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Baby, It’s Cold Outside- But Get Out There Anyway!

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Contributor Dr. Elise Herman

We know how important it is for our kids to get outside regularly; all that fresh air and running around has numerous benefits. When it is cold, parents sometimes hesitate to let their kids out for fear that colder weather will make them sick. But it is actually the exposure to sick people and the viruses they carry that causes problems this time of year.

Winter play boosts physical and emotional wellness, builds muscle mass, and improves sleep. It means getting away from electronics and the temptation for unnecessary snacking. It also means avoiding crowded indoor spaces which can make it easy for viruses to spread. Vitamin D absorption is another bonus, especially if it is sunny. Exploring the outdoors in winter gives kids important exposure to nature which can lower stress. Getting outside when it is cold, blustery, snowing, etc. builds grit and toughness- in kids and parents!     

Remember your childhood and what you loved to do in winter- maybe building a snow fort or creating a silly snowman. Sledding, cross-country skiing, and just going for snowy walks are terrific activities to do with kids. A scavenger hunt in winter helps kids slow down and pay attention. Can they find a bird’s nest in a tree or animal tracks in the snow? There are lots of suggestions online for outdoor play, but often children will just make their own fun without us adults “scripting” their activity. 

To help keep kids warm out there, remember to dress them in multiple thin layers. Boots and gloves should be insulated and ideally waterproof. A hat and neck gaiter (safer than scarves, especially on younger children) really help on cold days. Infants and babies should wear one more layer than an adult would as a rule of thumb. If clothing gets wet, kids should come in quickly and change to avoid hypothermia. 

There are some recommendations in terms of when it is too cold for kids to be outside safely. Pay attention to both the temperature and even more importantly the wind chill (what the temperature ‘feels like’). If the wind chill is 32 degrees and above, outdoor play is fine. If it is 13-31 degrees, just remember to take breaks to warm up perhaps every 30-60 minutes. Below 13 degrees windchill, outdoor play may not be safe for most kids though older kids may be OK for a limited time if they are dressed appropriately. Infants and babies tend to get cold faster since they are not playing actively and may also not complain of being too cold. Watch them carefully for signs of hypothermia- shivering, red cold skin, and decreased energy level. 

Admittedly, it is easier to get outside on a beautiful spring day, but outdoor exercise in these colder months is equally important. Try to get your kids outside regularly this winter and lead by example. Your whole family will benefit by embracing winter in all its beauty and opportunities.

The local Kittitas Environmental Education Network puts out a seasonal kids’ newsletter and has some great info and ideas for wintertime fun with kids of all ages:https://www.ycic.org/_files/ugd/fbe211_0fb63dcb09744990994f0d205f32cb52.pdf

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Mindfulness for Children

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Contributor Dr. Elise Herman

We live in a busy and often stressful world. Mindfulness is a simple concept that can help parents and kids be calmer and enjoy life more. Mindfulness means being present, paying attention to what is happening, and accepting it non-judgmentally. This technique is helpful at all ages but learning this when young means children will carry it forward as they grow up. Kids’ brains are still developing, including the prefrontal cortex, which directs focus and control. Mindfulness targets this part of the brain, so it is an excellent opportunity to encourage these skills while the brain is actively growing. Research has shown that mindfulness helps decrease anxiety and improve attention in school-age children. As a result, many schools include mindfulness in their curriculum.

Like so many other things in parenting, modeling behavior is very influential. Practicing mindfulness also helps you parent more effectively. Slowing down, noticing the ‘little things’, making good eye contact, and eliminating distractions (e.g., phones) will help you be present for your child. Start this mindful practice early, beginning with feeding your newborn. Put your phone out of reach (or turn it off), so you won’t be tempted to be looking at it instead of your child.

You can promote mindfulness with your toddler by engaging in activities encouraging focus, such as looking at books, going on walks, and coloring. Just looking closely at grass or flowers (and maybe you’ll find a bug!) teaches patience and calm. Toddlers can also learn to take slow breaths when upset or frustrated. You can demonstrate this, too, and be an excellent example of handling difficult emotions.

