How to Teach Kids to Be Smart About Strangers?

One of the biggest fears amongst Indian parents is child abduction,but that is not the thing happening, there are lots of other things like sexual harassment,harming the child etc.

"Don't talk to strangers" has been the rule for many parents for generations. But sometimes it's a good idea for kids to talk to strangers. Who else will they turn to if they're lost and need help?

So, instead of making a rule, it's better to teach kids when it's appropriate to talk to strangers and when it is not. When your kids are out with you, it's fine to let them say hello and talk to new people. You are watching the situation and will protect them.

But if your child is alone and approached by a stranger, that's a different story. Tell your kids that if a stranger ever approaches and offers a ride or treats (like candy or toys) or asks for help with a task (like helping find a lost dog), they should step away, yell "No!" and leave the area immediately. Your child should tell you or another trusted adult (like a teacher or childcare worker) what happened. The same goes if anyone — whether a stranger, family member, or friend — asks your child to keep a secret, tries to touch your child's private area, or asks your child to touch theirs.

Most kids are likely to be wary of strangers who are mean-looking or appear scary in some way. But most child molesters and abductors are regular-looking people, and many go out of their way to look friendly, safe, and appealing to children. So, instead of judging a person by appearance, teach kids to judge people by their actions.

It's also important to encourage kids to trust their own instincts. Teach them that if someone makes them feel uncomfortable or if they feel like something's just not right — even if they can't explain why — they need to walk away immediately.

So, what happens if your kids are alone and need to approach a stranger for help? First, they should try to find a person in uniform, like a police officer, security guard, or store employee. If there are no uniformed people, look for grandparents, women, and people with children who may be able to help. And again, remind them about instincts: If they don't have a good feeling about a certain person, they should approach someone else.

Some of the words used by the strangers to kidnap them         The “kidnappers” used phrases that are very popular and should’ve alerted anyone that heard them: 

•   “Let me buy you some candy?” 
•   “Let’s go feed the pigeons?”
•   “There are squirrels running around. Let’s go see?”
•   “Your father asked me to bring you to him. 
•   Let’s go!”Some of the most effective methods are requests to help some small kittens or puppies. 
•  Some criminals often pretend to be policemen, doctors, or firefighters.

It's not possible to protect kids from strangers at all times. But it is possible to teach them about appropriate behaviors and what to do if somebody crosses the line. Keeping these tips in mind can help your kids stay safe while they're out and about. 

Here are some things we can do to help our kids be safe:

For a child age 1 and up

• Teach them their name and their parents’ name(s)
• Under three years old, I don’t talk about “tricky people” or “bad people.” But, if I am in a situation where I feel uncomfortable, I show it with my body language, and I tell my child “I don’t like being here… I don’t feel safe right now. We’re going to leave.” Even at this age, I want to start teaching them to trust their instincts.
• Tell them they need to stay near you when you’re out in public, set boundaries – tell them where it’s OK to go and what’s not OK. If they step outside those limits, or refuse to hold your hand in a parking lot, or whatever guidelines you have set, then there should be consequences (e.g. you need to leave the park, or you need to carry them in the parking lot.)
• When going anyplace where you might become separated, put your contact info somewhere on them (e.g. on a card in their pocket, on a bracelet, etc.). Also, take a picture of them that day with your phone so if you become separated you have a photo of what they look like and they are wearing.
• Teach healthy touch: high fives and fist bumps, patting on the back, brief hugs, etc. Don’t force your child to give a hug to someone if they are not comfortable.
• Teach them names for their body parts, including private parts. It is best to use commonly used terms (e.g. penis or vagina), not family euphemisms. Feeling comfortable with these words makes it possible for a child to explain if something inappropriate happens. (Learn more.)
• You should always know the basic description of your child at all ages, so if they are missing, you can tell searchers: how tall they are, how much they weigh, piercings, tattoos, birthmarks. Take good head and shoulder pictures at least every 6 months (every 3 months for young children.       

 For a child age 3 and up:

• Everything listed above, plus:
• Be sure they know their address, parent’s names, and parent’s phone numbers.Help them know what adults you trust. Tell them: “if you ever feel scared or need help, then ____ and _____ are adults you can talk to.
• ”Talk to them about how to find a trustworthy stranger if they somehow become separated from you and need help. You could teach to look for a police officer, but they’re rarely around. So, I also tell my children to look for a person who is working there – I help them identify workers – they’re standing behind the check-out counter, or they’re wearing a uniform. I also tell them they could go to another parent – someone who has a child with them. From time to time, we practice this – I ask my child to look around and identify two people who they could ask for help if needed. Also, point out “safe spots” – the places they are most likely to find helpful people.
• Talk to them about “tricky people” and what behaviors are red flags. Don’t try to cover it all in one big “talk” – it should be an on-going dialogue.
• If your child is uncomfortable around someone and wants to avoid that person, don’t dismiss this. Respect your child’s instincts.
• If you go somewhere you might get separated (the zoo, an amusement park, a large event), talk to them on the way there about the importance of staying close to you the whole time. Tell them that if they look around and can’t find you, they should stop where they are and you will find them.
• By the time they are three, teach them that the parts of their body that are covered by a swimsuit are private. They should be kept covered around other people, and other people should not touch them there, except for parents or caregivers who are briefly helping to clean them, or a doctor, when the parents are in the room.
• Don’t label your child’s clothes or backpacks with their name in big, visible letters. “Tricky” adults often use a child’s name to convince the child they are safe.

