Pediatric Mental Health

We MUST make them strong!!! Survival Skills for Raising a Daughter!

/ Katie P. Tolley, RN, MSN, CPNP-PC / Leave a comment

Oh my, friends! Today, I had a 16 year old patient that I am worried may be in an abusive relationship…  I want those of you that have daughters to understand how important it is to make sure they are physically and emotionally healthy enough to make it in this difficult society!

I’d like to share a list of things I have come up with to help us all raise strong, capable, confident, and emotionally secure daughters!

Here are a few tips:

  • Teach Do unto others, this is the ultimate golden rule! Treat her with respect and set the example when dealing with others!

    My girl

    My girl

  • Always tell your daughter that she is beautiful! Let her know that the most important beauty is on the inside!  
  • Always use manners! ‘Yes, please’ and ‘No, thank you’ show kindness and respect!
  • Communicate openly! Talk to your daughter often, and let her know you are always there to listen. Regardless of what she tells you, never act surprised, anything and everything is open for discussion. Remember, if she doesn’t talk to you, she will talk to someone else.
  • Explain that everyone has flaws, that is what makes us all human. As a parent, set an example, don’t criticize yourself or your self image. Children often follow in our footsteps.
  • Encourage her to pick the right friends. The “cool” girls are only cool if they are nice to other people. Teach your daughter that true friends respect her choices and decisions and won’t make her feel inferior or left out.
  • Encourage involvement in sports and other group activities. Sports, playing an instrument, girl scouts, etc. teaches life skills and builds self confidence.
  • Teach your daughter to dress appropriately. It is best to leave what is underneath covered up, only to be discovered by someone that truly cares and respects her.
  • Limit social media! Today’s children can be cruel, and social media is an easy outlet for bullying.
  • Encourage your daughter to speak for herself. Don’t speak for her! Allowing her to speak and express herself prepares her for the future.
  • Teach your daughter that knowledge is power. Doing well in school really does pay off when it comes time to prepare for the future.
  • Encourage her to Read!! Reading makes you smarter!
  • Encourage her to bring her friends home to meet you. This will pay off when the boyfriends start coming around. Meeting your daughter’s friends is crucial to knowing what is going on in her world.

These are just some suggestions, please feel free to let me know of any suggestions you have to help us all raise healthy and happy young women!

Now, let me tell you why I felt so strongly about sharing this information with you. I am hopeful that Janie isn’t in as bad a situation that I fear she may be….

Janie came in because she had an “eye that was bruised” from hitting it on a table picking up her baby’s bottle. Janie is 16, has a 4 month old daughter, and was brought in by her fiance, aka, her baby daddy. When I first walked into the room Janie didn’t say a word, but the guy with her asked “how long would she look like that?” I informed him that bruises can take a couple weeks to go away. He immediately said that he needed me to write a note to keep her out of school for a week or two until this went away, because “he had a reputation to uphold!” Red flags immediately went off in my mind!! HE had a reputation to uphold… I refused to write an excuse to keep her out of school for something that is not contagious. Her education was important, and this bruise did not interfere with her learning. I continued, saying that appearances are not how we judge people. Someone’s value and self worth is not from outward appearances, but from what they can give to those around them and their community. He shrugged, and gave me a “humph” and it was obvious he didn’t like my answers. Janie proceed to tell me she had a little bit of pressure and watering from the eye, but otherwise was fine. Her fiance proceeded to tell me that he was going to move Janie a few states away to where his family was after she finished high school. At this point, all kinds of warning bells were going off in my head.  I had to figure out a way to talk to Janie one on one!!

I was worried that Janie was in an abusive relationship! How could I help???  I’m not sure why, but Janie’s fiance left the room, and I took my opportunity. I told Janie I had looked up the ER report and was not worried that there was something serious going on with her eye. I did ask her if anyone had ever hit her or hurt her? She said no, and the ER asked the same thing. I told her that I thought her fiance seemed a little controlling, and NO ONE should control another person!! I encouraged her to consider her situation. I also told her that emotional abuse is just as bad as physical abuse, and she should be in control of what goes on in her life. I invited her to come back and talk with me at anytime if someone hurt her or if she was worried about being in a relationship that she needed help getting out of. Janie responded by asking, “What’s your name again?” I told her, and she smiled, and said “Thanks.” I hope I see Janie again soon, and hope that I can help….

