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Issues - Aa-Cz

[Alochol Use]   [Automobiles Use]   [Bedwetting]   [Breast Examination]   [Breath Holding Spells]   [Car Safety Seats]   [Circumcision Pros and Cons]   [Cohabitation]  


Alcohol is the most commonly used drug in America. It is also one of the most commonly used beverages. It is a direct cause of about 20,000 traffic fatalities a year, a large percentage of whom are teenagers.

For each teenager alcohol has a different meaning. For some, it is a beverage (drug) to be avoided because of its tendency to decrease health. For others, it represents adult behavior, enticing them to partake before it is legal for them to do so. For others, it is a method to feel good temporarily in a life that might be full of sadness. For some, it is the way to feel like they are part of the "in" crowd.  And finally, some use alcohol only impulsively because of peer pressure during parties or other gatherings of poorly supervised teenagers. Addressing problems with alcohol and your teen will depend upon the reason your teenager uses alcohol or is drawn to alcohol.

Ways to Keep Your Teenager from Abusing Alcohol

  1. Do not abuse alcohol or other drugs yourself. He learns from your role model.
  2. Keep your marriage good. If her parents are divorced, she is more likely to abuse alcohol.
  3. Become involved in a good church or synagogue, especially one which has a strong high school program. Religious teenagers are much less likely to have alcohol problems.
  4. Spend time with him entering his world. In other words, plan events periodically that are ones that he wants to do.
  5. Talk honestly about the health (cirrhosis of the liver, heart disease), mental health (addiction disorder, depression), and social problems (divorce, lost jobs) associated with alcohol.
  6. If you drink socially in your home, allow her to taste the beer, wine, or drink so as to demystify drinking. Alcohol does not taste good when first tried. We do not recommend that she drink at home routinely, even if it is only beer or wine.
  7. His evening and weekend parties must always be chaperoned by responsible adults.
  8. Junior and senior high schools should have dances and other parties for their students to reduce the temptation for unsupervised dances and off-campus parties.
  9. If you do have a problem with drinking, get help immediately. You will not be able to hide such a problem from your son or daughter, regardless of how much you try.
  10. Make it very clear to him that drinking before 21 years of age is illegal in most states.  He should also know that he will suffer consequences from you if he drinks secretly.
  11. Remind her that teen pregnancy often results from drinking which leads to loss of inhibitions, clarity of thought, and passing out. Date rape is common under such circumstances.
  12. Encourage your son or daughter in areas that he or she has success such as athletics, music, hunting, writing, or computers. Such success helps your teenager to resist temptation by giving self-confidence and reasons to keep a clear mind and avoid trouble.




One of the great joys of life for your teenager is being able to drive an automobile. It is also one of the great dangers to his life. More teenagers die in automobile accidents than by any other cause. Death by car accidents is far more common than other causes of death.

Because of the danger associated with the automobile (and other motorized vehicles), the tendency toward risk-taking at this age, and the relative immaturity of the teenager, it is very important that parents keep a tight control over use of the car. Any deviation from the rules by your son or daughter should result in prolonged loss of the privilege to drive the car which should last for a minimum of 1 month. Too much is at stake to be lenient.

Guidelines for Car Usage


He should not get in a car with someone drinking alcohol or using drugs.
She should not pick up hitchhikers, regardless of how "nice" they appear.
He should not use the car without permission.
She should not drive in areas of the city or streets that you have forbidden her to drive.
He should not let another person drive your car without parental permission.
She should not drive recklessly.


He should always use seat belts and shoulder harnesses.
She should be where she says she is going to be in the car.
He should always call if he is going to be late.
She should always call and ask permission to change where she is going.
He should drive courteously.
She should be grateful for the privilege to drive the car.

Discipline for Breaking the Driving Rules

Your teenager needs to understand that your discipline will be immediate, harsh, and unaltered. Driving privileges will be taken away for a minimum of 1 to 3 months for any infraction that places his life in danger such as drinking and driving, driving places where he was not suppose to go, or driving recklessly.

For lesser infractions, a shorter discipline might be used. However, do not be too light on discipline on small problems because they may tend to become bigger, especially if he does not think you are serious about the consequences.

Any traffic violations should be paid in full by her. She should pay at least a quarter of the cost of an accident that is his or her fault. Even if there is no fault determined, your teenager should pay for at least some of the costs which will teach her to drive more defensively.



General Information:

Bedwetting is a common problem in boys and girls up to 5- or 6-years-old.  After that age it is more common to see bedwetting in boys.  Bedwetting will sometimes continue until 9 or 10, or even into the teenage years.  Although it is physically harmless, it can cause a lot of psychological distress in your child.

