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How do I talk to my grade-schoolers about sex? It’s a topic I’ve been avoiding (and dreading) with my 6-year-old son and 9-year-old daughter. They are young and impressionable, and they are being bombarded by so many negative influences (media, the Internet, peers). But, as their parent, I want to be the biggest, and most positive, influence. What’s the best way to approach this sensitive topic?
It is good you realize that to be the biggest and most positive influence on your children, you must address such sensitive topics head-on. Talking about sex with your children does not need be an uncomfortable task. Many people tend to think they must sit down and have “The Big Sex Talk.” In fact, you will not be having just one “big” sex discussion with your children if you are doing it right. You will have multiple, small discussions with your children throughout their adolescence. Talking to them early helps to take the “embarrassment” factor out of the discussion for them, too, and helps to set up a precedent for being able to come to you, their parent, for such sensitive information.
 A great way to broach the subject that is not just “out of the blue” is to find teachable moments to start the discussion. For instance, that news report that just came out regarding a young teenage celebrity’s pregnancy is a good time to impart your own values and thoughts about the subject. It is also a good time to ask your children if they have any questions regarding that.
In terms of answering questions your children might have, you don’t necessarily have to launch into a lengthy explanation. Listen carefully to what exactly your child is asking. Only provide enough information to answer the question that is developmentally appropriate for their age. Most likely, your 6-year-old son will be satisfied with a simple “non-technical” answer and go on about his day. Your 9-year-old daughter would be at the age in which she could understand more about this. This is also the time to enter your values into the discussion. What do you want your children to know about sex and what it means within a relationship?
Look upon these talks as wonderful opportunities to get to know what’s on your child’s mind and as an avenue for imparting your beliefs. With this new outlook, you will find such talks to be less dreadful and not something to be avoided until it’s absolutely necessary. —Sandra Wolf
I would like for my 3-year-old daughter to learn how to swim. She’s always been a “fish” in the water; but for safety’s sake, I think it’s time for her to learn simple swim techniques. What should I look for in a class and in an instructor?
For your daughter’s age and skill level, I would recommend the smallest class size available—private lessons if possible. The smaller the class the size the better she will be able to meet her specific needs and personality. I cannot stress enough that even though she is a “fish,” she is only three and is probably just getting used to following directions from other authority figures. It is possible, but not as probable, that she may find success in a group lesson situation.
 Most swim programs at community pools or private swim centers offer three kinds of lessons including: group (3+ students), semi-private (2 students) and private (one-on-one). If you are fortunate to have a pool in your backyard, there are freelance instructors who will travel to your home. This can be very convenient and practical for your child, who will learn to navigate in your own pool.
As far as what to look for in a program and instructor, seek out recommendations from friends and relatives. Always check references and interview. Ask questions about their teaching philosophy, their approach to working with a resistant child, their make-up policy, what kind of lesson program they think would best suit your daughter and instructor certifications and experience.
In addition, to be pro-active, you may want to purchase a swim lesson preparation book. This will help you introduce swim lessons to your daughter and possibly to start a dialogue about any questions or anxieties she may be having. There are no guarantees when it comes to children learning to swim, but taking a pro-active approach on your end will make you feel good about your swim program choice and increase the likelihood of your daughter’s success. Remember, all children learn at different rates; anticipating that this is a long-term experience will give your daughter the opportunity to gain the skills and confidence in water that she will rely on the rest of her life. Happy Swimming! —Barry Shrewbury
I am a 35-year-old mother of two young children who has a history of breast cancer in the family (my mother and my aunt are breast cancer survivors). Because of this, I know I am more at risk. Is there anything I can do in addition to yearly mammograms?
Family history does convey an increased risk for breast cancer. However, further details need to be known before we know how high that risk is. “Risk reduction strategies” will depend on your level of risk. For instance, knowing how many other family members had breast cancer or ovarian cancer and their ages of diagnosis would give additional information. Also knowing your ethnic background is helpful. For instance, if both your mother and aunt developed pre-menopausal breast cancer (before the age of 50, for example), this confers higher risk to you than if they had breast cancer later in life.
 You must remember that only 5 to 7 percent of all breast cancers are what we call hereditary. Women with hereditary breast cancer actually inherit a gene that predisposes them to develop breast cancer at an early age. This inherited gene also may predispose you to develop ovarian cancer. Women of Jewish ancestry have a higher risk of having this gene. Risk for breast cancer is a complex equation that takes into consideration your family history of breast and ovarian cancer and your ethnic background.
Also, there are individual factors that may alter that risk for you outside of family history: age your periods started, age you had your first child, previous breast biopsies in the past and whether they had atypical cells. A breast specialist can help you sort out how high your risk is.
Risk reduction can be very conservative or very aggressive depending on the level of risk. Most women have low to intermediate risk and we recommend the following:
- Breast exam by a physician once per year
- Yearly mammograms starting at age 40
- Lifestyle modification, including avoiding things like smoking and alcohol (one daily glass of alcohol increases breast cancer risk), healthy dietary habits and regular exercise
If the risk is higher things like a breast MRI (magnetic resonance imaging) would be advised. If a member of your family was diagnosed at a young age, your first mammogram should be done 10 years earlier than their age of diagnosis. Your risk reductions strategies should be individualized depending on your level of risk. —Dr. Lisa Curcio
What are the most common child-related dental problems I should be aware of? How soon should I take my child to the dentist?
The American Academy of Pediatric Dentistry recommends that a child’s first dental visit occur by age 1. This first visit is not intended to check for cavities, but instead is viewed as an educational session between the parent(s) and the dentist. During this visit, the dentist can review dietary recommendations, teach parents how to clean their child’s teeth, and discuss important issues such as fluoride and habits.
The establishment of a “dental home” by the age of 1 aims to emphasize preventive dentistry (proper hygiene and diet habits, sealants, fluorides) rather than restorative dentistry (fillings, extractions, stainless steel crowns, etc).
 The most common dental problems parents of young children should be aware of include:
Early Childhood Caries (ECC) ECC (formerly known as baby bottle tooth decay) is a common dental problem that occurs when the child is put to bed with a bottle containing juice or milk, or when the child is continuously nursing from the breast. Prolonged breast or bottle-feeding is discouraged after your child is 12 to14 months old. ECC can result in your child requiring extensive dental work at a very early age.
Injuries to teeth Injuries to the teeth are common as your child learns to walk, as well as during sports-related activities. The most commonly injured teeth are the upper front teeth. If this occurs, you should bring your child to the dentist for an evaluation. As your child learns to walk, make sure there are no sharp-cornered furniture or slippery surfaces that could cause a fall. If your child is involved in sports, consider a store-bought or custom-made mouth guard to protect the teeth and jaw bones.
Tooth grinding (bruxism) Many young children grind their teeth during sleep. Most cases are of unknown causes, and do not cause pain or discomfort. However, some children grind their teeth due to stress, and this can result in the wearing down of tooth enamel, causing temperature sensitivity. Treatment of the baby teeth is usually limited to parental and dentist observation at regular visits, because most children outgrow the habit by adolescence. If your child is still bruxing into adolescence, talk to your child’s dentist about treatment options. —Dr. Christina Chun
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