Taking a Mental Health Day Off from School

Taking a Mental Health Day Off from School: A Pediatrician-Mom’s Perspective by Hansa Bhargava, MD, FAAP

“I’m exhausted. Can I please have a day off from school?” My first instinct when one of my kids asks a question like this is to push them to get out of bed and get going. But when my daughter woke up last Friday and asked this question, I hesitated. My daughter has had a crazy month. Along with her usual load of 6th grade quizzes, tests, and homework, she’s had to stay at school until 7pm almost every day for rehearsals for the school play. After that, it’s a long drive home through traffic, and then dinner. She’s not able to sit down and start her load of homework until 8:30pm.

As a working mom and pediatrician, I’ve had weeks like these. The only difference is that I don’t have homework, studying, and projects to do when I get home after a very long day. And even without all of that, I will honestly admit, I have felt the need for a “mental health day.”

Kids and Stress

What I’m seeing as a pediatrician is that more and more kids are incredibly stressed. Not only have their academics been ramped up, but they are expected to do higher-level sports, high-level arts, and be on the go constantly. For many children, the lazy, after school, neighborhood playtime is long gone―as are the long summers of being bored.

What Parents Can Do

All kids are different and some can handle more than others. But as parents, we need to listen to our kids and know their limits. Studies have actually shown that boredom and long periods of unscheduled time can actually spur creativity and out of the box thinking, as well as reset the emotional needle. We ALL need this―and the kids do, too.

So, let’s all take time regularly to have that break. Reset and recharge by staying home, by being with family, or by just simply taking a walk and looking at the trees and the spring flowers. It will calm our soul and give us the “mental break” we need to recharge ourselves.

That day, I gave my daughter what she asked for. I did let her stay home and just be. And the next day, she was ready to go full force again.


Source: Copyright © 2018 Hansa Bhargava, MD, FAAP. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Cuts, Scrapes & Scar Management: Parent FAQs

It is almost impossible for a curious and active child to avoid some scrapes and cuts. And…while a kiss from mom or dad and some TLC is often all that is needed, it sometimes takes a little more know-how to help wounds heal properly.

The following FAQs will help you prevent serious bleeding and other problems such as scarring when your child gets a cut.

What’s the best way to treat a small cut or scrape?

Almost all active bleeding can be stopped by applying direct pressure with clean gauze or cloth over the site for five or ten minutes. The most common mistake is interrupting the pressure too early in order to peek at the wound.

  • Once bleeding stops: Gently wash the wound with soap and water for five minutes. If your child persistently objects, try soaking the wound in the bathtub. Cleaning the wound will decrease the chance of infection and prevent dark spots caused by dirt trapped in the skin.
  • After cleaning: Apply a small amount of antibacterial ointment to keep the wound moist and cover it with a dry gauze or bandage until healed.

How do I know whether or not my child needs stitches?

Here are some guidelines to help you determine whether or not stitches are needed:

  • Cuts that go all of the way through the skin may benefit from stitches.
  • Any cut that is gaping open with visible dark red muscle or yellowish fat should probably be closed, even if it is small.
  • Any cut that is gaping and is more than ½ inch long should probably be closed. Get a ruler and measure it if you are not sure. Cuts smaller than this may not require closure, but if they are gaping, then it is best to have them checked out.
  • Small cuts that are not gaping may not require actual stitches but may still benefit from steri-strips.
  • If your child has a cut that is deep, gaping, or in a cosmetically sensitive area, call your pediatrician to determine if stitches are needed.

What are the options available nowadays for closing a small cut?

  • Skin glue was approved for use in 1998 and has become very popular. It is applied by rubbing it over the cut while the cut is being held closed. It is a good choice for straight cuts and is quick and painless. If done well, the cosmetic outcome is the same as stitches. However, it cannot be used to close a wound that has any tension on it from muscle usage. This is because skin glue is not as strong as stitches and, when used in areas of tension, the risk of the cut reopening is high.
  • Steri-strips (or “butterfly” bandage closures) are narrow adhesive strips placed over a cut, with a bit of tension to keep it closed. They are used for small cuts that are not very deep or over a joint or areas of tension. If they stay in place for at least three days, the outcome can be just as good as stitches. However, they are not as strong as stitches and do not stay in place well.
  • Stitches provide more strength and little to no risk of being pulled off too soon. However, they can be traumatic due to the time and pain involved in putting them in. Absorbable sutures are stitches that do NOT need to be removed. Non-absorbable sutures are stitches that need to be removed, usually 5-12 days later, depending on the location.
  • Staples are most often used for cuts in the scalp (within the hair). They are very fast and close the cut almost as well as stitches.

