Image courtesy: American Dental Association
Oral health doesn’t start and end with the dentist. Times are changing as the Washington Dental Service Foundation has trained 1,600 pediatricians and family physicians throughout the state on the importance of oral hygiene in young children. Pediatricians are now applying fluoride during well-child check-ups and counseling families more comprehensively on how to prevent dental decay while also referring to dentists for prevention and acute dental problems. Just last month I attended the 1-1/2 hour oral health training with a pediatric dentist. That learning coupled with a new policy statement from The American Academy of Pediatrics highlighting the importance of oral health inspired me to get the word out. I suspect we can all do a bit better protecting our children’s mouths. Recommendations for fluoridated toothpaste have recently changed (use it with the very first baby tooth!) as has knowledge and reminders about how we share our bacteria with our children. What we do for our mouth may have direct effects on our children’s.
The Most Common Chronic Childhood Disease
- The facts about oral health in children are a little surprising. By their first birthday 8% of toddlers have cavities in their mouth and the Pediatrics policy detailed 24% 2-4 year-olds, 53% 6-8 year-olds and 56% 15 year-olds also have dental disease. Since oral health (even in babies and toddlers) is an integral part of overall health of children this is problematic. Dental disease has strong links between diabetes, respiratory infections and heart disease. The numbers for children with dental disease are high (!!) which makes dental disease the most common infection of childhood.
- Good news is much of this disease can be prevented (or corrected) and because infants and young children see the pediatrician more frequently than the dentist, it’s becoming clear that pediatricians need to hone skills on oral health, the disease process, prevention and dentist interventions when necessary.
4 Things I Learned About Oral Health
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Widespread news coverage over the last 24 hours has heightened concerns by many parents about a severe-symptom viral infection causing respiratory illness in children, predominately in the Midwest. Over the last month there has been a dramatic up-spike in children hospitalized with severe cold symptoms and wheezing. The virus isn’t new, but its effect on children seems to be. The Centers for Disease Control (CDC) has confirmed tests on children both in Kansas City and Chicago pinpointing the triggering virus as enterovirus D68. The biggest burden of illness has been in the Kansas City and Chicago areas where dozens of children were hospitalized daily, but there are reports of infections documented in about 10 additional states to date. The CDC report issued yesterday detailed data from their investigations
Of the tested and confirmed cases from Kansas City, their ages ranged from 6 weeks to 16 years, with a median of 4 years. Nearly 70 percent of patients had a previous history of asthma or wheezing. Of the Chicago group, ages ranged from 20 months to 15 years with a median of 5 years. Nearly three-quarters had a history of asthma or wheezing.
No question the illness has taken many by surprise as it’s an unusual time of year to see huge numbers of children with cold symptoms with severe wheezing. In areas where the infections started to pop up, schools been in session for a month or more so kids have been doing what they do best, playing in close contact and exchanging germs… Read full post »
We know children are sleeping less now than they did 30 years ago. Our children are unfortunately more tired and can suffer side effects in life because of it. Studies show that school-age children who create a sleep debt (chronic sleep deprivation) and are chronically tired have a more difficult time completing school work, they don’t score as well on tests, they may be more distractible, they can have difficulty maintaining attention, and they may be at higher risk for having an unhealthy weight. Even if your kids have already started school, you can provide a boost for your child’s attention, mood, and health by focusing in on sleep.
Starting out the year with better habits can help everyone at home (ahem, wouldn’t it be nice to avoid late evening battles?). If you’re not already there, think about moving to ideal bedtimes during the next couple of weeks.
How Much Sleep Do Children Need?
Sleep debt is created when we don’t sleep enough — it causes kids to crave “catch-up” sleep like those after-school naps, sleeping in until noon on the weekends, or falling asleep in the carpool on the way home. That being said, each child’s sleep need can be a bit different but in general children need:
- Preschoolers: 11-12 hours of total sleep
- School-age children: 10-11 hours total sleep
- 12 year-old to teens: 8 1/2-10 hours total sleep
5 Ways To Support Good Sleep
- Keep to an 8pm bedtime for young children. Move bedtime back slowly (move it by 30 minutes every 3-5 days) to prime your child for success and avoid battles!
- 10pm bedtime for children age 12 & up is age-appropriate. More info here.
- Habits: No screens 1-2 hours prior to bed, no caffeine after school, no food right before bed.
- Exercise or move 30-60 minutes a day to help kids sleep easier
- No sleeping with cell phones (create a docking station in the kitchen)
- Don’t use OTC medications (cough & cold, for example) to knock your kids out and get them to sleep. Using medications that have a side effect of drowsiness can cause sleepiness to extend into daytime which can negatively affect school and sports performance.
