WELLNESS Archives - Page 2 of 3 - Happy Healthy Kids

What You Need to Know this Flu Season

January 26, 2016 by Kelley Leave a Comment

Ever since my oldest son got the flu twice in three years despite being vaccinated, I go on high alert for news about “flu activity” come late January, when the virus typically starts to ramp up in the northeast. The flu is no joke—kids with a history of asthma or other respiratory issues are at high risk for pneumonia with the virus. Even my healthy son was listless, coughing, and had an around-the-clock 103-degree fever for a straight week.

Vaccine scientists predict what flu strain will be most prevalent from year to year and design a formula accordingly, so even the experts don’t know until the virus peaks how effective each season’s shots have been. Here’s what we know so far—and how we can help keep our kids as protected as possible.

1. This flu season looks mild—so far. As of last week, overall flu cases are low compared to recent years. Just three states—Maryland, Massachusetts and North Carolina—reported “widespread” flu activity across the state, and cases were “minimal” or “low” in 47 states. This time last year, only 17 states had minimal flu activity. Last flu season, the estimated number of flu-associated hospitalizations of 970,000 people in the United States was the highest ever during a single season, according to the Centers for Disease Control and Prevention. Many epidemiologists point to this winter’s warmer temperatures thus far as a partial explanation: Flu tends to circulate fastest in cold, dry conditions.

2. This year’s vaccine seems like a good match. The flu could be suffering from an even more formidable opponent than warm, humid conditions: a well-matched vaccine. Last year’s formula didn’t include coverage against the flu strain that wound up predominating for the better part of 2014-15. The 2015-16 vaccine covers either three or four strains of the flu, including the influenza A virus that’s striking people in greatest numbers thus far.

3. It’s not too late to get vaccinated. It takes about two weeks for the vaccination to set in, and since flu tends to peak in February and last through May, getting immunized now will cover you through the heart of sick season. While the vaccine isn’t 100 percent effective, it’s definitely your bet shot at either preventing the virus or shortening its severity and duration. I continue to vaccinate my kids even though my one son—for reasons doctors can’t definitively explain—has had an unlucky track record. Barring certain medical conditions, everyone 6 months and older should be vaccinated. Want to find the most convenient place to get your shot (or mist)? Check out this handy, searchable map. Most insurance plans cover shots in full, but vaccines are less than $50 (and at places like Costco, quite a bit less than that) out of pocket.

4. Good hygiene is as important as immunization. Getting kids in the habit of washing their hands—with regular soap—when returning home and just before eating can provide great defense. Keep alcohol-based hand sanitizer in your bag and the car and use a squirt after you’ve been in a well-trafficked place like the mall, a museum, or the library. And if they are hacking or feverish, do others a solid and teach them to cough into their elbows, even after the worst of their symptoms subside. Just as vaccines are as much a public service as personal protection, so are good hygiene habits.

5. If you suspect the flu, see a doctor right away. If your child runs a persistent fever, has headaches, is coughing, and/or feeling generally achy and unwell, flu is a possible culprit (even if he or she has been vaccinated). Make an appointment with the doctor sooner than later, since they can test for the flu easily and quickly. Once the flu is diagnosed, you can take extra care to keep your sick child away from siblings and other kids until their fever and symptoms subside; and if he or she is high risk for pneumonia or other complications, the doctor can possibly start your child on an antiviral medication that can reduce the flu’s duration and severity. But in most cases, ibuprofen or other fever-reducing medications (as well as plenty of rest, liquids, patience, and fun movies) will see sick kids—and tired parents—through a bout. For more ideas for keeping children comfortable during illness, check out HHK’s Sick Day Survival Kit.

photo credit: Influenza via Photo Pin, cc

5 Kids’ Health News Stories of 2015

December 23, 2015 by Kelley Leave a Comment

Unless you’ve been living under a rock, you know that 2015 was packed with big, debate shaping events, both here and abroad. In the global grand scheme of things, everyday kids’ health news may seem relatively unimportant, but to parents, good pediatric research—especially when paired with good, actionable advice—can lead to life altering positive changes. (Which is why I created this blog in the first place!) Here, I’m sharing the five, kids’ health headlines from 2015 that most fascinated—and in some cases, inspired—me.

1. Measles isn’t going away.

What started with a bout of measles among kids at Disneyland in December ballooned into a multi-state outbreak, affecting more than 100 kids in January alone. The CDC is “very concerned” about the possibility of an even larger outbreak down the road, says Tom Frieden, director of the Centers for Disease Control (CDC).

Besides being seriously dangerous, potentially leading to pneumonia, encephalitis, and even death, the problem with measles is that its one of the most contagious viruses there is. Measles spreads through the air when an infected person coughs or sneezes, and 90% of the people around an infected person will catch it if they aren’t protected, according to the CDC. So, talk to your pediatrician to make sure your children’s shots are completely up-to-date, and if your infant is too young for a vaccine, make sure he or she doesn’t come into contact with infected children.

