Author: Charish Barry, MD

New Medical Home

510 West Pueblo Street

Dr. Barry and the staff at Petite Pediatrics are excited to announce the move of our medical office this fall. We will be relocating to a free-standing medical home that will provide our signature care of personalized medicine for infants, children and adolescents.  We look forward to welcoming you to our new space! 

MAKE A PLAN for Media Use in School Aged Children and Adolescents

http://www.healthychildren.org/MediaUsePlan

The AAP has created an interactive tool to help families create a Media Use Plan. Media can create frustration for both parents and children, for example, both parties can feel ignored, or be concerned about excessive use.  Both parents and children can lose moments to connect emotionally if devices take the place of face-to-face conversations and interactions.  This tool can help set ground rules, and clear expectations around media use (TV, internet and social media) condusive to a healthy home environment and family relationships.  Check out today and see if it can help your family. Use the link above.

 

Back to School Tips

Summer is ending soon and the new school year will be starting up. Healthychildren.org has some great Back-to-School tips. 

This is a good time to organize and prepare your paperwork for immunizations, sports physicals, learning issues etc. and/or schedule necessary appointments to be ready for the school year. 

Back-to-School Tips

The following health and safety tips are from the American Academy of Pediatrics (AAP).

Making the First Day Easier
If your child seems nervous, remind him or her that there are probably a lot of students who are uneasy about the first day of school. This may be at any age. Teachers know that students are nervous and will make an extra effort to make sure everyone feels as comfortable as possible.

Point out the positive aspects of starting school to create positive anticipation about the first day. Your child will see old friends and meet new ones. Refresh his or her positive memories about previous years, when he or she may have returned home after the first day with high spirits because of a good time.

Find another child in the neighborhood with whom your student can walk to school or ride on the bus.

If it is a new school for your child, attend any available orientations and take an opportunity to tour the school before the first day.

If you feel it is needed, drive your child (or walk with him or her) to school and pick him or 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. Go through the pack with your child weekly, and remove unneeded items to keep it light.

Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles.

Adjust the pack so that the bottom sits at the waist.

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, they may be difficult to roll in snow, and they may not fit in some lockers.

Traveling To and From School
Review the basic rules with your child.

School Bus
Children should always board and exit the bus at locations that provide safe access to the bus or to the school building.

Remind your child to wait for the bus to stop before approaching it from the curb.

Make sure your child walks where he or she can see the bus driver (which means the driver will be able to see him or her, too).

Remind your child to look both ways to see that no other traffic is coming before crossing the street, just in case traffic does not stop as required.

Your child should not move around on the 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 system to buy or lease buses with lap/shoulder belts). See Where We Stand: Safety Restraints on the School Bus for more information.

Check on the school’s policy regarding food on the bus. Eating on the bus can present a problem for students with food allergies and can also lead to infestations of insects and vermin on the vehicles.

If your child has a chronic condition that could result in an emergency on the bus, make sure you work with the school nurse or other school health personnel to have a bus emergency plan.

Car
All passengers should wear a seat belt and/or an age- and size-appropriate car seat or booster seat.

Your child should ride in a car 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 he or she has reached the top weight or height allowed for his or her seat, his or her shoulders are above the top harness slots, or his 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, and do not allow eating, drinking, cell phone conversations (even when using hands-free devices or speakerphone), texting, or other mobile device use to prevent driver distraction. Limit nighttime driving and driving in inclement weather. Familiarize yourself with your state’s graduated driver’s license law and consider the use of a parent-teen driver agreement to facilitate the early driving learning process. For a sample parent-teen driver agreement, click here.

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 and ride in bake lanes if they are present.

Use appropriate hand signals.

Respect traffic lights and stop signs.

Wear bright-colored clothing to increase visibility. White or light-colored clothing and reflective gear is especially important after dark.

Know the “rules of the road.”

Walking to School
Make sure your child’s walk to school is a safe route with well-trained adult crossing guards at every intersection.

Identify other children in the neighborhood with whom your child can walk to school. In neighborhoods with higher levels of traffic, consider organizing a “walking school bus,” in which an adult accompanies a group of neighborhood children walking to school.

