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ACETAMINOPHEN (TYLENOL) and IBUPROFEN (MOTRIN) Dosing Charts
It is not recommended to alternate between Acetaminophen and Ibuprofen. Use only one medication as directed.
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1-800-222-1222
Its the new nationwide telephone number for poison control.
This toll free number puts poison first aid information and prevention at your fingertips.
This number works anywhere in the United States -- whether you're calling from home, your vacation spot or your car.
At the Greater Cleveland Poison Control Center, medical experts from Rainbow Babies & Children's Hospital are standing by 24 hours a day, 7 days a week to :
North Coast Health Ministry, a faith-based free clinic, provides healthcare services to eligible individuals in western Cuyahoga and eastern Lorain counties
For over 20 years, North Coast Health Ministry (NCHM) has been providing healthcare to uninsured people living on the West Side. A faith-based free clinic, we are a bridge to better health for 2,000 individuals who have no other place to go. With the support of dozens of volunteer physicians and nurses, as well as clerical volunteers, NCHM is able to provide primary health care, specialty referrals, prescription assistance, and health education to low-income individuals and families. Each year, the demand for our services grows. During the past two years alone, patient visits increased by nearly 40%. We are grateful that the generosity of others has enabled us to provide essential health services to our neighbors in need.
For more information:
Are there guns where your children play? The American Academy of Pediatrics supports the ASK (asking saves kids) campaign. This campaign is to highlight the importance of asking about guns in the homes where children play and to address a very real risk children may face when they play in friends' homes. 40% of homes with children have a gun, many of which are left unlocked or loaded, and every year thousands of children are killed or seriously injured with these guns. Just talking to your child about the dangers of firearms is not enough. Children are naturally curious. If a gun is accessible in someone's home, there is a good chance a child will find it and play with it. Hiding guns is not enough. There are countless tragic stories of kids finding guns parents thought were well hidden. If you have any doubts about the safety of someone's home, invite the children to your house instead.
Be non-confrontational when asking about guns in the home. Present your concerns in a respectful manner. You are simply assuring your child is playing in a safe environment. Include the question along with other things you might normally discuss before sending your child to someone's house, such as seat belts, animals and allergies.
Make sure that all guns are stored unloaded and locked - ideally in a gun safe - with ammunition locked separately.
~Louis Z. Cooper, MD, President, American Academy of Pediatrics
Bisphenol A (BPA) is a chemical used in polycarbonate plastics (usually hard, clear items like baby and water bottles, disposable tableware, CD packaging, certain medical devices, and some safety equipment). This chemical is used to harden plastics and prevent cans from rusting.
There is controversy over the possible harmful effects BPA may have on humans particularly on infants and children in their developmental phases. Animal studies have shown effects on endocrine functions in animals related to exposure to BPA . The recent panel study suggests the need for further clarification of what level of exposure to BPA might cause similar effects in humans.
Regulatory agencies in Canada, Europe and Japan agree that the current BPA exposure levels through food packaging do not pose an immediate health risk to the general population, including infants and children.
According to the National Toxicology Program, we may breathe in dust and air containing BPA or absorb the chemical through our skin when we swim or bathe. The first federal U.S. report (presently only a draft) states there is some concern that current human exposures of BPA in fetuses, babies and children could cause harmful effects such as behavioral and brain problems, early puberty in girls, and changes in the prostate and mammary glands. However, the official report will not be available until late summer 2008. In the meantime, here are some ways to reduce exposure to BPA in your home:
Advice for Parents - AAP
Breastfeeding is one way to reduce potential BPA exposure. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for a minimum of 4 months but preferably for 6 months. Breastfeeding should be continued, with the addition of complementary foods, at least through the first 12 months of age and thereafter as long as mutually desired by mother and infant.
Parents considering switching children from liquid to powdered formula should be reminded that mixing procedures may differ, so they should pay special attention in preparing formula from powder.
Parents with babies on specialized formulas to address medical conditions should not switch children off those formulas, as the known risks of doing so would outweigh any potential risks posed by BPA.
Concerned parents can take the following precautionary measures to reduce babies' exposure to BPA:
For plastic containers and sippy cups: look at the bottom for the recycling code (the number in the triangle). Those with a number 7 are made with polycarbonates and may contain BPA. Don't microwave them. Do not boil polycarbonate bottles. Do not wash polycarbonate bottles in the dishwasher. The heat can cause the chemical to "migrate" into the food and drinks.
Consider using certified or identified BPA-free plastic bottles
Use bottles made of opaque plastic. These bottles (made of polyethylene or polypropylene) do not contain BPA
Glass bottles can be an alternative, but be aware of the risk of injury to baby or parent if the bottle is dropped or broken
Call the manufacturer of your baby's formula to find out if they use epoxy resin in their cans.
Buy fresh or frozen fruits and vegetables if you are concerned about the lining inside canned foods.
Try to use glass and/or stainless instead of plastic food containers, bottles and plastic kids cups.
Remember to buy products that say they are BPA free.
Risks associated with giving infants inappropriate (home-made condensed milk) formulas or alternative (soy or goat) milk are far greater than the potential effects of BPA
Don't Panic--Just be BPA smart and start to make some changes in your products while keeping an eye open for more information about BPA to be released.
~Kids Health/AAP 10/2008
Twenty primary (baby) teeth form in early prenatal life. Shortly before
birth, the enamel of the first molars begins to form. At birth the crowns
of the primary teeth are almost completely formed. Eruption varies from
one child to another. Also, teeth erupt earlier in girls than boys, and
the lower teeth erupt before the corresponding upper teeth.
Early childhood tooth decay
Did you know that tooth decay is the most common childhood disease? Forty percent of American children have cavities by age 6. Baby teeth are essential for normal growth and development of the jaws and permanent teeth. They help guide permanent teeth into their proper position. Worst of all, if children get cavities in their baby teeth, the infection almost always passes to their permanent teeth. You can help prevent this disease.
Mom, your oral health matters
One of the biggest risks for your baby to get early tooth decay is the presence of dental cavities in your mouth. That's because tooth decay is a bacterial infection that can be transmitted from you to your baby. Everyone in the family should keep their teeth clean (brush and floss) to reduce the bacteria levels.Sugar feeds tooth decay
The tooth decay bacteria use sugar for energy, and they produce an acid that dissolves calcium, which causes a hole in the tooth. Any food or drink with sugar is potentially a problem; this includes juices, sodas, sports drinks, infant formula, and sweetened milk. Remember, after age 1 cups are always better than bottles. Never put your baby to bed with a bottle. Babies who suck on a bottle for long periods of time can develop "baby bottle tooth decay". Another common form of sugar that is often overlooked is cooked starch—the white flour that's in crackers, cereal, chips, and junk foods in general. Give your child whatever you feel is right and healthful, but be sure to clean their gums and teeth afterward.
Clean your baby's gums and teeth early (4 months)
The decay process can start as soon as the child's first tooth pokes out from the gum, typically at 5 to 9 months. To stop the attack from happening, it's important to begin cleaning baby's mouth very early, starting at 4 months. Simply wipe baby's gums and teeth several times a day, especially after feedings with a soft, clean washcloth. A soft toothbrush may be used when the baby will accept it.
The tooth-brushing habit (6 to 9 months)
Your child should be encouraged to brush their teeth themselves, as soon as they can hold a toothbrush, but parents should be there to supervise and complete the brushing. The night brushing is critical, as the bacteria that cause cavities have 12 hours or more to grow as your child sleeps. Make sure this brushing is done as effectively as possible to stop those cavity-causing bacteria from moving into your child's mouth as a permanent resident. A good rule of thumb is for parents to help with brushing until their child can write their name in cursive letters, which typically occurs at age 6 or 7. Choose a child-size brush with soft, rounded bristles for your child.
Flossing removes plaque from most tooth surfaces. Flossing should be done at least once a day. You should floss your child's teeth until he/she is old enough to properly do it themselves (about age eight or nine).
Look closely and often at your baby's teeth (9 to 12 months)
The first sign of a cavity is a white spot. These spots often start on the upper front teeth at the gum line. To look for these spots, lay your baby in your lap and lift their upper lip using your fingers. If you don't take care of your baby's first teeth, your child may wind up with a lifelong struggle with tooth decay.
See the dentist at age 1
Starting at birth, every baby needs a "medical home" for regular doctor visits to ensure they stay healthy and get their vaccinations on time. Many parents don't realize that babies need a "dental home" after their baby's first birthday, or even sooner if there's a problem. The dentist can help you make sure your baby doesn't get early childhood tooth decay. It's a whole lot easier to prevent tooth decay than it is to treat it.
*First published by El Rio Health Center Maternal and Infant Oral Health Program
How to find pediatric dental service:
Clinic Services: Many of today's pediatric dental residency programs operate in conjunction with a satellite clinic where children can receive dental services. A valuable resource to keep in mind.
Local Dentists: A list of local pediatric dentists is available through the AAPD's "Find a pediatric dentist" tab on their home page (www.aapd.org). This database of providers is updated weekly.
~september 2008 Contemporary Pediatrics
Your newborn is likely to eat about every 2 hours or about 12 times per day. Remember, each baby is different and this pattern may have irregular intervals. She will probably need nighttime feedings until about 4 months of age. During the first few months, she will gradually increase the amount she consumes and the time between feedings. Don't give cereal to help her sleep through the night.
Feed your baby when she is hungry, calm and awake; she will be ready to eat when her eyes are open wide and she begins making sucking motions. Try to feed her before she gets fussy from hunger. If she is not quite awake, give her some time to wake up first. Once the feeding starts, avoid unnecessary interruptions which may upset her.
Let her eat as much or as little as she wants. When she is full, her sucking will slow, she will release the nipple and turn away. You can offer the nipple after a few moments but if she is uninterested, respect that cue. Don't try to get her to eat more when she is full, don't try to have her finish a bottle.
Water or juice is not necessary at this age. Infants may be offered water if they are having hard, infrequent stools. The amount will vary, 2-4 ounces/day or until soft stools are achieved. Juice should not be given under 4 months of age.
This guide will help you know how much of what foods to feed your baby every day. Your baby may eat more or less than these amounts.
NO HONEY until child is older than 12 months.
Avoid foods containing peanuts until 3 years of age.
Birth to 4 months
1-2 months 5-7 servings/day 3-6 ounces/serving
2-3 months 4-7 servings/day 4-7 ounces/serving
3-4 months 4-6 servings/day 6-8 ounces/serving
4 months
5 months
6 months
7 to 8 months
9 to 12 months
Feeding your baby is still pretty easy, they still like to eat almost everything. Baby eats well with their fingers and drinks from a cup. They are often eating foods the rest of the family is eating. Be sure these foods are not too fatty or spicy, and are cut up in small pieces. Now is the time to get them off of the bottle. Ways to get rid of the bottle: Eliminate one bottle at a time, put formula or whole milk in a cup at meals, put only water in the bottle, get bottles out of sight, start a new bedtime routine.
Your child's growth is slowing down, they don't need as much food right now. Some days they will eat more than others, just make sure you are giving healthy foods.
Food Daily Servings Serving Sizes
Bread, cereal, rice, pasta 6 1/2 slice or 1/4 cup
Fruit 2 1/4 cup cooked, 1/2 cup raw
Vegetables 3 1/4 cup cooked, 1/2 cup raw
Milk, Yogurt, Cheese 2 1 cup, 3/4 ounce cheese
Meat, Poultry, Fish, Eggs, Dry Beans 2-3 1-3 tablespoon, 1 egg, 1/2 cup cooked beans
Sometimes its not easy to feed this age group! Some days they may eat very little and they say "no" often to many foods. This is normal. They are not growing as fast as last year and saying "no" is a stage that will pass. Often they begin to refuse milk, try not to worry. Give other milk group foods like yogurt and cheese.
Food Daily Servings Serving Sizes
Bread, cereal, rice, pasta 6 1/2 slice or 1/4 - 1/2cup
Fruit 2 1/4 cup cooked, 1/2 cup raw
Vegetables 3 1/4 cup cooked, 1/2 cup raw
Milk, Yogurt, Cheese 2 1 cup, 3/4 ounce cheese
Meat, Poultry, Fish, Eggs, Dry Beans 2 1-3 tablespoon, 1 egg, 1/2 cup cooked beans
Feeding your two year old is not always easy. Just give a little bit of food at each meal. Don't get into fights about food and don't force your child to eat. Don't give them a cookie or treat to get them to eat. Sometimes they may be too busy to stop and eat, try to have quiet activities before meals. Always try to offer at least one food the child likes and don't worry when they have food "jags" (the same food over and over). Children's likes and dislikes often change daily. Introduce new food gradually and serve with familiar foods. Set a good example yourself by eating healthy. Schedule regular meals and snacks for toddlers since they require frequent feedings to ensure adequate intake of calories and nutrients. Children very often will eat what they need.
Food Daily Servings Serving Sizes
Bread, cereal, rice, pasta 7 1/2 slice or 1/4 cup
Fruit 3 1/4 cup cooked, 1/2 cup raw
Vegetables 3 1/4 cup cooked, 1/2 cup raw
Milk, Yogurt, Cheese 5 1/2 cup, 3/4 ounce cheese
Meat, Poultry, Fish, Eggs, Dry Beans 2 1 tablespoon, 1 egg, 1/2 cup cooked beans
Snacks should be like little meals for your two year old. Try cheese and crackers, yogurt and fruit, cereal and milk or a half a sandwich and juice. Protein snacks last longer. Some protein foods are: milk, cheese, yogurt, meat, chicken, dried beans, and egg. To decrease the risk of peanut allergy, the new recommendation is to avoid peanuts until three years of age.
Praise your child for successful eating. Use lowfat milk or skim milk after the second birthday unless your child needs the extra calories of whole milk. When your child is thirsty, offer water. Be patient, feedings will get a lot easier as your child gets older.
Three year olds are very busy and have their own ideas about food and eating. Three year olds are growing slowly and may not need as much food as you think they do. They may be picky eaters or refuse to eat, this is very normal at this age. Your job is to provide your child with a good variety of healthy foods at regular meals and snacks. Your child's job is to decide what and how much to eat. Don't force your child to eat, just make sure you are providing the right foods for your child to choose from.
Helpful hints: Cut meat in small pieces, mix with other foods. Give small servings. Choking can be a problem, have your child sit down to eat and avoid hard, round foods. Milk is still important, so give with meals. If your child wants to drink and not eat, give milk after the meal.
Food Daily Servings Serving Sizes
Bread, cereal, rice, pasta 7 1/2 slice or 1/4 cup
Fruit 3 1/4 cup cooked, 1/2 cup raw
Vegetables 3 1/4 cup cooked, 1/2 cup raw
Milk, Yogurt, Cheese 5 1/2 cup, 3/4 ounce cheese
Meat, Poultry, Fish, Eggs, Dry Beans 2 1 tablespoon, 1 egg, 1/2 cup cooked beans
Four year olds are constantly learning. They need to be well fed to learn as much as possible. Good nutrition really does help your child learn. They need a variety of healthy foods and regular meals and snacks. Trust your child's appetite and don't let them snack right before a meal. Help them get in the habit of brushing their teeth after meals or at least rinsing with water. Most hotdogs and lunchmeat are high in fat. Read labels and buy brands that are low in fat. Freeze juice for popsicles, cut up fruit and raw vegetables and keep refrigerated for a quick and healthy snack.
Food Daily Servings Serving Sizes
Bread, cereal, rice, pasta 7 1/2 slice or 1/4 cup
Fruit 3 1/4 cup cooked, 1/2 cup raw
Vegetables 3 1/4 cup cooked, 1/2 cup raw
Milk, Yogurt, Cheese 5 1/2 cup, 3/4 ounce cheese
Meat, Poultry, Fish, Eggs, Dry Beans 2 1 tablespoon, 1 egg, 1/2 cup cooked beans
Your child has grown so much in five years! They still need milk, and lowfat or skim milk is best for most children. You can also give dairy in the form of yogurt, cheese, frozen yogurt and ice milk. You should aim for 4 servings of fruit and 3 servings of vegetables every day. They should be eating three meals per day plus snacks. Encourage lots of healthy exercise.
Food Daily Servings Serving Sizes
Bread, cereal, rice, pasta 9 1/2 slice or 1/4 cup
Fruit 4 1/4 cup cooked, 1/2 cup raw
Vegetables 3 1/4 cup cooked, 1/2 cup raw
Milk, Yogurt, Cheese 5 1/2 cup, 3/4 ounce cheese
Meat, Poultry, Fish, Eggs, Dry Beans 3 1 tablespoon, 1 egg, 1/2 cup cooked beans
Feeding Guide School Age Children (7-12years)
During the school age years, basic nutrition education concepts can be successfully introduced. Emphasis should be placed on enjoying the taste of fruits and vegetables rather than to focus on the healthful aspect of the food. During the period between 8 and 11 years, children begin making peer comparisons, including those pertaining to weight and body shape. Children often vary greatly in weight, body shape, and growth rate, and teasing of those who fall outside the perceived norms often occurs. Family, friends and television all influence a child's eating choices.
Food Daily Servings Serving Sizes
Bread, cereal, rice, pasta 4-5 1 slice, 1/2 - 1 cup
Fruit 3-4 1medium piece of fruit, 4oz. juice, 1/2 c
Vegetables 3-4 1/4 cup cooked, 1/2 cup raw
Milk, Yogurt, Cheese 3-4 (24-32 oz) 1/2 cup - 1 cup (4-8 oz )
Meat, Poultry, Fish, Eggs, Dry Beans 3-4 (6-8 oz) 2 oz.
Feeding Guide Adolescents(13-18 years)
Food habits of adolescents are characterized by:
- an increased tendency to skip meals, especially breakfast and lunch
- eating more meals outside the home
- snacking, especially candy
- consumption of fast foods
- dieting
These behavioral patterns are explained by the adolescents newly found independence and busy schedule, difficulty in accepting existing values, dissatisfaction with bodily image, search for self identification, desire for peer acceptance, and the need to conform to the adolescent lifestyle. These behaviors can result in poor nutrition for most adolescents.
In order to support the growth spurt during adolescence the body requires an increase in calories, protein, nutrients, vitamins and fat. Daily caloric requirements for a male, 11-14 years of age, is 2800 calories; a male 15-18 years is 3000 calories. Females, 11-14 years of age, is 2400 calories, females 15-18 years is 2100 calories. These requirements may need to be adjusted based on the activity level of the adolescent. These requirements are recommended averages and the particular daily demand depends on the growth phase, physical activity, metabolic rate and illness.
Protein is required during puberty. Protein can be derived from meat, milk and milk products, eggs, rice and beans.
Fats play an important role and are essential for the production of important chemicals, like hormones, which are necessary to stimulate puberty. Fats also transport vitamins A, D, E, and K into the body. Fats should comprise up to 30% of the total calories, with 10% of these total calories derived from saturated fats.
Important minerals in the diet are zinc, iron and calcium. Zinc is necessary for the normal development of the gonads (ovaries and testis), essential for healthy skin and general overall growth. The best source for zinc is animal protein. Beans and nuts also contain zinc. Iron is important for the functioning of enzymes. Boys need iron for muscle development, girls need iron to replace the monthly loss during their period. The best source for iron is red meat and vegetables. The absorption of iron is enhanced by eating a combination of foods rich in Vitamin C and iron. Calcium is another important mineral which is necessary for the skeletal system.
