Addressing breastfeeding, coronavirus, and the crisis of child abuse with one of the nation’s top pediatricians


This week The Means Report turned it’s attention to your children and their health with the president of the American Academy of Pediatrics, Dr. Sally Goza. From Adverse Childhood Experiences to protecting your child’s mental health. And, of course, you cannot turn on the television or the radio or pick up a newspaper without hearing about the coronavirus. Dr. Goza talks about it, how it impacts children, and what you need to know going forward to make sure that you keep your family in the best health possible.

Brad Means: She is Dr. Sara Goza. Her friends, because she’s from the state of Georgia, call her Sally. That’s a southern nickname, Dr. Goza tells me. So, I’ll try to stick with Sally the whole time. Congratulations on your post and welcome.

Dr. Sally Goza: Thank you, so great to be here, back in Augusta where I went to medical school.

Brad Means: Yeah, an MCG grad.

Dr. Sally Goza: That’s right.

Brad Means: Has the city changed much since you left?

Dr. Sally Goza: It has. As I was driving in today I went, “I don’t recognize much of anything.”

Brad Means: Yeah, now it’s blown up just in the past 20, 30 years or so. All right, so let’s talk about your role as president of the American Academy of Pediatrics. Just an incredible role and an incredible forum for you to advocate for our young people. Should we picture you mostly as a sort of a lobbyist? Do you meet with lawmakers and people in power and say, “Look, here’s our agenda, help us with it”?

Dr. Sally Goza: So, we have 67,000 members of our academy.

Brad Means: Wow.

Dr. Sally Goza: And my role is as the president to maintain the board, make sure the board’s doing what we need to do for governance, for the Academy. But we do go to D.C. a lot. We are educators, we are not lobbyists. We are educators because we are non-partisan. And are unabashedly pro-child, but we do not lobby. We try to educate our leaders as to what we think needs to happen for children.

Brad Means: Yeah, so 67,000 members, one voice, pretty much. I bet they listen to you on Capitol Hill.

Dr. Sally Goza: They do, we’re very well-respected up there. When the pediatricians come to town, they like to hear what we have to say. We have staff that work there also to help push the things that we need to get out to the members of Congress and to other people in the administration. We’re not shy. We’ll work with anybody that wants to talk to us about what’s best for children.

Brad Means: How’s this impacted your practice? Pediatrics, internal medicine, do you get to do any of that this year?

Dr. Sally Goza: I’m still practicing. I actually worked the first three days of this week, so I’m off the last two. But it’s much less than I was. So, I’m gone a fair amount of the time traveling and talking to people and going here and there, meetings, things like that. Now, that could change.

Brad Means: Yeah, things are constantly changing, especially the headlines every day when it comes to this pesky coronavirus. What are you telling the doctors of the United States? And what should the families know when it comes to their children? On the news each night, Dr. Goza, we say, the really young and the really old. But that doesn’t cover all young people.

Dr. Sally Goza: No, and the corona virus, the COVID-19, is kind of an unknown. The CDC is still trying to figure out exactly what guidance to give. They’ve given a lot of guidance and good guidance. We know that it’s spread through droplets. And so, covering your mouth when you cough. So, we’re telling kids to cough into their elbows or into a tissue and then throw it away. We’re talking about washing your hands, you know, with soap and water, 20 seconds, sing the “Happy Birthday” song twice and that will be enough time. And we’re actually trying to do that in our offices for the kids to see us doing it so that they’ll know to do that. You can also use hand sanitizer, but it needs to be at least 60% alcohol. Those are the things you can do to really prevent the spread of this. But the other things is, if your children are sick, keep ’em home.

Brad Means: If I hear somebody on TV say that this impacts the very young, among others, I’m gonna keep my baby home from daycare. I’m gonna live in fear. Is that smart?

Dr. Sally Goza: Really, we should not be panicking, you know? We have to wait and see what’s gonna happen. This virus is an unknown for the United States. We’re still trying to figure out where it is, how many people are infected, how it’s spreading. And so, the CDC will be guiding us on that. And we, actually, ar putting out things every day as well after talking to the CDC about what’s going on with it. Right now, we are saying, if you are sick, don’t send your children to school. Stay home. If you think you’ve been exposed to the COVID-19, you need to call your doctor’s office to find out what you should do. And if you’re very, very ill and you need to go to the emergency room or to your doctor’s office, you need to call them and let them know you think you may have been exposed so that they can take precautions so that other people aren’t affected by it. And so, it’s a very scary time, but I really want to say, don’t panic. You know, we need to be calm, we need to take care of this, and we will. And the CDC will guide us in that as we know more as it goes along. In China, children were not as affected as the older people. So, we’ll have to wait and see how it affects children here.