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I really love this TEDEd video explaining motion sickness. What I find most helpful is the admission that we humans still know very little about motion sickness, why gender differences exist (women get motion disturbance more often than men), and how to put a stop to it. No question children get motion sickness well before they’re old enough to tell us exactly how they feel. Often it’s screaming or fussing only in the car or a series of vomiting episodes that clues us in. A few tips for families, planning that last-minute summer road trip, to help support children who are prone to get sick in the car, on the train, at the park, or up in the air during a bumpy ride.
Motion Sickness In Children
- Disconnect: Know that motion sickness comes about when there is a disconnect between what our eyes see, what the fluid in our inner ears knows about our position and direction, what our skin senses, and what our muscles feel while we’re positioned wherever we are. This disconnect in all these sensors around our body leaves the brain “confused” and for unknown reasons we’re left feeling nauseated, uneasy or achy. This can happen quickly and can happen even on a swing at the park. It really doesn’t take a jet airplane or an automobile driving quickly on a curvy road to elicit this unease and malaise. This can happen in the back yard! There’s often another disconnect, for those who don’t get motion sickness there is often little insight into how horrible a child or adult can feel while experiencing this. This reality, of course, only increases the displeasure for the person ill. But know this, some experts observe that everyone, given enough mismatch and motion–say a group of people in a life-raft in turbulent seas–will get sick from motion.
- Common: Motion sickness is fairly common with most reports stating that 1/4 to 1/3 of adults may experience it. In school-age children, a recent European study found the prevalence of motion sickness was 43.4 % in car, 43.2 % on bus, 11.7 % on park swing, and 11.6 % on Ferris wheel. Like adults, most children report dizziness, nausea, or headache when their body is triggered by motion. And although some research claims motion sickness doesn’t start until age 2, I’ve certainly learned from parents that some young children don’t love riding in the car and show it. More preventing and treating it:
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It’s really very sunny out these days in the Pacific Northwest. And although summer can be shorter up here we certainly compensate with idyllic, cloudless days. However, many of us can be out of practice protecting our skin. I’ve seen lots of tan lines and sunburns in clinic this summer. In fact, those of us living in Northern climates may carry an additional risk when it comes to the sun. One rarely known risk factor for skin cancer is living in a cool climate but vacationing near the equator. The reason? If your skin is unaccustomed to living in the sun, you tend to burn more when entering those areas of more intense sunshine.
Further, many people get confused about cool weather and sunshine. Sun intensity and Ultraviolet (UV) radiation (UVA and UVB rays) have nothing to do with temperature. No difference in intensity if it’s 60 or 80 degrees out when it comes to the sun’s effect. Reality is people burn more when it’s 80 simply because they have less clothing on and more skin exposed. As a reminder, UVB radiation varies throughout the year (it’s most intense during summer) and UVA radiation is constant throughout all the seasons.
Although the best ways to protect your family’s skin from the sun remain seeking shade (umbrellas, trees, etc), planning long-lasting activities in the sun outside of the peak sun times (not between 10am and 4pm) and dressing right for the the occasion by wearing sun protective clothing (hats and/or UV shirts often labeled “UPF” for ultraviolet protective factor). Research finds that those who rely solely on sunscreen tend to burn more, so sunscreen needs to be thought of as just one tool. 5 tips: Read full post »
June is a lot of things to me this year: the month I turned 40 (yipeee!), the earnest start of summer, the beginnings of an awesome USA performance in the 2014 World Cup and also National Home Safety Month. Of course it may be easy to make time to celebrate turning 40 or to watch the taped game where USA beats Ghana (go team!) but there really is one thing we should move into position numero uno. Can you make your house more museum-like, at least when it comes to medication safety this summer? Here’s why it should be placed at the top of the list.
A quick digression: no question I’d really like to live in a museum — unlike lots of others, it seems — I’m one of those people who hates a messy house although our house really does get highly disorganized (I find errant legos in every room/every day, our beds aren’t always made and may I ask where in the world do all the dirty socks come from?). I would prefer a museum-like home, beautiful stone on the floor, gorgeous lighting, thoughtful works of art on the wall and no distracting debris. A clean surface on which to place my purse when I walk in the door would be a good compromise! When I looked at the Up & Away tools that helps provide tips for parents on medication safety at home it reminded me that yes- museum living is definitely what I want (I mean, heck, look at that kitchen!!). HOWEVER, the realities of having 2 kids and limited time to keep organizational systems in check I’m going to have to settle for my not-always-perfectly cleaned floors, the walls of childhood art, the stacks and piles of mail and school forms, and the lighting I’ve got. But one thing I won’t sacrifice are the safety systems we’ve made to keep medications and toxins out of reach, even as our boys get older. Some data here reminded me I need to revisit our systems. Read full post »
Our house is teeming with excitement about the impending reality: it’s almost summer break. As the hard-core school, sports and carpool coordination chaos eases up, you wanna know one thing I’m really hoping for this summer break? A bit more sleep. I do a great job protecting my children’s sleep and a mediocre job protecting my own. I work on sleeping with my cell phone off and away from while getting 7 to 8 hours of sleep but reality is my phone has a tendency to creep back up next to the bed and I am often up early to start working. Clearly I’m not unusual in this way. Parenting and sleeping a lot don’t necessarily go hand in hand. Studies find 14% of grade school children are still getting their parents up. The news is grim when it comes to sleeping with our phones, even 4 out of 5 teens say they sleep with their phone (on or near the bed). It’s becoming clear that quality sleep is one of the most undervalued power solutions to preserving wellness in our families. The more data I review, the more I know we have to get the word out on the value of sleep and the way that we protect it as we raise our children. Culturally, this is a swim upstream; we’re bred to revere those who do so much during the day they are left with limited sleep at night. Some new data, a funky article ending, and a 4-minute TED talk lay the foundation for my 3 quick reminders: Read full post »
It’s the time of year for seasonal allergies. It’s also still, unfortunately, the time of year for “colds.” Although it may be intuitive for many parents to decipher the causes of symptoms in their child during the month of May, some of us have a hard time determining what’s causing our children to wipe their nose!
