Wednesday, August 27, 2008

The New York State Fatherhood Initiative is hosting a statewide conference in Albany

On October 6th-9th the Office of Temporary and Disability Assistance, along with the Office of Children and Family Services, will host the first New York Statewide Fatherhood Conference. The conference will take place at the Desmond Hotel in Albany. Participants from around the country will convene to explore the issues, concerns, and impact of fatherlessness in
the lives of our children and families.

They've doing some good work: for instance, while it used to be said that babies
don't come with an owner's manual, they've published one. It's an interesting
tool for new dads and it does include information about Shaken Baby Syndrome...

OTDA has released A Driver's Manual for New Dads (1mb, PDF) that offers new dads information
that will help them be a good dad to their child, including supporting a partner emotionally during and after pregnancy and tips on interacting with a new baby.

Sunday, August 24, 2008

An interesting story from MSNBC's archives on how parents can help kids cope with the pain of vaccination.

Of course, in some cases, vaccinations can cause soreness and irritability that persists for a few days. That's important information to share with child care providers and other caregivers, so they're prepared to cope.

Soothing the screams from childhood vaccines
Study suggests sweetened pacifiers, blowing bubbles and other distractions

CHICAGO - Some children sob, others scream, and some get so upset they have to be restrained by medical staff. But a new study suggests parents can ease the anxiety about immunizations by telling a joke, reading a book or bringing a favorite toy from home.

Other proven distraction techniques include blowing soap bubbles and, for under six months, using a pacifier dipped in sugar water.

“All of those kinds of things can take children’s minds away from the needle poised to go into their arm,” said lead author Dr. Neil L. Schechter, the director of the Pain Relief Program at Connecticut Children’s Medical Center.

The study appears in the May 2007 edition of Pediatrics.

Parents who are overly apologetic or excessively reassuring during the procedure can actually cause more distress, the research found. Instead, parents should adopt a “matter-of-fact, supportive, nonapologetic approach,” researchers said.

Schechter’s team reviewed hundreds of previous studies regarding pediatric immunizations and referenced about 120 in their article, in which they also make recommendations for doctors.

While some may dismiss the shots as a rite of passage, children’s fear can interfere with important discussions pediatricians need to have with parents, said Schechter, who is also a professor of pediatrics at the University of Connecticut School of Medicine and a pediatrician at Hartford’s St. Francis Hospital.

At Children’s Memorial Hospital in Chicago, child life specialist Emily Rogers helps young patients deal with procedures including injections and getting their blood drawn.

Rogers said she believed the study was a valuable one. While somewhat surprised with findings that overly empathetic parents can cause more distress, she theorized it’s because children became scared and confused when they feel their parents lack control over a situation.

She carries a “distraction bag” packed with pinwheels, bubbles, whistles and books, and she also helps young patients practice relaxation and breathing techniques.

Rogers said it’s important parents not bargain with their child, instead emphasizing while it’s OK to feel scared, the medical procedure is designed to help them and the child isn’t being punished.
And a reminder of why vaccination is still a necessary thing...

Vaccine refusals mean more measles
Aug. 21: The CDC reported Thursday that the number of measles cases in the U.S. is at its highest level since 1997, almost half of which involve children whose parents refused to have them vaccinated. (NBC's Robert Bazell reported this story in August, 2007)
Diane at Foster Family Talk has a post about a shaken baby case in Florida. She reminds parents of the importance of checking references of child care providers.

This was my response:

A parent should certainly research all available references and history.

However, while that's necessary, it's not sufficient to ensure that you've done everything you can to protect your child.

You must talk with your child care provider about the danger of shaking young children, that frustration and anger is a normal response to caring for young children, and they need to agree to follow a simple coping plan: recognize that frustration, leave the baby in a safe place and call someone, either as a safety vent or to acknowledge the frustration. They need to know that it's OK with you to have feelings of frustration.

It can be done in a manner that doesn't accuse, but instead talks about sharing knowledge and opportunity to protect your child from injury. If your child is an infant, it can be especially effective coupled with SIDS information.

In New York and several other states, licensed providers must have training on the causes, consequences and prevention of shaken baby. That obligation doesn't extend to "exempt" providers, and it's not complete assurance - providers have attended training and still shaken children.

But this education model is based on a program for new parents in Buffalo that reduced the incidence of shaken babies and inflicted injuries by 50%.

Not perfect, but for a simple 15 minute intervention, pretty effective insurance!...

So, if a parent just checks references, they will have a false sense of security.

