Immunization/Vaccines for children

Immunizations are designed to protect against serious illnesses ranging from polio and tetanus to measles, mumps, and the seasonal flu. Many people consider them the most important part of well-child checkups.

How immunizations work

Immunizations are vaccines made of either weakened or "killed" versions of the bacteria or virus that causes a particular disease. When these altered viruses and bacteria are injected or taken orally, the immune system mounts an attack that stimulates the body to produce antibodies.

 Once produced, the antibodies remain active in the body, ready to fight off the real disease. For example, if whopping cough  broke out in your area, an immunized child would be much less likely to contract the disease than one who wasn't immunized.

Every year, the U.S. Centers for Disease Control's Advisory Committee on Immunization Practices publishes a new schedule showing which vaccines are recommended and when to get them. This schedule is endorsed by the American Academy of Pediatrics and the American Academy of Family Physicians.

If your child has gotten behind on immunizations, ask your doctor about the "catch-up" schedule.

Dtap, to protect against diphtheria, tetanus, and pertussis (whooping cough):

• At 2 months
• At 4 months
• At 6 months
• Between 15 and 18 months (can be given as early as 12 months as long as it's at least six months after the previous shot)
• Between 4 and 6 years old
• A booster shot at 11 or 12 years of age (called the Tdap)

Hepatitis A, to protect against hepatitis A, which can cause the liver disease hepatitis.

• Between 12 and 23 months, two shots, six to 18 months apart

Hepatitis B, to protect against hepatitis B, which can cause the liver disease hepatitis:

• At birth
• Between 1 and 2 months
• Between 6 and 18 months

Hib, to protect against Haemophilus influenza type B, which can lead to meningitis,pneumonia, and epiglottitis:

• At 2 months
• At 4 months
• At 6 months (not needed if the PedvaxHIB or Comvax brand of vaccine was given at 2 and 4 months)
• Between 12 and 15 months

HPV, to protect against human papillomavirus, the most common sexually transmitted disease in the United States and a cause of genital warts and of cervical, anal, and throat cancers:

• Three doses for girls and boys at age 11 or 12 years

Influenza (the flu shot or, for age 2 and up, nasal spray vaccine), to protect against seasonal flu and H1N1 (swine flu):

• Age 6 months and up, every year in the fall or early winter
• One dose for most children
• Two doses for children 6 months to 8 years old who are getting the flu vaccine for the first time or who had only one dose of the flu vaccine in the previous year's flu season

Meningococcal, to protect against meningococcal disease, the leading cause of bacterial meningitis in U.S. children in pre-vaccine days:

• Between 11 and 12 years
• A booster shot at 16 years of age

MMR, to protect against measles, mumps, and rubella (German measles):

• Between 12 and 15 months
• Between 4 and 6 years old

Pneumococcal (PCV), to protect against pneumococcal disease, which can lead tomeningitis, pneumonia, and ear infections:

• At 2 months
• At 4 months
• At 6 months
• Between 12 and 15 months

Polio (IPV), to protect against polio:

• At 2 months
• At 4 months
• Between 6 and 18 months
• Between 4 and 6 years old

Rotavirus, (given orally, not as an injection) to protect against rotavirus, which can cause severe diarrhea, vomiting, fever, and dehydration:

• At 2 months
• At 4 months
• At 6 months (not needed if the Rotarix brand of vaccine was given at 2 and 4 months)

Varicella, to protect against chicken pox:

• Between 12 and 15 months
• Between 4 and 6 years.

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Answer for Cassandra

If you're receiving long-term disability (LTD) benefits, keep in mind that your insurance company can terminate your monthly payments for any number of reasons. It's important to be familiar with the most common reasons that LTD benefits are cut off so that you can try to continue to receive benefits for as long as you're disabled. The most common reason to have your benefits terminated is that you are no longer disabled, or the insurance company finds this to be true.

Every LTD plan is different, so it's likely that not everything that follows will apply in your case. For information about your particular plan, check your policy's summary plan description or, even better, the policy itself.

Time Limitation on Mental and Chronic Conditions

Many policies contain a 24-month limitation on disabilities arising from mental, nervous, and psychological impairments. If you're receiving LTD payments due to depression, anxiety, post-traumatic stress disorder, chronic fatigue syndrome, or a similar impairment, you may be limited to receiving 24 months of benefits. There are often, but not always, exceptions for organic mental disorders like dementia and organic brain disease, as well as illnesses such as schizophrenia and bipolar disorder. The rationale behind this limitation, from the insurance company's perspective, is that most of these impairments can be exaggerated or outright faked. While this policy does keep premiums lower than they otherwise would be, this comes as cold comfort to the vast majority of LTD recipients with bona fide mental illnesses whose benefits are terminated after only two years.

