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Parenting

Family Fun Activities During the School Break!

2:30

Once the excitement of opening presents and playing with new toys starts to wane, many parents may be looking for ways to keep the kiddos entertained during the school break; especially if the weather turns bad and kids are inside a lot.

Here are some fun family activity ideas from thespruce.com, to consider:

Baking! From toddlers to teenagers, kids love the mixing and the measuring, but most of all, they love the treats at the end. As you teach kids to bake, scale holiday baking projects to your kids’ abilities and ages. Baking can be kept simple such as cookies or cakes, but even a go at bread might surprise everyone with a banana or zucchini loaf!

TV Holiday specials! TV you say? Keeping your kids from watching too much TV over Christmas break is always a challenge. But TV isn't all bad if you watch together--especially today when all family members could be watching on separate devices! There are plenty of funny and poignant holiday movies and specials that the whole family can enjoy together.

Try a winter sport! If you’re in a part of the country where snow is prevalent, take the family for a winter outing. Skiing, sledding and snow tubing are great fun. Ice-skating is now available in more places than ever with ice rinks popping up during the holidays in towns across the country. Not only are these activities exhilarating, but they are a great way to burn off calories and take in some fresh air. If the weather is nice, hiking and bicycle riding are other fun “get moving” activities.

No snow or ice-rink available? Try an indoor sport! Roller-skating, swimming, basketball, Ping-Pong and pool are a few indoor activities to try over your holiday break. If there’s a roller rink nearby, then it’s easy enough to find a place to skate. Some kid-friendly restaurants and arcades have Ping-Pong and pool tables. 

Volunteering is great to do any time of the year, but during the holidays, there are so many opportunities to lend a helping a hand to others.

Celebrate your child’s creativity with art! Art is one of those wonderful activities that can be scaled to almost every age and ability level. And depending on the project, it can be done with or without adult supervision. So you can work at home while the kids create art or you can roll up your sleeves and get messy too. Art projects can become gifts for relatives or decorations for the house. Setting up a dedicated art space makes set up and clean up easier.

Take a trip to a museum.  Many museums and attractions count on Christmas break for a big surge of visitors; so don’t expect to be the only ones there. However, many attractions put on special programs for kids and/or offer discounts on admission at off-peak hours.

Read a book together. Even if you regularly read together, change things up a little during Christmas break. Choose something a little different from your ordinary reading material so it stands out as a holiday tradition. Maybe try a book of Christmas poems or a classic novel read in daily installments. And if reading together is not part of your routine the holiday season is a great opportunity to start.

Another fun idea is not only to read a book together – how about writing a book together? Well, maybe not a whole book, but a story! Children who are just beginning to talk can contribute to a group story. Older kids can write or illustrate. This is also an activity you can participate in or something you can have them work on without you if you are working.

And then there’s the old standard activity that has been part of many a treasured holiday memory- playing games together. Kids games run the gamut from old-fashioned Candyland to video games. But one thing that is universal is:  kids like it when the parents play. You can also try puzzles. These are available for just about every child’s age group.

How about a talent show? This is an activity with so many possibilities! And it's great for all ages, including the grown ups. If you're working, the kids might put together a show and perform for you later. Or, the whole family could show off their talents for visiting guests--lip-syncing and dancing to a favorite song or just singing a few carols. The show can be as elaborate or simple as you like.

Story source: Laureen Miles Brunelli, https://www.thespruce.com/things-to-do-during-christmas-break-3542442

Daily Dose

Lice is Tough to Treat

1:15 to read

What are kids bringing home from school besides their homework? Lice! The good news is: lice are obligate parasites and don’t jump, or fly…they are transmitted by direct contact.  But, the smart louse has found another way to drive parents crazy…they are becoming more and more resistant to all of the over the counter products containing permethrin. 

A recent study has shown that 25 states now have a big problem with lice and permethrin resistance.  It seems that the lice are smart and they have developed “genetic mutations” which has made them drug resistant. Texas has had a problem for several years and I have had many patients coming into the office with bags full of “stuff” that they have used to treat their children’s head lice to no avail!!!  Many a mother has told me she is ready to try anything…including some things that might be considered unsafe, but you know a desperate mother.