In general, it’s time unfolding that helps us know if our children are beginning to suffer from allergies as opposed to another cold. If steady,unwavering symptoms of runny nose, coughing, sneezing, and/or itchy eyes persist longer than a week this time of year, allergies to pollens are likely be blame –with one caveat– if your child is a toddler seasonal allergies are far less likely. Although there are exceptions to every rule, most children don’t start to develop hay fever symptoms until around age 3 or 4 years of age after their bodies have been exposed to a few seasonal changes and pollen counts and their body starts to mount an over-reaction. Allergy symptoms are created when the body basically over-does-it to triggers (allergens) and starts an immune response to a normally harmless particle. Instead of having no response to a dandelion, for example, allergic people rapidly release a series of chemicals (including histamines) after encountering the flower that cause their eyes to itch and run, their mucus membranes to swell, and their airways sometimes to cough. There’s no sure-fire, singular way to know at first glance if your child has seasonal allergies when they start sneezing in the spring (or fall) but in general children will suffer from a constellation of symptoms and a set of circumstances: Read full post »
Constipation is really no fun for anyone. No fun for baby or child, no fun for the parent who cleans the clogged toilet, no fun for the sister or brother who waits while someone works on solving the problem in the room next door. In general, constipation is a frustrating, sometimes embarrassing, and often chronic problem for young children. Here are a few ideas to get rid of the no-fun part and ways to protect your children, support them positively, and avoid dangers that can rarely come from over-the-counter (OTC) medications.
Before you reach for OTC medications, consider what is normal and what is not normal when it comes to poop. I usually break this down for children (and parents) in visual terms. I talk about things you find outside.
In general, poop in the toilet can look like a pond, a snake, a log, or a pebble. When it comes to poop, we’re always looking for snakes. It seems to me that framed this way, school age children can do a better job knowing if they’re constipated or not. We’re looking for Snakes in the Lake, people! Frame it this way with your child and perhaps they will be more likely to get a glimpse of what they produce in the toilet?
In my experience, parents worry a lot about hard infant or toddler poop in the diaper but constipation sneaks up on many families to school-aged children. After children are toilet trained and wiping themselves (around age 4 or 5) many parents no longer gaze in the toilet bowl. Long gone are the days of staring at every diaper as parents lose track of the daily poops, how often they poop, and how a child feels when pooping. But first, some definitions: Read full post »
A new observational study illuminates some ugly truths about parental/caregiver use of cell phones and smartphones at the dinner table. More than anything else, the observations serve up a hearty reminder that cell phones are embedded into our lives (see my son’s “Lego iPhone” as case in point) and that we have to be diligent in making digital breaks a habit. As phones and devices get more useful, they become harder and harder from which to separate.
Reading the new study I felt a little queasy for two reasons.
ONE: there are moments I fail my children in this regard. I think you’re fooling yourself if you don’t think you are (if you own a cell phone, smartphone, tablet, or computer). I would suspect most parents who read the study see a bit of themselves in there. I certainly remember (vividly) the day that my then 3 year-old son wanted my attention while I was working on my phone. He must have asked and gotten no response. He then literally put his head between my cell phone and my face to get my attention. Talk about a wake-up call…
TWO: I really hate to read about children becoming either helpless and/or giving up on trying for their parents’ attention (this was observed in the study). I also hated reading about children who kept vying for their parents attention and then get shot down and yelled at for interrupting. Just so unfair to children during dinner. Parenting really is different now. We weren’t raised by parents with these distractions. The implications on our children’s (and our own) health are just starting to to come into focus.
We’re all vying for a sane balance with our digital devices. The study detailed below offers up some uncomfortable observations and fuel to make changes now:
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