Vitamin needs increase during adolescent growth spurts. Some food sources for vitamins are:
Snacking is a common practice among adolescents. Skipping breakfast, snacking during the day and eating dinner at night is a typical meal pattern for adolescents. It is important when choosing snacks to select foods that are low in sugar and fat, and are high in vitamins, minerals and protein. Fruits, raw vegetables, juice, nuts, cheese and crackers, and yogurt are good snack foods. Snacks to avoid: candy, cake, potato chips, cookies and soft drinks.
Throughout our lives we need iron in our diets to prevent anemia and iron is an essential nutrient for cognitive development. In order to ensure your toddler is getting enough iron limit the amount of milk she drinks per day to 16 ounces. More than 16 ounces of milk/day can interfere with iron absorption and can fill her up so she'll eat less, preventing her from getting iron from foods. Include at least one iron rich food at each meal. Also offer fruits and vegetables that are high in Vitamin C because they help increase the absorption of iron. Examples are tomatoes, green peppers, citrus fruits, and strawberries.
Certain foods are especially good sources of iron. Red meats (such as beef, pork and lamb), fish and dark poultry are best. Some young children will only eat lunch meats, and the low fat ones are fine. Adequate iron is also found in iron enriched cereals, beans of all types, egg yolks, peanut butter, raisins, prune juice, sweet potatoes, spinach, kale and broccoli.
New Guidelines Double the Recommended Amount of Vitamin D (October 2008)
Below is a news release on a press briefing at the 2008 National Conference and Exhibition (NCE) of the American Academy of Pediatrics (AAP). Frank Greer, MD, FAAP, chairman of the AAP National Committee on Nutrition and a lead author of the AAP Clinical Report "Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents," will present the key recommendations in the report at 10:45 a.m. Monday, Oct. 13 in the press briefing room 307 of the Hynes Convention Center. Carol C. Wagner, MD, FAAP, a member of the AAP Section on Breastfeeding Executive Committee and co-author of the report, will be available for telephone interviews. The report is embargoed until Monday, Oct. 13 at 12:01 a.m. ET.
For Release: Monday, Oct. 13, 2008, 12:01 am ET
BOSTON - The American Academy of Pediatrics (AAP) is doubling the amount of vitamin D it recommends for infants, children and adolescents. The new clinical report, "Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents," recommends all children receive 400 IU a day of vitamin D, beginning in the first few days of life. The previous recommendation, issued in 2003, called for 200 IU per day beginning in the first two months of life.
The change in recommendation comes after reviewing new clinical trials on vitamin D and the historical precedence of safely giving 400 IU per day to the pediatric population. Clinical data show that 400 units of vitamin D a day will not only prevent rickets, but treat it. This bone-softening disease is preventable with adequate vitamin D, but dietary sources of vitamin D are limited, and it is difficult to determine a safe amount of sunlight exposure to synthesize vitamin D in a given individual. Rickets continues to be reported in the United States in infants and adolescents. The greatest risk for rickets is in exclusively breastfed infants who are not supplemented with 400 IU of vitamin D a day.
Adequate vitamin D throughout childhood may reduce the risk of osteoporosis. In adults, new evidence suggests that vitamin D plays a role in the immune system and may help prevent infections, autoimmune diseases, cancer and diabetes.
"We are doubling the recommended amount of vitamin D children need each day because evidence has shown this could have life-long health benefits," said Frank Greer, MD, FAAP, chair of the AAP Committee on Nutrition and co-author of the report. "Supplementation is important because most children will not get enough vitamin D through diet alone."
"Breastfeeding is the best source of nutrition for infants. However, because of vitamin D deficiencies in the maternal diet, which affect the vitamin D in a mother’s milk, it is important that breastfed infants receive supplements of vitamin D," said Carol Wagner, MD, FAAP, member of the AAP Section on Breastfeeding Executive Committee and co-author of the report. "Until it is determined what the vitamin D requirements of the lactating mother-infant dyad are, we must ensure that the breastfeeding infant receives an adequate supply of vitamin D through a supplement of 400 IU per day."
The new recommendations include:
·
Breastfed and partially breastfed infants should be supplemented with 400 IU a day of vitamin D beginning in the first few days of life.·
All non-breastfed infants, as well as older children, who are consuming less than one quart per day of vitamin D-fortified formula or milk, should receive a vitamin D supplement of 400 IU a day.·
Adolescents who do not obtain 400 IU of vitamin D per day through foods should receive a supplement containing that amount.·
Children with increased risk of vitamin D deficiency, such as those taking certain medications, may need higher doses of vitamin D.Given the growing evidence that adequate vitamin D status during pregnancy is important for fetal development, the AAP also recommends that providers who care for pregnant women consider measuring vitamin D levels in this population.
Calcium requirements and sources
How much calcium your body needs varies
according to age. You need the most calcium between 9 and 18 years of age.
The
|
Age |
Calcium Need (mg
per day) |
Servings of Milk
to Meet Need |
|
4–8 years |
800 |
3 servings |
|
9–18 years |
1,300 |
4 servings |
|
9–50 years |
1,000 |
3–4 servings |
How to get calcium
The best way to get the calcium that you need
is by eating and drinking foods that naturally contain calcium. Many foods
contain some calcium, but the best sources include the following:
CALCIUM RDA (MG/DAY)
250 MG/8OZ. MILK OR YOGURT
300 MG/8OZ. CALCIUM FORTIFIED JUICE
100 MG/SERVING OF PROPEL FITNESS WATER
200 MG/CEREAL BAR
40 MG/SLICE OF BREAD
100-200 MG/MULTIVITAMIN
Consider also cheese (swiss) 2OZ. = 8OZ. OF MILK
What decreases calcium
The following can hurt your bone health:
How to get more calcium
There are many ways to get more calcium, such as
If you make the right choices, the foods you eat
or the things you drink can provide the calcium you need.
If your child cannot digest milk:
Tips to decrease fat, saturated fat and cholesterol in your diet
Steam, boil or bake vegetables.
Season vegetables with herbs and spices rather than sauces, butter or margarine.
Try lemon juice on salads, or use limited amounts of oil-based salad dressing.
To reduce saturated fat, use margarine instead of butter in baked products, and when possible use oil instead of shortening.
Try whole-grain flours to enhance flavors of baked goods made with less fat and cholesterol containing products.
Replace whole milk with skim milk or low-fat milk in puddings, soups, or baked products.
Substitute plain low-fat yogurt, blender whipped low fat cottage cheese or buttermilk in recipes that call for sour cream or mayonnaise.
Choose lean cuts of meat. (Chicken, turkey, veal and non-fatty cuts of beef. Also, fresh or frozen fish, and canned fish packed in water. Meats and fish should be broiled or baked on a rack.)
Trim off visible fat from meat before cooking.
Roast, bake, broil, steam or simmer fish, poultry or meat.
Remove skin from poultry before cooking.
Chill meat or poultry broth until the fat becomes solid. Spoon off the fat before using the broth.
Limit the egg yolks to one per serving when making scrambled eggs. Use additional egg whites for larger servings.
Try substituting egg whites in recipes calling for eggs. For example, use two egg whites in place of each whole egg in muffins, cookies, and puddings.
Vegetarian diets are not harmful to children as long as careful planning and research is done with the help of a parent. A vegetarian diet can be nutritionally complete for people of all ages. Meatless diets have also been recognized as having a role in disease prevention.
A common mistake for young people is to miss the vegetables in "vegetarian". Every day the diet should include a wide variety of fruits and vegetables; whole grains; sources of protein; and low-fat dairy products, such as cottage cheese and low-fat milk.
The following four nutrients may be compromised when switching to a vegetarian diet:
Vitamin B12 - Is found only in animal products. Those avoiding meat, dairy and eggs should look for grain or tofu products fortified with B12.
Iron - Iron is best absorbed from red meat. However, absorption of iron from plant sources can be increased when paired with Vitamin C. Plant sources of iron include broccoli, raisins, watermelon, spinach, black-eyed peas, blackstrap molasses, chickpeas and pinto beans.
Calcium and Vitamin D - These nutrients are necessary to promote optimal bone growth and bone density. Preteens and teens who avoid vitamin D-fortified dairy products may need a calcium and vitamin D supplement to meet their needs.
~Andrew Hertz, MD
Problem Solution
Refuses milk Serve at room temperature. Serve with a colored straw. Cook cereals with milk, offer cream
soups or milk based desserts. Offer milk substitutes like yogurt, cottage or other cheese.
Or flavor milk with chocolate, strawberry, ovaltine or carnation instant breakfast.
Drinks too much milk Offer milk with meals only. Offer water or juice between meals, maximum of 8oz. juice per day.
Refuses meat Provide bite size pieces, easy to chew meat such as chicken or turkey. Use meat substitutes such as eggs, peanut butter, nuts and legumes.
Refuses fruits or vegetables Use milk to moisten mashed potatoes. Offer extra fruit. Use raw or crisp vegetables. Add fruit to cereal, jello, puddings and ice cream.
Refuses breads and cereals Serve cooked cereal warm, not hot. Add raisins or fresh fruit to cereal. Offer toast instead of
bread and cut into small pieces.
Eats too many sweets Eliminate sweets from the home completely. Offer "natural" sweets such as fruit.
Helpful Hints to Make Meal Times Fun
Many people do not think about food safety until a food related illness affects them or a family member. The CDC estimates that 76 million people get sick, more than 300,000 are hospitalized and 5000 Americans die each year from foodborne illness. Follow these simple tips to protect you and your family.
Clean: Wash hands and surfaces often
Wash your hands with warm water and soap for at least 20 seconds before and after handling food, using the restroom, changing diapers and handling pets.
Wash countertops and cutting boards with hot, soapy water after preparing each food item.
Rinse all fruits and vegetables under running tap water, including those with skins that are not eaten.
Separate: Don't Cross Contaminate
Separate raw meat, poultry, seafood and eggs from other foods in your grocery cart, grocery bags and refrigerator.
Use one cutting board for fresh produce and a separate one for raw meat, poultry and seafood.
Never place cooked food on a plate that previously held raw meat, poultry, seafood or eggs.
Cook: Cook to Proper Temperatures
Food is safely cooked when it reaches a high enough internal temperature to kill harmful bacteria associated with foodborne illness.
Use a probe thermometer which measures the internal temperature of cooked food products.
Cook steak and fish to an internal temperature of at least 145 degrees.
Cook ground beef, pork and shell eggs to an internal temperature of at least 155 degrees.
Cook poultry, stuffed food products, and all exotic food products to an internal temperature of 165 degrees.
Reheat all leftover food products to an internal temperature of 165 degrees.
Chill: Refrigerate Promptly
Refrigerate foods quickly because cold temperatures slow the growth of harmful bacteria. Do not over-stuff the refrigerator. Cold air must circulate to help keep food safe. Keeping a constant refrigerator temperature of 41 degrees F or below is one of the most effective ways to reduce the risk of food borne illness.
Refrigerate or freeze meat, poultry, eggs and other perishables as soon as you get them home from the store.
Never let raw meat, poultry, eggs, cooked food or cut fresh fruits or vegetables sit at room temperature more than two hours before putting them in the refrigerator or freezer (one hour when the temperature is above 90 degrees F)
Divide large amounts of leftovers into shallow containers for quicker cooling in the refrigerator.
~Cuyahoga County Board of Health
Obesity is now the most common nutritional disturbance in the pediatric population in the United States. Nearly 1 in 4 children are overweight or at risk of becoming overweight. The prevalence of pediatric obesity has doubled for the toddler and child and tripled for the adolescent. Only a small percentage of childhood obesity cases, as low as 5%, are associated with a hormonal or genetic defect. Childhood obesity typically results from a caloric intake that consistently exceeds caloric requirements and expenditure. The risk of recurring obesity is on-going. It is estimated that 1/3 of obese preschoolers, 1/2 of school age children and 3/4 of adolescents remain obese into adulthood posing additional health risks.
The adage "a pound of prevention is worth a pound of cure" describes the most effective means of curbing the obesity epidemic. Toddlers who have one obese parent, have a two-fold risk of becoming an overweight adult compared to toddlers without obese parents. The primary predictor of obesity in adulthood for children under three years of age is the parents' obesity status. Assessments of nutrition and feeding practices, physical activity and environmental conditions aid in the development of a plan for good eating habits.
Parental feeding practices can influence the development of children's and adolescents food preferences. Children consume what is familiar to them and available to them in the feeding environment. Studies have indicated that a minimum of five to ten exposures to a new food is needed to increase acceptance of the item. Research has shown that parents who have problems regulating their own eating behavior tend to try and control their child's eating behavior more than families without obesity. They try to regulate the child's intake and as a result the child lacks self-regulation. There is a division of responsibility for eating between parents and children. The parent is responsible for supplying healthy foods and a supportive eating environment. The child's responsibility is to decide when and how much to eat. The parent establishes daily meal and snack times and determines what food is offered and when, allowing the child to decide whether to eat or not.
Ninety-one percent of children, ages 6-11 years, are not consuming the recommended 5 servings of fruit and vegetables per day. Adolescents consume only 28% of their fruit and vegetable intakes. Fresh fruits and vegetables provide variety and satiety in a nutrient dense and fiber rich package that is low in fat and simple carbohydrates. The sooner children can become interested in them the better.
Reduction in juice or sweetened beverage consumption will help to decrease the link to obesity incidence. Excessive juice consumption is defined as >12 ounces per day. The AAP offers these recommendations on the use of fruit juice:
- Fruit juice offers no nutritional benefit and should not be introduced into diets of infants younger than six months.
- Infants should not be served juice in bottles or easily transportable cups.
- Children, ages 1-6 years, should limit their juice consumption to 4-6 ounces/day.
- Children, ages 7-18 years, should limit their juice consumption to 8-12 ounces/day.
- Children and adolescents should be encouraged to eat whole fruits to meet their recommended fruit intake.
Physical activity behaviors may influence the development of overweight children. Approximately half of adults in the parental age group spend no leisure time engaged in vigorous physical activity. Increasingly, leisure time activities are more sedentary, with television viewing, video games and personal computing rated the most popular pastimes. The odds of being overweight were 4.6 times greater for youth watching more than 5 hours of television per day compared with those children viewing less than two hours.
Environment can affect the lifestyle choices made by the patient and family. Some factors that can influence weight management outcomes include family composition (eg. single parent households), single or dual family incomes, family schedules, childcare arrangements, and food availability. School environments affect food and activity choices through school lunch programs, a la carte snack programs and opportunities for physical activity and after school programs.
An assessment of the child's/adolescent's and parents' readiness to make lifestyle changes is an important measure of whether the weight management program will be successful. A family that is not ready to make lifestyle changes will not provide a supportive environment for the child.
~Pediatric Perspectives Newsletter (2004)
We all LOVE them but kids really NEED them. A snack for an adult is often a treat, but a snack for a child is important because children don't eat much at meals. They need snacks to grow.
DON'T RUN TO THE KITCHEN EVERY HALF HOUR!
Most mothers find it easier to have a regular snack time in the middle of the morning and afternoon. It saves a lot of trips to the kitchen.
Snacks are best about 1 to 2 hours before the next meal. If you give a snack or drink less than an hour before a meal, it can cut your child's appetite.
Sometimes you may have to give a snack close to mealtime because your child is too hungry to wait. Try giving part of the meal like milk, bread or a salad.
Sometimes your child may just be thirsty-offer water.
Snacks "last" longer with some protein in them. Protein foods are foods like milk, cheese, yogurt, meat, chicken, egg or peanut butter (if over 3 years of age).
Leftovers make great snacks.
Good snacks are: fruits, bananas, watermelon, cantaloupe, apples, oranges, strawberries, tomatoes and carrots. Try yogurt with fruit or milk. Cheese toast: melt cheese on a piece of toast. Cereals with or without milk. Crisp vegetables if your child can eat them.
Have at least three meals a day.
Drink milk with meals.
Enjoy family meals when possible.
Chew food well.
Eat until full, then stop eating.
Eat lots of vegetables and fruits.
Snack on healthy food not junk food.
Drink soft drinks only once in a while.
Brush teeth or rinse after eating.
The USDA has created My Pyramid just for children. You can enter your child's age, gender and level of physical activity and a tailored plan comes
out for your child. This plan includes amounts for overall calories, fiber and protein intake. Check it out at www.mypyramid.gov
Formula Preparation and Storage
REFRIGERATION:
Prepared from Powder: Store at 35-40 degrees Fahrenheit. Keep no longer than 24 hours after mixed.
Prepared from Concentrate or Ready-to-Use: Store at 35-40 degrees Fahrenheit. Keep no longer than 48 hours after opened.
ROOM TEMPERATURE:
Prepared from Powder, Ready to Use or Concentrate: Keep no longer than 2 hours. If bottle is warmed or fed from, discard after one hour.
~American Dietetic Assn., CDC, and the Center for Food Safety and Applied Nutrition
If you are pumping your breasts and feeding your baby breast milk at a later time, you must follow certain guidelines on storing the milk.
What type of bag or container should I use to freeze breast milk?
Many women use disposable bottle bags (made of polyethylene). Cheaper, generic bottle bags are fine to use too. They come in a tear off roll and can be purchased at your local pharmacy. Brand name bags, such as Medela and Playtex, work well but are more expensive and sometimes harder to find.
When using disposable bags, double bag the milk to eliminate the risk of contamination from nicks: Fill the bag with breast milk, tie off the top with a freezer tie, and then place that bag in a larger storage bag.
A hard sided container is best for storing milk. Options include glass (clear or brown), clear hard plastic (polycarbonate), and frosted hard plastic (polypropylene). These containers are more expensive than disposable bags and take up more room in the freezer.
How much should I freeze?
Freeze breast milk in small amounts-2-4 ounces. These small volumes thaw faster than larger amounts, and less is wasted if your baby is unable to finish the milk.
When filling any container with the breast milk that is to be frozen, leave a little space at the top. Breast milk like most other liquids, expands when it freezes.
Do not add fresh, warm milk to already frozen milk. This defrosts the previously frozen milk.
How will I know if the freezer is cold enough?
If the temperature is cold enough to freeze ice cream then it is cold enough to freeze breast milk. Choose the coldest location in the freezer to store breast milk; the back of the freezer is colder than space near the front or in the door.
Label the bag or container with the collection date and the volume. Also, write your baby's name if a day care provider or other caregiver will be preparing feedings for the baby. Place the newest milk in the back of the pile in the freezer and move older milk to the front.
How long can I store the milk?
That depends on where the milk is stored. The table below lists the different times by storage location. These guidelines apply to milk for healthy infants only.
Storage Location Temperature Storage Time
Room Temperature 77degreesF/25degreesC 4 hours
Cooler with Blue Ice 59degreesF/15degreesC 24 hours
Refrigerator (Fresh Milk) 39degreesF/4degreesC 72 hours
Refrigerator (Previously thawed milk) 39degreesF/4degreesC 24 hours
Frozen milk 4degreesF/-20degreesC
Freezer inside refrigerator 2 weeks
Freezer with separate door outside refrigerator 3-6 months
Separate manual-defrost deep freeze 6-12 months
How should I defrost frozen milk?
You can move it from the freezer to the refrigerator, in which case it will thaw in 12 hours. Or, you can place it on the counter at room temperature. Placing it in a container of tepid water or running it under warm tap water will speed up the thawing process and also warm it up. Do not microwave the milk!
