Gratitude As A Life Skill

Check out this video from Go Strengths: Nik receives an assignment in school to write down all the things he is grateful for in his Gratitude Journal. He has a hard time thinking of things to be grateful for, but when his friend Sam gives him a pair of GoGoggles!, he sees the world in a different way. He realizes there are many things around him that are part of his everyday life for which he can be grateful.

Go Strengths is an online resources for parents, teachers and mental health professionals that focused on eight skills for wwell-being: goal-setting, problem-solving, resilience, optimistic thinking, character strengths, emotional intelligence, social connections, and self-confidence. Click here to learn more.

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Encouraging Teens to Take Responsibility for Their Own Health

As children mature, they may become increasingly reluctant to share health concerns with Mom and Dad; partly out of modesty and partly to assert their independence. That is why teenagers need a pediatrician in whom they can confide.

Now is also the time for teens to learn to become savvy medical consumers. They should be encouraged to schedule their own doctors’ visits and to ask questions anytime they don’t understand something the pediatrician has said. Where health matters are concerned, there is no such thing as a “dumb” question. Every patient, regardless of age, is entitled to clear explanations of her condition and the recommended treatment plan.

Above all, adolescents need to be coached on the importance of taking medications as directed. If there is one source of frustration for pediatricians, it’s their young patients’ lack of compliance (although as Dr. Kulig, M.D., M.P.H. points out, “compliance among adults isn’t much better”). In one study of children suffering from throat infections, more than 80 percent failed to finish their antibiotics, which had been prescribed for ten days. Presumably, most of them started to feel better after several days and figured they could stop taking the medicine. But we know that the entire course of antibiotics must be completed in order to fully eradicate the infection. Otherwise, the bacteria regain a foothold, stronger than ever, and the symptoms return.

Teens may also resist following doctors’ orders as a display of rebellion. Dr. Kulig advises that parents monitor their youngster’s compliance, but without assuming the mantle of responsibility. The most successful strategy, he’s found, “is to solicit kids’ input about how to best stick to medication schedules, rather than demanding, ‘You must take this medicine.’ ” He offers several tips:

To eliminate confusion, post a calendar on the refrigerator and place a check mark in the appropriate box each time the medication is taken. Or purchase an inexpensive plastic pill holder, in which oral drugs are stored according to the day of the week and daily Sunday through Saturday, and dose (morning, afternoon, evening).

Have the teenager take the medicine at the same time as one of his daily rituals, like brushing his teeth. “It becomes a cue for compliance,” explains Dr. Kulig. “When they brush their teeth in the morning and at night, they remember they need to take their medicine.”

Practice positive reinforcement. Praise your adolescent each time he adheres to the medication schedule.

Remind young men and women why a medication has been prescribed. “Adolescents should understand the purpose of the therapy as well as the potential consequences of noncompliance,” says Dr. Kulig. “They should also be aware of how long they may have to be on the medication before they can expect to see optimum results.

“For instance, some acne medications can take upward of twelve weeks to start working. If a teen gets discouraged and discontinues the drug, obviously the acne won’t get better. Likewise, if he grows impatient and overuses it, he may irritate and dry out the skin.”

Another reason for supervising young people’s consumption of medicines is that some drugs have the potential for abuse, whether they’re prescribed or over-the-counter. “Tylenol is a good example,” says Dr. Kulig. “Too high a dose can basically destroy the liver.” Most overdoses of nonprescription agents are taken intentionally, as part of suicide attempts, but excessive amounts can be ingested accidentally. “Teenagers,” he stresses, “are not aware of how toxic these products can be.”

As a precaution, it’s wise to never leave a family member’s medication out where it can fall into the hands of an inquisitive child or a teenage pal looking for a “legal” high. According to Dr. Timothy Wilens, a pediatric psychiatrist at Massachusetts General Hospital, also in Boston: “Most prescription drugs are abused not by the kids for whom they’re prescribed, but by other children. All containers should be stored away, with each dose administered individually.”

