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Dr. Elise Herman

Indoor Activities with Your Child

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It is great for everyone to get outside daily but sometimes we are stuck inside, often due to stormy weather or extreme cold temperatures. It may be easy to default  to ‘screens’ like video games, iPads, and scrolling on smartphones, but there are lots of things your child can do that involve creativity, brainpower, and just simple play. Use your judgement with the following activities depending on the age of your child.

Art- In addition to drawing and painting, don’t forget Play-doh (home-made Play-doh recipe on-line), cut or torn paper, collages, etc.

Baking (with good supervision of course)

Crafts- Local craft and dollar stores have inexpensive materials appropriate for different ages. “C” can also be for ‘Charades’, the classic guessing game.

Dancing- Put on the classic music you grew up with and rock out with the kids!

Eggs- Use paints or markers to decorate the shells of hard-boiled eggs.

Fort- Let you child get creative making a fort of boxes, blankets, chairs, etc.

Giggling- Tell jokes, riddles, do hand clap routines, etc.

Hair- Have fun with wacky hair styles for the kids (and maybe for you—let them play hairdresser!).

Indoor scavenger hunt- Give kids a list of colors, shapes, and specific items to look for in one room or small area of the house.

Jump rope- This is great indoor exercise if you have enough space.

Kitchen duty can be fun when kids come up with a (simple) menu and you prepare food together.

Listen to music- Consider exploring music of different cultures and parts of the world.

Make music- Use real instruments or pots and pans, shaking a jar of beans, etc. Have a musical parade through the house- noisy but fun!

Necklace– Dye tube-shaped pasta using a small amount of food coloring mixed with white vinegar and let dry. Thread on yarn for a cute necklace (make big enough to go over the head).

Obstacle course-Your child can create a course with cardboard boxes, towels as ‘water’ to be jumped over, a length of string as a ‘tightrope’, throw pillows as rocks to be stepped on with the floor as ‘hot lava’, etc.

Pretending- Kids love to pretend, whether it is acting out a fairy tale or pretending to be a teacher. Endless options!

Quiet activities like puzzles and Legos are a nice way for your child to play independently.

Reading- The reader (either you or your child) can use funny voices and exaggerated emotions which make it very entertaining. Or try Racing in unusual ways: crab-walk, bunny hopping, while holding a big spoon of water, etc.  

Seal, swan, snake- Take turns acting like different animals and see if others can guess which critter is being imitated. Also do some ‘Science experiments’—you can find many ideas on-line.

Tell stories about when your kids were little or make up stories together about adventures their stuffed animals might have. There is a lot of guidance on-line for storytelling.

Uno or other kids’ card games are simple, fun and can encourage good sportsmanship.

Vet office for stuffed animals- Set up a pretend animal clinic- use a flashlight and other household items as ‘instruments’ to examine the ‘patients’.

Writing letters- Teach your kids this ‘lost art’ and let them experience how happy the recipients will be to get an actual letter!

X marks the spot- create a simple map of one room in the house and hide ‘treasure’ (small things like fridge magnets) and put an X on the map for their location. See how your treasure hunters do without too much help.

Yarn- Kids can learn finger knitting, crocheting, or standard knitting with on-line instruction.

Zinnia seeds- Plant zinnia or other (small) flower/ herb seeds in cups with seed or potting mix. A small UV light or a spot on a sunny windowsill will be needed once the seeds sprout.

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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 mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Mealtime without Screens

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Contributor Dr. Elise Herman

Mealtime should be a time to connect with our kids and enjoy healthy food in a stress-free environment. This idealized version is not always the case, and for many reasons, kids may end up eating in front of the TV, laptop, iPad, or smartphone. There are multiple problems with this—for both adults and kids.

Obesity:  In general, kids eat more in front of a screen. Some parents are happy to see their child (especially if they are a picky eater) eating more but being distracted while eating means eating mindlessly. This can lead to overeating in the long run since kids don’t pay attention to feeling full and therefore overeat. Research has shown that children who watch a screen during meals are more likely to be overweight.

