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Childhood Obesity

Childhood Obesity & Weight Management

Your Baby

Weight Gain During Pregnancy

2.00 to read

Every pregnant woman wonders how much weight she could gain during pregnancy. For some women, being pregnant is an open invitation to eat whatever and whenever they like, while other woman worry what the weight gain will do to their figure. There is no absolute law about weight gain during pregnancy, but there are set of guidelines that can help you.

Weight gain should be based on your pre-pregnancy body mass index (BMI.) Your health and your baby’s health also play a role in how much weight you should gain.

Here’s a list of suggested pregnancy weigh gain related to a healthy woman’s BMI.

  • Underweight (BMI less than 18.5) – 28 to 40 pounds
  • Normal weight (BMI 18.5 to 24.9) – 25 to 35 pounds
  • Overweight (BMI 25 to 29.9) – 15 to 25 pounds
  • Obese (BMI 30 or more) – 11 to 20 pounds

Multiples are a different story. If you are carrying twins or other multiples you’re likely going to need to gain more than average weight. Your health care provider can help you determine what is right for you. Here are the recommended weight gain options.

  • Normal weight (BMI 18.5 to 24.9) – 37 to 54 pounds
  • Overweight (BMI 25 to 29.9) – 31 to 50 pounds
  • Obese (BMI 30 or more) – 25 to 42 pounds

If you are overweight when you become pregnant, pregnancy increases the risk of various complications including diabetes and high blood pressure. Of course, a certain amount of weight gain is normal, but too much adds to the possibility of dangerous health risks for the woman and the child.

Remember that if you gain more than the recommended amount during pregnancy and you don't lose the weight after the baby is born, the excess pounds increase your lifelong health risks. Gaining too much weight during pregnancy can also increase your baby's risk of health problems at birth and childhood obesity.

If you're underweight, it's essential to gain a reasonable amount of weight while you're pregnant. Without the extra weight, your baby might be born earlier or smaller than expected.

Calculating your BMI is not difficult; you just need to know your height and weight. There are several online BMI calculators that will do the math for you. Your healthcare provider should also have a BMI chart that can show you your BMI.

So, how is the extra weight used by your body when your pregnant? Here’s a simple list to help you follow a normal weight gain.

  • Baby: 7 to 8 pounds
  • Larger breasts: 2 pounds
  • Larger uterus: 2 pounds
  • Placenta: 1 1/2 pounds
  • Amniotic fluid: 2 pounds
  • Increased blood volume: 3 to 4 pounds
  • Increased fluid volume: 3 to 4 pounds
  •  Fat stores: 6 to 8 pounds

During your first trimester, you probably won’t gain much weight. Steady weight gain is more important in the second and third trimesters, especially if you begin at a normal weight or are underweight.

Exercise is also important during pregnancy. Even a moderate amount of exercise will help keep your body strong as the extra pressure builds while you are carrying.

As your pregnancy develops, more than likely you’re appetite will increase. That’s not a bad thing. Just fill those hunger pains with healthy food choices!

Source: http://www.mayoclinic.org/pregnancy-weight-gain/art-20044360

 

 

Parenting

AAP Says Lice Shouldn’t Keep Kids Out of School

1:30

Typically, when a student has head lice or nits (the eggs of head lice), the school requires that he or she go home and not return until the lice are gone. The American Academy of Pediatrics (AAP) recently proposed new guidelines that say, "No healthy child should be excluded from school or allowed to miss school time because of head lice or nits."

The AAP says that while head lice may be annoying and cause itching, they don’t actually make people sick or spread disease. Many people believe that the insects are easily spread, but experts say that direct head-to-head contact is required.

The AAP notes that most doctors who care for children agree that school policies requiring children to be free from nits before returning to school should be abandoned.

The AAP also reported that screening kids at school for head lice does not reduce the occurrence in classrooms over time. However, pediatricians advise parents to check their children’s heads for lice and school nurses may check children who are showing symptoms such as repeated head scratching.

To treat lice, the AAP recommends parents start with over-the-counter medications that contain 1 percent permethrin or pyrethrins (types of insect-killing chemicals).

