Month: February 2011

Encouraging Physical Activity

All children need physical activity on a regular basis to grow up healthy in every way. But what physical activities are best for your child? Here’s how to make the choices that make the most sense for your youngster.

When cold, rainy weather prompted my 2-year-old son and me to stay indoors for days on end, Finn whipped through the house like a tornado. Puzzles, books, crayons, and cars were everywhere. The dog and cats were exhausted from being chased all day, and my energy was drained from keeping up with everyone. In other words, all was well in our active home.

If this scene sounds familiar, now is an excellent time to start fostering your child’s natural tendencies to run, jump, tumble, and in general, play harder than ever. The prevailing recommendation is for all children and adolescents to participate in some form of physical activity for at least 60 minutes every day.

As chair of the American Academy of Pediatrics (AAP) Council on Sports Medicine and Fitness, Teri McCambridge, M.D., FAAP, contributed to the organization’s policy on active healthy living. She says, “[That] does not need to be continuous exercise, but rather bouts of exercise.”

Practical Matters

Promoting an active lifestyle is the ideal way to encourage healthy habits that last a lifetime. Meeting our children’s physical needs also fits right into the fold of working towards their total well-being.

“Physical activity is important in the development of stronger muscle and bone density,” says Eric Small, M.D., FAAP, clinical assistant professor of pediatrics, orthopedics, and rehabilitation medicine at Mount Sinai School of Medicine. “It’s especially important for kids to exercise in order to promote heart and lung fitness, not only to regulate obesity, but also to prevent diabetes and cholesterol in children with a genetic disposition to those health problems.”

Estimates place more than 15 percent of the American children in the category of obese, and up to 80 percent of these will remain obese as adults.

Dr. Small, who also serves on AAP’s Council of Sports Medicine and Fitness, points out the boost in brain function as another benefit of getting children to participate in at least 20 to 30 minutes of vigorous activity each day.

“Studies show that IQ will suffer if a person is not active during his or her first five years, so we’re really talking about physical and intellectual development,” he says.

Ages and Stages

Attention span, motor skills, and emotional maturity are significant factors to consider before jumping into a new routine.

“It needs to be age appropriate,” says Dr. McCambridge, who is also an assistant professor of pediatrics at Johns Hopkins School of Medicine.

“Children under the age of 7 to 8 have not fully developed their hand eye coordination or balance, so their exercise should be on flat surfaces, with few directions, and should not require a lot of complex maneuvers.”

Both AAP and the Mayo Clinic offer excellent general guidelines for age-appropriate activities:

  • Toddlers (ages 2 to 3): Supervised, unstructured play should allow him to explore a variety of safe environments. Watch him master basic movement as he runs, walks, swings, tumbles, and swims.
  • Preschoolers (ages 4 to 6): She can walk greater distances, and also runs, dances, jumps rope, and plays ball with improved motor skills. Supervise playtime and keep it mostly unorganized. Introduce some structure through games like tag or hopscotch.
  • Elementary school (ages 7 to 9): Walking, running, playground time, gymnastics, and biking are popular for this age group, along with simple organized activities such as miniature golf. He can handle more sophisticated movement patterns while incorporating advanced visual tracking and balance. Let your child participate in a beginning team sport so long as it’s enjoyable, flexible, and low-pressure.

While supervision is essential for safety reasons, it’s also a great way to show your support and interest. Plus, spending time as an observer will allow you to evaluate whether or not to increase the challenge. “I think oftentimes the child will tell you or you will notice their need to progress when they get bored,” says Dr. McCambridge. “However, I think it is important for parents to realize the importance of success. So sometimes holding a child back in the age appropriate group and allowing a child to excel will help with his confidence level.”

The “You” in Youthful

Fun is the name of the game for all kids. Pressure to participate in activities that don’t match a child’s interests and skills, or trying to enforce mandatory “exercise” rather than play, can easily sap the joy out of physical activity.