I am sharing this with you because odds are at least 1/2 of you are raising daughters.  There are too many young women in our society that end up in physically or emotionally abusive relationships. 

As parents, it is our job to raise daughter’s that are strong enough to avoid partners that are going to be abusive or controlling.

And, if you are raising a son, make sure you teach him to treat girls with respect at an early age. Raising strong, confident, mentally healthy men is a huge responsibility too, but that’s for another post. 😉

No one said it was going to be easy, but I can promise you it will be worth all the effort and hard work! Enjoy the journey! 😉

Mean Moms are the Best Moms

/ Katie P. Tolley, RN, MSN, CPNP-PC / 6 Comments

“I loved you enough . . . to ask where you were going, with whom, and what time you would be home.
I loved you enough to be silent and let you discover that your new best friend was a creep.
I loved you enough to stand over you for two hours while you cleaned your room, a job that should have taken 15 minutes.
I loved you enough to let you see anger, disappointment, and tears in my eyes. Children must learn that their parents aren’t perfect.
I loved you enough to let you assume the responsibility for your actions even when the penalties were so harsh they almost broke my heart.
But most of all, I loved you enough . . . to say NO when I knew you would hate me for it.
Those were the most difficult battles of all. I’m glad I won them, because in the end you won, too.
And someday when your children are old enough to understand the logic that motivates parents, you will tell them.”

I saw this poem in a pediatrician’s office when Joshua was a baby, and immediately knew these were words to live by. I was once again reminded of it today when a friend of mine called me for some Mom advice. I’ve told y’all that I started this blog because many of my friends call me for advice about their kids health and parenting issues. I never mind sharing my perspective and professional advice with a friend. I think we should all help each other.

As I’ve said before, It takes a village to raise a child, and it really does!!! 🙂

housewifeToday when I got a call from CC’s mom and heard what was going on, I knew I needed to do some clean up work, and fast. Mom’s mental health and stability is crucial for a happy, healthy family!!  CC is 13.5 months old, and one of the cutest little girls you would ever want to meet. She has a handsome, athletic Papa, and a beautiful, smart, strong, athletic, determined, and caring Momma. 😉 From the beginning, CC has given her parents many happy moments, and also a few challenging moments along their parenting journey. I remember going over in the first few weeks and helping CC and her Momma get the breastfeeding challenges under control. I told Mom at the time this was going to be a very head-strong little girl. I could tell from the beginning that she was going to learn how to do things her way. Today’s phone call let me know once again how head-strong and smart little CC is going to be. Even though she can’t say anything yet, CC made it known that she wanted to spend more time with her grandmother than mom by pushing away and saying what sounded like ‘Go away’….Can you say Heartbreak!! 😦 CC isn’t really talking yet, but we are thinking her first words were ‘Go away.’ When Mom called me, she had been processing this for a little while and just couldn’t believe her baby girl’s first words might actually be Go Away.

What this tells me is that Miss CC is S.M.A.R.T!! She has already figured out that spending time with a grandparents is all fun and games! Children learn very early on how to wrap those grandparents right around their little finger. Unfortunately, Mommy and Daddy don’t have this same luxury. Mothers and fathers have to be the disciplinarians. Parenting is NOT always fun. Children depend on their parents to set boundaries, create limits, and teach them what the real world is all about.  Mom and Dad don’t have all day to sit and play; they have to prepare meals, clean, do laundry, and work all while keeping up with the daily routine of life. So, playing all day is out of the question. Kids learn very early that they can get away with so much more with grandparents than parents, and they definitely use this to their advantage. Mom referred to CC as Miss Independence. I agreed with her, and told her that the text books really do call this developmental stage “Miss Independence.” Yes, there is no doubt where CC gets her smarts. 😉

I tell the working  mom’s I know that they really have 2 jobs, but only one of those jobs pays a salary. I tell the Moms that stay home that they have the hardest non-paying job ever. Motherhood is the hardest thing we will ever do… EVER!  Being a mother is the most thankless job you will ever have, but you really won’t care.  There is a saying that motherhood is like having your heart walk around outside your chest …how very, very true!