Questions to Ask the Pediatrician Before a Teenager Starts Any New Medication

  • What are the medication’s generic name and trade name?
  • What is the purpose of using this medication?
  • How often should the medication be taken, and at what time(s) of day?
  • What is the dosage?
  • Is it necessary to swallow this medication with food or milk?
  • If your youngster has difficulty ingesting pills, ask if the medication can be crushed, or if it comes in the form of a liquid, skin patch, rectal suppository, inhaler or nose spray.
  • Are there any foods or beverages to avoid while on this medication?
  • Will the drug interfere with other medications my child is taking, or vice-versa?
  • List for the pediatrician all medications your teenager takes, including over-the-counter agents, nutritional supplements and “natural” herbal remedies.
  • What should we do if we miss a dose?
  • For how long must the medicine be taken? Does my child have to finish the entire prescription?
  • Does the prescription include refills? If so, how many? What should we do if we need a new prescription ordered?
  • What are the potential side effects of this drug, and which ones should we report to you?
  • If side effects occur, how will they be managed?
  • When will we be able to tell if the medicine is working?
  • How much does the prescription cost?
  • Is there any written information available about the medication?

Source: Caring for Your Teenager (Copyright © 2003 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.


Helping Children Handle Stress

How can we help our children handle the stresses of everyday life?

In middle childhood, pressures may come from a number of sources-from within the child herself, as well as from parents, teachers, peers and the larger society in which the child lives. Pressure can take many forms that challenge children and to which they must respond and, often, adapt. Whether these are events of lasting consequence like the divorce of their parents, or merely a minor hassle like losing their homework, these demands or stresses are a part of children’s daily existence.

Children welcome some events and are able to adapt to them with relative ease. They perceive other events as threats to their own or the family’s daily routines or general sense of well-being, and these stresses are more troublesome. Most stress faced by children is in the middle, neither welcomed nor seriously harmful, but rather a part of accomplishing the tasks of childhood and learning about themselves.

Youngsters may also worry about making friends, succeeding in school, combating peer pressure or overcoming a physical impairment. Whatever its form, if stress is too intense or long-lasting, it can sometimes take a toll on children. Clusters of stressful events seem to predispose children to illness. Major events, especially those that forever change a child’s family, like the death of a parent, can have lasting effects on children’s psychological health and well-being. Minor daily stresses can also have consequences. They can contribute to loss of sleep or appetite. Children may become angry or irritable or their school grades may suffer. Their behavior and their willingness to cooperate may change.

How different children cope with stress

Children’s temperaments vary and thus they are quite different in their ability to cope with stress and daily hassles. Some are easygoing by nature and adjust easily to events and new situations. Others are thrown off balance by changes in their lives. All children improve in their ability to handle stress if they previously have succeeded in managing challenges and if they feel they have the ability and the emotional support of family and friends. Children who have a clear sense of personal competence, and who feel loved and supported, generally do well.

Certainly, a child’s age and development will help determine how stressful a given situation may be. Changing teachers at midyear may be a major event for a child in the first grade and merely an annoyance for a sixth-grader. Being short may be a minor issue for a 5- or 6-year-old boy but a source of daily embarrassment for an adolescent. How a child perceives and responds to stress depends in part on development, in part on experience, and in part on a child’s individual temperament.

Ironically, many parents believe that their school-age children are unaware of the stresses around them and are somehow immune to them. After all, their children not only have all their basic needs met, but perhaps they also have a roomful of toys, friends to share them with, plenty of playtime, and a full schedule of extracurricular activities.

Yet children are very sensitive to the changes around them, especially to the feelings and reactions of their parents, even if those feelings are not communicated directly in words. If a parent loses a job, children will have to adjust to their family’s financial crisis; they must deal not only with the obvious family budgetary changes but also with the changes in their parents’ emotional states. Children may have to cope with a bully on the playground, a move to a new neighborhood, a parent’s serious illness or the disappointment of a poor sports performance. They might feel a constant, nagging pressure to dress the “right” way, or to achieve the high grades that can put them on the fast track toward the “right” college.

Stress and today’s middle-years child

Some psychologists believe that today’s middle-years youngsters actually are faced with more stress than the children of previous generations were and have fewer social supports available. The change in family structure from the large, supportive, extended families (including both parents, aunts, uncles and grandparents) of previous generations, to the present high incidence of divorced families, single-parent families and stepfamilies has drastically altered the experience of childhood. Millions of youngsters must adjust to such changes.

