KV Healthcare

Pediatrics

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

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Contributor Dr. Elise Herman

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

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

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

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

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

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

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

more about The contributor

Dr. Elise Herman

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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.

RSV in Kids

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Contributor Dr. Elise Herman

We are definitely in the sick season and Respiratory Syncytial Virus (RSV), a common fall/wintertime virus, is very prevalent right now. Most kids have had RSV at least once by age 2 years and usually it just causes a mild cold. In some children, especially preemies, young infants, and those with heart, lung, or immune system problems, RSV can be more serious. It can cause pneumonia (lung infection) and bronchiolitis (inflammation of the small airways). Adults also get RSV, though as with most kids, they usually just have mild cold symptoms. Elderly adults or those with compromised immune systems or underlying health problems can develop more severe RSV.

RSV spreads by direct contact with the virus by kissing, sharing drinks, or touching a contaminated surface). Airborne droplets from a cough or sneeze are also infectious. People are contagious for a day or two before signs of illness and then for 3-8 days after becoming sick.

RSV symptoms include runny nose, cough, sneezing, fever, and decreased appetite. There may be mild wheezing, which is a high-pitched musical sound heard with breathing out. RSV typically lasts 1-2 weeks.

If RSV is more severe, there may be signs of difficulty breathing such as rapid breathing and sucking or pulling in between the ribs or just below the neck (“retractions”). Other warning signs include grunting respirations, and the lips or tongue appearing pale or bluish. Trouble breast or bottle feeding and pauses in breathing are worrisome signs sometimes seen in young infants.

Testing for RSV (done with a nasal swab) is not needed if your child is mildly affected. If the illness seems more severe, RSV testing may be ordered.  Kids can test positive for RSV for days to weeks, even once they appear recovered. There is no need to do testing to see if a child is “over” their infection.

There is no cure for RSV and most kids just need basic at-home care. Ensuring your child gets enough fluids is important. Small frequent feedings may be better tolerated and using saltwater nasal drops and suctioning prior to infant feedings can help. Breast milk can be expressed and put in a cup or bottle if feeding at the breast is too difficult.

Tylenol (over 2 months) or Advil (over 6 months) for discomfort is fine, but do not worry about “getting a fever down”, as the fever may be helping your child fight the infection. Severely ill kids may need oxygen and IV fluids in the hospital to treat dehydration, but this is uncommon and usually is just for a few days. Only 1-2% of infants under 6 months of age need to be hospitalized with RSV.

To decrease the risk of kids and adults getting and spreading RSV, practice good handwashing with soap for 20 seconds. Teach your child to cover coughs and sneezes with tissue or their elbow. Avoid sharing drinks and utensils.  If your child is at high risk of severe RSV, you may want to avoid childcare and crowded settings if RSV activity is high. Masks in kids over age 2 years are effective at decreasing spread of the virus. Avoid smoke exposure which is harmful to lungs in general.

There is no vaccine for RSV yet, though some are in the works. If your child is 6 months or older, it is vital to vaccinate them against influenza and COVID-19 since these can make RSV more serious. There is an injected monoclonal antibody medication to prevent severe RSV only in very high-risk kids.

Remember that most kids with RSV will have a mild illness. You should call your child’s provider, however, if there are signs of dehydration (not drinking well, poor urination, or looking pale or weak), extreme fatigue, or difficulty breathing.

Find more information on our RSV resource page: kvhealthcare.org/rsv

more about The contributor

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.

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

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 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!

more about The contributor

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.

Kids & Allergies

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Contributor Dr. Elise Herman

Spring is here, the weather is improving and it’s great for kids to be outside, unless your child is itchy, congested, and miserable due to allergies. Seasonal allergies are rare under age 2 years but very common after that, affecting up to 40% of children. If your child struggles with allergies, there are strategies and treatments that can have them happily outside and relatively symptom-free this spring and summer.
Allergies are the immune system’s response to things such as pollens, grasses, dust, cat dander, and more. The immune system makes antibodies called Immunoglobulin E which then cause the release of histamines, chemicals in the body which cause allergy symptoms.