2. Pets make for healthier kids.

In case your kids needed any more fodder for their case for a fluffy new friend: Mounting research shows that having animals in or around the house can lead to big health benefits for growing immune systems and developing brains. In November, Swedish scientists published data on one million children that found that dog exposure during infancy was associated with a 13% lower risk of asthma in school-age children, while farm animal exposure was linked to a 52% risk reduction. Separately, CDC-funded researchers discovered that kids with dogs, specifically, were less anxious than their peers, even after controlling for family income, age, gender, and other variables. Pets may be hard work, but it appears they give back more than companionship.

3. Big kids are seriously sleep deprived.

Think you’re tired? In August, the CDC revealed that 2 out of 3 high school students get less than the recommended eight hours of sleep per night for their age group. Too-early school start times are partially to blame: The average start for middle and high schools is 8:03, which many sleep experts believe is out of sync with adolescent sleep cycles. But screen-based gadgets may be the worst culprit: A Norwegian study of 10,000 teens found that more than 90 percent of girls and 80 percent of boys use a cell phone in the hour before bed, a practice that’s been strongly linked in recent research to thwarted sleep (the blue light can trick the brain into thinking it’s daytime). If your children own gadgets, consider putting the phones and pads to sleep in a different room than them, and be sure to revisit the National Sleep Foundation’s guidelines on how long children of different ages should snooze: it’s 10 to 13 hours per day for preschoolers, nine to 11 for kids between ages 6 and 13, and eight to 10 hours for teens.

4. Cutting back on a little sugar goes a long way.

If you had to choose just one healthier habit to adopt for your family this year, clearing the kitchen of too-sweet snacks may be your best bet. Endocrinologists at the USCF Benioff Children’s Hospital in San Francisco showed that lowering overweight kids’ sugar intake dramatically boosted their health—in just 10 days. Even without changing the amount of calories they were consuming or exercise they were doing, children who cut out almost all sweetened foods were able to improve their levels of blood sugar, cholesterol, fasting glucose and insulin (all markers for diabetes). They also reported feeling less hungry. Need inspiration? Print out these easy ways to cut back on sugar from nutritionist Dana White, R.D., here and post on the ‘fridge.

5. Beware of “overvaluing” kids.

It seems intuitive to tell kids how special they are, but a new study adds to growing evidence that this could do more harm than good. In the first prospective study of its kind, scientists from Ohio State University and the University of Amsterdam surveyed families four times over one-and-a-half years to see if they could identify which factors led children to have inflated views of themselves. They found that kids of parents who “overvalued” them—thought they were more special than others—developed narcissistic behaviors later on. (The full report is an interesting read: In order to measure parental overvaluation, researchers asked parents, among other questions, whether their 8- to 12-year-olds are familiar with not only real historic people, like Neil Armstrong, but also fictional ones, like “Queen Alberta.” As you might have guessed, quite a few parents held firm that their little Einsteins knew all about “Queen Alberta.”)

Rather than convincing yourself and your kids’ of their greatness, researchers recommend greater “parental warmth”: simply letting kids know, often, how much you love them. This leads to high levels of much healthier self-esteem, without the narcissism. The difference? “People with high self-esteem think they’re as good as others, whereas narcissists think they’re better than others,” says study co-author Brad Bushman, Ph.D.

How to Comfort Kids with Colds

November 24, 2015 by Kelley Leave a Comment

If you have a child older than 9 or 10, you might remember a day when drugstore shelves were lined not only with cold medicines for kids, but formulas for babies—teeny little dropper bottles packing decongestants, cough suppressants and other ingredients. That changed in 2008, when the FDA issued an advisory against giving cold medicine to kids under 2. The AAP followed with an even stauncher stance: “Over-the-counter cough and cold medicines do not work for children younger than 6 years and in some cases may pose a health risk.”

These days, you’ll be hard-pressed to find a pediatrician who advocates medicating garden-variety viral colds in kids of any age. It’s nice to be advised against wasting any more money than I usually do at CVS, but at the same time, I’m left with a helpless feeling as the boys sneeze, sniffle, and cough their way to sleep. So I reached out to Drs. Julie Kardos and Naline Lai, the Philadelphia-based pediatricians behind Two Peds in a Pod and advisory board members for Happy Healthy Kids. With kids of their own at home and an office full of congested kids at work, they know what works, and what’s a waste of time. Here’s their advice for what really helps children with colds feel better.