As your child gets older, and more independent:

• Everything listed above, plus 
• They should know contact info for multiple trusted adults, and have a plan for how they could contact them. (For a younger child who doesn’t have a cell phone, they should know how to seek adult help. For older kids with phones, they need plans for what to do if their phone battery dies.)
• If going someplace  you may get separated, have a plan in advance for where you would meet up again. Make sure they can describe it to you, and from time to time, ask them “do you remember where our meet-up place is? Can you point to where it is?”
• A responsible adult should always know where they are. Set boundaries on where they can go, ask that they check in with you from time to time, and require that they check in if their plans change.
• In the places they frequent, they should be able to list “safe spots” where they could go for help if they were feeling worried – for example, if someone at the park was making them uncomfortable, they could go into the nearby convenience store. They should also know to avoid unsafe spots – isolated areas with no one around.
• They should know how and in what circumstances to call emergency number.
• They should know never to answer the door when they are home alone.
• They should know never to approach a stranger’s car. If someone calls them over to a car, they should not go.
• When out and about, they should use the buddy system, not go places alone.
• If someone offers them money, or an easy job, they should be wary.
• Consider a family password so that if you ever could need to send an unexpected adult to pick them up in case of emergency, your child could ask that adult for the password to be sure it’s really someone you sent. You could also use that code word or another one for your child to communicate to you “I’m feeling unsafe and I need your help.
• ”Tell them to trust their instincts. If they’re worried about something, they should talk to you or another trusted adult who can help them problem-solve. If they’re very frightened, they should call emergency number or shout for help. Tell them it is better to seek help and find out that everything is actually OK than it is to not seek help when things really are bad.
• Give kids examples of “tricky behavior”; have them describe how they would respond.
• Don’t talk about “bad touch” because sometimes sexual touch can feel good or can “tickle.” Instead, talk about “secret touch” that the other person wants you to hide from people, or touch that makes them feel wrong after it happened. Let children know that if anyone ever touches them in an inappropriate way (or makes the child touch them), that it’s not the child’s fault and they will not be in trouble with you. Perpetrators may first involve children by showing them pornography – let your child know that if someone shows them pornography, they should let you know.
• Explain that you’re teaching safety rules because they are more mature and ready to be responsible. You want to give them more freedom, but you also need to be reassured that they know how to stay safe.

©Dr.SHEBIN C E

For Consultation :- https://www.practo.com/kanyakumari/doctor/dr-shebin-c-e-paediatrics

Are You Finding Difficulty in Feeding Your Little One-Try This (Diet for 1-3 Years Child)

 

     When comes to food for our little ones we are more cautious on feeding them,we have lots of questions in mind like What food to be given?what time to be given? Did i can give this food? Is this food is allergy to my food? Is junks food good for her?  “I wish my baby could put on a little more weight by now”  Now you will get answers to all question  read the full article.

We often forget that toddlers do not have that much of consciousness to think “healthy” and all that they need is variety. Give your toddler variety in terms of colors, shape, size, and taste and he/ she will make mealtimes enjoyable for both you and him/her.

Importance of Number of Meals :

            When your child turns 1, you can give him anything except spicy, salty, and deep-fried foods. And secondly, you need to remember that your toddler needs little amounts of a variety of “interesting” foods to be given to him at various times of the day. So it is not a good idea to stuff him/her with food as a one-time option. When it comes to Kids, you should not follow the 3 meal patterns like us adults.

He/she is most likely to reject this option and stay hungry. A toddler has very little stomach capacity and he/ she cannot take 3 big meals a day. He/ she will typically need 6 small meals a day to fulfill his/ her body’s energy requirements. The best part about feeding your kid frequently is that you don’t need to worry much about his quantity of intake. Even if the kid eats 3-4  biscuits, he will be good for the next 1-2 hours… A little effort from your side will help him/her stay satiated and disturb you less during meal times.

Menu planning for Diet of Indian Toddlers :

 

In the above-given chart, the outer 6 boxes represent the different food groups.  This chart will help you in planning your own menu based on your convenience and timing for your baby. follow the following tips for planning a healthy menu for your toddler.