Even in intact and stable families, the growing number of households with two working parents often forces children to spend more time in after-school programs or at home alone. For some children this loss of time with their parents is quite stressful. So, too, is the responsibility for caring for themselves and the family home and sometimes for overseeing a younger sibling after school.

Many children and their families are stressed by the multiple activities that fill children’s “free time.” Overscheduled children with inadequate “down time” can become exhausted.

Today’s children are also being raised in an era in which they are exposed to violence and peer pressure about sexual activity and drug use and are warned to be cautious about kidnapping, sexual abuse and other crimes. This sense that they are living in an unsafe world is a constant source of stress for some children. In short, today’s youngsters are regularly confronted with challenges to their coping skills and often are expected to grow up too fast.

Good and bad stress

Not all stress is bad. Moderate amounts of pressure imposed by a teacher or a coach, for example, can motivate a child to keep her grades up in school or to participate more fully in athletic activities. Successfully managing stressful situations or events enhances a child’s ability to cope in the future.

When the stress is continuous or particularly intense, it takes a toll on both the psyche and the body. Sudden stressful events will accelerate your child’s breathing and heartbeat, constrict her blood vessels, increase her blood pressure and muscle tension and perhaps cause stomach upset and headaches. As stress persists, she might be more susceptible to illness and experience fatigue, nightmares, teeth-grinding, insomnia, tantrums, depression and school failure.


Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 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.


Halloween Safety Tips

​Halloween is an exciting time of year for kids. Here are some tips from the American Academy of Pediatrics (AAP) to help ensure they have a safe holiday.

All Dressed Up:

  • Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
  • Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.
  • Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives. Hats should fit properly to prevent them from sliding over eyes. Makeup should be tested ahead of time on a small patch of skin to ensure there are no unpleasant surprises on the big day.​
  • When shopping for costumes, wigs and accessories look for and purchase those with a label clearly indicating they are flame resistant.
  • If a sword, cane, or stick is a part of your child’s costume, make sure it is not sharp or long. A child may be easily hurt by these accessories if he stumbles or trips.
  • Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as “one size fits all,” or “no need to see an eye specialist,” obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss.
  • Review with children how to call 9-1-1 (or their local emergency number) if they ever have an emergency or become lost.

Carving a Niche:

  • Small children should never carve pumpkins. Children can draw a face with markers. Then parents can do the cutting.
  • Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.
  • Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and not on a porch or any path where visitors may pass close by. They should never be left unattended.

Home Safe Home:

  • To keep homes safe for visiting trick-or-treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations.
  • Parents should check outdoor lights and replace burned-out bulbs.
  • Wet leaves should be swept from sidewalks and steps.
  • Restrain pets so they do not inadvertently jump on or bite a trick-or-treater.

On the Trick-or-Treat Trail:

  • A parent or responsible adult should always accompany young children on their neighborhood rounds.
  • Obtain flashlights with fresh batteries for all children and their escorts.
  • If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.
  • Only go to homes with a porch light on and never enter a home or car for a treat.

Because pedestrian injuries are the most common injuries to children on Halloween, remind trick-or-treaters:

  • Stay in a group and communicate where they will be going.
  • Remember reflective tape for costumes and trick-or-treat bags.
  • Carry a cell phone for quick communication.
  • Remain on well-lit streets and always use the sidewalk.
  • If no sidewalk is available, walk at the far edge of the roadway facing traffic.
  • Never cut across yards or use alleys.
  • Only cross the street as a group in established crosswalks (as recognized by local custom). Never cross between parked cars or out driveways.
  • Don’t assume the right of way. Motorists may have trouble seeing trick-or-treaters. Just because one car stops, doesn’t mean others will!

Healthy Halloween:

  • A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats.
  • Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
  • Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.
  • Try to ration treats for the days and weeks following Halloween.​

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.


Avoid a Food Allergy Scare on Halloween

Halloween is one of the trickiest days of the year for children with food allergies. Kids often haul home pounds of treats, and even small amounts of an ingredient they are allergic to can cause a potentially life-threatening reaction.

Here are some tips from the American Academy of Pediatrics (AAP) to help ensure Halloween’s frights stay festive and don’t involve a medical emergency.

