We all have heard that childhood obesity is a major health issue in our country. Children who are overweight will be more likely to be overweight adults and develop significant health issues. We hear so much in the media about what to eat, what not to eat, how to cook, how much exercise we all need, and frankly sometimes it is simply overwhelming to parents. We all are busy and many times the drive through at the fast food restaurant just calls our name at the end of a long day. We can develop healthy patterns as families to guide our children to healthy lifestyles. These healthy patterns can be simple…it is just getting started. So, parents….let’s get started!
Breastfeed when possible and no solid foods before 4 months of age…
- A recent study showed that with children who were breastfed for at least four months, the timing of solid food introduction did not affect the obesity rate of the child at age 3. Children who were never breastfed or who stopped breastfeeding before age 4 months and were given solid foods before the recommended 4 months of age were 6 times more likely to be obese by age 3.
Know where your child is…(know where you are too!)
- At your child’s 2 year old well child visit, your pediatrician will calculate his body mass index (BMI). This is a better indicator of weight issues than simply where your child is on the growth chart. A child with a BMI greater than the 85th percentile for his age and sex is overweight, a BMI greater than the 95th percentile determines that your child is obese.
- Children that have parents who are overweight have an increased risk to become overweight too.
Know what a serving size is….
Remember, children need child size portions! A tablespoon per year equals a serving. This is a simple guideline. For a child age 2 to 3:
- Grain Group: About 3 ounces of grains per day, half of them whole grains. That is about three regular slices of bread or one slice of bread plus 1/3 cup cold cereal and ¼ cup cooked rice or pasta.
- Vegetable Group: 1 cup raw and/or cooked vegetables per day. (no ketchup is not a vegetable J, but tomato pasta sauce counts!)
- Fruit Group: 1 cup fresh, frozen, canned, or dried. Juice should be kept at a minimum. Whole fruits are better than juice!
- Dairy Group: 2 cups per day. Whole milk is recommended for children younger than 2, low-fat after age 2.
- Meat and Beans Group: 2 ounces total per day. Options include one ounce of lean meat or chicken plus one egg or 1 ounce of fish plus ¼ cup of cooked beans (black, pinto, etc.).
- Oils: 3 teaspoons or less per day of liquid oil or margarine.
- For more information about eating plans and serving sizes for other aged children, visit MyPyramid.gov.
- Unhealthy snacks fill up small tummies so children don’t eat the nutrient dense foods they need. Try giving fruits and vegetables as snacks. These foods are low-calorie, high fiber, and full of vitamins and antioxidants. Giving these foods when your child is hungry encourages your child to give them a try.
- Juice should be at a minimum…and no soda at all!
- Keep healthy snacks in plain sight. A bowl of fruit on the counter, fresh cut up vegetables on the first shelf in the refrigerator, dried fruit and trail mix in the pantry.
- Don’t let your child eat because of boredom. If your child has eaten well and had a healthy snack but still is begging for more…then suggest another activity. Ask you child what he would like to do besides eat. Help your child distinguish between “I’m bored” and “I’m hungry.”
- Make snack time planned…no grazing throughout the day. Have your child sit on the floor or at the table for snack time. Mindless eating is an unhealthy habit!
- Serve whole-grain breads and cereals.
- Whole milk until age 2 and then low-fat or skim milk after age 2.
- Full fat yogurt until age 2 and then lower sugar and low-fat yogurt.
- Serve lean meats like chicken, turkey, fish and lean beef cuts and pork cuts. Remove fat and skin.
- Bake, broil, poach, grill, or steam when preparing meat, fish, and chicken.
- Use vegetable oils like canola, corn, olive, and sunflower.
- Encourage fresh fruits and vegetables in season, frozen next and canned last. Have fruits and vegetables at EVERY meal.
- Limit fast food to an occasional meal only.
- Treats can include frozen fruit bars, frozen yogurt, low-fat pudding, angel food cake, graham crackers, vanilla wafers, and of course…the occasional Oreo! Balance and moderation are important to teach children so they do not “binge” later.