Parents should carefully follow the treatment instructions, and when using permethrin or pyrethrin products, should apply the treatment at least twice (about 9 days apart).

Because these medications do not kill 100 percent of the lice eggs, the treatments should be followed by manual removal of the eggs, the guidelines say. This can be a tedious process, but fine-tooth combs called "nit-combs" can make the process easier.

Some head lice have become resistant to OTC treatment, these cases may benefit from prescription medications such as spinosad or topical ivermectin.

Once a person is diagnosed with head lice, everyone in the family should be checked for the condition. Lice are usually transmitted by direct contact, so it's less likely that people will get lice from touching household items, but it is still wise to clean all hair-care items and bedding used by the person who had lice, the guidelines say.

Children should be taught not to share items such as combs, brushes and hats, although such precautions may not prevent all cases of head lice, they can reduce the risk of transmission.

Source: Rachel Rettner, http://www.livescience.com/50629-head-lice-recommendations.html

Your Toddler

Tricycles Cause Almost 9500 Injuries a Year

2:00

The brightly colored, tripled wheeled tyke-bikes may appear pretty harmless, but tricycles injuries send thousands of children to the hospital every year according to a new study.

Researchers found that lacerations were the most common type of injury kids suffered.  

But in an indication that some kids might need more or better quality protective gear, researchers also estimated that about 30 percent of injuries were to the head and another 8 percent involved the elbow, noted lead study author Sean Bandzar.

“Head injuries in particular are very common with any kind of moving toy and that’s why we recommend helmets, and based on our findings I would also encourage parents to have kids wear elbow pads,” said Bandzar, a researcher at the Medical College of Georgia in Augusta.

Based on the 328 tricycle injuries reported by participating hospitals in 2012 and 2013, researchers estimated that there were about 9,340 injuries nationwide during the two-year study period.

The total included 2,767 injuries to the head and 767 at the elbow, as well as 1,880 accidents damaging the face, 954 hurting the mouth and 483 harming the lower arms, researchers estimated.

The study noted that on average, three year-olds were the typical age group injured and one to two-year olds, made-up slightly more than 50 percent of the cases.

Boys made up almost two-thirds of the cases.

With this age group, it came as no surprise that about 72 percent of the injures occurred at home.

There were a couple shortcomings of the study, the authors acknowledge in the journal Pediatrics, is that researchers lacked data on how accidents happened, whether kids wore helmets or other protective gear, what types of tricycles children rode and whether adults were present.

It’s also possible that the study didn’t have data on enough accidents to draw broad conclusions about tricycle injuries nationwide, said Dr. Gary Smith, president of the Child Injury Prevention Alliance and a professor of Pediatrics, Emergency Medicine and Epidemiology at The Ohio State University in Columbus.

“Tricycles are safe, especially if a few simple steps are taken to prevent injuries,” Smith, who wasn’t involved in the study, he told Rueters by email.

Children should always wear helmets any time they are on wheels above a hard surface – including tricycles, skateboards, scooters, skates and bicycles, Smith said. Tricycle riders in particular should only ride in areas separated from cars, and when parents can keep a close eye on them.

“Tricycles are somewhat riskier than other toys children use but that doesn’t mean they are highly risky toys,” said David Schwebel, a researcher at the University of Alabama at Birmingham.

While Schwebel, who wasn’t involved in the study, echoed the need for parental supervision, he also stressed that tricycles can be good for kids.

“Tricycles are valuable tools to help children develop critical gross motor skills like balance, coordination and strength,” Schwebel said by email. “Any tricycle, when used carefully in a supervised situation, is likely to be a positive activity for children.”

Source: Lisa Rapaport, http://www.reuters.com/article/2015/09/14/us-health-children-tricycle-injuries-idUSKCN0RE1TQ20150914

 

Your Child

Good Sleep Habits Help Kids Succeed in School

1:30

If you’ve ever been sleep deprived, you know how difficult it can be to focus and get through the demands of the day.

So it’s not surprising that a new study says that children, who have good sleeping habits by the age of five, do better when they start school.

