Energy Out: Daily Physical Activity Recommendations

​Physical activity in children and adolescents improves strength and endurance, builds healthy bones and lean muscles, develops ​ motor skills and coordination, reduces fat, and promotes emotional well-being (reduces feelings of depression and anxiety). Activities should be appropriate for their age and fun, as well as offer variety.

The daily recommendation for physical activity for children 6 years and older is at least 60 minutes per day. Active play is the best exercise for younger children.

The types of physical activity should be moderate to vigorous. Vigorous activity is activity that makes you breathe hard and sweat. During vigorous activity, it would be difficult to have a talk with someone. Some activities, such as bicycling, can be of moderate or vigorous intensity, depending upon level of effort.

The 60 minutes does not need to be done all at once. Physical activity can be broken down into shorter blocks of time. For example, 20 minutes walking to and from school, 10 minutes jumping rope, and 30 minutes at the playground all add up to 60 minutes of physical activity. If your child is not active, start from where you are and build from there.

Here are some types of sports and activities for children and teens (and parents, too!)

Aerobic Exercises

  • Use body’s large muscle groups
  • Strengthen the heart and lungs
  • Examples of moderate-intensity aerobic exercises include: brisk walking, Bicycle riding, dancing,hiking, rollerblading, skateboarding, martial arts such as karate or tae kwon do (can be vigorous too)
  • Examples of vigorous-intensity aerobic activities include: basketball, bicycle riding, games such as tag, ice or field hockey, jumping rope, martial arts, running, soccer, swimming, tennis

Muscle-Strengthening (or Resistance) Activities

  • Work major muscle groups of the body (legs, hips, back, abdomen, chest, shoulder, arms)
  • Examples of muscle-strengthening activities include: games such as tug-of-war, push-ups or modified push-ups (with knees on the floor), resistance exercises using body weight or resistance bands, rope or tree climbing, sit-ups (curl-ups or crunches), swinging on playground equipment/bars

Bone-Strengthening (Weight-Bearing) Activities

  • Tone and build muscles and bone mass
  • Can be aerobic exercises and muscle-strengthening activities
  • Examples of bone-strengthening activities include: basketball, hopping, skipping, jumping, gymnastics, jumping rope, running, tennis, volleyball, push-ups, resistance exercises using body weight or resistance bands

About Strength Training

Strength training(or resistance training) uses a resistance to increase an individual’s ability to exert force. It involves the use of weight machines, free weights, bands or tubing, or the individual’s own body weight. This is not the same as Olympic lifting, power lifting, or body building, which are not recommended for children. Check with your child’s doctor before starting any strength training exercises.


Source: Energy In Energy Out: Finding the Right Balance for Your Children (Copyright © 2014 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Healthy New Year’s Resolutions for Children & Teens

The start of the new year is a great time to help your children focus on forming good habits. The American Academy of Pediatrics (AAP) provides the following list of ideas for you to talk to your children about trying, depending on their age. ​

Preschoolers

  • I will try hard to clean up​ my toys by putting them where they belong.
  • I will let my parents help me brush my teeth twice a day.
  • I will wash my hands after going to the bathroom and before eating.
  • I will learn how to help clear the table when I am done eating.
  • I will be friendly to all animals. I will learn how to ask the owners if I can pet their animal first.
  • I will do my best to be nice to other kids who need a friend or look sad or lonely.
  • I will talk with my parent or a trusted adult when I need help or am scared.

Kids, 5 to 12 years old

  • I will drink reduced-fat milk​ and water most days. Soda and fruit drinks are only for special times.
  • I will take care of my skin by putting on sunscreen before I go outdoors on bright, sunny days. I will try to remember to stay in the shade whenever possible and wear a hat and sunglasses, especially when I’m playing sports.
  • I will try to find a sport (like basketball or soccer) or an activity (like playing tag, jumping rope, dancing or riding my bike) that I like and do it at least three times a week!
  • I will always wear a helmet when riding a bike, scooter or skateboard.
  • I will wear my seat belt every time I get in a car. I’ll sit in the back seat and use a booster seat until I am tall enough to use a lap/shoulder seat belt.
  • I’ll try to be friendly to kids who may have a hard time making friends by asking them to join activities such as sports or games.
  • I will tell an adult about bullying that I see or hear about to do what I can to help keep school safe for everyone.
  • I will keep my personal info safe and not share my name, home address, school name or telephone number on the Internet. Also, I’ll never send a picture of myself to someone I chat with on the computer without asking my parent if it is okay.
  • I will try to talk with my parent or a trusted adult when I have a problem or feel stressed.
  • I promise that I’ll do my best to follow our household rules for videogames and internet use.