Brad Means: All right, maybe it plays out the same here. Let’s look at babies, still, and then we’ll sort of try to move our way up through the growth of a child as it relates to your role and the role of pediatricians across the country. So, let’s talk about vaccines. Some people are scared of them. They think that certain shots might, say, give your child, your baby, autism. Is there still, despite y’all’s efforts, misinformation out there?

Dr. Sally Goza: There is definitely misinformation out there. It is very live and well, the misinformation on the social media sites. There is a social media campaign that’s well-financed that is trying to convince parents not to vaccinate their children. I actually grew up in an age and trained when we did not have many vaccines. Some of the vaccines we have today were not there when I trained. And we saw many many, many children be sick and maimed and even die from these diseases. Vaccines are safe, they’re effective, and they save lives.

Brad Means: How can you say that? How do you know?

Dr. Sally Goza: Well, I’ve seen it. I mean, I’ve seen haemophilius and pneumococcal meningitis when I trained. I’ve actually seen it, actually, since I’ve been out of training as well. We’ve seen all these diseases. We’ve seen measles come back. We know measles can be deadly. And even if it’s not deadly, it can be damaging. So, these diseases are bad and the vaccines really do save lives.

Brad Means: Let’s talk about nutrition, when it comes to infants. Are we, parents and caregivers, doing all we can for our babies when it comes to feeding them right when they’re born and the years after?

Dr. Sally Goza: So, the American Academy of Pediatrics recommends breast feeding exclusively for the first six months, if at all possible. That is the best way to feed your baby. If that’s not possible, the formulas are there and that’s what they’re there for. But we do recommend that. And we’ve seen a really good increase in people initiating breast feeding. And now, we just need to make sure that they continue it for as long as they can.

Brad Means: And who can help hold a mom’s hand through that process? Perhaps mothers of newborns are watching. Is it all up to the pediatrician? Once you leave the hospital, you feel so lost, sometimes.

Dr. Sally Goza: There are pediatricians, there are lactation consultants, there are breast feeding support groups. But the best way to know where anybody is that can help you with that are your pediatrician. They can recommend where you can go to get some of that help as well.

Brad Means: Well, a lot of issues impacting babies, for sure. And Dr. Goza, I appreciate you touching on a few of them. I wanna leave the bulk of our time, though, to talk about adolescents and older children and how we, as parents, and as a society, can help them as we continue with Dr. Sally Goza, the president of the American Academy of Pediatrics. Has anyone ever, have you been able to say that without stumbling yet? It’s tough. I’ll practice during the commercial. We’ll be right back.

Part 2

Brad Means: Welcome back to “The Means Report.” Our special, special guest today is Dr. Sally Goza, president of the American Academy of Pediatrics. She is from Fayetteville, Georgia. So, we’re so pleased to have one of our own at the tippy top of the profession, if you will. And we talked about babies in our first segment. We’ll talk about older children now, and especially, Dr. Goza, what I’ve read about lately, and the way it impacts children, adverse childhood events. This is neglect, this is abuse. And so, we’re looking at what it does to children as they develop. Can a physician help spot these adverse childhood events and intervene and how?

Dr. Sally Goza: So, adverse childhood events happen and most people probably have at least one or so in their lives.

Brad Means: Right.

Dr. Sally Goza: The good thing is most people have supportive families and parents that can buffer some of those events. And so, there’s resilience there. The problem is the more of those childhood events you suffer in one childhood, the harder it is to recover from that. And so, the more likely you are to have problems with depression, drug abuse, other health illnesses. It can actually make you have more illnesses when you’re older, too, because what it does is the brain, is, in the early years, is very much forming. And so, all of these things that are toxic or stress, which we all have stress. I’m stressing now,

Brad Means: Sure.

Dr. Sally Goza: right, about coronavirus. But there’s stress, but usually it’s short-lived and it can be buffered by supportive adult figures or other things. But, for some children, when they have the adverse childhood events, that stress is long and it lasts for a long time. And so, it changes the architecture of the brain. And so, they do not have the same reaction to stress that other people have. We call it toxic stress. It’s fight or flight. If you can imagine being in fight or flight mode for most of your young life, that’s a hard thing on your brain.