Preschoolers can practice mindfulness and focus by being quiet for a short time and increasing this as their patience and ability to “be” increases. Some parents do this at bedtime, starting with kids having eyes closed, being quiet and calm for 15 seconds, then working up to several minutes or more. Your child may then be able to calm themselves more quickly at other times, such as when upset. Taking walks in nature and being attentive to clouds, leaves, birds, etc., encourages your child to be present and focused. Notice and discuss the five senses as you go about your day. What is your child aware of in terms of seeing, hearing, touching, tasting, and smelling? You can include mindfulness in eating– enjoying food slowly and being aware of taste and smell instead of just eating in a rush without truly paying attention.

Older kids can understand more about the concepts of mindfulness and master mindfulness techniques. By learning to observe something with curiosity and acceptance instead of having an immediate emotional reaction, your child will be better able to handle complex and stressful situations. By fully paying attention to the present, it is easier to let go of regrets about the past and worries about the future. A simple technique is focusing on the breath; counting each breath up to 10 (‘one breath’ equals breathing in and out) helps with this. Imagining each breath as a gentle wave can also be very calming. Mindful breathing is a form of meditating and can be done for just a minute or more throughout the day. This really does train the mind to focus and be more grounded.

There are lots of helpful online resources. “Smiling Mind” is an Australian website and free app with good info about kids and mindfulness, regulating emotions, and how to promote empathy and connectedness. Other apps have fees but can be very valuable including “Headspace for Kids” and “Calm.” Your child is always learning from you, so the more ‘present’ you are with your child (this means putting down phones), the more both of you can be mindful, calm, and enjoy life.

Resources

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Encouraging Healthy Eating Habits for Your Child

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Contributor: Dr. Elise Herman

As parents, we want our children to eat well. Yet all we can do is set the stage for healthy eating; it is up to the child in terms of how much and exactly what they eat from the food offered. Here are some guidelines that help kids develop healthy eating habits; starting early with these habits can help prevent childhood obesity, diabetes, and other problems.

Have family meals

Eating together encourages conversation, connection, and healthier food choices and portion sizes. Research has shown that teens who have regular family dinners have lower rates of depression, substance abuse, eating disorders, and obesity. And remember– no TV or electronic devices at the table for kids and adults alike.

Avoid struggles around food

Toddlers tend to be picky, and preschoolers often have a decreased appetite. It is better to look at their intake over a week as opposed to pressuring your child to ‘clean their plate’ or eat what is served at any one meal. Children actually eat less overall if they are coaxed to eat, and mealtime is not much fun. Trust your child to eat what they need to stay healthy. 

Go by “MyPlate.gov”

This is the government’s recommendation for healthy eating that has replaced the Food Pyramid (more information at MyPlate.gov). Half of the ‘plate’ should be fruits and veggies (with slightly more veggies than fruit), the other half should be split between grains and protein. Half the grains should be whole grains like oatmeal, whole wheat bread and brown rice. Protein may include non-meat sources such as beans, lentils, plain yogurt, and tofu. Turkey, chicken, and lean ground beef are appropriate choices if your family eats meat, though meat is not needed every day. 

Kids Activity Downloads / Fun Word Search Crossword Puzzle

Offer appropriate portion sizes

Portion sizes that are too large encourage overeating. An easy way to judge is to compare portions to the size of your child’s hand (this conveniently works as your child grows). Fruits, veggies, cereal, and rice servings should be about the size of a closed fist. Meat portions should be the size of the palm and added fats such as butter and mayonnaise should be about the size of the tip of the thumb. If kids want seconds, make it salad or veggies. 

Don’t forget the beverages

Water should be your child’s mainstay. From age 1-2 years, whole milk is recommended (unless your child is still breastfeeding) and thereafter choose low fat milk. 16-24 ounces is a good daily maximum. After age 2 years, 2-2 ½ cups of dairy (be it milk, cheese, yogurt, etc.) is recommended. Drinking milk excessively may decrease the appetite for healthy solids and interfere with iron absorption which can lead to severe iron deficiency. Remember to stop bottles by age 1 year and to limit juice (if any) to a max of 4 ounces a day. It is much better to eat a fruit (with its healthy fiber) than to drink juice which contains as much sugar as soda. No sugar-sweetened drinks should be given on a regular basis (this includes chocolate milk).