Reading before Eating

  • Always read the ingredient label on any treat your child receives. Many popular Halloween candies contain some of the most common allergens, such as peanuts or tree nuts, milk, egg, soy or wheat.
  • If the ingredients aren’t listed, arrange for a treat “exchange” with classmates or friends. Or, bag up the goodies your child can’t eat because of an allergy and leave them with a note asking the “Treat Fairy” to swap them for a prize.
  • Be aware that even if they are not listed on the ingredient label, candies (both chocolate and non-chocolate) are at high risk of containing trace amounts of common allergy triggers, because factories often produce many different products. Also, “fun size” or miniature candies may have different ingredients or be made on different equipment than the regular size candies, meaning that brands your child previously ate without problems could cause a reaction.
  • Teach your child to politely turn down home-baked items such as cupcakes and brownies, and never to taste or share another child’s food.

Food-Free Fun

  • Offer non-edible goodies to trick-or-treaters and classmates. Food Allergy Research &Education’s Teal Pumpkin Project, which promotes safe trick-or-treating options for food-allergic children, suggests items such as glow sticks, spider rings, vampire fangs, pencils, bubbles, bouncy balls, finger puppets, whistles, bookmarks, stickers and stencils. Consider supplying some to neighbors whose homes your child will visit.
  • Plan alternatives to trick-or-treating, such as slumber parties or get-togethers to watch age-appropriate creepy movies.
  • Center parties around festive activities such as costume parades, pumpkin decorating contests, Halloween themed games, crafts and scavenger hunts or spooky storybooks.

Don’t Keep Others in the Dark

  • Inform teachers and other adults with your child about the food allergy and how to react to an emergency.
  • Don’t let your child trick-or-treat alone, and make sure they have an epinephrine auto-injector with them. Anyone with a cell phone should fully charge it before heading out.
  • Explain symptoms of anaphylaxis, a severe allergic reaction, such as shortness of breath, difficulty swallowing, hoarseness, swelling of lips or tongue and dizziness.
  • Even if epinephrine is administered right away and anaphylaxis symptoms seem to stop, the child treated always should be taken to the emergency room.

Source: American Academy of Pediatrics (Copyright © 2015). 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.


Martial Arts for Your Child

More than 6 million children in the United States participate in martial arts. Martial arts are known to improve social skills, discipline, and respect in children. Children can also improve their abilities to concentrate and focus on activities, as well as bettering their motor skills and self-confidence. Martial arts can be fun and beneficial at any age.

The term martial arts can be used to describe any number of styles or disciplines of self-defense practices. There are many different styles practiced around the world, with the most popular forms being karate, tae kwon do, and judo.

  • Karate (KAH-rah-teh) means “empty hand,” as it
    is normally practiced without weapons.
    Karate is a traditional Japanese form. The hands and feet are trained and prepared for use in a weaponless form of self-defense.
  • Tae kwon do (tahy-kwon-doh) means “the way of foot and fist.” This is a traditional Korean martial art. It is also the most popular. This form highlights discipline, respect, and personal growth and focuses on the use of the feet for powerful kicks in self-defense.
  • Judo (joo-doh) means “gentle way” and is known for a variety of throwing techniques. It uses many methods to control an opponent while on the ground. In many ways it is more similar to wrestling than to the other martial arts.
  • Kung fu (kung-foo) most commonly translates to “hard work” and is one of the oldest forms of martial arts. The term may be used to describe all of the hundreds of Chinese martial arts. Kung fu is mainly a “stand-up” form of the martial arts, known for its powerful blocks. Wushu is the most popular and modern form of kung fu.
  • Aikido (eye-key-do) means “way of harmony.” This Japanese martial art is known as a throwing style. It teaches a nonaggressive approach to self-defense, focusing on joint locks, throws, and restraining techniques, rather than kicks and punches. While aikido may be learned at any age, it is especially popular among women and older adults. Aikido is not practiced as a competitive sport.
  • Jujitsu (joo-jit-soo) means “the art of softness” and emphasizes techniques that allow a smaller fighter to overcome a bigger, stronger opponent. First practiced in Japan, jujutsu is considered a ground fighting or grappling style of the martial arts. Many of the forms have been incorporated into other martial arts such as judo, karate, and aikido. The arm lock and submission techniques have been taught to police all over the world.