DURING THE DAY…

Encourage rest and naps. “Parents are often worried that kids will feel as miserable as we do with a cold,” say Drs. Kardos and Lai. “But, unlike adults, it’s not a big deal to let them sleep during the day.” And that’s what they should do. Rather than push kids who have more than a little sniffle, let them stay home and rest for a day or two. Waking up several times during the night because of annoying cold symptoms causes sleep deprivation which can make for a crankier kid. Naps help restore sleep and mood.

Hydrate well. Give kids with colds a bit more than they normally drink. Fluids help the body flush out germs, thin out mucus, and replace fluids lost from cough and fever. For sore throats, acidic fruit juices can be irritating, “but frozen Slurpies actually taste great,” say the docs (for more sore throat advice, see this Two Peds in the Pod post).

HHK note: My kids love these watermelon slushies when they are sick. To make: Place 1 cup of seeded watermelon chunks in the freezer for at least 30 minutes. Place in a blender with cold water and a tablespoon of honey. Blitz and serve.

Ease up on screen rules. “Distraction helps discomfort, and it’s (really!) okay to let kids watch some movies during the day. Relaxing on the couch takes a kid’s mind off of annoying cold symptoms.”

AT BEDTIME…

Start a warm bath or shower. A nice, steamy bath or shower always helps clear the head and may even help drain the nose.

Use saline or suction. A quick mist of saline spray into kids’ noses before bed—and maybe an extra pillow or two and a box of tissues—can be just the thing to clear congestion before they fall asleep. For infants, help them blow their noses by using a bulb suction. However, be careful: Over-zealous suctioning can lead to a torn-up nose and an overlying bacterial infection. Use a bulb suction only a few times a day.

HHK note: Not all children are fans of feeling the spray tickle their noses, but for some reason, the colorful bottle and fun grape and orange scents of Boogie Mist helps sweeten the deal.

Run a cool-most humidifier in their bedrooms.

Moist airs helps unclog stuffy noses and soothe dry-throat coughs. Cool is safer than warm: In case anyone falls on the humidifier while stumbling to your bed or the bathroom in the middle of the night, there’s no risk of a scalding injury.

HHK note: My boys loved picking out their favorite “pet” among Crane’s cute animal-themed humidifiers (choose from a frog, duck, owl, dog, elephant (here) or many others), and they are easy to clean.

5 Strategies for a Healthy Halloween

October 28, 2015 by Kelley Leave a Comment

Lest you assume from this post title that I’m going as Debbie Downer this Halloween, rest assured, I’m all for sweets and excitement on Saturday night. Some of my most cherished childhood memories involve running through the dark, gown or tail trailing perilously through the leaves, collecting enough Reese’s Peanut Butter cups to last me through Easter. But years of writing health columns and scouring E.R. data for various publications have taught me that the spookiest night of the year can pose some pretty real health challenges that can’t be fixed by just some extra tooth-brushing. Here, five quick tips to keep in mind as the sun goes down on Halloween 2016.

Teach kids to stick to lawns and sidewalks, not streets, when trick-or-treating. The scary truth: Halloween is ranked as the No. 1 day of the year for child-pedestrian accidents and fatalities. The majority of these fatalities occur during the peak trick-or-treating hours: 5 pm and 9 pm, with the deadliest hour of all being from 6 pm to 7 pm. The stimulus and crowds make it hard for drivers—think excited teenagers, or parents rushing home from work to join their kids—to navigate. So push these simple rules: Stick to lawns or sidewalks on one side of the street while trick-or-treating. Cross carefully, and only when necessary. Children under 12 should stick closely to parents, and older kids should travel with a large group of children.

Make sure trick-or-treaters know your cell phone number, or have it written on their hand or on a visible place on their costumes. My youngest son’s favorite book right now is Angelina’s Halloween, but for me, it’s terrifying: In it, little Polly mouse gets lost in the trick-or-treat shuffle, only to be found by her big sister on a doorstep hours later. Eek. Fact is, even experienced caregivers can lose sight of their ghosts and goblins. Make sure your child wears reflective tape or a glow stick necklace (grab 25 for just $10 on Amazon) in a color you’ve noted and identified, and teach or label them with your cell phone number before you set out for the night. If your older child is heading out with friends, pack a cell phone in their treat bag, and keep track of his or her whereabouts with a handy family-member locator app.

Keep sensitive kids shielded from too-scary imagery. While scary movies, haunted houses and the like may seem in the spirit of the season, be cognizant of how they might trigger your child’s fears. NYU researchers have that little kids who watch violent movies, including Halloween horror films, television shows or video games, may be more likely to develop anxiety, sleep disorders, and aggressive and self-endangering behaviors.