Digestion: Digestion is aided by really noticing the aromas, the preparation and the sight of food. If attention is more on the screen than the food, digestion can suffer.

Missed social opportunities: When eating alone and watching a screen, kids miss out on connection with others over a meal, learning to make conversation and basic etiquette (taking small bites, not talking with your mouth full, etc.). Mealtime is a chance to slow down, enjoy our food, and socialize. You can model all of this to your child if you eat together, undistracted—powerful stuff!

Exposure to commercials: Commercials during kids’ programming are often for fast food or processed foods high in sugar and calories and aimed specifically at children. Not surprisingly, screen time during meals is associated with increased junk food consumption.

So how to change this behavior in your house? Anticipate that it may not be easy (for either of you) to break this habit, but keep in mind how important this is and stay with it. Here are some suggestions:

Make change gradual: Target one meal at a time, either eliminating screens altogether for that meal or decreasing the time. Substitute music, conversation, or reading books to your child (not having an app read a book). Starting with a no-screen snack is an easy way to begin.

Adults adopt the change, too: No screens for adults as well at mealtimes, not even to text. You can tell your child this is hard for you, too, but you know how important it is for everyone to make this change. Explain your plan to other adults who may provide meals (childcare, sitters, grandparents) so they are also on board with this—consistency is vital for success.

Follow a schedule: Eliminate screens at one meal or snack every 1-2 weeks and you will accomplish the overall goal within 1-2 months. Talk about how different mealtimes are now that you are connecting and eating more mindfully.

Be firm: Don’t give in to tantrums or your child eating less. This behavior will be short-lived, so don’t let it throw you off track. You can however have some occasional exceptions such as snacks while watching sports, but these should be infrequent.

Children age 8-12 in the US look at screens for 5 ½ hours daily and teens spend an average of 8 hours a day on their devices—pretty stunning statistics. Kids who watch a screen during mealtime spend more time on devices overall. Changing this behavior is a good place to start to take control of the excessive screen use in most of our lives.

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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 mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Returning to School After an Illness

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Contributor Dr. Elise Herman

As kids head back to school and are together in classrooms again, parents know their child may pick up some illnesses. There are times when it is appropriate to keep sick children home, both for their own recovery as well as protecting fellow students and school staff. Students should be showing signs of improvement before returning to the classroom. Below are helpful guidelines for different illnesses your child may encounter as we move into fall and winter.

Fever: In general, kids should stay home if they have a fever over 100.4 degrees Fahrenheit. They may return to school if it has been about 24 hours without a fever (and no fever-reducing medications like Tylenol or Ibuprofen given).

Colds, RSV (Respiratory Syncytial Virus), COVID, and Influenza: if cough and congestion are mild and there is no fever, kids may stay in school. If they have a fever, follow the above guidelines. If your child has a more persistent cough or is very fatigued, keep them home until they are improving. When they return to school, kids should wear a mask for up to 5 days after becoming sick to protect others.

Gastroenteritis (Vomiting and Diarrhea): Kids should stay home if stools are very watery and hard to control (this may depend on the age of your child). If it has been hours since the last vomiting episode and the child is now keeping down liquids and solids, they may return to school.

Strep Throat: Children diagnosed with strep throat may return to school if it has been 12-24 hours since starting antibiotics and they are feeling better. Make sure they are drinking and eating adequately, too.

Pinkeye (conjunctivitis): If eye discharge is thin and watery with pink eyes, this infection is most likely due to a virus and no treatment is needed. This should resolve on its own within 5-7 days and your child may stay in school (be sure to review good hygiene to prevent spread). If eye discharge is thick, green/ yellow and eyes are very red, call your child’s provider since antibiotic drops or ointment may be appropriate if the cause is bacterial. Kids can return to school about 24 hours after starting this treatment.

Chickenpox (varicella): Chickenpox is less common now with effective vaccination, but if it occurs, all sores should be dry and crusted before returning to school.

Impetigo: This common skin infection may be treated with topical antibiotic cream or oral antibiotics. Kids can be in school once treatment has been started.