How soon after an injury does my child need to see a doctor for stitches?

Most cuts can generally be closed as long as 24 hours after the injury. Some cuts should be closed sooner, but it is very safe to wait at least 8 hours to have a cut closed.

If you do decide to wait: Wash your child’s cut under the faucet to get out any dirt. Do not let the cut dry out. Wet some gauze pads and tape them over the cut. Change the gauze every two hours to keep it moist.

My child’s cut is on his face. Should I be concerned about scarring from the stitches?

Facial cuts in children usually heal remarkably well and with very little scarring. Pediatric plastic surgeons recommend that most facial cuts be repaired using simple interrupted sutures. The suture size and needle type are specifically designed for the delicate skin of the face.

How can I make my child’s scar less visible?

There are some simple things you can do to help minimize your child’s scar appearance once the skin has fully healed.

Note: Scars cannot be completely erased, and no treatment can return your child’s skin to exactly the way it looked before the injury.

  • Sun protection. Damaged skin is very susceptible to becoming permanently discolored by the sun for up to 6 months after an injury. It is very important to minimize sun exposure to the healing cut. Keep it covered with a hat or clothing as much as possible or use a broad sunscreen to minimize darkening of the scar (called “hyperpigmentation”). Do not apply sunscreen until two weeks after the cut.
  • Scar massage. Scars may soften and flatten more quickly when they are massaged. To do this, use your fingers to apply moderate pressure and massage the scar in circles.
  • Silicone sheets or gels. Silicone products may help soften, flatten, and improve the coloration of a scar if used for at least 12 hours a day.

My child has a scar seems to be getting bigger. Should I be concerned?

Sometimes, no matter what you do, a scar might not look as good as you want it to. Most of the time, this is a cosmetic issue. Occasionally, there are medical problems that can arise.

  • Hypertrophic scar. These are prominent scars that form as a wound heals and may be pink, red, or purple. These are often thick and raised, but they do not extend beyond the initial injury.
  • Keloid. These scars have spontaneously enlarged to form a firm, smooth growth. They are typically raised above the surface of the skin, look shiny, rough, and irregular in shape. They can be pink, red, or purple. Some keloids can become quite large, much larger than the original injury and often extend beyond its original borders.

If you suspect a hypertrophic scar or keloid, talk to your child’s pediatrician. You may be referred to a pediatric plastic surgeon to see if treatment is needed.


Source: American Academy of Pediatrics (Copyright © 2019). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Cell Phones: What’s the Right Age to Start?

There really is no “right” age to allow our kids to dip a toe into the digital pond, but if we pay attention to the issues, we’ll be able to decide what makes sense for our kids without getting in the way of a process that will occur whether we like it or not.

At the same time, there is no rush. We can keep the pace reasonable and developmentally appropriate and allow our kids to use technologies that make sense without granting them access to technologies that don’t make sense for their age.

Cell Phones for Safety

For example, cell phone use seems to be trickling to younger ages. Studies and reports show that middle school is the time that adoption for cell phones and technology really takes off. Before then, kids who have cell phones don’t use them as expected. Why do they have them? Families I know who give their elementary school kids cell phones do so mostly for safety issues.

  • Medical: Some children have emergency issues for which every second counts. For these kids, having access to a cell phone matters because landlines are not as easy to find as when we were kids, even in afterschool programs (although the adults supervising those programs usually carry cell phones, or should). Some families whose children have medical issues feel more secure knowing their child can reach them if symptoms start to flare. Assuming these kids are supervised, this may not be needed but does give families peace of mind.
  • Emergencies: With both parents often working out of the home, many feel more secure if kids of all ages have a way to reach them and vice versa. This is an issue every family needs to sort out independently, but if elementary schoolkids are supervised after school, a personal cell phone for the child may not be needed.

