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The Informed Parent

Scanning the Journals

by John H. Samson, M.D., F.A.A.P.
Published on Apr. 30, 2004

Excess Fruit Juice Consumption by Preschool-aged Children is Associated with Short Stature and Obesity:

Pediatrics Vol.99 #1, Jan. 1997: 15-22

This startling title certainly attracted the attention of the news media. In so doing, it generated a great deal of concern to parents. The statistics in the paper indicated a numerical relationship between the child's height and weight and the amount of fruit juice consumed. Those children who drank more than 12 ounces per day had shorter stature than the 20th percentile for age, and greater weight than 90th percentile for age.

The study encompassed only 168 children; 94 were two-year-olds and 74 were five-year-olds. As usual the news media portrayed this with absolute certainty and instructed parents to limit fruit juice intake drastically.

If one reviewed the entire paper it became clear that the authors did not intend such a harsh dictum. They postulated several hypothetical reasons that might explain their findings. It was a well constructed study, but it only involved 168 children. The authors themselves honestly stated that obesity and short stature are caused by many factors, and further studies are needed before this relationship is unequivocally documented.

My advise to parents is to use common sense and moderation when providing nutrients to their offspring. Also, use these same qualities when gleaning medical information from the news media.

Behavioral Characteristics of Children with Stool Toileting Refusal: Pediatrics Vol.99 #1, Jan. 97: 50-53

"Potty training" for defecation is an extremely tense subject for many families. Everyone wants their little one to use the toilet as soon as possible. Requirements for child care facilities and the unsavory task of handling stool-filled diapers makes this something to achieve at the earliest age possible.

In the past, pediatric behaviorists have tried to link toilet refusal to significant behavioral problems.

The authors of this paper show that children who refuse to defecate in a toilet by age four years do not have more behavior problems than those who are trained. They also noted a higher incident of constipation and pain with bowel movement passage.

In my own patient experience, it seems that toilet use refusal for bowel movements is more common in family situations where parents exert great emotional pressure to "perform on the pot". The pressure can either be positive or negative. Today few people feel it is sound to punish a child for not using a toilet. In the same breath I would like to say, reward your child for using the toilet only if someone rewards you for a similar performance. Let toilet usage be as neutral and natural as possible.

The Use of Television in Two-to-Eight-Year-Old Children, and the Attitude of Parents About Such Use:

ARCH. PED. ADOL. MED. Vol 151, Jan. 1997: 22-26

This study from Italy shows something we should all know but perhaps do not want to acknowledge. In so many words, it shows that the children's amount of T.V.viewing and the content of the programs is directly related to the viewing of the parents.

I am sure many of you are saying, "Big deal! Who doesn't know that." Well, many parents behave as though this is a great secret. Before assessing your child's use of T.V., assess your own. The cliche "Chip off the old block" applies here.

I frequently hear parents admonish their children for not watching documentaries, educational programs and "family shows." Yet, when investigating the viewing habits of these very parents we find that 90 percent of their T.V viewing is composed of programs laced with violence, sex and criminal behavior.

It never works to parent by the philosophy "Do what I say, not what I do!"

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