Beat the Heat! Six Tips for Keeping Your Child Hydrated

thirsty six year old asian-american girl gulping down a cool refreshing drink of bottled water.
Make sure kids get plenty of fluids this summer.

When kids are having a lot of fun outside in summertime temperatures, it’s easy for them to forget to replace fluids, but doing so can lead to some problems. Less serious effects of mild-to-moderate dehydration can include lack of energy, headaches, dry mouth (which can cause bad breath) and dry skin, but severe dehydration can become dangerous. See below for a complete listing from the Mayo Clinic about the effects of mild, moderate and severe dehydration. One thing to remember – don’t wait for kids to say they are thirsty because by then some degree of dehydration has already occurred. Kids should drink throughout the day, and obviously increase intake when outside and active. For younger kids, it can be helpful for parents to keep an eye on how often kids are going to the bathroom. If your concerned, it’s also a good idea to occasionally check to make sure a child’s urine isn’t too concentrated, as that can be a good indicator of dehydration.

So, have fun this summer, but do so while drinking lots of fluids! See below for some additional tips. Thanks, and see you next month!!!

Six Tips to Help Your Kids Stay Hydrated:

1) Let kids pick out their own water bottles and personalize them however they like – this will increase the likelihood of their carrying it with them.

2) Push water as their main drink, but spice it up with bubbles (such as soda stream), lemon or lime wedges, or infuse with other types of fruit.

3) Put a drink chart on the fridge – check mark for every 8 ounces or more. Recommended intake varies by a child’s weight, but go here for a calculator.

4) Popsicles are a great, cool way to replenish fluids. Look for the no sugar added/all fruit variety. It’s also fun for kids to make their own.

5) Push fruit! One of the many great aspects of summertime is the abundance of fruits: watermelon, other types of melons, berries, peaches, plums, cherries . . . the list goes on and on. Find some your kids like, and you’ll have a healthy, easy way to help them rehydrate.

6) Kids love sports drinks, but they can often contain as much sugar as soda or juice. So, use them in moderation to replenish electrolytes, especially after sports or other heavy activity. One way to reduce the sugar hit is to cut sports drinks with water.

The Mayo Clinic provides signs and symptoms of mild to moderate and severe dehydration. Mild to moderate dehydration is likely to cause:

• Dry, sticky mouth
• Sleepiness or tiredness — children are likely to be less active than usual
• Thirst
• Decreased urine output
• No wet diapers for three hours for infants
• Few or no tears when crying
• Dry skin
• Headache
• Constipation
• Dizziness or lightheadedness

Severe dehydration, a medical emergency, can cause:
• Extreme thirst
• Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults
• Very dry mouth, skin and mucous membranes
• Little or no urination — any urine that is produced will be darker than normal
• Sunken eyes
• Shriveled and dry skin that lacks elasticity and doesn’t “bounce back” when pinched into a fold
• In infants, sunken fontanels — the soft spots on the top of a baby’s head
• Low blood pressure
• Rapid heartbeat
• Rapid breathing
• No tears when crying
• Fever
• In the most serious cases, delirium or unconsciousness

Let’s help our children beat the heat while enjoying their summer activities!

Additional dehydration resources:

Facts About Dehydration

Recognizing Dehydration

Treating Dehydration in Children Under 12

Summer Water Safety

Happy toddler girl having fun in a swimming pool

Now that summer is here and people are heading to the pool, the beach, pond, river or lake, it’s time for some water safety reminders.

Childsafetyblog.org wants parents and caregivers to put on their thinking-bathing caps when they do take in aquatic activities!  Being safe in and around water–even a child’s wading pool–is crucial to your child’s life and your happiness. Unfortunately, we must remind everyone that drowning can occur quickly.

SafeKids’ “drowning prevention” fact sheet ( http://www.safekids.org/our-work/research/fact-sheets/drowning-prevention-fact-sheet.html ) tells us that each year more than 830 children under the age of 14 drown and that nearly 3,600 injuries to children occur from near-drowning accidents.  No matter what we think about the recently televised Casey Anthony trial, the trial drew attention to very necessary pool safety and how easy it can be for very young children to access a family pool.  Here’s a sad factoid:

  • Home swimming pools are the most common site for a drowning to occur for a child between the ages 1 to 4 years.

