or who take regular medications that might interact with an ingredient in energy drinks or bars.

Proprietary Secrets? Nah.

Energy drinks and bars may claim to have all manner of special or secret ingredients. But there’s nothing all that secret or special about these ingredients. The mineral chromium, for instance, is found in some energy items. Chromium can help regulate blood sugar by increasing insulin sensitivity. When you control blood sugar, in theory, you may be regulating body energy. You don’t need to buy an energy drink, however, to get chromium. The mineral is found in beef, broccoli, and bananas.

One popular sports drink combines amino acids with a kind of lactic acid, which produces alpha L-polylactate, said to help athletes sustain energy and lessen fatigue during endurance training. The presence of alpha L-polylactate proves the point that this drink is meant for athletes rather than regular, ordinary teens. Some studies have shown that this compound can cause stomach problems.

Drinks like Red Bull and the like, often contain inositol and taurine. These ingredients aren’t specific to these drinks, nor do they have any special powers. Our bodies do a fine job of making both inositol and taurine from the food we eat. Inositol is found, for instance, in brown rice, corn, and beans. Taurine is found in meat, chicken, fish, and eggs.

Mixed Results

Some energy drinks are infused with rhodiola rosea, sometimes in combination with cordyceps mushroom. Rhodioloa rosea is an herb said to fight fatigue and improve mental and physical performance. But little is known about the herb and the results of studies are contradictory. The cordyceps mushroom has likewise not been well investigated by researchers. Some experts feel that cordyceps mushroom can provide an energy boost to young athletes.

Energy Treats Cost Big Time

It’s important to note that energy drinks and bars are more expensive than soft drinks or granola bars. The companies that manufacture energy drinks and bars figure they can charge more because their products supposedly have special ingredients with special effects. A teen may spend $3 on an energy bar, when he might have spent less money and received more nutrient value by buying and eating a whole grain bagel with cream cheese.

Meal Substitute?

Teens may grab energy bars because they think they have the same nutrition as breakfast or dinner. But while the bars may contain the same number of calories as breakfast or dinner, they don’t offer the same nutritional value or satisfy in the same way as a real meal. Illustrate this by asking your teen to think how he feels after a nice meal. Then ask him to pay attention to how he feels the next time he eats an energy bar. Teens should never opt to replace meals with energy bars if they can possibly help it.

It’s hard for teens to resist the marketing hype behind those energy drinks and bars. If a teen is feeling tired and hungry, a flashy package promising energy may seem like a good bet. That is why parents have to educate their teens about marketing and reading labels.

Teens must be taught that food products can’t make them better athletes or perform better in class. Doing well on the playing field or in the classroom depends on doing the work. Teens need exercise, sleep, study, and good nutritious food. There’s no such thing as a little something extra a teen can buy to perform better.

It’s pretty simple, actually. When teens and other people lead healthy lives, they feel good and have lots of energy. If they’re doing everything right and still don’t feel energetic, then it’s time to get a checkup. An energy product is never the right answer.

Devil’s Advocate

To play devil’s advocate, not all energy drinks are created equal. Some will keep teens going longer than others. Those based on sugar and caffeine may give teens a surge of energy. The rush from consuming sugar can last from 30 minutes to an hour, while the rush from caffeine can last up to around two hours. Then comes the crash and a serious loss of energy.

Energy bars containing complex carbohydrates, on the other hand, will help provide more of a lasting boost, which is useful for endurance sports. This is especially true if the source of carbohydrates is fiber rich, since fiber takes longer to digest.

Missing: Phytonutrients

Energy bars rich in protein can give an athlete greater stamina and strength. Protein builds the muscles and helps to regulate how energy is produced by the body. The problem is, while these manufactured treats may be fortified with vitamins and minerals, they’re still missing important phytonutrients, beneficial chemical compounds found only in plants.

Phytonutrients include carotenoids that give carrots their color, the isoflavones in soybeans, and polyphenols in tea, Phytochemicals do all sorts of wonderfully good things for our bodies. Some improve memory, while others are known to reduce cholesterol, or kill viruses.

Nutritionists suggest teens substitute a sandwich and a piece of fruit for that energy bar. These items can still be held in one hand, but are more nutritious than energy drinks and bars. Choose whole grain bread and you’re getting fiber, plus protein from the sandwich filling, and finally, phytonutrients from the fruit. Accompany the sandwich and fruit with a glass of milk and you’ve just added calcium and vitamin D.

Better Choices

When one is fatigued and hungry, it’s difficult to think what it is your body needs. That can make a teen grab for an energy drink or bar. But there are better choices. Next time your teen wants to grab something quick, choose one or several of the items listed here:

  • Yogurt
  • String cheese
  • Nuts
  • Dry whole grain cereal
  • A spoonful of peanut butter
  • Whole grain toast
  • A smoothie
  • Fruit, such as bananas, grapes, nectarines, or apples
  • Trail mix
  • Dried fruit
  • Chocolate bar

If faced with a choice between junk or fast food, an occasional energy drink or bar is probably the better choice. Teens in training for high activity sports may find that energy bars and gels serve as a useful addition to a healthy diet. But teens should never think that energy drinks and bars can replace a meal.

