Mary Rogers, MD FAAP
Central Oregon Pediatric Associates
Q: My six-year-old son was diagnosed with asthma a year ago. We have since moved to Bend and thankfully, he has had zero symptoms here. Should we see a physician about his condition or just assume he has grown out of it?
A: That is amazing that your little guy has done so well since moving. It is a great idea to establish care with a provider in the area for a variety of reasons. We like to review his medical history, his triggers and to review what we call an “asthma action plan,” in case he is ever triggered again. While there are typically many “location specific” triggers (usually seasonal allergies), there are also viral infection triggers, and depending on his situation, it is possible that he just hasn’t been triggered. He is, luckily, approaching the age where many kids “outgrow” asthma. Kids typically transition to more of an exercise-type or cold weather asthma trigger later in life.
Q: My daughter is 16 months old and very energetic. Whenever we go to the swimming pool to watch big brother during his lesson, she seeks out other toddlers and either hits them or squeezes them. Is this normal?
A: So very normal. This is the typical age that these behaviors emerge, and they are quite normal, but for parents, stressful. Some of these behaviors are hitting, squeezing, biting, pinching, etc. You will typically see more of these behaviors if the child is overtired, hungry or overstimulated. They are usually a manifestation of energy expressed in a big way and are not malicious in nature. If you see her moving towards that behavior, try to intervene with a distraction before it happens. Use short, consistent phrases that she will be able to remember, such as “Hands are not for hitting” (there’s a great board book with this mantra). If the behavior persists, remove her from the setting, and continue to use the slogan. Try not to be in view of others, as she will only get more worked up. Rest assured that this is normal, but one of those hard normal things. Hang in there!
Q: My son is going to be in kindergarten next year and is still sucking his thumb. I worry that he will be teased by the other students. Will he grow out of the habit?
A: Great question! Kindergarten is such a wonderful and exciting year. I can’t guarantee whether kids will tease him, but there is a chance they will. Your son might not care, but you may want to have a supportive conversation with him. You could reflect with him on how it helps him feel safe and calm, but also note that there may be other ways to feel safe and calm while he is at school. At his age, he will likely come up with ideas that could work, and you have plenty of time to try out other substitutes. Reach out to your provider about this if you’d like some ideas, as many have integrated behavioral health that can be helpful. Set little positive rewards for when he succeeds, as this will be hard for him. You might also connect with his dentist. Generally, after three years of age, thumb sucking is thought to impact dentition more negatively.
Q: Lately, my teenage daughter has been coming home from school and napping for about two hours before dinner. Yesterday, when we talked, she said if she doesn’t nap, things will spiral out of control. I’m not sure if this is normal adolescent behavior or if I should be concerned.
A: I applaud you for having the conversation with her. It can be very tricky at this age to be able to put the myriad of emotions into words, though her description of things spiraling out of control does make me wonder how things are going in her life. There could be new stresses and trouble with how to manage them. Regardless of the underlying reasons, she is using napping and retreating as a coping mechanism. This is an excellent opportunity to connect her with support with specialized care so that she learns additional skills that can help in this developmental stage of life. A good first step could be with her provider, as they can direct you to resources in the community. They will also be able to help differentiate between typical stress responses and more significant underlying problems.
This article appears in BendNest Summer 2023.
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