Marketing and Social Media

As the lead physician involved in the marketing of our practice, I am often faced with the dilemma of what the best route is to grow our practice.  We've been down many roads over the past several years: radio, newspaper, Val-Pak, parent magazines, online, the list goes on and on.  As a small pediatric only practice, we do not have the resources (time or money) that the larger multi-specialty groups have to make their presence known around the community.  In fact, a small survey I conducted in the office found that a majority of our new patients came from word of mouth rather than by advertising.  That is the best form of advertising, but it doesn't always produce the best results.  In this age dominated by social media, I've decided to turn my attention online to try and create/maintain a presence for our practice.  This, of course, is difficult as well with the plethora of sites that exist.  I've currently set our practice up on: Facebook, Twitter, Instagram, Google Plus, and, of course, this blog.  Keeping up to date with all of them is extremely challenging!  Then, if they are kept up to date, do they attract new patients?  What do you all think?  Is social media a good way to make a pediatric practice known within the community?  If you're happy with the care that we provide, do you have any suggestions on growing our practice?  Would love to see some comments on this one!

Sleep - It Does a Body Good!

As parents, many of us are all too used to sleep deprivation and we know the physical and psychological effects that it can have on us.  New research is now pointing out that sleep deprivation in children can have much the same effect.  A recent study from Australia tracked over 3,000 kids looking at their health and quality of life between birth and age 7.  Parents completed sleep journals and the authors broke the children up into four groups based on sleep habits (the percentage of children in each group is noted in parentheses):

1.)  Typical sleepers - Slept up to 14 hours as infants, gradually decreasing to 11 hours at age 7 (40%)
2.)  Persistent short sleepers - Similar to typical sleepers but averaged 1 less hour of sleep (11%)
3.)  Initially short sleepers - Started out like the persistent short sleepers, but by age 5 they were more like           typical sleepers (45%)
4.)  Poor sleepers - Slept less than 10 hours in infancy, gradually increasing with time (3%)

So, what does all of this mean?  Well, the researchers found that all but the typical sleepers had lower physical functioning scores on the quality of life scale.  Persistent short sleepers also had lower emotional and social functioning scores.  From there, the researchers dug even a little deeper and looked at obesity risk.  They found that the short sleepers were more than TWICE as likely to be obese than kids who rarely or never had shortened sleep.  The short sleepers also had a higher percentage of abdominal fat, which increases the risk for cardiovascular complications later in life.

I'm sure many of you are asking yourself two things: 1.) how much sleep should my child be getting, and 2.) how do I get them to sleep more?!  Great questions!

Here's a guide from the NIH with recommendations on how much sleep children should be getting at each age:

Now, part two of the question, how do I get them to sleep more?!  Here are some helpful hints:

1.)  Make sleep a priority - It seems these days, we all lead very busy lives.  Weeknights are often loaded with activities ranging from sports to clubs to music lessons and so on.  Try and avoid scheduling activities that will potentially interfere with your child's normal bedtime.

2.)  Exercise (but do it early) - The AHA recommends that all children exercise for 60 minutes a day.  Physical activity, when done regularly, can greatly improve a child's sleep habits.  Just be careful not to exercise too close to bedtime, as it can make it more difficult to fall asleep.

3.)  Turn off electronics - The LED light found in most modern electronics can interfere with the natural release of melatonin from our brain.  This will make it more difficult for your child to fall asleep.  Be sure to have them turn off the electronics at least 1 hour before bedtime.  In addition, violent or fast paced television shows or video games can also make sleep more challenging.  

4.)  Stick to a routine - A consistent bedtime routine will often do wonders for your child.  Try and do the same thing each night, and follow a similar schedule on weekends as well.  Staying up late and sleeping in on weekends are not good for sleep hygiene.  

For more information on healthy sleep, the NIH has published a very useful guide which can be found here.

If you have any questions about your child's sleep or have any advice or stories you'd like to share, please visit our Facebook page.

Dental Caries: The Scope of the Problem

When asked what the most common chronic condition in children is, you will get varying answers from asthma to eczema to allergies to obesity, just to name a few.  And while these are (unfortunately) common conditions in children, their incidence pales in comparison to dental caries (more commonly known as "cavities").  Early childhood caries are 4 times more common than obesity, 5 times more common than asthma, and 7 times more common than allergies.  In fact, by the age of 3, 10% of children will have an oral health problem and by the start of kindergarten, over 40% of children will have had at least one cavity.  This represents an increase of nearly 20% over the past 15 years.  Children from low-income and minority families are particularly at risk.