The fat in the breast milk rises to the top so it may appear layered after it defrosts. Swirl the milk to mix it before feeding. Breast milk may acquire a tinge of color depending on the mother's diet, but it remains perfectly good to use. Some mothers complain that defrosted milk smells sour, soapy, or fishy. It is not clear why this occurs, but general agreement in the lactation community is that the milk can still be used as long as the baby does not reject it.
~Contemporary Pediatrics
Although this time of year brings renewed life to our trees, plants and lawns, it also renews symptoms of allergy sufferers. If this time of year brings the onset of itchy, watery eyes, sneezing and a red, stuffy nose you probably suffer from seasonal allergies. Tree pollens tend to cause problems in winter and early spring, grass pollens arrive in late spring and early summer; weed pollens can cause allergies in late summer and early fall. Over the counter antihistamine products generally work well to relieve symptoms. Also, reducing your exposure to allergens will help to alleviate symptoms. Recommendations include:
Do learn when you're most likely to suffer symptoms. Dry or windy days are worse than rainy days, when residual pollen is washed away. Pollen counts are typically highest in the morning.
Do keep windows and doors closed and use your air conditioner to reduce pollen in your home.
Do wash your hair, face and hands before bed. Remove clothes and shoes before entering the bedroom.
Don't let pets that have been outdoors sleep with you.
Don't expose yourself to allergens to "desensitize" yourself. Learn what triggers symptoms and avoid the triggers.
Don't be afraid to have flowering plants in your garden. Flowers are pollinated by insects, unlike trees and grasses which are wind-pollinated plants. Trees and grasses cause the most allergy symptoms because their pollens are light, small and easily inhaled.
Asthma is a disease of the lungs in which there is reversible spasm of the muscles in the small branches of the bronchial tree, causing these airway tubes to narrow. Narrowing of the air tubes makes it difficult for air to get in and out of the lungs. The lining of these tubes swells and mucus production increases. This response is a result of over sensitivity or allergy.
The tendency to develop an allergic illness like asthma tends to run in families. A severe viral infection, bronchiolitis, which affects the lungs of babies, may produce asthma or symptoms that mimic asthma. This usually improves after a few years. Premature babies may have lung damage that can lead to asthma.
If your child has asthma, you can help by determining what they are sensitive to, "triggers". These allergens should be removed from your child's environment. If removal is not possible, limiting your child's exposure is helpful. Other situations that may make asthma worse include: cool damp weather, emotional upset or the presence of another illness like a cold. Some children have asthma that becomes worse with exercise.
Use of a peak flow meter is also helpful in providing an early warning of an asthma attack. The reading on the meter will be less than expected when the child's breathing tubes have become obstructed. You should know your child's personal best peak flow rate. To determine this you should have your child obtain two peak flow readings/day for an entire week when the child is well. These readings will then be used to determine your child's asthma zones and asthma action plan. The green zone equals 80% of your child's best peak flow rate and indicates your child is doing well on current medication. The yellow zone is when your child can achieve 50% to 80% of their best peak flow rate. This zone means an asthma attack may occur and medications may need to be altered. In this zone you should follow your asthma action plan. If the peak flow rate stays in the yellow zone after medication, call the office. In the red zone, your child is able to achieve less than 50% of their best peak flow rate. This suggests a moderate to severe asthma attack. Start your asthma action plan immediately and if the attack continues seek medical help immediately.
Symptoms of asthma include: Shortness of breath, difficulty breathing, wheezing (a vibratory whistling sound), decreased peak flow reading
Treatment: The main medications used are bronchodilators and anti-inflammatories. The bronchodilators relax the tight muscle surrounding the air tube. They will help breathing and relieve the attack. The anti-inflammatories treat the inflammation of the air tubes by decreasing the swelling of the airways and by decreasing the mucus production in the airways.
Management: Most asthmatic children are controlled with a simple medical plan (asthma action plan). Half of the children who have asthma will outgrow it. There is no way to predict the length of time your child will have asthma. Follow up with the doctor every 3 months and yearly physicals, are essential to review medications and past usage. These visits will help determine the best treatment for your child. Our office requires 3 month follow up visits in order to get refills on medications, so please plan accordingly.
For more information on asthma, go to www.everydaykidz.com.
Note: If your child is on the medication Pulmicort, and you use the same mask to deliver the medication as you do for Albuterol or Xopenex aerosols, you must cover the air holes on the mask. This is recommended to prevent prolonged contact with the eyes when administering Pulmicort. It is safe to leave the vents open with Albuterol or Xopenex.
Exercise induced asthma (EIA) is one of the most common medical conditions affecting individuals participating in physical activities. Exercise may be the only trigger of asthma symptoms in some patients. For most patients, EIA should not limit participation or success in vigorous activities.
Symptoms: EIA usually occurs during or minutes after vigorous activity, reaches its peak 5 to 10 minutes after stopping the activity, and usually resolves in another 20 -30 minutes. EIA should be suspected in any young person complaining of cough, shortness of breath, chest pain or tightness, wheezing or endurance problems during or shortly after vigorous exercise. Relief of symptoms after use of a bronchodilator helps confirm the diagnosis. An exercise challenge can also be used to determine the diagnosis.
Treatment: Since EIA is caused by the cooling and drying of inspired air during exercise, so any intervention (wearing ski masks or scarves, moving practice indoors etc.) that warms or humidifies the inspired air is helpful. Medication may also be used to relieve symptoms. The mainstay of medication treatment is 2 puffs of a short acting beta agonist, used as close to exercise as possible. This medication may be helpful for 2 to 3 hours.
~American Academy of Pediatrics
Numerous factors can affect any age patient's need for sleep, however unique to childhood is the affect the child's developmental level has on sleep habits. Sleep habits are learned behaviors and are significantly affected by parental consistency concerning bedtime. Children need the chance to learn how to self-soothe themselves back to sleep, beginning as early as infancy. It can take 20-30 minutes of fussiness for the normal baby to fall back to sleep, which can be quite frustrating to new parents.
Newborns: Birth to 28 days, may sleep from 12-20 hours a day. The average is 16 hours, divided into 3 - 4 hour naps between feedings and 1 -2 hours of wakefulness throughout the 24 hour cycle. As infants grow, the total time spent in sleep gradually decreases and they remain awake for longer periods in the day and sleep longer at night.
Infants: It takes infants 6-10 weeks to develop good 24 hour schedules with the longest period of sleep at night. In the first months of life when infants normally wake up during the night to be fed, parents should be encouraged to provide very little stimulation. One of the most constructive ways of teaching good sleep habits is by placing infants awake in their own crib at naptime or bedtime. The crib is the last thing infants should remember before going to sleep...not the breast, bottle or the parent's arms. If babies are always put in the crib sleepy they will soon learn that the crib is the place for sleep. By 3-4 months of age, most infants sleep 15 hours per day, six to eight hours at night and the rest divided between three naps decreasing to two naps between 6 and 12 months of age.
Toddler: One to three year olds, require an average of 12-14 hours per day. Most of this sleep occurs at night with one or two daytime naps, commonly 1-3 hours. By 18 months most toddlers have stopped taking a morning nap.
Preschooler: Three to six year olds, sleep between 10 and 12 hours a night and the daytime nap is given up. Many young children have difficulty going to sleep, especially after a lot of activity and stimulation during the day. Preschoolers with their vivid imaginations, may develop nighttime fears, such as of the dark, monsters, storms and dogs. Providing a night light and letting the child hold a flashlight or favorite toy, may be reassuring to promote sleep. Bedtime also commonly becomes a time for control and exertion of independence in young children. Attention seeking behavior, stalling and manipulative behaviors should be ignored. It is also advised that the child not be taken into the parent's bed or allowed to stay up past a reasonable hour. Non-stimulating rituals are important to young children. There is no correct routine, but it should be a period of calmness, helping make the transition to rest and sleep easier. If possible, bedtime rituals should occur in the same order and time.
School Age: For six to twelve year olds the amount of sleep needed decreases to approximately 10 hours per night. Later bedtimes may now be appropriate, helping reduce resistance to going to bed. Bedtime rituals should be continued but often can be done more independently at this age. The struggle for authority about bedtime should be avoided. Children as young as 7 years old can tell time, so the clock can tell them its bedtime, not the parent. Fears continue during this period, commonly delaying or interrupting sleep. Adult sleep patterns begin to develop, including problems with insomnia due to stress and anxiety.
Adolescence: The amount of sleep per day diminishes to the adult level of 7 -9 hours of sleep per night.
STEPS - Behavioral Consulting Services
A therapeutic socialization program for children with Autism Spectrum Disorder and Related Developmental Disabilities. For children ages: 3 to 12 years.
The goal of STEPS Social Skills Group is to increase social skills, enhance communication skills, and to assist in identifying positive and socially acceptable outlets for self-stimulatory behaviors. Reciprocal interaction skills with peers will be a primary focus, as well as conversation skills, nonverbal communication, social engagement, awareness of social cues, joint attention, generalized responding, eye contact, emotion identification, tolerance, and following group instruction.
Groups are offered weekly during 6 week sessions at the North Olmsted Recreation Center and the Strongsville United Church of Christ. Groups will begin in June and will last throughout the summer. The cost per 6 week session is $230.00. For more information contact Jennifer Might at 440-377-0029 or email STEPS at admin@stepsconsulting.org.
Internet Resources for Special Children
The following websites are just a few of the resources available to parents of special children. These sites provide information on resources, assistance, educational links and material, and online stores.
www.geocities.com links parents with resources and assistance
www.cshn.org center for children with special needs - provides information and educational materials
www.childrensdisabilities.info online store with books and resources for many disabilities (ADHD, Autism, Cerebral Palsy) to name a few
Guidelines for Successfully Parenting ADHD Children
In order to effectively parent a child with ADHD, you must be an effective manager. Your interactions should be consistent, predictable and most importantly, understanding of the chronic difficulties your child will likely experience.
There are many resources available on the internet in dealing with ADHD. The following books may also be beneficial: Taking Charge of ADHD: The Complete Authoritative Guide for Parents by RA Barkley, and Your Defiant Child: Eight Steps to Better Behavior by Russell A. Barkley, Christine M. Benton.
Ideas for Home Intervention For ADHD Children
ORGANIZATION AND TIME MANAGEMENT
1. Use a clear over the door shoe holder in your room. Use it to collect the little clutter that usually ends up on the floor, behind dressers or under the bed. You will be able to see immediately what is in the organizer and it will make keeping your room neater much easier.
2. Have one specific area in your room for personal items such as cologne, perfume, makeup, deodorant, etc. Keeping them in one area makes it easier to find them each day and get ready on time.
3. Have a place for everything.
4. Make a schedule of your day: what time you go to school, what time you arrive home, how long it takes to complete your homework, household chores and work hours. This will help you determine how much free time you have and then schedule your day so everything can be completed.
5. Make a list of things you want to do. When you find yourself sitting and watching TV for hours or just doing nothing, use your list to change your time into productive time.
6. Set goals for what you want to accomplish. Make your goals specific. It is much easier to reach a goal when you have something specific in mind.
7. Divide your daily activities into categories and decide on the priority of each category. Completing homework is a priority, hanging out at the mall is not.
8. Set time limits for yourself.
9. Keep as much routine as possible in your day. Knowing what you need to do and when you need to do it will help you accomplish more.
10. Don't procrastinate. Procrastination causes wasted time.
11. Take the time to complete a task correctly the first time. Having to do your work over again can waste time.
SCHOOL
1. If you have a study hall available, use it to take advantage of a quiet time to study and complete homework.
2. Take notes during class. This can help you keep focused on the material being taught.
3. Use your assignment notebook to keep lists of things to do. Don't make lists on scraps of paper or you may end up losing them or forgetting about them.
4. Talk to your teachers about your ADD and how it affects your work. Ask for their assistance in areas you are experiencing problems. They will be more willing to help if they understand that you are trying to overcome rather than making excuses.
5. Sit in the front of the classroom. This will help you focus on the lesson, will enable you to pay attention and minimize distractions.
6. Be prepared. Keep a supply of pens and small notebooks in your locker.
7. If you end up each day at home without the books needed to complete your assignments, use different methods to remember which books to bring home. One student wrote the class on his hand to remember. He wrote M for math, E for english, etc. While at his locker, he had on his hand what books he had homework in.
8. Find a partner to help you. Find someone you trust and work well with to help you stay focused during the day. Have a secret signal they can give you if they see you have lost your focus.
9. Clean out your locker every Friday. Bring home all loose papers from your locker. When you get home you can sort through the paper to see what you need and organize the papers.
10. Ask the school about bringing home an extra set of books. You will never forget your books at home or school.
11. Begin each semester by filling in a master schedule. First, fill in the things you must do and cannot change. Then, analyze the blanks that are left to find the most effective use for these times.
12. Make sure you eat breakfast each morning, your day will go much better if you take the time to stop and eat.
13. Get a large calendar for your room. Keep track of upcoming projects, tests, reports as well as other activities. Take a few minutes each night to fill in anything new. Take a few minutes each morning to review the calendar to see what is going on that day.
HOMEWORK SKILLS
1. Try to complete your homework in daylight hours. Some studies indicate it takes longer to complete the same task at nighttime.
2. Take the time to organize your homework after it is completed.
3. Prepare yourself the night before. Get your clothes ready and check your bookbag to make sure everything is there. Review your calendar to see if there is anything you forgot to do.
4. Create flashcards for yourself when studying for a test. These allow you to break down information into small segments and make it easier to study during odd times, such as while waiting for the bus or for class to start.
5. Use an assignment notebook. Don't rely on your memory to keep track of what you need to remember.
6. Create a space for yourself to complete your homework. Keep this area as clutter free as possible and have supplies available.
7. Use a cardboard box for all your loose papers. When you need old papers for school you will know exactly where to find them.
8. For long term projects, break into small chunks and make a schedule for completing each item. Keep the schedule on the wall in your homework area.
9. Complete the hardest homework, or the subject you dislike the most first and get it out of the way. If you save this for last, you could drag out the rest of your homework in order to delay it.
10. Keep a list of classmates and their phone numbers in your study area so that you can call if you have forgotten the assignment or have questions about what needs to be completed.
11. Take a short break every half hour to stretch and then get back to work. Be sure to limit your break time to 5 minutes and make sure you don't start watching TV during the break.
12. When studying for a test, read through the summaries of sections and chapters before reading the chapter itself. This will help you focus on the main ideas of the chapter.
13. Find out if your teachers post assignments online so you can check homework once you are home.
ADHD Meds & Eds (message board) www.millermom.proboards107.com
Adult & Young Adult ADD issues www.add.org
Children and Adults with ADHD www.chadd.org
Assistive Technology at Work (tools for school/work) www.idonline.org/article/11908
Resources for teens with ADHD www.add.about.com/od/forteens/web_sites_and_Resources_for_Teens.htm
ADHD Books
Parenting children with ADHD: 10 Lessons that Medicine Cannot Teach, Vincent J. Monastra, PhD.
Teaching Teens with ADD & ADHD, Chris A. Zeigler Dendy, MS.
American Heart Assoc. Recommends Cardiac Screening in Pediatric ADHD patients
On April 21, 2008, the American Heart Association released a statement recommending screening for children for cardiac conditions before and during treatment with stimulant drugs for ADHD. The AHA recommends using heart rate and blood pressure checks and screening for conditions with related cardiac symptoms before prescribing stimulant drugs for ADHD. It also recommends that each child diagnosed with ADHD be given an electrocardiogram before these drugs are prescribed. These medications can cause an increase in blood pressure and heart rate. For most children, this is not a problem. But in those children with heart conditions, it could make them more vulnerable to cardiac arrest-an erratic heartbeat that causes the heart to stop pumping blood through the body-and other heart problems.
The current AAP treatment guideline does not contain specific recommendations for cardiac screening or frequency of heart rate and blood pressure monitoring for these patients. It does more broadly recommend monitoring these patients for known side effects of the particular drugs they are taking. The AAP is currently revising its diagnosis and treatment guidelines for ADHD, and will be reviewing new science and case reports related to both cardiology and drug safety.
If you have concerns regarding your child or would like to have an electrocardiogram done for your child on ADHD medications, please follow up with your provider. Currently your child's heart health is evaluated at their yearly physical exam and at their three month ADD/ADHD follow-ups.
The American Academy of Pediatrics reviewed the recommendation by the American Heart Association and is making the following conclusions and recommendations.
Although the death of a child is a tragedy, there are no studies or compelling clinical evidence demonstrating that the likelihood of sudden death is higher in children receiving medications for ADHD than the general population.
A recommendation to obtain routine ECGs for children receiving ADHD medications is not warranted.
The AAP does not recommend the routine use of ECGs before initiating stimulant therapy for ADHD.
The AAP continues to recommend a careful assessment of all children, including those starting stimulants, using a targeted cardiac history and a physical examination, including a careful cardiac examination.
Given current evidence, the AAP encourages primary care and subspecialty physicians to continue currently recommended treatment for ADHD, including stimulant medications, without obtaining routine ECGs or routine subspecialty cardiology evaluation for most children before starting therapy with these medications.
The AAP urges further research on risk factors for Sudden Cardiac Death among all children and adolescents, including those with ADHD treated with stimulant medications. Improved methods to detect children with hidden cardiac disease should be another focus of such research efforts.
Vitamin D for Breastfed Infants
The American Academy of Pediatrics recommends 200 IU of Vitamin D daily, for 100% breastfed infants and for infants that are breastfed and supplemented with less than 16 ounces of formula per day. This vitamin is essential to reduce the child's chances of developing rickets. This vitamin can be found in multivitamin drops for infants.
The following tips will enhance your breastfeeding experience.
Positioning
Find a comfortable position
Use a pillow that gives support and makes feeding easier.
Bring baby to the level of your breast.
Bring baby to breast not breast to baby.
Have baby facing your breast.
Latch On
Hold your breast in a C-Hold (four fingers under your breast and your thumb on top).
Rub your nipple lightly across your baby's lips. This will cause your baby to open wide.
When baby is properly latched on the breast baby's nose should be near the breast but not pushed into the breast.
Feeding
Your milk should come in on the 3rd or 4th day after delivery.
Note: At birth, baby's stomach can only comfortably hold 2 teaspoons. This means that baby will get enough at first with only a little sucking. By the time your baby is 7 days old, the stomach can hold 2 ounces. Every day you will see your baby suck more at the breast.
Babies usually finish one breast in 15 to 20 minutes.
Let baby finish the first breast before offering the second breast.
Remember to always break the suction with your finger before removing baby from the breast.
Feeding Frequency
You should feed every 2-3 hours during the day and every 3-4 hours at night.
Total feedings should be 8-12 feedings each 24 hours.
Baby's Suck
You should be able to hear the baby swallow after your milk comes in.
You should notice a pause between swallows.
You should not hear smacking or clicking if the baby is latched on correctly.
How Do You Know Baby Has Had Enough?
In the first 48 hours baby may only have 2 wet diapers and 2 stools in a 24 hour period.
After 48 hours baby should have 5-6 wet diapers with 2-4 stools each day.
Baby's urine should be clear, light yellow or golden in color.
Urine should not be dark yellow, orange or brown. This means baby is not getting enough breast milk.
Baby's Weight Loss
Weight loss is normal during the first 3-4 days after birth.
Babies should regain their weight within 2-3 weeks of age.
