Holiday Toy Safety

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The holidays are fun but they also are a time for emergency department visits due to injuries from toys. Toys provide children the opportunity to explore the world and develop or refine skills. It is vital every child be given the freedom and encouragement to explore but that does not mean they should be unsupervised. One child in the US is treated in an emergency department every three minutes for toy related injuries. This adds up to over 3 million children receiving treatment from 1990 until 2011 and the number of injuries has increased by 40% since 1990.

The best way to protect your child is by buying toys that are age, interest and skill level appropriate. Read up on the toys you want to purchase before you buy them. Check into the safety record for the toy and make sure there has not been a recall. Make sure all the materials in a toy are labeled non-toxic. This includes lead paint and is especially important when purchasing used toys. Always follow the manufacturer age and restrictions guidelines and never use a toy before you have read all the instructions. This is especially important for all chemistry kit toys that may contain dangerous or toxic chemicals.

Certain types of toys are more risky than others. Toys that must be plugged into a wall outlet are never to be used by a younger child. Electricity can kill your child. Make sure all toys that plug into the wall are UL approved.  Also beware of choking injuries due to objects that are small enough to be swallowed or inhaled and block your child’s airway. Always think big for young children and avoid objects smaller than a ping pong ball. Beware of button batteries, magnets, balloons and plastic tags.  Toys that have a rope, string or ribbon attached can cause strangulation and all riding toys such as a scooter should only be used with supervision and with a properly fitting helmet.

Beware of loud toys that can damage your child’s hearing and be especially careful when using ear buds or head phones.  Always turn on the sound before the ear buds or head phones are placed in or over the ears. Stuffed animals pose the risk of toxic stuffing or stuffing that can be swallowed or aspirated. Loose plastic pellets should never be used for stuffing and beware of toys made of plastic where small pieces can be broken off and choked on. Broken plastic toys often have sharp edges that can cut your child.

Home safety is also important over the holidays. Make sure you properly use safety gates and beware of your child climbing on or falling off of raised surfaces. Electric rockers, exercise machines, recliners and lift chairs can cause entrapment injuries. Extremities and fingers can be caught and crushed. Lastly, be cautious about all furniture and objects that have sharp edges or glass components. These can lead to cuts and blunt trauma injuries.

Most injuries happen when your child is left unattended or unsupervised. Your informed, active and attentive presence is the best protection for your child. Keep all toys organized and in working order. Toys should be cleaned periodically to kill and wash away germs and they should never be used in unintended ways that place your child at risk for injury. Hanging crib toys pose a special risk for choking or strangulation and any toy that shoots objects into the air can cause eye injuries.

A final safety tip is to choose safe places to use a toy. Many toys are safe when used in one location but not in another. Store toys in a location where toys for older children can be kept away from younger children since many toys for older children are very eye catching to young children and can cause injury to a younger child who is not developmentally ready to use that toy.

Follow these guidelines and active play can be safe and a time of discovery and exploration for your child.

Healthier Fast Food

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Healthier fast food starts at home. Do your best to pack a meal or snack instead of stopping for fast food. Eating before leaving home is also important. Vacations and road trips are high risk occasions for increased fast food intake. Try to help your child prefer to eat at home rather than out by preparing healthy meals and snacks your child enjoys. A favorite home meal always trumps fast food choices.

Food and portion choice are two other important skills. Portion control and food choice are best taught at home and not when you are at the fast food restaurant. Teach your child that self-control is overrated. It is best to avoid calorie rich and unhealthy food both at home and when you are out. Eating should never be for comfort or distraction. Mindless eating is never healthy.

Make eating a social event rather than an escape or comfort event. Eating healthy is a key component of a healthy lifestyle and when paired with stress reduction, adequate sleep and an active lifestyle it leads to a long and healthy life. By decreasing sedentary time and helping your child stay active you will be making exercise an actual meal portion and reduce excess calorie intake risk.

How can you lower your child’s risk? Downsize food portions and beware of cheese, condiments and side dishes. Skip the fries and choose fruit or nonfat yogurt as a side order. Choose baked or grilled chicken and avoid chicken nuggets that are high in fat and are imposters of real chicken. Avoid liquid calories by choosing water and only drink low fat milk. Lastly, choose fruit and leave the chips and cookies behind.