Your child should have a complete physical exam and a urinalysis to make sure that he does not have bladder infection or kidney disorder.  If those tests are normal, then you can be reassured that he will not have any permanent problems from the bedwetting. Children who have problems with bedwetting often had parents who wet their bed as children. In general, it is best not to put pressure on your child to wet her bed less, since she is usually embarrassed and trying very hard already.  She may be such a deep sleeper that she may not feel the need to urinate and so does not wake up to go to her bathroom.  Nor will she be able to wait until morning to go to her bathroom then.  So it is not her fault.


  1. Do not give him liquids after 7 PM.
  2. Do not give her caffeine (coffee, tea, hot cocoa, cokes, chocolate, etc.) after 2 PM.
  3. Make him go to the bathroom just before bed.
  4. Wake her up to go to the bathroom just before her parents go to sleep.
  5. Give him lots of encouragement and perhaps little rewards for successfully going a few days or a week without wetting his bed.
  6. She may do much better when a friend is spending the night because she will be nervous about wetting the bed and may not sleep as deeply. 
  7. If all of the above fails with him (which it often does), get a bell and alarm system that rings  when he begins wetting the bed.  This trains him to have better bladder control.
  8. Medicines are sometimes used to strengthen the bladder control. These medicines include a type of antidepressant and a type of hormone inhaled in the nose or taken by mouth. Both of these work when your child is taking them, but usually stop working when her medicine is stopped.  These should not be used before she is 8 years of age.




Examining your breasts once a month is an excellent health habit to begin during your teenage years. One out of 11 women will develop breast cancer some time in their life (usually after age 40).  Breast cancer has an excellent chance of a cure if found early. 

Fortunately, most breast lumps in young women are not cancer. By doing monthly self-exams, you will become comfortable with the normal variations of your breast tissue.  It is best to do the examination at the same time each month, immediately after your period is over.  At that time, your breasts will be the least tender or swollen.

How to Do the Exam:

  1. Do your exam either in the bath or shower or while lying down on your back.
  2. First, lift your left hand and place it behind your head.
  3. Then hold the first 3 fingers of your right hand firmly together.
  4. Then press the outermost part of your left breast (near the armpit) firmly in a little circular motion with the pads of your fingers.  Continue in a large circle all around your breast.
  5. Move your fingers an inch closer to the nipple and feel another circle around the breast. Continue circling until you have felt every part of your breast, including the nipple.
  6. Squeeze your nipple gently to see if any fluid comes out.
  7. Now change hands and repeat the procedure for your other breast.

Your breasts are made up of fat, glands, and fibrous tissue, with muscle tissue underneath.  Occasionally tender cysts will develop before your period and shrink afterward.  Although, most lumps in the breast are not cancerous, but only a doctor can know for sure. Most breast cancer can be cured if found early. Early discovered cancerous lumps are also much more likely to be removed by surgical removal of the lump and not the entire breast as used to be done. But the longer a woman waits to consult her doctor the more likely extensive surgery will be required.

Call Your Doctor If:

Call Your Doctor 1. A lump does not go away within one month.
2. When you squeeze your nipples fluid is expressed.
3. Any unusual changes occur in your breasts.



Breath-Holding Spells


General Information:

About one-third of children when upset will hold their breath and turn bluish in the face, all the while scaring their parents to death. About 5% of children can actually hold their breath until they pass out which may be accompanied by a few twitches.  These normally begin between 6 months and two years of age and last until 4 or 5 years of age. They do not cause permanent brain damage or epilepsy.


  1. Your child's breath-holding spell will stop on its own.
  2. It is not necessary to place anything in his mouth, start CPR, or call 911; CPR and calling 911 should be initiated if the spell is 1 ½ minutes or longer.
  3. Use a watch with a second hand to time the length of the spell so you can tell your doctor.
  4. Do not give into her demands if she had a temper tantrum that initiated the spell; they will only become more frequent if you do.
  5. Do not let your child know that you are frightened after the spell even if you are.
  6. If your child is having breath-holding spells daily when he does not get his way, then he has probably learned to initiate the spells himself. It is best to ignore him when these happen.

Call Your Doctor If:

Call Your Doctor 1. Your child is unconscious for more than a minute.
2. Any muscle jerks occur during the attack.
3. Spells are happening several times a week.



General Information:

More children are seriously injured or killed by automobile accidents than any disease. About 80% of these can be eliminated by the proper use of car seats and restraints. All states have laws requiring children to wear car restraints. In a serious accident an adult cannot safely restrain a child by holding them. Either the adult will release the child at point of impact or crush the child with his or her body when she goes forward. 

Car seats also help to control the child's misbehavior, reduces motion sickness, and reduces the number of car accidents caused by the child distracting the driver. Since 1981, all safety seats have been required to meet government safety standards. Only choose a seat that has met Federal Motor Vehicle Standard 213; you can also call 1-800-424-9393 to check the safety of your car seat.