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 or have another adult 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.

Eating During the School Day
Studies show that children who eat a nutritious breakfast function better. They do better in school, and have better concentration and more energy.

Most schools regularly send schedules of cafeteria menus home and/or have them posted on the school’s website. 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.

Many school districts have plans which allow you to pay for meals through an online account. Your child will get a card to “swipe” at the register. This is a convenient way to handle school meal accounts.

Look into what is offered inside and outside of the cafeteria, including vending machines, a la carte, school stores, snack carts, and fundraisers held during the school day. All foods sold during the school day must meet nutrition standards established by the US Department of Agriculture (USDA). They should stock healthy choices such as fresh fruit, low-fat dairy products, water, and 100% fruit juice. Learn about your child’s school wellness policy and get involved in school groups to put it into effect.

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%. Choose healthier options (such as water and appropriately sized juice and low-fat dairy products) to send in your child’s lunch.

Bullying
Bullying or cyberbullying 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, over the Internet, or through mobile devices like cell phones.

When Your Child Is Bullied
Alert school officials to the problems and work with them on solutions.

Teach your child when and how to ask a trusted adult for help.

Recognize the serious nature of bullying and acknowledge your child’s feelings about being 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?”

Encourage your child to make friends with other children.

Support activities that interest your child.

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.

Monitor your child’s social media or texting interactions so you can identify problems before they get out of hand.

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 model. 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, school social workers or psychologists, and parents of the children your child has bullied.

When Your Child Is a Bystander
Encourage your child to tell a trusted adult about the bullying. Encourage your child to join with others in telling bullies to stop.

Help your child support other children who may be bullied. Encourage your child to include these children in activities.

Before and After School Child Care
During early and middle childhood, children need supervision. A responsible adult should be available to get them ready and off to school in the morning and supervise them after school until you return home from work.

If a family member will care for your child, communicate the need to follow consistent rules set by the parent regarding discipline and homework.

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, trained persons to address health issues and emergencies, and the rooms and the playground should be safe.

Developing Good Homework & Study Habits
Create an environment that is conducive to doing homework starting at a young age. Children need a consistent work space in their bedroom or another part of the home that is quiet, without distractions, and promotes study.

Schedule ample time for homework; build this time into choices about participation in after school activities.

Establish a household rule that the TV and other electronic distractions stay off during homework time.

Supervise computer and Internet use.

By high school, it’s not uncommon for teachers to ask students to submit homework electronically and perform other tasks on a computer. If your child doesn’t have access to a computer or the Internet at home, work with teachers and school administration to develop appropriate accommodations.

Be available to answer questions and offer assistance, but never do your child’s homework for him or 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, speak with your child’s teacher for recommendations on how you or another person can help your child at home or at school. If you have concerns about the assignments your child is receiving, talk with his or her teacher.

If your child is having difficulty focusing on or completing homework, discuss this with your child’s teacher, school counselor, or health care provider.

For general homework problems that cannot be worked out with the teacher, a tutor may be considered.

Some children need help organizing their homework. Checklists, timers, and parental supervision can help overcome homework problems.

Some children may need help remembering their assignments. Work with your child and his or her teacher to develop an appropriate way to keep track of his or her assignments–such as an assignment notebook.

Establish a good sleep routine. Insufficient sleep is associated with lower academic achievement in middle school, high school and college, as well as higher rates of absenteeism and tardiness. The optimal amount of sleep for most adolescents (13 to 18 years of age) is in the range of 8 to 10 hours per night. See Healthy Sleep Habits: How Many Hours Does Your Child Need? for more information.

Additional Information from HealthyChildren.org:
Ten Tips for Your Child’s Success in School

Administering Medication at School: Tips for Parents

Snacks & Sugary Foods in School: AAP Policy Explained

How You Can Help Your Child Avoid & Address Bullying

Back to School, Back to the Doctor

The Healthy Children Show: Energy Balance for School-Age Kids (Video)

Published 8/8/2016 12:00 AM

https://www.healthychildren.org/English/news/Pages/Back-to-School-Tips.aspx

 

California’s Law SB277 to End Vaccine Exemption PASSED.

