AAP Updates Recommendations to Prevent Drowning in Children

Drowning can be silent and quick, and it kills nearly 1,000 children every year. To refocus the attention of parents and physicians on one of the leading causes of death among children, the American Academy of Pediatrics is publishing updated recommendations on water safety.

“Drowning is the single leading cause of injury-related death among children ages 1 to 4,” said Sarah Denny, MD, FAAP, lead author of the policy statement, “Prevention of Drowning” published online March 15, 2019, in Pediatrics. “Many of these deaths occur when children are not expected to be swimming or when they have unanticipated access to water. Toddlers are naturally curious; that’s why we must implement other strategies, such as pool fencing and door locks.”

The second age group at highest risk of drowning deaths is teens, said Dr. Denny. Every year, about 370 children ages 10 to 19 drown. “Adolescents can be overconfident in their swimming abilities and are more likely to combine alcohol use with swimming – compounding their risk significantly. Children of color, especially African American teens are especially at risk.”

In the policy statement, the AAP lays out strategies to protect children at each stage of their life. New parents are advised to be vigilant at bath time and to empty all buckets and wading pools immediately. All children should learn to swim, and children and teens should wear life jackets while near open bodies of water. Teens can learn CPR and other water safety skills.

Injury prevention has long been a priority of pediatricians, and public health initiatives over the past 50 years have led to dramatic reductions in deaths from injuries related to motor vehicle crashes, sudden infant death syndrome, drowning, and other unintentional injuries. In the past few years, however, the rate of decline in these deaths has slowed.

Drowning remains the third leading cause of unintentional injury-related death among children ages 5-19 years. In 2017, nearly 1,000 children died from drowning and 8,700 visited a hospital emergency room because of a drowning event – with toddlers and teens at the highest risk.

The topic will be the subject of a panel presentation March 16, when leaders of the AAP will gather in Itasca, Ill., for an annual leadership conference. Family advocates, including Nicole and Jonathan Hughes, and Bode Miller, will share their experiences of losing a child to drowning. The panel will also include Sam Hanke, MD, FAAP, who lost his son to sudden infant death, and parent Greg Schell, chair of the AAP Family Partnerships Network. The panel will address recent trends in preventable child injuries, and how pediatricians can work with families to improve child health.

“We appreciate the chance to partner with these families, who have decided to channel their grief to help other parents prevent a similar tragedy. It is critically important for us to collaborate with families and communities to protect kids from drowning” said Ben Hoffman, MD, FAAP, Chair of the AAP Council on Injury, Violence & Poison Prevention. “Pediatricians should be talking about water safety routinely during well-child visits. But having families share their personal stories, we hope, will help connect with parents who may think it could ‘never happen’ to them. Tragically, it can happen to anyone.”

AAP will also publish new information for families on its website for parents, HealthyChildren.org, including water safety advice based on children’s developmental stages, and recommendations on choosing a good learn-to-swim program.

“Research has found that swim lessons are beneficial for children starting around age 1, and may lower drowning rates”, said Linda Quan, MD, FAAP, a co-author of the policy statement.

“Learning to swim is a great family activity,” said Dr. Quan. “Families can talk with their pediatrician about whether their child is developmentally ready for swim lessons, and then look for a program that has experienced, well-trained instructors. Ideally, programs should teach ‘water competency’ too – the ability to get out of the water if your child ends up in the water unexpectedly.”

Even the best swim lessons cannot “drown-proof” a child, and so AAP strongly recommends parents take steps that make a child’s environment safer. For homes with a pool, the most important safety measure is a 4-sided fence that completely surrounds the pool and isolates if from the house.

AAP also recommends:

  • Parents and caregivers should never leave children alone or in the care of another child while in or near bathtubs, pools, spas, or other open water.
  • Adults should empty water from buckets and other containers immediately after use.
  • Do not leave young children alone in the bathroom. Toilet locks can prevent drowning of toddlers.
  • When infants or toddlers are in or around the water, a supervising adult with swimming skills should be within an arm’s length, providing constant “touch supervision.”
  • Even with older children and better swimmers, the supervising adult should focus on the child and not be engaged with other distracting activities.

