Valentine’s Day, Adolescent Peers, Nursing at Night – PediaCast 109

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  • Saint Valentine's Day
  • Difficult Infants
  • Adolescent Peers
  • Nursing At Night
  • When To See A Dentist?



Announcer 1: Bandwidth for PediaCast is provided by Nationwide Children's Hospital. For every child, for every reason.


Announcer: Welcome to PediaCast, a Pediatric podcast for parents. And now, direct from Birdhouse Studios, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone, and welcome to PediaCast. This is episode 109, for Thursday, February 14th, 2008. Difficult Infants, Peers, and Dentists.


But before we get started I want to say Happy Valentine's Day. The US Greeting Card Association estimates that approximately one billion with the B… billion Valentines are sent each year worldwide. And that makes this day the second largest card sending Holiday of the year behind Christmas.

And also off note, the association estimates that women purchased approximately 85% of all those valentines. I kept on wondering about the origin of Valentine's Day. Was it the work of the greeting card companies to begin with?

I mean, I don't think that would have surprise me really and I have to say I'm a little embarrassed that I don't remember the origins of Valentine's day from school.


So I did some looking with the help of my good friend Wikipedia and I discovered something interesting, maybe I did learn it somewhere and just had forgotten it but kind of doubt it. Is it everyone ringing a bell with me at all.

But apparently, Valentine's Day goes back to 1382 and a poem written by Geoffrey Chaucer, now I'm not going to read you the poem it's a long one, I can't think 700 lines, it's called "Parliament of Fowls… and Chaucer wrote it to honor the first anniversary of the engagement of King Richard II of England of course, to Anne of Bohemia.

And in his poem Chaucer's says "For this was on St. Valentine's Day when every bird come up there to choose his mate…. But actually prior to this poem there had not been a Valentine's Day nor had there been any day really associated with romantic love.


He made it up. And then since that time, there's been lots of historical events associated with St. Valentine's Day. For instance in Paris in the year 1400 the high court of love was established to deal with the love contracts, betrayals, and violence against women and judges for the court were selected by women on a basis of a poetry reading.

I guess the gentleman who read the poetry the best were selected as judges, I assumed. In England in 16011 Shakespeare Ophelia mentions Valentine's Day in Hamlet. And in Rome in 1836, Pope Gregory the XVI donated the relics of a man referred to as St. Valentine to the Whitefriar Street Carmelite Church in Dublin, Ireland.


But unfortunately for this man, he was strip of his sainthood in 1969 when the Vatican removed him from the Roman Catholic Calendar of Saints, saying "That the memory of St. Valentine is ancient, part for his name nothing is known of St. Valentine, except that he was buried on the Via Flaminia on the 14th of February.

And then what about the greeting cards? Well the first mass produced Valentines of embossed paper lace were produced in the United States by Esther Howland in 1847 and today the Greeting Card Association honors an individual each year with the Esther Howland award for a greeting visionary.

I bet you didn't know that. All right I know, no that's pediatric related, but look tell your kids about the history of Valentine's day that will make you look smart. OK, see we can relate it to parenting.


So what our real topics today or we're going to talk about Difficult Infants which serve a continuation of our last episode. Also Adolescent Peers nursing at night and when to see a Dentist.

Don't forget if there's a topic that you would like us to discuss, just go to, click on the contact link or you can e-mail or call the voice line at 347-404-KIDS. The information presented in the show is for general educational purposes only.

We do not diagnose medical conditions or formulate treatment plans for specific individuals. So if you do have a concern about your child's health, make sure you call your doctor and arrange a face to face interview and hands on physical examination.

Also your use of this audio program is subject to the PediaCast Terms of Use Agreement which you can find at And with all that in mind, we'll be back News Parents Can Use right after this.



Some infants are called difficult, challenging parents because they cry frequently, are very active and may not adapt well to new situations or people. Other infants are described as easy, full of smiles, adaptable, and not very active.

Now conventional wisdom would suggest that easy baby's would do better in first grade than the difficult ones. There's also a new study tell us otherwise with the key being the type of parenting the children receive.

The study which followed infants from birth to first grade found that first graders who were difficult as infants and whose mothers provided excellent parenting had as good or better grade, social skills and relationships with teachers and peers as first graders who were less difficult as infants and had excellent parenting from their mothers.


The key to first grade adjustment for both difficult and easy infants was good parenting said Anne Dopkins Stright Associate Professor of Human Development at Indiana University and the studies led author. The study was conducted by researchers at Indiana University and The University of North Carolina at Chapel Hill.

