Starting preschool or daycare can special time for kids. It is a time to meet new friends and share new and exciting experiences. It is also a time when kids are in close proximity and germs are spread. The recent swine flu scare is latest fear of parents, but there are always bugs going around where little children congregate. Fortunately, there are a few things care providers and parents can do to reduce the spread of sickness.

Some things need to be done by the staff of the daycare, such as proper cleaning and disinfecting techniques. Toys need to be disinfected on a regular basis, particularly in the rooms with younger children. This should be done daily for infants and toddlers.

Ask about daycare’s policy regarding sick children. Children should be required to stay home when sick. Some are more lenient than others. They find themselves in a sticky situation and need to balance the need for parents to work with best interests and health of all children in mind. Some will go too far in accommodating parents and don’t send kids home quickly enough. This spreads sickness. You decide if the policy is one you can live with.

Reciprocate by keeping your own child home when he is too sick for daycare. Following the policies of your daycare center is one the best things you can do to reduce sickness. Don’t be the mom feeding the child Tylenol and sneaking him into daycare in order to meet that work deadline. Switch sick time with your spouse, split the day or call reinforcements, such as grandma if too sick for school.

One thing parents can do is teach their children proper hand washing techniques. The Centers for Disease Control guidelines include washing with warm water, rubbing hands together vigorously for at least 20 seconds, washing both the front and backs of the hands. Rinse the hands thoroughly and dry with a paper towel. Kids can also be taught to use the paper towel to turn off the faucet.

Hand washing is important in reducing the spread of illness. Ask about hand washing policies at the school your child attends. At minimum, the children should be required to wash hands after using the bathroom, before eating and after playing outside.

Another thing to teach kids is what to do when sneezing. Teaching them to use a tissue and the importance of covering the mouth and nose when sneezing helps reduce the spread of germs. Take it from someone with 12 years experience in preschool, they will go to school and teach their sneezing friends.

For the whole family, it never hurts to boost the immune system to ward off illness. This can be done with a healthy diet and plenty of rest. When run down and not taking care of yourself, you can get sick easier and the same is true for kids. Kids have to be up early for school or daycare, so enforcing an early bedtime is important to ensure they are getting enough rest.

Breastfed babies in daycare have the immune system benefit of mom’s milk to help prevent sickness. Eating foods that strengthen the immune system is a good idea for every member of the family.

Foods that support the immune system include:

• Probiotics support the immune system by increasing the white blood cell count. Probiotics are found in yogurt and are available in supplement form in health food stores.
• Vitamin C has been shown in numerous studies to have immune boosting benefits. This vitamin is found in abundance in citrus fruits, strawberries, cantaloupe, papaya and guava.
• Vitamin E is an antioxidant vitamin that boosts the immune system by increasing the production of cells that destroy germs and bacteria in the body. Vitamin E is found in seeds and whole grains.
• Omega 3 Fatty Acids increase the activity of white blood cells to enhance the immune system. These are found in fish, flax and fish oils. There are supplements available as well.
• Zinc is an essential mineral that increases the number of infection fighting cells that kill everything from bacteria to cancer cells. Zinc is found in beans, beef, turkey and cereals are fortified with this medicine.

Remember to always consult with your health-care profession before changing your child’s diet or introducing new foods.

The University of Michigan Health System has a document online with great information for preventing infections in daycare, at school and in the home.

Here is a CDC document on preventing the spread of flu in a daycare setting. Most child care providers should have this information, but if not, you can pass it along to your provider.

Biography
Patricia Hughes is a freelance writer and mother of four. Patricia has a Bachelor’s Degree in Elementary Education from Florida Atlantic University. She has written extensively on pregnancy, childbirth, parenting and breastfeeding. In addition, she has written about home décor and travel.

How Does I-Dosing Work?

You are probably wondering what i-dosing is and how it really work. Basically it involves your child going to a specific website, putting on headphones, and then listening to a type of music. Usually this music is loud and droning. These audio files are usually two-toned and they are designed to alter the brain waves, just like other drugs can do. All you have to do is check out YouTube and do a search of “idoser,” which brings up pages of different videos. One popular track that is often used for i-dosing is “Gates of Hades,” which is a track easily found on YouTube for free. When users listen to these tracks, supposedly it alters the mental state bringing about a “state of ecstasy.” Many times users of these tracks are encouraged to purchase a guide to using mp3s to properly get high with them.

What are the Risks of I-Dosing?

So, what are the risks to digital drugs? Are there really risks to something your kids listen to on the internet? Yes, there are some real risks that you need to consider as a parent. Although some experts do not believe that these tracks really later the brain and some feel that this is not a real danger, the problem is that kids who are exploring these areas of digital drugs may start exploring other types of drugs, such as marijuana, meth, or cocaine. At this point it is not really proven whether these tracks can truly make you high, but you need to look beyond that to the thinking behind your child using these tracks in the first place. The biggest concern here is that experimenting with digital drugs will lead to experimentation with other drugs in the future. In fact, these concerns have the Bureau of Narcotics in Oklahoma putting out warnings to parents about i-dosing and the affects that it can have on kids.

Looking for the Signs

Since this is something you definitely want to nip in the bud, you need to know what to look for so you can figure out whether your child is experimenting with digital drugs. The problem here is that it can be tough to crack down on this because it is so easy for kids to have access to i-dosing tracks. All they need is a computer with the internet and a set of headphones. In fact, some tracks can even be downloaded to their iPod. What you should be looking for in your child is a desire to constantly be online listening to “music” through their headphones. If you notice this happening all the time and then notice your child is in an altered state of mind, perhaps laughing and shaking uncontrollably, they may be involved with these digital drugs. Some i-dosers become extremely hyper or incredibly happy after listening to the tracks, so watch out for this as well.