However, what may surprise you is that according to the National Sleep Foundation, a 2004 poll revealed that 69 percent of children 10 and under experience some type of sleep problem such as insomnia, nightmares, restless legs syndrome, sleep terrors, sleepwalking and sleep apnea.

For this study, researchers reviewed the sleep behavior of nearly 2,900 children in Australia from birth until they were 6 or 7. They found that one-third had mounting sleep problems in their first five years that put them at added risk for attention disorders and emotional and behavioral problems in school.

"The overwhelming finding is it's vital to get children's sleep behaviors right by the time they turn five," researcher Kate Williams said in a Queensland University of Technology news release. Williams is on the faculty in its School of Early Childhood.

For many families, today’s social and home environment is a roller coaster ride; creating solid routines, winding down and focusing on good sleep habits has almost become a lost art.

Williams and her team found that children with increasing sleep problems in early childhood were apt to be more hyperactive and to have more emotional outbursts in the classroom.

"If these sleep issues aren't resolved by the time children are 5 years old, then they are at risk of poorer adjustment to school," she noted.

There are lots of online tips for helping children develop good sleeping habits. These are usually in every list:

·      No video games, TV or electronic gadgets for at least an hour before bed.

·      Set a bedtime and stick to it that allows for plenty of sleep.

·      Follow a routine – brush teeth, wash hands and face and settle in for sleep. Reading a book to your little one can help relax them.

·      Make sure their room is dark and cool when it’s time for light’s out.. If your child needs a night light, place it in the hallway or bathroom and leave the door ajar. Turn it off once they are asleep.

·      Avoid giving your child candy or food right before bedtime. Certain foods can be stimulating and creating the habit of eating before bed or during the night is a hard one to break.

·      Make sure your child is comfortable. Pajamas should not restrict movement. Blankets shouldn’t be so heavy as to cause them to be hot or too warm.

Story sources: Robert Preidt, http://consumer.healthday.com/kids-health-information-23/education-news-745/children-sleep-school-qut-release-batch-2570-708848.html

https://sleepfoundation.org/sleep-topics/children-and-sleep

Your Baby

Eating During Labor May Speed Up Delivery

1:45

In many hospitals, when a woman is in labor, all she is allowed to eat are a few ice chips. That rule may need updating, according to a new study that finds women who were allowed to eat before delivery had a slightly shorter labor than those who were restricted to ice chips or sips of water - although the study can't prove that eating caused deliveries to happen sooner.

The practice of limiting food during labor goes back a study in the 1940s in which women who delivered under general anesthesia were at risk of inhaling their stomach contents and choking in it, writes senior author, Dr. Vincenzo Berghella, of Thomas Jefferson University in Philadelphia, and his colleagues in Obstetrics and Gynecology.

“We really don’t know how much if anything people can eat or drink in labor," said Berghella,.

Whether women can have more than water or ice chips as they labor to give birth is a common discussion among healthcare providers, he told Reuters Health.

General anesthesia is not commonly used during delivery these days, but the old guidelines are still in use.

For the new study, the researchers compiled data from randomized controlled trials that compared the labor outcomes of women who were allowed to eat only ice chips or water and those who were allowed to eat or drink a bit more.

For example, one study allowed women to drink a mixture of honey and date syrup. Another study allowed all types of food and drinks. A few others allowed women to drink liquids with carbohydrates.

Overall, the researchers analyzed 10 trials that included 3,982 women in labor. All were only delivering one child - not twins or triplets - and were not at risk for cesarean delivery.

The women with the less restrictive diets were not at increased risk for other complications, including vomiting or choking, during the use of general anesthesia.

And women who were allowed to eat and drink more than the traditional ice chips and water had labors that were shorter, by an average of 16 minutes, compared to women with the more restrictive diets.

Speaking from experience, 16 minutes less of labor pains is a real bonus. How does adding more liquid or food during delivery help reduce the time before delivery? The researchers presented some ideas.

"If we’re well hydrated and have adequate carbohydrate in our body, our muscles work better," said Berghella. A woman's uterus is largely made of muscle.

