Charish Barry, MD Charish Barry, MD

Year: 2015

New Year’s Resolutions for Kids

Posted on by Charish Barry, MD in

Healthy New Year’s Resolutions for Kids

​​The start of the new year is a great time to help your children focus on forming good habits. The American Academy of Pediatrics (AAP) provides the following list of ideas for you to talk to your children about trying, depending on their age. ​

Preschoolers
I will clean up​ my toys by putting them where they belong.

I will let my parents help me  brush my teeth twice a day.
I will wash my hands after going to the bathroom and before eating.

I will help clear the table when I am done eating.
I will be friendly to all animals. I will remember to ask the owners if I can pet their animal first.

I will be nice to other kids who need a friend or look sad or lonely.

I will talk with my parent or a trusted adult when I need help or am scared.

Kids, 5 to 12 years old
I will drink reduced-fat milk​ and water every day, and drink soda and fruit drinks only at special times.

I will take care of my skin by putting on sunscreen before I go outdoors on bright, sunny days. I will try to stay in the shade whenever possible and wear a hat and sunglasses, especially when I’m playing sports.

I will try to find a sport (like basketball or soccer) or an activity (like playing tag, jumping rope, dancing or riding my bike) that I like and do it at least three times a week!

I will always wear a helmet when riding a bike, scooter or skateboard.

I will wear my seat belt every time I get in a car. I’ll sit in the back seat and use a booster seat until I am tall enough to use a lap/shoulder seat belt.

I’ll be friendly to kids who may have a hard time making friends by asking them to join activities such as sports or games.

I will always tell an adult about any bullying I may see or hear about to help keep school safe for everyone.

I will keep my personal information safe and not share my name, home address, school name or telephone number on the Internet. Also, I’ll never send a picture of myself to someone I chat with on the computer without asking my parent if it is okay.

I will try to talk with my parent or a trusted adult when I have a problem or feel stressed.

I promise to follow our household rules for videogames and internet use.

Kids, 13 years old and older

I will try to eat two servings of fruit and two servings of vegetables every day, and I will drink sodas only at special times.

I will take care of my body through physical activity and eating the right types and amounts of foods.

I will choose non-violent television shows and video games, and I will spend only one to two hours each day – at the most – on these activities. I promise to follow our household rules for videogames and internet use.

I will help out in my community – through giving some of my time to help others, working with community groups or by joining a group that helps people in need.

When I feel angry or stressed out, I will take a break and find helpful ways to deal with the stress, such as exercising, reading, writing in a journal or talking about my problem with a parent or friend.

When faced with a difficult decision, I will talk about my choices with an adult whom I can trust.

When I notice my friends are struggling, being bullied or making risky choices, I will talk with a trusted adult and attempt to find a way that I can help them.

I will be careful about whom I choose to date, and always treat the other person with respect and without forcing them to do something or using violence. I will expect to be treated the same way in return.

I will resist peer pressure to try tobacco-cigarettes, drugs, or alcohol. I will also avoid the use of e-cigarettes.

I agree not to use a cell phone or text message while driving and to always use a seat belt.

https://www.healthychildren.org/English/news/Pages/Healthy-New-Years-Resolutions-for-Kids.aspx

​
Published
12/16/2015 12:00 AM

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.

(805) 845-1221

Happy Holidays! Holiday Safety and Mental Health Tips

Posted on by Charish Barry, MD in

Holiday Safety & Mental Health Tips

The holidays are an exciting time of year for kids, and to help ensure they have a safe holiday season, here are some tips from the American Academy of Pediatrics (AAP).