Monitor your child eating his or her candy. Of course, you’ll want to confiscate a few of your own faves as a price for your chaperoning efforts, but there are other reasons for hanging out while your child sorts through his plunder. Thankfully, razor blades and poisonous chemicals planted in candy are an overblown threat to kids, but allergens aren’t. Even if your child hasn’t been diagnosed with an allergy, he or she can develop one at anytime—especially young childhood—and many candy bars contain the most common and dangerous allergen: nuts. If there are any signs of rash, oral or throat itchiness, trouble breathing, or a bellyache that can’t be explained by a few too many Hershey’s miniatures, contact a healthcare provider immediately (or 911 for respiratory distress), and administer a dose of Benadryl while you monitor the situation. (If your child has a diagnosed food allergy, look for houses with teal-colored pumpkins—parents there have pledged to dole out only non-food treats.) Also, make sure children under 3 don’t get into treats like Gobstoppers, gumballs, or stiff taffy, all of which are choking hazards.

Make a dinner and bedtime plan. This year’s Halloween presents a perfect storm of routine-wrecking possibilities. Not only is the holiday on a Saturday night, theoretically giving kids more freedom to stay out late, the next morning we turn the clocks back, giving everyone (save for the millions of us with small children who wake up with the sun) an extra hour of sleep. But as tempting as it is to allow children to trick-or-treat well past their bedtime—the childhood equivalent of a late-night bender—experts advise against it. In his child sleep blog, Dr. Craig Canapari recommends allowing kids to stay up just a half-hour later than their usual bedtime in the three nights before DST ends (that includes Halloween), and then switching back to the “regular” schedule on November 1. As for dinner: set aside a time for kids to have a real, filling meal so they don’t load up later on candy: There is a real uptick in hospital visits for abdominal pain and diarrhea related to candy consumed on Halloween.

Be safe and enjoy!

Do Plastic Containers Harm Kids?

August 7, 2015 by Kelley Leave a Comment

For years, I’ve read reports that certain ingredients in household plastic containers and bottles may be linked to health problems in children. But formal government and medical guidelines are scant, and objective, expert-sourced information can be hard to find. Plus, it’s not really something that comes up with the pediatrician. So I’ve continued to reheat and reuse a vast array of containers, mostly name-brand products but also those handy vessels that prepared foods often come in. After all, when you have three perpetually peckish, on-the-move young kids, is anything more convenient in the kitchen than lightweight, transparent, microwaveable containers—that are available in just about any size and shape your organization-hungry heart can possibly want?

But then I connected with Leonardo Trasande, M.D., an associate professor of pediatrics at New York University and one of the country’s foremost researchers on the effect of environmental chemicals on kids’ health. He led a 2012 study associating Bisphenol A (BPA), a common chemical used in household plastics, with obesity in children, and more recently, published a paper strongly linking two types of phthalates—another group of chemicals used in plastics manufacturing—with high blood pressure and diabetes in kids and teens. Ironically, phthalates have been added to some plastic products to replace other, seemingly more suspect chemicals in recent years.

What he told me has effectively changed the way I shop for, cook with, and even clean the plastic in my kitchen for good.

First, I asked Dr. Trasande what his big takeaway from his many years of plastic research. “Diet and a lack of physical activity are the main drivers of the epidemic of obesity and metabolic concerns we are seeing in children today,” he told me. “But this study adds further concern that chemicals in the environment are independent contributors.”

Then I asked him about his “rules” for using plastic food and drink containers. (He’s the dad of two boys, 7 and 5.) Here’s what he does; and advises others to do, too.

1. Look at the bottom of plastic containers before buying, and avoid ones with the recycling codes 3, 6, and 7.
A lot of companies now include “BPA-free” and “safe for microwave” on plastic container labels. But the real test, according to Dr. Trasande, is looking at the bottom of a bowl or bottle for its recycling code. Numbers from 1 to 7 indicate the chemicals used in the product, and some are more worrisome than others. “The number 3 means phthalates, which raises the possibility of contamination into liquid,” he says. He also advises families to avoid plastics with a 6 (polystyrene, often made in products meant to rigid) or 7 (a catch-all for miscellaneous “other” chemicals, including polycarbonate, which is produced using BPA).
I looked at the bottom of some of the containers in our house the other day. Most of our food storage containers had 5s and our beverage bottles were marked with 1s (relatively safer choices). But our Solo cups and lids were marked with 6s. And those styrofoam cups which hold endless cups of coffee and hot chocolate that are often reheated in the microwave? All marked with a 6. Our clamshell-shaped Chinese take-out containers, too.

2. Opt for wax paper or aluminum foil to wrap food whenever possible—and request that your deli and butcher counters do the same.
Most companies have eliminated BPA and phthalates from household wrap, but it’s harder to monitor what’s being used in products sold at the supermarket. Regardless, “using paper or foil reduces the amount of contact that (all) plastics have with food,” says Dr. Trasande. Plastic chemicals are especially likely to migrate into fatty foods like meats and cheeses.