While about 12 million children a year get head lice, the louse itself does not cause any disease, but just uncomfortable itching.  Parents spend multi millions of dollars each year trying to eradicate head lice. In states like Texas, California, Florida and Virginia the lice are immune to over the counter products, while in New York, New Jersey and several other states they are partially resistant. 

But don’t despair, despite the resistance to the over the counter products such as Nix, there are other prescription products available. Products such as benzoyl alcohol (Ulesfia), ivermectin (Sklice), malathion (Ovide), and spinosad (Natroba), may all be used to treat a case of head lice, but will require a prescription to obtain them.  Although prescription drugs typically are more expensive, treating head lice with an over the counter product may be an exercise in futility. It is likely to be more cost and time effective to start with a prescription product if you live in one of the 25 states which has shown drug resistance.

So, if you get a note that your child has head lice, pick up the phone and call your doctor’s office to see what advice they give you. 

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Daily Dose

Sleep

1:30 to read

Bedtime routines are very important!  Many kids are getting up earlier and earlier for some sort of practice (often before the sun comes up) so going to bed on time makes everyone in the house wake up in a better frame of mind and mood for the day ahead.   

 

Bed time battles are typical for a toddler who has learned to ask for “one more book”, or for the elementary school child who swears “they are not tired” but who falls asleep during bath time.  But who knew there would be even more battles with teens and their electronics??

 

Numerous studies have shown that electronics disrupt sleep.  But, trying to convince your adolescent son or daughter that they need more sleep is a daily struggle. While the studies on sleep recommend that teens get between 8 to 9 hours of sleep, most teens are not even close to that!  (90% report less than 9 hours).

 

During the summer teens keep all sorts of crazy hours and many get the majority of their sleep during what we would consider to be “daytime” hours…as they go to bed at 2 or 3 am and sleep past noon.  So, the minute that school resumes after summer vacation they already have sleep issues trying to “re-adjust” their biological clocks…and then you throw in the use of electronics right before bed and you have the perfect storm for sleep deprivation and daytime fatigue.

 

The American Academy of Sleep Medicine found that “adequate sleep duration on a regular basis leads to improved attention, behavior, learning, memory, emotional regulation, quality of life and mental and physical health”.  There isn’t a parent around who doesn’t want happy, rested, studious and healthy kids…of all ages. If you throw in less moodiness for teens who get more sleep most parents would sign their teens up on the spot.

 

Why do we all need to disconnect from electronics in order to have better sleep?  That blue light from the electronic screen…of any shape for or fashion works against sleep. It signals the brain to suppress melatonin secretion, which is the hormone that makes us get sleepy at the end of the day. The light from the screen also confuses the brain of it being daytime and increases alertness which may delay sleep…even after turning off the screen.

 

Try this new family rule, parents included, that all screens (phones, tablets, computers) will be off and docked outside of the bedroom at least 30-60 minutes prior to bedtime. While your teen may insist that they won’t use the phone, it is often too tempting to not “cheat” once you are in your own room and asleep. 

 

While this may initially be hard to enforce, once it is the family routine it becomes less of a battle. Everyone will have an easier time falling asleep and staying asleep, and maybe get a few more hours of “shut eye”.    

 

 

Daily Dose

Too Sick To Go To School

1:30 to read

Now that we are really in the throes of sick season I am often asked…when should you keep your child home from day care or school?  I noticed a recent article in one of the pediatric journals on this topic…which emphasized that hand washing and vaccines are still the best way to prevent transmission of infectious diseases. 

 

But, with that being said, especially at this time of year when so may upper respiratory tract infections are circulating do you need to keep your child home?  The short answer is that most minor illnesses are not a sufficient reason to keep a child home. That includes most colds and coughs. But if your child is running a fever, or seems terribly uncomfortable or is ill enough to “require extra care” by a day care worker or teacher they need to stay home. A day at home for some TLC (tender loving care) is often the best medicine, especially for the first day or 2 of a viral upper respiratory infection when a child may have a fever.