The New Normal Kids “Need”

For better or worse, we do have a new norm being established today which studies and reports are confirming. YouthBeat: The Syndicated Report by C&R Research reports on the use of digital devices by today’s kids and teens, YouthBeat confirms that today’s kids are starting very young, as young as first grade, and gravitate to:

  • TV
  • DVD
  • video
  • Computer
  • Cameras
  • Music
  • Cell phones

Use increases with age and parents provide the majority of purchasing power.

Despite views that kids “need” cell phones when they are young, cell phones use among younger kids is markedly lower than tweens and teens—22% of kids reported using cell phones, compared with 60% of tweens and 84% of teens. The percentages of use were not as wide for other digital technologies.

The Social Role of the Cell Phone

The reasons for this are likely developmental. Cell phones play a huge social role that doesn’t become interesting in a child’s life until the tween and teen years. Before that, show watching and gaming are the prominent interests and are reflected in the digital activities the younger kids gravitate toward.


Author: Gwenn Schurgin O’Keeffe, MD, FAAP. Source: CyberSafe: Protecting and Empowering Kids in the Digital World of Texting, Gaming, and Social Media (Copyright © 2011 American Academy of Pediatrics) The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Healthy & Effective Discipline Tips by Age/Stage

​Infants

  • ​Babies learn by watching what you do, so set examples of behavior you expect.
  • Use positive language to guide your baby. For example, say, “Time to sit,” rather than, “Don’t stand.”
  • Save the word, “no,” for the most important issues, like safety. Limit the need to say “no” by putting dangerous or tempting objects out of reach.
  • Distracting and replacing a dangerous or forbidden object with one that is okay to play with is a good strategy at this age.
  • All children, including babies, need consistent discipline, so talk with your partner, family members, and child care provider to set basic rules everyone follows.

​Toddlers

  • ​Your child is starting to recognize what’s allowed and what isn’t but may test some rules to see how you react. Pay attention to and praise behaviors you like and ignore those you want to discourage. Redirect to a different activity when needed.
  • Tantrums can become more common as your child struggles to master new skills and situations. Anticipate tantrum triggers, like being tired or hungry, and help head them off with well-timed naps and meals.
  • Teach your toddler not to hit, bite, or use other aggressive behaviors. Model nonviolent behavior by not spanking your toddler and by handling conflict with your partner in a constructive way.
  • Stay consistent in enforcing limits. Try short time-outs if needed.
  • Acknowledge conflicts between siblings but avoid taking sides. For example, if an argument arises about a toy, the toy can be put away.

Preschool Age

  • ​Preschool-age children are still trying to understand how and why things work and what effect their actions have. As they learn appropriate behavior, expect them to continue testing the limits of parents and siblings.
  • Begin assigning age-appropriate chores, like putting their toys away. Give simple, step-by-step directions. Reward them with praise.
  • Allow your child to make choices among acceptable alternatives, redirecting and setting sensible limits.
  • Teach your child to treat others as she wants to be treated.
  • Explain that it’s OK to feel mad sometimes, but not to hurt someone or break things. Teach them how to deal with angry feelings in positive ways, like talking about it.
  • To resolve conflicts, use time-outs or remove the source of conflict.

​Gradeschool-Age Children

  • ​Your child is beginning to get a sense of right and wrong. Talk about the choices they have in difficult situations, what are the good and bad options, and what might come next depending on how they decide to act.
  • Talk about family expectations and reasonable consequences for not following family rules.
  • Provide a balance of privileges and responsibility, giving children more privileges when they follow rules of good behavior.
  • Continue to teach and model patience, concern and respect for others.
  • Don’t let yourself or others use physical punishment. If you live in an area where corporal punishment is allowed in schools, you have the right to say that your child may not be spanked.

​Adolescents & Teens

  • ​As your teen develops more independent decision-making skills, you’ll need to balance your unconditional love and support with clear expectations, rules, and boundaries.
  • Continue to show plenty of affection and attention. Make time every day to talk. Young people are more likely to make healthy choices if they stay connected with family members.
  • Get to know your teen’s friends and talk about responsible and respectful relationships.
  • Acknowledge your teen’s efforts, achievements, and success in what they do―and don’t do. Praise the choice to avoid using tobacco, e-cigarettes, alcohol, or other drugs. Set a good example through your own responsible use of alcohol and other substances.

Source: American Academy of Pediatrics (Copyright © 2018). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

What’s the Best Way to Discipline My Child?

As a parent, one of your jobs to teach your child to behave. It’s a job that takes time and patience. But, it helps to learn the effective and healthy discipline strategies.

Here are some tips from the American Academy of Pediatrics (AAP) on the best ways to help your child learn acceptable behavior as they grow. 

10 Healthy Discipline Strategies That Work

The AAP recommends positive discipline strategies that effectively teach children to manage their behavior and keep them from harm while promoting healthy development. These include:

  1. Show and tell. Teach children right from wrong with calm words and actions. Model behaviors you would like to see in your children.
  2. Set limits. Have clear and consistent rules your children can follow. Be sure to explain these rules in age-appropriate terms they can understand.
  3. Give consequences. Calmly and firmly explain the consequences if they don’t behave. For example, tell her that if she does not pick up her toys, you will put them away for the rest of the day. Be prepared to follow through right away. Don’t give in by giving them back after a few minutes. But remember, never take away something your child truly needs, such as a meal.
  4. Hear them out. Listening is important. Let your child finish the story before helping solve the problem. Watch for times when misbehavior has a pattern, like if your child is feeling jealous. Talk with your child about this rather than just giving consequences.
  5. Give them your attention. The most powerful tool for effective discipline is attention—to reinforce good behaviors and discourage others. Remember, all children want their parent’s attention.
  6. Catch them being good. Children need to know when they do something bad–and when they do something good. Notice good behavior and point it out, praising success and good tries. Be specific (for example, “Wow, you did a good job putting that toy away!”).
  7. Know when not to respond. As long as your child isn’t doing something dangerous and gets plenty of attention for good behavior, ignoring bad behavior can be an effective way of stopping it. Ignoring bad behavior can also teach children natural consequences of their actions. For example, if your child keeps dropping her cookies on purpose, she will soon have no more cookies left to eat. If she throws and breaks her toy, she will not be able to play with it. It will not be long before she learns not to drop her cookies and to play carefully with her toys.
  8. Be prepared for trouble. Plan ahead for situations when your child might have trouble behaving. Prepare them for upcoming activities and how you want them to behave.
  9. Redirect bad behavior. Sometimes children misbehave because they are bored or don’t know any better. Find something else for your child to do.
  10. Call a time-out. A time-out can be especially useful when a specific rule is broken. This discipline tool works best by warning children they will get a time out if they don’t stop, reminding them what they did wrong in as few words―and with as little emotion―as possible, and removing them from the situation for a pre-set length of time (1 minute per year of age is a good rule of thumb). With children who are at least 3 years old, you can try letting their children lead their own time-out instead of setting a timer. You can just say, “Go to time out and come back when you feel ready and in control.” This strategy, which can help the child learn and practice self-management skills, also works well for older children and teens.

Source: American Academy of Pediatrics (Copyright © 2018). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

April is National Poetry Month

National Poetry Month was inaugurated by the Academy of American Poets in 1996. Over the years, it has become the largest literary celebration in the world with schools, publishers, libraries, booksellers, and poets celebrating poetry’s vital place in our culture. Click here to learn more.

Curious? Check out 30 Ways to Celebrate National Poetry Month with your kids!

  1. Sign-up for Poem-a-Day and read a poem each morning.

  2. Download a free National Poetry Month poster and display it for the occasion.

  3. Read 2020’s most-read poem, Naomi Shihab Nye’s “Kindness.”

  4. Record yourself reading a poem, and share why you chose that work online using the hashtag #ShelterinPoems. Be sure to tag @poetsorg on twitter and instagram!

