Tips and Tricks in Adoption and Pediatrics

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Learning to Use Spacers and Inhalers

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Inhalers for asthma, when used with a mask/spacer device, work just as well as nebulizer machines, with much less time and fuss. Here are some tips:

  • For younger children show them on yourself, then have them "teach" a stuffed animal, and practice on you.
  • Let them play with a new mask and spacer for a while before using it for meds
  • If they don't like the mouth taste of the medication, let them have a potato- or tortilla-chip before-hand, to coat their tongue, and then give them a sweet treat, fruit, or sugar-free gum afterwards to wash out the taste (from Contemporary Pediatrics)
  • For inhaled steroids (Flovent, etc), wipe around their mouth afterwards, and give them something to drink to wask out the medicine.

Weaning Nighttime Bottles

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After 6 months or so, certainly past 1yo, kids who are otherwise growing well don't physically need those middle-of-the-night bottles - they're what the behaviorists call "trained night wakers". It's up to you how aggressively you want to wean this, but here's a good tip.

Take the bottle that hurts you the most (4am, anyone?), and water it down over several nights, until you're offering a bottle of just water. That often helps the child give up that particular habitual wakeup. Remember to be brief and boring about it, as well.

Fun with Shopping Carts

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Parent Hacks: Real-world parenting tips from real parents
Ed's novel grocery store entertainment hack: Do you go grocery shopping with your child? My son Joshua enjoyed going to the grocery store and seldom created an issue.Sitting in the cart in front of me was good for me, but it really obstructs the view for your child. Try turning the cart around and pushing it from the front. This places the child at the front like he’s driving. He can see everything and is seldom less than an arm's length away. Give him directions where to turn, and don’t forget to run into a stack of paper towels to two. Joshua especially liked it when I’d turn the cart sideways and drive him right up to the item I wanted. He was happy to help as all children are and quickly learned the difference between a can of corn and a can of green beans.

Cooling Down Hot Food

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Clinical Tip: Cool way to make hot food edible - Contemporary Pediatrics
Children often have to wait a long time for food to cool before they can eat it safely. This is especially true for pizza, oatmeal, soup, and casseroles. Adding ice cubes cools food quickly, but the ice makes the food soggy, or dilutes it, as it melts. Instead, I tell parents to go to the housewares section of a good department store and buy a set of novelty plastic, liquid-filled "ice cubes" shaped like seashells, trees, hearts, or stars. They can keep the cubes in the freezer ready to add to hot food or float in a bowl of soup. The food cools quickly, and children enjoy watching the shapes sitting or floating in the food.Warn parents to make sure that the child doesn't try to bite into the plastic shapes or eat them. Parents also should inspect the shapes before use to be certain the liquid contents have not leaked. After use, the plastic shapes can be cleaned with soapy water, rinsed, dried, and "recharged" in the freezer for the next time they are needed.

Blood Testing for Aliens

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I can't wait to try this ...

Artfully Dodging Blood-Test Fears (Contemporary Pediatrics)

Between 5 and 12 years of age, children often ask, at the beginning of their annual physical exam, whether they need a blood test. I've learned to dodge this question because, if you tell a child that a blood count is in her immediate future, she asks over and over when it's going to happen and whether it will hurt. My dodge is simply to tell the child that I won't know if she needs a blood test until the end of the visit.
Once the moment of truth arrives, I use a simple technique to distract the child. After I tell her that she will need a finger poke, I quickly add that the reason for the test is to find out if she is an alien. I then take out a test tube filled with green or purple "blood" and mention that someone from outer space came in for a physical the previous week. This usually gets the child's mind off the poke and onto whether I'm making up the alien thing and what's really in the test tube (food coloring and water—an off-label use). The technique doesn't always work, but we have a lot of fun when it does.

Tip for Toe-Walking

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From Contemporary Pediatrics ...
Illuminating approach to toe-walking

A 5-year-old patient in my practice wore orthotics for 18 months to correct toe-walking—without success. Then, his mother bought him a pair of "light-up" sneakers for his birthday. For the lights to work, the child had to come down on his heel with each step. He was so motivated to get his sneakers to light up that he stopped walking on his toes. At first, the boy walked normally only when wearing sneakers. After he he had worn them for two months, however, his gait improved markedly, and now he toe-walks only 10% of the time.

Make-a-Schedule Software

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The folks at www.do2learn.com market online and downloadable Make-a-Schedule software that lets you create, print and save color picture communication cards, daily and weekly schedules, chore charts, and "social story" strips for kids with language/communication difficulties. Pictorial schedules like this are IDEAL for toddler and older adoptees during the transition; they're used to a very structured routine, and being able to anticipate the day's schedule can really help, especially as you introduce new outings and activities. For children with ADHD, FASD, autistic spectrum disorders, or kids who just need to have their schedule available visually, this can be an ongoing help in communicating and organizing their daily activities. They also have some free organizational resources, educational games, and learning strategies for various conditions.