Parents and kids alike love sports, and it’s easy to get caught up in a game and become focused on winning. Yet there is much more to be gained from the sports experience than a winning record. When children and teens are involved in sports, they are able to learn and put into practice values that will stay with them for the rest of their lives.

Good sportsmanship is one of the life lessons that children can learn from sports. You can help your children understand and value good sportsmanship while making sure they have a safe and fun sports experience. Here are some important principles to instill in your children:

• If you lose, don’t make up excuses.
• If you win, don’t rub it in.
• Learn from mistakes and get back in the game.
• Always do your best.
• If someone else makes a mistake, remain encouraging and avoid criticizing.

Parents are important role models, so let your children see you upholding these principles, whether you play a sport yourself or root for your child’s team from the sidelines.

Good sportsmanship also includes following certain guidelines for good behavior. Share these concepts with your children:

• Avoid arguing. Stay focused on the game instead of giving in to anger with teammates, coaches, or referees. Always avoid using bad language and negative words.

• Everyone should have a chance to play. In youth sports, it’s important to encourage even those players who are the least skilled to have fun playing in the game. Parents, coaches, and even other players have an important role in allowing less talented teammates time to participate.

• Play fair. Good sportsmen want to win because they followed the rules and played the best game they could. Never support any effort to win that attempts to go around the rules. Cheating is not acceptable.

• Follow directions. Emphasize the importance of listening to coaches and referees and following their directions while on the field and involved in team activities.

• Respect the other team. Whether your team wins or loses, it’s important to show respect for the effort of the other team. If the other team wins, accept defeat, acknowledge their abilities, and move on. If your team wins, resist bragging—that’s what it means to be a gracious winner.

• Encourage teammates. Team sports work best when each individual supports the team. Praise teammates for what they do well and encourage them when they make mistakes. Avoid criticism and unkind actions. Parents should model this behavior for children by praising them for specific things they have done well, even if they made a mistake or may not have played as well as hoped.

• Respect the decisions of referees and other officials. These people are charged with making difficult decisions about plays in the game. Good sportsmanship requires that you accept a call, even if you disagree with it. Remember that it’s only one call in a long game—get back into play and focus on the game.

• End with a handshake. Good sportsmen enjoy sports and know how to end a game on a positive note, whether or not they won. Threats, anger, criticism, and other negative expressions are not acceptable.

A recent study published by the American Academy of Pediatrics, that examined data for more than 300 children, found that at least 50 percent of those children experienced sunburns before age 11. Melanoma is one of the two most common cancers of young Americans, and children who have had a sunburn at an early age are at a higher risk for developing melanoma in adulthood.
Check out these safety tips to help keep your family protected:

• Use sunscreen with a SPF # of at least 30! Sunscreen not only protects against sun damage but also against wind damage by acting as a shield against irritants.
• No tanning oils or salons! Tanning increases the risk of melanoma and accelerates skin aging.
• Apply sunscreen every two hours to make sure you’re protected.
• Remember the sun is everywhere, protect your entire body, even your hands, nose and ears.
• Try to limit your time in the sun during the hours of 10 a.m. to 4 p.m. 
• Make sure your family drinks plenty of water throughout the day.

For more sun safety tips from the experts at CHOC, please click here:
http://www.choc.org/community/index.cfm?id=P00374
http://www.choc.org/publications/index.cfm?id=P00303&pub=KH&aid=522

Toddlers – may not eat as much in one sitting and often get hungry before the next meal. They may need to eat five or six times a day — three meals and two to three snacks. Remember: don’t use sweets to reward good behavior. Try these snacks: 

• cut-up fruit (keep pieces soft and small enough to avoid choking)
• graham crackers
• cut, small cheese slices
• yogurt
• applesauce
• low-sugar, whole-grain breakfast cereals
  

Preschoolers – are just learning to label their feelings. The commonly used “I’m hungry” at this age, could just mean they’re tired or in need of some attention. Figure out what your child really needs. Some may still need three meals and two snacks a day — usually one mid-morning and one after school. Try these snacks:

•   cut-up fruit or applesauce 
•   sliced veggies
•   yogurt
•  whole-grain crackers topped with cheese
  

