Warm and Safe Car Seat Tips

ss_190532921_baby_carseatIt’s cold out, and no doubt little ones are bundled up for warmth. But, while those layers may be protecting them from the cold, they actually pose a hazard in the car.

Bulky winter coats don’t allow the straps of the car seat to be tight to the child. In the unlikely event of a car crash, the coat will compress and make the straps loose.

The Importance of the Pinch Test

To make sure your child is secure in the seat, take the “pinch test.” First, remove any bulky jackets or snowsuits before placing your child in the car seat. Next, adjust the harness straps to the correct height for your child – at, or just below, the child’s shoulders when rear-facing, or at, or just above the shoulders when forward-facing. Next, buckle and tighten the straps.

Place the chest clip at armpit level and secure.

Now pinch the strap at your child’s shoulder. If you are unable to pinch any excess webbing, you’re good to go.

Options for Keeping Kids Warm and Safe in Their Seats

For infants, you can find blanket covers that fit over the car seat once they’re strapped in. Lighter-weight fleece body suits are also as option (and let’s be honest, adorable with little bear ears).

For older infants and even toddlers, you can tuck a blanket around them once they are strapped into their seat.

And while it may look silly (although kids may actually find it fun), remove the winter coat, strap the child into the seat and the put the coat on backwards so the child’s front is covered.

The Importance of Car Seat Safety Checks

Every car seat is different and even with an instruction manual it can be challenging to figure out whether the seat is properly installed, not to mention whether the child is as secure as he or she should be. Some experts suggest that as many as 90 percent of parents make mistakes installing and using car seats. Many local organizations offer free car seat safety checks (by appointment only). Certified child passenger safety technicians will help you ensure the car seat is properly installed and that your child is safely secured in the seat.

Check out the calendar of upcoming car seat checks in the Madison area.

Winter Car Seat Resources

Posted in Safety | Tagged , , , , ,

Why Habits Matter More than Weight

ss_127556750_parent_father_sonThe team at UW Health’s  Pediatric Fitness Clinic, believes that our environments influence our weight. We look for factors in our patient’s lives that could be causing the weight gain.  Many people talk about the obvious reasons, such as lack of exercise and poor eating habits, but let’s dig a little deeper at other contributing factors.

  1. Are your children getting enough sleep?
    When a body is tired, it tries anything it can do to stay awake. Eating is one of the body’s strategies to stay awake.
  2. Are your children going to bed with the TV, cell phone, I-pad, computer on?
    These screens trick their bodies into thinking it is daytime, thus difficulty falling and staying asleep becomes an issue.
  3. What is your evening meal plan? Are you too busy to eat together as a family?  Do you have time to plan ahead or does dinner sneak up on you?There are big benefits to eating as a family. Families who eat together at least 5 times per week have children who:
    • Get better grades
    • Are at healthier weights
    • Have better vocabularies
    • Have fewer behavioral problems
    • Maintain a strong family bond
  4.  Do you have the TV set on while you are eating?
    Distracted eating equals mindless eating. When the body is watching or listening to media it has trouble tuning into what the tummy is telling them and increases the chance of overeating.
  5. Do you eat whatever you can find in the kitchen?
    Meals and snacks are best when they are balanced with at least 2-3 different food groups. Aim for lean protein, healthy fat and unprocessed carbohydrates so your body feels full and stays full.
  6. Do you frequently end up going out for fast food?
    Researchers have shown us that people who eat outside of their homes more than 2 times per week often have trouble making healthy choices and thus weigh more than those who eat at home.
  7. How much screen time is baseline in your home?
    Aim for 2 hours or less of screen time. This allows for adequate time to sneak in 60 minutes of exercise everyday.
  8. Do you have a routine exercise time?
    New healthful habits are easier to make when you can be can be consistent. Is there a time of day that you can set aside 30-60min to exercise? If so, schedule it and invite a friend or family member, or enjoy this time for you!
  9. When you are grocery shopping, do unhealthy choices such as chips, soda, cookies, end up in your cart?
    If so, consider shopping the perimeter and steer clear of the center of the store where the tempting foods are.
  10. Are there any stressful events happening in your household? Do you have a support system?  Do you fall to food as a comfort response?
    Work with the safe people in your lives to process stress. Try to find healthy ways to combat and deal with stress.
  11. Are you setting a good example for your family?
    Children tend to always be watching and will follow in your footsteps.

These are a few things that can and do cause abnormal weight gain.  Let us help you identify what routines in your family are healthful and perhaps uncover opportunities for improvement. Remember, It’s not about weight.  It’s about habits; good and bad – It’s about life.

