Category Archives: Health tips

Serving up strategy at meal time

Kids are born wanting to eat. And they know when they’re hungry. It’s our job as parents to provide structure, support and opportunities.

Kids are born wanting to eat. And they know when they’re hungry. It’s our job as parents to provide structure, support and opportunities.

By Maggie Sonnek

We’ve tried peas. We’ve tried broccoli. We’ve even tried Brussels sprouts. Alas, our 2-year-old continues to ignore that pile of “green stuff” on his plate and reach for the carbs instead (just like his mother).

After chatting with Janie Cooperman, MS, RD, LD, CDE, Pediatric Clinical Dietitian at Children’s Hospitals and Clinics of Minnesota, I now can come to the table feeling a little more prepared to take on a toddler at dinnertime. (Sounds like a thrilling TV show, doesn’t it?). I feel so enthused with what I’ve learned that I just had to share. 

Keep offering

Cooperman suggests offering specific foods 12-15 times before retiring them from the household menu. That’s a lot of peas! She also touts variety when planning the weekly carte du jour. For example, instead of plain bread, try whole wheat tortillas or pita pockets.

Division of responsibility

Kids are born wanting to eat. And they know when they’re hungry. It’s our job as parents to provide structure, support and opportunities.

Cooperman sites Ellyn Satter, an expert on the topic of the division of responsibility in feeding. Basically, this means we the parents are responsible for what, when and where our kids eat. They’re responsible for how much and whether they eat.

Yep. I said “whether.”

Cooperman suggests offering three scheduled meals a day with two or three snacks in between. “Eventually the child begins to understand the schedule and expectations,” she said. “Since he is not receiving food other than at the scheduled meals and snacks, he will soon get hungry enough and realize that he has no other option but to eat what’s being offered.”

Subscribe to MightyMake it a non-issue

You know the old standby, “You can’t leave the table till your plate’s clean”? Well, turns out, forcing a clean plate prevents kids from learning to pick up on their own hungry and satiety cues. Apparently most of us unlearn the natural inclinations of when we’re full and hungry sometime between the ages of 3 and 5.

Cooperman suggests making the amount of food your child eats a non-issue. She dissuades from offering rewards for eating. “If they refuse to eat, let it go,” she said. “But keep offering it at future meals. Try not to let kids get power and control.” (Writer’s note: I’m totally guilty of bribing my son with a chocolate chip cookie for taking a bite of broccoli. Oops.) 

Eat mindfully 

Eating dinner together as a family has a lot of benefits. The Family Dinner Project, a grassroots movement driven by insights and experiences of families, says recent studies find regular family dinners can help lower rates of substance abuse, teen pregnancy and depression. Studies show that dinner conversation can help improve vocabulary more than reading.

But let’s focus on the obvious: eating together. Parents modeling healthy habits, like munching on fruits and veggies, provide a good example for kids. Cooperman touts the importance of eating mindfully.

“Slow down, connect and enjoy what you’re eating,” she said. “Appreciate the food and your time together; it’s a more-balanced way of eating and living.” 

Maggie Sonnek is a writer, blogger, lover-of-outdoors and momma to two young kiddos. When she’s not kissing boo-boos or cutting up someone’s food, she likes to beat her husband at Scrabble.

Break for breakfast: Tips for a healthy start

With the school under way, your child may be in a hurry to get ready in the morning – and that includes trying to fit in time to eat breakfast and pack a lunch.

Since diet plays a huge role in childhood obesity, it’s important to make sure a child is eating right even when you’re not there to supervise or cook. Four out of five kids from 12 to 19 years old have “poor diets” – high in salt and sugar-sweetened beverages and low in fruits, vegetables, fiber and lean protein.

In Minnesota, nearly one out of four kids has weight problems. Among Minnesota adolescents ages 10 to 17, about 11.1 percent are obese.

Subscribe to Mighty“Beginning your day with a healthy breakfast is a good way to wake up your body and brain,” said Julie Boman, MD, a pediatrician at Children’s Hospitals and Clinics of Minnesota.