Sharing information with all other caregivers of your child about the causes and consequences of SBS and the need for a simple coping plan - and ensuring they share your commitment to using it - is the key.

And not only will that help protect your child, it will help protect others.

For more info, visit the resources page on

Sunday, August 10, 2008

Unfortunately, the new Revolution Health website provides some good examples of lost opportunities to prevent shaking and other inflicted injuries....

Searching the website finds numerous pages on colic, which make no mention of the frustation and anger that a caregiver can experience when dealing with a colicky child, or how parents can help prepare a coping plan.

The overview page on colic suggests indirectly that colic could be upsetting, but offers only this advice on managing that upset:
Do what you can to comfort your baby, but accept that sometimes nothing works. If you feel stressed or worn out, ask a friend or family member to give you a
break. Take good care of yourself, and remember that colic will go away soon.
What to expect from colic is another page that fails to mention that frustration and anger can be a normal response, or that it is even more necessary to talk with the other caregivers of your child and discuss coping behaviors, so these less experienced caregivers have an opportunity to prepare for colic.

On the other hand, a page on crying under age 3 does discuss SBS. It could be improved by redirecting the focus from "you shouldn't shake your baby" and not claiming that throwing a child in the air will cause SBS
Never shake or harm your child. Shaking a child in anger or playing rough, such as throwing him or her into the air, can injure the brain.

While the Revolution site does have several pages on SBS, it's only the last page that talks about prevention.

On a health oriented website, that seems to be putting a cart before the horse.
If you wonder why journalists write about child abuse, but not prevention efforts, this teaser for the Dart Fellowship suggests one explanation:

JOURNALISM FELLOWSHIP Applications will be accepted through July 30 for the 2008 Dart Center Ochberg Fellowships in Journalism and Trauma.

The Dart Center Ochberg Fellows Program is designed for mid-career journalists who want to deepen their knowledge of emotional trauma and improve coverage of violence, conflict and tragedy.

Details and applications available at

A book review in the New York Times points out some reasons why thinking we're safe can be unsafe....

Some of those "thinks" to keep in mind, whether designing community prevention initiatives or an individual, personalized prevention program for your child:

- we think we're more skilled than experience suggests;
- when routines allow us to think less about safety, we are distracted from anticipating stress events and less prepared to cope; and
- we think we - and other caregivers, like babysitters and child care providers - know what we need to know about the skills required to raise a child.

Assuming you're safe can be fatal. Assuming you "know" what any individual taking care of your child will or won't do can also have tragic consequences.
Nowadays, the cause of collisions, or one of them, is people believing they’re better drivers than they are. We base our judgment on the number of crashes we’ve been in, rather than on the number of accidents we narrowly avoid, which, if we’re being honest (or we’re being me), happen just about every time we drive.

Compounding this vehicular hubris is the fact that most of the driving we do appears to be safer than it is. Driving rarely commands 100 percent of our attention, and so we feel comfortable multitasking: talking on the phone, unfolding a map, taking in the Barca-Lounger on the road’s shoulder. Vanderbilt cites a statistic that nearly 80 percent of crashes involve drivers not paying attention for up to three seconds. Thus the places that seem the most dangerous — narrow roads, hairpin turns — are rarely where people mess up. “Most crashes,” Vanderbilt writes, “happen on dry roads, on clear, sunny days, to sober drivers.” For this reason, roads that could be straight are often constructed with curves — simply to keep drivers on the ball.

This basic truth — feeling safe kills — lies beneath many of the book’s insights. Americans think roundabouts are more dangerous than intersections with traffic lights. Roundabouts require you to adjust your speed, to merge, in short, to pay attention. At an intersection, we simply watch the light. And so we may not notice the red-light runner coming at us or the pedestrian stepping off the curb. A study that followed 24 intersections that had been converted from signals or stop signs to roundabouts showed an almost 90 percent drop in fatal crashes after the change.

For similar reasons, S.U.V.’s are more dangerous than cars. Not just because they’re slower to stop and harder to maneuver, but because — by conferring a sense of safety — they invite careless behavior. “The safer cars get,” Vanderbilt says, “the more risks drivers choose to take.” (S.U.V. drivers are more likely to not bother with their seat belts, to talk on cellphones, and to not wear seat belts while talking on cellphones.) So it goes for much of the driving universe. More people are killed while crossing in crosswalks than while jaywalking. Drivers pass bicyclists more closely on a road with bike lanes than on one without.
An interesting article by Sharon Begley in Newsweek discusses the diverse impact of genes on child behavior (and in the process, removes any doubt that every child is different).

