Kids

A mealtime should be a happy ritual in which parents and children relax together to enjoy the comfort of good food. Teaching healthy eating behaviors involves parents knowing which aspects of eating they should control and which ones their child should control.

Many parents would agree feeding young children healthfully is a challenge. From older infancy and beyond, your child will seek to establish independence and a sense of self. Learning about foods, food preferences, and eating behavior are important aspects of your child’s physical and emotional development.

Setting Boundaries

It may seem children are born to test boundaries set by parents. However, research shows that children function best when parents are consistent and set reasonable limits that are developmentally appropriate for their children.

It’s your job as a parent to decide when each meal and snack will be.Children normally need to eat about every 2-4 hours during the day. If your child is in the habit of eating or drinking every hour or so (grazing), sticking to set meal and snack times may take some getting use to.

You can help your child by providing structure around mealtimes and offering a variety of foods while allowing your child to determine how much to eat at any given time. You should expect your child to sit at the table or high chair for meals and snacks, and not to be distracted by other activities.

You child will learn to wait for a meal if timing is consistent. Your child will eat better in the long run when he has security in knowing when meals are and is hungry for them. And for you, it is reassuring to know that if your child refuses to eat at a specified mealtime, another opportunity to eat is just around the corner.

Food Choices

Encouraging a child to eat a wide variety of foods can take a lot of perseverance. In order for your child to learn to eat a healthy and varied diet, you should offer nutritious foods repeatedly.

It is normal for children to refuse some new foods. In fact, research shows it may take offering a new food eight to 12 times before your child wants to eat that food on his own.

Given this, it is wise to offer at least one favorite food with a new food. This way, your child is likely to eat at least part of the meal while exploring the smell, taste, and texture of the new food.

Self-regulation

To foster self-regulation, it is important for your child to be in control of how much he eats at a meal or snack — or whether he eats at all. This way, your child will learn to recognize and respond to hunger and fullness cues without external pressures like coaxing, bargaining, or restrictions.

Part of learning self-regulation usually involves mistakes by your child. A tantrum at mealtime may result in refusal of part or all of that meal. When hunger sets in shortly after however, your child is less likely to act up at future meals and the next meal or snack will probably be well received.

Do’s and Don’ts

  • Do be a role model: Your eating habits are an important aspect of teaching your child what and how much to eat. Send the right message by eating lots of fruits and vegetables, serving appropriate portions, and not overindulging in less nutritious foods.
  • Do involve your child: Planning and cooking meals together with your child can be a fun opportunity to teach him about nutrition. When you shop, have your child look at food nutrition labels to help make healthier choices. When you cook, have your child figure out how to fix balanced meals and assign age-appropriate tasks for him to do when preparing food.
  • Don’t force your child to clean his plate: Forcing a child to eat when he’s not hungry teaches him to eat when he’s full.
  • Don’t bribe or reward with food: You should never use food as a bargaining chip for good or bad behavior.
  • Don’t use food to show love: A hug, spending time together, and praise are the most powerful ways to show your child how much you love him.

Did you know that drowning is the leading cause of death for children under the age of 5 in California? “About 50 percent of those deaths occur in residential pools, spas or hot tubs,” says Kacey Hansen, R.N., director of Trauma Services at John Muir Health.

To maximize kids’ safety, follow the recommendations below, developed by the Drowning Prevention Foundation and California Building Officials.

  • Never leave a child unattended near water, even for a few seconds. A child can drown in less than two minutes.
  • Always keep your eyes on children playing in or near any body of water. Assign an adult to supervise kids at large gatherings.
  • Place reaching and throwing aids, such as poles and life preservers, within easy reach on both sides of the pool.
  • Provide all non-swimmers with approved personal flotation devices to wear when they are near water.
  • Do not assume children are immune to drowning if they have had swimming lessons; falling into water unexpectedly could cause them to panic.
  • Be sure that you and all of your child’s caregivers know how to swim and how to administer CPR in an emergency. Immediate CPR can prevent death or massive brain damage. 

Pool Owners

  • Surround all four sides of your pool with a fence that is at least 5 feet high, and keep potential climbing aids, such as chairs, away from the fence. Studies in Australia and New Zealand suggest that these fences reduce drowning by 80 percent; an Arizona study showed a 50 percent reduction.
  • Install a self-closing and self-latching gate or door that opens outward, away from the pool. The latch should be on the pool side, out of children’s reach.
  • All house doors and windows leading to the pool area should have panic alarms, sliding doors should close automatically, and pools should have automatic safety covers. Don’t allow kids into the pool until the cover is removed completely.
  • Drain off the water that accumulates on top of the pool cover because a child can drown in just 2 inches of water.

The Centers for Disease Control (CDC) estimates that 20 percent of children annually have an emergency department visit and more than 9 million have unintentional injuries. Too often, these common injuries are easily preventable. 

John Muir Health emergency department doctors know all too well that some basic precautions can prevent an incident that causes a trip to the emergency room or urgent care clinic.

