Madonna Adoptions, Cold Medicine, Pumping At Work – PediaCast 122

 

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Topics

  • "Madonna Adoptions"
  • Cold Medicine: Australia Follows Suite
  • Physically Active Girls
  • Teenage Ethnic Identity
  • Pumping At Work
  • Biters At Daycare
  • Doctor Phobia

Links

Pediascribe

Transcription

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

[Music]

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, a Pediatric podcast for mums and dads. It is episode 122 for Monday, April 28, 2008. Pumping at Work, Biters, and Doctor Phobia. This is one of my favorite shows in a while because the listener's questions that I received this week are pretty typical of some of the nuts and bolts kind of issues that come up in the office.

01:20

So, it's not a complicated thing. It's some simple questions but there are simple questions that have some interesting answers. We'll keep the listener's segment; you'll see exactly what I'm talking about. I would like to thank the episode sponsored today, The Minute Pie Mold Company, makers of great camping cookware. They have the same quality since 1962.

And you can thank them for bring you this podcast episode only free by visiting them online at minutepiemold.com and we'll have a link in the show notes there for you. Its spring and it's the time of the year when the March of Dimes holds their annual walkathon used to be called "WalkAmerica…, you probably heard about it or you participated on it or you supported someone who has participated in it.

02:11

They changed the name this year. It is no longer "WalkAmerica…, it is now called the "March of Dimes… March for Babies…. And it's always been about babies. The March of Dimes that's really their thing and you know, it's one of those things you hear about lots of different charities and sometimes it's hard to keep straight who does what and you know, what it is that they sort of their mission is.

Well, the March of Dimes mission officially is to improve the health of babies by preventing birth defects, premature birth and infant mortality to carry out this mission through research community services, education and advocacy to save babies lives. March of Dimes researchers, volunteers, educators, out-reach workers and advocates worked together to give all babies a finding chance against the threats to their health, prematurity, birth defects and low birth weight.

03:01

OK, so that's the official what's the March of Dimes all about. So, why am I talking about this? Well, I want to encourage you if you don't give regularly to a charity to consider the March of Dimes. And if you are not participating in one of the March for Babies or you are not supporting someone who you know is in the March for Babies, I would encourage you to stop by Pediascribe and check out the note or the post, I should say that Karen did, called "Babies win and you may too…, and I'll make it really easy for you to find.

Just go to the show notes and it's right there under the Pediascribe header where I usually put which Pediascribe post I'm highlighting. I'll suggest check out the show notes, there'll be a link. And here's the deal, if you use the button at our site to donate to the March of Dimes for their annual campaign, then we are going to have a little contest. And I just want to say there's no kickbacks here.

04:01

We're not doing this in order to make money. There's no like, "hey! If you can make a thousand dollars for the March of Dimes, we'll give you $20 back…. We're really just doing this out of the goodness of our hearts. And more importantly, we're doing it for a friend. One of my really best friends who I went to College with, his name is Bob. And Bob and I were roommates throughout College, we actually… my first year in Medical School and he's first year in Law School, we were roommates.

Yes, I'm friends with the Lawyer. Actually, we both got married each of us to our, you know, individual wife, we got married. This show is not that progressive. After our first year of… my first year of Medical School and after his first year of Law School, we both got married and have been happy ever since. No, but really. So, Bob and I have been friends for long time and his first child, his name was Evan was born with hypoplastic left heart syndrome and he died from the disease when he was an infant.

05:14

And so the March of Dimes charity has been near and dear to our friends Bob and Cathy. They have two healthy kids now, a boy and a girl. But the March of Dimes have been really near and dear to their hearts in terms of helping other families who have babies with birth defects and helping ones who survived their defects and also being a support for parents for babies who don't survive their birth defects.

So the work of the March of Dimes, you know, they know it very well and if my friend Bob says, "The March of Dimes is a good charity… then I'm buying it. So there's more about their story if you go to the Pediascribe blog and again read the post "Babies Win and You may Too….

06:03

So here's what we're doing, for each and every $10 that you donate to the March of Dimes through our site, to the button on our site, for every $10 you donate, you get one entry in to a contest. So another words if you donate $50, you get five entries. OK as simple as that. There will be one automatic $50 price that we draw random out of all these people.

