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Family-Friendly New Year’s Resolutions for Parents

Now that the buildup to 2013 has come and gone and everyone has had ample opportunity to contemplate and commit to New Year’s resolutions, I thought it would be a useful time to look past the hype and consider what really makes for family-friendly and longer-lasting resolutions.

Let me first say that I’m a big believer in the benefits of goal setting, and I do really well with defined start dates – even those that I fully realize are arbitrarily defined. In fact, the thought of starting a New Year’s resolution a day past the first of the year, or failing to follow through for at least six months leaves me feeling unsettled.

My family, however, doesn’t exactly share my attitude. Ask my husband and he’ll tell you that New Year’s resolutions are silly. Not that he doesn’t share my belief in setting goals and sticking to them, but he questions what makes identifying life-enhancing goals and then committing to them on January 1st any different than doing so on June 1st (or any other day of the year, for that matter)?

And if I were to have waited for resolution revelations from my 3 children (one pre-teen and two teenagers), I would have been offered up some vague and non-committal pledges at best – somewhere along the lines of “I think I may try to start running some time this year…if I feel like it.” Given that it’s not uncommon for children to be similarly resolution challenged when left to their own devices, I’ve concluded that it’s not only worthwhile for parents to assist children with choosing resolutions, but to help them pick ones that are both positive and realistic. Better yet, it helps to pick resolutions you can both support and share in as a family.

So just what approach should parents take? It’s interesting to start by considering the most popular adult New Year’s resolutions. No matter what top ten list you look at, it’s likely to include such goals as eating healthier, getting fit, losing weight, getting a better education or job, helping others, and getting organized. Given that these are all things we repeatedly aspire to, it seems to me the best thing we can do for our kids is to join them in setting goals that will help them (and us) lead happier, healthier, smarter and more organized lives right from the start.

Healthier. Having your child commit to such basic things as daily tooth-brushing and regular hand-washing may seem somewhat insignificant in the grand scheme of New Years resolution-making, but they’re really not. In fact, along with making sure your child is up-to-date on immunizations, eats healthy and stays active, hand washing and tooth brushing rank right near the top of ways to stay healthy. As for eating healthier, my own family’s resolution is to eat out less and cook more meals at home using an online menu planner that comes complete with weekly shopping lists and healthy recipes. (www.thefresh20.com)

Happier. When it comes to resolving to be happier, I have two overarching suggestions. The first is to focus on spending more quality time as a family, whether it’s in the form of after-dinner walks, road trips and family vacations together, bedtime books or a weekly game night. The other is helping others – a commitment that has also been clearly shown to make people – children and adults alike – happier. Remember that when it comes to helping others, it can be as simple as teaching young children to use their manners and share their toys or shoveling a neighbors driveway, to volunteering at or contributing to a local non-profit or helping those in need around the world. One of my family’s favorites is a non-profit micro-lending site, kiva.org, where families can read about and help contribute to worthy causes such as supporting education in India, or helping to buy a bull for a farmer in S. America.

Wiser. While there are countless age-appropriate resolutions children can make that will make them smarter, a particularly worthy New Year’s resolution is to simply read more, whether it’s reading aloud every day with your child, your child resolving to learn to read on his own this year, making shared quiet reading time a regular family activity, or committing to reading a certain number of books over the course of the year.

More organized. In case you’re wondering if the tasks might be too mundane to qualify as New Year’s resolutions, having your children commit to such routine tasks as putting away their toys, cleaning their rooms, and sorting/putting away their laundry really do make a difference towards fostering important lifelong organizational skills.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Kids, Coats and Cold Weather

I have to say, it’s a good thing I have the opportunity to talk to lots of parents on a regular basis, if for no other reason than because I’m able to reassure myself that I’m not the only parent having conversations like this one:

Me:     “You can’t wear shorts today.”

Child who shall go nameless: “Why not?”

Me:     “It’s winter, and it’s too cold outside for shorts.”

Child (still wearing shorts):    “So?! I’m not cold.”

Me:     “It’s not just a little cold. It’s frigid outside. As in snow temperature. As in it’s sub-zero wind chill and like the arctic tundra outside. Now go change!”

Child (still not changing):        “But mom, WHY?!”

Me:     “Because I give people parenting advice for a living, and if you don’t, you’ll make me look bad, so end of discussion – go change!” Continue reading “Kids, Coats and Cold Weather”

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Your Family’s Health – There’s An App for That!

