Child – Canyon View Medical

Protecting Your Child’s Heart

Posted on January 23, 2018January 17, 2023 by Avery Dustin

You can help your child now to develop healthy behavior patterns that will prevent heart disease as an adult. Cardiovascular disease is the leading cause of death among adults in North America but studies show that starting heart-healthy habits in childhood can dramatically decrease the risks later in life.

Cardiovascular disease begins as atherosclerosis, also known as hardening of the arteries. When the inner lining of the artery is damaged by fat deposition, plaque will form and cause a bump on the artery wall. As the bump gets bigger, the arteries harden and narrow. The blood flow is reduced and can cause heart attacks, strokes, or disease in the vessels that supply blood to the arms and legs. Although atherosclerosis usually does not cause symptoms until adulthood, the process begins in childhood.

A family history of early heart disease can put your child at risk for future problems. Though you cannot change these inherited risks, you can help your child control as many preventative risk factors as possible. The following is a list of how to keep your child’s heart-healthy.

NUTRITION and DIET

Good nutrition beginning at birth has profound health benefits, with the potential to decrease the future risk for cardiovascular disease.

You, as a parent, can encourage healthy eating habits:

Eat breakfast every day and eat meals as a family
Encourage dietary fiber from foods. Have your child eat more whole grains, fresh fruits, and vegetables.
Limit fruit juice and sugar-sweetened beverages; encourage water and milk
Limit salt
Limit refined carbohydrates (simple sugars and white flour)
Limit saturated and trans fats. Choose lean meats and low-fat dairy products. Avoid fried foods, fast foods, and snack foods like chips, cookies, cakes, and donuts.

PHYSICAL ACTIVITY

Physical activity optimizes cardiovascular health in children and adolescents. Youth with a sedentary lifestyle have increased risks of developing other heart disease risk factors, such as high blood pressure, high cholesterol, obesity, and diabetes.

You should encourage heart-healthy physical activity and limit sedentary time:

Encourage unlimited active playtime for children under 5 in a safe, supportive environment
Encourage a mix of moderate and high-intensity activities for children over 5, such as bike riding, rollerblading, snowboarding, or jogging. Look into organized sports, lessons, or clubs that suit your child’s interests
Create family outings that involve some type of physical activity
Limit total media time to no more than 1 to 2 hours of quality programming per day
No screens in a child’s bedroom (TV, phone, computer, etc.)

TOBACCO EXPOSURE

Tobacco increases the risk of heart disease. Nicotine narrows the blood vessels and puts an added strain on the heart. Smoking increases heart rate tightens major arteries and can create irregularities in the timing of heartbeats, all of which make the heart work harder. Chemicals in tobacco smoke lead to the buildup of plaque in the arteries.

When parents smoke, the child is much more likely to start smoking as a teen. Children exposed to secondhand smoke have higher risks for cardiac disease, Sudden Infant Death Syndrome, respiratory infections, asthma, ear infections, and chronic cough.

You can discourage your child from smoking:

Be a role model for your child. If you smoke, quit. And do not allow others to smoke in your home.
Do not expose children to smoke in the home or in the car
Talk about the bad effects of smoking, such as yellow teeth, bad breath, smelly clothes, and shortness of breath
Talk about the dangers of smoking
If your child smokes, help them figure out why they should quit, advise them on how to quit, and have them see a doctor for advice on how to quit

HIGH BLOOD PRESSURE

High blood pressure is a serious condition in childhood. It can damage the cells of your arteries’ inner lining. High blood pressure can also damage your heart by causing it to work harder to pump blood to your body. Over time, the strain on your heart can cause your heart muscles to weaken and work less efficiently.

Parents can encourage lifestyle changes that will help children control high blood pressure:

Do not miss routine physical exams. Your doctor will measure your child’s blood pressure regularly. It is the only way to know if there is a problem.
Drop excess pounds. Children who are overweight often have a higher blood pressure than those who are not.
Limit salt
Increase physical activity
Warn about the dangers of smoking
If a program of diet and exercise does not lower your child’s blood pressure, medicines may be prescribed

LIPIDS

High levels of lipids circulating in the blood is a risk factor for developing heart disease. Lipids are another word for fats. Cholesterol and triglycerides are lipids. Over time, lipids can form a plaque inside an artery. This process can begin in early childhood. In some cases, high cholesterol runs in families. Other risk factors include obesity, high blood pressure, and smoking.