Hand, Foot, and Mouth Disease: This viral illness causes painful sores in the mouth and small blisters on the palms and soles. There often is fever and a body rash, too. Children should stay home till they are drinking and eating well and fever-free x 24 hours; the rash does not need to have resolved since that can take 1-2 weeks.

Lice, scabies, and ringworm (tinea): These infections are very common in school-age kids, and children may return to class after treatment is begun. Kids do not need to be ‘nit-free’ to be in school.

Make sure your child is up to date on vaccines to prevent common and potentially dangerous illnesses, including COVID-19 and influenza. Remind your child about handwashing and good hygiene– and be a good role model with this! Call your child’s healthcare provider if you have concerns about your child’s illness and return to school. Policies about returning to class may differ between school districts; many school districts post their policy online. Your child’s school nurse is an excellent source of information if you still have questions.

Resource

https://www.cdc.gov/orr/school-preparedness/infection-prevention/when-sick.html

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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 mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

How to Help Your Child Make Friends

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Contributor Dr. Elise Herman

As kids head back to school, it is easy to focus on the academics, but the social side of school, including friendships, is very important to a child’s development and overall success. You can help your child with the skills of making friends, keeping friends, and being a good friend, all vital to building social connections at school and beyond.

As the parent, you can be a good role model. Be friendly and social when you are out and about (and put away the phone, of course). Make conversation and express curiosity when interacting with others. At home, encourage conversation at the dinner table, taking turns asking and answering questions (again, no phones around). Having family game night or doing chores together teaches kids how to interact within a group. Let your child know that bragging and teasing will push other kids away.

Some kids need help reading others’ facial expressions; this is a skill that you can teach your child and practice at home. Active listening makes the other person feel heard and can be achieved with eye contact and verbal affirmations such as “uh-huh”, “yes”, and “tell me more”. Kids should also take turns speaking and let someone finish before jumping in and interrupting.  Role playing with your child for greetings, introductions, and conversation can help them feel more confident in social situations.

Bonding over a common interest or activity happens naturally, so encourage participation in clubs, sports, and other groups.  Arranging a playdate at a park or some other ‘neutral’ location is a great way for kids to build relationships. If there is a fellow student your child has mentioned positively, you may be able to reach out to their parent at school drop-off or a school event and discuss a get-together.

Help your child work on emotional regulation so interactions with other kids are positive and without anger or tantrums. Communicating calmly about feelings and stepping away briefly if upset are helpful strategies. Remind your kiddo to ‘let little things go’ and avoid being petty. Explain that annoying behaviors such as poking, imitating, and not respecting personal space can be very off-putting.

It is said that the best way to have a friend is to be one. Ask your child what they would want in a friend—and have them brainstorm how they can be that special person for someone else. Be positive about their efforts to master the important social skills needed to create friendships; this comes easier to some kids more than others. If your child is really struggling in this area, you may want to speak with your child’s health care provider or counselor.

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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 mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

How to Have a Good Family Road Trip

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Contributor Dr. Elise Herman

If you have a family road trip coming up this summer, you may be dreading the challenge of being together in the car for hours (or days). But with a little planning, you can employ some strategies to make this go more smoothly. Consider starting out when kids will sleep through the first part of the trip- either in the wee hours of the morning or at bedtime and remember to take any ‘loveys’ (favorite blanket or stuffed animal) along for the ride.

Plan on stopping about every 2 hours for younger kids (though we all need breaks from the car) and pick places like a park or playground so kids can get some fresh air and exercise. Have lots of healthy snacks on hand when you get out of the car; young kids should not eat in their car seat due to choking concerns. Avoid processed snacks with high sugar content which can spike the blood sugar and affect your child’s mood. Water is fine but sticky liquids like juice can be a big mess in the car. If anyone has symptoms of carsickness (queasiness, nausea), open the windows a bit and make a quick stop if you can. A bland snack like crackers can help.