School-age kids: are busier and a little more independent. Some may still need three meals and two snacks per day — usually one mid-morning and one after school. The morning snack could become unnecessary depending on lunchtime at school. Try these snacks:

•   low-sugar, whole-grain cereal with low-fat milk
•   low-fat string cheese
•   fruit smoothies made with low-fat milk or yogurt
•   whole-wheat pita slices, cut-up veggies, and hummus
•   whole-grain pretzels
•   fruit slices dipped in low-fat flavored yogurt
•   nuts and raisins 
    

Teens – might still need a snack or two during the day. You can’t monitor what your teen eats, but you can encourage healthy snacking by keeping nutritious foods at home, that your teen is likely to take along. Try these snacks:

• rice cakes with peanut butter and raisins
•  fresh or dried fruit
• veggie sticks with low-fat ranch dip or hummus
•  low-fat granola bars
•  air-popped popcorn 
•  trail mix
•  hard-boiled eggs

For more tips on healthy eating, please click here: http://www.choc.org/publications/index.cfm?id=P00303&pub=KH&aid=449

Furthermore, alcohol is the most commonly used and abused drug among youth in the United States – more than tobacco and illicit drugs. Although drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11% of all alcohol consumed in the United States. More than 90% of this alcohol is consumed in the form of binge drinks.

Make sure you talk to your kids openly about the consequences of this critical issue. Some of these consequences include poor or failing grades, legal problems, such as arrest for driving, unplanned and unprotected sexual activity, higher risk for suicide, alcohol-related car crashes and other unintentional injuries, abuse of other drugs, and death from alcohol poisoning. In addition, keep these helpful tips in mind:

• Help your child or teen build their self-esteem. Emphasize and reinforce their strengths and healthy behaviors. They are more likely to say no to peer pressure when they feel good about themselves and proud about their healthy habits.
• Be a good role model. Consider how your use of alcohol may influence your kids. Consider offering non-alcoholic beverages at parties and social events to show your kids that you don’t need to drink to have fun.
• Teach kids to manage stress in healthy ways, such as by seeking help from a trusted adult or participating in a sport or hobby they like.
• Look for signs, such as alcohol odor or alcohol disappearing from your home. Be mindful of a sudden change in mood or attitude in your child. This includes a change in attendance or performance at school, loss of interest in sports or other activities, and withdrawal from family and friends.

To learn more about binge drinking, click here for the report from the CDC:
http://www.cdc.gov/vitalsigns/BingeDrinking/index.html#Problem

The sniffles are common during the winter months, and are not always the result of the common cold or flu. Some people who are sensitive to allergy triggers, such as dust mites and mold, can be just as miserable these months as they are in the spring and summer. Check out some common causes of winter allergies and ways to manage them in this Q&A with Dr. Sherwin Gillman, Emeritus Chief, Division of Allergy and Immunology at CHOC Children’s. 

Q: What causes winter allergies?
A: In California, because of our temperate climate, we have things in the air year round that patients in areas of the country where there is frost, for example, don’t have to contend with. This includes mold spores, dust mites, pollens, and trees. Also, when the weather is damp and cooler, many families with outdoor pets tend to bring them in more, resulting in symptoms for those people who are allergic to animals, such as dogs and cats.

Q: What are the symptoms of winter allergies?
A: Some of the symptoms include sneezing, itchy nose and eyes, which are often red, and itchy throat and ears. Coughing and wheezing, as well as exertional limitation, especially if the outdoor air is cold and damp, are common in asthma patients. People with atopic dermatitis (eczema) are often allergic to things in the air, and because the indoor air is heated and dry, it makes their skin dryer and itchier. Patients with allergy to mold often feel worse one to two days after it rains, when the mold spores germinate. Allergies often interfere with getting a good night’s sleep, and with school or work performance.

Q: How are these symptoms different than cold symptoms?
A: People with colds usually have more malaise, body aches, headaches, sore throats, often fevers and usually end up with colored (yellow or green) mucous from their nose or lungs. Many times, they’ve had exposure to friends or family members who are ill with similar symptoms. In the first few days, however, it is often difficult to distinguish between colds and allergies, and the two may coexist. Evidence suggests that allergies may predispose individuals to infections, especially sinusitis, if not controlled.