So if you donate $10, you could win $50. Just kind like a raffle with the charity. If our donations through the link to the March of Dimes through our button on the Pediascribe blog. If they get a $300 then we are going to give a second $50 price and if the verified donors get to $700, so if you all donate $700 through the Pediascribe blog to the button that's there then we will have three $50 price winners that we draw out at a random.

07:10

If again, if you've not participated in the March for Babies from the March of Dimes, if you've not participated in that or if you've not supported someone who has participated in it and I would encourage you to check out Pediascribe. And if you can't find that links, really easy, it's in the show notes for this show at pediacast.org. Just click on the link "Babies win and you may too….

All right. What we're going to talk about today, Madonna adoptions, cold medicine, Australia follow suit and physically active girls, that's all coming up in the News Department. Also teenage ethnic identity. We're going to talk about that as well. And then our listener's segment, it's those nuts and bolts questions I was talking about. Pumping at work, Biters at Daycare, and my favorite Doctor Phobia.

08:00

So, that's all coming up. Don't forget if you have a topic that you would like to discuss, all you have to do is go to pediacast.org, click on the contact link. You could also email pediacast@gmail.com or call the voice line at 347-404-KIDS. I want to remind you, the information presented in PediaCast 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, 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 pediacast.org. And with that in mind, we will be back with News Parents Can Use right after this short break.

[Music]

09:19

Our News Parents Can Use is brought to you in conjunction with news partner Medical News Today, the largest independent health and medical website. You can visit them online at medicalnewstoday.com.

Psychologist at the University of Liverpool, say Madonna style intercountry adoptions are causing a rise in the number of children in orphanages. Researchers found countries with the highest rates of children living in Institutions also had the highest rates of International Adoptions rather than reducing the number of children institutional care. International adoptions may attribute to an increase instead. This process has been labeled the "Madonna effects… so called after the singer's high profile adoption of a young boy from Zambia in 2006.

10:03

Statistics showed immediate attention surrounding this case contributed to an increase in the number of international adoptions, but at the expense of local orphans. Child psychologist, Professor Kevin Brown said "Some argue international adoption is impart a solution to the large number of children in Institutional care but we have found the opposite is true.

Parents in poor countries are now giving up their children and believe they will have a better life in the West with a more wealthy family. Some families have unwittingly encourage international adoption, yet it has been showed that 96% of the children in the so called orphanages across Europe and probably across the globe are not true orphans and have at least one parent often known to look all authorities.

Government and orphanages can reap substantial financial gains from international adoption and these two appears to be feeling its growth. But the practice often breaks the UN convention of child rates which states international adoption should only be used as a last resort in situation where all other means of fostering adoption and care within the child's country of origin are exhausted.

11:11

The Liverpool researchers recommend more extrinsic guidelines for monitoring policy and practice to ensure that international adoption is use only as a last resort. The restrictions on cold and cough medicine in children has moved down under. Pharmacist in Australia now advised customers requesting over-the-counter cough and cold products that these medicines should not be used in infants and children less than 2 years of age.

The policy comes after a number of report showed serious adverse effects among infants and children given nonprescription cough and cold medicine. The main cause of misadventure with these products appears to be misused medication air, accidental overdose, accidental exposure and concurrent use of multiple products rather than consequences from usage in accordance with the directions. The restrictions include any medicine containing one or more of the following ingredients.

12:02

Anti-histamines, antitussive such as dextromethorphan otherwise known as DM, expectorants and decongestants such as pseudoephedrine. Recent announcement have also been made by the US Food and Drug Administration and the UK Medicines and Healthcare products Regulatory Agency. Both group say cough and cold medicines should no longer use to treat children less than 2.

Several reviews of the evidence indicate there was a lack of efficacy in taken together with the risk, there is no over-all health benefit. Labels of over-the-counter cough and cold medicine sold in Australia must now include the advised do not use in children under 2 years of age. Australian residence should be aware that changes to the labeling of current products may take some time to be fully implemented.

Pharmacists are asked to advised all customers requesting over-the-counter cough and cold products that this medicines should not be used in infants and children under the age of 2. A report by the University of Minnesota's Tucker Center for Research on Girls and Women in sport, shows that girls are participating in sports and record numbers.