Once babies have regained their birth weight, they should gain 4-8 ounces per week.
Information for Nursing Moms
As a nursing mother, you'll need to eat a balanced diet that contains 500 to 600 calories more per day than the diet you needed before pregnancy.
Nursing mothers should drink enough to satisfy their thirst.
Most foods eaten by the nursing mother will be well tolerated by her infant. If you find that certain foods seem to disagree with either you or your infant, avoid them temporarily.
Medications taken by a mother can pass into her breast milk. Some medications passed this way can be harmful to the infant. Please check with a provider before taking any medications other than Tylenol while you are breastfeeding.
Natural weaning begins when you start giving your baby food. Sometimes it may be necessary to wean for other reasons. The following are some helpful suggestions to guide you in the weaning process.
Recommendations:
Weaning should be done as slowly as possible for the health and welfare of both mother and baby. The American Academy of Pediatrics recommends that all babies be breastfed until 12 months of age. Supplemental foods are often started at 4-6 months of life, but the breast milk is considered the primary source of nutrition.
When Not to Wean:
If baby is sick or in the hospital
If mother is sick or in the hospital
During times of unusual stress
During a separation due to business or vacation
During the holidays
Weaning Should Be Done As Slowly As Possible
Replace the same feeding every day with a bottle or cup depending on the age of your baby. After replacing that feeding for approximately one week, replace a second feeding. Continue this method until baby is completely weaned. Weaning should not start out with bedtime or naptime feedings.
At four to six months you may supplement feedings with solid foods.
If you wean before 12 months of age you must use formula until your baby's first birthday.
Watch for signs of plugged ducts and mastitis
Your decreasing hormone levels may contribute to a feeling of sadness or a sense of loss.
Your menstrual periods may resume.
All babies sneeze, yawn, belch, pass gas and occasionally spit up small amounts of their feedings. Sneezing is the way lint, mucous and curds of milk are removed from the nose. Hiccups are spasms of the diaphragm and generally do not bother the baby. Often, a few sucks of water or milk will bring them to a halt. The cough, in sickness or in health, is a protective reflex which keeps the throat and bronchial tubes clear of foreign material. Please call if the cough is persistent.
Crying is your baby's way of saying "I'm hungry", "I'm thirsty", "My bottom is sore", "I'm too hot or cold", "I have a stomachache", "I'm bored", or "I don't know what I want". You will, in time, begin to interpret the meaning of these cries. Babies can cry for an hour or more without doing themselves any harm. The old folk song that asks "How can you have a baby with no crying?" is a good line to remember. Some babies cry more than others and at certain times of the day. They may be labeled as having colic. From three weeks to three months of age, many infants have a fussy period which may last for many hours in the evening. They pass large amounts of gas, get red in the face and pull up their legs. Most of these babies have nothing wrong with them. The cause of colic is not yet known, but it begins to taper off by the fourth month. Some comforting measures you can try include offering a pacifier, placing a warm heating pad on your infant's abdomen, holding your infant upright against your chest or shoulder and humming and offer more frequent burping. Sometimes simply walking with your baby in your arms, in a stroller or going for a ride in the car may help. When all else fails, let your infant cry (for someone else if possible) while you take a needed break.
For some babies, bath time turns out to be a battle. Eventually, all babies find this a very enjoyable part of the day. It is probably best to sponge bathe your infant until the navel is healed. While the cord is still on, keep it as dry as possible to facilitate its detachment. Because your infant's skin is dry, a bath every other day is sufficient. Mild soap, like Dove or Neutrogena can be used everywhere.
Please do not attempt to remove ear wax from the ear canal with cotton applicators. This frequently results in packing portions of the ear wax deeper into the canal, making visualization of the ear drum impossible and removal of the wax uncomfortable for your child.
Avoid the use of bubble baths and deodorant soaps. Some of these products are
extremely irritating to the skin in sensitive areas. Cradle cap, a
collection of yellow, greasy scales on the head, usually can be managed by using
a mild dandruff shampoo once or twice per week. If this condition persists
or worsens, consult your pediatrician regarding the use of additional
medication. Do not use baby oil during the first three months of life.
Your infant already has excess natural oils and these produce skin irritation
which is made worse by the addition of baby oil. A mild lotion like
Lubriderm is all that is needed.
Crying is your baby's first language. The only way they can communicate is
to cry. The sound of your baby crying can be very distressing and hard to
ignore. When your baby cries, respond. This teaches your baby trust.
It takes about a month to get to know you and trust in the care you give.
You will not spoil your baby by approaching every time a cry is heard. Cuddle Feed Pacifiers Massage Visual distractions Music Walks Position across
knee Rhythmic motion,
walking or rocking Get some fresh air Take breaks, get a
baby sitter Mechanical swing Bath Quiet time...allow
them to learn to comfort themselves Swaddle Car ride Rhythmic Noises -
Ceiling fan, washing machine, dishwasher, vacuum While infant is in
the crib, soothe by patting rhythmically and talking with a reassuring
voice. Do silly and
unexpected things Sing Change diaper Read to infant Use relaxation and
slow paced breathing
The best alternative to human milk is commercial infant formula because it is designed to closely approximate human milk. Formula supplies essentially the same quality and amount of protein, fat, carbohydrate, vitamins and minerals as human milk. Any iron-fortified milk or soy formula is satisfactory. Occasionally, an infant seems not to tolerate the usual formulas. If your infant seems to have difficulty with the formula you are presently using, discuss this with one of the providers. They may recommend a formula change.
It is not necessary to sterilize nipples and bottles or to boil the water for formula preparation. It is important to follow the directions on the formula can for proper mixing of the formula. Ready to feed formula is convenient but more expensive. If cost is a concern, the powdered formulas are more economical.
To feed your infant, find a comfortable sitting position with the infant cradled in your arm. Hold the bottle so that the milk is seen in the nipple and neck of the bottle to avoid having the infant suck a lot of air. To keep the nipple from collapsing, take it out of your infant's mouth frequently. Nipples should be tested regularly to avoid use of nipples with holes that are not the right size. Holes that are too large may cause the formula to come out too quickly. Throw these nipples away. Holes that are too small make feedings difficult for your infant and may cause much air to be swallowed. Enlarge the hole by passing a hot needle through the opening. There is not one type of bottle or nipple that is clearly better for all infants. Find what seems to satisfy your baby. Never allow your infant to take a bottle to bed, as this may encourage cavities.
No one is sure what causes babies to hiccup. They are quite common in newborns--sometimes beginning even before birth--and they tend to cause parents far more distress than they do the babies themselves.
Jaundice is the yellow color seen in the skin of many newborns. It happens when a chemical called bilirubin builds up in the baby's blood. Everyone's blood contains bilirubin, which is removed by the liver. Before birth, the mother's liver does this for the baby. Most babies develop jaundice in the first few days after birth because it takes a few days for the baby's liver to get better at removing bilirubin. The bilirubin level is usually the highest at 3 to 5 days of life.
The skin of a baby with jaundice usually appears yellow. Jaundice usually appears first in the face and then moves to the chest, abdomen, arms and legs as the bilirubin level increases. The whites of the eyes may also be yellow. Jaundice may be harder to see in babies with darker skin color. Most infants have mild jaundice that is harmless, but in unusual situations the bilirubin level can get very high and might cause brain damage. This is why newborns should be checked carefully for jaundice and treated to prevent a high bilirubin level.
Jaundice is more common in babies who are breastfed than babies who are formula-fed, but this occurs mainly in infants who are not nursing well. If you are breastfeeding, you should nurse your baby 8-12 times a day for the first few days. This will help you produce enough milk and will help to keep the baby's bilirubin level down.
Other factors that cause a greater risk for increased bilirubin levels include: early birth (more than 2 weeks before the due date), jaundice in the first 24 hours after birth, breastfeeding that is not going well, a lot of bruising or bleeding under the scalp related to labor and delivery, and a parent or sibling who had high bilirubin and received light therapy.
You should contact the doctor if your baby's skin becomes more yellow, the abdomen, arms or legs are yellow, the whites of the eyes are yellow, or if your baby is hard to wake, fussy, or not nursing or taking formula well.
Most jaundice requires no treatment. When treatment is necessary, placing your baby, undressed, under special lights (in the hospital), will lower the bilirubin level. Jaundice is treated at levels that are much lower than those at which brain damage is a concern. Treatment can prevent the harmful effects of jaundice. In breastfed infants, jaundice often lasts for more than 2 to 3 weeks. In formula fed infants, most jaundice goes away in 2 weeks.
At some point while your child is in diapers they will most likely develop a diaper rash. Irritant contact diaper rash is very common. Excessive moisture accompanied by chafing, elevated ammonia and ph levels within the diaper, as well as skin contact with stool irritate and damage the baby's skin.
To treat a mild rash we recommend: frequent diaper changes, discontinue the use of wipes (which can add to the irritation) and air dry whenever possible (this allows the skin to dry and restore its natural defenses). A barrier cream such as Desitin, Aquaphor or Diaperene can also be used. If the diaper rash does not improve with the above treatments after 72 hours or if there are any open areas, contact your pediatrician for further advice or follow-up.
All newborn babies are required by the state of Ohio to get tested for some rare disorders before they leave the hospital. Babies with these disorders may look healthy at birth. Serious problems such as mental retardation or death can be prevented if a disorder is diagnosed right away. If the result of the test indicates a possible problem, your physician will contact you and a repeat test will be ordered and information will be given to you regarding further follow up. Most disorders are treated with replacement hormone or drug therapy, or dietary changes. If a disorder is confirmed through repeat testing, your baby will be referred to a metabolic/endocrine/genetic specialist.
Disorders tested:
Biotinidase Deficiency (BIO)
BIO is an enzyme deficiency that occurs in about 1 in 60,000 newborns and can result in seizures, hearing loss and death in severe cases. Treatment is simple and involves daily doses of biotin.
Congenital Adrenal Hyperplasia (CAH)
CAH is caused by decreased or absent production of certain adrenal hormones. The most prevalent type is detected by newborn screening in about 1 in 15,000 newborns. Early detection can prevent death in boys and girls and sex misassignment in girls. Treatment involves lifelong hormone replacement therapy.
Congenital Hypothyroidism (CH)
Inadequate or absent production of thyroid hormone results in CH and is present in about 1 in 3500 newborns. Thyroid hormone replacement therapy begun by 1 month of age can prevent mental and growth retardation.
Congenital Toxoplasmosis (TOXO)
Infection of the fetus with a parasite ingested by the mother during pregnancy can result in TOXO in the newborn. The transmission rate is about 30% and the national incidence is approximately 1 in 10,000 newborns based on limited screening. Early diagnosis and drug therapy reduces the risk of blindness, mental retardation or other serious complications.
Cystic Fibrosis (CF)
Cystic fibrosis (CF) is the second most common life shortening, childhood onset, inherited disorder in the United States. It occurs in about 1 in 4,000 U.S. births. Cystic fibrosis is inherited when both parents carry an altered CF gene and pass it on to their child. A person who has one altered CF gene is called a "carrier". Carriers usually do not have any health problems caused by CF. When two CF carriers have children together, each baby has a one in four (25 percent) chance of having CF. Most children with CF do not have a family history of the disease.
CF affects breathing and digestion. It causes the body to make thick, sticky mucus that clogs the airways of the lungs, and it can prevent the pancreas from doing its job to help digest food. In people with CF, the sweat glands also make very "salty" sweat.
Beginning in the fall of 2006, newborns in the state of Ohio began being screened for CF as part of the routine screenings done on tiny samples of blood taken from a newborn's heel 24-48 hours after birth. These newborn screenings will allow for earlier treatment, although there is no cure at the present time.
A positive screen does not mean that an infant has CF. This result means that the infant is at increased risk for the disease. Further testing must be done to properly identify and diagnose infants with CF versus those who are simply carriers of the gene that causes CF. This further testing is done at the Rainbow Cystic Fibrosis Center for residents near Cleveland. If a newborn screen is positive, the next step is a sweat test and genetic counseling. The sweat test will determine if a child is affected or not. The test takes about 30 minutes. Small areas of the baby's arms and legs are stimulated to produce sweat, which is collected on gauze and sent to the laboratory. Genetic counselors then meet with the parents to discuss the results and the next steps. This test is most accurate if done when the baby is between 2 to 4 weeks of age.
Early diagnosis and treatment mean that there is a better chance that the baby with CF will grow up with fewer complications and an improved quality of life. Treatment includes eating a healthy, high-calorie diet with vitamins. To breathe better, many people with CF need help clearing mucus from their lungs each day. Some medications can help prevent lung infections and help with breathing.
This new screening will provide early diagnosis and immediate interventions to help the child live a longer, better life.
~Michael Konstan, MD, Rainbow Cystic Fibrosis Center
Galactosemia (GAL)
Failure to metabolize the milk sugar galactose results in GAL and occurs in about 1 in 50,000 newborns. The classical form detected by newborn screening can lead to cataracts, liver cirrhosis, mental retardation and/or death. Treatment is elimination of galactose from the diet usually by substituting soy.
Homocystinuria (HCY)
HCY is caused by enzyme deficiency that blocks the metabolism of an amino acid that can lead to mental retardation, osteoporosis and other problems if left undetected and untreated. The incidence is approximately 1 in 350,000 U.S. newborns. Treatment may involve dietary restrictions and supplemental medicines.
Maple Syrup Urine Disease (MSUD)
MSUD is a defect in the way that the body metabolizes certain amino acids and is present in about 1 in 200,000 U.S. newborns. Early detection and treatment with dietary restrictions can prevent death and severe mental retardation. There is an increased risk in Mennonites.
Medium Chain Acyl-CoA Dehydrogenase (MCAD) Deficiency
The most common disorder in the way the body metabolizes fatty acids is called MCAD deficiency. Undetected, it can cause sudden death. Treatment is simple and includes ensuring regular food intake. The incidence from newborn screening is not yet known, but is thought to be approximately 1 in 15,000 newborns.
Phenylketonuria (PKU)
An enzyme defect that prevents metabolism of phenylalanine, an amino acid essential to brain development, is known as PKU and occurs in approximately 1 in every 19,000 U.S. newborns. Undetected and untreated with a special diet, PKU leads to irreversible mental retardation. Persons of European descent are at increased risk.
Sickle Cell Disease (SCD)
Sickle cell anemia is the most prevalent SCD and causes clogged blood vessels resulting in severe pain and other severe health problems. Other common SCDs include various thalassemias. Newborn screening detects about 1 in 2500 newborns with SCD annually. Persons of African or Mediterranean descent are at an increased risk.
Other Fatty Acid Oxidation (FAO) Disorders
Besides MCAD deficiency, other FAO disorders may be detected through newborn screening. They are usually described in categories based on the length of the fatty acid involved. Undetected and untreated they can cause seizures, coma and even death. The incidence of various FAO disorders are not known since it is only recently that early detection through newborn screening has occurred.
Organic Acid (OA) Disorders
Organic acidemias are a group of metabolic disorders that lead to accumulation of organic acids in the blood and urine and may be detected in newborn screening through analysis of acylcarnitine profiles. Symptoms may be diminished by restricting protein in the diet and supplementation with vitamins and/or carnitine. Because newborn screening for these disorders is relatively new, the degree of occurrence in newborns is not yet known.
Urea Cycle Disorders (UCD)
A UCD is a genetic disorder caused by a deficiency of one of the enzymes responsible for removing ammonia from the blood stream. Some UCDs may be detected as a part of newborn screening. They are characterized by seizures, poor muscle tone, respiratory distress, and coma, and result in death if left undetected and untreated. Because newborn screening for these disorders is relatively new, the degree of occurrence in newborns is not yet known.
Helpful Websites for New Families
www.Kidshealth.org Parenting, growth, development and nutrition
www.linktohelp.org Search for organizations to help you
www.helpmegrow.org Birth to 3 years: services and programs for families
www.neofathering.net and www.fathers.com Information for new DADS
Hives are usually caused by an allergic reaction to medicine, food or plants. They can also appear with illness or as a result of stress.
Hives are generally sharply defined, slightly raised areas surrounded by redness and are usually circular in appearance. Hives are accompanied by intense itching. Each eruption is transient, lasting no more than 8 to 12 hours, but they may be replaced by new ones in different locations. These eruptions may appear immediately after exposure to an allergen or they may be delayed for several days. New lesions may continue to appear for one week.
Hives accompanied by swelling of the lips, face and/or hands may also occur. In severe reactions children may experience respiratory difficulty or swelling of the throat. If your child is experiencing any facial swelling or difficulty breathing seek medical attention immediately!
Head lice spend their entire lives on the human scalp, clinging to the hair while feeding, mating, and laying eggs. They are unrelated to hygiene or living conditions. Lice cannot jump or fly (they have no wings). Transmission is after close physical contact-head to head. The transfer of lice from host to an object to a new host is relatively rare. Though it is possible for lice to be transferred from a personal item; pillow, hat, towel, brush, it would have to be used immediately after it was used by an infested person. Lice cannot live off the human body for more than 24 hours.
Diagnosis: The main symptom is itching. Diagnosis is confirmed by the presence of a live, mobile louse. The louse is about the size of a sesame seed and brown in color. Nits (eggs) are deposited on the hair shaft usually within 6mm of the scalp. These eggs will hatch in 7-10 days. Nits can remain stuck on the hair shaft for weeks or months after an infestation has been treated. A positive diagnosis is based on the presence of a live louse. If someone in the family is diagnosed with lice, the entire family should be checked.
Treatment: Nits can be removed with a fine tooth comb. Part the hair into small strands and comb through hair. Examine the comb for any lice. If no live lice are found, repeat the procedure in 1-2 days. If live lice are found the first line of therapy is over the counter pediculicides (Rid, Nix, Lice Arrest, for example). Follow the package directions closely. Treatment is for external use only. A second treatment should be applied in 7-10 days, because 25-30% of lice eggs survive treatment. In general, these preparations are safe to use. Prescription treatment for lice is used only if infestation has not responded to over the counter treatment.
Linens, towels, clothes worn 2 days before treatment should be washed in hot water and dried on high heat. The room should be vacuumed or wet mopped. Dry clean items that are not washable or seal in plastic bags for 2 weeks or place plastic bag in the freezer for 3 days. Remember to vacuum furniture and car seats. Soak brushes and combs in dishwashing detergent and hot water for one hour, rinse and dry.
Background
Staphylococcus aureus (known as "staph") is a common bacterium that is carried on the skin or in the nose of healthy people. Approximately 30% of people carry the staph bacteria, and most never develop any symptoms or illness. Staph is a leading cause of skin and soft tissue infection and when an infection does occur, it is usually mild.
Staph skin infections can be just at the surface of the skin or can go into the soft tissue to form a boil or abscess. Invasive staph infections are different from skin and soft tissue infections. Invasive staph infections are more serious, but they occur much less often than skin or soft tissue infections.
Community-Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA) is a type of Staphylococcus aureus, which is resistant to some of the antibiotics that typically have been used to treat skin and soft tissue infections. CA-MRSA is resistant to methicillin and other penicillin type antibiotics such as amoxicillin and the cephalosporins.
How Staph Infections are Spread
Staph infections are spread by direct physical contact with the bacteria. It is almost always spread person-to-person, but can be spread through contact with contaminated surfaces, personal items or equipment. Spread of staph infections has occurred through skin-to-skin contact when playing sports, such as football or wrestling, or from surfaces in gyms and locker rooms.
