“My kid is so hyper…I am worried he has ADHD.”   Lot of parents voice this fear to me.  While hyperactivity may be  concerning, ADHD is much much more than just “being hyper”.  This post, though, is not about diagnosing ADHD.   It is about my journey and thought process in trying to avoid ADHD in my children.

Like many first-time parents, I can tell you that I did a lot of thinking and worrying about a myriad of things.   But being a pediatrician and seeing parents struggle with their child’s ADHD, I couldn’t help but think, “Can I prevent ADHD in my kid and other kids?”  Certainly there is a genetic component in many families that one cannot control.  We can do our best to have a healthy pregnancy by not smoking or drinking and getting timely prenatal care.  We can try to decrease our home and occupational exposure to chemicals, pesticides, and lead.  We cannot, however, prevent birth trauma, prematurity, and the stresses and catastrophes of life.

Some environmental factors, though, are indeed in our control.  One of them is to encourage the love of LISTENING.  Do babies really listen?  Unquestionably!!  Listening to a loving and gentle voice talking, singing, and cooing will teach them to concentrate.  Don’t put an “educational DVD” on.   There is absolutely no comparison between a baby who listens to his parent (or caregiver) singing a nursery rhyme versus a baby who listens to the same thing on TV.

Also, AVOID TV (as much as possible) in front  of the baby or the toddler.  As a new mom, sometimes I found myself taking care of the baby with the TV playing in the background.  While, I agree that keeping track of what is happening in the world restores some parental sanity, it can be done in small doses.  The fast-paced explosion of sounds, lights, and colors from TV or the computer can train their impressionable brain to seek that fast pace all the time.  Later, they can have a hard time focusing on slower activities like reading/reading comprehension and math logic.

Don’t forget that eating a HEALTHY VARIED DIET is crucial.  I can’t help but notice a pattern of sleep and behavioral issues in children who eat processed cheese products and high-sugar cookies/drinks for “snacks.”  Surely, these “foods” don’t provide any nutritional value to the body and by the way, we shouldn’t really call them food.

Be a SMART SHOPPER of toys and activities.  Fostering the fun in doing sit-down activities is important. Puzzles are great at not only building fine motor skills, but they ask the brain to concentrate, use logic, and build visual-spatial skills.  I personally like the wooden puzzles.  Once your child is able to pick up objects with the “pincer (forefinger and thumb),” introduce the big wooden puzzle blocks.   Start board games when you think they are ready and play as a family.  Age-appropriate blocks and legos are another excellent way for boys and girls to literally build their imagination.   Encourage the love of playing physical sports, but don’t forget the “mental” sports!

Remember the goal is to help increase their brain’s ability to focus, listen to their environmental cues, and respond appropriately.  Believe me, these are skills that they will use in all spheres of their life.   While I wish I could say that doing all these things can prevent ADHD, many factors are just not under our control.  Every child is unique, and it is hard to predict which child will have ADHD and which will not.  It is best to talk to your pediatrician who knows your child and your family well.

Please comment and let me know what you think.

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“Your child has a healthy BMI (Body Mass Index).  He’s had good growth from last year.” I repeat this line many times during the course of my workday as I am seeing kids for their annual check-ups.  The parents often will smile and say, “Great.”  At this point, if the conversation moves onto the next topic, then I, as a pediatrician, and you, as the parent, have just missed a golden opportunity.

That’s right, a wonderful teachable opportunity for yourself and your child.  Knowing that your child has a healthy weight and height is good, but what is even more important is the conversation that should come after.  This is THE BEST time for the pediatrician and parent to talk to the child and say, “You are healthy.  Let’s talk about ways to STAY healthy.”  This is the time I talk about 5 fruits and 5 vegetables a day.  “Whaaaat?? Five of each.  Can I have some treats too?” is what the kids ask at this point.  “Yes, one junky thing a day and small portion of it is ok,” is usually what I say.  This is the perfect conversation to bring up healthy portions.  Surprise.  Surprise.  Most parents don’t know what a healthy portion is for a five year old vs. a ten year old.  I would prefer to stop all sugary drinks for kids however I know that is not feasible or practical for many families.  So I ask everybody to water down juice and limit the total intake to 4 oz a day.  This conversation is especially helpful when the juice is about to be introduced to an infant or toddler.

Let’s not forget about healthy “screen time” of no more than 2 hours a day.  By screen time,  I mean all the gadgets that have a screen.  Exercise or staying active is another aspect of health that should be touched on for kids with normal weight (not just the kids who are overweight).

Many of us talk to our doctors about how to BECOME HEALTHY when our child is over or underweight.  I prefer to talk about STAYING HEALTHY, when they are already at a healthy weight.  We always hear that prevention is the key to health.  As a pediatrician, I have the unique opportunity to see a child grow up and for me, missing the opportunity to teach them about health is not acceptable.