Dr. Small, who is the founder and director of Family Sports Medicine & Fitness of Westchester, in Mount Kisco, N.Y., emphasizes joy as the key to long-term success. “The child completely loses natural interest if an activity is too structured. If it’s fun for them, they’re going to want to do it more.”

It’s likely that you will draw inspiration from your natural surroundings and by watching other parents, in addition to trying variations on your own favorite sports and activities. Children relate to their care providers’ enthusiasm and you can bet they will follow the lead.

Choosing the right activity will be an ongoing process of trial-and-error as you uncover the individual preferences of your child. The intuition you have developed as a parent along with routine observation will help you figure out the best way to keep your youngster healthy and active.

Quick Tips: Motivation

Give your child a gentle nudge off the couch with some tips from the experts (the AAP):

  • Lead by example: Your activity level sets a powerful example in the home. Parents who make exercise a priority in their own lives will significantly increase the chance that family members will do the same.
  • Get involved: Participating in family games and activities makes for solid bonding time — and the stuff of good memories. Sharing enthusiasm and a light-hearted challenge will get them moving; having fun will keep them moving.
  • Limit screen time: Restrict to two hours a day the number of hours your child is allowed to watch TV, play video games, and use the computer. Interactive video games that require the player to perform dance or sports moves can ease the blow of stricter guidelines and help kids transition from low to moderate levels of activity while in a somewhat private setting.
  • Hang loose: Keep the emphasis on fun and enjoyment. The more flexible you can be, the more your child will feel a sense of choice and control.
  • Eat well: Make the most of the benefits of physical activity by providing good nutrition and well-balanced meals at home.
  • Spread the word: Share your expectations with grandparents, teachers, and other caretakers to help reinforce healthy activities when your child is away from home.

Team Sports

Around the time children turn 10 years old, most have a refined understanding of tactics and strategies. The ability to understand verbal instruction and what their own senses tell them makes this age group prime for entering organized activities and team sports. Middle-school kids become even better candidates for team players as they age and become more social. It’s an exciting time for parents just as much as kids, but consider the practicalities before signing up.

  • Body type: Height, weight, and strength are serious contenders when it comes to reducing risk of injuries. Look for groups that are arranged by skill versus age.
  • Emotional maturity: The ability to handle ups and downs of competition, stick to routine, endure physical stress, and display sportsmanship are essential for a winning situation.
  • Cost: Equipment, uniforms, initiation fees, transportation, and medical care really add up. It’s not worth the expense if the strain on your budget creates stress at home, or if your child decides to try a new sport mid-season.
  • Leadership: Team with an instructor or coach whose experience, attitude, and values meet your approval.

This article was featured in Healthy Children Magazine. To view the full issue, click here.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

Crib-related Injuries

Crib Safety Awareness Heightens After Study Results

A study in the March 2011 issue of Pediatrics (published online Feb. 17), “Injuries Associated with Cribs, Playpens, and Bassinets Among Young Children in the United States, 1990-2008,”examined crib, playpen and bassinet injuries between 1990 and 2008.

During that time, an estimated 181,654 children younger than 2 years were treated in U.S. emergency departments for injuries related to cribs, playpens and bassinets. The majority of these injuries involved cribs, and the most common type of injury involved falls.

The authors point out that this study highlights the need for continued improvement in product design and acts as a reminder for parents to be aware of proper and safe use of these products.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

Make Valentines Day Everyday

Happy Valentine’s Day from Petite Pediatrics

 

To help you celebrate, here are 14 ways to show love for your child this Valentine’s Day.