One might think it would be just the opposite, that at home, parents, family members, caregivers or babysitters might be more available to watch a young child in and around the pool. However, these kinds of accidents usually occur when someone is not watching or paying attention, even though caregivers have claimed that children involved in drowning accidents were being supervised while in the water.

It bears repeating that accidents in and around the water happen fast.

These accidents happened, and the families of these children are bereft. It is painful to ask questions afterward–who was supervising, who was watching?   More facts:

  • 16 percent of drowning deaths in children under 5 years of age are at a family or friend’s pool, while 17 percent of deaths occur at a public, community, or neighbor pool.
  • The majority of infant (less than 1 year old) drowning deaths happen in bathtubs, buckets, or toilets.

This last fact, to us, is stunning.  But it also dictates that we, as parents and caregivers, can be the safety supervisor in our child’s lives when they are doing something as dangerous… as taking a bath.  Yes, dangerous.  Drowning can occur in as little as three inches of water.  SafeKids says that the most dangerous pools are children’s public wading pools, in-ground hot tubs or any others pools that have flat drain grates and/or a single main drain system. For these the danger is entrapment.

Childsafetyblog.org reminds parents to “actively supervise your children when they are in and around water at all times, and have a phone nearby to call for help in any emergency.

Spring, Allergies, and Your Kids

Photo of happy girls with handsome lads in front smiling at camera

I just finished reading an interesting and very relevant article in Parenting magazine about spring, kids and allergies.

It turns out that seasonal allergies, or hay fever, can strike a child for the first time in spring if he’s between two and five. How do you know it’s not another cold he picked up at school?

Princess Ogbogu, M.D., an assistant professor of medicine and pediatrics, specializes in allergy and immunology at the Ohio State University Medical Center in Columbus. She says there are seven signs to watch for and if your child has several of these signs, he might need to be seen by an allergist. They are:

1.  If you, your child, or his father has suffered from allergies, asthma, or eczema.

2. Ongoing congestion.  That runny nose that hasn’t cleared up after a week or so.

3.  He has itchy, watery eyes.

4. He’s not running a fever or complaining about his body aching.

5. He might have a rash. It can appear anywhere on his body.

6. Or an ear infection. Allergies can lead to inflammation in the ear.

7. The final sign to watch for…your child gets worse on days when the pollen count is high.

A resource I’ve used is the American College of Asthma, Allergy and Immunology: Children and Allergies.

Happy Spring! Make sure you have enough tissue handy!

 

 

Holiday Toy Safety

The consumer advocacy group, USPIRG, has released its annual Trouble in Toyland report highlighting toys that raise concerns because of toxic substances, choking hazards, magnets or excessive noise. All of these toys were purchased from national retailers or online.  Make this holiday a safe and happy one!

warning toy hazard photo

 

 

Kids and Bicycle Safety

Summer means ice cream and fireflies, cooking out, playing outside and bicycling. Riding bikes was such a vital part of my childhood memory. We want our kids to be out of doors and enjoying the break from school, biking to see friends or going on family bike rides.

Our job as parents is to make sure our children understand the rules of bicycle safety and that they’re wearing their helmets. Scraped knees, bumps and bruises are part of being a kid. We can’t protect our children from every little accident but we can do a great deal to make sure they are safe when bicycling.

The most important safety tool for bicycling is a helmet that fits properly and meets the Consumer Product Safety Standard. According to the NHTSA, wearing a bicycle helmet reduces the risk of brain injury and head injury by as much as 85 percent. The statistics show that only 25% of children ages 5 to 14 are wearing helmets, whereas for teen riders it’s almost zero percent. Read more from the NHTSA here.

A properly fitting helmet should be snug, worn level on the head without tilting back on the head or sitting low on the forehead. The chinstrap, made strong enough to sustain an impact, should be firmly fastened to ensure that helmet doesn’t move from side to side or slip up and down. Read how to fit a bike helmet here.

Second in importance is making sure the bicycle is sized for your child. Have your child stand over the bicycle. According to the NHTSA, there should be 1 to 2 inches between your child and the top bar if using a road bike and 3 to 4 inches if a mountain bicycle. The seat should be level front to back. The seat height should be adjusted to allow a slight bend at the knee when the leg is fully extended. The handlebar height should be at the same level with the seat.

