Kids drink. Luckily, fewer kids are drinking now than in the past, but the rates are still too high. The consequences are still too damaging to ignore this issue.
The American Academy of Pediatrics has just released the guideline that your child's doctor should be asking your child about his or her beliefs about and experiences with alcohol by age... nine. That's right, nine. The AAP was not quiet about these recommendations, or the reasons behind them.
So, is your child's doctor living (and practicing medicine) in a cave? No. Is the recommendation new? Not really. The old guidance wasn't all that different, we were told to start these conversations at age 11. And yet, many doctors aren't asking.
Why don't we ask? For all kinds of human reasons.
- The time crunch. At the average well child visit, I'm supposed to screen for at least 15 different problems. That's in addition to the time it takes to reestablish a rapport with the parent and child so that there is some connection and trust. When 15 minutes is considered generous for these appointments, it's easy to see why some issues get missed.
- I've known you since you were a baby. The beauty of great primary care is long term relationships between families and doctors. However, that longevity can give care providers the mistaken impression that we know you really well, and already know what you would or wouldn't do. So why ask?
- •Asking parents to leave can be tough. Actually, that's not true. Asking parents to leave can be simple, respectful and effective. Too often, though, getting time alone with a child, even if the parent has been told for a few years to expect this development, can cause a lot of conflict.
It is far more important that parents talk to kids and teens about drinking than anyone else. Parents are far and away the biggest influence on their kids' attitudes, beliefs and behaviors surrounding alcohol. But not all pediatric drinking behavior - even life-threatening alcohol use - is obvious to parents. Parents need some backup, and your child's doctor should be part of that team.
You can help.
- Make sure your child has a primary care provider he or she likes. It is easy to stay with same doctor's office for the entirety of your child's time in your home. It's definitely easier to have all your kids going to the same place, especially if that is where you're seen as well. However, different people develop different relationships, and a style that works for you or another of your child may not be right for everyone in your family. If your child doesn't trust or connect with her provider, help her find someone better.
- Encourage your child to develop that relationship. When you're in for a visit, do your best to let your child answer all the questions they can. As parents, it's so natural to speak for our kids in the medical setting. Stay quiet as long as you can, and defer to your child whenever possible. You'll build their confidence and competence as they learn to be responsible for their own health, and strengthen their connection to the do, PA or NP.
- Leave the room. Your neurotypical tween or teen should spend some time alone with his or her PCP at every well check. If you mention it to your child beforehand, they will know you expect them to have a private conversation with the doctor. If you're not sure your child's provider will ask the tough questions, ask them to do just that.
Yes, some kids drink. No one will ever have as much influence as you do on your child's relationship with alcohol. But you don't have to do this alone. Build your child's relationship with their primary care provider, and get the backup you deserve around the tough topics of adolescence.