1.    Use plenty of positive words with your child. Try to avoid using sarcasm. Children often don’t understand it, and if they do, it creates a negative interaction.
2.    Respond promptly and lovingly to your child’s physical and emotional needs and banish put-downs from your parenting vocabulary. Be available to listen to your child when he/she want to talk with you even if it’s an inconvenient time.
3.    Make an extra effort to set a good example at home and in public. Use words like “I’m sorry,” “please,” and “thank you.”
4.    When your child is angry, argumentative or in a bad mood, give him a hug, cuddle, pat, secret sign or other gesture of affection he favors and then talk with him about it when he’s feeling better.
5.    Use non-violent forms of discipline. Parents should institute both rewards and restrictions many years before adolescence to help prevent trouble during the teenage years. Allowing children of any age to constantly break important rules without being disciplined only encourages more rule violations.
6.    Make plans to spend time alone with your young child or teen doing something she enjoys. Send a Valentine’s Day card to your older child or teen. Make Valentine’s Day cards together with your preschool or younger school age child.
7.    Mark family game nights on your calendar so the entire family can be together. Put a different family member’s name under each date, and have that person choose which game will be played that evening.
8.    Owning a pet can make children, especially those with chronic illnesses and disabilities, feel better by stimulating physical activity, enhancing their overall attitude, and offering constant companionship.
9.    One of the best ways to familiarize your child with good food choices is to encourage him to cook with you. Let him get involved in the entire process, from planning the menus to shopping for ingredients to the actual food preparation and its serving. It is wonderful when families eat together as much as possible. Good food, good conversations.
10.    As your child grows up, she’ll spend most of her time developing and refining a variety of skills and abilities in all areas of her life. You should help her as much as possible by encouraging her and providing the equipment and instruction she needs. Start reading to your child beginning at six months. Avoid TV in the first two years, monitor and watch TV with your older children and use TV time as conversation time with your children. Limit computer and video games.
11.    Your child’s health depends significantly on the care and guidance you offer during his early years. By taking your child to the doctor regularly for preventive health care visits, keeping him safe from accidents, providing a nutritious diet, and encouraging exercise throughout childhood, you help protect and strengthen his body.
12.    Help your child foster positive relationships with friends, siblings and members of the community.
13.    One of your most important gifts as a parent is to help your child develop self-esteem. Your child needs your steady support and encouragement to discover his strengths. He needs you to believe in him as he learns to believe in himself. Loving him, spending time with him, listening to him and praising his accomplishments are all part of this process.
14.    Don’t forget to say, “I love you” to children of all ages!

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

IRS Ruling on Breast Pumps

IRS Ruling on Breast Pumps

“The American Academy of Pediatrics (AAP) hails the IRS ruling on February 10th that recognizes breast pumps and breastfeeding supplies as medical expenses worthy of reimbursement through Flexible Spending Accounts.

“Today’s IRS ruling providing favorable tax treatment for the purchase of breast pumps and breastfeeding equipment marks an important victory for the health of women and children across the country by making breastfeeding a more practical option for new and working mothers.

“For years, the AAP has been urging the IRS to recognize that breast milk is not just the best and most natural food for infants; it confers well-documented health benefits on both baby and mother that cannot be obtained any other way. The IRS has finally acknowledged this medical fact, and we applaud them for changing their regulations accordingly.

“Due to resounding evidence of improved child health and well-being, the AAP recommends that mothers breastfeed exclusively for the first six months and continue breastfeeding for at least the first year of a child’s life. As many as 45 percent to 50 percent of mothers return to work full time within six months of their infant’s birth; breast pumps allow working mothers to continue breastfeeding. Before today, steep cost burdens could prevent working mothers from purchasing breast pumps and related equipment.

“Now, more women will be able to pass on the health benefits of breastfeeding to their babies, which include protections against asthma and other respiratory illnesses, bacterial and viral infections, and obesity, among other ailments. Pre-tax dollars already cover expenses like immunizations and bandages, and thanks to today’s ruling, women who wish to breastfeed will experience these same cost savings for breastfeeding supplies.”

via HealthyChildren.org – AAP Applauds IRS Ruling on Breast Pumps.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

Dining In With Newborn

Going home with a newborn in your arms means the beginning of a whole new life for you and your family. Managing the differences between expectations and reality—especially in terms of feeding your baby—can go a long way toward making it not just a smooth transition, but also a time of joy.  To help moms prepare Petite Pediatrics is offering prenatal lactation consults for expecting moms.