Some policies also apply the 24-limitation to arthritis, carpal tunnel syndrome, back pain, and other chronic pain conditions.

In addition, disabilities based on alcohol or drug abuse will almost always be subject to the same limitation. If you're confined to an inpatient treatment facility when your 24 months expire, most insurance companies will continue to pay benefits until you're no longer confined, subject to a cap.

Failure to Apply for Social Security Disability Benefits

If you've been approved for LTD benefits, your policy likely requires you to apply for Social Security disability insurance (SSDI) benefits. Because insurance companies are allowed to "offset" SSDI payments against LTD benefits (not pay you the amount you get from Social Security), they naturally have an interest in seeing you approved for Social Security disability. Failure to file a claim with the Social Security Administration could result in your LTD benefits being terminated.

Failure to Continue Treatment

LTD policies generally require you to submit periodic proof of your continuing disability. This can consist of an annual re-certification by your doctor that you're still disabled or a requirement that you attend regular medical examinations. One of the most common reasons LTD benefits are terminated is that the person has failed to receive regular medical treatment. Even if your doctor has told you there's "nothing else that can be done for you," if you stop seeing a doctor, your insurance company may interpret your lack of treatment as proof that your condition has improved. (And of course, even if you've continued to receive regular treatment, your LTD benefits can be cut off if your records indicate that your condition has improved.)

Discovery of Activities by Surveillance

It is possible that your LTD insurer will arrange a surveillance team to track you for several days. This can include following you on your daily errands and to doctor's appointments, parking outside your house, and recording you. This can be a disconcerting experience, and LTD recipients should exercise caution when interacting with anyone they suspect to be an investigator. If you're observed engaging in activities that are inconsistent with your impairments, the insurance company may determine that your condition has improved and your benefits could be discontinued.

Shifting Definition of Disability After 24 Months

Many LTD policies contain a provision that changes the meaning of "disability" after 24 months. Initially, disability can be defined as "the inability to perform your own occupation" due to a physical or psychological impairment. When 24 months have elapsed, the definition of disability can narrow to "the inability to perform any occupation." That means that if you're medically capable of performing virtually any job that exists in the economy, your LTD benefits may be terminated. This determination usually doesn't take into account whether such jobs are available, only that they exist.

Aging Out of Coverage

Your LTD benefits will usually end when you reach your Social Security normal retirement age (66 or 67) or upon your death. If you're over 60 when you're approved for LTD, your benefits may continue past your normal Social Security retirement age, but generally only for a few years. Check out the Maximum Benefit Period chart in your LTD policy to see when your benefits expire.

Working

Working while receiving LTD benefits can also cause your payments to cease, though sometimes this applies only if you're earning a substantial portion of your pre-disability wages. Consult your policy for its rules on working to learn how working might affect your case.

What To Do If Your LTD Benefits Have Been Terminated

If you've received a letter that your disability benefits are being discontinued, you should contact a disability lawyer immediately to handle your appeal.

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Breast pain during pregnancy

  

Breast pain during pregnancy is nothing unusual or uncommon. In fact, it is one of the very earliest possible signs of pregnancy. Pain in the breast is prominent in the first trimester of pregnancy. Your breasts feel sore, swollen, tender, and sensitive. It begins from the fourth to sixth week of the pregnancy. Most expectant women note that the breast pain disappears or reduces in the second and third trimester of pregnancy. However, some may experience its re-occurrence from time to time. There are many factors that lead to breast pain during pregnancy. The most important ones are described here. 

What are the Causes of Breast Pain During Pregnancy 

Fibrocystic Breast Changes
The most common cause of pain in breast during pregnancy is fibrocystic breast changes. Such changes involve swelling of very tiny cysts, filled with fluid, present in the fibrous tissue of the breast. 

Hormonal Imbalance
As your body prepares to undergo various stages of pregnancy development, the hormonal levels also change quite fast. Imbalance in the level of estrogen often results in breast pain. 