• Add 1 item from each food group:

        The trick is to simply add at least 1 item from each group throughout the day. Of course, you can use a particular group more than 2 times too. However, in order to maintain variety in terms of taste and nutrition, its important to plan from each group.  Ex – you can plan for rice in the afternoon and oats in the evening menu. both the items belong to the cereal group and are equally healthy.

• Variety in terms of taste:

        Make your choices of food from the given food group more interesting for the kid. Ex  – instead of feeding your baby with rice and milk every day, introduce variety. Plan for rice and curd, or lightly lemon flavored rice, mix rice with mung dal from pulses group to add protein and variety to your kid’s menu.

• Mixing of 2 Food groups:

        After your kid turns 15 – 16 months old, you can mix up 2  or more food groups together. Ex – Oats porridge with apple. Here Oats cover the cereal group, Milk will cover up for protein and apple will cover the fruits group.  some kids with good digestibility can tolerate the mixed groups’ concept right from 12 months onwards.

• Cereal Group:

        This group includes cereals like Rawa (semolina), Ragi, Rice, Oats, wheat and its products like brown bread, wheat-based biscuits. These cereals are easy to digest. Initially, its best to grind the food product, or mash it well to avoid choking. some kids take time to learn to chew.

• Milk and Milk Products Group:

        As the name suggests this group includes all varieties with milk. Cows milk has the best digestibility. Hence it is preferable to give you kids cow’s milk.  You can later introduce him with milk products like cheese, curd,  buttermilk, and paneer.  Cheese on brown bread is a good snacking option for your 2+ years old toddler. They relish it.

• Non – Vegetarian Protein Group:

            This group includes chicken, eggs, and fish. I would really recommend you to start your kid a little late with fish. Maybe after he is 2 +. This will ensure his digestion capacity. It is not that kids do not eat fish before this age. There are individual differences and food preferences. All you need to do is ensure your kids’ digestion capacity and allergic reactions to these foods.

• Dals And Pulses Group:

        Start with easily digestible dals like mung dal. once they are tolerated well by the kid, you can then move forward to slowly introduce her with all the other varieties of dals, and pulses.  make sure the first time you try any new pulse, it should be diluted enough. If your baby has any sign of intolerance towards these foods, like change in color of stool, hard stool or  watery stool or gases or stomach ache after the intake, reintroduce the food after a week in a diluted form

•  Fruits and vegetables:

        The fruits and vegetables that are mentioned under the groups in the above infographic diagram, can be used in any form. you can mash the fruits, make juice out of it, pressure cook the fruit for 1 whistle and then mash it (apple). or you can hand over them as slices to your kids. So they also learn to eat on their own. you can use vegetables in soup forms or cooked vegetable form, just the way you consume it at home. make sure you add little or no spices to the preparation. You can introduce the spices and masala for the baby after she is 2.5 + years of age.

• Fats and Sugars:

        This group is placed in the center on purpose. although you need to use a very little amount of fats and sugar for your toddler, please do not ignore this group. Your baby really needs good fats for better digestion. don’t forget that these little ones also require tasty foods just like us. you can add sugar or jaggery to their food preparations.

• Milk Intake :

        Give your toddler the regular milk when he wakes up in the morning. Give him 100 to 200 ml of milk in the morning and in case he/she is allergic to milk and milk products, you can replace milk with whole fruit, almond milk, or soya milk. If your child has crossed 2 years of age, you may consider adding health drinks such as Pediasure to his milk. Make sure to give your toddler full cream milk and he/ she requires milk energy to support his body’s functions and to grow into a powerful adult with time. In the evening, give your toddler 100-50 ml of milk depending on his preference. Yes, do value his preference as many toddlers simply hate the taste of milk. You can’t help as I’m sure many of you also hated milk in your childhood. Use your imaginations, make them tasty smoothies or milkshakes

• Water Intake:

        A toddler’s daily water intake may typically consist of at least 5 glasses of water. This includes the juices, milk, and other fluids that your toddler consumes throughout the day.

• Bread:

        Make sure you give your toddler wholewheat or brown bread or bread that is fortified with vitamins and minerals.

• Fruits  And Vegetables:

        You may opt for cooked or pureed food. Cooked or pureed vegetables with bland flavors are the best options for toddlers. These may include vegetables such as pumpkin, potato, sweet potato, squash, carrots, and butternut. Try with mashed food items. It’s better to feed your toddler steamed vegetables and pulses

 

• Homemade Food:

        Today’s nuclear family setups coupled with an increase in the opportunities for women employment, the time has become a scarce resource for today’s families. It is always better to avoid tinned and packaged foods as they contain preservatives that may be detrimental to your child’s health. Make sure you invest some time to secure your child’s health and prepare meals at home. We are sure that love will help you find that time!

