Parent Involvement in School Health Programs I'm exhausted! When will my baby sleep through the night? # Answer: There are as many answers to that as there are babies! As you've discovered, newborns typically sleep as much as 16 hours a day -- but in much shorter stretches than we adults are used to. It takes time to settle into a consistent nighttime sleep pattern, as baby's nervous system matures and he's able to go longer between feedings. By the time a baby is 3 months old, she may sleep for five-hour stretches or more at night; a 6-month-old may sleep as long as eight to 10 hours at night, or even a little more. Or -- he may not. Don't worry that there's "something wrong" -- some babies don't sleep through the night until they're a year old, and a happily sleeping-through-the-night baby can sometimes start waking up again while going through milestones like rolling over or learning to stand. You can help your baby develop good sleep habits by: * Establishing a bedtime routine. Nursing or giving a bottle, reading a bedtime story, and singing a lullaby -- or whatever routine you choose -- done at the same time every night tells baby it's time to sleep. * Put your baby to bed sleepy, but still awake, to learn to associate falling asleep with being in bed. Be sure to put baby down on her back for safety, and keep fluffy blankets and toys out of the crib. * Don't jump at the first noise. You shift position during the night, don't you? Well, so does baby. Wait a minute to see if your baby settles back down before picking him up. * Keep nighttime feedings quiet. If you need to feed or change your baby in the middle of the night, don't turn the lights on or play bouncy games. Use a dim nightlight and speak softly, so she'll know it isn't playtime. What vaccinations should my baby/toddler have, and when? Are these vaccines safe? # Answer: Immunizations protect babies, toddlers, and children against many childhood diseases that were once devastating and even deadly. Prior to the development of vaccines, 3,000 children died of measles every year, whooping cough killed thousands more, and polio paralyzed 10,000 children each. Although these diseases are now rare in the United States, a drop in the level of immunizations could bring them back quickly, especially since international travel is now so common. The American Academy of Pediatrics has a recommended schedule for immunizations for your baby, toddler and child. If you choose to delay immunizations for your child, there is also a "catch-up" schedule provided. Immunizations are medications, and like other drugs, can have side effects. In most cases, vaccine side effects are mild, such as fever and redness or soreness at the injection site. Your doctor can tell you how to minimize these side effects -- for example, by using Tylenol to help prevent or bring down fever. (Be sure to get your doctor's guidance before doing this.) In some cases, more serious side effects can occur, such as allergic reactions. Very rarely, severe side effects occur. The CDC and FDA monitor vaccines closely to make sure they are as safe as possible. Many changes have been made in the last decade to improve vaccine safety, such as changing the polio vaccine schedule and switching to a new type of pertussis (whooping cough) vaccine. But in the rare event a severe reaction does occur, the National Vaccine Injury Compensation Program is available to provide compensation for injuries. For more on vaccine safety, see the CDC's Vaccine Safety information page. When should my baby start eating solid foods? # Answer: Years ago, babies started eating solids like rice cereal very early on, with moms putting rice cereal in their bottles as young as 2 weeks old. Myths about solids persist -- like the idea that giving a baby rice cereal will help him sleep through the night (not true). Current research indicates the best age to start a baby on solids is between 4 and 6 months -- until then, all their nutrition should come from breast milk or infant formula. Once your baby is in this age range and has sufficient head control to turn away when he's done eating, you can try solids. This schedule actually correlates well with another indication that solids are welcome in the digestive system -- the beginning of teething and the appearance of the first baby teeth. How to start? * Begin with rice cereal -- it's easiest on tender tummies. Mix it with breast milk or formula, and make it thin to start so the change in consistency is less surprising. Give baby a week or so to adjust before adding new treats. You'll likely need a new nipple for baby's bottle -- one with a larger opening. * Next, try vegetables for one serving a day -- either by steaming and pureeing your own (no added seasonings, please), or using Stage 1 baby food. Good foods to start with are carrots, squash, green beans, or peas. * Give each new food by itself at first. And wait two or three days before trying another one, so you can see if there's a reaction or food allergy. * Next, add one serving of white or yellow (but not citrus) fruit a day, like pears, peaches, or apples -- again, pureed by you or in Stage 1 baby food. * Wait until baby's 7 to 9 months old before trying pureed or strained meats, starting with chicken and turkey before moving up to red meat. * Usually around 9 months is a good time to start introducing your child to table foods -- soft items first, like mashed potatoes, pasta, and yogurt. * Four