Health Tips

My niece occasionally asks me for pediatric advice about her two beautiful girls. This is one concern that is shared by many parents in my practice…

Q:  We cannot get my 19 month old daughter to eat meat. We have tried (many times) lots of variety. We’ve tried it in things, on things, from our plates, when she asks for it….but she just won’t eat it. In fact, she usually wipes it off her tongue with a napkin or her fingers. I’m open to any tricky things I might not have considered

A:  Meat is an excellent source of protein and calories for toddlers, but it is not as easy to chew as starches, fruits and veggies. It also has a different “mouth feel” compared to many other foods.

Try these strategies to acclimate your young one to the taste and texture of meats…

Focus on offering thin sliced or shaved deli meats, chicken, turkey or ham. These have a saltier taste and lack the distinctive flavor and coarse texture of most meats. Mix crumb-sized pieces of meat with other foods that are moist and flavorful.

Disguise shredded meat in pureed veggies, sprinkle into a grilled cheese sandwich, stir into cooked pasta with butter or tomato sauce. Serve tiny pieces of meat with just a drop of ketchup, ranch dressing, mild BBQ sauce or applesauce if she likes those things. In the beginning, just add traces to her menu until you can let a bit more taste shine through.

Don’t let on that you are trying to push her in any way. It is important that she controls what she eats, and you control what is served. Keep up other sources of protein that she will eat.

And be patient. Most toddlers who don’t like meat soon acquire the taste. (Then you can try my healthy baked chicken nuggets, so stay tuned!)

The photo? Yes, that’s the one!

Halloween is just a week away, so celebrate safely. Whether it is a party with friends or “trick or treat” in the neighborhood, a few simple tips will ensure more fun.

Here’s lookin’ at you, kid. Your little ones (and big ones!) must be able to see in their Halloween get up. Masks can block vision, making navigating streets difficult when it is already dark. Enlarge eye openings for better visibility or use make up for little faces to keep vision unobstructed.

Now you see ‘em. Buy a roll of reflective tape and use it liberally to highlight their costumes. Look for it in fluorescent orange, green or white. More is better.

Walk, don’t run. Long robes can trip them up. Keep hemlines short enough for walking…staple the hemline in a costume for a quick and easy alteration. Walking should be comfortable in the costume.

Light the way. A flash light is a good accessory, not only to see the way, but also to increase visibility to others.

Candy is dandy. There was a time when stopping at a house that had home made goodies was a special treat. These days, packaged treats are best to ensure our children’s safety. Teach the kids to wait to eat candy until they are home and you have sorted it, checking for any open or damaged wrappers.

“My tummy hurts…” I think one of the most common phone calls I get as a pediatrician on Halloween is the late night stomach ache from too much candy. Avoid it by serving a light but healthy dinner before going out, so the treats tempt a little less. Then once you get home, sort the candy, set aside or toss the least favorite treats and indulge wisely. Store the rest in small bags for sharing and eating on other days.

No apples at this party…Avoid “bobbing for apples” at a Halloween party if you want to avoid exposure to everyone else’s germs. For healthier fun, check out Kaboose for some fun Halloween games.

Have a safe and happy Halloween!!

I love to bake…I feel so creative when I can serve a homemade dessert that tastes so much better than the store-bought version. And home baking also gives me the opportunity to make some healthy substitutions along the way.

Win-win? Not exactly. Homemade or not, pies, cakes and cookies can still pack a hefty number of calories. My delicious choco-chini cake is certainly lower in fat and healthier than a zucchini-free equivalent, but it is still a dessert…

Can we indulge in sweets without too many extra calories? Yes! Try these tricks to incorporate sweets into a healthy diet…

• Serve individual portions. When I talk with my young patients about sweets, I often tell them to “eat one cookie, not five cookies”. That may seem obvious, but it is not so easy when the serving plate is piled high. 
  

• Smaller servings. Of course, smaller portions have fewer calories. So measure cookie dough with a tablespoon scoop for smaller and more uniform cookies and they will also bake more evenly.