There’s no doubt about it – we live in an age where our children’s days (and nights!) are dominated by technology, and the level of their daily media “consumption” is justifiably a top concern for parents, teachers and pediatricians.

There’s no doubt that digital media has the potential to interfere with just about all that we, as parents, hold dear – our children’s safety, their schoolwork, exercise, reading, eating and sleeping habits.

But I thought I’d share some of what’s on the horizon when it comes to the upside of digital technology and your family’s well being. Having just returned from the Fourth Annual mHealth Summit – focused on the intersect of health and technology – I can assure you that there is, in fact, an upside.

I am more convinced than ever that if mobile or digital health isn’t yet on your radar, much less your smartphone, it should and soon will be. According to Mashable, there are now more than 40,000 health and fitness apps available. I’ve selected a few to share with you, including a couple that have even earned a place on my own smartphone.

  • Text4baby: With nearly half a million subscribers, this free national text messaging campaign is for anyone who is expecting or in their first year of parenthood. To sign up, text “BABY” (“BEBE” if you want the Spanish version) to 511411. Enter your baby’s due date or birthday, and voila! You’ll receive three health-related text messages a week. I participated in the creation of the actual text messages, and I can attest to the fact that they contain the most important, credible information relevant to each stage of your pregnancy or baby’s first year.
  • FitBit: FitBit takes the basic concept of a pedometer to a new (albeit more expensive) level. The “Zip” device measure steps, miles, calories burned, stairs climbed and more. FitBit has also created a scale and sleep monitor (purchased separately from the Zip). The program adds fun and motivating technology in the form of a mobile app, Bluetooth connectivity and a website where you can log daily accomplishments and challenge others. I considered myself fairly fit when my 11-year-old son and I committed to wearing our Zips, but the program seriously motivated us to step up our day-to-day exercise. Just check out some of my tweets over the past year and you’ll see that I was encouraged to walk to the grocery store, forego the train in the Atlanta airport and jump on the treadmill before bedtime – just to name a few!
  • Zamzee: By using the “Zamzee meter” (a $29.95 accelerometer) and a kid-safe website for tweens and teens, this company’s goal is to get kids and families moving – one step, avatar, badge and goal at a time.
  • Restaurant Nutrition App (by Unified Lifestyle): This free app may change the way you order and eat at restaurants. Despite being occasionally mocked by less tech- or health-conscious friends and family, I still make it a point to pull out my iPhone and use this app to assess the nutritional details for any of the 60,000+ restaurant meals it includes.
  • Band-Aid Magic Vision: What happens when augmented reality is applied to a childhood staple? Hold up your iPhone to your child’s Band-Aid and watch Kermit the frog come to life and sing with this free app. My kids are long past the age in believing that Band-Aids heal all ailments, but my parenting and pediatric instincts tell me that this app is likely to have great appeal for tech-savvy parents and Band-Aid-loving preschoolers alike. Note: App only works with Muppets Band-Aids.

Originally posted on Omaha World Herald’s Live Well Nebraska

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The advantages and disadvantages of organic foods

A recent trip to supermarket left me feeling better than usual about my family’s grocery shopping habits.

I made my way to the dairy aisle armed with new and must-have information from a recent American Academy of Pediatrics (AAP) report. The topic: Advantages and disadvantages of organic foods.

As someone whose family consumes about six gallons of milk every week, I’ve questioned whether my desire to save a not insignificant amount of money buying non-organic milk might be putting my three children at risk. And I’m fairly sure I’m not the only mom who has had this internal debate. After all, according to the report, as of 2010 the U.S. organic food industry was estimated to be over worth over $28 billion. And on average, organic products cost anywhere from 10 to 40 percent more than those that are non-organically produced.

So I was relieved, and albeit a bit surprised, to learn that the AAP committee (comprised of experts in both nutrition and environmental health) concluded, “There is no evidence of clinically relevant differences in organic milk and conventional milk.”

That’s right, no evidence that organic milk has less bacteria in it. No evidence that conventional milk has any worrisome bovine growth hormones. And few, if any, nutritional differences of any significance.

While not only renewing my confidence in my longstanding milk purchase habits, the report went one step further noting that organic foods are not nutritionally superior to their traditional counterparts. This isn’t to say the two are created equal, because organic foods do contain fewer pesticides. It’s just not yet clear whether the reduced pesticide exposure makes any difference to our health.