Don’t force your child to be members of the “Clean plate club”…
- Forcing children to eat everything that is put on their plates often leads to overeating.
- Focus on the quality of the food your child eats and no the quantity. Let your child learn what it feels like to be full and what it feels like to be hungry.
Get your child excited about healthy food….
- Go to local Farmer’s Markets and let them pick out fresh produce.
- Start a garden and grow some vegetables of your own.
- Give them age appropriate jobs in the kitchen. Letting children help prepare healthy foods encourages healthy eating and excitement!
- Get creative and expand everyone’s palates. Try new foods!
Eat breakfast every day…
- Start every day out right with a healthy breakfast. Children often eat their best meal of the day in the morning. Include healthy grains, fruits and proteins to give your child a great start.
- Children and adults who eat breakfast are less likely to be overweight.
Establish good sleep habits…
- Making sure your child gets good sleep can help prevent obesity! Research has shown that people who sleep less than the recommended amount gain weight faster. One theory is that fatigue decreases activity or may increase appetite.
Get your child active…60 minutes of active play at least every day…
- Get outside every day.
- Choose developmentally appropriate activities. Be careful about organized sports too early…burnout can happen. Let your child just be a kid and play!!!
- Provide active toys. You should have balls, jump ropes, bikes and other active toys.
- Be a role model. Build physical activity into your daily life so you can keep up with your children and feel better!
- Turn off the TV and limit computer time. The American Academy of Pediatrics recommends no more than 1 to 2 hours of total screen time a day after age 2. That includes video games, TV, movies, and computers.
There is so much that parents can do to prevent childhood obesity and lifelong weight issues and medical problems. Outdoor play, limited TV, limited fast food, healthy food choices, teaching appreciation for good foods, and soon everyone in the house is feeling better, having fun, and living a healthier lifestyle. We can do this Moms and Dads!
Take a breath, enjoy the joyful moments of each day, and remember you don’t have to be perfect to be the perfect parent.
Talking to your child and using lots of animated facial expressions are important for your child’s language development!
Believe me, hearing the sweet voice of your child say “Ma Ma” or “Da Da” is one of those moments you always remember. Later, I can remember thinking….”Maybe I should change my name, I am tired of hearing “MO-OMMMM!” Suddenly it was a two syllable word that rocked the house! Now, I love hearing “Mom” when I get that phone call or one of the kids bursts through the door for a visit! The fact is, language development in your child is exciting and fun, and early development is important. Studies show us that the number of words your child hears is proportionate to the size of his or her vocabulary that is developed. This is through direct spoken words to your child, through conversation or reading, not words heard from the TV or radio, or conversations around your child. Some experts tell us that a parent should be saying 30,000 words per day to their child. Wow, that is a lot of talking! Now I tell you this as a fun fact, not to have you tally mark each word you say to your child! I don’t want to add another task to your day, or worry to your list! The 30,000 per day number does send the message home though that talk is important, and as parents we have to work at talking and reading to our children! In this age of TV, computers, I-Pods and I-Pads, and smart phones; sometimes the spoken word and art of conversation is lost. As a parent we need to bring that art of truly talking with our children back!
What can we do to foster language development in our children?
- Talk to your child! When your infant is looking at you or an object…talk to your child! When your child coos, coo back…this is the start of the art of conversing. Describe what your baby is seeing. Talk about what you are doing during the day. Read stories and talk about the pictures in board books. Studies show that children that hear 30,000 words a day from birth to age 3 have better language skills at 3 but also have an academic edge still in 3rd grade…no matter the socioeconomic level! TALK A LOT TO YOUR CHILD! It can be the great equalizer for academic success!
- Repeat. This helps a child link sound and the meaning of words. By the time a child is about 1, they have most of the sounds that put words together, they just don’t have the words! Repetition helps a child put those sounds into words.
- Always respond to any sound your child makes. When your baby coos, talk back. When your child squeals with a favorite toy, talk about how much your child likes that special toy. When your child babbles and reaches for an item, say what the item is before you give it to your child.