The statement below is from the American Academy of Pediatrics’ (AAP) California chapter website. The AAP, whose members are pediatricians, supports the new law that ends personal belief exemptions for mandated vaccines. The new law signed by Governor Brown takes effect July 1st and impacts the 2016/2017 school year (Gov. Brown’s statement is attached). All children will need proof of vaccination for mandated vaccines to enter school and be unable to opt out of vaccination for personal or religious beliefs. 

According to the website, https://www.aapca1.org/articles/california-governor-brown-signs-sb-277,

“California Governor Brown signs SB 277 to eliminate personal belief exemptions for school and child care entry in California. We applaud Senator Richard Pan, MD, and Senator Ben Allen, their co-authors and staff for this tremendous accomplishment – a landmark in public health legislation!

Thank you to the hundreds of AAP California member pediatricians who called and wrote in support of SB 277. Special thanks to Vaccinate California, the California Immunization Coalition, the California Medical Association, the Health Officers Association or California, the California Academy of Family Physicians and everyone who joined the effort to advocate, educate, and enact SB 277.

Children and the public health are the clear winners !

http://gov.ca.gov/docs/SB_277_Signing_Message.pdf

Now is a good time to review your child’s vaccine records and discuss with your health care provider to make sure immunizations are up to date before the new school year. 

 

ZIKA Virus

https://www.healthychildren.org/English/news/Pages/CDC-Outlines-Ways-to-Prevent-Diagnose-Treat-Children-with-Zika-Virus-Disease.aspx

CDC Outlines Ways to Prevent, Diagnose & Treat Children with Zika Virus Disease

​Noting the rapid spread of the Zika virus, an article to be published in the May 2016 edition of Pediatrics offers health care providers guidance on how to recognize, test and treat children who show signs of infection.

Diagnosis can be challenging, based on limited data that shows that most infants and children with Zika virus display mild symptoms that resemble common childhood illnesses, according to the report, “Zika Virus Disease: A CDC Update for Pediatric Health Care Providers,” by the U.S. Centers for Disease Control and Prevention, published early online March 23.

Zika virus has been identified in 37 countries and territories as of March 9, 2016. No vaccine is available to prevent infection with the virus, which is typically spread by mosquitoes and has also been reported to occur through sexual transmission from male partners.

The Zika virus has been associated with birth defects, including microcephaly, with warnings issued for pregnant women to postpone travel to areas where local Zika virus transmission has been reported. Children and adults who contract the virus may show symptoms of fever, rash, joint pain or conjunctivitis.

Health care providers should suspect mosquito-borne transmission of Zika virus infection in children who have traveled to or resided in an affected area within the past two weeks and exhibit at least two symptoms. Treatment consists of supportive care, including rest and fluids.
 
Published
 3/23/2016 12:00 AM

 

 

ALLERGIES

Allergies
 

Allergies and asthma, which typically start in childhood, are by far the most common chronic diseases among children in the United States. Consider the following statistics:

Some 50 million Americans have allergies (about 1 in 5 people in this country).
The most common type of allergy is hay fever (allergic rhinitis); the medical cost of treating it, when direct and indirect costs are added up, now exceeds $7 billion a year.
More than 17 million Americans have asthma, and about one-fourth of these are younger than 18 years. Asthma accounts for about 4,000 deaths a year.
Seventy to 80% of school-aged children with asthma also have allergies, which are among the most common triggers for asthma, closely tied with viral respiratory infections.
If one parent has allergies, there’s a 25% chance that a child will also be allergic. The risk is more than doubled to 60% to 70% if both parents have allergies.
Many aspects of allergies, eczema, and asthma still are not fully understood. But advances in the diagnosis and treatment of these disorders are helping millions of sufferers.

What Are Allergies?
Many people mistakenly use the word allergy to refer to a disease or almost any unpleasant or adverse reaction. We often hear someone say, “I have allergies,” “He’s allergic to hard work,” or “She’s allergic to anything that’s green.” In reality, allergies are reactions that are usually caused by an overactive immune system. These reactions can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever, and eczema.

