Thursday, October 21, 2010
What to expect from your toddler

By Dr. Anthony Policastro

I often discuss behavioral expectations with parents. The most extreme incident I saw of this was when I was a pediatric resident. We had a 3-year-old child admitted to the hospital for a developmental work-up. Her parents both had post graduate degrees and they were convinced that there was something wrong with their daughter since she was not reading yet. Their expectations were unrealistic. I see similar things happen in other situations such as when parents take their children out in public. Toddlers do not understand what it means to behave in public. Teaching them the correct way to behave is like any other developmental training. It takes time and practice. Unfortunately, some parents simply do not have the patience. The typical toddler has a desire for immediate gratification. When they go to a store, they see things they want, right then and there. They do not understand why they can't have everything they want. They also do not understand about waiting until they get home to use it. For that reason, they will react as they normally do when they do not get their way. Many years ago researchers gave a questionnaire to mothers of 2-year-olds, 3-year-olds, 4-year-olds and 5-year-olds. They asked a series of questions as to whether the children had any problems with certain behaviors. The logic was that if more than 50% of the parents said yes, then it was just normal behavior for that age. One of the questions was about temper tantrums. 85% of mothers felt that their 2-year-olds had a problem with temper tantrums. That means if a 2-year-old is in a store, and does not get what he or she wants, the normal reaction would be to have a temper tantrum. The issue is not the tantrum which is normal. The most important piece is how the tantrum is handled. Unfortunately, there isn't one solution that fits every child. Therefore, advice needs to be addressed to the specific situation and the specific child. A similar issue occurs when toddlers are taken out for dinner. They often will do fine while they are waiting for their food or working on an appetizer. They usually will do very well while they are eating. However, once they are done, there is no need to be there any longer. They will want to get down, run around and play. They will want to make noise. In other words, they become hyperactive. The study that was done of toddlers also asked a question about hyperactivity. 100% of the mothers of 2-year-olds indicated that their child had a problem with hyperactivity. This behavior is normal and is to be expected. It is frequently a lot easier to deal with childhood behavior when you can accurately predict what to expect which might lead you to plan better in an attempt to avoid problem situations. Above all, it might lead you to see your child as the normal toddler he or she is.

Fall's arrival means the start of a brand new flu season

By William G. McNett, MD

That slight nip in the morning air, the sun setting earlier and earlier, sure signs of fall's arrival and the start of another flu season. The months of November through May are considered "flu season," and flu shots will be available in your doctor's office and local pharmacies soon, if not already. Having your children receive the seasonal flu vaccine this year (beginning fall 2010) will now protect them against the H1N1 flu virus as well. Because the flu virus changes from year to year, children need to be revaccinated every flu season. Flu symptoms include: fever & chills, headache & muscle aches, dizziness, loss of appetite, cough, nausea or vomiting, weakness, ear pain and diarrhea. While the flu vaccine may be the first one on your mind, it's also important to keep track of other vaccines and boosters your children need. Over the past year, two vaccines in particular have been in the spotlight: whooping cough (pertussis) and measles. A typical case of pertussis starts with a cough and runny nose for one-to-two weeks, followed by weeks to months of rapid coughing fits that sometimes end with a whooping sound. The pertussis vaccine is safe for children and adults. Vaccination begins at two months of age, but infants are not adequately protected until the initial series of three shots is complete at age 6 months. For this reason, if parents of infants have not been vaccinated for pertussis, they should think about doing so as an added way to protect their baby from this disease. Measles is a viral infection that spreads easily through the air by sneezing and coughing. The illness causes a total-body skin rash and flu-like symptoms, including a fever, cough, runny nose, and irritability. Like pertussis, the best way to protect children from getting measles is immunization. Children should get the measles, mumps, rubella (MMR) vaccine at 12 to 15 months and then the follow-up booster shot between 4 and 6 years. When it comes to immunizations, rumors and worries about their safety have caused some parents to avoid vaccines. An individual child's chance of catching a disease is low if everyone else is immunized. But if the number of unimmunized children in a population grows, the risk of sparking an epidemic increases dramatically. Although it's natural to want to ensure that everything you do is in your child's very best interest, when parents don't have their kids vaccinated, it can affect everyone. Before making any decisions about immunizations, talk to your doctor first. For more information on vaccinations and other health issues that affect your children, visit Nemours'

About the author Dr. William McNett is the chief of Primary Care Pediatrics at Nemours Pediatrics, Philadelphia, Pa.

NHS appoints new board member Nanticoke Health Services announces Michele Procino-Wells, Esquire as a new member who will serve on the board of directors of Nanticoke Health Services. Procino-Wells is a graduate of Laurel High School (1987); Penn State University (B.A., Communications, 1991); Widener University School of Law (J.D., cum laude, 1995); and Villanova University School of Law (LL.M., Taxation & Estate Planning, 1998). Procino-Wells is a member of the bars of the Supreme Court of the State of Delaware, the United States District Court for the District of Delaware and the United States Tax Court. She is also a member of the National Academy of Elder Law Attorneys, a past president of Soroptimist International of Seaford Inc., and is the treasurer of Soroptimist's related foundation, the Curiosity Service Foundation, Inc. Practicing law since 1995, Procino-Wells has over 15 years experience as an attorney and is the owner and managing attorney of Procino Wells, LLC in Seaford.