Why Habits Matter More than Weight
About Judy Hilgers, RN, BSN
Judy is a clinic nurse with the UW Health Pediatric Fitness Clinic.

View all posts by Judy Hilgers, RN, BSN
Posted in Pediatric Fitness | Tagged , , , , ,

Managing Meltdowns in Older Children

Boy having a TantrumTemper Tantrums- think toddlers, right?  Just when we think we are done with that stage of development with our children, we learn that our older children are prone to bursts of emotions.

Once our children are past the toddler years, it is easy to assume that tantrums or meltdowns will be a thing of the past. But, try standing next to the check-out register at a store with a tired and hungry eight-year-old surrounded by candy displays, and you both may experience a meltdown. Yes, it still happens but the reasons and the strategies to help with these meltdowns differ with older children.

For children past the toddler years meltdowns, or outbursts of emotion such as yelling or crying, can be caused by many different factors. While it can be difficult in the moment, try to identify the possible causes. Is it late in the day? Has it been awhile since your child’s last meal or snack? Could your child be nervous? Hunger, fatigue, feeling misunderstood, over-stimulation or agitation are common reasons children may meltdown when presented with a seemingly innocent situation, like being told “no, we are not buying candy.”

Remember too that even older children are continuing to learn how to cope with emotions and express themselves. It is important as parents that we continue to help them recognize and positively manage disappointment and frustration.  We want them to express themselves.  We want to help them learn how to deal with their emotions.

When presented with a meltdown, although it may be difficult, it is important to remain calm. Now is not necessarily the time to discipline a child. Instead try to remain loving but firm. Instead of just saying no to the candy, try acknowledging that you recognize it is disappointing. If you feel like it is appropriate, you can return to discussion later, once everyone is calm.  Too many words (albeit, well-meaning words) at the wrong time can often add to intensity of the situation.

Also, try to recognize when you might be setting your child up for a meltdown. For example, if your child has been at school all day, followed by soccer practice, he is likely to be tired and hungry. If you must run errands on the way home as often is the case with our real lives, consider bringing a healthy snack for your child to help so he isn’t waiting a long time until dinner.

Consider whether there are regular times when your child melts down. Is bedtime always a challenge? Rather than try to correct the behavior in the moment, find time away from the situation when you can all sit down and talk about expectations and consequences. And, make sure the expectations are the same every day. If your child is expected to be in bed by 8pm, give her a 20 minute foreshadowing.   If, after a period of time there has not been any movement toward getting to bed, remind her of the consequence, “I see you are choosing no ______ for tomorrow because you are not following the plan we set.”

Being consistent, firm, calm and patient can actually be reassuring and help children learn to manage their own behaviors. And, while meltdowns are normal, if your child is having multiple tantrums a day, biting, hitting, or is unable to calm him- or herself down within 15 minutes, consider talking with your child’s physician.

How do you handle a meltdown? Are there times when your child is more likely to have them?

Managing Meltdowns in Older Children
About Caroline R. Paul, MD
Dr. Caroline R. Paul is a pediatrician at UW Health West Clinic.

View all posts by Caroline R. Paul, MD
Posted in Parenting | Tagged , , , , , ,

Bronchiolitis and RSV

Bronchiolitis and RSVWinter is right around the corner, and with it cold and flu season. One of the most common conditions we see in the winter is called “Bronchiolitis.” It is an infection of the lower respiratory tract characterized by cough, congestion, and wheezing, and is very common in children.

The infection causes cells lining the small airways to die and can clog those airways causing difficulty breathing. Bronchiolitis is most commonly caused by a viral infection, so antibiotics do not help. The virus most frequently associated with bronchiolitis is called RSV which usually circulates between November and April, with most infections and hospitalizations occurring in January and February. Almost all children have been infected by age 3, but most do not need to be hospitalized.

Children most likely to require hospitalization include:

  • Infants under 6 months old
  • Infants with underlying lung disease
  • Infants born before 35 weeks gestation
  • Infants and children with congenital heart disease
  • Children with compromised immune systems
  • Children with asthma and/or exposure to second hand smoke

RSV and other infections that cause bronchiolitis are spread through secretions from the nose and mouth, prevention includes minimizing exposure to those secretions as well as other airway irritants.

Preventative steps include:

  • Minimizing exposure to tobacco and other smoke
  • Keeping high risk infants out of daycare if possible
  • Ensuring good hand washing, especially among siblings
  • Practicing good cough hygiene-coughing into elbow or tissue and washing hands after cough or sneeze

When a child does need to be hospitalized for bronchiolitis, the majority of treatment is supportive

  • If the child has a history of asthma, or there is a  family history, he or she may get a breathing treatment with asthma medication to relieve any asthma component to their increased work of breathing
  • If the child is unable to drink enough to stay hydrated, fluids through the IV
  • And if the child is unable to get enough oxygen from the room air,  supplemental oxygen through a mask or tubes in the nose may be given

Bronchiolitis is a self-limited illness that usually resolves within 2 weeks from the first symptoms. The most severe symptoms usually occur on days 5-7 of illness, but the cough can last up to 2-3 more weeks.