Compliance with healthy dietary rules is essential. Choosing a children’s meal with healthy substitutions allows your child to participate in food choice. Never ban sweets entirely since this decreases compliance and often increases behavior issues.

Healthy children’s meal alternatives include: Kraft macaroni and cheese with apple slices and bottled water at Arby’s (205 calories).  Veggie or turkey breast delight (without cheese) on whole wheat with apple slices and fruit juice at Subway (285 calories).   Chicken nuggets (4) with sweet and sour sauce and apple slices and unsweetened iced tea at Burger King (265 calories); Grilled chicken nuggets (4) with barbecue sauce and fruit cup and low fat milk at Chick-fil-A (260 calories); Chicken drumstick with green beans and low fat milk and string cheese at KFC (365 calories); Chicken McNuggets (4) with barbecue sauce and a double portion of apple slices and low fat milk at McDonald’s (370 calories); Hamburger with apple slices and low fat milk at Wendy’s (380 calories).

For teenagers choose a fajita with grilled chicken and vegetables or baked or grilled chicken instead of breaded chicken or macaroni. Always leave off the cheese. Order a baked potato instead of French fries and leave off the fat laden trimmings. When in doubt always order a salad with grilled chicken and low fat or fat free dressing. Order non-fat yogurt with fresh fruit instead of dessert or cereal and consider a fruit smoothie instead of a regular milkshake.

Limiting fast food visits and following these guidelines will help your child eat healthier.

Fast Food Risks

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Childhood obesity is a common problem in the US. One in three children has high cholesterol and almost 20% of children between the ages of 6 and 11 years are obese. This number has tripled since 1980. The risk of obesity in teens has quadrupled in the last 30 years. Obesity has been linked to heart disease, diabetes, stroke, cancer and an early death.

Every parent needs to know the fast food industry and eating outside the home has grown dramatically in the last few decades. The US has almost one million restaurants and approximately 10,000 new restaurants are added each year. In the US about half a trillion dollars is spent every year by people who eat out and the fast food industry spends about 700 million dollars a year marketing directly to children through advertising and gifts given to children to entice a return for another children’s meal. Children and teens view between three and five fast food ads every day and 75% of these ads focus on unhealthy foods. The fast food industry is now pursuing social media as the new wave of influence to further expand the fast food market for children and teens using deceptive marketing and advertising.

What is the risk of fast food? Fast food choices are high in fat, carbohydrates and salt. The portions are large and sugar-laden drinks are encouraged. These factors lead to excess calorie intake and unhealthy weight gain.

Sugar-laden drinks provide liquid calories with minimal nutritional benefit and increase your child’s risk for obesity and diabetes. Many protein choices increase the risk for heart disease and stroke due to a waxy substance called cholesterol that clogs blood vessels. High fat cheeseburgers, unhealthy fried chicken or chicken nuggets and highly processed meats provide large amounts of saturated fat, low amounts of fiber and increase the risk of cancer, diabetes and heart disease.

Excess salt intake is another risk. Most food choices have a high sodium content which increases the risk for high blood pressure, heart disease and stroke. They also increase the risk for certain types of cancer.  Excessive intake of these types of foods increase your risk of premature death by 20%.

What is the best response for parents? Your best response is to eat outside of the home as little as possible and to choose wisely and healthier when you eat out.  Know the calories and salt content of the foods you choose for and with your child. Remember to downsize the portion, skip the fries, choose your protein wisely, avoid the cheese and condiments and choose water or fat free milk.

Healthier fast food is possible but the best plan is to avoid fast food and plan ahead.

Eating Right

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Food choice and learning to deal with stress rather than using food for comfort are essential to eating right. Always choose whole fruit for snacks and desserts and consider adding fruit to your salad. Add beans, peas and lentils to salads, soups and main dishes and try to eat more red, orange and dark green vegetables like tomatoes, sweet potatoes and broccoli. When using canned fruit always choose fruit canned in water or 100% fruit juice and choose canned vegetables with no added salt. Frozen fruit and vegetables are always a good choice as is whole grains for bread, rolls, cereal, bagels, crackers, pasta and rice. Always check to make sure whole grain is first on the ingredient list.

