Petite Pediatrics

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A Vitamin a Day?

Do toddlers need vitamins to make up for their picky eating?    You may be surprised at the answer!

It has been estimated that just over half of all preschoolers are given multivitamins. We’re pretty sure that’s a good bit more than are served broccoli on any given day. And we’re quite sure we can relate to the reasons why. When the going gets tough, it is often a whole lot easier to reach for a quick fix in a bottle of Flintstones vitamins and forget the fight. The fact that there are so many parents who do just that isn’t so much a food fight, per se, but a reflection on the parental feelings that so many share that what we’re feeding our children is nutritionally inadequate. While we can definitely understand the sentiment, it compels us to address the fundamental question: What role should multivitamins play in your child’s diet, and is it you or your child that stands to benefit from them more?

Who Needs ‘Em, Anyway?

We’ll come right out and say what most nutrition experts have been saying all along: Most children don’t need vitamin supplements at all! Yes, we realize that the perfect, vegetable-loving, cooperative eater we all long for doesn’t exist. But even taking all food fights into consideration, there are nevertheless very few instances in which a child’s diet is likely to leave him truly deficient.

If you need further convincing, we suggest you consider the following facts:

  • The amount your child needs to eat to get enough vitamins and minerals from his food alone is probably much smaller than you think. Even for the pickiest of eaters, it doesn’t take more than a very few picks from each of the basic food groups for children to get their recommended daily dose.
  • Many vitamins can be stored in the body. This means that your child doesn’t have to eat each and every one every day—affording you the option of spreading your efforts at achieving a balanced diet out over the course of a week or two without spreading the vitamins too thin.
  • Ironically enough, parents who are most likely to give multivitamins are also those who are most likely to be feeding their children healthy diets in the first place.
  • Vitamins can be found in some unlikely sources. Calcium doesn’t just have to come from cows, since it is contained in both supplements and many nondairy foods ranging from salmon, tofu, spinach, and sardines to rhubarb, baked beans, bok choy, and almonds—admittedly not all of which are an easy sell at the dinner table, but at least you have plenty to choose from!
  • And finally, many foods these days are fortified. That means that even if your child favors foods that do not come naturally loaded with all of the necessary nutrients, all hope is not lost; it’s entirely possible that food manufacturers have added them in for you. Classic examples include the vitamin D fortification of milk, margarine, and pudding, and the calcium contained in kid-friendly foods such as orange juice, cereals, breads, and even Eggo waffles.
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Head Lice… what to know

Category: Health Issues

No denying… Head lice is a nuisance, but they don’t cause serious illness or diseases ~

Also, head lice can be treated at home.

The following information from the American Academy of Pediatrics (AAP) will help you check for, treat, and prevent the spread of head lice.

What are head lice?

Head lice are tiny insects. They are about the size of a sesame seed (2–3 mm long). Their bodies are usually pale and gray, but color may vary. One “lice” is called a louse.

Head lice feed on tiny amounts of blood from the scalp. They usually survive less than a day if not on a person’s scalp. Lice lay and attach their eggs to hair close to the scalp.

The eggs and their shell casings are called nits. They are oval (about 0.8 x 0.3 mm) and usually yellow to white. Nits are attached with a sticky substance that holds them firmly in place. After the eggs hatch, the empty nits remain attached to the hair shaft.

Head lice live about 28 days. They can multiply quickly, laying up to 10 eggs a day. It only takes about 12 days for newly hatched eggs to reach adulthood. This cycle can repeat itself every 3 weeks if head lice are left untreated.

Who gets head lice?

Anyone can get head lice. Head lice are most common in preschool- and elementary school–aged children. It doesn’t matter how clean your hair or home may be. It doesn’t matter where children and families live, play, or work.

How are head lice spread?

Head lice are crawling insects. They cannot jump, hop, or fly. The main way head lice spread is from close, prolonged head-to-head contact. There is a very small chance that head lice will spread because of sharing items such as combs, brushes, and hats.

What are symptoms of head lice?

The most common symptom of head lice is itching. It may take up to 4 weeks after lice get on the scalp for the itching to begin. Most of the itching happens behind the ears or at the back of the neck. Also, itching caused by head lice can last for weeks, even after the lice are gone. However, an itchy scalp also may be caused by eczema, dandruff, or an allergy to hair products.

