This pediatrician has watched your mental battles from the sidelines this year, Mama.

2020 was not an easy year to be a mom.

Personally, I can tell you it kind of sucked, right? Just a little. The pandemic brought about so many hard choices that NO mother should ever have to make. My brain’s stream-of-consciousness ran a little something like this:

“Should I let my kids play with other kids? Will they get sick if they do? Will not interacting with others harm them more than catching COVID will? Should we start in-person school? Will masking all day be hard for them? Is virtual school a better option for us? Will looking at a screen all day hurt my kid’s eyes? Will lack of interaction with peers lead to social regressions? Are my kids eating and snacking too much? Do I need to choose between my kids seeing their friends, and my kids seeing their grandparents? Is my child in his room too much? Is he exercising enough? Is he sad too often? Is social media going to influence his behavior? Is it normal for sleep to be this much of a struggle – for both me and my kid? Am I telling my kids to wash their hands too much? Will this give them a germ complex? What do I tell my kids when they see those protests on the street? What do I tell them when they see the news on TV? What do I say when they hear people angry and shouting at each other?”…and so on and so forth…over and over…and for me, usually happening at 3 a.m.

So now that you know that I worried about a lot of the same things you did, let’s talk.

This Mother’s Day I’d like to tell you about what I’ve seen and heard in the privacy of my exam rooms.

More anxiety than I’ve ever seen in my career. In both parents and kids.

More depression in children and teens.

More mental crises.

More weight gain.

More screen addiction.

More sleep problems.

More suicidal thoughts.

Momming has never been more difficult. Not only have we been burdened by our own mental struggles, but we’re trying to cope with our kids’ mental strain now more than ever.

Some advice:

1. “Put on your own oxygen mask first – and then help your children with theirs”. Take care of yourself so that you can then throw that energy into your child and his/her struggles.
2. Look for help – Cook Children’s pediatricians, psychologists, and psychiatrists and hospital staff are here for you. We know kids - especially the mental health of kids. Check out the new Cook Children’s JOY Campaign for TONS of resources.
3. Please, ask questions. If your kid is struggling, ask your pediatrician – will some socializing be okay? Should my kiddo return to school/ go to camp? Is it safe? What are the pros/cons? What is the risk by doing this activity or that one? How much screentime is healthy for my kid? Is this behavior normal, or is my teenager showing signs of a problem? What are some resources so I can learn more?
4. Look into counseling. At my office EVERY DAY I tell parents: every single human on the planet goes through a time in their life where they’d benefit from therapy. Do it. Don’t feel weird about it. Just go talk to someone – and take your kid to talk to someone. Psychologists are trained to help you through this.

From one mom to another: we are not meant, as humans, to deal with as much stress as we have in the past year and come out unscathed.

There’s a reason you keep hearing the word “unprecedented” when it comes to 2020 and 2021. The pandemic, the politics, the civil unrest - this was a year that no one anticipated, and no one was prepared for. Know that you’re not alone in what you or your child may be dealing with.

So put down your armor, you warriors. And reach out your arms and accept some help! And give yourself a little grace.

This year was a scary and painful mess. And this Mother’s Day, no matter how much you yelled at your kids, no matter how much you felt you didn’t have the answers, and no matter how much you questioned your decisions, I want you to pat yourselves on the back. Because just surviving has been the victory here. And you’re doing the best you can.

But I hear from my patient families all the time that it's anything but relaxing.

The American Academy of Pediatrics recommends doctors ask parents three questions about mealtime:

1. How anxious are you about your child’s eating?

2. How would you describe what happens during mealtime?

3. What do you do when your child won’t eat?

When offered a healthy, well balanced meal with fresh fruits, vegetables, and lean proteins, kids will stop eating when they are full. Children will naturally refuse to eat when they are not hungry. We often describe these as normal appetite slumps. We can disturb children’s natural satiety cues by either forcing them to eat or by offering foods high in added sugar or salt when they won’t eat. This results in a child who will “only eat chicken nuggets.”