When choosing your protein for a meal, consider substituting seafood, peas, beans and nuts instead of animal protein. When an animal protein is chosen make sure it is 90% lean and trim and drain fat from the meat.

Salt intake must also be managed. Sodium is often hidden in foods. Canned vegetables are often high in sodium. Always choose no salt added canned vegetables. One teaspoon of salt contains about 2,500mg of sodium. The amount of sodium needed per day varies by age. Estimated intake allowances include the following: 1 to 3 years: 1,500mg; 4 to 8 years: 1,900mg; 9 to 13 years: 2,200mg and 14 and up: 2,500mg. Packaged, processed, restaurant and fast food options are high in sodium. Avoid salty snacks and always choose low sodium products.

The golden rules for healthy eating include choosing a luncheon plate rather than a dinner plate for your meals. Half of the plate should be for fruits and vegetables. One fourth of the plate should be for your whole grains and the rest for your protein. Meat should be considered a garnish rather than the main part of your meal. Consider serving low fat cheese and low fat yogurt for two of your three recommended servings of milk products per day and the serving size for milk is only four ounces. Never drink sweetened drinks. The sugar intake for 12 ounces of soda is 10 teaspoons (40 grams) of sugar. The recommended intake of refined sugar per day is 16 grams for children and 32 grams for adults.

Serving sizes must be understood or portions often are over-sized.  A serving of cereal, potatoes, pasta, rice or vegetables is equal to a closed fist or computer mouse (1/2 cup). One serving of leafy vegetables is equal to a baseball or a cupped hand (1 cup). A deck of playing cards or an iPod is the size of one serving of fish, poultry or beef and a checkbook is the size of one serving of a fish fillet. A CD case is one serving of bread and a thumb or two 9 volt batteries is equal to one serving of low fat cheese. A thumb tip or a pair of dice is equal to a 1 teaspoon serving of high fat foods such as mayonnaise or peanut butter. Two handfuls of baked chips or pretzels or one handful of nuts are equal to one serving. The recommended servings per day are 3 to 5 vegetables, 2 to 4 fruit, 5 to 10 whole grains, 3 protein and 3 dairy products.

By following these simple rules you can be a healthy food model for your child and your child will eat right.

Weight and Bullying

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One-third of all children in the US are overweight or obese and being overweight is a stigma that leads to teasing and bullying. One study found that over 85% of children report seeing an overweight peer being teased and bullied during gym class. It is more common than gender issues, race, ethnicity, physical disability or religion. Children and especially teenagers are very sensitive to the social effects of being singled out as overweight. Children who are overweight are bullied since they are viewed by others as being different or undesirable. Weight is a visible way to stigmatize children.

Overweight bullying leads to increased stress and social isolation. It diminishes self-esteem and self-worth and causes children to be excluded from social opportunities. It often leads to depression, anxiety, loneliness and sadness. Children who are bullied due to their weight are more prone to become bullies themselves and often rely on binge eating for comfort.

When a parent is told about this type of bullying the focus must be on attentive, sensitive and responsive reflective listening. Parents must be attuned to the feelings and needs of their child and tell the child: “I am sorry this happened, and I am glad you told me.” The child must be told teasing is never right or fair. The parent must explain how teasing hurts others and is always wrong. The focus of the discussion is then pivoted to the fact that how much a person weighs does not define who they are. Weight is only one of many measures of good health, and it is a measure that can be changed and controlled.

The language that is chosen when talking about being overweight is very important. Judgmental or stigmatizing language causes overweight children to shut down and withdraw and hinders discussions. The weight-based terminology you choose will have a lasting effect on your child’s willingness to lose weight. Parents must emphasize how their love is unconditional no matter what the child’s weight is, and how the extra or added weight the child is carrying can make the body work extra hard and cause the child to have less energy. The child should be asked: “How does the extra weight make you feel?” At the same time the parent reaffirms the importance of a healthy lifestyle and why how you feel is more important than how you look. For the final step the parent explains how working together will help the child to lose weight and become healthier.

Losing weight is never easy. It takes time, consistency and effort. Small incremental changes in dietary intake and activity level are essential as are stress reduction and adequate sleep. The modeling of a healthy lifestyle and weight pattern by parents is also essential. By increasing active time and time spent outdoors risk factors such as excessive screen time and sedentary time are decreased. An emphasis on family play time and joint activity time also helps as does shopping together for healthy foods such as fruits and vegetables. Choosing and preparing healthy and favorite recipes together increases compliance and make losing weight a more enjoyable experience.