It's published in the January, February 2008 issue of The Journal of Child Development. The researchers followed children taking part at the National Institute of Child Health and Human Development Study of Early Child Care from birth to first grade and 1364 families came from 10 geographic areas in the United States and included ethnic minorities 24% and single moms 14%.


When the children were six months old their mother filled out a questionnaire on their baby's temperament. Children who did not respond well to new situations and people were very active, had intense emotions, cried a lot and did not adapt well were classified as having difficult temperaments.

That was my daughter. The researchers observes mothers as parenting specifically the mother's warmth and age appropriate control six times from infancy to first grade.

When the children reach first grade their teacher's filled out questionnaires on children's adjustment to school including their academic competence, social skills such as cooperation, assertion and self-control and relationship with teachers and peers.

The results of the study support the notion that infants may vary in the degree to which their nervous systems are sensitive to input from their surrounding environment with more sensitive infants, more likely to have difficulties according to the researchers.

Because of their more sensitive nervous systems, infants who have more difficult temperaments may be more likely to be irritable and cry more frequently.


But these infants also may be more positively affected by excellent parenting and more harmed by poor parenting. And for this reason, the quality of the parenting they receive may mean more for this children's development than for other children.

This study may have important implications for early intervention and the early identification of difficult temperament during infancy may help to more effectively plan and implement interventions according to Stright, for example, physicians can identify parents who perceive their children as temperamentally difficult at infancy and refer these parents for supportive services.

The findings also provide support for parents of difficult infants. These infants may exhaust and frustrate their parents but with high quality parenting these infants may become the most academically competent and socially skilled students in the first grade compared to infants who are easier to parent. Data collection for the study was funded by the National Institute of Child Health and Human Development.


Girls in High School take us many Math courses as boys influenced by close friends and peers who are doing well in school. More than boys, girls look to their close friends when they make important decisions such as whether to take Math and what Math classes to take.

Confirming how significant peers are during adolescence. Those are the findings of a new study conducted by researchers at the University of Texas at Austin, the University of Pennsylvania and Michigan State University. The study is published in a January, February 2008 issue of the Journal Child Development.

The researcher's look at 6547 good sample size high school girls and boys who had a variety of relationship with peers and track the math courses they took. All of the students have taken part of the National Longitudinal Study of Adolescent Health from 1995 to 2001.

The researchers found that contrary to popular opinion but in line with recent government findings, girls have caught up with boys in terms of the math courses they take in high school.


One reason, as so they found is the kinds of friends and peers they have in high school. All teens, girls as well as boys with close friends and other peers who make good grades took more higher level math than other teens according to the study, but the connection between this relationships and the math classes were stronger for girls than for boys.

In the end social factors meant more for girls than for boys in decisions about math course work especially when enrolment in math classes was optional and when girls are doing well in school. These findings stressed the need to turn attention away from documenting gender differences in math course taking in high school and toward looking at the reasons why girls and boys take different path as to the same outcomes.

According to Robert Crosnoe, Associate Professor of Sociology at the University of Texas at Austin and the studies led author. In other words, just because girls and boys might have the same academic standing at the end of high school does not mean that they got there in the same way.


The study also was funded in part by the National Institute of Child Health and Human Development and the National Science Foundation. And that wraps up today's News Parents Can Use. We will be back to answer your question, on the other side of this break.



Natalie: Hi Dr. Mike. This is Natalie from Westminster, Colorado, and I was calling because I had a question about nursing my daughter. She'll be 13 months next week and I still nurse her at night but my doctor says I needed to stop that because it would cause her teeth start decaying.

And I was just trying to find out because I heard conflicting information and then seems like one place is telling me that… actually most places are telling me nursing is not a problem, it's just putting her down with the bottle of milk. So, I just wanted your opinion on it and thanks for the great podcast, really appreciate it and look forward to hearing your answer. Thanks, bye.


Dr. Mike Patrick: All right, thanks Natalie. So, we have a nursing question. Natalie has a 13 month old daughter, she's only nursing at night now and her doctor told her she needs to stop because baby's teeth will start to decay if she nurses at night time.

And mom seeing some conflicting information, most sources saying that nursing is not a problem but that putting her down with a bottle of milk is problem. So what I'll think about this.


Well, the problem with milk at night as it relates to dental caries which is, what we're talking about, cavities in the baby teeth that occurs when milk or juice or really any other sugar containing fluid regardless of the vehicle, whether it's a bottle, or sippy cup or the breasts.

If that sugar containing fluid sets on the teeth too long and the bacteria in the mouth begin to digest the sugar which they're up to do then this bacteria produce an acid by product and that acid is what dissolves the tooth enamel dentin and that result in dental caries or cavities, and this can end up being quite severe, very quickly because the thickness and toughness of the enamel and baby teeth is not even nearly what it is in adult teeth.