How do you check for head lice?

Regular checks for head lice are a good way to spot head lice before they have time to multiply and infest your child’s head.

  • Seat your child in a brightly lit room.
  • Part the hair and look at your child’s scalp.
  • Look for crawling lice and for nits.
    • Live lice are hard to find. They avoid light and move quickly.
    • Nits will look like small white or yellow-brown specks and be firmly attached to the hair near the scalp. The easiest place to find them is at the hairline at the back of the neck or behind the ears. Nits can be confused with many other things, such as dandruff, dirt particles, or hair spray droplets. The way to tell the difference is that nits are attached while dandruff, dirt, or other particles are not.
  • Wet the hair. Use a fine-toothed comb to help comb out the lice or nits. Comb through your child’s hair in small sections. After each comb-through, wipe the comb on a wet paper towel. Examine the scalp, comb, and paper towel carefully.

How do you treat head lice?

Check with your child’s doctor first before beginning any head lice treatment. The most effective way to treat head lice is with head lice medicine. Head lice medicine should only be used when it is certain that your child has head lice.

When head lice medicines are used, it is important to use them safely. Here are some safety guidelines.

  • Follow the directions on the package.
  • Never let children apply the medicine. Medicine should be applied by an adult.
  • Check with your child’s doctor before beginning a second or third treatment. A second treatment is usually needed 10 days after the first treatment. In some cases a third treatment 10 days after the second treatment is needed.
  • Do not use medicine on a child 2 years or younger without first checking with your child’s doctor.
  • Do not use or apply medicine to children if you are pregnant or nursing without first checking with your doctor.
  • Store medicine in a locked cabinet, out of sight and reach of children.
  • Ask your child’s doctor if you have any questions.

Note: The comb-out method (removing head lice without medicine from damp hair with a fine-toothed comb) often fails. Also, home remedies, like using petroleum jelly, mayonnaise, tub margarine, herbal oils, or olive oil, have not been scientifically proven to work. Never use dangerous products like gasoline or kerosene or medicines made for use on animals!

What head lice medicines are available?

Here is a list of head lice medicines approved by the US Food and Drug Administration. Check with your child’s doctor before beginning any treatment.

Head Lice Medicines
Treatment Description
Permethrin cream (1%) Available without a prescription

Applied to shampooed and towel dried hair, then rinsed off after 10 minutes

Approved for use in children 2 months and older

Pyrethrin-based product (shampoo or hair mousse) Available without a prescription

Applied to dry hair and rinsed off after 10 minutes

Should not be used in people who are allergic to chrysanthemums

Malathion lotion (0.5%) Prescription needed

Applied to dry hair and rinsed off after 8 to 12 hours

Approved for use in children 6 years or older

Flammable; may cause chemical burns

Benzyl alcohol lotion (0.5%) Prescription needed.

Applied to dry hair and rinsed off after 10 minutes. Repeat in 7 days.

Contains no neurotoxic pesticide.

Approved for use in children 6 months and older. Not recommended for infants younger than 6 months.

Spinosad topical suspension (9%) Prescription needed.

Applied to dry hair and rinsed off after 10 minutes.

Approved for use in children 4 years and older. Not recommended for infants younger than 6 months.

Made from a naturally occurring soil bacterium that causes lice to become paralyzed and then die. Also contains benzyl alcohol.

Ivermectin lotion (0.5%) Prescription needed.

Applied to dry hair and rinsed off after 10 minutes.

Approved as a one-time-use, topical treatment of head lice in children 6 months and older. If there is leftover medicine, it needs to be thrown out, not reused.

Lindane shampoo (1%) Prescription needed

No longer recommended by most experts

What else do I need to know about treating head lice?

You do not need to throw away any items belonging to your child. However, you may want to wash your child’s clothes, towels, hats, and bed linens in hot water and dry on high heat if they were used within 3 days before head lice were found and treated. Items that cannot be washed may be dry-cleaned or sealed in a plastic bag for 2 weeks.

Do not spray pesticides in your home; they can expose your family to dangerous chemicals and are not necessary when you treat your child’s scalp and hair properly.

If your child has head lice, all household members and close contacts should also be checked and treated if necessary.

About “no-nit” policies

Some schools have “no-nit” policies stating that students who still have nits in their hair cannot return to school. The AAP and the National Association of School Nurses discourage such policies and believe a child should not miss school because of head lice.