It is vital for every parent to strive to stop weight based bullying and its consequences. By working with the government, schools, organizations and other parents this stigma can be eliminated as the most common cause of victimization and bullying in the US.

Night Terrors and Nightmares

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Dreaming and nightmares occur in REM sleep and night terrors occur during non-REM (rapid eye movement) sleep. These two types of sleep disruptions are called sleep disturbances.

Night or sleep terrors are episodes of fear or agitation, panic and confusion with repetitive behaviors. They can occur in children and adults. During a night terror (pavor nocturnus) the child often seems partially awake and frantic. It often begins with a panicked scream and is associated with signs of fear and autonomic arousal. Speech may be difficult to understand or words and phrases may be repeated over and over. The child is not responsive to efforts to comfort the child. There may be some sleep walking and talking and children during a night terror are difficult to arouse. When the child wakes up they do not remember a dream or nightmare.

Night terrors are usually benign in nature and no specific treatment is required other than education and trying to keep a consistent bedtime routine. Children who are overtired are more prone to night terrors. The best management focuses on allowing the child to pass through the night terror without trying to wake the child up. Night terrors are most common in children between the ages of 3 and 12 years and most occur within 1-2 hours of falling asleep.

Children who are having a “bad” dream wake much easier and usually recall the dream. The best treatment is support and reassurance. Most nightmares occur in the second half of the night. Nightmares tend to decrease after age 10 years. Children under stress in or out of the home or children with separation anxiety and attachment difficulty are more prone to nightmares.

 

How to Protect Your Child From Sexual Abuse

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Sexual abuse includes any type of sexual act or behavior with a child including non-contact behaviors such as showing or taking pornographic images of children. The best way for parents to prevent sexual abuse is through knowledge, education and understanding.

Most sex offenders are not strangers to a child. Sexual abuse is most often committed by someone who knows the child. This may be a friend, relative, teacher, coach or neighbor. Someone in a position of authority is commonly the perpetrator and children who are compliant, respectful and obedient are especially susceptible to abuse. In almost all situations the abuser intimidates the child to remain silent and not say anything or tell anyone about the abusive behavior. Often the child assumes a personal responsibility for the actions of another and feels he or she is the cause of the abuse. With time progressive guilt and shame deepen the silence and may actually block out memories for many years or even a lifetime.

Common signs and symptoms of being sexually abused include depression, oppositional or destructive behavior, anxiety, social-withdrawal, new academic difficulties, aggressive behavior, high risk behaviors and self-injurious behaviors. Parents must be aware however, that children who are being abused or who have been abused in the past do not always show signs or symptoms of abuse.

The risk of molestation can be decreased by establishing and supporting an ongoing parent-child relationship focused on open and trusted communication and connection. By spending time with your child and talking about sexuality you will be providing your child information on how to respond if an abuse occurs. Parents who believe their child is not at risk for abuse are hiding behind a mask of ignorance and denial. By talking openly and directly about sex and sexual abuse, using age and developmentally appropriate terms, your child will be able to respond in the right way and at the right time to sexual abuse. There must be no secrets between parents and children.

Children must recognize, understand and respond to the boundaries and limits of sexual behaviors and sexual exploration. Discussions must be open, non-judgmental and shame, fear and guilt must always be avoided.  Your child must understand the meaning of privacy and how certain body parts of his or her body are private and cannot be touched, looked at, talked about or photographed without permission. Children must be taught to allow their own feelings to lead their response. If a child feels scared or uncomfortable he or she must say no and immediately notify a parent about the incident. If a parent is not available then a teacher or guardian should be immediately notified.

When your child is outside of your care special precautions are necessary. Be cautious of adults who take your child on unsupervised outings or special events and make sure your child is adequately supervised during overnight stays away from your home. Verify who is in the away household where your child is staying overnight and talk to those adults directly. Alcohol and drugs must be avoided since both encourage risk taking behaviors by children and adults. If concerned about a location or situation then consider being a chaperone or making an unscheduled visit to check on your child. An open door policy allowing parent visits is always best.