 

• Oatmeal Cereals:

        It is a good idea to help your child build healthy eating habits at a very young age. You may introduce oatmeal cereals at a very early stage as they are healthy breakfast options and your child is most likely to develop an acceptance for oatmeal cereals as well as other complex carbohydrates.

 

• Portion Intake:

        1 tablespoon of each food: The Rule of Thumb. At one time, a one-year-old child should be fed 1 tbsp of cooked cereal, pureed fruit, pureed cereal, cooked meat, cooked vegetable, one egg, and a ½ cup of milk and dairy products. On a similar line, a 2-year old child should be given 2 tablespoons of different foods at a time. And as you can already guess, 3 tablespoons of different foods at a time constitute the perfect dietary portions for a 3-year old child.

 

• Nutritious Snacks:

            Your kid will eat when he/she is hungry and will stop when he/ she feels full. Sometimes, you may consider providing nutritious snacks to your kid. This does not mean that you have to put a lot of extra effort into preparing healthy snacks as a lot of healthy yet no-hassle snacks are available in the market. Prepare some finger-friendly, bite-size foods and your toddler will take the responsibility of feeding himself/ herself:
• Thinly-sliced fresh fruit
• Low-sugar breakfast cereals
• Mini muffins with whole-grain crackers
• Shredded cheese
• 2-4 ounces of pure fruit juice, with one part juice being mixed with two parts of water.
• Tart with pureed or strained vegetables such as green beans, squash, or carrots.

In a Nutshell:-

• Kids who are fed at small intervals are not only healthy but are also less irritable and less cranky in comparison to the kids who are fed with more time gaps.
• You need to feed your growing toddler every 2- 3 hrs, don’t wait for them to signal for hunger. Kids get really cranky and irritated if they go without food for long.  To become a smart mom, you need to set your timetable accordingly. Keep your busiest hours for their milk feeds. But do not overdo Milk. Excess milk feeds and no solid will make her/him hate food.

Some Common Mistakes that You Should Avoid:

• Making your child drink more than 16-24 ounces of milk per day.

• Forcing them to eat when they are not hungry.

• Allowing your child to eat sugary snacks

©Dr.SHEBIN C E & Payal Banka (Dietician)

Diaper Rash-Things to be noted

What Is Diaper Rash?

      Diaper rash is a common condition that can make a baby's skin sore, red, scaly, and tender. Most cases will clear up with simple changes in diapering.

What Causes Diaper Rash?

Usually, diaper rash is the result of an irritation, infection, or allergy.

Irritation. A baby's skin can get irritated when a diaper is left on for too long and poop (or the diaper itself) rubs against the skin repeatedly.

Infection. Urine (pee) changes the skin's pH levels, and that lets bacteria and fungi grow more easily. The substances that stop diapers from leaking also prevent air circulation, creating a warm, moist environment where bacteria and fungi can thrive, causing a rash.

Allergies.:- Babies with sensitive skin also can develop rashes. Some types of detergent, soaps, diapers (or dyes from diapers), or baby wipes can affect sensitive skin, causing a rash.

Also, starting new foods can change the content and frequency of a baby's poop, which can sometimes lead to a diaper rash. And diarrhea can make an existing case of diaper rash worse.

Diaper rash that lasts for more than a few days, even with changes to the diapering routine, might be caused by a yeast called Candida albicans. This rash is usually red, slightly raised, and has small red dots spreading beyond the main part of the rash. It often starts in the deep creases of skin and can spread to skin on the front and back of the baby. Antibiotics given to a baby or a breastfeeding mom can cause this, as they kill off the "good" bacteria that keep Candida from growing.

How Is Diaper Rash Treated?

To help clear up diaper rash, check your baby's diaper often and change it as soon as it's wet or soiled. Gently clean the diaper area with soap and water and pat dry. Creams and ointments containing zinc oxide or petroleum help to soothe skin and protect it from moisture. They should be smeared on thickly (like cake icing) at each diaper change.

Some experts suggest letting your baby go without diapers for several hours each day to give irritated skin a chance to dry and "breathe." This is easiest if you place your baby in a crib with waterproof sheets or on a large towel on the floor.

Diaper rash usually goes away within 2 to 3 days with home care, although it can last longer.

How Can I Prevent Diaper Rash?

To prevent diaper rash, keep your baby's skin as dry and clean as possible and change diapers often so that poop and pee don't irritate the skin.

Try these tips:

-> Change your baby's soiled or wet diapers as soon as possible and clean the area well.

->Occasionally soak your baby's bottom between diaper changes with warm water. You can gently scoop the water over your baby's bottom with your hand or squeeze it from a plastic bottle.

->Let your baby's skin dry completely before you put on another diaper.

-> Pat the skin gently with a soft cloth when drying it — rubbing can irritate skin.

-> Put the diaper on loosely to prevent chafing.