TREES
When purchasing an artificial tree, look for the label “Fire Resistant.”
When purchasing a live tree, check for freshness. A fresh tree is green, needles are hard to pull from branches and needles do not break when bent between your fingers. The trunk butt of a fresh tree is sticky with resin, and when tapped on the ground, the tree should not lose many needles.
When setting up a tree at home, place it away from fireplaces, radiators or portable heaters. Place the tree out of the way of traffic and do not block doorways.
Cut a few inches off the trunk of your tree to expose the fresh wood. This allows for better water absorption and will help keep your tree from drying out and becoming a fire hazard.
Be sure to keep the stand filled with water, because heated rooms can dry live trees out rapidly.
LIGHTS
Check all tree lights (even if you’ve just purchased them) before hanging them on your tree. Make sure all the bulbs work and that there are no frayed wires, broken sockets or loose connections.
Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights, and a person touching a branch could be electrocuted.
Some light stands may contain lead in the bulb sockets and wire coating, sometimes in high amounts. Make sure your lights are out of reach of young children who might try to mouth them, and wash your hands after handling them.
Before using lights outdoors, check labels to be sure they have been certified for outdoor use. To hold lights in place, string them through hooks or insulated staples, not nails or tacks. Never pull or tug lights to remove them.
Plug all outdoor electric decorations into circuits with ground fault circuit interrupters to avoid potential shocks.
Turn off all lights when you go to bed or leave the house. The lights could short out and start a fire.
DECORATIONS
Use only non-combustible or flame-resistant materials to trim a tree. Choose tinsel or artificial icicles of plastic or nonleaded metals.
Never use lighted candles on a tree or near other evergreens. Always use non-flammable holders, and place candles where they will not be knocked over.
In homes with small children, take special care to avoid decorations that are sharp or breakable. Keep trimmings with small removable parts out of the reach of children to prevent them from swallowing or inhaling small pieces. Avoid trimmings that resemble candy or food that may tempt a young child to eat them.
Wear gloves to avoid eye and skin irritation while decorating with spun glass “angel hair.” Follow container directions carefully to avoid lung irritation while decorating with artificial snow sprays.
Remove all wrapping papers, bags, paper, ribbons and bows from tree and fireplace areas after gifts are opened. These items can pose suffocation and choking hazards to a small child or can cause a fire if near flame.
Keep potentially poisonous holiday plant decorations, including mistletoe berries, Jerusalem cherry, and holly berry, away from children.
TOY SAFETY
Select toys to suit the age, abilities, skills and interest level of the intended child. Toys too advanced may pose safety hazards for younger children.
Before buying a toy or allowing your child to play with a toy that he has received as a gift, read the instructions carefully.
To prevent both burns and electrical shocks, don’t give young children (under age 10) a toy that must be plugged into an electrical outlet. Instead, buy toys that are battery-operated.
Young children can choke on small parts contained in toys or games. Government regulations specify that toys for children under age three cannot have parts less than 1 1/4 inches in diameter and 2 1/4 inches long.
Children can have serious stomach and intestinal problems – including death — after swallowing button batteries or magnets. In addition to toys, button batteries are often found in musical greeting cards, remote controls, hearing aids and other small electronics. Small, powerful magnets are present in many homes as part of building toy sets. Keep button batteries and magnets away from young children and call your health care provider immediately if your child swallows one.
Children can choke or suffocate on uninflated or broken balloons; do not allow children under age 8 to play with them.
Remove tags, strings, and ribbons from toys before giving them to young children.
Watch for pull toys with strings that are more than 12 inches in length. They could be a strangulation hazard for babies.
Parents should store toys in a designated location, such as on a shelf or in a toy chest, and keep older kids’ toys away from young children.
FOOD SAFETY
Bacteria are often present in raw foods. Fully cook meats and poultry, and thoroughly wash raw vegetables and fruits.
Be sure to keep hot liquids and food away from the edges of counters and tables, where they can be easily knocked over by a young child’s exploring hands. Be sure that young children cannot access microwave ovens.
Wash your hands frequently, and make sure your children do the same.
Never put a spoon used to taste food back into food without washing it.
Always keep raw foods and cooked foods separately, and use separate utensils when preparing them.
Always thaw meat in the refrigerator, never on the countertop.
Foods that require refrigeration should never be left at room temperature for more than two hours.
HAPPY VISITING
Clean up immediately after a holiday party. A toddler could rise early and choke on leftover food or come in contact with alcohol or tobacco.
Remember that the homes you visit may not be childproofed. Keep an eye out for danger spots like unlocked cabinets, unattended purses, accessible cleaning or laundry products, stairways, or hot radiators.
Keep a list with all of the important phone numbers you or a baby-sitter are likely to need in case of an emergency. Include the police and fire department, your pediatrician and the national Poison Help Line, 1-800-222-1222. Laminating the list will prevent it from being torn or damaged by accidental spills.
Always make sure your child rides in an appropriate car seat, booster seat, or seat belt. In cold weather, children in car seats should wear thin layers with a blanket over the top of the harness straps if needed, not a thick coat or snowsuit. Adults should buckle up too, and drivers should never be under the influence of alcohol or drugs.
Traveling, visiting family members, getting presents, shopping, etc., can all increase yourchild’s stress levels. Trying to stick to your child’s usual routines, including sleep schedules and timing of naps, can help you and your child enjoy the holidays and reduce stress.
FIREPLACES
Before lighting any fire, remove all greens, boughs, papers, and other decorations from fireplace area. Check to see that the flue is open.
Use care with “fire salts,” which produce colored flames when thrown on wood fires. They contain heavy metals that can cause intense gastrointestinal irritation and vomiting if eaten. Keep them away from children.
Do not burn gift wrap paper in the fireplace. A flash fire may result as wrappings ignite suddenly and burn intensely.
If a glass-fronted gas fireplace is used, keep children and others well away from it with a screen or gate. The glass doors can get hot enough to cause serious burns and stay hot long after the fire is out.
HOLIDAY MENTAL HEALTH TIPS
Take care of yourself both mentally and physically. Children and adolescents are affected by the emotional well-being of their parent or caregivers. Coping with stress successfully can help children learn how to handle stress better, too.
Make a plan to focus on one thing at a time. Try a few ideas from “mindfulness” as a strategy to balance the hustle and bustle of things like shopping, cooking, and family get-togethers during the holidays: Stop and pay attention to what is happening at the moment, focus your attention on one thing about it ,and notice how you are feeling at the time. Withhold immediate judgment, and instead be curious about the experience.
Give to others by making it an annual holiday tradition to share your time and talents with people who have less than you do. For example, if your child is old enough, encourage him or her to join you in volunteering to serve a holiday meal at your local food bank or shelter or sing at a local nursing home. Help your child write a letter to members of the armed forces stationed abroad who can’t be home with their own family during the holidays.
Remember that many children and adults experience a sense of loss, sadness or isolation during the holidays. It is important to be sensitive to these feelings and ask for help for you, your children, family members or friends if needed.
Try to keep household routines the same. Stick to your child’s usual sleep and mealtime schedules when you can, which may reduce stress and help your family enjoy the holidays.
Kids still need to brush their teeth twice a day!
Don’t feel pressured to “over-spend on gifts.” Consider making one or two gifts. Help your child make a gift for his or her other parent, grandparents, or other important adults and friends. Chances are, those gifts will be the most treasured ones and will teach your child many important lessons.
Most important of all, enjoy the holidays for what they are — time to enjoy with your family. So, be a family, do things together like sledding or playing board games, and spend time visiting with relatives, neighbors, and friends.
Published
11/17/2015 12:00 AM