While the martial arts are relatively safe, injuries can happen because there is physical contact between opponents. The following is information from the American Academy of Pediatrics (AAP) about how to prevent martial arts injuries. Also included is an overview of martial arts forms.

Injury prevention and safety tips

  • Instructors. Experienced instructors will teach at a level appropriate for your child’s age and maturity. Lessons should emphasize technique and self-control. Experienced instructors will carefully advance your child through more complex training. Lessons should also be fun. Visit a variety of instructors and ask about their experiences with young children and their teaching philosophy.
  • Technique. An instructor’s emphasis on technique and self-control is very important in limiting the risk for injury. Children should learn to punch and kick with their hands and feet in proper position and using the appropriate amount of force. Kicks and punches with the hand or foot in the wrong position can cause injuries to fingers and toes. Punches or kicks that are too hard can cause pain or bruises. Contact to the head should be discouraged.
  • Equipment. Safety gear should fit properly and be well maintained.
    • Headgear. When the rules allow, protective headgear should be worn for sparring or for activities with risk of falling, such as high jumps or flying kicks.
    • Body pads can help protect against scrapes and bruises and limit the pain from kicks and punches. Arm pads, shin pads, and chest protection for sparring.
    • Mouth guards.
  • Environment. Mats and floors should be safe to play on. Gaps between mats can cause sprained ankles. Wet or worn floors can cause slips and falls.

Common injuries may include scrapes and bruises, sprains and strains, finger and toe injuries, head injuries. Martial arts injuries can be prevented with proper supervision and compliance with the rules and safety guidelines in place for martial arts.


Source: Care of the Young Athlete Patient Education Handouts (Copyright © 2010 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.


Helping Your Child Learn to Read

How can I help my child learn to read?

Reading books aloud is one of the best ways you can help your child learn to read. This can be fun for you, too. The more excitement you show when you read a book, the more your child will enjoy it. The most important thing to remember is to let your child set her own pace and have fun at whatever she is doing. Do the following when reading to your child:

  • Run your finger under the words as you read to show your child that the print carries the story.
  • Use funny voices and animal noises. Do not be afraid to ham it up! This will help your child get excited about the story.
  • Stop to look at the pictures; ask your child to name things she sees in the pictures. Talk about how the pictures relate to the story.
  • Invite your child to join in whenever there is a repeated phrase in the text.
    Show your child how events in the book are similar to events in your child’s life.
  • If your child asks a question, stop and answer it. The book may help your child express her thoughts and solve her own problems.
  • Keep reading to your child even after she learns to read. A child can listen and understand more difficult stories than she can read on her own.

Listening to your child read aloud

Once your child begins to read, have him read out loud. This can help build your child’s confidence in his ability to read and help him enjoy learning new skills. Take turns reading with your child to model more advanced reading skills.

If your child asks for help with a word, give it right away so that he does not lose the meaning of the story. Do not force your child to sound out the word. On the other hand, if your child wants to sound out a word, do not stop him.

If your child substitutes one word for another while reading, see if it makes sense. If your child uses the word “dog” instead of “pup,” for example, the meaning is the same. Do not stop the reading to correct him. If your child uses a word that makes no sense (such as “road” for “read”), ask him to read the sentence again because you are not sure you understand what has just been read. Recognize your child’s energy limits. Stop each session at or before the earliest signs of fatigue or frustration.

Most of all, make sure you give your child lots of praise! You are your child’s first, and most important, teacher. The praise and support you give your child as he learns to read will help him enjoy reading and learning even more.
Learning to read in school

Most children learn to read by 6 or 7 years of age. Some children learn at 4 or 5 years of age. Even if a child has a head start, she may not stay ahead once school starts. The other students most likely will catch up during the second or third grade. Pushing your child to read before she is ready can get in the way of your child’s interest in learning. Children who really enjoy learning are more likely to do well in school. This love of learning cannot be forced.

As your child begins elementary school, she will begin her formal reading education. There are many ways to teach children to read. One way emphasizes word recognition and teaches children to understand a whole word’s meaning by how it is used. Learning which sounds the letters represent—phonics—is another way children learn to read. Phonics is used to help “decode” or sound out words. Focusing on the connections between the spoken and written word is another technique. Most teachers use a combination of methods to teach children how to read.