The typical culprits for seasonal allergies are flower and tree pollens (like cottonweed) which cause symptoms from spring through early summer. Grass pollen starts to cause problems in the spring and lasts the entire summer. Ragweed and mold spores (often found in hay) are typically problematic in late summer to fall.
Itchiness is the ‘hallmark’ of allergy and can involve the nose, eyes, and skin. Runny or stuffy nose, sneezing, throat clearing, and itchy pink, watery eyes are common. Children do not develop a fever with allergies. Kids can get raised pink itchy bumps called hives if their skin is exposed to something they are allergic to, like grass. Allergies can make asthma worse, causing wheezing, cough, and shortness of breath.

Allergies are often diagnosed by simply recognizing the symptoms and when they occur. Classic symptoms, which occur in spring and summer and worsen with outdoor exposure, do not need testing to make the diagnosis. Testing is indicated if allergy symptoms do not improve with typical treatments or if symptoms are severe or confusing. Skin testing is usually done in an allergist’s office with results in about 15 minutes. Allergy meds need to be stopped for at least 5 days before skin testing. Blood testing, which is best for kids who cannot stop their allergy meds or who have a skin condition like severe eczema which would make skin testing difficult, looks at the amount of Immunoglobulin E for certain allergens.

So how to help your itchy, allergic kiddo?

  • Rinsing off from head to toe and changing clothes helps, both when they are having lots of allergy symptoms and routinely before bed.
  • They should also wash their hands and face when they come in from playing outside to remove pollens.
  • Cool moist compresses to those itchy eyes provide relief, too.

There are multiple long-acting over-the-counter antihistamines which are safe and effective. Cetirizine (Zyrtec) is for kids 6 months and older, and Loratadine (Claritin) and Fexofenadine (Allegra) are approved for those 2 years and up. Loratadine and Fexofenadine are non-sedating; Cetirizine may cause mild sedation in a small percentage of people. Benadryl is not ideal since it only lasts 6 hours and typically is sedating.

If an oral medication is not adequate treatment, there are other options including nasal sprays such as Flonase and Astelin, and eye drops such as Zaditor and Pataday. Young kids may resist these at first but become more accepting as they get older. If allergies are severe, allergy immunotherapy (injections) may be recommended by the allergist. For kids 5 and above with severe grass or ragweed allergies, the allergist might prescribe immunotherapy pills that are placed under the tongue daily.

Every kid deserves to be able to get outside this spring and summer! Discuss your child’s allergies with their health care provider for more information.

more about The contributor

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.

Dr. Elise Herman Retirement Party

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May 15, 2022 @ 3:00 pm – 5:00 pm

Facebook Event

After 31 years of pediatric practice in our valley, Dr. Elise Herman has retired from her position at KVH Pediatrics.

She continues to remain active in the community, volunteering for local children’s organizations and blogging about healthy families.

On May 15, we’re throwing an informal celebration party for Dr. Elise, and we’re hoping you and your family will attend. She’s chosen to have it at North Alder Street Park, which offers plenty of space for active children.

Please plan to drop by the park between 3-5 p.m. to enjoy light refreshments and give Dr. Elise your best wishes. She will be glad to see so many of her patient families again.

North Alder Street Park

2400 North Alder
Ellensburg, Washington 98926 United States + Google Map

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:

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 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

more about The contributor

Dr. Elise Herman

Blog Posts
Provider Profile

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

Encouraging Healthy Eating Habits for Your Child

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Contributor: Dr. Elise Herman

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

Have family meals

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

Avoid struggles around food

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

Go by “MyPlate.gov”

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

Kids Activity Downloads / Fun Word Search Crossword Puzzle

Offer appropriate portion sizes

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

Don’t forget the beverages

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

Be smart about snacks

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

Be a good role model

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

Get your child involved

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

more about the contributor

Dr. Elise Herman

Blog Posts
Provider Profile

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