-> Change diapers often — ideally every 2 hours or so — and after every poop.

-> Applying diaper cream or ointment with each diaper change can help some babies with sensitive skin, but not all babies need this.

If you use cloth diapers, check the manufacturer's directions on how to best clean them. Only use detergents in the amount recommended, and run an extra rinse cycle after washing to remove traces of soap or detergent that can irritate your baby's skin. Avoid using fabric softeners and dryer sheets — even these can irritate skin.

Some babies get a rash after switching to a new type of diaper. While experts don't recommend any particular brand, if your child is sensitive, look for diapers free of dyes or fragrances. Some babies are sensitive to baby wipes — water and a washcloth work just as well and may be a gentler option.

When Should I Call the Doctor?

If the rash doesn't go away, gets worse, or if sores appear on your baby's skin, talk to your doctor. Also get medical care if your baby has a fever, pus is draining from the rash, or if your child is fussier than usual.

Depending on what type of rash your baby has, the doctor may choose to use an antifungal cream or an antibiotic cream, or may recommend other changes to your diapering routine. Sometimes, if those changes don't help a rash caused by an allergic reaction, the doctor may prescribe a mild steroid cream for a few days until the rash goes away.

 

Constipation- Parenting Tips.

 What Is Constipation?

Kids might have constipation if they:

- > have fewer than three bowel movements (BMs) in a week 

 - > have trouble having a bowel movement have stool (poop) that's hard, dry, and unusually large . Constipation is a very common problem in kids. It usually isn't a cause for concern. Healthy eating and exercise habits can help prevent it.

What Are the Signs & Symptoms of Constipation?

Different kids have different bathroom habits. A child who doesn't have a bowel movement every day isn't necessarily constipated. One child might go three times a day, while another might go once every 1–2 days.Generally, signs of constipation in kids include:going less than usual having trouble or pain when going to the bathroom feeling full or bloated straining to poop seeing a little blood on the toilet paper .It's also common for kids with constipation to sometimes stain their underwear with bits of stool.

What Causes Constipation?

Constipation can be due to a diet that doesn't include enough water and fiber, which help the bowels move as they should. Kids who eat lots of processed foods, cheeses, white bread and bagels, and meats may become constipated fairly often.Sometimes, medicines like antidepressants and those used to treat iron deficiencies can cause constipation. Constipation can happen in babies as they move from breast milk to baby formula, or from baby food to solid food. Toddlers who are toilet training sometimes can become constipated, especially if they're not ready.Some kids avoid going to the bathroom, even when they really have the urge to go. They might ignore internal urges because they don't want to use a restroom away from home, stop playing a fun game, or have to ask an adult to be excused to go to the bathroom. Ignoring the urge to go makes it harder to go later.Stress also can lead to constipation. Kids can get constipated when they're anxious about something, like starting at a new school or problems at home. Research has shown that emotional upsets can affect how well the gut functions and can cause constipation and other conditions, like diarrhea.Some kids get constipated because of irritable bowel syndrome (IBS), which can happen when they're stressed or eat certain trigger foods, which often are fatty or spicy. A child with IBS may have either constipation or diarrhea, as well as stomach pain and gas.In rare cases, constipation is a sign of other medical illnesses. So talk to your doctor if your child continues to have problems or if the constipation lasts for 2 to 3 weeks.

How Can We Prevent and Treat Constipation?

To prevent and treat constipation:

Give your child more liquids. 

Drinking enough water and other liquids helps stools move more easily through the intestines. The amount kids need will vary based on their weight and age. But most school-age kids need at least 3 to 4 glasses of water each day. If your infant is constipated during the move from breast milk or to solid foods, try serving just a few ounces (2–4) of apple, pear, or prune juice each day. If the constipation lasts or upsets your child, a health problem could be the cause, so call your doctor.

Serve more fiber.

 High-fiber foods (such as fruits, vegetables, and whole-grain bread) can help prevent constipation. Fiber can't be digested, so it helps clean out the intestines by moving the bowels along. A diet full of fatty, sugary, or starchy foods can slow the bowels down. When adding more fiber to your child's diet, do so slowly over a few weeks and make sure your child also drinks more liquids.Fiber doesn't have to be a turn-off for kids — try apples, pears, beans, oatmeal, oranges, ripe bananas, whole-grains breads, and popcorn. Adding flax meal or bran to homemade fruit smoothies is another way to slip fiber into a child's diet.

Make sure kids get enough exercise. 

Physical activity nudges the bowels into action, so encourage your kids to get plenty of exercise. It can be as simple as playing catch, riding bikes, or shooting a few hoops.

Develop a regular meal schedule.

 Eating is a natural stimulant for the bowels, so regular meals may help kids develop routine bowel habits. If necessary, schedule breakfast a little earlier to give your child a chance for a relaxed visit to the bathroom before school.