foods to avoid during your child's first year: honey, which can cause botulism in infants, and strawberries, nuts, and eggs, which are common allergens. When should my baby/toddler start: sitting up, crawling, talking, and walking? # Answer: Just as with sleeping through the night, every baby is different and these "milestone" events will happen at different times for different children. Some will crawl early and not talk until much later -- and vice versa. And babies born prematurely will usually reach these milestones based on their due date, not their birthday -- that is, a baby born two months premature will likely sit up two months later than full-term babies. But preemies usually "catch up" in development between ages 2 and 3 (earlier for babies born at or after 28 weeks' gestation; later for babies born prior to 28 weeks). So don't panic if your son isn't talking yet while another child in his playgroup already says a dozen or more words. Let your baby develop at his own pace -- but if you're worried that your child is lagging behind, talk to your pediatrician. * By the end of 3 months, most babies can support their head well, begin to babble, follow a moving object with their eyes, and raise their head and chest while lying on their stomach. * By the end of 7 months, most babies can roll both ways (back to front and front to back), sit with the support of their hands, recognize their own name, laugh and squeal, and support their whole weight on their legs (while you keep them balanced, of course). * By the end of 1 year, most babies can sit unaided, get into a hands-and-knees position and crawl, pull themselves up to stand and "cruise" by holding onto furniture, say simple words like "dada" and "mama" and use simple gestures like waving bye-bye, and feed themselves finger foods. * By 15 to 18 months, most babies can say several simple words. * By their second birthday, they can walk unaided, and use simple phrases and short sentences like "No juice" and "Want that." My kids are always fighting! How do I deal with sibling rivalry? # Answer: Where there is more than one child, there will occasionally be battles. That's normal. Each child is a unique individual, and just because they're related doesn't mean they will always get along. But parents can take steps to help keep sibling rivalry to a minimum: * Set aside time to spend with each child individually, so they don't feel like they're always competing for your attention. Don't play favorites. * Be sure each child has personal time and space of his or her own. Everybody needs privacy! * Work with your children to set ground rules -- like no tattling, hitting, or name-calling, no fighting in the car (or the car pulls over until it stops), and no taking someone else's property without permission. * Jump in if there's physical violence or other dangerous escalation, but otherwise, try not to intervene in your kids' fights. Instead, talk with them when they're calm about how they can compromise, share toys, take turns, and respect each other -- then give them a chance to use those skills rather than relying on you as referee. * Head off fights at the pass by observing the kinds of situations that start them and avoiding those situations. Do your kids always argue over who does the dishes? Then set up a chore chart so it's clear who does what job when. * Show them good conflict resolution skills. How do you resolve disagreements with your spouse or other family members? If you handle them calmly and respectfully, children will learn from that behavior. * Give your kids materials that help them think about and talk about sibling rivalry, like the sibling rivalry pages at PBS Kids. My child is being bullied at school. What should I do? # Answer: First, know she's not alone. As many as half of all children experience bullying at some point during their school years, and at least 10% are bullied regularly. Whether it's physical intimidation (more common with boys), or verbal taunts and harassment (seen more often with girls), bullying has real consequences -- it's not just "kids being kids." Some 160,000 children miss school every day because they fear bullying, according to the National Education Association, and kids who are bullied are more likely to do poorly in school and have low self-esteem. To help reduce the problem: * Talk with your children from a young age about respectful behavior toward others, so that by the time they go to school, they'll know how they're expected to act themselves and what they should expect from their friends and classmates. * Teach your child how to be assertive -- practice together at home by role-playing, so that they can learn how to express their feelings, say “no” clearly when they feel uncomfortable, and stand up for themselves without fighting. * If your child tells you he's being bullied, listen in a calm and open way -- don't make him feel like he's done something wrong. Let him know he did the right thing by coming to you. Ask him what's been done already and what he would like to see happen. * Teach your child to speak out when someone else is being bullied, and involve a teacher. * Talk with teachers and guidance counselors about anti-bullying efforts and policies, such as peer mediation and conflict resolution programs. Education World has an excellent set of 10 lesson plans . * Give your child resources, like the Stop Bullying Now! w eb site. How can I teach my child healthy