Leaky Breast
Many expectant mothers complain of breast leaking in the second or third trimester of pregnancy. This occurs because your breast start producing a thick-fluid called colostrum. Colostrum is the fluid that provides nourishment to the new-born in the first few days, before your breast start producing milk. Your breasts secrete it during a breast massage and sexual arousal. This a major cause of breast pain in the later stages of pregnancy. A very effective remedy to this problem is the use of a nursing pad. 

Change in Breast Shape and Size
The main function of the breasts is to feed the baby after childbirth. Your body prepares the breasts gradually. There is a formation of milk-ducts and milk-producing cells during pregnancy. This causes your breasts to enlarge. More layers of fat begin to grow beneath your breasts. This changes both the shape and size of your breasts. Your breasts keep growing by almost a cup-size in the first three months of maternity. All of these factors ultimately cause breast pain.

How to Alleviate Breast Pain
Wear a bra that supports your breasts. You can even try wearing two or three bras, if the need arises. Not wearing a bra can worsen the pain in the breast during pregnancy.
Try to wear a padded or a sports bra in case your breasts are too voluminous and heavy. They will be the most suitable for you.
Cut short on the intake of salt. Salt can worsen the breast pain by helping the body retain water in the breasts.
Drink plenty of water. This will help your body in flushing out excess of fluids.
Keep yourself physically active. Take a walk for about 20-25 minutes daily. Keep doing some light household chores.
Ask your gynecologist for some painkillers. Generally, Tylenol is prescribed. Avoid self-medication.
Either heating or ice pads can help provide comfort. Test both and choose the one that suits you the best.
Take the help of yoga and meditation to relax your body. Even this will help you tolerate the pain under breast during pregnancy.
Though breast pain during pregnancy, especially accompanied with leaky breasts, is uncomfortable, embarrassing and painful, it is absolutely natural and harmless. Still, it is advisable to consult a gynecologist to rule out any possibility of complication associated with this pregnancy symptom.

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Child abuse is a very serious matter, and is extremely important when dealing with babies and small toddlers because they often cannot effectively communicate their situation and are thus more helpless and at greater risk than school-age children. If you suspect a child is the victim of abuse, be aware of any of the following warning signs.
An abused child may exhibit a sudden fear of a particular location, gender, or physical appearance (e.g. women with long brown hair, men with beards, etc.) They may cry when being dropped off at daycare or seem uncomfortable and avoidant around caregivers and other adults. Conversely, they may exhibit greater fear of being left alone or separated from a parent when in the presence of the abusive party.
Sexual abuse victims may be afraid of getting undressed for bathing, or abnormally uncomfortable with doctor visits. They may also show signs of regression, i.e. a potty-trained child going back to wetting his pants; thumb sucking; decrease in verbal skills.
Toddlers may have interruptions in their sleep pattern and more frequent nightmares.
Be aware of increased interest in sexuality or an age-inappropriate knowledge of sexual behaviors.
Abused toddlers may be unable to engage in normal, interactive play with their peers.
Look for sudden, drastic personality changes. A normally outgoing and assertive child may become unusually compliant and passive, while a generally mild child may act in a demanding and aggressive manner. The child may become less talkative or stop communicating almost completely, or display signs of a speech disorder such as stuttering.
Watch out for external signs of physical abuse such as bruises, burns, black eyes, cuts, abrasions, and other injuries. It's normal for children to bruise their knees, shins, elbows, and forehead as they interact with the physical environment -- but bruises are more suspect if they appear in unusual places such as the face, head, chest, back, arms, or genitalia.
Infants may display changes in appetite, a total loss of interest in food, unexplained gagging and vomiting, and other symptoms related to emotional stress
Since every child develops at a different rate, it can be difficult to determine whether a developmental delay stems from abuse or complaining of headaches or stomachaches that have no medical cause.
Shaken Baby Syndrome (SBS) is a common form of abuse in which the infant is subject to forceful, violent shaking that can lead to long-term disability and even mortality. Depending on the duration and intensity of the episode, signs of SBS can include retinal damage, lethargy, tremors, vomiting, irritability, seizures, decreased appetite, an inability to lift the head, and difficulty breathing

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Can I be pregnant after tubal ligation

Is Pregnancy Possible After Tubal Ligation?

Pregnancy is possible after tubal ligation. Tubal ligation procedures are intended to be permanent and effective. Although tubal ligation procedure are highly effective at preventing pregnancy, pregnancies can occur after the fallopian tubes have been blocked. Tubal ligation procedures do have failures and pregnancy can occur after a tubal ligation.