Being a mom does not mean you are your child’s friend. You can be their friend when they grow up and realize what a great person you are, and what a good mom you have been. Being a mom does not mean that you will do your child’s homework, they have to learn how to solve problems on their own. If they don’t struggle a little with learning, how will they ever persevere when things get tough.  Do not allow your child to think they are better than someone else. Being a mom means that you will discipline your child when they start to act inappropriately to another person. If children are not taught right from wrong, they will not learn what is right or wrong.  A mom should not let you talk disrespectfully to other people. A mom will make you use your manners, even if people are unkind. All of these Mean Mom things are going to help your child cope with the world around them, and build their confidence and self esteem. I could go on and on, but I think you get my point. And, yes, there are times, that you can let your guard down and just have fun with your children.

So, to my friend, I hope you are feeling better about being a Mean Mom. You are doing a fabulous job along this challenging  journey called Parenthood. Keep up the good work!! CC will thank you someday. 😉

As Mean Moms, we are teaching our children what is right and helping them become better people.

Mean moms are the world’s best moms! The world needs more mean moms on this journey, don’t you agree??

Leave the schedule behind & Enjoy Family Time!

/ Katie P. Tolley, RN, MSN, CPNP-PC / 2 Comments

Over the Easter holiday, my family spent a long weekend with cousins in Charleston, SC. We had such a great time, and the kids just love spending time with their cousins.

Today’s families have so much on their schedules; work, school (parents and kids), homework, sports, music lessons, church, choir practice, birthday parties, appointments, etc., etc….

Sometimes we need to schedule unscheduled time! 

It is so obvious when we watch how our children react to unscheduled time that it is necessary, and a valuable must for all of us! Being able to enjoy the great outdoors, a family meal, or holiday memories is more special than many of us realize.  The over-commitment and over-scheduling of today’s society can create stress and anxiety. Having time to just relax and enjoy each other without the rest of life’s demands keeps us healthy in ways that we don’t even think about. These demanding schedules can raise stress hormones, such as cortisol. Increased cortisol levels can cause difficulty concentrating, obesity, depression, sleep problems, high blood pressure, thyroid problems and many other health issues. Many of today’s kids are over-scheduled, it is important to make sure that children have time to unwind and relax. Given time to relax, cortisol levels will decline.

Unscheduled time allows for creativity. I’ve mentioned it before, creating and accomplishing things builds self esteem. Kids learn to make up games, build forts, and just explore their surroundings. One thing that time playing outdoors can do is help regulate neurotransmitters such as dopamine and norepinephrine. These neurotransmitters are important for normal brain function, concentration, organization, retention of information and paying attention. There is no doubt that kids need all the help they can get with focus and attention, especially those ADHD kids I talked about in my previous post.

Josh and AK battling it out!

During our time away, our children didn’t have a schedule, they ran around outside playing, jumping, climbing, bouncing, swimming, building, and just doing things that kids do. One thing I noticed during this time is that their was no complaining, no crying, no battling over attention, and the kids worked together to help one another! What a bonus for everyone!! 🙂

G reading Drew a book on our way to dinner.

Another cool thing I notice about hanging with our cousins is how kids bond, and you just can’t predict these things.  Most of us, as I did, would would assume that the girls would play girl things, and the boys would play boy things, but that isn’t necessarily the case. What happened is that the oldest cousin, Garrett (13) and the youngest, Drew Elizabeth (5) spent time together, and Joshua (10) and Anna Kat (11) spent time together most frequently.  It has been this way ever since they were very young. It is so cool to watch Garrett try to teach and explain things to Drew, and help her learn new things. I even caught him reading to her on our way to dinner. This changed just a little on this trip because Cousin Garrett has a girlfriend. When G’s girlfriend was around, Drew had to share , but she didn’t seem to mind. Even adding another kid to the mix didn’t cause any problems, everyone got along great. Drew climbed right up in the paddle boat with G’s girlfriend, and he had to take care of both girls, it was pretty cute! He bucked up and met the challenge, I think it really got him some brownie points with the GF! 😉

Overall, I think the unscheduled time is good for everyone, kids and adults alike! Taking time out to relax and smell the roses is one of the best coping mechanisms we can teach our children! It never hurts, and always helps to let those cortisol levels go down every now and then! The hard part is leaving to go back to the schedule of day to day life. Both of our children were very unhappy when it came time to leave, Morgan and I were too. 😦 Joshua hid in my cousins Suburban so he didn’t have to leave, it took a few minutes to find him too, crazy kid. Drew Elizabeth was carried on the verge of tears, kicking and pouting to the car. You don’t have to be very old to know that unscheduled time is the best for everyone. 😉

I hope that you figure out how to balance your children’s time.  There are so many things we want our children to experience and enjoy as they grow up.  Don’t forget some of the best things in life are things that happen by chance, not by a schedule.

