Tweens Archives - Page 30 of 34 - Two Peds in a Pod®

Organic fruit and veggies: health or hype?

Two Peds in a Pod turns today to guest blogger Dr. Alan Woolf, Director of the Pediatric Environmental Health Center at Children’s Hospital Boston and president-elect of the American Academy of Clinical Toxicology, to tackle the question, “Should you feed your kids organic fruits and vegetables?”

Nutritionists are urging parents to feed kids one and one-half cups of fruit and two and one-half cups of vegetables daily and the American Academy of Pediatrics suggests whole fruit rather than juice to meet most of the daily fruit requirements.

OK, so that’s fine, but why spend a lot more money to buy those fruits and veggies labed organic? Are they worth it? Will non-organic produce harm your kid? No easy answers here. American consumers demand a bountiful supply of blemish-free, perfect fruits and vegetables. We want unspotted shiny red apples, brightly colored large oranges and arrow-straight asparagus. Farmers want to give us just that. Since pests attack crops causing blemishes, worms, blight, and other forms of costly crop damage, farmers have been using pesticides for years to increase crop yield, profit, and visual marketability.

The US Dept of Agriculture (USDA) regulates the agricultural procedures and labeling that use the buzz word organic. Obviously every business wants to put that word on their product if it means consumers will run out and buy it. The USDA will certify farms that use organic methods. But even the USDA’s definition of organic allows a percentage of synthetic chemicals to be added to products labeled organic. Also organic does not mean that the food contains increased amounts of essential minerals and vitamins or is more nutritious for you. And remember that organic produce doesn’t necessarily come from small, cuddly, local, family-run farms. Most large, international agribusinesses are touting organic foods for sale these days.

Well over one billion pounds of pesticides, according to the Department of Agriculture, are used on American crops annually. And pesticides tend to be nasty chemicals—otherwise they wouldn’t kill bugs. In large amounts, some types can cause seizures or coma in people. However, all foods , whether organic or non-organic, must contain pesticide residues well below the standard that the government considers safe. Not every piece of non organic fruit even contains a residue; it’s hit and miss.

But what about the long-term safety of pesticides in trace amounts, the amounts barely present as micro-grams or nano-grams? The fact is that no one knows the safety for sure. The science just isn’t there yet. Some dispute the government’s definitions; arguing that children don’t eat the same market basket as adults (they eat more fruit). They reason that using adult pesticide residue standards may not protect children. Recently some scientists did a study where they measured pesticide residue in the urine of school-aged children who were fed regular, market-basket produce, and then measured again after they switched them to organic-only fruits and vegetables. Guess what—kids fed organic foods excreted less pesticide residues in their urine. There’s a powerful argument for organic.

One thing that everyone agrees with—wash all of your fruits and vegetables after you buy them and before anybody in your family eats them. And that means soap and water, not just a quick rinse. Also keep in mind that infants and children are resilient even in this modern age filled with all sorts of hazards. Kids and adults are armed with marvelous defense mechanisms that prevent chemicals from doing bodily harm. Even if a chemical does cause some injury, the body has remarkable mechanisms that repair the damage in a hurry. No need to be “chemical phobic;” you can’t keep your kids in a bubble.

That being said, you still need to be cautious. In pediatrics we often invoke the “precautionary principle.” The idea is that if you don’t exactly know what a chemical will do to a child’s health because there aren’t enough scientific studies out there, then you assume that what it is capable of is bad and so, if possible, try not to expose them, just as a precaution.

When you can, buy from local farms or stands where you can ask them their growing practices, or else just grow your own. If you decide to buy organic foods, you should eat them right away. They may not stay edible as long without preservatives. Again, no matter what type of food you buy, wash, wash, wash.

Finally, alternative “greener” farming techniques, integrated pest management (IPM), and more resistant varieties of plants have increased crop yields, in many cases without using as much pesticide. That’s good news for all of us. Breeding of genetically-engineered plants require less use of pesticides, but they may not be acceptable to most consumers. That’s a whole column in itself!

