Talking to Children about Disasters

 

Our hearts and prayers go out to the families and communities of Boston and West, Texas. We look for answers as parents and want to know the best way to talk to our children about two events, while very different, still both devastating. Here is an amazing resource that  the American Pediatric Association has put out. Please feel free to talk to your pediatrician about any of these hard topics. Thanks to the AAP for a great article!

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Children can cope more effectively with a disaster when they feel they understand what is happening and what they can do to help protect themselves, family, and friends. Provide basic information to help them understand, without providing unnecessary details that may only alarm them.

For very young children, provide concrete explanations of what happened and how it will affect them (eg, a tree branch fell on electrical wires and that is why the lights don't work). Let children know there are many people who are working to help them and their community to recover after a disaster (such as repair crews for the electric company, or firefighters, police, paramedics, or other emergency personnel). Share with them all of the steps that are being taken to keep them safe; children will often worry that a disaster will occur again.

Older children will likely want, and benefit from, additional information about the disaster and recovery efforts. No matter what age, start by asking children what they already know and what questions they have and use that as a guide for the conversation. Limit media coverage of the disaster—if children are going to watch media coverage, consider taping it (to allow adults to preview) and watch along with them to answer questions and help them process the information. While children may seek and benefit from basic information about what happened so that they can understand what is happening in their world, they (and adults) don't benefit from graphic details or exposure to disturbing images or sounds. In the aftermath of a crisis is a good time to disconnect from all media and sit down together and talk as a family.
Be sure to ask children what questions or concerns they have. Often they have fears based on limited information or because they misunderstood what they were told. Reassure children when able to do so, but if their fears are realistic, don't give false reassurance. Instead, help them learn how to cope with these feelings.

Help Children Cope:

After a disaster or crisis, children benefit from adults who can help them learn how to cope effectively. Although it is not useful for adults to appear overwhelmed by the event, it is helpful to share some of their feelings and what they are doing to deal with those feelings. Children can't be expected to cope with troubling feelings if no one models effective coping. Allow children to "own" their feelings. Let your child know that it is all right to be upset about something bad that happened. Use the conversation to take the opportunity to talk about other troubling feelings your child may have. A child who feels afraid is afraid, even if adults think the reason for the fear is unnecessary. If you feel overwhelmed and/or hopeless, look for some support from other adults before reaching out to your child.
Don’t feel obligated to give a reason for what happened. Although adults often feel the need to provide a reason for why someone committed such a crime, many times they don’t know. It is okay to tell your child that you don’t know why at this time such a crime was committed.
Children are not only trying to deal with the disaster, but with everything else that follows. They may have to relocate, at least temporarily, and could be separated from friends or unable to attend the same school. Parents may have less income and the change in finances may impact their ability to participate in activities they enjoyed or travel to visit family out of town. Allow children to express their regrets over these "secondary losses" (without accusing them of being selfish) and help them figure out ways to minimize the impact or find alternatives.
Children, just like adults, often feel helpless after a disaster. Help them figure out what they can do—that is meaningful to them—to help others in their community impacted by the disaster. For more information on helping your child cope, click here.

Support Grieving Children:

Children who have experienced the death of a family member or friend need to understand and grieve a personal loss, above and beyond adjusting to the disaster itself. For more information on how to support grieving children, click here.

Talking to Children about the Economy:

The current economic situation is impacting adults throughout the United States and abroad. The effect that it may have on children and adolescents may be less direct—they may be worried about changes they see in their parents' mood or behavior because their parents are concerned about finances—but it is still something that parents and pediatricians should address. Talking to children about the economy, and the impact it is having on their family, can help them develop strategies for coping with the current financial situation and their day-to-day life.

Talking to Children in the Aftermath:

Click here for resources and information to help children cope with the aftermath of community or school shootings. If you have concerns about your child’s behavior, contact his or her pediatrician, other primary care provider, or a qualified mental health care specialist.