“Water is everywhere, and we need multiple layers to protect children from the deadly risks it poses,” said Dr. Quan. “As pediatricians, we cannot overlook this risk. Pediatricians can help by counseling families and working in their communities to improve safety, especially around pools, lakes and in boating communities.”


©The American Academy of Pediatrics, March 2019. The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.

Community-Based Resilience-Building

Whether the community encompasses civic groups, religious organizations, schools, sports leagues, or any and all groups that serve youth, it can promote healthy development by creating conditions in which families can thrive and by offering community-based resources including youth development and enrichment programs.

If you represent a school, community, or program that’s thinking about using a positive youth development or resilience-based strategy to transform the way young people are approached, consider organizations that will work closely with you to evaluate needs, suggest infrastructure changes, and frame interventions. Here are a few well-respected groups that can rise to meet your needs:

What Parents Can Do Within Their Community or as a Community Leader

  • Notice the acts of generosity and compassion shown by youth and spread these good news stories. Don’t notice only the heroic acts, but also the everyday acts; recognize kindness and contribution as the norm.
  • Advocate for the positive portrayal of youth in the community. Ask for a shift away from media coverage where only the highest achievers and delinquents get airtime.
  • Advocate for public health messages that don’t just tell kids what not to do but fervently tell kids what to do, and recognize that most youth are already doing the right thing.
  • Advocate for enrichment programs in communities and schools, especially in those areas most at risk that currently only have prevention programs. This doesn’t mean you should suggest that risk-based programs be cut.
  • Give youth opportunities to contribute to their communities. When they’re out serving others, their value will be noticed and they’ll receive those vital reinforcing displays of gratitude.
  • Work with the parents in your community so that young people have appropriate role models, rules, and boundaries that ensure safety. If these are seen as normal in your community, adolescents will have less reason to rebel.

Including Youth Wisdom

Young people who contribute to the well-being of their community and are noticed for their efforts will be more likely to stay engaged. We must never forget that youth are the experts on themselves. We increase the quality of the program and the benefits to the participants when we ask youth for advice in designing a program. Young people who help programs design services may become leaders in those same or future programs.

If you want to guide the youth of a community toward positive behaviors, consider creating peer educators and positive role models. Messages hold a certain resonance when transmitted from someone to whom peers can relate. At the same time, peer educators have more credibility when they’re linked with respected adult experts. Understand also who the peer opinion leaders are (not necessarily the best students or class officers) and influence them to model appropriate behaviors.


Source: Building Resilience in Children and Teens, 2nd Edition , 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.


Celebrate Earth Day, April 22!

Earth Day is an annual event celebrated on April 22. Worldwide, various events are held to demonstrate support for environmental protection. First celebrated in 1970, Earth Day now includes events in more than 193 countries, which are now coordinated globally by the Earth Day Network.

Here are a few ways you and your family can celebrate in Connecticut:

For more, try a Google search on “Earth Day 2019 events in CT.”

A Guide to Reading With Your Child

Start talking, singing, and reading with your child from the beginning. He will learn that reading is a fun activity you share together.

  • Point to words as you read them, showing your child that the print carries the story.
  • Ask your child to name things she sees in the pictures. Talk about how the pictures relate to the story.
  • Reading doesn’t have to be a huge project. Even a 3 minute story every night before bedtime will help your child learn.

Discuss Healthy Active Living using The Very Hungry Caterpillar:

  • Teach your child that apples, pears, plums, strawberries, and oranges are all fruits. Ask him if he can name other fruits.
  • Talk to her about how fruits are good for the body.
  • Talk about how when the caterpillar overeats, he gets a stomachache— so it is important to stop eating when you feel full.
  • Talk about how some foods are “sometimes” foods—like cake and ice cream—and how it is not a good idea to eat them all the time.
  • After reading the page where the caterpillar eats the green leaf and feels better, talk to your child about how you too eat green leaves (lettuce, spinach, cabbage, etc.) and how it is good for your body.
  • Teach your child that is important to eat healthy foods, so he can grow up healthy and active like a butterfly.

