Let's eat.

With the holidays approaching, I wonder how many of us are engaging in food, fun, and family the traditional way - sitting together around the table.

Anymore it seems that families and their overstuffed schedules are running in fifty different directions from the time the bell rings to the time everyone falls into their beds way past bedtime. So how are we making time to actually sit and eat together? 

According to a spokesperson for the American Dietetic Association, "families who eat together have healthier, more balanced diets. Making family mealtime a priority not only improves everyone's physical health, but it also contributes to their overall well-being and mental health."

One thing about eating together that appeals to me is that it allows me to control what my son is putting in his mouth. When he is elsewhere, I never know what he is receiving in terms of food and nutrition. And as he gets older and spends more time away from home (boo-hoo), I know that this will be an even greater struggle.

Additionally, eating together as a family allows parents to establish hopeful habits for their children. One day my son might go off to college thus taking a sabbatical from home-cooked meals for weeks or even a month at a time (say it ain't so). But I will have some peace in knowing that five years at college surely can't negate my eighteen years of meal-together rituals established here in my home.

Furthermore, my husband was raised in a small town miles away from a restaurant of any sort. Nearly every evening meal that he consumed was prepared in his mother's kitchen and delivered to the family at the dining room table. Now my husband might be a rare breed, but because of this delicious upbringing, my husband can cook a serious meal - breakfast, lunch, dinner - you name it, he can cook it. What joy that brings me my family!

Additionally, mealtime is a perfect lab setting for learning socialization skills and manners. The dinner table is a wonderful place for children to practice how we want them to behave in public. Though mealtime can and should be enjoyable, there is no harm in learning how to keep our napkin on our lap or how to ask, "can you please pass the salt?"

Finally, eating together establishes ritual and tradition. I take great comfort in knowing that, no matter what happens during the day, my family will be together for dinner. Growing up, I always sat in the same seat on the same side of the table during our meals together, and it would not have felt the same had my father, for instance, taken a different chair at the table one evening. To me, our everyone-has-an-assigned-seat was like a security blanket.

In fact, a 2004 Archives of Pediatric and Adolescent Medicine study found that families who regularly eat together are closer than those who eat separately. When we sit down with our children we create an environment conducive to communication. Mealtime is a great opportunity to actually talk with our kids rather than simply mentioning something in passing as we often do when we are scurrying off to the next event. Also, dinnertime occurs at the end of the day, which means that by then, we all have some catching up to do.

As we approach the holidays, it would do us all good to break-in the dining room table before our company arrives. Nothing fancy, nothing formal - just family, food, and memories.

To read more about the wonders of mealtime, visit this article.

Candy, Consumption, & Cavities

If you still have Halloween candy lingering around your house, you might want to consider ridding of it, and quick. 

According to a CNN.com/health article, the fewer episodes of candy eating, the better. The author states, "although some parents may be tempted to space out the amount of candy their children consume after Halloween, dentists have advice to the contrary: When it comes to teeth, it's better to eat a whole lot of candy at once than to space out candy consumption over time." Repeated consumption leads to cavities thus it's better to eat a bunch of candy and then brush your teeth rather than spreading that candy out over time.

So if you must, spend the rest of the day gorging on leftover Halloween candy. Do what you can to limit your child's exposure to the cavity-producing substance over time, and insist that your children brush their teeth after any candy consumption from this point forward. 

And really, did you need another reason to be the one to finish off the last few Snickers?

Drive through flu shots

Often I roll my eyes at our culture's demand for convenience. I could literally spend the entire day in my car - not getting out once - and still accomplish A LOT. A productive yet staionary day could look like this: drive through for coffee, drive through the bank, drive through the pharmacy, drive through for lunch, drive through the dry cleaners, drive through for a daiquiri (only in Louisiana), drive through the library book drop-off, and pick up dinner curb-side. Whether it's our increasing "drive" for cramming more into our already over-scheduled day or just sheer laziness, America has found a way to make almost everything quicker and more convenient.