FROM HEALTHYCHILDREN.ORG

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.

(805) 845-1221

UPDATED Media and Screen Time Recommendations

Posted on by Charish Barry, MD in

Where We Stand: TV Viewing Time

The American Academy of Pediatrics (AAP) recommends that parents and caregivers minimize or eliminate altogether media exposure for children under the age of two.

For older preschool-aged children, media limits are very appropriate and parents should have a strategy for managing electronic media when choosing to maximize its benefits.

Remember that supervised independent play for infants and young children has been shown to have superior benefit to the use of screen media when you cannot sit down and actively engage in play with your child. For example, have your child play with nesting cups on the floor nearby while you prepare dinner.

Also, avoid placing a television set in your child’s bedroom and recognize that your own media use can have a negative effect on children.

Additional Information:
How to Make a Family Media Use Plan
The Benefits of Limiting TV
What Children are NOT Doing When Watching TV
Why to Avoid TV Before Age 2
Sleep and Mental Health
Last Updated
8/20/2015
Source
Caring for Your Baby and Young Child: Birth to Age 5, 6th Edition (Copyright © 2015 American Academy of Pediatrics)

The Benefits of Limiting TV

The AAP discourages TV and other media use by children younger than 2 years and encourages interactive play. For older children, total entertainment screen time should be limited to less than 1 to 2 hours per day.

You’ll all discover more constructive ways to fill the time, separately and together. Some examples include:

Reading

Exercising

Taking part in outdoor activities

Talking more to one another

Expect to encounter resistance at first. After all, change is never easy. If yours is a household where the TV regularly blares for five, six or seven hours a day, wean the family gradually. Try cutting down by an hour a week or go cold turkey. The two-hour maximum includes time spent in front of any screen, including the computer and video games.

Make TV viewing an active choice, as if you were picking a movie from the newspaper. “How about if we watch at seven-thirty?”

Hide the remote! Eliminate channel surfing, which encourages passive viewing. When family members have to get up to change the channel, they may be more selective about the programs they watch. If nothing else, at least they’ll be getting some exercise.

When the show you wanted to watch is over, turn off the set. Also, if the program you choose isn’t compelling enough to watch actively, it’s not worth keeping on as background noise.

Make a household rule: no TV in your youngster’s bedroom. Although adolescents deserve their privacy, they hardly need another reason to isolate themselves from the rest of the family. Children should watch their favorite shows in a central area of the home. Even if you’re not sitting down with them, this allows for conversation when you’re passing through and enables you to  keep closer tabs on what they’re watching.

Whenever possible, videotape programs and watch them later. Fastforwarding through commercials will shave ten minutes off every hour of TV viewing, not to mention help your youngster hold on to her allowance longer. (When watching TV in “real time,” mute the sound during the breaks.) Taping shows ahead of time also allows you to hit the PAUSE button when you want to make a point or have a family discussion about something you’ve just seen onscreen. 

Discourage repeated viewings of the same video. The graphic language, violence and sexual content of movies rated PG-13 and R can have a cumulative effect on a child if they’re watched over and over again.