Have everything you need for your child in a separate bag in the front, so it is easy to find things quickly. Bring lots of books, toys, puzzles (with big pieces that are less likely to get lost), crayons and paper, etc. Etch A Sketch and magnetic drawing boards work well for a variety of ages. Kids are more entertained by new things—or at least new to them; see if you can borrow from a friend as opposed to buying lots of new stuff.

Depending on the age of your child, classic activities such as “I Spy with My Little Eye” and license plate bingo work well; there are lots of variations found online. Singing songs together is a perennial favorite, as are word games such as GHOST (each person adds a letter with the goal being not to end the word). Kids’ podcasts (for example, NPRs “But Why?”) and kids’ music playlists and audiobooks can help pass the time.

Older kids can help navigate and point out interesting places along the way. Give them a paper map (remember those?!) and ask them to give input on routes, provide updates on location, and how much distance has been covered and how much lies ahead.

Screen activities can have a place in your road trip, but much better to use judiciously than have everyone with their head down on their own device the whole time. Try to save this till later in the trip when you ‘really need it’. If there is whining for devices, don’t give in—these are a privilege and are ‘awarded’ for good behavior.

Family road trips can be exciting and lots of fun, but it is realistic to expect there may also be crabbiness and bickering. Acknowledge to your child that it may be challenging but that you are on your way to somewhere special. Remember this is also a time for kids to learn patience, kindness, and compromise. With planning and preparation, you can all have a pretty good (and memorable) time on your adventure.

Resources

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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.

Helping Kids Deal with Climate Change

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Contributor Dr. Elise Herman

We are hearing and reading a lot about climate change and our kids are getting lots of exposure to this topic, too. The terms “eco-anxiety” and “climate change grief” refer to the psychological effects- feelings of worry, fear, despair, and hopelessness- that can develop with awareness of the realities of climate change including more extreme weather, increased heat, wildfires, and loss of biodiversity. There are steps we can take to help our kids be more resilient in the face of climate change and help ourselves cope at the same time.

Decreasing your own and your children’s exposure to media, especially media that is sensationalistic, is very important. There is a fine line between being informed and being overwhelmed—our kids feel it, too. Don’t have the news on (radio or TV) a lot, and don’t constantly refresh your online news source. There are media sites such as Earth Rangers which can give information that is more positive, such as what steps are being taken to combat climate change. The National Geographic Kids website explains this issue in a developmentally appropriate way while offering steps kids and parents can take together to help, even in small ways. The documentary show “An Optimist’s Guide to the Planet” on Apple Plus explores people, traditions, and ideas which foster optimism in the face of climate change. Look for books that explain climate change in age-appropriate ways and offer a hopeful outlook. Books that show kids as the ones coming up with some solutions and creating positive change are particularly empowering.

When discussing climate change, ask your child what they have heard and believe. Ask open-ended questions to encourage a conversation. What do their friends think? How are their teachers approaching climate change education? Don’t be afraid to discuss negative environmental stories (wildfires, etc.) and how they are feeling while reassuring them that they are safe. Validate your child’s emotions and response and share some of your own. You may be able to dispel some alarming misconceptions right up front. The bleak and scary possibilities may not come to pass; it is important to leave room for hope and to discuss what positive steps are being taken. Point out some ‘climate victories’ such as more electric vehicles and increasing use of solar and wind power. Knowing that scientists, governments, and environmental organizations are working together to combat climate change can be reassuring.

Encourage a positive mindset and take positive actions. When your child sees you driving less, being mindful with water use, and aiming to conserve energy, you are being a good role model. Find things you can do together—buy less, especially things encased in single-use plastic; consider a more plant-based diet; try to walk and bike instead of driving if possible, at times. Your child may be able to work with their school to help it be more eco-friendly perhaps by decreasing unused food waste, eliminating plastic straw use, or recycling, for example. You can become active with an environmental group or even help your child start one at school. Earth rangers.com has a free club portion geared towards kids with great ideas for your child to take action. Older kids may enjoy sites such as earth.org which highlight young adults making a difference through climate change activism.