Get kids into the habit of going. 

If your child fights the urge to go to the bathroom, have him or her sit on the toilet for at least 10 minutes at about the same time each day (ideally, after a meal).These small changes help most kids feel better and get the bowels moving the way they should. Talk with the doctor before giving your child any kind of over-the-counter medicine for constipation.

This a food pyramid where the top of the pyramid food should be used in less in quantity and bottom of the pyramid food should be used daily more in amount.

For any suggestions and queries mail me at hai2shebin@gmail.com or consult me at Dr.Shebin C E Practo. 

Overweight and Obesity - a Real Emerging Childhood Concern .

 

        India has the second highest number of obese children in the world, according to a new study published in The New England Journal of Medicine. While India has 14.4 million of them, China tops the chart with 15.3 million obese children.

Preventing kids from becoming overweight means making choices in the way your family eats and exercises, and how you spend time together. Helping kids lead healthy lifestyles begins with parents who lead by example.

What Health Problems Can Obesity Cause?

        Obesity puts kids at risk for medical problems that can affect their health now and in the future. These include serious conditions like type 2 diabetes, high blood pressure, and high cholesterol — all once considered adult diseases.

Overweight and obese kids are also at risk for:

• bone and joint problems 
• shortness of breath that makes exercise, sports, or any physical activity more difficult. This also can make asthma symptoms worse or lead kids to develop asthma.
• restless sleep or breathing problems at night, such as obstructive sleep apnea
• a tendency to mature earlier. Overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are. Overweight girls may have irregular menstrual cycles and fertility problems in adulthood.
• liver and gallbladder disease.

Cardiovascular risk factors (including high blood pressure, high cholesterol, and diabetes) that develop in childhood can lead to heart disease, heart failure, and stroke in adulthood. Preventing or treating overweight and obesity in kids may help protect them from these problems as they get older.

Obese kids also might have emotional issues to deal with (such as low self-esteem), and may be teased, bullied, or rejected by peers. Kids who are unhappy with their weight can be at risk for:

• unhealthy dieting and eating disorders
• depression
• substance abuse

How Are Overweight and Obesity Defined?

        Body mass index (BMI) uses height and weight measurements to estimate a person's body fat. But calculating BMI on your own can be complicated. An easier way is to use a BMI calculator.

On a standard BMI chart, kids ages 2 to 19 fall into one of four categories:

• underweight: BMI below the 5th percentile 
• normal weight: BMI at the 5th and less than the 85th percentile 
• overweight: BMI at the 85th and below 95th percentiles 
• obese: BMI at or above 95th percentile

For kids younger than 2 years old, doctors use weight-for-length charts instead of BMI to determine how a baby's weight compares with his or her length. Any child under 2 who falls at or above the 95th percentile may be considered overweight.

BMI is not a perfect measure of body fat and can be misleading in some cases. For example, a muscular person may have a high BMI without being overweight (extra muscle adds to body weight — but not fatness). Also, BMI might be hard to interpret during puberty when kids have periods of fast growth. Remember, BMI is usually a good indicator of body fat, but it's not a direct measurement.

If you're worried, take your child or teen to see the doctor. The doctor will ask about eating and activity habits and make suggestions on how to make positive changes. The doctor also may order blood tests to look for some of the medical problems associated with obesity.

Depending on your child's BMI (or weight-for-length measurement) and health, the doctor may refer you to a registered dietitian or a weight management program.

Why Do Kids Become Overweight or Obese?

    A number of things contribute to a person becoming overweight. Diet habits, lack of exercise, genetics, or a combination of these can be involved. In some instances, too much weight gain may be due to an endocrine problem, genetic syndrome , or some medicines.

Diet and Life style

     Much of what we eat is quick and easy — from fat-filled fast food to processed and prepackaged meals. Daily schedules are so busy that there's little time to make healthier meals or to squeeze in some exercise. Portion sizes, in the home and out, are too large.

Plus, modern life is sedentary. Kids spend more time playing with electronic devices than actively playing outside. Kids who watch TV more than 4 hours a day are more likely to be overweight compared with kids who watch 2 hours or less. And kids who have a TV in the bedroom also are more likely to be overweight.

Exercise and Physical Activity;

     Many kids don't get enough physical activity. Older kids and teens should get 1 hour or more of moderate to vigorous exercise every day, including aerobic and muscle- and bone-strengthening activities. Kids ages 2 to 5 years should play actively several times each day. 

Genetics

     Genetics can play a role in what kids weigh. Our genes help determine body type and how the body stores and burns fat. But genes alone can't explain the current obesity crisis. Because both genes and habits are passed down from one generation to the next, multiple members of a family may struggle with weight.

People in the same family tend to have similar eating patterns, levels of physical activity, and attitudes toward being overweight. A child's chances of being overweight increase if one or both parent is overweight or obese.

