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Teen Dating Violence

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By: Mary B. Hammock, MSN, CPNP

Dating is an important part of growth and development for teenagers. It molds emotional health, identity and self-worth and helps to prepare a teen for future relationships. Healthy relationships can have a positive impact on development and unhealthy relationships can negatively impact a teen’s entire future. Learning to communicate effectively, appropriately managing uncomfortable feelings, such as jealously or anger, and treating others with respect are learned tools of healthy relationships. Dating violence is a widespread problem crossing the boundaries of age, gender, ethnicity and financial status. Research indicates one of 3 teens experiences dating violence and two of every three victims tell no one it has occurred. Many fail to report abuse due to embarrassment, fear, and the notion that the violence will never occur again. Dating violence has long-term and short-term effects on its victims. Knowing what to look for and early intervention can help safeguard your teen.

What is Teen Dating Violence?

Teen dating violence is defined as the physical (pinching, hitting, shoving, slapping, or kicking), sexual (forcing a sexual act without consent – can be physical or nonphysical through threatening to spread rumors or stop dating the partner), psychological or emotional (harming his or her sense of self-worth via bullying, shaming, intentionally embarrassing or other such behaviors) violence within a dating relationship, including stalking. It can occur in person or electronically and might occur between a current or former dating partner. Youth who experience teen dating violence are more likely to experience dating violence during college and later. Being the victim of dating violence often leads to symptoms of depression and anxiety and potentially could result in abuse of tobacco, alcohol, and/or drugs. Antisocial behaviors, including avoiding typical activities, skipping school, and isolating oneself with or without the dating partner, and thoughts of suicide are much more common among victims of dating violence.

Ramifications of Teen Dating Violence

Violent relationships in adolescence can have serious ramifications by placing the victims at higher risk for substance abuse, eating disorders, risky sexual behavior and further domestic violence. While researchers are still trying to define the problem and how big the problem is, it is estimated that half of the youth who have been victims of dating violence attempt suicide, as depression is a common reality for them. It has been determined that teen girls who have been sexually or physically abused are six times more likely to get pregnant and twice as likely to have recurrent sexually transmitted diseases from high risk sexual behavior.

How to Stop Dating Violence

The ultimate goal is to stop dating violence before it begins. Again, it is vital to lead by example and promote healthy relationships. Help your teen work through case scenarios to strengthen their self-worth. This will also train him or her arming him or her with the ability to appropriately and rapidly respond in an unhealthy relationship. Communicate that you are your child’s most staunch defender; that no matter the circumstances you will do your very best to protect him or her, as long as there is an open dialogue between the two of you.

As it turns out, getting a little one to sleep through the night and to use the potty may have been easier parenting jobs than protecting teens from themselves and others. While they search for the own identity, it is important that we give them enough space to explore but stay close enough to continue to protect and guide them. Healthy Steps Pediatrics is helping to grow healthy children one step at a time. Call today if you need teen guidance or any other pediatric need. 678-384-3480.

Protecting Our Most Precious Resource –Our Children

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By:  Mary B. Hammock, MSN, CPNP

Protecting Our Most Precious Resource –Our Children

We have all passed that adorable child in the park or the mall that refuses to acknowledge our friendly banter or smile. That is a child that likely has been educated to avoid contact with strangers, as a way to protect the child. Parents naturally want their children to feel safe, secure, and valued and part of a parent’s responsibility is to teach them the skills which will keep them safe from harm.

Most importantly, your home must be a place of trust and support by your taking an active interest in your children’s day-to-day lives and listening to them intently. Building a child’s confidence and self-esteem will equip him with the ability to assert himself in potentially any dangerous situation, rather than simply identifying strangers to avoid. Statistics repeatedly point out that most perpetrators are known to the child or family. Identifying a bad guy will not be a particularly helpful skill.

Safety At An Early Age

Talking about safety with your child should begin at an early age. Discuss safety in an open, matter-of-fact, and calm manner. This will teach your child that safety is part of reality and will be less likely to induce stress. Young children can be taught safety rules. Preschoolers are concrete thinkers who are very much focused on themselves. A preschooler can quickly and easily identify his name and his parents’ names. Making up a song can assist teaching them addresses and telephone numbers.