There's an interesting point about fussy babies: their behavior is much more susceptible to being shaped by their parents.

Hopefully, as word spreads, it will help those parents with colicky babies, or with high need for control, to know that some things are indeed beyond their control.

PS. The asides about professionals in the child advice business are also of interest - when advice works, it may well be because the baby has characteristics that fit the advice, and many professionals resist, or are at least reluctant to acknowledge, the importance of genetic factors.

But I Did Everything Right!
DNA discoveries are revealing why even the best parenting doesn't have the effects experts promise, from breast-feeding to letting kids learn from mistakes.
By Sharon Begley NEWSWEEK
Published Aug 9, 2008 - Aug. 18-25, 2008 issue

If there is one thing experts on child development agree on, it is that kids learn best when they are allowed to make mistakes and feel the consequences. So Mom and Dad hold back as their toddler tries again and again to cram a round peg into a square hole. They feel her pain as playmates shun her for being pushy, hoping s he'll learn to back off. They let their teen stay up too late before a test, hoping a dismal grade will teach her to get a good night's sleep but believing that ordering her to get to bed right now will not: kids who experience setbacks rather than having them short-circuited by a controlling parent learn not to repeat the dumb behavior.

But not, it seems, all kids. In about 30 percent, the coils of their DNA carry a glitch, one that leaves their brains with few dopamine receptors, molecules that act as docking ports for one of the neurochemicals that carry our thoughts and emotions. A paucity of dopamine receptors is linked to an inability to avoid self-destructive behavior such as illicit drug use. But the effects spill beyond such extremes.

Children with the genetic variant are unable to learn from mistakes. No matter how many tests they blow by partying the night before, the lesson just doesn't sink in.

The discovery, reported last December, is part of what is fast becoming the newest frontier in studies of why children turn out as they do. Since the first advice book for American parents appeared in 1811, the child-rearing industry, as well as researchers who have made child development a science, have assumed that, although every child is an individual, there are certain universals. If parents are too take-charge about homework, the child becomes disengaged and eventually gives up; if they are warm and affectionate, kids don't act out. But while most children do respond the way research shows, there have always been "outliers," kids who don't turn out the way experts promise.

After years of ignoring those children, a few scientists now realize that they are telling us something that promises to revolutionize our understanding of child development. In an echo of "personalized medicine" (matching drugs to people's DNA), scientists are finding that how parents treat their children is filtered through the prism of DNA. Parents may intuit that, as they notice that what worked with one child is failing abysmally with another, but now science is pinpointing exactly what combinations of nature and nurture spell gridlock.

It is finally dawning on experts that "individual genetic differences are the 800-pound gorilla of child development," says Jack Shonkoff, director of the Center on the Developing Child at Harvard University. "The promise of genomics is that you will be able to tailor experiences as we tailor drugs."

Research showing that the most scientifically rigorous child-rearing advice can blow up on you couldn't come at a worse time for the millions of American parents who are desperate for direction. They are gobbling up how-to books and DVDs, even hiring coaches and consultants. They are tearing their hair out over conflicting advice on even such basics as sleep—let baby cry herself to sleep? Co-sleep? (As it turns out, the conflicting advice may reflect the fact that the "experts' " experience happens to have beenwith children whose genetic disposition is amenable to their way of doing things.)

More than earlier generations, new parents are panicked that they're going to screw up. That feeling is fed by posts on Web sites such as UrbanBaby, in which someone, somewhere, can be counted on to flame your every parenting decision.

But for parents who look back in sadness—perplexed that although they did everything "right," their child is not as kind, or intelligent, or self-confident, or well adjusted as the recipes promised—the emerging science offers an explanation, and perhaps an out: with the DNA stacked against you, it wasn't your fault.

One of the strongest and most counterintuitive findings in this nascent field is that children with a sweet temperament, which is under strong genetic control, are the least likely to emulate their parents and absorb the lessons they teach, while fussy kids are the most likely to do so.

Fussy children have a hypersensitive nervous system that is keenly attuned to its surroundings—including what Mom and Dad do and say. In studies that are shaking up textbook dogmas, Jay Belsky of Birkbeck University of London has shown that fussy babies are therefore wired to be more strongly shaped by their parents than mellower children are.

It is the fussy baby who, read to night after dutiful night, is likely to develop a love of books; the mellow baby, given the same literary diet, might just as easily grow into a teen who has no interest in reading anything longer than a text message. The mellow baby, immune to your charms, is more likely to show signs of road rage from the day she first takes her tricycle out for a spin, even though she grew up watching your saintly temper control.