3. Don’t microwave plastic.
This goes for any kind of plastic container or wrap, in Dr. Transande’s book, regardless of recycling code. “When you cook foods at these high heats, you’re inviting plastics to melt at a microscopic level and travel into your food,” he says. Stick with glass or ceramic instead.

4. Don’t wash plastic in dishwasher.
This is one I’d never thought of. “Use soap and water in the sink instead,” says Dr. Trasande. “Harsher detergents etch the plastic and increase absorption into liquids and foods.”

5. Pitch plastic that’s become scratched up.
Once plastic is “etched,” that increases the odds of chemical leaching, Dr. Trasande says.

6. Don’t reuse plastic drink bottles.
If plastic bottles were meant for single use, keep them that way, advises Dr. Transade. “Besides, reusing them raises the chance of bacterial contamination.”

Plastic may be ubiquitous these days, and keeping track of every odd container that comes from a store or restaurant may be futile. But making a few better choices at the kitchen and grocery store? That, I think I can do. For more information about Dr. Transande’s research, visit his page at NYU School of Medicine, here.

5 Common Summer Ailments in Kids

July 16, 2015 by Kelley Leave a Comment

Most of us associate sick days with wintertime. That’s when storefronts and commercials are dominated by cough syrup and Kleenex; not now, when sunscreen and beach balls take center stage. So when our kids spike a fever or complain of a sore throat on vacation, it may take us a bit longer to catch on—and, frankly, accept—that they’re under the weather.

As much of a drag as summer ailments are, it’s important they’re on every parents’ radar. Some health problems that go along with warm weather are as, if not more, serious to kids’ health than the coughs, colds, and flu that circulate during the school year. To get the scoop on what pediatricians are seeing in the office right now, I talked to my friend Laura Scharf, M.D., a pediatrician at Quincy (Ma.) Pediatric Associates who also serves as a physician at Camp Becket in the Berkshires, as well as HHK’s advisors Naline Lai, M.D. and Julie Kardos, M.D. of Two Peds in a Pod. Here, they weigh in on how to recognize and treat some of kids’ most common summer ailments. (In each case, be sure to consult with your child’s own healthcare provider for individualized treatment.)

Coxsackie (Hand, Foot, and Mouth Disease)
Common in kids, Coxsackie often spreads around pools, sprinkler parks, public bathrooms, and other “wet” places. Part of the large family of enteroviruses that live in our gut, different Coxsackie strains cause different symptoms, but hallmarks are a high fever and small, sometimes painful blisters around the mouth, hands, feet, and sometimes buttocks. “A new strain we’re seeing can also cause a more extensive rash, often on the lower legs,” says Dr. Scharf. Kids can also get runny noses and pinkeye.
How to treat: Ibuprofen or acetaminophen (administered as directed on the label) can control fever and pain. Soft, cool foods and drinks like yogurt and milkshakes can help soothe blisters in the mouth and throat. Symptoms usually go away in 3-7 days.

Summer Colds
Believe it or not, we’re seeing a lot of colds in the office, says Dr. Lai. Often caused by different enterovirus strains than the ones that cause Coxsackie, these colds may bring on a fever and cough. They circulate where a lot of kids congregate, like camps and daycare. “So it’s not surprising we saw a spike after the July 4th holiday,” Dr. Lai says.
Prevent and treat: Viral colds can’t be eradicated with an antibiotic. Rest and lots of fluids is the best prescription. Your child should feel better within a week; if not, see a doc.

Lyme Disease
Prevalent in the northeast, Pacific northwest, and midwest, particularly in woodsy areas (but not always), Lyme disease is the most common illness spread by infected ticks. (Other tick-borne illnesses include babesiosis, ehrlichiosis, and Rocky Mountain Spotted Fever. For a complete rundown, with geographic trends, check out the CDC’s page, here.) Kids who end up testing positive for Lyme come to the doctor’s office with a nagging fever, aches and pains, and sometimes a bulls-eye-shaped rash. Read more about diagnosing and treating Lyme in this previous HHK post I did with Lyme expert Nevena Zubcevik, D.O.).
Prevent and treat: Apply sprays with 20% picaridin or 30% DEET on your child before he or she goes outside for long periods, especially around wooded or grassy areas. See a doctor right away if he or she has a strange, circular rash or unexplained, recurring fevers or achiness (without other symptoms). Lyme can be diagnosed through blood tests (though false negatives are common, so be sure to follow up if symptoms persist), and treated successfully with antibiotics, especially if caught early.