 

I am also asked about GI illnesses and whether a child with diarrhea needs to stay home from day care. It seems that some day care facilities now exclude a child from care if they are having more than 3-4 loose stools/day, even if they are still playful, fever free and eating and drinking.  The recommendation by the CDC does not require a child with diarrhea to stay home, if the stools can be contained within the diaper.  This gets back to good hand washing!  A child with vomiting is a different story and should not be sent to school or day care.

 

I am seeing a lot of children with pink eye (conjunctivitis). Pink eye may be caused by both bacteria and viruses. Transmission occurs by direct contact with contaminated secretions from the eye or via respiratory droplets. Unless a child has other symptoms to keep them out of daycare they should be allowed to return to school once appropriate therapy has been started.   

 

Even with good hand washing it is not unusual for children who are crawling and walking to get up to 11-12 viral infections in a season! This is often difficult for a family with two working parents, as the decision is made whether a child can attend day care and who will stay home if the child needs to be home.  At the same time, young parents will often get several of their children’s viral infections as well- even with good handwashing. What parent has not had their child cough or sneeze directly into their face (this is not purposeful but age related), and within several days you find yourself sick! This is a hazard for us pediatricians as well.

 

Lastly, do not “try” to figure out “who got your child sick”. There are just too many places we all go on a daily basis where we are exposed to viruses and bacteria. Trying to “track down” the exposure for most of the common infectious diseases that children get is a big waste of time. Serious illnesses like meningitis, mumps, measles etc are a different story…but fortunately, because of vaccines this is rarely the case.

 

So keep up hand washing and hope for the best during this time of year.

Daily Dose

Start the Back-to-School Sleep Routine Now

2.00 to read

Getting back into the routine of school days also means getting back to good bedtime routines.How can it be that school is just around the corner? Getting back into the routine of school days also means getting back to good bedtime routines. With that being said, you have to start the process now to ensure plenty of time to slowly get bedtimes re-adjusted. By starting early you can avoid the battles that some parent’s talk about when discussing bedtimes.

Children need a good night’s sleep to wake up happy, rested and ready to learn. Numerous studies have shown that elementary age kids need about 10 hours of sleep a night while tweens and teens still need a good 8 – 9 hours of sleep. I wonder how many children really get the recommended amount of sleep? I think too few. Unfortunately, I know from my own experience that teens seem to operate on a different sleep schedule and rarely are in bed as early as they should be. Most of us have relaxed bedtime a little during the summer and children are staying up later and sleeping longer in the mornings. This is great during the lazy summer months, when schedules are also different. But within a few weeks the morning alarms will ring forcing everyone to get up earlier to get to school. In order to try and minimize grouchy and tired children (and parents too) during those first days of school, going to bed on time will be a necessity. Working on re-adjusting betimes now will also make the transition from summer schedule to school schedule a little easier. If your children have been staying up later than usual, try pushing the bedtime back by 15 minutes each night and gradually shifting the bedtime to the “normal” hour. At the same time, especially for older children, you will need to awaken them a little earlier each day to re-set their clocks for early morning awakening. Why is it that pre-school children want to get up early, no matter what, while school-aged children are happy to sleep through alarms?  Such is life. Also, make sure that you are not only ensuring that you children get a good night’s sleep during the school year, but they also awaken in time for breakfast! Just like my mother used to say, “breakfast is the most important meal of the day’” and that adage is still true. A good night’s sleep followed by a healthy breakfast has been shown to improve mood, attention, focus and over all school performance, as well as even helping to prevent obesity. Start off the school year on the right foot. It is easier to begin with good habits than to try and break bad ones. That’s your daily dose, we’ll chat again tomorrow.

Daily Dose

Time for Report Cards

It seems that it is report card time and many parents are looking at their children's grades.It seems that it is report card time and middle of the semester so many parents are looking at their children's grades. Hopefully, there were no surprises at your house and your child is doing well in all areas, which includes academics as well as socialization and peer relationships in the younger grades. But, if you were not thrilled with your child's report card it may be time to sit down with both your child and their teacher for a conference.