Harness the power of television in a positive way. For all its flaws, TV can be a valuable tool for learning and expanding one’s awareness of the world.

Here’s what you can do to help your child get the most enjoyment out of the experience:

>Peruse the TV listings for programs, specials, documentaries and other films that explore areas of interest to him.
>Use events in the news and subjects of fictitious programs as springboards for discussion.
>Encourage your youngster to broaden her horizons by watching programs that transport her to other times and places, or that expose her to different perspectives or philosophies.
>Make use of ratings systems to know whether or not a program or movie is appropriate for your child. The National Association of Broadcasters (NAB), the National Cable Television Association (NCTA) and the Motion Picture Association of America (MPAA) jointly developed the “TV Parental Guidelines,” similar to themovie-rating system adopted by the MPAA in 1966.

Talk back to your TV! Parents are rightfully perturbed about  the seemingly endless stream of violence and sex in television  programs and films, including those aimed at young people. We  should be equally concerned about what they don’t show: namely, the real-life consequences of such actions. For example, 75 percent of the violent scenes on TV fail to show the perpetrator expressing remorse, or being criticized or penalized  for his actions. Similarly, a study from the Henry J. Kaiser Family Foundation found that over a one-week period, roughly 90 percent of the television programs containing sex scenes did not include a single reference to the risk of pregnancy or acquiring a sexually transmitted disease from unprotected sex.
Last Updated
8/20/2015
Source
Adapted from Caring for Your Teenager (Copyright © 2003 American Academy of 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.

(805) 845-1221

Insect Bites and Stings

Posted on by Charish Barry, MD in

Your child’s reaction to a bite or sting will depend on her sensitivity to the particular insect’s venom. While most children have only mild reactions, those who are allergic to certain insect venom can have severe symptoms that require emergency treatment.

In general, bites are usually not a serious problem, but in some cases, stings may be. While it is true that most stings (from yellow jackets, wasps, and fire ants, for example) may cause pain and localized swelling, severe anaphylactic reactions are possible, although uncommon.

If your child is having a severe reaction to an insect bite or sting, call for medical help immediately.  If your child is experiencing moderate pain or itching for a prolonged period of time, call (805) 845-1221 to schedule an appointment at Petite Pediatrics today. Our highly trained pediatrician, Dr. Charish Barry, can treat the bite or sting and test for allergies if deemed necessary.

Treatment

Although insect bites can be irritating, they usually begin to disappear by the next day and do not require a doctor’s treatment. To relieve the itchiness that accompanies bites by mosquitoes, flies, fleas, and bedbugs, apply a cool compress and/or calamine lotion freely on any part of your child’s body except the areas around her eyes and genitals. If your child is stung by a wasp or bee, soak a cloth in cold water and press it over the area of the sting to reduce pain and swelling. Call your pediatrician before using any other treatment, including creams or lotions containing antihistamines or home remedies. If the itching is severe, the doctor may prescribe oral antihistamines.

If your child disturbs a beehive, get him away from it as quickly as possible. The base of a honeybee’s sting emits an alarm pheromone (hormone) that makes other bees more likely to sting as well.

It is very important to remove a bee stinger quickly and completely from the skin. The quick removal of a bee stinger will prevent a large amount of venom from being pumped into the skin. If the stinger is visible, remove it by gently scraping it off horizontally with a credit card or your fingernail. Avoid squeezing the stinger with a pair of tweezers; doing this may release more venom into the skin. The skin may be more swollen on the second or third day after a bee sting or mosquito bite.

Keep your child’s fingernails short and clean to minimize the risk of infection from scratching. If infection does occur, the bite will become redder, larger, and more swollen. In some cases you may notice red streaks or yellowish fluid near the bite or your child may get a fever. Have your pediatrician examine any infected bite right away, because it may need to be treated with antibiotics.

Call for medical help immediately if your child has any of these other symptoms after being bitten or stung:

  • Sudden difficulty in breathing
  • Weakness, collapse, or unconsciousness
  • Hives or itching all over the body
  • Extreme swelling near the eyes, lips, or penis that makes it difficult for the child to see, eat, or urinate
  • Prevention
  • Some children with no other known allergies may have severe reactions to insect stings. But if you suspect that your child is allergy-prone, discuss the situation with your doctor. He may recommend a series of shots (hyposensitization injections) to decrease your child’s reaction to future insect stings (but not bites). In addition, he will prescribe a special auto-injection kit containing epinephrine for you to keep on hand for use if your child is stung.

It is impossible to prevent all insect bites, but you can minimize the number your child receives by following these guidelines.