Remember

Head lice don’t put your child at risk for any serious health problems. If your child has head lice, work quickly to treat your child to prevent the head lice from spreading.

Additional Information

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A New Sleep Book for Parents…

What Every Parent Needs to Know

American Academy of Pediatrics

Edited by: Rachel Moon, MD, FAAP

Description

New! Sooner or later, most parents face challenges at bedtime. From infants and toddlers, to school-age kids and adolescents, sleeptime problems can affect everyone in the family. And no matter what your child’s difficulty may be – getting to sleep, staying asleep, bed-wetting, fears or nightmares – it’s never too late to take steps to correct it.
The latest in a series of parenting books from the American Academy of Pediatrics (AAP), Sleep: What Every Parent Needs to Know helps caregivers like you better understand sleep, answering questions and examining conflicting theories in order to help you make the best decisions for your family.
Topics include:
• The functions of sleep and how much your child needs
• Newborn sleep patterns
• Sleep theories and strategies for success
• Bedtime routines and rituals
• Coping with fears and nightmares
• Tips for solving common problems
• Helping regulate multiples’ sleep
• Changes during adolescence
Sleep: What Every Parent Needs to Know was written and edited by pediatricians – many of whom have been sleep-deprived parents at one time or another – and who have helped many families in their care. They recognize that there is not always an easy, one-size-fits-all answer to a sleep problem. With their recommended strategies for establishing good sleep habits, and your unique understanding of your child, this book can help ensure you and your family get all the rest you need.

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Eating Healthy. Growing Strong.


The Very Hungry Caterpillar helps families learn about healthy eating habits. Learn more here…

The Alliance for a Healthier Generation and the American Academy of Pediatrics have joined with the best-selling children’s book by Eric Carle.

The Very Hungry Caterpillar eats many foods on his journey to becoming a butterfly. You can help your child on his or her own journey to grow up healthy and strong.  To help you in this journey, we have created the following resources:

Tips for Healthy Eating at Home Simple tips from the Alliance for a Healthier Generation and the American Academy of Pediatrics for eating healthy with your kids at home.

Reading Guide Discuss healthy active living using The Very Hungry Caterpillar by Eric Carle!

Growth Chart (PDF) Download a special The Very Hungry Caterpillar growth chart and keep track of your child’s journey to becoming healthy & strong.

Learn more about the collaborators and the campaign. Find out how this collaboration started and explore additional resources available for parents and healthcare professionals.

Find out more about The Very Hungry Caterpillar and author and illustrator Eric Carle atwww.eric-carle.com and www.penguin.com/ericcarle

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Infant Care Guidelines for Home Births

Although still uncommon, the rate of home births has increased during the past several years…
In a new policy statement, “Planned Home Birth,” in the May 2013 Pediatrics (published online April 29), the American Academy of Pediatrics (AAP) makes recommendations for the care of infants born in a home setting.
Regardless of the circumstances of the birth, including location, every newborn infant deserves health care that adheres to AAP standards. The AAP concurs with the recent statement from the American College of Obstetricians and Gynecologists (ACOG) that the safest setting for a child’s birth is a hospital or birthing center, but recognizes that women and their families may desire a home birth for a variety of reasons.
  • Pediatricians should advise parents who are planning a home birth that AAP and ACOG recommend only midwives who are certified by the American Midwifery Certification Board.
  • There should be at least one person present at the delivery whose primary responsibility is the care of the newborn infant and who has the appropriate training, skills and equipment to perform a full resuscitation of the infant.
  • All medical equipment, and the telephone, should be tested before thedelivery, and the weather should be monitored.
  • A previous arrangement needs to be made with a medical facility to ensure a safe and timely transport in the event of an emergency.
  • AAP guidelines include warming, a detailed physical exam, monitoring of temperature, heart and respiratory rates, eye prophylaxis, vitamin K administration, hepatitis B immunization, feeding assessment, hyperbilirubinemia screening and other newborn screening tests.
  • If warranted, infants may also require monitoring for group B streptococcal disease and glucose screening. Comprehensive documentation and follow-up with the child’s primary health care provider is essential.
Published
4/28/2013 7:00 PM
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Re-opening Petite Pediatrics after a “Twin Sabbatical”

I am excited to re-open and return to the practice of pediatrics after a wonderful year away…

I like to think of this past year as my “Twin Sabbatical,” as my husband and I are now the proud parents of twin boys who are active, healthy and thriving!