Download a printable guide that contains healthy eating tips and a reader’s guide to using The Very Hungry Caterpillar to encourage conversations about healthy eating. Print it out and share it with family and friends.


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 Active Living for Families

Healthy nutrition starts as early as infancy with breastfeeding. Once your baby begins eating solid foods, introduce nutritious foods early on and often. Sometimes toddlers need to try a food 10 times before they actually accept and enjoy it. It is also important to encourage play time as soon as they start crawling and walking. As your children grow, continue to help them live a healthy active lifestyle.

To lead a healthy active life, families can strive to reach these goals:

  • 5 fruits and vegetables a day,
  • 2 hours or less of screen time (TV, computer, video games) per day,
  • 1 hour of physical activity a day, and
  • 0 limit sugar-sweetened drinks.

To help children live healthy active lives, parents can:

  • be role models themselves by making healthy eating and daily physical activity the norm for their family.
  • create a home where healthy choices are available and encouraged.
  • make it fun – find ways to engage your children such as: playing a game of tag, cooking healthy meals together, creating a rainbow shopping list to find colorful fruits and vegetables, go on a walking scavenger hunt through the neighborhood, or grow a family garden.

In addition to 5, 2, 1, 0, families can make small changes in their family routines to help everyone lead healthier active lives. Try:

  • Eating breakfast every day;
  • Eating low-fat dairy products like yogurt, milk, and cheese;
  • Regularly eating meals together as a family;
  • Limiting fast food, take out food, and eating out at restaurants;
  • Preparing foods at home as a family;
  • Eating a diet rich in calcium; and
  • Eating a high fiber diet.

Help your children form healthy habits now. Healthy active children are more likely to be healthy active adults!


Source: American Academy of Pediatrics (Copyright © 2010). 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.


5 Great Reasons to Cook with Your Kids

When it comes to raising an adventurous eater, it is not just about coaxing kids to eat their veggies. Bringing up a child who can enjoy a cantaloupe as much as a cupcake takes patience and persistence, but it does not have to feel like a chore.

Kids may need to have frequent joyful experiences involving food to overcome the anxiety they may have around tasting the unfamiliar. Over time, cooking with your children can help build that confidence—and provide rich sensory experiences.

Here are five ways to enjoy cooking with your children while raising an adventurous eater along the way.

  1. Engage other senses. For a hesitant eater, tasting an unfamiliar food can sometimes be intimidating. You can help your child explore foods when cooking using other senses besides taste. This helps to build positive associations with food. Kneading dough, rinsing vegetables, and tearing lettuce all involve touching food and being comfortable with texture. The complex flavors we experience when eating food come from both taste sensations from the tongue AND smelling with the nose. While cooking with new ingredients, some children may feel too overwhelmed to taste. If this happens, you can try suggesting smelling a food first; this may provide a bridge to tasting in the future.
  2. Use cooking to raise smart kids. There are so many lessons that can be taught while cooking. Math concepts like counting, measurement, and fractions naturally unfold when navigating a recipe with kids. Explaining how food changes with temperature or how certain foods can help our body be healthy provide great lessons in science. While cooking with your child, practice new vocabulary as you describe how food looks, feels, and tastes. Following a recipe from start to finish helps build the skills for planning and completing projects.
  3. Make cooking part of the family culture. The family meal can start in the kitchen as you cook together. Family meal preparation is an opportunity to celebrate your cultural heritage by passing down recipes. Help your kids find new, seasonal recipes to add to your repertoire and family cookbook. Cooking together and prioritizing health over the convenience of processed food are great ways to lead by example and help your children buy into a culture of wellness. Building daily and seasonal traditions around cooking together helps strengthen your family’s commitment to a healthy lifestyle.
  4. Keep it safe. Teach kids the importance of staying safe while cooking by showing them how to hold kitchen tools safely, how to use oven mitts to protect hands from heat, and how to turn appliances on and off safely. Always supervise children when cooking to ensure they are sticking with safe and age-appropriate tasks. The best way to keep cooking safe is to know your child’s abilities and his or her stage of development. A four-year-old child, for example, may not be ready to sauté vegetables over a hot pan, but may have the fine motor skills to rinse fruits or tear salad leaves. Keeping safety in mind, it is not difficult to get kids—even toddlers—involved in the kitchen.
  5. Ask for input. Children feel more included in mealtime when they are asked to be a part of meal preparation. Collaborate with your kids when selecting recipes for main dishes or sides. Let them help you make the shopping list and find groceries in the store or farmers market. When cooking together, let children offer a critique of the foods you are preparing. Together you can decide what ingredients you should add to enhance the flavor. Talk about how people enjoy different tastes, and share your preferences with each other. Letting children be “in charge” of details like how to set the table will help them feel invested in mealtime.