The most important thing is to determine if your child is trying their hardest and working to their capabilities. If not, that area can be addressed with some goal setting and maybe a little more supervision of homework and what your child is doing with their "extra time". On the other hand, it may be that your child is working as hard as they can but not achieving the results that you would expect. In that case it may be worth discussing if there might be any learning disabilities that need to be addressed. Most of these learning differences show up in elementary school, but occasionally they are missed and will still need to be addressed in the upper grades. Discuss your child's learning style with their teacher and see if educational testing might be warranted to evaluate their learning. This may be done within in the school district or through private educational diagnosticians. Looking at your child's report card from the aspect of how they may improve and how you their parent might help them figure it out may be the path to future success. That's your daily dose, we'll chat tomorrow.

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Daily Dose

Viruses Linger During End of School Year

Viruses linger during end of school year and disrupt many events. Dr. Sue explains what parents can do to keep their kids healthy.Well, it seems all students, from preschoolers through those in high school and college, are in full end of the school year mode. Graduations are ahead, from kindergarten through college, and of course there also seem to be several spring/summer viruses lurking around that are disrupting students (and parents) end of year plans.

Just like we have influenza during the winter months (and over the Christmas and New Year’s holidays), we also see other viruses that cause fever, myalgias (muscle aches), cough, congestion and sore throat, that are equally bothersome at this time of year.  While it is not influenza, other viruses such as  adenovirus, enteroviruses and parainfluenza virus (just to name a few), can make you run fairly high fever, feel horribly, have a sore throat and congestion and eventually a cough. Most viruses last anywhere from 7 -14 days, and for the first 2-4 days it is not unusual to see kids running fever, which only makes them feel that much worse.  Something about having a 103 degree fever, while the weather is in the 70’s to 90’s around the country, just doesn’t seem right! Unfortunately, these viruses don’t really care what we all have happening in our lives, and so you may find your child trying to wrap up end of school activities, but really needing to stay home for a few days due to illness. I am writing this as I have seen dozens and dozens of sick kids in the last few weeks with a litany of things to “do” before school ends. Parents bringing their sons and daughters in to my office for “the cure” so that they may attend the end of preschool party, or the field trip, prom or graduation.  I only wish that I had “the cure”. As we have discussed so many times, viruses are bigger and brighter than the best minds, and they cannot be cured in 12 hours with a magic shot of penicillin (although I must say some doc in the boxes still do this).  Despite my best efforts as a physician (and a mother too), the only thing that really cures a viral illness is “tincture of time”, which no one seems to have any more. I am not pointing fingers, because I am guilty of feeling like that too.  I only wish that I could get everyone, including my own children, better in time to attend all of these important functions!!  Viruses always occur at the most inconvenient times. One mother has brought her son to see me both in my office and by my house in hopes of finding “something” that we can treat. She has thrown out options like “antibiotics, inhalers, vitamins and steroids” in hopes of getting him better faster. Now throughout this illness, he like many others has “drug” his sick body out of bed to attend “special” events, all the while running fever and coughing. So, he is indeed contagious and might spread the virus to others. Whether intentional or not, viruses are spread very easily, especially in the close contact that our adolescents all have. I LOL when a parent says “my child has not been around anyone that is sick”!!  But of course they have.  The viruses are at  school, at  after school activities, while sharing water bottles on the sports field, or sandwiches at lunch, our children are exposed. Then throw in all of the parties going on now and it is perfect storm for germs to spread. So bottom line, if your child has a fever, they should stay home.  Rest, fluids, fever control and time are really the only cures.  But thankfully, I feel certain that one of these bright students will one day find the “CURE” for the viral illnesses that we all dread, and they will be a Nobel Prize winner. Not only that, they will be loved by all parents who want to figure out how to  “fix” their child in time for  the next party or event! That's your daily dose for today.  We'll chat again tomorrow. Send your question or comment to Dr. Sue now!

Your Child

School Kids Benefit From Mindfulness Programs

2:00

Mindfulness is purposely paying attention to the present moment in a nonjudgmental way. A new study says that adding a mindfulness based stress reduction program to middle schools may help reduce kid’s stress and trauma.  

"High-quality structured mindfulness programs have the potential to really improve students' lives in ways that I think can be really meaningful over the life course," said lead author Dr. Erica Sibinga of the Johns Hopkins School of Medicine in Baltimore.

