Wellness in Action

Written by a guest blogger and mother of two girls, ages 15 and 12.  It is heartwarming and shares a refreshing perspective about the onset of menses in her oldest daughter.  
This is the second and final post for this article.

A hint of fall is in the air accompanied by the rising tide of back-to-school activities.  For each child, returning to school in the fall is a unique experience.  Some children are excited, some are nervous and some are down right scared.  For a number of middle school girls, there is also the anticipation, or perhaps uncertainty, around the onset of menses.  Below is the second and final part of our open discussions about the onset of menstruation. 

Involve Dad

While a take-charge young woman, our daughter at first didn’t share much with her dad about getting her period. He sensitively let many months pass before one night looking her in the eye and letting her know that he cares, too, about her changes and her struggles. He said she had no need to hide from him, for instance, a bed sheet she may have stained, or the need for a dose of acetaminophen to relieve cramping.

He has since even taken her to the store specifically so she could buy bras. His initial opening dialogue with her has gone a long way toward letting her know that he’s another adult in the house who – despite his gender! – can love and care for both his daughters’ needs as they become young women.

Mark the Mark

Something else my youngest can look forward to – besides gaining a treasure trove of information in advance of the onset of menses – is a mother-daughter shopping outing.

When my older daughter started spotting, I knew it was the beginning of an exciting, sometimes difficult, sometimes shocking change. It needed to be acknowledged by something special. We went to the lingerie department, where I told her she could pick out whatever she wanted (within reason). Appropriate to her age, she selected a pair of very soft jammies. The purchase served as a physical “congratulations” to mark her first tentative step into womanhood.

She has long since outgrown this pair of period pajamas. They will not be handed down to her little sister; the younger daughter will get to pick out her own when it’s her turn.

Written by a guest blogger and mother of two girls, ages 15 and 12.  It is heartwarming and shares a refreshing perspective about the onset of menses in her oldest daughter.  
This is the first of this two part series.

"I remember the call three years ago from my daughter’s overnight camp. Her counselor passed my daughter the phone, and I could hear the choke in her voice even before she spoke. “I got my period,” she sobbed.  She was still 11 years old; that’s three years younger than I was when I first got my period. Her body had recently begun to round out a bit; she felt most comfortable, for example, wearing a training bra. I’d thus had a sense she’d get her period soon. But at sleep-away camp? One week before her 12th birthday?

She didn’t exactly ask to come home; she put on a quavering-yet-brave voice and said the counselors were giving her the empathy and attention she required at this time of huge change in her life. I figured that besides being at home, my newly budding young woman was in the second-best place she could be: In an all-girls cabin with two older teens as counselors, each of whom had reached menses – the onset of menstruation – years prior.  My maturing daughter just needed to hear my voice that night; I didn’t get another call from her for the rest of the camp session.

The actual start of menses is the result of years of changes in a young woman’s body. What my daughter and I were soon to learn was that for her, her “first period” did not mark the start of regular menstruation; rather, it kicked off more than a year of on-again, off-again spotting. If her body now – at nearly 15 years old – is a smooth-running car with an automatic transmission, nearly four years ago it was a bucking manual with a novice driver at the wheel and the herky-jerky clutch.  

Upon my daughter’s return from camp – timed with her 12-year well-check – I took her to our pediatrician. We talked during that visit about the recent spate of spotting.  My daughter had only breast buds and scant pubic hair; these were signs that while puberty had begun, her period would come a bit later. The doctor explained to us that a number of physical – as well as emotional – indicators would crop up on a girl’s body (and in her mind) before the occasional droplet of blood in her panties would give way to the need to use pads to keep from staining her pants.

The thoughtful, sensitive pediatrician further explained that spotting is normal and similar to the experience of losing baby teeth to make way for adult chompers. After a milk tooth is lost, the adult tooth will slowly push its way through the gum – sometimes retreating a bit before eventually revealing its crown – and then its whole self.  The onset of menses can run a similar course as a girl’s body prepares to become that of a woman.

Sure, I was a woman who decades prior had gone through the changes my daughter now was experiencing. But the pediatrician’s explanation was somewhat new and gave both my daughter and me language and a visual guide for her rapid metamorphosis… and that of my younger daughter.

Periods, Too, are Snowflakes: Every Girl’s Experience is Unique 
My 6th grader now has breast buds and a hint of pubic hair. She has so far experienced no spotting, and she may not. While my eldest’s body played a bit of a peek-a-boo trick on her for one full year, my younger daughter may well have an entirely different experience with menses’ onset. In fact, just as she’s her own person, her flowering will probably look nothing like her big sister’s.