Failed Tubal Ligation

A tubal ligation can fail in three ways: the fallopian tube may be missed during tubal ligation surgery and the tube may not be closed at all, the tube may form a fistula (new opening), and recanalization (rejoining of the tubal lumens) can occur.

Most times the fallopian tubes will be closed after a tubal ligation; however, if a patient has severe scar tissue it may be much harder to identify where the fallopian tubes are located. A fistula is a small opening which may remain after the healing response has been completed. This allows sperm to get through to fertilize and egg but the egg may have a harder time finding the small opening and getting back into the uterus. Recanalization occurs when the tube is not adequately closed and the tube reopens after the tubal ligation.

What Are the Chances of Tubal Failure?

The largest study to date on tubal ligation failure is the CREST study. This study found that tubal ligation failures do occur and can be as high as 3%  depending on the method of tubal closure. Tubal ligation failures occured more often in women who had Hulka clip procedures and in younger women. These are the failure rates in the CREST study for the different methods of tubal ligation:
Unipolar Coagulation  0.8%

Unipolar Coagulation 0.8%
Tubal Ring 1.8%
Interval Partial Salpingectomy 2.0%
Bipolar Coagulation 2.5%
Hulka Clip 3.7%

Can You Have a Pregnancy After a Tubal Ligation?

Pregnancy can happen after a tubal ligation. A pregnancy after a tubal ligation is considered high risk because there is a greater likelihood the pregnancy will be ectopic (tubal). If a woman becomes pregnant after her tubes have been tied, she should see her doctor immediately to be evaluated for an ectopic pregnancy. Some post tubal ligation pregnancies will be inside the uterus but a large portion (30-40%) of them will be outside the uterus and in the tube. This is condition requires immediate evaluation and appropriate treatment.

Can You Have A Baby After A Tubal Ligation?

The possibility of pregnancy after a tubal ligation is very real for many women who have had their tubes tied. The chances are higher among women in their twenties and among women who have had Hulka clip tubal occlusion. The reality is women who have had their tubes tied can become pregnant after the procedure. If you have become pregnant then you should see your doctor immediately to be evaluated for a tubal pregnancy. If you want to be pregnant and have a baby then you should not rely on the failure of a tubal ligation to achieve this for you. Many women will find better and safer success in becoming pregnant after a tubal ligation though tubal ligation reversal surgery or IVF.

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Handling allergies in children

Allergies in children can range from a minor annoyance a couple times a year to a debilitating condition that seems to take over the lives of your entire family. Allergies have become far more commonplace over the years, to the point where around 50 million Americans suffer from some kind of allergy. And as a parent, if you’ve ever suffered with your child while you try to discover just what irritant is causing your child’s allergy, you know they can be horrible to deal with.

Children who are discovered to have severe allergies to things like peanuts often suffer from airborne allergies, meaning even breathing in the irritant can cause an allergic reaction. This can cause drastic changes in your child’s life.  A kid with an airborne peanut allergy can’t even be around a classmate who has eaten a peanut butter sandwich at school. Other allergies are milder and are much more manageable.

If you see symptoms in your child such as a runny nose, red, watery eyes and congestion it is important to take them to their doctor and have them tested to find out what they’re allergic to. If your child has a more serious reaction such as swelling or trouble breathing, go to the emergency room immediately. Once you discover your child’s allergy be sure to get them medication if possible to manage the symptoms.

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Potty training is a major milestone. Get the facts on timing, technique and handling the inevitable accidents.

Potty training is a big step for kids and parents alike. The secret to success? Patience — perhaps more patience than you ever imagined.

Is it time?

Potty-training success hinges on physical and emotional readiness, not a specific age. Many kids show interest in potty training by age 2, but others might not be ready until age 2 1/2 or even older — and there's no rush. If you start potty training too early, it might take longer to train your child.

Is your child ready? Ask yourself these questions:

• Does your child seem interested in the potty chair or toilet, or in wearing underwear?
• Can your child understand and follow basic directions?
• Does your child tell you through words, facial expressions or posture when he or she needs to go?
• Does your child stay dry for periods of two hours or longer during the day?
• Does your child complain about wet or dirty diapers?
• Can your child pull down his or her pants and pull them up again?
• Can your child sit on and rise from a potty chair?

If you answered mostly yes, your child might be ready for potty training. If you answered mostly no, you might want to wait awhile — especially if your child has recently faced or is about to face a major change, such as a move or the arrival of a new sibling. A toddler who opposes potty training today might be open to the idea in a few months.