How do you make sure your child gets a healthy start? Boman weighs in with these four tips:

  1. Stock the cupboards and refrigerator with healthy choices. They can include whole grain cereal, fresh fruit, yogurt and eggs.
  2. Make it convenient. If you buy strawberries, wash and slice them up so they’re ready for your child to grab and go.
  3. Whenever possible, encourage your child to sit down and have breakfast.
  4. If your child is older, plan the menu for the week together.

Trauma: When it’s critical, so is your choice

Why would you take your child to Children’s emergency room over any other hospital? Our team members are on staff, not on call. Your child gets treated immediately.

When it’s critical, so is your choice. Children’s Level I Pediatric Trauma Center, Minneapolis.

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Define safe boundaries for kids and play

Encouraging the learning and exploration process will increase your child’s confidence and creativity, and defining safe boundaries and rules will keep you both happy. (iStock photo / Getty Images)

Encouraging the learning and exploration process will increase your child’s confidence and creativity, and defining safe boundaries and rules will keep you both happy. (iStock photo / Getty Images)

Dex Tuttle

Not long ago, I watched my toddler daughter, Quinnlyn, as she played with her favorite blocks. She picked one up, stacked it carefully on top of another, and repeated until she had a tower four or five blocks high. Without warning, she pummeled the tower while sounding her signature high-pitched battle cry, sending blocks flying in all directions. She immediately seemed to regret not having a tower and ran to pick up the blocks to start the process over.

Young children begin to understand their world by cause-and-effect experimentation. Psychologist Jean Piaget was one of the first to put this concept into organized thought.

This behavior is apparent with my daughter: “If I stick my hand in the dog’s water dish, my shirt gets wet. This pleases me and I must do this each morning, preferably after mommy helps me put on a clean shirt.”

Then, something occurred to me as I watched Quinnlyn build and destroy her tower; there is a trigger missing in her young mind that could change her behavior: She does not understand consequence, the indirect product of an effect.

I began to notice this in her other activities as well. At dinnertime, we give her a plastic fork and spoon so she can work on her motor skills. If she’s unhappy with how dinner is going, she throws her fork and spoon on the floor in a fit of toddler rage. She is then immediately puzzled by how she’ll continue her meal now that her utensils are so far away.

subscribe_blogAs frustrating as toddler tantrums can sometimes be for parents, I’d love to be in my daughter’s shoes. Who wouldn’t want the satisfaction of taking all those dirty dishes that have been in the sink for two days and chucking them against the wall? That decision, of course, would be dangerous and reckless and I have no desire to clean up such a mess. And, with no dishes in the house, I’d be forced to take a toddler to the store to shop for breakable things; not a winning combination.

There’s an important lesson here for safety-minded parents: Kids will explore their environment in whatever way they can. It’s like the feeling you get when you find a $20 bill in the pocket of a pair of pants you haven’t worn in months, or when you discover the newest tool, gadget or fashion. For toddlers (and us adults), it’s fun finding new things and learning new skills; it’s motivating and creates a feeling of accomplishment. However, the cognitive skills of a toddler haven’t developed beyond that cause-effect understanding.

This is why we need to consider the environment in which our young children play. I recommend giving them plenty of space and opportunity to experiment without worry of the consequence:

  • Make sure stairs are blocked off securely and unsafe climbing hazards are eliminated; encourage kids to explore the space you define.
  • Create a space to explore free of choking hazards, potential poisons and breakable or valuable items; leave plenty of new objects for children to discover, and change the objects out when the kids seem to grow tired of them.
  • Allow children to fail at certain tasks; be encouraging and positive without intervening as they try again.
  • If possible, discuss their actions and consequences with them to help them understand the reason for your rules.

Encouraging the learning and exploration process will increase your child’s confidence and creativity, and defining safe boundaries and rules will keep you both happy.

At Children’s Hospitals and Clinics of Minnesota, we care for more pediatric emergency and trauma patients than any other health care system in our region, seeing about 90,000 kids each year between our St. Paul and Minneapolis hospitals. Children’s Hospital in Minneapolis is the area’s only Level I pediatric trauma center in a hospital dedicated to only kids, which means we offer the highest level of care to critically injured kids. When it’s critical, so is your choice – Children’s Level I Pediatric Trauma Center, Minneapolis.