The bottom line: My wife and I will try to buy organic foods when we think of it, but we don’t obsess over it when we forget.

Alan Woolf, MD, MPH, FAACT, FAAP

Director, Pediatric Environmental Health Center, Children’s Hospital Boston

Fact or fiction? A flu vaccine quiz for all teachers, babysitters, parents, and anyone else who breathes on children

A few days ago, I spoke with the faculty of a local early childhood education center about flu vaccine myths. See how you do on the true and false quiz I gave them:

I can tell when I am getting the flu and will leave work before I infect anyone.

False. According to the CDC (US Center for Disease Control), you are infectious the day before symptoms show up.

I never get the flu so it’s not necessary to get the vaccine.

False. Saying I’ve never had the flu is like saying, “I’ve never a car accident so I won’t wear my seat belt.”

I hate shots. I hear I can get a flu vaccine in a different form.

True. One flu vaccine, brand name Flu Mist, provides immunity when squirted in the nose. Non-pregnant, healthy people aged 2-49 years of age qualify for this type of vaccine.

I got the flu shot so I was healthy all year.

False. Perhaps it was the half-hour a day you added to your workout, or the surgical mask you wore to birthday parties, but your entirely healthy winter was not secondary just to the flu vaccine. The United States flu vaccine protects against several strains of flu predicted to cause illness this winter. This year’s vaccine contain both seasonal and the 2009 H1N1 strains. Your body builds up a defense (immunity) only against the strains covered in the vaccine. Immunity will not be conferred to the thousands of other viruses which exist. On the other hand, the vaccine probably did protect you from some forms of the flu, and two fewer weeks of illness feels great.

My friend got the flu shot last year, therefore, she was sick all winter.

My condolences. True, your friend was sick. But the answer is False, because the illnesses were not caused by the flu vaccine. Vaccines are not real germs, so you can’t “get” a disease from the vaccine. But to your body, vaccine proteins appear very similar to real germs and your immune system will respond by making protection against the fake vaccine germ. When the real germ comes along, pow, your body already has the protection to fend off the real disease. Please know, however, there is a chance that for a couple days after a vaccine, you will ache and have a mild fever. The reason? Your immune system is simply revving up. But no, the flu vaccine does not give you an illness.

I got the flu vaccine every year for the past decade. I will still need to get one this year.

True. Unfortunately, the flu strains change from year to year. Previous vaccines may not protect you against current germs.

I am a healthy adult and not at high risk for complications from the flu, so I will forgo the flu vaccine this year.

False. The flu vaccine is now recommended for everyone greater than 6 months of age. When supply is limited, targeted groups at risk for flu complications include all children aged 6 months–18 years, all persons aged ≥50 years, and persons with medical conditions that put them at risk for medical complications. These persons, people living in their home, their close contacts, and their CARETAKERS are the focus of vaccination.

Even if I get the flu, I’ll just wash my hands a lot to keep the germ from spreading. I have to come back to work because I don’t have much time off.

False, According to the American Academy of Pediatrics Report of the Committee on Infectious Diseases, the influenza virus can spread from an infected person for about a week after infection.

Yes, kids get sick from others kids, but as a parent who comes in contact with two children, an early childhood educator who comes in contact with ten children, an elementary school teacher who comes in contact with twenty children or a high school teacher who comes into contact with one-hundred children daily, you may end up the one who seeds your community with a potentially deadly illness. Right now, flu vaccine clinics are as plentiful as Starbucks. Hit that CVS or Walgreens on the way home, wander into your doctor’s or grab a shot while you get groceries. By protecting yourself from the flu, you protect the children you care for.

Naline Lai, MD with Julie Kardos, MD

Of Bracelets and Breast Exams

Move over liveStrong bracelets, move over Silly Bandz. Just when you thought you threw away the your last Oriental Trading Company gadget, here come “I Love Boobies” bracelets. As I see the newest overpriced piece of fashionable rubber dangle from my daughter’s wrist, I sigh at the cost, but console myself that at least the money goes towards breast cancer research. Use the bracelets as a reminder to teach your girls to do monthly breast exams. The American Cancer Society recommends monthly self-breast exams starting at age twenty. However, most pediatricians recommend starting exams earlier. Breasts are full of normal lumps and bumps and your teen or young adult should know her baseline. For directions on conducting a breast exam refer to American College of Obstetrics and Gynecology’s online pamphlet . Yes, even a fashion accessory can turn into a parental teaching point. Now what do jeggings teach kids?

