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.

Fat, Salt and Sugar: Not All Bad

Forcing children to eat food doesn’t work. Neither does forbidding foods. When children think that a food is forbidden by their parents, the food often becomes more desirable.

It’s important for both children and adults to be sensible and enjoy all foods and beverages, but not to overdo it on any one type of food. Sweets and higher-fat snack foods in appropriate portions are OK in moderation.

The following is information about fat, sugar, and salt and dietary recommendations based on recommendations from the US Department of Agriculture and the US Department of Health and Human Services.

Encouraging Healthy Eating for a Healthy Heart

Childhood is the best time to start heart healthy eating habits, but adult goals for cutting back on total fat, saturated fat, trans fat, and cholesterol are not meant generally for children younger than 2 years.

Fat is an Essential Nutritent for Children. Fat supplies the energy, or calories, children need for growth and active play and should not be severely restricted.

Dangers of High Fat Intake. However, high fat intake—particularly a diet high in saturated fats—can cause health problems, including heart disease later in life. Saturated fats are usually solid at room temperatures and are found in fatty meats (such as beef, pork, ham, veal, and lamb) and many dairy products (whole milk, cheese, and ice cream).

For that reason, after age 2 children should be served foods that are lower in fat and saturated fats.

Healthier, More Low-Fat, Low-Cholesterol Foods for Children Over Age 2:

  • Poultry
  • Fish
  • Lean meat (broiled, baked, or roasted; not fried)
  • Soft margarine (instead of butter)
  • Low-fat dairy products
  • Low-saturated fat oils from vegetables
  • Limiting egg consumption

The General Rule on Fats

As a general guideline, fats should make up less than 30% of the calories in your child’s diet, with no more than about one-third or fewer of those fat calories coming from saturated fat and the remainder from unsaturated (polyunsaturated or monounsaturated) fats, which are liquid at room temperature and include vegetable oils like corn, safflower, sunflower, soybean, and olive.

Some parents find the information about various types of fat confusing. In general, oils and fats derived from animal origin are saturated. The simplest place to start is merely to reduce the amount of fatty foods of all types in your family’s diet.

Note: Whole milk is recommended for children 12 to 24 months of age. However, you child’s doctor may recommend reduced-fat (2%) milk if your child is obese or overweight or if there is a family history of high cholesterol or heart disease. Check with your child’s doctor or dietition before switching from whole to reduced-fat milk.

Serve Children Foods Low in Salt

Table salt, or sodium chloride, may improve the taste of certain foods. However, researchers have found a relationship between dietary salt and high blood pressure in some individuals and population groups. High blood pressure afflicts about 25% of adult Americans and contributes to heart attacks and strokes.

Take the Salt Shaker Off the Table. The habit of using extra salt is an acquired one. Thus, as much as possible, serve your child foods low in salt. In the kitchen, minimize the amount of salt you add to food during its preparation, using herbs, spices, or lemon juice instead. Also, take the salt shaker off the dinner table, or at least limit its use by your family.

Check Sodium Levels in Processed Foods. Processed foods often contain higher amounts of sodium. Check food labels for levels of sodium in:

  • Processed cheese
  • Instant puddings
  • Canned vegetables
  • Canned soups
  • Hot dogs
  • Cottage cheese
  • Salad dressings
  • Pickles
  • Certain breakfast cereals
  • Potato chips and other snacks

Sugar in Your Child’s Diet: More Than Just a Sweetener

Caloric sweeteners range from simple sugars, like fructose and glucose, to common table sugar, molasses, honey, and high fructose corn syrup. Although the main use of sugar is as a sweetener, sugar has other uses. For example, sugar can be used as a preservative, can change the texture of foods, and can enhance flavors and add color.

Sugar Supplies Energy. Sugars in foods, whether natural or added, provide calories—the fuel that supplies energy necessary for daily activities. And if given the choice, many children would probably request sugary foods and beverages for breakfast, lunch, and dinner—research shows that humans are naturally drawn to sweet tastes.

Too Much Sugar Means Too Many Calories. Parents should keep in mind that calories from sugar can quickly add up and over time can lead to weight gain, and sugar also can play a role in the development of tooth decay.


Source: Healthy Children, Fit Children: Answers to Common Questions From Parents About Nutrition and Fitness (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.

Backyard Pool Safety

Swimming pools can have a powerful pull on little children―even when it’s not swimming time. Those glistening turquoise-blue ripples may look especially inviting to an active toddler or an overly confident preschooler.

Kids can slip away from the watchful eyes of adults in seconds. It happens every day.

The American Academy of Pediatrics (AAP) recommends several ways parents can help keep children safe around home swimming pools and hot tubs―all year long―in your own backyard, your neighbor’s, or on vacation.

Fact: Most drownings in kids 4 and under happen in home swimming pools.

The U.S. Consumer Product Safety Commission (CPSC) studied drownings among children age 4 and under in Arizona, California, and Florida, where pools are especially common. It found that nearly 70% of the children were not expected to be at or in the pool, yet they were found in the water. In fact, 46% of the children were last seen in the house.

Pool fences. Safety precautions not ​to ignore.