Your immune system is made up of a number of different cells that come from organs throughout the body—principally bone marrow, the thymus gland, and a network of lymph nodes and lymph tissue scattered throughout the body, including the spleen, gastrointestinal tract, tonsils, and the adenoid (an olive-shaped structure that is located at the top of the throat behind the nose).

Normally, it’s the immune system that protects the body against disease by searching out and destroying foreign invaders, such as viruses and bacteria. In an allergic reaction, the immune system overreacts and goes into action against a normally harmless substance, such as pollen or animal dander. These allergy-provoking substances are called allergens.

Who Is at Risk?
Although allergies can develop at any age, they most commonly show up during childhood or early adulthood. A search of family medical histories of a child with allergies will usually turn up a close relative who also has allergies. If one parent, brother, or sister has allergies, there is a 25% chance that a child will also have allergies. The risk is much higher if both parents are allergic. But the child will not necessarily be allergic to the same substances as the parents or always show the same type of allergic disease (eg, hay fever, asthma, eczema).

Symptoms Associated With Allergies
Eyes, Ears, Nose, Mouth
Red, teary, or itchy eyes
Puffiness around the eyes
Sneezing
Runny nose
Itchy nose, nose rubbing
Postnasal drip
Nasal swelling and congestion
Itchy ear canals
Itching of the mouth and throat

Lungs
Hacking dry cough or cough that produces clear mucus
Wheezing (noisy breathing)
Feeling of tightness in the chest
Low exercise tolerance
Rapid breathing; shortness of breath

Skin
Eczema (patches of itchy, red skin rash)
Hives (welts)

Intestines
Cramps and intestinal discomfort
Diarrhea
Nausea or vomiting

Miscellaneous 
Headache
Feelings of restlessness, irritability
Excessive fatigue

When to Suspect an Allergy
Allergies can result in various types of conditions. Some are easy to identify by the pattern of symptoms that invariably follows exposure to a particular substance; others are more subtle and may masquerade as other conditions. Here are some common clues that should lead you to suspect your child may have an allergy.

Patches of bumps or itchy, red skin that won’t go away
Development of hives—intensely itchy skin eruptions that usually last for a few hours and move from one part of the body to another
Repeated or chronic cold-like symptoms, such as a runny nose, nasal stuffiness, sneezing, and throat clearing, that last more than a week or two, or develop at about the same time every year
Nose rubbing, sniffling, snorting, sneezing, or drippy nose
Itchy, runny eyes
Itching or tingling sensations in the mouth and throat
Coughing, wheezing, difficulty breathing, and other respiratory symptoms
Unexplained bouts of diarrhea, abdominal cramps, and other intestinal symptoms.

Where does ASTHMA fit in?
Although allergies can trigger asthma and asthma is often associated with allergies, they are actually 2 different things. In simple terms, asthma is a chronic condition originating in the lungs, whereas allergies describe reactions that originate in the immune system and can affect many organs, including the lungs. Many different substances and circumstances can trigger an asthma attack—exercise, exposure to cold air, a viral infection, air pollution, noxious fumes, tobacco smoke, and for many asthma sufferers, a host of allergens. In fact, about 80% of children with asthma also have allergies. Although allergies are important in triggering asthma, severe asthma exacerbations are often set off by the good old common cold virus, totally unrelated to allergy.
Last Updated
 11/21/2015
Source
 Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)

Ear Infections

Ear Infection Information
 
When is it an Ear Infection?
A typical middle ear infection in a child begins with either a viral infection (such as a common cold) or unhealthy bacterial growth. Sometimes the middle ear becomes inflamed and causes fluid buildup behind the eardrum. In other cases, the eustachian tubes — the narrow passageways connecting the middle ear to the back of the nose — become swollen.

Children are more prone to both of these problems for several reasons. The passages in their ears are narrower, shorter, and more horizontal than the adult versions. Because it’s easier for germs to reach the middle ear, it’s also easier for fluid to get trapped there. And just as children are still developing, so are their immune systems. Once the infection takes hold, it’s harder for a child’s body to fight it than it is for a healthy adult’s.

