Category Archives: Parenting

Ensuring kids get enough exercise in every season

By Samara Postuma

We all know that kids need exercise, but how much exercise should kids be getting and how do we ensure they are getting enough when those too cold (or too hot) to play outside days come around? Dr. Julie Boman, a pediatrician here at Children’s, has some tips and ideas to share on making sure kids are getting the full 60 minutes a day of the exercise they need.

It’s important to note that while all kids need 60 minutes of exercise, the way that looks for your preschooler and the way that looks for your middle-schooler might be different.

“Younger kids need frequent bursts of activity versus an hour of activity straight, where an older child can get their exercise by being active for an hour,” said Dr. Boman.

So what about those days – those miserably, cold days – where it’s deemed unsafe for kids to play outside? Or, as we dream of warmer days, those hot, summer days where the heat index is so high, it’s dangerously hot for kids to be outside?

Well, according to Dr. Boman, it’s time to get creative.

Some of the more obvious options to get your kids active would be indoor parks, community centers, YMCAs, parks and recreation centers. Most of which will offer special extended hours on the days that outside play might be limited.

“Younger kids just need a space to run,” Dr. Boman mentioned, noting that this is when an unfinished basement can come in handy.

You don’t have to get too crazy to get kids active though – games like hide and seek, building forts and even cleaning the house can get kids active and exercising.

The only time you’ll hear Dr. Boman suggest video games is when it comes to moving your body versus your thumbs and there are plenty of games out there that do just that.

“Dancing games on the Wii are a good workout even for adults,” she said.

Another more creative way to get kids active is by looking for active apps or videos such as the IronKids App which was developed by the American Academy of Pediatrics and is available for iPhone or iPad for $3.99. The app has several different workouts for both cardio and core and kids can follow the app for five minute bursts of circuit training and weight lifting using household items.

Don’t have a smart phone or tablet? No problem. A simple YouTube search will bring you thousands of work out videos for both kids and adults.

“It’s all about exploring ways to keep kids interested,” Dr. Boman said.

What are your tried and true ways to keep your kids active and exercising all year round?

Bonus: This morning, the TODAY Show ran a story about the America’s Healthiest Cities. The Zumba class shown in the segment was part of Vida Sana, a partnership between Children’s and HealthPartners working to address obesity among Latino children and families in Minneapolis. Vida Sana is the brainchild of Dr. Boman and her colleagues here at Children’s.

The Star Tribune profiled Vida Sana last August.

For more information about Vida Sana, you can contact Dr. Julie Boman at julie.boman@childrensmn.org. For more information about Children’s childhood obesity efforts, contact Anna Youngerman at anna.youngerman@childrensmn.org.

Samara Postuma is a freelance writer. Her five kids range in age from 7 months to almost 15. When she is not busy driving kids to school and activities, taking care of baby or teaching her second grader, she writes and works in social media. She blogs at http://simplicityinthesuburbs.com. She can also be found on Twitter.

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.

Traveling with kids during the holidays

Dr. Molly Martyn

By Molly Martyn, MD

With the holiday season coming, many families are making plans to travel to see family and friends.  Airline travel with infants and young children can be both joyful and stressful.  Travel is often unpredictable, but advance preparation can go a long way when it comes to traveling as a family.

The Travel Security Administration (TSA) and Federal Aviation Administration (FAA) both have tips on their websites for safe airline travel with children.  Below are some ideas and information to help your trip go more smoothly.

PLANNING AND PACKING

1.  Many families find it helpful to use a checklist for packing, something you can use for the next time you travel.  Keep a pencil and piece of paper nearby while you go through your daily routine with your child and make notes of things that you will need to remember to pack.  In general, the less gear you have to tote around the better, but having an extra pacifier or a favorite comfort object with you will help make life easier for everyone.

2.  For older children, talk with them in the week prior to your trip about what they can expect at the airport and the new things they will get to explore and experience with a trip to the airport, an airplane ride, and at their destination.

3.   Check with your airline ahead of time regarding checking car seats and strollers.  If you bring a car seat or booster seat, they can often be checked as an extra piece of luggage without additional fees.  Most airlines will allow you to check a stroller at the gate, which is helpful because it means you can use your stroller to go through security and navigate the airport.

4.  Pack more food in your carry-on bag than you think you will need in case your travel is delayed or you find yourself waiting on a runway.  If you are traveling with an infant who drinks formula, bring extra.  If you are traveling with young children, pack plenty of nutritious, filling, familiar snacks that do not need to be refrigerated.