And in an effort to stay active and have real interactions with human beings, I try and avoid the drive-through whenever I can (but it's so darn easy to simply drive through when I need a diet coke). 

But there is a drive-through initiative that I can support: drive through flu shots! That is one cause that really is better when made easier!

Face it, no one wants to get their flu shot. Sure they want to be healthy and stay healthy, but a needle in the arm? No thanks. So in an effort to make this less-than-desirable task easier, many groups have worked towards making this less of a hassle and more of a convenience.

Most of us have been to the grocery store when it's announced that flu shots are available near the pharmacy, but now there isn't even a need to get out of your car!  

I first heard about this in my own community. Our county's health board is offering flu shots for a minimal fee at a nearby park. All they ask is that you wear short-sleeves so that your shot can be administered with your window rolled down as you remain seated in your car. Can you believe this? 

I then googled "drive through flu shots," and found that this is a nationwide trend. "Clinics" are popping up all around the country. Many of these clinics offer free shots to individuals on Medicare and Medicaid stating that no one will be turned away for the inability to pay. Wow - how awesome. Efficient and cost-effective! 

If you are interested in driving through for your flu shot, I encourage you to google "drive through flu shots" and the name of your city. 

Because I would feel guilty if I wasn't completely honest, I must admit that I never get a flu shot. I might get a cold a couple of times a year, but that's about it. I have my reasons for not getting the shot, but I'm not a physician, so this certainly isn't my recommendation. According to the Center for Disease Control and Prevention, it is recommend that most people get a flu shot, especially people over 50, children ages 6 months and older, and women who are pregnant. For a complete list of Who Should Get Vaccinated and Who Should Not Be Vaccinated, check out the CDC's website. 

I should also note that there is now a nasal-spray flu vaccine available and is approved for use in healthy people 2-49 years of age who are not pregnant. To my knowledge, FluMist is not available at drive-through clinics, and usually FluMist is only offered per request at your doctor's office.

Vitamin D & Kids

A recent report released by the American Academy of Pediatrics recommends doubling the amount of vitamin D consumption for infants, children and adolescents. It recommends that all children receive 400 IU of vitamin D a day. 

According to the AAP's website: "adequate vitamin D throughout childhood may reduce the risk of osteoporosis. In adults, new evidence suggests that vitamin D plays a role in the immune system and may help prevent infections, autoimmune diseases, cancer and diabetes." Additionally, it is recommended that children receive daily supplements of vitamin D as most children do not get enough vitamin D through diet alone.

Cold meds update

Less than a week after the FDA reported that they saw little evidence that over-the-counter cold medications work in children under 6-years-old (but fearing that parents would give kids adult medicines if the products were taken off store shelves), drug companies conceded that children under four should not be given over-the-counter cough and cold remedies. Pediatricians have asked that the drug companies take this one step further by ceasing all marketing of these medications to children under six.

According to an article Tuesday in the AP, drug companies stated that this warning, along with a warning to parents to not give children antihistamines to make them sleepy, will appear on the medications' labels this cold season.

The AP article offered these additional tips for giving cough and cold medicine to children (source: Consumer Healthcare Products Association):

Parents should never:

• Give adult medicines to a child.
• Give two or more medicines with the same ingredients at the same time.
• Give antihistamines to make a child sleepy.

Parents should:

• Give the exact recommended dose, using the measuring device that comes with the medicine.
• Keep OTC medicines out of sight and out of reach.
• Consult their doctor if they have any questions.

Child Health Day

Today is the 80th annual Child Health Day, a health awareness day initiated by the Health Resources & Services Administration, an agency of the U.S. Department of Health & Human Services. Child Health Day's tagline is Eat Healthy & Be Active for a Healthy Future. 

As part of the initiative, the surgeon general asks everyone to take this pledge because "a healthy future is our gift to our children":

I pledge to:

Be a role model by making healthy choices for myself.
Help children be physically active through everyday play and participation in sports.
Support children's healthy eating habits.