Q: How can I treat my child’s winter allergies?
A: The most important thing parents can do is to find out what their child is allergic to. This can be done by allergy testing with a special blood test (usually done by their child’s pediatrician) or skin tests, which are usually favored by allergists. Once they have that knowledge, the best treatment is avoidance when possible, such as dust control for those who are allergic to mites, and keeping animals outside or in the garage when animals are the problem. Otherwise, there are excellent safe medications that are currently available to control the symptoms. Getting proper rest and a good diet are also helpful. We also recommend flu shots as another way of keeping an allergic child free from complications of influenza.

Folic acid (also known as vitamin folacin, folate, tetrahydrofolic acid, tetrahydropteroylglutamic acid, and THF) is a water soluble vitamin that plays an important part in cell division, the creation of cells in the blood-forming organs and bone marrow, and in the proper development of the fetal spinal cord and brain during pregnancy. The U.S. Public Health Service recommends that all women of childbearing age consume about 400 micrograms of folic acid each day.

Like many vitamins, folate is needed by children for proper growth and development. This critical nutrient is found in some green, leafy vegetables, most berries, nuts, beans, citrus fruits, and enriched grain foods such as cereal, bread, pasta and rice.

To ensure your kids are getting folate in their diet, try these easy snacks:

•  Cut up fresh vegetables and fruits such as broccoli, carrots, oranges and strawberries; serve with a yummy, low-fat dip.

•  Use kidney, pinto, or black beans in wraps or burritos. Have the kids create their own wraps!

•  Freeze orange juice and make juice pops.

•  Make a tasty salad. Include darker green lettuce or greens such as romaine, green leaf, or spinach.

•  Make a refreshing smoothie using orange and strawberries, among other fruits of your choice.

•  Make trail mix by combining a higher fiber cereal with folic acid, peanuts (if your child is not allergic to peanuts), and dried fruit such as raisins or banana chips.

Now comes the tough part. Do you send her to day care, or keep her home?

The American Academy of Pediatrics and the American Public Health Association have guidelines that can help you make up your mind. Drawn up in 1992 and revised in 2002, they cover kids in group care and school.

According to the guidelines, kids should stay home if the illness:

•Poses a risk of spreading a serious or harmful disease

•Needs more care than the staff can provide without a risk to the health and safety of other children

•Would keep the child from joining in activities

These are specific examples of when to keep children home:

•Fever higher than 101 degrees Fahrenheit orally or 102 degrees Fahrenheit rectally

•Diarrhea or blood in stools

•Persistent abdominal pain

•Vomiting twice or more in 24 hours

•Conjunctivitis (pinkeye), strep throat or chicken pox, until no longer contagious

•Sluggishness, uncontrolled coughing, constant crying or other signs of possible severe illness

Children with colds, runny noses or mild fever may be able to go to school or day care depending on other factors.

Deciding whether a mildly ill child can go to day care or school is difficult. What may have been just a tummy ache in the morning could lead to vomiting and diarrhea later in the day. Parents usually make good decisions,  but sometimes work obligations make it hard for parents to keep children home.  However, child care and school personnel have the final say on whether the child is too sick to attend day care or school.  And, whenever in doubt, call the pediatrician!

Photo courtesy of office.microsoft.com

Soups have been a dietary staple for centuries in many different cultures. The word soup comes from the word “sop,” meaning a broth or liquid eaten with a piece of bread to “sop” up the liquid. Soups all have similar basic ingredients; are often easy to prepare; are high in nutrients; and they won’t break your food budget! Here are four steps to making a great soup:

1. Choose a base. Whether you are a vegetarian or meat eater, you can choose a broth or stock for the liquid foundation of your soup. Homemade is great, but if you need to save time like most of us, choose a prepared broth or stock from your favorite grocer. Many are available in low sodium and non-fat versions.  Stock has a more intense flavor compared to broth.

2. Choose your vegetables, herbs, meats or protein sources. Dried peas, beans and lentils are inexpensive, in comparison to meats, chicken and fish. They are high in protein, iron, fiber, and low in fat. This makes them excellent nutritional choices, and will stretch your food dollar.