5.  Baby formula, breast milk, and jarred baby foods are allowed through security, but must be presented to a TSA officer.  Pack them separately from your other liquids or aerosols.  You can read more on the TSA website.

6.  Bundle diapers, wipes, a changing mat, and a few plastic bags together so that they are easy to access for diaper changes.  Pack extra clothes in your carry-on.  Footed pajamas are a good option because it is only one item of clothing to change in case of an accident, spit-up, etc.

SAFETY TIPS

1.  Children less than 2 years of age can legally travel in a parent or guardian’s lap, which is what most families opt for given the cost savings.  The American Academy of Pediatrics recommends that children travel in their own airplane seat, restrained in a car seat appropriate for their size and age.  A car seat that can be used in an airplane will carry a label stating that it is certified for use in both motor vehicles and airplanes.  Once children are 40 pounds, they can use the aircraft seatbelt.  Unlike in cars, booster seats are not routinely used for airline travel.

You can find out more information on the FAA’s website.

2.  Babies and small children can be carried through TSA screening (strollers and car seats have to go through the XRay machine).  TSA should not ask travelers to do anything that will separate them from their children.

3.  Have a plan with older children about what they would do in case you get separated while traveling (a place to meet, who they can safely ask for help, etc).

IN THE AIR

1.  Changes in altitude during take-off and landing can cause uncomfortable pressure and fullness in ears.  You can help keep infants comfortable by having them nurse or suck on a bottle (this mimics what older children and adults learn to do to “pop” their ears by yawning or chewing on gum).

2.  To occupy older children, pack a bag of “special treats” such as books/crayons/games to be used on the plane.

3.  Look forward to a safe arrival at your final destination!

Good luck and travel safely.  If you want to read more, here are some good sites and additional tips:

1.  TSA Policies: http://www.tsa.gov/traveler-information/traveling-children

2.  FAA Car Seat and Safe Travel Information:http://www.faa.gov/passengers/fly_children/crs/

3.  American Academy of Pediatrics Travel Tips:http://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/pages/Travel-Safety-Tips.aspx

How Children’s is exploring the health impact of bullying

Click to see the full image.

Hardly a day goes by when we don’t hear a story about bullying: from television reports, to pending legislation, to our own children coming home with tear-streaked faces. For most, school is out for the summer and while our attention to this pressing health issue may wane during the next few months, the problem of bullying doesn’t disappear.

Today, we released a report on the health and developmental impacts bullying has on kids in our communities.

We know that kids and parents struggle with how to address this issue. From a developmental perspective, it’s important for children to learn how to resolve conflict independently. The trick for all of us is to understand when a conflict is no longer healthy and to intervene appropriately. We discuss this idea in the paper and offer some developmentally appropriate guidance to parents (see below) to monitor for and address bullying-related activity with their children.

So how do you do that? Here’s adapted guidance from the American Academy of Pediatrics and other experts on how to address conflict resolution and bullying.

Preschoolers (ages 5 and younger)

Parents can help their child handle conflict by teaching them to:

  • Share
  • Use language rather than action to express anger or feelings, and
  • Respond to physical aggression by another child by saying, “That hurts. Don’t do it.” Seek the help of an adult.

Grade school (ages 5-12)

To assess whether a child has been involved in bullying, parents should ask and consider enlisting others to help if the answers reveal that a child is experiencing bullying:

  • Have you been involved in any fights?
  • How do you avoid (or not avoid) getting into fights?
  • Are you afraid of getting hurt or bullied by other children?
  • How would you react if you saw a fight or bulling incident?

If responses to these questions are concerning, consider some of the following as next steps:

  • If the child is reluctant to talk about bullying, it may make sense to get a counselor or pediatrician involved.
  • Once the child talks about what happened and identifies the bully or bullies, contact the relevant teacher and/or administrator to develop an approach that works in the school setting and is comfortable for the bullied child.
  • Explore methods for providing the child skills he/she needs to respond to future situations.

Parents also need to stay on top of these issues as the child gets older. When their child is in second grade, parents should:

  • Assess if their child has a regular group of friends.
  • Ask what happens when friends disagree.
  • Be familiar with those friends, and
  • Observe what happens when your child is with those friends.

By fourth grade, it’s especially important that children develop self-esteem and feel good about themselves. Parents should observe if their child is:

  • Unhappy or withdrawn,
  • Unable to listen or do homework, or
  • Engaging in destructive behavior.