- Play taking turn games. This teaches conversation! Blow on your baby’s tummy and wait for his response. Repeat it again. Play peek-a-boo and other games that encourage taking turns in conversation…cause and effect.
- Eye contact. Your child needs to see your face when you are talking. This helps your child see how the words are formed by watching your mouth. Your smiles, facial expressions and encouragement gives your child positive reinforcement for their attempts in communicating.
- “Motherese” is good! The high-pitched sing-song voice most moms use to talk to their baby is good! Babies like the pitch of this type of talk and the slow pace helps them understand better. Teach Dad how to do it! It tends to come more naturally to Moms.
- Give your child the opportunity to talk. Don’t anticipate every need, allow your child to point and make attempts to ask for what he or she wants.
- Narrate your day. Talk to your baby as you change a diaper, give a bath, cook a meal. Describe what you are doing and what your child is doing.
- Expand your child’s communication. When your child says “dog”, you can say “Yes that is a dog! It is a brown dog!”
- Read. Reading is a great opportunity to engage with your child. Your child will learn more words and will develop a love of books. Hearing the same book over and over helps to make language connections in your child’s brain.
- Go on field trips! Take your child to the grocery, the post office, on hikes…talk about what you see! Watch your child, and see what he or she is interested in or excited about. Talk about that rock or stick he or she picks up!
- Use music. Music encourages your child to pronounce words and practice putting sentences together. Songs also help children remember things…I still can’t put things in alphabetical order without singing my A B C’s! 🙂
- Play language games. Point and name games like “Where is your nose?” “This is Mommy’s toes, where are your toes?” Helps your child becomeaware of himself and make language connections, plus it is fun!
- Don’t worry but refer early. There is a wide range of normal with speech development. Don’t obsess and worry over your child’s development of speech. Every day work on providing the opportunities to allow your child’s speech to develop. If you have questions or concerns, the earlier you refer for evaluation, the easier most speech delays can be handled.
Language Milestones from The American Speech – Language – Hearing Association
- Baby will startle to sound
- Quiets or smiles when you speak to him
- Recognizes your voice
- Smiles at you
- Babbles and uses sounds with p, b and m
- Makes excitement sounds and unhappy sounds
- Makes gurgling sounds
- Likes music
7 Months – 1 Year
- Likes “peek-a-boo”, “patty cake”, “soo big!”
- Uses “speech” not crying to sometimes get your attention.
- Uses gestures like pointing, putting arms up, waving.
- Recognizes words that you say like “cup” and other common words.
- Starts to follow 1 step directions.
- About the first birthday will have about 2 or 3 words like ball, ma ma, da da, dog.
1 Year – 2 Year
- Points to pictures in a book when named.
- Knows animal sounds.
- Points to a few body parts when asked.
- Can say a two word question or sentence by age 2.
- Vocabulary expanding every month.
2 Year – 3 Year
- Follows two step directions.
- Has a word for almost everything.
- Is understood most of the time by those with him often.
- Speaks in 2 to 3 word sentences.
- Starting to understand concepts like big and little, up and down, in and on.
When do you refer?
- A baby who doesn’t respond to sound or who doesn’t make vocal sound.
- A child who does not point, or wave “bye bye” at 12 months.
- A child at 18 months that uses gestures over words to communicate.
- A child at age 2 or older that only imitates speech and does not speak spontaneously.
- A child at age 2 who can’t follow simple 1 or 2 step directions.
- A child at age 2 who parents are unable to understand at least 1/2 of the child’s speech, or a 3 year old child that a parent cannot understand 3/4 of the child’s speech.
- A 4 year old child who is not understandable by others.
- Don’t sit and worry….refer early. Most speech referrals are made between 15 months and 2 years of age.
Remember, infants, toddlers, and preschoolers are like little language sponges. Talk, talk, talk, and turn that TV off! Your child will soon be yelling “MO-OMMMMM!”….be careful what you wish for!! 🙂
Take a breath, enjoy the joyful moments of each day, and remember you don’t have to be perfect to be the perfect parent.
