Q & A with Kate L. Broadman, MD
You asked. Local pediatrician, Kate L. Broadman, Bend Memorial Clinic Pediatrics, answers!
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Q: My kindergartner is a worrier and has a hard time falling asleep. On average, he sleeps about nine hours per night and does not nap during the day. I worry that he is not getting enough rest but don’t know how I can help him to relax and get more sleep. Any suggestions?
Dr. Broadman: Bedtime struggles are one of the most common and frustrating, parenting challenges. The first question is whether your child is getting enough sleep. Most kids this age need 10-11 hours of sleep per night to be well-rested but like adults, there is a range. If your son wakes up on his own in the morning and seems rested, nine hours may be enough for him. Even so, the difficulty he’s having falling asleep can be stressful, and it’s a good idea to focus on sleep hygiene to help tackle this. Just like when you are trying to teach a baby to sleep through the night, it’s important to develop a calming bedtime routine that he does the same way, in the same order, every night. Also, avoid electronics for 1-2 hours prior to bedtime. During the daytime, practice ways for him to relax his breathing, and brainstorm some happy or calming things he can think of while trying to fall asleep. If he is still having a hard time after you have done all of this, it’s probably a good idea to talk to his regular doctor about what’s going on.
Q: I was at my book club meeting one evening, and one of my friends was talking about the HPV vaccine for her 12-year old daughter. I don’t remember my two teenage sons receiving this one. Is it only for girls, and if not, is it too late or should I try to schedule them an appointment? Any other information about this vaccine would be helpful.
Dr. Broadman: The HPV vaccine is an amazing breakthrough for this generation of kids, protecting them from a very common virus that can ultimately result in cancer. When the vaccine was originally released, it was only recommended for girls, since HPV is most commonly associated with cervical cancer. However, over the past several years, researchers have found other types of anogenital and oral cancers that are also associated with HPV and that can occur in boys and men; the vaccine also protects against many types of genital warts.
Because of this, it is now part of the standard recommendation for boys as well as girls. Many parents are apprehensive about immunizing their adolescents against a sexually transmitted virus, but the whole point is to immunize all kids before they become sexually active, rather than waiting until adulthood when many people will already have been exposed to the virus. It was tested down to age 9 and shown to be safe and effective in this age group. It is recommended for boys up through age 21 (26 in some cases) if they were not previously immunized, so I would definitely schedule an appointment for your sons.well as girls. Many parents are apprehensive about immunizing their adolescents against a sexually transmitted virus, but the whole point is to immunize all kids before they become sexually active, rather than waiting until adulthood when many people will already have been exposed to the virus. It was tested down to age 9 and shown to be safe and effective in this age group. It is recommended for boys up through age 21 (26 in some cases) if they were not previously immunized, so I would definitely schedule an appointment for your sons.
Q: My one-year-old is well into eating solids and seems to have an unending appetite. He still drinks three bottles per day and eats three to four mini meals, as well. The problem is, whenever we eat anything around him, he gets upset and wants to eat too. Typically, we give in because we feel badly, but I worry that we are overfeeding him and am concerned about the consequences. He is in the 85th percentile for height and weight. Do we need to change our habits?
Dr. Broadman: As babies make the transition away from an infant eating schedule toward toddlerhood, it’s a great time to pay attention to developing healthy eating habits. At this age, most toddlers have three meals per day as well as 1-2 small snacks. This allows them to have a few hours between feeding times rather than just grazing all day long, so that they can learn to recognize signals of hunger and satiety. At age 1, milk should start to be seen as a nutritious drink rather than a meal itself, so offer milk or water in a sippy cup at mealtime, rather than using the bottle; other than 12-18 oz of milk, he should drink water the rest of the time. Toddlers are naturally social and want to eat when the rest of the family is eating, so as much as possible, try to have these be times when you can eat together; that way when he wants to eat what you are eating, you can go ahead and let him try some.