Naline Lai, MD with Julie Kardos, MD

Stopping a bully: Talk, Walk, Squawk and Support

Can you identify your child in any of these scenarios?

-Your second grader comes off the school bus crying because another student was teasing him the entire ride home about his new glasses.

-Your fifth grader was punched on the school yard by a sixth grader and none of the playground teachers saw it happen. Your child’s friend shoved the older child off your child before more damage was done.

-Your ninth grader keeps missing the school bus so you have to drive her to school. When she comes home from school she uses the bathroom immediately. You find out she avoids the bus and the school bathroom because verbal abuse occurs in both places.

Whatever your child’s age, when you realize he or she is being bullied you will be outraged. In fact you might be tempted to retaliate against the bully yourself. However, here are more appropriate ways to help your child.

Bullying should never be tolerated. Teach your child how to directly deal with a bully, but be quick to talk also to the adult supervising your child when the bullying occurs. Your child should always feel safe in school, day camp, on a sports team, or any other adult-supervised activity.

Bullies are always in a position of power over their victims; either they are physically larger, older, or more socially popular. Teach your child first to try a strong verbal response (talk) such as “STOP talking to me that way!” or “Don’t DO that to me!” Speaking strongly and looking the bully in the eye may take away some of the bully’s power as well as attract attention of nearby peers or adults who can help your child.

Teach your child to walk away from a fight. Tell him to keep on walking toward a teacher, a classroom, a peer, or anyone else who can offer safety from a bully. Train him to breathe deeply/ignore/de-escalate situations to diffuse a bully’s anger.

Have your child tell a teacher, camp counselor, coach, or other supervising adult about the abuse (squawk) as soon as it occurs. Always encourage your children to talk to you as well. Remember at home to ask your child questions such as “How is school,” “How are your friends,” “Do you know any kids who are being bullied?,” and “Are YOU being bullied?”

If your child says he is angry at a friend or a classmate, be sure to ask questions that encourage your child to elaborate, such as “Oh, what happened?” or “Did something happen between you?” Listen carefully to his response. He may be taking out his anger at a bully on his own friends. This response is in retaliation for his friend’s failure to protect him from a bully. Also, is your child becoming more reluctant to attend school, “missing” the bus more often and thus requiring a ride, or acting angry or sad more often? Kids who are victims of bullying can act like this.

In school, once you are aware that your child is a victim, talk not only to your child about how she should handle a bully but also alert your child’s teacher and/or school principal about the situation (support). You should tell them in your child’s words what happened, what was said, and be clear that you are asking for more supervision so that the bully has less access to your child. Ask for more supervision during times when there is usually less adult presence such as in the lunchroom or on the schoolyard. Your school may already have a “no bullying” policy. Often, the aggressor gets the heavier consequence in the event of a conflict. Again, children have a right to feel safe in school.

Restore your child’s self-confidence. Bullies pick on kids who are smaller and weaker than they are, physically as well as psychologically. So your child has more positive experiences with kids who do not bully, encourage your child to invite friends over to your home or host a fun group activity (kickball game in your backyard, show a movie/supply popcorn, etc.). Do family activities and show your child that you enjoy spending time with him. Enroll your child in activities that increase his self esteem such as karate, sports, or music lessons. A child who feels good about himself “walks taller” and is less likely to attract a bully.

As a parent, you might read this post and think, “Yes, but I’d rather just teach my child to take revenge.” Unfortunately, escalating the situation only breeds anger and in fact may get your child into trouble. Rather than “hate” the bully, help your child see that a bully deep down feels insecure. A bully resorts to making himself feel better by making others feel bad. Teach your child to pity the bully. With your guidance, your child will project self-confidence and a bully will never, ever, be able to touch him.

