6 Ways to Keep Your Kids Safe from the Flu

Flu season is here. We spoke to Dr. Katherine Williamson, a CHOC Children’s pediatrician, about how to keep your kids safe from the flu.

Dr. Katherine Williamson
Dr. Katherine Williamson, a CHOC Children’s pediatrician

#1 Get the flu shot

Make sure that each member of your family gets the flu shot every year. The Centers for Disease Control recommends annual influenza vaccinations for everyone age 6 months and older. Vaccinations are especially important for those at increased risk for flu complications, including pregnant women. Encourage family members and caregivers around your child to get the flu shot. Of the more than 170 pediatric deaths from the flu during the 2017-2018 influenza season, 80 percent of those did not receive a flu shot.

#2 Practice proper hand washing

Remind your child that we always wash our hands for at least 15 seconds (always with soap, and always with vigorous rubbing) after using the restroom, before and after eating, after playing outside, and after sneezing, coughing or touching your face. Aside from getting the flu shot every year, proper hand washing is the best way to prevent the spread of illnesses including the flu.

#3 Stay away from people who have a fever

Ask friends, family, or caregivers who have had a fever or chills within the past 24 hours to stay away from your child. Do not send your child to school or daycare for at least 24 hours after they experience a fever or chills.

#4 Teach proper cough etiquette

Teach your child to cover his nose and mouth when he coughs. Parents should model good behavior.

#5 The importance of sleep

Sleep! The best immune system boost you can give your child is good sleep at any age. The right amount of sleep for your child is however much sleep he/she needs when he/she can wake up naturally without an alarm clock or mommy clock waking them up. For some kids this is 8 hours, while other need more than 10.

#6 Healthy eating

Healthy vegetables, fruit, and protein. You are what you eat! Eating processed sugar-filled foods can decrease your immunity by inhibiting your body to fight against diseases. Offer your kids healthy foods without the option of choosing the less healthy snack. They will eat when they are hungry, and when they are hungry, make sure it is healthy options that are available.

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How to Help Your Child Navigate the Emotional Aftermath of a Traumatic Event

By Dr. Sheila Modir, pediatric psychology post-doctoral fellow at CHOC Children’s

It’s difficult for adults to make sense of a tragedy, so consider how difficult it can be for children. To help parents support their children as they navigate trauma either in their own lives or process a tragic event they see on the news, consider the five E’s of helping a child navigate the emotional aftermath of a traumatic event: 

  • Explore what your child already knows in a gentle and calm manner. You can start with a neutral question inquiring about how their school day was or if anything happened while they were at school.
  • Explain what has happened in a way that your child can understand based on his/her age.
    • This is the time to address any misinformation your child might have picked up at school and help them understand that a scary thing did happen, but also reassure their sense of safety as schools and adults work hard to keep their children safe on daily basis.
    • Limit information that you provide to your child to the questions that they ask you, so that you avoid overwhelming them with information that they may not already have been exposed to.
    • You can provide examples of ways you and others in your community keep your child safe every day (i.e., how when you drop them off at school in the morning and you look both ways before crossing the road, how doctors are working hard to help the children that have been hurt).
  • Express to your child that feelings are normal and it is okay to feel sad, mad or angry when a tragic event occurs. Remember to reduce media exposure after a traumatic event, as repeated exposure to the event has been associated with psychological distress and intensifying already heightened emotions.
  • Emotionally model for your child healthy expression of feelings as children take their cues from their parents. Describe how you cope with your distressing emotions to your child (i.e., When I feel scared when something bad happens to me, I talk about it with someone who makes me feel safe or I take three deep breaths).
  • Ensure stability by continuing to adhere to your child’s daily routine. This will provide them with a sense of reassurance and safety during a chaotic time. Engaging in a daily routine is not meant to ignore what has happened, rather to continue to provide the child with structure, stability, and predictability.

If you are struggling to help your child process a traumatic event, or if you feel your child could benefit from additional support, ask your pediatrician for a referral to a pediatric psychologist or psychiatrist.

Below are a few additional resources on coping with trauma that I often share with my patients and their families:

Helping Children Survive the Aftermath– Florida International University

Mobile App: PTSD Family Coach– U.S. Department of Veterans Affairs

Responding to a School Crisis– The National Child Traumatic Stress Network

Resources for Parents and Caregivers– The National Child Traumatic Stress Network

Helping Traumatized Children: A Brief Overview for Caregivers– Child Trauma Academy

Tragic Events: Parent Resources – The Fred Rogers Company

Learn more about mental health services at CHOC

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The Latest Guidelines for Introducing Solids to Babies

Many parents are familiar with this scene: It’s dinner time, and your baby is eyeing every bite of food you put in your mouth. Is it time for baby to try solid foods?

