Trusted professionals help children and parents

Kids are different

“We have a saying: Children are not just little adults,” says Dr. Sara Kreckman, a pediatrician at the West Washington Clinic of UnityPoint Health-Meriter. Not only do children have unique diseases, she notes, but they may react differently than adults to common illnesses and could exhibit different symptoms.

Because children are different from adults, the practice of pediatrics is in many ways different from general medical practice. “In pediatrics, we focus on growth and development,” says Dr. Kreckman. Parents may come to an appointment with concerns about certain symptoms or behaviors, but if growth and development are on track, that can help to put other worries in perspective. “Growth and development are a kind of barometer for overall well-being,” she says.

A similar principle applies when children visit the dentist. It’s true that the dental chair can sometimes be too big for young patients, but the most significant way that they differ from adults is their steady growth. “You have continually developing and growing lower and upper jaws, and exfoliating baby teeth,” says Dr. David Ducommun, a dentist at Madison No Fear Dentistry. There’s a great deal of change in the first 12 years or so, he says, after which growth slows down.

Another important difference in treating children is that they don’t show up alone for medical or dental appointments; they’re accompanied by parents or guardians. “There are really two patients–the child and the parent,” says


Dr. Alicia Plummer, a pediatrician at SSM Health in Madison. “It’s a team approach,” she says. “I try to make a good connection with the kids, and I also try to gauge what the parents’ goals are for the visit. I may have goals, too, but I’m not the one taking the kids home. The parents are the experts on their kids.” The pediatrician’s role, she says, is to help parents navigate changes their children go through as they grow up.

Satisfying the needs of two patients at once may sound challenging, but Dr. Plummer says it is quite rewarding. “Parents are letting us into a very intimate part of their lives: helping them raise their children,” she says. She notes that parents today often face a big challenge in trying to sort through all the health information that they find online, which may contain inaccurate information. This can cause needless worry, so Dr. Plummer reminds parents that they can turn to her as a source of reliable information. “I try to give them all the tools they need to be the best parents they can be,” she says.

Working together with parents is a big part of caring for kids’ health. “Kids can’t always tell you what’s wrong or what’s hurting,” says Dr. Kreckman. Sometimes she has to rely on a parent to explain symptoms. “So there’s a lot of parent education involved,” she says.

This is especially true of first-time parents. “There’s so much education in that first year,” she says. It takes all parents time to acquire a better sense of which concerns are more serious problems, and which ones will simply work themselves out. “It’s hard, though, to have that perspective when it’s your first,” Dr. Kreckman says.

In addition to putting worried parents at ease, medical professionals recognize that their young patients may often be frightened by unfamiliar experiences and surroundings when they come in for appointments. Dr. Kreckman says she and her colleagues often “examine” a child’s doll or stuffed toy, or even an older sibling, “to try and show them that it’s okay and it doesn’t hurt.”

At Madison No Fear Dentistry, Dr. Ducommun finds that kids react best to dentists, hygienists and dental assistants who look at things in a positive way. Children interact as much with hygienists as with the dentists themselves, he notes, and a hygienist who works well with children can encourage and inspire them to maintain good dental health habits.

Dr. Ducommun and his colleagues attempt to banish some of the unease that can accompany a trip to the dentist. “Many times,” he says, “they take you down a maze of hallways and say, ‘Wait here.'” At No Fear Dentistry, new patients–including kids–get taken on a tour of the building, showing them, for instance, restrooms, doctors’ offices and the sterilization room. Once patients are in the chair, he makes sure they are comfortable by offering a blanket, a hot or cool neck wrap, and noise-reducing headphones. He notes that children’s fear of dental appointments sometimes results from a worried parent’s body language, or from well-meaning parents who say, “You’re going to the dentist [but] it won’t hurt.”

Another challenge to overcome with small children is that their trust can be undermined by even momentary pain. With an adult, says Dr. Ducommun, a dentist can say, “You might feel a pinch here,” when administering an injection of anesthetic, and the patient understands what’s happening. “With a child,” he says, “you could lose cooperation.” With children, therefore, it’s especially important to take extra care in the placement of topical anesthetic to minimize the discomfort of the injection. Once the anesthetic takes effect, Dr. Ducommun says, young patients can usually be happily distracted by headphones and the big-screen TV overhead. “And we go on doing what we need to,” he says.

All the team members at Madison No Fear Dentistry, says Dr. Ducommun, are committed to the same mission: to make sure every patient has a good experience. “We have meetings on a daily basis on how to give better experiences to each patient,” he says. “It’s a daily focus.” That’s especially valuable for young patients, whose experience at the dentist or doctor may color their attitude toward health care visits for years to come.