And she’ll probably handle it quite differently, too
For example, my older daughter can be a very take-charge individual. Shortly after her first few spotting experiences, she realized a “real” menstrual flow could happen at any time; she didn’t want to be caught unprepared.  She selected a cute zipper pouch and filled it with one thin pad, one thick pad, one tampon (though not all girls are ready, willing, or able to use this method of protection), and one clean pair of underwear. She called it her Period Pouch; now on the cusp of high school, she has it still and keeps it appropriately stocked and in her locker (for both herself and any young woman surprised during the school day).

There’s an App For That
She also took recommendations from older girls about how they deal with their periods. One suggestion has remained vital: Select a period-tracking app to download to your phone. There are a number of them out there. My daughter clicked around and particularly likes Life. Available via iTunes, it tracks vital information for now – such as when premenstrual symptoms like mood swings and cramps may occur – and for later – such as ovulation.  My younger daughter loves peeking over her big sister’s shoulder to learn how it works…as well as to prepare herself for one of her sister’s key premenstrual indicators: grumpy, irritable moods.

To be continued next week with more dicusssion about the important role of dads and ways to acknowledge this important time of transition in a young woman's life.

Dr. Avery will be a Keynote Speaker at the 2016 BabyFest NW.  All patients and families of The Pediatric Practice are invited to attend.  There are a limited number of tickets available; please call our office to reserve your tickets.  BabyFest NW is taking place this Saturday, April 23rd from 11 - 4 pm at the Oregon Convention Center.  Dr. Avery's talk is titled "Let's Talk Toxins” It will cover four major sources of toxins that can negatively affect a child's health and how to minimize or mitigate them in your environment.  We look forward to seeing you there! 

You’ve heard the expression, “A picture is worth a thousand words.” Proper manners work similarly. While they are unspoken, good manners, and their unfortunate counterpart, speak volumes. Luckily, you don’t have to be Emily Post to model and teach age-appropriate manners to your child.

Good manners and polite behavior demonstrates self-respect and respect for others. Good manners can help older children navigate new or sticky social situations with ease.  Can you imagine a world without manners? Like you, I’d rather not.

Manners are a skill to be enjoyed, not forced. Be reasonable in your expectations and know that teaching and learning manners is a life-long process.  Start early and start often by gently showing and lovingly teaching manners to your child.  Soon, they’ll become routine and – like teeth brushing – a regular part of daily life.  Here is an idea of how manners might progress with age:

2- to 4-year-olds: They can learn to say, “please” and “thank you” consistently when an item is desired or given to them.

4- to 6-year-olds: They can learn how to use a knife and fork at the table and refrain from talking with food in their mouths; and begin to distinguish between “indoor” and “outdoor” voices. 

6- to 9-year-olds: They can say, “excuse me” when appropriate (for example, after passing gas or accidentally bumping into someone in a corridor); hold their tongue from parroting potty or swear words; and write thank-you notes, with guidance from you.

9- to 12-year-olds: They can initiate polite conversation; look adults in the eye when they are speaking to them and being spoken to; offer a firm handshake; and pen thank-you notes with little prompting.

13- to 16-year-olds: They can engage in more advanced polite social conversation; learn to set an informal and formal dinner table; (politely) assist younger siblings with tasks; and write thank-you notes independently.

And parents, as hard as it may be, modeling expected behaviors and good manners is the best way to teach your child good manners.  More information can be found at www.theamericanschoolofprotocol.com  or www.askdrsears.com/topics/parenting/discipline-behavior/morals-manners/7-ways-teach-your-child-manners

December 18, 2015
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I learned to make this while visiting dear friends who live in Lille, France.  It is easy to make, fresh and delicious.  We no longer purchase salad dressing from the store; this is my go-to recipe.  It takes less than 5 minutes to make.  You can tweak this recipe with fresh herbs if you wish, but the authentic French way is simply divine.



French Dijon Vinaigrette

3  TBSP of Extra Virgin Olive Oil

1  TBSP of Red Wine Vinegar

1  TSP finely diced shallots

2  TSP dijon mustard

pinch of coarse sea salt & ground black pepper to taste


Add all ingredients to the bottom of salad bowl and whip vigorously with a fork until dressing is well mixed.  Use immediately on your favorite salad.  This is also a wonderful dip for crudités.  Enjoy!


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In 2018, Dr. Avery and her team made the very difficult decision to close the practice due to relocation.  It was a privilege and honor to serve the children and families of the practice.  Together, a new vision for healthcare was born and it is our hope that each of you will take that seed of innovation with you to your next practice. We, as pediatricians, treasure our time with our young patients and their families and we are grateful for the time spent healing, laughing and learning at The Pediatric Practice. 

To Obtain Medical Records:

We are happy to assist you in the transfer of your child's medical records.  Please have your new pediatrician fax a signed, dated and completed Medical Record Release form to our office at (503) 716-4734.  

If you have any questions, you can call and leave a message at the office and we will return your call as soon as we can.


In Your Best Health,  Dr. Avery and Team