Julie Kardos, MD with Naline Lai, MD
© 2010 Two Peds in a Pod℠

Evaluating Vaccine Sites on the Internet

A concerned parent wrote to us:

Can you please read this and comment?www.thinktwice. com.
I’m terrified to vaccinate due to sites like these. There seems to be many horrifying stories out there to what happens to kids after getting vaccines. If the chance of them getting these diseases is small, is it worth taking the risk of them suffering these near death or death experiences?

Here is our response:

Dear Concerned,

We looked at the web site you sent to us. When evaluating the merit of information that you read on the internet, it is important to know the source of the information. The thinktwice site has an easy to read disclaimer. To highlight: the founders of the site explain that they are NOT medical professionals and that they do NOT give medical advice. They refer their readers to “licensed medical professionals” for medical advice. In addition, they acknowledge that their site is NOT endorsed by the American Academy of Pediatrics (AAP), the Food and Drug Administration (FDA), or the US Center for Disease Control (CDC). In fact, they refer their readers to these organizations for vaccine information and advice. They post “information” that will certainly cause a stir on the internet but actually defer to well established medical experts at the AAP, the CDC, and the FDA for definitive advice about vaccines. If you investigate those sites, you would find that all of the organizations actually endorse the use of vaccines.

It makes sense to consult experts in the field for any problem that you have. When researching a health care issue, actresses, political figures, and web site sponsors, while experts in knowing their own children, are not medical professionals. If, for example, we had a car problem, we would consult a mechanic. We would not read testimonials of car owners on the internet to figure out how to fix a car. If we did not trust our mechanic’s recommendation, we would get a second opinion from another car expert.

Doctors are trained to evaluate evidence. We are medical professionals who read all the medical textbooks for you. Pediatricians go to school and train for nearly a quarter of a century before they even begin practicing on their own. We base our medical advice on the pediatric standards set forth by the American Academy of Pediatrics. These standards represent consensus of thousands of pediatricians who dedicate their lives to improving the well being of children. We would never support a practice that causes more harm than good.

If you are moved by testimonials, then you should also read testimonials of parents whose children were not vaccinated and then died or suffered disability from vaccine preventable diseases: http://vaccinateyourbaby.org/why/victims.cfm, http://vaccine.chop.edu. In addition, we encourage you to read our own vaccine posts: How Vaccines Work and Do Vaccines Cause Autism? Please visit the websites we provide in these articles for more information about vaccines.

Experts in pediatrics have evaluated data based on millions of vaccine doses given to millions of children. The evidence shows that the benefits of vaccines outweigh risk of harm. Think of seat belts. You may imagine that your child’s neck may get caught in a seat belt, but you would never let your child go without a seatbelt. The reason is that rather than trust a “feeling” that theoretically the seat belt could cause harm, we know from evidence, data, and experience that seatbelts save lives.

Vaccines are a gift of protection against childhood disease. As moms, both of us vaccinated our own children on time according to the standard schedule. Tragically, the more parents don’t vaccinate, the easier it will be for all of our children to contract these preventable and often deadly disease. Proof of this is California’s current whooping cough epidemic which has killed six infants so far. Most of the illness is breaking out in areas where parents stopped vaccinating their children.

If you are wondering about the merits of a web site, try to cross reference the information with organizations which set medical standards such as The American Academy of Pediatrics, the Centers for Disease Control, and your local Children’s Hospital. And of course, you can always ask your pediatrician.

By asking questions you are being a responsible parent.

Keep on asking.

Julie Kardos, MD with Naline Lai, MD
© 2010 Two Peds in a Pod℠

Rotten News: A Salmonella Story

Eeew! Pictured is the raw chicken I left sitting out in a pot for a day (inadvertently, of course). The putrid mess was teaming with germs and amongst them was probably salmonella. This bacteria is in the news because of the thousands of eggs recently recalled for contamination (Centers for Disease Control , New York Times, National Public Radio.)

