As a teaching attending in pediatrics, I learn a lot from my medical students and residents. One such pearl was an acronym that a resident inserted into a patient presentation that I have since adopted and utilize in my own practice. GEEDDSS. It’s memorable perhaps because it’s non-sensical and stands for the key components of any and every yearly well visit. It’s a mnemonic device to ensure a comprehensive investigation of the wellness of every child and it stands for:
– Social Media
‘Social Media’ has been a relatively late add to the group over the past decade or so but plays an increasingly important and central role in the well-being of my patients. If I recall these topics, then, taken in tandem with specific parental concerns, I know I’ve adequately addressed two central objectives of every annual physical- disease detection and disease prevention.
And so, looking ahead to 2022 this little pithy acronym serves as a foundation for advice to parents for their children of all ages. It can serve as a checklist of sorts that professionals and parents alike can employ periodically to ensure all the important factors that comprise the holistic health of a child receive their due attention. Let’s take a closer look at a few of these.
o For me as a doctor, this means checking physical growth parameters for adequate height increase and commensurate weight gain as well as detecting aberrations. This is quite possibly the part of the visit to which parents pay most attention. They want to see the curve, know percentages, and predict final heights. Every little dot in space signifies another triumphant year of successful child rearing in the most concrete sense.
o The vast majority of children I see follow healthy curves. I often reassure parents that nature is smarter than all of us, that regardless of the variation in our at-home food and sleep rituals, in our society of bounty, genetics almost always finds a way to physically grow our children exactly as they should. Take a breath, parents. Nobody does it perfectly. Do the best you can but take comfort in the resilience and adaptivity of the human organism. It will flourish even after skipped meals and midnight freezer raids.
o For me, this means completely different things at different ages. For a toddler it means they’ll likely be more interested in the underside of a chair or doorknob than the food in front of them. For teenagers this means snacks and meals at odd hours of the day to go with an altered sleep schedule.
o One unifying principle for all ages is the importance of establishing a mealtime routine. The best chance you have at getting the toddler to try a new food or consume anything at volume is if they see you doing it. The only time you might get an informative nugget out of your teenager might be at dinner time. Routines ground children on their jerky seesaw ride to individuation and autonomy. Outwardly, they might protest but inwardly they’ll feel comforted.
o Toilet humor pervades in most households and it creeps into the office as well. Voiding issues- especially potty training and constipation- often comprise a sizeable portion of my conversations with parents.
o Don’t ever underestimate constipation. It can sneak up and be utterly debilitating. And just because your kid ‘goes’ every day, does not mean they don’t have a ‘traffic backup,’ a metaphor I’m apt to use. Here’s one of the biggest culprits- school. Kids refuse to ‘go’ at school and that’s how the backup begins! Inquire proactively about this anxiety and consider a dry run to the school to practice with them. Even schedule bathroom time 20 minutes or so after lunch. But begin with awareness.
o Sleep is so important for, well, everything and its absence or dearth can lead to disruptive behaviors like attention deficits, hyperactivity, aggressive outburst that can mimic other disorders. Every age comes with its unique sleep challenges. Infants learn to self sooth and experience separation anxiety. Toddlers and school age children develop night fears. And adolescents are on a different sleep-wake cycle entirely. But regardless of age, the importance of routine is critical.
o The basic components of an effective sleep routine include
§ Make your child’s room a place they enjoy being and find cozy. As difficult as it may be to relinquish control, elicit your child’s input regarding the feng shui of their personal space.
§ Ensure a comfortable sleeping environment, usually dark and cool.
§ Stop stimulating activities 1-2 hours before bedtime. Keep it low key. That means more books and puzzles and less screen time.
§ Develop a sleep ritual that you perform every single night with little to no variation, something like take a warm shower, drink a warm glass of milk and hop into bed with book.
§ Above and beyond stimulating content, screens emit a blue light that can trick your child’s brain into thinking it’s day time. Stop screens and devices 2 hours before bedtime!
– Social Media & Screen Time
o This topic has become an increasingly prominent part of my discussion with families, one that I proactively ask about and discuss. Alongside its benefits, the detriments of screen time and social media are elucidated with greater clarity every day.
o Here’s the fundamental reason you should limit your child’s screen time and it has nothing to do with the content they’re viewing. The brain is a muscle like all others and it needs to be exercised. The muscles of emotional regulation, executive function and empathy are exercised only when a child can hear themselves think, when they are given the space to be bored, to feel, and to interact with other children in spontaneous play. Time spent behind a screen is time lost from exercising the emotional and intellectual muscles needed for healthy growth and maturation. If your child whines that they’re bored, maybe it’s not such a bad thing. They’re exercising.