KV Healthcare

Dr. Elise Herman

How to Talk with Your Teen

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Contributor Dr. Elise Herman

We all want to feel connected to our kids, but as they become teenagers, it may seem harder to engage them in conversation. Between their appropriate need to become more independent, their frequent use of their phones and social media, and all of life’s distractions, how can you create opportunities to have an honest conversation with your teen? Here are some suggestions that might help:

Be a good listener: Ask open-ended questions, avoiding those which would have a short “yes” or “no” answer. Do not interrogate but ask with a desire to learn- about their school day, friendships, and interests. Avoid lecturing and try to reserve judgment unless there is a real safety issue. If you disagree with what your child says, ask why they feel a certain way; try to see things from their point of view. Often, teens want to chat about a concern but do not want you to “solve” it. Ask if they like your advice or help before offering. Remember to listen without the distraction of phones or computers.

Empathize: Your teen has a lot going on with social media, relationships, and school pressures. Life is likely more complicated for them than it was when you were their age. Listen and empathize; don’t discount their feelings and struggles.

Please respect their privacy: Do not share your conversations with others. You want your teen to feel safe and comfortable being open with you.

Location counts: The dinner table is an excellent place to chat casually about school, activities, etc. (research has shown that regular family meals decrease risky behavior in teens). Start the family dinner habit when kids are young and keep it going as much as possible through the teen years. Even if they are quiet at the table (don’t force anyone to talk), connecting as a family is essential. When driving, it is also a great time to chat, especially if it is just the two of you. Frequent brief conversations are more accessible than longer, more formal ones and can make you both feel connected..

Let your teen lead:

  • Be open to discussing things they care about, such as social media, music, trends, etc.
  • Try to be aware of what teens are viewing and discussing online.
  • Don’t try too hard to be “hip”; aim to be curious and informed.

Encourage confidence: You know your teen and their strengths. Let them know you believe them to be capable of handling challenging situations but that you are always there for them, too, to be a sounding board or assist if it is appropriate.

Having regular, non-judgmental chats with your teen can maintain open lines of communication and increase your emotional connection. In addition, this will make it easier if they need to come to you to discuss important issues such as relationships, sexuality, mental health, or substance abuse.

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Dr. Elise Herman

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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.

Respiratory Virus Season and Children

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Contributor Dr. Elise Herman

As cooler weather approaches, the “sick” season does, too. For kids, this usually means respiratory illnesses, ranging from cold to croup or pneumonia. While these sicknesses are usually mild, more severe cases are rapidly increasing, with more kids going to the ER and being hospitalized. The viruses responsible include Respiratory Syncytial Virus (RSV), rhinovirus, adenovirus, and enterovirus. To complicate things, influenza season typically starts in October, and with COVID-19 currently spiking in Europe, a surge is predicted to hit the US soon.

Children are walking in nature, fall leaves.

This earlier and more severe start to the respiratory season for kids is felt to be related to gathering again (without masks) in schools and social settings. Kids do not have much immunity from last year when the respiratory season was milder due to social distancing and other anti-COVID measures. Wildfire smoke exposure may also be a contributing factor.

Most kids who contract these viruses will get a simple cold (“upper respiratory infection”), nasal congestion, mild cough, and mild fatigue. A low-grade fever is common for the first three days of illness. Kids may be sick for 1-2 weeks but remain fairly active with good fluid intake though overall eating is often decreased.

Younger or premature infants and children with lung problems like asthma are at increased risk of more severe illnesses like pneumonia. General warning signs include the pale or dusky color of the lips or skin, and increased work of breathing—rapid breathing with the ribs showing on inspiration (“retractions”). Unusually noisy breathing, such as wheezing (high-pitched musical noise with breathing out) or stridor (crowing noise with breathing in), is concerning. An infant who cannot feed well from a breast or bottle is worrisome. Extreme lethargy or limb weakness at any age is very concerning.

For mild respiratory illnesses, the diagnosis is usually based on symptoms and examination alone. Checking respiratory rate, heart rate, and oxygen level are routine when the child is seen by a medical provider. Testing for viruses with a ‘respiratory panel’ can be done but is expensive and usually reserved for those more severely ill since there are few specific anti-viral treatments available. Specific testing for COVID-19 and RSV may be done, given that the implications of having these viruses are more significant regarding attending school, childcare, etc.

If your child has typical cold symptoms, it is essential to ensure they stay well-hydrated; solid food intake is less important. Offer infants extra breast milk or formula. Saltwater nose drops and nasal suction for infants can be helpful in terms of clearing mucous which interferes with breathing through the nose. Fever control with Tylenol (over age two months, though talk to a provider first) or Advil (over age six months) is primarily for comfort since fever, as part of the immune response, may help fight the virus.