What Parents Can Do

There are some things that you can do as a parent to help keep your child from becoming involved in the digital drug realm online. First, be aware of what sites your kids are visiting and the music that they are listening too. Parental controls on a computer can be set to block these sites. You also should be asking your kids from time to time what music they are listening to. Take an interest so you know what is going on in their life. You also may want to approach this topic with your child. Talk to them about digital drugs and the real dangers that are out there if they get involved in i-dosing. Kids need to understand how dangerous this can be, since most sites proclaim to kids that this is totally safe for them.

Although it may seem incredulous that kids are now getting high online, it appears that it truly is happening today. You need to be well informed as a parent so you can spot any problems with your own children. Keep your eyes open for some of the warning signs in your own child and always keep communication open between you and your child. This way they can come to you about questions they may have and you can talk to them about things that are dangerous to them, such as starting out with digital drugs.

The worst part is that your teen is caught right smack in the middle of it all.

So how do you combat these wrong and potentially harmful messages?  First, realize that all this misinformation that your teen is receiving could turn them into a dangerous dieter.  A dangerous dieter is not quite a victim of an eating disorder, but they certainly aren’t pursuing a healthy lifestyle when it comes to diet and exercise.  Learn the warning signs and head them off before it is too late.

10 Warning Signs your Teen may have an Eating Disorder

1. They seem to lose a lot of weight very quickly. In the beginning of a diet, the person may seem to lose a lot of weight the first week or so.  This is “water weight.”  It isn’t a loss of fat, but just a loss of fluids that the body has been retaining.  Healthy weight loss should be no more than 2 pounds per week.  Any more weight loss than that should be done under the supervision of a health care professional.
2. Lack of energy. This, of course, comes from a lack of calories.  You need calories in order to create energy for your body.  If you don’t take in any calories, you won’t have the energy.  If your teen is lethargic or seems to have no energy, then you need to look into what they are eating, how much and how often.  While in and of itself this characteristic is not necessarily indicative of a dangerous dieter, when combined with other warning signs it could signal a problem.
3. They have a distorted body image. If your rail thin daughter still claims to feel “fat” then there may be a problem.  And don’t assume that she is just seeking attention or “fishing” for compliments.  If she seems sincere in her feelings about being fat even when she isn’t, that should be a very big red flag.  This can happen to boys too.
4. They over exercise. It may seem that when it comes to exercise you can’t get too much of a good thing.  However, dangerous dieters will over exercise to the point of physical exhaustion.  If they are engaging in unhealthy eating practices, this could also lead to a physical state that increases their risk of injury.  If you note that their exercise seems to be going overboard, it is probably time to sit down and have a conversation.
5. They are hungry all the time. A healthy eating plan should not leave you feeling hungry all the time.  If you are always hungry then there is probably something missing in your diet.  It could also signal a medical problem, but if it has never been a problem in the past, first assess your child’s diet.  How balanced is it?  How often are they eating?  Ideally, they should be eating three small meals a day and two or three healthy snacks.  That means they should be eating every two to two and a half hours.
6. They get sick after eating. While this is a hallmark trait of bulimia, it isn’t confined solely to that disorder.  Whether they purge after eating or they just get sick after eating can indicate the same type of problem.  The mind is a powerful thing and if the child is convinced that they will get fat from eating, they make get sick enough to vomit.  This could also indicate a gastrointestinal or other medical condition.  Additionally, you should note that if someone has been eating very healthy for a period of time and then eats something loaded with fat it could make them sick because their body is accustomed to the healthy eating.
7. They seem preoccupied with calories, fat, sugar, carbs, etc. It is normal to read labels and even keep food journals where you record what you eat and analyze it later.  However, with that becomes an obsession and your teen is fanatical about counting calories, fat and other “diet busters,” then it may be time to tighten the reins.  A diet should have boundaries, but if you go a gram or two of sugar over your daily allotment, it isn’t going to cause a time space paradox.  You need to help your teen understand that.
8. They exhibit medical and/or dental problems. Again, teens with eating disorders typically exhibit these, but a dangerous dieter can also experience things like dental problems, irregular or absence of periods, bloating or swollen cheek glands.  If someone vomits frequently it could cause the blood vessels around the eyes to burst, making dark circles and bags.
9. They are depressed or have mood swings. Improper diet, unhealthy foods and irregular meals can all cause you to be depressed or have mood swings.  If you notice that your teen is suddenly experiencing these symptoms and it seems to coincide with weightloss or the decision to diet, then you need to look into what they are eating, how much and how often.  Take steps to get them on a healthy eating plan, ensure that they are eating regularly and that they are getting enough calories.
10. They become withdrawn. A combination of a lack of energy, poor body image and depression can cause a teen to withdraw from friends and family.  They may begin to shun friends and stop engaging in activities that they once found enjoyable.  If you notice that your teen is shrinking away from family and friends, you need to stop and talk with them.  If you notice that it seems to occur in conjunction with a diet, then you need to take a good look at what exactly they are doing to lose weight.

The best thing that you can do for your child is to be involved with them.  Talk to them regularly, not always as an authority figure, but as a friend.  Then listen to what they have to say.  If you aren’t in touch with your child, if you aren’t listening, you could wind up with a dangerous dieter and not even realize it until it is too late.

Biography
Stephanie Partridge is a freelance writer and photographer as well as a FOIA analyst for a federal agency in Washington, D.C. She is a single mom to Jeffery, 19; Micah Elizabeth, 17 and Benjamin, 15. She is also the author of the ebook, “Diet is a Dirty Word.”

No part of this article may be copied or reproduced in any form without the express permission of More4Kids. © and All Rights Reserved by More4kids Inc.

When I was younger one of the things you looked forward to when you went to high school was being able to buy your lunch through the “snack line” instead of the hot lunch line. Yes you could get fries, chips, ice cream cookie sandwiches and such. That was high school a number of years ago but to us back then it was a sign of … well maturity, we weren’t little kids anymore and the proof was that they were giving us the option of what type of lunch we wanted to buy.

