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.
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.
- 4/28/2013 7:00 PM
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,
National Infant Immunization Week (NIIW) was April 20-27. Highlighting the importance of vaccines…
Since 1994, NIIW has served as a call to action for parents, caregivers, and healthcare providers to ensure that infants are fully immunized against 14 vaccine-preventable diseases.
This year, the American Academy of Pediatrics highlighted its global immunization activities on Wednesday, April 24, as part of World Immunization Week.
The NIIW web page provides many tools and messages that pediatricians and others can use to help observe the week, including a public service ad/poster, parent-friendly audio spots, and fact sheets.
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.
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.
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.
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.
- 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:
- 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.
- 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.
- 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 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:
- Look the bully in the eye.
- Stand tall and stay calm in a difficult situation.
- Walk away.
- Teach your child how to say in a firm voice.
- “I don’t like what you are doing.”
- “Please do NOT talk to me like that.”
- “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.
Any parent who has tried to navigate a well-stocked grocery store with a hungry child in tow knows it is a challenge. Weaving through endless aisles of candy, frozen pizza, chips, soda, and sugary cereals without at least one incident of pleading or bargaining is considered a major accomplishment.
But on a daily basis, where is the proper guidance to steer through the numerous food choices?
Getting to Know MyPlate
Since 1894, the United States Department of Agriculture (USDA) has been providing Americans with dietary guidelines. In general, they have focused on eating from specified food groups and emphasized moderation, proportionality, and variety. An updated version of the USDA’s guidelines is called MyPlate. It shows the image of a dinner plate divided into colored sections:
- Orange—grains (eg, wheat, rice, oats, cornmeal, barley)
- Purple—protein (eg, meat, chicken, fish, beans, eggs, soy products, nuts, seeds)
- Red—fruits (eg, apples, bananas, strawberries, blueberries, oranges, peaches)
- Green: vegetables (eg, broccoli, romaine lettuce, spinach, corn, carrots)
Plus, there is a blue cup to the right of the plate to symbolize dairy foods (eg, milk, cheese, yogurt).
An important feature of MyPlate is that each section is a particular size. This is to highlight the proportions that Americans should aim for when planning their meal, for example:
- Half the plate should be fruits and veggies!
- About a quarter of the plate should be grains (especially whole grains).
- The rest should be protein.
Before Your Next Shopping Trip…
MyPlate provides parents with important concepts that virtually all experts agree on: making healthy food choices and practicing eating in moderation. So before hitting the grocery aisles with your little one, take the time to catch up on the suggestions found on MyPlate! The USDA’s main messages include:
- Encourage your child to enjoy his food, but to eat portions that are right for his age and activity level.
- Fill half of your child’s plate with fruits and vegetables.
- Have your kid drink fat-free or low-fat (1%) milk.
- Read food labels! Find out how much sodium is in packaged food. Choose lower sodium options!
- Encourage your child to drink water. Leave the sugary drinks behind.
Beginning June 28, 2011, new federal safety standards prohibit the manufacture or sale of drop-side rail cribs. Crib safety standards have not been updated in nearly 30 years and these new rules are expected to improve the quality of cribs and make them safer for babies.
But drop-sides are not the only changes. The new regulations also require that all new cribs have stronger slats and mattress supports, better quality hardware, and to undergo more rigorous testing.
Since 2007, over 11 million cribs have been recalled. In addition, drop-sides were associated with 32 infant suffocation and strangulation deaths since 2000. These new standards will help prevent these tragedies and keep children safe in their cribs.
Child care centers, family child care homes, and places of public accommodation, such as hotels and motels have until December 28, 2012 to comply with these new rules.
What Parents Can Do
Please consider getting a new crib for your baby. If that is not possible, the AAP and the Consumer Product Safety Commission (CPSC) encourage you to check the crib frequently to make sure that all hardware is secured tightly and that there are no loose, missing, or broken parts. Also be sure to:
- Check CPSC’s crib recall list to make sure that your crib has not been recalled.
- Stop using the drop-side rail of your crib. If the crib has been recalled, see if you can get a free immobilizer from the manufacturer or retailer (immobilizers vary depending on the crib).
- Consider using a portable play yard, so long as it is not a model that has been recalled.
- As always, keep items like pillows, cushy bumper pads, quilts, comforters, stuffed toys, and positioning devices out of the crib.
Re-sale of Cribs
Keep in mind that these new rules also apply to the re-sale of cribs, including at garage and rummage sales, on online auction sites, or even by donation to thrift stores. Unsafe cribs should be disassembled and thrown away.
For more information on choosing a safe crib for your baby, click here.
You can also find more details about the new regulations from the CPSC here.