Archive for the 'Health & Wellness' Category

Hand washing: Instilling healthy habits in your children

mom teaching boy to wash hands

Hand washing is one of the most important preventative measures that everyone can take to stay healthy. Making this part of a routine from an early age can help prevent many future illnesses. While it can take only a few seconds for your little ones to accidentally infect themselves from dirty hands, the resulting illness can last days to weeks. So take the time now to prevent those lengthy illnesses as we focus on the importance of hand washing.

Teaching kids about germs

Proper hand washing can remove germs that lead to illness but the idea of germs can admittedly be a bit abstract for young children. In my family, we often look to books when embarking upon a new adventure and there are plenty of books about hand washing—including “Germs Are Not for Sharing” by Elizabeth Verdick—that are perfect for a young audience.

For older, school-age children, glitter or washable paint are cool visuals for demonstrating the spread of germs. Try this fun project to help visualize the spread of germs, although I think I might save this lesson for the summertime when it can be done outside.

When should we wash hands?

As a general guideline, hand washing should occur:

  • Before and after playing with other children
  • After playing outside
  • After touching a pet
  • After using the bathroom
  • After coughing or sneezing
  • Before and after eating

While hand sanitizer is great in some situations, it isn’t always best. Children’s hands are often visibly dirty; soap and water will remove dirt and soil unlike hand sanitizer. However, if you are on the go, hand sanitizer can be very helpful when water is not accessible.

Making it fun

Hand washing should take about 20 seconds, which is about the length of time it takes to sing “Row, Row, Row Your Boat” twice. I like to use these lyrics to make it more fun for my children:

Wash, wash, wash my hands

I can wash my hands

Washy, washy, washy, washy

Now I’ll wash some more

Wash, wash, wash my hands

I can wash my hands

Washy, washy, washy, washy

Now my hands are clean

While singing the song, the following steps should be done to ensure clean hands:

  1. Roll sleeves up
  2. Thoroughly wet hands
  3. Place a dollop of soap on hands
  4. Scrub fronts and backs of hands
  5. Rinse
  6. Thoroughly dry on a disposable towel

Other helpful tips

  • Place a step stool near the sink and put soap within arm’s reach, so hand washing is more accessible for smaller children.
  • Rewarding children with a sticker (for step stool decorating) after proper hand washing can make hand washing more fun for toddlers when they’re learning and in that “do it myself” phase.
  • Letting children pick the scent of the soap can give them something to look forward to as well.

Take the time now to instill this healthy habit into your routine and it can pay dividends in your family’s future health.

– Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of three young children and volunteers with the Parenting Program.

Source: https://www.healthychildren.org/English/health-issues/conditions/prevention/Pages/Hand-Washing-A-Powerful-Antidote-to-Illness.aspx

Is using a car seat covering safe?

woman carrying infant carrier with canopy

image credit: Amazon

As the winter months approach, children will soon be sledding down snow hills, building snowmen, and really little ones will be traveling in cold weather in their car seats. As a Certified Child Passenger Safety Technician (CPST), I can assure you that there are many steps that a parent can take to ensure their children stay warm and safe this upcoming cold season.

One recommendation is to avoid heavy, bulky coats on children harnessed in their car seats; there are many articles and infographics that discuss why this is important. However, there is a hidden danger that many parents are unaware of: using car seat covers or aftermarket canopies that cover your infant’s head for a long period of time while installed in his or her car seat.

Before diving into the research and reasons why this is potentially dangerous, let’s rewind for a minute. The practical reason for a covering children is to protect them from wind, rain and snow while you transport them in and out of the vehicle. As the parent of a winter-born baby, I can tell you that I covered my child with a blanket in his infant carrier many times after strapping him in the car during our Michigan winters. My job as a CPST is to provide you with information so you can make an educated decision about keeping your child safe.