Why would your child need a glass of juice? The short answer that the American Academy of Pediatrics (AAP) gives is almost never. While a juice box of 100% juice for an older child isn’t the worst thing to have, it certainly isn’t the best choice. The AAP recommends even stricter guidelines for juice in a child’s diet. The new pediatric recommendations for juice is NEVER before the age of one and very limited intake through the age of 18!
Fruits are an essential part of a child’s healthy diet, but juice is not. Even 100% juice! Juice has very little nutritional benefit, it is basically water and natural sugar. It is high in calories and low in nutritional benefit. A piece of fruit is eaten slower, has healthy fiber, and is more filling. Often we forget to count the calories of a drink, and a child can “fill up” with those quick calories and then decrease the amount of healthy food that is eaten. This may increase the risk of unhealthy weight gain.
If 100% juice is not the best choice for children, then fruit drinks are even worse! To be labeled fruit juice, it must be 100% juice. Any other drink or “juice box” that is not labeled 100% juice really is no better than soda. Many labels try to “fool” parents by stating it contains 100% juice! If it is not 100% juice it really is a sugar sweetened drink with high calories and no nutrition.
So what should our children be drinking?
- Breast milk or formula for the first full year of life. No juice, period. Small amounts of water can be introduced in a cup when solid foods are started.
- Children age 1 to 6 should consume no more than 4 ounces of juice a day in a cup with a snack or meal. Toddlers should not carry a sippy cup around with juice as it can result in dental decay. Fruit should be encouraged rather than juice. Water and milk only are adequate for fluid intake for toddlers and young children.
- Children age 7 to 12 can consume up to 8 ounces of juice a day, but fruit should be encouraged over juice. Water and milk are adequate for fluid intake for older children. Sports drinks usually are not necessary for most activities, they are high in sugar and calories.
What does this mean?
- Juice has no nutritional benefit for children younger than 1.
- Fruit is always a better choice than 100% fruit juice.
- Fruit drinks that are not 100% juice are no healthier than soda.
- Juice is not a good fluid choice for rehydration for a child who is dehydrated or has vomiting and diarrhea.
- Drinking too much juice may increase the risk of obesity in children and may decrease the amount of healthy food a child eats.
- Children over the age of 1 can drink 100% juice as part of a balanced diet that also includes whole fruits if they stay within the recommended amounts by the AAP.
So don’t introduce juice to your infant and offer it sparingly to your older children. Remind your children that low-fat milk and water are always the best choice. “Take back the snack” and encourage “snack parents” to provide water for young athletes after practices and the games. Control your refrigerator and cupboards, make fruit available and low-fat milk and water more available than juice. Make it easy for you and your child, steer clear of the “juice box aisle” at the store!
Take a breath, enjoy the joyful moments of each day, and remember you don’t have to be perfect to be the perfect parent.
Parents must be sure that their child’s car seat is being used correctly…we all have precious cargo!
I read an study recently in the Journal of Pediatrics which really shocked me.
A total of 291 families (81% of those eligible) participated. Nearly all (95%) CSSs were misused, with 1 or more errors in positioning (86%) and/or installation (77%). Serious CSS misuse occurred for 91% of all infants. Frequent misuses included harness and chest clip errors, incorrect recline angle, and seat belt/lower anchor use errors. https://www.jpeds.com/article/S0022-3476(15)01459-6/fulltext
95% had errors in car seat installation of positioning! That is such a scary thought since car accidents are the leading cause of death for children. But to be honest, car seats are not easy to install correctly! The manuals are long and sometimes confusing, there are different recommendations by auto manufacturers, and I know the installation of a car seat has caused many an argument between Moms and Dads!
The newest recommendations from the American Academy of Pediatrics state that until at least age 2 your child should sit in a rear facing seat and preferably a child should be rear facing until they reach the highest weight or height allowed by the car seat manufacturer (that means your child most likely will be older than age 2 and still rear facing). Children over the age of 2 may sit in a front facing seat with a 5 point harness until their weight and height exceeds the car seat’s recommendation for the seat. A booster seat should be used until a child is 57 inches tall, which is the average height of an 11-year-old (wow…bet you didn’t realize that!) No child should sit in the front seat until age 13!