I am sure you are wondering which line was the longest, hot lunch or snack line. In all honesty the hot lunch line was usually longer and the majority of “kids” that went into the snack line went because they were running late or the lunch being offered was disgusting. We all remember the Salisbury steak lunch that we all opted to go hungry over instead. But the majority of students, if they were eating, were eating the healthy hot lunch.

Today there seems to be a huge controversy over the food that is being served in school and how healthy it is. Some communities are going as far as banning vending machines and junk food from schools and quick marts that are close to the school in an effort to put a kabash on kids eating junk. I have yet to figure out why. Not why are people upset over kids consuming too much junk food, I think everyone should be concerned about that especially in our obese nation where childhood obesity is on the rise reaching numbers it has never seen before.

What I want to know is “Why are we blaming the schools?” Why is it the job of the school to teach our children how to make healthy food choices? I know this next statement is really going to make a lot of people very angry with me, but I urge you to hear me out and think about what I am saying.

Too many parents today are looking to schools to do all of the child rearing with the exception of changing diapers. They expect schools to teach their children manners, how to be respectful, how to read, how to write, how to add and subtract, how to eat, how to dress… they want schools to foster their children’s talents… inspire them to be the best they can be. Then when schools don’t do that we come down on the school… they blame the teachers… the school… the government. Rarely do they stop and look in the mirror and put the blame on themselves or their children.

Look, the schools did not decide to become parents. They did not bring your child into this world and it is not their responsibility to raise them. It is the responsibility of the school to teach your child the essentials needed to be an intelligent human being. It is our responsibility to teach them right from wrong, respect, manners, and how to make healthy food choices.  Its our job…not the schools.

If we as parents all took the time to talk to our children about food, the importance of food and how proper nutrition is important to make us feel better and help our body perform the way it is meant to, then maybe having a “snack line” at school wouldn’t be a bad thing.

If we as parents set a good example for our children when we were hungry and went to get a snack and grabbed an apple or a bunch of baby carrots instead of a bag of chips, our kids would get the idea of how to eat the right foods.

If we as parents explained to our children that it is okay to have a salty or sweet snack once in a while, but not every day… I think the snack lines and the vending machines would be okay to have in high schools. You can have a piece of candy… and not need to eat a King Size candy bar. You can have a brownie and not eat the entire batch.

With that being said about highschools… I don’t think that chips and candy should be an option in elementary school. The reason is that even the most educated child at age 9 is going to opt for the candy bar over the banana. Middle schools, well that depends, there are some middle schools that start with 6^th grade and others start with 7^th grade. I think that middle schools can offer options such as fruit snacks, gogurt, trail mix and the like. But I don’t think Middle School children need to be able to order Pizza Hut pizza for lunch.

You see, I remember when I was younger they said that ketchup was considered the vegetable in our lunch. Yes, ketchup… a condiment was an actually serving of food! If parents are doing their jobs at home, they will have less to worry about when it comes to their children making a food choice at school. Kids will be kids, but it is very important to remember the positive influence we can have on them.

Biography
Jennifer Shakeel is a writer and former nurse with over 12 years medical experience.  As a mother of two incredible children with one on the way, I am here to share with you what I have learned about parenting and the joys and changes that take place during pregnancy. Together we can laugh and cry and rejoice in the fact that we are moms!

No part of this article may be copied or reproduced in any form without the express permission of More4Kids Inc © 2009 All Rights Reserved.

Part I: On Tuesday October 6th, the very first doses of swine flu vaccine started to arrive in doctor’s offices around the United States. These doses however will arrive in extremely limited quantities and initially are targeted for those considered to be “in high risk”. Soon however, as supply becomes more readily available, there will be some very important decisions to be made by every individual – and more important to us here at Pediatric Safety – by every parent. Not surprising, there are some difficult questions that need to be answered for each parent to feel comfortable making these decisions. That’s what our goal is…over the course of this post and the one following.  There’s an incredible amount of information out there about the swine flu…along with a lot of mixed messages.  What we hope to do is pull together some of the best, most reliable information currently available from some of our best sources and provide you with some “real world” answers to some very important questions.  AND THEN…we will let you make your own decision about what’s right for you and your child.  So to start us off…a little background…

What exactly is the “swine flu” and how is it different from the regular or “seasonal” flu?

CDC:  Swine flu is a new influenza virus causing illness in people. This new flu was first detected in people in the United States in April 2009.  It was originally referred to as “swine flu” because laboratory testing showed that many of the genes were very similar to flu viruses that normally occur in pigs in North America (note:  that theory didn’t actually pan out – but the name stuck).

Swine flu spreads the same way that seasonal flu spreads -mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something – such as a surface or object – with flu viruses on it and then touching their mouth or nose.

AAP:  At this point the 2009 H1N1 virus does not appear to be any more severe than seasonal flu.  However there are some small differences.  Unlike seasonal flu, which tends to cause more significant illness in elderly people and very young children, H1N1 flu (swine flu) is most common in people 5 to 24 years old.  Also, while seasonal flu usually peaks in January or February, the 2009 H1N1 virus has caused illness during the summer months and remains active as we head into the fall and early winter.

How do I know if I or my child has swine flu?

AAP: Children with influenza have a sudden onset of fever, chills, sore throat, cough, and runny nose. It may also cause headache, muscle aches, tiredness, nausea, vomiting and belly ache.  The flu is different from the common cold, but it can be hard to tell which one your child has because typically a child with a cold can have a stuffy nose, sneezing, scratchy throat, hoarse voice, dry cough (usually from mucous dripping down the throat), and slight fever.  One additional comment from the CDC:  most people with 2009 H1N1 have had mild illness and have not needed medical care or antiviral drugs, and the same is true of seasonal flu. Most people with flu symptoms do not need a test for 2009 H1N1 because the test results usually do not change how you are treated.

Are there actual tests for the flu and are they accurate?

