Vitamin D–Is Your Child Getting Enough?

March is National Nutrition Month, so it seems appropriate to share new recommendations about vitamin D from the American Academy of Pediatrics (AAP).  This new advice, which was presented in the November 2008 issue of  Pediatrics, changes the way we think about vitamin D.

Long known to prevent rickets (weakened bones caused by vitamin D deficiency), research now suggests that vitamin D is also related to healthy immune system function and to prevention of diseases such as certain cancers and diabetes.  Unfortunately, rickets–an entirely preventable condition for most people–is still being reported in the US, even in teens.  While several factors contribute to vitamin D deficiency, our fear of skin cancer could play the biggest role.  

Heeding warnings about the link between sun exposure and skin cancer, conscientious parents now prepare for outdoor events by slathering their kids in sunscreen, perching hats on their heads, and confining them to the shade.   Vitamin D isn’t found in many unfortified foods, but our bodies can make it from sunshine.  Therefore, cloistering ourselves from the sun makes it harder for us to get adequate amounts without using supplements. 

In fact, this lifestyle change can even affect children before they’re born, because the fetal vitamin D level is related to the mother’s.  Therefore, newborns may be at greater risk for deficiency than we thought.  Finally, as kids get older, they tend to eat less of vitamin D-fortified foods, so even teens are at risk for low levels–especially if they don’t get enough sunlight. 

The AAP has recommended vitamin D supplements for several years now, but the original recommendation was 200 IU/day to all breastfed infants within the first 2 months of life.  The new guidelines increase the recommended amount, begin supplements earlier in life, and address the dietary needs of older children as well.  Here are the recommendations in a nutshell:

1. Breastfed infants:  The AAP now recommends that infants who are exclusively or partially breastfed be supplemented with 400 IU/day of vitamin D beginning in the first few days of life.  The supplement should continue unless the baby is weaned to at least 1 quart per day of either vitamin D-fortified formula or fortified whole milk.  Check with your doctor for recommendations if you are concerned about your child’s fat intake.
2. Nonbreastfed infants and older children:  Any child drinking less than 1 quart per day of vitamin D-fortified formula or fortified milk should take a supplement of 400 IU/day.
3. Teens:  Teens who do not get 400 IU of vitamin D per day through fortified milk or foods should take the supplement as well.

Remember, vitamin D defiency is entirely preventable for most people, and with new evidence that vitamin D may prevent other serious health conditions, it’s important that all parents be aware of the new guidelines.   Be sure to work with your child’s doctor to determine the proper supplement amount, since some medical conditions may require different treatment.  Also ask your doctor for directions on proper administration of any supplement, to avoid a potentially dangerous overdose.   Here are a few handy links–

If you’d like to read the AAP article, you can find it here:   Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents

For more information about National Nutrition Month and other nutrition issues, check out the American Dietetic Association web site .

For more information about Vitamin D intake for all ages as well as good sources of dietary Vitamin D, check out the National Institute of Health Dietary Supplement Fact Sheet .

Mom, don’t leave!

It’s great to be loved, but sometimes you can get too much of a good thing.  If your child has separation anxiety, then you might consider it a luxury just to go to the bathroom by yourself.

Most kids go through bouts of separation anxiety–in fact, it’s a perfectly normal part of development for young children.  It’s only when the anxiety is severe, or when it persists in older children, that there’s reason for concern. 

When our kids are upset, our first instinct is to make them feel better.  Forcing a panicky, crying child to face his fears feels cold-hearted at best.  Unfortunately, letting the child avoid the safe-but-scary things in life only deprives him of an opportunity to overcome those fears.  In many cases of separation anxiety, well-meaning parents accidentally create a fear cycle that’s hard to break.  You should consider talking to a professional if you notice any of the following:

1. Your child won’t go to bed.  If your child cannot sleep alone or refuses to sleep in his own room, separation anxiety may be the culprit.  Unless your family is planning long-term co-sleeping, you need to teach your child to sleep independently.
2. Your child won’t go to school.  Morning jitters are common, but if you’re leaving your child crying at her desk every day, or worse–if you have to pick up your child because the crying won’t stop–then you need to address the problem.
3. Your child won’t play with friends.  Again, all kids experience occasional nervousness when going to a friend’s house, especially overnight.  But when older kids persistently avoid play dates or sleep-overs, separation anxiety can significantly disrupt friendships.