Rashes
“Summer is rash season,” says Dr. Scharf. Some skin flare-ups are associated with illnesses, such as Coxsackie or Lyme, above. But our peds are also seeing a lot of bumps and welts due to photosensitivity (a reaction to excessive sunlight), contact dermatitis (sensitivity to a material or a product, often a new sunscreen), heat rash (when sweat gets trapped under clogged pores), poison ivy, and bug bites.
Prevent and treat: Limit sun exposure, especially if you have a sun-sensitive kid, and do a patch test to make sure a new sunscreen or product agrees with your child before sending him or her out for the day (sensitive kids often do best with mineral-based sunscreens with titanium dioxide or zinc oxide.) Teach your kids to avoid overgrown wooded areas and keep to paths to avoid poisinous plants. Dressing your child in loose, lightweight clothes can help ward off heat rash. If rashes develop, consult your pediatrician or dermatologist; treatments range from calamine lotion to topical steroids in more extreme cases, to temper welts and stave off itching. It’s important to keep sores clean with soap and water, and to teach kids try to avoid scratching too much, especially with unclean hands. “We see a lot of infected bug bites from this, “says Dr. Lai.

Stomach Bugs
Foodborne illnesses peak in summer months. Bacteria on food grows fastest in warm, moist conditions, and people are often cooking and eating far away from refrigerators and trusted heat sources that can regulate storage and cooking temperatures (think of picnics and beach barbecues). Illnesses usually strike within minutes or hours of eating a contaminated food, and can be mild or severe, causing abdominal pain, diarrhea, vomiting, and sometimes fever. Kids can also pick up bugs from swimming in—and often swallowing—contaminated water. Between 1978 and 2010, norovirus was the second-leading cause of illness outbreaks associated with untreated recreational water, such as lakes, according to the CDC.
Prevent and treat: Clean hands frequently when preparing food, and be sure to keep food that’s susceptible to bacteria (like raw meats) packaged tightly and separated from other edibles. Keep raw produce and meats cold with frequently changed ice packs if outdoors, and cook foods to recommended temperatures (145 for beef steaks, 160 for ground meats, and 165 for pork). The USDA recommends bringing a meat thermometer to picnics and cookouts. If a queasy stomach strikes, keep a child hydrated with plenty of non-acidic, non-dairy fluids. When kids are swimming, especially in untreated lakes or ponds, make sure they avoid swallowing water, and wash up afterwards.You can also replenish them gradually with small sips of oral rehydration solutions made with electrolytes.

Photo credit: Dave Jacquin via Flickr, cc license 2.0

How to Choose Kids’ Sunscreen

July 1, 2015 by Kelley Leave a Comment

Step into just about any pharmacy in America right now, and you’ll see an aisle filled with neon-colored sunscreen bottles—and a bewildered-looking mom or two standing in front of it. I’ve been there—just last week, in fact, when I realized that my boys needed to pack their own sunscreen bottles for camp. But what was supposed to be a five-minute stop at CVS turned into a 30-minute morning-spoiler, in which I alternately studied labels and scanned scary website reports about how listed ingredients might throw my kids’ hormonal development out of whack.

We all know by now that sunscreen is essential for protecting our kids from skin cancer and future sun damage (after a childhood spent comparing sun blisters with my cousins every July 4th, I count this as major progress). But it remains frustratingly difficult to find straightforward information about what formulations, among the sea of choices at the store, we should be using (or avoiding). In search of some trustworthy advice, I reached out to Albert Yan, M.D., the chief of dermatology at Children’s Hospital of Philadelphia, with whom I’ve worked on articles about kids’ skin problems in the past. Thanks to insights from Dr. Yan and my friend Julie Karen, M.D., a mom as well as a dermatologist at CompleteSkinMD in New York City, I’ve come up with five facts every parent should know before stocking up on sunscreen for summer’s most scorching month.

1. Narrow your choices down to sunscreens with SPF 30 and “broad-spectrum” coverage.
Theoretically, the higher the SPF, the longer you’re protected against sunburn-causing UVB rays; but beyond SPF 30, especially, gains are negligible. “Broad-spectrum” sunscreens are essential for protecting skin not just from sunburn-causing UVB rays, but also dangerous UVA rays. Sunscreens that provide broad spectrum protection will say so on the label (the FDA monitors this), but you can also check for zinc oxide, titanium oxide, Mexoryl SX, or certain chemical combos (such as homosalate or octisalate with avobenzone) in the list of active ingredients. Don’t assume you have to buy ‘kids’ sunscreens: these formulas aren’t necessarily different than others.