Pool fences are for above-ground pools that are portable as well as those that are permanent, in-ground pools, and hot tubs.

Between 2013 and 2015, most (58%) drownings among children age 4 and under took place in a pool or spa at their own home. Most children drowned when they wander out of the house and fell into a swimming pool that was not fenced off from the house. They slipped out a door, climbed out a window, or even crawled through a doggy door to access the pool.

But, a family swimming pool isn’t the only one a child can get into unnoticed. More than a quarter (27%) of drownings among children age 4 and under took place at the home of a friend, relative or neighbor. Only some individual states and municipalities have laws requiring pool safety fences; there is no national pool fence law. Whenever your child will be in someone else’s home, always check for ways your child could access pools and other potential hazards.

Fact: Fences are the most effective, proven way to prevent drowning of young children.

Pool Fencing Recommendations:

  • 4 feet, 4 sides. The pool fence should be at least 4 feet high and completely surround the pool, separating it from the house and the rest of the yard.
  • Climb-proof. The fence shouldn’t have any footholds, handholds, or objects such as lawn furniture or play equipment the child could use to climb over the fence. Chain-link fences are very easy to climb and are not recommended as pool fences. (If they are used, make sure openings are 1¾ inches or smaller in size).
  • Slat space. To ensure a small child can’t squeeze through the fence, make sure vertical slats have no more than 4 inches of space between them. This will also help keep small pets safe, too.
  • Latch height. The fence should have a self-closing and self-latching gate that only opens out, away from the pool area. The latch should be out of a child’s reach—at least 54 inches from the ground.
  • Gate locked, toy-free. When the pool is not in use, make sure the gate is locked. Keep toys out of the pool area when it is not in use.

Alarms. A child drowning is rarely heard.

Beyond a fence, additional layers of protection such as pool alarms, door and gate alarms, and pool covers can provide some added safety around a pool. Make sure alarms are in good shape with fresh batteries, and keep in mind none are substitutes for a properly installed pool fence.

Drowning is silent. Alarms break that silence.

  • Pool alarms. Children can drown within seconds, with barely a splash. Swimming pool alarms can detect waves on the water’s surface and sound off to attract attention when someone has fallen into the pool.
  • Consider alarms on the pool fence gate and house doors. Door and gate alarms can be equipped with touchpads to let adults pass through without setting them off. House doors should be locked if a child could get to the pool through them.
  • Window guards. These can be especially helpful for windows on the house that face the pool.

A word on pool covers:

Pool covers should cover the entire pool securely enough that a child can’t slip under them. Make sure no standing water collects on top—children can drown in less than 2 inches of water. Power-operated covers are often the safest and easiest to use. Remember: Floating solar and winter covers are not safety covers and can actually increase drowning risk. Because a floating cover makes the pool surface appear solid, a small child might try to retrieve a ball or other light toy that landed on it and quickly slip underneath—often trapped and hidden from view. ​

What Else Can Parents Do?

Even with safety measures in place, parents should be prepared in case that their child gets into a swimming pool unseen.

Some precautions that may help:

  • Assign a water watcher. His or her job is to watch all children swimming or playing in or NEAR water―such as on a backyard swing set―even if they know how to swim. This person should:
    • not be under the influence of drugs or alcohol
    • put down his or her cell phone
    • avoid other activities
    • supervise even if there are lifeguards
    • switch off with another adult for breaks
  • Life jackets: Put your child in a properly fitted US Coast Guard approved life jacket when around or near water, such as when visiting a home with a pool.
  • Swim lessons. The AAP recommends swim lessons as a layer of protection against drowning that can begin for many children starting at age 1.
  • CPR training. Parents, caregivers, and pool owners should know CPR and how to get emergency help. Keep equipment approved by the U.S. Coast Guard, such as life preservers and life jackets at poolside.
  • Check the water first. If a child is missing, look for him or her in the pool or spa first. This is especially important if your child is prone to wandering.

Last Updated: 7/13/2020. 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.


Hand Sanitizers: Keep Children Safe from Poisoning Risk

​​​​​Washing hands with soap and clean water for at least 20 seconds is the best way for children to get rid of germs, including COVID-19. If soap and water are not available, they can use hand sanitizer with at least 60% alcohol.

However, swallowing just a tiny amount of hand sanitizer can cause poisoning in children. Many hand sanitizers are made with alcohol or rubbing alcohol (ethanol, ethyl alcohol, or isopropanol, isopropyl alcohol). Alcohol poisoning symptoms include sleepiness, low blood sugar, seizures and coma, and it can be fatal.

Children and adults also have been poisoned after using hand sanitizer that contained methanol (also called wood alcohol, methyl alcohol, or methylated spirits). It should not be used in hand sanitizer, and these products were recently recalled. Methanol is toxic if swallowed or after repeated use on skin. It may cause nausea, vomiting, headache, blurred vision, blindness, seizures, coma, permanent damage to the nervous system, or death.

The American Academy of Pediatrics urges parents to keep hand sanitizers out of children’s reach. Don’t forget about travel-size bottles of sanitizer in purses, diaper bags, backpacks and cars. Parents and caregivers also should supervise children ages 5 and younger when they use hand sanitizer.