Avoid areas where insects nest or congregate, such as garbage cans, stagnant pools of water, uncovered foods and sweets, and orchards and gardens where flowers are in bloom.
When you know your child will be exposed to insects, dress her in long pants and a lightweight longsleeved shirt.
Avoid dressing your child in clothing with bright colors or flowery prints, because they seem to attract insects.
Don’t use scented soaps, perfumes, or hair sprays on your child, because they also are inviting to insects.
Insect repellents are generally available without a prescription, but they should be used sparingly on infants and young children. In fact, the most common insecticides include DEET (N, N-diethyl-m-toluamide), which is a chemical not recommended for use in children under two months of age. Do not apply DEET-containing repellents more than once a day on older children.

The concentrations of DEET vary significantly from product to product—ranging from less than 10 percent to over 30 percent—so read the label of any product you purchase. Some products have concentrations much higher than 30 percent, and the higher the concentration of DEET, the longer the duration of action. Its effectiveness peaks at a concentration of 30 percent, however, which is also the maximum concentration currently recommended for children. The safety of DEET does not appear to be related to its level of concentration; therefore, a prudent approach is to select the lowest effective concentration for the amount of time your child spends outdoors. You should avoid products that include DEET plus a sunscreen, because sunscreen needs to be applied frequently while DEET should be applied only once a day. If you apply DEET more frequently, it may be associated with toxicity. Also be sure to wash off the DEET with soap and water at the end of the day.

An alternative to DEET is a product called picaridin (KBR 3023). While it has had wider use in Europe, picaridin has more recently become available in the US. It is a generally pleasant- smelling product without the oil residue associated with DEET, and is available in concentrations of 5 to 10 percent.

The American Academy of Pediatrics recommends that repellents used in children over six months of age have 30 percent DEET or 5 to 10 percent picaridin repellent, applied once before going outdoors. These repellents are effective in preventing bites by mosquitoes, ticks, fleas, chiggers, and biting flies, but have virtually no effect on stinging insects such as bees, hornets, and wasps. Contrary to popular belief, giving antihistamines continuously throughout the insect season does not appear to prevent reactions to bites.

Insect Bites and Stings

Mosquitoes
Water (pools, lakes, birdbaths)
Stinging sensation followed by small, red, itchy mound with tiny puncture mark at center.
Mosquitoes are attracted by bright colors and sweat.

Flies
Food, garbage, animal waste
Painful, itchy bumps; may turn into small blisters.
Bites often disappear in a day but may last longer.

Fleas
Cracks in floor, rugs, pet fur
Multiple small bumps clustered together; often where clothes fit tightly (waist, buttocks).
Fleas are most likely to be a problem in homes with pets.

Bedbugs
Cracks of walls, floors, crevices of furniture, bedding
Itchy red bumps occasionally topped by a blister; usually 2–3 in a row.
Bedbugs are most likely to bite at night and are less active in cold weather.

Fire ants
Mounds in pastures, meadows, lawns, and parks in southern states
Immediate pain and burning; swelling up to 1⁄2 inch (1.2 cm); cloudy fluid in area of bite.
Fire ants usually attack intruders.

Bees and wasps
Flowers, shrubs, picnic areas, beaches
Immediate pain and rapid swelling.
A few children have severe reactions, such as difficulty breathing and hives/swelling all over the body.

Ticks
Wooded areas
May not be noticeable; hidden on hair or on skin.
Don’t remove ticks with matches, lighted cigarettes, or nail polish remover; grasp the tick firmly with tweezers near the head; gently pull the tick straight out.

 

Introducing CloudVisit Telemedicine at Petite Pediatrics

Posted on by Charish Barry, MD in ,

 

We are excited to offer our patients the option of a telemedicine visit.

Telemedicine is a secure way to communicate with Dr. Barry via electronic devices such as smart phones, tablet and lap/desktop computers. For families that may be traveling outside of the Santa Barbara area, this enables us to maintain continuity of care by discussing and evaluating non-emergent medical concerns.

The American Academy of Pediatrics has endorsed the use of telemedicine for children’s healthcare and recommends that telemedicine services be delivered in the context of a medical home, because this model of health care provides continuity and efficiency.

You can register with our telemedicine service CloudVisit Connect by linking to the icon above.

This is a service that is billable to insurance and  is based upon the duration of time for the telemedicine appointment.

Newborn Eye Color

Posted on by Charish Barry, MD in

https://www.healthychildren.org/English/ages-stages/baby/Pages/Newborn-Eye-Color.aspx

Newborn Eye Color

New parents often ask what color I think the baby’s eyes are going to be. I never answer this question until the child is at least 1 year old; I mean, what if the parents believe me and use my answer to make major life decisions? When we talk about eye color, we’re really talking about the appearance of the iris, the muscular ring around the pupil that controls how much light enters the eye. After all, the pupil will always be black, except in flash photos, and the whites (sclera) should stay pretty much white, although jaundice may turn them yellow and inflammation may make them look pink or red.