The short and long term risks of dental caries are many.  Acutely, dental caries can cause significant pain which can affect the mental health and well being of children to a greater degree than asthma.  They increase the risk of infection, both in the teeth and in other parts of the body.  They can lead to speech problems, difficulty chewing which can affect growth, and poor self-esteem.  Chronically, dental caries can lead to life-long problems with adult teeth, increased infections, and an increased risk of conditions such as obesity, diabetes, and heart disease.  This does not even mention the societal, pharmaceutical and economic impacts, such as missing school and work, the need to pay for costly procedures, and dealing with side effects of medications used to treat dental pain and infections.

So what can you do to prevent all this?  As with anything else, the best treatment plan is prevention.  That means starting good dental hygiene habits when your baby is young.  Even before their first tooth erupts you should be wiping their gums clean after feedings.  Once their teeth erupt, the ADA is now suggesting parents use a small amount of fluoridated toothpaste once or twice daily (about the size of a grain of rice for children under 2). Avoid putting them to bed with a bottle as the natural sugars in milk can lead to tooth decay.  Parents are discouraged from sharing food with their children as they may unknowingly be passing harmful bacteria to their infants.  Pacifiers are discouraged beyond 6 months of age, and should never be dipped in anything sweet.  Finally, a first dental visit should be arranged by the child's first birthday.  

For toddlers, it is recommended to try and introduce a cup by their first birthday and to avoid using juices.  Did you know that, for example, apple juice has the equivalent of 8 teaspoons of sugar in just one glass?!  Combine all that sugar with bacteria that are present in your child's mouth and you have a recipe for tooth decay!  One other big pitfall that I assume children and parents are falling into is carbohydrate laden snacks.  Things such as goldfish, pretzels, animal crackers, and fruit snacks (even, gulp, raisins!) are very popular among children these days.  In fact, not a day goes by in the office that I don't see one or many children munching on them.  Unfortunately, these snacks are very high in sugars and when combined with saliva become almost "cemented" in a child's teeth.  Another recipe for disaster.  Try and feed your child dairy products or fruits and vegetables at snack time and they will be sure to have happier teeth!  Once they turn 2, you can increase the fluoride toothpaste to a pea sized amount.  

If you are looking for a pediatric dentist, there are several options in the area and your child's physician would be happy to recommend one.   One office that we have had a tremendous amount of positive feedback on is Valley Pediatric Dentistry in Hopewell Junction.  A great group of people.

Here's some helpful resources regarding dental health in children:

Mouth Healthy, Courtesy of the ADA

2min2x.org, Courtesy of the Ad Council

Family Oral Health Resources, Courtesy of the AAP

Early Childhood Caries Info, Courtesy of the AAPD

The State of Little Teeth, Courtesy of the AAPD

Speaking To Your Baby May Be As Important As What You Feed Them

Two recent studies that caught my attention have to do with how we speak to our babies and what that does for their future language development. 

The first study comes to us from psychologists at Stanford University.  They looked at what you might consider word or language quality and found that infants who were spoken to in complex language and grammar had significantly improved language processing and learned words more quickly as toddlers.  An example used by the authors is as follows: instead of saying "here is an orange", you might say "Let's put this orange in a bowl with the apples and grapes and bananas." 

The second study comes to us from researchers at Brown University.  They looked at how talking to premature babies in the NICU affected their later language development.  In this study, babies were either spoken to by their mother, stroked by their mother, or only had interactions with the NICU staff.  The researchers found that for every increase in 100 words that adults spoke to the babies, there was a 2 point increase in their language scores at 18 months!

In looking at these studies, it's important to note that the human brain forms 1,000 trillion connections in the first year of life, so it's easy to see why speaking to your baby can be so influential.

Some tips for speaking to your baby courtesy of Stanford University:

-The sooner you start talking with babies, the better. Their brains are absorbing vital information well before they're able to respond.

-The high-pitched, sing-song tone that many people take with babies does get their attention. But don't dumb it down: Use rich, varied language and longer sentences, said Erika Hoff of Florida Atlantic University.

-Don't just label things, make connections. "The dog is wagging his tail" isn't as effective as, "Look how fluffy that dog's tail is. It's much fatter than the cat's skinny tail."

-What matters most is speech directed to babies and toddlers, not what they overhear, said Anne Fernald of Stanford University.

-Turn off the TV. "Television does not help the brain learn language," said Noble. Babies and toddlers especially require personal interaction to learn.

-Reading a book for 10 minutes a day adds up fast, Fernald noted. If Mom or Dad isn't a good reader, just talk about the pictures.

-Fit conversation into everyday activities. Instead of turning on music while fixing lunch, talk about the bowl of fruit on the table.