If you think your child’s separation fears are beyond normal levels, it’s best to intervene sooner rather than later.  Separation anxiety is much harder to treat the longer it goes on. 

Start by talking with your child’s doctor, or a mental health professional trained in working with childhood anxiety.  Left untreated, separation anxiety disrupts a child’s development.  The good news is, treatment can help your child to say good-bye without so much as a backward glance.

How To Lobby For Your Child Without Losing Your Head

A friend of mine recently complained to me about the trouble she’s having getting special education services for her child.  Now, this friend holds a master’s degree in an education-related field.  She is actively involved in her child’s education.  She is a patient but persistent advocate.  She has attended many meetings with many people to address her child’s well-documented needs. 

Despite these advantages, she encountered numerous roadblocks — many of them violations of the standard procedures in her child’s school.  But because she was unfamiliar with those procedures, she doubted her instinct that something was wrong.  

Unfortunately, this isn’t the first time I’ve heard this complaint.  Since we don’t live near each other, I couldn’t simply rattle off the name of a local school expert my friend could call for advice.  So, I started thinking about what other parents in her situation need to know.  

Facing a group of teachers, counselors, and principals in a special education meeting is intimidating.  Most parents consider this a panel of experts, so they don’t feel comfortable questioning the panel’s decisions.  What’s more, special education laws are extremely complicated, so even when school officials are doing their absolute best to follow guidelines (and they usually are!), they can stumble without knowing it.  

Remember, educating a child is a collaborative effort.  If you disagree with decisions about your child’s services, don’t attack.  Instead, prepare yourself to get the most out of those meetings.  Here are several web sites that can help:

1. ldonline.org  This site contains a wealth of information about learning disabilities, strategies to help students with disabilities, and laws protecting those students’ rights.
2. bridges4kids.org  While this site is designed for the Michigan school system, it provides general information about learning disabilities and special education law.  It also contains links for each state, so you can still find information relevant to your area.
3. nagc.org  The National Association for Gifted Children reminds us that academically gifted children have specialized needs — and are covered by laws to meet those needs — just as children with learning problems.  Their site provides information about gifted learners and how to advocate for these students. 

While advocating for your child can be stressful, it’s easier when you know what you’re doing.  In addition to these web sites, remember that your state’s own Department of Public Instruction site is likely to have information about special education policies, procedures, and people to contact.  By educating yourself about your state’s identification guidelines and your legal rights, you’ll know what questions to ask — and what to do if you disagree with the answers.

How To Be A Perfect Parent

I’ve been cleaning my house for over an hour, but the more I clean, the more I find to do.  Such is the life of a perfectionist. 

Now, contrary to what you might think, I don’t have an orderly household.  If anything, my perfectionism derails me to the point that I can’t get anything done.  After all, why start something when you already know you won’t be satisfied with the result?

So what does this have to do with parenting?  A lot, actually.  Perfectionism blocks spontaneity and increases family stress.  No matter what you try to do for your family, that nagging voice in your head keeps reminding you of all the things you still haven’t finished.    

Perfectionism seeps into everything you do; fighting it is a never-ending battle.  While you may never beat perfectionism, there are plenty of strategies to keep it under control.  Of course, the perfectionist in me wants to give you a complete list, but for now, I’m forcing myself to stick to just a few.

1. Let your kids do their own work.  I know it’s hard to let your child clean up when he dawdles, puts toys in the wrong basket, leaves wrinkles in the bedspread, or whatever.   But allowing your child to discover his own skills is a gift.  If he’s tried his best, don’t ruin it by “helping” him straighten the covers on the bed.  If you do, he learns that his best work isn’t good enough.  
2. Forgive yourself.  It’s impossible to do everything at once, so accept that fact.  Don’t procrastinate household jobs because you’re waiting for a time that you’ll be able to finish them all.  That time will not come.  Instead, do what you can, when you can — and then do it again tomorrow.  Berating yourself won’t help you accomplish your goals.  Only steady work can do that.
3. Get some tech support.  Until I found Marla Cilley’s web site, FlyLady.net, I never considered how much my perfectionism interfered with my success. The ideas I’m sharing today are Marla’s, and I thank her for them.  I also recommend her book, Sink Reflections.  It’s a must-have for overwhelmed perfectionists. 