Gray or Blue Eyes at Birth
Iris color, just like hair and skin color, depends on a protein called melanin. We have specialized cells in our bodies called melanocytes whose job it is to go around secreting melanin where it’s needed, including in the iris. When your baby is born his eyes will be gray or blue, as melanocytes respond to light, and he has spent his whole life in the dark.

Eye Color Changes Over Time
Over time, if melanocytes only secrete a little melanin, your baby will have blue eyes. If they secrete a bit more, his eyes will look green or hazel. When melanocytes get really busy, eyes look brown (the most common eye color), and in some cases they may appear very dark indeed. Because it takes about a year for melanocytes to finish their work it can be a dicey business calling eye color before the baby’s first birthday. The color change does slow down some after the first 6 months of life, but there can be plenty of change left at that point.

Eye color is a genetic property, but it’s not quite as cut-and-dried as you might have learned in biology class.

  • Two blue-eyed parents are very likely to have a blue-eyed child, but it won’t happen every single time.
    Two brown-eyed parents are likely (but not guaranteed) to have a child with brown eyes.
    If you notice one of the grandparents has blue eyes, the chances of having a blue-eyed baby go up a bit.
    If one parent has brown eyes and the other has blue eyes, odds are about even on eye color.
    If your child has one brown eye and one blue eye, bring it to your doctor’s attention; he probably has a rare genetic condition called Waardenburg syndrome.

Cross-Eyed?
Parents also often note that their newborns’ eyes appear to cross from time to time. For the first 6 months of life this can be normal. To begin with, to look at something the brain has to know where to point the eyes. For the first 2 to 4 weeks of life vision is not accurate enough for the baby’s eyes to find a target a lot of the time. Parents often feel like their newborns are looking past them rather than at them, because they are. By the fourth week of life, however, your baby will focus on your face if you’re cradling him.

Most visual development occurs in the brain, not in the eyes themselves. One of the greatest challenges for the developing brain is to coordinate visual signals from one side to the other. Nerve signals from the eyes travel through optic nerves and split off to both sides of the brain. To make sense of those signals, the 2 sides of the brain have to cooperate, comparing information and coordinating eye movement in the desired direction. Until age 2 months you may notice your infant will follow your face or a toy a little way, then lose it as it crosses from one side to the other. By 2 months, however, he should be able to track from right to left and back again.

The next big visual milestone occurs at 6 months of age. By this time the 2 sides of the brain are on good terms with each other. Until this point the eyes track together as long as they both have something to look at, but if one is deprived of input (from being covered by a hat, for example), it might drift off in its own direction. By 6 months of age the eyes should continue looking the same direction even if one of them is covered temporarily. We test this in the clinic by covering 1 eye for 3 seconds, then suddenly uncovering it and looking to see if it’s still tracking with the opposite eye. We call this test the cover-uncover test.

Sometimes the shape of a child’s face makes it look as though the eyes are crossed even when they are not. A child with a broad nasal bridge may appear to have an inward-looking eye, when in fact he’s just looking off to the side. You can check this by watching the light reflection in your child’s eyes from a window or lamp; if it falls in the same place on each eye, the eyes are working together.

Even with office screening, however, we don’t always catch an eye that tends to deviate. Deviations occur more often when the child is tired. If you ever notice that your 6-month-old or older child has an eye that doesn’t always look the same way as its partner, alert his doctor. It’s critical that an eye specialist (ophthalmologist)examine the child. What some people call a lazy eye (amblyopia) may be a sign that one eye doesn’t see as clearly as the other. When the brain is forced to make 1 picture from 2 very different inputs, it starts to ignore the signals from the worse eye. Over time this process becomes irreversible, leading to partial blindness in the weaker eye. In most cases, you should address the problem before the child turns 3 to ensure he’ll grow up with normal depth perception. Treatments for amblyopia vary based on the cause and severity of the condition. Some children require glasses or patches that force the brain to pay attention to signals from the weaker eye. Other kids need surgery to shorten or lengthen certain muscles that control eye movement.
Author
David L. Hill, MD, FAAP
Last Updated
5/6/2015
Source
Dad to Dad: Parenting Like a Pro (Copyright © American Academy of Pediatrics 2012)

Tips on Physical Activity for School-Aged Children

Posted on by Charish Barry, MD in

https://www.healthychildren.org/English/healthy-living/fitness/Pages/Energy-Out-Daily-Physical-Activity-Recommendations.aspx

Energy Out: Daily Physical Activity Recommendations

​Physical activity in children and adolescents improves strength and endurance, builds healthy bones and lean muscles, develops ​motor skills and coordination, reduces fat, and promotes emotional well-being (reduces feelings of depression and anxiety). Activities should be appropriate for their age and fun, as well as offer variety.