No cold medications are recommended under the age of four years and should be used with caution for those 4-6 years old. These meds are usually not helpful and may have harmful side effects in younger kids. Honey (1/2 to 1 tsp by mouth) may help to cough but is safe only for those over one year of age.

To help prevent respiratory illnesses, keep up the frequent handwashing we have all gotten good at during the pandemic. In addition, kids should be reminded not to touch their faces and not to share food or drinks. Although not easy, masking (especially if your child will be in a large group) does help prevent illness. Lastly, it is vital to get your child vaccinated against those respiratory viruses for which we have safe, effective vaccines—COVID-19 and influenza.

Resource / HealthyChildren.org

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Dr. Elise Herman

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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.

Curiosity in Children

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Contributor Dr. Elise Herman

There are characteristics we hope to see in our kids such as kindness, intelligence, and perseverance. We may not put ‘curiosity’ high on this list, but in fact it is crucial to a child’s success in learning and school—and maybe, even in life.

Research has shown that those who are curious tend to be happier, less anxious, and have a greater sense of well-being. In children, studies connect curiosity to higher academic performance, and in adults it is tied to greater achievement at work.  When people are highly curious about a subject, they are more engaged with it and more likely to remember what they have learned. General memory is also improved for information unrelated to the original area of interest. It seems curiosity primes the brain to absorb and retain new information better.

Being curious has been shown to improve one’s patience. Those who are very curious seem willing to do the work themselves to figure something out as opposed to needing an answer immediately. Curiosity can lead to increased creativity, more original ideas, and a willingness to ‘think outside the box’. It also translates into greater empathy and stronger interpersonal relationships.

So despite the sometimes endless “why?” questions from our kids that can be a bit much, curiosity is a very good thing. There are lots of ways we can encourage this important trait:

  • Express curiosity and wonder yourself, e.g., “I wonder why the moon looks so big tonight?”  Have a back-and-forth discussion about possible explanations. Together with your child find resources to get answers (and not just online) such as books, the library, and knowledgeable individuals.
  • Ask your child questions about things from the everyday to the more fantastical and encourage them to go deeper with their theories and ideas.
  • When your child asks you questions, avoid the “just because” response and research together if you don’t know the answer.  You do not need to know everything, and it is valuable to show your child that you are still learning, too.
  • Encourage your kids to be aware and mindful, to be thinking about what they experience, and to use their full senses to engage completely.
  • Limit “screens” including TV, smartphones, and social media which generally are passive entertainment, though quality programing such as nature shows can encourage curiosity. Watch educational programs (on PBS and National Geographic for example) together so you can have discussions about the content.
  • Explore new things such as ethnic food, museums, and new cultures either through travel or online resources. This promotes not just curiosity but an openness to people different than us.
  • Encourage books about subjects that inspire curiosity such as history-making individuals, exploration, and science fiction.
  • Help your child to follow their interests and learn more about what they are naturally intrigued by.
  • Embrace outdoor activities, especially in nature such as walking in a park, hiking, birdwatching, and camping. These immerse us in the natural world and foster curiosity and wonder.

And enjoy being a bit of a kid yourself as you marvel and explore the world we live in with your child!

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Dr. Elise Herman

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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.

Parent Advice / Back to School

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Contributor Dr. Elise Herman

As summer winds down, parents and children are well aware of the approach of the new school year. Some kids are very excited about learning and seeing their teachers and friends again, while others have more reservations. COVID and recent school shootings complicate this often emotional transition. There are steps parents can take now to make this go more smoothly.

Sleep

If sleep schedules got lax over the summer, start now to get back on track. To make bedtime earlier, adjust the wake-up time, moving this up by 15 minutes a day. Kids ages 3-5 years need 10-13 hours total sleep daily, those ages 6-12 years should get 9-12 hours, and teens need 8-10 hours. Remember, no ’screens’ of any kind for at least one hour before bedtime. Reading to your child before bed (or kids reading on their own) aids in falling asleep and is an excellent habit to develop now.

Nutrition

Ensure your child gets up early enough to have a healthy (not sugary) breakfast, improving attention and mood. If your child is taking lunch to school, review what they would like to bring—plan on including fruits and veggies and avoiding processed foods. Water is much better than juice; if they drink milk, nix the chocolate milk, which has as much sugar as soda. Family dinners are a great way to connect during the school year and have been shown to improve nutrition and emotional health. Although it can be tricky to have family dinners with kids’ sports and activities, try to make this a priority.

School Prep

For younger kids, being able to go to school and play on the playground now is very reassuring. Some schools will allow a visit to the classroom and a brief meeting of the teacher as well. You and your child can look at their school online, where they can see photos of the building and the school staff. Review transportation plans and always spend 10 minutes of “getting ready” time on school mornings so your child can be on time with less stress.