Middle school (ages 12-14)

Kids need to be encouraged to talk, but may be reluctant to be open and honest if parents or pediatricians come on too strong.

What parents can do:

Some questions for older kids might include:

  • How are things going at school?
  • What do you think of the other kids in your classes?
  • Does anyone get picked on?

Effective action

There are a number of actions parents can take once they determine their child is a target of bullying. These actions range from teaching kids social skills and building their self-confidence to knowing when and how to contact the school or law enforcement authorities.

We hope this report will contribute to important ongoing discussions happening in our state on how to best address bullying. If you’d like to learn more about our in-depth review of how bullying impacts the health of Minnesota kids, visit childrensmn.org/bullying.

A Q-and-A on emergency contraception, safe sex

News came out last week that the Food and Drug Administration approved the sale of the emergency contraceptive pill without a prescription to girls 15 and older.

Specifically, the agency approved Plan B One-Step, an emergency contraceptive intended to reduce the possibility of pregnancy following unprotected sexual intercourse – if another form of birth control like a condom was not used or failed, the FDA said. It’s a single-dose pill that is most effective in decreasing the possibility of unwanted pregnancy if taken immediately or within 72 hours after unprotected sexual intercourse.

“Research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States,” said FDA Commissioner Margaret A. Hamburg, M.D. “The data reviewed by the agency demonstrated that women 15 years of age and older were able to understand how Plan B One-Step works, how to use it properly, and that it does not prevent the transmission of a sexually transmitted disease.”

This presents a timely opportunity to talk to your child about safe sex. Think your kid isn’t having sex? That may be true. But, that doesn’t mean you should avoid talking about it.

We spoke with Children’s physicians Dr. Dave Aughey, medical director of adolescent health, and Dr. Rachel Miller, a pediatric gynecologist, about safe sex.

How/when do I start talking about sex with my child? How often should I have the conversation?

Dr. Miller: A 2011 national survey of high school students found that 19 percent of female and 24 percent of male ninth-grade students were sexually active. The percentage increases to 51 percent of female and 44 percent of male high school seniors. Rates of sexual activity, pregnancies and births among adolescents have continued to decline during the past decade to historic lows, however many adolescents remain at risk of unintended pregnancy and sexually transmitted infections (STIs). The United States has the highest rate of unintended teen pregnancy of any industrialized nation and adolescents acquire half of all STIs in the country each year.

Dr. Aughey: Parents should look for every opportunity to talk and encourage discussions with sons and daughters about feelings, emotions, friendships and relationships. In general, boys have fewer of these opportunities and a lower comfort level than girls.  Use these discussions to reinforce expectations and values. Ground these discussions in their lives — their music, movies, games, schoolwork. Frequent conversations build comfort and trust. Mothers have a particularly strong influence on their daughter’s sexual attitudes and behaviors.

Realize that most teens have their first sexual experience between 16 and 18.  If the current generation of adolescents ends up marrying, it’s not likely to be until their mid- to late ’20s.  So, the “sex talks” need to include protecting oneself from Chlamydia, dating violence, exploitation, getting drunk, and using condoms in addition to the risks of unplanned pregnancy or fathering a child.  Scare tactics never work.  But being responsible includes all of this and more.  Young men, in particular, need to hear these messages more than ever.

Parents hope their children will delay these things as long as possible. But it won’t be forever. The longer your child knows someone, the stronger their feelings, the more in love they are, the more the bets are off. Rather than being scared about the physical aspect of sex, parents should prepare their children to be prepared emotionally, spiritually, and if needed, contraceptively.

My child says he’s not having sex. Should I make protection available anyway – just in case?

Dr. Miller: Condom education and availability programs improve use of condoms, delay sexual initiation of youth and reduce the incidence of STIs and pregnancy. It has been shown that an advanced prescription increased the use of emergency contraception and decreased time to use. No randomized study has shown an increase in sexual activity or decrease in ongoing contraceptive use in adolescents given advanced access to emergency contraception.

Dr. Aughey: Be honest with yourself. You’ve known your child for at least the last 15 years.  What do you think? When teenagers fall in love, everything changes.  It’s not hormones. It’s human nature. It pains me when a patient tells me her mother found her birth control pills and threw them away. Or threw his condoms away.  Really…is this logical? In 25 years, I’ve never encountered a teenager who, in this situation, has said, “I’ve seen the errors of my way…I will break up with my lover.”