Dex Tuttle is the injury prevention program coordinator at Children’s Hospitals and Clinics of Minnesota and the father of a curious and mobile toddler. He has a Master of Education degree from Penn State University.

Don’t forget kids in cars

Cracking a window does little to reduce the heat inside a car. Never leave your child unattended in the car. (iStock photo / Getty Images)

Cracking a window does little to reduce the heat inside a car. Never leave your child unattended in the car. (iStock photo / Getty Images)

Dex Tuttle

I’ve often surprised myself by how forgetful I am as a parent. It’s possible I’m the only dad who has nearly forgotten that his daughter needs to eat and, more specifically, that he’s responsible for making sure that happens. I know for a FACT, however, that I’m not the only dad who has forgotten the diaper bag in the car and been forced to speed-run the grocery shopping to get a stinky child out of the store as fast as possible. On tired days after sleepless nights, I’ve forgotten that my keys are in the ignition of the car I’m driving and seriously debated being late for work to turn around and go get them.

I’m exposing a vulnerable part of myself a little when I admit this type of fault, but I know I’m not alone. As the injury prevention program coordinator at Children’s, I feel even more responsible to be mistake-free in providing a safe environment for my child, and I feel that much more silly when I fail to do so.

subscribe_blogWhen Quinnlyn was learning to walk, she pulled herself up on me as I sat in my “dad chair” in the living room. (I’ll admit, realizing that the recliner was a crucial part of fatherhood was a huge part of my excitement for becoming a dad, but I digress.) She grabbed my hands and smiled at her accomplishment. After a few happy moments, she started to turn and walk away, and I forgot that she wasn’t yet able to stand on her own. I let go of her hands and down she went, flat on her back. Thankfully, she was OK. She actually laughed it off (her reaction to near-injury that would soon give me anxiety) and got herself back up.

So far, my follies have been rather benign. Still, I live in eternal fear of finding myself in that vulnerable, forgetful moment when something more serious happens.

As the summer ramps into full swing, one such mistake I’m determined NOT to make is forgetting Quinn in the car. This can happen for one of two reasons: we don’t realize the danger, or we find ourselves in a moment of distraction and leave out one very important detail.

Let me first convince you that this is extraordinarily dangerous:

  • Children have lower water reserves, so their body temperatures rise three to four times faster than an adult.
  • The temperature inside a car can rise 50-60 degrees Fahrenheit every 15 minutes (on a 70-degree day, the temperature inside a car can reach 116 degrees).
  • Since 1998, more than 580 children in the United States have died from being left in vehicles.
  • In car seats, children are insulated, making it more difficult for their bodies to regulate overheating.
  • Signs of hyperthermia set in when body temperature reaches just 100.9 degrees Fahrenheit, which children will surpass in only a matter of minutes; internal organs can begin to fail at 104 degrees, and death can occur when body temp reaches 107.
  • Cracking a window does little to reduce the heat inside a car.

On most days, strapping my daughter into her car seat easily could be the final challenge on a reality game show that tests strength, patience and fortitude. Therefore, I’m admittedly hesitant to take her in and out of the car more than I need. However, you never know what will happen; on an average day, there are so many things that are out of your control and could delay a quick stop or create catastrophic failure of your car’s air conditioning. Please take control of what you can and never, ever leave your child unattended in the car.

But as I’ve already admitted, I’m forgetful. Here are some tips on making sure you don’t forget your most-precious package:

  • Place an important item in the backseat. My recommendation is to leave your phone there – thus removing a major distraction while driving – but it can be a purse, wallet, computer, jacket or any other item you know you’ll need when you arrive at your destination.
  • If you don’t carry items often and you drive a car with an automatic transmission, take the shoe off the foot you don’t use for the pedals and put it in the back seat. This can be a fun game where everyone in the family participates.
  • Leave yourself a note on the dashboard: “BABY IN BACK!”
  • Put a stuffed animal or doll in the car seat when your child isn’t in it. When you strap your kid in for a trip, put the stuffed animal in the seat next to you up front – a reminder that something is out of place.
  • If you have a GPS-enabled device, set location reminders when arriving at your favorite locations – the grocery store, work, restaurants, etc. Kars 4 Kids is developing an app that works with your car’s Bluetooth capabilities to remind you as you walk away from the vehicle.