eating and exercise habits? # Answer: Child and adolescent obesity are a growing public health crisis. Studies estimate at least 15% of American children are overweight and another 15% are at risk of becoming overweight -- a rate that's tripled since the 1960s. The best way to prevent childhood obesity and related health problems that can last into adulthood is to give your child a healthy start, with good eating habits and an enjoyment of exercise that can last a lifetime. Some tips for doing this include: * Don't use food as a reward. Instead, reward your child with praise, hugs, attention, and fun activities -- like a bike ride with Mom or Dad! * Create opportunities for "active play." Turn off the TV and video games and go to the park to walk the dog, throw a ball, climb on rocks, or shoot some baskets. When you go along, your child will have more fun and you'll get some healthy exercise too. * Avoid the temptations of high fat and high sugar foods like candy, chips, and sugary soft drinks by keeping them out of the house. Instead, fill the fridge and pantry with healthy snacks like fresh fruit, raw veggies cut into slices with a yogurt dip, pita breads and lean sliced meats, yogurt, raisins and other unsweetened dried fruit, and granola bars. * Limit the amount of time your child watches TV. Studies show a clear correlation between the amount of time a child watches TV and his or her weight, and programs designed to cut TV time have led to weight loss in kids. They'll also see fewer ads for junk and fast food! * Serve healthy meals at home as much as possible, rather than eating out. You can involve your child in cooking and eating healthy foods from a young age by letting them help plan menus and take on small tasks. Younger children can help wash fruits and vegetables and help you stir liquids; as they get older, kids can set the table, peel fruit, and help measure ingredients. * When you go shopping, encourage your child to help you choose healthy foods. Talk to them about the nutrition we get from different foods. They'll be more likely to eat a healthy snack if they helped pick it out! How can I keep my child from smoking, drinking, and using drugs? # Answer: Every day, 3,600 young people try cigarettes for the first time, according to the CDC. Over 10 million adolescents drink alcohol. So it’s important to: * Model good behavior for them: don't smoke, drink to excess, or use drugs. If you do now, quit. What better motivation can you have than the health of your child? * Start young. With children under age 7 or 8, take advantage of "teachable moments" -- such as when a TV or movie character, or someone on a billboard or in a magazine, is smoking or drinking to excess -- to talk about the health consequences of these behaviors. You have a better chance of influencing a child's behavior before they start drinking, smoking, or using drugs. * As your child gets older, ask them what they think about drinking, smoking, or drugs. Ask open-ended, nonjudgmental questions. You can use events in the news -- like steroids in professional sports -- to bring the topic up. * Keep the lines of communication open. Schedule time for you and your child to spend together, and show that you're really listening to what she has to say by asking questions. * Preteens want to feel grown up, and substance use can seem like the way to do that. Offer other opportunities for your child to feel like they're maturing: by giving them responsibilities in the family, such as caring for pets, helping plan a vacation, or organizing the annual yard sale. * Junior high and high school kids are likely to know people who are drinking, smoking, and using drugs. Establish clear ground rules: no driving with someone under the influence, for example. Let your child know that they never have to accept a ride with someone who's not sober; this may mean you have to pick them up at 3 a.m., but their safety is worth it. How do I talk to my child about sex? # Answer: Talking about sex with your children isn't the most comfortable thing in the world. But that doesn't mean you can put it off or hope they'll learn good values about sex, intimacy, and love some other way. They will definitely learn -- but not necessarily what you want them to. There are ways to make the process go more smoothly: * As with conversations about substance use, start talking with your child about sex, in an age-appropriate way, when they're young. Children will have questions about their body parts from an early age, and soon after will want to know where babies come from. * Use appropriate names for body parts. When you're teaching your child about their toes, eyes, and nose, also teach them that they have a penis or a vagina. Don't be embarrassed to use these words -- they're names for parts of the body like any other. * Younger children can be given simple explanations for things like how babies are made. "The daddy puts his seed inside the mommy, and it grows in her tummy to become a baby." With an older child, you can talk about the seed coming from the penis and going into the vagina. * Don't just talk about the mechanics of sexuality -- talk about the emotions and responsibilities too, especially as children get older. A young child can simply be told, "Mommies and daddies make babies because they love each other," but preteens are old enough to talk about the responsibilities and consequences of sexual activity, such as unwanted