Your next step is to teach children bicycle safety tips. The NHTSA has bicycle safety advice and activities geared to the age of your child. Tips include:

  • Don’t wear loose fitting pants or have drawstrings or shoelaces that might get caught in the gears.
  • Don’t carry things in your hands; keep both hands on the wheels. Use a basket or backpack to carry items.
  • Be alert to things in the road like broken glass, rocks or potholes that might cause the bike to fall over.
  • Wear brightly colored clothes. For night riding wear a reflective vest or strip on clothing. It’s important to remember that just because you can see a car doesn’t mean they can see you.

Our children look up to us and they copy our behavior. It’s part of our duty to teach them the rules of bicycle safety and to show them, by example, the importance of staying safe.

Rules of the Road

If your child is allowed to ride on the street, he should follow these road rules:

  • Always ride with your hands on the handlebars.
  • Always stop and check for traffic in both directions when leaving your driveway, an alley, or a curb.
  • Cross at intersections. When you pull out between parked cars, drivers can’t see you coming.
  • Walk your bike across busy intersections using the crosswalk and following traffic signals.
  • Ride on the right-hand side of the street, so you travel in the same direction as cars do. Never ride against traffic.
  • Use bike lanes or designated bike routes wherever you can.
  • Don’t ride too close to parked cars. Doors can open suddenly.
  • Stop at all stop signs and obey traffic (red) lights just as cars do.
  • Ride single-file on the street with friends.
  • When passing other bikers or people on the street, always pass to their left side, and call out “On your left!” so they know that you are coming.

Additional Resources:

Helmets for Every Activity

Helmet Safety for Kids’ Sake

Information on Concussions

 

 

 

 

Helping Your Children Develop a Healthy Body Image

My eldest daughter, Jane, is almost 12, and my second child, Libby, is almost 10.  The “tween” stage can be a difficult time of life for all kids, but especially girls.  I worry about the world they are entering–a place where beauty and unhealthy thinness are often emphasized over intellect and character.  As parents, it’s critical for my wife Jennifer and I to lay the groundwork from an early age to give my daughters, and my son, a healthy body image and self-esteem.

As early as the pre-teen years, girls begin to struggle with body image. They are bombarded with unrealistic images and messages in magazines, billboards, television, music videos and movies. Here is a great ad by Dove® – part of itsCampaign for Real Beauty – which dramatically shows how girls are facing an unfair, and unwinnable, battle if they try to live up to the “creation” of unnaturally (literally) thin and beautiful models by the fashion industry.

Creating a Healthy Body Image

What can a parent do to help foster a healthy body image for children? It starts with how we act and what we say in front of our children. The mother who obsesses about her own weight and talks about being too fat, is teaching her daughters to obsess about their body image. Children are impressionable and incredibly observant; at the earliest age they begin to pick up these cues from us.

We can help our kids create a healthy body image.

1.      Be a good role model. Eat right, exercise and promote a healthy lifestyle for the whole family. Children watch and imitate their parents–we can help them develop good life habits.

2.      Be positive. Compliment children, pre-teens and teens on their hard work and achievements–not their looks. Don’t nag or criticize a child with weight issues. Focus on the positive aspects of behavior and activities, rather than things related to attractiveness.  If your child is overweight don’t put them on a diet or talk constantly about their weight.

3.      Talk about the culture of thinness. If your children watch television, watch with them. Talk about how models are portrayed, reminding your teens that these women are too skinny (and unhealthy). Talk about photo-shopping and how pictures in magazines are altered to make people look perfect. Help your children understand that what they see isn’t real.

4.      Encourage a healthy lifestyle. Exercise with your kids, do family activities and other things together. Prepare and eat meals together, emphasizing a variety of good-for-you foods.  (Adapted from WebMD, Help Teens Develop a Healthy Body Image)

As girls reach the pre-teen years they’re facing so many changes, physically and emotionally. As their bodies begin to develop so does their concept of who they are. This is the point at which young girls begin to worry about how they look. How can they avoid it?

Dr. Wendy Oliver-Pyatt, a specialist in eating disorders, describes this period of change:

As children’s bodies undergo these changes, they also develop a new image of their own sexuality and attractiveness. In addition, as they add weight and round out, their casual relationship with food and eating becomes more complex.