Mammography Van back on the road The Women's Mobile Health Screening van, newly retrofitted with state-of-the-art digital mammography equipment, was re-dedicated on Oct. 4 at Legislative Hall in Dover.

State Senator Nancy Cook and the Delaware General Assembly sponsored the upgrade. The Delaware Breast Cancer Coalition (DBCC) manages and operates the van, which provides free or reduced cost mammograms to eligible uninsured or underinsured women. Digital technology (Hologic Lorad Selenia) replaced x-ray film equipment on the 2002 Airstream Commercial medical vehicle. Digital technology provides greater image resolution, while allowing health providers to access mammograms from any workstation. Digital records are also easier to store. The Delaware Cancer Consortium recommends annual clinical breast exams for all women, with mammograms by age 40, and annual mammograms and clinical breast exams afterwards. Women at greater risk for breast cancer may need earlier and more frequent screenings, and should discuss those options with their doctors. For more information about arranging a screening mammogram, call DBCC at 1-888-672-9647 weekdays between 8:30 a.m. and 5 p.m. Van staff works some Saturdays and early evenings. Women should have a mammography prescription from their doctor and if possible, a copy of their previous mammogram films for comparison. Van staff will help those without a prescription or a primary care provider.

Corn maze Science has shown that exercise, fresh air and a positive attitude are keys to healthy living.You can get all three every weekend in October by having a fun-filled family outing at a one-of-a-kind corn maze presented by the Seaford Historical Society at the Ross Plantation. The maze will be open to the public every Saturday (10 a.m. - 5 p.m.) and Sunday (1 p.m. - 5 p.m.) in October.Admission is $5 over 12 years old and $3 for ages 6 - 12 (must be accompanied by an adult). A free Kiddie Maze is available. Use the main plantation entrance and follow the signs for parking. Added information is available at

NHS Tribute awards Nanticoke Health Services has announced the recipients of the 6th Annual Nanticoke Tributes for Healthcare Leadership. Nanticoke Tributes awards individuals who have made significant contributions to the provision and improvement of health care in the communities of Western Sussex County.The awards will be presented at a dinner and reception on Thursday, Oct. 28, from 6 to 9 p.m., at Heritage Shores in Bridgeville. The Founders Award will recognize two new inductees, Sister Rosita Alvarez and the Soroptimist International of Seaford.The Charles C. Allen, Jr. Philanthropy Award is being presented to Rex L. Mears who is being recognized for his dedication and commitment to Nanticoke Health Services. The Nanticoke Tribute Awards also recognizes a new inductee into the Nanticoke Physicians Hall of Fame. This year, Louis F. Owen, Jr., MD will be presented with the Hall of Fame Award. Tickets are $100 and may be purchased by calling Nanticoke Health Services Foundation at 629-6611, ext. 8944 or

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. The program is facilitated by Nanticoke Memorial Hospital Cancer Center professional staff - Terri A. Clifton, MS, NCC, Cancer Care coordinator; Mary Brown, RN, DSN, manager Cancer Care Center; and Wendy Polk, nutritionist - with assistance from Lois Wilkinson, DBCC special projects manager, who helps facilitate the program at Bayhealth. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Cancer Support Group The Wellness Community-Delaware offers a general cancer support group for people affected by cancer and their loved ones held at Nanticoke Memorial Hospital. The monthly support group meets in the second floor conference room of the Cancer Care center on the third Monday of each month from 4:30 to 6 p.m. The next meeting takes place on Nov. 15 at 4:30 p.m. The Wellness Community, an affiliate of the Cancer Support community, is dedicated to helping people affected by cancer enhance their health and well-being through participation in a professional program of emotional support and hope. Facilitators are trained mental health professionals with a master's degree or more. Call 645-9150 for information or to register. All support groups offered at the Wellness Community are free of charge. This program is made possible by the support of Nanticoke Memorial Hospital.

Delaware Hospice support group Delaware Hospice's Bereavement Counselor, Paul Ganster, LCSW, will lead an eight-week grief support group on "Grieving the Loss of a Loved One," on Thursdays, from Oct. 14 through Dec. 9, from 5 to 6:30 p.m., at Nanticoke Memorial Hospital in Seaford. There is no fee for this service which is provided as a community outreach by Delaware Hospice. To register, call Paul Ganster, LCSW, at 357-7147, or send him an email at

Competition to improve school meals Agriculture Secretary Tom Vilsack has announced the Recipes for Healthy Kids Challenge to improve school meals and the health of children across the nation through the creation of exciting new recipes for inclusion on school lunch menus. The competition - part of the First Lady Michelle Obama's Let's Move! initiative - will draw on the talents of chefs, students, food service professionals, and parents or other community members working together to develop tasty, nutritious, kid-approved foods. There will be a grand prize chosen by the judging panel as well as a Popular Choice winner based on public voting. The judges will also choose award winners for the top two recipes in each category. Winning teams will be invited to prepare their nutrition-packed meals alongside White House chefs. To recognize and share the culinary creativity nationwide the top ten recipes in each category will be published in a Recipes for Healthy Kids Cookbook to share with students and families. To learn more about the First Lady's Let's Move! campaign, visit The deadline for recipe submissions is Dec. 30. For more information, visit