You can encourage lifestyle changes that will help children control lipids and cholesterol:

See your doctor regularly. Your pediatrician may order a lipid panel to look at the different kinds of fats in the blood at routine physical exams.
Eat foods low in cholesterol and fat. Choose lean meats, avoid fried foods and add little or no fats to foods.
Increase in fiber. Have your child eat more whole grains, fresh fruits, and vegetables.
Limit sugar and simple carbohydrates (ice cream, crackers, sugary cereals, crackers, and white bread)
Get plenty of exercises
Drop excess pounds
Warn about the dangers of smoking
If a program of diet and exercise does not lower your child’s lipids, medicines may be prescribed

OBESITY

The presence of obesity in childhood and adolescence is associated with increased evidence of atherosclerosis and is a risk factor for developing heart disease. Even a moderate amount of weight loss can translate to big improvements. Your child’s doctor can usually help you with a diet and exercise plan that includes reasonable weight loss goals, lifestyle changes, and family support and involvement.

Parents can encourage lifestyle changes to help their child lose weight:

Control portion sizes to eat fewer calories
Limit snacking and be aware of the snack foods your child is eating
Reduce the intake of sweetened beverages and sugary foods
Increase fruits and vegetables
Eat meals as a family
Increase physical activity and fun exercise activities you can do as a family
Limit the amount of time your child spends watching TV and playing on the computer

DIABETES

Diabetes is a very serious risk factor for developing heart disease. When combined with other risk factors, such as obesity, diabetes further raises the risk of heart disease.

There are two types of diabetes. Type 1 diabetes usually starts at a younger age. In type 1 diabetes, the body does not make enough insulin. This causes blood sugar to rise. Type 2 diabetes usually starts in adult life but can start in adolescence. In type 2 diabetes, the body’s cells don’t respond to insulin properly. At first, the body reacts by making more insulin. Over time though, the body can’t make enough insulin to control the blood sugar level. There is no way to prevent Type 1 diabetes, but Type 2 diabetes is often preventable with weight management.

You can encourage your child to keep blood sugar in a normal range:

Take your child to their routine physical exams. Your doctor will check your child’s blood sugar or hemoglobin A1c, which is a marker of chronically high blood sugar.
Follow your diabetes treatment plan and see your doctor for ongoing care
Eat healthy foods. A registered dietitian can help you develop a plan of eating to keep blood sugars from fluctuating too much and also meet the needs of your growing child.
Manage weight
Get plenty of exercises. Regular physical activity helps your body use insulin more efficiently.
Stop smoking

METABOLIC SYNDROME

Metabolic syndrome is a cluster of risk factors that dramatically increases the chance of heart disease and type 2 diabetes. Kids with metabolic syndrome have three or more of the following risk factors: Excessive belly fat, high blood pressure, abnormal levels of blood fats (lipids) including cholesterol and triglycerides, and high blood sugar. Metabolic syndrome is one of the things your doctor routinely screens your child during physical exams.

Encourage lifestyle changes to reduce the risks of developing Metabolic Syndrome:

See your doctor for routine physical exams
Drop excess pounds
Get more exercise
Eat more fruits and vegetables
Avoid soda and sweets
Do not smoke
When lifestyle changes are not enough, your child may be prescribed medications to treat individual risk factors

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Resources:

“Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents”. National Heart, Lung, and Blood Institute. NIH Publication NIH 12-7486A. October 2012

“The Effects of Secondhand Smoke”. WebMD . https://www.webmd.com/smoking-cessation/effects-of-secondhand-smoke

“Hearti-Facts” Texas Heart Institute. http://www.texasheart.org/

“Metabolic Syndrome”. KidsHealth. http://kidshealth.org/en/parents/metabolic-syndrome.html?ref=search&WT.ac=msh-p-dtop-en-search-clk

Is It Just Dry Skin?

Posted on November 22, 2017January 17, 2023 by Avery Dustin

Have you ever looked at your child’s skin and wondered if the dry redness you were looking at was eczema or just dry skin? While dry skin may be irritating to your child and yet simple to manage, eczema can present a different set of challenges when it comes to caring for your child’s skin. Eczema is a very common skin condition seen in about 10-15% of pediatric patients, usually starting before age 5. It is a chronic inflammatory condition of the skin that tends to run in families and occurs often with allergies and asthma. As we head into the winter months and drier air, our skin can become more vulnerable to general dryness, and children who suffer from eczema tend to have it worse.