Thank you to all of the Petite Pediatric parents who have remained supportive during this time away. I also want to extend a warm thank you to the pediatricians in the Santa Barbara community who have helped to care for my patients. In particular, Drs. Iris Castaneda-Van Wyk (Dr. Iris) and Dr. Vic Phungrasamee (Dr. Vic). I am excited to continue to provide care for children in Santa Barbara. I look forward to ongoing supportive coverage with Dr. Iris and her Pediatric Nurse Practitioner, Nicole Downer.  We will continue to work together as “Sister Practices” in order to provide the best care for our patients.

My year away from clinical practice was filled with lessons and insights into parenting that, I believe, can only be gleaned from hands-on experience. Although I know my years of training and practice prepared me to be the best doctor I can be, my first year as a mother of twins has enhanced my doctor skills in ways I could have never imagined.  The years to come will be filled with growth, both as a parent and pediatrician. I look forward to sharing these experiences with parents in my practice via my Blog, Twitter and Facebook accounts.

Please share your experiences and insights too. This will be a new forum for parents at Petite Pediatrics to discuss topics of interest. I cannot provide direct medical advice via this forum, but I’m happy to share general knowledge and welcome families to contact me directly if they have specific questions or concerns.

Thank you for your support of Petite Pediatrics!

Come Grow With Us,

Dr. Barry

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Family Rituals

Category: Healthy Living

Every family should have activities that they enjoy together and that become a regular, predictable, and integral part of their lives. Some can be serious pursuits, like attending community functions or religious services as a family; oth ers can be more lighthearted, like going fishing. Whatever they are, they can help bond a family together. These are some rituals that many families have made parts of their lives:

Important Conversations. Communication between parents and children should be a top priority in your family. Set aside time to talk, discussing the day’s and the week’s activities, sharing feelings and really listening to one an other.

Respect the privacy of each of your youngsters as they begin to assert their independence during these middle years; they may have certain problems and difficulties they may not want to divulge to their brothers and sisters. You should be able to have a one-on-one conversation with each child without all the other children listening to it. If you honor his wishes for confidentiality, this can build trust between you.

Some families establish a weekly time for a family meeting. When everyone is present, family issues, relationships, plans, and experiences are discussed, and everyone from the youngest to the oldest gets a chance to be heard and to participate.

Recreation and Cultural Activities. Family recreation is an important way to strengthen the family. Sports (participation and spectator), games, movies, and walks in the park are good ways to increase cohesiveness and reduce stress.

Cultural activities can be valuable too. Visits to museums, libraries, plays, musicals, and concerts can expand the family’s horizons and deepen appreci ation for the arts.

Shopping. Shopping trips can provide regular opportunities for parents and children to spend time together. Whether you are grocery shopping or buying birthday gifts, these excursions can be fun and exciting for youngsters in mid dle childhood. Let your children make lists, find items in the store, carry the bags to the car, and unpack them once you return home. Allowing your child some choices and assigning some meaningful responsibilities can help build his self-confidence.

Reading and Singing Aloud. Reading and singing aloud as a family promotes feelings of closeness and an appreciation for music and books. Parents should find out what stories their children like to read, and what music they like to lis ten to. It is lots of fun to take turns reading aloud, and to let the children hear the stories and songs you enjoyed when you were growing up.

Holiday Traditions. These are another source of fun family activities. By learning about the history, significance, and rituals of a particular holiday, chil dren will feel a greater sense of involvement in the holiday preparations and celebrations.

Spiritual Pursuits. For many families, religion plays an important role in pro viding a moral tradition, a set of values, and a network of friends and neigh bors who can provide support. Attending services is something family members can do together.

You do not necessarily need to go to a church, synagogue, or other place of worship regularly, however, to share moral values with your children and help them develop a sense of their history and the continuity of the family. Many families develop a strong spiritual life without the formal structure of orga nized religion.

