TEENS: Independence, One Step at a Time

It is an adolescent’s job to gain the confidence to be able to stand on his own. As challenging as it is to watch our children grow up, it is critical to their well-being and to the health of our relationships that we honor their growing independence. When we hold them back they rebel against us. When we monitor their safety while guiding them towards independence – sometimes actively and sometimes by getting out of the way – they appreciate us. When our children know that we supported them to become independent, they will return to us for that interdependence that defines loving families well beyond childhood.

It’s everyday issues, even seemingly mundane ones, that trigger most parent-child struggles and offer opportunities for fostering independence. Your child thinks she should be allowed a new privilege just because she’s a certain age or because her friends are doing it, but she might lack the skills needed to manage the situation. If you focus on preparing your adolescent, you will turn potential sources of conflict and rebellion into opportunities for your child to master new skills and demonstrate responsibility.

Adolescence is naturally filled with opportunities for trial and error and ultimately success. Your challenge is to make sure your adolescent learns from day-to-day mistakes rather than views them as catastrophes. At the same time you need to be vigilant in helping your teen avoid those errors that could cause irreparable harm. Just as importantly, you want to ensure your child doesn’t miss out on the many possibilities for growth that are coming along.

The answer to when your child is ready to meet a new challenge is about recognizing when there are enough pieces in place so the chances for success are enhanced. A request by your 14 year old to spend the afternoon at the mall won’t hinge on answering on the spot “Is she old enough?” if you’ve taught her, in part through your example, about spending wisely and treating clerks with respect. The day your teen begins to drive won’t be so nerve-wracking if you’ve modeled safe driving behaviors and made it clear you will monitor your teen’s progress even after he gets his license.

Sometimes you should start by doing some observing. Think back to when you baby-proofed your home. If you just guessed what needed safeguarding, you might have missed some opportunities to protect your baby. The first step was to walk around on your knees and see the surroundings at the same level as your toddler. Once you saw the world from his vantage point, you knew to turn that pot handle inward. That same sort of observing — getting a “kid’s eye view” of the mall or the route to school — will heighten your senses about the challenges your teen is likely to encounter. You’ll be better positioned to think of how best to phase in new privileges and what kinds of support and monitoring need to be in place to help things go smoothly.

It is important to use a step-by-step approach to allow your child to demonstrate he’s ready to assume more responsibility. A thoughtful step-wise strategy will help both your child and you gain confidence, and will allow you to give a little bit of rope at a time and tighten up again as needed.


Author: Kenneth R. Ginsburg, MD, MS Ed, FAAP. Source, adapted from Letting Go with Love and Confidence: Raising Responsible, Resilient, Self-Sufficient Teens in the 21st Century (Copyright © 2011 Avery). 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.

Mask Mythbusters: 5 Common Misconceptions about Kids & Cloth Face Coverings

Along with physically distancing and good hand washing, masks or cloth face coverings are an effective way to help prevent the spread of COVID-19. Some parents may have questions and concerns about cloth face coverings, and we’re here to help.

Here are 5 common questions about kids and masks, along with evidence-based information that will put your mind at ease:

1. Can wearing a mask make it harder​ for my child to breathe?

There have been concerns that cloth face coverings can reduce oxygen intake, and can lead to low blood oxygen levels, known as hypoxemia. However, cloth masks are made from breathable materials that will not block the oxygen your child needs. Masks will not affect your child’s ability to focus or learn in school. The vast majority of children age 2 or older can safely wear a cloth face covering for extended periods of time, such as the school day or at child care. This includes children with many medical conditions.

2. Can masks interfere with a child’s lun​​g development?

No, wearing a cloth face covering will not affect your child’s lungs from developing normally. This is because oxygen flows through and around the mask, while blocking the spray of spit and respiratory droplets that may contain the virus. Keeping your child’s lungs healthy is important, which includes preventing infections like COVID-19.

3. Do masks trap the carbon dioxide ​that we normally breathe out?

No. There have been false reports that cloth face coverings can lead to carbon dioxide poisoning (known as hypercapnia) from re-breathing the air we normally breathe out. But this is not true. Carbon dioxide molecules are very tiny, even smaller than respiratory droplets. They cannot be trapped by breathable materials like cloth masks. In fact, surgeons wear tight fitting masks all day as part of their jobs, without any harm.