Check First

They can also be taught to CHECK FIRST. They should check first before going outside to play. They should check first before leaving the area to go to the restroom. They should check first before accepting anything from anyone. Finally, preschoolers should be taught it is OK to SAY NO if someone does anything that makes them feel scared, uncomfortable, or bad.

Elementary Age

Elementary aged children are generally eager to please and cooperative, which can make them vulnerable in dangerous situations. Children this age learn better through role-playing a wide variety of situations and through repetition. Be sure the child knows his full name, his parents’ names, address, telephone, and even driving directions to his home. Make a plan for addressing phone calls or doorbells. Continue to reiterate the need to CHECK FIRST and it is OK to SAY NO. Teach your elementary-aged child the NO-GO-TELL system. First, the child should say NO if someone is trying to do something that makes one feel scared, uncomfortable, or bad. Second, the child should GO away from the situation quickly. Finally, the child should TELL an adult – someone that you and your child have established as trustworthy and reliable.

Middle and High School

Middle and high school children benefit from on-going discussions and open dialogues. Discussing real-life situations provides opportunities to problem-solve and practicing saying NO should a situation of peer pressure arise. Practicing standing one’s ground against bad choices makes for a confident youngster. Encourage teens to never go out alone, as there is safety in numbers. If your child is old enough to go out alone, demand to know the three W’s – Who he is with, Where he will be and When he will return home. Communicate with your teen that it is incredibly smart of them to let someone know who, where and when.

Let Us Help

Although talking to your child about safety can be unpleasant to downright daunting, it will pay off in prevention. Healthy Steps Pediatrics is helping to grow healthy children one step at a time. If you need advice teaching your child to be smart, strong, and safe, call 678-384-3480.

Probiotics and How They Help

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Probiotics and How They Help

In the human body, one can find more than 500 types and more than 100 trillion bacteria living throughout the digestive, urinary and genital systems.  The predominant bacteria are considered “friendly” and necessary to maintain good health. Friendly bacteria aid in breaking down food, absorbing nutrients, and fighting off harmful overgrowth of “unfriendly” bacteria.  Maintaining a balance is essential to good health but the typical American diet includes many processed foods, resulting in the intake of fewer natural probiotics. Probiotics have been commonly used in other developed countries for decades – added to beverages, foods and through supplements – and now the US seems to be catching on. 

Probiotics are defined as live microorganisms similar to “friendly” bacteria that will benefit its host.  The first intentional use of probiotics was to prevent spoilage in food preparation. Probiotics are naturally found in yogurt and cheese, as well as fermented foods, including sauerkraut.  Through the demonstrated safety of food preparation, probiotic use has evolved and research is demonstrating the many, many benefits of probiotic intake on health.

Nature’s Mighty MICRO-Minerals

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By: Mary B. Hammock, MSN, CPNP

Nature’s Mighty MICRO-Minerals

Last month, the benefits and necessity of macro-minerals were discussed at length. To review, minerals are necessary for the production of vitamins, enzymes and hormones; the maintenance of healthy blood circulation; efficient nerve conduction; muscle growth and contraction; and for the metabolic processes that turn the food we eat into energy. Macro-minerals are necessary in larger amounts and include calcium, iron, magnesium phosphorus, and zinc. Micro-minerals, also called trace minerals, are needed in much smaller amounts but are still very necessary for good health. Micro-minerals include manganese, copper, iodine, cobalt, fluoride, and selenium.

Common Micro-minerals

Manganese, in addition to calcium and phosphorus, is critical in the formation of bone. It is also necessary in muscle contraction and the proper function of the nervous system. Manganese has also been found essential for enzyme reactions, especially those involved in the breakdown of carbohydrates and cholesterol. A deficiency of manganese could result in glucose intolerance leading to increased risk of diabetes or poor healing in the skeletal and cartilaginous systems. Manganese can be found in whole grains, nuts, berries, legumes, vegetables and tea. This micro-mineral can easily be lost in the processing of foods, making fresh foods a much better choice for manganese intake.