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Some Helpful Allergy Tips

When to Suspect an Allergy

  • Repeated or chronic cold-like symptoms that last more than a week or two, or develop at about the same time every year. These could include a runny nose, nasal stuffiness, sneezing, throat clearing, and itchy, watery eyes.
  • Recurrent coughing, wheezing, chest tightness, difficulty breathing, and other respiratory symptoms may be a sign of asthma. Coughing may be an isolated symptom; symptoms that increase at night or with exercise are suspicious for asthma.
  • Recurrent red, itchy, dry, sometime scaly rashes in the creases of the elbows and/or knees, or on the back of the neck, buttocks, wrists, or ankles.
  • Symptoms that occur repeatedly after eating a particular food that may include hives, swelling, gagging, coughing or wheezing, vomiting or significant abdominal pain.
  • Itching or tingling sensations in the mouth, throat and/or ears during certain times of year or after eating certain foods.

Common Allergies on the Homefront

  • Dust mites (dust mites are microscopic and are found in bedding, upholstered furniture and carpet as well as other places)
  • Furred animal allergens (dogs, cats, guinea pigs, gerbils, rabbits, etc.)
  • Pest allergens (cockroaches, mice, rats)
  • Pollen (trees, grasses, weeds)
  • Molds and fungi (including molds too small to be seen with the naked eye)
  • Foods (cow’s milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish)

How to Manage Allergic Nasal Symptoms

  • Nasal allergy symptoms can be caused by a variety of environmental allergens including indoor allergens such as dust mites, pets, and pests as well as outdoor allergens such as pollens.  Molds, which can be found indoors and outdoors, can also trigger nasal allergy symptoms.
  • Allergy testing should be performed to determine what, if any, of these environmental allergens your child is allergic to.
    An important step in managing allergy symptoms is avoidance of the allergens that trigger the symptoms.
  • If your child is allergic to pets, the addition of pets to your family would not be recommended. If your child has allergy symptoms and is allergic to a pet that lives with your family, the only way to have a significant impact on your child’s exposure to pet allergens is to find the pet a new home.
  • If your child is allergic to pests, professional extermination, sealing holes and cracks that serve as entry points for pests, storing foods in plastic containers with lids and meticulous clean up of food remains can help to eliminate the pests and reduce allergen levels.
  • Dust mites congregate where moisture is retained and food for them (human skin scales) is plentiful. They are especially numerous in bedding, upholstered furniture, and rugs. Padded furnishings such as mattresses, box springs, and pillows should be encased in allergen-proof, zip-up covers, which are available through catalogs and specialized retailers. Wash linens weekly and other bedding, such as blankets, every 1 to 2 weeks in hot water. (The minimum temperature to kill mites is 130 degrees. If you set your water heater higher than 120 degrees, the recommended temperature to avoid accidental scald burns, take care if young children are present in the home.)
  • If your child is allergic to outdoor allergens, it can be helpful to use air conditioners when possible. Showering or bathing at the end of the day to remove allergens from body surfaces and hair can also be helpful. For patients with grass pollen allergy, remaining indoors when grass is mowed and avoiding playing in fields of tall grass may be helpful. Children with allergies to molds should avoid playing in piles of dead leaves in the fall.

Medications to Control Symptoms

Your child’s allergy treatment should start with your pediatrician, who may refer you to a pediatric allergy specialist for additional evaluations and treatments.

  • Antihistamines – Ones taken by mouth can help with itchy watery eyes, runny nose and sneezing, as well as itchy skin and hives. Some types may cause drowsiness.
  • Nasal Corticosteroids – Highly effective for allergy symptom control and are widely used to stop chronic symptoms. Safe to use in children over long periods of time. Must be used daily.
  • Allergy Immunotherapy – Immunotherapy, or allergy shots, may be recommended to reduce your child’s allergy symptoms. Allergy shots are only prescribed in patients with confirmed allergy. If allergen avoidance and medications are not successful, allergy shots for treatment of respiratory allergies to pollen, dust mites, cat and dog dander, and outdoor molds can help  decrease the need for daily medication.
  • Ask your doctor about additional therapies.