How Can We Prevent Overweight and Obesity?

        The key to keeping kids of all ages at a healthy weight is taking a whole-family approach. Make healthy eating and exercise a family affair. Get your kids involved by letting them help you plan and prepare healthy meals. Take them along when you go grocery shopping. Teach them how to make good food choices.

Try to avoid these common traps:

• Don't reward kids for good behavior or try to stop bad behavior with sweets or treats. Find other ways to change behavior.
• Don't have a clean-plate policy. Even babies turn away from the bottle or breast to send signals that they're full. If kids are satisfied, don't force them to keep eating. Reinforce the idea that they should only eat when they're hungry.
• Don't talk about "bad foods" or completely ban all sweets and favorite snacks. Kids may rebel and overeat forbidden foods outside the home or sneak them in on their own. Serve healthy foods most of the time and offer treats once in a while.

Recommendations by Age 

Additional recommendations for kids of all ages:

• Birth to age 1: Besides its many health benefits, breastfeeding may help prevent excessive weight gain.
• Ages 1 to 5: Start good habits early. Help shape food preferences by offering a variety of healthy foods. Encourage kids' natural tendency to be active and help them build on developing skills.
• Ages 6 to 12: Encourage kids to be physically active every day, whether through an organized sports team or a pick-up game of soccer during recess. Keep your kids active at home with everyday activities like playing outside or going for a family walk. Let them be more involved in making good food choices, such as packing lunch.
• Ages 13 to 18: Teach teens how to prepare healthy meals and snacks at home. Encourage them to make healthy choices when outside the home and to be active every day.
• All ages: Cut down on TV, phone, computer, and video game time and discourage eating in front of a screen (TV or otherwise). Serve a variety of healthy foods and eat family meals together as often as possible. Encourage kids to eat breakfast every day, have at least five servings of fruits and vegetables daily, and limit sugar-sweetened beverages.

Talk to kids about the importance of eating well and being active. Be a role model by eating well, exercising regularly, and building healthy habits into your own daily life. Make it a family affair that will become second nature for everyone.

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Fevers-When to Alarm.

        All kids get a fever from time to time. A fever itself usually causes no harm and can actually be a good thing — it's often a sign that the body is fighting an infection.

But when your child wakes in the middle of the night flushed, hot, and sweaty, it's easy to be unsure of what to do next. Should you get out the thermometer? Call the doctor?Here's more about fevers, including when to contact your doctor.

What Is a Fever?

        Fever happens when the body's internal "thermostat" raises the body temperature above its normal level.Most people's body temperatures change a little bit during the course of the day: It's usually a little lower in the morning and a little higher in the evening and can vary as kids run around, play, and exercise.

What Causes Fevers?

      It's important to remember that fever by itself is not an illness — it's usually a sign or symptom of another problem.

Fevers can be caused by a few things, including:

Infection:  

       Most fevers are caused by infection or other illness. A fever helps the body fight infections by stimulating natural defense mechanisms.

Overdressing:  

        Infants, especially newborns, may get fevers if they're overbundled or in a hot environment because they don't regulate their body temperature as well as older kids. But because fevers in newborns can indicate a serious infection, even infants who are overdressed must be checked by a doctor if they have a fever.

Immunizations:      

        Babies and kids sometimes get a low-grade fever after getting vaccinated.Although teething may cause a slight rise in body temperature, it's probably not the cause if a child's temperature is higher than 100°F (37.8°C).

When Is a Fever a Sign of Something Serious?

        In healthy kids, not all fevers need to be treated. High fever, though, can make a child uncomfortable and make problems (such as dehydration) worse.

Doctors decide on whether to treat a fever by considering both the temperature and a child's overall condition.

        Kids whose temperatures are lower than 102°F (38.9°C) often don't need medicine unless they're uncomfortable. There's one important exception: If an infant 3 months or younger has a  temperature of 100.4°F (38°C) or higher, call your doctor or go to the emergency department immediately. Even a slight fever can be a sign of a potentially serious infection in very young babies.

        If your child is between 3 months and 3 years old and has a fever of 102.2°F (39°C) or higher, call to see if your doctor needs to see your child. For older kids, take behavior and activity level into account. Watching how your child behaves will give you a pretty good idea of whether a minor illness is the cause or if your child should be seen by a doctor. 

The illness is probably not serious if your child:

• is still interested in playing
• is eating and drinking well 
• is alert and smiling at you 
• has a normal skin color 
• looks well when his or her temperature comes down 

And don't worry too much about a child with a fever who doesn't want to eat. This is very common with infections that cause fever. For kids who still drink and urinate (pee) normally, not eating as much as usual is OK. 

Is it a Fever?