Copper acts as an antioxidant, which prevents chemical reactions that can damage tissues within multiple organ systems in the body. Copper, along with iron, is necessary to the production of red blood cells, helping to preserve one’s energy level. While copper is most concentrated in the liver and the brain, it is important for healthy cardiovascular, immune and nervous systems. Whole grains, dark green leafy vegetables, nuts, and shellfish are great sources of copper.

Iodine is essential for the formation of thyroid hormones. The thyroid regulates one’s metabolism, as well as growth and development of the brain and body, making it extremely important during the fetal period and infancy. The good news is that iodine is extremely easy to obtain. Most of the salt available for resale is iodized. Milk contains iodine because it is used in the sterilization of equipment. Iodine is also found in shellfish, seafood and seaweed. The bad news is that very large of amounts of iodine can result in breathing difficulties or skin irritations for anyone with sensitivities or allergies. A typical diet provides for more than adequate iodine intake.

Cobalt is required for the formation of red blood cells and the proper functioning of some enzymes and the composition of vitamin B12. Vitamin B12 is important for good health in our DNA and blood. Cobalt can be obtained from liver, kidney, meats and dairy products. Toxic levels of cobalt would be extremely difficult to obtain through dietary intake.

Fluoride is well known for strengthening the enamel on teeth. Too much fluoride can cause permanent spots on the teeth, called fluorosis. Too little fluoride increases the likelihood of cavity formation and tooth decay. For these reasons, pediatric dentists and healthcare providers recommended the intake of tap water or bottled water fortified with fluoride beginning in infancy, as well as a small pea -sized amount of fluoridated toothpaste on toothbrushes for those over two years old. Fluoride helps new bone formation or in maintaining healthy bones. Fluoride can be found in seafood and tea, in addition to toothpaste and fortified waters.

Selenium has been discovered to work, in conjunction with vitamin E, as a powerful antioxidant, reducing the risk of abnormal cell growth. It also boosts the immune system, which fights against viruses and destructive bacteria. Selenium is required for healthy heart and thyroid function. Selenium has also been found to be a natural chelation agent, binding with toxic heavy metals, including lead and mercury, and rendering them harmless. Rich sources of selenium include cereals, meat, fish, dairy products, eggs and brazil nuts. Selenium is becoming increasingly uncommon in soil, making legumes, fruits, and vegetables less likely to contain selenium. Too much of a good thing isn’t so good. Toxic levels of selenium cause hair loss, skin changes, nausea and nerve damage. If taking a supplement, limit the intake to 200mcg a day.

Micro-minerals Help

Minerals help the body grow, develop, and stay healthy. A wide variety in a healthy diet is always the best place to start for mineral acquisition but a high quality supplement can make up for what may be lacking. Be sure to check with your child’s healthcare provider if you are considering a supplement. Healthy Steps Pediatrics is helping to grow healthy children one step at a time. Call 678-384-3480 for your child’s nutrition assessment today.

Increasing Threats in the Lunchroom

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By: Mary B. Hammock, MSN, CPNP

Increasing Threats in the Lunchroom

Several years ago, when it was recommended to wait until two years of age to introduce peanuts, I reviewed the guidelines with a mother who was eager to give her two-year old son a peanut butter and jelly sandwich. As this is her favorite food, she made a big event out the situation – checkered tablecloths, fancy napkins and cutting off the crusts. The first bite made John smile and the second bite made him vomit twice (including two doses of antihistamine), turn blue, start with heavily labored breathing, and finally, left him on the floor unconscious. All of this occurred within 8 minutes of his first ingestion of peanut butter. After a panicked call to me, I told his mother to hang up and dial 911. EMS arrived quickly, gave him epinephrine and breathing treatments, and transported him to the hospital, where he stayed for awhile. This mother still tells me it was the worst day of her life. She was frightened by what occurred and felt utterly helpless watching her child nearly pass away before her.

Facts To Know About Food Allergies

More than 50 million Americans are estimated to have some kind of food allergy. The Centers for Disease Control and Prevention estimate 4-6 % of children are affected by some food allergy. An allergy is a hypersensitivity response triggered by the immune system. It can be as mild as a temporary stomachache or as severe as an anaphylactic reaction – which can be life-threatening, and at times even fatal. The response can occur with the first exposure or the thirty-first exposure and it can illicit different symptoms and/or a different severity of symptoms with each exposure. While food allergies tend to run in families, it is impossible to predict whether a child will inherit a parent’s food allergy or whether siblings will have a similar hypersensitivity response. It is more likely that having two parents with food allergies predisposes the child to developing food allergies.

