Talking to Children about Tragedy


Tips for speaking to your children about tragedies such as shootings, mass disasters, natural disasters.

US National Archives kids

Photo courtesy of National Archives

Unfortunately there have been shootings and other tragedies in many communities, large and small, in America. Children and teenagers are affected by disasters and tragedies just as are adults.

The most important thing that a parent can do is ask the child or teen his or her understanding of the tragic event, so that the child feels comfortable expressing emotion. Silence suggests to the teen that the subject is too awful to even discuss, even though of course, the teen is thinking and worrying about the event. Start by gently correcting any misconceptions. You don’t have to describe the event in detail, but allowing the child or teen to discuss her feelings is important.

Parents think toddlers don’t understand what they see on television, but toddlers recognize the emotions their parents are feeling. Preschool children may regress in their behavior and become more clingy. They may start sucking their thumbs, or wetting the bed. Other toddlers may act out. Strong emotions bring out strong behavior. When toddlers, preschool, and school age children see the disaster or tragic event on television, they think the event is occurring again and again. Keeping the television off to prevent retraumatization is helpful. Recording television programs and reviewing the broadcasts before the children see it can be helpful. Watching the television with your child so he can ask questions is also helpful.

School age children may also either act out or regress in their behavior. Sleeping in parents bed or skipping chores for a day or two is okay! It allows the child to feel more secure and safe. Security is a huge concern for children. Make sure they know that measures have been taken by law enforcement or the community, or that your family has a safety plan.

With teens, they may feel that life is meaningless and may take more risks than normal. Watch for this type of behavior because risky behavior can affect the adolescent in a significant way. Discussing positive actions carried out by heroes or bystanders can also be helpful. The teen may want to be closer to their parent for a period of time, to feel safe, and that is fine. Trouble sleeping and a decline in grades (transiently) can also occur. Some teenagers may try to avoid the people and situations that occurred at the time of the tragedy because these triggers cause

If your child or teen continues to have negative feelings and depression after 2 weeks, professional consultation with a physician, psychologist, or counselor will be helpful.

Last updated by Dr. Vee on October 22, 2015.

Tips to Make Your Halloween Safe!


Take your kids to fun and safe trick-or-treating event in Myrtle Beach, S.C.

Pumpkin carving safety

Only Adults Should Carve Pumpkins

  • Never let children carve pumpkins. Kids can help by drawing a pattern on the pumpkin and removing the pulp and seeds once the pumpkin is cut.
  • A sharp knife can become wedged in the thicker part of the pumpkin, requiring force to remove it, causing hand injury when the knife finally dislodges from the thick skin of the pumpkin. Injuries are also sustained when the knife slips and comes out the other side of the pumpkin where your hand may be holding it steady.

Use a Pumpkin Carving Kit

  • Special kits are available in stores and include small, serrated pumpkin saws that work better because they are less likely to get stuck in the thick pumpkin tissue.
  • When cutting, adults should cut away from themselves in small, controlled strokes.

Help for An Injury

  • If you cut your finger or hand, apply direct pressure to the wound with a clean cloth. If pressure does not slow or stop the bleeding within15 minutes, be evaluated in the Emergency Room

Halloween Safety Tips

Costume Safety

  • Be sure your kids are wearing flame-resistant costumes.
  • Never walk near lit candles or luminaries.
  • Keep candle-lit Jack O’Lanterns and luminaries away from steps, walkways, sidewalks, landings, and curtains.
  • Place Jack O’ Lanterns on sturdy tables, keep them out of the reach of pets and small children, and never leave them unattended.
  • For greater visibility attach to costumes reflective tape that will glow in the beam of a car’s headlights. Halloween bags should also be light colored or decorated with reflective tape. Reflective tape is usually available in hardware and sporting goods stores.
  • Children should carry flashlights while trick or treating to see where they are walking and so that cars can see them as they walk
  • Costumes should be short enough to prevent children from tripping and falling.
  • Children should wear well-fitting, sturdy shoes to prevent trips.
  • Apply a natural mask of cosmetics (avoiding the eye area) rather than a loose-fitting mask that might restrict breathing or obscure vision. If wearing a mask make sure keyholes are large enough to allow good vision
  • If wearing a mask, use a well-fitting masks to avoid blocked vision
  • Swords, knives, and similar costume accessories should be soft and flexible to avoid injury.
  • Test makeup on a small patch of skin before applying to face or body.
  • Don’t decorate your face with things that are not intended for skin
  • Do not use face paint near the eyes, even if the label has a picture of people wearing it near the eyes.