Make arrival habits:

  • Always do a walk-around of your vehicle to ensure you’re a safe distance from other hazards and make note of items that will help you remember where you parked.
  • Always use the passenger-side doors to load and unload for trips. This will force you to walk around the car to collect your items.
  • Make a game with your child where you always sing a song, say a phrase, do an activity each time you stop at a destination. Even if your child is sleeping, the habit will keep your mind thinking about the little person in the backseat.

Other resources:

Dex Tuttle is the injury prevention program coordinator at Children’s Hospitals and Clinics of Minnesota.

Minnesota spring means ticks, health risks

Deer ticks are tiny – about the size of a pencil tip – and brown-black in color. Wood ticks are larger and do not carry Lyme disease.

Erin Fritz, RN, CNP

The snow has now melted and the temperatures are rising, allowing our energy and activities to bring us outdoors. Spring weather brings sprouting trees, blooming flowers – and creepy crawly ticks that lurk in the woods, grass and marshy areas.

Whether you are heading up north to the cabin or playing in your backyard, ticks may be present and a tick bite may occur. Due to the extreme seasonal temperature changes and high humidity, Minnesota has a lot of ticks and high rates of tick-borne illness such as Lyme disease, and the risk remains high. Lyme disease is an infection caused by bacteria that is carried by some deer ticks. Deer ticks are tiny – about the size of a pencil tip – and brown-black in color. Wood ticks are larger and do not carry Lyme disease.

Prevention

Playing outdoors increases the risk of encountering a tick, but there are ways to prevent a tick from attaching and biting. The American Academy of Pediatrics recommends the following for tick and Lyme disease prevention:

  • Cover arms and legs by wearing long-sleeved shirts and pants tucked into socks
  • Wear a hat to cover hair
  • Wear light-colored clothing in order to see ticks more clearly
  • Wear enclosed shoes, use insect repellent with DEET
  • Stay on cleared trails whenever possible
  • Routinely check for ticks immediately after coming indoors

When you find a tick

Most ticks are noticed when crawling around on clothing or skin and easily can be removed by taking it off before it attaches to the body. If a tick already has attached, removal is rather easy and should be removed as soon as possible. While prompt removal is important to decrease the risk of developing Lyme disease, be aware that most medical experts agree that the tick must be attached for at least 24-36 hours before Lyme disease is transmitted.

In order to remove the tick:

  • Simply grasp the tick with a tweezers as close to the skin as possible
  • Without squeezing the tick’s body, slowly pull the tick away from the skin
  • Clean the bitten area with soap and water
  • Apply an antiseptic ointment

Be on the lookout

After tick removal, it’s important to monitor the site for expanding redness that might suggest a “bull’s eye” rash. This particular rash can be the first and most obvious sign of Lyme disease.  The rash usually doesn’t cause other symptoms, but burning or itching is a possibility. Further examination by a health care professional is needed if there is a bull’s eye rash, headaches, chills, fever, fatigue or muscle aches. If Lyme disease is suspected, a health care professional probably will prescribe an oral antibiotic for treatment. There’s no benefit in testing for Lyme disease at the time of the tick bite; even people that become infected will not have a positive blood test until approximately two to six weeks after the infection post-tick bite. Early identification and treatment is important to reduce the risk of worsening illness.

While ticks and tick-borne illness easily can be overlooked, prevention is vital. This is the time of year to take full advantage of the long-awaited summer. Get outside and play safely.

Erin Fritz is a certified nurse practitioner at Children’s Hospitals and Clinics of Minnesota.

Stress test: Helping kids lessen testing anxiety

To combat testing anxiety, students should have some go-to solutions such as engaging in a brief relaxing activity, outlining notes or playing a memory game. (iStock photo / Getty Images)

Guest post by Maggie Sonnek

Mae Hyser is one smart cookie. At 12 years old, she already has her career planned out: become a writer and an illustrator. And mom Beth couldn’t be prouder.