13:07

But their participation in physical activity outside of the organized sports is declining, especially as they moved from childhood in to adolescence. The report developing a physically active girls and evidence based multi-disciplinary approach summarizes the most recent research pertaining to the physical, psychological, social and cultural benefits. Girls derive from participation in sports and physical activity. It also describes the barriers that prevent girls from reaching their full potential and the kinds of environment in which girls learn how to develop and foster the best parts of themselves both on and off the playing field. "Our research confirms many good things are happening when it comes to girls on physical activity… said Nicole LaVoi, Researcher and Associate Director of the Tucker Center. Girls are participating in organized sports more than ever and in all levels from organize youth sports, to interscholastic sports and up to Olympic competition.

14:04

The report outlines the benefit girls' reap from physical activity such as improved health and reduced risk of obesity and chronic disease such as type II diabetes, osteoporosis and cardiovascular disease. Positive development of social, psychological, and motor skills and better academic performance in lower dropout rates.

Girls participate not only for competitive reasons but also to get in shape, socialized with their peers, develop physical skills and to have fun. However, the report also shows many barriers, stereotypes and gender inequities firmly in place against girls. Poverty substantially limits access to, and participation in, physical activity and sports especially for girls of color who are overrepresented in lower socio-economic groups.

So, while some girls are physically active, many others fail to meet minimum standards of physical activity. The report also found the following: girls' participation rates in all types of physical activity consistently lag behind boys and active girls have higher dropout rates.

15:07

Girls' experiences are shaped by the quality and expertise of the adults who make decisions, manage, govern, deliver and coach physical activity programming, many of whom have minimal… if any… formal training themselves. Out dated stereotypical standards of femininity and masculinity continue to influence the extent to which girls participant in or shun physical activity.

Female athletes continue to be trivialized through the popular media's widespread sexualization of women. Physical education is too often organized around competition, team sports, power strength and aggression and it focuses on the "motor elite… rather than skill development. Disadvantage kids were less skilled to begin with or often shun leading to lack of enjoyment and adverse consequences on their life long participation in physical activity.

So what can be done? Well, the reports calls on "the United States as a whole from parents and coaches, the school administrators and community leaders to policy makers to make a commitment of eliminating the barriers girls in this nation face when it comes to engaging in sports and physical activity,… said Mary Jo Kane, Director of the Tucker Center.

16:17

"Physical activity is not an add on but rather a core value and principle for healthy and effective living…. The Tucker Center report is designed to provide a road map that puts the nation on the path to ensuring that every girl has ample opportunity to fully engage in sports and physical activity.

"Often research done by sports scholars sit on the shelves and practitioners such as coaches, parks and recreation directors and physical education teachers view the research as having no practical application…. We aim to bridge the gap between theory and practice by detailing the best sports and activity programs for girls and how to implement those programs. And if you are interested in taking a look at the entire Tucker Center report, check out the show notes to the link.

17:02

When young people dress according to the customs of their own ethnic group, they may be less likely to have mental health problems later in life. According to research in the Journal of Epidemiology and Community Health, adolescents are especially prone to mental health problems and often their identities are displayed in clothing and in their choice of friends.

As a result, it is valuable to understand how this clothing and kinship can influence mental health status. These findings were based on an investigation of approximately 1000 white British and Bangladeshi students between the ages of 11 and 14 in schools in East London. These schools display some of the highest levels of population diversity in the United Kingdom.

The pupils were asked about their culture, social life and health in 2001. Then two years later they were surveyed again with the focus on mental health. Having friends from their own and other cultures, called integrated friendships, or having friends exclusively with the same culture made no difference in the mental health of the student.

18:02

However, clothing choices did. Those Bangladeshi students who wore traditional clothing were less likely to have a problem with their mental health than those whose dress tended to mix traditional styles with British and North American tastes. In comparing the genders, females in particular showed this association.

The author say cultural integration is generally the healthiest option for young people confronted with today's increasingly multicultural society. However, social pressures toward changes in lifestyle added towards behaviors can cause added stress.

They conclude from this study that retaining cultural identity through clothing in particular, may be an important way to contribute to better mental health of adolescents. All right that wraps up the news, and we will be back with your questions right after this.

19:25

All right, first up in our listener department today is Liz in Boston Massachusetts. Liz says "Dear Dr. Mike I am positively addicted to your podcast and have recommended it to all my friends…. Now isn't that nice? "I have a question: I'm currently nursing and working full time, I pump at work and when I continue until my son is at least a 2-year-old.