So with new information in hand, as a consumer, pediatrician and parent, my stance is simple: Until we know more, err on the side of caution. Limiting pesticide exposure, especially in pregnant women, infants and young children, isn’t a bad idea considering the potential risky effects these chemicals may have on brain development.

Another big take away from the AAP report was that, above all else, we should focus on eating plenty of fresh fruits and vegetables. More importantly than the organic vs. non-organic debate is the conversation about simply eating fruits and veggies in the first place. The average American diet is lacking in fresh produce, so any, organic or not, is better than none. If cost isn’t a concern to your family, then by all means, feel free to buy organic. But if it is, don’t let that keep you away from the produce section or feel guilty when grabbing your next gallon of milk.

Other links of interest:

2008 Consumer Reports Article: Fruits and Vegetables, When to Buy Organic

Environmental Working Group’s “Shopper’s Guide to Pesticides”

Originally posted on Omaha World Herald’s Live Well Nebraska

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The truth about American Idol’s “Idol Bug”

I recently got around to watching a recorded episode of American Idol. Aside from all the melodrama associated with stress, sleep deprivation, and watching people who dream of living life in the spotlight compete against each other, I was struck by the fact that the episode was impressively reminiscent of the opening scenes from the movie Contagion. For anyone who hasn’t seen the movie, suffice it to say that the storyline is focused on the ensuing devastation invoked by the uncontrolled spread of a dangerous new virus.

Okay, so no one died on American Idol’s Hollywood Week episode. But I did experience the same sense of foreboding. Idol contestants shaking hands, exchanging frequent high-fives, offering each other lots of hugs, and just generally partaking in a whole lot of close contact also known as germ-sharing behavior. Worse yet, there was a clearly identified “Patient Zero” in the mix – runny nose, fever, fatigue and all. If germs were visible, I’m pretty sure any viewers who somehow missed the not-so-subtle foreshadowing by the shows producers would have been cringing along with me long before contestant after contestant proceeded to fall ill.

Hmmmm…If only germs were visible…Now there’s a thought. I majored in cellular, molecular biology, so I’ve admittedly had more opportunities to visualize germs than most. But the concept of helping people – even young children – be visually reminded of the presence of germs isn’t out of reach. In fact, there are even cool (and relatively inexpensive) soaps and science  kits that help children (and adults) visualize just how effective (or ineffective) they are at washing germs off their hands.

It is my sincere hope, however, that it won’t take actually visualizing germs for all of us to take stock in what simple measures we already know are effective in preventing the spread of germs. For a quick refresher, let me spell them out for you so you will have them at your (hopefully clean) fingertips! After all, the truth about the “Idol Bug” is that it was likely just another (admittedly nasty and poorly timed) virus making the most of making people sick.  More than just another virus, however, it was also a really good, attention grabbing reminder for the reported 19 million  that we’re still in the middle of cold and flu season, and that the sharing of germs that happened in Hollywood while the cameras were running could happen anywhere – especially to those who neglect to take the following actions!

Wash your hands with soap and water. Handwashing is particularly important not only before eating and after using the bathroom, but any time you or your children are sick or come in contact with people who are sick (or germy surfaces like grocery cart handles). And don’t just settle for a quick rinse. Lather up the soap and be sure to get all areas of the hands – both front, back and in-between fingers.

Cover your cough. I can tell you from lots of child-care-owning experience that it’s entirely possible to teach even very young children to not only cover coughs, but to do so with their arms rather than their hands. They may not get it right early on or every time, but over time they’ll pick up on this very important form of prevention. The fewer illness-causing germs that are coughed into one’s hands, the fewer that stand to contaminate surfaces or get shared directly with others.

Vaccinate. I often get asked longingly in interviews about whether or not we’ll ever discover how to prevent the common cold. I agree that this would be nice, as the symptoms associated with the common cold can certainly be quite pesky. But the severity of the common cold is nothing compared to all of the vaccine-preventable diseases (think measles, mumps, rubella, diphtheria, tetanus, polio) we are now able to effectively prevent. Simply put, vaccination is deserving of its recognition as one of the biggest public health success stories of the past century.

Avoid contact with those who are ill. Within reason, that is. That means that when you’re sick, it’s best to limit contact with others whenever possible – especially in the first days of an illness, when you have a fever, the flu, or other significant symptoms likely to spread germs and infect others (such as a lot of coughing).