Children who navigate these changes successfully can mature into confident, healthy individuals who value their own bodies and are in control of their eating. Those who fall prey to societal pressures or destructive dieting during their teen years, however, are targets for eating disorders or lifelong obesity. That’s why parents need play an active role in understanding their children’s changing bodies and feelings during puberty and adolescence, and promoting a positive body image and a healthy relationship with food and eating. ”  EatingDisorderHope.com

If you suspect your pre-teen or teen has an eating disorder call your family doctor or pediatrician.

Resources on healthy body image and eating disorders in teens and preteens:

Fostering Healthy Body Image and Weight in Your Pre-Teen or Teen  (http://www.eatingdisorderhope.com/information/body-image/teen-adolescent-issues)

 Eating Disorders, What Families Need to Know (http://www.med.umich.edu/yourchild/topics/eatdis.htm)

Center for Young Women  (http://www.youngwomenshealth.org/self_esteem.html )

Raising Healthy Eaters

As the parent of 4 children ranging from 5 to 12 years old, I know how challenging it is to promote healthy eating. Good nutrition is one of those things we know we need to pay attention to, but sometimes it can get shoved aside as we deal with the business of daily life.

Our children’s future eating habits, and consequently their health, are based on what they learn now. Our role as parents is to help shape this awareness of nutrition and healthy eating.  We can’t control what our children are exposed to when they’re not at home, but we can teach them to develop an appreciation for good, nutritious foods.

Some Basic Tips for Focusing on Good Nutrition

Eat meals together. Sit at the table and enjoy the food. Try to serve nutritious meals–minimize the fast food on paper plates. Mealtime should be pleasant and easy going.

Try to reduce the use of prepared foods in favor of home-cooked meals.

D    Don’t force children to clean their plates or finish a food they don’t like. Associating discipline with food sets the stage for emotional eating. Allowing a child to stop eating when he’s hungry teaches him to listen to his body’s needs and will help reduce overeating.

  • If a child doesn’t like a new food, don’t force him to eat it. Quietly find a way to introduce the food another time. Tastes change over time as do eating preferences–if you continue to offer a wide variety of foods, your child is more likely to expand her list of foods she’ll eat.   Just last week, our daughter Cate decided that she now likes milk and green beans – foods that she used to “hate.”
  • Don’t use sweets or salty processed snacks as a reward. No more “Be a good boy and we’ll stop at McDonalds for fries.” Offer treats and rewards like a new book or outing to a favorite place.
  • If you need a refresher on nutrition, see www.choosemyplate.gov for recommendations and tips for parents.

 Get Children Involved In The Foods They Eat

Encourage children to help with menu planning, grocery shopping, and food preparation. When children help prepare meals they develop an interest in the food. Talk about the food, read the nutritional labels and make it a learning experience. Talk as you shop; “what’s fresh today?” “These squash look really nice and colorful, how about we buy these.”  “What would you like for dinner tomorrow night, chicken or fish?” Even the youngest child can help with meal preparation in some fashion. Michael, my five year old, loves to stand on a chair and help me make pancakes by pouring in the measured ingredients.  Toddlers can help by washing a bunch of carrots and this is a great environment to teach an older child how to properly use a kitchen knife.

Change your family’s snacking habits. Dad can’t eat potato chips 24/7 and expect to deny them to the kids. Buy healthy snack foods and make them available to children. Slice veggies and put them in bags, ready to be eaten without preparation. Stock fruits and veggies in the front of the refrigerator.  Move chips, sweets and other less-healthy foods to higher shelves, put them in containers, or stop buying them all together. If you’re a soft drink family, transition to vitamin waters or all natural fruit juices (no sugars added). Offer up water on a regular basis–and let them see you drinking it as well.

If your family is fond of fried foods, sweets and salty snacks, you’ll want to take it slow. Gradually reduce one item at a time so your children barely notice.  Developing healthy eating habits can be done successfully–it just takes time.

Do you have any tips on getting children to eat nutritious meals?