So they do get cavities easily. And why is this occurs at night time? Well, one of the reason is that when the child is awake the flow of saliva washes the acid from the surfaces of the teeth.


See there's a reason for all that drool. And that when babies are asleep the saliva flow is significantly reduced allowing the acid to pull around the teeth if there's sugar present and the bacteria are digesting the sugar.

So really you don't want any formula or milk or juice or any sugar containing substance in bottles or sippy cups when your baby is asleep or at the breast when your baby is asleep, so don't do it.
Knowing this, what's the deal with breast feeding? Well it's only going to be an issue if you let your baby fall asleep on the breast for a long period of time and allow him/her to suck intermittently which by the way is called "at will night time breast feeding….

That's the situation you want to avoid but if it's a night time feeding and 10 minutes on each breast and then baby's back asleep that's fine, that's not going to be a problem at all, it's when they're sucking intermittently all night long next to you which some people do, shouldn't but some people do and that is how the milk is going to pool on the teeth while they're sleeping, the bacteria are going to digest the breast milk, we got sugar present, then you got acid and that's going to dissolve the enamel of the teeth.


So unless Nathalie that your doctor can tell you some other mechanism that I don't know about that would make you not want to breast feed normally during the night time, let me know then I can share my ignorance with the rest of the audience but I don't think there's another mechanism.

All right, let's move on to another one, I'm all out on Skype Messages so load me back up folks, call the Skype line and 347-404-KIDS and shoot me your messages that way and we'll get to them really quickly. OK so here's one that came by e-mail, Alicia, in Washington D.C. says, "Hi Dr. Mike, I have a question about caring for my 16-month-old daughter's teeth.


Do you like how I put these two together? She has 12 teeth, including four molars and we brushed them every night with some protest, when in your opinion should we take her to the dentist for the first time? Every book, website or person I ask, seems to have a different answer.

Our pediatrician said not until age three but I've also read that the first dentist visit should be before the first birthday if the mother, me has any cavities which I do, and if she's still nurses during the night which she sometimes does. When I heard that recommendation I wonder how someone would get a one year old to sit still and cooperate for dental exam but I don't want her to have any cavities that could have been prevented by earlier care.

Also what are the advantages of any taking her to a pediatric dentist instead of our regular family dentist? Thanks for the show, it's always fun and educational to listen to on my commute to work and again this is Alicia in Washington, D.C.


Dr. Mike Patrick: Commuting in Washington, D.C, I love the metro, the subway in D.C., we had a family trip, couples of springs ago to the D.C. area and my kids loved that trip and we all want to go back. And honestly, you know probably our favorite vacation spot is Disney World.

But going to Washington, D.C. is a lot like going to Disney World. I am not talking about the politicians, but you know, it's you've got a monorail, you've got the metro, instead of magic kingdom and upcat and MGM, animal kingdom, you got this Masonian, you got the National Zoo, you got the Washington Monument, you got tours at the Capital Building, really it's just a great place to go.

So I would recommend it, it's a family vacation, this is great, but I take rest. OK, so dental advice, I think I need to have another podcast were we just talk; just call it talk-talk.


OK, really the dental advice is going to be the same for all babies, that really there's no provision for if mom has cavities or doesn't have cavities or does she nurse at night or not nurse at night. OK, the advice for babies is the same so what's the recommendation?

Well according to the official recommendations, this comes from American Academy of Pediatrics and the American Academy of Pediatric Dentists; babies should be seen shortly after the eruption of the first tooth or round the time of their first birth day. According to most doctors and dentists, however most are going to say around age three.

So, why is there's a difference. Well, age three, traditionally that's when pediatricians and family doctors who see a lots of kids usually say see a dentist by age three, it's just been more recently that the recommendations had come out for kids to be seen younger and an effort to try to prevent bad dental caries and a lot of community's manpower is an issue, they're just aren't enough dentists maybe there are no pediatric dentists, or the regular dentist in town, don't like to see babies, they're not as profitable.


Many dentists are busy doing a procedures and that's how they make their money and I am not suggestin, money is the end-all or be-all, but you got to pay your bills at the end of the day and if you're seeing a bunch of babies for 20 bucks a crack, 40 bucks a crack, whatever, the insurance, they have dental insurance is willing to pay them, it's a lot more profitable to fill your schedule filling teeth and again I am not making a criticism here, I am just, it's just the realities of the economics of practice so a lot of regular dentists don't want to take the time to see babies and they're may not be any pediatric dentists in town.

