babyshrink.com

There’s a lot of confusion out there about illness, the flu, vaccines, medications, and autism. This poor Mom is terrified that her son may have contracted Autism from a bout of Swine Flu. Here’s her email to me:

Dear Dr. Heather,

Please help. I saw your article on autism, and I am very intrigued and impressed by your knowledge and insight.

I don’t know what to do. I have two beautiful, 91/2 month old identical twin boys who were always very social, smiley, interactive, looking directly into the face, etc. The one I am most concerned about would turn his head and smile at his brother in their crib, smile at everybody, I would play the ‘up’ game with him and he would gaze into my eyes, smile, and giggle… and they both almost always responded by looking when I said their names.

Then one of them got sick with Swine Flu on August 6th. His brother got sick on August 8th. I will never forgive myself as the last time I remember him (the baby who got sick on the 8th) acting distinctly like himself was the 6th when I went to pick up his sick brother at daycare… he looked right up into my eyes, threw up his arms, smiled, and said ‘Mommmmm’…. And I barely paid attention to him, I rushed to his sick brother… I should’ve thrown my arms around him and hugged him and praised him…. I have such guilt and keep worrying/wondering what if that is the last time he ever does that?

They were both put on Tamiflu due to being high-risk (they have asthma symptoms). The baby I am most concerned about didn’t get as high a fever, but the virus infected his eye, and we think he also got a bacterial infection, so he got eye-drops and Amoxycillin as well. He was miserable and cranky for days. I know he can hear (by testing by loud noises, etc.) and he doesn’t have an ear infection, as he’s seen a doctor.

Now he is not himself. I first noticed this as he got better. He is not responding when I say his name, hardly ever. If he does he just looks for a second. He will make eye contact, but only for a second or two. He looks away when I try to play the ‘up’ game with him. He is still babbling, but not as much. He did this weird whisper-babbling this morning and smacked his lips. He is still playing with his toys, but is also playing with non-toy objects like straps and blinds.

The doctor has an ear test set up for him, but I have to wait two weeks just for a call to make the appointment.

Can a virus or antibiotics trigger autism? Does a flu ever attack the ears, eyes, or brain which might cause sudden symptoms? What are the other possibilities might be going on if he doesn’t have an ear infection? This is a very, very abrupt change.

What tests should I push for to find out what is wrong as soon as possible? What are the possibilities?

So far his brother is acting normally, but I am terrified as I’m worried about it affecting both twins eventually.

Please, I would love a response. We have (mega-large HMO) and it is hard to get tests/things done. I am eagerly awaiting your response and guidance.

Very, very sincerely,
Concerned Mom

Obviously, this mom is in a state of desperation, so I responded immediately:

Dear Concerned Mom,

Of course I cannot evaluate your son myself and as such, I can only provide some educational information for you. But I did want to respond right away because you sound so very upset and worried.

First of all, please know that autism is thought most likely to be a genetically-related developmental issue, and I have seen no convincing information that it can be caused by a simple flu or other virus in a child, nor by antibiotics or antivirals. Additionally, the timeframe you mention of the abrupt changes in your son do not sound like the onset of autism. After all, it’s been barely 2 weeks since the onset of his flu symptoms.

A (temporary) step backwards in response to illness
However, it is VERY common to see temporary developmental regression in response to illness. This means that your child can take several steps BACKWARD developmentally — in response to illness and/or stress — and then “bounce back” days or weeks later. It’s all part of the normal developmental process,which is full of starts, stops, and reversals — the old “one step forward, two steps back” thing. Young children don’t understand that the course of illness is temporary; that they will get better. They simply know they feel lousy. They are not up to showing off all their “best” developmental skills. They commonly regress to earlier stages of development, temporarily, until they feel better. And often times, symptoms of illness can linger for WEEKS in children — especially for something as yucky as a flu. If he is showing regression in response to illness, the regression itself can linger for weeks as well, past the time that he gets better. This may vary from child to child and from illness to illness, so his brother may be fine (at least this time).

Personalities vary in response to illness and stress
I don’t know about your husband, but when mine gets sick, he just wants everyone to GO AWAY. (is this a guy thing?) He’s crabby and won’t talk to me and is just a completely different personality than when he’s feeling well. Everyone is different, and your boys also will have different responses to stress and illness. The point is that there are very reasonable possible explanations as to why your son is acting so differently than his usual self, for this relatively short timeframe.