Children in many U.S. cities are at an increased risk of stresses and traumas due to the effects of community drug use, violence, multigenerational poverty, limited education and economic opportunities, Sibinga and her colleagues write in the journal Pediatrics.

 The study involved 300 students, in grades five through eight, at two Baltimore public schools. Children were randomly selected for either a twelve - week mindfulness based stress reduction program or health classes to take during the school day.

Nearly all the students were from low-income families and African-American.

The mindfulness program contained material about meditation, yoga and the mind, body connection; practice of those techniques; and group discussion.

The program helped the children be aware of their response to what was happening to them at the time.

"It allows them to not only know what is happening, but to stop and take three breaths and figure out how they want to respond to what is happening the present moment," Sibinga told Reuters Health.

By the end of the program, children in the mindfulness program had lower levels of general health problems, depression, recurrent thoughts about negative experiences and other symptoms of stress and trauma compared to the children enrolled in the health classes only.

Sibinga said the differences would be enough for the students to notice in their day-to-day lives.

The researchers acknowledge some limitations to the research, like children missing some classes and possibly being exposed to mindfulness practices outside the sessions.

While Sibinga acknowledged that she couldn’t say if the program would have the same results in other student populations, she suspected there would be benefits.

The next step is to look at how to spread the program to other schools, and look at how the program may work, she said.

"It doesn’t get us off the hook of trying to reduce the sources of trauma in our urban life," she said. But the study suggests adding structured mindfulness programs in urban settings would be beneficial, she added.

Some private schools in the U.S. have already implemented mindfulness classes in their school programs and have reported positive effects such as fewer behavioral problems and an increased ability to focus during class on school work.

Sources: Andrew M. Seaman, http://www.reuters.com/article/us-health-mindfulness-stress-school-idUSKBN0U12MY20151218

 

Daily Dose

The Importance of a Healthy Lunch

Now that our school-aged children have gotten back to class it is a great time to discuss school lunches. I like to ask my patients and their parents about their school lunches. It is interesting to hear what kids like to eat for lunch. Of course like so many things, there is a huge amount of variability surrounding school lunch choices.

It seems that elementary school aged children enjoy buying school lunch especially when the cafeteria experience is novel. But because the choices are typically not as plentiful in the elementary school cafeteria, some children will choose to the take their lunch. The one thing that I find to be most typical is that the pizza and chicken nugget lunch days are a lot more popular than grilled chicken and vegetable days. Unfortunately, school lunches are not typically the most “healthy” and are often loaded with fats. By the time children reach middle school and high school the cafeteria becomes more of a smorgasbord of choices and the “hot lunch” tray is not the only choice available. With the vast array of choices from salads, to sandwiches and many snack items, I often hear that the “tween” and teen set pick and choose their favorite foods and fall far short of anything that resembles a well balanced lunch. The combination of a hamburger and fries, or a bagel and yogurt may be the chosen lunch items. I rarely hear milk as the beverage of choice. By the time teens their junior and senior year in high school many campuses allow their students to have “off campus” lunches. In this case the “fast food world” awaits them around every corner. It is not unusual for this age group to enjoy a “super sized” combo meal and a large Coke. Most of the girls I see opt for a “diet” Coke to round out the meal. Probably not what most parents would consider a healthy lunch. The word fruit is rarely mentioned. To start teaching children about healthy eating habits we need to begin in early elementary school. Sit down with your child and the school lunch menu and look over the choices. It might make sense to “make a deal” that they may buy their lunch two days a week and you will pack them a lunch on the other three days. They can put stars or check marks on the days that they want to buy. When packing a lunch let your child be involved, while at the same time guiding their choices. The prepackaged pizza and lunchables are not good choices. Choose whole grain breads for the sandwich. Use lean sandwich meats. Add some cheese for some added calcium. Peanut, almond or cashew butter provides protein too. Cut up veggies in clever ways to make them more appealing. Chips may be baked and put them in your own sandwich bag. There are many great ways to pack and delicious and healthy lunch, and it is probably cheaper too! That’s your daily dose, we’ll chat again tomorrow.

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