Be smart about snacks

Avoid chips and processed snack foods and instead choose healthy snacks such as fruits, veggies, peanut butter, and plain yogurt. Adding a bit of honey or jam to plain yogurt is better than fruited yogurts which are high in sugar. Canned fruit is fine but choose “no sugar added” types.

Be a good role model

Talk about enjoying nourishing yourself with healthy food. Don’t discuss any food struggles you may have (dieting, poor body image, etc.). Model the idea of stopping eating when you are satisfied and full. Limiting fast food and processed food is important, but still OK to enjoy occasionally. 

Get your child involved

Kids love to help and can do so by looking at recipes, setting the table, assisting with cooking when age appropriate, and learning to pick healthy foods at the grocery store. This may translate to more enthusiasm at the dinner table as well as good training for when they are older and more independent.

more about the contributor

Dr. Elise Herman

Blog Posts
Provider Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Talking about racism to children

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Contributor: Dr. Elise Herman, KVH Pediatrics

Racism is front and center now, and parents may wonder how to have important conversations with their child about diversity, equality, and discrimination. It helps to keep your discussion age-appropriate, share your feelings and listen to your child.

Under age 5 years – Studies have revealed that even infants notice different skin tones and preschool kids have been shown to view those who look like themselves more positively, so addressing racism early is important. Kids relate easily to the concept of fairness so it can simply be explained as treating someone unfairly based on how they look. Young kids may ask about why people’s skin colors are different. Explain simply that darker skin has more of the pigment melanin in it and that no skin color is ‘better’ than another. Celebrate human diversity by noting that “we are all human but can have lots of differences, too, making everyone special!”. Encourage your young child’s appreciation for diversity by reading books and playing with toys featuring people of different races.

6-11 years old – At this age, children are more aware of current events based on what they have heard and seen from adults, other kids and on the news or in social media. Ask your child about what they know and what questions they have. Kids this age understand empathy so discussing how it would feel to be judged unfairly can be helpful. Children of all ethnicities can be assured that people world-wide are upset about racism and are working to make things better.

12 and older – Kids this age are often very informed and have developed their own opinions about issues such as racism and protests. Discussing the news and current events and how it affects them opens the door to a deeper conversation. The same concepts of fairness and empathy apply, but now taking action may be a logical next step. It may be sharing something on social media, reading more about the history of oppressed peoples or attending an event.

All kids benefit from social experiences with a variety of people. Cooking food and listening to music of different cultures broadens our horizons. It is alright to let your child know that you are upset or sad about what is happening, but you also need to assure your child that they are safe in what can be a frightening time. This conversation will look different for families of color where the issue hits a lot closer to home than for whites.

As always, what we do and say speaks volumes to our children. It is vital that as parents we confront our own prejudices and biases and work to be more open and understanding. Let your kids see you speaking out against racism, embracing diversity and calling for justice for all people.

Healthy Holiday Eating

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KVH Contributor*
Nicole Norton, MDA, RDN, CDE
KVH Diabetes Education

The holidays are upon us and many of us are preparing for gatherings with friends and family. Although it can be a joyful time of the year to celebrate, a common worry revolves around overindulging on holiday favorites, and the potential for weight gain and elevated blood sugars. While it isn’t necessary to deprive yourself during the holidays or feel guilty about eating sweets, there are several things you can keep in mind to make it through the holidays without going overboard.

One trick to prevent overeating is having a pre-snack before heading to a holiday party. Going on an empty stomach may leave you famished and overeating large quantities of less than ideal foods. Try a combination of complex carbohydrates with protein and healthy fats for a satisfying snack you can feel good about. Examples include an apple with almonds or whole wheat pita chips with hummus.

To avoid excess calories from mindless eating at parties, distance yourself from the food table. It may be easy to continuously eat with the temptation of appetizing food within arm’s reach, so dish up a plate and hold a conversation away from the food. If you find yourself tempted to return to the table often, chew a piece of gum to keep yourself from reaching for the snacks.

While alcohol is common for people to consume during the holidays, it can add several hundred calories on top of the calorie dense foods you may already be eating. Alcoholic beverages can range from 100 to 300 calories, depending on the alcohol and mixers. To reduce your calories, drink a glass of water or flavored seltzer water between drinks.