The symptoms of an ear infection may be hard to detect. A child who constantly tugs or pulls at the ear could simply be exploring, or simply showing a self-soothing reflex — even though that tops the list of signals listed in many books and Web sites.

Other symptoms can include:
More crying than usual, especially when lying down
Trouble sleeping or hearing
Fever or headache
Fluid coming out of the ears
Doctors can use special instruments to see if an infection is present.

Treatment: Less May Be More
Perhaps the most surprising news is that common ear infections rarely require medication or any other action, except when severe or in young infants. “The body’s immune system can usually resolve them,” says Dr. Robert M. Jacobson, chair of the Mayo Clinic’s Department of Pediatric and Adolescent Medicine. “More and more studies show that children treated or untreated are at the same place 10 days out. We are constantly amazed at how many ear infections resolve on their own.”

It’s true: Fewer doctors are relying on antibiotics. As Dr. Jacobson points out, it’s important to understand that taking antibiotics might or might not speed recovery, and overusing them can lead to bacteria developing resistance to the drugs, as the germs mutate to defend themselves against medicine. As a result, many pediatricians have adopted a wait-and-see approach, rather than prescribing antibiotics at the first sign of infection.

Asking the parents to observe the child for 48 to 72 hours is becoming the most common first step among pediatricians. That doesn’t mean that an office visit isn’t a good idea, however. Doctors can prescribe numbing drops and suggest over-the-counter pain relievers to treat symptoms, which can help the child feel better as she recovers. 

Along with getting away from prescriptions, pediatricians are also shying away from ear tubes, a procedure in which a small tube is surgically inserted in the ear to drain fluid. According to Dr. Jacobson, tube placement is best used with those children who have recurring hearing problems caused by multiple infections.

“Tubes don’t actually stop ear infections, just symptoms and fluid retention,” says Dr. Jacobson. “We don’t want to do it too often because there is an increased risk of damage to the eardrum.”

According to Dr. Jacobson, diagnosis and treatment should be a three-step process:
First, the pediatrician determines whether or not an ear infection is present.
Second, the pediatrician and parent discuss risk factors and how to reduce them.
Finally, observation and treatment of symptoms ensure the child is recovering without pain.
Reducing the Risks for Ear Infection
While parents can’t head off every germ that’s headed for their children, they can take steps to reduce their children’s risks.

Avoid Secondhand Smoke Exposure
Smoking is a huge contributor to childhood illness. Ear infections are no exception to that rule. Smoking is addictive and hard to quit, but not every smoker realizes the harmful effects that secondhand smoke could have on his or her child. Quitting is just as important for your child’s health as your own.

Proper Hygiene
Bad hygiene habits are another major problem. Children in child care are more exposed to widespread bacteria, as are those who drink from a bottle as opposed to asippy cup, says Dr. Jacobson. That’s because bottles have more surface area for germs to live on. Teach children to wash their hands frequently to prevent the spread of germs that spread illness.

Keep Your Child Up-To-Date with Vaccines
Talk with your child’s doctor about the vaccines that protect against pneumonia and meningitis. Studies show that vaccinated children experience fewer ear infections.

Breastfeed Your Baby
Breastfeed infants for the first year. Breast milk has many substances that protect your baby from a variety of diseases and infections. Because of these protective substances, breastfed children are less likely to have bacterial or viral infections, such as ear infections.

Get A Flu Shot
Consider getting immunized against influenza. Aside from protecting against this yearly disease, it can help prevent ear infections.
Last Updated
 11/21/2015
Source
 Adapted from Healthy Children Magazine, Summer 2007
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Baby Teeth Eruption Charts

http://www.mouthhealthy.org/en/az-topics/b/baby-teeth

 

http://www.mouthhealthy.org/~/media/MouthHealthy/Files/Kids_Section/ADAPrimaryToothDev_Eng.pdf?la=en

Eruption Charts

 Teeth vary in size, shape and their location in the jaws. These differences enable teeth to work together to help you chew, speak and smile. They also help give your face its shape and form. At birth people usually have 20 primary (baby) teeth, which often erupt about 6 months of age. They are then shed at various times throughout childhood. By age 21, all 32 of the permanent teeth have usually erupted.

