Quick Tips To Avoid Health Issues Associated With Winter

Written by Richard Lander, MD

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Winter is here and as the song says, “baby it’s cold outside”. Here are a few quick tips to avoid some health issues commonly associated with winter.

First of all, make sure your children are dressed appropriately for the cold weather. That doesn’t just mean a warm coat or layering of clothes.

Since heat is lost from the top of our heads, have your child put on a hat on their head. Also, put a scarf or face mask and be sure to protect hands and fingers from getting wet and/or cold.

Gloves help protect the skin on  hands which tends to get dry.

When skin becomes too dry, your child’s hands may become cracked making the skin more susceptible to infection.

Be aware of frostbite. This is caused when the skin has become so cold that the circulation to the fingers is compromised.

The skin becomes pale or grayish in color and may blister. Next your child may lose feeling in her fingers. If your are worried that this has happened, place your child’s hands in warm water, about 104 degrees, which is average bath water.

Then carefully pat them dry and place them on dry warm cloths. If this happens to their nose, use warm, wet compresses initially,  but be careful not to rub and then use warm dry compresses.

Often playing outside in the cold weather leaves your child’s clothes wet. Take off the wet clothes as soon as they return inside, put on warm, dry clothes and drink warm liquids, such as soup, hot chocolate.

If you and your children are spending extended periods of time outside, remember to keep yourself hydrated; drink lots of fluids.

There are many outdoor activities to enjoy during the winter months, such as skiing, ice skating and sledding.

Make sure your equipment (skis, snowboards, blades on the ice skates or the runner of the sled) are in good condition and that your children have not outgrown them.

If they are taller this year you might need longer ski poles. Perhaps their feet have grown since last year and their ski boots or ice skates are too small.

Does their helmet still fit properly?

If the children are going to use a sled, make sure the the steering works and tell them to go down feet first, not head first.

Parents, when sending your children to the bus stop remember that it is dark and cold outside. Remind your children to stay on the sidewalk and look both ways before crossing the street.

A brightly colored scarf, hat or gloves is a great way to ensure that they are visible in the dark.

Winter is a fun time of the year. Be safe and be smart.

Dr. Lander has been practicing pediatrics for 32 years in New Jersey and is the immediate past chairman of the American Academy of Pediatrics Section on Administration and Practice Management.  He says if he had to do it all over again he wouldn’t hesitate to be a pediatrician

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Will Having a Baby Stand Make Them Bow Legged?

Written by Kristen Stuppy MD. Dr. Stuppy is a practicing pediatrician in Kansas. She feels privileged to be able to help families keep their children healthy and she loves watching entire families grow!  Dr Stuppy is active on Facebook and puts a more personal touch to pediatric topics on her blog.

I am surprised how often I am asked if having a baby “stand” on a parent’s lap will make them bow legged or otherwise hurt them.

Old Wives Tales are ingrained in our societies and because they are shared by people we trust, they are often never questioned.

Allowing babies to stand causing problems is one of those tales. If an adult holds a baby under the arms and supports the trunk to allow the baby to bear weight on his legs it will not harm the baby.

Many babies love this position and will bounce on your leg. It allows them to be upright and see the room around them. Supported standing can help build strong trunk muscles.

Other fun activities that build strong muscles in infants:

Tummy time: Place baby on his tummy on a flat surface that is not too soft. Never leave baby here alone, but use this as a play time. Move brightly colored or noisy objects in front of baby’s head to encourage baby to look up at it. Older siblings love to lay on the floor and play with baby this way!

Lifting gently: When baby is able to grasp your fingers with both hands from a laying position, gently lift baby’s head and back off the surface. Baby will get stronger neck muscles by lifting his head. Be careful to not make sudden jerks and to not allow baby to fall back too fast.

Kicking: Place baby on his back with things to kick near his feet. Things that make a noise or light up when kicked make kicking fun! You can also give gentle resistance to baby’s kicks with your hand to build leg muscles.

Sitting: Allow baby to sit on your lap or the floor with less and less support from you. An easy safe position is with the parent on the floor with legs in a “V” and baby at the bottom of the “V”. When fairly stable you can put pillows behind baby and supervise independent sitting.

Chest to chest: From day one babies held upright against a parent’s chest will start to lift their heads briefly. The more this is done, the stronger the neck muscles get. This is a great cuddle activity too!

What were your favorite activities to help baby grow and develop strong muscles?