Kathy Klammer is a nurse who is an International Board Certified Lactation Consultant (IBCLC) who has many years of experience working with breastfeeding moms.   She provides Lactation Services and is available for home or office visits within the first few weeks of life, but is also available prenatally for expectant mothers who are anxious about breastfeeding or have specific concerns such as reduction and other breast surgeries as well as illnesses or medications that could affect the breastfeeding relationship. This provides a unique opportunity to discuss concerns, teaching of latch-on techniques and suggestions on how to get off to a good start in the early weeks.

To help prepare you for feeding your newborn, here is some helpful information about breastfeeding and formula feeding.

Breastfeeding

You’ve probably heard it before: “Breast is best.” But is it really?

Yes, from both a nutritional and infection prevention standpoint. Breast milk is currently unrivaled as the ideal food for infants. The infection fighting antibodies it contains just can’t be bottled in even the most expensive of commercial formulas, and breast milk has been shown to reduce a newborn’s chance of developing everything from ear infections, allergies, vomiting, and diarrhea to pneumonia, meningitis, and potentially even sudden infant death syndrome.

True, breastfeeding is “natural.” But that doesn’t mean that getting started with breastfeeding is easy. Those first couple of weeks can be challenging, because in reality, there is usually a period of self-education and on-the-breast training. We recommend taking it step by step, keeping a few precautions in mind, and being patient as you and your baby learn how to do it. Remember, millions of women have successfully breastfed their babies; you can do it, too.

Here are some tips for breastfeeding success:

  • If all goes well with the birth of your baby and you’re both doing well after delivery, start breastfeeding as soon as possible—right there in the hospital.
  • Ask for help – Lactation nurses can assist with techniques to help mom and baby get started in the right direction.
  • Focus on getting the process of “latching” (how your baby attaches to your breast) down pat. First, make yourself comfortable; use pillows for support and put anything you might need during breastfeeding within easy reach. Then get your baby interested in breast milk by rubbing a few drops around your nipple. If baby doesn’t respond, try stroking around his mouth to stimulate what’s known as the “rooting reflex.” If he still doesn’t open wide enough, gently press down on the chin.
  • Don’t settle for “almost on”: Improper latching on can quickly result in sore breasts and a frustrated (and still hungry) baby. Keep repositioning until baby’s tongue is under the nipple, so he can draw the nipple and the darker-colored area around the nipple (called the areola) into his mouth. This will make breastfeeding success more likely for you both.

Formula

So if breastfeeding is so beneficial, is formula even acceptable for feeding your newborn? The answer is yes. In fact, most parents will use formula at some point during their child’s first year. And while formula can’t exactly match the nutritional makeup of breast milk and doesn’t contain the added benefit of infection-fighting antibodies, it nevertheless serves a very valuable purpose for those who are not able or choose not to breastfeed.

There are three basic types of formula—those based on cow milk, those based on soy, and those that are “specialized,” “hypoallergenic,” or “elemental” (which means the formula’s components are broken down for easier digestion). Most babies do fine with the first two types, but some babies may need an elemental formula if they have difficulty digesting the other types.