Hand sanitizer & COVI​​D-19
As families began buying more hand sanitizer during the COVID-19 pandemic, the National Poison Data System started getting more reports of unintentional exposures in children. In the first half of 2020, there have been 46% more reported cases about hand sanitizer than during the same time last year. Many reports were about children ages 5 years and younger.

Health experts recommend using hand sanitizer that is 60% to 95% alcohol to kill the virus that causes COVID-19. Drinking alcohol typically has 5% to 40% alcohol.

Check th​​e label
The Food and Drug Administration (FDA) began letting companies that do not normally produce hand sanitizer make and sell it during the COVID-19 pandemic. When buying hand sanitizer, parents should make sure it has a label that lists the ingredients, warnings and precautions.

To reduce the risk of injury from children drinking hand sanitizers, producers should add ingredients to make them taste bitter. This important step helps prevent children from eating the product. However, the FDA has been alerted that some young people have tried drinking hand sanitizers from distilleries that have not taken the step to make them taste bad.

To help make sure the sanitizer’s taste will not appeal to children, look for the word “denatured” on the bottle. You can also check for bitter ingredients such as denatonium benzoate (Bitrex); sucrose octaacetate; or butanol (also called tert-butyl alcohol).

Some products are made with isopropyl alcohol (isopropanol). Be especially careful with these sanitizers around children, since they can be more toxic than those made with ethanol or ethyl alcohol.

A word about homemade​​ hand sanitizers
​With some shortages of hand sanitizers during the COVID-19 crisis, it may be tempting to make your own hand sanitizer. However, this may not be the best option. The FDA warns that if made incorrectly, hand sanitizer may not work. There have also been reports of skin burns from homemade hand sanitizer.

Disposing of ​recalled products
Do not flush or pour recalled hand sanitizers down the drain. These products should be disposed of in hazardous waste containers, if possible. If unsure, check with your local waste management and recycling center.

Remem​​ber…
Call 911 right away if your child has collapsed, is having a seizure, is having a hard time breathing, or if they can’t wake up after using or swallowing hand sanitizer products. If you have questions about hand sanitizer product safety, call your regional poison control center at 1-800-222-1222 or visit WebPoisonControl.


Source: AAP Council on Injury, Violence and Poison Prevention (Copyright © 2020). 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.

Mood-Boosting Tips for Families During the COVID-19 Pandemic

Feeling connected to the people and world around us is a key part of good mental health. After months of social distancing for COVID-19, families are still spending less time with others as the pandemic continues. If cancelled summer plans like festivals, family reunions, and other gatherings have made it challenging to keep your family’s spirits up, you’re not alone. Here are some simple ways to help boost everyone’s mood during the pandemic:

Lighten up

Sunshine can help brighten mood. Try to spend 30 to 60 minutes outdoors daily with your children and other members of your family, whenever possible. Bright lights, especially in the early morning, can also help.

Get plenty of sleep

Try to help your children stick to bedtime routines so they get enough sleep each night. Some ways to help promote relaxation and a good night’s sleep:

  • A shower or bath before bed
  • A story, song, or relaxing music
  • A back, hand, or foot rub
  • A cool, dark room
  • Using the bed just for sleep (not using your phone, watching TV or doing work or homework)

Talk it out

Talk with your children and teens ​regularly and be a good listener. Parents can also benefit from finding a friend or family member to discuss worries and disappointments. If conversation cannot be in person because of social distancing, then connect by phone, video calls, or other virtual connection.

Help your Family Eat Wisely

  • Include protein-rich foods for breakfast and lunch. Protein helps keep your blood sugar stable and gives your brain the fuel it needs. Also, if possible:
  • Eat foods rich in omega-3 fatty acids. Sources include fish (salmon, sardines, mackerel, herring); plants (flaxseeds, chia seeds, dark leafy vegetables, kidney beans, pinto beans, soybeans, walnuts, tofu); and certain oils (canola, soybean, walnut). Research suggests a diet rich in omega-3 fatty acids may help support mood.
  • Choose plenty of vegetables, fruits, and whole grains. They contain vitamins, fiber, and minerals your brain needs.
  • Limit junk food and fast food. They’re often full of fat, cholesterol, salt, and added sugars, which can cause spikes and slumps in energy that may leave us feeling irritable.

Go for gratitude

Focus on the positive. For what do you feel gratitude or appreciation? Research shows that regularly expressing gratitude helps boost overall happiness, leading to lower rates of stress and depression. Help your child write down at least three people, places, events, or things each day that make them feel thankful. Keep your own gratitude journal, too!

Step it up

Help your children to exercise or play so hard they break a sweat every day. When we exercise, our bodies release chemicals that can help boost mood. Remember to choose activities that help them stay at least 6 feet away from people outside your household. Also, try to avoid anything that involves sharing equipment such as balls, bats, and playground equipment.

Lend a hand

Helping other people makes us feel better about ourselves. It can be as simple as calling a neighbor or family member who is home alone or putting up a sign thanking people who deliver the mail. Help your children come up with at least one kind act each day. Keep a journal of all the things you and your family do for others—even the little things.