• Special times. Save fancy desserts for special occasions and special meals. The only “dessert” that most of us can afford to have every day is fresh fruit.

• Just enough. I made cookies for my son’s scout meeting today, but I baked only half the batch. I’ll freeze the remainder of the dough (or refrigerate for up to a week), then bake just a few cookies at a time.

• Out of sight, out of mind. Avoid temptation by keeping sweet treats out of sight. Store extra cookies or baked goods in the freezer, or better yet, share extras with neighbors and co-workers. They will love you for it!

• Add fiber. Fiber-rich ingredients make healthy additions to dessert recipes because fiber can decrease the absorption of fat! (Hmmm…like oatmeal cookies! ) Fruit and veggie ingredients (like applesauce, carrots and zucchini) add moisture that can replace some of the fat in a recipe…another calorie saver.

Tip of the day…Next time you make chocolate chip cookies add 2 cups of oats along with the 2 cups of chips (and decrease the flour in the recipe by ½ cup). I love the texture of chocolate chip oat cookies so much better than plain. You might never make plain chocolate chip cookies again!

MRSA, or methicillin-resistant Staphylococcus aureus, is a nasty germ even under the best of circumstances. It is also a “superbug”, a term that refers to a number of bacteria that have developed resistance to many standard antibiotics.

That’s the bad news. The good news is that a few simple precautions can keep most of us clear of staph infections, even MRSA. Staph is actually relatively harmless to normal, healthy skin. But a cut, scrape, bug bite, or even dry, cracked skin can let bacteria penetrate to start an infection.

Waterless hand cleansers can be very effective at killing bacteria, but most are so drying to hands that it’s not practical to use them frequently throughout the day. Noodle and Boo’s Instant Hand Sanitizer is different. I use it several times a day and I cannot believe how smooth and moisturized this product leaves my hands. But does it really kill germs? Yes, 99.99% of them, even MRSA.

Here are some simple steps to help protect you and your family from serious skin infections:

• Practice good skin care and wash hands frequently. Use Noodle and Boo’s Instant Hand Sanitizer whenever soap and water are not readily available.

• Don’t share towels and personal items (like razors). Bring your own clippers to the salon for manicures and pedicures.

• Keep wounds covered until they are healed to protect the open skin from bacteria, and also to prevent the spread of any infection.

• Have your doctor check any open wound or sore that is getting worse or not healing promptly.

Remember, your best defense against any type of skin infection is normal, healthy skin…by Noodle and Boo.

Read more by Dr. Pat in Healthy Lifestyles…

When I think of all the emotions I associate with motherhood, most are really wonderful…love, empathy, pride, hope. But another biggie creeps in… guilt.

Over and over I see wonderful mothers who can’t help but blame themselves for all of their child’s woes. When my son was only 15 months old, he sliced his hand on a can I had just thrown in the trash. I saw him go for it, but didn’t get there in time to stop him. He needed six stitches. I was fairly calm under the circumstances, but I knew it was my fault. Just like all the other mothers I see with injured children, I was blaming myself. I was guilty.

We know who we are. Did we feed them enough or too much? Are they warm or cool enough? Is the house clean enough? Too clean, too scheduled, too much?

I don’t really know where all that negative stuff comes from (maybe our mothers?), but I do know we don’t have to keep up the tradition. I spend the better part of my day reassuring parents that they are doing the right thing. And usually, they really are. It also turns out that our children will thrive in spite of us, in spite of themselves. Work for a balance as best you can, but try to leave guilt out of it.

Guilt ranks right up there with other stress hormones and they all take a big toll on our well being. Just say NO to guilt, and mean it. No, I won’t feel guilty or take responsibility for every failing, every problem my family encounters. Keep your sense of humor and life’s little crises won’t seem so bad.

Check out a few good books on the subject, like Motherhood without Guilt, by Debra Rosenberg or Mommy Guilt, by Julie Bort, Aviva Pflock and Devra Renner. If you don’t feel guilty anymore, your family won’t have to feel guilty for making you feel guilty. Then everyone feels better. Hooray!

More articles by Dr. Pat in Healthy Lifestyle.