3. Develop the flavor. Sauté or brown the meat or vegetables in a small amount of oil or use cooking spray. Some soups need an acidic ingredient such as wine or vinegar. These are used to deglaze the pan after sautéing the meat and vegetables, bringing out the flavor of the browned bits in the pan. The broth or stock is added next, becoming infused with flavor as your soup simmers.

4. Choose your texture and garnish. Soups can be pureed for a smooth appearance and texture. Leave your soup chunky for a more rustic look. A light sour cream or shredded cheese can help balance a spicy soup; fresh lime juice or chopped herbs can compliment a soup’s complex flavors.

You can find a plethora of great tasting soup recipes at www.cookinglight.com or www.myrecipes.com. Check out the nutritional information listed for each recipe. Try Golden Winter Soup, made with butternut squash, russet potatoes and leeks. It tastes great with a tossed salad and a slice of French bread and Gruyere cheese!

And don’t forget, there are many soup recipes that do well in a slow-cooker, which can be a godsend for the working parent or just those of us who are too tired to cook at the end of the day. A great cookbook series for slow-cooker recipes is “Fix It and Forget It” by Phyllis Pellman. It is available in low fat, diabetic and 5 ingredient versions.  Try Chicken Tortilla Soup, a family favorite!  With a little planning, you can avoid the fast food habit and start your way to a healthier and budget-wise New Year!

Dr. Chris Koutures

The consumption of special holiday foods combined with festive gatherings and vacation time do not have to be temporary distractions from practicing healthy habits. Dr. Chris Koutures, a pediatric and sports medicine specialist at CHOC Children’s, offers several easy ways for families to stay active during the holiday break. Dr. Koutures’ tips are a great way to promote good tidings and cheer!

• Light up your day. There are many wonderful holiday light displays around the area. Rather than drive through them, park or leave the car at home and take a stroll on foot. Walking will give you more time to appreciate the beauty and also burn a few extra calories.

• Become a mall walker. Malls and stores are more crowded this time of year, as are their parking lots. Take advantage of this – avoid the crowds looking for a closer parking spot and find those lonely spots farther away. The extra steps will be good for you! Once inside, make a plan to take the stairs, walk around or plain “window shop” for 10-15 minutes before stopping and making purchases.

• Give the gift of movement. Strongly consider gifts that involve and encourage activity.  Even video games now have more interactive components that keep kids jumping, turning and breaking a sweat.  Outdoor play toys and games are also a big hit with our consistent good weather, local parks and fields.

• “Pre-load” before a big party. Having a small meal before a big holiday party or gathering may reduce the temptation to overeat. At the party, remember sensible portion sizes (size of your fist is a good guide)and include healthy foods., Supervise younger children so they don’t have unlimited access to all the specialty holiday foods.

• Save some for later. Don’t be afraid to store away or freeze holiday candies or other sweets for later in the year. This will help reduce the risk of overeating and provide a special surprise months later, extending the good feeling of the holiday season.

• Don’t forget the “Big Five!” Make the commitment to include at least five fruits and/or vegetables a day. We are blessed in this area to have an ample selection of colorful, healthy foods that will complement the wonderful colors of the season.

Children 8 years or older may use a vehicle seat belt if it fits properly with the lap belt low on the hips, touching the upper thighs, and the shoulder belt crossing the center of the chest. If children are not tall enough for proper belt fit, they must ride in a booster or car seat. The new law imposes fines and penalties for violations.

California joins more than 37 other states with strict booster seat laws. The law mirrors the recommendations of the American Academy of Pediatrics and the National Highway Traffic Safety Administration, among other agencies.  Car crashes are the leading cause of death for children ages 4-12 and one of the leading causes of injury and disability. For your and your family’s safety, please remember to have everyone buckle up!

For car seat guidelines from the American Academy of Pediatrics, please click here: http://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

For more information, please contact a certified child passenger safety technician in CHOC’s Community Education Department, by calling 714-532-8887. A free child passenger safety class and a low cost car seat program (in English and Spanish) is available.