The initiative cites that 1 in 6 U.S. children between 2 and 19 is overweight (that is roughly 12.5 million children or 17 percent). Overweight children are at greater risk for many serious health problems including asthma, diabetes, and heart disease. 

The Child Health Day website is packed with resources, information, and relevant links. I am especially fond of the site's resources pertaining to community involvement. Too many times people turn a blind eye to issues related to children because they do not have children of their own (I have heard, all too often, individuals in my community say, "I'm not voting in favor of that school levy because I don't have any children"). But I believe that we should all be invested in the next generation regardless.

Here are a few of my favorite community involvement suggestions:

• Increase the "Walkability" of your community. I live in a community full of bike paths, parks, and green space (roughly one acre of park space for every 40 residents). In addition to backyards and sidewalks, there is a bounty of run-around space.
• Increase the number of places people can get healthy food they can afford. I love this idea but I know how difficult it is. Fast-food is convenient and cheap, but it often lacks nutrition. One idea is to host a farmer's market in your community. I think every community should have a farmer's market. My community does not offer a farmer's market, and I think that is ridiculously unbalanced considering my community is resourceful, loaded with "green space," and surrounded by farm land. But don't worry, I have contacted my city's community services department regarding my concern and disappointment.
  
• Build and keep up community recreation areas. My community has a beautiful recreation facility, and I am grateful to its investors for the development and maintenance of the facility. A rec facility is one of the best investments that a community can make as it offers a place for physical activity, recreation and community involvement AND it can be a source of income for the community if the facility has space for performances and workshops.

I encourage everyone to take a minute to consider the health and well-being of a child. You will be giving a gift not only to the next generation but to generations to come.

FDA for Kids

Yesterday I was putzing around the Food and Drug Administration's website when I found their Kids' Home Page. The kids' web page lacks upmh and appears dated, but it does offer some great information for children and adults.  

Allow me to highlight a few of my favorite links from the site:

• Food Safety Quiz - Questions about properly handling raw chicken, defrosting meat, and packing a lunch (the quiz only contains five questions - it could use more substance)
• Pet ownership information including Are You Ready to Own a Dog & Provide a Safe Home for Your Pet - Both resources are good starting points for a child who wants a pet, but I think both pages need to be beefed up a bit.
• FDA in the News - Offers brief statements about different FDA news stories relevant to children

Overall, the information provided on the kids site is informative, but the FDA might invite a considerable amount of additional traffic if they invested in making the site "cool." It could use better graphics and a more interactive layout. I believe that an FDA kids site is important because the FDA is a key player in our child's health and well-being. In the meantime, allow your child to check out the current site, and encourage him/her to send feedback to the FDA's webmaster about the website. Kids know what they want in a web page; let their voice be heard.

Cold meds: Still no answer.

The Food and Drug Administration is still not ready to ban cough and cold medicines for young children, according to a hearing on Thursday. Their biggest concern is that a ban on children's medication might result in parents giving adult medication to their children.

The head of the FDA's Office of New Drugs stated, "we do not want to do something that we think will have a positive impact, only to have an unintended negative. That could be an even worse situation." But many pediatricians are urging the FDA to take action as cold season is right around the corner.

The FDA did make a statement earlier this year warning against giving over-the-counter cold medicines to children younger than 2. Yet the agency is currently seeking more advice and research (particularly studies involving children) before making a finite decision on the children's medication. In general, the concern is not low doses of the medication but the risk from unintentional overdoses.

In the meantime, most doctors recommend rest and plenty of fluids to cure the common cold, even in children. 