Photo courtesy of Sourcebooks, Inc.

Patents often ask me about the safety of the vaccines we give. Even though I may reassure them that vaccines are as safe as ever, it is also important for me to give them specific information on the issues being raised.If you want to make sense of the vaccine issues, look to reputable sources. The American Academy of Pediatrics’ Parenting Corner has a fact sheet for parents on vaccine safety that is a good update of current concerns. The Center for Disease Control is another great resource on vaccines and vaccine safety.Here are some of the more frequent questions being asked about infant vaccines:Can MMR cause autism? Autism is a brain disorder affecting an individual’s behavioral, social and communication skills. A number of controlled studies have confirmed there is no relationship between autism and MMR. The cause of autism is not known, but it is clear that genetic factors are involved. Features of abnormal development associated with autism are present early in development prior to receiving MMR, and rates of autism have been shown to be equal in groups of vaccinated and unvaccinated children.Mercury and autism, another risk? A scientific review in 2004 confirmed that there is no relationship between mercury in vaccines and autism. Even so, all routinely recommended vaccines for infants have been mercury-free since 2001 as a precaution.Vaccine schedule…Should we delay vaccines until children are older? Infants are at greatest risk, so delaying vaccines only increases the risk from these life-threatening illnesses. In 20 years of practice, I have seen deaths from whooping cough (pertussis) and even chicken pox (varicella). The risk to our children from these diseases is real and is highest in infancy. The recommended vaccine schedules have been developed to provide maximum safety and effectiveness.Still confused after doing your homework? Trust the professional you chose to care for your child. Ask your pediatrician. You both have the same interest at heart…your child’s health and safety.Other articles by Dr. Pat…

Babies as young as a few months old communicate with their eyes, their expressions and their cries, but without words, we don’t realize how much they really want to say.

I see many babies who communicate with signs as young as 9 months to a year old. Signing is physically easier for a young infant than learning to form spoken words.

Teaching your baby to communicate by signing not only enhances social interaction, but also decreases frustration from being unable to convey basic wants and needs.

Start with an introduction of a few basic signs; watch a video like Common Sign Language for Babies to get started. Parents.com has a few different slideshows that demonstrate more signs. These are fun to view and easy to teach.

The next step is to pick up a book and DVD like The Everything Baby Sign Language Book, by Teresa R. Simpson. This is a recent publication that will help you expand your signing vocabulary. Another book to consider is Signing Smart with Babies and Toddlers: A Parents’ Strategy and Activity Guide, by Michele E. Anthony and Reyna Lindert. This book is a comprehensive resource and also offers plenty of information on the benefits of baby signing.

And don’t worry that early signing will delay speaking. Babies who learn to sign often talk earlier than their non-signing peers.

So if you are not already signing with your infant, try a few words to get started. It will be fun for both of you!

Check out Healthy Lifestyle for more articles by Dr. Pat…

Photo courtesy of barnesandnoble.com

Is your baby fussy outside when it is very bright and sunny? It may be more than the heat getting to your little one; it may be the sunshine.

Squinting is uncomfortable for infants and young toddlers and their eyes are much more sensitive than adult’s eyes to damage from bright sun.

Even shade will not protect eyes in bright sun, because it is the  brightness and reflected sunlight that are damaging. The cumulative effect of bright sunshine plays a role in a number of serious eye conditions, like macular degeneration (a cause of blindness in later life), cataracts and chronic irritation of the cornea.

Kids need sunglasses! It may not seem practical to introduce sunglasses to infants and young children, but Frubi Shades are different. The soft, spongy nosepiece and wrap-around design make these sunglasses stay in place comfortably. The little ones may need a short period to adapt, but the improved comfort in bright sun makes the adjustment quick. The trick is to acclimate children to sunglasses at an early age, so they will continue the habit throughout their lives.

And there’s more to this story. Frubi Shades has donated thousands of sunglasses to children’s organizations as part of their Protect Their Eyes Campaign.

It feels good to endorse a great product from a company that also gives back. Hmm…just like Noodle and Boo!