Diagram showing ways to prevent accidents on halloween costumesPhoto:Consumerist|CC

Trick or Treating Safety

  • Young children should always be accompanied by an adult or an older, responsible child.
  • All children should walk, not run from house to house and use the sidewalk if available, rather than walk in the street.
  • Children should be cautioned against running out from between parked cars, or across lawns and yards where ornaments, furniture, or clotheslines present dangers.
  • Glow sticks contain a liquid that produces a temporary burning sensation and bad taste in the mouth when tasted. Small amounts that are swallowed are generally not harmful.

Choosing Safe Houses:

  • Children should go only to homes where the residents are known and have outside lights on as a sign of welcome.
  • Children should not enter homes or apartments unless they are accompanied by an adult.

halloween-safety.jpg

Halloween Candy Safety

  • Before kids go trick-or-treating, serve a healthy meal so they’re not hungry when they collect candy.
  • To prevent temptation, know how much candy your child has collected and don’t store it in his or her bedroom.
  • Consider being somewhat lenient about candy eating on Halloween, within reason, and talk about how the rest of the candy will be handled. Candy and snacks shouldn’t get in the way of kids eating healthy meals.
  • If a child is overweight — or you’d just like to reduce the Halloween stash — consider buying back some or all of the remaining Halloween candy. This method acknowledges the candy belongs to the child and provides a treat in the form of a little spending money.
  • Be a role model by eating Halloween candy in moderation yourself. To help avoid temptation, buy your candy at the last minute and get rid of any leftovers.
  • Encourage your kids to be mindful of the amount of candy and snacks eaten — and to stop before they feel full or sick.

Alternatives to Candy

You also can offer some alternatives to candy to the trick-or-treaters who come to your door. Here are some treats you might give out:

  • Non-food treats, like stickers, toys, temporary tattoos, false teeth, little bottles of bubbles and small games, like tiny decks of cards (party-supply stores can be great sources for these)
  • Snacks such as small bags of pretzels, sugar-free gum (for older kids), trail mix, small boxes of raisins, and popcorn
  • Sugar-free candy
  • Small boxes of cereal
  • Avoid toys that could pose choking hazards to very young children.

Children Trick-or-treating

Children Trick-or-treating — Image by © Royalty-Free/Corbis

Candy Safety

  • Parents should instruct their children not to open their candy until they return home.
  • Inspect all candy for tampering before allowing them to start eating.
  • Accept only wrapped and packaged candy.
  • Do not eat candy that has been unwrapped or opened.
  • Never eat fruit or other unwrapped items.
  • Prevent a stomach ache by limiting 2- 3 small pieces of candy at a time.
  • Throw away any candy or food that is not wrapped tightly by the candy company.
  • Accept and give out candy that isn’t easily unwrapped. Candies such as Tootsie Rolls, hard candies and certain bubble gums with twist-type wrappings can be tampered with more easily than those that are sealed.
  • When in doubt, throw it out
  • Keep small hard candies, gum, peanuts, from children under the age of five because it is a choking hazard.
  • Keep chocolate candy, raisins, and macadamia nuts away from dogs. It is toxic to them, even in small amounts.

