child health

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…

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

Fish and rice with a Southwestern twist! This is a variation of Colorful Fish Fillets, but a few substitutions make it an entirely new dish. Fire-roasted corn, tomatoes and green chilies flavor the fish, and the rice cooks with salsa for a quicker version of Spanish rice…

Look for roasted corn in the freezer section of specialty markets or better yet, make extra to freeze next time you are grilling.

Salsa Fish Fillets

salt and freshly ground pepper to taste

Add a quick side dish of sliced avocadoes on a bed of lettuce and dinner is served!

More from Dr. Pat…

This “two-for-one” will give you two different meals from one recipe…and I don’t mean leftovers! As cook and magician, you will make fabulous chili, Sloppy Joe’s or a combination of both all at the same time…and that’s just the beginning.

This is another “I can’t believe this is turkey” recipe: ground turkey masquerading as ground beef. The spices give the ground turkey a whole new identity, and with fewer calories and only a fraction of the saturated fat of ground beef, this version definitely comes out on top.

Preparation is easy, but the trick is to let everything simmer long enough to develop the rich flavor. (If you want to cut prep time, look for packaged chopped onion and pepper in the fresh produce or freezer section of the supermarket.) Make this meal ahead and reheat it for a quick weekday supper with a salad and whole grain bread.

Kid-friendly chili or two meals? If the munchkins in your family aren’t into chili yet, just divide the meat mixture into separate portions before the chili powder and spices are added and simmer separately. You will have hearty “Sloppy Joe’s” for them and delicious chili for you with no extra effort!

1. Heat the oil on medium-high in a Dutch oven; add the onions and peppers and cook about 3 minutes until the onions are translucent.
   
2. Add the ground turkey and brown well.
3. Add the beans, tomatoes, paste, water and vinegar.
4. Add remaining ingredients (*adjust the amounts if you split the recipe).
5. Bring to a boil, then reduce the heat to simmer for 1 ½ hours (or more), stirring occasionally. Serves 6 to 8.
   

For Sloppy Joe’s: Follow the instructions above through #3, then transfer half the meat mixture to another pan and omit the spices (*).  Simmer as above, stirring occasionally. Serve on buns.

These recipes pack a lot of flavor and nutrition into a simple meal…and you won’t believe this is turkey!

Good nutrition tasting good…more recipes by Dr. Pat…

Since you are reading this, chances are you already know about Noodle and Boo products. There is a lot to like, and I love that their products are wholesome and natural for all skin, not just sensitive skin. They are the best I have ever used personally or have recommended as a pediatrician.

But there is more. This company has been committed to charitable giving since it began, and now the circle has widened. If you haven’t browsed the website in a while, check out the Raise Your Hand Campaign. I always felt good knowing that Noodle and Boo supported a number of children’s charities, but soon their impact will be even greater. In addition to the charities that Noodle and Boo already supports, soon you and I will be sponsoring the health and well being of an entire village in Africa just by buying a bar of soap!

Noodle and Boo’s contribution to our world is up front and personal, because these are products we use every day. And now we will feel just as good inside as we do outside!

Sausage bread that is healthy? You bet! This has become one of my favorite recipes, made with turkey sausage and low fat mozzarella…

When I saw this recipe prepared on Fine Living  more than a year ago, I couldn’t wait to try it. My version is even better; you won’t believe how tasty (and easy) this is.

This is great finger food at parties, or as a quick supper with a big salad of rainbow veggies (greens, tomatoes, red onion, cucumbers, carrots).  It is definitely a keeper.

Healthy Sausage Bread

(Adapted from Pairings with Andrea, Turkey Sausage Bread)

8 oz. Italian-style turkey sausage, casing removed
2 cloves garlic, mashed and minced
4 oz. shredded mozzarella cheese
¼ cup grated Romano cheese
1 tablespoon Italian seasoning or oregano
12 oz. pizza dough*, at room temperature
egg wash: 1 egg, beaten with 2 tablespoons water

1. Preheat oven to 350F.
2. Preheat skillet to medium and brown the sausage with the garlic and seasoning.
3. Cook meat fully, drain on paper towels and let cool.
4. Roll or press dough into 8 x 12-inch rectangle.
5. Place the sausage mixture and cheeses along the middle of the dough.
6. Fold long sides of dough over the sausage and cheeses, overlapping. Enclose ends and pinch all seams to seal. Invert the roll seam-side down onto parchment paper and brush entire loaf with egg wash.
7. Place on baking sheet (use cooking spray if you don’t have parchment paper) and bake for 20-25 minutes, until golden brown.
8. Cool slightly on a rack then cut into one-inch slices.

Serves 8 as an appetizer, 4 as an entree.