Additional Resources:

Getting Your Family Prepared for a DisasterHow to Prepare for Disasters
Communicating with Children and Families: From Everyday Interactions to Skill in Conveying Distressing Information
Tips for Talking to Children After a Disaster (Substance Abuse and Mental Health Services Administration)
School and Family Resources (National Center for School Crisis and Bereavement)
Catastrophic Mass Violence Resources (National Child Traumatic Stress Network
Talking to Children About Earthquakes and Other Natural Disasters (AACAP)

--Info all from Healthychildren.org Click on all links about for more information!

Car seats--Have you checked your car lately?

One of the most important jobs you have as a parent is keeping your child safe when riding in a vehicle. Each year thousands of young children are killed or injured in car crashes. Proper use of car seats helps keep children safe. But with so many different car seats on the market, it’s no wonder many parents find this overwhelming. The APP has a great new article about car seats. CLICK HERE for the full story. Here is a few key points:

The type of seat your child needs depends on several things, including your child’s age, size and the type of vehicle you have. Note: The “Types of car seats at a glance” chart is a quick guide on where to start your search. It’s important to continue reading more about the features and how to use your car seat. Additional safety tips are at the end of this article.
To see a list of car seats and safety seat manufacturers, click here.

Types of car seats at a glance

Age Group	Type of Seat	General Guidelines
Infants/toddlers	Rear-facing only seats and rear-facing convertible seats	All infants and toddlers should ride in a Rear-Facing Car Seat until they are 2 years of age or until they reach the highest weight or height allowed by their car seat's manufacturer.
Toddler/preschoolers	Convertible seats and forward-facing seats with harness	Any child 2 years or older who has outgrown the rear-facing weight or height limit for their car seat, should use a Forward-Facing Car Seat with a harness for as long as possible, up to the highest weight or height allowed their car seat’s manufacturer. This also applies to any child younger than 2 years who has outgrown the rear-facing weight or height limit of their seat.
School-aged children	Booster seats	All children whose weight or height is above the forward-facing limit for their car seat should use a Belt-Positioning Booster Seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are between 8 and 12 years of age.
Older children	Seat belts	When children are old enough and large enough to use the vehicle seat belt alone, they should always use Lap and Shoulder Seat Belts for optimal protection. All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection.

Important reminders

1. Be a good role model. Make sure you always wear your seat belt. This will help your child form a lifelong habit of buckling up.
2. Make sure that everyone who transports your child uses the correct car seat or seat belt on every trip, every time. Being consistent with car safety seat use is good parenting, reduces fussing and complaints, and is safest for your child.
3. Never leave your child alone in or around cars. Any of the following can happen when a child is left alone in or around a vehicle. A child can
• Die of heat stroke because temperatures can reach deadly levels in minutes.
• Be strangled by power windows, retracting seat belts, sunroofs, or accessories.
• Knock the vehicle into gear, setting it in motion.
• Be backed over when the vehicle backs up.
• Become trapped in the trunk of the vehicle.
4. Always read and follow the manufacturer’s instructions. If you do not have the manufacturer’s instructions for your car seat, write or call the company’s customer service department. They will ask you for the model number, name of seat, and date of manufacture. The manufacturer’s address and phone number are on the label on the seat. Also be sure to follow the instructions in your vehicle owner’s manual about using car seats. Some manufacturers’ instructions may be available on their Web sites.

-- Info from AAP and Healthychildren.org Link to the full story above

Spring Break Safety Tips

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Spring break is a great time for the family to get away from the cold, dark days of winter and have some fun in the sun. Every year the AAP post a list of safety reminders for Spring Break---Here they are and have a safe and fun Spring Break this year! 

Sun Safety for Babies

• Babies under 6 months of age should be kept out of direct sunlight. Move your baby to the shade under a tree, umbrella or stroller canopy. It is okay to apply a small amount of sunscreen on infants under 6 months if there is no way to avoid the sun.
• Dress babies in lightweight clothing that covers the arms and legs, and use brimmed hats.

Sun Safety for Kids

• Choose sunscreen that is made for children, preferably waterproof. Before covering your child, test the sunscreen on your child’s back for an allergic reaction. Apply carefully around the eyes, avoiding eyelids. If a rash develops, talk with your pediatrician.
• Select clothes made of tightly woven fabrics. Cotton clothing is both cool and protective.
• When using a cap with a bill, make sure the bill is facing forward to shield your child’s face. Sunglasses with UV protection are also a good idea for protecting your child’s eyes.
• If your child gets sunburn that results in blistering, pain or fever, contact your pediatrician.