What Food Allergies Do To The Body

WebMD provides a great description of food allergies and the toll it takes on one’s body. Food fragments responsible for allergic reactions are proteins within the food that usually are not broken down by cooking or by digestion, allowing them to survive and cross the gastrointestinal lining, enter the bloodstream, and migrate to target organs. “The complex process of digestion affects the timing and location of an allergic reaction.” The first symptom experienced may by “itching in the mouth as one starts to eat the food. After the food is digested in the stomach, abdominal symptoms, such as vomiting, diarrhea, or pain may start. When the food allergens enter and travel through the bloodstream, the can cause a drop in blood pressure. As the allergens reach the skin, they can induce hives, or when they reach the lungs, they may cause bronchospasm, which is wheezing or constriction of the airways.” Any and all of these symptoms can result in anaphylaxis and typically occur within moments or up to an hour after ingestion. Scientists are currently trying to determine why food allergies have become so frequent and prominent in the last decade and what is the best way to prevent or manage them. Eggs, milk, soy, and peanuts are the most common food allergies in children and unlike adults, children can outgrow some of their allergies through avoidance of the offending agents. The exceptions are peanuts, fish and shellfish.

When Is A Food Allergy Happening

Food allergies can be particularly tricky. A cross-reactivity food allergy can occur when one is highly allergic to birch pollen and has an itchy mouth after eating the peel of an apple or one is allergic to latex and simply cannot eat bananas. This is called “oral allergy syndrome.” Food allergies have to be differentiated from possible food poisoning; histamine toxicity, which is common in some cheeses, wines or large fish; lactose or gluten intolerance; sulfite intolerance, from some foods and preservatives and naturally occur during wine fermentation; and there are even cases of unpleasant events in a person’s life resembling an allergic reaction

Ways To Diagnose Food Allergies

Fortunately, there are a few ways to diagnose food allergies. First, one’s healthcare provider should take a thorough history, which may include detailing a food diary of what was eaten, lists of ingredients, and symptoms. An elimination diet may also be suggested in the hopes of removing the offending food or foods and the symptoms resolve. A second way to diagnose food allergies is through skin prick testing. Skin tests are rapid, simple and relatively safe. The downside to skin testing is that anaphylactic reactions should not be skin tested because it could be very dangerous. Secondly, patients with extensive eczema are not good candidates for skin testing as well. Finally, skin testing may reveal more positive reactions that the patient is not responding to. For that reason, determining true allergies relies on testing results and a patient’s food ingestion/reaction history. The third way to diagnose food allergies is to consent to RAST or ELISA testing of the blood, which measures the presence of food-specific IgE in the patient’s blood. This testing can also pick up cross-reactivity or positive results for which patients do not have symptoms. This too should be interpreted, along with the patient’s food ingestion/reaction history. These tests can come back in 1 -7 days depending upon the lab used.

Stay Tuned For Treatments

Next month, I will detail treatment for food allergies. Given that some are severe and life threatening, I feel the more prepared everyone, including the general public, is, the safer our children and families will be. Healthy Steps Pediatrics is helping to GROW healthy children one step at a time. If you have questions or concerns about possible allergies and your children, call 678-384-3480 for an appointment today.

How To Stop The Summer Slide

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By Mary B. Hammock, MSN, CPNP

How To Stop The Summer Slide

Summers bring water parks and beach trips, picnics and barbecues, and hopefully, rest and relaxation. For children, it can also bring the “summer slide.” This is name given to the period of time that little brains sit idle in the summer. According to the National Summer Learning Association, “A conservative estimate of lost instructional time is approximately two months of the school year…It’s common for teachers to spend a least a month re-teaching” the forgotten material at the start of the next school year. Families are children’s most important teachers and there are some great ways to keep your children reading, and thus retaining, during the summer.