Another of his studies, which found women who received more fluid than normal delivered faster than other women, reinforces the finding.

Berghella said it's still common practice for women with uncomplicated births to be restricted to water or ice chips during labor.

"The evidence from well-done studies is they can have more than that," he said.

Do women really want to eat much during labor? Probably not, there’s a lot going on in the body as labor progresses.  But more liquids and some light carbohydrates during the early part of labor may be welcomed – especially if they shorten the time between labor and when baby enters the world.

Story source: Andrew M. Seaman, http://www.reuters.com/article/us-health-pregnancy-labor-food-idUSKBN15O2ZR

 

Daily Dose

Exercise Can Maintain Heart Health

1.30 to read

Moms and dads...you have an exercise plan but what about your kids? Your child's heart health is important too! Heart health is based on genetics, diet and lastly exercise. (For adults and my teen patients as well, need to add smoking and drinking to the discussion).  

While I start talking about healthy eating during infancy the discussion about exercise comes a bit later.  If you have a toddler you know they “exercise”.....all day long, and never stop except to sleep! But as our children get older, once again it is up to the parents to model behavior, including exercise. 

I regularly ask, “how much time does your child play outside?” (I know it is much harder in winter months), “what does your child do for exercise outside of school?” and “do you exercise as a family?’”.  Once a child is older, say 5 or so, I include them in the questioning as well as they are a wealth of information. I ask them “if they ride a bike”....they love to tell me about taking off their training wheels. Then I ask “who they ride with and where do they go?”.  I also ask about bike helmets, you would be amazed at how many children tell me that they wear a helmet, but their parents don’t! (HINT HINT to parents). 

I find that most children under the age of 10 or so do get a fair amount of exercise, but as they get older many have stopped playing sports outside of school and have chosen to spend more time being sedentary.  They are not just watching TV, but have found other interests like music, art, drama, chess and even computer programming.  All of that is great, but children still need exercise and many schools have cut PE programs especially once you get to middle school and high school. This means that parents once again may have to encourage exercise, for the whole family. Walking the dog, family bike rides, tennis matches, front yard kickball or badminton.  Get the family exercising together....they may not even realize. 

The hardest group I have to encourage to exercise are my teens who are just not athletes (I can sympathize).  We all have our talents, but for some sports are not it.  I find myself asking my teenage patients, how much exercise they get and so many say, “None”.  Many say, “walking between classes” is all of their exercise, and the idea of walking to school is long gone for most.  Many of my teens start to gain weight after puberty and have to be reminded that we all stop growing....so you can’t keep gaining weight. Exercise has to be done on a regular basis...again it is about lifestyle. 

So, heart health and exercise should be a focus for families year round, see if you can get your family moving as we head into spring!

Your Baby

Obese During Pregnancy Linked to Obesity in Offspring

2:00

Not every time, but often, you’ll see obese couples and their kids are either obese or on the threshold of obesity. While adults have the power and the life experience to understand the health issues associated with obesity, their children – depending on their age- are reliant on on their parents making healthy choices for them.  

 Is generational obesity inherited or a case of families making poor choices where food and exercise are concerned – or both?

Researchers from the University of Colorado School of Medicine wondered if children born to obese moms might be predisposed to being obese due to their womb environment.

The team of scientists analyzed stem cells taken from the umbilical cords of babies born to normal weight and obese mothers. In the lab, they coaxed these stem cells to develop into muscle and fat. The resulting cells from obese mothers had 30% more fat than those from normal weight mothers, suggesting that these babies’ cells were more likely to accumulate fat.

No cause and effect was established, but the scientists noted that further research was needed. “The next step is to follow these offspring to see if there is a lasting change into adulthood,” says the lead presenter, Kristen Boyle, in a statement.

She and her colleagues are already studying the cells to see whether they use and store energy any differently from those obtained from normal-weight mothers, and whether those changes result in metabolic differences such as inflammation or insulin resistance, which can precede heart disease and diabetes.