A good routine can keep your child’s dry skin healthy. Skin becomes dry when it has a hard time retaining moisture. Moisturizers are the cornerstone of a good skincare routine. The drier your skin gets, the thicker your moisturizer should be. You should avoid lotions that are dispensed with a pump as these tend to contain alcohol, which can dry out your skin. Another important factor is water. Anyone who washes their hands multiple times per day will know that frequent washing in hot water is a fast way to dry out your skin. Opt for luke-warm water rather than hot, and always remember to moisturize after you wash.

When your child has eczema, the routine suggested above won’t be enough, especially during eczema flares. Eczema is also known as “the itch that rashes.” Dry skin begets itching, itching begets redness and thickened skin, and thus you have what is classically seen as an eczema flare: those thick, red patches of skin with a scaly appearance and vertical lines called excoriations that are a sure sign of your child scratching. The first line of defense against an eczema flare is to have a solid daily lubrication routine down. Since your child already has dry skin, try using a thicker moisturizer such as Aquaphor, Aveeno, or CeraVe once to twice daily, even during times between eczema flares. You may even opt for the greasiest – and messiest – of them all: vaseline. Moisturize the entire body once or twice daily, increasing as necessary with drier weather or worsening rashes.

For children with eczema, a common bathing technique called the “soak and seal” is an excellent bathtime routine. This method helps your child’s skin retain the moisture from the bath, and adds moisture to the skin via a thicker moisturizing ointment such as one mentioned above. First, start with lukewarm water. Allow your child to soak for 10-15 minutes in the tub before washing them with soap at the end of the bath. For children with particularly sensitive skin, try using soap just a couple of times per week, and only on visibly dirty skin, the groin, and the armpits. and bathe your child as you regularly do. Avoid any soaps with dyes or fragrances. Anything with “Baby” on the label will surely have some additive to give it a scent or color that we associate with babies, so steer clear of these if your child tends towards dry skin or eczema. Once bathtime is over, rather than drying your child off completely, simply dab away water from their skin so that beads of water still remain. While still covered in these beads of water, use vaseline, Aquaphor, Aveeno, or CeraVe to seal in the moisture from the remaining water and provide additional moisture to the skin. Do this with each bath to encourage skin hydration. Additionally, you may choose to add colloidal oatmeal to the bathwater and allow your child to soak in this for 15-20 minutes before sealing in the moisture.

Of course, even the best laid out plans are not fool-proof and some children will still get those inflamed red patches of eczema. When this happens, there are different strengths of prescription steroid creams and ointments that may be necessary to help clear up your child’s skin. If these red patches start to ooze or your child develops a fever, they may have an infection of their eczema rash. If you are concerned about any of these things, bring your child in to see one of our pediatricians here at Canyon View Pediatrics and we can help determine the best treatment plan.

Some children who have eczema also have allergies. Avoidance of allergens will help control your child’s eczema. Occasionally, we encounter an eczema rash that doesn’t improve despite using prescription-strength steroid ointments. When this happens, we as pediatricians start to think about other factors that may be exacerbating your child’s inflammatory process. After careful evaluation, certain allergies may be discovered that once treated or avoided, make your child’s eczema more easily managed.

If you are concerned about your child’s skin or are having trouble controlling their eczema with over the counter creams and lotions, visit one of our pediatricians at Canyon View Pediatrics to discuss different options.

A Better Night’s Sleep

Posted on August 25, 2017January 13, 2023 by Avery Dustin

We all know the feeling of hearing the alarm go off after a long night of counting sheep. Getting a good night’s sleep is essential to maintaining health and enjoying life. There is no magic recipe for getting the perfect night’s sleep, but there are several basic practices that can help increase the chances of getting a long, restful night’s rest.