My wish for you and yours is that you find lots of opportunities for unscheduled time along your journey! 😉

Bullying Info from Child Psych Mom

/ Katie P. Tolley, RN, MSN, CPNP-PC / 2 Comments

BULLYING IS NEVER OK!

What most kids don’t realize is that most bullies really have low self esteem and need to pick on others to make themselves feel better.

Bullying is such a huge problem in our society! I am grateful that my children go to a school that is very in tune with the students and their interpersonal relationships. Not all children have an environment that keeps them as safe as we hope. Now that I have delved into the world of blogging, I have found a few really great parenting blogs, one of which is Child Psych Mom. I recently read a post by Child Psych Mom that dealt with Bullying that I wanted to pass along to my readers. She has some great references to check out too.

Parents, teachers, and all adults should be hyper-vigilant about how children interact with one another. Bullying can affect a child’s self esteem for the rest of their life. Growing up in this society is hard enough without having some bully make it worse.

Read Child Psych Mom’s post Bullying: How Do I Save Myself? to educate yourself. The more parents and other adults know about bullying, the better we can protect our children.

And, remember, your children watch what you do, and learn from what you do! Spread happiness and smiles! 😉

BE CURIOUS, NOT JUDGMENTAL – Walt Whitman

Small Dose #7 – A little TLC goes a long way!

/ Katie P. Tolley, RN, MSN, CPNP-PC / Leave a comment

When your child is sick, the most important thing you can do is be there!!

Last night when Drew Elizabeth was vomiting, even though I am a Pediatric Nurse Practitioner, I couldn’t do anything…..except BE THERE & LOVE HER! Just being there beside her between the bouts of vomiting made all the difference in the world. Most of the time, Children tolerate illness better than adults. Children don’t know what to expect when they are sick. If  parents can be brave, strong, supportive and loving, it makes their children brave and strong.

The one thing we all want to do when our children are sick is make them better. This usually isn’t possible, most illnesses will last a certain amount of time no matter what we do as parents.Trust that your support can fix it just a little bit. So, as you travel along this unbelievable journey, remember how important a little TLC can be! 😉

Just being there and holding their hand makes all the difference in the world!

Small Dose #5 – Don’t just say it, live it!!

/ Katie P. Tolley, RN, MSN, CPNP-PC / 4 Comments

Be an example for your children!

Children watch and learn from the adults in their life.

Do not judge other’s for their differences, but embrace what makes us all unique! 

SMILE!

Be kind to others, and teach your children to treat others the way they want to be treated!

Say “Hello” to passersby.

Encourage your children to help those in need.

We all need to come together in our own community to make it a better place for our children’s future.

Volunteer in your community and encourage your children to do the same!

SPENDING TIME with your child is the MOST VALUABLE thing you can do for them,

and the one thing they WANT and NEED most in this world!

Don’t just say it, live it! 


“Spring Forward” without meltdowns…. Help your child adjust to the Time Change

/ Katie P. Tolley, RN, MSN, CPNP-PC / 5 Comments

If you have a baby or small child, it maybe painfully obvious that they don’t tell time! 

So, How can you help your little one adjust to the time change? 

Children have a difficult time changing schedules, especially by an entire hour. When babies in the hospital need schedule changes, the change is made in small time increments.

Try to change your child’s schedule by 15 minutes at a time each day.