The problem I'm having is finding time to clean my bottles between each pumping session. It's all very time consuming. Is it OK to let the empty bottle sit for a couple of hours then reuse them up to three times a day, or is that dangerous? Already my supply has decreased and I'm finding it more and more difficult to pump. Anything to make it easier so I can keep doing it, would be great. Thanks for your help, Liz….

20:13

All right. Pumping it works. See this is the kind of bread and butter, nuts and bolts questions, you know, pediatricians get asked daily in exam rooms across America. When you're done pumping at work, Liz, I assume that you're pouring the milk into another container and putting that in the refrigerator.

Thus the question becomes: What to do will the collection container between pumping sessions? Can you just leave it set? And the simple answer to that is no, breast milk is nutritious for babies but it's nutritious for bacteria as well. They love it, which is why you have to refrigerate breast milk because the cold keeps bacteria from growing. So you really do need to clean them.

Now on the other hand, do you have to scrub the collection container for 10 minutes or boil it to sterilize it in between pumpings? No. I mean that behavior is at the other extreme end of the spectrum. And I think the right answer is somewhere in the middle of the two extremes. Isn't that where the right answer usually lives?

Anyway, you know, I would rinse the collection container after each pumping session put a dab a dish, soap open, shake it around, rinse it well, turn it upside down to dry. I mean the whole ordeal should take you all over one minute. Now, I'm not sure what kind of washing technique you are using.

But if it's taking so long as to interfere with your day at work, then I think you're probably doing too much. I'll admit, people get a little crazy sterilizing things for babies. You know, maybe it's appropriate for kids under a couple of months of age. But come on, older babies have immune systems their skin is crawling with bacteria. But yet, they are able to handle it. They have bacteria killing acid in their stomach. They've got their immune system to take care of it.

22:01

Babies, most babies, OK there are exceptions. There are kids with immune system problems that they're born with, but those are the rare exception and not the norm. Most babies are not little delicate things that can't fend for themselves against illness. On the other hand, leaving dirty leftovers of your pumping extravaganza on the counter at work isn't such a hot idea either.

So at the middle of the road, OK. Middle of the road. A quick wash and a rinse, I think that's all you need. I heard someone on the radio say the other day and I really like this. Common sense isn't so common anymore. Now I'm not picking a new list, really I'm not. OK, maybe I'm picking a new a little bit.

But in a good natured way, you know like I'd picked up my wife. I think at least that common sense dictates the right answer here. I didn't have to go to medical school to figure this one out, it's common sense. But you know, as they say common sense isn't so common anymore.

23:01

All right. Next stop is Sandy in Columbus, Ohio. A place very close to where I am right now. "Hi Dr. Mike, I've been listening to your podcast since January. And I am completely addicted…. I love hearing that. "I have a little boy Alex, who'll be two next month.

I worked full time so Alex is in Daycare full time. In the last two months Alex has been bit six times. It is been very concerning to me and I have met with the director at the Daycare and she keeps confirming that it is perfectly normal and the biter will eventually go out of it. The director also told me that biter is very good friends with my son and that's why he's getting bitten so frequently.

Almost like the biter is doing it for my son's attention. Some of the other things the Director told me where: 1. Time-outs don't work for this age group. 2. Biters don't realize why they are biting or that it hurts the other child. 3. My son won't take the biting just because he is being bitten.

24:01

Well, first we used time-outs and Alex does seem to learn from them. So, is the Director statement true? Do toddlers really not understand that biting is hurting others? And finally, after Alex has been bitten he has come home and tried to bite my husband. The director says, he absolutely did not learn to bite because he was bitten.

That's seems very strange to me, but I'm asking you Dr. Mike because well after all you are the doctor. They said they are shadowing the biter and they're doing everything possible. I'm wondering if I'm over reacting or if I really should be concern? I do like his teachers and Alex has a horrible time adjusting to new atmospheres.

We've already switched daycare once and my husband thinks I'm being completely unreasonable. I would appreciate any guidance and thoughts. By the way, I think Karen should join this show as a mum. I really enjoyed having her around. Thanks, Sandy…. All right, while I'm going to give you my opinion on this. And I'm not… you know, don't look at me as siding with husband or wife. I don't want to get involved with any squabble Sandy that you have with your husband.

25:06

But before we get to that regarding Karen, show number 124, so a couple of shows from now. We'll be another Rants and Raves show with Karen. So watch for that. And you're aren't the first to suggest that Karen should be a permanent fixture of PediaCast that seems to be a theme these days.