Over many years, cooking as a family will help develop a happy, adventurous eater with some pretty valuable life skills—and plenty of happy memories in the kitchen. With enough practice, your child will someday be able to cook YOU a delicious meal!


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


March is National Nutrition Month

Choosing nutritious foods and getting enough physical activity can make a real difference in your health. For National Nutrition Month® 2019, in March, the Academy of Nutrition and Dietetics encourages people to make informed food choices and develop sound eating and activity habits.

Each March, the Academy focuses attention on healthful eating through National Nutrition Month®. “Through the campaign, we share good eating tips such as how to keep nutritious meals simple, the importance of making food safety a part of your everyday routine, the value of preparing meals with foods you have on hand to avoid wasting food, and how to select nutritious food options when dining away from home,” says registered dietitian nutritionist Robin Foroutan, a New York-based spokesperson for the Academy.

“Eating right doesn’t have to be complicated,” Foroutan says. “Think about what you want your plate to look like and ask if it’s incorporating all the major food groups. Select a mix of lean protein foods, vegetables, whole grains and fruits to enjoy a healthful meal.”

The Academy recommends balancing nutritious foods with physical activity most days of the week. According to the U.S. Department of Health and Human Services’ physical activity guidelines, adults should participate in at least 150 minutes of moderate-intensity aerobic physical activity per week, including at least two days of muscle-strengthening activities. Being physically active up to 300 minutes per week has even greater health benefits.

“Look into incorporating physical activity into your daily routine,” Foroutan says. “Walk to work or take a walk during your lunch hour. Do something physical during the weekend, such as playing basketball with your kids or going dancing with your friends. The goal is to get moving; every little bit helps.”

Initiated in 1973 as National Nutrition Week, National Nutrition Month® became a month-long observance in 1980 in response to growing interest in nutrition.

As part of National Nutrition Month®, the Academy’s website includes articles, recipes, videos and educational resources to spread the message of good nutrition and the importance of an overall healthy lifestyle for people of all ages, genders and backgrounds.

Consumers can also follow National Nutrition Month® on the Academy’s social media channels including Facebook and Twitter using #NationalNutritionMonth.

LISTEN: Teaching Empathy & Compassion

Empathy starts with understanding other people’s emotions and feelings. Kids have to get in touch with their own emotions and feelings first. You can’t understand emotions unless you communicate face-to-face. Talk through what could help others feel better so your child understands how others feel. Then, expand your child’s experiences through travel and reading, and encourage community involvement.

Want to learn more? CLICK HERE to listen to podcast with host Melanie Cole, MS.

 

Talking to Children about Racial Bias

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

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

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

How Do Children Learn Racial Bias?

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

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

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

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

Strategies to Help Children Deal with Racial Bias

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

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

How Parents Can Confront Their Own Racial Bias

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

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

Tips for Talking About Racial Differences & Racism

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

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

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

Remember:

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


Author: Ashaunta Anderson, MD, MPH, MSHS, FAAP & Jacqueline Dougé, MD, MPH, FAAP. Source: American Academy of Pediatrics (Copyright © 2016). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.