The daily recommendation for physical activity for children 6 years and older is at least 60 minutes per day. Active play is the best exercise for younger children.
The types of physical activity should be moderate to vigorous. Vigorous activity is activity that makes you breathe hard and sweat. During vigorous activity, it would be difficult to have a talk with someone. Some activities, such as bicycling, can be of moderate or vigorous intensity, depending upon level of effort.

The 60 minutes does not need to be done all at once. Physical activity can be broken down into shorter blocks of time. For example, 20 minutes walking to and from school, 10 minutes jumping rope, and 30 minutes at the playground all add up to 60 minutes of physical activity. If your child is not active, start from where you are and build from there.

Types of Sports and Activities for Children and Teens (and Parents, Too!)

Aerobic Exercises

Use body’s large muscle groups
Strengthen the heart and lungs
Examples of moderate-intensity aerobic exercises include:
Brisk walking
Bicycle riding
Dancing
Hiking
Rollerblading
Skateboarding
Martial arts such as karate or tae kwon do (can be vigorous too)

Examples of vigorous-intensity aerobic activities include:
Basketball
Bicycle riding
Games such as tag
Ice or field hockey
Jumping rope
Martial arts
Running
Soccer
Swimming
Tennis

Muscle-Strengthening (or Resistance) Activities
Work major muscle groups of the body (legs, hips, back, abdomen, chest, shoulder, arms)

Examples of muscle-strengthening activities include:
Games such as tug-of-war
Push-ups or modified push-ups (with knees on the floor)
Resistance exercises using body weight or resistance bands
Rope or tree climbing
Sit-ups (curl-ups or crunches)
Swinging on playground equipment/bars
Bone-Strengthening (Weight-Bearing) Activities
Tone and build muscles and bone mass
Can be aerobic exercises and muscle-strengthening activities

Examples of bone-strengthening activities include:
Basketball
Hopping, skipping, jumping
Gymnastics
Jumping rope
Running
Tennis
Volleyball
Push-ups

Resistance exercises using body weight or resistance bands

About Strength Training
Strength training(or resistance training) uses a resistance to increase an individual’s ability to exert force. It involves the use of weight machines, free weights, bands or tubing, or the individual’s own body weight. This is not the same as Olympic lifting, power lifting, or body building, which are not recommended for children. Check with your child’s doctor before starting any strength training exercises.

Last Updated
5/5/2015
Source
Energy In Energy Out: Finding the Right Balance for Your Children (Copyright © 2014 American Academy of Pediatrics)

Play Time for Preschoolers

Posted on by Charish Barry, MD in

Let’s Play: Study Finds Preschoolers Need More Opportunities for Active Play

​​​​Physical activity is important for young children’s health and development, yet most 3- to 5-year-olds are not getting the two hours per day of recommended physical activity.

A study in the June 2015 Pediatrics, “Active Play Opportunities at Child Care​,” published online May 18, finds kids simply are not given enough opportunities for active play.

For the study, researchers observed 98 children from 10 child care centers in the Seattle area. All of the centers had scheduled at least 60 minutes per day of outdoorplay time, and they all had outdoor play areas as well as indoor space for physical activity. Researchers categorized children’s activity levels throughout the day, and the children wore accelerometers. In the study, children averaged 48 minutes per day of active play opportunities and only 33 minutes per day of actual outdoor time. Children had less than 10 minutes per day of teacher-led physical activities. For 88 percent of the time children were in the center, they were not given opportunities for active play, which explains the finding that children were sedentary for 70 percent of their time. Children were more likely to be active when outdoors and engaged in free play, rather than in teacher-led activities indoors or outdoors.

Study authors conclude that children should have more opportunities for active play during preschool. Possible strategies include increasing outdoor time, more child-initiated and teacher-led active play, and flexibility in naptime for older preschoolers.

Published
5/18/2015 12:00 AM

 

The Milestone of Riding a Bicycle…Tips to Get Started

Posted on by Charish Barry, MD in

https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Choosing-the-Right-Size-Bicycle.aspx

Choosing the Right Size Bicycle

A bicycle of the wrong size may cause your child to lose control and be injured. Any bike must be the correct size for the child for whom it is bought. To keep your child safe, the American Academy of Pediatrics recommends the following:

Do not push your child to ride a 2-wheeled bike until he or she is ready, at about age 5.
Take your child with you when you shop for the bike, so that he or she can try it out. The value of a properly fitting bike far outweighs the value of surprising your child with a new bike.
Buy a bike that is the right size, not one your child has to “grow into.” Oversized bikes are especially dangerous.
How to test any style of bike for proper fit
Sitting on the seat with hands on the handlebar, your child must be able to place the balls of both feet on the ground.
Straddling the center bar, your child should be able to stand with both feet flat on the ground with about a 1-inch clearance between the crotch and the bar.
When buying a bike with hand brakes for an older child, make sure that the child can comfortably grasp the brakes and apply sufficient pressure to stop the bike.
A helmet should be standard equipment. Whenever buying a bike, be sure you have a Consumer Product Safety Commission (CPSC)-approved helmet for your child.
Consider the child’s coordination and desire to learn to ride. Stick with coaster brakes until your child is older and more experienced.
Last Updated
5/11/2015
Source
TIPP: The Injury Prevention Program (Copyright © 1994 American Academy of Pediatrics, Updated 9/2005)