What are the most effective forms of protection for my child?

Dr. Miller: It is not only the use of contraceptive method but also the type of method used that can significantly impact unintended pregnancy. Long acting reversible contraceptives demonstrate the greatest success in reducing unintended teen pregnancy. Examples are the subdermal implant and intrauterine systems. I always recommend dual use of a condom to protect against STIs.

Dr. Aughey:With few exceptions, contraception is safe for adolescents, much safer than is pregnancy, by comparison.  That’s not even factoring in all the economic and social perils of unplanned pregnancy or fatherhood.  Long-acting methods like the intrauterine device (IUD) or implant are best as it is difficult for anyone to consistently use pill, patches, rings or condoms.

Plan B is “emergency” protection.  It is never as good as an ongoing method of birth control.  It’s most effective taken as soon as possible.  It needs to be easily accessible to the teen for “emergency” use.  This doesn’t mean calling a clinic the next day, waiting for a prescription, getting it filled, finally taking it and hoping for the best. Ideally it’s taken within 12 hours.

I know my daughter is sexually active. If she needs emergency contraception, where can she get it?

Dr. Miller: Emergency contraception is available at most every pharmacy. One dose usually costs $40 plus tax. Comparatively:

  • Four months of oral contraceptives are $9 per month. Without insurance, it’s about $36 plus tax at some local retailers.
  • 120 Lifestyles Ultra Thin condoms (3 40-count boxes) are about $33 plus tax.

For more information on talking to your child about sex.

Q-and-A with Dr. Troy: How to talk to children about death

During the past 12 months, we’ve been rattled by the tragedies we’ve read and heard about in the news.

In July 2012, 12 people were killed and 58 others were injured in an attack in an Aurora, Colo., movie theater shooting.

Twenty children and six adult staff members were shot to death in December 2012 at Sandy Hook Elementary School in Newtown, Conn.

Closer to home, an insanity trial is underway for a man who admitted to murdering his three daughters this past summer. Last weekend, a woman and her two children were found dead in their home after authorities say she drowned them and then committed suicide.

As parents, we want to protect our children from these horrors. It’s hard to comprehend discussing the unthinkable – a mother or father taking the life of their child – with our own kids. Do we bring it up? How do we respond when they come to us looking for answers?

We spoke with Dr. Michael F. Troy, Ph.D., L.P., our medical director of behavioral health services, in an attempt to answer some of those questions:

How do I explain death to my child in an age-appropriate way?

Dr. Michael F. Troy

There are important differences between explaining the death of an important person in your child’s life and talking about a tragic death in the news. The former is likely to be a challenging, but near universal, role for a parent.  Eventually, all families will face the loss of a loved one requiring parents to share sad news with their child. While it is typical for parents to find these junctures difficult, this does not mean that they are unable to do so with skill and sensitivity.  Parents are used to explaining things to children in developmentally appropriate ways. Whether it’s why they have to have a shot at a doctor’s office or why they need to move to a new community, parents generally know – by instinct and knowledge – how to do this. Talking about death, while less common and inherently sad, is not an entirely different kind of task. Parents should think of it as being like other kinds of sad or disappointing news they might have to discuss with their child.  The specifics, for example, the closeness of the person who died, whether it was an expected loss, and the age of the child, will determine what is communicated.  But the general point, that parents actually do have experience in talking about difficult things and that they should rely on that experience, is most important.

Talking about deaths reported in the news is a different situation. While there are always exceptional circumstances, it is generally best to wait and see if your child raises the issue.  Whether they are aware of a news story is likely to depend on factors such as their age, how routinely they are exposed to the news, and how direct the event in the news is to their day-to-day lives.  If they don’t have knowledge of the story, raising the issue with them is unlikely to be a helpful. If they do raise the issue, it’s important to first find out what they have learned and what specific questions they have (there is no need to respond with answers to questions they don’t have). Additionally, it is important to keep your feelings and thoughts about the news story separate from the actual, specific concerns your child has. Your job as a parent is to help your child understand the event in a way that’s consistent with their developmental level, as well as to reassure and comfort them as necessary.

How do I explain why a parent killed his/her child?