Sun Safety for the Family

• The sun’s rays are the strongest between 10 a.m. and 4 p.m. Try to keep out of the sun during those hours.
• The sun’s damaging UV rays can bounce back from sand, snow or concrete; so be particularly careful of these areas.
• Most of the sun’s rays can come through the clouds on an overcast day; so use sun protection even on cloudy days.
• When choosing a sunscreen, look for the words "broad-spectrum" on the label - it means that the sunscreen will screen out both ultraviolet B (UVB) and ultraviolet A (UVA) rays. Choose a water-resistant or waterproof sunscreen and reapply every two hours.
• Zinc oxide, a very effective sunblock, can be used as extra protection on the nose, cheeks, tops of the ears and on the shoulders.
• Use a sun protection factor (SPF) of at least 15.
• Rub sunscreen in well, making sure to cover all exposed areas, especially the face, nose, ears, feet and hands, and even the backs of the knees.
• Put on sunscreen 15-30 minutes before going outdoors - it needs time to work on the skin.
• Sunscreens should be used for sun protection and not as a reason to stay in the sun longer.

Beach Tips*

• Drink plenty of water, non-carbonated and non-alcoholic drinks, even if you do not feel thirsty.
• Stay within the designated swimming area and ideally within the visibility of a lifeguard.
• Never swim alone.
• Be aware of rip currents. If you should get caught in a current, don’t try to swim against it. Swim parallel to shore until clear of the current.
• Seek shelter in case of storm. Get out of the water. Get off the beach in case of lightning.
• Watch out for traffic – some beaches allow cars. .

--Info from AAP.org and links to healthychildren.org

Save the Date: CPR Class for Parents!

Announcing CPR Courses for Parents! Such a huge hit every time and so many of you keep asking for it!

Saturday, May 11th 2013 at 2:00 pm

The class will last approximately 1 hour

$15 per person

15-20 spots available

To sign up, please speak with our office coordinator, Margie. You can contact her by calling the office or email her at margiet@wasatchpeds.net.

Spots will be offered on a first come first serve basis!

This is only a CPR class, NOT certification. It will be taught by Christine Keddington, who is certified to teach CPR.

Hiring Energetic and Friendly MA

Our office is looking for an energetic and friendly MA for one of our amazing, busy pediatricians. This is a full time position with insurance and benefits provided. Requirements for this position require someone that is high energy, pleasant and loves to work with children.

Please send your resume to margiet@wasatchpeds.net

Daylight savings alters sleep patterns

Did day light savings alter your sleeping patterns at home? It seems to take most families a few weeks to get back in the routine. If you are lacking sleep with this day light savings, read below for some great tips on how to help you and your child's sleep!

Sleeping Environment

• Get comfy. Make sure your bed and bedding are comfortable.
• Remove distractions. Get the TV out of the bedroom. Avoid watching or listening to upsetting, violent, or scary materials within 2 hours of bedtime. That includes the news, conflict-filled talk shows, and high-anxiety dramas. Use the bed only for sleep and intimacy, not for TV, reading, working, talking on the phone, or playing electronic games.
• Soothing sounds. Listen to relaxing music, sound from nature, or the sound of silence. Keep the noise level down. Consider earplugs if you can’t control the environment.
• Security and safety. Before you head for bed, make sure your doors are locked, the stove is off, the iron in unplugged, the water taps are turned off, and there are no bogeymen under bed (just kidding on this last one, but it does help to go through a routine to ensure you’ve done what you can to ensure your personal safety).
• Darker is better. Turn the light off. Darkness promotes sleep and healthy levels of melatonin, an important hormone that regulates sleep and wakefulness.
• Keep it cool. Cool room temperatures promote sleep and minimize interfering itchy sensations.
• Smell the roses, or better yet, lavender or chamomile. Soothing scents such as lavender have proven effective in helping people fall asleep, even in noisy intensive care units.
• Warm it up. A person warmed passively by a hot bath or sauna (not from intense exercise) falls asleep more quickly than someone who is cold. Even just a hot foot bath has proven helpful to ensuring good night’s sleep in a scientific study; so even if for some reason you can’t soak your entire body, consider a warm foot bath before bed to help you drift into dreamland. Keep the body warm and the room cool