Brad Means: Constantly on edge.

Dr. Sally Goza: Right, and so, those children are more likely to have mental health issues, they’re more likely to abuse drugs and alcohol, they’re more likely to end up in jail, they’re more likely to have other health illness, like diabetes and heart disease later in life. So, there are a lot of things that can be from that. Adverse childhood events can be things like losing parent or a sibling. It can be a divorce or separation in the family. It can be, like you said, physical or abuse. It can be neglect. It can be any of those things. There are a lot of things that can cause these adverse child, separation, like we’re seeing at the border with separation of children from their parents at the border. That’s a big adverse childhood event.

Brad Means: Well, how can you spot it? Is that something they teach in med school? Here are some warning signs of these events. Make sure you look out for ’em?

Dr. Sally Goza: So, if you have a child who’s acting strange, if they’re throwing a lot of temper tantrums, they’re acting just really not, you know, like a normal child would to stress, that’s a red flag for us to go, “Okay, what’s really going on?” And so, and especially if you know one of these adverse events has happened, a child has lost a parents or a sibling or a family’s gone through a divorce. You can be on the lookout for those and get counseling and help those children deal with that because sometimes their adult in their lives are not able to deal with it as well. So, they’re having their own stress from it. And so, you need to help those children deal with that stress. We’re really trying to switch the comments on adverse childhood events because people feel like, I failed my child, if this happened to them.

Brad Means: Yeah.

Dr. Sally Goza: And what we’re trying to change the conversation to is that we want to help encourage parents to lean into their strengths and to have healthy, social, and emotional development. And so, trying to turn that corner of, you know, yes, you have stress in your life and it can be pretty toxic at times, but what can you do? What strengths do you have to help make those children be resilient so that they’ll come out on the other side happy and healthy?

Brad Means: Do you think children are more stressed today?

Dr. Sally Goza: I definitely think children are more stressed today.

Brad Means: What is it, why? What happened to the days of just runnin’ around barefoot and havin’ fun and bein’ a kid?

Dr. Sally Goza: I don’t know, it went somewhere.

Brad Means: It did.

Dr. Sally Goza: But we’ve seen, I’m still practicing and so I do more mental health in my practice, I think, than other things at this point. I don’t see as near as many ear infections, sore throats, all of that kind of stuff probably because of vaccines. But, I had to throw that in.

Brad Means: No, I’m glad you did.

Dr. Sally Goza: But I see a lot of anxiety in as young as age five. I’m seeing anxiety, depression in the pre-adolescents and the adolescents.

Brad Means: What’s it from?

Dr. Sally Goza: There’s just, I think social media contributes to it. I think these kids are constantly being talked about. There’s a lot of bullying that goes on there that parents probably aren’t even aware of. When I have child who comes in and they’re startin’ to not well in school or they’re having other issues or dropping out of their activities, my first thing is, what’s going on? You know, who’s, where ar you getting bullied? What’s happening, you know? You know, what’s going on at home? You know, those kinda questions because it’s usually a sign that something’s going on.

Brad Means: After you notice it and after you ask about it and after you potentially intervene for the child or the family, can you turn it around? Can you, can the outcome be happy kid?

Dr. Sally Goza: Oh, absolutely, absolutely. I’ve had many children in my practice that we’ve treated for anxiety and depression who have come back in and gone, “Wow, I am so much better.” And so, it’s really catching it before it gets to that breaking point where, you know. We’re seeing more and more kids doing the cutting, attempting suicide, having suicide ideation. It’s really an epidemic. If you look at the numbers of the number of children that are attempting suicide, it has drastically increased in the last few years.

Brad Means: If coronavirus hadn’t popped up, would this be your primary focus as president?

Dr. Sally Goza: So, that, probably not just suicide, but unintentional injuries, suicide and the homicide are the three leading causes of death in children zero to 19, still.

Brad Means: Just stunning.

Dr. Sally Goza: And so, that’s probably going to be high at the list of things we’re gonna start looking at. We’re also looking at equity and health equity and trying to make sure that every child has every opportunity and the same opportunities, because we know that there are a lot of inequities in healthcare.