Sun Safety to Enjoy a Healthy and Fun Summer

Posted on by Charish Barry, MD in

https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Sun-Safety.aspx

Sun Safety: Information for Parents

About Sunburn & Sunscreen

It’s good for children and adults to spend time playing and exercising outdoors, and it’s important to do so safely.

Simple Rules to Protect your Family from Sunburns
Keep babies younger than 6 months out of direct sunlight. Find shade under a tree, an umbrella, or the stroller canopy.
When possible, dress yourself and your children in cool, comfortable clothing that covers the body, such as lightweight cotton pants, long-sleeved shirts, and hats.
Select clothes made with a tight weave; they protect better than clothes with a looser weave. If you’re not sure how tight a fabric’s weave is, hold it up to see how much light shines through. The less light, the better. Or you can look for protective clothing labeled with an Ultraviolet Protection Factor (UPF).
Wear a hat with an all-around 3-inch brim to shield the face, ears, and back of the neck.
Limit your sun exposure between 10:00 am and 4:00 pm when UV rays are strongest.
Wear sunglasses with at least 99% UV protection. Look for child-sized sunglasses with UV protection for your child.
Use sunscreen.
Make sure everyone in your family knows how to protect his or her skin and eyes. Remember to set a good example by practicing sun safety yourself.
Sunscreen
Sunscreen can help protect the skin from sunburn and some skin cancers but only if used correctly. Keep in mind that sunscreen should be used for sun protection, not as a reason to stay in the sun longer.

How to Pick Sunscreen
Use a sunscreen that says “broad-spectrum” on the label; that means it will screen out both UVB and UVA rays.
Use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15 (up to SPF 50). An SPF of 15 or 30 should be fine for most people. More research studies are needed to test if sunscreen with more than SPF 50 offers any extra protection.
If possible, avoid the sunscreen ingredient oxybenzone because of concerns about mild hormonal properties. Remember, though, that it’s important to take steps to prevent sunburn, so using any sunscreen is better than not using sunscreen at all.
For sensitive areas of the body, such as the nose, cheeks, tops of the ears, and shoulders, choose a sunscreen with zinc oxide or titanium dioxide. These products may stay visible on the skin even after you rub them in, and some come in fun colors that children enjoy.
How to Apply Sunscreen
Use enough sunscreen to cover all exposed areas, especially the face, nose, ears, feet, hands, and even backs of the knees. Rub it in well.
Put sunscreen on 15 to 30 minutes before going outdoors. It needs time to absorb into the skin.
Use sunscreen any time you or your child spend time outdoors. Remember that you can get sunburn even on cloudy days because up to 80% of the sun’s UV rays can get through the clouds. Also, UV rays can bounce back from water, sand, snow, and concrete, so make sure you’re protected.
Reapply sunscreen every 2 hours and after swimming, sweating, or drying off with a towel. Because most people use too little sunscreen, make sure to apply a generous amount.
Sunscreen for Babies
For babies younger than 6 months: Use sunscreen on small areas of the body, such as the face, if protective clothing and shade are not available.
For babies older than 6 months: Apply to all areas of the body, but be careful around the eyes. If your baby rubs sunscreen into her eyes, wipe her eyes and hands clean with a damp cloth. If the sunscreen irritates her skin, try a different brand or sunscreen with titanium dioxide or zinc oxide. If a rash develops, talk with your child’s doctor.
Sunburns
When to Call the Doctor
If your baby is younger than 1 year and gets sunburn, call your baby’s doctor right away. For older children, call your child’s doctor if there is blistering, pain, or fever.

How to Soothe Sunburn
Here are 5 ways to relieve discomfort from mild sunburn:

Give your child water or 100% fruit juice to replace lost fluids.
Use cool water to help your child’s skin feel better.
Give your child pain medicine to relieve painful sunburns. (For a baby 6 months or younger, give acetaminophen. For a child older than 6 months, give either acetaminophen or ibuprofen.)
Only use medicated lotions if your child’s doctor says it is OK.
Keep your child out of the sun until the sunburn is fully healed.​

Last Updated 5/11/2015
Source Fun in the Sun: Keep Your Family Safe (Copyright ? 2008 American Academy of Pediatrics, Updated 4/2014)

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