pregnancy. * Anticipate the next stage of development. Don't wait to talk to your daughter about menstruation or your son about his voice getting deeper until these things have happened. Children get frightened by changes they don't understand. * Communicate your values about sex. Your child may ultimately develop different values, but knowing what his parents believe will give him a solid foundation as he struggles with his own feelings. * Have a sense of humor -- and relax! It's less important that you have all the answers than that you're open to your child's questions and make her feel she can always come to you. There's nothing wrong with saying, "You know, I'm not sure of the answer to that. Let's try to figure it out." # My children are so busy and so am I. How can I find time to stay involved in their lives? http://www.webmd.com/parenting/frequently-asked-questions-about-parenting 1. How do I decrease my child's anxiety about starting school? For a happier, healthier transition, don't wait until the night before school starts to set up sleep and nutrition routines that might not have been strictly enforced over the summer. Try setting bed and wake-up times a few weeks before school starts and gradually adjusting them to be earlier as the first day approaches. Also, take a trip to the school in advance so children know where their classroom is. Give them a chance to meet their teacher, the school nurse, and other staff, if possible. If your child has a chronic health condition requiring medication, such as asthma or diabetes, a food allergy, or any type of health care concern requiring special attention, contact the school nurse early to put a plan in place well in advance of the first day of school. Immunizations, which are a very necessary part of the back-to-school routine, can be a little scary for kids, but you don't need to drag them kicking and screaming to the doctor's office. Ease kids' worries by talking with them about the health benefits of vaccines so they understand why the shots are important and are less anxious about getting them. Make sure immunizations are current and ask your health care provider about other immunizations that might be recommended but not required, such as the flu vaccine. 2. How do illnesses spread among school children? Colds and flu are typically spread from person to person from respiratory droplets. Viruses enter the body through the eyes, mouth, or nose. A sneeze can spray thousands of infectious particles into the air at 200 miles per hour, and they can travel 3 feet. If children don't cover their mouths and spray other children or an object, such as a doorknob, and other children touch it and wipe their noses or mouths, they're more likely to get sick. 3. What's the best way to help my child prevent picking up an illness at school? Further Reading: * Swine Flu Slideshow * Best Back-to-School Shoes * Schools Are Fighting Obesity * Testing Your Child's Vision * Guidance Counselor Challenges * Convenience of School-Based Health Centers * Is Your Child Ready to Work Out? * See All Back to School Topics Top Picks * 12 Dirtiest Places Your Kids Will Find * From Fit: Bedtime Battles? Try This Printable Game * Surprising Ways You May Be Hurting Your Kids' Health * Tips for Parenting When You Have Lupus * Assess Your Pet's Health * 7 Tips for Keeping Your Child's Teeth Healthy It's important to teach kids to wash their hands before eating and after playing outside and using the restroom. Hand washing is one of the best ways to prevent illness. If parents enforce that at home, we'll reinforce it at school. Talk to your kids about covering their mouths with a tissue when they cough and sneeze, and send them to school with a bottle of antiviral hand gel and instructions to use it often. Also, the CDC recommends the flu vaccine for kids ages 6 months and older. 4. Can I send my child to school if he's not feeling well? If your child has a temperature higher than 100 degrees, body aches, and extreme sleepiness or is coughing or vomiting, you need to keep him home until he is free of those symptoms for 24 hours. If he's not really sick, but something seems off, let the school nurse know and ask her to monitor your child. 5. What if there is a sibling at home who is sick? Tell the school nurse, "Joey's brother has been out with an illness. Joey's not having any symptoms, but I'm just letting you know." Then, reinforce healthy hygiene practices at home and school, and make sure all your kids are getting enough sleep. 6. How can I tell if my child has a cold or the flu? A cold often begins with a sore throat that lasts for a day or two and is accompanied by sneezing, sniffling, and, in some cases, a temperature. It usually lasts for no more than a week, but symptoms can linger longer. The flu usually comes on fast and includes more intense symptoms such as body aches and soreness, fever, headache, sore throat, and congestion that can last about a week. Kids with the flu don't want to get up and play. Flu can cause gastrointestinal symptoms, such as nausea and vomiting (swine flu tends to be associated with vomiting and diarrhea). 