Download the following eruption charts:
Primary Teeth Eruption Chart (PDF) : click below

ADAPrimaryToothDev_Eng

Primary Tooth Development

 

Permanent Teeth Eruption Chart (PDF)

ADAPermanentTeethDev_Eng

 

Baby Teeth

A child’s primary teeth, sometimes called “baby teeth,” are as important as the permanent adult teeth.

When Do Baby Teeth Come In?
A baby’s 20 primary teeth are already present in the jaws at birth and typically begin to appear when a baby is between 6 months and 1 year.

Check out this baby teeth eruption chart to see the order in which teeth break through and at what ages you can expect specific teeth to appear. 

When teeth first come in, some babies may have sore or tender gums. Gently rubbing your child’s gums with a clean finger, a small, cool spoon or a wet gauze pad can be soothing. You can also give the baby a clean teething ring to chew on. If your child is still cranky and in pain, consult your dentist or physician. Most children have a full set of 20 primary teeth by the time they are 3.

Why Baby Teeth Matter
Not only do primary teeth help children chew and speak, they also hold space in the jaws for permanent teeth that are growing under the gums. When a baby tooth is lost too early, the permanent teeth can drift into the empty space and make it difficult for other adult teeth to find room when they come in. This can make teeth crooked or crowded. That’s why starting infants off with good oral care can help protect their teeth for decades to come.

When Should I Start Taking My Child to the Dentist?
The ADA recommends that a dentist examine a child within six months after the first tooth comes in and no later than the first birthday. A dental visit at an early age is a “well-baby checkup” for the teeth. Besides checking for tooth decay and other problems, the dentist can show you how to clean the child’s teeth properly and how to evaluate any adverse habits such as thumbsucking.

How to Care for Your Child’s Teeth
It’s important to care for your baby’s teeth from the start. Here’s what to do:

Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth. As soon as teeth appear, decay can occur. A baby’s front four teeth usually push through the gums at about 6 months of age, although some children don’t have their first tooth until 12 or 14 months.
For children younger than 3 years, caregivers should begin brushing children’s teeth as soon as they begin to come into the mouth by using fluoride toothpaste in an amount no more than a smear or the size of a grain of rice. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing to ensure that they use of the appropriate amount of toothpaste.
For children 3 to 6 years of age, use a pea-sized amount of fluoride toothpaste. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing and remind them not to swallow the toothpaste.
Until you’re comfortable that your child can brush on his or her own, continue to brush your child’s teeth twice a day with a child-size toothbrush and a pea-sized amount of fluoride toothpaste. When your child has two teeth that touch, you should begin flossing their teeth daily.

 

 

 

 

UPDATES Car Seat Safety

Car Seat Checkup
 

Using a car seat correctly makes a big difference. Even the right seat for your child’s size must be used correctly to properly protect your child in a crash. Here are car seat tips from the American Academy of Pediatrics (AAP).

