Month: March 2011

Good nutrition and your child

One of the most frequent questions I am asked is, “Is my child eating enough?” It’s not realistic to expect parents to watch everything their child eats. Children generally eat when they’re hungry and stop when they’re full. A child who is gaining weight and growing well is getting enough to eat.

Our culture has become accustomed to large portions, but a child-sized body should consume a child-sized portion. A child-sized portion is approximately one-third to one-half of an adult-sized portion. With their small stomachs, children cannot eat enough at meals alone for their high-energy needs. They need to eat more frequently than adults, and so snacks make up an important part of childhood nutrition. Three meals and two or three healthy snacks a day help children meet their daily nutrition needs. If possible, try to stop snacking two hours before meals; otherwise, your child will not feel hungry when mealtime comes along.

One challenge parents might encounter is when their child seems to go for days without eating. This is normal behavior for children, especially toddlers. Toddlers and preschoolers grow in spurts, and they also tend to eat in spurts. Don’t be alarmed if your toddler seems to go a whole day or two without eating. Children reliably eat when they are hungry. As long as you offer them a healthful selection of foods, they will get what they need.

One of the more difficult tasks that parents face is helping their children to eat a healthy diet. Healthy food can be more expensive, more time consuming to prepare, and less appealing to a child’s picky palate. Better diet translates to better health, so it really is worth the effort. Here are a few steps you can take to help your child eat more healthfully:

  • Model healthy eating. Children are nothing if not keen observers. Anyone who has ever heard their toddler quoting them word for word knows this all too well. Toddlers and preschoolers certainly have their own ideas about things, but nevertheless, they want to do what their parents are doing. If you want your child to eat his vegetables, eat your vegetables. Your struggle will become infinitely easier.
  • Start with a healthy breakfast. Cereal is a great breakfast option. Most kids love cereal, and it’s a good way to sneak in a little milk to those kids who don’t like it. Kids over two years old should be drinking low-fat milk. Cereal can be tricky so use a little caution. Most cereals are loaded with sugar and lose most of their nutritional value this way. Choose cereals with less than 10 grams of sugar and at least 2 grams of dietary fiber per serving. Also, adding fruit to cereal is a great way to get in one of each day’s fruit and vegetable servings. Frozen fruits are just as healthy as fresh fruits and make a great topper to breakfast cereal.
  • Focus on “five a day.” School-age children should eat four to five different fruits or vegetables per day. Try to incorporate at least one at each meal and for at least one snack. The more variety of colors children eat, the better, so encourage them to “eat a rainbow,” meaning eat fruits and veggies of as many different colors as they can. Offering dips can really help kids eat more fresh fruits and veggies, for example, dipping apples in peanut butter or carrots in ranch dressing.
  • Eat together. Children are healthier when families eat together. Try to avoid eating while doing other activities such as watching television, and do your best to sit with your kids while they are eating.

Your child’s annual well-child check is a good time to talk to your family doctor or pediatrician about your child’s nutrition. A schedule of well-child exams is available on our website. The foods they eat as children will influence the food choices they make as adults, and also their overall future health.


Safety and your school-aged child

Did you know that injuries are the leading cause of death for school-aged children? Every year, thousands of kids in the United States die or are seriously injured by car or bicycle accidents, drowning or guns. The good news is that there is plenty you can do to help prevent injuries and protect your child.

Seatbelts and Booster Seats

Motor vehicle accidents are by far the leading cause of death for school-aged children in this country. Many of these deaths could be prevented by the use of proper safety restraints. Every person in a car should be properly restrained with a seatbelt, booster seat, or car seat. No exceptions! As a parent, it is important that you model this behavior for your child by always wearing your own seat belt and shoulder belt. Proper restraints can reduce the risk of death and serious injury by 60 to 70 percent.

Here are some guidelines:

  • Kids under 4 years old and under 40 lbs should be in a car seat, rear-facing until age 2.
  • Kids 4 to 8 years old, 40 to 80 lbs, and less than 4?9? tall should be in a booster seat.
  • The lap belt should fit low and snug across the hips.
  • The shoulder belt should always be worn together with the lap belt, crossing the chest, shoulder, and collar bone to prevent abdominal and spinal injuries.
  • Children younger than 13 years old should not sit in the front seat.

For more information, visit

Pedestrian Skills Training

For kids under 10 years old, car versus pedestrian accidents are a common cause of death and serious injury. Most accidents occur during the day, in the afterschool hours. Nearly one-third of accidents occur in marked crosswalks. To help protect children:

  • Don’t let kids play in driveways, alleyways or near streets.
  • Teach younger children to stop at the curb and wait for an adult before crossing the street.
  • Older kids can be taught to cautiously cross quiet streets on their own.
  • Don’t let kids younger than 10 years old cross busy intersections alone.

Bicycle Helmets

Bicycle injuries result in approximately 200 deaths each year in children and account for 300,000 emergency room visits nationwide. The majority of deaths and severe injuries are caused by head trauma. Bicycle helmets are an effective way to prevent such trauma, as they can reduce the risk of head and brain injury by 85 to 90 percent. To keep children safe:

  • Everyone—including you—should wear a helmet whenever riding a bicycle.
  • Ensure a snug fit by using the helmet’s pads and adjustable straps. Make sure the helmet doesn’t move around on the head or slide over the eyes.
  • The helmet should be worn squarely on top of the head, covering the forehead.

Keep an eye out for kids’ health fairs, or contact your local hospital to see if they know of venues that offer free or low-cost bicycle helmets.

Water Safety

Drowning is the second most common cause of trauma death in children in the United States. Three children die every day from drowning. For younger children, bathtubs and swimming pools are the most common places where drowning occurs; for older children, the danger tends to be natural bodies of water where they are swimming or playing. Here are some guidelines to prevent drowning:

  • If you have a backyard pool, fence it off completely to keep unsupervised kids away.
  • Never leave young children alone around bathtubs, pools, or natural bodies of water.
  • All kids should use a life jacket when on a boat, fishing, or playing in a river or stream.
  • Teach children to swim when they are old enough, usually around age 5.
  • Never let children swim without an adult watching, even if the child knows how to swim.

Gun Safety

More than 40 percent of US homes with children have guns. A recent survey at a family practice clinic in Seattle found that one in seven families had guns at home. Having a gun in the house increases the risk of homicide by 3 times, and the risk of suicide by 5 times. Although many gun owners buy guns for self-defense, a gun in the home is over 40 times more likely to kill someone known to the family than someone in self-defense. The best way to keep your child safe is:

  • Keep all guns out of the home.
  • If there are guns in the home, make sure they are always kept locked and unloaded, with ammunition locked separately and keys hidden away.
  • Find out if there are guns in the homes where your child plays.
  • Talk to your child about the danger of guns and tell them to stay away from them.

For more information about ways to keep your child safe, talk to your pediatrician, or visit: