Keeping city kids healthy and happy A pediatrician on what Manhattan parents need to know about childhood asthma, cyberbullying and the “Three B's”
Dr. Alok Patel, pediatrician, NewYork-Presbyterian Morgan Stanley Children's Hospital and Columbia University Irving Medical Center. Photo courtesy of Dr. Patel
By Michael Garofalo
Dr. Alok Patel, a pediatrician with NewYork-Presbyterian Morgan Stanley Children's Hospital and Columbia University Irving Medical Center, spoke with Straus News about what Manhattan parents can do to foster healthy habits in their kids. The conversation that follows has been edited and condensed.
What is a health topic that is particularly important to keep in mind for Manhattan parents?
Asthma has been on my mind lately. Thousands of New York children with asthma will have asthma attacks, visit ERs or get hospitalized, and this is all preventable. Asthmatic children are at risk here because it's a crowded city and there are a lot of triggers. Parents need to be on top of their children's medications, doctor visits, and have emergency plans ready. Also, it's especially important to take note of your child's triggers and to keep living areas clean. Cleaning up dust, pet dander, carpets and avoiding smoke — these small steps can all prevent an asthma attack.
How do you address parents who are concerned about vaccinating their children?
I get a lot of vaccine questions from parents in New York City from all cultural and socioeconomic backgrounds. I generally avoid the term “anti-vaccine” and instead use “vaccine-hesitant.” While we do have a small portion of people who are truly anti-vaccine, because they come to us and say “absolutely not,” many are simply vaccine-hesitant, meaning they want to do what's best for the child but they really want to have a dialogue. They've heard rumors on the internet and they come in questioning vaccines. They raise questions about vaccines' ingredients, safety and efficacy. Pediatricians know that vaccines save lives but we can't fault a parent that's been scared by an article and has a question or two.
One of the most important things to get out is that it's OK to have an open conversation with parents that are vaccine-hesitant. It's not OK to label them or avoid the conversation. The minute we break down that provider-patient communication, we're leaving people to their own information source. With vaccinations, we want to be that source. We want to be the ones that are getting the vaccine-hesitant parents, sitting them down, and saying, “What is your concern? Let me tell you what I know. Let's do this together.” Because at the end of the day we're all in it for the same reason, and that's the child's health.
Do you have any recommendations for helping kids deal with bullying?
One large issue that we have is cyberbullying, which we see on such a large basis that it's almost unavoidable, especially with some of our teenagers. The thing that's tough about this is that, as far as I know, there's not a great way to prevent it. So what I do is try to reiterate that cyberbullying is not a personal reflection and that these bullies are insecure. It may be hard for a teenager to accept that, but listening to their concerns and giving them a safe place to speak can make feel empowered. It helps to remind patients to focus on their strengths and to avoid acknowledging cyberbullying — to just ignore it, it's noise on the internet!
If they feel unsafe from the bullying — meaning they're being assaulted at school — that's a completely separate issue that needs to be raised immediately with administrators to protect our children. Also, if a child is getting psychologically affected, we want to make sure we get them the right support.
What are a few things parents can do to promote good health in their children?
We are still seeing an increase in overweight teens and adolescents and childhood obesity, and we don't seem to be doing the best that we can to get on top of this issue. Right now, about one in three American kids or teens are overweight or obese. Eating healthy and getting kids more active is key. Doctors recommend that all kids get at least 60 minutes of moderate to vigorous exercise a day. When I say that to an adult it sounds like a tough workout plan, but if you think about being a child it could be playing in a park, playing a sport or riding a bike with parents. Parents have to set a good example and create an environment in which your kid is excited to go out and play with you.
Another topic that we have to bring up is sleep. Over the last decade, more and more scientific studies are proving the importance of sleep. Not getting enough sleep is more detrimental to childhood development than previously thought, and an alarming number of American teens — studies state as much as 90 percent — don't get the recommended nine hours per night. There are a lot of culprits for this. An important thing to do would be to first, look at how much sleep your own children get. If they're not getting enough sleep, take a step back and ask what the reason is. Are we keeping them up too late with schoolwork? Are they overloaded on activities? Are they using their smartphone in bed? Knowing your teen's bedtime patterns, or “sleep hygiene,” is crucial when it comes to helping them get quality sleep.
For young kids, keep it simple: brush, book, bed. The three B's. Brush your teeth, read a book and then get to bed. Make sleep time a little more systematic, at the same time every day. Remember to be a positive role model for young ones — good habits start early!