Injuries

An assortment of injuries including bumps, bruises, sprains, strains, and broken bones land Contra Costa children in the hospital. 

“An injury-free summer may only be a reality if you keep a sharp eye on your children,” says David Birdsall, M.D., medical director of the John Muir Medical CenterSM-Concord Campus Emergency Department.

While that is hard to do, Birdsall says, “if they are on their own, they are much more at risk. You need to help them learn to understand consequences and to think twice, instead of not at all.”

Topping the list of common injuries are those involving bikes and skateboards — mostly from riding without proper gear. 

“A helmet can literally make the difference between a minor injury and a life-threatening one,” says Theo Koury, M.D., medical director of emergency services at John Muir Medical CenterSM – Walnut Creek Campus. 

“Protective gear such as knee pads and wrist guards can also prevent broken bones, such as wrist fractures, that can put a child in a cast for six weeks or more,” Says Koury.  He advises that if a parent knows a child is biking, “go out and actually watch him or her put on the helmet.”

Summer

Summer means more outdoor activities, and heat can bring serious consequences such as overexertion, heat exhaustion, or heat stroke to the unprepared.

 “Team sports, hiking, and just running around in the heat can cause dehydration much quicker than  people realize, especially in young children and older adults,” says Dr. Koury. 

Doctors agree that drinking fluids every 20 minutes is important, especially if you are in the sun for more than an hour.  If you feel thirsty, dizzy, or get a headache, then you have probably gone too long. Sunburn can also be a serious threat — so apply sunscreen liberally, multiple times.

“Remember drinks, breaks, and shade,” says Dr. Birdsall.  He also notes that summer fun can cause children to forget to eat and drink, and that traveling can take children out of their normal healthy routines, sometimes causing dehydration, constipation, and sleep deprivation. 

Every summer brings reminders about pool safety.  Dr. Koury says you must be sure your pool is secured and that the gate cannot be opened by a child, children must be supervised, and that you need a dedicated pool watcher.

Another predictable issue is trampoline injuries. Many people have trampolines at home — where most injuries occur — and don’t realize how unsafe they are.

In fact, the American Academy of Pediatrics says trampolines should never be used as play equipment in homes, on playgrounds, or at schools. Collisions and falls often cause head and neck injuries or bone breaks.

If you choose to have a trampoline in spite of the risks, you should follow these tips from the Consumer Product Safety Commission:

  • Adult supervision at all times
  • Allow only one person on the trampoline
  • Do not allow somersaults, which can cause head and neck injuries
  • Place the trampoline away from things that can cause injury, such as trees or other structures
  • Forbid children under the age of six from using the trampoline
  • Use a trampoline net or enclosure to prevent falls

Cars

The CDC reports that injuries due to transportation are the leading cause of death for children. Where your child sits in a car and whether or not your child wears a seat belt can mean the difference between life or death in a car crash.

According to the CDC, child safety seats significantly reduce the risk of death for children (by 71 percent for infants and by 54 percent for toddlers).

Unfortunately, many parents accidently install their children’s safety seats incorrectly. Trauma services’ child passenger safety program at John Muir Health reports that 82 percent of car seats the program checks are not used correctly. 

Seating your children in the back seat may also protect them from injury. Children who ride in the back seat reduce their risk of serious injury in a car crash by 40 percent, according to the CDC.

In case an injury does occur to your youngster or teen, John Muir Health’s two ERs are fully equipped to take special care of children.

In addition, an after-hours pediatric clinic, Pediatric Resource Medical Group, is available at 1479 Ygnacio Valley Road, at the corner of La Casa Via, in Walnut Creek. The phone number, (925) 930-6295, is also an advice line that can help parents decide whether to treat a child at home, visit their pediatrician or urgent care, or go directly to the emergency room. Please note that this clinic is not a John Muir Health facility, and they are contracted with John Muir Physician Network for after-hours pediatric services only.

Painful middle ear infections, or acute otitis media (AOM), are the most common type of bacterial illness in U.S. children and the one most commonly treated with antibiotics. This has prompted calls in recent years for more judicious use of these drugs, due to concerns about resistance to antibiotics, says Dr. Lisa Rood, a pediatrician at John Muir Health Outpatient Center, Brentwood. “We’re not saying we don’t want to treat all ear infections,” Rood explains. “We want to treat the ones that need to be treated and not overtreat.”

If your child has symptoms of a middle ear infection, be aware that the American Academy of Pediatrics and the American Academy of Family Physicians advise doctors to:

  • Confirm AOM diagnosis and differentiate it from middle ear fluid, which requires different treatment.
  • Relieve pain, especially in the first 24 hours, with acetaminophen or ibuprofen.
  • Give parents, in some cases, the option of seeing if the infection will resolve on its own for 48 to 72 hours, then start antibiotics if symptoms don’t improve. (For otherwise healthy children without underlying conditions that may alter the natural course of AOM.)
  • Prescribe amoxicillin for most children if antibiotic treatment is agreed upon.