It’s natural to want only the best for your family.  But if that desire is rooted in perfectionism, it can make the whole family miserable.  The perfect parent is not the one without flaws; that parent doesn’t exist.  The perfect parent is the one who can accept imperfection with grace and dignity.

Is Your Toddler Eating Enough?

How can toddlers move so much yet eat so little?  These tiny packages of human dynamite speed through everything — the living room, the back yard, and yes, meals.  You spend five minutes wrestling them to the table, and in thirty seconds flat, they’ve gobbled a few bites and climbed back down. 

Many parents worry that their young children don’t eat enough.  You may recall the baby books saying that an infant’s stomach is only the size of his tiny fist.  Well, toddlers (ages 2 and 3) aren’t much different.  It doesn’t take much to fill them up, so you have to make the most of what goes in their mouths.  Here’s how:

1. Nix the juice.  Little kids can slurp away incredible amounts of juice or milk.  Unfortunately, these drinks fill them with sugar, so when meal time comes, they aren’t hungry.  If your child is thirsty, substitute water for some of those other drinks.
2. Feed little, feed often.  Little kids still have little bellies, so watch how much you put on the plate.  They don’t need huge servings to feel full, but they burn those calories fast.  They may need a couple of snacks each day to keep them going.  Use those snacks to squeeze in a few more healthy calories. 
3. Take the long view.  Toddlers often get stuck on a food — say, bananas every day for a week.  These food fetishes aren’t unusual, so at this age, consider the nutrients your child consumes over several days, not several hours.  Continue offering healthy variety, but don’t worry too much about serving the same thing several times in a row. 

Feeding kids can be a challenge, especially when they’re too busy to bother with a meal.  If your toddler is growing well and eating a nice variety of foods over time, you probably don’t need to worry.  If you’re still concerned, phone your pediatrician for advice.  For more information about your child’s dietary needs, check out this link from the American Academy of Pediatrics:

http://www.aap.org/healthychildren/08fall/whattoeat.pdf

Happy eating!

Sleepy?

You might be, but chances are your preschooler is not! 

Even if your child has always been a great napper, you can expect some changes in the preschool years.  Somewhere between the ages of 3 and 5, most kids give up napping.  Compared to toddlers, who typically need about 12 to 14 hours of sleep in a 24 hour period, kids this age only need about 11 to 13 hours.   

Unfortunately, the transition can be tough.  Many kids this age aren’t quite ready to go all day without a rest, so by late afternoon, they’re cranky.  On the other hand, if they sleep during the day, they toss and turn at bedtime. 

It’s often just as hard for parents to make the switch.  If you’ve relished this luxurious daily quiet time, you may be tempted to force the nap.  It probably won’t work.  After all, your child’s body may be telling him he doesn’t need to sleep. 

Consider how much your child sleeps at night.  For example, if he’s already sleeping a solid 11 hours, it may be time to honor his no-nap wish.   If so, try these tips to handle the transition.

1.  Shorten the nap.  Reduce nap time in 15 or 20 minute increments over a few weeks.  A gradual adjustment may prevent your child being so sleepy and irritable in the early evenings. 

2. Go to bed early.  Similarly, you can send your child to bed 15 or 20 minutes earlier at night during the transition period.  If he starts waking too early in the morning, you can shift bedtime back to where it was.

3. Require a rest period.  Even if your preschooler isn’t sleepy, it’s OK to enforce 30 minutes to an hour of quiet time.  He can look at books or draw quietly in his bed.  This may help recharge his battery (and yours) without disrupting his nighttime sleep.  If he falls asleep anyway, keep the nap short so he can still sleep well at night.

Most parents relish nap time as a brief respite from the harried world of parenting , but eventually, the daily doze must go.  Although it can be just as hard for a parent to give up the nap as it is for the child, eventually you’ll both adjust.  And the bonus?  You’ll be surprised how much more freedom you have when your child can hang with you all day.

Best Behavior Books

Allie raced to the bookstore the minute she saw the plus sign on her home pregnancy test.  Eager to be the perfectly prepared mom, she carefully searched the store shelves, poring over countless how-to-have-a-baby books.  When she finally approached the checkout counter, her arms were so laden with books that she waddled like a woman seven months pregnant, not seven weeks.  For the rest of the pregnancy, Allie studied those books as if preparing for a final exam. 