Nutritional information and eating disorders

I read this article yesterday, and I am still digesting it: Harvard removes calorie info, cites eating disorders. According to the article, Harvard University Dining Services removed the index cards detailing nutritional information from dining halls. Why? Because of concern that the information was contributing to an already serious issue affecting colleges and universities nationwide: eating disorders. A member of the Dining Services committee said,  "Those individuals can place an undue emphasis on calories and other literal food values, making their placement over every food item a real challenge...we did what we felt best addressed the special health needs of those individuals."

Although Harvard will no longer display the nutritional information alongside the food, the information is still available on the Internet and in dining hall kiosks. Additionally, Dining Services will continue to promote healthy eating among students through forums and informational sessions.

I don't have statistics, but I imagine that the percentage of individuals suffering form eating disorders is relatively high at colleges and universities. I commend any institution that is cognizant of this and wants to do something about it. Nonetheless, it is hard for me to imagine that removing the nutritional information makes that much of a difference. Is it likely that someone suffering from anorexia nervosa is capable of acquiring that information regardless. In fact, an individual so obsessed with food (or the lack thereof) is likely to memorize the caloric value of foods as part of their ritual and survival (or lack thereof). 

Then again, someone obsessed with food might see the caloric value of an apple and decide not to eat the apple whereas someone not suffering from an eating disorder would have no problem with that information.

I'm curious if Harvard is going to try and research the affects of removing the nutritional information. This is such an important issue, and I urge colleges and universities to follow Harvard's lead by looking into the ways that the institution is contributing to this serious health concern.

For richer or for poorer: Health care in the U.S.

Grrrrraaaahhhhh!!!! That's what I think about health care in the United States. I get FIRED UP when I hear about children who were denied appropriate health care simply because of their socioeconomic status (SES).

According to a recent report by the U.S. Government Accountability Office, about 6.5 million children enrolled in Medicaid had untreated tooth decay in 2005 and were nearly twice as likely as children with private health insurance to have untreated tooth decay. According to a CNN.com article, "the report was ordered after widespread publicity of the case of Deamonte Driver, a 12-year-old boy boy who died last year in suburban Washington when an untreated infected tooth led to a brain infection." Driver "had extensive dental disease and his family was unable to find a dentist to treat him," the report said.
Does that fire up anyone else? A boy DIED because he couldn't get proper dental care???!!!

The report also states that 14.8 percent of Medicaid recipients said their children had not received necessary dental care because their dentist refused to accept Medicaid, which typically pays providers less than private insurers. Grrrraaaahhhhhh!!!!!!

When did health care become an institution of profit, profit, profit??? How can we allow young people (or any person) to suffer simply because they fall victim to a backwards system where money and profit are put before health and well-being. Oh, this makes me mad.

Yes, there are other factors to be considered. A family with low SES might have less available time to take their children to a dentist every 6 months. Individuals with low SES might also be less educated therefore they might not understand the importance of seeing a dentist on a regular basis. But anyone in their right mind knows that, in general, the poor are not receiving the same caliber of health care as the rich. 

But ask yourself this question, does the child of a restaurant dishwasher deserve the same access to appropriate health care as the child of a medical surgeon?

Probably the greatest factor in all this is health insurance. It is no secret that insurance is a for-profit industry. But does for-profit have to mean crazy-outlandish-millions-and-billions-of-dollars kind of profit??? It makes me sick.

I realize that I am generalizing and pointing fingers at an industry that can be beneficial. My son, a perfectly healthy six-month old, has visited his pediatrician four times since coming home from the hospital, and we have not had to pay a penny out of pocket. I am thankful. But I also understand how fortunate my family is to have a great insurance plan through my husband's employer. I wonder if I would be as grateful if my son was not perfectly healthy and needed to see costly specialists and receive expensive treatments. 

What about those parents who aren't as fortunate? What about those parents who have children enrolled in Medicaid and they are waiting hours in an overcrowded and understaffed urgent care just so their injured or sick son can see a physician's assistant? 

Let's take a hard look at health care in this country. Let's think about how we can better the lives of not just our own children, but all children. 

