Back to School – Hot vs. Cold Lunch

School LunchThe transition back to school is an opportunity for change. If there are unhealthful habits that have snuck into your family’s life over the summer, take a time-out to identify what they are. For example, perhaps summer was very busy with family engagements and your family got into the habit of dining out 3 or 4 nights per week. Try to use the transition back to school to keep everyone at home for dinner.

When returning back to school many have to decide if they are going to eat hot lunch versus bringing a lunch from home (cold lunch). Some families decide to do a mixture of both. In order to ensure a healthful lunch, it was previously recommended to pack a lunch. However, after the multitude of revisions to the school lunch program, public school lunches have improved greatly. The school lunch program now serves portions of food in accordance with the child’s age. It also must provide low-fat dairy, a fruit and a vegetable at every meal. Within the year, the school lunch program will also be incorporating more whole grains and working to reduce the amount of salt, or sodium, in the food.

When assessing the school lunch program at your child’s school it is important to ask your child if:

  • They enjoy the food.
  • They take and eat both the fruit and vegetable option daily.
  • They choose low-fat white milk to drink.
  • They get second helpings at lunch.

Their answers can help you to decide whether a cold lunch may be a healthier option. The ideal cold lunch includes a serving of whole grain, lean protein, fruit, vegetable, low-fat dairy and healthy fat. When it’s all packed up it may look like:

  • ½ Peanut butter and banana sandwich on wheat bread,
  • Low-fat string cheese,
  • Baby Carrots, and
  • Water bottle.

If you are looking to liven up your child’s lunch box check out this month’s recipe!

September Recipe: Kid Friendly Wraps

The following ingredients can be used to make a variety of wraps, including:

  • Turkey and Cheese roll-up
  • Philly Beef and Cheese with Peppers Wrap
  • Hawaiian wrap with Ham, Cheese and Pineapple
  • Personal pizza wrap with turkey meat balls, shredded cheese and assorted vegetables
  • Veggie wrap with hummus and assorted vegetables
  • Taco Wrap with refried beans, greek yogurt, shredded cheese and vegetables with guacamole and salsa


  • 1 Low-Fat, Whole Wheat Tortilla (Small or Medium)
  • 1 serving of Lean Protein (Turkey, Chicken, Lean Ham, Lean Roast beef, Turkey meatballs, Peanut butter, Refried beans)
  • 1 serving of Low-Fat Dairy (Shredded cheese, sliced cheese, soft cheese spread, Greek yogurt)
  • 1 serving of vegetables (spinach, cucumber, tomato, lettuce, bell pepper, tomato sauce)
  • 1 serving of healthy fat (1 Tbsp Hummus, ¼ Avocado, 1 Tbsp Guacamole)

Lay the tortilla flat and then spread the healthy fat of your choice on the tortilla.

Lay the lean protein on top of the spread.

Place the low-fat cheese or yogurt on top of the lean protein. Spread the vegetables over the dairy evenly.

Then, fold one side of the wrap towards the center about 1-inch.

Begin to roll the wrap tightly beginning at an edge to the left or the right of the fold.

If your kids bring lunch to school from home, what do you pack?

Back to School – Hot vs. Cold Lunch
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.

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Posted in Nutrition | Tagged , , , , , , ,


CyberbullyingBullying is not new, but the widespread use of technology has created an entire new method of bullying. Cyberbullying is the use of technology to embarrass, harass, impersonate, intimidate or even threaten another person. The mode of technology includes emails, text messages, chat rooms, or messages and photos posted and shared through social media. The use of technology means that bullying is no longer limited to face to face contact, but can happen anywhere and at any time. In addition, the bully can remain anonymous.

It is estimated that one third of teenagers have been a victim of cyberbullying. What are some of the signs that an adolescent is being bullied? The victim may hide his or her phone or computer to prevent others from seeing the messages. If the bullying is occurring within the group of friends, the victim may avoid social activities and spend more time at home. Teenagers who are bullied may avoid school, even faking illness to miss class, and as a result grades begin to slip. Other signs include difficulty sleeping , inability to concentrate and increased worry, irritability or guilt. Victims of cyberbullying are at an increased risk of developing anxiety or depression and in extreme cases, even thoughts of hurting themselves.

What can you do if you are the victim of cyberbullying? Stop all communication with the bully. Although it may be challenging, block the individual from Facebook and other social media websites and delete messages without reading them. Talk to someone about the bullying! Start with a close friend who you can trust. You may also need to talk with an adult such as a teacher, a coach, your doctor or your parents. Most importantly, whether or not you are being bullied, remember to protect yourself online. The internet is accessible to millions of people all over the world and everything posted online is permanent. Never post personal information such as your phone number or address. Never share passwords. Talk openly with your parents about what you do online.

As a parent, the most important first step if you are concerned your child is the victim of cyberbullying is to talk with him or her. Find out what is happening. You may need to contact the school, the internet service or content provider, or even the police. Let you child know these are steps you need to take for his or her safety. You can also take steps at home, including closer monitoring of technology. Teach your child about the importance of online privacy.