Manage screen time

Make a family media plan and limit your family’s exposure to TV and internet ads suggesting that buying things can make people happy. This will help limit messages about happiness that are false or unrealistic. It will also help you manage your family’s exposure to upsetting news. Consider instead: reading, playing cards or board games with family members, working a puzzle as a family, playing music or singing together, making a video to share, cooking together, or taking a family walk or bike ride.

Keep in mind: our electronic devices can also be used to create and maintain healthy social connections during the pandemic. You and your children may consider participating in online educational programs, virtual visits with grandparents and loved ones at higher risk from COVID-19, and participating in virtual online community events. It’s also good to become familiar with telehealth options offered by your doctor and your child’s pediatrician in case health questions arise.

Address stress

Try meditating as a family or other relaxation techniques such as yoga to help everyone decrease stress and improve mood. There are helpful mobile apps that that offer reminders take deep breaths and other tips to relax. Time in nature may help too.

What if your child’s mood doesn’t improve?

Sometimes, steps like these aren’t enough to improve your child’s mood or reduce their anxiety. Be sure to contact your pediatrician if you are concerned that your child is struggling with stress or anxiety or if you are worried they might hurt themselves or someone else. Your pediatrician can also help determine if underlying health conditions or medications may be causing mood problems. They can also connect you with other health professionals such as a psychologist, psychiatrist, or social worker.


By Kathi Kemper, MD, MPH, FAAP, a professor of Pediatrics at the Ohio State University College of Medicine. She is member of the AAP Section on Section on Integrative Medicine and is the author of Mental Health, Naturally: The Family Guide to Holistic Care for a Healthy Mind and Body published by the AAP. Last Updated: 6/24/2020. Source: American Academy of Pediatrics Section on Integrative Medicine and Mental Health Leadership Workgroup (Copyright © 2020). 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.


Stay Safe this 4th of July

On any other day of the year, would you hand your child matches or a flaming candle to play with? Probably, a hard no. You work so hard all year long to keep your child safe. Don’t let the 4th of July mess with your common sense.

With many 4th of July fireworks shows cancelled because of COVID-19 this year, there’s been a big jump in consumer fireworks sold. Lighting fireworks in the backyard or nearby field might seem like a festive and fun way to entertain the kids. However, thousands of people, most often children and teens, are injured each year while using fireworks.

Most of these injuries happen in the month around the 4th of July. In fact, an average of 180 people go to the emergency room with fireworks-related injuries every day during this time!

The AAP is part of the Alliance to Stop Consumer Fireworks, a group of health and safety organizations that urges the public to avoid the use of consumer fireworks and to only enjoy displays of fireworks conducted by trained professionals.

Fireworks were involved at least 12 deaths and more than 10,000 injuries treated in U.S. hospital emergency departments in 2019, according to the Consumer Product Safety Commission (CPSC).

Children under 15 accounted for more than a third of the injuries, which included burns and wounds to the hands, fingers and arms, the head and face, and eyes. Some of the most severe and fatal injuries happened when lit fireworks seemed not to work correctly and were being held by the victim when they exploded.

SAFER WAYS TO CELEBRATE

View from a distance.
While there are fewer community firework displays this year, some are going forward with firm social distancing rules in place. Some communities will be launching the fireworks higher so they can be seen from farther distances. Others are being held in parking lots so families can stay in their cars to view them. In addition, some displays will be televised for home viewing.

Wave a flag instead of a sparkler. Sparklers may seem relatively harmless, as fireworks go. But according to the CPSC, nearly half of fireworks injuries to children under age 5 are related to sparklers. Surprising? Consider this:

  • Sparklers burn at an extremely high heat: 1,200 degrees Fahrenheit—hot enough to melt some metals.
  • Sparks can ignite clothing on fire and cause eye injuries.
  • Touching a lit sparkler to skin can result in third degree burns.

There were about 900 emergency department-treated injuries associated with sparklers in 2019. Roughly 800 more injuries were related to firecrackers, and 400 more to bottle rockets.

Even if fireworks are legal to purchase and use in your community, they are not safe around children.

Keep the 4th of July fun, and leave the fireworks to the professionals.


Source: American Academy of Pediatrics (Copyright © 2020). 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.

Recommended Reading: Books to Build Character & Teach Your Child Important Values

​In today’s world, children and teens are bombarded with conflicting, ever-shifting standards of ethics and morality. At the same time, you are trying to teach and instill good values at home. Fortunately, a really great book has the power to counterbalance these outside influences and teach children important lessons as they grow.

It might be a book on kindness after your child experienced or witnessed cruelty. It might be a book on expressing emotions after your child s​aw or heard scary news coverage, or maybe a book on understanding differences after your child saw someone who looked differently than they do.

The American Academy of Pediatrics (AAP) and Reach Out and Read have compiled the following list of books—organized by age and topic—to help you raise children who are aware of the world around them, curious, brave, kind, and thoughtful. Parents and caregivers are encouraged to review these titles in advance of sharing them with their children.

Then read together! Books are great conversation starters that can give you an opportunity to talk to your children about these issues and help them learn and understand your family’s values.