Read – Combine – Provide – Motivate


Read aloud to your children. Reading to an infant stimulates brain growth as the child listens, looks at the pictures and begins to turn the pages of board books. That brain growth continues for decades to come. The summer months provide extra time for read-alouds at the local library or special school functions. Read-alouds help stimulate the imagination and those themes will evolve into playtime. Once children are old enough to read for themselves, encourage them to read to you. This continues to strengthen interest and appreciation of reading.

Combine summer activities with book reading. Choose books about the beach or a baseball game. Discuss what you read about over the sand castle building or over hotdogs at the ballpark. Tell your child why you liked the book, what you learned from the book, or how the book helped you and then listen as they tell you the same.


Provide plenty of reading material. Storybooks are great for young readers but informational material may spark interest in constellations, underwater sea animals or dinosaurs. Older readers may be interested in magazines and newspapers. Books that teach children how to make or do something will do wonders to break the boredom. A weekly trip to the library will keep reading materials fresh.

Motivate your children to be active readers. Leading by example helps teach children the “skill and will” to learn. Reading for enjoyment can get lost among the job-related reports and journal articles but when nearly half of all young adults are not reading for pleasure, it is imperative to turn off the television and curl up with a good book.

A Real Book Does Wonders


A recent study published in The Reading Teacher revealed findings that are suggestive the E-Books may not be the best way for young readers to read. It seems that the multitude of features may be interfering with the comprehension of the text. Certain flourishes, including creatures that emit noise and move around the screen or birds that flutter and sounds playing in the background, cause comprehension to fragment. E-books can also lead to less time reading overall. Another study cited that children spent 43% of their e-book engagement time playing games embedded within the e-books rather than reading the text. It is imperative to review E-books for the best reading opportunities for your children.

Learning Is Fun!

Children who do not read over the summer will hit that “summer slide” and lose up to two months of learning. You and your children need to keep reading this summer and keep the learning fun. So, grab a good book and take it along to the beach, the pool, and the picnic. Enjoy! Healthy Steps Pediatrics is helping to grow healthy children one step at a time. Call 678-384-3840 to schedule your children’s summer check-ups.

Helping Children Deal With Grief

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By: Mary B. Hammock, MSN, CPNP

Helping Children Deal With Grief

There is evidence all around us that children are not little adults. That is certainly noted in the grieving process. Most young children don’t understand, nor can explain death, but most young children are aware of it. Death and loss are all around them – cartoons, video games, and movies. Some are also aware of the death of a pet or the loss of a loved one. Death is often a confusing process for children but giving guidance through the process can equip children with the coping skills needed for healing.

We All Grieve Differently

Everyone grieves differently, especially children. Children express over 100 acknowledged symptoms of grief. Quick-changing moods are common in children and playing often helps children cope. Symptoms tend to come and go for children. A child that cries and then runs off to play doesn’t indicate the child is no longer sad. That can simply be a defense mechanism to prevent from feeling overwhelmed –overwhelmed by loss, lack of routine, fatigue, the number of people visiting or new people present in the home. Crying, lethargy, sadness, bargaining, anxiety, anger, numbness and denial are common symptoms of grief, as well as learning and attention issues, decreased performance in school or activities, behavioral problems including irritability, arguing, and fighting, and disengaging from friends and family.

Asking Questions

Children learn by asking questions. When a child asks questions about death, even the hard ones, it is important to provide sensitive, age appropriate answers. Avoid telling them un-truths to buffer them from the loss. Think about the age group you are talking with. Telling a preschooler that “Papa passed” or overhearing a mom tell someone “I lost my husband” may lead the child to believe the person will return or simply needs to be found. When a child questions what happened, use concrete words such as “died” instead of vague terms like “passed away.”

Stages of Grieving

Children grieve in stages as they grow and brain development occurs. Comprehension increases as thinking becomes more abstract. Younger brains tend to be more protective and may produce mild symptoms. Times of stress and hormone development can make children vulnerable to reviving grief and may lead to major symptoms.