Managing Eczema (Atopic Dermatitis):

  • Steroid creams are very effective. When used sparingly and at the lowest strength that does the job, they are very safe.
  • Non-steroidal anti-inflammatory creams or ointments can be used for itching and redness and decrease the need for steroid creams.
  • Antihistamine medication may be prescribed to relieve the itching, and help break the itch-scratch cycle.
  • Long-sleeved sleepwear may also help prevent nighttime scratching.
    Soaps containing perfumes and deodorants may be too harsh for children’s sensitive skin.
  • Use laundry products that are free of dyes and perfumes and double-rinse clothes, towels and bedding.
  • Lukewarm soaking baths are good ways to treat the dry skin of eczema. Gently pat your child dry after the bath to avoid irritating the skin with rubbing. Then, liberally apply moisturizing cream right away.
  • Eczema, particularly when severe, may be associated with food allergies (e.g., milk, egg, peanut).
  • Launder new clothes thoroughly before your child wears them. Avoid fabric softener.
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Some Childrens TV Shows Are Bad for Their Brains

Some Childrens TV Shows Are Bad for Their Brains

A new study in the October, 2011, issue of the journal, Pediatrics, finds that some TV shows may be worse than others. The study, “The Immediate Impact of Different Types of Television on Young Children’s Executive Function,” published online Sept. 12, tested 4-year-old children’s attention, problem solving, self regulation and other executive function abilities after they watched one of two cartoons for nine minutes. A control group of children received crayons and markers for free drawing for the same time period. The children who watched a fast-paced cartoon featuring an animated kitchen sponge did significantly worse on tests than the drawing group. There was no difference between the drawing group and children who watched a slower-paced, realistic Public Broadcasting Service cartoon about a typical preschool boy.

Study authors stated they cannot tell which features of the TV show created the effects, though they speculate the combination of fantastical events and the fast pacing are responsible. They conclude that parents should be aware that watching similar television shows may immediately impair young children’s executive function.

In a commentary, “The Effects of Fast-Paced Cartoons,” pediatrician and researcher Dimitri Christakis, MD, FAAP, discusses the study and the implications that media exposure has for children’s health.

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Back to School Tips

Helpful health and safety tips from the American Academy of Pediatrics (AAP)

Making the First Day Easier

  • Remind your child that she is not the only student who is a bit uneasy about the first day of school. Teachers know that students are anxious and will make an extra effort to make sure everyone feels as comfortable as possible.
  • Point out the positive aspects of starting school: It will be fun. She’ll see old friends and meet new ones. Refresh her positive memories about previous years, when she may have returned home after the first day with high spirits because she had a good time.
  • Find another child in the neighborhood with whom your youngster can walk to school or ride with on the bus.
  • If you feel it is appropriate, drive your child (or walk with her) to school and pick her up on the first day.

Backpack Safety

  • Choose a backpack with wide, padded shoulder straps and a padded back.
  • Pack light. Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back. The backpack should never weigh more than 10 to 20 percent of your child’s body weight.
  • Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles.
  • If your school allows, consider a rolling backpack. This type of backpack may be a good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried up stairs, and they may be difficult to roll in snow.

Traveling To and From School

Review the basic rules with your youngster:

School Bus

  • If your child’s school bus has lap/shoulder seat belts, make sure your child uses one at all times when in the bus. If your child’s school bus does not have lap/shoulder belts, encourage the school to buy or lease buses with lap/shoulder belts.
  • Wait for the bus to stop before approaching it from the curb.
  • Do not move around on the bus.
  • Check to see that no other traffic is coming before crossing the street.
  • Make sure to always remain in clear view of the bus driver.
  • Children should always board and exit the bus at locations that provide safe access to the bus or to the school building.

Car

  • All passengers should wear a seat belt and/or an age- and size-appropriate car safety seat or booster seat.
  • Your child should ride in a car safety seat with a harness as long as possible and then ride in a belt-positioning booster seat. Your child is ready for a booster seat when she has reached the top weight or height allowed for her seat, her shoulders are above the top harness slots, or her ears have reached the top of the seat.
  • Your child should ride in a belt-positioning booster seat until the vehicle’s seat belt fits properly (usually when the child reaches about 4′ 9″ in height and is between 8 to 12 years of age). This means that the child is tall enough to sit against the vehicle seat back with her legs bent at the knees and feet hanging down and the shoulder belt lies across the middle of the chest and shoulder, not the neck or throat; the lap belt is low and snug across the thighs, and not the stomach.
  • All children younger than 13 years of age should ride in the rear seat of vehicles. If you must drive more children than can fit in the rear seat (when carpooling, for example), move the front-seat passenger’s seat as far back as possible and have the child ride in a booster seat if the seat belts do not fit properly without it.
  • Remember that many crashes occur while novice teen drivers are going to and from school. You should require seat belt use, limit the number of teen passengers, do not allow eating, drinking, cell phone conversations or texting to prevent driver distraction; and limit nighttime driving and driving in inclement weather. Familiarize yourself with your state’s graduated driver license law and consider the use of a parent-teen driver agreement to facilitate the early driving learning process. Click here for a sample parent-teen driver agreement.