Disinfect contaminated surfaces. Think snotty tissues on the nightstand, door knobs, telephone receivers, or any other high-traffic surfaces that are likely to have come in contact with unwashed, germy hands.  Germs can live for hours (and in some instances, days), so don’t forget to disinfect contaminated surfaces.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Brushing teeth: Parental reflections on the importance of oral health and pink princess toothbrushes

I sometimes cringe when I witness the power that putting Disney Princesses on pink and purple toothbrushes has on increasing the likelihood that girls will happily engage in the ever-so-healthy habit of brushing their teeth. To be fair, let me also say that I’m sure I’d be equally impressed by Transformers or Cars or Spiderman or any other enticing children’s toothbrushes that predictably coax boys into opening wide and brushing. That said, I’m going to save my concerns about of the influence of today’s societal “norms” on children and gender stereotyping for another day in order to focus on the very important topic of the month: children’s oral health.

It seems a bit superficial to start out by admitting that I do, in fact, love Princess toothbrushes. Not that I use one personally, of course, but rather I love that they have a way of getting even the feistiest and most willful of four, three, and even two-year-old girls to proudly tell me just how excited they are to own and use one (or two or even three) of these agents of change.

That’s right, I am hoping to convince you (in hopefully 800 words or less) that what may seem like a cute little toothbrush is actually much more than what it may seem. Especially in combination with a few other crucial factors (such as toothpaste, fluoride, and dental sealants), toothbrushes really can serve as powerful agents of change.

I am aware that for many of us, getting our kids to brush their teeth is something we know we should do and therefore commit to implementing from very early on in our parenting careers. Based on the number of questions I’m asked, I’m pretty sure a majority of us have also had to cope with babies’ erupting teeth, searched for ways to get toddlers to open their mouths, and/or struggled to get tweens and teens to take us seriously when we remind them to brush their teeth. All their teeth. With toothpaste. Not every so often, but every day.

So each February, when Children’s Dental Health Month rolls around, I’m happy. Happy because I am painfully aware of how difficult it can be to draw much-needed attention to the importance of children’s oral health – especially as a topic of key national importance. If setting up a campaign and dedicating a month to this worthy cause is what it takes, I’m all for it.

If this month serves as a useful reminder for all of you to brush up on tips for taking care of teeth – from baby’s to teen’s and everyone in between – then we’re off to a good start. It’s also a good time to double check your calendar and make sure your children (starting at the age of one!) are scheduled to get dental check-ups every six months.

But I also hope February’s increased focus on children’s oral health gives you an even healthier appreciation for just how much impact oral health – or the lack thereof – can have on children’s overall health, self-image, and well-being. Cavities and tooth decay (or “dental caries”) are actually considered a chronic disease. And not just any chronic disease, but one that affects more children in the U.S. than any other (five times more than asthma!) and is projected to afflict fifty percent of all children entering kindergarten this year. When left untreated, tooth decay has the very real potential to cause pain, infections, and subsequent difficulty playing, eating, speaking and learning. In fact, it is estimated that children miss nearly 51 million school hours each year because of dental-related illnesses alone. That’s not even to mention the social importance of a smile and just how damaging tooth decay can be to one’s self-esteem.

So I’m willing to admit that making the leap from Princess toothbrushes to this serious of a topic is a big one. But the fact of the matter is that I couldn’t agree more with Jeff Sheldon (a Community Health Educator in the Nebraska Department of Health and Human Services Office of Oral Health and Dentistry) and Nebraska’s Chief Medical Officer, Dr. Joanne Schaefer that taking care of our children’s teeth is an under-emphasized health priority in Nebraska. I’m fairly certain that Rick Ruggles’ recent article entitled Children walk out with smiles put a smile on their faces like it did mine as he described Creighton Dental School’s Give Kids a Smile event earlier this month. I just hope that everyone remembers that oral health is important every day of every month – for your children, and for all children. If we want to invest in our kids, let’s be sure to invest in their smiles too.

For more information on children’s oral health, you can go to:

Originally posted on Omaha World Herald’s Live Well Nebraska

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Starfish & Mittens: Helping Teach Our Children Kindness and Empathy

As you are probably well aware, my focus is and always has been on kids, parenting, and families. Quite often – whether in the books I write or at my childcare center – this translates into helping parents better understand, educate, and guide children towards happier, healthier futures.