By listening to your child with love and sensitivity you will encourage openness and increase your child’s willingness to share any concerns. This prevents embarrassment and decreases the chance your child will keep the incident or behavior hidden. Never discount your child’s feelings or blame your child for his or her part in an abusive situation. By providing ongoing support, professional counseling and unconditional love to your child healing can begin.

How to Talk to Your Child About Sex

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There are three topics parents must be prepared to talk about when sex is discussed between parent and child. These three topics are body parts, sexuality and romance or love. Love is both simple and complex. It is one of the strongest human drives at every age, and yet, its meaning changes from infancy to adulthood. This is why parents must educate their children about the meaning of love or someone else will.

Parents must discuss sex with their child early and often. Proper timing and location are essential. Public places should be avoided, and it is best to follow a child’s lead and wait for a question, situation or event to incite the discussion.

Sex discussions are age, knowledge and maturity dependent. The focus must be on how sex and sexuality makes you and your child feel. Proclamations, don’ts and judgment must be avoided. By discussing the do’s with your child a positive attitude about sexuality is portrayed to your child and fear, anger, shame and guilt are avoided.

Common parental mistakes include talking down to a child or not respecting a child’s intelligence or curiosity. Generational, gender, religious and cultural biases also must be recognized and dealt with. These mistakes often limit your ability to teach your child.

Topics to be addressed include the importance of being both sexually aware and sexually healthy. The physical, emotional and spiritual components of sexuality must be recognized, understood and responded to. In addition, the role of peer and partner pressure must be discussed and rumors or myths concerning sex must be dispelled. Safe sex must always be supported and the risks of pregnancy and sexually transmitted diseases must always be openly and honestly discussed and accurate information provided.

Parents must talk about how sex fits into a relationship. Learning how to set expectations empowers children and teens to establish and follow appropriate boundaries concerning sexual behaviors and practices. This type of preparation teaches children why many types of sexual behaviors are worth waiting for and at the same time enhances expectations of future sexual experiences made more powerful by experience and maturity.

The best teaching tools for parents are role-playing and the media. By using the media as a springboard for role-playing discussions your views, behavior and attitude are easily represented and expressed to your child. Family and personal values can be discussed as can the timing of sexual behaviors. Parents who focus on asking rather than telling will obtain more engagement. At the same time it is important not to ask too many questions and to always speak in generalities unless specifically asked.

A final skill every parent must master is the acceptance of experimentation and exploration by children and teens. Never tell a child that his or her behavior disappoints you. This engenders guilt and decreases your child’s opportunity to learn from a mistake and make healthier future decisions about sex.

Sexuality in Children and Teens

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Acceptance, understanding, mutual respect and commitment are the foundation of healthy sexuality. Sexuality is more about personal openness and love and less about pleasure and the binary politics of gender and sex. It is about conscious giving and receiving and not about social and societal expectations and dogma. It is about the support of relationships rather than what is right or wrong. The teaching of love, connection and communication allows children and teens to develop the resilience to expect and accept joy and disappointment while searching for one’s own sexuality and happiness.

Although the content and context of sexuality portrayed in the media are a strong influence on your child, the sexuality modeled in your feelings, thoughts, words and actions are the most important influence in what your child learns, believes and practices. Parents who teach a child fear, anger, shame and guilt are not supporting a life filled with happiness and conscious giving and receiving. The setting of reasonable exploration limits encourages young children to learn the limits of healthy sexuality in terms of nudity, sexual play and self-exploration. Healthy limits teach young children what is a healthy “touch” and who is allowed to safely touch the body of another.

Sexuality topics and interests differ by age. Allow your child’s age and developmental level to guide you in your teaching of sexuality. Look for teachable moments where your child is ready to learn about sexuality. Listen to your child’s questions and find out what he or she knows before answering a question. Allow your child’s questions to guide the discussion and be ready for “testing” questions your child will ask attempting to cause friction and stretch boundaries.

An interest in touching and exploring genitals and other “private” body parts on one self and another is normal in toddlers and young preschoolers. This provides you the opportunity to teach the proper names of body parts and to discuss personal and physical boundaries and the importance of exploration limits.  In this way limit setting becomes a family matter that is addressed early in life with non-judgmental understanding.

