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Raising Healthy Kids: Reaching for the Low-Hanging Fruit of Parenthood

For good or for bad, parents today are faced with the fast paced nature of both the real world and a virtual one. Much of the virtually continuous stream of information, videos, tweets and texts we receive on a 24/7 basis relate in one way or another to what we can, should, and/or are expected to do to be good parents. And let’s face it – keeping up with all of the modern-day parenting advice would be hard enough even if all of it was fact-checked for us. Unfortunately, this is not often the case, as much of what we hear, see and read is unfiltered, potentially unfounded, and confusingly contradictory.

Having spent much of my professional career as a pediatrician increasingly committed to making sense of pediatric and parenting advice in both of these worlds, I have found that what parents often want to know from me is simply how to filter the good from the bad and separate fact from fiction.

Knowing that you all are probably as busy as I am, I decided that this week I would distill down to as few words as possible the handful of things I consider to be some of the most well-founded, important things you can do as parents can do to make your kids smarter, safer and healthier. In other words, the following is my list of the “low-hanging fruit” of parenting.

Move more. I feel the need to say this because it’s painfully obvious that it has become incredibly easy for our children (and for us) to barely move in the course of any given day. Whether it’s walking instead of driving to school (or work) or taking an evening walk around the block, getting out of the car instead of rolling your way through drive-thrus, or signing up for organized sports, joining a gym, or participating in more vigorous daily exercise regimens – every step counts towards an healthier life style.

Use restraint. Literally speaking, I’m simply referring to the use of car seats and seat belts in motor vehicles. With motor vehicle crashes clearly identified as the number one cause of death in children, and the correct use of car seats and seatbelts clearly shown to have a huge impact on reducing motor vehicle-related injuries and deaths, taking the time to buckle up comes with a huge return on your parenting investment.

Read. For every parent who has ever asked my opinion on what they can do to help their children become smarter, excel in school, or head down a path of success, reading always factors in to my answer. Reading aloud to babies, toddlers, young children and teens alike not only fosters improved language skills, but also a love of reading that will serve children well for their lifetime. One of my favorite sayings to emphasize this point is that children spend the first few years of school learning to read, and the rest of their lives reading to learn.

Sleep. For parents of infants and young children, this conversation usually focuses on getting children to fall asleep, stay asleep, sleep in their own room, and do so without requiring repeated interventions. For parents of teens, the conversation often shifts to too little and too late. But regardless of your child’s age, it is becoming convincingly clear that instilling your child with good sleep habits is not only a good thing for your own chances of getting a good night’s sleep, but your child’s overall health and well-being.

Wash your hands…and while you’re at it, remember to cover your cough (preferably with your arm rather than your hand) and vaccinate. The fact of the matter is that while modern day science and research is continually coming up with new medicines, treatments and technologies to improve our families’ health and more effectively treat disease, the simple act of teaching our children to wash their hands (which includes committing to consistently doing so ourselves) remains one of the single most effective things we can do to limit the spread of disease. So is protecting against all of the vaccine preventable diseases.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Childhood By the Numbers: Helping Parents Count on Fostering Their Children’s Healthy Development

I admit that I sometimes (often) sit down to my computer to get work done while at the same time leaving the TV playing in the background. It was in this context that I recently overheard a discussion on one of the national morning news shows about how numbers can define women – most notably numbers that pertain to one’s age and weight. Without paying too much additional attention to the ensuing conversation, the idea nevertheless spurred me to write a blog on the subject. In part, that’s because I think it’s a fairly sad statement on our society when someone’s weight and waistline does more to define them than their skills and accomplishments. But that’s a topic for another day.

For now, I thought I’d take this interesting concept and take a closer (and hopefully more uplifting and lighthearted) look at how various numbers have a way of defining several stage of childhood.

Newborns by the numbers. Even the instant newborns make their appearance in the outside world, many run the risk of being defined by the number of hours of labor they subjected their mothers to. That said, newborns also start out being largely defined by their birth weight – which is more often than not included in announcing a baby’s arrival. I feel compelled to note that the accompanying but often-neglected length and head circumference measurements may seem of less immediate interest to proud parents, but they’re actually of equal importance.

And then, of course, there’s the number of diapers, the numbers of hours of sleep (or lack thereof), and the numbers of daily feedings that make up the bulk of a new baby’s day. These numbers are unarguably important, but I like to remind new parents that it’s good to make sure that these numbers don’t count for more than they’re worth. After all, getting to know and love your newborn goes well beyond a singular focus on numbers.