“She’s kind of a Type-A personality,” Beth Hyser laughs. But, as end-of-the-year finals and projects approach, sixth-grader Mae is aware of the extra pressure. And so is her mom.

Are your kids stressed over tests? Here are some tips to help kids like Mae – and their parents – decrease stress and improve results.

Set up good study habits at an early age

It sounds obvious, right? Michelle Goldwin, MA, doctoral psychology intern at Children’s, says developing effective study habits earlier is a way for kids to feel more confident about their abilities to study and take tests.

“We’re noticing kids are becoming nervous about tests earlier and earlier,” she explains. “There are more standardized tests sooner; kids are learning that they have to do well in order to get good grades…to get into a good college…to get a good job.”

To combat that anxiety, students should have some go-to solutions at the ready, such as engaging in a brief relaxing activity, outlining notes or playing a memory game.

Create a positive bedtime routine

Bedtime can be the hardest time of the day for parents. But, it doesn’t have to be. Mary Sheedy Kurcinka, MA, writes about practical strategies for getting a good night’s sleep in her book, Sleepless in America.

“Researchers have discovered that the sleep/wake cycle, or what researchers like to call the circadian rhythm, runs on a cycle closer to 25 hours than 24,” she writes. “In order to bring your child’s cycle into line with a 24 hour day, you have to set it with cues, like light and a regular sleep-and-wake schedule.”

Create a calming end-of-day routine, whether it’s quiet music, dim lighting or a scented candle.

Here are more ways to help your kids get a good night’s sleep.

Take breaks and use incentives

Even at the college level, students are still encouraged to take breaks. MIT supports several scheduled breaks throughout the day, saying, “Our minds need an occasional rest in order to stay alert and productive, and you can look forward to a reward as you study.”

For 12-year-old Mae that reward is a few coveted minutes on the iPad, which mom will gladly hand over after she practices her spelling words.

Value your child’s self-worth

Both Goldwin and Beth Hyser expound on the importance of valuing kids beyond the report card.

Goldwin says, “Parents can remind their kids, ‘I like that you’re working hard on this and giving it your all.’ But, be sure to remind them that they’re also a great artist or bowler. There are lots of special things about each child.”

Beth Hyser agrees. “If a C is your best, then that’s great.”

Change the way you think

Goldwin and the rest of the team in Psychological Services at Children’s utilize Cognitive Behavioral Therapy as a way to help patients with anxiety.

“We encourage students to pay attention to their negative thoughts, like ‘I’m not going to do well on this test’ and replace them with more helpful thoughts, like ‘I’ve studied and I feel confident that I know this material.’ ”

Practice self-care

This means eating a hearty breakfast the morning of a test, staying away from caffeinated beverages and paying attention to breathing.

“Before the day of the test, I encourage kids to practice deep breathing by placing a hand on their bellies,” Goldwin says. “Then, slowly breathe out and notice that their belly deflates.” She adds that sometimes she draws the analogy of the stomach being like a balloon that’s filling with air and then emptying.

Lessening testing anxiety may not always be easy for kids, but these strategies can get them started on the path to a less stressful testing season.

In what ways do you work with your kids to lessen anxiety before tests or other stressful times? Share in the comments.

More information: Psychological Services at Children’s

Maggie Sonnek is a writer, blogger, lover-of-outdoors and momma to two young kiddos. When she’s not kissing boo-boos or cutting up someone’s food, she likes to beat her husband at Scrabble.

Sleep health in children

Teaching kids to fall asleep on their own at the beginning of the night without your presence is an important skill for them to learn. (iStock photo / Getty Images)

By Karen Johnson, RN, CNP

Getting enough sleep is essential for your child’s growth and health. Studies show that many children don’t get enough sleep each night. This can result in behavioral problems, mood swings and poor school performance. A lack of sleep also can cause problems with memory, concentration and problem solving.

Occasional bouts of sleeplessness or restless nights are normal for kids as their bodies and brains develop, and the tips below can help you ensure your kids are getting enough rest.