2. Mineral-based sunscreen is ideal if your kids tolerate it, but chemical sunscreens are also safe for most.
Because titanium dioxide and zinc oxide work by providing a physical barrier on top of the skin rather than being absorbed into it, sunscreens made from them are great for those with sensitive skin (like babies and children with eczema). But many kids dislike titanium and zinc’s thick feel and the white-ish cast they leave on the skin—and as a result, they or their parents may apply formulations hastily, and resist reapplication. If this tends to be the case, and sensitivity isn’t an issue, Drs. Yan and Karen recommend chemical sunscreens instead. “Above all, I ask families to buy something that their kids will tolerate and be willing to use,” says Dr. Yan.
What about the chemical ingredient oxybenzone, which the recent Environmental Working Group (EWG) report on sunscreens was chiefly concerned about? “When administered at high doses to animals, it has shown to mimic the effects of estrogen, but the doses were extremely high and used over a long period of time,” says Dr. Yan. A recent editorial on the website of the Skin Cancer Foundation reported on a CDC study that found that oxybenzone is already prevalent in our bodies and “has not been associated with adverse health effects,” but did note that researchers called for more studies into the chemical’s effect on human bodies. For parents who are skeptical, Dr. Yan recommends sticking with zinc or titanium or choosing a chemical sunscreen that doesn’t contain oxybenzone. (Our current household favorite is Ocean Potion Protect & Nourish SPF 30, which spreads well, smells great—like lemon layer cake—and contains no oxybenzone.)

3. Sunscreen sprays can be used—with caution.
Sprays have gotten a bad rap lately, mostly over concerns that children might inhale aerosol particles when they’re being applied. The FDA is in the process of investigating the safety of aerosol sprays, but has yet to come out with definitive guidelines on their use. In the meantime, my doc sources say they like sprays for their ease of use and light feel, but with some caveats. Dr. Karen worries about how well they cover the entire body, so usually starts with a good lotion-based sunscreen on her kids, and relies on sprays for easy reapplication. When kids are in and out of water, Dr. Yan prefers the thicker coverage of a lotion or gel, but in other circumstances, gives parents the green light on sprays. To reduce the possibilities of inhalation when using on facial areas, he does suggest that people apply aerosol sprays to their own hands and then rub it on the face, or look into newer, non-aerosol sprays (they look like pump bottles).

4. Reapply more than you think.
When patients’ parents say their kids are burning even though they’re putting on sunscreen, Dr. Yan usually discovers they aren’t reapplying often enough. Diligent reapplication every 2 to 4 hours, especially during water-based activities, is key. And don’t skimp when it’s cloudy. According to the Skin Cancer Foundation, 70-80 percent of the sun’s rays—above all, UVA rays—go through clouds and fog.

5. Don’t rely on just sunscreen for sun safety.
Warwick Morison, M.D., chair of the Skin Cancer Foundation’s photobiology committee, calls sunscreen “just a part of a package of protection.” Hats, rash guards or tightly woven shirts, and frequent breaks from the sun can go a long way toward keeping kids safe and happy during a long day at the beach, park, or pool.

Preparing for the Worst

April 30, 2015 by Kelley 1 Comment

I was organizing my kids’ closets the other day when I got an alert on my phone that April 30—today—is America’s PrepareAthon Day. Spearheaded by FEMA, it encourages communities, families, and individuals to practice what needs to be done in the event of a disaster.

It occurred to me that while I painstakingly organize hand-me-down clothes in basement storage bins every season, I haven’t assembled much of a family emergency kit—or plan—since I (and every other New Yorker) put together a “go bag” in the days after 9/11. That was before having kids. Since then, I’ve had brief, one-off conversations with my older boys about what they should do if there was a fire in the house, and I’ve purchased a fireproof box for some important documents. But if we were suddenly housebound due to a natural disaster, or needed to skip town quickly, we’d be woefully ill-equipped.

If you’re anything like me, it would be worth an hour of your time today or some day soon to sit down with your partner and map out some simple preparedness strategies for your family. Sure, some of the measures recommended by the government may feel a little “fearful.” But think of it like locking your doors in a “safe” neighborhood, or holding your child’s hand near a road even if there are no cars coming. Part of good parenting is anticipating worst-case-scenarios. You may need a more detailed game-plan if you live in a region that’s at high-risk for a particular natural disaster, but these five tips from Ready.gov are a really helpful starting point for everyone.

1. Assemble an emergency supply kit to keep at home and make sure all family members know where it is. More info here…

2. Keep your car ready for an emergency. More info here…

3. Opt in to wireless emergency alerts (WEAs) messages on your phone (look in “settings”). Many people switch off Amber Alerts and inadvertently disable WEA’s, too. More info here…

4. Sit down with family members and make sure you have a plan of where to go and how to connect an emergency. Make sure kids have memorized your cell phone numbers, how to call 911 for help, and where to go if they are alone, can’t call or text anyone, and need help. More info here…

5. Tell family members to “text, not talk” in an emergency. Texts transmit faster and more easily than voice calls, and use less battery power.

For quick reference, print out the cheat sheet below. If you have any other great resources, or tips for talking to your children about how to prepare for the worst (without raising anxiety levels unnecessarily), please share here.

Environmental Health Doctor’s Wish List

January 28, 2015 by Kelley Leave a Comment

This post is part of a “Wish List” series in which I ask experts in different kid-related fields—medicine, education, etc.—what they really want parents to know and do better. Interested in hearing from a certain type of expert? Please make a suggestion here.

