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Feeding Tips for Picky Eaters

It is important that children develop healthy eating habits early in life. Here are some ways to help your child eat well and to make meal times easier.

What to Expect:

  • After the first year of life, growth slows down, and your child's appetite may change.
  • It's normal for your child to eat more on some days and very little on other days.
  • A child may refuse to eat in order to have some control in his life.
  • A child may be happy to sit at the table for 15 to 20 minutes and no longer.
  • A child may want to eat the same food over and over again.

How can I encourage my child to eat more?

  • Set regular meal and snack times. Avoid feeding your child in between these times, so that they are hungry at meal and snack times. If you want your child to eat dinner at the same time you do, try to time his snack-meals so that they are at least two hours before dinner.
  • Limit juice and milk between meals. Offer water between meals, which will satisfy thirst without spoiling the appetite. Serve drinks at the end of the meal.
  • Respect tiny tummies. Keep portion sizes small. Here's a rule of thumb – or, rather, of hand. A young child's stomach is approximately the size of his fist. A good serving size for a young child is 1/2 slice of bread, 1 oz of meat, or 1/4 cup of fruit or vegetable pieces.
  • Respect changing appetites. Offer ...

Advocating for Your Child with Hearing Loss in the Classroom

By now, the new school year is in full swing.  And while it might have started with newly made memories of a great summer, it may also bring new challenges—a new classroom, a new teacher, a new setting.  All parents want the same thing for their children—to be safe, healthy, happy and successful.  But the latter can be more challenging in the educational setting for children with hearing loss of any level.  So, as a parent, how do you ensure that your child with hearing loss succeeds in the classroom?

  1. Understand the impact of hearing loss on learning, and how to manipulate the classroom on your child’s behalf.  Hearing loss, even a minimal degree, can have a significant impact on learning.  Request preferential seating for your child.  Sitting closer to the teacher will help improve the signal-to-noise ratio (or how loud the teacher’s voice is relative to background noises).  This will help make listening and learning easier.  Work with your child’s teacher(s) to minimize background noises.  Your child should be positioned away from noise sources, such as HVAC systems, heaters, windows if there tends to be a lot of external noises like traffic or the playground.  Being informed on acoustics and noise management is also helpful.  
     
  2. Work closely with your child’s team in the development and updating of his/her IEP (Individual Educational Plan).  Any child with special needs (ie: ADHD, autism, hearing loss) is a great candidate for an IEP, which is uniquely developed for each child with goals for progress during the school year.  It is important to know that the IEP should be updated every 6 months. 
     
  3. Keep the school, teachers, and educational audiologist informed of the hearing loss. Provide ...

Signs of Hearing Loss for Babies and Children

Early identification and intervention of childhood hearing loss is linked to improved outcomes in communication and learning. Most newborns receive a hearing screening before being discharged from the hospital. However, some children may experience hearing loss sometime after that initial screening. Childhood hearing loss can be caused by a number of factors including family history, health problems at birth, syndromes, persistent middle ear fluid, chronic ear infections, and exposure to loud noise or head trauma. Children with normal hearing typically demonstrate similar listening and vocalization behaviors. If your child does not display these behaviors, it may be a sign of possible hearing loss or other problems.

Does your baby…

 

Birth – 3 months

  • Wake or startle in response to a sudden noise?
  • Seem to be soothed by your voice?

4-6 months

  • Move ...

Dirt is good for kids

I remember one day during my pediatric gastroenterology fellowship, a mother and child were walking in front of my professor and me, as we made our daily rounds in the hospital.  When the pacifier fell out of the toddler’s mouth and the mother picked it up and put it right back into the child's mouth, my professor remarked to me, "mark my words....that child will never get Crohn’s disease!"   My professor was referring to the theory of the "Hygiene Hypothesis".  This theory  is thought to explain (at least in part) why so many more people in developed nations become afflicted with autoimmune diseases such as Inflammatory Bowel Disease (IBD - Crohn's disease and Ulcerative Colitis) as well as food allergies, compared to people in non-developed nations. 