Look for Healthy Lifestyle every week for health tips, recipes, fun with gardening!

Photo courtesy of frubishades.com

Get more game ideas from PreschoolRock.com. Here is a fruit and vegetable color guide to get you started:

Red: Strawberries, raspberries, tomatoes, tomato sauce, watermelon

Orange: Sweet potatoes, carrots, oranges, orange juice, mangoes, cantaloupe, peaches, pumpkin and other orange squash

Yellow:Pineapples, yellow peppers, lemons, yellow grapefruit

Green: Spinach and leafy greens, beans, peas, broccoli, asparagus, green peppers, avocado

Blue and Purple: Blueberries, blackberries, dark beans, purple grapes, eggplant

White: Don’t forget white! Think bananas, potatoes, onions, white beans, apples and cauliflower.

The kids won’t be the only ones having fun… this is an imaginative way for all of us to include more nutrients in our diet. The pigments that make fruits and vegetables so colorful are actually phytochemicals that contain vital nutrients, says  James A. Joseph in The Colour Code.

A recent review of his book summarizes the benefits of the colors: lycopene, the red in tomatoes, is linked to lower rates of cancer and heart disease; lutein, which gives spinach its dark-green tint, helps fight certain types of eye disease; anthocyanins, contained in blueberries and other dark-purple and red fruit, aids memory and improves other cognitive problems of ageing, and there are immune-boosters found in white root vegetables like in garlic and onions. (Of course, don’t tell the kids all that!)

Turn some of your favorites into “rainbow recipes”, like fish (colorful fish fillets), veggie stew (ratatouille), or dessert.

And last but not least, don’t miss the song, I Can Eat a Rainbow. It’s a kick! 

More Dr. Pat…

The refreshing taste of citrus is so nice in the water served at your favorite restaurant…or is it?

Recent reports of a study in the Journal of Environmental Health have revealed that the lemon slice or wedge served with the water in restaurants is contaminated with disease-causing bacteria about 70% of the time. This doesn’t mean people get sick that often, but I don’t find that very reassuring.

The study found that servers usually do not use gloves or tongs when adding a lemon slice or wedge to the glass, causing contamination when hands are dirty. This is not only unsanitary, but violates the health code in many regions.

Must we forego even that little slice of luxury when eating out? The risk seems to be low, but now the whole idea seems quite unappealing.

I guess it just comes down to personal choice. For me it’s going to be…
“Water please, no lemon.“

More Dr. Pat…

Take a deep breath, and change your focus from those wet or dirty diapers to a whole new routine for your two year old, potty time.

• The right age is two, or just a couple of months before or after. (By 2 ½ they love to say NO!) Start by getting a good potty book your child…

• Get a potty timer, a loud timer that you keep in the bathroom to set for 1 to 2 hours as a reminder for potty time. The timer, not you, is interrupting your child to announce that it is time for the potty.

• Buy really cool underwear or cloth training pants for your toddler. Getting wet is important physical feedback when your child starts to pee, so use diapers or pull ups only for naps and bedtime, never daytime.

• The bathroom is the happening place. No more changing table, bed or floor for changing wet or soiled clothes. Have your child sit on the potty while you get him cleaned up. Talk about how the pee got his clothes wet, and how he’ll stay nice and clean when the pee or poop goes in the potty.

• Praise, praise, praise and reward the effort each time he sits on the potty. Your child may pee in his pants just two minutes after potty time, but remember that this is a learned skill. It takes time to learn to relax those muscles on command. Accidents are a necessary part of the learning process.

• Be prepared. Try to spend more time at home the first week and keep any outings super short. Watch the clock (or keep the timer in your purse) and stop for bathroom breaks on schedule. Carry multiple changes of clean clothes and line the car seat with an absorbent pad, but DO NOT put your child in a diaper if you need to go out. You will be saying that it is OK to wet in your pants when it is not convenient to use a toilet.

• Keep the routine going. Once your child gets the idea, don’t assume he will tell you when he needs to use the bathroom. It will be important to keep potty breaks first thing in the morning, before and after every meal, nap, outing, etc.