Books to Teach Kindness

Teaching kindness to children is an important skill to build and reinforce at all ages. Young children can learn how small acts of kindness help and please others, but teens can learn broader, larger concepts grounded in morals and ethics.

Preschoolers & Early Grades

  • Stand​ in My Shoes: Kids Learning About Empathy, by Bob Sornson; illustrated by Shelley Johannes
  • Those Shoes, by Maribeth Boelts, illustrated by Noah Z. Jones
  • Kindness is Cooler, Mrs Ruler, by Margery Cuyler, illustrated by Sachiko Yoshikawa
  • What Does It Mean To Be Kind?, by Rana DiOrio, illustrated by Stéphane Jorisch
  • Ordinary Mary’s Extraordinary Deed, by Emily Pearson, illustrated by Fumi Kosaka
  • Each Kindness, by Jacqueline Woodson, illustrated by E.B. Lewis
  • The Invisible Boy, by Trudy Ludwig, illustrated by Patrice Barton
  • Heartprints, by P.K. Hallinan

Middle Grades

  • Charlotte’s Web, by E.B. White, illustrated by Garth Williams
  • Wonder, by RJ Palacio
  • Kindness: A Treasury of Buddhist Wisdom for Children and Parents, by Sarah Conover and Valerie Wahl

Teens

  • Freak the Mighty by Rodman Philbrick
  • Rules, by Cynthia Lord

Books About Expressing Emotions

Children may see anger, sadness, and loss in parents and other adults in their lives and be uncertain how to respond. Younger children may have difficulty naming their emotions, but find it easier to identify with a character in a book. Older children may have difficulty sorting through complex feelings and worry about burdening adults who are struggling themselves. Books can help children process, clarify, and put a name to their feelings.

Preschoolers & Early Grades

  • Moody Cow Meditates, by Kerry Lee MacLean
  • That’s How I Feel (Asi Me Siento), by Rourke Publishing
  • Have you Filled a Bucket Today?, by Carol McCloud, illustrated by David Messing
  • What if Everybody Did That?, by Ellen Javernick, illustrated by Colleen M. Madden
  • I Was So Mad, by Mercer Mayer
  • Do Unto Otters: A Book About Manners, by Laurie Keller
  • My Many Colored Days, by Dr Seuss

Middle Grades

  • Michael Rosen’s Sad Book, by Michael Rosen, illustrated by Quentin Blake
  • Queenie Peavy, by Robert Burch

Teens

  • Don’t Let Your Emotions Run Your Life for Teens, by Sheri Van Dijk
  • A Still Quiet Place: A Mindfulness Program for Teaching Children and Adolescents to Ease
  • Stress and Difficult Emotions, by Amy Saltzman MD
  • Learning to Breathe: A Mindfulness Curriculum for Adolescents to Cultivate Emotion
  • Regulation, Attention, and Performance, by Patricia Broderick PhD

Books About Bullying & Harassment

Bullying and harassment are difficult topics for everyone, and they are an increasing issue in schools across the country. It’s common for younger children to repeat language they’ve heard without understanding the implications of what they’re saying. Those who are harassed (or are worried about being harassed) may have strong fear and anxiety. Children who are bystanders may not know how to respond, particularly if they fear being bullied themselves.

Preschoolers & Early Grades

  • Chrysanthemum, by Kevin Henkes
  • The Hundred Dresses, by Eleanor Estes, Illustrated by Louis Slobodkin
  • Edwardo: the Horriblest Boy in the Whole Wide World, by John Burningham
  • Say Something, by Peggy Moss, Illustrated by Lea Lyon
  • Babymouse: Queen of the World, by Jennifer Holm and Matthew Holm
  • Bully B.E.A.N.S., by Julia Cook, Illustrated by Anita DuFalla
  • Confessions of a Former Bully, by Trudy Ludwig, Illustrated by Beth Adam

Middle Grades

  • Stitches, by Glen Huser
  • To This Day: For the Bullied and the Beautiful, by Shane Koyczan
  • Understanding Buddy, by Marc Kornblatt
  • Loser, by Jerry Spinelli
  • Veronica Ganz, by Marilyn Sachs
  • Blubber, by Judy Blume

Teens

  • Dear Bully: Seventy Authors Tell Their Stories, by Megan Kelley Hall and Carrie Jones
  • Speak, by Laurie Halse Anderson
  • Freak Show, by James St James
  • Stargirl, by Jerry Spinelli
  • 7 Days at the Hot Corner, by Terry Trueman

Books on Listening to Others’ Views

Learning how to listen well and respect different views are important life skills. While younger children find it difficult to take the perspective of others, they gain that ability over time. Older children may become great debaters—especially with their parents. Books can offer models for engaging with others who have different views in a respectful and productive manner.