Non-typhoidal Salmonella usually causes fever and crampy diarrhea. This stomach bug mainly lurks in raw poultry, raw eggs, raw beef, and unpasturized dairy products. Luckily, salmonella does not jump up and attack humans. People are safe from disease as long as they do not eat salmonella-infested food.

In the case of my pot of rotten chicken, the obvious stench warned me that it was inedible. However, salmonella often hides in food and it is difficult to tell what is or is not contaminated. A perfectly fine looking egg may harbor the germ. Even before this outbreak, the Centers for Disease Control estimates in the United States as many as 1 in 50 people are exposed to a contaminated egg each year.

Luckily salmonella is killed by heat and bleach. Even if an egg has salmonella, adequate cooking will destroy the bacteria. Gone are the days when parents can feed kids soft boiled eggs in a silver cup, have kids wipe up with toast the yolk from a sunny-side up egg, or add a raw egg to a milkshake. Instead, cook your hardboiled eggs until the yolks are green and crumble, and tolerate a little crispness to your scrambled eggs. Wash all utensils well. The disinfecting solution used in childcare centers of ¼ cup bleach to 1 gallon water works well to sanitize counters. Do not keep perishable food, even if it is cooked, out at room temperature for more than two hours.

A mom once called me frantic because her child had just happily eaten a half-cooked chicken nugget. What if this happens to your child? Don’t panic. Watch for symptoms — the onset of diarrhea from salmonella is usually between 12 to 36 hours after exposure but can occur up to three days later. The diarrhea can last up to 5-7 days. If symptoms occur, the general recommendation is to ride it out. Prevent dehydration by giving plenty of fluids. My simple rule to prevent dehydration is that more must go in than comes out.

According to the American Academy of Pediatric’s 2009 infectious diseases report, antibiotic treatment may be considered for unusually severe symptoms or if your child is at risk for overwhelming infection. People at high risk for overwhelming disease include infants younger than three months old and those with abnormal immune systems (cancer, HIV, Sickle Cell disease, kids taking daily steroids for other illnesses). Using antibiotics in a typical case of salmonella not only promotes general antibiotic resistance, but in fact does not shorten the time frame for the illness. Also, the medication can prolong how long your child carries the germ in his stool.

I ended up tying the chicken up, pot and all, in a plastic grocery bag and throwing out the whole mess. Don’t tell my husband, he is the kind of guy who gets annoyed because I throw out germy sponges on a frequent basis. If he knew, he’d probably want me to at least keep the pot. Yuck.

Naline Lai, MD with Julie Kardos, MD

Back to School Transitions

Ah…you’ve tucked in your tired kids, now kick back and take out your Kleenex while you read Dr. Lai’s personal letter to her own child as she started school. The post is meant for all parents with a child who is approaching a major milestone. Then, come back to reality and read Dr. Kardos’s post on how to help kids get back to a healthy school year sleep pattern.

Best wishes for a smooth transition to school.

Julie Kardos, MD and Naline Lai, MD
© 2010 Two Peds in a Pod℠

Packing your child’s school lunch: Beware of junk food disguised as healthy food

Need ideas on what to pack in your child’s lunch bag? Beware of junk food masquerading as healthy food. Dr. Roxanne Sukol, an internist who writes the popular nutrition blog Your Health is on Your Plate , mom of three children, and friend of Dr. Kardos’s from medical school, shares her insights…

What should we pack in our children’s lunch bags? The key to retraining our children to eat real food is to restore historical patterns of food consumption. My great-grandparents didn’t eat potato chips, corn chips, sun chips, or moon chips. They ate a slice of whole-grain rye bread with a generous smear of butter or cream cheese. They didn’t eat fruit roll-ups. They ate apricots, peaches, plums, and grapes. Fresh or dried. Depending on where your family originated, you might have eaten a thick slice of Mexican white cheese (queso blanco), or a generous wedge of cheddar cheese, or brie. Sunflower seeds, dried apples, roasted almonds. Peanut butter or almond butter. Small containers of yogurt. Slices of cucumbers, pickles, or peppers. All of these make good snacks or meals. My mom is proud to have given me slices of Swiss cheese when I was a hungry toddler out for a stroll with my baby brother. Maybe that’s how I ended up where I am today.