How Staph Infections are Treated
Staph infections are treatable. The treatment may include drainage of the infection site and/or treatment with antibiotics. There are antibiotics available for all forms of staph infections, including CA-MRSA.
How to Prevent/Control Spread
Students and staff should be encouraged to wash their
hands for 15-20 seconds frequently with warm
water and soap. School health services staff should
educate students and staff on the importance of hand
washing. If soap is not available, alcohol-based
sanitizers should be used.
Students should shower after every athletic activity
using soap and clean towels
Students should not share personal hygiene or
other items
such as towels, soap, clothing and razors. If
schools are responsible for washing towels, athletic
uniforms, etc. these items should be washed after every
use. To avoid sharing of bar soap, schools should
consider placing soap dispensers on walls,
particularly in locker rooms, etc
Skin cuts, scrapes or breaks should be kept clean and
dry to minimize the chance of developing an
infection.
Proper bandages should be used to keep all infected
wounds covered. Students should not be allowed
to participate in athletics, gym class, etc., if an
infected wound cannot be covered.
Schools should have and follow protocols for routine
cleaning that includes sanitizers and a regular
cleaning schedule. Particular attention should be
given to damp or wet areas and those areas that may
be contaminated by body fluids. Particular attention
should be given to locker rooms, showers and the
school health services office. It is recommended
that a disinfectant that is EPA registered as
effective against MRSA be used to clean surfaces
Perform daily surface cleaning of locker room
surfaces (examples: showers, benches, countertops)
and scheduled cleaning of weight room
equipment and other gym or other athletic equipment
that is shared. These surfaces should be washed
after each use with a disinfectant, such as bleach
or hospital-grade disinfectant
Messages for School Personnel
School
closure is not an appropriate response to CA-MRSA
infections in students. Response should focus on
following the above measures to prevent and control
spread of staph to other students
If
a student is determined to have a skin or soft tissue
infection, school health services staff or other
designated personnel should clean and cover the wound
site and notify the child's parents
Parents should be advised to seek further evaluation
and/or treatment by their child's doctor.
Keep a first aid kit with ample dressings available at
athletic events.
Staff should report skin and soft tissue infections to
the school nurse and to coaches/athletic
trainers/physical education teachers so that hygiene
practices can be reviewed and corrected if
deficient.
School nurses should consider a CA-MRSA diagnosis in all
students who present with signs of skin or soft
tissue infection
School health services staff and other school personnel
who might have contact with students suspected of
CA-MRSA infection should use contact
precautions.
Messages for Students/Parents
Good hygiene is the best prevention!
Children and youth should be encouraged to wash
their hands frequently with warm water and soap.
Parents should educate children about the importance
of hand washing, particularly after nose-wiping. If
soap is not available, alcohol-based sanitizers can
be used.
Skin cuts, scrapes or breaks should be kept clean and
dry to minimize the chance of developing an
infection.
Proper bandages should be used and changed daily or more
frequently, if necessary to keep all infected
wounds clean and covered.
If your child has a skin infection that is not
getting better, contact his or her doctor.
If your child is taking antibiotics for an infection,
make sure they complete the full number of doses as
prescribed. Antibiotics should not be shared or
saved for future use.
Take your child to see a medical provider if the skin or
soft tissue begins to appear infected- red, hot,
swollen, tender or draining pus.
Students should report skin and soft tissue infections
to the school nurse and to coaches/athletic
trainers/physical education teachers.
Resources
American
Academy of Pediatrics - Hot Topics: Community-Acquired
MRSA
Centers
for Disease Control and Prevention.
Community-Associated MRSA Information for the Public
CDC.
Methicillin-Resistant Staphylococcus aureus
Infections Among Competitive Sports
Participants---Colorado, Indiana, Pennsylvania and
Los Angeles County, 2000-2003. MMWR 2003;52:793-795.
Molluscum is a rash caused by a poxvirus. The rash appears as raised, round, smooth surfaced bumps on the skin that look like thick-walled pimples. They have a waxy or skin colored surface with a dimple in the center of the bump. They are found on just one area of the body and usually range in size from a pinhead to 1/4 inch across. They are not painful but are occasionally itchy.
Molluscum is transmitted through skin to skin contact with an infected person. Molluscum is only mildly contagious, the incubation period is 4 to 8 weeks. Your child can attend child care, preschool and school without undue concern about spread. Children 2 to 12 years are most likely to be infected by this virus.
Molluscum can spread to other parts of the body if a child picks at a bump and then scratches elsewhere. Use distraction to stop younger children from picking. Chewing or sucking on molluscum can lead to similar bumps on the lips or face. If your child is doing this, cover the molluscum with a Band-Aid. Keep your child's fingernails cut short and wash your child's hand frequently.
Most molluscum disappear without treatment in 6 to 18 months. Molluscum can spread rapidly and last longer in children who have atopic dermatitis. If repeatedly picked at, molluscum can become infected with bacteria and change into crusty sores (impetigo). Most children only develop 5 to 10 molluscum, but some acquire more. Regardless of the number, this is a temporary condition.
Because molluscum are harmless, painless, and have a natural tendency to heal and disappear, some physicians recommend not treating them. The treatment itself may be painful and frightening, especially to younger children. Treatment may be unsuccessful or need to be repeated. Treatment will be considered if your child picks at them, the molluscum are in areas of friction (ex: the armpit), you feel they are a cosmetic problem, or the molluscum appear to be spreading rapidly.
There is no successful home treatment for molluscum. The following techniques must be performed in a physician's office. The molluscum can be destroyed by freezing or burning with a mild acid. Another type of treatment involves piercing the center of the molluscum with a needle or scalpel and scraping out the core. Newer techniques may become available.
If the molluscum are spreading rapidly, appear infected or your child continues to pick at them, call your physician.
Pinworm infections are caused by a small, white intestinal worm. Pinworms live in the rectum of humans. While an infected person sleeps, the female leaves the intestine through the anus and deposits eggs on the surrounding skin. The main symptoms of infection are rectal itching, disturbed sleep and irritability. Pinworms are the most common worm infection in the United States. School age children have the highest rate of infection. The mode of transmission is the fecal-oral route. You can become infected after ingesting infective pinworm eggs from contaminated surfaces or fingers.
Diagnosis: Checking the rectum at night or first thing in the morning could reveal the presence of adult worms. These will appear as tiny white threads. Occasionally, worms are seen in the stool of infected persons. If you have found worms on your child call the office for treatment.
Treatment: Pinworms are treated with prescription medication which is a two dose treatment. Close family contacts may also require treatment.
To prevent the spread of infection: change and wash your underwear each day, change pajamas frequently, trim fingernails short, encourage good hand washing after using the toilet, before eating and after changing diapers. Discourage nail biting and scratching of bare anal areas, these practices help reduce the risk of continuous self infection.
After diagnosis, linens and towels of the infected person should be washed in hot water. Vacuuming the entire house or washing sheets everyday are probably not necessary or effective.
Your child is almost certain to have one nosebleed-and probably many-during there preschool years. Some preschoolers have several a week. This is neither abnormal or dangerous, but it is very frightening. If blood flows down from the back of the nose into the mouth and throat, your child can swallow a great deal of it, which in turn may cause vomiting.
There are many causes of nosebleeds, most of which aren't serious. Beginning with the most common causes they include:
Colds and allergies. A cold or allergy causes swelling and irritation inside the nose and can cause spontaneous bleeding.
Trauma. A child can get a nosebleed from picking his nose, or putting something into it, or just blowing it too hard. A nosebleed can also occur if he is hit in the nose by a ball or other object, or falls and hits his nose.
Low humidity or irritating fumes. If your house is very dry, or if you live in a dry climate, the lining of your child's nose may dry out, making it more likely to bleed. If he is frequently exposed to toxic fumes (fortunately, an unusual occurrence), they may cause nosebleeds, too.
Anatomical problems. Any abnormal structure inside the nose can lead to crusting and bleeding.
Abnormal growths. Any abnormal tissue growing in the nose may cause bleeding. Although most of these growths, (polyps) are benign (not cancerous), they still should be treated promptly.
Abnormal blood clotting. Anything that interferes with blood clotting can lead to nosebleeds. Medications, even common ones, can alter the blood clotting mechanism just enough to cause bleeding. Blood diseases, such as hemophilia, also can provoke nosebleeds.
Chronic illness. Any child with a long-term illness, or who may require extra oxygen or other medication that can dry out or affect the lining of the nose, is likely to have nosebleeds.
Treatment
There are many misconceptions and folktales about how to treat a nosebleed. Here are a list of do's and don'ts:
Do:
Remain calm. A nosebleed can be frightening, but it is rarely serious.
Keep your child in a sitting or standing position. Tilt his head slightly forward. Have him gently blow his nose if he is old enough.
Pinch the lower half of your child's nose (the soft part) between your thumb and finger and hold it firmly for a full ten minutes. If your child is old enough, he can do this himself. Don't release the nose during this time to see if it is still bleeding.
Release the pressure after ten minutes and wait, keeping your child quiet. If the bleeding hasn't stopped, repeat this step. If after ten more minutes of pressure the bleeding hasn't stopped, call your pediatrician or go to the nearest emergency room.
Don't:
Panic. You'll just scare your child. Keep in mind that the blood coming from the nose always looks like a lot.
Have him lie down or tilt back his head.
Stuff tissues, gauze, or any other material into your child's nose to stop the bleeding.
Call your pediatrician if you think your child has lost too much blood, the bleeding is coming from your child's mouth or he's coughing or vomiting blood, or if he has a lot of nosebleeds and a chronically stuffy nose. If your child is unusually pale or sweaty, or is not responsive, take your child to the emergency room.
Prevention:
If your child gets a lot of nosebleeds, ask your pediatrician about using salt water nose drops every day. Doing so may be helpful if you live in a dry climate or when the furnace is on. In addition, a humidifier or vaporizer will help maintain your home's humidity at a level high enough to prevent nasal drying. Also tell your child not to pick his nose. If he picks it at night or in his sleep, put him to bed wearing thin cotton gloves or socks over his hands.
~AAP
This is the season of outdoor activities which means the number of injuries increases significantly. Maintaining outdoor equipment in proper working order and wearing appropriate safety gear will help to reduce injuries. Treatment for the most common injuries is as follows:
Abrasions: These result in injury to the top layer of the skin.
Treatment: Cleanse with an antibacterial soap, apply antibiotic ointment and observe for signs of infection: increased redness, tenderness, swelling or discharge at the site.
Cuts or Lacerations: These are generally deeper, more irregular wounds. Depending on the wound these may require sutures.
Treatment: If the wound won't stop bleeding after pressure is applied or if the wound is gaping (like a buttonhole) it is recommended to seek treatment at an emergency department for possible suture closure.
Falls: These accidents can result in the above injuries and also could include fractures and serious head injury.
Fractures: If your child has sustained a fall or trauma and is unable to move an extremity, has limited range of motion, bruising, swelling or point tenderness at the site of the injury, they should be seen at an emergency department for radiographic evaluation of the injury.
Head Injury: If your child has sustained a fall or blow to the head it is important to assess for signs of serious head injury. These include:
- loss of consciousness.
- persistent headache or vomiting (greater than two times)
- clumsiness or inability to move a body part
- abnormal speech or behavior
- oozing of blood or fluid from ears and or nose
- convulsions
If your child exhibits any of these symptoms following a head injury call 911 or seek treatment at an emergency department.
If your child has none of the above symptoms, apply ice to the injured area and observe for the above signs of a more serious head injury. It is not unusual to see a lump form over the injured area. This is normal and could last for several days.
The term "scoliosis" involves lateral curvature and rotation of the spine. Although it can span all age groups, the deformity is most frequently seen in normal, rapidly growing, preadolescent or adolescent children. Because most of the serious consequences of scoliosis can be prevented, it is a deformity particularly amenable to early diagnosis and proper treatment. It is therefore important that the health care community and general public be knowledgeable about the deformity; that screening programs be promoted in every locality; and that pediatricians focus particular attention on the spine during the adolescent growth spurt.
There are several different "warning signs" to look for to help determine if you or someone you love has scoliosis. Should you notice any one or more of these signs, you should schedule an exam with a doctor.
Shoulders are different heights – one shoulder blade is more prominent than the other
Head is not centered directly above the pelvis
Appearance of a raised, prominent hip
Rib cages are at different heights
Uneven waist
Changes in look or texture of skin overlying the spine (dimples, hairy patches, color changes)
Leaning of entire body to one side
A standard exam that is often used by pediatricians and in initial school screenings is called the Adam's Forward Bend Test. Most schools test children in the fifth or sixth grade, and the Adam's Forward Bend Test can be administered easily by school nurses or parent volunteers. For this test, the patient is asked to lean forward with his or her feet together and bend 90 degrees at the waist. The examiner can then easily view from this angle any asymmetry of the trunk or any abnormal spinal curvatures. It should be noted that this is a simple screening test that can detect potential problems, but cannot determine accurately the exact severity of the deformity.
Once suspected, scoliosis is usually confirmed with an x-ray, spinal radiograph, CT scan, MRI or bone scan of the spine. The curve is then measured by the Cobb Method and is discussed in terms of degrees. Generally speaking, a curve is considered significant if it is greater than 25 to 30 degrees. Curves exceeding 45 to 50 degrees are considered severe and often require more aggressive treatment.
Once it has been determined that a patient has scoliosis, there are several things to take into consideration when discussing treatment options:
Spinal maturity – is the patient's spine still growing and changing?
Degree and extent of curvature – how severe is the curve and how does it affect the patient's lifestyle?
Location of curve – according to the Scoliosis Research Society, thoracic (upper spine) curves are more likely to progress than thoracolumbar (middle spine) or lumbar (lower spine) curves.
Potential for progression – patients who have large curves prior to their adolescent growth spurts are more likely to experience curve progression.
After this complex set of variables is
analyzed, treatment options are discussed. There are three basic types of
treatments for scoliosis: observation, bracing and surgery.
Observation
includes follow up x-rays 4-6 months after the first x-ray to measure any
changes. The greatest changes occur
during the growth spurt of puberty.
Bracing can be moderately effective
for a growing child with a spinal curvature between 25 and 40 degrees.
Plastic braces are worn at night for two to three years to prevent the
curve from worsening.
Surgery is recommended for curvatures over 45 degrees.
Warts are caused by a virus and appear as firm raised areas with a rough or horny surface. Plantar warts are found on the soles of the feet and are usually tender, circular lesions with a speckled core. Warts are transmitted through direct contact but contaminated floors are often implicated. The incubation period is about 4 months, they are communicable as long as visible lesions persist. Plantar warts and hand warts are most often seen in young children. Warts nearly always regress spontaneously within a period of months. However, to decrease transmission and to treat warts for faster resolution, it is recommended to try one of the over the counter preparations containing salicylic acid. The over the counter freezing medication also works well. Be careful when using to avoid applying to normal skin. If your child has more than one wart or warts on the face or genitals, or if the warts don't respond to over the counter treatment, referral to a dermatologist is recommended.
Consider the following guidelines if you want to teach your baby that nighttime is a special time for sleeping, that her crib is where she stays at night, and that she can put herself back to sleep. It is far easier to treat sleep problems before 6 months of age than it is to treat them later.
Newborns:
Place your baby in the crib when he is drowsy but awake. This step is very important. He must learn to put himself to sleep without you. It often takes 20 minutes of restlessness for a baby to get to sleep. If he is crying, rock him and cuddle him; but when he settles down, try to place him in the crib before he falls asleep.
Hold your baby for all fussy crying during the first 3 months. Babies can't be spoiled during the first 3 or 4 months of life.
Do not let your baby sleep for more than 3 consecutive hours during the day. In this way, the time when your infant sleeps the longest will occur during the night. Many newborns can sleep 5 consecutive hours and you can teach your baby to take this longer period of sleep at night.
Keep daytime feeding intervals to at least 2 hours for newborns. More frequent daytime feedings (such as hourly) lead to frequent awakenings for small feedings at night.
Make middle of the night feedings brief and boring.
Don't awaken your infant to change diapers during the night. The exceptions are: soiled diapers or if you are treating a bad diaper rash.
Don't let your baby sleep in your bed. Teach your child to prefer his own bed.
Give the last feeding at your bedtime (10 or 11 pm). Try to keep your baby awake for the 2 hours before this last feeding. Going to bed at the same time every night helps your baby develop good sleeping habits.
Two-Month-Old Babies:
Move your baby's crib to a separate room. Your baby may forget that her parents are available if she can't see them when she awakens.
Try to delay middle of the night feedings. By now, your baby should be down to one feeding during the night. Never awaken your baby at night for a feeding except at your bedtime.
Four-Month-Old Babies:
Try to discontinue the 2:00 am feeding before it becomes a habit. If you do not eliminate the night feeding at this time, it will become more difficult to stop as your child gets older. If your child cries during the night comfort him with soothing words instead of a feeding.
Don't allow your baby to hold his bottle or take it to bed with him. A bottle in bed leads to middle of the night crying because your baby will inevitably reach for the bottle and find it empty on the floor. Also, bottles in bed can lead to tooth decay.
Make any middle of the night contact brief and boring. All children have four or five partial awakenings each night. They need to learn how to go back to sleep on their own.
Six-Month-Old Babies:
Provide a friendly soft toy for your child to hold in her crib. At this age children start to be anxious about separation from their parents. A stuffed animal, doll or blanket can be a security object that will give comfort to your child when she wakes during the night.
Leave the door open to your child's room.
During the day, respond to separation fears by holding and reassuring your child.
For middle of the night fears, make contacts prompt and reassuring. Keep the interaction brief, do not take out of the crib, keep the light off and don't talk too much.
One Year Old Children:
Establish a pleasant and predictable bedtime ritual. Children need a familiar routine. Finish the bedtime ritual before your child falls asleep.
Once put to bed, your child should stay there. Some infants have tantrums at bedtime. You should ignore these protests and leave the room. If he is standing up, leave him in that position. He can lie down without your help. Encouraging him to lie down soon becomes a game. If you respond to his protests the same way every time, he will learn not to try to prolong bedtime.
If your child has nightmares, reassure him.
Don't worry about the amount of sleep your child is getting. The best way to know that your child is getting enough sleep is that they are not tired during the day. Children stop taking morning naps between 18 months and 2 years of age and give up the afternoon nap between 3 and 6 years of age.
These children are over two years old and refuse to go to bed or stay in the bedroom. They can come out of the bedroom because they no longer sleep in a crib. These are attempts to test the limits, not fear. Your child has found a good way to postpone bedtime and receive extra entertainment. If given a choice, over 90% of children would stay up until their parents' bedtime. These children often try to share the parents' bed at bedtime or sneak into their parents' bed in the middle of the night. The following recommendations apply to children who are manipulative at bedtime, not fearful.
Start the night with a pleasant, predictable bedtime ritual. Most pre-bedtime rituals last about 30 minutes and include taking a bath, brushing teeth, saying prayers, reading stories, talking about the day, and other interactions that relax your child.
Establish a rule that your child can't leave the bedroom at night. Expect to hear some crying or screaming.
Ignore verbal requests. All of these requests should have been dealt with during the pre-bedtime ritual. Exception: If you child says he needs to use the toilet, tell him to take care of it himself. If he says his covers have fallen off, promise him you will cover him when you go to bed. You will usually find him well covered.