Today is no different. In fact, I was halfway done writing my Live Well Nebraska blog in honor of National Children’s Dental Health Month, a topic I truly believe should be hugely important for all parents – perhaps more so than many are even aware.

As is often the case when I’ve promised myself I’m not going to be distracted while writing, however, I’ve found myself distracted. As soon as I opened my web browser with what I swear was for work purposes only, I saw a top-of-the-page CNN video entitled Children of the Trash Dump. These kind of titles always lure me in, and I’ve never been able to keep from clicking on the links and watching the videos. When I do, it inevitably solidifies my desire to do more to improve the lives of children and their families. Today, my conviction was made stronger than ever.

You see, I’m fresh on the heels of a very powerful trip to S. Africa, during which I had the opportunity to tour the makeshift shantytown of Dunoon just outside of Cape Town, where I witnessed firsthand both the terrible poverty and incredible resilience of its women and children. I left there more determined than ever to do something. I imagine watching CNN’s story about the plight of Vietnamese children living on a trash dump and at great risk of falling prey to child trafficking may have nearly the same effect on some of you.

The question that often arises, however, is what can one really do to tackle such a huge problem or even make a dent in such desperate situations as poverty, child trafficking or illiteracy. In the case of S. Africa, I joined about fifteen other members of the Global Hygiene Council to see firsthand the incredible power of teaching basic handwashing. Sure, I talk about handwashing all the time, and yes – we teach the students at my childcare center this basic life skill on a daily basis. But calling it a “life skill” has a way of taking on a very different meaning when one is teaching handwashing in a community with little running water and barely able to scrape together the dollar per week it costs to buy one’s family a bar of soap.

The hopeful news in Dunoon is that the four-year handwashing study conducted in the face of both poverty and health illiteracy yielded very promising results – on the order of reducing diarrheal illness by 30-50 percent! Those results would be great even here in Omaha, where parents inevitably are plagued by diarrheal illness and fret over the accompanying need to keep their children from becoming dehydrated. Now consider the fact that diarrheal disease worldwide is one of the leading causes of death for children . That’s why I’m now dead serious about finding a way to donate to the Dunoon community as much soap as I can get my hands on (along with books and beads). If you’re interested in helping me make this happen, by all means let me know.

But back to the children in Vietnam. The “hope” part of the story promised in the video’s promo is based on one woman’s vision to set up a non-profit to fight trafficking in Vietnam. This small organization is currently educating 200 of these poorest-of-the poor girls in hopes of giving them a chance for a better future and a better likelihood of avoiding predatory child traffickers. The visionary founder interviewed in the segment not only refers to the hugely important focus on “saving” girls through education, but also touches on the importance of improving the community’s reported illiteracy level from it’s staggering 99+ percent.

Let me just say that I couldn’t be more touched, or more in agreement. I thoroughly agree that education and literacy is fundamentally important and the key to helping people out of poverty and lead more successful lives. I’ve also become increasingly convinced with the notion that the education and empowerment of girls is absolutely key to solving not only poverty, but quite honestly – a good many of the world’s problems.

If you don’t believe me, then maybe you’ll believe Oprah. Or Hillary or Bill Clinton. Or pretty much anyone who has ever read Nicholas Kristof’s powerful book Half the Sky. Those who read it are likely to be permanently changed in the way they view the importance of girls, ready to join this global movement, and all but insist that everyone needs to read this book.

And finally – I am a huge believer in the power of doing something over nothing. You may have heard the anecdote of the boy and the starfish. It goes like this: a man and a boy are walking on a beach littered with washed-up starfish. Boy picks up starfish and throws it back in the ocean. Man sees this and applies the all-too-common viewpoint when he tells the boy that there are far too many washed up starfish to possibly save them all. Boy responds, “Well, I made a huge difference to that one.”  I love this story. I try to live by it. Clearly, so do the people whose far nobler efforts are recounted in Kristof’s book and CNN’s poignant video. The point is, every human being counts, and each and every one of us can do something to help those less fortunate than ourselves.

At Primrose, my teachers have t-shirts that state, “No matter how big or small, we all stand to make a difference in the world.” My husband and I were convinced to move to Omaha nine years ago in large part because we believe that here in Omaha, we are not alone in our belief that teaching even our youngest children to be involved in the community and help others is fundamental. And our Helping Hands curriculum isn’t just about the actual dollar amount the kids raise to donate, or about how many mittens, books or cans of food they collect “for kids who don’t have them” (although I’ll tell you that I couldn’t be more proud of the students for their selfless and impressive accomplishments). It’s that they’re learning the lifelong lesson that we really can make a difference if we all just take whatever opportunity we have to throw starfish back into the ocean.