Building your health care support network

Choosing the professionals who will help with your child’s health care can be a daunting challenge. For dental care, however, that problem is often solved when parents have an existing relationship with a dentist whom they trust. “Sometimes Mom and Dad have been my patients for years,” says Dr. Ducommun. “Then they get married and start bringing their kids.”

Finding a pediatrician, on the other hand, generally requires a different approach. “We’re fortunate to live in a community where there’s quite a bit of choice,” says Dr. Kreckman. More choice, however, can mean more homework before deciding. The first step is to determine which pediatricians are within a given health insurance’s network. Next, websites can useful in finding out about office procedures and hours, after-hours policy, same-day access, phone triage, and waiting time for an appointment.

But the most important factor is the one that’s the most intangible. “It should be somebody that you can communicate openly and honestly with,” says Dr. Plummer. “Somebody with whom you feel comfortable asking questions, somebody that you trust will listen to you and respond to your needs.”

Staying healthy between appointments

While regular medical and dental visits are important, they account for only a small number of hours in a child’s life. As a result, what happens between those appointments is just as important when it comes to raising healthy kids. Medical professionals offer advice on healthy habits and preventative care and, if needed, some tools to help put those habits into daily practice.

Healthy eating habits and exercise are good for the whole family–parents not only improve their own health, but set an example for their children. “Habits formed in childhood follow us into adulthood,” says Dr. Kreckman. “That’s why obesity is such a focus. We know that obese kids can turn into obese adults.” UnityPoint Health-Meriter has nutritionists and a fitness clinic, says Dr. Kreckman, “but I would say that for the most part, parents are pretty well educated about what to do; it’s more a matter of putting it into a daily routine.”

In some ways, advice for staying healthy between checkups sounds like good old-fashioned common sense. Dr. Plummer notes that it’s important to make time to “let kids be kids.” Well-meaning parents want to give their children the opportunity to explore a variety of sports and activities. But sometimes, says Dr. Plummer, that results in over-scheduling. And it leaves little time for youngsters to simply play.

Busy sport schedules also make it difficult to achieve what many experts consider a mainstay of a healthy family: a daily family meal. “Make it a goal to have a family meal once a day,” says Dr. Plummer, even if it’s a challenge. “Maybe the family meal is breakfast.” She advises family members to put down their phones when they’re at the table. Turn off the television. “You can just talk and be together,” she says.

A changing world

Much in American life has certainly changed since they days when nearly every meal was a “family meal.” Parents have new worries, unimagined just a generation ago. Dr. Plummer says that foremost among these concerns for many parents is how to help kids safely navigate their use of the internet and social media. When elementary-school students get email accounts and internet access at school, they naturally want it at home as well. As a result, parents must learn to evaluate what’s safe, or how to make online searches safe. Dr. Plummer recommends being present when young children are online, checking on what youngsters find, and discussing it with them. As children get older and use social media, she says, “parents need to discuss what is and isn’t appropriate to post online, and to be aware of risks such as bullying.”

The most significant change in health care, says Dr. Kreckman, is the adoption of a team-oriented approach in which a physician says, “These are our options,” instead of, “I’m the doctor, and this is what you must do.” For example, to parents of a 5-year-old with an ear infection, she might suggest Tylenol instead of antibiotics if the child is not losing sleep or experiencing too much pain. Thus, parents feel more invested as they become involved in the decision-making process. Of course, some things are not negotiable. Strep throat, for example, must be treated with antibiotics. Still, says Dr. Kreckman, even when there are not multiple options to discuss, she does not simply say, “Here’s what we must do,” but “Here’s why.”

Technology has driven major changes in how medical service is delivered: appointments can be scheduled and records accessed online and texts remind us of upcoming appointments. And most significantly, computerized medical records have replaced charts. “It’s a huge change for the better,” says Dr. Kreckman. She notes that computerized information has improved medical records, reduced medical errors, and enhanced continuity of care.

Still, says Dr. Plummer, “We all strive to keep that personal touch in there.” The increased use of computers, combined with the growth of large medical practices, can make that hard to do, she observes, especially if parents grew up in a small town. But once they develop a relationship with the doctors and staff, even in larger practices, they’re more likely to feel at home.

“At the heart of it,” Dr. Plummer says, “we’re still striving to take the best care of patients that we can, and to have a good relationship with their families.”–