Texas Parenting News

Helping children attain a healthy weight

Ms. Johnson, picking up her 5-year-old at the afterschool program, notices that her child has been crying.

“What’s wrong, Honey?” she asks.

“We were playing tag and I got caught,” she sniffs. “I can’t run as fast as the other girls, and they say it’s because I’m fat.”

Ms. Johnson sighs. “I don’t like seeing my child so unhappy,” she thinks. “Maybe it’s time to ask for some professional guidance.”

The next day, she calls the child’s kindergarten teacher and the director of the afterschool program. She follows their suggestions, starting with a visit to a health clinic to measure the child’s height, weight, and body mass index (BMI).

“Yes, your child is overweight,” the nurse says. “Unless she gets down to a healthy weight, she will probably develop some big health problems as a teenager and as an adult—like diabetes and heart disease.”

“Does this mean putting her on a diet?” Ms. Johnson asks.

“Not to count calories,” says the nurse. “Just a change in eating habits and activity.”

Over the next year, Ms. Johnson follows the nurse’s suggestions. By the second grade, her daughter has grown taller, has more energy, is more alert in class, and has a new best friend. Everyone has noticed the difference.

What has changed? Here’s what Ms. Johnson has done:
She has adopted the slogan “Easy does it.” She understands that changing habits takes time, so she has made changes gradually in feeding her family and getting active.
She gives positive emotional support, refraining from criticism and shame. She has avoided using words like fat and skinny and pretty and ugly. Instead has talked about healthy foods and moving to feel good.
She has switched from sweet rolls for breakfast to oatmeal with raisins or a breakfast taco and fruit. She buys fresh fruits, instead of cookies and chips, for snacks. She serves more fruits and vegetables as part of meals.
She bakes or grills meat and fish instead of frying it. She serves low-fat dairy products and whole-grain breads and cereals.
She has stopped buying soft drinks and juices. She keeps a small pitcher of water in the refrigerator and fills a glass with it whenever anyone is thirsty.
She acts as a role model by eating healthy foods and smaller portions, eating and chewing slowly, and sitting down to eat.
She has limited TV watching to no more than one hour a day. She has found ways to be physically active with her daughter, such as dancing, walking, and climbing up and down stairs.
She has talked with her child’s teachers to gain their support. She is pleased that both the school and afterschool program serve healthy meals and snacks and set aside time for at least 30 minutes of physical activity every day.

For more information on preschoolers and obesity, see “Childhood Obesity and Overweight,” the Centers for Disease Control, http://www.cdc.gov/obesity/childhood/index.html.

Can preschoolers have concussions?

Doctors have started paying greater attention to sports-related concussions in school-age children as well as in college and professional athletes. But preschoolers are also prone to head injuries, and parents need to know how to prevent them.

What is a concussion?
A concussion is a brain injury usually caused by a fall or bump on the head. Because the brain consists of soft tissue cushioned by spinal fluid, a hard blow can make the brain move around in the head and damage nerves and blood vessels.

Babies and toddlers fall often while learning to sit, crawl, and walk. They have trouble balancing because their head is disproportionately large compared to the rest of the body. Preschoolers can simply fail to appreciate what adults know as unreasonable risks while playing indoors or on the playground.

Concussions can also happen as a result of physical abuse or violent shaking (see www.cdc.gov/concussion/headsup.html).

What are the signs of a concussion?
Babies and preschoolers may not be able to fully explain where it hurts or what they’re feeling. An injury may not leave a bruise or cut, and the damage inside the skull can remain hidden. Consequently, parents need to carefully monitor a child after a fall or bump for signs such as the following:
crying more than usual
headache that won’t go away
changes in eating, sleeping, or playing
sensitivity to light or noise
sluggishness or inability to pay attention
dizziness
nausea
lack of interest in favorite activities
tendency to become upset more easily

Older children may display other signs such as blurred vision, a feeling of confusion or anxiety, difficulty in concentrating, or memory loss. Signs may appear shortly after the injury and linger for days. Depending on the child’s age, the type of impact, and the severity of the warning signs, parents would do well to consult a doctor.
The child should not be given medication without a doctor’s advice. Aspirin, for example, can cause bleeding, further damaging brain tissue.

