Halloween Tricks and Treats

Halloween can be a very special but difficult holiday. Parents have numerous opportunities before and during this holiday to support healthy behaviors and to share important health and safety information with their child. Sugar laden treats and “scary” costumes are learning opportunities for your child. During the Halloween season remember to see things through the eyes of your child. This requires an understanding of your child’s perception and development.

Infants and toddlers become fearful when appearances suddenly change. This can happen when a mask or costume is worn by someone they love or trust or when they see a garden hose coiled like a snake. For a preschool child certain categories and themes are common causes of fearful thoughts and behavior. These include darkness, thunderstorms, loud or unexpected noises, animals, robbers and hidden monsters. Children do not develop the ability to separate fantasy from reality until about five years of age. For older children fear is heightened when there is a social element such as group fear or social isolation.

Begin to prepare your child for the sights and sounds of Halloween long before the holiday. Become a follower of your child. Help your child substitute imagination and creativity for confusion and fear. Always listen to your child and take all fears seriously. For the school aged child it is important you show your concern. Never dismiss or disavow the way your child interprets symbols. Start by naming and discussing specific fears. Discuss calming strategies and techniques. Use rational and reasonable explanations to help your child re-interpret the emotions that are being experienced. Your ongoing support will decrease associated anxiety and bolster your child’s ability to self-manage future feelings and emotions. This type of empowerment allows your child to focus on the creative and imagination benefits of this holiday and not react with fear and anxiety.

When shopping with your child or discussing costumes for Halloween never choose or direct your child to choose a certain costume. Allow your child to be led by her own comfort level and interest. By recognizing and understanding your child’s needs you will be better able to interpret and respond to difficult emotional responses while avoiding feelings and emotions your child is not yet prepared to address.

Halloween also provides opportunities to discuss issues of health and safety. Choose a costume that is reflective, brightly colored and flame resistant. Avoid sharp accessories and facial masks that obscure your child’s vision or increase the risk of tripping or hurting oneself or another. Always test any make-up on a small area of your child’s skin before it is applied to the face.  Talk about food and nut allergy risks. Discuss safe and courteous behaviors including the use of a flashlight, avoiding candles and stairs, traveling in a protective group, never entering a house alone and not running between houses or across a street. Making eye contact and graciously saying thank-you are also important as are proper hand washing, general food safety techniques and proper inspection of all “treats” before they are eaten.

On this holiday take the time to discuss with your child the importance of healthy treats and how much sugar is healthy. Talk about balance and view this holiday as a tasting “buffet” opportunity for your child. Avoid becoming the “sugar policeman.” By including sugar education in your daily lives long before Halloween your child will know ahead of time the importance of limiting sugar intake. Help provide what and when guidelines for sugar intake for the younger child and for the older child avoid critique and criticism about sugar intake. Show by example how you limit your own sugar intake. You are your child’s greatest teacher. Children should eat no more than 16 grams of sugar a day and an adult no more than 32 grams. A can of juice or soda contain about 40 grams of sugar and a single starburst about 4 grams. Make food label awareness and healthy food choice a part of your everyday life.

Halloween can be filled with magic and learning for every child.

Recommendations for Weight Management in Children and Adolescents

It is important you follow and are aware of your child’s yearly height and weight assessments. This allows a body mass index (BMI) to be calculated. If your child’s BMI is > 95% than he is severely over weight. Another term for this is obese but be cautious when this term is used. It is very important not to instill fear or a feeling of hopelessness when discussing weight issues. If he is between the 85% and the 95% he is overweight. If your child is in either of these categories an assessment by your pediatrician is needed and a decision must be made whether intervention is necessary.

The quality of every meal your child eats should be evaluated. Quantity and portion size are important but quality is just as important. Limit eating outside of your home, always eat breakfast, encourage family meals and avoid all sugar or artificially sweetened drinks. Eating whole fruit is much healthier than drinking juice. Make certain your child is eating a high fiber diet based on low caloric density that is high in fruits and vegetables. Avoid excessive consumption of foods that are high in energy density such as fat and protein.

Look at the environment your child lives in. Does it support a healthy dietary intake and an active lifestyle? Are there environmental or social barriers to physical activity? Is there excessive unbalanced media exposure to a diet high in unhealthy foods? Is adequate time spent every day away from sedentary activities such as television watching, video games and computer use?

Goals should include five or more servings per day of fruits and vegetables, less than two hours per day of screen time, one or more hours per day of moderately strenuous physical activity, no electronic devices in the bedroom and no sugar or artificially sweetened beverages.

A family history of obesity, heart disease, stroke and type 2 diabetes is important. If there is a history in your family of one or more of these then added attention to your child’s growth, activity level and dietary intake is essential. Special testing may also be required.

As a parent you must disengage from many of the minor food and activity decisions. Your child must be encouraged and allowed to self-regulate both food intake and daily exercise. This does not mean you do not discuss guidelines but rather establish a setting where success is easier to achieve and healthy choices become easier to make.

If routine interventions are unsuccessful then structured weight management protocols should be pursued under the direction and guidance of your pediatrician. This will include determination of the components of a healthy diet as well as structuring of daily meals and snacks. Activity time will also need to be supervised and screen time decreased to less than one hour per day. Structured behavior modification programs can also be used.