* The original recipe calls for a 10 oz. can refrigerated pizza crust dough, but I use fresh dough for a lot more flavor. Look for fresh pizza dough at your market…our local Trader Joe’s has a selection of white, whole wheat, low carb and herb dough in 1 lb. bags for only $1.29.

More by Dr. Pat…

Photo courtesy of fineliving.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…

Yes, it is good to eat fish! Fish is loaded with Omega-3 fatty acids, making it one of the healthiest foods around.

Kids can eat fish up to once a week, as long as you choose fish that has the lowest risk of contamination. The best choices also consider the health of the fish population, so don’t miss Seafood Watch by the Monterey Bay Aquarium.

Here is recipe for healthy fish that strikes gold on several counts. It is easy, assembles quickly and adapts to the fresh vegetables you have on hand. It is also fast, only 10 to 12 minutes in the microwave. It will be another family favorite…even those who are “so-so” about fish will appreciate the delicate flavor of the whitefish.

Colorful Fish Fillets

(Substitute any combination of veggies: sliced mushrooms, zucchini, asparagus, yellow or red peppers, leeks)

Arrange the fish fillets in a single layer in a greased microwave-safe dish. Season the fillets with salt and pepper, sprinkle with onion, green pepper, and tomato. Dot with butter. Cover with microwave-safe plastic wrap, venting one corner to allow steam to escape. Microwave on high 6 to 8 minutes, then check the fish for doneness. Thicker fillets will require more time, but check every 2 minutes to avoid overcooking. The fish is done when it is opaque and flakes easily with a fork. Let stand covered 2 to 3 minutes before serving. Serves 3.

I like to start the rice before preparing the fish, so while the fish cooks I’ll have just enough time to make a quick salad. Dinner is served in less than 30 minutes…move over, Rachael Ray!

Here is more by 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…

Love those bananas! Bananas are one of the most nutritious fruits you and your kids can eat. They are loaded with potassium, B vitamins, vitamin A, vitamin C, and even calcium and magnesium. I like them firm, so when they get soft and over-ripe, I just put them in the freezer as is, peel and all. They stay perfectly packaged until I pull them out to make this extra hearty, kid-friendly banana bread.

What’s so special about this recipe, besides being delicious? This banana bread is a good choice for toddlers because it uses less sugar, has heart-healthy canola oil and applesauce instead of butter, and raisins instead of nuts. It also makes a nutritionally balanced snack for kids when paired with cream cheese. Yum!

This is a double recipe, so your family will appreciate your effort twice as much. I like to use mini loaf pans; the extra loaves are easy to wrap and store in the freezer…but freeze them quickly before they disappear!

Dr. Pat’s Banana Bread

1 cup canola oil (or use ½ cup oil and ½ cup applesauce)
1 ½ cups sugar
4 eggs, beaten
5 or 6 ripe bananas (about 2 ½ cups mashed)
4 cups all purpose flour
2 teaspoons baking soda
1 teaspoons baking powder
1 teaspoon salt
¼ cup milk
1 teaspoon vanilla
1 cup raisins

Wisk oil and sugar together. Add eggs and banana pulp and mix well. Add sifted dry ingredients, then milk and vanilla. Stir in raisins.

Pour into greased and floured pans (or use Pam for Baking). Bake at 350 degrees F approximately 1 hour for two 9 x 5 x 3 inch loaf pans. For mini loaf pans, shorten the baking time to 45 minutes (or less). (In my convection oven the mini loaf pans take only about 30 minutes, so be careful not to overbake.) Cool, then wrap and store overnight before cutting or freezing. (This is important, because the raisins plump up and the bread really is more moist and flavorful the second day).

When comparing my banana bread recipe to other quick breads (ah yes, the buttery recipes…), I found another recipe that intrigued me, kumquat bread.

It looked wonderful, especially since I have a kumquat tree in my yard (yes, I live in California). I never have figured out what to do with kumquats, so I am eager to try it! I’ll keep you posted…

Happiness is…picking fruit from your own back yard.

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!

I often find myself sharing food ideas with parents. This recipe is delicious, and so simple I have often written it down for parents as a great way to increase the milk and protein intake of finicky toddlers.

Dutch Baby (or German Baby) is a large oven pancake. I clipped the recipe below many years ago from a Williams-Sonoma catalog. Their current website has only the Dutch Apple Pancake recipe shown in the photo. The apple version has less milk and more eggs, but try the plain one first; I love the less “eggy” version so much more.

So here it is…

Dutch Baby

This recipe for Dutch Baby has been a long-time favorite in my family and when my son’s friends come for a sleepover, it is always the most requested breakfast. Enjoy!

To view other articles by Dr. Pat…click here.

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…