Parents, Are You An Active Participant When It Comes to Video Games And Your Children?

Post written by Dr. Natasha Burgert. Dr. Burgert is a pediatrician. She works at Pediatrics Associates in Kansas City, MO .  She is a distance runner and enjoys road races around the city. She also has a passion for travel that will certainly lead to many memorable family vacations with her husband and two children. And, of course, she bleeds Husker red. Dr. Burgert regularly blogs at kckidsdoc.com

GamingI am a child of the Nintendo generation. I remember spending hours with that grey box, blowing on the game cartridge base to keep the game from being glitchy.

Personal gaming was fascinating, innovative, and exciting.  Our whole family loved it.  In fact, my brother spent so much time playing Super Mario Bros., he actually gave himself blisters on both thumbs.

Playing video games remains a hobby in our current home.  My husband and I own a gaming system, and a new video game is on my Christmas list this year.

My preschooler loves to play on the iPhone and iPad.  I am in no position to be doom and gloom for gamers.  I do, however, have parental control over our system, create limits for all members of our family, and engage cautiously.

There have been lots of studies about gaming and its effects.  What I find interesting is all the positive things about gaming.  Manipulating interactive media is going to be a critical skill for our kids to learn, and gaming is a fun way to practice.

Gaming is a wonderful social activity, allowing kids to engage in a form of fantasy play.  Developing relationships with peers of similar interest enhances self-esteem.

Studies have even suggested that individuals who are more inclined in gaming will be better surgeons due to improved hand eye coordination.

Games are being developed to help kids with medical conditions communicate and learn.  New Nintendo Wii games and XBox Kinect  are great examples of using gaming systems, or “exergaming,” for possibly productive weight loss.  And, games are fun!

So, why all the negative press about video games?

As game developers and creators know very well, games are additive.  Pediatricians are really concerned about the increasing numbers of overweight kids we are seeing in our clinics.

We know sedentary kids are at increased risk of developing obesity, and gaming is a sedentary activity. Excessive gaming may be associated with ADHD.  Certain types of games, such as first-person shooter games, have been associated with aggressive behavior and desensitization to violence.

Exposure to gaming may be associated with an increased risk of dangerous behaviors.

If your child wants a video games for the Holidays, here are some suggestions of how you can keep gaming a fun and safe activity in your home.

The AAP recommends no media (TV, computing, gaming) until after the age of 2

.Concerning studies have suggested that some families are allowing earlier media exposure.

I agree with the AAP that the formative years of development don’t need to be complicated with digital enhancement.

Learning to engage in independent play is such a critical, early skill that must be learned.  Developing this self-entertaining skill not possible if the majority of play is a passive activity consisting of watching pictures on the screen, regardless of the “educational content” of the program or game.

Early video systems do not help kids “learn” despite the marketing claims.

After the age of 2, what is appropriate for your family? 

There are many early gaming systems available including LeapFrog gaming systems, Nintendo DS, Sony PSP, computer and smartphone games.  These systems are getting increasingly advanced.

Browse the web to see the pros and cons of each gaming system.  In addition, see how much online support you are easily finding for each system. Included in many early gaming systems is an online partnership for additional activities.

For example, LeapFrog has coordinating non-gaming activities to do with your kids available on their website.

For more advanced systems, review the capabilities to determine what options you want available (web browsing, online gaming networks, exergaming, movie streaming, DVD/blu ray, music/photo storage, wifi capability.)

All major gaming companies have extensive websites to review.

When considering games to purchase, know what the game is about. 

Game content can be implied from advertisements about the game.  Most of the game ads can be easily found online, check youtube.com or gaming blogs.  Do you think the content is appropriate for the members of your family?

Does the game have any components that may not coincide with your family values?  After purchasing a game, as soon as the game is opened, be ready to watch your child play the game. If you find some unexpected game situations you are not comfortable with, engage in conversationwith your child about those feelings.

Mind the game ratings, know what they mean. 

Every game is assigned a rating based on content.  Be sure that these ratings seem appropriate for the intended player.

A pre-teen/teen mind is physically unable to receive and process information like an adult.  Even though you think he is “old enough” to play a game like COD Black Ops, he or she may not be processing that input with appropriate filters.

In my opinion, “mature” or M-rated games are not appropriate for kids until late high school, if appropriate at all.

Consider what expectations you have for your family. 

What must be accomplished before play is allowed… homework? chores?  Explain to your kids that the gaming unit isyour property and may be removed from the home at any time.