Solid foods can be introduced as early as six months of age, according to guidelines from the American Academy of Pediatrics and the World Health Organization. That’s when a baby’s digestive system is developmentally ready for food. Prior guidelines recommended starting solids at four months, but research has shown that introducing solid foods earlier could increase the chances of developing diabetes, obesity, allergies and eczema, according to Vanessa Chrisman, a pediatric dietitian at CHOC Children’s.

Age is not the only requirement for solid foods. A baby should also show the following signs of readiness: they can hold their head up, they can sit up without support, they can close their mouth around a spoon, and they no longer reflexively push things out of their mouth with their tongue.

“If a baby spits the food back out with her tongue every time a parent offers food, she’s probably not ready for solids yet,” says Chrisman.

At first, solid foods are more for practice and exposure to new flavors and textures, rather than for nutrition. A baby’s main source of nutrition will continue to be breast milk or formula up until one year of age. As a baby eats larger amounts of solid food and approaches the one year mark, they may begin to drink less breast milk or formula.

Introducing Solids to Babies

Solid foods are traditionally introduced in puree form. Single foods are blended to a smooth consistency and fed by spoon. As a baby eats larger volumes and tries more foods, parents can move on to a thicker texture: mashed foods. At around nine or 10 months old, a baby may start eating finger foods in small pieces.

Baby Led What?

Another method of introducing solid foods to babies is called baby-led weaning (BLW). This method has been popularized in the United Kingdom over the last decade and is starting to gain popularity in the United States.

“Baby-led weaning is a way of introducing solid foods beginning with whole but manageable pieces, and skipping purees and mashed foods,” Chrisman says.

Babies are offered foods that the rest of the family is eating, except for choking hazards such as whole grapes, hot dogs, raw carrots, popcorn, nuts, raisins and very tough meat. Parents can cook and spice the food as they normally would for themselves.

BLW teaches baby to feed themselves, helps them develop motor skills and gives them control over how much food they want and if they want it. “If they’re the ones deciding when to stop eating, it can help them regular their appetite later,” Chrisman says.

A recent study by the AAP determined that babies are not at a higher risk of choking from BLW than they are with traditional purees. Regardless of the food method, it’s always a good idea for parents to know infant CPR, Chrisman says.

As with puree-fed babies, BLW babies must meet the same signs of developmental readiness before starting solid foods. One thing a baby doesn’t need, though, is teeth. “Babies have strong gums that can soften food, along with their saliva,” says Chrisman.

Chrisman recommends that parents choose the method that fits their baby’s personality. An independent baby may take to BLW more than a baby who prefers to be spoon-fed. The key to remember is that every baby is different: “What might work for your friend’s baby might not work for your baby,” Chrisman says.

Straight from a Pediatric Dietitian

Chrisman offers these expert tips to parents as they introduce baby to solid foods:

  • Introduce simple foods one at a time, such as individual fruits, vegetables and proteins. Wait at least three to four days before introducing another food, to watch for adverse reactions. “Don’t go too fast, too soon,” Chrisman says. “Your baby has their whole life to eat all these foods.”
  • As solid foods are introduced, give baby a variety, which will help ensure they will like a variety of foods later in life.
  • Don’t add salt or sugar to baby’s foods. Not only could this cause baby to develop a taste for these strong flavors, it also prevents baby from experiencing the true flavor of a food.
  • Model healthy eating habits. Include a variety of healthy foods on your own plate so baby will learn to imitate your behavior. Encourage your family to sit at the table together and put away distractions so baby understands what meal times should be like.
  • “Make sure feeding time is a relaxing time, not stressful,” Chrisman says. Don’t force baby to eat more than they want and pay attention to their signals. If they are throwing food off their tray, pushing food away or turning their head away, they are done.
  • Feed baby solid foods in between their regular mealtimes, when they’re only somewhat hungry. A hungry baby won’t have the patience for solid foods to reach their tummy.
  • Avoid honey for babies under age one. Honey can carry spores that cause botulism, which is dangerous for infants.
  • Avoid fruit juice before age one. A recent change in AAP policy says fruit juice should not be given unless a doctor recommends juice to manage constipation. The high sugar content in juice may increase a child’s risk of obesity and teeth problems.
  • Avoid cow’s milk before age one. Cow’s milk should not be given on its own, according to the AAP, though it may be fed in other foods, such as whole fat yogurt.
  • Don’t give up on foods that baby rejects a few times. It could take up to 15 times of trying a food before they like it.
  • If baby isn’t eating any solids or purees by 10 months of age, talk to your pediatrician. There could be a feeding issue that needs extra help. Some babies may have an oral aversion to foods, oral motor dysfunction, textures issues and/or poor muscle tone.

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