Reading is an important skill for children to learn. Most children learn to read without any major problems. Pushing a child to learn before she is ready can make learning to read frustrating. But reading together and playing games with books make reading fun. Parents need to be involved in their child’s learning. Encouraging a child’s love of learning will go a long way to ensuring success in school.

Reading tips

The following are a few tips to keep in mind as your child learns to read:

  • Set aside time every day to read together. Many children like to have stories read to them at bedtime. This is a great way to wind down after a busy day and get ready for sleep.
  • Leave books in your child’s room for her to enjoy on her own. Make sure her room is reading-friendly with a comfortable bed or chair, bookshelf, and reading lamp.
  • Read books that your child enjoys. After a while, your child may learn the words to her favorite book. When this happens, let your child complete the sentences or take turns reciting the words.
  • Do not drill your child on letters, numbers, colors, shapes, or words. Instead, make a game out of it and find ways to encourage your child’s curiosity and interests.

Source: Helping Your Child Learn to Read (Copyright © 1999 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.


Is Your Child Overweight?

Pediatricians evaluate children’s growth and build by means of standardized growth charts and body mass index (BMI). Growth charts show whether a child falls within the normal range of height and weight for her age. Children whose weight or height is above the 85th or below the fifth percentile should be examined by a doctor to determine whether further evaluation is needed. Pediatricians also will watch for fluctuations in children’s weight, which may mean something has changed and put them on the path toward gaining excess weight.

Body mass index is a calculation of your child’s weight relative to height. A BMI above the 85th percentile means overweight, while children above the 95th percentile are considered obese, which increases their risk of chronic diseases such as heart disease and diabetes. The BMI percentile that defines severe obesity is 120% of the 95th percentile. If your child’s BMI is between the 85th and 95th percentiles, her excess weight may be fat or muscle. Growth charts and BMI tell only part of the story because neither method measures body fat. Children and adolescents who are particularly athletic with unusually muscular or lean builds may have a high BMI without having excess fat or being obese. In some obesity clinics, as many as 10% to 15% of children fall into this category. Also keep in mind that there are small differences between African American and white children; at the same BMI measurement, African American children and teenagers tend to have more muscle and bone mass and less body fat. However, almost all children and adolescents with a BMI above the 95th percentile have too much body fat, regardless of their ethnicity or muscularity.

Some parents wonder how it is possible for 17% of 2- to 19-year-olds to be obese when only 5% of the population should have a BMI above the 95th percentile. The BMI charts were based on children and teens studied before 1988, when not as many youth were obese. At that time, only 5% of children and teens were obese.

If your child is overweight because her frame size is increased, reassure her that her extra weight is not fat and encourage her to be physically active to maintain her muscle tone. Also, be actively involved in any discussions with your pediatrician and your child about your child’s weight. To prevent worries about body size, parent and child need to accept the child’s body type. Other members of the family may have a similar build. If you focus inappropriately on weight alone and pester your child to lose weight, she may develop a distorted body image and risk an eating disorder. It’s estimated that 70% to 80% of girls perceive themselves, whether rightly or wrongly, as too fat. Experts warn that a misperception of body image may be partly fueling the current obesity epidemic, with inappropriate dieting followed by rebound weight gain.

Choose to Be Happy – Many adolescents, particularly girls, become deeply unhappy when they realize that they are never going to be shaped like supermodels or earn multimillion-dollar contracts as movie stars.

Help your daughter feel comfortable with who she is. Reassure her that real beauty is more than skin deep. Help her develop her skills and talents and emphasize her positive attributes. Offer her female role models who have made the most of their talents, achieving intellectual and humanitarian goals or raising healthy, balanced children, instead of trading on their looks for superficial success.


Source: Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011). 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.


Types of Exercise for Teens

Aerobic Exercise

A teen’s fitness program should include aerobic exercise such as brisk walking, basketball, bicycling, swimming, in-line skating, soccer, jogging—any continuous activity that increases heart rate and breathing. Regular workouts improve the efficiency of the cardiorespiratory system, so that the heart and lungs don’t have to work as hard to meet the body’s increased demands for freshly oxygenated blood.