CDC: A number of flu tests are available to detect influenza viruses. The most common are called “rapid influenza diagnostic tests” that can be used in outpatient settings and they provide results in 30 minutes or less.  Unfortunately a rapid test’s ability to detect the 2009 H1N1 flu varies, therefore you could still have the flu, even though your test result is negative. Rapid tests do however appear to be better at detecting the flu in children than adults.   There are other more sensitive flu tests that require specialized laboratories, but these tests are typically only recommended for cases with serious health risks.  In most cases, if a healthcare provider suspects you have the flu – whether seasonal or swine flu – having test results that confirm it will not change how they will treat you.

What is the best way I can protect my child (and myself) from getting sick?

AAP:  There are some everyday actions that you and your child can do to help prevent the spread of germs that cause respiratory illnesses like influenza.  Most of these are common sense recommendations, but it doesn’t hurt to have a reminder…plus we threw in a little fun with kids in mind:

• Cough or sneeze into your elbow or upper sleeve. If you use a tissue instead, cover your nose and mouth with it when you cough or sneeze. Throw the tissue in the trash right after you use it. (See who has the best aim – extra points for making sure it gets in the trash)
• Wash hands often with soap and water, especially after you cough or sneeze. Wash hands for 20 seconds, which is about as long as it takes to sing the “Happy Birthday” song twice. You can use alcohol-based hand cleaners but keep in mind that alcohol-based products are toxic if ingested by children. (Don’t worry about the small amount left on hands after use.)
• Avoid touching your eyes, nose or mouth. Germs spread this way.  (Kind of like that old game of “operation” – see who avoid touching for the longest period of time)
• Make sure your kids know to go to the school nurse if they start to feel sick during school. Children who are sick should stay home until 24 hours after their temperature has fallen below at least 100.4°F without the use of fever-reducing medications.  Note:  Normal body temperature is different for each child. In general, 100.4°F (38°C) or higher is a sign of fever.
• On a serious note – make sure to seek medical care if you or your child is severely ill, such as having trouble breathing. Antiviral medicines may help.
• The H1N1 vaccine is currently in production, but supply will be limited for the next couple of weeks.  The U.S. plans to have 195 million doses of vaccine, but it will be distributed in several batches on a weekly basis. Once it is available, this is a decision you as a parent will need to make for yourself and your child.  More detail on vaccines in Part II of Swine Flu for Parents.

Finally, make a plan in case you or your child get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs (for when soap and water are not available), tissues and other related items could help you to avoid the need to make trips out in public.  Also, keep your child’s pediatrician’s number handy, just in case.

What should I do if my child gets sick?

AAP:  Any child younger than 3 months who has a fever (rectal temperature of 100.4°F or higher) should see a pediatrician.

In a child older than 3 months has mild illness, he should stay home from school or child care until he has been fever-free for 24 hours without the use of fever-reducing medications.  Encourage them to drink liquids, especially if they are not eating well. Chicken soup can provide liquids and has been found to alleviate symptoms. If your child is otherwise healthy, call your pediatrician to see if an appointment is needed.

If your child has underlying health problems (for example, heart or lung problems, weakened immune system, chronic kidney disease, sickle cell disease, asthma, or a severe neurological disorder not including ADHD or autism), see a pediatrician as soon as mild flu symptoms start.

If your child has severe symptoms, has been to an area where there have been cases of swine flu, or been directly exposed to a swine flu patient, call your doctor for advice. Your doctor can help you decide whether your child needs to be seen or if they may need to be treated with an antiviral medicine.

If on the other hand, your child experiences any of the following warning signs, seek urgent medical care.

• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough

 Are any medicines recommended to help children with swine flu?

AAP:  Children with influenza should never receive any product that contains aspirin. Acetaminophen (Tylenol) and ibuprofen (Advil and Motrin) are fine to treat fever and body aches in children. Cough and cold medications do not help, and should not be used, especially in young children under 4 years of age.

Most adolescents, adults and children do not need antiviral medicines. Overuse of these medications could be counter-productive and lead to resistance.  Parents with children who are at high risk of complications from flu (such as those with chronic disease or cancer, or very young children) should talk with their doctor in advance about what to do if they notice flu-like symptoms.

It is expected that oseltamivir (Tamiflu) will be more effective if taken soon after the onset of symptoms, rather than later in the course of the illness. Based on a recent study, Tamiflu may have more side effects in children than in adults; your pediatrician can help you decide if this medication is right for your child. Zanamivir (Relenza) is not for young children under 7 years of age.

Your pediatrician will decide when treatment is indicated and which drug is best to treat your child.

We hope our swine flu overview has been a help.  And we promise to provide just as detailed a review of vaccines in Part II.  We also know that no matter how good the information, sometimes you just need a few words of advice from someone that makes you feel confident…that’s your doctor, not a government doctor…and while we can’t ask each of your pediatricians to comment, we can leave you with some words from our own in-house pediatrician, Dr Kim…so for today, here are her thoughts on the upcoming flu season for children this year:

In the upcoming winter, we expect that there will be both seasonal influenza and the new strain of H1N1 influenza commonly known as swine flu.  There is already quite a lot of H1N1 virus circulating, and I see children daily who have swine flu.

When we first discovered the new H1N1 flu virus, the world watched and worried to see how severe it would be, and there was a great deal of anxiety and even panic.  We now know a great deal about this virus, and luckily, there is no reason to panic.  We have seen many many cases in my own office, and throughout the US.  And public health officials watched it evolve in the winter of the southern hemisphere. 

The good news is that the new H1N1 illness is generally no more severe than the usual seasonal flu strains.  There are several differences, however.  Since none of us has any innate immunity to this strain, H1N1 has been incredibly contagious: in my practice when one family member gets sick, it usually wipes out the whole family for a few days. 

Another difference is that we have seen more severe illness and even deaths in pregnant women, which is why the current recommendations for vaccination have pregnant women on the list of high-risk groups who should receive priority for the vaccine.