Car Seat Usage:

  1. Use an infant car seat until your baby is 20 pounds and able to sit up on his own.
  2. Keep her facing backwards as long as possible since it protects her neck.
  3. When more than 20 pounds he can be in a convertible car seat and face forward.
  4. When she is more than 40 pounds and 40 inches tall she can use a booster seat. 
  5. When he is more than 60 pounds he can use a regular seat belt across his lap.
  6. She needs to be 48 inches tall to use a shoulder strap; otherwise the shoulder strap can cause neck injuries. If the shoulder strap crosses her neck put it behind her until she is taller.
  7. Always put young children in the backseat; in the near future all cars will have airbags in the front seat which can harm a child younger than 12-years-old.
  8. Make sure that everyone in the car is buckled up. Not only is this safer but it alsokeeps the children from thinking that they can discard the seat belts when they are older.
  9. Keep toys in the car so that your bored child will have something to occupy him.
  10. If a child starts to crawl out of their safety restraints, pull over to the side of the road and refuse to move until the child returns to her car restraints.
  11. Use cloth over the vinyl car seat to make it more comfortable in hot weather; check the hotness of the seat and buckles before you put your child down in one to avoid burns. Consider using a towel or car seat cover if the car is in the sun for extended periods of time.
  12. Plan for frequent stops on long trips to allow children to stretch their legs.




General Information:

Circumcision is a surgical procedure involving removal of some of the foreskin or tissue that covers the head of the penis. It is done for religious reasons by Jews and Muslims, but the most common reasons are for "hygienic" or social reasons. The rate of circumcision varies a lot between different countries even in the English-speaking world. It is done in 1% of the babies in Britain, 10% in New Zealand, 40% in Canada, and 50% in the United States.

The foreskin may serve to protect the head of the penis from irritation from urine, feces, and injury. The risks and benefits are too small to give a definite recommendation. This is a parental decision, not a medical decision.

Benefits of Circumcision:

  1. Protects against urinary tract infections in the first year of life.
  2. Protects against irritation and infection under the foreskin.
  3. Decreases the rare incidence of cancer of the penis.
  4. Each of these problems in uncircumcised males is uncommon or rare.

Risks of Circumcision:

  1. Since this is a surgical procedure bleeding and infection are the most common side-effects; minor infections or bleeding occur in about 5% of cases.
  2. Rarely, infection might spread to the bloodstream or bleeding might be severe.
  3. The procedure does cause some pain and a local anesthetic should be used.
  4. Rarely scarring or even surgical accidents can lead to a permanent problem. 



Cohabitation occurs when a man and woman lived together in a sexual relationship without having married. Although men and women have cohabited throughout history, the number of couples who have cohabited has increased dramatically since the early 1970's. The increase in cohabitation was probably due to a rising divorce rate which caused people to doubt the permanency of marriage and a greater social acceptance of cohabitation as sexual practices of people liberalized in the late 1960's.

While many cohabiting couples have no plans of getting married or having children, most couples plan to do one or both if their relationship lasts. The most common reason given for cohabiting is that "we want to see if we are compatible before getting married." But research invalidates this goal of cohabiting couples and shows that there are a lot of problems with cohabiting for the couple and their children. Scientific studies consistently show that cohabitation does not help couples discover if they are more compatible. Rather, they are more likely to divorce than a couple who had never cohabited before marriage. Cohabitation causes many other problems for the couple, children of the union, and society.

According to Research the Problems Include the Following:

  1. Cohabiting couples are much more likely to divorce if and when they marry. Divorce has dramatically negative consequences on children as does the absence of a father if the couple splits up without ever having married.
  2. Domestic violence is much higher in cohabiting couples.
  3. The man and woman in the cohabiting relationship are much more likely to have sex with someone outside the relationship and thus increase the risks for sexually transmitted diseases.
  4. In most partnerships, the man and woman have dramatically different goals for their relationship. Women are more likely to look at cohabitation as a step toward marriage. Men are more likely to see cohabitation as a convenience with no particular future goals.
  5. Men in cohabiting relationships are more likely to be violent because they have less "invested" in the relationship than if they are married. They are also more likely to be accepting of forced sex on their partner. 
  6. The couples in cohabiting relationships are much more insecure in their relationships than people who are married because they are not sure what their true status is in the relationship.

According to Research, What Are the Costs to the Children?

Any practice that increases divorce and fatherless children is very detrimental toward children. Research over the last 20 years has shown many problems with children of divorced families including more physical ailments, more mental health problems, greater poverty, fewer feelings of security, greater problems in school, more delinquency, greater chances of teen pregnancy, drug and alcohol abuse, increased chances of sexual abuse and date rape, and greater chances of future divorce.

Are There Any Benefits to Cohabitation?

The one benefit of cohabitation seen in research is that cohabiting couples are less lonely than single persons. However, this "benefit" is seen even more strongly in couples who marry.



The information contained within this website is no substitution for timely medical care.

Feel free to copy the information on this web site and give to friends and family. Contact Dr. Glenn Wood at
Carousel Pediatrics (512) 744-6000 We are located at 7112 Ed Bluestein Blvd., #100 - Austin, TX 78723

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