When my own children were toddlers, I gave them tiny cubes of frozen tofu to grasp and eat. I packed school lunches with variations on the following theme: 1) a sandwich made with whole grain bread, 2) a container of fruit (usually apple slices, orange slices, kiwi slices, berries, or slices of pear), and 3) a small bag of homemade trail mix (usually peanuts + raisins). The sandwich was usually turkey, mayo and lettuce; or sliced Jarlsberg cheese, sliced tomato, and cream cheese; or tuna; or peanut butter, sometimes with thin slices of banana. On Fridays I often included a treat, like a few small chocolates.

Homemade trail mix is one terrific snack. It can be made with any combination of nuts, seeds, and/or dried fruit, plus bits of dark chocolate if desired. Remember that dark chocolate is good for you (in small amounts). Dried apple slices, apricots, kiwi or banana chips, raisins, and currants are nutritious and delicious, and so are pumpkin seeds and sunflower seeds, especially of course in homes with nut allergies. Trail mix can be simple or involved. Fill and secure baggies with ¼ cup servings, and refrigerate them in a closed container until it’s time to make more. I would include grains, like rolled oats, only for children who are active and slender.

If possible (and I do know it’s a big “if”), the best way to get kids interested in increasing the amount of real food they eat is to involve them in its preparation. That might mean smearing their own peanut butter on celery sticks before popping them into the bag. It might mean taking slices of the very veggies they helped carry at the weekly farmer’s market. Kids are more likely to eat the berries in their lunch bag if they picked them themselves. There’s a much greater chance they’ll eat kohlrabi if they helped you peel it, slice it, or squeeze a fresh lemon over it. That’s the key to healthy eating.

What do I consider junk food? Chips of all kinds, as well as those “100 calorie packs,” which are invariably filled with 100 calories of refined carbohydrate (white flour and sugar) in the form of crackers (®Ritz), cereal (®Chex), or cookies (®Chips Ahoy).

You can even find junk food snacks for babies and toddlers now: The main ingredients in popular ®Gerber Puffs are refined flour and sugar. Reviewers tout: “You just peel off the top and pour when you need some pieces of food, then replace the cap and wait for the next feeding opportunity.” [Are we at the zoo?] “He would eat them all day long if I let him.” [This is not a benefit. It means that the product is not nutritious enough to satisfy the child’s hunger.]

Beware not only of drinks that contain minimal amounts of juice, but also of juice itself. Even 100% fruit juice is simply a concentrated sugar-delivery system. A much better approach is to teach children to drink water when they are thirsty, (See my post entitled One Step at a Time) and to snack on fresh fruit when they are hungry. Milk works, too, especially if they are both hungry and thirsty!

TeachMed, LLC

http://yourhealthisonyourplate.com

Reprinted with permission in edited form for Two Peds in a Pod

Roxanne B. Sukol, MD is a 1995 graduate of Case Western Reserve School of Medicine. She is board-certified in Internal Medicine and practices in suburban Cleveland, Ohio. With special interests in the prevention and management of diabetes and obesity, Dr. Sukol writes the blog Your Health is on Your Plate . Because her patients (the grown-ups) are the ones packing the school lunches for our patients, we thank her for this post.

Julie Kardos, MD and Naline Lai, MD

Avoid back strain- what to look for in a school backpack

Just in time for the fall sales, physical therapist Dr. Deborah Stack returns to give us the low-down on backpacks.

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Believe it or not, there are only a few weeks left before school starts for the fall. As I look at last year’s first day of school photo, I notice my not-quite-100-pound child bending in half under the weight of a backpack, trombone, lunchbox and art portfolio. This year, I quietly decree, that scenario will not happen again. To make sure it does not happen at your house either, consider a few tidbits as you plan your back-to-school purchases:

-A traditional backpack with two shoulder straps distributes the weight more evenly than a pack or messenger bag with a single strap.

-Look for wide, padded straps. Narrow straps can dig in and limit circulation.