However, children under 2 years of age should not wear masks since they may not be able to remove them without help. Children with severe breathing problems or cognitive impairments may also have a hard time tolerating a face mask and extra precautions may be needed.

4. Can masks lead to a weaker immune​ system by putting the body under stress?

No. Wearing a cloth face covering does not weaken your immune system or increase your chances of getting sick if exposed to the COVID-19 virus. Wearing a cloth face covering, even if you do not have symptoms of COVID-19, helps prevent the virus from spreading.

5. How do masks prevent the ​​spread of COVID-19?

When worn correctly, cloth masks create a barrier that reduces the spray of a person’s spit and respiratory droplets. These droplets play a key role in the spread of COVID-19 because they can carry SARS-CoV-2, the virus that causes COVID-19. Masks also can protect you from others who may have coronavirus but are not showing symptoms and who could come within 6 feet of you, which is how far respiratory droplets can travel when people sneeze or cough or raise their voices.

In order to be effective, masks should:

  • Cover both the nose and mouth​​
  • Fit snugly but comfortably against the sides of the face
  • Be secured with ear loops or ties
  • Have multiple layers of fabric
  • Allow for unrestricted breathing
  • ​Be washed and dried carefully after use​

Another benefit of wearing masks is that they may keep people from touching their mouths and faces, which is another way COVID-19 can be spread. There are many types of masks, but cloths masks are best choice for the general public and families should choose a mask that is most comfortable while still providing a secure fit.

Remem​​ber

Cloth face coverings are an important tool in preventing the spread of COVID-19. They are safe and effective for children over the age of 2 years and adults. Cloth face coverings are especially important when social distancing, or keeping 6 feet away from others, is hard to do. Washing hands, staying home and physical distancing are still the best ways to keep your family safe from COVID-19. But when you go outside your home, wearing a cloth face covering will help keep you and others safe.

Don’t hesitate to talk with your child’s pediatrician if you have any questions about your child wearing cloth face coverings.


Image courtesy of the CDC. Article written by Kimberly W. Dickinson, MD, MPH, is a pediatric pulmonary fellow at Johns Hopkins University in Baltimore, MD and a member of the AAP Section on Pediatric Pulmonology and Sleep Medicine Trainee Subcommittee; and Theresa W. Guilbert, MD, MS, FAAP, is a Professor of Pediatrics at the University of Cincinnati and the Director of the Cincinnati Children’s Hospital Medical Center Asthma Center in the Pulmonary Division. She has 20 years of experience in providing clinical care to children and adolescents with preschool, childhood and severe asthma and conducting clinical and epidemiologic research. She is a member of the AAP Section on Pediatric Pulmonology and Sleep Medicine Committee. Source American Academy of Pediatrics Section on Pulmonary and Sleep Medicine (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.

Return to School During COVID-19

​​​​​​​With the start of a new school year, a lot needs to happen so that students can learn and thrive without raising the risk of spreading COVID-19.

The goal of having children attend school in person–which is how they learn best — will only be safe when a community has the spread of the virus under control.  And then, when it is possible to reopen a school for in-person learning, a layered approach is needed to keep students, teachers and staff safe.

Why students should go back to school–when it is safe

​Schools provide more than just academics to children and adolescents. In addition to reading, writing and math, students learn social and emotional skills, get exercise, and have access to mental health support and other services that cannot be provided with online learning. For many children and adolescents,  schools are safe places to be while parents or guardians are working.  For many families, schools are where kids get healthy meals, access to the internet and other vital services.

​The pandemic has been especially hard for Black, Latinx, Native American/Alaska native children and adolescents, and those living in low-income families.  One in 5 teens cannot complete schoolwork at home because they do not have a computer or internet connection.

But whatever form learning takes, the AAP ​advises that schools need funding to provide safety measures for in-person learning and to be able to support all students in virtual learning plans.

WHAT SCHOOLS CAN DO

To stay safe, there are a number of steps schools should take to help prevent the spread of COVID-19. They include:

Physical distancing. The goal for students and adults is to stay at least 6 feet apart to help prevent the spread of the virus. However, research has found that spacing desks at least 3 feet apart and avoiding close contact may have similar benefits — especially if students wear cloth face coverings and do not have symptoms of illness. Teachers and staff should stay 6 feet apart from other adults and from students when possible. Teachers and staff should also wear cloth face coverings, limit in-person meetings with other adults and avoid areas such as staff lounges.

