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Dr. Hillary is a pediatric nurse practitioner with a doctoral degree in health promotion and risk reduction. She knows that when it comes to family, everyone has questions that can't wait for the next available doctor's appointment. She also knows that some questions are too personal to ask a doctor face-to-face. For these reasons, Dr. Hillary is here for you.

Here are a few of Dr. Hillary's recent questions and answers!

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Q: My 9-year-old son was diagnosed with ADHD. His doctor gave him a medication named D-AMPHETAMINE SALT COMBO 5MG. I am so worried to give it to him. I asked his doctor about a diet, and he said only the medication works for ADHD. Do you have any suggestions? Please help.

A: Psychostimulants, like the amphetamine salts, are the gold standard of ADHD treatment. They can be effective, and, when the treatment is closely monitored by a health care provider, they are relatively safe. Medications for ADHD are not prescribed until a diagnosis of ADHD is made by a qualified practitioner, and the child's symptoms interfere with his or her academic or social development, or compromise the child's safety. If you worry about the medication and its potential side effects, please discuss it with your child's health care provider. He or she will be able to address your specific concerns.

As to the alternative treatments of ADHD, a body of preliminary scientific evidence suggests that neurofeedback and essential fatty acids supplementation might be effective in treating ADHD symptoms.

Resources:
ADD/ADHD: Conventional, Innovative, and Alternative Therapies for 21st Century
Attention Deficit Disorder Association
The Biofeedback Center: Brain Training for You, Your Family, for Life

Q: I just gave birth to my second child (a boy) 6 weeks ago and I'm worried my first born, who is 3, isn't taking the adjustment well at all. He has always been a little strong willed, but in a good way. With the new baby, he is acting out more than ever. I know this is common, but my worry is that I am not reacting to him correctly. I am so tired with all the lack of sleep that I find myself very short tempered. I do give him one-on-one time whenever I can and when we are together he is an angel. But when I am tending to the baby, he'll throw toys, scream, hit the cat, etc. And after I repeat, "Please stop. Please don't do that, STOP right now!" all I can do is scream back! I regret it as soon as I give in to this childish behavior because it is so not like me to be this way. We give time outs, and those do work, but I feel like I'm still yelling as I am telling him to sit down. (he actually will sit there and cry without trying to get off the chair, and it do calm him down. I follow the minute per age rule, so 3 mins is all I make him sit for.

What can I do to stop losing MY temper? It just seems the more I say the word 'stop,' the more he continues to do it, and then out of frustration I yell (almost hurtful things) at him. At bedtime is when he and I bond the best. We cuddle and I read him books and he is so sweet. This is how we were before the baby came. I don't want him to resent the baby.

Is it okay for me to say, "Please stop?" Do I need to sound more foreceful? I need to find the line between forceful and being a pushover. I know this is long, and I appreciaite you taking the time to read this. I love both my children dearly, and I miss the fun my 3-year-old and I used to have. I go back to work from my maternity leave in 6 weeks, and I would like to get a handle on this situation soon.

A: Sounds like you are extremely stressed out from taking care of a newborn and dealing with a toddler who is acting up. Being a mom is exhausting, especially when you don't get enough sleep because of your baby. If at all possible, find somebody to help you take care of the baby so you can get some sleep! When you are rested, things will look a little better and you might find more effective ways to deal with your toddler's behaviors.

First of all, ignore tantrums. They are just a way for your toddler to get your attention. He will take any attention you give him, even if it's negative, such as yelling, scolding, etc. If you react to his tantrums, they will continue, because he will realize that throwing a tantrum gives him what he wants: mom's attention.

Time out is a good way of punishing "bad" behaviors. However, using positive reinforcement might work a little better. Most children want to do things that will make their parents happy. So, try to involve him in activities with the baby as much as possible, and of course, praise him for his good behaviors (positive reinforcement).

Be consistent with your discipline, exercise it in a loving way, and above all, get some sleep!

You might want to read our article, How To Teach Your Child Respect, which shows simple examples of reinforcing and encouraging positive behaviors instead of negative.

Q: I feel very frustrated and embarrassed. Sometimes my boys (6 and 3) are very good, sweet, inquisitive, clever, playful... then I cannot figure out what makes them truly awful. It seems as if there is absolutely no getting through to them. It is a barrage of hitting the dog, spitting, running, yelling, hitting each other... When they are in this "mood" (I don't know how else to describe it) no discipline whatever seems to be even remotely effective. What do I do?

A: As much as it is stressful, phases like that are a part of growing up and being boys! A couple of suggestions: be consistent with discipline and pick your battles. Try to discipline behaviors that are absolutely unacceptable and try to ignore little things.

Please read this article: Practicing Healthy Discipline

Q: My son is 9 and since the age of 6 or 7 has been wetting the bed every night. There is no bladder infection, we have tried medication (so he can go for sleepovers), but it does not work for him. My GP says he will just grow out of it. However, this summer he’ll have his first sleep over, and I am so worried. He doesn't seem to be concerned and I would never let him know that I am worried for him. Our GP and I have told him many times that many children have this problem, but he just stares at the floor and looks so sad about it. Any advice???

A: Nocturnal enuresis (bedwetting) is a common problem among children. From your description, I am not sure if your son had a full workup for nocturnal enuresis. You stated that a bladder infection was ruled out, and that he tried a medication. He should have had an ultrasound of the bladder and the kidneys to make sure they are anatomically normal. As to the medication for the treatment of bedwetting, I use desmopressin, which does not cure the problem, but helps to deal with bedwetting while children work on growing out of it. The starting dose is 0.2 mg at bedtime for a month. If that does not work, the dose is increased to 0.4 mg at night for a month. If at that dose there is still no resolution, a dose of 0.6 mg at night is tried for a month. For most kids that works pretty well. On the other hand, along with desmopressin, you can use a bed alarm. The success of controlling bedwetting is higher if both are used at the same time. And above all, time is what your son needs to outgrow the problem, as your GP advised.

Please read this article on bedwetting:
Bedwetting: Finding a Solution

Q: My 4 and half year old's cough seems to stay with her forever. We went to her doc and he gave her some oral medication. After using for weeks, there was no improvement. We took her to another doc , she examined her lungs and said that she seems to be having slight bronchitis and asked her to use a nebulizer. It seems to be working at times and suddenly at some point in the day she starts coughing again. She also has some dark circles under her eyes. Wondering what is going wrong?

A: Sorry to hear about your child's constant cough.

Chronic cough in children that some health care providers describe as "bronchitis" indicates asthma, a chronic inflammatory disease of the airway that requires a daily treatment with inhaled corticosteroids, such as Pulmicort. In children, allergies are the number one trigger for asthmatic symptoms. I would recommend that your child be evaluated for allergies. If you find out that she is allergic to something, you will be able to remove it from her environment or decrease her exposure to it, thus helping her symptom get better. About 30% of children outgrow their asthma by the time they reach adolescence. In the mean time, your daughter needs to be treated, because asthma can be controlled.

Please read this article: Understanding Asthma

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