Look to other moms for encouragement and keep a sense of humor about potty training. Soon you and your child will be celebrating your success!

Happiness is…no more diapers!

Protecting our children is always our number one concern, so it is especially worrisome to think we may be unintentionally causing them harm. We tackled phthalates in baby products, only to be confronted with BPA in plastic baby bottles.

BPA (bisphenol A) is a chemical found in hard plastics made of polycarbonate, like baby bottles, Nalgene bottles, and even the plastic lining inside soda cans. The chemical leaches out of the plastic into food or drink, only to be consumed. (Add that to the long list of reasons for kids to avoid soda!)

Even small amounts of BPA are a concern for any infant, but a baby who is fed canned formula, especially if it is heated in the bottle, can consume potentially toxic levels on a daily basis. Developing infants and young children are most susceptible to the hormone-disrupting effects of BPA, but the chemical can be toxic to adults as well. Concerns about BPA have come from many sides, ranging from scientific journals to health blogs to ABC News.

Parents have asked me if they should avoid plastic baby bottles because of BPA. As a pediatrician and a mother, this is an easy call. Why put our children at risk?

What to do? Most brands of clear plastic baby bottles (like the one pictured here) contain BPA, so use glass bottles or plastic liner bags (which do not have BPA) for infant feeding. Look for BPA-free plastic bottles and toddler cups and as well as “safe” plastics, like #2 HDPE (high density polyethylene) or #5 polypropylene (PPE). Don’t heat foods or liquids in plastics if possible.

My son is long past babyhood, but now I’m off to inspect the Nalgene bottles in his camping gear. (If they are #7, then they’re history.) The bottles are probably past their prime anyway, so after reading the Green Guide I think I’ll replace them with HDPE.

Hmm…glass baby bottles. I think we have come full circle…

Eating is a hot topic at doctor visits for children of all ages. Even more than adults, kids go through phases with eating…a food they loved one week is taboo the next.

I tell parents that many toddlers average one good meal every other day… it may simply not happen that your little one eats green vegetables every day. You keep offering them, but more often than not, they aren’t being eaten.

These phases are normal…yes, picky eaters are normal! And since the rate of your child’s growth slows down dramatically in the second and third years, appetites are smaller too.

Is there hope for healthy nutrition at these tender ages? Yes, but you must lay the groundwork.

• Be upbeat and positive about healthy food choices. You should decide what is offered and when the meals and snacks are given. Your youngster must choose from what you have served, but be sure to include some favorites.
• Set regular times for meals and snacks, more frequently for younger children. Eating should be at the table (or for the younger set, the high chair), not on the floor while playing or watching TV.
• Allow your child to decide how much he eats and even whether he eats or not. If your child wants to leave the table without eating at all, it is a mistake to try to force him to eat. He will eat when he is hungry, and that’s OK. At the next meal or snack your child may be more willing.
• Eat together. You set an example when eating healthy foods.
• Involve older kids in planning and preparing meals.

Children who control their own intake eat better and ultimately choose more variety than children who are forced or pushed to eat. Nutrition Explorations by The National Dairy Council has many ideas for fostering healthy eating with your child. Try their fun facts and games with your kids.

So how to get a picky eater to eat? Put him in charge, sit back and…be patient!

Many parents worry that their infant is eating too little (or too much) and don’t realize that baby usually knows best…

I recently watched a video of a very loving Dad spoon feeding his infant. The baby fed readily for a time, but once he stopped opening his mouth for the spoon, the dad would get him to laugh so he could sneak in another spoonful. Only by crying and squirming did the baby finally get the dad to quit. This dad was teaching the baby to keep eating after he was full…a set up for overeating and later obesity.

Here are a few tips to keep in mind for healthy infant feeding:

• Breastfeed as long as you can. Studies have shown that breastfeeding is associated with a reduced risk of obesity in later life compared to formula feeding.

• Delay solids until 6 months. Many pediatricians are now recommending solids at 6 months old, when babies’ digestions are better able to handle solid foods. Early feeding has been linked to excessive weight gain as well as increased risk of food allergies.