But sometimes your child may not be getting enough sleep due to a sleep disorder. One of the most common sleep disorders in children is Obstructive Sleep Apnea (OSA). Signs of OSA in children are loud snoring, restless sleep, gasping and hyperactivity when awake. Risk factors for having OSA in children are having enlarged tonsils or adenoids, being overweight or certain other genetic or health disorders. Speak with your child’s health care provider if you think that your child might have OSA.

Here are some tips for helping your kids get a good night’s sleep:

Create a soothing and regular routine for sleep: A routine can help your child get ready for bed much easier. Studies show that children who have a bedtime routine wake up fewer times during the night. The bedtime routine should be the same every night, such as reading one book and singing one song, not lasting more than 15 to 20 minutes.

Maintain a consistent bedtime and wake time: Keeping the wake time and bedtime the same, even on weekends and vacations, is important to help maintain circadian rhythm.

Be conscious of light and darkness: Both are very influential in sleep-wake cycles. Bright light in the morning is influential in setting the circadian rhythm and helping children wake easier. Opening the curtains in the morning to let in the sunlight is the most powerful source of light; artificial light can be helpful as well. Dim the lights in the evening prior to the bedtime routine to cue your child’s internal clock that it’s time for sleep.

Keep electronics out of the bedroom: The light from televisions, computer screens, video games and mobile devices like cellphones can prevent your child from sleeping. It’s best to turn off all electronics at least one hour before bedtime, and in their place, do a calming activity such as reading or coloring.

Naps are important: Younger children need regular and predictable naps during the day. When your child is napping only once a day, don’t let him or her nap late into the afternoon, as this will interfere with the child’s ability to fall asleep at the regular bedtime.

Teach your child how to self-soothe: At an early age, put your child into his or her crib or bed when he or she is drowsy but still awake. Teaching kids to fall asleep on their own at the beginning of the night without your presence is an important skill for them to learn. Children naturally wake two to six times a night, and if they do not know how to self-soothe, they will cry to alert you that they are awake. Not only does that disrupt their sleep, but yours as well.

No caffeine allowed: Caffeine is not recommended for kids, but if you allow your child any, make sure it is before 3 p.m., as it can delay the onset of sleep at bedtime.

Consistency is key to success: Be patient and persistent, as the investment is well worth it when your child is sleeping better.

Make sleep a priority for your child and family: Teach your child about the importance of sleep by being a good role model in your own sleep habits.

Karen Johnson, RN, PNP, is a nurse in the Children’s Sleep Center at Children’s Hospitals and Clinics of Minnesota. Her interest in pediatric sleep medicine stems from her passion to assist children in improving their sleep. She views sleep as a necessary function so that children can be alert, focus in school, reach their learning potential and have energy to play and be kids.

The Children’s Sleep Center is one of the only pediatric-centered programs in the region and one of only a handful that is nationally accredited by the American Academy of Sleep Medicine.

Signs and symptoms of a concussion

(iStock photo / Getty Images)

March is Brain Injury Awareness Month. As part of that, we’re sharing some concussion safety tips.

What is a concussion?

A concussion is a type of traumatic brain injury caused by a blow to the head or body. Symptoms can show up right after the injury or may not be noticed until hours or days later.

Signs and symptoms to watch for:

  • Headache or dizziness
  • Drowsiness or sleepiness
  • Focus or concentration problems
  • Blurry or double vision
  • Balance or coordination problems
  • Disorientation or mental confusion
  • Memory loss
  • Slowed thinking or speech
  • Blank or vacant look
  • Loss of consciousness
What to do if your child displays concussion symptoms:
  • Immediately remove your child from activity
  • Seek medical attention
  • Tell your child’s coach or teacher
Children’s Concussion Clinic

651-220-5230
8 a.m. to 4:30 p.m. Monday-Friday

Children’s Specialty Center (ground floor)
2530 Chicago Ave. S.
Minneapolis, MN 55404

Garden View (third floor)
347 N. Smith Ave., Suite 300
St. Paul, MN 55102

Influenza is now widespread in Minnesota. Here’s what you need to know.

By Patsy Stinchfield, MS, CPNP

Patsy is a pediatric nurse practitioner in infectious disease and the director of infection prevention and The Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota.