So you're kind of, they got this recommendations but you just don't have the manpower of willing people to do it, and now if you do… great! Take advantage of it. But in general your pediatrician or family doctor is going to able to do what's necessary from the time their first tooth eruption until they're about three years old.


So, what is it that's necessary? OK, what is it that your doctor should be doing that the American Academy of Pediatrics and the American Academy of Pediatric Dentists once done? Well first, you got inspect for problems, look at the teeth, look at the gums, make sure there's no disease.

You want to provide anticipatory guidance for how to take care of those teeth and you want to consider applying a fluoride varnish every six months to erupted teeth, starting at age six months or when the first tooth erupts if it's afterwards after six months. And I do want to add disclaimer here because not all babies have a teeth at six months of age, so don't get all crazy if you're baby doesn't have a tooth by six months of age, I am not saying that they should at six months, if they have a tooth at six months you can put the fluoride varnish on if it is after that fine.

That's something you want to consider depending on, what other sources of fluoride that the baby is getting, also we want to consider a fluoride supplement, again depending on what other sources of fluoride babies are exposed to, and that is to help their unerupted teeth, so the one that are still up in the gums and the adult teeth which forming up above the baby teeth.


So you want someone who is going to be have knowledge on what kind of fluoride supplementation or fluoride varnish to do, who can inspect for problems and provide anticipatory guidance and more and more pediatricians are providing even the fluoride varnish, if they feel it's needed, we can provide fluoride supplements if it's needed, we can inspect for problems and we can instruct parents on how to take care of the teeth.

Now, would a pediatric dentists be better than your pediatrician doing this? What it might be if one is available, I mean they're probably going to do a more thorough job, realistically, your pediatrician has a limited amount of time he can spend with you and he's also listening to heart and lungs and looking at the skin and looking at the ears, so, will the pediatric dentist be more thorough? Probably, realistically they probably will.


Is the job that your pediatrician or family doctor does good enough? Probably, it's probably yes. And what about a regular dentist? Yeah the regular dentist, if they're willing to do it, they're probably can do all those things as well and do a good job.

But the point is, somebody should be doing this things, someone should be inspecting, teaching you how to take care of the teeth, providing a fluoride supplement if it's necessary and willing and able to apply a fluoride varnish to the teeth if they feel that is necessary as well. So I hope that helps Alicia.

I do have a couple of resources for you in the show notes, there's a recent article from parents magazine on Baby Teeth Basics which has an endorsement from the American Academy of Pediatric Dentists, the article does, not the entire magazine, it's a nice article, it addresses brushing teeth as well, when to start brushing, what to use, that's sort of things I don't cover all that here because Alicia you didn't ask it because we're running a little short on time. So, she can check out the article, there's a link in the show notes to it.


Also I have a link to the official Updated Guidelines on Fluoride Therapy from the American Academy of Pediatric Dentists and that was updated in 2007. By the way, the actual link on the American Academy of Pediatric Dentistry's website is not to their latest revision.

But my link is, so PediaCast show notes are more up to date than the American Academy of Pediatric Dentistry's own website. So if your dentists, she may want to or should e-mail to your society to change their link to the updated version, the newer version which was published in 2007 mentions the fluoride varnish because that's sort of newer recommendation, the older version of that document which is still the one that's linked to at the website of the American Academy of Pediatric Dentists does not mentioned fluoride varnish.


All right, we're going to have a quick break and we will wrap up the show and the week right after this.



Thanks to all; the Nationwide Children's Hospital for providing the Bandwidth for our show. Also Medical News today for providing the information that we presented in the news portion of today's program.


Also I'd like to thank Vlad over for providing the artwork for the website and the feed and of course thanks to all of you for joining us for PediaCast and for contributing with your comments and your questions.

I haven't mentioned this in detail in a while because I promise that I wouldn't, iTunes reviews are important. I don't want to say if you like the show and you haven't taken the time to give us a review on iTunes, please consider doing so. Many of you are new listeners because are numbers are up quite a bit since Christmas.

So I think a lot people got new iPads, checking out the iTunes directory. They came upon PediaCast and they saw lots, and lots and nice reviews and then stay – checked this out because of the reviews, and then stayed because of the content.

So if you're one of these new listeners, who got an iPad at Christmas, you've been listening to a few shows now, please help us recruit more moms and dads by providing your thoughts in that form… in the form of an iTunes reviews so that we can help more moms and dads find us.


All right, I want to say again, Happy Valentine's day, have a great weekend and until next time. This is Dr. Mike saying, "Stay safe, stay healthy, and stay involved with your kids….

So long everybody.


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