Both parents and kids benefit from time in nature, which is known to improve mental and physical health. Getting outside regularly builds connection and a sense of responsibility to nature, as does showing gratitude, especially for the beauty here in Eastern Washington. Do things that help our local environment-plant trees, have a garden, scatter native wildflower seeds. These actions inspire hope and increase a sense of stewardship for the planet. Kids can feel powerless but listening to them and taking action together, even in seemingly small ways, can give them (and us!) a sense of optimism and control. Do consider talking with your child’s healthcare provider or counselor if you note persistent or severe feelings of anxiety or depression related to climate change.

Resources

http://www.earthrangers.com

http://www.natgeokids.com/uk/parents/eco-anxiety-guide-for-parents/

10 Young Climate Activists Leading the Way on Global Climate Action

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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 mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

    Measles Cases Rising 2024

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    Contributor Dr. Elise Herman

    Measles cases are on the rise, and although numbers in the US are small right now, there is cause for concern. Measles is one the most contagious human viruses, with a 90% chance of someone who is not immune getting infected if they are near someone with measles. People with measles can infect others for 4 days before they have any signs of being sick, and for 4 days after the rash appears. The virus stays in the air and is infectious for 2 hours after the infected person has left. There is no treatment for the measles virus, however there is life-long immunity (protection) after vaccination as well as infection.

    This recent rise in measles in the US is in part due to a mild drop in kids’ vaccination rates, often related to children missing routine health care visits during the pandemic. Although the current rate of kindergarteners fully vaccinated against measles is good at 92%, the previous rate of 95% was better particularly because that level gives ‘herd immunity’, meaning protection of those that were not or could not be vaccinated (due to young age, cancer treatment, or other immune system problems) by those who are vaccinated.

    The number of measles infections world-wide has increased dramatically, up almost 80% in the last year to 306,000 cases. As people travel more, they can bring the infection home if they are not immune, potentially exposing many people before they know they are sick.

    Measles spreads easily through airborne secretions from coughing or sneezing. Infection is also caused by direct contact with droplets from the mouth, nose, or throat. Symptoms develop 7-14 days later and start with profuse runny nose, cough, and red, swollen, watery eyes. Fever is often up to 104 degrees. The rash develops 3-5 days after cold symptoms begin and starts as flat red spots on the forehead, spreading downwards to the trunk and extremities. Some spots may become raised and join to from larger blotches. It is not usually itchy.

    Measles itself is miserable, but the biggest concern is regarding complications. Serious complications include pneumonia in 1 out of 20 of those infected, encephalitis (brain inflammation and swelling) in 1 out of 1000 infected, and rarely, temporary or permanent blindness (more common in developing countries). One out of 5 unvaccinated people in the US with measles will be hospitalized, and 1-3 out of 1000 will die. Children under 5 and adults over 20 are most at risk of serious complications. Also at increased risk are pregnant women and those with immune system problems.

    Measles vaccination is safe and effective and gives life-long immunity. Prior concern of a connection between the MMR (measles, mumps, and rubella) vaccine and possible autism was based on fake ‘research’ and has been disproven by multiple studies by the American Academy of Pediatrics, the World Health Organization, and the Institute of Medicine.

    There has been a 99% decrease in measles cases since the vaccine came out in 1963. Prior to the vaccine, there were 3-4 million cases annually in the US and about 48,000 people hospitalized, most of which were children. Add approximately 500 deaths and 1,000 cases of encephalitis each year, and it is easy to see how miraculous vaccination has been.

    The best way to protect ourselves, as well as the approximately 9 million people in the US who cannot get the vaccine due to an immune system problem, is to be vaccinated. Measles vaccine is recommended for kids aged 12 months and again between 4 and 6 years. It is also approved for adults who did not receive it as children. There are 2 types of measles vaccines- the MMR (as above) and the MMRV (also protects against varicella/chickenpox). Your child’s health care provider can provide additional information on measles vaccination.