I urge you to consider what roll profit plays in life or death situations, and what could have been different to save the life of that young boy who merely had an infected tooth.

BPA: A threat?

When we began registering for baby products one  year ago, the research surrounding the effects of bisphenol A was beginning to make headline news. Because we had to buy bottles for our baby, we went with BPA-free brand BornFree simply because if we were going to buy new anyway, why not buy BPA-free "just to be safe." But like so many things that I have encountered during my motherhood journey, a mom can make herself crazy worrying about the effects of this plastic, and that paint, and these germs, and those vaccines. Between the controversies, the research, the opinions and the recalls, trying to be the best-mom-that-you-can-be is truly mind-boggling. At times I have tried to take the "we had lead-infested toys when we were kids and we survived" attitude, but it is nearly impossible to ignore all the WATCH-OUT! information inundating parents today.

Bisphenol A, a chemical found in many plastics, continues to receive attention because research has linked it to cancer and brain, reproductive, and immune problems especially when babies and young children are exposed. The research has also shown that this is especially true when plastics containing BPA are heated up. Because so many baby bottles are made of plastic, most bottle manufacturers now make bottles that are BPA-free.

Although we use BPA-free bottles, I have not been as careful with any of the other plastics used in our kitchen. In fact I recently attended a baby shower where the topic of BPA came up, and like a couple of the other moms there, I agreed that we are beginning to make ourselves BPA-free crazy (there were some who disagreed, stating that BPA-free plastics are essential to safe and healthy children). 

But then today I stumbled across this online posting by health editor, Elizabeth Shaw. Shaw believes that products containing BPA should be banned completely from any product intended for use by a child 7-years-old and younger. In fact legislation supporting the ban has been introduced to Congress and is under further review.

Shaw's argument is supported by a recent Journal of the American Medical Association study that links the chemical to heart disease and diabetes. Unlike previous research, this study involved actual human beings, not animals.

Although I will continue to make BPA-free choices for my family when I can, I don't imagine that I'll become too-hyper about the issue just yet (though I would support the bill if it makes it through Congress). And for those of you struggling to do what's best in your household, I will pass on this link: Minimize Your Baby's Exposure to BPA. If you are like me, you do what you can when you can without freaking out about every little thing. It's a struggle to find a balance, and many kudos to those of you who have found that healthy medium.

Kids Health

KidsHealth.org is a great site for health-related questions regarding your child. I used this site often when I was counseling in schools because not only does it include information and resources regarding a child's physical health, but it also provides information regarding a child's emotional and mental health. Additionally, it is a safe site for your child to use. The site is broken into three areas: for kids, for teens, and for parents. 

The site is by no means a substitute for seeing a doctor, but KidsHealth is a convenient place to start when you are faced with a medical-related question or dilemma. If you are wondering about the site's credibility, here is what I found:

"The KidsHealth team of top-notch editors and medical reviewers develops a wide array of topics about medical, emotional, and developmental issues of children and their families...Physicians and other health experts review all content before it's published on KidsHealth. All content is re-reviewed on a regular basis (about every 1 to 3 years, or more frequently if needed)."

Also, the site is advertisement free which is a breath-of-fresh-air when I am trying to sift through ad-filled pages for a bit of relevant information.

I encourage anyone to check out KidsHealth.org. It might be exactly what you are looking for when you have a question about your child's health.

Secondhand smoke and children

Poked & Prodded recently posted this commentary, Should smoking around kids be illegal? In my ideal world, smoking would be illegal - period. So should smoking around kids be illegal - definitely! But is that going to happen? I don't think so.

Unfortunately we have selfish parents who smoke in the presence of children, and here is why this is so troubling. The Centers for Disease Control and Prevention reported that the effects of secondhand smoke (SHS) are down, and this most likely is in part to the smoking bans in public places. Good news, right? Well, sort-of. While the effects of SHS are down, they are down very little in children. As the CDC reported, “The primary source of SHS exposure for children is the home; therefore, eliminating smoking in workplaces and public places is less likely to reduce children’s exposure to SHS.” Poked & Prodded put it best, "Ironically, laws designed to protect nonsmokers against involuntary exposure to SHS don’t extend to the most vulnerable. It’s even possible that cigarettes not smoked in restaurants and bars are smoked at home—around kids."