Update

Influenza is now “widespread” in 35 states, including Minnesota.

There is still time to get vaccinated if you and your family have not yet done so.

To learn more about how Children’s is helping prevent the spread of influenza in the community, click on over to www.childrensMN.org/flu.

This post originally appeared on the Mighty Blog on Jan. 2.

As of Jan. 2, 2014, the Minnesota Department of Health has declared influenza “widespread” across the state, the highest designation level. Over the past two weeks, influenza cases at Children’s have more than doubled, however they still remain below where they were at this time last year. Now that influenza has arrived, it’s likely that it will remain in full swing in Minnesota for the next two months.

So what can you do? The No. 1 way to prevent the flu is to get vaccinated. And it’s not too late. Anyone 6 months of age and older who has not received their flu vaccine should do so now. Most clinics and pharmacies are still vaccinating and have a good supply of vaccine. The most common influenza strain we’re seeing is the H1N1 strain which is contained in this year’s vaccine. In addition to getting the vaccine, we also recommend frequent hand washing and avoiding touching your eyes, nose or mouth prior to washing your hands to help prevent the spread of illness.

If the flu has already reached your house, here are few helpful tips for caring for your child while they’re ill.

What’s the difference between the cold and the flu and how can I tell?

Sometimes it’s hard to know whether a child has a cold or the flu because she may cough, have a runny nose, sore throat and fatigue with both. However with the flu, a child tends to have a high fever which comes on more suddenly and may include severe fatigue and body aches. Colds tend to come on more gradually, and many kids may feel well enough to keep playing and going to school with a cold. Clinics may use a rapid nose swab test to determine if someone has influenza.

What should I do if I suspect influenza?

Most cases of influenza are mild and can be managed at home with rest, plenty of fluids, and fever-reducing medicines. Tender-loving care is good medicine, too. Most over-the-counter “cough and cold” medicines do not help a sick child get better faster and won’t have much effect on influenza. Sometimes, the flu can make a child very ill and a visit to the clinic or emergency room is necessary.

When should I take my child to the emergency department?

Take your child to be checked if they have difficulty breathing (fast, grunt-sounding, noisy breathing or small breaths), if their color looks bad (pale or bluish), if they aren’t drinking fluids often or urinating at least once every eight hours, or if they just aren’t themselves and you’re worried. Signs of dehydration are dry lips, sunken eyes, sleepiness or crankiness. Children who seem like they’re getting better and then suddenly get worse should be taken to the Emergency Department immediately. This could mean they have another infection such as pneumonia in addition to the flu.

What are the best ways to get my child’s fever down when she has the flu?

Fever is one of the tools our immune system uses to kill germs. However, children with high fever can feel quite miserable, get crabby, have trouble waking up and may drink less fluids causing dehydration. If you can’t keep the fever down with a fever-reducing medicine such as Tylenol or ibuprofen, then the child should be taken to the clinic or emergency department.

Is there anything else I can do to help make my child more comfortable?

You can keep your child home from day care, school, sports or other activities and have them rest early in their illness until they show signs of getting back to “their normal.” If your child doesn’t want to eat regular meals, don’t insist, but do make sure they drink small amounts of fluids every hour to prevent dehydration.

Is there anything I can do to help my child recover more quickly?

There is an anti-viral medicine called Tamiflu that can be given to children as young as 2 weeks of age. This is used if the child is hospitalized with moderate or severe influenza or if the child is outpatient but at higher risk for complications from influenza. These would be children with immune system problems or neurological, pulmonary, or metabolic underlying conditions. Tamiflu works best if given in the first two days of illness which can cut the severity and number of days of illness in half.

How long will my child be contagious?

Influenza is most contagious the day before symptoms present through about day four of illness. Your child should stay home from school during this time. After viral illnesses, kids can have lingering muscle or body aches and really do need time to rest and recover before rushing back to school. They can often pick up other viruses easily and may have a lingering cough as their airway heals. Depending on the severity of the flu, this may be a few days to a few weeks. Most kids recover within a week. Remember that many schools require that your child be fever-free (without the help of medicines) for one to two days before returning to school or day care.