There is an increasing amount of research that discusses how car seat canopies and other coverings are potentially dangerous. A specific concern is the risk of CO2 rebreathing. During the breathing process, your body inhales oxygen and exhales carbon dioxide (CO2), maintaining a balance between these two gases. However, rebreathing CO2 can have harmful effects on the body. When an infant has soft, fluffy or loose fabric around his face, the carbon dioxide can build up around the baby’s head. Rather than breathing fresh oxygen, the baby is rebreathing the expelled CO2 (Blair, Mitchell, Heckstall-Smith and Fleming, 2008). Many babies may cry, turn their head or attempt to get out of this unsafe situation, however infants who are at-risk (i.e., preterm, respiratory concerns) may have extra difficulty notifying a caregiver they are struggling (First Candle – Rebreathing Carbon Dioxide and Suffocation as they related to SIDS, 2009).

In April 2014, Baby Carrier Industry Alliance (BCIA) issued an executive statement regarding infant carrying that is applicable to car seat safety and any situation to where a child’s face might become covered and breathing could be compromised. It stated, “[C]overing a baby’s face makes it impossible to monitor a child’s breathing, in addition to putting the baby at risk for suffocation, or CO2 rebreathing.”

This does not mean that you have to expose your infant to cold weather and crippling winds when taking baby to the car in the winter. The key is to protect your child with a temporary cover. Use a receiving blanket to protect your child from the elements, but be sure to remove it once baby is secured in the vehicle. The American Academy of Pediatrics (2016) recommends against over-bundling and covering the face and head.

My recommendations

  • Avoid car seat canopies that strap onto the infant carrier’s handle. Parents often pull back the cover and leave the strap for convenience, but this poses a suffocation risk if the fabric accidentally falls down over the infant’s face.
  • Avoid car seat covers that zip close to a child’s face.
  • Always be aware of your infant’s airways and the car seat environment. We recommend using the “visible and kissable” phrase, which means keep your baby’s face uncovered and able to receive kisses at any given moment. This ensures that you can easily see and assess your child’s breathing while in the car seat.

Together we can ensure all babies stay warm and safe while traveling to and from the vehicle. As we know all too well, the sledding and snowman season will be here before we know it.

– Stephanie Babcock, CPST, is an IFS coordinator with the Parenting Program. She’s also the proud mommy of two boys.

Nutritional considerations for children with Crohn’s disease

child holding bowl of berries

For children with Crohn’s disease, good nutrition is important to allow them to grow and develop at a healthy rate. What your child eats or is able to eat can depend greatly on whether their Crohn’s is in remission (not active) and experiencing few symptoms or if it is active and causing increased inflammation of the digestive tract.

When your child’s disease is in remission, the goal is to maintain a well-balanced diet featuring a wide variety of nutrient-dense foods. These foods include: protein (meats, fish, poultry, dairy products, beans and legumes), carbohydrates (whole grain cereals and breads, vegetables, fruit), and fats (monounsaturated and polyunsaturated oils, avocado, nut spreads). A well-balanced diet can help make sure that your child gets enough calories, protein and vitamins/minerals.

When the disease is active and your child is experiencing more symptoms, the goal is to make sure your child is consuming sufficient calories and nutrients. Your child’s health care provider may suggest a modified diet that may be helpful during this time such as a low fiber/low residue diet or a lactose-free diet. Changes to your child’s diet are recommended mainly to help with any discomfort or unpleasant symptoms your child may be having.

Low fiber/low residue diet

Fiber is the part of food that cannot be digested; it is also known as bulk and roughage. Fiber helps the body move food through the digestive tract. Eating foods high in fiber — such as fresh vegetables and fruit, whole grains, nuts and popcorn — when your child’s disease is active may increase diarrhea, increase pain and discomfort with bowel movements, and increase bleeding. A low-fiber diet can help to “rest” the intestines.

If your child’s doctor recommends a low-fiber low/residue diet, this article might be a useful reference for appropriate foods on a low-residue diet. In addition, a multivitamin or vitamin supplements may be recommended in order to add nutrients normally found in fruits and vegetables.

Remember to always check with your child’s health care provider before beginning a new diet.

Lactose-free diet

Lactose is the carbohydrate portion of milk. Children may experience lactose intolerance, especially with the disease in the small intestine. Symptoms include nausea, bloating, increased burping, increased gas, stomach pain and diarrhea. These symptoms can decrease or go away completely when milk and other dairy products, such as cheese, ice cream and yogurt, are removed from the diet.