  5. Subscribe to the Poem-a-Day podcast.

  6. Check out an e-book of poetry from your local library.

  7. Begin your virtual meetings or classes by reading a poem.

  8. Talk to the teachers in your life about Teach This Poem.

  9. Learn more about poets and virtual poetry events nation-wide.

  10. Read about your state poet laureate.

  11. Browse Poems for Kids.

  12. Buy a book of poetry from your local bookstore or from Three Chairs Publishing.

  13. Make a poetry playlist.

  14. Browse the glossary of terms and try your hand at writing a formal poem.

  15. Create an online anthology of your favorite poems on Poets.org.

  16. Attend a poetry reading, open mic, or poetry slam via a video conferencing service.

  17. Sign up for an online poetry class or workshop.

  18. Donate books of poetry to little free libraries and mutual aid networks.

  19. Research and volunteer with poetry organizations in your area.

  20. Take a socially safe walk and write a poem outside.

  21. Start a virtual poetry reading group or potluck, inviting friends to share poems.

  22. Read and share poems about the environment in honor of Earth Day.

  23. Take on a socially safe guerrilla poetry project.

  24. Read essays about poetry like Edward Hirsch’s “How to Read a Poem,” Mary Ruefle’s “Poetry and the Moon,” Mark Doty’s “Tide of Voices: Why Poetry Matters Now,” and Muriel Rukeyser’s “The Life of Poetry.”

  25. Watch a movie, lecture, or video featuring a poet.

  26. Write an exquisite corpse or a renga with friends via email or text.

  27. Make a poetry chapbook.

  28. Make a poem to share on Poem in Your Pocket Day on April 29, 2020.

  29. Submit your poems to a literary magazine or poetry journal.

  30. Make a gift to support the Academy of American Poets free programs and publications and keep celebrating poetry year-round!

Choosing Healthy Snacks for Kids

MARCH IS NATIONAL NUTRITION MONTH

​​While meals make up the majority of a child’s nutritional intake, most children eat at least one snack per day. While many of the most commonly offered kids’ snacks tend to be of lower nutritional value than meals, snacks still can support—or even enhance—your child’s overall healthy eating plan. Here’s how:

  • Use snack times as a way to increase fruits and vegetable intake. Most kids do not eat the recommended amount of fruits and vegetables. Snack times offer a great opportunity to increase access and exposure to these nutrient-dense foods. Consider pairing them up with dairy products or dairy substitutes (such as grapes and cheese) lean proteins (such as celery and peanut butter), or whole-grain cereals and bread (such as banana sandwich on whole grain bread).
  • Keep a range of healthy foods handy at home. It is much easier to make easy, healthy snacks when you keep a few key items stocked at home. Ideas include different types of raw vegetables and fruit, yogurt dip, hummus, and cheese sticks.
  • Avoid processed foods and added sugars. Processed foods (made in a factory and sold in bags and boxes) do not have many nutrients and often have a lot of added sugar and salt. In addition, children may become hungry faster after eating processed foods.
  • Teach your children to eat a rainbow of colors. Arrange your children’s foods to show the beauty of fresh, brightly colored foods. Talk about the farms where food comes from and the farmers who help grow it.

Copyright © 2016 American Academy of Pediatrics. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Avoiding Food Traps

MARCH IS NATIONAL NUTRITION MONTH

Food traps are situations a​nd places that make it difficult to eat right. We all have them. The following tips may help your family ​avoid some of the most common traps.

Food Trap #1: Vacations, Holidays, and Other Family Gath​erings

Vac​ations

When on a trip, don’t take a vacation from healthy eating and exercise.

What You Can Do:

  • Plan your meals. Will all your meals be from restaurants? If so, can yo​u split entrees and desserts to keep portions from getting too large? Can you avoid fast food? Can you bring along your own healthy snacks?
  • Stay active. Schedule time for physical activities such as taking a walk or swimming in the hotel pool.

Holidays

It’s easy to overeat during holidays. But you don’t need to fear or avoid them.