For more information:

Bronchiolitis and RSV
About Daniele Gusland, MD
Dr. Gusland is a pediatric resident at the University of Wisconsin Pediatric Residency Program.

View all posts by Daniele Gusland, MD
Posted in General | Tagged , , , , , , , , , , ,

Guide to Mindful Eating

Mindfulness is often described as an awareness of reality, or the present moment. Mindful eating begins with quieting the environment at meals and snacks and tuning into what is going on inside the body and mind. The following is guide to pursuing a mindful meal during the holidays, or anytime of the year.

  • Take a moment to relax. Breathe deeply in through your nose and out through your mouth. Allow your belly to rise when you breathe in and fall as you breathe out. Ask yourself where you feel hungry; Mind? Belly? Anywhere else? Rate your hunger using the following scale:
  1. Starved with severe hunger pangs that are present on and off for greater than 30 minutes. You may also have a headache, or feel fatigued or irritable.
  2. Very hungry with hunger pangs on and off for at least 15 minutes. You may also have constant thoughts about food with increased sense of taste and smell.
  3. Hungry and notice that the stomach is growling with an increased sense of taste and smell.
  4. Somewhat hungry and may first experience feelings of true hunger. Make a plan to eat in the next 30 minutes.
  5. Neutral and feel neither hungry nor full.
  6. Somewhat satisfied and starting to feel food in the stomach but do not feel ready to stop eating.
  7. Satisfied and could most likely go at least 2 hours without feeling hunger.
  8. Starting to feel full and could go 3-4 hours without feeling hunger.
  9. Very full with some discomfort and desire to sit and rest or nap.
  10. Stuffed with painful pressure inside the stomach is painful and feeling of sleepiness.
  • Imagine what type of food would satisfy the hunger
    • Texture: crunchy, smooth, chewy
    • Temperature: cold, warm, cool
    • Density: heavy, light
    • Taste: sweet, salty, spicy, sour
  • Prepare and portion the food.
  • Choose a peaceful place to eat. Try to eat most of the meals seated at a table where the food is prepared, such as the kitchen or the dining room. Limit distractions such as TV, computer, phone, radio, books or magazines.
  • Eat slowly and savor every bite. Notice all that you can when eating, such as what the food tastes, smells and feels like. Chew the food slowly and take a moment to rest between bites. Try to make meals and snacks last at least 20 minutes.
  • Do a check-in. Stop after you have eaten about 10 bites to assess your level of hunger or satisfaction using the scale above. Continue to eat and evaluate every few bites. Stop eating when you would rate yourself as a 7 or 8 on the scale above.

Pause after eating to enjoy the satisfaction.

December Recipe: Chewy Oatmeal Cookie Bars

Chewy Oatmeal Cookie BarsIngredients

  • 2 Tbsp light butter, room temperature
  • ¼ cup prune puree
  • 1 Tbsp flaxseed, ground mixed with 2 T Water
  • 1 tsp vVanilla extract
  • ½ cup white sugar
  • ¼ cup + 2 Tbsp splenda® brown sugar
  • 1 cup whole wheat flour
  • 1 tsp baking powder
  • ½ tsp baking soda
  • ½ tsp salt
  • ½ tsp ground cinnamon
  • 2 cup oats
  • ½ cup raisins (optional)
  • ½ cup walnuts (optional)

Preheat oven to 375°F. Grease a 11 x 14 baking dish.

In a medium bowl, whisk together flour, baking powder, baking soda, salt, and cinnamon.

In a large bowl, cream together the butter and the white and brown sugars; Add the egg, prune puree and vanilla extract.

Stir in the wet mixture into the flour mixture.

Add the oats and raisins and mix until combined.

Pour mixture into baking dish and smooth with rubber spatula.

Bake for about 9 to 12 minutes, or until the edges are light brown and pull away.

Guide to Mindful Eating
About Cassie Vanderwall, MS, RD, CD, CDE, CPT
Cassie Vanderwall is a registered dietitian, certified personal trainer and certified diabetes educator at the UW Health Pediatric Fitness Clinic and Pediatric Diabetes Clinic. Cassie is passionate about empowering families by equipping them with the tools they need to achieve a healthier life.

View all posts by Cassie Vanderwall, MS, RD, CD, CDE, CPT
Posted in Nutrition | Tagged , , , , ,