With that said, I hope all of you will consider what you might do. Start big or start small. Think globally or act locally. Get your kids involved and I promise, the world will be a better place for it.

On that note, I’ll get back to writing about getting kids to brush their teeth. After all, teeth are really important too. And even pink princess toothbrushes can play a part in the grand scheme of oral health promotion.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Parenting a sick child: When a child’s cough is cause for concern

I was recently asked by a concerned parent, “When is a kid’s cough something you should worry about?” As a pediatrician, I feel obligated to point out from the outset that, in most instances, this is a question that really needs to be discussed directly with one’s own pediatrician. There are, however, several general cough concepts I can share with you that will hopefully help you gain a better big picture perspective.

It’s first worth pointing out that a cough, at the most basic level, is simply a reflex that exists to help keep things out of the airway. Even though it may not seem like it when your child is up and coughing in the middle of the night, a cough (like a fever) can actually serve a useful purpose.

As for considering the various causes of a cough, some of the most common in children include infections, asthma, choking or having something stuck in the airway, croup, habit coughing, and certain medical conditions (usually ones children are born with). Some are easy to identify, while other causes can take a bit more sleuthing. Even when you have identified the underlying cause, it may not always give you a definitive answer as to whether to be concerned. In the case of cough-inducing infections, plenty of common colds can cause an inconvenient, annoying cough. Pertussis, on the other hand (also caused by an infection and referred to as “whooping cough”) is known for it’s nagging cough…and the fact that it can prove deadly to infants.

When it comes right down to it, figuring out when to worry about a cough needs to be treated as a problem-solving venture. The following are some of questions most worth considering and the symptoms you’ll want to be on the lookout for.

Age matters.  Any cough in a baby three months or younger warrants a visit to the doctor’s office.

At a loss. It’s one thing to cough. It’s altogether another when the cough takes one’s breath away and is accompanied by more concerning signs such as troubled, noisy, and/or fast breathing.

Time of day. Taking note of how much, how often, and even when during the course of the day and/or night your child coughs can provide some telltale clues. Mucus drainage, for example, typically tends to trigger an increase in nighttime coughing. Habit coughs, on the other hand, tend to go away during sleep.

Persistence counts. More than 2 weeks of a cough definitely warrants a check-up. Coughs associated with run-of-the-mill colds don’t usually last this long, while pneumonia, sinusitis, and other causes of persistent cough often do.

Describe the circumstances. Any history of a sudden cough – especially following a gagging or choking episode – is particularly concerning for a foreign object in an airway.

Over-exposure. Consider if your child’s cough matches that of his siblings, his preschool classmates, or others he’s recently come in contact with. While I’m on the subject, let me also take this opportunity to add that while it’s a very wise idea to take advantage of practical and effective measures to stop the spread of germs – think hand washing, vaccines, and basic disinfection of contaminated surfaces – it’s unnecessary and, more importantly, unrealistic to think that you can (or should) keep your child away from all germs.

Wet or Dry. A mucusy cough is often referred to as a “wet” cough, whereas a cough without mucus is more likely to be called a “dry” cough. While determining whether a cough is wet or dry doesn’t automatically determine the underlying cause or inherently tell you how concerned to be, it can prove to be useful information.

For better or for worse. It’s fairly straightforward but worth saying that taking note of what triggers your child’s cough and what makes it better can be key in figuring things out. Croupy coughs tend to be worse at night and better with moist air. Asthma coughs can be caused by known allergens, may worsen with exercise and respond well to albuterol or other asthma medications.

Additional warning signs. Any time a child has other accompanying symptoms of concern such as a high fever, coughing so hard they are vomiting, coughing enough that they refuse (or are unable) to drink, or cough up blood, it’s time to head to the doctor. to the doctor.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Tending to Tummy Time Troubles & Going Back to Sleep

Back-sleeping and tummy time are common phrases in today’s parenting lexicon. Yet that hasn’t always been the case.

The Back to Sleep Campaign – primarily responsible for the switch to back-sleeping babies and related recommendations for tummy time while awake — was launched in the mid-1990s to educate parents, caregivers and health care providers about ways to reduce the risk for Sudden Infant Death Syndrome (SIDS).