Because milk and dairy products are very important sources of calcium and vitamin D for a growing child, your health care provider may suggest switching to lactose-free milk or fortified soy milk/almond milk/rice milk, or recommend your child take a lactase supplement when eating milk products.

Consult your health care provider before taking dairy products out of your child’s diet. A dietitian can also make suggestions that will help to lessen symptoms and keep up the amount of calcium and vitamin D in your child’s diet.

Supplements

Children with Crohn’s disease may benefit from vitamin and mineral supplementation of calcium, iron, B12, magnesium and/or phosphorus due to a variety of reasons including location of disease within the GI tract, poor absorption, surgical resections or poor food intake due to decreased appetite. Do not start supplementation without consulting your child’s medical health provider.

There is not one set diet that is applicable to every child with Crohn’s disease. Keeping a daily food journal can help identify foods that may trigger symptoms and avoiding these foods, especially when your child’s disease is active, may help lessen symptoms. It can be helpful to consult with a dietitian who can help develop a specific dietary plan for your child. A dietitian can also review your food journal to see if there are any patterns in your child’s diet in relation to his/her symptoms.

Mary Ligotti-Hitch, R.D., is a registered dietitian with the Beaumont Health Center’s Weight Control Center.

Resources:

Dysphoric Milk Ejection Reflex

mom breastfeeding baby

Cropped image. Cheryl, Flickr. CC license.

What is Dysphoric Milk Ejection Reflex (D-MER)?

D-MER is a condition affecting lactating women that is just recently been recognized. It is characterized by abrupt dysphoria, or negative emotions, that occur just before milk release. This reaction to letdown may occur when pumping, breastfeeding or when experiencing spontaneous letdown (i.e., milk releasing when not breastfeeding/pumping).

Moms have used many different words to explain the feelings that take place with D-MER. Some of the most frequent descriptions are anxiety, sadness, dread, nervousness, emotional upset, irritability and hopelessness.

D-MER presents itself with slight variations depending on the mother experiencing it, but it has one common characteristic: a wave of negative emotion just prior to letdown. This emotional response is the consistent key component in D-MER. The breastfeeding mother experiences a surge of negative emotions 30 to 90 seconds prior to her milk release when breastfeeding, pumping, or with spontaneous letdown.  It can last for a few seconds at the beginning of a feeding or it can happen repeatedly with multiple letdowns in the same feeding.

For some mothers D-MER is gone by the time the baby is 3 months old, but for other moms it lasts until weaning.

What is the cause of D-MER?

Before discussing what it is, it is important to discuss what it is not.

  • It is not a psychological response to breastfeeding.
  • It is not postpartum depression or postpartum mood disorder.
  • It is not general dislike of breastfeeding.
  • It is not breastfeeding “aversion”.
  • It is not due to a history of depression, a history of physical/sexual abuse.
  • It is not related to the mother’s birthing experience.
  • It is not because she doesn’t love her baby enough or because she’s a bad mother.

Other important things to note:

  • Mothers themselves cannot cause D-MER. It is a hormonal problem.
  • The feelings a mom experiences with D-MER are not real. They are her hormones are fooling her and even though it feels like it’s in her head, it’s not.
  • Mom did nothing to cause it, and she cannot make herself snap out of it

Research tells us that D-MER is physiological not psychological. This means that hormones in the mom’s body, not past experiences or repressed memories, that are causing the condition.

Preliminary studies found that D-MER is the result of the drop in dopamine levels at letdown. This drop must occur to allow the prolactin (milk-making hormone) level to increase. This happens to all mothers, but in women with D-MER, the dopamine level drops too far or too fast in the central nervous system. This results in a wave of negative emotions.

What treatment is available?

For mothers with mild to moderate D-MER, education may be the best treatment. Many women find their symptoms are more easily managed once they are aware it is a medical problem and not an emotional one. Tracking symptoms in a log and learning what makes them better or worse is helpful for many moms.

Mothers with more severe D-MER are encouraged to visit their health care provider. Together, they can determine the best way to treat this condition effectively. So far, it has been proven that medications that increase dopamine levels in a mother can treat D-MER effectively. The best way to receive the proper treatment is to let your doctor know exactly what is happening when you experience these feelings.