It’s important that you respond in a positive and supportive way, and not convey to him that you’re so worried. He’s able to pick up your anxieties, and internalize the message that “something must be wrong with him”. He needs reassurance that he WILL get better, and WILL feel better, but for now he still feels lousy and needs to be babied — and that’s OK.

As I said, however, I cannot evaluate your child from afar, so it’s important you get your doctors’ advice, as it sounds like you are doing. But since you have to wait for appointments, I would take this time to hang out with your boys in a relaxed way, giving them the chance to fully recover.

Please let us know how you’re all doing in a few weeks’ time.

Aloha,

Dr. Heather
The BabyShrink

I love that Dog Whisperer show on the National Geographic channel, and not because I’m a dog lover. Watching Cesar focus in on the “parenting” approach of the humans involved is quite similar to my approach with parents of toddlers. He’s great at empowering people to embody the authority they already have over their dogs, but are reluctant to use.

I see a similar disconnect in the way we parents often interact with our toddlers. We’re flustered and upset at the annoying thing they’re doing over and over, and we can’t understand why they won’t just LISTEN to us! We feel like what we say is going “in one ear, and out the other”. Either we “baby” them, or we “talk over” them. It’s difficult to get the feel for the wacky developmental level of a toddler, but it’s essential if we’re to gain confidence in parenting them.

Dogs and toddlers are similar in many ways. While they want to “fit in with the crowd”, they’re certainly not above some very gross and annoying violations of social norms. They need us to shape their behavior, and in return they’ll reward us with all sorts of adorable and loving behavior.

Now, don’t get the idea that I’m recommending you take Cesar’s approach and directly apply it to your toddler. There are MANY things in the Dog Whisperer’s approach that WILL NOT WORK with toddlers. However, there are some interesting lessons to be learned from him, including some of these nuggets:

TODDLERS (AND DOGS) —

— CAN’T understand most of your words. They “feel” your emotions and read your intentions via body language. Your state of mind, in the moment, will help determine whether your toddler responds to you — or ignores you.

— NEED you to be “in charge”. They need boundaries and limits in order to be able to feel safe, and that their world is predictable. Be the “alpha parents”!

— are VERY FORGIVING. If you start out in the wrong parenting direction, you can usually change course, with good results.

I’ve been thinking about these similarities for awhile now, so I was tickled to see new research presented this week at the American Psychological Association’s yearly convention. Check out the story here if you want to read more about it! It seems that there are some scientifically demonstrable details to back up my hunch about the similarities between our dogs and our toddlers.

I’d also love to hear your thoughts about this…Is your toddler like your dog?

Aloha,

Dr. Heather
The BabyShrink

I’m not prone to depression; I’m more of an anxious type, with a tendency to overreact and sweat the small stuff. So when our (4th) baby is born (I’m 30 weeks along now, folks!), I’m anticipating some hormonal upheavals (as well as the excruciating sleep deprivation that comes along with a new baby), but not depression per-se.

But as a clinician, I’m very concerned about the high rate of postpartum mood disorders, as well as the tendency of new mothers to ignore or deny their symptoms. Many of you have written to me, with stories of untreated PPD in your pasts, begging me to help get the word out to moms who might be experiencing the condition now. POSTPARTUM DEPRESSION IS ONE OF THE MOST TREATABLE DISORDERS WE KNOW. If you, or someone you know, might have PPD, PLEASE help her to get help…immediately. You can show her this article, which is a nice, straightforward review of the condition, and you can also listen to my 16-minute, free podcast on PPD.

And I know you don’t read BabyShrink for a dose of politics, but the situation regarding health care in America is at a point of critical mass. Insufficient numbers of primary care services in this country result in our missing PPD far more than we diagnose it. This is especially true in rural and semi-rural areas — where many of us live. We MUST reform our health care system to ensure that ALL women are screened for PPD — and given the treatment that we know works — for the benefit of their babies, their families, and themselves. And that will only happen if we reform health care to emphasize the prevention and wellness approaches that we know WORK. Treating PPD isn’t the hard part. Reforming health care IS. But it must be done.

Aloha,

Dr. Heather
The BabyShrink