At the time, this represented a big parenting shift. Before this public education campaign, parents had little reason to think twice about putting babies to sleep on their bellies. Generations of parents routinely did so. But with compelling evidence to support the Back to Sleep campaign’s primary message — that placing babies to sleep on their backs reduces the risk for SIDS (sometimes referred to as “crib death”) – great progress was made in helping babies sleep safer.

Just how much progress? It is estimated that since the campaign started, the percentage of infants place on their backs increased dramatically while at the same time, overall SIDS rates decreased by more than half.  As far as public health campaigns go, the Back to Sleep campaign is a hands-down success, and the benefits of raising back-sleeping babies and creating safe sleep environments are as clear as ever.

What isn’t always so clear, however, is how parents and caregivers should go about compensating for all this additional time that babies spend sleeping on their backs. By compensating, I mean tummy time. Encouraging back-sleeping babies to spend awake time on their bellies can help stave off the dreaded “positional plagiocephaly,” more understandably referred to as a flat head.

This all might sound fairly straightforward, but I am routinely asked about, interviewed on, and pressed on the subject of tummy time (and the challenges it seems to pose). How much time should babies spend on their tummies? What can one do to encourage tummy time? Is there a certain position babies should be put in? What if they don’t like it?

My first child was born right around the time that the Back to Sleep Campaign was really taking hold. As a pediatrician-in-training, I was well aware of the recommendations, and my daughter didn’t seem to have any problem following them as she established herself as a very good back sleeper. The problem was that I was far more comfortable with the recommendation for her to spend plenty of time on her tummy while awake than she was. Every time I put her on her belly, she’d squawk, cry, push off with her feet, and convince most everyone around her that she was in great distress. I managed to convince myself that her tummy time displays weren’t truly those of a distressed child, so she did get in a sufficient amount of tummy time. I find, though, many parents find tummy time troubling.

Try the following tummy time tips and tricks to help take the pressure off of you as well as your baby!

  • Tummy timing: The key here is quite simple. Just remember back while sleeping and tummy while awake. Despite what you may have been led to believe, there are actually very few rules about how much time a baby needs to spend on his tummy. There’s no need to set a timer, mark your calendar or otherwise formalize what essentially boils down to a simple concept. Just make sure your baby sleeps on his back, and then I commit to trying to make tummy time your baby’s default for hours when he’s awake.
  • Make tummy time a habit. I’m well aware that this may sound like stating the obvious, but it has been my experience – both in dealing with parents and with child care providers – that laying a baby down on her back seems to be somewhat of a force of habit. That’s great if you’re talking about a baby who’s going to sleep. But if it’s on the floor or a playmat, for example, it can take a conscious  effort to switch to the routine of placing an awake baby on her tummy.
  • Understand the benefits. There’s no magic to tummy time. Simply put, until they  learn to roll, sit and crawl, babies generally spend an impressive amount of their time laying down. If all of this down time is spent with pressure being put on the same spot(s) on the back of their skull while it’s still somewhat soft and not fully formed, it’s bound to make an impression. Tummy time not only takes the pressure off, but also allows babies the ability to strengthen their head and neck muscles.
  • Tummy time entertainment. Not all babies need to be entertained in order to be coaxed into spending time on their tummies. Some are perfectly content to lay there and look around. Feel free, however, to help your baby enjoy this new view of the world by placing toys in front of him, help him prop himself up a bit on his elbows, and even lay down facing him so you can look at, talk to, and even sing face-to-face.
  • Tummy time dissenters. If your baby is a tummy time squawker, as mine was, then don’t be discouraged. Make sure you ask yourself whether your baby’s squawks truly count as cries of distress or rather of effort. While my daughter’s cries certainly had my mother-in-law distressed, in reality my squawking little newborn really wasn’t truly upset, she managed to keep her perfect little round head and build up her tolerance for tummy time while all the while mastering the skill of scooting long before she could even roll, and I have some impressive baby videos to prove it.

Originally posted on Omaha World Herald’s Live Well Nebraska

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I admit it – I do well with resolutions. I truly believe that people tend to accomplish more when they have a set goal in mind. I personally love to rise to a challenge, and find that setting a formal (and preferably public) goal definitely has a way of bringing out one’s competitive nature.

