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Interview with John Medina

April 17, 2014  |  Posted by Brain Rules | No Comments
Many parents are concerned about the sleep patterns of their children but in some cultures (Argentina, Spain), staying up late seems not to be a problem. Finally, is there any impact of bedtime or sleep pattern on babies and toddler’s cognitive development?

The most important factor appears to be establishing a consistent bedtime rhythm, regardless of what schedule you follow.

There is room for variation. Different people have different internal clocks – under partial genetic control - regardless of culture. These differences begin to appear in childhood. Some kids turn out to be natural night-owls, for example, and seem to be at their cognitive peak at night (we call them late chronotypes). Others show peaks in the morning (we call them early chronotypes) – and there are all shades in between. What chronotype your child possesses is important for parents to determine - and for kids to follow. Getting the proper amount of regular sleep certainly influences positive cognitive development. But what “proper” means may depend on what child you are talking about.

Several studies showed the benefits of co-sleeping, but some articles also highlight the fact that frequent awakenings during the night can generate stress for babies. Finally, do we know what is the global impact of this practice on sleep quality?

There are pros and cons to cosleeping and the current state of research gives no clear recommendation. There is no permanent damage done if you cosleep with them. There is no permanent damage done if you do the tried-and-true Cry It Out protocols. You can say that frequent awakenings not only stress the baby, they also stress the parents. Continuously stressed parents usually don’t make continuously good parents. Whichever style gives the adult more sleep is generally the healthier option.

Of course this has global implications. The less sleep you get, the more susceptible you become to anxiety and depressive disorders. Sleep loss also affects how you age. The global impact of depression and a poor transit through aging is incalculable.

Baby-wearing, with scarves for example, is increasingly used in western societies, but it has been practiced for centuries in other parts of the world. Does this practice have an impact on babies’ psychomotor development? By fostering visual or tactile exploration of the world for example. And do we know if the induced proximity between parents and babies strengthens the attachment?

I know of no studies conclusively determining whether baby-wearing has either a negative or a positive effect on a baby’s psychomotor development. It’s important for kids to move, for sure, but it’s also important they feel safe. And though safety cues are extremely important for a baby, how that is perceived depends on the child. Some babies seem to love scarves. For others, it’s their worst nightmare.

There are a variety of family structures, from nuclear families to multi-generational families. Does growing up in an extended family and multiplying interactions have an impact on children’s learning abilities, language acquisition or social skills?

I am deeply in favor of multi-generational families. The exposure to multiple intellects provides terrific opportunities for kids to hear alternate points of view -  and learn a great deal about navigating social relationships in a safe, loving atmosphere. Provided the family has a safe, loving atmosphere, that’s a net positive intellectual experience

In some countries, at an early age, toddlers spend much more time with their peers than with their parents and are very independent. What can be the impact of this early autonomy on their cognitive development?

Its not about providing autonomy. It’s about providing perceptions of safety, as I mentioned previously.

The reason is that the brain – even a child’s brain - is the world’s most sophisticated survival organ. If the child feels safe in an independent peer-filled environment, their brain development will maximized. And if that happens, I am all for early independent interactions. But not all kids feel safe in an independent peer-filled environment at an early age. Some get that later.  Parents should pay very close attention to what type of baby they have brought into the world, not into what country the child was born - and decide for themselves how much autonomy they can stand.

Conversely, in some cultures, parents are especially present and try to stimulate their babies’ intellectual growth from the very first months. What are the effects of this enhanced involvement on children’s development?

The greatest predictor of intellectual success is the emotional stability of the home - not the presence of toys or devices built to improve infant cognitive development. Most of those products haven’t been tested, and the few that have been tested don’t work very well. One study actually showed it did more harm.

If you want to maximize your child’s intellectual growth, the best thing you can do is to go home and love your partner. 

Insurance changes starting in January 2014

October 31, 2013  |  Posted by Dr. Madhavan | No Comments

By now everyone knows that their insurance plan is probably going to be different starting in January 2014.  I am going through this, too.  As such I thought I would write about some of the confusion I am working through as both a doctor and an insured person.

Today I learned about pharmacy benefits.  Apparently, like doctors, pharmacies also have contracts with insurance companies to provide services to members of an insurance plan.  Earlier today, I saw on the Washington Health Plan Finder website the words “not covered” in the “Out of Network” prescriptions column.  Initially I was concerned that this meant that I would not get any insurance coverage if an out-of-network provider writes me a prescription.  That would be really bad because I am an out-of-network provider for most of my patients.  Good news!  It turns out that the “out-of-network” term here applies to pharmacies.  I called and spoke to a customer service person who clarified this for me.  He said that an out-of-network doctor can write a prescription  for me and that it will be covered the same as an in-network doctor as long as I take it to an in-network pharmacy.  In other words, as long as you take your prescription to a network pharmacy, it will be covered (based on your plan details).  It does not matter who writes the prescription (in network or out-of-network).  This is exactly how it has always been so there is no change here.

Whew, I feel a strong sense of relief!

Best regards,

Dr. Madhavan

John Medina Video Interview

September 19, 2013  |  Posted by Brain Rules | No Comments
John Medina talks with Sixty&Me about the importance of exercise, managing stress, sleep, visual learning and how to use tricks and tips to address and reduce memory loss. He explains how understanding the brain can be applied to education and business. Dr. Medina explains the difference between simple forgetfulness and more serious brain disease and also surprises us with a 13 ‘rule’ that he would add if he was updating his best-selling book – power of nostalgia to improve brain function.

No new patient appointments available in September

September 9, 2013  |  Posted by Dr. Madhavan | No Comments

I regret to announce that I am not accepting new patients in September.  I have made a commitment to provide the best service I can to my current patients and right now that is taking all of my time.  I am hopeful that I will have some openings for new patients in October.  My plan is to start posting my availability at the beginning of each month.  As with any plan, I may run short of my goal.  If this is the case, you can always call to see if I have availability.

Best regards,  Dr. Madhavan

5 Brain Rules for Parents

June 26, 2013  |  Posted by Brain Rules | No Comments
There's a great ongoing conversation over at the Brain Rules for Baby Facebook page amongst new parents who have learned from Brain Rules for Baby. Author Dr. John Medina recently shared his 5 essential Brain Rules for Parents:
1. You are going to make lots of mistakes.
2. That’s okay. 
3. If you pay close attention to the safety needs of your children, – both the emotional and physical ones - you will almost always win.

4. If you treat your kids like they were merit badges, you will almost always lose.

5. Be prepared to live with contradictions. The parenting social contract is singular: they take and you give. Yet if you do it right, it won’t matter. You would die for them anyway, which means parenting is the best way to become a saint. Or a martyr. It is hard to believe that ripping your heart out of your pleural cavity and pinning it to your shirtsleeve could be the best thing that will ever happen to you. But it is. Parenting is probably the hardest thing you will ever do, but it is so much on the right side of worth it.