 

When daughter Grace was born, Allie still relied on those books, tracking Grace’s development with the charts dog-eared at the back of her favorite reference.  By the time Grace was potty trained, Allie was no longer a nervous newbie.  She relaxed a bit, living parenthood rather than reading about it.  Caught up in laundry, playing, and bed-time stories, she stopped referring to books.  But when Grace entered preschool at age three, Allie found herself in new territory.  Grace had grown her own little personality, refusing to eat vegetables, taunting the dog, running amok at bedtime.  No longer the doe-eyed baby eager to please Mommy, Grace experimented with quirky or downright defiant behaviors.  These new challenges surprised Allie, who had been winging it pretty well.  

 

Like Allie, many parents expect pregnancy, delivery, and infant care to be the hardest parts of parenting.  Relieved to be done with diapers and sleepless nights, they are surprised to find that an older child’s independence can make their job harder rather than easier.  Fortunately, there are great books out there to help you with the rest of parenting–from diapers to college.  Here are three classics:

 

1. Good Behavior, by Stephen W. Garber, Marianne Daniels Garber, and Robyn Freedman Spizman.  A must-have, especially for parents of younger children.  These authors start with a simple explanation of basic behavioral principles, then launch into over 400 pages of solutions for a huge assortment of childhood problems.  Have a picky eater?  Check page 261.  Preschooler refusing to go to bed?  Page 83.  Nose picking?  Yep, it’s there, too, on page 399.  The advice is short and action-packed—no psychobabble here.  This book is a quick reference for handling all manner of little-kid weirdness.
2. How to Talk So Kids Will Listen, and Listen So Kids Will Talk, by Adele Faber and Elaine Mazlish.  A classic among child mental health professionals for years.  Don’t let the copyright date fool you.  Although it may appear a little dated, this gem delivers some of the best communication tips you will find.  Because it teaches you how to improve family communication patterns rather than solving small problems, this book does require some commitment.  You have to read the whole thing and stick with the method, but your reward just might be a closer relationship with your child. 
3. Assertive Discipline, by Lee Canter with Marlene Canter.  For clear, step-by-step instructions on overall discipline, this book is hard to beat.  Again, this one requires a bigger commitment to change the family, but the authors break down the method into short, easy-to-digest chapters.  The clear examples and no-nonsense approach help you stay in command of your kids without a lot of browbeating or punishment. 

As Allie learned, even experienced parents need some help tackling new developmental territory.  While the old joke is true—kids don’t come with instruction manuals—today’s three books come pretty close.  Good luck troubleshooting.

Resolve to Reconnect: Resolutions for the Family

A new year is coming and you’re determined that this year, things will be different.  You promise to lose weight, to save more for the college fund, to stop yelling at the kids so much.  While we usually just think of improving ourselves, the new year is also a perfect time for the family to start over, pulling back together after the hectic holidays.  This year, don’t just resolve to trim your waistline or your budget–reconnect to your loved ones, too.  Here’s how:

1.  Don’t over-schedule.  Before you add new habits, take a look at your old ones.  Too many commitments run the family ragged.  Don’t take on anything new until you review your current obligations.  Decide what’s important, then let go of the rest.  Next, make a plan to avoid over-scheduling this year.  Try to anticipate which sports, lessons, or church activities you will want to do later in the year.  This way, you won’t accidentally agree to something now that will overload you in October.
2.  Eat together.  Have meals together several nights a week, preferably about the same time each night.  Mealtime should be family time.  That means no television, no newspapers, no telephone.  It also means no nit-picking.  Don’t nag the kids about science projects or half-cleaned rooms.  Stick to fun, interesting topics, or just absorb the minutiae of your child’s day. 
3. Exercise together.  You don’t have to run marathons.  Just get outside with the kids a few times a week.  Walk around the block, toss a ball in the yard…whatever your kids enjoy.  A little bit of sunlight builds vitamin D, while the physical activity helps keep us healthy.  Exercise also boosts our bodies’ natural “feel-good” endorphins–neurotransmitters that give us a sense of calm and well-being.  Even a few minutes exercising can drain the day’s tension, improving everyone’s mood.
4. Go to sleep.  What child can sleep with all those sugarplums dancing in her head?  After the holiday chaos, a regular sleep schedule helps the kids catch up on those lost Zs and helps you recover from your mall marathons.  Plus, if everyone gets enough sleep, there will be fewer morning battles, less afternoon irritability, and more family harmony. 
5. Take a meeting.  In addition to lifestyle changes, improving your communication also strengthens family bonds.  Plan regular, brief sessions to review any disagreements.  Take turns, be nice, and look for solutions.  Don’t criticize or brow-beat.  Listen to and acknowledge feelings, but don’t wallow in whining.  Save a few minutes to check everyone’s schedule for upcoming events and plan accordingly. 