Close the bedroom door for screaming. Tell him you will open it when he is quiet. If he pounds on the door, you can open it after 1 or 2 minutes and suggest he go back to bed. For continued screaming or pounding on the door, reopen it approximately every 15 minutes, telling your child that if he quiets down, the door can stay open. Never spend more than 30 seconds reassuring him.
Close the bedroom door for coming out. If he does come out, return him immediately to bed. Tell him you will open the door when he is in bed. CAUTION: If your child has bedtime fears, don't close his door.
Barricade the door for repeated coming out. While this may seem extreme, it can be critical for safety reasons for children who wander through the house at night without an understanding of dangers (such as the stove, hot water, electricity, knives and going outdoors).
Return him if he comes into your bed at night.
Praise appropriate sleeping behavior.
Start bedtime later if you want to minimize bedtime crying.
Nightmare Night Terror
A scary dream followed by complete awakening. A partial arousal from very deep sleep.
Occurs in the second half of the night. Usually one to two hours after falling asleep.
After waking is fearful and crying. Sitting up, thrashing, crying. Fear and confusion disappear after awake.
After waking, child is reassured by your presence. Child is not aware of your presence.
May have trouble returning to sleep. Returns to sleep rapidly without fully awakening.
Often remembers the dream and talks about it. No memory of the dream or of yelling or thrashing.
Confidentiality in the care of Young Adolescents
A Note to Parents about Confidentiality
Now that your child is entering adolescence, we would like to let you know about some changes that will be taking place in our office visit routines. These changes are being made to recognize your child’s growing independence and enable us to provide the best medical care.
During early adolescence, young teens and preteens are learning to think and behave like the adults that they are destined to become. With their parents’ support, they practice the skills they will need as they become increasingly independent. Taking responsibility for choices related to health and safety is an important developmental task of adolescence, which is why gradual changes are made in the structure of pediatric office visits at this time.
Sometime between ages 11 and 14, your son or daughter will begin to spend part of the office visit alone
with the pediatrician. The first part of your visit will not change; pediatrician, parent, and child will continue to meet together and talk about anything that any of us might want to discuss. After this initial conversation, the pediatrician will spend some one-on-one time with your child to talk privately and to complete the physical examination. (Your teen or the physician may request your presence during the physical examination.)
When your pediatrician meets privately with your adolescent, conversations will be confidential. A teen might want to share something that they consider “private” with the doctor, and private does not necessarily imply something that you need to be concerned about. It is critical that young people in this age group have a chance to ask questions directly and have an open dialogue with a trusted physician without embarrassment or fear of blame. The exception to confidentiality would be if your pediatrician felt that there was a threat to your son or daughter’s life or that of another person, including suicidal or homicidal thoughts. This information would be shared with you immediately. Your adolescent’s need for respect, privacy, and autonomy does not lessen their need for your continued guidance and support. Your involvement in your adolescent’s development will always be extremely important. Please feel free to telephone at any time. We are always glad to hear from you
Staying in Touch With Your Teen
Home life changes as children begin to enter adolescence. Wise parents work to keep the lines of
communication open. Look for opportunities to get your teen talking. What kinds of things are on most
young adolescents’ minds?
• Physical and emotional changes of puberty.
Does your adolescent understand what to expect?
Do they know that it’s perfectly normal to be the first or last of their peers to begin to menstruate
or to find that their voice has “changed”?
• Diet and exercise. Does your adolescent appreciate the benefits of exercise? Have you
taught him or her to take a mental inventory when they’re feeling low, to ask themselves how
much they’ve slept, how well they’ve eaten, how recently they’ve had a good workout?
• Sex and sexuality. Parents who talk to their children and teens about dating and sexual decision
making encourage healthier attitudes and safer choices.
• Need for privacy. If you’ve noticed your teen needs more time alone, let him or her know that
they’re missed in the TV room! Their need for privacy is normal; don’t take it personally. Just
keep asking (and monitoring for opportunities to draw them out).
• Alcohol and drugs. Don’t let this be the elephant in the room! Talk about what to do if someone
asks them to try alcohol or drugs. Tell them early and often that you will pick them up at any time,
no questions asked. And make sure your home is a safe place for friends to gather.
• Tell them you love them. Your adolescent may be stressed, but you will miss his or her passion
and they’ll be gone before you know it. Hug them, love them, and remember, “This too shall
pass.”
Adolescents are notorious for not getting enough sleep. The average amount per night is 7 to 7 1/4 hours. What they need is between 9-91/2 hours. There are a number of reasons teenagers do not get enough sleep:
Shift in sleep schedule. After puberty, there is a biological shift in an adolescent's internal clock of about 2 hours, meaning that a teenager who used to fall asleep at 9:00 p.m. will now not be able to fall asleep until 11:00 p.m. It also means waking 2 hours later in the morning.
Early high school start times. This means some teenagers may have to get up as early as 5:00 a.m. to get ready and travel to school.
Social and school obligations. Homework, sports, after-school activities and socializing lead to late bedtimes.
As a result, most adolescents are very sleep deprived. Sleep deprivation will impact on many aspects of your teen's functioning.
Mood. Sleep deprivation will cause your teenager to be moody, irritable and cranky. They have difficulty regulating their mood and will often be frustrated and upset more easily.
Behavior. Teens that are sleep deprived are more likely to engage in risk taking behaviors such as drinking, driving too fast and engaging in other dangerous activities.
Cognitive ability. Inadequate sleep will result in problems with attention, memory, decision making, reaction time and creativity.
Academic performance. Studies show that teenagers who get less sleep are more apt to get poor grades in school, fall asleep in school, and have school tardiness/absences.
Drowsy driving. Teens are at the highest risk for falling asleep at the wheel. Drowsy driving is most likely to occur in the middle of the night (2:00 - 4:00 a.m.) but also in the mid-afternoon (3:00 - 4:00 p.m.)
Help your teenager get enough sleep.
Maintain a regular sleep schedule.
Avoid oversleeping on the weekends. Although catching up on some sleep on the weekends can be helpful, sleeping in until noon on Sunday will make it hard to get back on a school schedule that night.
Take early afternoon naps. A nap of 30-45 minutes can be beneficial.
Turn off television, radios and computers. Stimulating activities at bedtime will cause problems falling asleep.
Avoid caffeine, smoking, alcohol and drugs.
Contact the doctor if your teen has difficulties falling asleep or staying asleep, snores or seems excessively sleepy during the day.
~Mindell & Owens (2003)
With school just around the corner, it is time to review with your children some safety tips for school. We as motorists must also refresh ourselves on the laws regarding school busses and school zones. Please drive safely in any area with a nearby school as many children walk several blocks to get to school.
Riding the Bus
School bus transportation is safe. In fact, buses are safer than cars! Even so,
last year, approximately 26 students were killed and another 9,000 were injured
in incidents involving school buses. More often than not, these deaths and
injuries didn't occur in a crash, but as the pupils were entering and exiting
the bus. Remember these safety tips:
Have a safe place to wait for your bus, away from traffic and the street.
Stay away from the bus until it comes to a complete stop and the driver signals you to enter.
When being dropped off, exit the bus and walk ten giant steps away from the bus. Keep a safe distance between you and the bus. Also, remember that the bus driver can see you best when you are back away from the bus.
There is a 10- foot area around the bus known as the Danger Zone.
The bus driver is not able to see anything in this area.
The Danger Zone is right in front of the bus and the area all around the rear wheels and the back of the bus.
Use the handrail to enter and exit the bus.
Stay away from the bus until the driver gives his/her signal that it's okay to approach.
Be aware of the street traffic around you. Drivers are required to follow certain rules of the road concerning school buses, however, not all do. Protect yourself and watch out!
Walking and Biking to School
Even if you don't ride in a motor vehicle, you still have to protect yourself. Because of minimal supervision, young pedestrians face a wide variety of decision making situations and dangers while walking to and from school. Here are a few basic safety tips to follow:
Mind all traffic signals and/or the crossing guard -- never cross the street against a light, even if you don't see any traffic coming.
Walk your bike through intersections.
Walk with a buddy.
Wear reflective material, it makes you more visible to street traffic.
-National Traffic Safety Administration
Motorist Safety
Motorists also have a responsibility to know the meaning of the flashing light system on school buses. The yellow and red lights are designed to help ensure the safety of both motorists and children.
Yellow flashing lights indicate the bus is preparing to stop. Motorists should slow down and prepare to stop.
Red flashing lights and the extended stop arm on a school bus indicate the bus has stopped for children to get on or off the bus. Motorists approaching from either direction are required to stop at least 10 feet from a stopped school bus until the bus resumes motion. If a school bus is stopped on a road divided into four or more lanes, only traffic driving in the same direction as the bus must stop.
Parents have an additional responsibility to school bus safety. Children should be taught about school bus safety before they step into a school bus for the first time, and this responsibility lies with the parent. It is important for children to learn how to stay safe both in and outside the school bus. Statistics show students are actually at a greater risk standing outside a bus than riding in a bus.
Students should arrive at the bus stop at least five minutes before the bus is scheduled to pick them up. While waiting for the bus, they should stand at least three giant steps away from the curb, and line up away from the street. Before stepping into the bus, children should wait until the bus stops, the door opens, and the driver gives permission.
Parents should encourage their children to sit quietly in their seat and
follow the driver’s instructions on school bus safety. When exiting the bus,
care should be taken to ensure that clothing with drawstrings and book bags with
straps do not get caught in the handrails or doors. Additionally, students
should never go back for anything left on the bus, and never bend down near or
under the bus to pick up something that has fallen.
Passengers should always walk in front of the bus when they must cross a street
to get on or off the bus. Children should walk far enough in front of the bus --
about 10 feet ahead of it -- to enable them to see the bus driver. Children
should never walk behind a school bus, and should stay at least three feet away
from the side of a bus.
Colonel Paul McClellan
Superintendent
Ohio State Highway Patrol
Practices for fall sports will begin this month. Most forms require that a physical has been done within the last year. If your child meets this qualification, forms can be dropped off at the office for completion. When dropping off forms, please complete as much information as possible and allow 3-5 days for pickup. Please call the office if you are unsure if your child needs to schedule an appointment.
A child who refuses or misses a lot of school with vague physical symptoms is often considered to have a school phobia. These symptoms are usually the type that people get when they are upset or worried. These include stomachaches, headaches, nausea, vomiting, diarrhea, tiredness or dizziness. These symptoms occur in the morning and worsen by school departure time. Your child is otherwise healthy and vigorous. School phobia is very common and affects 5% of all elementary school age children. The symptoms often begin in September or October. These children are usually afraid of leaving home in general. Ways to help your child overcome their fears:
Insist on an immediate return to school. The best therapy is to be in school everyday.
Be extra firm on school days. Do not ask your child how he feels because it will encourage him to complain.
Work closely with your child's physician to determine the cause of the illness. If the symptoms are anxiety related they should return to school after being seen by the doctor.
Talk to the staff at school.
Talk with your child about their fears and worries.
Encourage play with classmates. Usually school-phobic children tend to prefer to be with their parents, play indoors or watch television. Encourage your child to join clubs or athletic activities. Have them play at other friend's homes.
Seek additional help if your child continues to have fears or separation problems, or seems withdrawn or depressed.
Bullying is when one child picks on another child repeatedly. Usually children being bullied are either weaker or shyer and generally feel helpless. Bullying can be physical, verbal, or social. It can happen at school, on the playground, on the school bus, in the neighborhood, or over the Internet.
When your child is bullied:
Help your child learn how to respond by teaching your child how to:
1. Look the bully in the eye.
2. Stand tall and stay calm in a difficult situation.
3. Walk away.
Teach your child how to say in a firm voice.
1. "I don't like what you're doing."
2. Please do NOT talk to me like that.
3. " Why would you say that?"
Teach your child when and how to ask for help.
Encourage your child to make friends with other children.
Support activities that interest your child.
Alert school officials to the problem and work with them on solutions.
Make sure an adult who knows about the bullying can watch out for your child's safety and well-being when you're not there.
When your child is the bully
Be sure your child knows that bullying is never OK.
Set firm and consistent limits on your child's aggressive behavior.
Be a positive role model. Show children they can get what they want without teasing, threatening, or hurting.
Use effective, non-physical discipline, such as loss of privileges.
Develop practical solutions with the school principal, teachers, counselors and parents of the children you bullied.
When your child is a bystander
Tell your child not to cheer on or even quietly watch bullying.
Encourage your child to tell a trusted adult about the bullying.
Help your child support other children who may be bullied. Encourage your child to include these children in his or her group of friends.
Encourage your child to join with others in telling bullies to stop.
-2005- American Academy of Pediatrics
Choose a backpack with wide, padded shoulder straps and a padded back.
Pack light. Organize the backpack to use all of its compartments. Pack heaviest items closest to the back. The backpack should never weigh more than 15 percent of the student's body weight. If your child has to carry more he should hold it or use a pack with wheels.
Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles. Wearing a backpack over one shoulder may also increase curvature of the spine.
The bottom of the pack should hang no more than 4 inches below the waistline and rest in the curve of the back.
Consider a rolling backpack. This type of backpack may be a good choice for students who must tote a heavy backpack. Remember that rolling backpacks must still be carried up stairs, and may be difficult to roll in the snow.
Whatever
sport your child may be involved in, it is important to prepare properly to
avoid injury. This preparation includes proper nutrition, hydration,
conditioning and equipment. Hydration
- Parents and coaches need to be sure children drink plenty of fluids before
and during any exercise. A good starting point is about 4 to 6 ounces
of fluid every 15 minutes for a 90 pound child. Athletes should weigh
the same before and after exercise. Cold water is fine for
re-hydration, but flavored sports drinks may stimulate your child to drink
more. Fruit juices and soda are not good choices, as they contain too
much sugar. Conditioning
- warming up exercises and cooling down exercises are important to prepare the
body for more strenuous exercise and to prevent injury. Equipment
- Proper fitting equipment according to the sport played should
always be worn. Special attention should be paid to appropriate head
gear to reduce the risk of serious head injury. Too
much of a good thing can be harmful, especially when it
comes to children playing sports. As more children
and adolescents participate in organized and
recreational sports, pediatricians are seeing an
increasing number of children and adolescents with
overuse injuries caused by too much training and not
enough rest. The
AAP defines an overuse injury as a micro traumatic
injury to a bone, muscle or tendon that has been
subjected to repetitive stress without sufficient time
to heal or undergo the natural healing process.
The risks of overuse are more serious in the
pediatric/adolescent athlete because the growing bones
of the young athlete cannot handle as much stress and
the mature bones of adults. It
is recommended that young athletes limit training in one
sport to no more than five days a week, with at least
one day off from any organized physical activity.
In addition, athletes should take time off from one
sport for two to three months each year. Taking a
break from a sport allows injuries to heal and the
opportunity to work on strength training and
conditioning to reduce the risk of future
injuries. It also helps kids take a psychological
break, which is necessary to avoid burnout, or over
training syndrome. Symptoms
of burnout include chronic muscle or joint pain,
personality changes, elevated resting heart rate,
decreased sport performance, fatigue, lack of enthusiasm
about practice or competition, or difficulty completing
ordinary activities. Youth athletes need to be
educated about proper nutrition and fluids, and how to
avoid hypothermia, hyperthermia, over training, overuse
injuries and burnout. Additional recommendations
include: Weekly
training time, number of repetitions, or total
distance should not increase by more than 10%
weekly. Focus
of sports should be on fun, skill acquisition,
safety and sportsmanship. Join
only one team per season. Be
aware of risks associated with weekend tournaments
(soccer, baseball, tennis), such as heat related
illness, nutritional deficiencies, overuse injuries
and burnout. Multi-sport
athletes who use the same body parts for different
sports especially need to take a break between
seasons to avoid overuse injuries. Getting
caught up in making the professional leagues or
Olympics is unrealistic. Children and
adolescents often train year round on multiple teams
of one sport with the hope of earning a college
scholarship in that sport or becoming a professional
athlete, but less than one percent of high school
athletes make it to the professional level. Lifelong
fitness and enjoyment of physical activity should be the
overall goal of participating in athletics. ~American
Academy of Pediatrics, June, 2007 All
sports have a risk of injury. In general, the more
contact in a sport, the greater the risk of injury. Most
injuries occur to ligaments, tendons and muscles.
Only about 5% of sports injuries involve broken
bones. However, the areas where bones grow in
children are at more risk of injury during the rapid
phases of growth. In a growing child, point
tenderness over a bone, should be evaluated further by a
medical provider even if minimal swelling or limitation
in motion is appreciated. Most
frequent sports injuries are sprains (injuries to
ligaments) and strains (injuries to muscles), caused
when an abnormal stress is placed on tendons, joints,
muscles and bones. As always, contact your
pediatrician if you have questions or concerns. To
reduce injury: Wear
the right gear. Players should wear
appropriate protective equipment such as pads,
(neck, shoulder, elbow, chest, knee, shin), helmets,
mouthpieces, face guards, protective cups, and/or
eyewear. Increase
flexibility. Stretching exercises before and
after games can increase flexibility. Strengthen
muscles. Conditioning exercises during
practice and before games strengthens muscles used
in play. Use
the proper technique. This should be
reinforced during the playing season. Take
breaks. Rest periods during practice and games
can reduce injuries and prevent heat illness. Play
safe. Strict rules against headfirst sliding
(baseball and softball), spearing (football), and
body checking (ice hockey) should be enforced. Stop
the activity if there is pain. Avoid
heat injury by drinking plenty of fluids before,
during and after exercise or play; decrease or stop
practices or competition during high heat/humidity
periods; wear light clothing. Emotional
stress is also another risk associated with
sports. The pressure to win can cause significant
emotional stress for a child. Sadly, many coaches
and parents consider winning the most important aspect
of sports. Young athletes should be judged on
effort, sportsmanship and hard work. They should
be rewarded for trying hard and for improving their
skills rather than punished or criticized for losing a
game or competition. Between
1990 and 2002, nearly 209,000, 5 to 18 year olds, most
of them girls, were treated in emergency rooms for
cheerleading injuries. To help keep young
cheerleaders injury free: ~Make
sure coaches are certified. Coaches should
have completed the Cheerleading Coaches and
Administrators safety course. ~Don't
let kids try it at home. Explain to them the
cheerleaders they see on TV have had extensive training. ~Check
out the practice location. Cheerleaders should
practice on materials that can absorb the impact of a
fall. Grass isn't an adequate buffer. ~Scope
out the spotters. If your child is doing
aerial moves, ask whether the spotters have been trained
to anticipate falls and know how to catch someone.
Stunting in high school is prohibited.
Safety for all ages
Did you know that hundreds of children younger than
1 year die every year in the United States because of injuries — most of which
could be prevented? Often, injuries happen because parents are not aware of what
their children can do. Children learn fast, and before you know it, your
child will be wiggling off a bed or reaching for your cup
of hot coffee. BE PREPARED. While siblings and pets generally mean
well, they should never be left alone with a baby. Car Injuries
Make certain that your baby's car seat is
installed correctly. Read and follow the instructions that come with the car
safety seat and the sections in the owners' manual of your car on using car
safety seats correctly. Use the car safety seat EVERY time your child is in a
car. NEVER put an infant in the front seat of a car
with a passenger air bag. Your baby may be able to crawl as early as 6
months. Use gates on stairways and close doors
to keep your baby out of rooms where he or she might get hurt.