7. How should I treat my child who has a cold or flu? Make sure your child gets plenty of rest and fluids, such as water or 100% fruit juice, especially if your child has diarrhea or vomiting. Giving her a pain reliever, such as acetaminophen or ibuprofen (not aspirin), for fever is OK if taken as directed. But don't give your child an over-the-counter cold remedy without first talking to your health care provider. Many of these medicines are no longer recommended for children. If symptoms continue after three days and your child is still running a fever, call your health care provider. It's also helpful to contact the school nurse and ask what she sees going on at school. Is she noticing strep throat? Other illnesses? Ask what you should be watching for. And call your health care provider if the symptoms persist beyond three days, your child's fever is higher than 101 degrees, or your child has ear pain, a worsening cough, or a sinus-type headache. 8. If my child has been immunized for flu and the kids around her haven't, will her immunity be less effective? No, your child's immunity is not going to be compromised because other children haven't been vaccinated. But there is a certain herd phenomenon with vaccine-preventable illnesses, such as the flu. That means that the more children who are vaccinated, the fewer kids will become sick and miss school. 9. What should my child's school be doing to protect kids from germs? Ask what the school is doing to keep the grounds clean. Particularly during flu season, we make sure drinking fountains and other surfaces are cleaned several times a day. Also ask what the school is doing about prevention and if it has a plan for what to do during a flu outbreak. Is it providing classroom instruction about hygiene and making sure kids follow through? Will it be offering a flu vaccine on site? Ultimately, it's important to remember that a sanitized room is clean only until you and I walk into it. Getting Your Kids Off to a Healthy School Start Need some more basic tips on keeping kids healthy? Follow these guidelines: Healthy lunches for kids • Primary colors. Load up their lunchboxes with a colorful mix of fruits and vegetables to keep them energized and ready to learn. Apples, pears, berries, dried fruit, baby carrots, cauliflower, and edamame are easy to pack -- and fun to eat. • Fluid motion. Drinking plenty of fluids helps active children stay hydrated. But not all drinks are created equal. According to the American Academy of Pediatrics, kids who drink one can of soda a day increase their obesity risk by 60%. Offer water and limit soft drinks (some can pack 150 calories per 12-ounce can). • The whole truth. Whole grains are an important part of a healthy diet for kids. Offer whole grain, low-sugar cereals at breakfast and low-sodium whole grain snack bars or crackers in their lunch box. Try making sandwiches with whole grain bread (look for "100 percent whole wheat" on labels to get the most grains). • Dairy queen. Strengthen their bones and brains with nonfat or low-fat dairy foods, including yogurt and flavored milk (choose products with no more than 30 grams of sugar). Exercise for children • Class action. Don't assume your child is getting enough physical activity at school. Giving kids a chance to move and get their heart rates up before studying makes it easier for them to learn. Ask your child's teacher about having the class do jumping jacks, run in place, and other quick exercises in between classroom activities. • Power hour. Make sure your kids run around for at least an hour each day. Don't have a full hour for exercise? Try short 15-minute bursts of running, jumping, or games that encourage these activities to keep them interested and active. Getting Your Kids Off to a Healthy School Start continued... • Family affair. Busy families tend to skip physical activities together. Bond with your kids and boost the whole family's health by planning family bike rides, walks, or other exercise you can all do together. Stress reduction for children • Slow start. Want to help make the start of school easier -- and halt the moans and groans before they begin? Set up back-to-school routines early and ease kids into them gradually. Push back bed and wake-up times by 15 minutes each week, for example. • Open sesame. Encourage your child to talk about the anxiety he may feel about starting school. Remind him he's not the only kid feeling nervous and that teachers are there to help. • Meet and greet. Take your child to visit the school so she knows where her room is and can meet her teacher, the school nurse, and other staff before school starts. • Buddy system. A friendly face can reduce first-day jitters. Have your child ride the bus or meet on the playground with a friend. • Scare tactics. Talk to your child about bullying and give him tools to cope: Stand tall, look the bully in the eye, and firmly tell him, "I don't like what you're doing." Other healthy habits for children • Hands on. Adopting good hand-washing habits is the best way to avoid illness. Teach your child to rub her hands for at least 20 seconds with soap and warm water before eating and after using the restroom and playing outside. • Cover up. Teach your child to sneeze and cough into a tissue or the inside of her elbow to keep infectious droplets from spraying into the air and making other kids sick. • Home works. Most kids catch colds or flu from an under-the-weather classmate. Give your child the rest she needs and her classmates a break by keeping her home when she doesn't feel well. • Lighten up. Carrying a backpack shouldn't be a workout for your child. Pack the bag as lightly as possible, with heavier items in the center compartment. The load should never be more than 10% to 20% of her body weight.