Preschoolers/Early Grades

  • When Sophie’s Feelings Are Really, Really Hurt, by Molly Bang
  • I’m the Best, by Lucy Cousins
  • Chocolate Milk, Por Favor, by Maria Dismondy, illustrated by Donna Farrell
  • The Sandwich Swap, by Queen Rania of Jordan & Kelly DiPucchio, illustrated by Tricia Tusa
  • Junkyard Wonders, by Patricia Polacco
  • The Conquerers, by David McKee

Middle Grades

  • Zero Tolerance, by Claudia Mills
  • The Cat at the Wall, by Deborah Ellis
  • The Three Questions, by Jon Muth

Adolescents

  • This Side of Home, by Renee Watson

Books About Respecting Differences

Children are naturally curious about others (particularly other children) who fall into groups other than their own. Think of your child’s curiosity as an opportunity to teach him or her about respecting these differences. Remember, in order to raise kids to embrace diversity, you’ll need to give them access to a variety of different cultures and traditions—books are a great way to do that!

Preschoolers & Early Grades

  • I Like Myself!, by Karen Beaumont, Illustrated by David Catrow
  • Red: A Crayon’s Story, by Michael Hall
  • Giraffes Can’t Dance, by Giles Andreae, Illustrated by Guy Parker-Rees
  • Strictly No Elephants, by Lisa Mantchev, Illustrated by Taeeun Yoo
  • Two Speckled Eggs, by Jennifer K. Mann
  • Willow, by Denise Brennan-Nelson and Rosemarie Brennan, Illustrated by Cyd Moore

Middle Grades

  • Out of My Mind, by Sharon M. Draper
  • Inside Out and Back Again, by Thanhha Lai
  • The Ordinary Princess, by M. M. Kaye

Books on Social Change & Civic Engagement

Many children are drawn to helping others—even at young ages. Maybe it is raising money for a cause or having a passion for issue impacting their community. Books can help them understand the broader concepts of social justice and civic engagement. Younger children tend to thinking of things as “good vs. bad,” but as they get older they develop very sophisticated and nuanced moral reasoning.

Preschoolers & Early Grades

  • Grace for President, by Kelly DiPucchio, Illustrated by LeUyen Pham
  • A Chair for My Mother, by Vera B. Williams
  • Mama’s Nightingale: A Story of Immigration and Separation, by Edwidge Danticat, Illustrated by Leslie Staub
  • House Mouse, Senate Mouse, by Peter W. Barnes and Cheryl Shaw Barnes
  • Being Me, by Rosemary McCarney, Illustrated by Yvonne Cathcart

Middle Grades

  • Zero Tolerance, by Claudia Mills
  • Paper Things, by Jennifer Richard Jacobson
  • The Kid’s Guide to Social Action, by Barbara A. Lewis
  • Hoot, by Carl Hiaasen
  • The Chocolate War, by Robert Cormier

Teens

  • The Great Greene Heist, by Varian Johnson
  • The Grapes of Wrath, by John Steinbeck
  • The Plain Janes, by Cecil Castellucci and Jim Rugg
  • Samir and Yonatan, by Daniella Carmi
  • The Lions of Little Rock, by Kristin Levine
  • March: Book One, by John Lewis and Andrew Aydin

By Dipesh Navsaria, MPH, MSLIS, MD, FAAP. Source: American Academy of Pediatrics (Copyright © 2016). Editor’s Note: Our collective thanks to the following colleagues who also helped compose this list: Amy Shriver, MD, FAAP, Jenny Radesky, MD, FAAP, Perri Klass, MD, FAAP, Dina Joy Lieser, MD, FAAP, and the librarians at the Cooperative Children’s Book Center, School of Education, University of Wisconsin–Madison.

Talking to Children about Racial Bias

By Ashaunta Anderson, MD, MPH, MSHS, FAAP & Jacqueline Dougé, MD, MPH, FAAP

Given the tragic and racially-charged current events, many parents are wrestling with their own feelings, the hopes they have for their children, and the difficulty of helping those children thrive in a world full of racial bias.

Parents may better face today’s challenges with an understanding of how racial bias works in children, as well as strategies to help them deal with and react to racial differences.

How Do Children Learn Racial Bias?

Children learn about racial differences and racial bias from an early age and learn from their first teachers — their parents — how to deal with and react to these differences.

The process of learning racial bias is a lot like learning a new language (e.g., a child raised bilingual vs. a child who starts learning Spanish in junior high). Biology determines a critical early learning period as well as a later window where learning is much harder.

  • As early as 6 months, a baby’s brain can notice race-based differences.
  • By ages 2 to 4, children can internalize racial bias.
  • By age 12, many children become set in their beliefs—giving parents a decade to mold the learning process, so that it decreases racial bias and improves cultural understanding.

But like language immersion, children exposed to society will gain fluency in racial bias even if their parents do nothing.

Strategies to Help Children Deal with Racial Bias

There are three strategies that parents can use to help their children deal with racial bias:

  • Talk to your children and acknowledge that racial differences and bias exist.
  • Confront your own bias and model how you want your children to respond to others who may be different than them.
  • Encourage your children to challenge racial stereotypes and racial bias by being kind and compassionate when interacting with people of all racial, ethnic, and cultural groups.

How Parents Can Confront Their Own Racial Bias

Parents must first confront their own biases, so that their example is consistent with messages of racial and ethnic tolerance.