-A chest or waist strap can distribute weight more evenly.

-Look for a padded back to protect your child from pointy pencils etc.

-Look for a lightweight pack that does not add much overall weight.

–Multiple compartments can help distribute weight.

–Compression straps on the sides or bottom of a backpack can compress and stabilize the contents.

–Reflective material allows your child to be more visible on those rainy mornings.

–A well fitting backpack should match the size of the child. Shoulder straps should fit comfortably on the shoulder and under the arms, so that the arms can move freely. The bottom of the pack should rest in the contour of the lower back. The pack should “sit” evenly in the middle of the back, not “sag down” toward the buttocks.

How much should your tike tote? Experts, including the American Academy of Pediatrics and the American Physical Therapy Association, recommend kids should not carry backpacks weighing more than 15-20% of the kid’s weight.

Here’s a chart to give you an idea of the absolute maximum a child should carry in a properly worn backpack:

Child’s Weight (pounds)	Maximum Backpack Weight (pounds)
50	7.5-10
60	9-12
70	10.5-14
80	12-16
90	13.5-18
100	15-20
110	16.5-22
120	18-24
130	19.5-26

Here are some ideas to help lighten the load, especially for those middle school kids who have a plethora of textbooks:

-Find out if your child’s textbook can be accessed on the internet. Many schools are purchasing access so the students can log on rather than lug home.

-Consider buying an extra set of books for home. Used textbooks are available inexpensively online.

-Limit the “extras” in the backpack such as one free reading book instead of five. I am not exaggerating; one day I found five free reading books in my child’s backpack!

-Encourage your child to use free periods to actually study, and leave the extra books in his locker.

-Remind your child to stop by her locker between classes to switch books rather than carrying them all at once.

-Consider individual folders or pockets for each class rather than a bulky 3-ring notebook that holds every subject.

You may need to limit the load even further if your child is still:

-Struggling to get the backpack on by herself

-Complaining of back, neck or shoulder pain

-Leaning forward to carry the backpack

If your child complains of back pain or numbness or weakness in the arms or legs, talk to your doctor or physical therapist.

When used correctly, backpacks are supported by some of the strongest muscles in the body: the back and abdominal muscles. These muscle groups work together to stabilize the trunk and hold the body in proper postural alignment. However, backpacks that are worn incorrectly or are too heavy can lead to neck, shoulder and back pain as well as postural problems. So choose wisely and lighten the load. Happy shopping!

Deborah Stack, PT, DPT, PCS

Dr. Stack has been a physical therapist for over 15 years and heads The Pediatric Therapy Center of Bucks County in Pennsylvania www.buckscountypeds.com. She holds both masters and doctoral degrees in physical therapy from Thomas Jefferson University.

It’s a tough pill to swallow

In the wake of liquid Tylenol and Motrin recalls, some parents are facing empty shelves of liquid medications in the stores. Check to see if your child weighs enough to take the dose in pill form. If so, it’s time to learn to swallow pills! Here are some of our favorite helpful ideas:

-Don’t wait until your child is ill. She may not feel up to learning a new skill.

-Practice swallowing peas, tic-tacs or watermelon seeds. You can start with a cake sprinkle and move up to something larger.

-Demonstrate for your child the process of swallowing.

-Thick liquid will carry down a pill better than thin liquid. Try orange juice or milk instead of water.

-Try having your child tilt her head forward as she drinks so that she is “upside down.”

-Use mind over matter, for a nervous kid, tell him to first take three breaths, sit-down, gulp and quickly swallow.

-Take a pill while simultaneously eating apple sauce, yogurt, or pudding.

-Put a pill in his mouth and have him suck liquid quickly up through a straw. This action will push back the pill before it dissolves in the liquid.

-Remind your child: if you can swallow food, you can swallow a pill.

What if nothing works? Some pills can be chewed, and the contents of some capsules can be sprinkled on food; check with the pharmacist first. Then teach your child the song “I know an old lady who swallowed a fly…”

Naline Lai, MD and Julie Kardos, MD