What does it feel like to get the swine flu?  The symptoms are similar to the usual seasonal flu, except many patients with swine flu get not only rapid onset fever, cough, body aches and headaches, but also have the pleasure of some vomiting and diarrhea.  Fun. 

The illness can be mild but is usually miserable and can be severe, especially in younger children without a fully developed immune system or in those children with chronic illnesses like asthma or compromised immune systems.  And it does cause deaths in children.  We would like to prevent childhood deaths if at all possible. 

I am strongly recommending both the regular seasonal flu vaccine and the H1N1 vaccine to my most vulnerable patients this winter: young children, those with chronic illnesses like asthma, pregnant women, and the parents and caregivers of babies younger than 6 months old who cannot yet be vaccinated.  They will save lives and decrease pain and suffering this winter. 

I am also recommending, as I always do, that families focus on their overall health, especially in the winter cold and flu season.  That means getting enough rest (sleep-deprived bodies are much more vulnerable to illness), staying well hydrated, practicing extra-vigilant hand hygiene, and reducing stress and increasing joy (both of which have measurable impacts on the immune system)!

I hope that you all have a fun and safe fall and winter!     -Dr Kim

***************************************************************************

Relevant Links

•  Influenza Diagnostic Testing During the 2009-2010 Flu Season by CDC.gov  Sept 29, 2009  http://www.cdc.gov/h1n1flu/diagnostic_testing_public_qa.htm
• 2009 H1N1 Flu (Swine Flu) and You  by CDC   Sept 24, 2009  http://www.cdc.gov/h1n1flu/qa.htm
• Frequently Asked Questions About H1N1 Flu (Swine Flu) http://www.aap.org/advocacy/releases/may09swinefluqanda.htm
• Each week the CDC publishes an update on flu statistics including location of flu activitiy, type of flu, hospitalization and mortality stats.  For those interested, the data can be found here:  2009 H1N1 Flu: Situation Update by CDC October 2, 2009  http://www.cdc.gov/h1n1flu/update.htm
• At Pediatric Safety, we have an active link to the latest flu news from flu.gov.  Visit us here for updates or sign up for email updates http://www.pediatricsafety.net/awareness/

About the Author

Stefanie Zucker is President and co-founder of Pediatric Medical Devices and Managing Director and co-founder of Axios Partners, a consulting firm dedicated to developing highly focused, creative strategies for clients. After a number of years spent researching the child safety issues associated with transporting children on ambulances she became a child health safety advocate and formed Pediatric Safety with a goal of creating a world-wide movement of parents and caregivers inspired to protect the health and safety of kids. Stefanie is a member of the PedSafe Team

Dr Kim is a pediatrician in a busy outpatient practice in San Francisco. Dr. Kim was raised in western North Carolina but lost her southern accent intermittently during summers spent in Colorado and finally when she went to college at in New Jersey. At Princeton University she studied the history of religious thought and practice around the world. She attended medical school at the University of Pennsylvania to learn the practice of medicine in a busy urban teaching hospital. Along the way she lived in India for a year and worked at hospitals in Guatemala, Uganda, and on the Navajo reservation in New Mexico, where she learned to be grateful for the luxury that allows her patients to fret over the small things. She completed her pediatric residency at the University of California at San Francisco (UCSF).  Dr. Kim would like to help parents build healthy families by arming them with knowledge and tools, as well as a bit of lightness and laughter. She believes that the joys of parenting should outweigh the worries. Dr. Kim blogs about child health, parenting, and doctoring children at: www.drkimmd.com

http://www.pediatricsafety.net/ PediatricSafety.net is a community for everyone who cares about the health and welfare of children – that includes parents, teachers, medical professionals, emergency responders, etc. Our goal with this site is to raise awareness of child health and safety issues and provide a community for all caregivers to have an open exchange of questions and ideas.  The reality is the world of child health safety issues are changing at an incredible pace. Every day we are faced with new challenges, but we also discover incredible new cures and new technologies as people work to find better ways to make this a safer world for our kids…and for the people taking care of them. Community posts by experts and by other parents can guide and reassure, inform and advise…or in some cases just provide a little hope that things will get better.  They say “it takes a village” to raise a child.  We created Pediatric Safety

Each and every new parent’s worst nightmare is not being able to tell when they should call the doctor. You don’t want to be the hypochondriac parent who calls the doctor or rushes to the ER for every sneeze, but you also don’t want to be the parent that should’ve called the doctor when your child wouldn’t stop crying.

Unfortunately children do not come with instruction manuals. Raising kids is really a trial and error process. You try what you think will work based on your past experiences… or based on what you have seen other parents do or not do. While I cannot tell you the best way to raise your child, or how to avoid the many pitfalls of childrearing (because that would take away all of the fun of parenting)… what I can do is atleast help you know when you need to call the doctor.

First, as a parent and a nurse, my motto is that it is always better to be safe than sorry. But if your little munchkin starts to experience any of the following, pick up the phone and call your pediatrician:

• A fever greater than 100 degrees Fahrenheit
• Sweaty or clammy skin
• Unusual and persistent crying
• An injury that causes more than 15 minutes of crying
• Disruptions in feeding patterns, especially a sudden loss of appetite
• Ingestion of anything you suspect may be poisonous
• Vomiting that differs in force or volume from normal spitting up
• Diarrhea that smells foul or shows blood or mucus or is accompanied by a fever
• Constipation that is accompanied by vomiting
• Signs of blood in the urine or bowel movements
• Unusual listlessness or inactivity
• Convulsions or twitching fits
• Marked changes in color or behavior
• Any unfamiliar or widespread rash
• Any burns that result in blisters
• Difficulty in breathing
• A persistent cough
• Redness of the eyes or the discharge of pus from the eyes
• Discharge from the ears or ear pain, which you may be able to recognize by the baby’s constant turning of his head or pulling at his ear
• Swelling or sinking of the fontanels (the two soft spots in your baby’s head)

(courtesy of http://www.familyeducation.com/home/)

Trust your gut. While you may not have an instructional manual, you do know when there is something wrong with your child. If the symptoms your child is experiencing is not on the list and you are concerned call your doctor that is what they are there for.

