KV Healthcare

Your Home for Health

family

Mealtime without Screens

· ·

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.

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.

Preventing Respiratory Syncytial Virus Infections

· ·

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.

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.

Avoiding Picky Eating in Kids

· ·

Contributor Dr. Elise Herman

Most parents are familiar with the ‘picky eater’- the child who is suspicious of new foods, has strong favorites, and may refuse to eat what the rest of the family is eating. Picky eating is very common in young children, but usually improves by age 5 years. This behavior occurs in part to exert some control over mealtime (and parents) in a way that is often attention-getting.

Regarding feeding your child, it is a parent’s job to offer healthy foods and decide the time and place for eating; it is the child’s job to decide what to eat and how much. Remember that children will eat when they are hungry, and with enough opportunities (it may take 15 ‘exposures’ to something new), will accept and eat most foods. Pressuring a child to eat creates conflict and can make mealtime stressful actually resulting in the child eating less. It is OK if your child occasionally misses a meal because they refuse to eat what is served.

There are things parents can do to minimize “picky eating” and encourage good eating habits that last a lifetime:

  • Offer a variety of foods including vegetables as soon as your child starts solids in infancy.
  • Have set mealtimes and decide how long meals will last; most kids can sit at the table for about 15 minutes for breakfast and lunch, and 20-30 minutes for dinner.
  • Sit down for meals and do not allow kids to come and go from the table; if they are ‘done’, the plate and any uneaten food is removed.
  • The kitchen is ‘open’ for planned meal or snack time and otherwise is ‘closed’; no other eating or drinking (except for water) as it may decrease the appetite for the next meal. Kids need 3 healthy balanced meals and 1-2 small snacks daily.
  • Get your child involved–gardening, preparing food/ helping with cooking (keep this age appropriate), planning the meal, or setting the table.
  • No separate meals; you are not running a restaurant! You can have a ‘boring’ option available (for example, plain bread) occasionally, but ignore whining or tantrums about food.
  • Give new foods in very small amounts so it is not intimidating.
  • Do not offer crackers, cookies, chips, etc. to get your child to eat ‘something’; if they are truly hungry, they will eat some of what is served.
  • Do not use dessert as a bribe to eat a meal.
  • Model healthy eating habits and keep discussion of eating neutral; no elaborate praise if they eat ‘well’ and no criticism if they refuse to try a new food. Keep conversation light and upbeat so mealtimes are positive.

If you have concerns about your child’s ability to eat or swallow normally, or if you worry they may not be getting enough nutrition, talk to your child’s health care provider.

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.

Mindfulness for Children

· ·

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.

Family Feeding Dynamics

· ·

Feeding kids can be stressful! This webinar focuses on a simple, stress-free approach to mealtime that will help your child create a lasting healthy relationship with eating.

About the Presenter:

Dana Ogan is an Associate Professor at Central Washington University where she directs the Dietetic Internship and undergraduate Food Science & Nutrition program. Dana’s research interests include vitamin D, nutrition in athletes with spinal cord injury, and child nutrition. In her spare time, she enjoys hiking, yoga, and reading. She lives in Ellensburg with her husband (Greg), their 2 sons (Michael & Andy) and their beloved goldendoodle (Fergie).

All presenters for KVH Childbirth & Family Education’s free webinar series are local experts covering a range of topics of interest to families at all stages.

KVH Childbirth & Family Education offers free webinar series

· ·

Julie Harwell, RN, BSN is hosting a free webinar series through our Childbirth & Family Education Program at Kittitas Valley Healthcare. The most recent webinar titled “Creating Meaningful Learning Communities: How Covid has helped us to Reimagine Possibilities in Education” details how one local school adapted to the COVID-19 restrictions and found opportunities for resilience and growth in the classroom and our community.

“The Covid-19 Pandemic brought about many changes in the way we as a society approach school. In addition to the challenges, the past year brought many opportunities for us to reflect on education and how we can best support engagement in learning for children. We found great value in more outdoor education, multi-age groups, parent partnerships in learning, and extending the walls of the classroom to include more community places and partners. This year illustrated the great potential we have to provide meaningful learning experiences for our children when families, children, schools and community members work together.”

Webinar presenter Natalia Parker, a founder of and the current Director at Discovery Lab of Ellensburg, has worked with children and families in varying capacities for the past 20 years. After graduating with degrees in Psychology and Infant Mental Health, Natalia worked in various roles educating and supporting caregivers, children and students in grades Kindergarten through Post-Secondary. Currently, in her role at Discovery Lab she works to support meaningful and engaging teaching and learning practices that best support healthy child development. When she isn’t at work she loves to be outside exploring the beautiful area we live in.

Check out our website to learn more about the KVH Childbirth & Family Education Program.