You can’t really explain what you may not understand yourself. If you find the news of a parent killing her children and then herself perplexing and distressing, then it is OK to say that you are confused and upset by it. At the same time, you can also provide reassurance of your child’s safety and, if necessary, of your own ability to take care of them. If you feel you have some understanding of the event, for example, if it was the result of the mother’s severe mental illness, do your best to explain this briefly and in developmentally appropriate ways and with an emphasis on how rare such events are. You might also want to communicate empathy for those most affected by the loss.

Should I talk about the mental health of the parent? How do I do that?

You should talk about the mental health of the parent if your child asks about it, or if you feel that it’s important and appropriate for you to include in your response to the specific questions your child has asked. It’s unlikely that we would actually know the mental health status of a parent taking the violent and tragic actions reported in these recent cases, especially in the immediate aftermath of the tragedy when it is most likely to be in the news. Consequently, you might note that questions regarding mental health issues have been raised – and what this might mean – without suggesting that you know for certain what led to act of violence. It may also be important for you to note that while mental health issues are sometimes linked to violent acts, the vast majority of people with a mental health diagnosis are not violent.

At what age is it appropriate to approach my kids about this topic? Should I always wait for him/her to bring it up?

Unless you have specific reason to anticipate your child encountering discussion of these issues, it is generally better to wait and see if your child raises such concerns with you. Of course, the older children are, the more likely they are to both hear about and initiate questions about news of a tragic event. Similarly, the older your child is, the more reasonable it likely is to bring up the issue.

Are there things I can say or do to make my child feel safe and at ease?

First, it’s worth remembering that our goal as adults caring for children is to help them feel safe without needing frequent reassurance. If such reassurance is necessary, then the most important thing to emphasize is just how incredibly rare these types of events (school shootings, parents killing their children) are. They are extremely upsetting to hear about, and terribly tragic for the families affected, but also quite unlikely to happen. Because they are so rare and so dramatic, they tend to receive intense media coverage. But it also this pervasive media coverage that can make it seem as if these tragedies are more common than they really are. Consequently, it is almost always reasonable to reassure children that they are safe and that there are many adults in their lives looking out for their wellbeing. Some children will have specific concerns requiring specific reassurance. Younger children are likely to need you to talk about the ways in which their own home and school are safe places, while older children might need help understanding the rarity of these events through comparison to other types of risks.  For example, you might point out that while there are people struck by lightning every year, the odds of any given individual beings struck is exceedingly low.

You can lead kids to water, but can you get them to drink?

By Jeri Kayser

We all know drinking water is important. After air, it is pretty much what we need to survive. We mostly consist of water and everything in our bodies work better with an adequate amount of water in them. Try explaining this to a toddler. Try explaining this to a toddler who is sick or has just had their tonsils out. Now try explaining this to a toddler who has discovered they can clamp their mouth shut and no one can make them drink, not even Mom. And whoa, this is so cool to have power over Mom!

This daunting task is universal throughout time and cultures and is more easily dealt with when you plan ahead rather than try to persuade your child to drink when they’re at risk of getting dehydrated. Also, dehydration can cause irritability and a killer headache, which brings out the best in absolutely no one. So, I’ve prepared a few tips for parents:

Drink water: Your child watches you closely. They’re going to be more inclined to drink if they see you drink, and they will be more inclined to drink water if they see you drink water. Plus, your body will appreciate it!

Serve it up cold: Water tastes better cold. Add some ice cubes because they’re fun. You can also add a little juice to the water in the ice cube tray to make the cubes even more fun with a splash of color.

Add slices of fruit: if it’s age appropriate, fruit adds just a touch of freshness and may also encourage more exploration of different fruits.

Find a fun water bottle: There are tons of water containers to choose from. Letting your child pick out a water bottle will help encourage their water intake. They might be inclined to pick one with a fun character, something “pretty,” or, if they’re older, something that fits best in their backpack or clips easiest on their sports bag.

Start early: Habits are best developed and maintained when started early. Have your child’s first beverages be milk or water so they begin to associate water with the way to quench thirst.

If your physician has directed you to encourage your child to drink because they are at risk of being dehydrated, here are some additional tips:

Encourage them to talk: When you say a few words, you swallow your saliva without thinking about it to be better understood. This is especially helpful if they are choosing not to swallow because of pain from a sore throat.

Licking feels less overwhelming than drinking: This is partially why Popsicles work so well. Frozen Popsicles are frozen liquids.

Use sibling rivalry: If there are other children in the household, let them have the popsicles as well. No kid wants a sibling to get something they aren’t getting.

Blenders are a giant toy: They have buttons, smash stuff and make a lot of noise—a really awesome toy! Experiment with smoothies.