Learn more about  cyberbullying and online safety:

About Kerry Gannon, MD
Dr. Kerry Gannon is a pediatric resident at the University of Wisconsin Pediatric Residency Program.

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Posted in Teens | Tagged , , , , , , ,

Parent’s Guide to Pain Prevention

Mom, Child and PediatricianDoes this situation sound familiar?

“You have a doctor appointment for a check-up today after school.”

“Am I going to get a shot? I hate shots. I don’t think I want to go to the doctor today.”

Before the age of 2 years old, the CDC recommends children receive 24 immunizations. While this sounds like a lot of shots, and it is, immunizations are one of the Public Health initiatives that have resulted prevention of the most deaths and disability early in life.

Often children need sports physicals, annual check-ups or other appointments to ensure they are up-to-date on their health care needs. Not all of these appointments will require immunizations or blood draws, but children become focused on that task early in life.

There is a phrase in pain management that I have adopted as my personal mantra – “If you can anticipate pain, you can prevent pain.” On a daily basis I work with students, staff and families to learn how to anticipate and prevent (or reduce) pain in everyday life. Pain management is not just about medication, today there are many tools available to help control pain.

Here are some tips to prevent (or reduce) pain:


The Five S’s

  • Swaddling
  • Side/stomach position
  • Shushing
  • Swinging
  • Sucking

The Five S’s are frequently used to comfort a crying infant. Typically injections are given in the thighs and blood draws are often heel sticks in this age group. By swaddling their upper body and leaving their legs out, you can provide some comfort for the baby. Laying them on their side and shushing or singing quietly in/near their ear can also provide comfort. Allowing them to suck on a pacifier alone or with sugar water (sweet ease™), formula or breast milk can provide pain relief during the procedure. Allowing them to breastfeed during the procedure has been shown to provide great pain relief. Finally, gently swinging them after the poke can help to calm them after the procedure.  While we may not be able to use all of these techniques with every infant, think about which ones will be appropriate as you prepare for your next well baby check-up.

Older Infants to Toddlers

Music provides pain relief in a couple ways. Many times music evokes an emotional response, it can trigger memories or it can relax or excite us. Music is a great tool to use during painful procedures like needle sticks. If you have a smart phone, music can be easily found through a variety of applications, websites or music downloads. If you have ear buds available that can increase the success of relieving the child’s pain. If you do not have an electronic device, you always have your voice and your child’s voice. You might choose to sing or hum a song that is soothing to the child or you may choose one that is fun and upbeat. Once they are old enough, ask the child to sing along and tap the beat with their finger, hand or toes. The more you involve them, the more successful the music will be!

Toddlers through Teenagers

Distraction is a big word for dividing someone’s attention from one task to multiple tasks. Take the child’s attention off the object of pain (needle poke) and distract them with something fun. The items that can be used for distraction are almost limitless – books, movies, games, applications, and other toys.  You can bring a book with you that your child has not seen recently, or a new book they have never seen.  While you read to them, ask questions about objects on the page. If you forget to bring a distraction item, most clinics that cater to pediatric patients will have something available that you can borrow.  Look around the room you are in – is there a picture you can ask your child about? Or a fish mobile to have them watch? Do you have a cell phone with applications the child likes? Are there books or magazines in the waiting area they can bring with them to read during the procedure? Use your imagination; unless you are in a solid white room, the available distractions are limitless!!

Buzzy Bee

A final option to consider is Buzzy Bee. It works by using cold and vibration to make temporary changes to the central nervous system that works to prevent the pain signal from getting through to the brain. It is cute and fun to look at, so it also provides some distraction. Many clinical sites at UW Health have Buzzy Bee available.

During September, Pain Awareness Month, we will be selling Buzzy Bee in the outpatient pharmacies and at the Gift Shops. Look for one at a site near you. If you cannot find one locally, Buzzy can be purchased at

Remember, if you can anticipate pain, you can find a way to prevent it, or at least decrease the amount of pain your child experiences.

What are some ways you comfort or distract your child during needle pokes?

Parent’s Guide to Pain Prevention
About Peggy Riley, RN, MN, MPH
Peggy Riley has been a Pain Clinical Nurse Specialist for 6 years and a Pediatric Pain Clinical Nurse Specialist for the last year. She is passionate about partnering with patients, families and staff to achieve the best pain relief for each person.

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Posted in General | Tagged , , , , , , , , ,

What Parents Should Know About Enterovirus D68

Sick BoyParents have been seeing a lot in the news this week about Enterovirus D68 (EV-D68), the virus that has been causing respiratory illness in several states primarily among children, and even hospitalization among kids with severe symptoms. What symptoms should parents look for? And what can parents do to help prevent infection?