If your child is unable to engage in other activities without the constant desire to get back home to game, recognize the red flag that is waving.  If you think your child is spending too much time, or too much engagement with the screen, create and enforce new boundaries.

Games are great for passing some time, but gaming should never be a replacement for interacting with your environment. I am surprised how often I am unable to have a conversation with a patient during a visit because they are allowed to stare at a personal gaming unit.

In our family, games are down when kids have the opportunity to improve and explore their social interactions with peers and adults.  That means we, as parents, need to be a model of this respectful behavior for our kids.

Set limits. 

The AAP recommends no more than 2 hours of screen time per day for our kids.  This includes all screens (TV, gaming, movies, internet, smartphones.)

I would argue that with all the media to which kids are currently exposed, limiting gaming to one hour per day is appropriate.

Gaming systems can provide very powerful motivation. Longer amounts of time can then be more effectively used as “special occasion” gaming or as a reward for responsible behavior.

Consider allowing play for the equal number of minutes engaged in active play (gym class, karate class, sports practice.) There are great tools to limit playtime, such as the BOB and the Time Machine.

Consider using these tools early in your child’s gaming experience.  Enforcing limits after your child is already overly involved in gaming is much more difficult.

If engaging in online play, be cautious. 

This is the area of gaming that starts to make me nervous for early gamers.  I am amazed how many families allow their young child to play online without supervision.

Some parents don’t even know their kids are even playing online! I get concerned when parents are not fully aware of the capabilities of the gaming unit in their home.

Online gaming is unregulated, the language can be vulgar and repulsive.  Online gaming is certainly part one part of the gaming experience kids love, and that parents need to be most aware.

One problem…where do most families have their system? In the basement!

Consider only allowing online play in a common area of the home.  Be present by frequently walking through the gaming area.

Headsets off for online play, you should be periodically listening to the conversations.

Know your network downloading capabilities, including pay upgrades, movies, and game update downloads.  Unregulated participation can end up with a pocketbook surprise.

Control your gaming unit. 

If you are allowing online play in your home, review the parental controls for your system. For example, XBox Live has an online family timer and security controls.

PS3 has an online “Playstation Knowledge  Center” to learn about unit settings.   Be aware that although you may have your privacy and security settings up to date, the person with whom your child has engaged play may not have similar values.

With very little effort, information on how to hack games, bypassing parental settings, is available through Google.  Bottom line… if you allow online gaming in your home, be aware.

That being said, keeping lines of communication open about gaming and the games your child likes to play is important.  You can only control what happens in your own home.  Exposure to gaming and an online community may happen when your child visits other homes.

Have fun shopping for these games. Watch their faces light up, then be an active participant.  If you need additional help, here is some information on choosing good video games.  There is also a book available about all things media which may give some good ideas.  Happy Holiday season, and happy gaming!!

P.S.  I do not have any vested interest nor endorse any products mentioned in this post.

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The Call For “Meaningful Action” After Newtown

Written By Jennifer Shaer MD, FAAP, FABM, IBCLC

Nobody would argue that there should be meaningful action after such a massacre. However, I would argue that the focus on gun control as that meaningful action is misguided.

Someone disturbed enough to walk into an elementary school and start shooting is going to find a way to inflict tragedy in one way or another. There will always be access to guns or bombs or whatever the device of destruction for those motivated to find them.

I am not saying that there should not be a meaningful discussion about gun control but the crux of the issue here is prevention.

You stop a tragedy like this by recognizing signs and intervening in the potential shooter before he becomes a shooter. What possesses a twenty year old young adult to walk into an elementary school and start shooting? An act like this does not come out of nowhere.

In the field of pediatrics, we are experts in prevention. We use vaccines to prevent life threatening illness. We support things like breastfeeding, exercise and helmets to promote wellness and safety.

However, when it comes to supporting mental health, we ourselves are ill prepared. In our busy pediatric offices we do not have the time or the advanced training to help our patients who need mental health support.

When we look to refer them to psychiatrists, psychologists or social workers all too often the patient cannot find one who takes their insurance.

Gun control or not, tragic incidents like this murder of so many innocents will not stop unless we figure out how to provide affordable and accessible mental health wellness to our children and young adults.

That is the meaningful action that needs to take place in the wake of this tragedy.

Dr. Shaer is a pediatrician and a board certified lactation consultant (IBCLC). She is director of the Breastfeeding Medicine Center of Allied Pediatrics of New York.