What You Can Do:

  • Approach the holidays with extra care. Don’t lose sight of what you and your child are eating. Plan to have healthy foods and snacks on hand. Bring a fruit or veggie tray with you when you go to friends and family.
  • Celebrate for the day, not an entire month! Be sure to return to healthy eating the next day.

Other Family Gatherings

In some cultures, when extended families get together, it can turn into a food feast, from morning to night.

What You Can Do:

  • Eat smaller portions. Avoid overeating whenever you get together with family. Try taking small portions instead.
  • Get family support. Grandparents, aunts, and uncles can have an enormous effect on your child’s health. Let them know that you’d like their help in keeping your child on the road to good health.

Food Trap #2: Snack Time

The biggest time for snacking is after school. Kids come home wound up, stressed out, or simply bored, so they reach for food.

What You Can Do:

  • Offer healthy snacks such as raw vegetables, fruit, light microwave popcorn, vegetable soup, sugar-free gelatin, or fruit snacks.
  • You pick the snack. When children are allowed to pick their own snacks, they often make unhealthy choices. Talk to your child about why healthy snacks are important. Come up with a list of snacks that you can both agree on and have them on hand.
  • Keep your child entertained. Help your child come up with other things to do instead of eating, such as playing outside, dancing, painting a picture, flying a kite, or taking a walk with you.
  • Make sure your child eats 3 well-balanced meals a day. This will help cut down on the number of times he or she needs a snack.

Food Trap #3: Running Out of Time

Finding time every day to be physically active can be very difficult. However, if you plan ahead, there are ways to fit it in.

What You Can Do:

  • Make a plan. Sit down with your child and plan in advance for those days when it seems impossible to find even 15 minutes for physical activity. Have a plan B ready that your child can do after dark, such as exercising to a workout video.
  • Make easy dinners. If you run out of time to make dinner, don’t run to the nearest fast-food restaurant. Remember, dinners don’t have to be elaborate. They can be as simple as a sandwich, bowl of soup, piece of fruit, and glass of milk.

Remember

Your job is to provide good nutrition to your child and family and encourage regular physical activity. Stay positive and focus on how well your child is doing in all areas of life. It can help keep nutrition and activity change moving along.


Written by Sandra G. Hassink, MD, FAAP. Pediatric Obesity: Prevention, Intervention, and Treatment Strategies for Primary Care (Copyright © 2014 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Beyond Chicken Nuggets: Protein-Rich Alternatives for Picky Eaters

MARCH IS NATIONAL NUTRITION MONTH

All parents want their children to have healthy diets—and part of that is getting enough protein. With picky eaters, that can feel hard. But it doesn’t have to be hard.

Here are some things about protein that you may not know—and some ideas to make mealtimes easier.

When all your child will eat is chicken nuggets:

As a pediatrician, I talk with parents all the time about what their children eat. And very often I find that when it comes to giving their children protein, families feel frustrated—and worried. “All he will eat is chicken nuggets” is something I commonly hear.

When babies are small it’s not really an issue, because they are on breast milk or formula. But as they grow into toddlers and preschoolers and we expand their diets, that’s where the worry sets in—because the age when they are expanding their diets is also the same age when they become more independent and willful. It’s a power struggle that often plays out as picky eating.

Enter the chicken nugget. I’m not sure what it is about them that makes kids almost universally like them; perhaps it’s the same thing that makes French fries universally appealing. Some even look like French fries. And for many families it can seem like once you’ve started the “nugget habit,” there’s no turning back. But here’s the thing: you don’t need to start that habit. And for those of you already in the habit, there is hope.

Why protein is an important part of your child’s diet:

When we think of protein we think of muscles, but protein is a building block for many other parts of the body, such as hair, bones, enzymes, skin and blood. Our bodies are very good at recycling and reusing proteins as they break down, but we do need to get some from our diet.