There's no need to postpone potty training if your child has a chronic medical condition but is able to use the toilet normally. Be aware that the process might take longer, however.

Ready, set, go!

When you decide it's time to begin potty training, set your child up for success. Start by maintaining a sense of humor and a positive attitude — and recruiting all of your child's caregivers to do the same. Then follow these practical steps.

Pull out the equipment
Place a potty chair in the bathroom. You might want to try a model with a removable top that can be placed directly on the toilet when your child is ready. Encourage your child to sit on the potty chair — with or without a diaper. Make sure your child's feet rest firmly on the floor or a stool. Help your child understand how to talk about the bathroom using simple, correct terms. You might dump the contents of a dirty diaper into the potty chair to show its purpose, or let your child see family members using the toilet.

Schedule potty breaks
If your child is interested, have him or her sit on the potty chair or toilet without a diaper for a few minutes several times a day. For boys, it's often best to master urination sitting down, and then move to standing up after bowel training is complete. Read a potty-training book or give your child a special toy to use while sitting on the potty chair or toilet. Stay with your child when he or she is in the bathroom. Even if your child simply sits there, offer praise for trying — and remind your child that he or she can try again later.

Get there — fast!
When you notice signs that your child might need to use the toilet — such as squirming, squatting or holding the genital area — respond quickly. Help your child become familiar with these signals, stop what he or she is doing and head to the toilet. Praise your child for telling you when he or she has to go. Teach girls to wipe carefully from front to back to prevent bringing germs from the rectum to the vagina or bladder. When it's time to flush, let your child do the honors. Make sure your child washes his or her hands after using the toilet.

Consider incentives
Some kids respond to stickers or stars on a chart. For others, trips to the park or extra bedtime stories are effective. Experiment to find what works best for your child. Reinforce your child's effort with verbal praise, such as, "How exciting! You're learning to use the toilet just like big kids do!" Be positive even if a trip to the toilet isn't successful.

Ditch the diapers
After several weeks of successful potty breaks, your child might be ready to trade diapers for training pants or regular underwear. Celebrate this transition. Go on a special outing. Let your child select "big kid" underwear. Call close friends or loved ones and let your child spread the news. Once your child is wearing training pants or regular underwear, avoid overalls, belts, leotards or other items that could hinder quick undressing.

Sleep soundly
Most children master daytime bladder control first, often within about two to three months of consistent toilet training. Nap and nighttime training might take months — or years — longer. In the meantime, use disposable training pants or plastic mattress covers when your child sleeps.

Know when to call it quits
If your child resists using the potty chair or toilet or isn't getting the hang of it within a few weeks, take a break. Chances are he or she isn't ready yet. Try again in a few months.

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How to grow your baby's mind

Author John Medina's new book BRAIN RULES FOR BABY outlines a workable formula for growing your baby's brain to its healthiest potential. It starts in utero, as you probably guessed. And it does not include playing classical music up against your bulging waistline or sitting in poetry readings at the public library. It DOES include eating healthy foods, getting plenty of rest, trying not to stress out, exercising and otherwise leaving your fetus alone.

Researchers say the good news is that the brain takes a long time to fully develop, so you have months and years to contribute to the healthy growth of your child's brain. Your baby's brain has to tie together 1.8-million new connections per second to make up a complete brain. Only 17-percent of that work is done before birth. 83-percent continues AFTER birth, up until the child is in his/her early 20s. Obviously, in humans, the brain is the last organ to finish developing. So take a deep breath... your child's healthy brain development has a long growth-curve that you can continually contribute to.

The first senses to develop are for survival...the senses of touch, sight, and hearing come by 4 weeks in the womb. The senses of smell, balance and taste come in weeks 5 to 8 during pregnancy.

To help your newborn during this developmental stage, take what Medina calls the "GOLDILOCKS" approach, where conditions are not too hot, not too cold, but just right. So try to eat the right amount of foods that are obviously healthy, so that you'll gain a healthy amount of weight during pregnancy (that differs for each woman, but approximately 25 pounds for a single fetus.) Your baby's IQ rises with their birth weight, so a full-weight baby is a smarter baby (up to 8 pounds, then a chubby baby's IQ starts to drop). And try to get plenty of Omega-3 fatty acids which are found in prenatal vitamins regularly prescribed during pregnancy.