Children who go with the flow of new people and new situations are like Teflon: good parenting doesn't stick to them—but neither, necessarily, does bad parenting. They're the young adults who can't form close, meaningful relationships despite the unconditional love you showed them. "Kids with difficult temperaments are more sensitive to the effects of parenting," says Belsky. "You can get by with sloppier parenting if you have a 'good temperament' kid." Even children who fall between the extremes are generally closer to one than the other.

Although whether you have an easy or a fussy child is obvious, other innate differences that shape whether and how a child will respond to how parents raise them are less apparent. But since they reflect the presence of a DNA variant, they are all candidates for being pinpointed with a genetic test that will help parents know what to expect:

• The gene variant that influences whether children learn from their mistakes. With the misspelled gene, brains have about 30 percent fewer dopamine receptors and less activity in the brain's frontal cortex (the site of higher-order thinking, including monitoring negative feedback) and hippocampus (memory) than do people with the more common form of the gene. In an experiment at the Max Planck Institute for Neurological Research in Germany, people with the misspelling weren't able to avoid choices that they were told over and over were incorrect. Numerous other studies have linked this gene variant to addiction, obesity and compulsive gambling, suggesting that the underlying problem is trouble learning the negative consequences of your actions.

• The DNA variant that affects whether a baby's brain development will be spurred by breast-feeding, which has been reported to confer an extra half-dozen or so IQ points by kindergarten. But not all breast-fed babies are little Einsteins, making their mothers wonder why all the milk-stained blouses didn't seem to boost cognitive development. The reason seems to be that there are two forms of a gene called FADS2. In the 90 percent of babies who carry the "C" form, breast-feeding raises intelligence by an average of nearly seven IQ points, scientists led by Terrie Moffitt and Avshalom Caspi of Duke University reported last year. This version of FADS2 produces an enzyme that helps convert the fatty acids in breast milk into compounds that help signals zip along brain neurons and spur neurons to sprout connections, which underlie intelli gence, memory and creativity. The 10 percent of babies who carry the other form of the gene lack the enzyme and therefore derive no cognitive benefit from breast-feeding (though they still get an immune-system boost from it).

• DNA variants can protect children from bad parenting. For instance, most girls who are sexually abused are at higher risk for becoming alcoholics, as well as for developing other mental-health problems. But girls who have a "sluggish" version of the gene called MAOA seem to be vaccinated against this effect, reported scientists led by neurogeneticist David Goldman of the National Institute on Alcohol Abuse and Alcoholism last year. With the active version of MAOA, the brain's hippocampus—which processes emotional experiences and memories—becomes hyperactivated when it remembers something upsetting, such as abuse, and the woman turns to alcohol for solace. With the sluggish version, those memories lose their awful power.

Another protective gene insulates children from the effects of an emotionally distant mother, one who is cold and uncaring, who turns away when her child feels the pain of a skinned knee no less than from a crushed dream. That is supposed to make a child more likely to develop "externalizing behavior," acting out in a bid for attention. But children with a certain form of a gene called DRD4, which stands for dopamine-receptor D4, are Teflon-coated, at little to no risk of becoming emotionally insecure as a result of mothers who are emotionally distant, found a 2007 study.

The discoveries questioning the connection between what parents do and how children turn out has not exactly taken the science of child development by storm. That seems to reflect a culture clash within the field. Most researchers who study child development were trained as psychologists, and—to overgeneralize, but only a little—are uncomfortable with or even suspicious of genetics. Geneticists tend to see behavioral research as squishy, not hard science.

That produces a body of scientific literature that is remarkably ignorant of genetics. As we reported in this story, we were struck by how clueless so many "experts" in child development were about the new genetics—and how resistant they were to it. Almost all were unaware of the studies showing that genetics acts as a filter between environment and child, letting some influences in and keeping others out. "Even the stuff published in the best journals ignores the underlying genetics," says one leader in the field.

Since companies already offer storefront DNA tests, the day is not far off when parents can determine their child's MAOA or DRD4 status, or the presence of any other variant that influences the effect of parenting. But perhaps it is time to acknowledge that there is only so much influence parents can h ave. In her best-selling book "I Feel Bad About My Neck," Nora Ephron laments how American society "came to believe in the perfectibility of the child just as it also came to believe in the conflicting theory that virtually everything in human nature was genetic." Both views—that everything is genetic and that parents can transform a child like a lump of clay—are as wrong as wrong can be.