Education

D-MER is not a new condition, but until recently, little was known about it. Many mothers were embarrassed to talk about this; they thought they were the only ones struggling with the feelings they had during letdown. If they did speak of it, many times a mother’s feelings were dismissed. We are just discovering how widespread this is. As more people continue to speak up about this condition and awareness increases, progress will continue to be made in the education, support and treatment of D-MER.

– Pat Ashley, RN, IBCLC, Beaumont Hospital, Grosse Pointe

Summer salads to bring to your next BBQ

chopped vegetable confetti salad

image credit: fooddonelight

With summer right around the corner, what better way to celebrate than with some fresh vegetables? As one of the dietetic interns at Beaumont, I wanted to share two of my favorite salad recipes with you. I love to eat salad, especially in the summer time and with so many delicious vegetables to choose from, I like making a different salad every day and trying new recipes. There are so many temptations in summer from graduation parties, holidays, and birthday parties, but bringing a salad to one of your social events will keep you full, on track, and it’s sure to be a hit at the festivity.

Chopped Vegetable Confetti Salad (pictured above)

Ingredients:

  • 4 cups cauliflower, roughly chopped
  • 4 cups broccoli, roughly chopped
  • 2 cups carrot, roughly chopped
  • 2 cups celery, roughly chopped
  • 1 red pepper, roughly chopped
  • 1 cup onion, roughly chopped
  • 2 cloves garlic, minced
  • ½ cup fat-free Italian dressing
  • Fresh ground black pepper to taste
  • *Note: To save time buy your vegetables pre-cut at your local grocery store

Directions:

  1. Place cauliflower into a food processor and pulse until cauliflower is very finely diced. Pour into a large bowl.
  2. Repeat with broccoli and remaining vegetables, one at a time.
  3. Add the minced garlic to other vegetables.
  4. Pour dressing over vegetables and toss well and season with pepper.
  5. Refrigerate for an hour and serve. (Counts as low starch vegetables.)

Yield:

10 servings

Recipe adapted from https://fooddonelight.com/chopped-vegetable-confetti-salad/#_a5y_p=1560257

Creamy Tomato and Cucumber Salad

Ingredients:

creamy cucumber and tomato salad

image credit: Natasha’s Kitchen

  • 3 medium tomatoes
  • 2 medium cucumbers
  • ½ medium onion
  • 1 large garlic clove
  • 3 tablespoons fat-free mayo
  • 2 tablespoons fat-free sour cream or plain Greek yogurt
  • ⅛ teaspoon pepper
  • Salt to taste

Directions:

  1. Cut tomatoes into 1-inch pieces.
  2. Cut cucumbers in half and slice, then thinly slice the onion.
  3. Combine all the prepared vegetables in a medium bowl.
  4. In a small bowl, combine mayo, sour cream or plain Greek yogurt, garlic, and pepper. Mix well.  Mix the dressing into the vegetables.
  5. Add salt to taste just before serving. (Counts as low starch vegetables.)

Yield:

6 servings

Recipe adapted from http://natashaskitchen.com/2010/08/16/creamy-cucumber-and-tomato-salad/

– Chelsea Bono is dietetic intern going through the Beaumont Dietetic Internship program.

Breaking digital addictions

girl holding smartphone while looking out window

Did you see the recent study from Harvard noting that increases in Facebook use correlated with decreases in well-being, even after controlling for baseline levels of use? This was the case even when the study participants were “liking” and posting, rather than merely “lurking” on social media. The authors conclude:

“The full story when it comes to online social media use is surely complex. Exposure to the carefully curated images from others’ lives leads to negative self-comparison, and the sheer quantity of social media interaction may detract from more meaningful real-life experiences. What seems quite clear, however, is that online social interactions are no substitute for the real thing.” – Shakya & Christakis, 2017 (emphasis is mine)

In previous posts, Phubbers and the iPhone Effect and Stuck in Cyberspace: The hidden dangers of Internet addiction, we discussed the power of technology to pull us out of our everyday lives and even put our relationships at risk.