Schedule tea party time: Drink out of novel containers, tea party dishes, syringes–whatever is appropriate and fun.

Use sticker charts: For kids, it is hard to understand why they need to drink, especially when they don’t feel well, so sticker charts can work great. We are all well motivated when we can easily see how we will benefit from our choices. Make a chart with your child and give them a sticker for whatever amount a fluid swallowed seems reasonable. Create a “sticker store” where they can “buy” things with various amounts of stickers. These items could be something like a coloring book or maybe an activity like choosing a book to be read to, whatever works best in your family.

Communicate with your doctor: They need to know how much your child is drinking so they can best care for your child. They will also be helpful on letting you know what the goals should be for the amount of fluids your child needs.

Communicate with your child: Don’t underestimate your child’s capacity to understand that drinking is important. Even at a very young age children are actively involved in taking care of their bodies: baths and brushing teeth are good examples. They are able to understand that drinking is one more thing they can do for themselves to feel their best.

Jeri Kayser has been a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota since 1985. Her educational background is in child development and psychology. She has three children who have been a great source of anecdotes to help illustrate developmental perspective. They’re good sports about it.

Dried cheese and oatmeal crumbs fall on deaf ears

By Maggie Sonnek

My family’s kitchen floor is dotted with dried oatmeal crumbs, pieces of cheese and this particular morning, the shepherd from our Christmas nativity set (which during the Christmas season has quickly become my son’s new favorite toy).

I used to sweep this lived-in kitchen every morning after my 1-year-old finished eating some of his toast and oatmeal and dropping the other half on the floor. He thought that was hilarious.

Even though sweeping the floor only took a moment or so, it was still a moment away from what I really wanted to be doing – playing with my son. And, I noticed that every piece of cheese that left his small hands and hit the floor made me cringe. It was another thing for me to pick up. So, I put the broom away and put a towel under his highchair. Problem solved.

This new attitude got me thinking. What else can I solve with a simple towel, figuratively speaking? So often, we (especially us mommas) try to be all things to all people. We try to have quality meals with our kids but also spotless kitchens. Is it all really possible? Maybe living with imperfection is the answer. It allows us to enjoy our kids and our lives and not feel guilty when things aren’t picture-perfect.

So, I’ve decided to proudly share my imperfections. Here goes (deep breath): I spread jam on my son’s toast and then use that same knife as a mirror to put on my mascara. I occasionally feed my family McDonald’s for dinner and don’t feel guilty about it. I even use my scarf to wipe my son’s runny nose. And then wear that scarf to work.

Here’s a secret: Although my eyelashes may not have triple the lash power, they look OK. My son is still alive, even after eating fast food once in a while. My co-workers didn’t run from me in disgust when I showed up wearing a scarf that has seen better days.

The other day, my husband and I were cleaning  the house, getting ready to celebrate Christmas with some friends. He gathered up my catch-all towel in search of a covert hiding place so our guests wouldn’t have to look at it. I stopped him. This towel may not be pretty, but it represents where we are in our lives right now. Someday that towel will be put away permanently, but until that day comes, I’ll live with it in my kitchen. In fact, I’ll enjoy the fact that it has become part of our house and our lives. Along with the dried oatmeal and cheese. And the shepherd from the nativity set.

Maggie Sonnek works in the marketing and communications department at Children’s Hospitals and Clinics of Minnesota. She lives in St. Louis Park with her husband and 15-month-old son.

Getting and giving parenting advice

By Jeri Kayser 

The holiday season is upon us, full of celebrations and gatherings with family and friends. There are plenty of cookies, leftover turkey and fortunately (or unfortunately) unlimited parenting advice.

  • The advice can be fun when Grandma recounts the temper tantrum your mother threw in the grocery store when she was little and how it was handled.
  • The advice can be helpful when your sister-in-law tells you about a website with deeply discounted baby supplies.
  • The advice can feel judgmental, overwhelming or misinformed when a bunch of aunts declare your baby must be cold because they are. “Why don’t you put a sweater on that child? He’s going to catch pneumonia!”

On the flip side, when you’ve lived life and raised kids, you do have some worthwhile advice to share. It’s hard to watch others struggle when you have good parenting tricks up your sleeve. So, how do we maintain family harmony and actually make this advice business work?  Some thoughts….