References:

Kids Health.org

American Society for the Surgery of the Hand

CDC. gov

American Academy of Pediatrics

AAA

PismoBeach.org

Red Cross

MyrtleBeach.com

Halloween Safety - AAA

Last Updated by Dr. Vee on October 14, 2015

How to Please a Picky Eater (Toddler or Teenager)


Top 5 Mistakes Parents Make with a Picky Eater

  1. Forcing a child to eat everything put on the table for a meal
  2. Bargaining with a child to eat healthy items in a meal in order to get a dessert or treat
  3. Not re-introducing a food item if the child doesn’t like it the first time
  4. Parents don’t eat healthy food themselves but expect their children to eat healthy food
  5. Stocking the refrigerator and pantry with junk food but expecting a child to choose healthy items over the non-nutritious snacks

1. Forcing a child to eat everything put on the table for a meal

  • A child doesn’t have to eat everything on the table, but should try at least one bite. If after the bite he says, “No, thanks” at least you’ve exposed the child to the new food.
  • Don’t force a child to eat an entire serving of something she doesn’t like, but don’t make a separate meal for the child
  • Remember, kids will not starve! They will learn to be more flexible with food choices rather than go hungry.
  • If a child skips a meal because he doesn’t like anything, the child will be hungry enough at the next meal to be more willing to eat what is served
  • Try to include at least one item the child likes at every meal, but don’t avoid all items the child does not like.
  • Don’t threaten or punish—this only results in power struggles with your child!

2. Bargaining with a child to eat healthy items in a meal in order to get a dessert or treat

  • Bargaining does not work long term to help the child learn to eat and enjoy healthy food such as vegetables.
  • It also promotes the false belief that a cookie or cupcake or other dessert item has more value than the healthy food item

3. Not re-introducing a food item if the child doesn’t like it the first time

  • The 10-15 Rule: Studies show that it can take up to 10-15 tastes of one kind of food before a child accepts or likes the food. Repetition is important!

4. Parents don’t eat healthy food themselves but expect their children to eat healthy food

  • Parents are the best role model for their kids. It helps if they eat the kind of food they want their children to eat. If parents don’t eat vegetables or fruits, chances are, their kids won’t either. 
  • If kids see their parents ENJOYING vegetables and fruits, they are more likely to choose to eat them as well.

5. Stocking the refrigerator and pantry with junk food but expecting a child to choose healthy items over the non-nutritious snacks

  • Don’t stock unhealthy items like candy. If a child is hungry, give her the choice of two healthy snacks to eat instead of giving in to the candy that she requested
  • Put healthy foods like cut up fruit where your toddler or teenager can quickly find them when they are hungry.
  • Avoid giving milk or juice before a meal to pacify hunger. This prevents kids from eating the rest of the meal
Home made macaroni and cheese, with some dried...

Home made macaroni and cheese, with cauliflower. (Photo credit: Wikipedia)

Some ideas to encourage your kids to eat a healthier, wider variety of food:

  • It is normal for kids to eat less as they turn one year of age because of slowing of their growth at this age. At age two toddlers want to make their own food choices. Many toddlers appear to be picky eaters to parents because they don’t like to try new foods and prefer to snack.
  • It’s normal for kids to like one thing one day and not like it the next, or want the same food three days in a row and then say they are sick of it. In general, try to avoid preparing only the things a child eats—say prepared chicken nuggets, hot dogs and macaroni and cheese, to the exclusion of other food.
  • Involve your child in food shopping so that she can choose the vegetables and fruits she wants to try. Kids are more likely to eat a food they picked out. Remember not to bring your kids to the grocery store when they are hungry. Set ground rules in advance of shopping: no candy, no soda, no sugary snacks or cereal. They can choose any fruits and vegetables as long as they are willing to try them when brought home.
  • Involve your kids in making meals. They are more likely to eat the food “masterpiece” they made. Making cooking a fun experience will encourage kids to eat the food they cooked.
  • Kids are also more likely to eat food they have helped grow, so a having your child involved in a home garden or going to the farmer’s market will encourage them to eat more vegetables.
  • Avoid “grazing” all day long, because prevents a child from learning when he is hungry or full. Kids learn to manage their appetites by knowing when meals and snacks will be available.
  • Don’t encourage filling up on snacks, especially junk food or sugary snacks, because kids will learn to skip meals and eat only the unhealthy snacks.
  • Breastfed or formula fed babies should eat on demand because this is a period of high growth. Toddlers also need three meals and up to three snacks a day, so they should be encouraged to have a healthy snack before meals.
  • Let kids as young as 9 months of age feed themselves. Children should be able to use utensils by age 15-18 months. Having this control will help kids learn how much food it takes to fill them up and not overeat.
Healthy Berries are Good Food for Health