For this installment of the expert “Wish List” series, we’re honored to share the wisdom of Jerome Paulson, M.D., a professor of pediatrics at George Washington University School of Medicine and Health Sciences and chair of the executive committee of the Council of Environmental Health for the American Academy of Pediatrics. Here, he tells us the five things he wishes every parent knew or did to help all kids—your own and future generations’ —consume healthier air, water, and food.

1. Consuming a variety of fresh, whole foods is more important than eating organic. We know that produce is full of antioxidants and other nutrients that help protect kids from all sorts of problems. But many people will be surprised to learn there’s actually no documented long-term health benefit of eating organic foods. Eat organic if you want to, but don’t limit your child’s intake of fresh fruits and vegetables, calcium-containing foods, and whole grains if buying organic makes these choices too expensive. If you want to be choosy about organic purchases, look at the Environmental Working Group’s Dirty Dozen and the Clean 15, here. They have an app that will allow for quick reference at the grocery store.

2. Take steps to be more energy conscious. Climate change is one of the major health problems facing the globe. Any parent concerned about the future of their children and the planet should make an effort to use public transportation and carpools whenever possible, buy the most fuel efficient vehicle consistent with safety and their budget they can find; conserve energy at home; and encourage their elected officials to change local, state, and national policy so the U.S. can contribute to climate change mitigation where possible and adapt to climate change where it must.

3. Avoid toiletries and cosmetics that include endocrine disrupting chemicals. Certain chemicals common in household products are thought to possibly interfere with many chemical processes in growing bodies and are known to have adverse health effects in animals. Err on the side of caution and avoid buying soaps, lotions, and makeup for your kids that contain triclosan, phthalates, parabens and certain other ingredients (for a full and helpful list, check out the EWG’s Skin Deep page, here).

4. Keep indoor air free of pollutants. Polluted indoor air is a big asthma risk. Don’t allow people to smoke in your home—ever—and work with your local school district to take steps to keep the school’s indoor air clean by avoiding air fresheners and keeping humidity down to inhibit mold growth. Moms Clean Air Force and the American Lung Association have great tips on their websites.

5. Take your shoes off when you enter the house. You’d be amazed by how much bad stuff is tracked in on the soles of shoes—pesticides and harmful chemicals, just to name a couple. Make a designated spot by the door where everyone in the family can stow their boots and sneakers, and get everyone into the habit of removing their shoes when they come into the house.

Photo credit: Odin Thomas via Photo Pin, cc

Sled Safer: Six Things to Know

January 28, 2015 by Kelley Leave a Comment

Today, while watching my sons hurtle down a bumpy, tree-banked hill on a dinky plastic saucer, the thought occurred to me: Why don’t we take sledding safety more seriously?

I know this is making me sound like the wettest blanket around, but think about it: We make our kids wear helmets while skiing, biking and skating, and make all sorts of rules and parameters when it comes to their participation in these activities. But sledding is usually a free-for-all: no protective gear, loose boundaries, and minimal vigilance on our part.

Turns out, doctors are concerned about sledding safety, too. A 2010 study by researchers at Nationwide Children’s Hospital showed E.R.s see more than 20,000 sledding injuries a year, four percent requiring hospital admission. The most frequent injuries were fractures, and the head was the most commonly injured body part. Snow tubes were associated with the most serious injuries, a fact borne out tragically on Monday, when a teenager in New York died after crashing into a light pole.

I did some digging to find some expert advice on how we might have a safer sledding experience tomorrow, and here’s what I learned:

Don’t sled where it’s overcrowded. Pair up with just one or two friends and find a clear hill to do your runs—or hit a popular spot early or late in the day to avoid collisions. Injuries to the head are twice as likely to occur from collisions as from other mechanisms.

Choose wide-open spaces. Don’t sled where there are lots of trees or a road, parking lot, or body of water at the end of the sledding hill.

Use caution on snow tubes. Traumatic brain injuries were more likely to occur with snow tubes than other sled types, possibly because they reduce the rider’s visibility. (This is news to me: I assumed they were somehow safer, because they were more cushioned.) If you are going to tube—and I know, it’s so fun—do it in a spot where there are few people and no obstacles.

Consider helmets. Kids are so used to wearing them for other activities, why not sledding? Be the first in your ‘hood and set a trend.

Banish belly slides. This will be a hard one to enforce in our house. But experts urge parents to teach their kids to only ride sitting upright, and facing forward, to reduce the chance of crashes and collisions.

Teach kids to keep their eyes open for other sledders at all times. They should watch where they are going on the way down, and to move out of the way and look up immediately when they finish a run.

I know we have some work to do to meet these safety goals; do you?

Photo credit: Yooperann via Photo Pin, cc