Brad Means: o, how does that look when you’re talking to a group of lawmakers, face-to-face? What do you tell ’em to do or ask them to do to get to that equity?

Dr. Sally Goza: So, there’s a lot. There’s poverty, there’s homelessness, there’s racism.

Brad Means: So, we’re talkin’ more clinics, more access, so that these,

Dr. Sally Goza: Really,

Brad Means: so that people of all walks can go to the doctor?

Dr. Sally Goza: Right, right. Absolutely.

Brad Means: Yeah.

Dr. Sally Goza: We definitely need to get access under control. We, Georgia, unfortunately, has one of the highest rates of uninsured children in the country. And we also have one of the highest numbers of children that have now become uninsured in the last two years.

Brad Means: So, this is something that’s constantly changing, especially when you mention technology, social media. It’s different every day. Just as soon as one site gets popular, another pops up and the kids gravitate to that. So, how do you train doctors, you know? Pretend like you’re still in the classroom at MCG. Does the lesson plan change month to month to say, “Look, now you need to look out for this”?

Dr. Sally Goza: So, it is a fast-moving field. And so, back when I was in school, we had textbooks. Now, we have

Brad Means: Sure.

Dr. Sally Goza: the computer. And, actually, we have Google. I mean, honestly, sometimes we will Google. Some child will come in and tell me somethin’ I’ve never heard of. And I will go to my phone and Google it to find out what they’re talking about. So, we have epidemics with e-cigarettes now. We have the opioid crisis, which is not as much in the teenage, but it affects everybody.

Brad Means: Yeah, let’s take that step by step. Let’s start with vaping. And it may eat up the rest of the show, but I don’t care because it is absolutely everywhere. Are we making any headway? We banned flavored e-cigs, but you can’t stop this. The kids are gonna, vaper’s gonna vape.

Dr. Sally Goza: So, you know, we had reached a really good point, only 7% of children were using tobacco products before e-cigarettes came on the market. Now, one in four middle and high school students are vaping.

Brad Means: One in four?

Dr. Sally Goza: One in four. And they are vaping, 60% to 70% of those are vaping at least 20 times a month. So, that means they are probably addicted because the nicotine in those e-cigarettes is much more highly addictive than the nicotine in regular cigarettes.

Brad Means: Listen, I need you to tell me, and I can promise you I speak for a lotta moms and dads watching, how do we communicate not only the high nicotine content but the unknowns, the potential health impacts, to a kid who thinks you’re just an old person preachin’?

Dr. Sally Goza: You know, I think you just have to keep talkin’ to ’em. You have to show ’em what’s out there, the data that’s out there. And you just have to say, I love you no matter what you’re doin’, but we need to talk about it. Because the problem is, once they start vaping, they get addicted really quickly. And it’s, we have no real good way to get children unaddicted from this nicotine.

Brad Means: That’s horrible.

Dr. Sally Goza: And so, it’s behavioral things. The best thing you can do if you find your child’s vaping is to talk to your pediatrician about what you need to do. But these vapes, I was on a show doing interviews, there’s one that looks like an iWatch. And you push the button and you take the vape off, and then you put it back on and it tells you what time it is.

Brad Means: No way.

Dr. Sally Goza: There are ones that look like little, they’re like little tear drops and you can hold ’em in your hand. The parent would never know they’re there. There are some that look like pens. And so, you said flavors have been banned. Only a very small proportion of flavors were banned in that ban. I was at The White House when we talked to the President. That’s a whole ‘nother story. But they did not do what we asked them to do. They banned the pod flavors, like you would put in a jewel.

Brad Means: Right.

Dr. Sally Goza: So, there are now pens that are disposable that have all the 15,000 flavors that can still be bought. All of the container ones where you can get the liquid still have all of the flavors. And so, what children have done now, is they’ve gone from the jewels to the other, to the disposable ones and to the other forms of it. So, the flavor ban that is out there did nothing.

Brad Means: How much ground does a parent have to stand on, really, when ultimately, we don’t know everything about vaping? Because, Dr. Goza, the kids know that we don’t know everything about vaping. And they’ll come back at you and say, “Stop it! “You have no idea whether this can kill me or not.”