• Transition quickly to finger foods. As soon as your baby can sit in a high chair, offer small soft foods he can scoop up, even if it is just for play at first. Pea-sized pieces of banana, steamed carrot or sweet potato are easy for a baby to pick up and eat. Self-feeding is an important way for your baby to control his intake.

• Look for signals that your baby is full. Breast fed babies will stop feeding when they are satisfied, so give your bottle-fed infant the same control and don’t push him to finish a specific amount. Spoon feeding should end when your baby loses interest, not when the bowl is empty.

• Keep feedings pleasant. Never let the baby fuss in the high chair. If he doesn’t want to eat now, try again later.

Offer extra meals for a small eater, but trust your baby to decide how much to eat…you will both be happier! Next week…the picky eater.

“Hey, where is an Ultimate Cleansing Cloth when I need one…?”

My niece asked me if she should consider using DHA-fortified milk when her daughter turns a year old in a few months. It seems this was a popular topic at a one year old friend’s birthday party recently.

DHA (docosahexaenoic acid) is an Omega-3 fatty acid (a good thing). DHA occurs in large amounts in breast milk and now all infant formulas are supplemented with DHA, recognizing the critical role of DHA in infant nutrition. DHA is an important nutrient for developing brain and nerve tissue in infants and children and contributes to brain, eye and heart health in adults as well.

Unfortunately, your child loses his or her main source of DHA once breast milk or formula is replaced with cow’s milk, which is low in DHA. DHA is found primarily in fatty fish, but the typical toddler just doesn’t eat much salmon and tuna. Ditto the vegetarian sources like spinach and soybeans-not exactly hot items on a kid’s menu.

The good news? Now you can find milk fortified with DHA. In 2007 Horizon Organic Dairy became the first U.S. company to supplement milk with DHA. Check out Horizon’s interactive site for a fun and easy way to learn more about kids and DHA.

So what did I tell my niece? I told her I thought DHA-fortified milk would be a good idea when she introduces cow’s milk. See if your pediatrician agrees…

Beware of the sun even in winter months; tender skin can burn before you know it! Even at this time of year, exposure of more than 20 minutes risks damage to your little ones’ sensitive skin.

Here are a few tips for winter sun safety…

• Your child needs sunscreen outside in all weather. Even on overcast days, 80% of the sun’s damaging rays filter through the haze.

• Plan ahead. Apply sunscreen 15 to 30 minutes before going outside. Sunscreen won’t work well unless it has had time to be absorbed. Better yet, use sunscreen on your child’s face and exposed skin each morning; now you can be smart and spontaneous when your toddler wants to play outside. A school age child needs sunscreen every morning year round.

• Sunscreen is absorbed better by dry skin, so don’t wash your child’s face right before applying. When sunscreen is absorbed better, it protects better.

• Bring your sunscreen along on winter vacations. You might not think of packing sunscreen when it is 35 degrees outside, but snow increases exposure. Reflected rays from the sun increase by 80% in snow. The risk of burn goes up even more at high altitude. (And don’t forget the sun goggles in snow country.)

These are a few important features in a sunscreen…

• Sun Protection Factor. There is just a small increase in protection beyond SPF 30, but there is a lot more sensitivity. I see more contact dermatitis with gels of SPF 45 to 50 and higher, so I tell parents to avoid them and choose a water-resistant lotion with SPF 15 to 30 for young children.

• Broad spectrum. The two types of harmful rays in sunlight are UVA and UVB. They are both dangerous, but UVB is the major cause of sunburn and skin cancer. A broad spectrum sunscreen protects against both types of harmful rays.

• Hypoallergenic. When using sunscreen on a young infant, always test on a small area to watch for redness or irritation. You and your older child will benefit from the same mild formula you use on your infant.

Question: Who makes a hypoallergenic, broad spectrum lotion with an SPF 30 that is safe enough for babies? Answer: Noodle and Boo, of course. Play-Day is the perfect sunscreen for sensitive skin of all ages. Don’t leave home without it!