Parents are most successful in feeding their children more fruits and vegetables when they model healthy eating, set appropriate limits, and have a positive attitude at mealtime. “The parent determines where, when, and what the child is fed; the child determines what to eat.” ⁽¹⁾ In other words, “parents provide and kids decide”. ⁽²⁾ 

Here are some tips on eating mindfully and encouraging your kids to eat in a manner that gives them more energy and helps them avoid chronic disease. These are easy ways to change your lifestyle that don’t involve a ton of work and expensive supplements.

1.Drink more water. Kids should not drink juice or soda except on special occasions.

2.Drink milk with meals. Children from age 1-2 should be on whole milk. After the age of 2, low fat or skim milk is recommended.

3.Vitamin supplements are not needed unless your child does not drink milk. Vitamin D is essential for bone health and immune function and may play a role in prevention of chronic disease.

4.Serve 5-9 servings of fruits and vegetables daily. Encourage your children to at least take a bite of everything you serve. Remember that children will need to taste a food 10-15 times before they decide they like it. Lean protein like fish and baked chicken might be better accepted if you add ketchup as a condiment.

5.Add healthy protein likes nuts (for older children) and legumes. Peanut butter is fine for younger children and new allergy immunology guidelines suggest that early introduction of peanut may actually decrease the risk of peanut allergy.

6.Eat more meals at home. Keep staples such as eggs, whole grain pasta, pasta sauce, yogurt, carrots, frozen vegetables, chicken breasts, and fruit stocked at all times so that in a pinch you could throw together a simple meal.

7.Double your recipes and freeze 1 meal at the same time that you cook the other meal. This will save you from making a trip to a fast food restaurant when you have that go to meal in your freezer.

8.Serve only whole grain breads and pastas.

9.Avoid buying, eating, or serving processed foods (chips, cookies, cakes).

10.Avoid fried foods and fast foods.

To read more about nutrition needs of children at different ages, I highly recommend the book “Nutrition: What Every Parent Needs to Know" available on the American Academy of Pediatrics (AAP) online bookstore.

See choosemyplate.gov for more information about how your child’s plate should look at meal time.

Realize that children’s tastes will change over time. They will sometimes refuse foods they readily accepted in the past, and they will readily accept foods that they refused in the past. Involve your children in shopping and meal planning. Let them help in the kitchen! Take them to a local farmer’s market and let them choose something new for everyone to try.

Take a matter of fact and pleasant approach to meal times and ENJOY YOUR FAMILY! Create wonderful childhood memories.

References:

1. “A Practical Approach to Classifying and Managing Feeding Difficulties” Pediatrics Volume 135, number 2, February 2015

2.Nutrition: What Every Parent Needs to Know. AAP

The doctor’s office should not be a Haunted House.

The “evil nurse” lurks around the corner with their pointy needle, ready to stab anyone who comes across their path.

We might as well put on some eerie music and serve hot chocolate.

Is your child afraid of shots? Are you?

Here are some things that you should NOT say to your child about shots:

1. “I promise you are not getting shots today.”
2. “If you don’t behave, you are going to get a shot today!”
3. “Shots don’t hurt.”

Why not? Recommendations change and sometimes we get our flu shots in early. Shots are live-saving, not punishment. Shots hurt, period. For some kids they seem to hurt worse than others, but pretending they feel great isn’t helpful.

Here are some easy ways you can help your child’s shot hurt less:

1. Prepare them - If you know they are getting shots, please let them know ahead of time but you don’t have to give them all the details either. “It will hurt but only for a second” is usually enough. You don’t have to go on to say, “It’s a little needle and they only stick it in this far and push this hard, blah blah blah.”
2. Distract them - You can talk to them, show them a movie, read a book; whatever takes their mind off of things.
3. Relieve them - As soon as everything is over, hold them. For babies, nurse or feed them.
4. Reward them - Stickers or stamps are my favorite rewards…why do kids love them so much?

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page. He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.