More Information:

Healthy Eating Suggestions    (Link to: http://kidshealth.org/parent/nutrition_center/healthy_eating/food_labels.html#)

Understanding Nutrition Labels, Video  (Link:  http://bcove.me/nq9hn96t)

Children and Junk Food  (Link:  http://www.childsafetyblog.org/2012/11/children-and-junk-food.html)

Go, Slow, Whoa – Teens and Food  (Link: http://teenshealth.org/teen/food_fitness/nutrition/go_slow_whoa.html )

One Text or Call Could Wreck It All

As part of a nationwide effort to raise awareness of the dangers of distracted driving and to help teens (and everyone) make safer driving decisions, I and other attorneys from MichieHamlett have been making safety presentations to schools in the area for the past several years.

Teens, who are inexperienced drivers and often passengers in cars being driven by other inexperienced drivers, are particularly at risk. Traffic crashes are now the leading cause of death for this age group. The vast majority of teen crashes are caused by some type of driver distractions. As a trial attorney with nearly 15 years of practice, I have personally seen many senseless traffic tragedies involving teens and how these tragedies devastate families and communities.  And, as you know, many adults are guilty of distracted driving, which further subjects our children, and us, to danger on the road.

Most people don’t know that distracted driving was the 2009 word of the year chosen by Webster’s Dictionary. Unfortunately, this is no passing fad. Distracted driving has become a trend with deadly, real consequences.

Why do so many people participate in this dangerous behavior? With more technology now than ever, driver distractions have risen to unprecedented levels. We live in a world where people expect instant, real-time information 24 hours a day and those desires don’t stop just because they get behind the wheel. Drivers simply do not realize – or choose to ignore – the danger they create when they take their eyes off the road, their hands off the wheel, and their focus off driving.

For those who think they can do two things at once, think about this: According to a study by Carnegie Mellon, driving while using a cell phone reduces the amount of brain activity associated with driving by 37 percent. Can you really afford to lose that much brainpower? It is effectively equivalent to driving under the influence of alcohol. Driving is an activity that requires your full attention and focus in order to keep yourself and others safe.

This is a national problem. No one is immune from the dangers of distracted driving. So please remember: One text or call could wreck it all.

Ten Tips on How to Stop Driving Distracted:

  • Turn off your phone when you get in your car.
  • When you’re in the car, put your phone where you can’t get to it, like the trunk or glove box.
  • Turn your phone notifications off. The less you hear your phone, the less tempted you’ll be to reach for it while you’re driving.
  • Designate a texter. Borrow the thumbs of a friend. Or lend yours to a friend. Passengers get the privilege of texting while in motion.
  • If you need to contact someone, pull over to a safe location and put your vehicle in park.
  • Change your voicemail greeting to indicate you are driving and will call back when safely parked.
  • If you are a passenger and the driver wants to use a cell phone, tell the driver you are uncomfortable with his or her cell phone use.
  • If you are talking to someone who is driving, ask the person to call you when he or she is parked in a safe location or tell the person you’ll call back later.
  • Concentrate on your driving and don’t use your drive time as your down time to catch up on other things.
  • Recognize activities that distract you and make an effort to eliminate them.

Guest Blogger – UVA’s Donna Broshek, Ph.D. on Concussions

As part of brain injury awareness month, we have been featuring a series of articles to educate readers about how to prevent and treat concussions in children.  We were also fortunate to have Donna Broshek, who is a neuropsychologist and the Associate Director of the UVA Health System’s Brain Injury and Sports Concussion Institute, film a public service announcement with us. You can see the PSA here.  Happily, Donna also agreed to write a blog post for us.  Please join me in thanking Donna for all of her help in educating us about this important topic, and keep reading for her post:

As Bryan noted in Kids and Concussions, Part 2, Virginia passed a state law that became effective in July 2011 that requires that public schools develop a protocol for identifying and managing sports concussions, as well as providing education to students and parents.  This legislation has been very important in increasing awareness of sports concussions and keeping kids safe.  The Virginia Board of Education Guidelines For Policies on Concussions in Student-Athletes incorporated key aspects of safe management:

1)      Any athlete suspected of having a concussion should be removed from play and evaluated by a health care provider with experience in sports concussion.

2)      The student must obtain written medical clearance before being allowed to resume physical activity.