        A gentle kiss on the forehead or a hand placed lightly on the skin is often enough to give you a hint that your child has a fever. However, this method of taking a temperature (called tactile temperature) won't give an accurate measurement.

Use a reliable digital thermometer to confirm a fever. It's a fever when a child's temperature is at or above one of these levels:

• measured orally (in the mouth): 100°F (37.8°C)
• measured rectally (in the bottom): 100.4°F (38°C)
• measured in an axillary position (under the arm): 99°F (37.2°C)

        But how high a fever is doesn't tell you much about how sick your child is. A simple cold or other viral infection can sometimes cause a rather high fever (in the 102°–104°F/38.9°–40°C range), but this doesn't usually mean there's a serious problem. In fact, a serious infection, especially in infants, might cause no fever or even a low body temperature (below 97°F or 36.1°C).

           Because fevers can rise and fall, a child might have chills as the body's temperature begins to rise. The child may sweat to release extra heat as the temperature starts to drop.

        Sometimes kids with a fever breathe faster than usual and may have a faster heart rate. Call the doctor if your child has trouble breathing, is breathing faster than normal, or is still breathing fast after the fever comes down.

How Can I Help My Child Feel Better?

        Again, not all fevers need to be treated. In most cases, a fever should be treated only if it's causing a child discomfort.

Here are ways to ease symptoms that often accompany a fever:

Medicines;

        If your child is fussy or uncomfortable, you can give acetaminophen(paracetamol) or ibuprofen based on the package recommendations for age or weight. (Unless instructed by a doctor, never give aspirin to a child due to its association with Reye syndrome, a rare but potentially fatal disease.) If you don't know the recommended dose or your child is younger than 2 years old, call the doctor to find out how much to give.

        Infants younger than 2 months old should not be given any medicine for fever without being checked by a doctor. If your child has any medical problems, check with the doctor to see which medicine is best to use. Remember that fever medicine can temporarily bring a temperature down, but usually won't return it to normal — and it won't treat the underlying reason for the fever.

Home Comfort Measures;

         Dress your child in lightweight clothing and cover with a light sheet or blanket. Overdressing and over bundling can prevent body heat from escaping and can cause the temperature to rise.

Make sure your child's bedroom is a comfortable temperature — not too hot or too cold.

While some parents use lukewarm sponge baths to lower fever, this method only helps temporarily, if at all. In fact, sponge baths can make kids uncomfortable. Never use rubbing alcohol (it can cause poisoning when absorbed through the skin) or ice packs/cold baths (they can cause chills that can raise body temperature).

Food and Drinks;

         Offer plenty of fluids to avoid dehydration because fevers make kids lose fluids more rapidly than usual. Water, soup, ice pops, and flavored gelatin are all good choices. Avoid drinks with caffeine, including colas and tea, because they can make dehydration worse by increasing urination (peeing).

If your child also is vomiting and/or has diarrhea, ask the doctor if you should give an electrolyte (rehydration) solution made especially for kids. You can find these at drugstores and supermarkets. Don't offer sports drinks — they're not made for younger children and the added sugars can make diarrhea worse. Also, limit your child's intake of fruits and apple juice.

In general, let kids eat what they want (in reasonable amounts), but don't force it if they don't feel like it.

Taking it Easy;

         Make sure your child gets plenty of rest. Staying in bed all day isn't necessary, but a sick child should take it easy.

It's best to keep a child with a fever home from school or childcare. Most doctors feel that it's safe to return when the temperature has been normal for 24 hours.

When Should I Call the Doctor?

        The exact temperature that should trigger a call to the doctor depends on a child's age, the illness, and whether there are other symptoms with the fever.

Call your doctor if you have an:

• infant younger than 3 months old with a  temperature of 100.4°F (38°C) or higher 
• older child with a temperature of higher than 102.2°F (39°C)
• refuses fluids or seems too ill to drink adequately 
• has lasting diarrhea or repeated vomiting 
• has any signs of dehydration (peeing less than usual, not having tears when crying, less alert and less active than usual)
• has a specific complaint (like a sore throat or earache)
• still has a fever after 24 hours (in kids younger than 2 years old) or 72 hours (in kids 2 years or older)
• is getting fevers a lot, even if they only last a few hours each night
• has a chronic medical problem, such as heart disease, cancer, lupus, or sickle cell disease
• has a rash
• has pain while peeing

Get emergency care if your child shows any of these signs:

• crying that won't stop
• extreme irritability or fussiness
• sluggishness and trouble waking up
• a rash or purple spots that look like bruises on the skin (that were not there before your child got sick)
• blue lips, tongue, or nails
• infant's soft spot on the head seems to be bulging out or sunken in
• stiff neck
• severe headache
• limpness or refusal to move
• trouble breathing that doesn't get better when the nose is cleared
• leaning forward and drooling
• seizure
• moderate to severe belly pain

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