Types of car seats:
- Rear facing only
This seat is used for infants up to 22 to 40 pounds depending on the seat. They are small and have handles to carry the seat. Some have a base that can be left in the car.
- Convertible seats that can be used for rear facing
These seats can be used rear facing and then “converted” to forward facing when your child is older. They are bigger than infant seats and do not have handles or a separate base. They often have a higher rear facing weight and height limits which is great for larger babies. They should have a 5 point harness.
- 3 in 1 seats
These seats can be used rear facing, forward facing and as a booster. They may be used longer by your child. (But remember every seat has an expiration date…about 5-6 years)
Installation for rear facing
- The shoulder straps should be at or below your baby’s shoulders.
- The straps should be snug (you shouldn’t be able to pinch any slack) and the chest clip should be at the nipple line.
- The seat should be tight in the car. You should not be able to move it more than an inch side to side or front to back.
- Never put a rear facing seat in the front seat of a car!
- Make sure the seat is at the correct angle so your baby’s head does not flop down. Many seats have an angle indicator or adjusters that can help with this.
- I recommend having a certified car seat technician help install the car seat. This will help with the many questions parents have and may even prevent Mom and Dad from having an argument! 🙂 Check out this website for great information on car seats, car seat recommendations and locations of car seat technicians in your area. It is an excellent resource! http://www.nhtsa.gov/cps/cpsfitting/index.cfm
Common questions parents have about car seats:
Rear Facing Seats
- What if my child’s feet touch the back of the car seat?
No problem…your baby will cross his legs and find a comfortable position. There are few reports of leg injuries from a crash with a baby in this position, but a leg injury is a much less severe injury than a head and neck injury which you are helping to prevent by keeping your child backward facing until age 2 or older.
- What do I do if my baby is slouching in the seat?
You may put blanket rolls on both sides of your baby and a small cloth diaper or blanket between the crotch strap and your baby for a while until your baby grows a bit. Do not ever put padding or blankets or anything behind your baby or add any car seat insert unless it came with the seat or was made by the manufacturer of the car seat. Any additions to a seat may make it work a bit differently and provide less protection for your baby!
- What do I do about winter coats?
Remember that thick winter coats, blankets, or clothing should not be put under the car seat harness or straps. Dress your baby in thin layers and then tuck a blanket around your baby over the harness straps if necessary.
Installation of forward facing seats
- Always know the restrictions of your model. Know the maximum weight and height limits for your seat!
- The shoulder straps should be in the slots that are at or above your child’s shoulders. (This is the opposite from the rear facing position)
- You may need to adjust the angle of the seat when you turn it to forward facing, check your car seat manual.
- Choose to use the LATCH system if your car or van has it OR the seat belt. Do not use both. Check your car or van manual and your car seat manual for proper installation with the LATCH or seat belt. Latch does have a weight limit of 65 lbs total, meaning the weight of the car seat plus your child. If the car seat and your child together weighs over 65 lbs, then you must use the seat belt to secure the seat.
- Use a tether strap. This is a strap that attaches to the top of the seat. It is often on the seat back of the car or van. This gives extra protection by not allowing the car seat and your child’s head to move too far forward in a crash. All vehicles manufactured from 2000 on have them. Check the weight limit for the use of the tether anchor.
Common questions about forward facing car seats
- Where is the safest spot for the car seat in the back?
The safest spot is where the seat can be installed properly, it is convenient for you to use safely every time. Some LATCH systems are only on the sides of the back seat. Some car seats only fit well in the middle. It depends on your car seat, your vehicle and the number of children you have on where is best for the car seat!
- Should we use a car seat on a plane?
Most infant and convertible car seats can be used on planes. The seat must have a FAA (Federal Aviation Administration) approval label on it. The FAA and the AAP recommend that children use car seats when flying until age 4. This keeps your child safer during takeoff and landing and in turbulence.
So much information…but so important to keep your child safe. We will continue the conversation over the next few days with more tips. What car seat do you use? Why do you like it?