The amount of sleep needed varies depending on the individual and the age group. Babies generally need 16 hours of sleep each day, teens should get 9 hours and it’s recommended that adults sleep 7-8 hours each night. These numbers may vary and it’s important that you FEEL like you are rested after each night’s sleep. Signs of a good night’s rest may include:

Waking up when the alarm sounds
Clear thinking
More energy
Less worry or stress (or maybe better able to handle the challenges of life)

Better sleep does mean a better life! What are some basic things that all of us can do to better our night’s rest? The answer is Sleep Hygiene. Sleep Hygiene is a lot like personal hygiene. It includes the basic things that we should do every day (like brushing our teeth and taking an occasional shower) that will keep us on track to getting a solid night’s sleep every night. I won’t list all the aspects of Sleep Hygiene but a few of my favorites are listed below.

Scheduled Bedtime and Wake time. We all remember getting told to get to bed, but somewhere along the way we forget the wisdom of our mothers and we start thinking other things are more important. Going to bed at the same time every night and waking up the same time every morning might be challenging at first, but once the habit is created, sleep will improve.
No screen time. The blue light that comes from our TVs, phones, tablets, etc. can keep you awake, so do your best to decrease usage and do not use them in the bedroom!
Get up as soon as your alarm goes off.

Getting a good night’s sleep is essential for the enjoyment of life. I believe we are here to enjoy the time we have, and by doing the small things to achieve a better night’s sleep, I have no doubt you will feel better and enjoy life more!

Sources:

https://www.sleepassociation.org/patients-general-public/insomnia/sleep-hygiene-tips/

http://www.cci.health.wa.gov.au/docs/Info-sleep%20hygiene.pdf

Never Too Young to Read

Posted on July 19, 2017January 17, 2023 by Avery Dustin

When parents come in with their young infants, I at some point ask if they are reading with their baby. Often times I get confused looks, “You mean I should be reading with them already?” It’s true that your 2-week old infant won’t really be paying attention to the book, they may not even be able to see the pictures, and definitely won’t understand a storyline, but they are interested in the sound of your voice and the loving attention that reading affords. Starting the habit of reading early can have a profound effect on a child’s developing brain, particularly in the areas of language development, focus, and attention.

Studies have shown that children who are exposed to reading books at home have stronger activation in the parts of their brain associated with language processing, comprehension, and imagination. These children also enter school with better language and literacy skills and tend to have stronger parent-child bonds when compared to children who are not read to on a routine basis. Given all of these factors, it should come as no surprise that we as pediatricians encourage reading at an early age. Additionally, The American Academy of Pediatrics, in a 2014 statement recommended that parents start reading with their infants starting shortly after birth.

Language acquisition is an important milestone during a child’s development. Over the first two years, your child’s comprehension and understanding of language really take off, while expressive communication lags behind. Studies have shown that toddlers who have been read to often have a larger vocabulary than those who have not been read to and may even start talking earlier. As your infant starts making vowel sounds with “coos” and “goos”, followed by consonant sounds and babbling with “bababa” and “mamama”, they are starting to understand the words and sentences that you are speaking to them. They engage in conversations with you, babbling away as you acknowledge their utterances and teach them the back and forth pattern of mature conversations. By the time they can utter 3 to 5 words, they may also be able to follow a simple command such as “wave bye-bye.” What you get with this discrepancy in learning pace is a toddler who can understand what she is hearing, but is unable to communicate her thoughts, wishes, and needs. Once a toddler is able to communicate more effectively with caretakers, they can start to interact with their environment and express their own thoughts.

Exposure to words is vital to both expressive and receptive language development in children. An intensive observational study published in 1995 by Betty Hart and Todd R Risley (The Early Catastrophe: The 30 Million Word Gap by Age 3, published by the American Federation of Teachers) demonstrated a large gap in the spoken vocabulary of 3 year old toddlers based on the number of words that their child heard daily during those first years. The researchers observed differences amongst three groups of children: those who heard 600 words per hour, those who heard 1250 words per hour, and those who heard 2100 words per hour. Children from the group who heard just 600 words per hour during those first few years spoke only about 600 words at age 3 compared to 750 words in children who heard 1250 words per hour and nearly 1200 words in children who heard 2100 words per hour. What’s more, is that ongoing observation found that the gap in a child’s spoken vocabulary only continued to widen as the children got older. Children who had a faster rate of learning new words performed better in elementary school, and had better language skills and reading comprehension by age 10. Based on the observations of the study, the authors hypothesized that a major contributor to this discrepancy was the number of words the child heard during the first 4 years of life. When the researchers extrapolated the words heard per hour over a 4 year period, they came up with a total word-experience of 13 million for children who heard 600 words per hour, 26 million words for children who heard 1250 words per hour, and 45 million for children who heard 2100 words per hour. This created the idea of the 30 million word gap by age 4, which many educators reference today to really highlight the importance of reading with young children. While language development and scholastic achievement are very complex areas that cannot be solely explained by the findings of this study, early exposure to more words can certainly be helpful in your child’s development. What better and easier way to do this than incorporating reading, starting at an early age?