Avoid stress during your pregnancy. Stress can make your infant more irritable, can lower your child's IQ and literally be the difference between a bright baby and a child with an average IQ. Stress can also limit your baby's motor skills and ability to concentrate as well as his/her stress-response system from birth to age 6. In effect, stress during your pregnancy can shrink your baby's brain. David Laplante, lead author of a key study on baby brain development says "we suspect that exposure to high levels of stress may have altered fetal neurodevelopment, influencing the neurobehavioral abilities in early childhood." Getting a little stressed out one day in a traffic jam is one thing. But frequent, severe recurring stress will hurt your little one. Take a stretch or yoga class, take a warm shower, get a pedicure, take a walk around the block...do whatever lessens your stress level and your baby's brain will thank you!

Also try to get a moderate amount of exercise to both relieve stress and to help grow your baby's brain. It will reduce the toxic effects of day-to-day stress during pregnancy and will make delivering your child quicker and less painful, which is less stressful for both you and your baby. Because when your heart rate goes up, so does your baby's. Which is good in moderation for the baby's heart and oxygen supply. But overly strenuous exercise near the end of the pregnancy is also bad. It can overheat the baby and actually cause his/her oxygen supply to restrict from lack of blood flow. Again, think GOLDILOCKS - not too much of anything.

Interestingly, evolutionary biologists say morning sickness has a positive role to play, because it tends to make a mom stick to a bland diet, rest more and stay away from harmful activities - all of which protect her unborn baby. And here's one that will save you some money: Medina emphasizes that despite the boastful claims, no commercial product has EVER improved brain performance in a developing fetus! So don't buy expensive books, videos and DVD's expecting to increase IQ.

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Sleep deprivation

Sleep deprivation is not just for new moms or stressed-out parents. Plenty of kids don’t get enough shut-eye, leaving them ill-equipped to handle the rigors of life. Can these junior insomniacs turn their sleep habits around before adulthood?

CAN MELATONIN HELP YOUR CHILD SLEEP?

When a child is tossing and turning instead of snoozing and dreaming, she typically wakes in the morning struggling to face the day. Childhood insomnia is more common than many think but there could be a solution to this nagging condition.

A sleepy generation

Most parents are at least familiar with exhaustion, but few realize how many kids don’t get enough sleep on a regular basis. “[A] study by Boston College revealed that the United States has the highest number of sleep-deprived students in the world,” says Dr. Robert Oexman, director o the Sleep to Live Institute. “Seventy three percent of 9- and 10-year-olds and 80 percent of 13- and 14-year-olds in the U.S. are identified by their teachers as being adversely affected by sleep deprivation.” Most children fall far short of the 8 to 9 1/4 hours of recommended sleep per day, leaving them functioning at a less-than-optimal level.

Causes of junior insomnia

Kids definitely need time to recharge, especially while trying to maintain their busy schedules. A lack of truly restful sleep could result in nodding off in class, shortened attention spans and a compromised immune system. While there are many causes of sleeplessness, Dr. Oexman believes that three main factors significantly contribute to insomnia in children — electronics in the bedroom, competing activities and changes in melatonin production. “[B]ringing electronics in the bedroom can decrease sleep time, lower test scores and even increase the risk of depression," says Dr. Oexman. "The bedroom should remain a ‘tech-free’ zone!” Furthermore, parents need to find a healthy balance between scheduling commitments and opportunities for sleep while respecting the fact that a child's circadian rhythm changes with maturity.

Melatonin: The body’s sleep aid

Often in desperation, parents will turn to prescriptions or, more commonly, over-the-counter (OTC) medications to help their children sleep. While these may provide short-term relief, the focus should be on achieving restful sleep, naturally. “Melatonin is something that our body produces naturally each night — it helps us to fall asleep and stay asleep throughout the night,” says Dr. Oexman. “As with all OTC medications, melatonin should be used for short-term treatment only — and only after behavioral modification techniques have failed. If your child can’t sleep but they’re playing video games and watching TV right before bed — the answer isn’t melatonin. Change the behavior first and remove the electronics from the bedroom.”

Practical tips

Dr. Oexman provides the following tips for parents of children dealing with insomnia:

• Behavioral modification is the best solution for adolescent insomnia.
• Keep strict bedtimes. Establishing a bedtime routine is helpful (warm bath, reading a book etc.)
• No staying up late to do homework. Establish a cut-off time.
• Keep electronics out of the bedroom — including the cell phone!
• Do not allow your kids to consume caffeine — soda, tea or energy drinks. Caffeine consumed past 12:00 p.m. can keep children up later that night.

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