For example, if dinner is usually at 6:00, keep in mind 6:00 is now 7:00. Waiting an extra hour for food is way too long for a little one. I’m sure I don’t have to tell you how quickly a hungry or tired child can have a meltdown. 😉 You could have dinner at 5:15 the first day, 5:30 the second day, 5:45 the third day, and by the fourth day, dinner is at 6:00 again. If you have the opportunity, spend a few days at each new time before moving on. Keep in mind, bedtime is now an hour later, which means they may wake an hour earlier than you plan if you don’t help them adjust. It may be that your child is off schedule enough that it is more difficult to wake them in the morning, small changes can help. If you have little ones that don’t go to school, this is much easier. If you have a little one that has to get up and go to school or daycare, you may have more of a challenge. If you need to be back on schedule by Monday (only 2 days away), you can force the change a little quicker by changing things by 30 minutes vs 15 minutes. It will not be as smooth of an adjustment, but it should be helpful.

Filling the time before meals with small healthy snacks such as fruit or veggies to help hold them over until the new dinnertime can be helpful too.

I learned early along my parenting journey that the time change can wreak havoc on a child with a good schedule. Good parenting involves schedules, so most kids will have some adjustment to make.  I hope this info makes “Springing forward” easier for your family! Good luck and I hope you are Enjoying the Journey! 🙂

There is no such thing as INNOCENT VIOLENCE!

/ Katie P. Tolley, RN, MSN, CPNP-PC / Leave a comment

After seeing today’s news about yet ANOTHER high school shooting, I felt compelled to share some information on children and violence.  The future of our children and the society we are creating weighs heavily on my mind.

Children that do not get the needed love, support and guidance during the first few years of life will constantly be seeking attention for the remainder of their life. This can lead to many issues for the child, as they do whatever it takes (good or bad) to feel valued. This feeling of worthlessness leads to inappropriate and high-risk behavior (see below).

I found some information online at the American Academy of Child and Adolescent Psychiatry that I wanted to share. This is serious stuff, so I’m not going to have any funny jokes or stories today, just feel the need to share some info….

The following information is copied directly from www.aacap.org:

1. “Hundreds of studies of the effects of TV violence on children and teenagers have found that children may:

Children with emotional, behavioral, learning or impulse control problems may be more easily influenced by TV violence.”
(if you click on the above writing in red, you can view the website directly)
2. “Factors Which Increase Risk of Violent Behavior: Numerous research studies have concluded that a complex interaction or combination of factors leads to an increased risk of violent behavior in children and adolescents.  These factors include:
  • Previous aggressive or violent behavior
  • Being the victim of physical abuse and/or sexual abuse
  • Exposure to violence in the home and/or community
  • Genetic (family heredity) factors
  • Exposure to violence in media (TV, movies, etc.)
  • Use of drugs and/or alcohol
  • Presence of firearms in home
  • Combination of stressful family socioeconomic factors (poverty, severe deprivation,    marital breakup, single parenting, unemployment, loss of support from extended family)
  • Brain damage from head injury”

3. “What are the “warning signs” for violent behavior in children? Children who have several risk factors and show the following behaviors should be carefully evaluated:

  • Intense anger
  • Frequent loss of temper or blow-ups
  • Extreme irritability
  • Extreme impulsiveness
  • Becoming easily frustrated

Parents and teachers should be careful not to minimize these behaviors in children.”

4. “Can anything prevent violent behavior in children?

Research studies have shown that much violent behavior can be decreased or even prevented if the above risk factors are significantly reduced or eliminated.  Most importantly, efforts should be directed at dramatically decreasing the exposure of children and adolescents to violence in the home, community, and through the media.  Clearly, violence leads to violence.  In addition, the following strategies can lessen or prevent violent behavior:

  • Prevention of child abuse (use of programs such as parent training, family support programs, etc.)
  • Sex education and parenting programs for adolescents
  • Early intervention programs for violent youngsters
  • Monitoring child’s viewing of violence on TV/videos/movie”
Pretty heavy info, I know, but so important to share. The well being of our children and the future of our society are at risk.  The one thing we can do to make a difference is try our best to raise mentally and emotionally healthy children.  What a difficult, but important journey we are on friends! I hope some of my advice helps you along your journey!

Small Dose #3 – Sleep

/ Katie P. Tolley, RN, MSN, CPNP-PC / 1 Comment

Sleep is a vital need for good health! Make sure your kids have a good bedtime routine.  If your child wakes up tired, they are not getting enough sleep.  If your child wakes up ready to take on the world, sounds like the zzzzz’s were enough. A child that doesn’t get enough sleep is not able to function at their best potential.  Children that do not get enough sleep will exhibit symptoms similar to ADHD; they may have trouble paying attention and retaining important information. More info in a future post on the importance of sleep! Thanks for joining me on this amazing journey called parenthood!! 😉

Praise & Encouragement go a long way…Be your child’s cheerleader!