Books are a great, easy way of introducing new words and ideas to young children. When we read with our children, we teach them new words. Babies won’t start uttering their first words until around their first birthday, and even after that, you can expect to hear about 8 to 10 words by 18 months and roughly 50 words by 2 years. Long before they start speaking, however, your children understand what you are saying and forming their own opinions. For example, my 14-month-old daughter only says a few words, but she can carry out a simple command such as “Can you bring me that toy?” or even a more complex set of instructions like “Can you find your bunny and give it to dad?” As your child approaches their first birthday, their attitude towards books may change. Where they may have been uninterested in the bright, colorful pictures and rhythm of The Bear Snores On by Karma Wilson when they were 6 months old, around 12 months old, they may be reaching for that book on the bookshelf and pointing for you to read it over and over and over again. Take this opportunity to invoke different emotions with your voice, use hand gestures to entertain your little one throughout the story, point out different objects in the pictures, and share in a giggle or two with your budding bibliophile.

Be sure to choose age-appropriate books with your children. With infants and toddlers, opt for sturdy board books and look for ones that offer fun illustrations or pictures with just a few words per page. Let your baby reach for the book, turn it over in their hands, and chew on it. This is how they learn about their environment at this age, and what better way to teach them a love for books than allowing them to manipulate it as they would their favorite toy? As your toddler grows into a pre-schooler, help them choose more complex books with more of a storyline. Start asking them questions about the story such as what emotions the characters may be experiencing at different points, or why a certain event may have taken place. Once your child has learned to read on their own, encourage personal reading time but don’t neglect to continue to read with them on a routine basis. When reading with your older children, let them choose which books they want to listen to. Help them choose books that are 1 to 2 reading levels beyond what they are capable of. Reading with your older children helps them develop their imagination, and can also have a positive effect on their ability to focus and concentrate. Continue to delve deeper into the meaning of the book, asking your children deeper questions about the plot and events. This will encourage them to think critically about the story and further deepen their reading comprehension abilities.

The benefits of family reading time cannot be praised enough. From exposing children to a larger and wider variety of words to developing their imagination and creating a love of literacy from an early age, reading certainly has its benefits. Even if family reading time hasn’t been a part of your routine, there’s no reason to not start today. If you’re at a loss for where to start, there are two great resources at your fingertips: your local librarian and your child. Start with either of them, asking for recommendations, and let your journey begin.

Childhood Nutrition – A Healthy Start (Part 1 of 2)

Posted on March 8, 2017January 13, 2023 by Avery Dustin

March is National Nutrition Month in the United States. I realize that every month has a number of designations such as this, and most people pay little attention to them, myself included. However, as it relates to child health, I can think of few topics of greater importance. In fact, the way we eat as a nation is contributing to the fact that generational life expectancy is actually decreasing for the first time. This is a tragedy that can be avoided.

The Extent of the Problem

It’s no secret that we have a very serious problem in this country with overweight and obesity. Although awareness of the problem has increased, there has not been any significant improvement in national statistics. In fact, they continue to get worse.

It is estimated that 35 to 40 percent of adults in the United States are obese. Overweight accounts for another 30 to 35 percent. These rates represent a threefold increase since the 1970s, and the rates of childhood obesity parallel those of the adult population. About 20%of children in the U.S. are obese. That’s 1 out of every 5! The lifelong health consequences of this problem are well documented.

It’s impossible to fully cover such a broad topic in a single article (or a thousand-page book for that matter!), so I wanted to offer a few important ideas about helping our children develop and maintain healthy eating habits. This article will focus on the broad issue of intuitive eating and how to cultivate this in our children (and ourselves). The next will offer more specific advice.

But First, a Disclaimer

I will not address physical activity in this article, simply due to the fact that it is also an incredibly expansive topic. However, its absence does not suggest a lack of importance. Indeed, physical activity is a vitally important part of a healthy lifestyle and should not be overlooked. But it will have to be the subject of another article.