There is much to consider with baby formula. For starters, here are some tips for making sure your baby gets what she needs from her formula:

  • Formulas are iron fortified because iron is a critical part of a healthy baby diet. Some people mistakenly assume that iron causes stomach pain or constipation in infants. In fact, babies only absorb a small percentage of the iron in their food, and most babies tolerate iron-enriched formulas without a problem. If you have concerns about this, talk with your pediatrician.
  • Consider how often you intend to use formula for feeding before buying a certain type. Also factor in whether you want to pay for the added convenience of ready-to-feed, or if using powdered formula on the road, or at home, better suits your needs and your budget.
  • Stock up so you don’t run out. Before you do this, however, make sure your baby is happy with the formula you’ve chosen.  Check the expiration dates, too; you don’t want to buy more than you can use before that date.
  • It’s worth mentioning that about 10 percent of babies are lactose- or soy-intolerant, a condition called milk soy protein intolerance (MSPI). These babies tend to start fussing soon after eating, spit up, become gassy, or have problems with constipation or diarrhea. If your baby reacts this way to eating formula, talk with your pediatrician.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

Changing Parental Behavior May Help Obese Kids Lose Weight

Young children of parents who took classes in nutrition, exercise kept weight off for 2 years

According to study findings reported in the February issue of Pediatrics, it’s hard to help overweight children lose weight, and keeping it off over the long-term is even tougher. But obese children whose parents took classes on the importance of healthy eating and exercise lost weight and kept it off for the next two years, according to a new Australian study.

Researchers said the study shows that targeting parents — rather than the children — can help stave off weight gain in children aged 5 to 9.

“We believe it makes developmental sense to involve only parents,” said lead study author Anthea Magarey, a senior research associate of nutrition and dietetics, at Flinders University School of Medicine in Adelaide, Australia, where the study took place. “It takes the stigma away from the child and supports a whole family approach.”

For young children, parents play a huge role in their eating and exercise habits, Magarey explained. The kids are still spending most of their time at home and eating most meals at home. Parents buy and prepare food, and decide what and how much kids can eat. They are responsible for providing opportunities for children to be active and can set rules for TV and video game use.

The researchers enrolled mostly mothers of 169 moderately obese or overweight children aged 5 to 9 years in a six-month “healthy lifestyle” course, in which parents were taught about portion size and reading nutrition labels, being a good role model for their children and setting limits. (Half of the parents also took a parenting course, although the study authors found little difference between the two groups).

At the end of six months, children’s body mass index (a measurement that takes into account weight and height) dropped an average of 10 percent, as did their waist circumference. Eighteen months later, the children had kept the weight off, the investigators found.

In the United States, about 17 percent of children and adolescents aged 2 to 19 years are obese, a number that has been increasing since the 1970s, according to the U.S. Centers for Disease Control and Prevention.

About 24 percent of U.S. children aged 2 to 5 are overweight, meaning they have a BMI in the 85th percentile or above for their height and age. That number rises to 33 percent among children aged 6 to 11, according to the CDC.

After the healthy lifestyle sessions, parents said they felt more comfortable saying “no” to their children’s demands, setting limits on the type of food the children could eat, limiting the amount of time they spent watching TV or playing video games, and establishing consequences for breaking the rules.

Parents assessed their own current eating patterns and set their own goals for change, such as limiting TV to no more than two hours a day, doing more active family activities and making small dietary changes that can go a long way, such as eating more fruit and vegetables, using reduced-fat dairy products and drinking fewer sweetened beverages such as sodas.

Kathy Kolasa, a professor of nutrition services and patient education at East Carolina University in Greenville, N.C., said she does not believe children have to be excluded from obesity prevention programs because of the risk of stigmatizing them.

But making sure parents know about nutrition, portion size and how to make sure their children are getting enough physical activity is critical.

“In my experience, there are plenty of parents who tell me they know what to feed their kids and that they are eating healthy,” Kolasa said. “When we analyze their diet, they are surprised that they are not following or providing age-appropriate portions and healthy foods for their kids.”

As for the parents included in the study, their weight did not change over the two years.

SOURCES: Anthea Magarey, Ph.D., senior research associate, nutrition and dietetics, Flinders University School of Medicine, Adelaide, Australia; Kathryn M. Kolasa, Ph.D., R.D., professor, nutrition services and patient education, East Carolina University, Greenville, N.C.; February 2011, Pediatrics

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

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