Newsletters

Healthy Child Fall/Winter 2000

Questions & Answers

by SUSAN J. MARGOLIN, M.D., M.P.H.
CHIEF, GENERAL PEDIATRICS

If you have a question for the pediatrician, please e-mail it to ESALAMON@SBHCS.COM or mail it to Elizabeth Salamon, Public Relations, Saint Barnabas Medical Center, 95 Old Short Hills Road, West Orange, NJ 07052

Dear Dr. Margolin,

Q.
My daughter is 10 and she has just gotten her period. She is feeling a little self-conscious because she is the first one in her group of friends. Is it unusual to begin at this age, and how can I help her to feel more comfortable with the changes she is experiencing?
A.
It is not unusual for a ten-year-old girl to have gotten her first period. As nutrition in the U.S. has improved, growth and pubertal development have accelerated and breast development in girls can begin as young as age eight with the onset of menstruation about two years later. Your daughter may be the first of her friends to experience this, but many others will follow shortly. The best way to help your child adjust is to explain, in as simple a way as possible, what is happening to her body. The time to begin an explanation of maturation is when you see breasts beginning to develop. In that way, you can gradually introduce the concept of body change so that by the time menstruation occurs your child will be prepared.

Dear Dr. Margolin,

Q.
Are there any recommended guidelines for television viewing for children at various ages?
A.
The American Academy of Pediatrics recommends that children below the age of 2 years not watch television at all. Research on early brain development has shown that babies and toddlers have a critical need for direct interaction with parents and other caregivers so that appropriate social, emotional and cognitive skills will develop. Television disrupts that interaction. Ideally, after 2 years of age, the Academy recommends only one hour of TV viewing daily. Currently, the average American child or adolescent spends more that 21 hours per week watching television and this seems to be significant factor leading to obesity. It may also lead to decreased school achievement and more aggressive behavior.

Dear Dr. Margolin,

Q. My three-year-old son seems to become constipated fairly frequently, even when he was an infant. Is constipation a function of diet or heredity or both? What do you recommend to help the situation?
A. Constipation is not the frequency of bowel movements, but the consistency of the stools. As long as stools are soft, a child is not constipated. If your child has hard stools that are pellet-like, that is constipation. Some children normally move their bowels daily, others every few days, and both are acceptable. If your child has hard stools, increase the fiber in his diet by giving bran cereal, leafy vegetables and fresh fruits. Should the problem persist, consult your pediatrician.

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