Encouraging children to express whatever they are feeling is important. Sometimes, it easier for a child to express him or herself through drawings or through play. It is important to simply talk with children about the person who died. Share what you remember about the person and encourage the child to share memories as well. Talking about the person who died will give the child permission to share feelings and it will tell the child that you are hurting as well and you can provide comfort to each other. Listening without judgment is extremely important. Don’t try to fix or evaluate a child’s feelings and avoid phrases such as “it will get better,” or “I know how you feel.” This can quickly negate the child’s feelings. Validating their experiences and emotions through open-ended questions and reflections will help a child to regain a sense of safety, balance and control.

In Conclusion

Prepare a memory box with and/or for your child. Put photos, special items and keepsakes in the box and place it in a special place for your child. Write down your own memories and help to record the child’s memories for them to review later. Be available to go through it with the child as often as they like.


It is equally important that parents don’t ignore their own grief. It is imperative to discuss your own grief and emotions with your friends, family, and support groups as needed. Parents never intend to forget a child’s grief but it can easily happen, especially if they are grieving for a child or over an unexpected loss. School teachers, church leaders, friends, and extended family can all play a role in supporting and encouraging a child through the difficult times so don’t forget to ask for help.
The important thing is to recognize that no matter how or when it happens, grief will eventually hit and a child will need to experience it to heal. Be available to love, listen and role model for your child. Healthy Steps Pediatrics is helping to GROW healthy children one step at a time. If you feel your child is suffering through the grieving process, call 678-384-3480 for a consultation today.

Good Nutrition In Childhood Improves Long-Term Health

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By: Mary B. Hammock, MSN, CPNP

Good Nutrition In Childhood Improves Long-Term Health

Heather Morgan, a nutritionist, has been quoted as saying, “Every time you eat or drink, you are either feeding disease or fighting it.” Providing good nutrition for a child can be challenging at any age but time and again, is proven to lay the foundation for enduring good health. There are many opportunities to make a positive impact on a child’s health through their dietary habits and those habits formed during childhood will make a lasting impression. Your child is watching your every move. So of course, lead by example and eat a variety of nutrient rich foods for your health, as well. Lean proteins, dairy products, whole grains and fruits and vegetables are the keys to balanced nutrition.

Start At Infancy


Infancy is a wonderful time of exploration. Breast milk and baby formulas are necessary to provide enough calories, calcium, iron, vitamins and minerals to meet a rapidly growing child’s needs. Cow’s milk introduction should be delayed until the first birthday because early introduction of milk has been linked to gastrointestinal bleeding, anemia and diabetes.

Baby Food


Baby foods come in a rainbow of colors and flavors to peak the curiosity of the new palate. And of course, your baby is always watching what is being served at the table. The older infant will be eager to try some table food. Be careful to avoid honey because of the botulism risk. For all children 9 months to four years, be careful of the size and texture of foods to prevent choking hazards.

Common choking hazards include:

  • popcorn
  • peanuts
  • hotdogs
  • raw vegetables and fruits
  • including carrots and apples
  • whole grapes and hard candy.


Baby foods come in a rainbow of colors and flavors to peak the curiosity of the new palate. And of course, your baby is always watching what is being served at the table. The older infant will be eager to try some table food. Be careful to avoid honey because of the botulism risk. For all children 9 months to four years, be careful of the size and texture of foods to prevent choking hazards. Common choking hazards include popcorn, peanuts, hotdogs, raw vegetables and fruits including carrots and apples, whole grapes and hard candy.

Toddlerhood

Toddlerhood can be especially challenging during feeding times. Toddlers are known for asserting their independence and for the “Me do” mantra. A toddler’s growth is less robust than an infant’s, which explains the typical decrease in appetite and leaves no need for concern. According to the 2002 Feeding Infants and Toddlers Study, the most commonly consumed vegetable in toddlerhood is french fries. The same study found toddlers don’t consume enough fiber, potassium or the recommended five servings of fruits and vegetables a day. Small changes make for big results and can help to reverse this trend. You may have more success feeding a toddler if you involve them in the decision-making. Offer two or three healthy choices and allow them to choose.

Make mealtimes fun by offering interesting shapes and colors

  • Cut ripe apples, pears and even peaches into sticks to allow for self-feeding.
  • Offer sliced strawberries and grapes to dip in yogurt.
  • Cut cucumbers and potatoes into intriguing shapes with cookie cutters. Dress broccoli trees with cheese.
  • Julienne some vegetables into the macaroni and cheese or spaghetti or bake them into whole grain muffins and breads.