Here are answers to some common questions about Enterovirus D68:

Q. What are enteroviruses? Why is this one special?

A. Enteroviruses are common viruses that can cause a number of different viral illnesses, colds, diarrhea, meningitis, etc. This particular one is not seen very often and is associated with prominent respiratory issues – breathing fast and wheezing – that is not common with the typical cold illness.

Q. Since kids with asthma and other respiratory issues seem to be more susceptible to Enterovirus 68, can parents of kids with these issues take any preventive measures?

A. Hand hygiene (frequent hand washing) is important, as is avoiding exposure to others who are sick. Exposure to smoke makes everything worse.

Q. Does the flu shot protect against Enterovirus 68?

The flu shot protects against the flu. EV68 is not the flu virus. But it’s still a good idea to get the flu shot as soon as it becomes available. (Call your child’s UW Health clinic to schedule an appointment, or if you have MyChart, you may schedule online.)

Q. What symptoms should parents look for, and when should they see a doctor or seek emergency care?

A. Parents should look for cold-like symptoms. Seek care when your child is having breathing difficulty, or is breathing fast, not getting air, or wheezing.

Additional Resources

You can learn more about the Enterovirus through the following resources:

What Parents Should Know About Enterovirus D68
About Nasia Safdar, MD
Dr. Nasia Safdar is a UW Health infectious disease specialist and UW Hospital medical director of infection control.

View all posts by Nasia Safdar, MD
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Four Steps to Foster Resiliency in Kids

Mom and Teen TalkingWe want to raise children who are resilient and can adapt well in the complex and sometimes challenging world we live in, but they don’t become this way automatically. There are four basic steps parents can focus on to help their kids cope effectively with difficult situations they will encounter whether in school or as they navigate social interactions with peers.

Validate feelings

Keep open lines of communication with your children. One way to do this is when they share a worry or upset, don’t immediately discount their concerns by saying things like, “don’t worry,” “don’t be upset,” “you’re not scared,” or “everything will be fine.” They may be worried about facing bullies or feeling “uncool,” or trying to cope with academic pressure or managing relationships with peers. Remember to validate the experiences and emotions by saying something simple like, “it’s okay to be afraid, a lot of kids experience this too” or “it makes sense you would feel upset.” And then pause, listen and give them space to share their thoughts. This helps them feel safe and comfortable to talk with you and more likely to discuss challenges and difficulties in the future.

Help them learn to problem-solve

There are always going to be obstacles to overcome and challenges to face. Maybe it is peer pressure to do something like shoplift at the mall. Or, it could be watching peers treat another student poorly. Take the opportunity to create teachable moment to help your children learn critical thinking and resourcefulness through problem-solving. Remember, it’s not about you solving the problem for them. It means helping them think of ways to solve their own problems. You could say, “Let’s think of some ways you could handle this situation” or “if someone says a mean thing, how could you react?” It’s ideal if they can generate some solutions, but sometimes you can also offer different options and ask, “What do you think might happen if….?” This also gives you an opportunity to teach them life skills of how to cope with any difficult situations they may encounter in the future.

Practice relaxation and mindfulness together

It is a stress filled world and it’s never too early to introduce children and teens to mindfulness techniques they can use to calm and center themselves. For kids, it’s not necessarily about establishing a formal practice. Instead, it’s about learning simple exercises to help when they are feeling anxious or stressed. Check out these exercises especially for kids from UW Health’s mindfulness instructors.

Encourage compassionate self-talk

Many kids struggle with negative thoughts and self-criticism. Parents can help their kids build a positive sense of self. Focus on their strengths more than on their shortcomings. Help them focus on their positive attributes and the good aspects of a situation. Communicate that you see what is right with them, no matter what they have done in the past, no matter what problems they are currently facing. Your belief in your child’s capacity to handle any difficulty is a powerful one. Share it with them and give them a lot of positive attention when they do manage something difficult. This helps children believe in themselves and builds up a supportive inner dialogue.

While it can be challenging to get kids to open up and talk with you, you can try a few different strategies to help. Make family meals a priority to help create a calm, relaxed space where you and your child can talk about the day.

Many parents of teens also find that car rides, even just to run errands, create an environment where kids may open up more and not feel “put on the spot.” And when your kids finally do open up, try to remember to remain neutral, even if your child tells you something that may be upsetting. Kids, especially teens, may be reluctant to share in the future if you react strongly when they do. Keeping calm and non-judgmental during the conversation can help create a sense of trust that you’ll listen and hear what they’re saying. That’s not to say there shouldn’t be consequences if their actions or behavior warrant it. But, set the stage for that conversation to be had at a later time.

Helping kids develop deep, strong roots now will carry them successfully and independently into the future. And remember, if your child shows signs of anxiety over a longer period, or even show a change in behavior or personality, don’t hesitate to seek professional help.

Watch my recent interview on this topic from NBC 15.

How do you help your child build a positive sense of self?

Four Steps to Foster Resiliency in Kids
About Shilagh Mirgain, PhD
Dr. Shilagh Mirgain, PhD, is a health psychologist with UW Health

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Posted in Parenting | Tagged , , , ,