Now, how hard was that?  Making (and keeping) a few simple resolutions for the family will pull you closer together throughout the year.  Now if only losing weight were that easy….

 

 

 

Talking the Talk

One of the most important tasks your child learns is how to use language.  Yet language development is so different from one child to the next, it’s often hard to tell if quirky speech is just that—a quirk—or if it represents a bigger problem. 

 

Speech/language problems range from simple mispronunciations to severe problems forming logical sentences or understanding what others are saying.  Delayed communication skills can also be a symptom of other childhood disorders, such as autism, hearing problems, or intellectual delays.  These websites will teach you more about communication milestones and how to find help if you think your child has a delay.

 

 childdevelopmentinfo.com.  This site, for Dr. Robert Myers’ Child Development Institute in California, provides a wealth of information on a number of child development topics.  You can research speech/language development by age, but you can also look at many other areas of development that may concern you.  Dr. Myers’ site also contains general parenting articles, as well as information about common childhood mental health issues and learning challenges.  He includes an extensive resource list for parents, along with up-to-date links about current research in child psychology.

  

asha.org.  The site for the American Speech-Language-Hearing Association teaches visitors about communication milestones, and it covers a broader variety of communication issues, such as concerns for bi-lingual families or disorders often associated with speech-language problems.  The site explains how to find a professional to assess your child, including information about insurance benefits or other treatment funding sources.  Finally, this site also includes helpful information about school law for children with identified disabilities, so you can be prepared to work with your child’s teachers.

 

speechdelay.com.  Jennifer Fusco is a licensed speech-language pathologist in Ohio; her website helps parents review communication milestones, understand what is “normal” speech, and learn what to expect from your child’s evaluation.  On her list of developmental milestones, she includes tips for talking with children at each stage of development.  In addition to general tips for each age group, she also gives more detailed advice for specific communication problems.  She has a nice collection of links under a variety of categories to help you learn more about related topics.  Finally, this site provides a discussion forum where visitors can consult other parents for support or advice. 

  

Of course, you should check with your child’s medical provider if you have questions about his speech or language development.  While you’re waiting for that appointment with the doctor, check out these sites to gather more information.  Don’t delay if you have concerns; many school systems provide speech evaluations and therapy for children as young as age three. 

 

Since untreated communication disorders can affect both a child’s social functioning and learning, it is important to trust your gut if you’re worried.  A trained professional can help you figure out the difference between normal variations in language development and a problem that requires treatment.  If your child does have a communication disorder, early treatment can improve the chances of a smooth transition to Kindergarten and future academic success. 

Why Preventive Parenting?

Parenting is tough work.  To be good at it, you have to balance two opposing philosophies:  (1) don’t sweat the small stuff, and (2) nip it in the bud.  Unfortunately, it’s often hard to tell which philosophy to use in the moment.  

Preventive Parenting teaches parents when to let go and when to intervene.  This column will show you how to recognize ”normal” childhood behaviors, how to handle common parenting dilemmas, and how to identify the early signs of childhood disorders. 

Preventive Parenting is about keeping families healthy, both mentally and physically.  Preventive Parenting is also a philosphy in itself:  just as we brush our teeth and eat our vegetables to keep our bodies healthy, we should parent with an eye toward long-term behavioral and  emotional well-being. 

Since mental health can affect physical health, Preventive Parenting is an essential component in a healthy lifestyle.  By learning about your child’s developmental needs, how to meet those needs, and when to seek help, you can improve the health of your entire family.