  • Be a role model. Identify and correct your own racially biased thoughts, feelings, and actions. If you want your children to believe what you preach, you have to exhibit those behaviors as well. Your everyday comments and actions will say more than anything else.
  • Have a wide, culturally diverse social network. Encourage your children to have diverse circles of friends, as well. This lends itself to engagement in multicultural activities and experiences.
  • Travel and expose your children to other communities. This can help them understand that there is diversity in the world that might not be represented in the community that you live in.
  • Do not reverse stereotype police officers and other groups or talk about law enforcement in a negative way.
  • Get involved in your child’s school, your place of worship, and politics. Parents who are involved in this way are better able to advocate for fair treatment of racially marginalized groups and raise awareness of race issues in other groups.

Tips for Talking About Racial Differences & Racism

Talking about race is not racist. It’s OK—and important. From a young age, children may have questions about racial differences and parents must be prepared to answer them. But, it’s important to keep your child’s developmental readiness in mind.

  • For preschoolers: At this age, your child may begin to notice and point out differences in the people around you (i.e., at the grocery store, at the park, etc.). If your child asks about someone’s skin tone, you might say, “Isn’t it wonderful that we are all so different!” You can even hold your arm against theirs to show the differences in skin tones in your family.
  • For gradeschoolers: This is the age that is important to have open talks with your child about race, diversity, and racism. Discussing these topics will help your child see you as a trusted source of information on the topic, and he or she can come to you with any questions. Point out stereotypes and racial bias in media and books such as villains or “bad guys” in movies.
  • If your child makes comments or asks you questions about race based on school incidents or something they read or watched: Further the discussion with questions such as, “How do you feel about that?” and “Why do you think that?” This is also helpful if your child heard something insensitive or if your child experienced racial bias themselves. Before responding to his or her statement or question, figure out where it came from and what it means from his or her perspective.

These conversations begin to lay the groundwork for your child to accept and respect everyone’s differences and similarities. As children mature, the answers to questions will become more complex. These are moments to learn what your child understands or is struggling to understand about racial bias.

Remember:

To create a culture of inclusiveness, we all must look at and acknowledge our biases, so we can do something about the ones that are unfair or cause harm to others—like racial bias. Understanding the way people feel about and behave toward those outside their own group can help communities heal after a tragedy, as well as prevent future ones.


Author: Ashaunta Anderson, MD, MPH, MSHS, FAAP & Jacqueline Dougé, MD, MPH, FAAP. Source: American Academy of Pediatrics (Copyright © 2016). 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.


Talking to Children about Racism: The Time is Now

Horrific events like the killing of George Floyd and the protests and civil unrest that followed graphically illustrate how racism and discrimination harms everyone in our communities.

The American Academy of Pediatrics condemns racism in all forms. And pediatricians are deeply concerned about the effects of racism on children. Even vicarious racism – secondhand racism witnessed through social media, conversations with friends or family, or media images – harms children’s health. ​

Children are listening

As a parent, you must assume children of almost any age are hearing about what is happening in our nation today. They may overhear adult conversations, see a video on YouTube, or watch news coverage of violent protests. They may feel afraid for their own safety or their family’s safety. They might have questions about what the protests mean, why people have been killed by police, and if they are safe. ​
How to help your children understand

Ideally you can talk with them first, in ways they can understand, before they hear about it from other sources. When talking to your children, keep the following tips in mind:

  • Check in with your child. Ask what they know, what they’ve seen, and how they are feeling. Tell them you understand their feelings and reassure them it’s normal to feel these emotions. You know your child best and what information they can handle. For younger children, tell them what you are doing to keep your family safe. For pre-teens and older children, ask if they’ve ever experienced mistreatment or racism, or seen it happening to others.
  • Watch for changes in your child’s behavior. Some children may become more aggressive, while others will become withdrawn or scared. If you are concerned that your child may be struggling with anxiety, fear or distress, call your pediatrician or mental health provider for additional support.
  • Limit what your child sees in the media. Do not leave the TV on in the background. With older children and teens, watch with them and talk together about what you’re seeing. Listen to their observations and share your own. Use commercial breaks, or pause the video, to have brief discussions. With younger children, limit TV, smartphone, or tablet use, especially when the news is on. Make sure the media they do see occurs in a common area where you can check in.
  • Be aware of your own emotions. As an adult, tune into how you are feeling and check that you are ok. If you are not, ask for help to deal with the trauma and emotional impact of these events and images. Make a list of your own coping strategies, and when you need to use them, tap into that list.
  • Use this teachable moment. For all families, this is an opportunity to discuss the history of racism and discrimination in the US and help your children discover ways to make change. ​
  • Resources can help. If you struggle to find the “right” words, try using books or other resources to share with your child. The tips in this article can also help. Remind your children that no one is perfect, talk about what you are doing to be anti-racist, what you have learned, and how you as a family can step up.

Talk and act

It’s OK to acknowledge that people are treated differently based on the color of their skin and where they live and share examples of this happening. But this is also an opportunity to show your children how to make a positive difference. For example, perhaps your family can call your city council person or superintendent to advocate for issues faced by communities of color. Think about how you might confront your own biases and show how you want your children to respond to others who may be different than them.​

Remember

These are conversations that many Black American families have had for years. But if this is not something your family has discussed yet, what is happening right now is a teachable moment. If we are to progress in this country, it’s going to be because we help our children, adolescents and young adults learn not just that racism exists, but that it is something all of us can work together to dismantle. ​


By Nia Heard-Garris MD, MSc, FAAP & Jacqueline Dougé, MD, MPH, FAAP​. Source: American Academy of Pediatrics (Copyright © 2020).