Dr. Sally Goza: So, we know nicotine is the worst addiction there is. We know whenever you talk about addictions, nicotine is one and everything else goes from there because it is the worst addiction. If you talk to addictionologists they will tell you that. We know it is hard to get off that addiction. We know that it causes, it can cause them to have trouble in school. The kids that are addicted to nicotine start having trouble in school. They can start losing weight and having GI symptoms. And their behaviors change. I mean, their personalities change. And so, we know that it has that. And then we have the vaping lung issues that we really are not hearing much about right now, but there were quite a few deaths. The youngest death from the vaping lung-related illness was 15. They said that a lot of those kids were vaping other products other than what was in, what was suppose to be in the vapes, but we really still don’t know because there’s just not enough evidence out there. The CDC’s still very worried about that. It’s kind of lost its edge on the news media right now, but.

Brad Means: It’s kinda been pushed down, yeah.

Dr. Sally Goza: It’s been pushed down. But it’s still, it’s truly an epidemic. And if parents suspect their children are vaping, they need to talk to their pediatrician about what they can do. And they need to be just open and honest about, we don’t know all there is about vaping and what it can cause. But if you talk to emergency doctors and hospitalists, they’re seeing lung injury from vaping, not the severe lung injury, but other lung injury from it.

Brad Means: Yeah, folks, just rewind that last answer and play it for your children. What can we do to help your doctors out there? To help your 67,000 members do their job better?

Dr. Sally Goza: Just support us. I mean, we need help with making sure that people understand that vaccines are safe and effective and that children need to be vaccinated. We need to get, protect them from all these illnesses. And if you look at, you know, we’re talking about coronavirus now, but if you look at flu. We’ve lost 105 children in this country to flu this year. There have been five in Georgia.

Brad Means: You don’t hear about that anymore.

Dr. Sally Goza: And you don’t hear about that. And so, it’s more than that. There’s, I think it’s, I can’t even remember the number for adults that have died from the flu this year. But, so infectious diseases are still out there. They will be new infectious diseases coming through that we need to protect our children against. And then, just with the mental health, watch your kids. If there’s a change in their behavior, you need to talk to you pediatrician. You need to bring it up and make sure that they’re understood, that you understand what’s going on with that. Don’t just say, “Oh, they’re just having a bad day,” because it’s usually something going on. And there are many, many things it can be. And then, for the infants, love ’em.

Brad Means: Yeah, just love them, hold them, read to them.

Dr. Sally Goza: For the teenagers, too. It’s a little harder,

Brad Means: Yeah, adults.

Dr. Sally Goza: but you can do it.

Brad Means: But you can still hug ’em and tell ’em you love ’em. Well, now that you have this vantage point from the top, are you optimistic about the future for our children? You’ve talked about some heavy subjects. Can we overcome?

Dr. Sally Goza: I think we can. The American Academy of Pediatrics turns 90 this year. And so, we’ve done a lot of research and going back to 1930 when the American Academy of Pediatrics was formed and looking at what the pediatricians there thought. And so, it’s very interesting. Our first president had, his ideals for the Academy were to right the wrongs that were happening, to introduce reform. And they were aggrieved by the disparity between what is and what ought to be for children in this country. And I think that’s still where we are. We’ve come a long way since 1930. We’ve done a lot for children in that. If you look at all the data, we’ve done a lot. But we still have a lot to do. So, it’s still that gap. It may be narrower than it was in 1930, but it’s still there and there are different things in it, but a lot of the things are the same. There’s a charter from the 1930s. Herbert Hoover, White House Conference on Children, it goes through all of the points we just talked about. E-cigarettes was not on there. But,

Brad Means: Sure.

Dr. Sally Goza: things that could harm your children from the environment. So, you know, but it was very, it’s very interesting. I mean, it lists everything that we’re still working on.

Brad Means: Yeah, kids.

Dr. Sally Goza: And so, it’s funny.

Brad Means: Well, I wish you all the best and a heart-felt gratitude on behalf of a lot of people out there for what you do for our children. Thank you, Dr. Goza.

Dr. Sally Goza: Oh, thank you for having me.

Brad Means: Absolutely, yo;re welcome any time. Representing Georgia well on the national stage.

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The Means Report first aired in January of 2009 offering coverage that you cannot get from a daily newscast. Forget about quick soundbytes -- we deliver an in-depth perspective on the biggest stories. If they are making news on the local or national level, you will find them on the set of The Means Report. Hosted by WJBF NewsChannel 6 anchor, Brad Means, The Means Report covers the topics impacting your life, your town, your state, and your future.