Kids, 13 years old and older

  • I will try to eat two servings of fruit and two servings of vegetables every day. I will drink sodas only at special times.
  • I will do my best to take care of my body through fun physical activity and eating the right types and amounts of foods.
  • When I have some down time for media, I will try to choose educational, high-quality nonn-violent TV shows and video games that I enjoy. I will spend only one to two hours each day – at the most – on these activities. I promise to respect out household rules for videogames and internet use.
  • I will do what I can to help out in my community. I will give some of my time to help others, working with community groups or others that help people in need. These activities will make me feel better about myself and my community.
  • When I feel angry or stressed out, I will take a break and find helpful ways to deal with the stress, such as exercising, reading, writing in a journal or talking about my problem with a parent or friend.
  • When faced with a difficult decision, I will talk about my choices with an adult whom I can trust.
  • When I notice my friends are struggling, being bullied or making risky choices, I will look for a trusted adultso that we can attempt to find a way to help.
  • I will be careful about whom I choose to date. I will treat the other person with respect and not force them to do something they do not want to do. I will not use violence. I will expect to be treated the same way in return.
  • I will resist peer pressure to try tobacco-cigarettes, drugs, or alcohol. I will also avoid the use of e-cigarettes.
  • I agree not to use a cell phone or text message while driving and to always use a seat belt.

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


The Greatest Gift You Can Give Your Child

For you to care for your child properly, you need to be OK.​ In this video, pediatrician and adolescent specialist Ken Ginsburg, MD, FAAP discusses that the greatest gifts you can give your child are to live a balanced life and to show that when life offers us challenges, we take active steps to get back on track.​


Source: Building Resilience in Children and Teens: Giving Kids Roots and Wings, 3rd Edition (Copyright © 2015 Kenneth R. Ginsburg, MD, MS Ed, FAAP, and Martha M. Jablow). 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.


Holiday Food Safety Tips

Whether it is holiday cookies, perogies, roast goose, latke or tamales, foods are an important ingredient of holiday celebrations. Teaching children to cook your family’s recipes can impart ethnic identity and culture, and offers a sense of accomplishment for young chefs. The American Academy of Pediatrics offers some tips to keep holiday feasting fun and healthy:

  • When preparing food for a holiday celebration, follow food safety guidelines. Bacteria are often present in raw foods. Fully cook meats and poultry, and thoroughly wash raw vegetables and fruits.
  • While you’re teaching your children family recipes, also teach them about good food safety. Wash your hands frequently, and make sure children do the same.
  • If you offer your helper a taste, be sure to wash the spoon before putting it back into the food.
  • Make sure that taste doesn’t include raw eggs or other ingredients that should be cooked before be eaten.
  • During preparations for a party, the refrigerator and freezer can become crowded with with sweets, roasts and other goodies, but don’t let these become breeding grounds for bacteria. Always keep raw foods and cooked foods separate, and use separate utensils when preparing them.
  • Always thaw meat in the refrigerator, never on the countertop.
  • Keep hot food and liquids away from the edges of counters and tables, where they can be easily knocked over by a young child’s exploring hands. Be sure that young children cannot access microwave ovens. Turn pot handles toward the side or back of the stove.
  • Foods that require refrigeration should never be left at room temperature for more than two hours.
  • After a holiday party, clean up immediately. A toddler could rise early and choke on leftover food or come in contact with alcohol or tobacco.

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


10 Non-Tech Holiday Gift Ideas to Promote Kids’ Language & Learning

​​​Children of all ages are filling their holiday wish list with things like tablets, cell phones, wearables, headphones, and other tech-related gifts. But it’s important to find a balance and ensure that today’s connected kids ha​ve some quality off-line time, too. The holidays are a great time to get back to some of the basics in childhood play that foster communication and social interaction. Here are some ideas for a low-tech holiday gift list:

Traditional toys remain superior to electronic toys for children’s language development. For example, when toys talk, parents talk less—and subsequently, kids vocalize less. Blocks, dolls, musical instruments, cars, trains, shape-sorters, and other low-tech toys get kids—and parents—talking, singing, playing, and interacting. These all help build foundational communication skills.