Yikes! This is not good. Of course I do not suggest that we reverse the smoking bans, but what can we do? How do we protect our children from SHS?

As a School Counselor, I always enjoyed educating elementary school students on the effects of smoking. Their reactions were equally impassioned and innocent. I used to show an enlarged picture of a cigarette, and pictured around the cigarette were various chemicals that were found in a cigarette. I would then talk about these different chemicals. For example, methane is one chemical found in a cigarette. I would say, "methane gas is also found in sewers where our toilet waste ends up." The kids thought this was so repulsive that many of them would hold their mouths as if they were going to puke. One six-year-old said, "that is the most ridiculous thing that I have ever heard - toilet waste in a cigarette? Disgusting!" And that's the great thing about kids. They have no problem going home and telling their mom or dad or aunt or grandpa that what they are doing is disgusting and gross. 

But I also understand how very difficult it is to stop smoking. That is why I am such a believer in educating our children from a very young age, because once someone starts smoking, it is extremely difficult to stop. I do not support abstinence education. I have yet to find quality and unbiased research that supports abstinence education. Rather I believe in education and information. The truth sticks with a person a lot longer than a "just say no" campaign. If "just say no" worked, then my generation, the "just say no" generation, would be free of smoking addictions, alcoholism and premarital pregnancy, and well, my generation is FULL of those things.

I have a few parent-friends who smoke. They are really amazing people who happen to have an addiction. I appreciate them so much because I have never seen any of them smoke in front of their kids. They always go outside or into the garage when they need a cigarette. Sure, their kids know that when mommy goes outside she is going outside to smoke, but at least my friends are trying to protect their kids. And equally important, my friends don't want to be smokers. Like so many, they have tried and tried to quit, and unfortunately, nothing has worked - yet. Maybe one day their kids will come home from school and say, "did you know that a cigarette has toilet waste in it?" And that will be the last cigarette they ever smoke.

In the news: Kids and fast-food

Recently the Center for Science in the Public Interest released a report that looked into the nutritional quality of kids' meals at thirteen major restaurant chains. They found that 93% of 1,474 possible choices at the thirteen chains exceed 430 calories (an amount that is one-third of what the National Institute of Medicine recommends that children ages 4-8 should consume in a day). This got me thinking...are people really looking to feed their children healthfully at fast-food restaurants, and if they are, then what exactly is the fast-food restaurants' responsibility concerning this issue?

Quite frankly, I don't have much sympathy for those individuals who are upset that fast-food restaurants do not offer more healthy food choices. There was a time when a family could not drive-through for dinner, and if you planned on eating on-the-road, you had to pull out the cooler and fill it with sandwiches and fruit. Really, is it that hard to plan ahead? I understand that fast-food is usually the cheapest way to go when we are in a hurry, but if we find ourselves in that predicament every night, then we have a greater problem. If we are only running through for dinner on occasion, then a 450-calorie meal isn't going to catapult our child into obesity. 

As for the fast-food restaurants . . . I argue that they are getting better. By no means are fast-food chains healthy choices, but they seem to be offering more options like fruit cups and yogurt. The report found Subway to offer the healthiest choices for a child, and that is no surprise. Subway brings a much healthier image to my mind than Burger King or McDonalds. I would expect Subway to offer the same healthy choices to kids as they offer to adults.

Overall, the report does not alarm me. It notes that eating out now accounts for a third of children's daily caloric intake, and the Center's nutrition policy director states that "America's chain restaurants are setting parents up to fail." I disagree. If a parent is failing to serve his/her child healthy meals, the only one to blame is the parent.