School Supplies

Look at the list for your child’s school and classroom (schools often post this on their website) and buy supplies early. Have your child practice packing their backpack and designate a place at home where it goes at the end of the day. All papers and notebooks should come out of the backpack daily so homework gets done and other things don’t accumulate. Pack the backpack with completed homework and any needed items the night before to help mornings go smoothly.

School Safety

In view of recent events, your child may have questions or concerns about school safety. Reassure them that a school is a safe place and that you are comfortable having them there. Although there may be a spike in COVID this fall, we have good tools (vaccines, treatment, etc.) to help. As tragic as school shootings are, they are rare, and schools continue to work on security to help prevent such violence. We must display confidence in our child’s safety at school, even if we are concerned.

Back to school “nerves”: If your child feels a bit nervous about the return to school, let them know they are not alone. This is common, especially if they are going to a new school (as will be true of many kids in Ellensburg with the new attendance zones). Talk up the positives of learning new things, making new friends, and meeting their teacher. If you recall feeling the same way, share that with them and how your nervousness dissipated over time.

Going back to school in the fall is a big deal for you and your child; let them know you have confidence in their ability to rise to this challenge. Planning a fun post-school activity and a special family dinner after that first day will give them something to look forward to and be a terrific way to celebrate this transition.

Local School Districts

Below is a list of Kittitas County school districts and their Facebook pages. Schools often post supplies lists, drop-off/pick-up info, scheduling, and other important information for parents and students.

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Dr. Elise Herman

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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.

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.

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Dr. Elise Herman

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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.

Update: Talking to Your Child about Traumatic Events

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Note: This article was first published in 2017 after the Las Vegas mass shooting. Other than updating the location of recent mass shootings, little else was changed. A sad statement that these horrific tragedies continue.

Contributor Dr. Elise Herman

In the wake of the most recent mass shootings in Buffalo, New York and Uvalde, Texas, we all feel sad and stressed.  Parents also wonder if they should discuss traumatic events such as this with their children, what they should say and how to best reassure their child. Depending on the age of the child, how to do this will vary. 

Under age 2 years, kids do not understand exactly what is happening but often pick up on the emotions of the adults around them, and may cry more often, be fussy and be less social. Preschoolers may have some understanding that something bad happened and will look to their parents for reassurance and a sense of normalcy.  Kids in elementary school may develop fears depending on the trauma (especially a school shooting) and not want to go out to school or other activities. Regressive behavior and wanting more help from their parents are normal.

Preteens through teens, often very informed due to their exposure to media, may feel very worried and overwhelmed. They may minimize their feelings, withdraw, or not want to talk about the event. Their stress could come out in being more argumentative or they may have more physical complaints such as headaches.

Parents are crucial in helping their kids through a traumatic event such as a mass shooting. For the child old enough to express themselves who asks about the event, find out what they know or have heard. Keep your discussion age appropriate, and don’t volunteer additional details that may add to your child’s distress. For a preschool child, a simple explanation that a bad person hurt people but can’t hurt anyone anymore is enough. Of course, reassurance that they are safe is vital.

With their access to the news via their phone or computer, older kids may have more specific questions and worries.  They may have heard misinformation from their friends and social media. Give them your full attention and listen carefully. Address their concerns and correct misperceptions. Remind them of the plans in place to help prevent these events and plans that go into action if /when such events occur- and that as tragic as a mass shooting is, it is very rare.

Kids of all ages benefit in these situations from parents being very available, whether it is for questions and conversation or just warm hugs and time together (take your lead from your child). Keeping the family routine including school, activities, and family meals is important.

It is healthy to express your emotions and encourage your child to do the same but process your own feelings before addressing the event with your child. Seeking help from a counselor, health care provider, or clergy member is appropriate for anyone feeling distraught and overwhelmed weeks later, or if you are worried about how your child is coping. 

We have ‘screens’ everywhere and younger children may think every photo or video is actually another tragedy happening. Children with Internet-connected devices should avoid overexposure to the event- the same goes for parents. Younger kids (some say under age 11) should not watch the news or news videos online at all because the visuals can be too overwhelming.

In the face of such incomprehensible tragedy, we can remember PBS’ Mr. Rogers recalling what his mom told him:

Look for the helpers. You will always find people who are helping.

Good advice for all of us. Highlight the bright spots—the first responders, the heroes, average people doing what they can, be it donating blood or giving money to help. Tweens and teens may want to get involved to help promote social change; the non-profit website DoSomething.org is a fine place to start. There is a lot of the good in the world, and we can be the good and an example to our children. Be extra kind, help your child do something nice for someone else, and make your corner of the world a reassuring place for your child. 