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13 Reasons Why Your Teen Should Not See This Show

Think of this as a sort of companion piece to last week’s blog piece, How to Prevent Teen Suicide. That piece was meant as a resource for parents. This piece has a different focus. It’s about the Netflix series, 13 Reasons Why. I just watched the first season of this compelling drama and I had to (somewhat) concur with my teenage son, “Don’t watch it. You’ll just want to kill yourself.”

It’s not that I want to kill myself after watching the series. It’s that I think teens will want to kill themselves after they watch this show, or at least some teens, many teens (thankfully, my son is still with us).

I think a lot of us forget how intense it felt to be a teen.

13 Reasons Why captures that intensity and makes the case that it just feels like too much sometimes and that the only way to get away from it—from all that stress and pain—is to end your life.

See, I remember that and even if I didn’t, this show was going to bring it back to me. It’s brilliant. The kids, though they’re from a more modern era, aren’t all that different from the kids with whom I went to school. The dynamic is exactly the same. The kinds of things that happened then, those are the same things that happen now, if the show is to be believed.

And the show is utterly believable.

Experts are warning people not to let their children watch 13 Reasons Why. They say that teen suicide is “contagious.” They say they’ve known for more than three decades that when kids watch TV shows that depict suicides, it makes them kill themselves.

They say the show makes suicide glamorous.

I agree. I watched all those shiny, pretty teens, and I felt like I knew them. I felt totally involved in their drama. It was like I was one of them. I kind of wanted to be one of them.

Now imagine a kid watching that, instead of yours truly, a woman of 55 years and counting.

The problem with 13 Reasons Why is that it shows us, shows our kids, that there’s nothing to do and nowhere to go to get away from stress, abuse, rape, drugs, and alcohol. That suicide is really the only way out, the only option. Otherwise, you’ve just got to go through it, deal with it, live with it, cope. And it’s just too much to bear.

Is that really the message we want to give our teens?

Now, the actor that plays one of the main characters in this story, Dylan Minette (Clay Jensen), told Ellen Degeneres, that the show is about starting the conversation on a very difficult topic.

But I don’t buy it. Minette is not a psychiatrist or someone in the mental health profession who works with teens. He’s an actor and this is his bread and butter. Of course he doesn’t want to admit that the show may be dangerous to teens. He’s suddenly famous and he wants that to continue.

The thing is, Minette as Clay Jensen, the good guy/nice teen in this series, seems credible That means we’ll be sure to take his word for it when he says the show is safe. That it’s just a conversation starter. Right?

Wrong. He’s an actor. We must NOT take his word for anything that impacts on the safety of our children.

And truthfully? No matter what Selena Gomez, the co-producer of 13 Reasons Why says about teen suicide being a difficult discussion that has “to come no matter what,” no matter what Dylan Minette says on Ellen, it’s not possible for either of them to assure any parent that it is safe to watch this show, that there is absolutely no danger that kids will watch this and follow suit. Because that’s absolutely the opposite of what this study found:

We examined the relation between 38 nationally televised news or feature stories about suicide from 1973 to 1979 and the fluctuation of the rate of suicide among American teenagers before and after these stories. The observed number of suicides by teenagers from zero to seven days after these broadcasts (1666) was significantly greater than the number expected (1555; P = 0.008). The more networks that carried a story about suicide, the greater was the increase in suicides thereafter (P = 0.0004).

These findings persisted after correction for the effects of the day of the week, the month, holidays, and yearly trends. Teenage suicides increased more than adult suicides after stories about suicide (6.87 vs. 0.45 percent). Suicides increased as much after general-information or feature stories about suicide as after news stories about a particular suicide. Six alternative explanations of these findings were assessed, including the possibility that the results were due to misclassification or were statistical artifacts. We conclude that the best available explanation is that television stories about suicide trigger additional suicides, perhaps because of imitation.

And it’s also the opposite of what this, newer study, found:

Increasing evidence suggest that imitative behavior may have a role in suicide among teenagers. We studied the variation in the numbers of suicides and attempted suicides by teenagers in the greater New York area two weeks before and two weeks after four fictional films were broadcast on television in the fall and winter of 1984-1985. The mean number of attempts in the two-week periods after the broadcasts (22) was significantly greater than the mean number of attempts before the broadcasts (14; P less than 0.05), and a significant excess in completed suicides, when compared with the number predicted, was found after three of the broadcasts (P less than 0.05).

We conclude that the results are consistent with the hypothesis that some teenage suicides are imitative and that alternative explanations for the findings, such as increased referrals to hospitals or increased sensitivity to adolescent suicidal behavior on the part of medical examiners or hospital personnel, are unlikely to account for the increase in attempted and completed suicides.

Now if you think about the quality of television shows in the 70’s, at the time of the first study cited above, and even during the mid-80’s when the second study was performed, and compare it to the quality of a Netflix series, you know there’s just no comparison. Today the acting and the videography is so much more real and compelling. A series from the 80’s looks wooden, stilted, by comparison.