Intuitive Eating

Most of us are born with the natural instinct to eat when we’re hungry and stop when we’re full. But somewhere along the way many of us develop habits of eating which have nothing to do with the basic reason for food consumption. Add in access to bottles for too long, foods that are for pleasure only, treats given as a reward for good behavior, as well as many other contributing factors, and it’s easy to see how caloric excesses may arise.

The assault on our natural intuition toward eating starts early on. As a toddler or preschooler, most of us were told by proud parents, “You’re such a good girl (or boy) for finishing all of the food on your plate!” We beamed with pride as we learned that eating a lot of food pleased our parents and equated to us being “good.” How many of us have said similar things to our children?

It’s best if we try to leave value judgment out of eating. Instead of using the above phrases, or similar ones, with our children, we might consider saying things like; “It looks like you’re really hungry today. Would you like some more vegetables?” or, “I see that you don’t feel like eating right now. I’ll save your food for later when you’re hungry.” If we try to state our observations rather than make value judgments about our children’s eating, mealtime will be more enjoyable for all.

We should remember that one of our jobs as parents is to provide healthy foods for our children to eat, several times per day. The child will then decide what she eats and how much. This applies to the vast majority of children, with rare exceptions. I know that sounds too easy, but most of the complicating factors in this arena are created by us, the parents. Anxiety, feelings of rejection, power struggles, age-related behavioral issues, and many other factors, contribute to making the feeding relationship seem overly complex. We will do better if we try to leave our own emotions out of it, and encourage the feeding intuition our children come equipped with from the start.

The following topics are related to intuitive eating, including some exceptions to the rule:

“…but she doesn’t eat anything!”

On occasion, this can be a concern. But only when a child is not growing well and not gaining enough weight to stay consistent on the growth curve. Fortunately, this is typically not the case. The vast majority of children who go on hunger strike altogether (or hold out for only their favorite foods) are healthy and growing fine. Let’s face it… it doesn’t take many calories to keep a little 2-year-old going. Even older grade school kids don’t need as much as we might think. As I have told the parents of some overweight and obese children who expressed this concern, sometimes we have to adjust our expectations.

“He has what you might call a narrow diet”

If your child will eat only chicken nuggets and french fries, then it might be appropriate for those foods to disappear from the house (and the car, and grandma’s house, etc.) for a little while. Until he or she discovers that there are other edible substances available, there may be some whining and dramatic displays of deprivation, but survival is very likely (for all involved parties). Keep in mind that it may take up to a dozen tries before a new food is accepted, but if the child is hungry, that number is likely to decrease.

A tried and true technique on this front is the “one bite method” or the idea of “no thank you bites.” It’s essential that we respect the child’s tastes in this process. One bite means one bite. If they don’t like it or say, “No, thank you,” to more, then that’s it. Don’t try to cajole your child into eating “just 5 more bites” of something he obviously doesn’t like. It’s exceedingly rare for a child to be so picky and stubborn that he will actually stop growing, lose weight, or become malnourished. So once again, offer the healthy foods you would like your child to eat, and eventually things will work out.

The Forrest Gump Eater – “You never know what you’re gonna get”

Toddlers and preschoolers are often known for their inconsistency regarding different foods. As parents, this can drive us crazy! I remember saying to my sons when they would refuse to eat something they had devoured the day before, “But you just ate this yesterday! What’s going on?” We tend to worry about those “not hungry” days, and fear that our child will be unable to make it through the week. But as long as some “hungry” days are in the mix, and we take full advantage by allowing them to eat their fill on those days, everything should be okay. Inconsistency is aggravating, but I, for one, am still working to overcome this tendency in my parenting style. So we should probably cut our kids a little slack here, too.

“She’s a good little eater!”

On the other end of the spectrum is the child who never met a food she didn’t like, and lots of them. This brings delight to the parents of an eight-month-old… less so for those of an eight-year-old. It all depends on where the child is on the growth curve. There are some children who seem to be able to eat more than their parents and maintain an appropriate weight, but this is not generally the case. If the child is in the overweight or obese category, something has likely gone wrong with the eating intuition, and appropriate interventions should be made. It’s essential that a child who likes everything is offered healthy foods for both meals and snacks, and that portions are appropriate, both in size and number. “Only fruits and vegetables as snacks” is a good rule for these children (and basically everyone). There will be more specifics about this in the next article.