Photograph used with permission from epoSo.de

It is ok to disguise healthy foods in your kids’ favorite dishes:

  • Kids generally love pizza. Kids will eat vegetables like broccoli or spinach if it is on a pizza
  • Add a healthy vegetable like cauliflower to a kid pleaser like macaroni and cheese.
  • Add fruits or even vegetables to “milk shakes” Adding pre-frozen fruit to smoothies gives them a creamier texture similar to a milkshake.
  • Combine dried fruits, unsalted nuts and unsweetened cereal for a healthy snack mix
  • Make yogurt parfaits with fruit and granola. Even kids who won’t eat yogurt, fruit or granola separately tend to like them when they are served up as an appealing parfait.
  • Kids love peanut butter and jelly. Add peanut butter to celery sticks or apples for a healthy snack.
  • Add pureed vegetables like spinach to homemade hamburgers or turkey burgers
  • Add vegetables like squash or zucchini to spaghetti sauce. Kids tend to like pasta, so adding any vegetable to a pasta dish makes it more palatable to kids.
  • Add pureed cauliflower to mashed potatoes
  • Substitute sweet potatoes for French fries, and bake in the oven instead of deep frying.
  • Make baked vegetable “fries” or “fingers” by coating zucchini, eggplant or squash with egg substitute and bread crumbs
  • Make homemade baked chicken fingers coated with parmesan cheese and breadcrumbs instead of the fast food variety.
  • Légumes

    Photo credit: Wikipedia

    Carrots and corn are vegetables with high natural sugar content, so these are good vegetables to make in a pinch for picky eaters

Pay attention to the texture of foods or the way it is prepared. For example, some kids love applesauce but not raw apples.

Some kids will only eat vegetables if it is with a sauce, and others will eat only if there isn’t any sauce

Kids often prefer stir fried veggies (use a small amount of canola or olive oil) to steamed

  • Add vegetables like broccoli to a baked potato
  • Sometimes kids don’t like “mushy” foods. Cooking vegetables so they are tender-crisp may be more appealing to these children.
  • Yes, it is ok to add a small amount of ketchup or barbecue sauce to any food item including broccoli if it will encourage your child to eat the food item.
  • Make healthy whole grain waffle “sandwiches” (no syrup) containing lunch meat or vegetables inside. Use hummus or salad dressing as a spread inside the waffle.

Last Updated by Dr. Vee on October 22, 2012

  • English: vegetables

    (Photo credit: Wikipedia)

Healthy Chicken and Mushrooms Fricassee


To help busy people and families shop for, prepare, and serve healthy meals, the National Heart, Lung, and Blood Institute (NHLBI) of NIH created and published Keep the Beat Recipes: Deliciously Healthy Dinners. The new cookbook features 75 simple and delicious recipes influenced by Asian, Latino, Mediterranean, and American cuisine that are good for your heart and taste great, too.