Books always make excellent presents, and sharing the joy of reading is a lifelong gift.

  • ​For infants and toddlers: Books with textures inviting touch are ideal, as are colorful board and picture books.
  • For children learning how to read: Give books appropriate to their skill level to facilitate emerging literacy.
  • For older children: Find engaging chapter books and book series. Family members can take turns reading chapters aloud. This may be the start of a family book club.

​​Board, card, and conversation-based question games are great to enjoy and play as a family. They get everyone talking and laughing and build some great memories. There are games for all age ranges. And what better time of year than winter to begin family game nights for building conversation, connections—and fun!

Costumes and other dress-up accessories allow kids to use their imaginations and foster creativity. Children’s language skills expand as they make up dialogues, tell stories, sing, and take turns.

Building toys, blocks,​ and crafts make for some fun indoor activities to occupy kids on cold days. They also help hone fine motor skills for all ages. For young children, motor skills are closely linked to language development.

Outdoor toys such as balls, sleds, jump ropes, and yard games encourage running, jumping, sports and other active play. Physical activity and movement prime children for learning.

Puzzles — ranging from basic options for young children to complex types the whole family can attempt as a team—spur conversation while building analytical, problem-solving and other skills.

Cooking supplies work as fun gifts for children of almost any age. Involving young kids in making and trying new foods offers a wealth of opportunity for conversation and language-building, including likes and dislikes, tastes, textures, and more. For older kids, cooking together sets the scene for family bonding. Following recipes also helps improve reading and comprehension skills, planning, organization, sequencing, and following directions.

Crayons, colored pencils, coloring books and other writing supplies are a childhood staple, and they help children build fine-motor skills. Coloring also helps young children build their vocabulary and learn their color names.

​Tickets to child-friendly shows, sporting events, or other performances are great gifts, as they allow parents and children to enjoy special activities together. These outings promote family interaction, conversation, and bonding. In addition, memberships to local zoos, museums or aquariums make great gifts for entire families to enjoy!

Of course, technology gifts will likely remain on your child’s shopping lists year after year—the reality of growing up in today’s world. Parents can help their children balance their online and off-line lives. If you do give your child a technology-related gift, use it as an opportunity to lay out some ground rules and make a family media plan.


Copyright ©2016 American Academy of Pediatrics and American Speech-Language-Hearing Association/ASHA Leader. 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.


Holiday Mental Health Tips

​The holidays can be a happy time of year for many people, as they gather with family and friends, exchange gifts and celebrate traditions. But the changes in family routines and extra demands on time can also cause some stress, especially for children. The American Academy of Pediatrics offers some tips to help your family enjoy the best of the holiday season:

  • During the busy holiday time, try to keep household routines the same. Stick to your child’s usual sleep and mealtime schedules when you can, which may reduce stress and help your family enjoy the holidays.
  • Take care of yourself, both mentally and physically. Children and adolescents are affected by the emotional well-being of their parents and caregivers. Coping with stress successfully can help children learn how to handle stress better, too.
  • Make a plan to focus on one thing at a time. Try a few ideas to balance the hustle and bustle of things like shopping, cooking, and family get-togethers during the holidays: Stop and pay attention to what is happening at the moment, focus your attention on one thing about it, and notice how you are feeling at the time. Withhold immediate judgment, and instead be curious about the experience.
  • Give to others by making it an annual holiday tradition to share your time and talents with people who have less than you do. For example, if your child is old enough, encourage him or her to join you in volunteering to serve a holiday meal at your local food bank or shelter, or sing at a local nursing home. Help your child write a letter to members of the armed forces stationed abroad who can’t be home with their own family during the holidays.
  • Remember that many children and adults experience a sense of loss, sadness or isolation during the holidays. It is important to be sensitive to these feelings and ask for help for you, your children, family members or friends if needed.
  • Don’t feel pressured to over-spend on gifts. Consider making one or two gifts. Help your child make a gift for a parent, grandparent, or other important adults and friends. Chances are, those gifts will be the most treasured ones and will teach your child many important lessons.
  • Most important of all, enjoy the holidays for what they are — time to enjoy with your family. So, be a family, do things together like sledding or playing board games, and spend time visiting with relatives, neighbors and friends.

Source: American Academy of Pediatrics (Copyright © 2017). 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.


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.

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.