If you are made to feel bad for calling, find a different doctor. I am not kidding on this one. Your child’s doctor should be more than willing to talk to you if you are concerned about your child’s well being. They should not make you feel bad, or talk down to you. I say this as a nurse, who has dealt with numerous patients who were afraid to talk to their doctor because of the way the doctor made them feel.

And if for some reason your doctor does not return your call, and your child is in distress, don’t wait, call 911 or head to the emergency room.

Biography
Jennifer Shakeel is a writer and former nurse with over 12 years medical experience.  As a mother of two incredible children with one on the way, I am here to share with you what I have learned about parenting and the joys and changes that take place during pregnancy. Together we can laugh and cry and rejoice in the fact that we are moms!

No part of this article may be copied or reproduced in any form without the express permission of More4Kids Inc © 2009 All Rights Reserved.

The best way to do that is by setting a good example. There is the old adage, “Do as I say, not as I do…” but our children like to emulate us. Whether we want to admit it or not, they are more likely to do what they see us doing then they are to do what we tell them to do. With school starting and the current debate going on about health care… now is the time for all of us to step back and re-educate ourselves and our children on healthy eating.

Nutritionists have stated that in order for a child to try a new food they need to see it four or five times, possibly even 10 times. This means that just because the avoided the broccoli at dinner tonight, doesn’t mean that in a week or two they won’t try it if you keep showing it to them at meals. This also means that you shouldn’t take the first, “bluck!” as an “I will never eat this again.” You can also try making a rule, similar to what we have in our home, and that is called the “No Thank You Bite.”

Everyone at the table has to have one bite of everything on their plate. If they don’t try it how will then ever know if they like it? Knowing that kids prefer the sweeter things in life, try introducing them to the sweeter healthy foods such as corn, tomatoes, sweet peas, mandarin oranges, cherries and strawberries. You can also mix these sweeter foods with other healthy foods that may be less appealing such as brussel sprouts and broccoli. Make an apple and brussel sprout side salad… or tomatoes, whole wheat pasta and corn. Get creative and make it fun, give the dishes you create names that kids will think are funny.

You can also let your children help in the process of preparing meals, buying groceries and picking foods, let them come up with their own recipes. I can tell you that my son’s biggest joy in life is telling everyone about the recipes he has created and the great names he has given them… such as “Turds” and “Turds on Toilet Paper.” While the names are, well, disgusting… the recipe is actually pretty impressive and good.

If your kids are apprehensive about trying the healthier foods consider playing food tricks, hide them in the food. This is my favorite thing to do more on my husband then our kids. Chopping veggies and fruits finely and mixing them in their favorite dishes will help. Carrots can be chopped finely and mixed in with your favorite spaghetti sauce and so can spinach and broccoli. If burgers are a favorite in your house, finely chop or puree veggies and mix them into the burger meat when you patty the burgers. Use turkey or ground sirloin as healthier alternatives to hamburger.

Casseroles can also be a fun new dish. Casseroles are fun because you can throw whatever you want in there for a really healthy and tasty meal. Other healthy eating options for kids can include making fruit breads, such as banana and apple. Use real fruit, even if you buy a premixed box, you can still add real fruits to enhance flavor and nutritional value.

The sooner you can start practicing healthy eating habits for the family the better, but know that it is never too late to start. Making healthy eating choices can help the entire family get in shape, trim down and decrease the risk of many diseases.

Biography
Jennifer Shakeel is a writer and former nurse with over 12 years medical experience.  As a mother of two incredible children with one on the way, I am here to share with you what I have learned about parenting and the joys and changes that take place during pregnancy. Together we can laugh and cry and rejoice in the fact that we are moms!

No part of this article may be copied or reproduced in any form without the express permission of More4Kids © and All Rights Reserved

The first thing I want to address here is that no one will test your child when they are a toddler for ADHD. The reasoning… whether I agree with it or not, is that the testing that is done to diagnosis children with ADHD would not be accurate if done on children at that age. This doesn’t mean that you, the parent, can’t figure it out on your own. The first thing I want you to do if you are worried that your toddler may have ADHD is read another post I did on what ADHD, called Is ADHD Genetic.

Now, you need to know this. There are certain behavioral traits that if you pay attention to your child, you will pick up that will tell you that your child may have ADHD. I say may because there is a chance that what you are seeing is simply part of the growing process for your child. So you really are going to need to know your child, what is normal for them, what is normal in general at their age and what seems… obsessive to you.
From my personal experience, I can look back and tell you the fact that my 3 year old was anal about the way his toys were put away was a sign of ADHD. I would help him clean his room, put the toys in the toy box and his books on shelves… he would then go through all the toys in the toy box, take out each car and truck that he had and line them up against the wall around his room bumper to bumper… by size and type. That is not normal 3 year old behavior, and while it was normal for my son to do that… at 3 it was an early sign of ADHD.

When our son would get excited, either talking or get excited over what he was doing his hands and feet would twirl uncontrollably. The more excited he would get the faster they would twirl. While we thought it was cute… funny at times… that was an early physical symptom of ADHD. You should also pay attention to their ability to be attentive.

I used to think that my son was just very energetic. He would jump from one thing to the next with out hesitation. If something sparked his interest he was off doing it. Now, 2 and 3 year olds have a very short attention span anyway, so when do you know it is a sign of ADHD? When they can’t even sit with you and read a story or color a page in the color book… they may have ADHD. Our son loved to be outside, still does, he could really play outside from the moment he got up to the moment he passed out after dinner. He was also attracted to video games at an early age and legos. Yes, those are two very different games, but he would build elaborate things with his legos, and he would have a story as to why things were the way he built them, and what you could do with it… and so on. The video games, again, if we let him, he could sit and play for hours.