Sleeping Routines

• Consider eating a light snack containing a protein (eg, seeds, nuts, low-fat milk, hard-boiled eggs) and a complex carbohydrate (eg, whole grain cracker or toast, slices of fruit or vegetables) within 2 hours before bed.
• Take a warm bath or shower within an hour before bedtime.
• Make it routine. Head to bed at the same time daily.
• Read something soothing, reassuring, or inspiring. Save the action/adventure stories, headline news, and murder mysteries for daytime reading.
• Manage your stress constructively. Practice mediation, autogenic training, progressive muscle relaxation, guided imagery, prayer, counting your blessings, extending good will to others, or other relaxing stress management techniques.
• Keep a journal. Write down or record any worries, anger, irritations, or other negative perceptions. Get them out of your head, set them aside, and let them wait until tomorrow. Write down or record a list of things you appreciate or for which you are grateful. Make notes about little kindnesses you have observed in others or offered to others. Did someone smile at you today? Offer a handshake? Ask how you were? Open a door? Let you go first? Just noting small acts of kindness can help us feel better and more connected to other people. This helps us feel more positive and secure.

During the Day

• Limit daytime naps to 45 minutes, maximum.
• Expose yourself to bright light in the morning; this helps set your biological clock so you’ll be tired in the evening. Avoid bright lights before bed.
• Exercise during the day; yoga or other slow, meditative exercises may be helpful in the afternoon or evening.
• Check with your doctor. Make sure you can breathe easily at night; congestions and obstructions to breathing reduce restful sleep. If you snore, ask your doctor to check for obstructive sleep apnea syndrome. If you have a painful or itchy condition, discuss optimal management with your health professionals. Review your medications (if any) to make sure they aren’t the culprit.

What Else Can You Do?

• Consider a cup of calming herbal tea such as chamomile, lemon balm, hops, or passion flower.
• Talk with your clinician about trying valerian, melatonin, tryptophan, or 5-HTP (5-hydroxytryptophan) supplements.
• Get a massage or at least a hand, foot, shoulder, or back rub from someone you trust.
• Consider trying acupuncture, especially if pain makes it hard for you to sleep. (Sleepiness and a sense of calm and relaxation are side effects of acupuncture.)
• Ask your clinician about cranial electrotherapy stimulation or electrosleep.

What to Avoid

• Avoid alcohol within 4 hours before bedtime (alcohol use just before bed can lead to rebound wakefulness 2-4 hours later).
• Avoid caffeine 4 to 6 hours before bedtime.
• Avoid heavy or spicy foods 4 hours before bedtime.
• Avoid strenuous exercise within 2 hours of bedtime.
• Avoid stimulating TV, electronic games, and arguments within an hour of bedtime

If you can’t fall asleep within 20 minutes, get out of bed, leave the bedroom, and try one of these strategies – snack, warm bath, soothing music, inspiring book, making a list or jotting in a diary.

--TIPS from the AAP

Time to schedule Sport and Yearly Physicals

It is that time of year again where your child may need a physical to play sports or to attend a scouting event for this summer/spring. Also, remember if you have a child going into Kindergarten or junior high they need to come in for a physical and updates on immunizations before registration. Our doctors will try to fit every child in but please call as soon as possible to get those scheduled.

We do recommend the following schedule for Well Child Check ups.

Schedule of Well-Child Care Visits

Visits can include physical measurements, patient history, sensory screenings, behavioral assessments, and planned procedures (immunizations, screenings and other tests) at the following suggested intervals:

• 2 weeks
• 2 months
• 4 months
• 6 months
• 9 months
• 12 months
• 15 months
• 18 months
• 24 months
• 3 years
• 4 years
• And once every year thereafter for an annual health supervision visit that includes a physical exam as well as a developmental, behavioral, and learning assessment.

See you soon!