Here are three things about protein that many parents don’t know:

1. Children don’t need as much protein as you might think. The body is remarkably good at recycling.

Daily Protein Foods Table
Daily Recommendation•
Children 2-3 years old
4-8 years old
2 ounce equivalents 4 ounce equivalents
4 ounce equivalents
Girls 9-13 years old
14-18 years old
5 ounce equivalents
5 ounce equivalents
Boys 9-13 years old
14-18 years old
5 ounce equivalents
6 ½ ounce equivalents
Women 19-30 years old
31-50 years old
51 + years old
5 ½ ounce equivalents
5 ounce equivalents
5 ounce equivalents
Men 19-30 years old
31-50 years old
51 + years old
6 ½ ounce equivalents
6 ounce equivalents
5½ ounce equivalents
*These amounts are appropriate for individuals who get less than 30 minutes per day of moderate physical activity, beyond normal daily activities. Those who are more physically active may be able to consume more while staying within calorie needs. Source: choosemyplate.gov/protein-foods

2. If children are drinking the recommended amount of cow’s milk, they are likely getting all or most of the protein they need. Every ounce of cow’s milk has 1g of protein (soy milk has nearly as much, though not all soy and plant-based milks do).

Recommended Amounts of Cow’s Milk by Age
Daily Recommendation
1-2 years old
24 ounces
2-3 years old 16 ounces
4-8 years old
20 ounces
9+years old
24 ounces

If you compare this to the recommended amounts of protein above, you’ll see that milk alone could take care of all a child’s protein needs until age 9! Hopefully, that eases some parents’ worries. After age 9, your child is hopefully old enough to negotiate about healthy food choices.

It’s certainly true that some children don’t like milk, and that drinking more than the recommended amount can lead to constipation or anemia (and sometimes poor eating habits when children want milk instead of food). Which leads to the third point…

3. There are lots of ways besides meat or cow’s milk to get protein and mix it up at mealtime. Here are some other protein-rich ideas.

  • Other animal products. Salmon, fish sticks, eggs, turkey lunch meat, yogurt, or mozzarella string cheese.
  • Beans and grains. Soy products like soy milk or tofu. (You can even try soy “chicken” nuggets). Lentils, nut butter, hummus, oatmeal, or whole wheat pasta are more options.
  • Vegetables. Yet another reason to get kids to eat their veggies! Peas, broccoli, and even potatoes have protein. (Not that potatoes are the best vegetable, but it’s good to know they have some protein).

The bottom line:

When it comes to getting protein into your child’s diet, you don’t have to get into battles—or give in to the daily chicken nugget diet. There are lots of ways to do it, and with a bit of creativity and persistence, your child can get what he or she needs.

  • No clean-plate club. Don’t force your kids to eat something or finish everything, because that doesn’t work well (and makes everyone miserable). Kids don’t need a balanced meal at every meal of the day―what’s important is achieving balance over a day or two.
  • Keep it on the plate; have a “one bite” rule. It can take lots of tries before a child realizes that something tastes good. It also helps when others set an example, so eat meals together whenever you can!
  • Cook more meals at home. A homemade breaded chicken breast, for example, is healthier than takeout nuggets. Kids learn a lot about different foods and how to read food labels when they are involved in shopping for groceries and preparing meals―making them into healthier adults. Here are five more great reasons to cook with your kids.

​If nothing is working, or you are worried about your child’s diet, call your doctor.

Yes, picky eating can just be a phase. But it’s important to bring up any concerns with your pediatrician, so you can brainstorm possible solutions together.


Written by Claire McCarthy, MD, FAAP. Source: American Academy of Pediatrics (Copyright © 2019). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Childhood Nutrition

MARCH IS NATIONAL NUTRITION MONTH

​Nearly 1 in 3 children in America is overweight or obese. Despite all the focus on kids being overweight and obese, many parents are still confused, especially when it comes to what kids eat. How much does your child need? Is he getting enough calcium? Enough iron? Too much fat?

Whether you have a toddler or a teen, nutrition is important to his or her physical and mental development. Here’s what children need — no matter what the age.

Babies

During this stage of life, it’s almost all about the milk — whether it’s breast milk, formula, or a combination of the two. Breast milk or formula will provide practically every nutrient a baby needs for the first year of life.

  • At about six months most babies are ready to start solid foods like iron-fortified infant cereal and strained fruits, vegetables, and pureed meats. Because breast milk may not provide enough iron and zinc when babies are around six to nine months, fortified cereals and meats can help breastfed babies in particular.
  • Once you do start adding foods, don’t go low-fat crazy. Although the AAP guidelines state fat restriction in some babies is appropriate, in general, you don’t want to restrict fats under age two because a healthy amount of fat is important for babies’ brain and nerve development.

