10 Things Your Nanny Won’t Tell You

nanny safetyI saw this article in the Wall Street Journal on October 13, 2013 and the title made me smile. What does my (your) nanny know that I (you) don’t? From a pediatrician’s perspective, this is a great opportunity to raise a few thought-proviking questions.

1. “Your kid loves me more than you.”

Wow – this means the parent is never around or the nanny is over stepping boundaries. TIme to change your lifestyle or nanny.

2. “You’re the worst part of my job.”

This is a natural yet unfortunate and avoidable situation. When you have two people caring for a child, they both want to be the ‘gatekeepers’ of health and wellness.  This creates a tension as the two people may have different value systems and thus caring styles. I see this all a lot with mothers and mother-in-laws. The solution is to make clear boundaries and know the child is yours. Always be open to advice and guidance but do not be afraid to hold your line and your family’s boundaries.

3. “I can’t save your kid’s life (or treat his injuries).”

Enroll all caregivers, is parents, grandparents, older children, nannies, etc, in a CPR course.

4. “I’m sleeping with your spouse.”

Umm, no comment.

5. “You’re not paying me enough.”

Salary is always a debate and fairness depends on the level of responsibility and availability of the nanny. $16 an hour is the median. I suggest thinking about the nanny’s  family needs as well. Your nanny is part of your community and if you do not take care of your community then points #1-4 are more likely to occur. Enough said.

6. “I’ll sue you.”

Be professional and respectful and this should not happen. If I were writing this for the nanny, I would make sure they created their own boundaries and would have them express these at the start of their employment to avoid unnecessary problems. Clear communication and respect are the key to to any healthy relationship. Karma, karma, karma.

7. “I’m smarter than you are.”

This may be true and often is true. However smarts do not determine who runs the house or how the children are cared for. Many times the employee is smarter than the boss but again let professionalism and respect rule the day.

8. “Your secret’s not safe with me.”

Having someone live in your house makes one vulnerable since they get to see you with your guard down. Again if you are respectful and professional then there should not be a problem but I suggest having the nanny sign a confidentiality and nondisclosure agreement.

9. “I know about that nanny cam.”

Technology allows 24 a day surveillance. Use it especially if your child is less then 6 years old. Every job should have markers of performance and when working with toddlers who cannot provide an adequate history then a camera (or several of them) are fine.  I would let the nanny know they are there too.

10. “You better do a thorough background check on me.”

This goes without saying. I have had parents run background checks on me as their pediatrician. This is not only smart to do but necessary. I work on the child protection team and never want to see your child in my office for a suspected abuse.

The bottom line is treat your nanny with respect, be clear about your boundaries, do not worry about disagreements as long as both sides are professional, and treat them like family. Working with a co-gatekeeper will force you to acknowledge your own strengths and weaknesses, will demonstra
te to your children how to work with others and give you time to contribute to your larger community. After all, our lives are about service.


Parents Magazine features Dr. J Brian Thornburg as a doctor “Making A Difference”

Parents Magazine selected Dr. J Brian Thornburg as one of the top 7 pediatricians in the country “Making A Difference.” The magazine highlights the 7 of us in their November 2013 issue, and the American Academy of Pediatrics is honoring us at their 2013 National Convention and Exhibition Welcome Reception.

At the opening reception of the AAP’s national conference, Parents Magazine and Desitin will provide each of us a $1,000 check for a charity of our choice.  My check will go to the Children’s Advocacy Center of Collier County for abused children.

Thank you to everyone from my family and friends to my patients for giving me the courage to pursue a vision and to care for so many wonderful children. I am grateful to Parents Magazine, Desitin and the AAP for this recognition.

Teach New Baby to Sleep by 3 months old

babyzzzs243Infants are capable of sleeping through the night by 3 months of age. But most textbooks, and pediatricians, will tell parents that infants should sleep through the night by 12 months of age.  A new study in the Journal of Pediatrics investigated whether infants really could sleep through the night. It explored three different criteria for sleeping through the night: midnight to 5 a.m.; for eight hours; or for the eight hours from 10 p.m. to 6 a.m. (the pattern that most likely matches the family pattern of sleep). The researchers asked parents of infants to keep sleep diaries for six days each month for a year. The infants were also monitored by a time-lapse video recorder.