Imagine your child watching a true-to-life depiction of Hannah Baker in a bathtub with running water, scared but determined, slitting her wrists (deeply—the blood gushes). Then think of Hannah panting from the effort as she settles in and closes her eyes, waiting for the end. Because that is what your child will see in this series.

I went to the experts to see what they had to say.

A specialist in dialectical behavior therapy (DBT), Nechama Finkelstein sees suicide as the result of depression and hopelessness, in tandem with deficits in problem solving.

“The show exacerbates and feeds this issue—faulty problem solving—by portraying suicide as a logical solution to Hannah’s troubles. In fact while this show seems to be about the 13 reasons that explain Hannah’s suicide, the true reason she committed suicide is 1) depression and 2) her lack of reaching out for proper help when the school counselor failed her. Hannah spent more energy and time on her revenge tapes then trying to get help.

“Viewers find themselves nodding along with Hannah and getting pulled into this sick and twisted logic,” says Finkelstein.

“I can see some benefits and yet I can see even more dangers that teens can have from watching this show. A struggling teen viewing this show is in danger of being influenced by the lack of any problem solving or a more proactive search for help. The message to stop teen bullying and prevent suicide is lost through Hannah’s sensationalized revenge,” explains Finkelstein. “Hannah’s choice, to teen viewers, seems empowering, and she is presented as a winner instead of a loser.

“I would recommend any teen battling depression, bullying, or any form of emotional instability to stay far away from the show.”

Dr. Fran Walfish, a Beverly Hills family and relationship psychotherapist and author of The Self-Aware Parent, says that if teens are going to watch the show, parents should be watching it with them. “Suggest watching this show, or others that address the complexities of adolescence, together with your teen. If not literally together, then at least watch it at the same time and decide upon a shared meal to talk about the latest episode. If your teen is too embarrassed to talk about it with you, then he/she may not be developmentally ready to watch it,” says Walfish, who refers parents to talking points from the National Association of School Psychologists, for having that conversation about suicide with their teens.

Walfish feels that parents need to fill in the gaps left by the writers of 13 Reasons Why, “Mental health issues and their effects on teens are only minimally addressed in this show. Instead, the very premise of the show is the idea that other teens ‘caused’ the main character’s suicide. By downplaying the character’s depression and lack of appropriate intervention, this show fails to address the complexity of mental illness,” says Walfish, who suggests parents visit the website on the National Alliance on Mental Illness to read up on teens and mental health. “Genetic history, self-concept, biochemistry, coping strategies and access to support systems are just a few of the many factors that play into mental illness and suicidal ideation. This is why there is a critical need to help teens understand mental health more completely.”

As a response to complaints by mental health professionals, Netflix has added a warning to the beginning of most episodes of 13 Reasons Why. But from my purview as a parent, you know what Netflix doesn’t give you? Any place to turn to if you feel you or your teen need help after watching the show. There should be hotline information on that final screen of each episode—a way for parents and teens to get help if they feel triggered or hopeless after watching the show.

Instead there is nothing of the sort.

13 Reasons Why Classified in New Zealand

New Zealand, a country with the highest rate of teen suicide in the developed world, has banned teens from watching the show without their parents. The show was given a new classification, RP18. The New Zealand Classification Office issued a long explanation on its predicament with the show. Here is an excerpt:

The most immediate concern for the Classification Office is how teen suicide is discussed and shown in 13 Reasons Why. Hannah’s suicide is presented fatalistically. Her death is represented at times as not only a logical, but an unavoidable outcome of the events that follow. Suicide should not be presented to anyone as being the result of clear headed thinking. Suicide is preventable, and most people who experience suicidal thoughts are not thinking rationally and therefore cannot make logical decisions.

Which gets us to the next big issue. The show ignores the relationship between suicide and the mental illness that often accompanies it. People often commit suicide because they are unwell, not simply because people have been cruel to them. It is also extremely damaging to present rape as a ‘good enough’ reason for someone to commit suicide. This sends the wrong message to survivors of sexual violence about their futures and their worth.

13 Reasons Why does not follow international guidelines for responsible representations of suicide. The scene depicting Hannah’s suicide is graphic, and explicit about the method of suicide she uses, to the point where it could be considered instructional. As The Mental Health Foundation New Zealand notes of the scene in which Hannah dies, “It was detailed and lengthy, and is likely to have caused distress and an increased risk of suicide in people who are vulnerable. Research has demonstrated an increased use of particular methods of suicide when they are portrayed in popular media.

Reading this statement I can’t help but wonder why the United States has not followed New Zealand’s good example. Suicide is the second highest cause of death in U.S. teens. We should be doing everything in our power to keep our children safe.

The upshot? If your child has already watched this show, sit down and have a talk together (or two or three). Make sure your child isn’t thinking about suicide. If s/he is, get your teen to a mental health professional immediately.

Don’t blow this off as no big deal. You really don’t want that on your conscience.

Netflix’s 13 Reasons Why, in my opinion, fails teens utterly, by making suicide attractive and by failing to offer teens the resources to seek help. The bottom line for me, as a parent, is that Netflix may have found a good draw to bring in the big bucks, but the television programming monolith has done so at the expense of our children’s safety. I find that completely unforgiveable.

As should you.