All right, under your issues here Sandy. First of all, let me just say "the director is crazy…. OK let's moved on to our next question. No I'm kidding. Seriously, though, there's… not a lot more to say, other than may be common sense isn't so common anymore. Sandy, you've done time-outs at home. You've seen them worked for your child.

So for the director to make that blank statement that time-outs don't work at this age is crazy. I mean they can't work, you know that. You've seen them worked in your own home. The better statement for the director would have been, time-outs don't work for this biting child because they won't stay put and we aren't able to physically restrain him. OK, that's more likely the truth.

26:04

In terms of the biter not knowing that biting hurts, I mean, that's crazy too. Two-year olds know about pain. I mean, otherwise, they wouldn't cry when the doctors say, "Hi Joey, you need a shot today…. OK. They know shot hurts. They know tether sharp, they know their teeth rip in the food. And they know that the child on the other end yells out in pain when they get bit.

So they know biting hurts and they say otherwise just shows a total lack of common sense. The third issue is imitation. OK, two years old imitate all the time. They imitate actions they see, they imitate lines from movies they watch, they pretend they are someone else. It's all part of normal childhood development.

And why would biting be any different. Now, I don't know what kind of child development training this director has had but if she believes the things that she's telling you, I don't think her training has really amounted too much.

27:02

But here's the thing, in my opinion, I don't think she believes what she is telling you is true. I think she knows that time-outs can work. I think she knows that biters realize they are causing pain. And I think she knows toddlers imitate behaviors including biting. I think she's telling you these things because you are easier to deal with than the biters parents.

I think that's the issue. You know, I understand your concern about not wanting to change your child's environment. You know, he seems to like the daycare, otherwise you like the care that he's getting. And you don't really want to have to put him in a new environment. And the crazy thing here is you shouldn't have too.

You know, the biter and his parents, they're the ones that should have to change and if you were my daycare the biter would be gone. Now, I may try behavior modification at first. But in the end if the parents won't let us do a plan that works then it be gone. You know this kind of biter amounts to a toddler terrorist.

28:03

And the sad thing is, it's not the little guys fault. It's the parents fault and it's the director's fault for not dealing with the behavior in an effective manner. You know, the parents and the director are basically creating a bully. And they're rewarding him for his bad behavior.

So why should he stop? I mean, come on the teachers are shadowing him for crying out loud. I mean that's code for he's getting all their attention. And it's not negative attention, you know. There's no time-out, there's no likely significant reprimands probably just constant redirection and oh no Bobby biting it's not nice, it hurts, you wouldn't want someone to bite you and is that working for them?

No of course, it's not. You see you got me started here. You know, and second thought, you might want to look for a new daycare center after all. Not to get your child away from biter but to distance yourself from this crazy people who in essence are helping raise your kids. OK, Sandy, you said you trust my opinion because I'm the doctor but look folks they don't teach about biters in medical school.

29:05

OK. There's no biter 101. This is common sense stuff and you have to trust yourself, Sandy. I don't care if the director has a degree in child development just because you read something in a book doesn't make it true. They're simply aren't any case control double blind studies to help us understand toddler biters.

Biter are there room of common sense, which it appears isn't so common anymore. OK. Tommy, in Columbus, Indiana says, "I have a 16-month-old daughter who has a serious issue with the doctor's office. She's had many recurrent ear infections and has visited the doctor's office very frequently.

It used to be, she would start her screaming and crying when he pulled out the scope to look in her ears. It progress earlier in the appointment when he wanted to listen to her chest, then to when he enters the room. Then she started crying when we entered the room.

30:01

And finally she starts crying when we get out of the car in the parking lot. She is to the point of hysteric each visit. We've even tried having her appointment in the waiting room, but that's not an option anymore…. Good! "She recently had tubes put in and behave the same way with the ENT doctor.

And at the hospital the day of her surgery two of the patient with similar issues or she's just developing a strange phobia. What can we do help her through the doctor's visits? Thanks, Tommy…. All right, Tommy. The prescription for this, I love this phrase "Is tincture of time…, do you remember tincture of merthiolate?

I remember, when I was a kid, you would fall and scrape your knee and mum would weep out this bottle of tincture of merthiolate, which is basically mercury in a bottle and have a little applicator stick. And let me tell you, it burn like crazy. OK, so tincture is not a word that we used very much anymore. But in this case you just need tincture of time.