Other studies have found a high correlation between parents’ Body Mass Index (BMI) numbers and their children ‘s BMI, particularly between mothers and their kids. Further, the BMI of grandmother’s and their grandchildren is also high.

What is a healthy weight gain for a pregnant woman? It depends on how much you weigh before getting pregnant.

The guidelines for pregnancy weight gain are issued by the Institute of Medicine (IOM); most recently in May 2009. Here are the most current recommendations:

•       If your pre-pregnancy weight was in the healthy range for your height (a BMI of 18.5 to 24.9), you should gain between 25 and 35 pounds, gaining 1 to 5 pounds in the first trimester and about 1 pound per week for the rest of your pregnancy for the optimal growth of your baby.

•       If you were underweight or your height at conception (a BMI below 18.5), you should gain 28 to 40 pounds.

•       If you were overweight for your height (a BMI of 25 to 29.9), you should gain 15 to 25 pounds. If you were obese (a BMI of 30 or higher), you should gain between 11 and 20 pounds.

•       If you're having twins, you should gain 37 to 54 pounds if you started at a healthy weight, 31 to 50 pounds if you were overweight, and 25 to 42 pounds if you were obese.

These recent findings point out again, how important it is for pregnant women to consider the possible long - term health affects on their unborn offspring when making decisions about their own health.

The report was presented in May to the American Diabetes Association.

Sources: Alice Park, http://time.com/3906135/obese-moms-wire-kids-obesity-during-pregnancy/

http://www.babycenter.com/0_pregnancy-weight-gain-what-to-expect_1466.bc

 

Parenting

Holiday Decorating Safety Tips

1:45

Millions of American families will enjoy the beauty and fun of decorating a Christmas tree and hanging lights this Holiday season.  Whether you choose an artificial tree or a fresh tree, there are steps you can follow to make sure that your tree and decoration space are safe.

Many house fires occur during November and December when Christmas lights and candles are pulled out and used. Not only are fires a hazard, but plenty of people end up in an emergency room due to injuries from falls, lacerations, back strains and children ingesting foreign objects.

The Consumer Protection Safety Commission has a great list of tips to help you make safety a priority.

1. Take special care with sharp, weighted, or breakable decorations. Lacerations were among the top reported decoration–related injuries last year.

2. Avoid trimmings that resemble food or candy that may tempt a child to mouth or swallow them.

3. Place decorations with small removable parts that can pose a choking hazard to young children out of reach.

4. Purchase only holiday light sets that bear the marking of a safety-testing laboratory. Fires sparked by holiday lights caused 10 deaths last year.

5. Examine new and old light sets for damage. Discard sets with cracked or broken sockets, frayed or exposed wires, and loose connections.

6. Keep burning candles in sight and away from places where kids and pets can knock them over. Between 2010 and 2012, candles were the source of an estimated 6,500 residential fires annually, causing 80 deaths, 650 injuries, and $237 million in property loss per year.

7. Place lighted candles away from items that can catch fire, such as trees, other evergreens, decorations, curtains and furniture.

8. Look for a label that reads “fire resistant” when purchasing an artificial tree. Check live trees for freshness. If the tree is fresh, the needles should stay in place and not break. It should be hard to pull them off the branches. Check the trunk to see if it is sticky. If so, it's definitely fresh. Check for loose needles by banging the tree up and down on the ground. Expect some needles to fall off but if a lot fall off, move to another tree. One that loses a lot of needles is no longer fresh and could be dry enough to be a fire hazard.

9. Place live Christmas trees away from heat sources, and keep trees well watered.

10. Read “Ladder Safety 101” for tips to prevent ladder falls this season. You may think you know everything there is to know about using a ladder, but even the “experts” can make mistakes and wind up in the ER.

It’s easy to get complacent when decorating for the holidays; it’s something a lot of families do year after year often using the same decorations. After a certain amount of time, these decorations can become worn and damaged. Make sure your holiday doesn’t turn into a visit to the emergency room or worse by brushing up on some simple safety tips.

Source: http://onsafety.cpsc.gov/blog/2015/12/07/tis-the-season-to-decorate-safely/

 

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Why kids need to wear life jackets while boating.

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