First year figures. What often wins out in the most noticeable numbers category for infants is simply the number of times you’re likely to call and/or visit your doctor, if for no other reason than the first colds, first fevers, and first (and many subsequent) shots that typically take place during this first fun-filled year. That said, don’t let these numbers scare you. Having numerous questions is to be expected, it’s a great time to take advantage of the frequent contact to establish a healthy relationship with your pediatrician, and the five to seven well-visits (along with their associated vaccinations) and any necessary sick-visits will all serve as an integral part of insuring your child’s health and well-being , not to mention your confidence as a parent.

Toddlerhood by numbers. Toddlerhood is all about numbers. Numbers of words, number of steps, numbers of teeth, and making the celebrated association between one’s age and one’s finger count as evidenced by the skill of holding up two finger to proudly answer the commonly asked question, “How many years (or fingers) are you?” Of course this age may also unfortunately give rise to keeping count of how many times one bites ones friends before learning to curb this normal but socially unacceptable impulse. While it can be painful to live through for everyone involved, toddlers usually overcome this impulse within a matter of weeks to months.

Keeping Count for Preschoolers. Number one and number two come immediately to mind, as three is the typical age at which children master the life skill of putting their pee (number one) and poop (number two) in the potty. While using the potty is a frequent focus of the age, this is also a time when children start to figure out (please note that as the owner of a child care center as well as a pediatrician, I said start, not necessarily master) social skills involved with interacting with, playing with, and negotiating with an increasing number of friends.

Kindergarten counts. At this age, the number of new crayons in the box (with the more the better) and the number of wheels on ones bike (the fewer the better) endearingly add up to quite a lot in the world view of a kindergartener (and more than a few early elementary age children as well!).

I could keep counting, but for the sake of space and time I won’t, except to fast forward to the age at which children start middle school. I can tell you from recent parental personal experience that an impressive amount of effort (and sometimes anxiety) is directed towards remembering the numbers associated with ones newly assigned locker combination, as well as the added challenge of finding ones way to a larger number of classes in a larger number of classrooms.

There are obviously plenty more numbers that relate to each of the ages and stages of early childhood. I’m just glad that for the most part, they all generally add up to fun, meaningful, and important aspects of an healthy childhood.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Applying the “Kohlrabi Principle” to Practical Parenting

I recently made it out to Midtown Crossing. This was actually the first chance I had to see it since it’s completion, and I was quite impressed with the family-friendly atmosphere, the Jazz on the Green’s outdoor festivities, the whole layout, the convenient free parking, and the wide array of stores and restaurants.

As a LiveWell Nebraska blogger, I also enjoyed the opportunity to spend time at the Omaha World Herald’s booth and meet those of you who chose to stop by and say hello. As is often the case, I was asked what I thought the secret was to getting people – parents and children alike – to change their ways and live healthier, safer lives. While this is clearly a subject I spend a lot of time thinking about, I don’t presume to have the one right answer. In fact, I don’t believe that there is one, single cure-all answer to the question of how to get people to change their behaviors. But for the sake of today’s blog, I’m going to go with kohlrabi.

That’s right, kohlrabi (pronounced “cole – rah – bee”)

For those of you who have never heard of kohlrabi, much less know what it means or how to pronounce it, you have to admit that the word itself has a way of catching your attention. Try teaching your preschooler the word, or better yet – reading aloud the ever-popular Eating the Alphabet book – and you’re sure to find that children are easily intrigued with an impressively wide range of fruits and vegetables.

Okay, so reading about (and hopefully popularizing) kohlrabi, along with other fruits and vegetables, is a big step in the right direction towards better health. But better yet is when you’re able to translate linguistic & literary intrigue into dietary practice.

This noble goal brings me back to the subject of kohlrabi. Prior to three years ago, I knew nothing about it beyond the fact that it had helped round out the “K” page of Lois Ehlert’s bestselling book. Until my 8-year-old son and I came across kohlrabi at the Village Pointe farmer’s market, it had never occurred to me to actually buy or try kohlrabi (or jicama or boysenberries, for that matter).

Before deciding to buy one, we first had to ask what one was supposed to do with a kohlrabi. Not unlike an artichoke, kohlrabi can admittedly be somewhat intimidating if one doesn’t know what to do with it. Fortunately, all it takes is simply cutting off the outer “rind” and cutting up the white, crunchy interior.

Billed by wikipedia as “a low, stout cultivar of the cabbage that will grow almost anywhere,” the taste and texture are said to be “similar to those of a broccoli stem or cabbage heart, but milder and sweeter.” My kids and I think it’s better described as more like the cross between a radish and a cucumber – with the crunch of a radish, but a more mild taste. Cut it up like a carrot stick and it can be dipped in ranch dressing or hummus. Dice it up and you can sprinkle it on a salad. Google it and you’ll find that you can also season, sauté, bake, or puree it.