/ Katie P. Tolley, RN, MSN, CPNP-PC / Leave a comment

Kids need to know that they are doing the right thing, and they depend on Mom and Dad to keep them in check!  We all have had our moments when our children are definitely not acting the way we raised them, or so we thought.

Remember, much of our teaching is by example, and much of what kids learn about behavior is observed.

I find myself raising my voice more often than I like, it is a bad habit that I am trying to stop.  There are days that Joshua just makes me lose it, and if I don’t walk away, I could turn into a Drill Sargent. When I say do something, I expect it to be done, you know what I’m saying??? I don’t want to have to repeat myself 2, 3, 4 or more times!! It definitely takes a lot of patience to be a parent, more than I ever imagined!

The louder I get, the less they hear…. The longer I talk, the less they hear…. 😦

It’s not that I have chosen to parent this way, there are just those days that I’m on the go and/or stressed over something, and I have less patience. On days like this, I am grateful for a husband that can balance me.  Fortunately, we balance each other well! 🙂 When he has his days, I have to call him down too. We talk about it, and know we need to keep our cool and address the issue at hand.  Instead of focusing on what Josh has done wrong, focusing on the behavior and how to change it is the key. I mention Joshua, because he IS the reason James Dobson wrote the books, Raising the Strong Willed Child and Bringing Up Boys! Which I highly recommend! Good info, and fun to read!

Consequences are the best answer to unacceptable behavior!! I have tried to chose my words carefully with my children.  It is important to mean what you say, and follow through! Don’t give empty threats; like Santa won’t bring you any toys……Really? I doubt it! I do tell Josh that I can take those toys Santa brings and put them in the basement!!  😉 This is the ultimate consequence for Josh. If we take a toy that he is currently obsessed with, he straightens right up.  We have started to take some of the toys and electronics away during the school week.  It makes for better focus, and actually more “creative time”!!  I’ve talked about the importance of what I call “creative time” for a child’s self esteem. Win – Win!

Praise is one of the most effective mechanisms of good parenting. Praising a child makes them feel good about what they have accomplished…making them feel good about their self… building self esteem! When children feel good about an accomplishment, it creates drive and ambition to create something else that mimics that ‘feel good’ feeling.

Encourage your child to reach for the stars!! Children are limited or unlimited by their surroundings. An environment that is negative and lonely can severely limit a child. Children want to be loved and accepted, it is a basic human need. If a child feels neglected, they will do whatever it takes to seek the attention they so desperately crave. These attention seeking behaviors can be acting out, crying, throwing toys, and in adolescents drug use and sexual promiscuity, just to name a few.  Encouraging a child to take that next step, like singing that song in front of the church congregation, or playing a sport, or building a lego house….. Whatever it is that they want to do, encourage it! 

Basically, if you praise and encourage your children for their positive actions and behaviors you will get positive behavior in return. Be your child’s cheerleader! Tell them they have nice manners.  Encourage them to do well on that test and on the playing field. Cheer them on! Be an example of happy, positive behavior!

Pick your battles. Let them express themselves! Encourage pink or purple hair, if that is what makes them happy, it’s only hair, long, short, or different colors, what’s the big deal (unless there is a special or formal event).  I saw two kids yesterday, one with pink and one with purple streaks. I thought it was a fun way for them to express themselves. BTW- Drew Elizabeth wants purple hair, we settled for a couple feathers in her hair the for the first time, but I’m all for the purple hair.  I’ll definitely keep you posted on this one!

I ask the teenagers that I see in the office what they want to do when they grow up, some know, some don’t.  I ask them what they like to do the most?  When they have free time, what is it they are doing? I tell them to take whatever it is that they like the most, and think about a career that is similar. I tell them they can take whatever it is they like the most in the world and use their imagination to find a way to make a living doing it. They look at me, smile a little bit, and I can see the wheels start turning.  Teens are a different bunch, they torment their parents, I’m not looking forward to the teen years.

SO, Praise your children & Encourage them to reach for the stars….It makes for happy healthy kids!! Happy, healthy kids are what this journey is all about, ENJOY!