Install operable window guards
on all windows above the first floor. If your baby gets
burned, immediately put the burned area in cold water. Keep the burned area in
cold water for a few minutes to cool it off. Then cover the burn loosely with a
dry bandage or clean cloth and call your doctor.
To protect your baby from house fires, be sure
you have a working smoke alarm on every level of your home, especially in
furnance and sleeping areas. Test the alarms every month. It is best to use
smoke alarms that use long-life batteries, but if you do not, change the
batteries at least once a year. To prevent possible suffocation and reduce the
risk of sudden infant death syndrome (SIDS), your baby
should always sleep on his or her back. NEVER put your baby on a water bed, bean
bag, or anything that is soft enough to cover the face and block air to the nose
and mouth. Plastic wrappers and
bags form a tight seal if placed over the mouth and nose and may
suffocate your child. Keep them away from your baby.
Often, accidents happen because parents are not
aware of what their children can do. Your child is a fast learner and will
suddenly be able to roll over, crawl, sit and stand. Your child may
climb before walking or walk with support months before you expect. Your
child will be able to grasp at or reach almost anything.
FALLS
Because of your child's new abilities, he or she
will fall often. Protect your child from injury.
Do not use a baby walker. Your child
will tip it over, fall out of it, fall down the stairs in it, or get to places
where hot foods or heavy objects can be pulled down on himself.
BURNS
At 6 to 12 months children grab at everything.
NEVER leave cups of hot coffee on tables or counter edges. And NEVER
carry hot liquids or food near your child or while holding your child. He
or she will get burned. Also, if your child is left to crawl or walk
around stoves, wall or floor heaters, or other hot appliances, he or she is
likely to get burned. A safe place for your child while you are cooking,
eating or unable to provide your full attention is the playpen, high chair, or
crib.
If your child does get burned, put cold water on
the burned area immediately. Then cover the burn loosely with a bandage or
clean cloth. Call your doctor for all burns.
Test the batteries in your smoke alarm every month
to be sure they work. Change the batteries yearly.
DROWNING
POISONING AND CHOKING
Your child will explore the world by putting anything and everything into his or
her mouth. NEVER leave small objects or balloons in your child's reach,
even for a moment. Don't feed your child hard pieces of food such as hot
dogs, raw carrots, or grapes. Cut all food into thin slices to prevent
choking.
Be prepared if your child starts to choke. Learn how to save the life
of a choking child. Ask your doctor to recommend the steps you need to
take.
Children will put almost anything into their mouths, even if it doesn't taste
good. Almost anything in your house can be poisonous to your
child. Be sure to keep household products such as cleaners, chemicals, and
medicines up, up, and away, completely out of sight and reach. Never store
lye drain cleaners in you home. Use safety latches on drawers and
cupboards. Remember, your child doesn't understand or remember "No" while
exploring.
If your child does eat something that could be poisonous, call the Poison
Control Center immediately.
CAR SAFETY
Remember, the biggest threat to your child's health and life is an accident.
Did you know that injuries are the leading cause of
death of children younger than 4 years in the United States? Most of these
injuries can be prevented. Often, injuries happen because
parents are not aware of what their children can do. At this age your child can
walk, run, climb, jump, and explore
everything. Because of all the new things he or she can do, this stage is a very
dangerous time in your child's life. It is your responsibility to protect your
child from injury. Your child cannot understand danger or remember "no" while
exploring. Your child is now able to get into
and on top of everything. Be sure to keep all household products and medicines
completely out of sight and reach. Never store lye drain cleaners in your home.
Keep all products in their original containers. If your child does put something
poisonous into his or her mouth, call the Poison Help Line immediately. Attach
the Poison Help Line number (1-800-222-1222) to your phone. Do not make your
child vomit. If your child has a serious fall
or does not act normally after a fall, call your doctor. Children who are learning to walk
will grab anything to steady themselves, including hot oven doors, wall heaters,
or outdoor grills. Keep your child out of rooms where there are hot objects that
may be touched or put a barrier around them. Your child will reach for
your hot food or cup of coffee, so don't leave them within your child's reach.
NEVER carry your child and hot liquids at the same time. You can't handle
both. If your child does get burned,
immediately put cold water on the burned area. Keep the burned area in cold
water for a few minutes to cool it off. Then cover the burn loosely with a dry
bandage or clean cloth. Call your doctor for all burns. To protect your child
from hot tap water scalds, the hottest temperature at the faucet should be no
more than120°F. In many cases you can adjust your water heater. Make sure you have a working
smoke alarm on every level of your home, especially in furnace and sleeping
areas. Test the alarms every month. It is best to use smoke alarms that use
long-life batteries, but if you do not, change the batteries at least once a
year. If you have a swimming pool, fence
it on all 4 sides with a fence at least 4 feet high, and be sure the gates are
self-latching. Most children drown when they wander out of the house and fall
into a pool that is not fenced off from the house. You cannot watch your child
every minute while he or she is in the house. It only takes a moment for your
child to get out of your house and fall into your pool. Always walk behind your car
to be sure your child is not there before you back out of your driveway. You may
not see your child behind your car in the rearview mirror.
Often, injuries happen because
parents are not aware of what their children can do. Children learn fast,
and before you know it your child will be jumping, running,
riding a tricycle, and using tools. Your child is at special
risk for injuries from falls, drowning, poisons, burns, and car crashes. Your
child doesn't understand dangers or remember "no" while playing and exploring. Your child can fall off play
equipment, out of windows, down stairs, off a bike or tricycle, and off anything
that can be climbed on. Be sure the surface under play equipment is soft
enough to absorb a fall. Use safety tested mats or loose-fill materials
(shredded rubber, sand, woodchips, or bark) maintained to a depth of at least 9
inches underneath play equipment. Install the protective surface at least 6 feet
(more for swings and slides) in all directions from the equipment. Lock the doors to any dangerous
areas. Use gates on stairways and install operable window guards above
the first floor. Fence in the play yard. If your child has a serious fall or
does not act normally after a fall, call your doctor. Remember that kitchen appliances
and other hot surfaces such as irons, ovens, wall heaters, and outdoor grills
can burn your child long after you have finished using them. If your child
does get burned, immediately put cold water on the burned area. Keep the burned
area in cold water for a few minutes to cool it off. Then cover the burn loosely
with a dry bandage or clean cloth. Call your doctor for all burns. To protect
your child from tap water scalds, the hottest temperature a the faucet should be
no more than 120°F. In many cases you can adjust your hot water heater.
Make sure you have a working smoke
alarm on every level of your home, especially in furnace and sleeping areas.
Test the alarms every month. It is best to use smoke alarms with long-life
batteries, but if you do not, change the batteries at least once a year.
If your child does put something
poisonous in his or her mouth, call the Poison Help Line immediately. Attach the
Poison Help Line number (1-800-222-1222) to your phone. Do not make your child
vomit. Do not allow your child to play or
ride a tricycle in the street. Your child should play in a fenced yard or
playground. Driveways are also dangerous. Walk behind your car before you
back out of your driveway to be sure your child is not behind your car. You may
not see your child through the rear view mirror.
At age 5, your child is learning to do many
things that can cause serious injury, such as riding a bicycle or crossing a
street. Although children learn fast, they still cannot judge what is
safe. You must protect your child. You can prevent common major injuries by
taking a few simple steps. Never let your child ride a bike in the
street. Your child is too young to ride in the street safely.
Be sure that the bike your child rides is
the right size. Your child must be able to place the balls of both feet on
the ground when sitting on the seat with hands on the handlebars. Your
child's first bicycle should have coaster brakes. Five-year-olds are often
unable to use hand brakes correctly. Water Safety Do not let your child play around any water
(lake, stream, pool, or ocean) unless an adult is watching. NEVER let your
child swim in canals or any fast-moving water. Teach your child to never dive into water
unless an adult has checked the depth of the water. And when on any boat,
be sure your child is wearing a life jacket. Teach your child not to play with matches or
lighters, and keep matches and lighters out of your child's reach. Also, do
not smoke in your home. Most fires are caused by a lit cigarette that has
not been put out completely.
Firearm Hazards Would you be able to help your child in
case of an injury? Put emergency numbers by or on your phone today. Learn
first aid and CPR. Be prepared...for your child's sake! It takes time to form a safety habit.
Remind each other what it says. Make safety a big part of your lives.
Did you know that injuries are the greatest
threat to the life and health of your child? Injuries are the leading cause
of death of school-aged children. Yet you can prevent most major
injuries! At age 6, your child will become more
independent. He or she will be able to do more things that are dangerous.
Your child will try to prove that he or she is grown up. But children still
aren't good at judging sound, distance, or the speed of a moving car at this
age. Your child can learn a few simple things to do for protection, but
you must still be in charge of his or her safety. Do not smoke in your home. Most home fires
are caused by a lit cigarette that has not been put out completely.
Install smoke alarms on every level in your
house, especially in furnace and sleeping areas, and test the alarm every
month. It is best to use smoke alarms that use long-life batteries, but if
you do not, change the batteries once a year. Bike Safety And Remember Car Safety It takes time to form a
safety habit. Remind each other what it says. Make safety a big part of your
lives.
Did you know that injuries are the greatest
threat to the life and health of your child? Injuries are the cause of death
of school-aged children. Yet you can prevent most injuries!
At age 8, children are now taking off on
their own. They look to friends for approval. They try to do daring things.
They may not want to obey grown-up rules. But your child can learn safety
rules with your help and reminders. Your child now goes out more without you
and could drown, be hurt on a bike, or be hit by a car. And your child still
can be hurt or killed while riding in a car if he is not buckled by a seat
belt. Water Safety Car Safety Firearm Hazards Would you be able to hlep your child in
case of an injury? Put emergency numbers by or on your phone today. Learn
first aid and CPR. Be prepared....for your child's sake! It takes time to form a safety habit.
Remind each other what it says. Make safety a big part of your lives.
Car crashes are a great threat to your child's life and health. Most
injuries and deaths from car crashes can be prevented by the use of car
safety seats. Your child, besides being much safer in a car safety seat, will
behave better, so you can pay attention to your driving. Make your newborn's
first ride home from the hospital a safe one — in a car safety seat. Your infant
should ride in the back seat in a rear-facing car seat.
Falls
Babies wiggle and move and push against things with their
feet soon after they are born. Even these very first movements can result in a
fall. As your baby grows and is able to roll over, he or she may fall off of
things unless protected. Do not leave your baby alone
on changing tables, beds, sofas, or chairs. Put
your baby in a safe place such as a crib or playpen when you cannot
hold him. Many children can wiggle out of infant seats. Beware of leaving
them on a counter or in a seat.
If your child has a
serious fall or does not act normally after a fall, call your doctor.
Burns
At 3 to 5 months, babies will wave their fists and grab at things.
NEVER carry your baby and hot liquids, such as coffee, or
foods at the same time. Your baby can get burned. You can't handle
both! To protect your child from tap water scalds, the hottest temperature at
the faucet should be no more than 120°F. In many cases you can adjust
your hot water heater.
Choking and Suffocation
Babies explore their environment by putting anything and everything into their
mouths. NEVER leave small objects in your baby's reach,
even for a moment. NEVER feed your baby hard pieces of food such as
chunks of raw carrots, apples, hot dogs, grapes, peanuts, and popcorn. Cut all
the foods you feed your baby into thin pieces to prevent choking.
Be prepared if your baby starts to choke. Ask your doctor
to recommend the steps you need to know. Learn how to save the life of a choking
child.
Firearm Hazards
Children in homes where guns are present are in
more danger of being shot by themselves, their friends, or family members
than of being injured by an intruder. It is best to keep all guns out of the
home. Handguns are especially dangerous. If you choose to keep a gun,
keep it unloaded and in a locked place, with the ammunition locked
separately. Ask if the homes where your child visits or is cared for have
guns and how they are stored.
Poisonings
Children continue to explore their world by
putting everything in their mouths, even if it doesn't taste good. Your
child can open doors and drawers, take things apart, and open
bottles easily now, so you must use safety caps on all medicines and
toxic household products. Keep the safety caps on at all times or
find safer substitutes to use. Contact your Poison Center for more
information.
Falls
To prevent serious falls, lock the doors to any
dangerous area. Use gates on stairways and install operable window
guards above the first floor. Remove sharp-edged furniture from
the room your child plays and sleeps in. At this age your child will walk
well and start to climb, jump, and run as well. A chair left next to a
kitchen counter, table, or window allows your child to climb to dangerously
high places. Remember, your child does not understand what is dangerous.
Burns
The kitchen is a dangerous place for your child
during meal preparation. Hot liquids, grease, and hot foods spilled on your
child will cause serious burns. A safer place for your child while
you are cooking, eating, or unable to give him your full attention is the
playpen, crib, stationary activity center, or buckled into a high chair.
It's best to keep your child out of the kitchen while cooking.
Drowning
At this age your child loves to play in water.
NEVER leave your child alone in or near a bathtub, pail of water, wading
or swimming pool, or any other water, even for a moment. Empty all
buckets after each use. Keep the bathroom doors closed. Your child can drown
in less than 2 inches of water. Knowing how to swim does NOT mean your child
is safe near or in water. Stay within an arm's length of your child around
water.
And Remember Car Safety
Car crashes are a great danger to your child's life and health.
The crushing forces to your child's brain and body in a crash or sudden
stop, even at low speeds, can cause severe injuries or death. To prevent
these injuries USE a car safety seat EVERY TIME your child rides in the
car. Your child should ride rear facing until she is at least a year old AND
weighs at least 20 pounds. It is even better for her to ride rear-facing to
the highest weight and /or height her car safety seat allows. Be sure that
the safety seat is installed correctly. Read and follow the instructions
that come with the car safety seat and the instructions for using car safety
seats in the owners' manual of your car. The safest place for all infants
and children to ride is in the back seat.
Do not leave your child alone in the car. Keep vehicles and their trunks
locked. There are dangers involved with leaving children in a car; death
from excess heat may occur very quickly in warm weather in a closed car.
Remember, the biggest threat to your child's life and health is an injury.
Did you know that injuries are the leading
cause of death of children younger than 4 years in the United States? Most
of these injuries can be prevented.
Falls
Because your child's abilities are so great
now, he or she will find an endless variety of dangerous situations at home
and in the neighborhood.
Firearm Hazards
Children in homes where guns are present are in
more danger of being shot by themselves, their friends, or family members
than of being injured by an intruder. It is best to keep all guns out of the
home. If you choose to keep a gun, keep it unloaded and in a locked place,
with ammunition locked separately. Handguns are especially dangerous.
Ask if the homes where your child visits or is cared for have guns and how
they are stored.
Burns
The kitchen can be a dangerous place for your
child, especially when you are cooking. If your child is
underfoot, hot liquids, grease, and hot foods can spill on him or her and
cause serious burns. Find something safe for your child to do while you are
cooking.
Poisonings
Your child will be able to open any
drawer and climb anywhere curiosity leads. Your child may swallow
anything he or she finds. Use only household products and medicines that
are absolutely necessary and keep them safely capped and out of sight and
reach. Keep all products in their original containers.
And Remember Car Safety
Car crashes are the greatest danger to your child's life and
health. The crushing forces to your child's brain and body in a collision or
sudden stop, even at low speeds, can cause injuries or death. To prevent
these injuries, correctly USE a car safety seat EVERY TIME your child is
in the car. If your child weighs more than the highest weight allowed by the
seat or if his or her ears come to the top of the car safety seat, use a
belt positioning booster seat.
The safest place for all children to ride is in
the back seat. In an emergency, if a child must ride in the front seat, move
the vehicle seat back as far as it can go, away from the air bag.
Remember, the biggest threat to your child's
life and health is an injury.
Did you know that injuries are the greatest
threat to the life and health of your child? Injuries are the leading cause
of death of school-age children. Yet you can prevent most major injuries!
Your child should always wear a helmet when riding a bike. Buy the helmet
when you buy the bike! Make sure your child wears a helmet every time he
or she rides. A helmet helps prevent head injuries and can save your
child's life.
Your child is in danger of being hit by a car if he or she darts out into
the street while playing. Take your child to the playground or park to play.
Show your child the curb and teach him or her to always stop at the curb
and never cross the street without a grown-up.
Now is the time to teach your child to swim. Even if your child knows how to
swim, never let him or her swim alone.
Household fires are a threat to your child's life, as well as your own.
Install smoke alarms in your house, and test the batteries every
month to make sure they work. Change the batteries once a year.
Car crashes are the greatest danger to your child's life and
health. The crushing forces to your child's brain and body in a collision or
sudden stop, even at low speeds, can cause injuries or death. To prevent
these injuries, correctly USE a car safety seat or booster seat and seat
belt EVERY TIME your child is in the car. Your child should use a car
safety seat or a booster seat until the lap belt can be worn low and flat on
the hips and the shoulder belt can be worn across the shoulder rather than
the face or neck (usually at about 80 pounds and 4 feet 9 inches tall).
The safest place for all children to ride is the back seat. Set a good
example. Make sure you and other adults buckle up, too!
Children in homes where guns are present are in more danger of being
shot by themselves, their friends, or family members than of being injured
by an intruder. Handguns are especially dangerous. It is best to keep
all guns out of the home. If you choose to keep a gun, it should be kept
unloaded and in a locked place separate from the ammunition. Ask if the
homes where your child visits or is cared for have guns and how they are
stored.
Dear Parent: Your child is old enough to start learning how to prevent
injuries.
Make an escape plan in case of fire in your home. Your fire
department can tell you how. Teach your child what to do when the smoke
alarm rings. Practice what you and your child would do if you had a fire.
Children in homes where guns are present are in more danger of being shot by
themselves, their friends, or family members than of being injured by an
intruder. It is best to keep all guns out of the home. Handguns are
especially dangerous. If you choose to keep a gun, keep it unloaded and
in a locked place, with ammunition locked separately. Ask if the homes where
your child visits or is cared for have guns and how they are stored.
Protect your child from bad head injuries or even death. Make sure
your child wears a properly fitted, approved helmet every time she rides a
bike. Never let your child ride in the street. Your child is too young
to ride in the street safely!
Never let your child play near the street. Your child may dart out into
traffic without thinking. The park or playground is the best place to play.
Begin to teach your child safe street habits. Teach your child to stop at
the curb, then look to the left, to the right, and back to the left
again. Teach your child never to cross the street without a grown-up.
Your child must now use a booster seat in the car. Always check to be
sure that he or she is correctly restrained in the booster seat before you
start the car. Your child should use a booster seat until the lap belt can
be worn low and flat on the hips and shoulder belt can be worn across the
shoulder rather than the face or neck (usually at about 4 feet 9 inches tall
and between 8 and 12 years old). The safest place for all children, even
through school age, is in the back seat of the car. Set a good example.
Make sure you and other adults buckle up, too!
Dear Parent: Your child
is old enough to learn how to prevent injuries.
Ask your doctor which sports are right for your child. Be sure your child
wears all the protective equipment made for the sport, such as shin
pads, mouth guards, wrist guards, eye protection, or helmets. Your child's
coach also should be able to help you select protective equipment.
At this age, your child is not safe alone in water, even if he or she knows
how to swim. Do not let your child play around any water (lake, stream,
pool, or ocean) unless an adult is watching. Never let your child swim in
canals or any fast-moving water. Teach your child to always enter the
water feet first.