3)      Return to physical activity must occur in a gradual supervised manner – various levels of physical activity are introduced gradually while concussion symptoms are monitored.  If symptoms increase or return, the student-athlete returns to a lower level of activity until their symptoms get better.

An important issue for parents to know is that this law only applies to public schools.  Private schools are not covered, although many such schools do have good concussion policies.  Of particular importance is that private youth leagues, such as elite soccer organizations or lacrosse travel teams, are not required to have concussion policies since they are not covered by the state legislation.  It is even more important for parents to be able to recognize signs of concussion in their children and respond by seeking appropriate care when their children are not covered under the state law.

What parents can do:

1)      During the month of March, the Concussion Recognition and Response™ Coach and Parent Version phone app can be downloaded free of charge on iPhone, iPad, iTouch, and Android platforms.  The app was developed in collaboration with the Centers for Disease Control and provides step by step guidance in identifying symptoms and seeking medical evaluation.   The app also has information on monitoring symptoms at home and suggestions for school.

2)      Parents can insist that coaches of independent sports leagues develop a concussion policy that mirrors the one established by the state for public schools.

3)      Parents can lobby their legislators to fix this loophole in the state law so that any private leagues using public sports fields are required to follow the same policies as public schools.

4)      It is better to err on the side of conservative concussion management in youths as the developing brain is more vulnerable to concussions and concussion symptoms last longer in kids and teens.  If in doubt, sit them out!

Donna K. Broshek, Ph.D.

Clinical Neuropsychologist

Kids and Concussions, Part 2

Recently Donna Broshek, Associate Director of the University of Virginia Health System’s Brain Injury and Sports Concussion Institute, and I recorded a public service announcement about concussions and other traumatic brain injuries (TBI) in children. During our shoot, I was able to talk with her about this important topic.  One of the things I took away from that conversation is the importance of our role as parents in educating ourselves and our children about concussions.

Four Ways To Help Keep Your Child Safe

Bruised egos, broken bones and concussions are the biggest risks children face in sports–at an age and almost any sport. As parents we can lessen our safety concerns by becoming informed, engaged and in communication with our children, the schools and their coaches.

1)  Educate yourself.  Learn what a concussion is, its symptoms and what you can do to help your child or teen reduce the chances of a traumatic brain injury. For valuable resources see my first article, What Parents Need to Know About Concussions, Part 1.

2) Ask questions. Is your school system in compliance with the 2011 Virginia Student Athlete Protection Act? This bill established the Virginia Board of Education Guidelines For Policies on Concussions in Student-Athletes, requiring specific protocols for sports, protective gear and training.  

Talk to the coach, school administration, league representative and anyone else who is involved in your child’s sports.  How knowledgeable are they about concussions? Ask to see a copy of the school or league’s training manual for coaches and parent volunteers.

b) Check to see that helmets and equipment are up to date, in good repair and certified, if applicable.

c) Are athletes given any materials on safety, sportsmanship and injury?  Are parents given materials   on concussions?

3)  Talk to your children.  Talk about peer pressure and well-meaning adults who say, “tough it out” after an injury.  Explain in age-appropriate language what a concussion is and the dangers from returning to play too quickly. Talk from a place of love and concern about why their physical health is more important than playing when injured. Talk about the long-term effects of concussions.

4)  Get involved. Your level of involvement may depend on your child’s age. High school football players aren’t as comfortable with mom around as they were when they were children.  There are ways to become a ‘team parent’–from volunteering with fundraisers and parents’ groups to sitting on advisory committees. Attend games and practices (for younger children), show your support for the team and get to know your child’s coaches.

Your involvement as the parent of a young athlete is vital–it shows you care about your child’s participation and safety. And, should an accident occur you’re right there and able to see what happened and to take an active role in your child’s recovery from a concussion.

In my next article we’ll talk about how to prepare your child to play team sports.

Resources:

Parents’ vigilance can head off kids’ concussion risk (http://www.usatoday.com/story/news/nation/2012/09/29/concussion-kids-cantu/1581173/)

The CDC Parent/ Athlete Concussion Information Sheet (http://www.cdc.gov/concussion/headsup/pdf/Parent_Athlete_Info_Sheet-a.pdf)

MomsTEAM.com (http://www.momsteam.com) – Helpful website for sports moms and dads.