Bike

  • Always wear a bicycle helmet, no matter how short or long the ride.
  • Ride on the right, in the same direction as auto traffic.
  • Use appropriate hand signals.
  • Respect traffic lights and stop signs.
  • Wear bright color clothing to increase visibility.
  • Know the “rules of the road.”

Walking to School

  • Make sure your child’s walk to a school is a safe route with well-trained adult crossing guards at every intersection.
  • Be realistic about your child’s pedestrian skills. Because small children are impulsive and less cautious around traffic, carefully consider whether or not your child is ready to walk to school without adult supervision.
  • If your children are young or are walking to a new school, walk with them the first week or until you are sure they know the route and can do it safely.
  • Bright colored clothing will make your child more visible to drivers.
  • In neighborhoods with higher levels of traffic, consider starting a “walking school bus,” in which an adult accompanies a group of neighborhood children walking to school.

Eating During the School Day

  • Most schools regularly send schedules of cafeteria menus home. With this advance information, you can plan on packing lunch on the days when the main course is one your child prefers not to eat.
  • Try to get your child’s school to stock healthy choices such as fresh fruit, low-fat dairy products, water and 100 percent fruit juice in the vending machines.
  • Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child’s risk of obesity by 60%. Restrict your child’s soft drink consumption.

Bullying

Bullying is when one child picks on another child repeatedly. Bullying can be physical, verbal, or social. It can happen at school, on the playground, on the school bus, in the neighborhood, or over the Internet.

When Your Child Is Bullied

  • Help your child learn how to respond by teaching your child how to:
  1. Look the bully in the eye.
  2. Stand tall and stay calm in a difficult situation.
  3. Walk away.
  • Teach your child how to say in a firm voice.
  1. “I don’t like what you are doing.”
  2. “Please do NOT talk to me like that.”
  3. “Why would you say that?”
  • Teach your child when and how to ask for help.
  • Encourage your child to make friends with other children.
  • Support activities that interest your child.
  • Alert school officials to the problems and work with them on solutions.
  • Make sure an adult who knows about the bullying can watch out for your child’s safety and well-being when you cannot be there.

When Your Child Is the Bully

  • Be sure your child knows that bullying is never OK.
  • Set firm and consistent limits on your child’s aggressive behavior.
  • Be a positive role mode. Show children they can get what they want without teasing, threatening or hurting someone.
  • Use effective, non-physical discipline, such as loss of privileges.
  • Develop practical solutions with the school principal, teachers, counselors, and parents of the children your child has bullied.

When Your Child Is a Bystander

  • Tell your child not to cheer on or even quietly watch bullying.
  • Encourage your child to tell a trusted adult about the bullying.
  • Help your child support other children who may be bullied. Encourage your child to include these children in activities.
  • Encourage your child to join with others in telling bullies to stop.

Before and After School Child Care

  • During early and middle childhood, youngsters need supervision. A responsible adult should be available to get them ready and off to school in the morning and watch over them after school until you return home from work.
  • Children approaching adolescence (11- and 12-year-olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age.
  • If alternate adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone.
  • If you choose a commercial after-school program, inquire about the training of the staff. There should be a high staff-to-child ratio, and the rooms and the playground should be safe.

Developing Good Homework and Study Habits

  • Create an environment that is conducive to doing homework. Youngsters need a permanent work space in their bedroom or another part of the home that offers privacy.
  • Schedule ample time for homework.
  • Establish a household rule that the TV set stays off during homework time.
  • Supervise computer and internet use.
  • Be available to answer questions and offer assistance, but never do a child’s homework for her.
  • Take steps to help alleviate eye fatigue, neck fatigue and brain fatigue while studying. It may be helpful to close the books for a few minutes, stretch, and take a break periodically when it will not be too disruptive.
  • If your child is struggling with a particular subject, and you aren’t able to help her yourself, a tutor can be a good solution. Talk it over with your child’s teacher first.
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