Want to know more? The American Academy of Dermatology is a great resource; read Facts About Sunscreens or take a sun-smart survey called RAYS: Your Grade!

Pearls?…these are some of my pediatric “tricks of the trade.” Time tested, parent tested, and pediatrician approved from over twenty years of baby and child care…

Most people know to avoid diaper rash by keeping those little bottoms dry. But too much cleaning can be a problem too.

Newborns and very young infants are especially sensitive to wetness, and that includes over cleaning. A newborn may need to be changed 12 or more times a day; that’s a lot of wetness and wiping on such sensitive skin. Most diapers wick wetness away quickly, so when changing a wet diaper in a newborn, simply switch it for a dry one. Save the cleaning for a soiled diaper (which may still end up being almost every change!)

When there is any soiling, cleanse with gentle wiping, without rubbing or pressure. And after the bottom seems clean, use another fresh wipe to be sure. Any trace of stool left behind (no pun intended) can trigger irritation and rash.

Older babies and toddlers do not urinate as frequently as newborns, so a quick wipe with every change is better to freshen them.

Which wipe to use? Choose Noodle and Boo’s Ultimate Cleansing Cloths for soft, gentle pampering of your baby’s sensitive skin.

They are just what the doctor ordered.

Your child wakes up with fever, cough and congestion…is it flu?

Fever, headache, body aches, fatigue and cough occur in both colds and flu, but flu symptoms are more sudden and severe than cold symptoms. Children with flu may also have vomiting and diarrhea, which adds to their risk of dehydration.

If you suspect flu, here is what your child needs:

• Rest. Sleep is an even better aid to recovery.

• Fever reducers. Medications such as Tylenol or Motrin help with fever, headache and achy muscles.

• Fluids. Some kids won’t drink when their fever is high, so treat the fever with medications and offer sips of clear fluids once the fever is responding. Clear fluids are best if your child has nausea or vomiting.

• Comfort. Saline sprays for dry noses, popsicles to soothe sore throats, chicken soup for warmth and nutrition.

Call your pediatrician’s office. Your pediatrician (or nurse) will review your child’s symptoms to decide if a visit is needed. If your child is at risk for complications from flu, your pediatrician may do a test to confirm flu. In specific cases, antiviral medications may be prescribed.

A flu shot will prevent most cases of flu, so if you or your children are still not vaccinated, it’s not too late. Call your doctor today!

Tylenol and Motrin are registered trademarks of McNeill-PPC-Inc.

Many people choose health-related resolutions for the New Year…and I suspect that diet and exercise rank at the very top of the behaviors many of us would like to improve.

Year after year, I drop more resolutions in the first week of January than I would like to admit. Some years I even refuse to make resolutions, telling myself that if I had more discipline I wouldn’t need them. Probably true.

This year is going to be different. I always liked the idea of a New Year’s Resolution because of the feel of a fresh start. Here are a few tips for creating successful resolutions:

• Write it down. Keep your written resolution in a prominent place, like on the refrigerator or the steering wheel of your car.
• Keep it focused. Instead of “I am going to eat healthier,” try something specific like “I will eat three fruits a day.”
• Allow yourself some wiggle room. If you resolve to “exercise for an hour every day,” you will feel like a failure the first time you miss a day. Give yourself a range, like exercising three times a week.
• Keep it practical. Lofty goals are harder to attain and will be abandoned sooner. Even if you need to lose 20 lbs., resolve to lose 5 or 10 pounds as an initial goal, so that you can actually succeed. You will be more motivated to keep going.
• Reward the effort, not just the result. Sometimes the hardest part is just getting started, so if you splurge on your reward (just had to have those earrings) on your way to your goal, remember to add another teaser for the next level. Just be careful not to sabotage your efforts. (Ice cream is not an appropriate reward for following your diet!)
• Share your ideas for healthy resolutions. Consider a weekly “salad day” at work and have each co-worker bring an ingredient for a big chef’s salad to share for lunch. Your friends will love it!

Remember that routines take time to change, so keep a positive outlook. When you lapse, plan to restart tomorrow or next week, just don’t wait until next year!