Nonetheless, we all see the benefits of using computers and smartphones, and even television and video games can have valued uses. Ideally we want a balanced relationship with our technological gadgets. Remember that overuse of technology is a habit, and like all habits, it can be hard to break. Also, we often handle social anxiety by retreating into our digital worlds; this doesn’t help us build relationships or deal with discomfort.

This HelpGuide.org resource lists key features of smartphone addiction, includes an online quiz, and offers tips to help break digital addictions. Here are some of the highlights, along with a few tidbits I’ve learned through working on my own smartphone use:

  • Make technology your servant, not your master.
  • Goal is to cut back to healthy levels of use.
  • Think before you automatically pick up phone.
  • Turn off notifications on apps and games.
  • Review responses before sending.
  • Make “good habits” easier and “bad habits” harder. Remove apps or move icons off home screen
  • Keep phone away from bed (light filter).
  • Read “real” books in bed. Also, e-readers that do not emit light should not disrupt sleep.
  • Buy an alarm clock.
  • Adjust your settings to silence your phone at night. The timer/alarm will still go off and certain contacts can still call through for emergencies.
  • Realize: You don’t get those minutes back that you spent aimlessly drifting through the internet.
  • Set goals for when you can use your smartphone and use a timer to keep yourself honest.
  • Turn off your phone at certain times of the day.
  • Replace your smartphone use with healthier activities (e.g., physical activity, talking to others, reading, etc.).
  • Spending time with other smartphone addicts? Play the “phone stack” game: Everyone stacks their phones in a location out of arm’s reach, and just interacts with each other.
  • Limit “checks” of your phone. Wean yourself off compulsive checking.
  • Maybe most importantly, curb your fear of missing out, and tune in to what is going on around you. You may really be amazed at what you see and who you talk to when your face is not stuck in a screen!

– Lori Warner, Ph.D., LP, BCBA-D, Director, HOPE Center at Beaumont Children’s

Stuck in cyberspace? The hidden dangers of internet addiction

We are surrounded by cyberspace! Computers connect and help us in so many ways. We often take for granted all of the resources at our fingertips, at least until the power goes out! I’m enjoying the wonders of technology right now as I write this post on my computer and technology will allow you to read it. Technology is an amazing tool.

However, any tool can be used as a weapon. This same technology can be used for cyberattacks, cyberbullying, and even increased depression and anxiety resulting from too much negative news consumption. Too much screen time can horribly impact our relationships, health and mood.

How does this happen?

The immediate gratification from computers and mobile devices create a powerful reward loop that works something like this:

feel bored or unhappy → tap into internet or game → feel entertained/better

The reward pathways that light up in our brains when we use the internet are the same pathways that light up when we use alcohol, nicotine, or other drugs. Wow! Whether we use technology to escape bad feelings or just in a habitual way, risk factors for significant problems.

Taken to extremes, people can actually become addicted to the internet. There is scientific debate whether it’s truly considered a “mental disorder,” but we do know that psychological and social problems occur. Both China and South Korea identify internet addiction as a significant public health issue, and the United States is starting to take this issue more seriously as well.

How do you know if you or someone you love is addicted to the internet? A recent study describes signs, and you should consult a professional if you see:

  • “changes in mood,
  • preoccupation with the Internet and digital media,
  • the inability to control the amount of time spent interfacing with digital technology,
  • the need for more time or a new game to achieve a desired mood,
  • withdrawal symptoms when not engaged,
  • continuation of the behavior despite family conflict, a diminishing social life and adverse work or academic consequences” (Cash et al., 2012).

Parents know that kids need reduced screen time and lots of face-to-face, active interactions to thrive and grow. But at the same time, screens are all around us and the constant pull of notifications from emails, text messages, games and apps can leave us distracted and scattered. So how do we balance the benefit of technology with the hidden dangers of these amazing machines?

First and foremost, practice what you preach! If your phone is your constant companion, start being more mindful of how and when you use it. Specific tips for breaking digital addiction in our next post, so stay tuned!

– Dr. Lori Warner, Ph.D., LP, BCBA-D, Director, HOPE Center at Beaumont Children’s


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