Surprise! Infants are capable of sleeping through the night by 3 months of age regardless of which of the three criterion was used to define sleeping through the night. Although it was harder for infants to meet the 10 p.m. to 6 a.m. goal by 3 months of age, many could do so. 

After the infant is 1 month old, parents should begin planning, and working with the pediatrician, on getting the infant to sleep through the night.


What’s Your Feeding Style?

Meals to parentingby http://justtherightbyte.com/2010/10/whats-your-feeding-style/

Feeding is arguably one of the most time-consuming and grueling jobs of parenthood.  Often thankless, and plagued with parental insecurity and low confidence, parents struggle and muddle through the process of feeding their children. Here is a sobering statistic:  throughout an 18 year childhood, a parent will feed their child over 28,000 times (assuming age-appropriate meals and snacks). The effort to feed a child can be overwhelming…planning, procuring, preparing, serving, and cleaning up.

Parent feeding styles, and their impact, warrant attention, particularly when you look at the magnitude of feeding interactions throughout a child’s life.

Researchers suggest that feeding styles, or the attitudes and actions a parent uses in the process of feeding their child, closely mirror parenting styles.  Did you know that each parent has a style of their own when it comes to feeding?  And while one style is generally used most of the time, all the parenting styles can overlap and mingle.

Our feeding styles also tend to mimic our own experiences as a child;  they are deeply ingrained, and our “go to” method for feeding our own children.  In other words, parent feeding styles reflect childhood experiences with food and eating.  In the current climate of childhood obesity, it is sobering to think about the feeding styles that our current generation of children may be using with their future offspring.

There are four parenting styles and as an extension of this, feeding styles:

Authoritarian, also known as “parent-centered” parenting.  In the realm of feeding, this style is associated with “The Clean Your Plate Club”, where rules about eating predominate, from trying foods to completing a meal. Dessert is contingent upon eating dinner.  Parents plate the food for their children.  Eating is directed by the parent, rather than self-directed by the child.  A child’s true feelings and subsequent actions about food and eating may be hidden, while potential animosity and compensatory behaviors build around eating.  Weight problems, both underweight and overweight, are correlated with this parenting style.

Permissive, also known as “The ‘Yes’ Parent”.  A parent with this parenting style feeds their child in a similar fashion: even though “no” or limitations may be the first response, “yes” ultimately reigns.  The classic example of this is the mother who is attempting to manage the vocal child in the grocery store who wants candy at the checkout stand.  He begs and begs, hearing, “no, no, no…well….okay, I guess so.”  Children of permissive feeders may become overweight, as research shows that the limits on calorie-dense foods may be unlimited.

Neglectful parenting, when aligned with feeding, often produces the ill-prepared parent: irregular shopping, empty cabinets and refrigerators, and no plan for meals. Food and eating may lack importance for the parent, and that may transcend to feeding their child.  Children who experience this feeding style may feel insecure about food and eating, and unsure about when they will have their next meal, if they will like it, and if it will be enough.  These children may become overly focused on food and frequently question the details around mealtime.

Authoritative, or the “Love with Limits” parenting style, promotes independent thinking and self-regulation within the child, but also sets boundaries within which the child is expected to operate. The authoritative feeder determines the details around the meal (what will be served, when it will happen, and where it will be served), but allows the child to decide if they will eat what is prepared, and how much they will eat.  Trust and boundaries are the basis of this parent feeding style.  Children who have authoritative parents in the home tend to be leaner, good at self-regulating their food consumption, and feel secure with food and eating.  The most current research advocates this style of parenting/feeding as an effective childhood obesity prevention approach.

So, mom and dad, what’s your feeding style and how is it affecting your child?