“Do as I say, not as I do” vs. “Let’s do this together!”

As with almost everything regarding our children’s behaviors, we should also consider our own. Here are a few potentially revealing questions we can ask ourselves about how well we are modeling the intuitive eating behaviors we encourage in our children:

Have I ever eaten a meal and then realized that I wasn’t hungry before I ate?

Have I bought into the “clean your plate” mentality?

Do I often eat until feeling overfull?

How many of my calories come from foods or drinks which offer no nutritional value?

How much time do I spend thinking about food?

Are there foods in my house that are off-limits to the children?

Do I follow the recommendations for fruits and vegetables and limit my sugar intake?

Some of the most powerful influences in our children’s lives are the things they see us do, much more so than what we say. This is rarely truer than in the realm of nutrition. Remember with regard to our food choices, if it’s in the house, it’s fair game, for everyone! If the eating expectations we have for our children are far afield from our own habits, our words will often fall on deaf ears. However, if we set specific goals as a family, and encourage each other along the way, there is a much greater likelihood of success.

[…to be continued later this month]

References:

Food Fights (Second Edition) by Laura Jana, MD, FAAP, and Jennifer Shu, MD, FAAP

Center for Disease Control website (www.cdc.gov)

American Academy of Pediatrics website (www.aap.org)

2015-2020 Dietary Guidelines for Americans (https://health.gov/dietaryguidelines/2015)

The Power of Sleep

Posted on January 12, 2017January 17, 2023 by Avery Dustin

Considering how important sleep is to our proper functioning as human beings it is interesting how easy it is for our sleep cycles to be disrupted, either by circumstances outside our control or more commonly by our own choices. While some view sleep as a necessary nuisance it is clear that good sleep patterns contribute to improved school/work performance, help us maintain a healthier weight, and give us time for mental and physical restoration.

When it comes to school or the workplace sleep deprivation often manifests as decreased attention span and difficulty in task completion. You may notice these are similar symptoms that we associate with Attention Deficit and Hyperactivity Disorder (ADHD). At times academic struggles can be linked directly back to poor sleep routines and once those bad habits are corrected there is a corresponding improvement in school. During my time as a Medical Officer for the Navy if there is one thing that I learned, and learned well, it was that the effectiveness of at Sailor or Marine declines rapidly once they become sleep deprived and at times you needed to order them to get some sleep to ensure that they were ready to complete the mission. As a parent, I’ve also found this same principle frequently holds true for my own children as well.

Another interesting correlation is that the more sleep deprived you become the more likely you are to be overweight. One interesting study by Janice F. Bell, Ph.D., MPH, of the University of Washington conducted in between 1997 and 2002 found that children who did not get adequate nighttime sleep between the ages of zero to 4 years were 33%more likely to be obese than children who had adequate sleep. These effects were slightly more noticeable in those aged 5 to 13 years who were 36% more likely to be obese. People often ask me why would inadequate sleep lead to this weight gain? While the complex answer involves the changes that occur to hormone release, the more straight-forward answer is that when we are tired we eat more to try to increase our energy levels. Any good weight maintenance or weight loss plan should begin with ensuring adequate sleep is occurring.

One final thing to consider is that sleep is essential to the restoration of both mind and body. I frequently talk with teenagers who have always been good students but begin struggling in their very busy lives as they are involved with multiple after school activities and part-time jobs. The primary concern they present with is that “I just feel tired.” Parents are often concerned this reflects a thyroid problem or some other chronic disease, but once I ask a few questions it becomes clear that the real problem is they are only getting 5-6 hours of sleep a night. While a person can compensate for a while with decreased sleep, eventually they will become rundown because it is during sleep that the body rebuilds muscle and the brain organizes all the information and stimuli that it has received during the day. When you or your child begin to feel to run down a good first step is to double your efforts to get adequate sleep.

Some general guideline on sleep amounts are listed below:

Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health.
Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health.
Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health.
Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health.
Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health.

If your attempts to improve your child’s sleep patterns have been unsuccessful and you would like to discuss it further, all of the Pediatricians here at Canyon View Pediatrics are ready to help.

Links:

American Academy of Pediatrics Sleep Recommendations