So when it comes to New Year’s resolutions, I have to say I’m a believer. As someone dedicated to promoting health and safety year-round, I obviously think it’s important to set goals throughout the year. But if ushering in a new year happens to give you an increased sense of motivation, then by all means, run with it because now is the perfect time to shift gears from helping your children create holiday wishlists to helping them (and you) focus on setting some realistic family goals that are sure to deliver on the promise of an even happier, healthier 2012.

Okay, so what’s the best way to figure out what one’s family goals should be? While each of your family members’ individual resolutions can be customized according to age, ability, and circumstance, I figured it might be helpful to get you started by offering you some simple family-friendly resolutions – you know, those completely do-able resolutions that don’t seem nearly as challenging as, say, signing up for a gym membership in January only to lack the willpower come March to make use of it. Or running a marathon. While there’s nothing wrong with either of those resolutions (I’ve made them both myself in years past), there’s nothing wrong with first reaching for the “low-hanging fruit” resolutions that are sure to give your family both a sense of accomplishment and a big bang for your buck when it comes to improved healthy, safety and well-being.

–       Walk more. That’s right, walk more. Around the block, to the grocery store, with friends, on the treadmill – wherever and whenever you can. Running is fine, too. But if that seems a bit daunting or impractical, the important thing for kids and adults alike is to be more active in 2012. As someone who just placed my own order for a FitBit, let me add that if you and/or your children are more likely to put their best foot forward with a concrete goal (or a cool new gadget), then using a pedometer may prove to be just what it takes to get up and get going.

–       Sleep more. You see – I told you these resolutions would be attainable, if not downright desirable. I mean, who doesn’t want to sleep more? But as a pediatrician married to a surgeon and therefore accustomed to dealing with the demands of both professional schedules and with the many sleep-related challenges of parenthood, I fully understand why most of us simply don’t get enough sleep. I have also become increasingly impressed with how important sleep is to one’s overall health. So whether it’s an improved bedtime routine for babies or toddlers, taking/keeping the TV set out of your child’s bedroom, keeping tabs on your teenager’s sleep habits or simply placing more value on your own sleep needs – I strongly recommend it.

–       Read more. Daily, whenever possible. Not just for work, not just when your kids are required to, but for fun. Read aloud to your kids. Read quietly alongside them.  Make a point of reading the newspaper. Encourage your tweens or teens to start reading it too. Read on paper or in any electronic form you choose. Regardless of what angle you take, resolving to read more will enrich your family’s new year.

–       Drink more. Water, that is. Just back from a recent trip to NY where I discussed water as a key aspect of health, hydration, and tackling the obesity epidemic with a wide range of magazine editors, I decided to toss it in my resolution list. It’s not just because I think drinking more water is the one and only solution to better health, but because it strikes me as such an easy one once you and your family set your minds to it. The goal in encouraging more water consumption in large part actually relates to getting everyone (kids and parents alike) to drink less soda, less juice, and less sugary liquids in general. If your family is not in the water-drinking habit, consider committing to milk with meals and water with snacks, and making water more appealing by filtering it (typically tastes better), bottling it (re-usable water bottles are both convenient and better for the environment), or simply adding some natural flavor (a wedge of lemon/lime or even a slice of cucumber!).

–       Engage more. Social networking now seems to be the key to everything from successful weight loss to professional success. Yet one of the things we risk in what is sure to be an increasingly wired (or wireless) 2012 is the lack of meaningful, personal engagement with others in our community. That’s why I firmly believe that all families should set a goal of teaching their children to more actively engage and become contributing members of society. Taking some lessons from the Helping Hands curriculum at my child care center, this can be as simple yet meaningful as having even very young children visit the Humane Society or a local retirement home; send letters of thanks to those serving in the military; and/or collect mittens, books, pennies, diapers, coats or cans of food for those less fortunate. Whatever you choose, remember that one of the most powerful lessons we stand to teach our children (and live by ourselves) is that it is our meaningful connection with others that brings the most happiness.

–       Laugh more. At yourself, with your kids….the point is that while resolutions can be a good way to improve one’s health, it’s just as important to make sure that stress doesn’t get the best of you. I’ve found the best way to do this is to remember to laugh, and always remind yourself of how fortunate you are to have your family, your friends, your health, and the gift of another year.

On that note, I want to take this opportunity to wish you all a very happy, healthy and accomplished new year. I’ll look forward to sharing 2012 with you and everyone in the Live Well Nebraska community.

Originally posted on Omaha World Herald’s Live Well Nebraska