Resources:

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Dr. Elise Herman

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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.

Nature & Children

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photo courtesy of KEEN

Contributor: Dr. Elise Herman

Many of us recall childhoods filled with lots of outdoor time, whether it was playing in the backyard, going to parks, building forts, or just running around. Our kids, however, are having very different childhoods, with most spending less than 30 minutes a day outside and up to 7 hours daily in front of some type of technology. The negative physical and emotional effects of this shift are far-reaching and concerning. Rising obesity rates and more mental health issues are huge problems in kids and too much time inside and on electronics are felt to contribute. Research shows that simple outdoor time in nature (recommended to be at least 60 minutes a day) can help reverse these trends.

The benefits for children of getting outside in nature are well documented:

  • Increased physical activity, decreased snacking, and therefore decreased obesity
  • Increased imagination, creativity, and focus
  • Improved distance vision (kids without much outdoor exposure are more likely to have nearsightedness)
  • Increased Vitamin D levels (important in bone and immune system health)
  • Decreased stress, depression, and anxiety
  • Better behavior with less anger and aggression
  • Boost in confidence and self-reliance
  • Improved sleep

So what does outside nature time look like? It could be exploring the backyard or park, hiking, gardening, riding bikes, or just sitting under a tree daydreaming. Unstructured time, without a specific plan, encourages a child to get creative and be independent.

There are some terrific opportunities in our community for kids to get outside this summer. We have wonderful city parks and lots of hiking trails, including the Palouse to Cascades Trail (formerly called the John Wayne Trail) which is easily accessible and great for all ages.

We are fortunate to have nature/outdoor camps as well. Lazy F Camp and Retreat Center in the nearby Manastash Canyon offers day, overnight, and family camps. Kittitas Environmental Education Network (KEEN) provides nature-based education for all ages year round and will once again hold the “Windy City Park Rangers” day camp program in local parks this summer for kids in kindergarten through 8th grade (more information coming mid-April). KEEN also has the Pond to Pines nature-centered summer camp for children in pre-K through 10th grade which is based at Helen McCabe Park. KEEN has been awarded substantial grants and is able to provide 80 full scholarships for kids from families in need.

KEEN
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KEEN Summer Camps 2022
June 20 through July 29
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So get your kiddo out regularly in nature now and make summer plans for more of the same. Enjoy the benefits of turning your child into a nature-loving, active, outdoor enthusiast!

More summer camp info at:

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Dr. Elise Herman

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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.

Reach Out and Read

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Contributor: Dr. Elise Herman

The pandemic has affected so many things for our children, including their education. Despite incredible efforts by devoted teachers and school staff, progress in reading has suffered significantly, with many more students at risk of not learning to read than prior to the pandemic. Kids who do not learn to read in elementary school are at greater risk of dropping out, earning less, and getting in trouble with the law.

A valuable community resource for helping children become good readers may surprise you—it’s your child’s healthcare clinic. The national literacy program for children, Reach Out and Read, has been at Community Health of Central Washington for about 10 years and started at Kittitas Valley Healthcare pediatric and family medicine clinics this month. Reach Out and Read (ROR) was founded in 1989 by a group of pediatricians and educators. It promotes reading by giving out free books at every well child visit from age 6 months through 5 years, and is the only children’s literacy program endorsed by the American Academy of Pediatrics.

The books chosen are age appropriate and culturally sensitive to be ideal for each child. At the well child check, the provider shows the book to the child, perhaps modeling for the parents how to engage with their child through reading, while encouraging the child to handle and explore the book. This is typically an extremely positive part of the visit for all!

The effects of reading together with kids early and consistently are impressive. This activity and the extra love and attention that go along with it help promote brain development, especially important in the first three years of life. Children who are read to tend to develop better recognition of letters and sounds, have a bigger vocabulary, and become better listeners. The connection between parent and child while reading is also reassuring and soothing.

Research has shown that kids who are part of Reach Out and Read show better language scores (both speaking and listening) and their language development continues to improve with ongoing involvement with the program. ROR parents are twice as likely to read to their kids at least 3 times a week, and report increased enjoyment with reading together.

Here are a few tips to best encourage reading in your home:
  • Read together daily, especially at bedtime
  • Encourage your child to hold the book and turn the pages
  • You don’t have to read the words exactly, especially to young children; you can just talk about the pictures
  • Encourage your child to point to things in the book and ask your child questions Simple books, with rhyming and repetition, are perfect for young kids
  • Bilingual books and books about people from different cultures build empathy and understanding of others
  • Be a good role model and regularly read yourself, ideally using traditional books as opposed to an electronic device
Early Literacy Resources in Spanish

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Dr. Elise Herman

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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.

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.

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Dr. Elise Herman

Blog Posts
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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.