When possible, schools should use outdoor spaces and unused spaces for instruction and meals to help with distancing. For example, activities like singing, band and exercising are safest outdoors and spread out.

Cloth face coverings & hand hygiene. All children over age 2 years and all adults should wear cloth face coverings that cover the nose and mouth to stop the spread of the virus.  When worn correctly, cloth face coverings are  safe to wear for long periods of time such as during the school day.  In addition, frequent hand washing with soap and water is important for everyone.

Classroom changes. To help limit student interaction outside the classroom, schools should consider:

  • Having teachers move between classrooms, rather than having students fill the hallways during passing periods.
  • Allowing students to eat lunches at their desks or in small groups outdoors instead of in crowded lunchrooms.
  • Leaving classroom doors open to help reduce high touch surfaces such as doorknobs.

Testing & temperature checks. The CDC currently does not recommend COVID testing of students and staff​. Testing only shows whether a person is infected at that specific moment in time and may not be useful in preventing outbreaks in school communities.  Taking students’ temperatures at school may also not be feasible, but you can monitor your children’s health at home and keep them home if they are not feeling well. Schools should frequently remind students, teachers, and staff to stay home if they have a fever of 100.4 degrees F or greater or have any signs of illness.

Exposure.  While current evidence suggests that children younger that 10 years may be less likely to become infected with SARS-CoV-2, and less likely to spread the infection to others, schools still need to plan for exposures.  If a student of staff member has close contact with someone known to have SARS-CoV-2 infection, they should quarantine for 14 days from the day they were in close contact.  Close contact means being within 6 feet of the person for at least 15 minutes.  A person is known to be infected if they have a laboratory-confirmed infection or illness consistent with COVID-19.

Symptoms at school. School nurses will take the temperature of anyone who feels ill during the school day, and there should be a specific area to separate or isolate students who are not feeling well. To stay safe, school nurses should use PPE (personal protective equipment) such as N95 masks, surgical masks, gloves, disposable gowns and face shields.

Cleaning and disinfecting. Schools should follow CDC guidelines on proper disinfecting and sanitizing classrooms and common areas.

Buses, hallways and playgrounds

Since these are often crowded spaces, schools can:

  • Give bus riders assigned seats and require them to wear a cloth face coverings while on the bus.
  • Encourage students who have other ways to get to school to use those options.
  • At school, mark hallways and stairs with one-way arrows on the floor to cut down on crowding in the halls. Assign lockers by group or eliminate use of lockers.
  • Encourage outdoor activities such as using the playground in small groups. Playground equipment should be included in cleaning plans.

Other considerations

In addition to having plans in place to keep students safe, there are other factors that school communities need to address:

Students at higher risk. While COVID-19 school policies can reduce risk, they will not prevent it.  Some students with high-risk medical conditions​ may need other accommodations. Talk with your pediatrician and school staff (including school nurses) to see if your child needs additional solutions to help ensure safety at school.

Students with disabilities. The impact of schools being closed may have been greater for students with disabilities. They may have a difficult time transitioning back to school after missing out on instruction time as well as school-based services such as occupational, physical and speech-language therapy and mental health support counseling. School should review the needs of each child with an Individual Education Program before they return to school, and providing services even if they are done virtually.

Immunizations & well-child exams. It is important as students return to school that they are up to date on their immunizations. It will be critical that students and staff get their flu shot this year to reduce the spread of influenza this fall and winter.

Screenings. ​Vision and hearing screening should continue in schools, when possible. These services help identify children in need of treatment as soon as possible and prevent interferences with learning.

Behavioral health/emotional support. Your child’s school should anticipate and be prepared to address a wide range of mental health needs of students and staff. This includes providing mental health support for any student struggling with stress from the pandemic and recognizing students who show signs of anxiety or distress. Schools also can help students with suicidal thoughts or behavior get needed support.​

Nutrition. Many students receive healthy meals through school meal programs. More students might be eligible for free or reduced meals than before the pandemic. Schools should provide meal programs even if the school closes or the student is sick and stays home from school.

​Remember

Returning to school during the COVID-19 pandemic may not feel like normal – at least for a while. But whatever form school takes, it will require everyone’s support to make sure that it is healthy, safe and equitable for students, teachers, staff and families.​


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.

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.