Does your car have air bags?
Never place a rear-facing car seat in the front seat of a vehicle that has a front passenger air bag. If the air bag inflates, it will hit the back of the car seat, right where your baby’s head rests, and could cause serious injury or death.
The safest place for all children younger than 13 years to ride is in the back seat.
If an older child must ride in the front seat, a child in a forward-facing car seat with a harness may be the best choice. Be sure you move the vehicle seat as far back from the dashboard (and air bag) as possible.
Is your child facing the right way for weight, height, and age?
All infants and toddlers should ride in a rear-facing car seat until they are at least 2 years of age or reach the highest weight or height allowed by their car seat manufacturer.
Any child who has outgrown the rear-facing weight or height limit for his car seat should use a forward-facing seat with a harness for as long as possible, up to the highest weight or height allowed by his car seat manufacturer.
Is the harness snug?
Harness straps should fi t snugly against your child’s body. Check the car seat instructions to learn how to adjust the straps.
Place the chest clip at armpit level to keep the harness straps secure on the shoulders.
Does the car seat fit correctly in your vehicle?
Not all car seats fi t properly in all vehicles.
Read the section on car seats in the owner’s manual for your car.
Can you use the LATCH system?
LATCH (lower anchors and tethers for children) is a car seat attachment system that can be used instead of the seat belt to install the seat. These systems are equally safe, but in some cases, it may be easier to install the car seat using LATCH.
Vehicles with the LATCH system have anchors located in the back seat, where the seat cushions meet. Tether anchors are located behind the seat, either on the panel behind the seat (in sedans) or back of the seat, ceiling, or floor (in most minivans, SUVs, and hatchbacks). All car seats have attachments that fasten to these anchors. Nearly all passenger vehicles and all car seats made on or after September 1, 2002, are equipped to use LATCH. All lower anchors are rated for a maximum weight of 65 pounds (total weight includes car seat and child).
The top tether improves safety provided by the seat. Use the tether for all forward-facing seats, even those installed using the vehicle seat belt.
Always follow both the car seat and vehicle manufacturer instructions, including weight limits, for lower anchors and tethers. Remember, weight limits are different for different car seats and different vehicles.
Is the seat belt or LATCH strap in the right place and pulled tight?
Route the seat belt or LATCH strap through the correct path. Convertible seats have different belt paths for when they are used rear facing or forward facing (check your instructions to make sure).
Pull the belt tight. Apply weight into the seat with your hand while tightening the seat belt or LATCH strap. When the car safety seat is installed, be sure it does not move more than an inch side to side or toward the front of the car.
If you install the car seat using your vehicle’s seat belt, you must make sure the seat belt locks to keep a tight fit. In most newer cars, you can lock the seat belt by pulling it all the way out and then allowing it to retract to keep the seat belt tight around the car seat. Many car seats have built-in lock-offs to lock the belt.
It is best to use the tether that comes with your car seat to the highest weight allowed by your vehicle and the manufacturer of your car seat. Check your vehicle owner’s manual and car seat instructions for how and when to use the tether and lower anchors.
Has your child outgrown the forward-facing seat?

All children whose weight or height is above the forward-facing limit for their car seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are 8 through 12 years of age.
A seat belt fits properly when 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 upper thighs, not the belly; and the child is tall enough to sit against the vehicle seat back with her knees bent over the edge of the seat without slouching and can comfortably stay in this position throughout the trip.

Do you have the instructions for the car seat?

Follow them and keep them with the car seat.
Keep your child in the car seat until she reaches the weight or height limit set by the manufacturer. Follow the instructions to determine whether your child should ride rear facing or forward facing and whether to install the seat using LATCH or the vehicle seat belt.
Has the car seat been recalled?
You can find out by calling the manufacturer or the National Highway Traffic Safety Administration (NHTSA) Vehicle Safety Hotline at 888/327-4236 or the NHTSA Web site.
Follow the manufacturer’s instructions for making any repairs to your car seat.
Be sure to fill in and mail in the registration card that comes with the car seat. It will be important in case the seat is recalled.
Do you know the history of your child’s car seat?
Do not use a used car seat if you do not know the history of the seat.
Do not use a car seat that has been in a crash, has been recalled, is too old (check the expiration date), has any cracks in its frame, or is missing parts.
Make sure it has a label from the manufacturer and instructions.
Call the car seat manufacturer if you have questions about the safety of your seat.
Questions
If you have questions or need help installing your car seat, find a certified child passenger safety technician (CPST). Lists of certified CPSTs and child seat-fitting stations are available on the following Web sites:

NHTSA Parents Central
SeatCheck
National Child Passenger Safety Certified Technicians  
Additional Information from HealthyChildren.org:
Car Seats: Information for Families
Car Seats: Product Listing  
Car Seats and Obese Children: Suggestions for Parents
​ 

Figure 1 adapted from National Highway Traffic Safety Administration. LATCH Makes Child Safety Seat Installation as Easy as 1-2-3. 2011. DOT HS publication 809 489. Published March 2011. Accessed November 5, 2015.

Figures 2, 3, 4, 5, and 6 by Anthony Alex LeTourneau.​

 
Last Updated
 2/16/2016
Source
 Car Seat Checkup (Copyright © 2016 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

New Year’s Resolutions for Kids

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