In older preschoolers, learning about sexuality progresses from exploration to questioning. Common questions include: “How did I get in your tummy?” “Where was I before I was in your tummy?” “How did I get out of your tummy?” “Where do babies come from?” and “Why do girls not have a penis?” Being prepared to respond to physical exploration and these common questions are the first steps in the teaching sexuality to your child.

As children enter school age sexuality questions progress to bodily changes and the function of body parts. During early school age children make the connection between making babies and the relationship between two people. Common questions include: “What is an erection?” “What is a period?” “When can a girl have a baby?” “How do two people have sexual intercourse?” and “What does it mean to be homosexual?” These questions must be answered with language and information that matches the developmental level and maturity of the child asking the question.

In middle school questions about love, romance and gender are common. By late school age the body and emotional changes that accompany puberty become the primary driving force for questions. The risks of risk-taking sexual behaviors, STDs and pregnancy become the focus of questions during these bridging developmental years.

During teen years the portrayal and content of sexuality in society and the media are the driving forces for questions and concerns. Teens spend more than seven hours a day on electronic devices and social media and much of this time is unsupervised and unregulated. Parents must provide media counseling to address media and peer influences on sexual behavior. Specific support and discussions must be provided concerning gender issues, respect, equality, safety and security. Talk with your teen about the pervasive sexual content in advertising, the entertainment industry and in social media. Issues such as contraception, pregnancy, STDs and sexual responsibility must be addressed in an open, non-confrontational and non-judgmental fashion. Events in the daily life of every family and teen provide the windows of opportunity to discuss these and other issues.

Knowledge, love, patience and understanding will enable you to teach your child conscious giving and receiving and the attainment of a healthy relationship with self and others. In this way healthy sexuality can become the greatest gift you can give your child.

Difficult Discipline Situations

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Every parent must deal with many of the same problem behaviors. Developing a reasonable, rational and targeted strategy ahead of time will prepare you to respond in the right way and at the right time.

Stalling behaviors are common for children and teens of all ages. By setting clear and concise expectations your child will be aware of both responsibilities and boundaries. Family meetings and posted chore lists and family rules provide the social venue for both discussion and the sharing of reasonable and rational expectations. Teens and children of all ages flourish with structure. Structure prepares your child for both positive and negative consequences and allows opportunity for genuine praise and ongoing feedback. If your child stalls, be prepared to provide an immediate natural or logical consequence and look for underlying emotional issues which may help you understand why your child has chosen to stall and not comply. Recognizing and understanding your child’s behavior allows you to respond in the best way possible to your child’s stalling behavior.

Toddlers are often unhappy. Situations and events make it difficult for toddlers to communicate their feelings. This makes them difficult to understand, and they respond with unhappiness, outbursts and minor temper tantrums. Parents who listen to their toddler and preschooler rather than simply try to solve their problem are better able to avert the progression to major outbursts and more overt signs and indications of unhappiness. Toddlers love schedules, routines and rituals. Planning helps decrease the risk for unhappiness. Consider using sign language or providing acceptable behavior alternative to replace unhappiness. Never be fearful of stating the obvious. Children are rational and are better able to accept change when warnings are given and preparations are made. By allowing your child to have some control the power of choice often becomes the best way to eliminate unhappiness.

Aggression is a common problem. Boys are seven times more likely to express aggressive behavior than girls and young school-aged children who are under stress are the most likely to choose aggressive acting out behaviors. Aggressive behaviors usually have a cause. Is your child angry, frustrated or fearful? Does he feel threatened? Is he experiencing rage? Aggression is common in children who have issues with self-worth and self-esteem. Many of these children have negative or hostile feelings about themselves and express these feelings by projecting these thoughts on others through acts of aggression. Teaching these children how to recognize and respond to their emotions provides the means to manage the aggression and at the same time learn the coping and social skills that are necessary to happily live and interact with others.

Lying and cheating are two other common issues. In children these behaviors are often a defense mechanism and a response to excessive parental expectations. Children between the ages of three and five years must learn the power of acceptance, how to give and share and how to be non-judgmental and to tell the truth. Lying and cheating are often behaviors learned by watching parents or may be a sign of peer or social issues. Telling the truth is a learned behavior that must be supported from the earliest age if a child is to learn the importance of high moral values for oneself and for others.