    Recursos en español

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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 mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

    Teen Acne

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    Contributor Dr. Elise Herman

    Teen acne is very common, affecting 85% of adolescents. It can occur on the face, neck, back, shoulders, and chest. Mild acne usually resolves without scarring, but more severe acne can cause darkened areas and permanent depressions in the skin. Teen acne does improve in most by age 20, but in the meantime, it can worsen a teen’s self-esteem, emotional health, and result in bullying.

    Acne occurs in teens due to increased pubertal hormones which cause sebaceous glands in the skin to make more sebum (oil which lubricates the skin). This sebum can plug the pores (hair follicles), resulting in swelling. Bacteria then can create inflammation, irritation, and redness in these swollen pores.

    There are factors which are known to increase acne, including stress. Hormones related to menstruation can also worsen acne the week or so before a girl’s period. Some skin products (moisturizers, sunscreen, and cosmetics) can make acne worse. Look for water-based products and avoid any that contain mineral oil, beeswax, sodium lauryl sulfate, cocoa butter, or coconut oil. Products labeled “non-comedogenic” (meaning not acne-causing) are ideal. Things that rub or cause excessive sweating can contribute to acne; think of phones, chinstraps, and backpacks. Research has not shown a connection between diet and acne, though a healthy diet with lots and fruits and vegetables and minimal processed food is recommended for all teens.

    There are four types of acne. Whiteheads are plugged pores that remain closed. Blackheads are plugged pores that are more superficial and open up, turning dark. Pimples are deeper plugged pores that become irritated and red due to bacteria (though this is not a true infection). Cysts or nodules are deeper, bigger, and may be painful. This severe type of acne can leave permanent scars.

    If acne is mild or moderate, start with over-the-counter products. Washing twice a day with a mild soap such as Cetaphil or an acne wash can help. Clean fingertips are ideal for washing the face; avoid scrubbing. After the skin has dried for about 20 minutes, apply a low strength (2.5%) benzoyl peroxide product sparingly to the face and other problem areas (not just on pimples) once a day, perhaps in the morning. Lower strength benzoyl peroxide products have been shown to work as well as higher strength for most people. Benzoyl peroxide can bleach towels and clothing, so apply carefully. After washing the face in the evening and allowing it to totally dry, apply a thin layer of adapalene (also called ‘Differin’) which is derived from Vitamin A. Both benzoyl peroxide and adapalene can cause irritation, dryness, and redness so always apply to dry skin and use a small amount. These products can initially be used every other day, slowly working up to daily, to help minimize this.

    It can take 2-3 months for acne to improve with an appropriate skin care routine, so patience is key. Squeezing acne lesions makes them more inflamed and take longer to heal as well as potentially causing scars, so should be avoided. If acne is more severe or not improving with over-the-counter care, seek help from your medical provider or a dermatologist. Treatment of more severe acne can help prevent permanent scarring.

    Remember that although acne does usually resolve after the teenage years, it can be a very big deal to your teen in the present, affecting them not just physically but emotionally. Let your teen know that you empathize, and together you will do what’s needed to treat their acne.

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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 mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

    Helping Your Shy Child

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    Contributor Dr. Elise Herman

    By nature, some kids are more outgoing than others. Many children are shy and reserved when younger but become less so as they grow up. Being shy, however, just characterizes a child’s approach to the world (especially new situations) and does not have to be seen as a negative. There are felt to be some benefits of this personality trait as these children tend to be more observant and less impulsive. Shy kids may be slower to warm up and more cautious about jumping into a new social situation but given time and the opportunity to be involved when they feel ready, do fine socially.