Send me your ideas for healthy resolutions and in a few weeks, lets see how we’ve done! Leave a comment, or e-mail me at chatterbox@noodleandboo.com. Questions on any other health issues? . . . Just ask!

Here’s to a Happy and Healthy New Year!

Oh, to sleep like a baby…it does sound wonderful, doesn’t it? But as adults, sometimes we just don’t have enough time for sleep. And if we are busy or stressed, our sleep may not be as restful.

We may not sleep 15 to 18 hours like most infants and toddlers, but sleep is just as important for our well-being and health. Inadequate sleep in adults saps energy, dampens our mood, inhibits memory and mental sharpness, decreases productivity, and even affects our immune system. We are more likely to get sick when we are “run down” (tired, fatigued, or exhausted).

So wake up! The National Sleep Foundation offers some tips for healthy sleep:

• Keep regular sleep times. Don’t “sleep in” more than an hour or so on weekends or you may upset your internal clock, which sets our sleep and awake cycles.

• Exercise regularly. It’s easier to fall asleep, as long as you finish exercising a few hours before bedtime.

• Establish a relaxing bedtime routine. I love this tip…what’s not to like about a warm bath, soothing music, and a good book before bed?

• Create the right sleep environment. Have a comfortable bed in a room that is dark, quiet and cool. (And don’t bring a stack of work reports to review in bed.)

• Eat earlier. A meal too close to bedtime disturbs sleep.

• Avoid caffeine and alcohol late at night. Caffeine is a stimulant and triggers wakefulness, sometimes lasting up to 12 hours. Alcohol may be sedating, but also disrupts normal sleep so you will feel less rested.

• See your doctor for ongoing problems with sleep or excessive daytime sleepiness. If you have an underlying medical problem or sleep disorder, your doctor can help.

I wish all of you healthy and happy holidays. And for those travelers who will be driving, remember to get enough sleep before you drive so that you arrive safely!

Happiness is…Zzzzzzzzz..…zzzzzz.

Especially in the winter months, I see sick children every day. And while I can’t say that I never get a cold, it is not often.

My secret is really very simple…good hand washing. Germs (viruses and bacteria) are usually transmitted by direct contact. And that almost always means hands…your hands or someone else’s hands.

Viruses and bacteria can live on surfaces for hours. In the course of a day we touch hundreds of surfaces…we shake hands with co-workers, we take change from the store clerk, we push a shopping cart, we open doors. The list goes on and on.

In my pediatric office, I wash my hands dozens and dozens of times every day. It takes a little more effort when I’m not at work, but one of the most important times I never miss hand washing is before eating or handling food. Every virus and bacteria we come in contact with all morning lands in our mouths at lunch time if we don’t wash before eating that sandwich or slicing that apple.

We all know to wash our hands every time after using the bathroom, but if you’re in a public place, save the paper towel to open the door on your way out. At home this winter, give everyone their own color-coded hand towel and drinking cup in the bathroom (and wash them frequently). You may find that you won’t be sharing every cold your child brings home!

Waterless gel cleansers? These products are very effective in killing germs, but they are mostly alcohol and can be extremely drying. Use cleansing cloths for hands in the car or at the gym, anywhere without a sink. After all that washing, use lotions to moisturize your hands, but if they do get chapped and need real work, then add ointments at bedtime.

My favorites: I use Noodle and Boo Super Soft Lotion or the new Glowology Lovely Body Lotion for moisturizing by day. For problem hands I’ll add The Balm or even Ultimate Baby Ointment; they really work! And for waterless cleansing, try the Ultimate Cleansing Cloths.

This is the second in a series of “Winter Health Tips.” Next week: “Sleep…It’s Not Just for Babies Anymore.”

Winter is on its way…brisk days and pink cheeks, hot cider and gingerbread, shopping for December holidays…and what else? Flu shots!

As a pediatrician, I am often asked if flu shots are a good idea for kids…and the answer is YES! For many, a flu shot can be life-saving.

Even so, some people wonder if it isn’t better to get the illness to