Preschoolers


When your children become preschoolers, it is easy and fun to get them involved in their own nutrition. Take them to the grocery store or farmer’s market and peruse the produce aisles. Explore new recipes and ask for their help preparing snacks and meals. Think about enrolling your child in a cooking class or grow a garden. Their excitement will be contagious.

School-agers

School-agers have similar nutritional needs but can come with their own challenges. School success improves with a balanced breakfast with protein. This leads to higher test scores, lasting energy and fewer complaints of headaches, dizziness and fatigue. School-agers are generally a very active group of children. Running from soccer to Boy Scouts and from swimming to ballet can easily lead to an excess of fast food, if there is no planning. Limit fast food to less than twice a week, make healthy choices and avoid sweetened beverages. Being prepared for hunger allows one to offer fresh food that isn’t processed and full of fat, preservatives and artificial ingredients. Be the parent at the soccer field that provides healthy alternatives and watch the children gravitate to your cooler.


Mealtime is a place and time to come together and enjoy food and loved ones. Bon appétit! Healthy Steps Pediatrics is helping to GROW healthy children one step at a time. Call for an appointment today so that we can get your family on the road to nutritional health.

Enough Is Enough!!!

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The Effects Of Bulling

By Mary B. Hammock, MSN, CPNP

Effects of bullying

A 14-year-old hangs herself. A 19-year-old jumps off a bridge. A 13-year-old shoots himself. Another loads his backpack with stones and leaps into a river. Still another swallows her father’s prescription meds to get rid of the pain and humiliation. These are a few recent sickening headlines as a result of bullying. There are three components to bullying – the bully, the bullied and the bystander.

What Is Bullying?


Bullying is a form of aggressive behavior manifested by the use of force or coercion to affect others, particularly when it involves an imbalance of power. It can include verbal harassment, physical assault, coercion or intimidation. No one is safe from bullying and it may be directed towards particular victims based on race, religion, gender, sexuality, social class, one’s looks or abilities. Often those targeted are seen as passive, easily intimidated, smaller or younger, and have a harder time defending themselves.

What Makes Bullies Tick?

Bullies thrive on controlling or dominating others and have often been victims of bullying or abuse themselves. Some argue that a bully reflects a learned behavior from his close caregivers. Further studies have shown that envy and resentment may be motives for bullying – using bullying to conceal anxiety or shame. Bullying behavior often has its origin in childhood. As the bully ages, his or her behavior patterns become more sophisticated, engaging in less obvious, yet equally intimidating behaviors such as character assassination, sabotage, or humiliation. Male bullies are more likely to be physically aggressive – shoving, poking, slapping, choking, punching, kicking, beating, stabbing, pulling hair, scratching, biting, and pinching. Female bullies tend to favor exclusion and mockery – name calling, manipulation, gossip, lies, rumors, staring, giggling, laughing and saying trigger words to bring on recall of past events.

Understanding and What To Do

Being bullied is a common experience for many children and adolescents. Some surveys indicate as many as half of all children are bullied at some point during their school years. Individuals who are bullied experience true suffering that can interfere with sleep, appetite, school performance, social development including confidence, and emotional development. Researchers have proven many times that being bullied and/or excluded by peers is a strong predictor of depression and anxiety. In the long-term, bullying can lead to Post-traumatic Stress Disorder and an inability to form relationships. Bullying also increases the risk of suicide. For some, the thought of suicide is easier to contemplate than to endure such harassment and punishment.


Another concern is the typical bystander. Often bullying takes place in the presence of a large group of relatively uninvolved bystanders. Bystanders often do not recognize the true cost of silence. Bullies like an audience and the lack of intervention by bystanders will not deter the “bully mentality.” Some bystanders will even tease the victim or encourage the bully. Many are faced with overwhelming fear that if they intervene, they will become the victim. However, research has shown that any form of intervention diminishes the chances of another event by 50%.
Enough is enough. It is time to get involved. Research has shown school administrators, church youth leaders and community leaders play a powerful role in bullying prevention. Leaders can inspire others and maintain a climate of respect and inclusion making students feel safer, parents worry less, and teachers focus on teaching. Students can take leadership roles, communicating with peers and helping to develop policies. Parents can volunteer and participate in the PTSA. Parents should also communicate with their children by asking questions about their day and listening to the answers. School staff can keep parents informed and treat them as partners in their child’s education and safety.