Unsolicited advice is rarely valuable. To be motivated to follow advice, it’s best if we actually sought it. As a Child Life Specialist, my day is filled with offering advice to parents on how they can help their child cope with their medical care experience. If the advice is going to be valuable, it has to be given with respect to the individual child and families’ needs, as well as their ability and desire to hear the information. Letting someone know what you have to offer and then respecting their decision as to whether they’d like the advice will encourage a dialogue that’s supportive.

No two situations are the same.  We’re unique individuals. A parenting technique that worked with one child might not work with another. Plus, every parent has their own set of skills and challenges that they work with when parenting. My mother-in-law gave me one of the greatest gifts possible (not counting her incredible, perfect son!). She told me when we had our first child that she wouldn’t tell me how to raise him if I didn’t tell her how to raise her kids. She recognized and respected the fact that we would each have our own style and would be more supportive of each other when we removed judgment.

Is now the right moment? In the midst of a huge toddler meltdown, no one is going to hear anything clearly. During the middle of a challenge is when you feel the most vulnerable as a parent. If you’re the advice giver, find a time later to reflect on what happened. If you’re the recipient of advice at an inopportune moment, be ready to redirect, “I would love to hear your perspective later Aunt Bertha, but I need to deal with this right now.”

Be open to the possibilities of great ideas in the sea of advice. When you’re pregnant, you’re a magnet for advice. People feel compelled to give it. During each of my pregnancies, parents at the hospital would offer me advice. Some of the hints I politely listened to and discarded because it wasn’t right for me, but most of the advice proved to be phenomenally helpful.

When people love us they want to help. They want to know the knowledge they have acquired in life is valuable. We also want to forge our own unique paths. When we are respectful in giving and getting advice, it can be priceless in the tremendous challenge of parenting.

This is a post by Jeri Kayser, who’s been a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota since 1985. Her educational background is in child development and psychology. She has three children who have been a great source of anecdotes to help illustrate developmental perspective. They’re wonderful at being good sports about it.

Supporting kids after trauma

By Lizzi Kampf

As adults, we often face a variety of difficult emotions in the face of tragedy. The impact of a traumatic event can be substantial, whether it’s a natural disaster such as a hurricane or tornado, one that is man-made as we saw last week with the horrific mass shooting in Connecticut, or even one that is within a family, such as a car accident or the sudden death of a loved one. Our strong emotional reactions stem from an assault on our basic sense of safety and security. Children can experience these same emotions; however, their young brains aren’t yet fully developed and able to process them in the same way.

Many children express symptoms and feelings of helplessness and fear following a traumatic event. They may become unusually quiet, have problems sleeping, or be weary of separating from caregivers. They may react with agitation, or be unusually restless or aggressive. They may voice more worries or concerns about their own health, the health of others, and their general safety. Some children regress to behaviors they haven’t had since early childhood, such as sucking their thumb, wetting their bed, or baby talk. The good news is that children are naturally resilient and tend to return to whatever level of functioning they were at prior to the event.

Here are some things parents can do to support their children following a traumatic event:

  • Children live their lives through play. Utilize dolls, drawing, or role-playing games to help them express themselves and talk about what happened. Most kids want to talk about what they’ve experienced. Sometimes scary events need to be played out to be worked through. It helps them process what has occurred and use problem-solving skills.
  • Allow your children space to talk about their feelings. They may need to express their fears multiple times and be reassured of their safety frequently. Validate the feelings they are having and assure them that it is “normal” to feel the way they do.
  • Maintain as much structure and daily routine as possible. It can be difficult if your home is unlivable, you have to attend a funeral, or general daily life is disrupted. As much as possible, do the things your family enjoyed prior to the event, such as particular bedtime routines. Children also still need to have rules and discipline; this gives them a sense of order in the chaos.
  • Stay in check of your own reactions. It’s okay for children to witness parents having their own emotions, but they also need to hear an adult talk about how they manage those emotions. Model good self care for your child, making sure to take care of your own physical and mental health.

If you or your child is struggling following a tragedy and feel you need additional assistance, seek professional help through local crisis resources, a mental health counselor, or your doctor.

Lizzi Kampf is a Licensed Independent Clinical Social Worker who works primarily in the Emergency Department on the St. Paul campus of Children’s Hospitals and Clinics of Minnesota. She is also a volunteer with the Red Cross and recently returned from a deployment to New Jersey. As part of the Disaster Mental Health team, she worked to provide brief therapeutic services to individuals and families who had been affected by Superstorm Sandy.