Breastfeeding During the COVID-19 Pandemic

The outbreak of COVID-19 is a stressful time for everyone. This may be especially true for mothers who are breastfeeding and concerned about their baby’s health. However, new moms can successfully start and maintain breastfeeding during the pandemic​, with some recommended precautions.

Benefits of breastfeed​ing d​uring a pandemic

  • Breastfeeding is good for babies. It protects them from many infections. While it is still not clear if this is true for the COVID-19 virus, breastfed infants are generally less likely to have severe respiratory symptoms when they get sick.
  • Breastfeeding i​s good for moms. Hormones released in the mother’s body during breastfeeding promote wellness and can relieve stress and anxiety.
  • Breast milk is readily available. No purchase necessary!

Is breastfeeding and exp​ressed breast milk feeding safe during the COVID-19 pandemic?

COVID-19 spreads between people who are in close contact, mainly through respiratory droplets when an infected person coughs, sneezes, or talks. To date, there is no evidence that COVID-19 is passed from mother to baby in breastmilk. Breastfeeding has been shown to be safe when a mom has other illnesses like the flu.

Can my baby continue breas​tfeeding or drinking expressed breast milk if I test positive for COVID-19 or if I am a person under investigation?

Yes, babies can still receive breast milk even if you test positive for COVID-19. It is recommended that you pump or express your breast milk after carefully cleaning your breasts and hands and have a healthy caregiver feed your baby the expressed breast milk.

It’s also very important to clean your breast pump after each use. Follow CDC guidelines for proper cleaning and disinfecting recommendations.

Remind all caregivers to wash hands thoroughly before touching bottles, or feeding or caring for your baby. If you decide to breastfeed directly, take all the recommended steps to prevent the potential spread of the virus, including using a mask and following careful breast and hand hygiene.

If I have COVID-19, can​ I stay in the same room with my infant?

If you have COVID-19 or are suspected of having COVID-19, staying in a different room from your baby is the safest way to keep your newborn healthy. A healthy caregiver should take care of the baby and can feed expressed breast milk.

If you and your family decide to keep your baby in the same room as you, keep a distance of at least 6 feet from your baby. When closer than 6 feet, wear a mask and make sure your hands are clean.

If you have COVID-19, you can stop isolating yourself from your baby once you are fever-free without use of fever medicines (acetaminophen or ibuprofen) for at least 72 hours; when your other symptoms of COVID-19 are improving; and when at least 10 days have passed since your symptoms started.

​Tip: Ask your pediatrician​ for help with getting your baby to latch on again once you can restart breastfeeding.​

How can I maintai​n my milk supply if I am sick with COVID-19?

Hand pumping and hand expressing breast milk is especially helpful in the first few days after your baby is born to get the milk supply going. Frequent pumping (or breastfeeding if you have chosen to directly breastfeed and are following the strict precautions noted above) should line up with your infant’s feeding demands, about 8-10 times in a 24-hour period.

Most medications are safe to take while breastfeeding, but always check with your doctor.

​While this may be a stressful time, try to stay optimistic and practice healthy habits to reduce stress as much as possible. This includes getting enough sleep, eating​​ plenty of healthy foods, and getting regular exercise.​

Do not hesitate to ask for help if you have trouble with feeding, nipple pain, low milk supply, or with any other concerns.

How can I protect my infant from​ COVID-19 infection?

Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer. Look for one that is 60% or higher alcohol-based. Avoid touching your face, eyes, nose, or mouth with unwashed hands. Also, be sure to clean visibly dirty or possibly contaminated surfaces your infant may touch.

If you feel sick, be extra careful to cough or sneeze into your sleeve or a tissue. Throw away used tissues immediately and wash your hands.

Practice physical distancing by avoiding public spaces and stay 6 feet away from others whenever possible. And be sure that everyone in your home avoids close contact with anyone with respiratory symptoms such as coughing or individuals with probable COVID-19.

Your pediatrician is here to ​help

After leaving the hospital, it is important that your baby’s first follow-up visit happen in person so your baby can be measured and weighed accurately. Many doctors are scheduling newborn visits during specific times (such as first thing in the morning) to limit exposure to sick patients. While some doctors are also doing more work via phone and video, this is not the best option for newborns.

Rem​ember

Breastfeeding is a key preventive health step for baby and mother, even during the pandemic. Talk with your pediatrician about how to keep your baby healthy and what resources might be available in your community to help you.


By Temitope Awelewa, MBCHB, MPH, FAAP, IBCLC, is a board-certified general pediatrician, a physician informatics officer and a clinical assistant professor of pediatrics at the University of Iowa. Within the American Academy of Pediatrics, she is a member of the Section on Breastfeeding and the Chapter Breastfeeding Coordinator for the Iowa Chapter of the American Academy of Pediatrics. Source: American Academy of Pediatrics (Copyright © 2020). 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.