Toddlers & Preschoolers

Toddlers and preschoolers grow in spurts and their appetites come and go in spurts, so they may eat a whole lot one day and then hardly anything the next. It’s normal, and as long as you offer them a healthy selection, they will get what they need.

  • Calcium, the body’s building block, is needed to develop strong, healthy bones and teeth. Children may not believe or care that milk “does a body good,” but it is the best source of much-needed calcium. Still, there’s hope for the milk-allergic, lactose-intolerant, or those who just don’t like milk. Lactose-free milk, soy milk, tofu, sardines, and calcium-fortified orange juices, cereals, waffles, and oatmeal are some calcium-filled options. In some cases, pediatricians may recommend calcium supplements.
  • Fiber is another important focus. Toddlers start to say “no” more and preschoolers can be especially opinionated about what they eat. The kids may want to stick to the bland, beige, starchy diet (think chicken nuggets, fries, macaroni), but this is really the time to encourage fruits, vegetables, whole grains, and beans, which all provide fiber. Not only does fiber prevent heart disease and other conditions, but it also helps aid digestion and prevents constipation, something you and your child will be thankful for.

Gradeschoolers

It isn’t uncommon for a 6- or 7-year-old to suddenly decide to be a vegetarian once they understand animals and where food comes from. This doesn’t mean your child won’t get enough protein; animal tissue isn’t the only place we get protein. Rice, beans, eggs, milk, and peanut butter all have protein. So whether your child goes “no-meat” for a week or for life, he or she will likely still get sufficient amounts of protein.

Areas that might be a little too sufficient are sugars, fats, and sodium.

  • This is a time when kids first go to school and have a little bit more choices in what they eat, especially if they’re getting it in the cafeteria themselves. Cakes, candy, chips, and other snacks might become lunchtime staples.
  • The body needs carbs (sugars), fats, and sodium, but should be eaten in moderation, as too much can lead to unneeded weight gain and other health problems.
  • Packing your child’s lunch or going over the lunch menu and encouraging him or her to select healthier choices can help keep things on track.

Preteens & Teens

As puberty kicks in, young people need more calories to support the many changes they will experience. Unfortunately, for some, those extra calories come from fast food or “junk” foods with little nutritional value.

  • Some adolescents go the opposite way and restrict calories, fats, or carbs. Adolescence is the time kids start to become conscious of their weight and body image, which, for some, can lead to eating disorders or other unhealthy behaviors. Parents should be aware of changes in their child’s eating patterns and make family dinners a priority at least once or twice a week.
  • Like calories, calcium requirements are higher. Calcium is more important than ever during the tween and teen years because the majority of bone mass is built during this time. Encouraging kids to have milk, milk products, or calcium-rich alternatives, should help them get more calcium.
  • Your child’s gender may play a role in whether he or she needs more of a particular nutrient. For instance, teen girls need more iron than their male counterparts to replace what’s lost during menstruation, and males need slightly more protein than girls.

Although getting your child to eat healthy — regardless of his or her age — can be a constant battle, its one well worth fighting. A healthy child becomes a healthy adult, and only with your support and guidance will your child be both.

Water: Drink Up!

Water makes up more than half of kids’ body weight and is needed to keep all parts of the body functioning properly.

  • There’s no specific amount of water recommended for children, but it’s a good idea to give them water throughout the day — not just when they’re thirsty.
  • Babies generally don’t need water during the first year of life.
  • If your child doesn’t like the taste of water, add a bit of lemon or lime for flavor.
  • Fruits and veggies are also good sources of water.
  • Kids should drink more water when ill, when it’s hot out, or when engaged in physical activity.

Recommended Amount of Calories

Here’s what the United States Department of Agriculture (USDA) recommends kids get calorie-wise and from each food group for a healthy, balanced diet:

Calories per day table


SOURCE: Committee on Nutrition (Copyright © 2016 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.