Later we learned it was because video games throw enough stimuli at him to keep him entertained and attentive. See, what you need to realize is that a child with ADHD doesn’t just hear you talking to them, they hear you talking, the hear the wind outside, the see the curtain blow, they hear their sister in the bathroom, they think that a big monster may come out of the sky and how cool would that be, the car horn outside, the firetruck down the road. Where as you and I, and other children who do not have ADHD would block out or ignore all of the other “noise” a child with ADHD not only hears it all, their mind tries to pay attention to it all.

Can you imagine what it would be like if in your head all the time you heard Blue’s Clues, Dora the Explorer, the ABC song, the birds outside, the sound of the microwave and your kids all talking to you at the same time and your mind was trying to pay the same amount of attention to it all! You would pull your hair out. Your toddler isn’t going to pull their hair out… they are going to look for ways that they can bring some order into their head.
So when you come home and your 2 year old has gotten out the bottle of Hershey’s syrup and not only covered the kitchen floor with it… and the refrigerator… and himself… along with making a very nice finger painted picture in it… you may want to pay attention to other things and start talking to your doctor. This would be known as impulsive behavior. Hey it sounds like fun, let’s do it. Their mind is unable to send out the message, “HEY!!! This is wrong!” loud enough for them to hear.

The final “trait” that you can pay attention to is how active they are. Now, all kids are hyper from time to time. (I am pretty sure that energy drinks are manufacturer’s clever way of catching some of that toddler energy and putting it in a drink so we can keep up with them.) But toddlers with ADHD are above and beyond normal hyper… and they are that way all the time. They are always on the go, always in motion, always running, jumping, spinning… always on the go.
Now, I don’t know that your doctor will medicate your child. Actually I am pretty sure that most ADHD meds are not safe for children to use until they are 7. Plus you may not want to medicate them. WE didn’t, even once we found out our son had ADHD (I was in denial). There are other things you can do to help them learn how to control what is happening to them.

Pay attention to what they are eating. You want to limit any stimulants, refined sugars and processed foods. Studies have shown that “green therapy” has also been very effective in helping kids with ADHD. Green therapy is nothing more then get them outside so that they can play in the grass, be among the trees. Talk to a nurse practitioner or an OD (doctor of osteopathy.) The reason that I recommend these two medical professionals is this, they are taught to look at the whole person and find other ways outside of giving them a pill to help them cope with, deal with, and control what is happening to them. You can also go to your local health food store and talk to an expert there. There are things you can do to help your toddler if you suspect that they have ADHD.

Biography
Jennifer Shakeel is a writer and former nurse with over 12 years medical experience. As a mother of two incredible children with one on the way, I am here to share with you what I have learned about parenting and the joys and changes that take place during pregnancy. Together we can laugh and cry and rejoice in the fact that we are moms!

No part of this article may be copied or reproduced in any form without the express permission of More4Kids  © and All Rights Reserved

by Jennifer Shakeel

As nurse I my first reaction is yes, this is a vaccine that I believe all young females should get. As a mother, I can understand the hesitation that many mothers have over getting their daughter vaccinated. I will say for the record that my oldest daughter did get the vaccination, and it was a decision that she and I made together.

I am going to address this issue as a both a nurse and a mother, why, because it is important. First, let’s start with what the cervical cancer vaccine Gardasil does. The vaccine will help protect women from a variety of ailments, ranging from minor to serious. The most talked about is cervical cancer. Cervical cancer is caused by the human papillomavirus, also known as HPV. Understand that there are 100’s of different HPV strands, and they are responsible for everything from cold sores, to warts to yes cervical cancer.

The vaccine is designed for adolescent girls, and what is causing many parents to pause is the fact that what the vaccine protects them against is a sexually transmitted disease. There it is… sex. That is the name of the battle that goes on in every parents head. We don’t want our children to have sex until they are an adult, many parents don’t know how to talk to their children about sex, and many believe that if you talk about it then they are encouraging their children to do it.

This is where I am going to step in as a nurse. I am going to give you a small reality check here. I worked at Planned Parenthood, which I feel is a wonderful organization for what it provides girls and women. Now, as a nurse there I have seen things that would make your stomach turn. I have educated children on sex… often after it is too late, I have had to school young adults about sex and I have even talked to parents to try to get them to understand the importance of talking to their kids about sex.

So let me dispel this myth right now, talking to your children about sex will not make them go out and have sex. As a matter of fact, you may actually stop them from having sex until they are mature enough to understand the consequences. I lost track of the number of young girls and young women that would come into my office to be treated for sexually transmitted diseases or to get birth control because they had nowhere else to go. I can not tell you how many times I asked them if they could talk to their parents and the answer was no, and then I would ask if I could talk to their parents and the answer was, “NO! They don’t know I am sexually active.”

Children are curious; we live in a very sexual society. Take a look at the ads on billboards and the commercials on television… take a listen to the lyrics of the music your children listen to. It is only natural for them to be curious. If they can’t come to their parents where they are going to get better information then what they are getting from their friends… I know that it is hard and scary. I have given THE talk to children of my friends because they just couldn’t.
You should also understand that HPV is the common cold of sexually active people. People can carry the virus and not even know that they have it. Which means that they can spread it and not even realize it. It only takes one exposure, so it only takes having sex once with an infected person and you have it. Consider the HPV vaccine then your vitamin C against cervical cancer.

Now as a mother, thankfully I have always had an open relationship with my children. We have had THE talk numerous times in their lives, always making sure that they understood what I was saying based on the ages they were at the time. Yes, they got out my anatomy books from nursing school, which doesn’t use cartoon pictures… which lead to a number of explanations about the body… about their body. So when it came to getting the vaccine I let my daughter decide what she wanted to do.