In non-developed countries, where children are...

Back to School Health Tips

The last days of summer are counting down!  Here are some timely tips to help ensure the school year goes well.

To and From School Safety:

  • The school bus is a great way for children to get to school.  To ensure safety, make sure young children are supervised at bus stops.  Parents trust bus drivers to keep our kids safe, therefore it is very important for children to know and follow bus safety rules.
  • Carpooling?  Buckle up!  The American Academy of Pediatrics recommends that children ride in a booster until the seat belt fits correctly, typically when they are 4’9” (age 8-12). Use the seat belt fit test to determine if your child still needs a booster. (For safety reasons, it is against the law in Washington for a child under 13 to ride in the front seat.)  

  • Supervise young children and make sure well-fitted helmets are worn when riding a bike, scooter, or skateboard.  And, don’t forget to review pedestrian safety rules for when they are commuting.

  • In case of unforeseen circumstances, ensure your child knows your phone number and address.  An ID with this information in your child’s backpack can be helpful in case of emergency.  (A review of “stranger danger” is also a good idea.)

Nutrition:

  • Provide your children with ...

Food allergies and emergency epinephrine in Washington State schools

Food allergies have been on the rise in recent years.  Studies suggest that up to 1 in 13 children are affected by a food allergy.  Egg and cow’s milk are the most common food allergies for infants and toddlers.  Fortunately, most children will lose a milk or egg allergy by the time they enter school.  Peanut and tree nut allergies are also becoming more common.  Unfortunately, only 10-20% of children will ever outgrow a nut allergy.

Currently there is no cure for food allergies.  Instead, doctors rely on an accurate diagnosis, avoiding food triggers, and being prepared in the event of a severe reaction.  Making the situation more challenging, nearly half of children with a food allergy may be at risk for a potentially life-threatening reaction called anaphylaxis. 

Symptoms of anaphylaxis may include:

  • hives or itchy welts
  • swelling
  • vomiting or diarrhea
  • difficulty breathing (cough, wheeze or shortness of breath)
  • dizziness or passing out

During a severe food allergy reaction, epinephrine (“adrenaline”) can be a life-saving medication. Epinephrine is typically injected into a thigh muscle with an “auto-injector” device like EpiPen® or Auvi-Q™.  Oral antihistamines like Benadryl, Allegra, or Zyrtec can help with some anaphylaxis symptoms, but are not considered life-saving treatment.

Emergency Epinephrine in Schools

Until recently, only certain students in Washington State could receive a life-saving epinephrine injection while at school.  They needed to be diagnosed with a food allergy and already have an epinephrine injector in the health room.  However, some students may not have an injector at school, or they have their first serious allergic reaction while at school.  In that case, the school could only call 911 and hope they arrived in time to save a life.

In January 2013...

Beware: Magnets May Be Hazardous To Health!

Magnets, a common household object with which we are all familiar, can be surprisingly dangerous, especially to children.  If this statement is startling to you, here’s what you need to know. 

Beginning in the 1970s and 80s, scientists discovered a new type of magnet, the so-called “rare-earth magnet”.  Made from some of the “rare earth” metals of the periodic table such as “Neodymium”, these new magnets are not only the strongest, most powerful magnets known to man (magnetic forces up to ten times that of other magnets), they are also permanent and relatively inexpensive to manufacture.  These properties revolutionized the production of many household products, even toys.  Basically, magnets we find in everyday items today are no longer made using old-fashioned magnets from a generation ago!

As a pediatric gastroenterologist, I am writing this blog to warn you of the dangers, should these powerful magnets be accidentally swallowed.  If more than one magnet is swallowed, or if a magnet is ingested along with another metallic object, the formidable strength of these magnets can attract 2 pieces of bowel to stick together with such great strength, it results in serious injury, even death.

This video ...

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