Aerobic exercise also affects body weight composition, by burning excess calories that would otherwise get converted to fat. In general, the more aerobic an activity, the more calories are expended. For instance, if a teenager weighing 132 pounds walks at a moderate pace for ten minutes, he burns forty-three calories. Running instead of walking more than doubles the amount of energy spent, to ninety calories.

Low-intensity workouts burn a higher percentage of calories from fat than high-intensity workouts do. However, the more taxing aerobic exercises ultimately burn more fat calories overall. One study compared the burn rates for a thirty-minute walk at three and a half miles per hour and a thirty-minute run at seven miles per hour. The walking group expended an average of 240 calories. Two-fifths came from fat, and three-fifths came from carbohydrates, for a total of ninety-six fat calories. In the running group, the ratio of fat energy burned versus carbohydrate energy burned was significantly less: one to four. Yet overall, the runners consumed 450 calories. Total number of fat calories burned: 108.

Weight Training

Under the guidance of well-trained adults, children aged eight or older can safely incorporate weight training (also called strength training and resistance training) into their workouts to increase muscle strength and muscle endurance. Muscle strength refers to the ability to displace a given load or resistance, while muscle endurance is the ability to sustain less-intense force over an extended period of time. Males will not be able to develop large muscles until after puberty. Females generally are not able to develop large muscle mass. They do not have to worry about getting too muscular.

The Proper Technique: Less Weight, More Reps – Multiple studies show that young people gain strength and endurance faster by lifting moderately heavy weights many times rather than straining to hoist unwieldy loads for just a few repetitions.

Teens should always be supervised by a qualified adult, who can help them and demonstrate the proper technique. For that reason, it’s safer to work out at school or at a health club than on home exercise equipment. Other precautions to take include the following:

  • See your pediatrician for a physical and medical checkup before your youngster starts training.
  • Remember that resistance training is a small part of a well-rounded fitness program. Experts generally recommend that adolescents exercise with weights no more than three times a week.
  • Don’t overdo it (part 1): Excessive physical activity can lead to injuries and cause menstrual abnormalities. Your teenager may be exercising too much if her weight falls below normal or her muscles ache. Complaints of pain warrant a phone call to your pediatrician.
  • Don’t overdo it (part 2): Teens should be reminded not to step up the weight resistance and number of repetitions before they’re physically ready. Getting in shape takes time.
  • Drink plenty of fluids when exercising. Young people are more susceptible to the effects of heat and humidity than adults. Teens’ ability to dissipate heat through sweating is not as efficient as adults. The Centers for Disease Control and Prevention recommends that teens drink at least two six-ounce glasses of water before, during and after working out in steamy conditions.
  • Always warm up and cool down with stretching exercises before and after training. Stretching the muscles increases their flexibility: the ability to move joints and stretch muscles through a full range of motion, and the fourth component of physical fitness. It also helps safeguard against injury.

Source: Caring for Your Teenager (Copyright © 2003 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.


Keeping Preschoolers Active

Pediatricians are more aware than ever that a growing number of children are overweight. Your doctor has been keeping track of your child’s height and weight since infancy, and he’ll be able to calculate whether your child weighs more than he should.

Steps You Can Take Now to Reduce Your Child’s Likelihood of Becoming Obese and on Track for a Healthy Life

  • Give some thought to the physical activity in your child’s life. Even though he continues to be a bundle of endless energy, a lot of that energy often goes to waste. Many preschoolers spend several hours a day in front of the TV or computer screen, rather than playing outdoors. In fact, today’s children are only one-fourth as active in their day-to-day lives as their grandparents were.
  • Whether or not your four- or five-year-old is overweight, you need to make sure that physical activity becomes and remains a priority in his life. These preschool years are a time when he should be developing his motor skills, improving his coordination, and playing games and sports with greater skill. You should make sure that he has access to age-appropriate play equipment, such as balls and plastic bats that will make exercise fun and something he looks forward to doing. Of course, these play periods must be supervised; you need to keep him away from dangerous situations like running into the street to chase a ball.
  • Make an effort to turn family time into a physically active time. On a Sunday afternoon, rather than going to the movies, take the entire family on a hike in the hills near your home. Or fly a kite in the park, play tag, or throw a ball back and forth.​

Source: Caring for Your Baby and Young Child: Birth to Age 5, 6th Edition (Copyright © 2015 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.