Make sure your child always wears a helmet while riding a bike. Now
is the time to teach your child "Rules of the Road." Be sure he or she knows
the rules and can use them. Watch your child ride. See if he or she is in
control of the bike. See if your child uses good judgment. Your 8-year-old
is not old enough to ride at dusk or after dark. Make sure your child brings
the bike in when the sun starts to set.
NEVER start the car until you've checked to be sure that your child is
properly restrained in a booster seat. Your child should use a booster
seat until the lap belt can be worn low and flat on the hips and the
shoulder belt can be worn across the shoulder rather than the face or neck
(usually at about 80 pounds and about 4 feet 9 inches tall). Be sure that
you and all others in the car are buckled up, too. Install shoulder belts in
the back seat of your car if they are not already there. Serious injuries
can occur with lap belts alone. The
safest place for all children to ride is in the back seat.
It is best to keep all guns out of your home. If you choose to keep a gun,
store it unloaded and in a locked place, separate from ammunition. Ask if
the homes where your child visits or is cared for have guns and how they are
stored. Your child is at greater risk of being shot by himself, his
friends, or a family member than of being injured by an intruder.
The death rate from Sudden Infant Death Syndrome has dropped by about 40% in the U.S. since 1992 when the American Academy of Pediatrics (AAP) began urging parents to put babies to sleep on their back or side instead of their tummy. Since nearly 3,000 babies still die every year from SIDS, the AAP recently updated its guidelines for preventing SIDS:
Always lay your baby on his back. Don't place your baby on his side to sleep. Its too unstable and raises the odds that he will roll onto his stomach.
A
Kaiser Permanente study showed that using a fan in a baby's room reduced the
risk of sudden infant death syndrome (SIDS) by 72%. If the room was warmer
than 69 degrees F, the fan cut the risk even further, to 94%. Experts
still don't know what causes SIDS, but one theory is that babies breathe in
exhaled carbon dioxide that gets trapped between their airways and bedding.
By increasing ventilation, a fan may reduce trapped carbon dioxide. (Dec
2008)
Baby sleeps on his or her back.
Baby sleeps alone.
Baby sleeps in a crib or on a firm mattress.
Baby sleeps in an area that is free of toys, pillows, loose blankets, bumper pads or other soft items.
Baby does NOT sleep on the couch, sofa or other soft furniture.
Baby sleeps in a smoke free, drug free, alcohol free environment.
Remember, babies need tummy time while awake for proper development.
Ways to help your infant sleep through the night
No long naps in the evening.
Play with the baby in the evening, go for a walk.
Create a routine...play, bath, eat, then sleep.
Music
Try not to allow the baby to get overtired.
Do not allow middle of the night feeding to be playtime. No lights (use night light). Little or no talking. Decrease stimulation.
Do not rock until falls asleep, needs to be able to comfort self and get to sleep on own.
Six Sleep/Awake States for Babies DEEP SLEEP -
Baby is very still and relaxed, rhythmic breathing, occasionally jerks and
makes sucking movements, rarely awakens. If you arouse the baby they
will only wake for a moment and then resume a deep sleep state. No eye
movement. When startled, no change in sleep state. LIGHT SLEEP
- Most common in newborns, eyes are closed, but they move behind their lids.
The baby moves and makes momentary crying sounds, sucks, grimaces or smiles.
They breather irregularly. The baby responds to noise and efforts to
arouse him. Startle causes change in state. May go to drowsy
state or fall back to a sleep. DROWSY -
Appears sleepy, activity level varies and may startle occasionally.
Eyes lose focus or appeared cross-eyed. Breathes irregularly and
reacts to sensory stimuli in a drowsy way. If you want the baby to
return to sleep, avoid stimulation. If you want to wake him up, talk
to him, pick him up and massage him or give him something to suck. QUIET ALERT
- It is pleasing and rewarding for parents because baby lies still and looks
calmly with bright wide eyes. Breathes with regularity and focuses
attentively on what he sees and hears. By providing something for him
to look at, listen to or suck on, you will encourage him to stay awake. ACTIVE ALERT
- The baby is readily affected by hunger, fatigue, noises and too much
handling. They cannot lie still and may be fussy. Eyes are open
and do not appear as bright and attentive as in the quiet alert state.
Breathes irregularly and makes faces. It is time to feed or comfort.
If you act immediately, you may bring him to a calmer state before he enters
the crying state. CRYING STATE
- Difficult state for every parent. Over stimulated, tired, ill,
hungry, frustrated, wet, cold, too warm, or lonely. Baby moves body
actively, opens and closes eyes, makes unhappy faces and breathes
irregularly. Sometimes crying is a release, a self-comforting
mechanism that enables him to enter another state. At other times he
needs you to feed or comfort him.
Parents role in preventing substance abuse
Teens are prone to experiment with alcohol and drugs. The best ways for parents to prevent this substance abuse is to keep the lines of communication open and set a good example. About 4,000 young people under the age of 21 will die annually because of alcohol misuse alone. Parents should look to themselves to provide a good example. Kids watch how parents handle stress. If you need "a drink" or a pill to sleep or relax your teen may choose those substances when they are feeling stressed. Parents should make it clear the family does not approve of drinking or drugs. Other things parents can do:
- Help your child build confidence and strong values and learn to cope with peer pressure.
- Encourage healthy, creative activities.
- Get to know your child's friends and their parents.
- Keep track of your child's whereabouts and stay in touch by phone.
- Check out secretive behavior.
- Watch for signs of a drug or alcohol problem, like declining grades, missing medication, drug paraphernalia, and new friends and clothes that seem to promote the drug culture.
Finally, parents should have a "rescue plan" in place for their kids. If they have had too much to drink or are with someone who is going to drive and has been drinking or using drugs, let your children know they can call you and you will come pick them up with no questions asked.
~American Academy of Pediatrics April 2006
Just about everyone knows that the legal drinking age throughout the United States is 21. But according to the National Center on Addiction and Substance Abuse, almost 80% of high school students have tried alcohol.
Experimentation with alcohol during the teen years is common. Some reasons that teens use alcohol and other drugs are:
From a very young age, kids see advertising messages showing beautiful people enjoying life — and alcohol. And because many parents and other adults use alcohol socially — having beer or wine with dinner, for example — alcohol seems harmless to many teens.
If all your friends drink and you don't want to, it can be hard to say "no, thanks." No one wants to risk feeling rejected or left out. Different strategies for turning down alcohol work for different people. Some people find it helps to say no without giving an explanation, others think offering their reasons works better ("I'm not into drinking," "I have a game tomorrow," or "my uncle died from drinking," for example).
If saying no to alcohol makes you feel uncomfortable in front of people you know, blame your parents or another adult for your refusal. Saying, "My parents are coming to pick me up soon," "I already got in major trouble for drinking once, I can't do it again," or "my coach would kill me," can make saying no a bit easier for some.
If you're going to a party and you know there will be alcohol, plan your strategy in advance. You and a friend can develop a signal for when it's time to leave, for example. You can also make sure that you have plans to do something besides just hanging out in someone's basement drinking beer all night. Plan a trip to the movies, the mall, a concert, or a sports event. You might also organize your friends into a volleyball, bowling, or softball team — any activity that gets you moving.
Girls or guys who have strong self-esteem are less likely to become problem drinkers than people with low self-esteem.
When large amounts of alcohol are consumed in a short period of time, alcohol poisoning can result. Alcohol poisoning is exactly what it sounds like — the body has become poisoned by large amounts of alcohol. Violent vomiting is usually the first symptom of alcohol poisoning. Extreme sleepiness, unconsciousness, difficulty breathing, dangerously low blood sugar, seizures, and even death may result. It takes from 30-90 minutes after you stop drinking before you reach your highest level of intoxication. "Passing out" from alcohol intoxication could lead to death in two ways: you may fall into a deep sleep, vomit and choke on it because you are too intoxicated to wake up or you fall asleep and never wake up because the alcohol concentration in your brain is so high that your life functions are so depressed that they stop functioning and so do you.
Symptoms of an overdose reaction:
What to do when someone is intoxicated:
~kidshealth.org / Bellefaire JCB
STUDY REDEFINES BINGE DRINKING FOR BOYS AND GIRLS
The U.S. Surgeon General issued a call to action on underage drinking in 2007, with the goals of bringing more attention to the issue, increasing research, and improving prevention efforts. In response, the study “Estimated Blood Alcohol Concentrations for Child and Adolescent Drinking and Their Implications for Screening Instruments,” has re-examined the number of standard drinks that constitute binge drinking in tweens and teens. Binge drinking is defined as a pattern of drinking that results in a blood alcohol concentration (BAC) of .08 grams per deciliter of blood within two hours. However, children weigh less than adults and can therefore achieve a higher BAC than adults after consuming the same number of drinks. The study estimated that in a two-hour period, three or more drinks for 9- to 13-year-old children would theoretically result in a legally drunk BAC of .08. The same BAC level would be reached with four or more drinks for boys and three or more drinks for girls 14 or 15 years of age, and with five or more drinks for boys and three or more drinks for girls 16 or 17 years of age. This information is important because it suggests that fewer drinks can result in hazardous levels of alcohol impairment in teens, especially girls, a message that is even more important at this time of year when proms and graduation celebrations begin taking place.
~AAP (june09)
Hands down, teens' favorite mode of communication is the text message. Kids 13-17 text more than any other age group, according to a 2008 Nielsen study.
When kids and teens text, they're thinking about what to say, focusing on what their thumbs are doing, and reading constantly incoming messages — rather than paying attention to what they're doing or where they're going. And that significantly ups their risk of getting hurt and injuring others, possibly even seriously.
And it doesn't matter if kids can practically text with their eyes closed, as many profess they can! Even if it feels like second nature, their brain is still focused on trying to do two things at once — and one of them is bound to get less attention.
Texting while driving, in particular, can turn tragic. In 2007, a 17-year-old driver and four passengers were killed in New York when her SUV crashed, head on, into a tractor-trailer. Though police couldn't say for sure that it was the driver doing the texting or talking, her phone records showed constant activity of sending and receiving text messages and calls in the seconds and minutes right before the crash. The friends had just graduated from high school together less than a week earlier.
Another 17-year-old was suspected of texting while driving when he hit and killed a bicyclist.
Driving while texting (or DWT) is even against the law in some states (Minnesota, Washington, New Jersey, and now Louisiana). And many more are trying to put the same kind of regulations into action.
A growing number of states don't allow drivers to talk on their cell phones either. Although some laws apply to all drivers, other states' legislation are specifically devoted to young people, especially inexperienced drivers and those with learning permits.
Still, a summer 2007 survey, conducted by AAA and Seventeen magazine, found that nearly half of the more than 1,000 16- and 17-year-olds interviewed said that they text during driving. And a little more than half admitted to using a cell phone while behind the wheel.
Another survey that same summer by Students Against Destructive Decisions (SADD) showed that almost 40% of the nearly 1,000 guys and girls with licenses polled considered driving while texting to be "extremely" or "very" distracting.
Love it or hate it, texting is a major part of life for many people today, especially teens. They're often compelled to stay connected and in touch from sunup to sundown.
As attached to their communication technologies as they might be, you can help educate your kids about when it's appropriate and, especially, safe to use them. Because not only can it be dangerous for kids (or anyone) to partake in texting while in motion, texting at all times can be downright disruptive and distracting.
To help teens keep their texting in perspective:
Emphasize that there's a time and place for texting. When teens are in a texting "conversation" and feel compelled to read responses and answer right away that diverts their attention and prevents them from focusing.
Create and
enforce family rules about texting, as well as cell
phone use overall. Put your foot down and prohibit
talking on the phone or texting while:
o walking
o running (in public or on a treadmill)
o riding a bike (or a horse!)
o skateboarding
o inline skating
o walking in crowds, especially at night (they may
be at greater risk of theft or assault)
o driving any kind of vehicle (car, scooter, ATV,
motorcycle)
o operating any type of equipment or machinery (like
a lawnmower, the fries machine at work, or the gear
at the gym)
o in class, doing homework, or eating dinner with
the family
Tell them that if they need to text right away, to first pull off the road, stop jogging, etc., to do it and then resume the sport or activity. Even better, they should wait until they're done to text.
Encourage teens to keep both hands on the wheel when driving and skip distractions like eating, reaching for things, switching CDs, changing radio stations, fiddling with portable music players, whooping it up with lots of friends, and applying makeup, says SADD.
Find out about your state's young-driver laws (visit The Governors Highway Safety Association's website at www.statehighwaysafety.org), like whether text and cell phone restrictions exist and when teens are permitted on the road (many states have curfews for teen drivers).
Recommend ignoring calls or texts (or turning off their phone altogether) while they're involved in anything that requires their full attention, says ACEP.
Tell kids to keep their cell phones in easily accessible places like a specific pouch or pocket in their backpack or purse (so they won't have to stop what they're doing to search for it).
Encourage kids to pick up the phone and talk instead of using texting as their main source of communication. Messages can be misunderstood (just like email) Sometimes it's better to just have a real live conversation.
Be a good role model — don't text or talk on your cell when you should really be focusing your attention elsewhere (like on chauffeuring your kids around town). While you're at it, model other safe driver behaviors like following the speed limit and rules of the road, nixing road rage, and always wearing your seatbelt.
Bottom line: Teach your kids the importance of texting in moderation and to never put their thumbs into action when it places them or other people at risk.
~kidshealth.org, august 2008
Sexting is the teen trend
of sending sexual/nude images of oneself via the cell
phone. Some teens think this behavior is "fun and
games", but in reality it is illegal. Currently
teens could be charged with a felony and labeled as
sexual offenders. Two Ohio lawmakers want to make
sure teens are not labeled felons and sex offenders.
They are proposing legislation that would make sending,
receiving and viewing electronically transmitted nude
pictures of juveniles by juveniles a misdemeanor.
If the new law is passed, juveniles would more likely face probation or be placed in an educational program. A judge could still sentence them to a short stint in a local juvenile facility but they would not be labeled as a sex offender.
Sexting may be more prevalent than parents are aware based on the online survey conducted by the National Campaign.org.:
39% of teens have sent or posted sexually suggestive emails or text messages
20% of teens have sent or posted nude or semi-nude images of themselves
25% of teen girls and 33% of teen boys say they have nude or semi-nude images, originally meant for someone else, shared with them
22% of teens say that they are personally more forward and aggressive using sexually suggestive words and images when they text
40% of teen girls say "they sent the pictures as a joke"
51% of teen girls who sent sexually suggestive messages or pictures say they did it because "they felt pressure from a guy"
18% of teen boys cited pressure from their female counterparts
66% of teen girls and 60% of teen boys who have sent sexually suggestive content did it to be "fun or flirtatious"
~excerpt from The Cleveland Plain Dealer
A recent survey of about 2,000 teens ages 12 through 17, found that teens watching television shows with sexual content were twice as likely as their peers to be involved in a teen pregnancy in the following three years. Parents should be aware of the shows their teens are watching and watch with them. Watching with your teen can create opportunities to talk about sex, its emotional and physical consequences and the risks and responsibilities associated with it. Common Sense Media (commonsensemedia.org) is one website that monitors television shows content.
Almost all teenagers get acne at one time or another. You haven't done anything to cause your acne and its not your fault if you have it. Pimples are caused when oil ducts in the skin get plugged and then build up, causing redness and swelling. Although there are many myths about acne, the following are the three main causes of acne.
1. Hormones
When you begin puberty, certain hormones, called androgens, increase in both males and females. These hormones trigger oil ducts on the face, back and upper chest to begin producing oil. This can cause acne in some people.
2. Heredity
If other members of your family had acne as teenagers, there may be a chance that you've inherited the tendency toward getting acne as well.
3. Plugged oil ducts
If you are prone to acne, the cells that line the oil ducts in your skin tend to get larger and produce more oil and the ducts get plugged. This traps the oil and leads to the formation of blackheads or whiteheads and the plugged ducts allow germs in the skin to multiply and produce chemicals that cause redness and swelling. That is why simple blackheads and whiteheads may turn red and bumpy and turn into the pimples of acne.
There is not much you can do about heredity, so your best control efforts are those that keep the oil ducts unplugged.
What doesn't cause acne?
If you have acne, there are some things that can make it worse. To keep acne under control, try to avoid the following:
1. Use topical benzoyl peroxide lotion or gel
Benzoyl peroxide helps kill skin bacteria, unplug the oil ducts and heal acne
pimples. It is the most effective acne treatment you can get without a doctor's
prescription. Many brands are available in different levels of strength (2.5
percent, 5 percent or 10 percent). Read the labels or ask your pediatrician or
pharmacist about it.
2. If you don't see results, consult your pediatrician
Your doctor can prescribe stronger treatments, if needed, and will teach you how
to use them properly. Three kinds of medications may be recommended:
3. What about the "miracle drug" Accutane?
Isotretinoin (Accutane) is a very strong chemical taken in pill form. It is used
only for severe cystic acne that hasn't responded to any other treatment.
Accutane must NEVER be taken just before or during pregnancy. There is a danger
of severe or even fatal deformities to unborn babies whose mothers have taken
Accutane while pregnant or who become pregnant soon after taking Accutane. You
should never have unprotected sexual intercourse while taking Accutane. Patients
who take Accutane must be carefully supervised by a doctor knowledgeable about
its usage, such as a pediatric dermatologist or other expert on treating acne.
Your pediatrician may require a negative pregnancy test and a signed consent
form before prescribing Accutane to females.
If you are experiencing acne problems, remember that your pediatrician can help you. And as you begin treatment, keep these helpful tips in mind:
A Word About ... Acne and Birth Control Pills
In 1996, the Food and Drug Administration (FDA) approved a low-dose birth control pill to be used as an effective treatment for acne in women over 15 years of age. Research has shown that certain birth control pills lower the levels of hormones that cause acne.
However, taking birth control pills along with other medications for the prevention of acne may reduce the effectiveness of both medications. If you are taking birth control pills, talk to your pediatrician about their effect on acne.
Finally, many people don't understand acne and may say hurtful things about it. Although acne may bother you, keep in mind it's only temporary. With present-day treatment, it usually can be controlled.
~American Academy of Pediatrics
Growth and Development 0 to 3 months
Developmental Milestones Birth to 3months
Children develop at their own pace, so it's impossible to tell exactly when yours will learn a given skill. The developmental milestones below will give you a general idea of the changes you can expect as your child gets older, but don't be alarmed if your child takes a slightly different course.
Social and Emotional
Movement
Vision
Hearing and Speech
Developmental
Health Watch
Alert your child's doctor or nurse if your child displays any of the following
signs of possible developmental delay for this age range.
~CDC/AAP
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Developmental Milestones 4 to 7 months
Children develop at their own pace, so it's impossible to tell exactly when yours will learn a given skill. The developmental milestones below will give you a general idea of the changes you can expect as your child gets older, but don't be alarmed if your child takes a slightly different course.
Social and Emotional
Cognitive
Language
Movement
Vision
Developmental Health Watch
Alert your child's doctor or nurse if your child displays any of the following
signs of possible developmental delay for this age range.
Growth and Development 8 to 12 months
Developmental Milestones 8 to 12 months
Children develop at their own pace, so it's impossible to tell exactly when yours will learn a given skill. The developmental milestones below will give you a general idea of the changes you can expect as your child gets older, but don't be alarmed if your child takes a slightly different course.
Social and Emotional
Cognitive
Language
Movement