Prevent head injuries
Parents can take simple but effective steps to prevent concussions and serious head trauma in young children.
Use a crib or bed with side rails. Make sure crib rails are locked into place when the baby is inside.
Never leave an infant alone on a high place such as a bed, changing table, or sofa.
Remove slippery throw rugs, install gates at both top and bottom of stairs, and keep the floor clear of toys and other objects to prevent tripping.
Discourage adults from overly vigorous play, such as tossing a child up and down in the air and whirling a child around by an arm and a leg.
Install window guards or secure screens on all windows that can be opened.
Supervise children on jungle gyms, swings, and other playground equipment as well as riding tricycles on concrete surfaces.
Insist that children wear helmets when riding a bicycle, learning to ride a skateboard, and batting a baseball. Never allow boxing, even with a helmet.
Cooperate with other parents to discourage unnecessarily aggressive play in soccer and other team sports.
Follow recommended guidelines for child safety seats and safety belts while riding in cars. A quick summary: Infant—rear-facing seat until age 2. Preschooler—forward-facing seat with harness. School-ager—booster seat with seat belt until child is 4 feet 9 inches tall. Call 1-800-252-8255 or go online to www.dshs.state.tx.us/saferiders for information on free child safety seats for income-eligible families.
Never allow children to ride in the back of a pickup.

Summer: Escaping the routine

Summer often brings changes in routines for families. Parents may still need child care while they’re at work, but they also may want to try different activities that can provide stress-free fun and educational enrichment.

Start with a plan
Effective planning starts with a calendar, printed or electronic, where one can block out events and combine the whole family’s activities in one place. Some questions to consider:
Which family events must we attend? Think about reunions, weddings, and birthdays as well as celebrations such as the Fourth of July.
Do parents’ jobs allow for holidays and vacations? Will grandparents invite children to spend a week or go on a trip with them?
What do friends and relatives recommend? They may suggest an occasional baseball game or a week-long day camp. Ask for specifics about why a friend or relative likes or dislikes an activity. Remember that different families may have different goals: education versus entertainment, for example.
What information is available in print and online? Some newspapers insert a summer camp guide (including day camps) in early spring. Churches announce their offerings, such as Vacation Bible School, in bulletins or on websites.
What are children’s interests or needs? Your children might choose gymnastics at the Y, a woodworking class at the local art museum, or a week of bird watching given by the nature society. Some day camps cater to specific interests such as sports or theater, and others seek to serve children with physical or learning disabilities or chronic health conditions.
Does the local library offer a storytelling or reading program? Research has shown that children, especially in low-income families, experience learning loss in summer. Prevent this loss by reading aloud with children, telling stories, and engaging children in conversation. To keep math skills fresh, play dominoes or card games, invite children to count items (toys, red cars, crackers, for example), and challenge children to sort items (sea shells, buttons, leaves, for example) by color or type.

Choose safe and suitable activities
Placing children in anyone else’s care for a day or even an hour requires some advance investigation. Affordability may be a priority issue, but safety is also a No. 1 concern. A particular activity might raise the following concerns:
What company or organization is offering the activity? What is the group’s mission? Who are the administrators or board members?
Who are the personnel who will actually work with children? What training is required of them? What is the adult-to-child ratio?
Where will the activity be held? Is the area safe? What are the days and hours of operation?
Is transportation provided? Where are the pick-up and drop-off locations? Is carpooling possible?
What is a typical agenda for an activity or day camp? Does it offer variety: rest as well as vigorous play, for example?
What are the specific activities, such as crafts, swimming, and hikes, for example? What is the level of interaction between children and adults and between one child and another? Avoid activities that rely on watching TV and playing video games.
Will supplies be provided? It might be a good idea to wear hats, sunscreen, and comfortable walking shoes and bring a backpack with water and a change of clothes.
Will lunch, snacks, and water be provided? How nutritious are the lunch and snacks?
Is the activity appropriate for my child’s age and development? An overnight camp, for example, is best saved for children who are older and have experience being away from home. Similarly, visiting a theme park such as Disney World and Sea World can be more enjoyable when children are older and can better tolerate the heat, crowds, and excitement.
How and when do we sign up? What about refunds if we choose to withdraw?
Are parents allowed, or expected, to participate? Beware of any activity that forbids parents to drop in at will.
Is the schedule too tight or overbooked? Remember to pencil in down time, or do-nothing days. Allow time to nap, watch a movie, have an impromptu picnic, or simply watch the clouds float overhead.