When it comes time for the big meal, be smart about your choices. Resist the urge to put everything on your plate. Scan the buffet first to check out all of your options so you can decide which items you are most interested in. And remember to pile on the veggies. A general rule for someone with diabetes to follow is to fill half the plate with vegetables. If you aren’t sure what foods will be available at the party, bring a vegetable dish so you know you’ll be able to include vegetables at the meal. Try parmesan mashed cauliflower or garlic roasted green beans.

Even with those additional vegetables, your overall calorie intake may still be higher than usual. Eating your meal slowly and stopping to take a break after finishing can help you allow time for the signal to get to your brain that you are full. Recheck your appetite before continuing to eat.

Continuing to stay active can help as well. Suggest a family walk after the big meal and before bringing out the dessert. Taking a 30 minute walk can burn about 109 calories for a 150 pound person, or 145 calories at 200 pounds; about the amount of calories in a scoop of ice cream or a cookie.

And in the end, remember to focus on more than food during the holidays. Focus on what matters most; spending quality time with friends and family, laughing, sharing stories and creating memories together. Cheers and happy holidays!

Resources: Harvard Health Publishing

Find healthy holiday recipes at diabetesforecast.org

*Opinions expressed by KVH Contributors are their own. Managed by Kittitas Valley Healthcare, HealthNews does not provide medical advice. For medical advice, please see your healthcare provider.

Grilled Fajita Medley

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Fajitas are a staple in our household for an easy week-night dinner. Grilled fajitas take on a whole new twist! Summer is great for throwing things on the grill and having your meal quickly without heating up your house. Try this recipe tonight!

 Grilled Fajita Medley

Grilled Fajita Medley


Ingredients:
•4 steaks of choice (we used porterhouse and bottom round steaks)
•3 green bell peppers
•4 jalapenos
•8-10 large carrots, cut in half
•2 small red onions
•1 lb of mushrooms
•2 tbs chili powder
•2 tsp cumin
•2 tsp smoked paprika
•2 tsp garlic powder
•1 tsp onion powder
•Salt and pepper to taste
•1 lime, juiced
•1 tbs olive or avocado oil


Directions:
In a small mixing bowl, combine together your seasonings, lime juice, and oil. Mix well! In a large mixing bowl or Ziploc bag, combine your veggies and pour your seasoning mixture into the bag and make sure to coat well. Set aside and prepare your steaks. If you like a lot of flavor, use the same seasonings as your veggies! Looking for something a bit more simple? Season with salt and pepper to taste.
Preheat your grill to medium heat. Once ready, place your veggies (it’s best to put the mushrooms on a skewer) and steaks onto the grill. Flip your vegetable after about 5 mins as well as your steaks. If more time is needed, flip again until you have grill marks on both side and your steak is cooked to desired doneness.
Enjoy for the week with burrito bowl lunches or serve this up for a big family dinner!

Coconut Flour Zucchini Bread

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Looking for a low carb, high-fiber and protein way to enjoy bread? Look no further! We combined coconut flour, farm fresh eggs, and backyard grown zucchini into this delicious bread. Bake this today for a healthy breakfast on-the-go for the morning.

Coconut Flour Zucchini Bread

Ingredients:
•6 large eggs
•1/2 cup oil (we used walnut oil!)
•1 tsp vanilla
•1/3 cup honey
•2 tsp cinnamon
•1 tsp baking powder
•½ tsp baking soda
•Dash of salt
•1 cup grated zucchini, squeezed to drain out the liquid.
•OPTIONAL: 3 tbs protein powder & chocolate chips!

Directions:
Preheat your oven to 375 degrees F. In a large mixing bowl, whisk together your eggs, oil, vanilla and honey until well combined. In a smaller, separate bowl, combine your flour, baking soda, baking powder, cinnamon and salt and mix well. Combine your dry ingredients into the large mixing bowl with your egg mixture. Gently stir until well combined. Fold in your zucchini making sure that you have drained most of the moisture out so not to disturb the structure of the bread. Add in your optional ingredients at this point if you wish. Pour your batter into a well-oiled bread pan and bake for 34-45 minutes or until your bread is firm in the center. Top with honey and enjoy!