I would love to hear your thoughts too.  When you or your child is given a clean bill of health, how many of you talk about how to stay that way?

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camping trip

Living in the lush landscape of the Northeast has it advantages.  While summer activities abound, so do the insects.  Every summer, parents ask me if there are any bug repellents that I recommend.  For my family, I use bug repellents that are made of natural oils.  Oils of citronella, soybean, peppermint, lemongrass, eucalyptus, and geranium are effective for small periods of time.  Being particular about smells and fragrances, I find that Citronella and Peppermint ones smell less overpowering than others.  If you are going for a heavy-duty hike with the kids, then use insect repellant lotion or spray that contains 5-30% DEET (not for kids under age 2 months).  The higher DEET concentration does not mean that it is more effective, rather it just lasts longer.

Wearing loose and light-colored clothing, which provides good coverage is important.  I prefer application by hands, rather than spraying because I do worry about fume inhalation from sprays.  Avoid hiking during dawn and dusk, which increases one’s chances of being bitten.

Hope this helps.  Happy hiking!!

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Forget Mr. Smith.  I think the whole family should go to Washington.  Why?  Because it is awe-inspiring.  By the way, Mr. Smith goes to Washington is an old Hollywood classic (yes, I do watch AMC and TCM in the middle of the night).

If you look beyond the politicking and lobbying that occurs in Washington D.C., and just look at the city itself, I gotta say it is amazing.  There is no better way for school-age kids to jump into learning history than to visit the presidential memorials.  Standing at the foot of the Thomas Jefferson memorial and reading excerpts from the Declaration of Independence is, unquestionably, inspiring.  “We hold these truths to be self-evident: that all men all created equal…”  Also, reading the Gettysburg Address out loud, while Abraham Lincoln’s statue smiles serenely near us, is great fun.  At the FDR memorial, the depiction of the Great Depression offers many teachable moments about humility.  And there is so much more…

Speaking of U.S history, recently, I watched an interview of David McCullough on 60 minutes.  Mr. McCullough is a Pulitzer prize-winning historian (by the way, I highly recommend reading his biography of John Adams.)  During the interview, he talked about early American thinkers and politicians who shaped the country’s past and present.  At one point, he talked about today’s college students saying they lacked fundamental knowledge of U.S. history.

His comments got me thinking, especially since July Fourth is approaching.  This holiday is more than backyard barbecues, pool parties, and fireworks.  I think Fourth of July is about reminding us (the older generation) to teach our children about our country’s history.  Traveling to Washington D.C. is a great way to develop their interest.  Watch a group of people protesting in front of the White House and your kids will recognize the true meaning of free speech.  Tell me which historical sites (local or national) you have been inspired by and why?



Summer is here.  Let the camps and play-dates begin.   After all, the busier the kids are, the more accomplished they will be as adults, right?   Wrong.  Every summer, I become adept at chauffeuring rather than PARENTING, scheduling rather than TEACHING, the future rather than the PRESENT.

Well, not this time.  Summer presents a unique opportunity for parents to do major life-planning (for their kids).  Not the getting-into-the-Ivy-Leagues kind of planning. Parents…this summer…let’s plan to foster good habits in our children.  Keep the bed and wake times structured.  Don’t let them sleep into the late morning.  Teach them to pick up after themselves.  No more clothes or games all over their bedroom during vacation.  Let’s plan to foster independence.  Get them used to doing chores and duties during the summer.  Let’s plan and teach them the true meaning of friendships, so that they stand up for friends in need.  Let’s plan to teach them thoughtfulness, kindness, and respect.  I could go on and on.

These are just some of the habits and values that will guarantee their success in life.  The music, the arts, the sports, and the camps are all wonderful and important.  But, they are poor substitutes for what we REALLY need to teach our children.

What do you think? Let me know your thoughts on this topic.


dirtydozen1Organic…non-GMO…pesticide free…free range…locally grown…who know grocery shopping could be this complicated?  My mother surely did not anticipate this.  As a young child, she would take me to the farmers markets.  “This is how you pick a “good” one,” she would say.   She chose fruits and vegetables based on how they looked or smelled and how they fit into her menu for the week.

One topic we never talked about was organic versus inorganic.  Amazingly, this question is now part of the mainstream parental consciousness.  Being one of these parents, I have reached several conclusions (for now).

One, eating fresh nutritious food is more important to me than only eating organic foods.  So if that means I am preparing non-organic green beans for dinner, I will live with that.

Two, when possible, I try to reduce the pesticide and chemical exposure whether in my food or in my environment.  I do this by reviewing the “dirty dozen” list of produce, while I am shopping.  The Environmental Working Group ( has a great foldout card (included in the post) that helps me choose fruits and vegetables with lower pesticide content.

A few years ago, an apple was an apple (with or without wax/pesticides).  Fortunately, now we know better (although we have a long way to go).  Finding good resources of information is important.  Two resources of mine are and  What resources do you use for nutrition-related information?