So back to my initial conclusion that part of the answer to getting people to live healthier lives involves kohlrabi. No, your family’s discovery of the existence of kohlrabi won’t rival Alexander Fleming’s discovery of penicillin. But I am convinced that if we all committed to applying some basic “kohlrabi principles” like those I’ve listed below to how we feed our children (and ourselves), we might all be a bit healthier for it.

  • Read all about it. It’s no secret that I’m an outspoken advocate for early literacy and reading books to kids (and babies). And there’s certainly no shortage of books with positive, healthy messages. Eating the Alphabet will get you off to a good start, but there are many, many more that stand to get your children interested in a much broader range of fruits and vegetables. Check out How Are You Peeling?, for example, and you’ll see what I mean.
  • Paint a positive picture. Books can paint a positive picture, but so can you. Rather than taking a “you have to eat your vegetables” approach, remember to put a more positive spin on it. You’ve got plenty of shapes, sizes and colors to choose from and work with as you expand your family’s palette.
  • Reach for the unknown. Given that people don’t tend to buy what they don’t know, I like to think of this as taking the kohlrabi challenge. Whether you go to a local farmer’s market or take a closer look at what the produce department in your grocery store has to offer, challenge yourself and your children to find a fruit or vegetable you’ve never had or heard of before… and then buy it.
  • Challenge yourself in the kitchen. Like I said before, I am not a kohlrabi expert. I simply asked a few questions of a friendly kohlrabi farmer and made good use of Google. Fast forward three years and our refrigerator is frequently stocked with cut-up kohlrabi, which now plays a role in helping my family meet the latest MyPlate recommendations (which include the challenge of consistently filling half the plate with fruits and vegetables).

Originally posted on Omaha World Herald’s Live Well Nebraska

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The Importance of Early Literacy: Why We Need to Commit to Closing Nebraska’s Reading Gap

I recently learned the results of Nebraska’s first statewide reading assessment. I must admit that the test itself didn’t actually catch my attention until I received my own children’s scores in the mail. As a long-standing early literacy advocate and someone who read literally tens of thousands of pages aloud to my children even before they could read for themselves, I am proud to report that all three scored very well.

Unfortunately, I find it difficult to celebrate my own children’s reading success in light of how the rest of our state’s children scored. Sure, results released in August revealed that nearly 70 percent of Nebraska’s third through eighth grade and 11th grade public school students scored in a range that met or exceeded expectations, but that 70 percent doesn’t tell the whole story.

Last Friday, Joe Dejka and Paul Goodsell shared the rest of the story with Omaha World Herald readers in their article, Reading gap called troubling. In it, they paint a much more dismal picture, simply by offering a more detailed look at the test results: Fewer than half of Nebraska’s Hispanic, black and American Indian students can read proficiently – a number that is in stark contrast to the three out of four white students taking the same test. When poverty was factored into the equation, low-income students also were found to have scored significantly lower than their more well-to-do classmates (on the order of 53 percent compared to 80 percent, respectively).

So why should you or I find the results of Nebraska’s first statewide reading assessment so distressing? In addition to the obvious racial, ethnic and socio-economic disparities, the fact of the matter is that the ability to read matters. A lot. Learning to read, learning to love to read, and the ability to read well all play a fundamentally key role in children’s future school and life success. In fact, it is often said that children spend the first several years learning to read, and the rest of their lives reading to learn. Yet Nebraska is not the only state with a reading gap, as an estimated 34% of American children enter kindergarten without even the basic language skills needed to learn to read, and fewer than half of parents read to their young children daily.

Now for the good news: we already know what works when it comes to preparing America’s youngest children to succeed in school, thanks in no small part to the efforts of Reach Out and Read. By partnering with doctors who prescribe developmentally-appropriate books, encourage families to read together beginning at birth, and advise parents about the importance of reading aloud – this national non-profit organization now offers us all an effective, evidence-based model that reaches nearly 4 million children each year, with a particular focus on those living in poverty.

As a pediatrician who had the good fortune to train with one of the founders of Reach Out and Read nearly two decades ago and has championed the cause ever since, I hope you’ll not only commit to helping your own children learn to love to read, but also commit to helping close Nebraska’s reading gap.

The following are a few simple but important Reach Out and Read tips to help get all children started on the path to lifelong learning and success:

  • Host a book-themed baby shower.
  • Make reading books to your child a part of your daily routine.
  • Make reading fun: hold your child on your lap when you read stories together, point to the pictures, let your toddler fill in the ends of your sentences, and be willing to read the same book (or page) over and over again.
  • Ask your two-year old questions about the story.
  • Relate what you read to your child’s own experiences.
  • Visit reachoutandread.org to find out more about the developmental milestones of early literacy, recommended book lists, and information about Reach Out and Read programs right here in Nebraska.
  • Consider supporting organizations such as Reach Out and Read and play a role in helping all children reach their full potential.           

Originally posted on Omaha World Herald’s Live Well Nebraska