I explained to her what it was and why I felt it was something that she should get. I think what the boost was, as funny as it is, she wanted to be a part of the one less campaign. So she went through the series of three shots. Yes, she will tell you that the shot did hurt, and that it hurt for the rest of the day. But she will also tell you that she has taken the steps to make sure that she is protected against cervical cancer.

Is she sexually active? No she isn’t. Would she tell me if she was? Yes, she would tell me. I have stressed the importance of waiting until she is mature enough and that her life is the way she wants it because having a baby changes everything. I have also stressed that it only takes having sex ONE time to get pregnant. I think making it her decision was important. It is her body.

As with any vaccine, make sure you discuss this, the benefits, and side affects, with your health care provider. What you as a parent need to remember is this. It is a vaccine, just like the chicken pox vaccine the mumps and measles vaccine and the hepatitis vaccine. Why do you get those for your children? You get them to keep them healthy and safe… not just as children but as adults as well. The HPV vaccine isn’t a vaccine that only protects them while they are young. It protects them for life. Don’t make the HPV vaccine about sex. Make it about lifelong protection for your daughter.

Biography
Jennifer Shakeel is a writer and former nurse with over 12 years medical experience. As a mother of two incredible children with one on the way, I am here to share with you what I have learned about parenting and the joys and changes that take place during pregnancy. Together we can laugh and cry and rejoice in the fact that we are moms!

No part of this article may be copied or reproduced in any form without the express permission of More4Kids Inc © 2009 All Rights Reserved

While their may be kids who love their veggies, they seem to be few and far between… at least, none of them live at my house. Instead, we try to make things interesting enough so the kids will eat more of what is good for them and less of what isn’t.

After many years of fighting with our kids about eating, sneaking vegetables into something where they wouldn’t be noticed, and just about pulling my hair out, I have come to a couple of conclusions. Are you ready? Presentation is important. Yes, it’s true. Kids like to see something nice on their plates. I don’t mean to arrange food like you’d get at a high end restaurant… I mean it should be colorful and preferably bite size. This is why the original concept of fruit cocktail got the reputation of being great for kids… it was bite size and full of color and different shapes.

Japan seems to have it . Do a search for "bento boxes" and you will be amazed at the artistry and color in these little lunch boxes. Does it look fun to eat? You bet! Who wouldn’t want to eat a boiled egg molded to look like a teddy bear and rice shaped into one of the Mario Brothers? While you certainly don’t have to go this far, you can learn a lot from looking at bento box presentations.

The basic concept is colorful food cut into small pieces and arranged to look appealing. Add a small pick or chopsticks and the food is a challenging game as well. Include some sauce or dip in a small container that they can dip the pieces in. Dipping rates highly with my five year old. He freely admits he’ll eat almost anything if he can dip it.

Here are some simple recipes. Make sure your child does not have any food allergies before trying.

Ants on a Log

This one is so simple that my kids love. All you need is a little celery, peanut butter and raisins. The picture in this article makes it self explanatory. My youngest son is allergic to peanut butter so we have to keep him away, but my oldest son loves it. He likes the taste and the crunchyness.

Finger Omelets

Omelets are different in bento boxes. The eggs are made very flat, and then rolled into something that can easily be handled by chopsticks or fingers. They don’t add fillings like we do here, but you could put a thin layer of cheese and maybe a little spinach in there before rolling. Call them Finger Omelets and you’ll have a new taste sensation your kids will love.

The other major concept that I realized is that kids like to be involved with their food. This can be taken care of by letting them help prepare their food, making the food creative so they can interact with it while they eat, or by making it a fun surprise.

Kids are fascinated with learning new skills. If it is time for them to learn how to spread something on bread or peel a carrot, all the better. Even if what you are preparing is beyond their skill levels, encourage them to watch and ask questions. You may be amazed at some of the questions they will come up with. Let them taste a bite or two as things are being prepared.

Sandwich Paintings

One way to let them play with their food while eating it is to let them create pictures with it. Start with a pancake or a piece of bread. This can be spread with peanut butter or fruit spread to keep the smaller pieces in place. Let them use raisins, sunflower seeds, dried cranberries and other small foods to make pictures.

Serving food that packs a surprise is always fun. This is another trick we discovered while studying Japan. We modified it to suit our family’s preferences. In Japan they make a rice ball called onigiri (oh-nih-gee-ree). They use sticky sushi rice for this dish. Sometimes they flavor it with dried fish flakes or other Japanese seasonings or add a filling.

Onigiri

At our house, we use the leftover sticky rice (which we love anyway) to make onigiri. You can blend it with the seasonings of your choice. We usually add a little garlic, salt and pepper. Sometimes we may add soy sauce to it. Mix up the rice well. Cover your hand with a plastic bag so the rice doesn’t stick to you. Form the rice into a ball using the palm of your hand or get special molds from Asian markets. Fill the center with something especially tasty. This can be leftover barbecued chicken, salmon or steamed vegetables. Close up the rice ball. Refrigerate for at least an hour or more. This is a convenient on the go snack that kids can eat while out playing or that can be easily taken in the car. You could do something similar with leftover mashed potatoes, but you’d probably want to serve it on a plate.

Another trick you can use is to make a fun name for a food. Instead of hamburgers on the kids’ menu, a local restaurant used to call them "hangerbers" and "cheeburgers." Sounds a lot more fun, doesn’t it? When I was a kid, my family made lefse on holidays. This is a type of flat potato bread from Scandinavia. It is cooked on a flat pan similar to tortillas. Like tortillas, they are white with browned spots on them. Once my grandparents started calling lefse "dirty napkins" all of us kids couldn’t wait to eat it.

So, to make food fun for kids, be creative. Surprise them. Share with them a funny name or some new skills. You’ll be surprised how much more interested your kids will become with healthy foods.

No part of this article may be copied or reproduced in any form without the express permission of More4Kids Inc © 2009 All Rights Reserved