31:01

This is a very typical behavior. Babies are smart. You know, they get hurt when they come see the doctor and they learn to associate us with being held down, with poking plastics in the holes that are already hurt. Was stabbing them with needles, taking their blood. And you couple that with a healthy dose of stranger anxiety.

It makes the 9 to 18-month range. Pretty challenging and interesting as a pediatrician. Most kids go through up to some extent. There are few kids who don't, I mean, there's a few kids which is – and even kill personality, they do well every time they come in. even when you them shots and you hold them down, you look in their ears.

They take it like it's nothing. But that's the exception of the rule. You know Tommy, your daughter actually sounds more like the rule. There's a few, you know, have it sort of. You know really badly and you know just started screaming when you go in to the parking lot, you know and OK, so that may be a little extreme. But again it's not then common.

32:02

But the good news Tommy is that, as they get older, they gets better. And you just have to believe me on this. It really does. And I've been in practice long enough now to see school age kids who were the bad ones and did everything you have mentioned and I remember them, it was that bad I remember them screaming when I looked in their ear.

And it was fun to kid those kids when I see him now years later. You know, when I see them for their well checkup, so I looked in their ear and say "man, I remember when you used to scream and kick when I looked in here, then we all smile and have a good laugh. Your child won't be scared for life over death. OK, you just going to trust me on this. It will get better.

And what can you do for her now while you are waiting for her to outgrow it? Not much. I mean, sort of not going to the doctor's office which just isn't reasonable. You know, sort of refusing vaccines, and refusing blood draws because you don't want her to be hurt and crying. You know, those things are not reasonable. Will you be able to talk sense in the world that age? No, will you be able to bribe her, or lie to her, or destruct her in some way that's really going to work? No, no, no.

33:07

And the waiting room tactic is kind of silly if you asked me. So I'm glad you're not doing that anymore. OK, you just have to back up and get the job done. I know you don't like to see you kids distress. I mean, no good parent does. But being a parent goes beyond focusing only on their comfort.

I mean, there's trustees in life, there's disappointment in life, there's pain in life. And a parents job is often to help are kids avoid these things, but an even more important job is to teach our kids how to handle it when stress and disappointment and pain can't be avoided.

OK. To always shelter them and never teach them how to deal with negative experiences as doing kids are great to serve us. That's my two sense anyway, which wanted to know. All right, we're going to take quick break and we will be back to wrap up the show, right after this.

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34:26

All right we are back. And a big thanks goes out to Nationwide Children's Hospital, The Minute Pie Mold Company, Vlad Studio, Medical News Today, and of course listeners like you. I love saying that, it sounds like public radio and you know "PBSish."

Let me remind you, Babies win and you may too, again the way this works is that between now, I think it's May 11, through May& 11, I believe, don't cook me on that though. I should have my fax together before I do my podcast. But check out the website, go to pediacast.org and click on "Babies win and you may too… with all the details are there in term on when the deadline is.

35:09

But the basic jest is, if you donate to the March of Dimes. Each and every $10 that you donate gets you one entry. So if you donate $50 you get five entries as simple as that. There'll be one automatic $50 price drawn randomly if verified donations get the $300, we'll have the second $50 price and if verified donations go to $700 we will add a third $50 price.

Just drawn randomly out of all the entries. So, please, if you're not participating in the March for Babies or supporting someone who is obviously, if you're doing it, that's great. If you're supporting someone you know who is walking, that's fabulous. But if you don't have a way to support the March of Dimes and the great work that they do, please consider donating through our site by pushing the button on the blog.

36:03

OK, don't forget iTunes reviews are very important. So, which is an honest review on iTunes is very helpful. Please, if you've not done that, please do. I'm sure lots of you found the PediaCast and give us a chance because you read those reviews. So, please help us out there.

Poster page is available at the website with PDFs that you can download and post up on bulletin boards everywhere. Also our listener survey really helps with demographics and helps with sponsorships. We have an old listener survey up at the site done through Podtrac which ask lots of questions just like page after page of questions.

This one sure and sweet and will take you all a 30 seconds to fill out. Really it's quick. So if you have not done the new listener survey which is done through wizard media, please stop by the website and do that. It's in the side bar up toward the top. All right, I hope everybody has a wonderful week, 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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