    You can help your child if they fall into the ’shy’ category:

    • Don’t allow people to label your child as ‘shy’ which can make them feel negatively about themselves. You can say something like, “He just sometime needs a little time to observe and warm up”. You can suggest your child give a little wave or smile if they are not ready to talk to someone.
    • Accept your child’s shyness and acknowledge their feelings, but don’t be overprotective. Gently encourage them to try challenging situations such as answering a question in class, ordering an item at a restaurant, or saying ‘hi’ to a child they see on the playground.
    • Create opportunities to practice social skills especially in low-risk settings such as going on playdates, casually getting together at a park with another family, etc.
    • Roleplay certain situations such as meeting new adults and approaching kids at school. It is fine to be near your child if they ‘need’ you, for example when meeting other kids at a playground, but try to let them speak for themselves. If they seem comfortable, you can move away while reassuring your child that you will be nearby.
    • Participation in group activities can build social skills and confidence. Small groups or classes such as scouts, dance, sports, or music give your child a chance to get to know a group that they will see regularly and so become increasingly comfortable.

    It is important to separate common shyness from social anxiety disorder, which is more severe, long-term, and interferes with everyday life to a greater degree. Those with this issue worry excessively about social interactions and seek to avoid social situations when possible. This can negatively impact school, friendships, and overall emotional well-being. Talk to your child’s healthcare provider if you think your child may have social anxiety disorder as counseling and other treatments can be very helpful.

    But don’t fret if you have a shy child—things will get easier! Accepting your child for who they are and supporting them as they work on social skills will help them gain the confidence they need as they grow.

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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 mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

    Preventing Respiratory Syncytial Virus Infections

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    Contributor Dr. Elise Herman

    As the winter weather approaches, so does the ‘sick season’, including illness due to RSV (Respiratory Syncytial Virus). RSV typically starts in fall, peaks in winter, and causes cold symptoms including runny nose, cough, and fever in children and adults. Most kids have had RSV by age 2. Although usually mild, RSV can cause more serious problems like wheezing, pneumonia, and trouble breathing. These problems are more likely in premature babies or in kids with heart disease, lung issues like asthma, and immune system problems. Between 58,000 and 80,000 kids under age 5 are hospitalized due to RSV each year. Adults aged 60 and above are also at higher risk of more severe RSV illness. Reinfections with RSV are common.

    Like other colds viruses, RSV spreads by the droplets released by coughing or sneezing. You can also get it by direct contact (for example kissing) or touching a contaminated surface like a counter or cup and then touching your eyes, nose, or mouth.

    There is no effective treatment for RSV and since it is a virus, antibiotics do not help. There are, however, two new good ways to prevent RSV—vaccines for adults and antibody treatment for young children. Vaccines stimulate the formation of antibodies to help fight infection (active immunity). Antibody treatments give antibodies directly to the body (passive immunity).

    RSV vaccines are available for those 32-36 weeks pregnant during RSV season and if given at least 2 weeks before delivery, will help protect the baby from severe RSV. RSV vaccine is also recommended for those 60 years and older.

    Antibody therapy (Nirsevimab) is approved for babies less than 8 months during RSV season (if mom did not get vaccine at least 2 weeks before delivery). Nirsevimab is also appropriate for some infants aged 8-19 months with severe health issues including extreme prematurity, immune system problems, cystic fibrosis, and heart disease. Nirsevimab is an injection and lasts 5 months, so helps protect for the entire RSV season. There is another antibody treatment called Palivizumab that has been used for years, but this is only approved for very high-risk children under age 2 and requires a monthly injection.

    Side effects of Nirsevimab are uncommon and include temporary discomfort, redness or mild swelling at the injection site, and a rash. Nirsevimab can be given with routine childhood vaccines and may be given if a child has mild cold symptoms. Children who have had RSV should still receive the antibody therapy due to the risk of getting infected again later in the sick season.

    There may be some difficulty having enough Nirsevimab for all kids who are eligible this year; contact your child’s provider about this. Supplies of RSV vaccine for those who are pregnant or 60 and over seem adequate; check with your provider or local pharmacy.

    Remember the routine ways we can all help prevent the spread of RSV and other viruses, such as frequent hand-washing, avoiding touching one’s face, staying home if sick, and wearing a mask when appropriate. Also, cover sneezes and coughs, do not share cups or utensils, and keep countertops and other frequently touched surfaces clean. Don’t forget your child’s other important vaccines including Influenza and COVID vaccines as these are also important to help keep your child healthy this winter season.

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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 mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.