Getting Help

If you suspect your child is the bully, seek the help of your pediatric care provider and a child psychiatrist as soon as possible. Without intervention, bullying can lead to serious academic, social, emotional and legal difficulties. If you suspect your child is the bullied, provide a lot of opportunities for open dialogue between the two of you. Don’t encourage your child to fight back. Instead, help your child practice what he or she will say to the bully and help your child practice being assertive. When possible, have your child avoid unsupervised situations, like hallways and bathrooms, and encourage your child to be with friends and travel in groups, as bullies are less likely to pick on someone in a group. Seek assistance from your child’s adult supervisors, teachers, guidance counselors and principals.
Summer is coming to an end and another school year is getting ready to zoom by. We wish you a productive and healthy 2012-2013 school year. Healthy Steps Pediatrics is helping to raise healthy children one step at a time. Please call 678-384-3480 if you have questions or concerns.

Do You Have Spring Fever?

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By Mary B. Hammock, MSN, CPNP

Spring is a lovely time of flowers blooming and birds singing. It also means your car, house, shoes and even your eyelashes will likely be covered in that yellow haze. Spring brings beautiful, comfortable weather, mood-enhancing sunshine and the itch to spend time outdoors tossing the ball or riding a bike. But Spring hay fever also arrives and for some it brings allergy misery.

Allergic Response

An allergic response starts when the immune system mistakes a normally harmless substance, such as pollen or pet dander, for a dangerous invader. Your body produces antibodies to protect you from the unwanted substances. With allergies, your body makes antibodies to particular allergens and the resulting reaction can inflame skin, sinuses, airways or the digestive system. The severity of the allergies varies from person to person and can range from minor irritation to life-threatening anaphylaxis.

Hay fever, also known as allergic rhinitis, can cause congestion; runny nose; coughing due to post-nasal drip and irritation; itching in ears, nose and throat; and itchy, watery, swollen eyes. If one is prone to reactive airway disease or asthma, upper airway allergy irritation will irritate lower airways resulting in chest tightness and wheezing. Allergies and asthma account for more than 10 million lost work and school days a year and pose a very real and miserable problem.


Age is a risk factor for developing allergies. Although allergies can develop at any age, children are more likely to develop allergies. If one parent has allergies, there is a 40% chance of passing it on to the child. If both parents have allergies, there is a 90% chance of passing it on to their child. It is not uncommon for allergies to go away and then return in the future.

Another risk factor is having one type of allergy. It simply increases the risk of developing other allergies.

Common Complications

Common complications of allergies include eczema, sinusitis, ear infections or lung infections. Having an allergy makes one more prone to developing asthma. Symptom management becomes extremely important for the best health outcomes. It is helpful to identify what triggers you or your child may have. Consider keeping a symptom diary to help identify what the allergens may be in your environments. Also, primary care providers or allergists can help to identify allergens, through RAST testing or skin-prick testing, which allows for specific avoidance of the allergens.

How To Avoid It

Allergen avoidance is generally the most important step in preventing allergic reactions and reducing symptoms. Benadryl used to be the best treatment for hay fever, but it wears off in about 8 hours and generally causes sedation. The newer OTC second- generation antihistamines provide 24-hour coverage, are generally non-drowsy and have a great safety profile. Allergy eye drops provide immediate relief and last twelve hours when needed. For some patients, prescription nasal steroid sprays may be necessary to manage symptoms, in addition to the antihistamines.

When to get Help

For severe allergies or allergies not completely relieved by other treatment, immunotherapy via allergy shots or newer options may be necessary. An allergist can determine if you or your child is a candidate. Healthy Steps Pediatrics is helping to grow healthy children one step at a time. If your child is suffering with allergies and you would like to know what to avoid and how to make him more comfortable, call 678-384-3480.