Chicken and Mushroom FricasseePhoto: Keep the Beat Recipes

Chicken and Mushroom Fricassee

Serves 4

Ingredients:

1 Tbsp olive oil
1 carton (10 oz) white button mushrooms, rinsed and quartered
1 Cup leeks, split into quarters, then sliced into small squares and rinsed well
1 Cup potatoes, peeled and diced
1 Cup celery, rinsed and diced
1 Cup pearl onions, raw or frozen
3 Cup low-sodium chicken broth
1 lb skinless chicken legs or thighs (4 whole legs, split, or 8 thighs)
2 Tbsp each fresh herbs (such as parsley and chives), rinsed, dried, and minced (or 2 tsp dried)
1 Tbsp lemon juice
1 Tbsp cornstarch
2 Tbsp fat-free sour cream
½ tsp salt
¼ tsp ground black pepper

Instructions:

  1. Preheat oven to 350º F.
  2. Heat olive oil in a medium-sized, heavy-bottom roasting or braising pan (a large sauté pan with a metal handle will work as well).
  3. Add mushrooms to pan, and cook until golden brown, about 3–5 minutes. Add leeks, potatoes, celery, and pearl onions, and continue to cook until the vegetables become soft, about 3–5 additional minutes.
  4. Add chicken broth to the pan, and bring to a boil. Add chicken legs to the pan, cover, and place in the heated oven for about 20 minutes or until the chicken legs are tender when pierced with a fork (to a minimum internal temperature of 165° F).
  5. When chicken legs are tender, remove legs from the pan, return the pan to the stovetop, and bring the liquid to a boil. Add herbs and lemon juice.
  6. In a bowl, mix the cornstarch with the sour cream, and add to the pan. Bring back to a boil and then remove from the heat.
  7. Season with salt and pepper, and pour 1 cup of vegetables and sauce over chicken.

Nutrition Information Per Serving: Calories 242, Total Fat 9 g, Saturated Fat 2 g, Cholesterol 42 mg, Sodium 430 mg, Fiber 3 g, Protein 20 g, Carbohydrates 24 g , Potassium 807 mg
* Recipe taken from Keep the Beat Recipes: Deliciously Healthy Dinners, from the National Heart, Lung, and Blood Institute

Last Updated January 16, 2012 by Dr. Vee

Restriction Elimination Diet Helps ADHD Without Medication


Photographs courtesy of epSos.de

The INCA study was a placebo controlled study carried out in the Netherlands that showed a hypoallergenic diet helps treat hyperactivity, inattentiveness and oppositional defiant behavior (such as temper tantrums!) in children not on stimulant medication.

The restriction elimination diet included turkey, lamb, rice, water, salt and pepper, and many vegetables, including cauliflower and cabbage. Children were then challenged with foods, added back one by one, to see which foods caused worsening attention and behavior symptoms. Surprisingly, foods that worsened symptoms in an individual child did not correlate to high IgG immunoglobulin levels as would be expected in food allergy/intolerance. IgE allergy to food was not tested. The authors recommend that food allergy testing not be used to guide food therapy in children with ADHD, instead eliminating food that clinically caused problems in a particular child.

The details of the restriction elimination (RED) diet and the Food Journals used by families enrolled in the study are included n the appendix of the journal The Lancet.

An important detail of this study is that all children were screened to determine if they actually met criteria for ADHD, were of school age and did not take any stimulant medication.

Remember that many kids with ADHD have been found to have zinc deficiency, so it is a good idea to supplement with a multivitamin/mineral. High doses of zinc are not recommended.

Here is my WJXT Morning Show interview discussing a hypoallergenic diet and ADHD.

Reference:

Dr Lidy M Pelsser MSc, Klaas Frankena PhD, Jan Toorman MD, Prof Huub F Savelkoul PhD, Prof Anthony E Dubois MD, Rob Rodrigues Pereira MD, Ton A Haagen MD, Nanda N Rommelse PhD, Prof Jan K Buitelaar MD. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. The Lancet, Volume 377, 5 February 2011 doi:10.1016/S0140-6736(10)62227-1.

Last updated by Dr. Vee on October 22, 2012