Age-Specific Wellness Topics

WELLNESS FOR INFANTS AND TODDLERS:

Diapers / Toilet Training

I’ve seen more sturm and drang responses from parents over diaper and potty issues than just about anything else. Whether it’s because of a rush to see one’s child reach the goal line of being potty trained, or alarm at having to slip on the diapers beyond two months old, parents need to take a chill pill on this matter big time. Earth-to-parents: the Harvard application does not include a line asking you when you graduated from Potty Prep. The more worry your face exudes during these early years, the more anxiety you’re going to engender in your child, and in turn that may extend the time of completing this rite of passage.

Power Struggles

Once you start engaging in these power struggles as the parent, you’ve lost. You are much better off responding to such demonstrative challenges from your toddler with a chuckle of disregard, a humorous gesture of dismissiveness, or even a cheerful tone suggesting an alternative behavior you’re hoping to see. Facially reflecting the fit or stubbornness that you see in your defiant and challenging child will only solidify the strategy and hand over “victory” to your little one. The more you can exude an “I’m above this” tone, the more you will have leverage over these tantrums, and they’ll begin to dissipate. Conversely, the more you exude upset-ness, exasperation, and anger, the more likely it is that you are being set up for a disastrous many years of being manipulated by your child.

Separation Anxiety—This is bound to set in at some point… six months, eight months, maybe later. The best approach is to have caretakers/babysitters handle your child, so that there is some routine to having different people (meaning not always you) nearby to give comfort and assurance. Also, make departures quick and straightforward. Don’t linger or indulge every whimper or crying fit when you are heading out the door by heading back in for another hug. Say goodbye respectfully and lovingly, then leave. The cries will be short-lived, and you will have a better chance at limiting anxiety in your child down the road.

Shaken Baby Syndrome—Lots of literature and sites devoted to this troubling phenomenon of babies being shaken violently. There is a proliferation of support groups, seminars, and resources. There may be all kinds of reasons, disturbing and unfortunate, that adults/parents have the urge to shake their child aggressively or violently, but the impact can be tragic. A baby’s vulnerability to this action stems from head size/weight being disproportionate to the neck at these infant and toddler ages, while their brains are fragile and undeveloped. The force of the shake is more troubling because of the differential in size between the shaker and the baby—a crucial fact that adults prone to this behavior are typically not aware of or don’t care about. However you can intervene on a matter where this type of behavior is taking place, you must do so, and you must report it to the authorities.

SIDS—Sudden Infant Death Syndrome: Read up on this one—the experts don’t have all the answers since so many of these sudden deaths will go unexplained. However, many of the deaths that are explained happen during the nighttime hours, when babies are overly swaddled in blankets or have been sleeping on their stomachs. There are risk factors associated with SIDS, like smoking, drinking, and drug use during pregnancy; low birth weight; and very young (teenage) mothers. When you rule out accidents or unhealthy conditions or abuse, you’re left with few preventable factors associated with sleep, so researching sleep safety is crucial.

Social/Emotional—Often parents of infants and toddlers won’t see these topics of social and emotional development as applicable to their little ones—it’s something to be concerned about years later. But the skills of sharing, or taking turns, or caring for others, or self-regulation, or learning how to interact positively with other children and with adults—the stepping stones toward acquiring these skills are laid down during the first two years.  The guideposts to aim for during the first year would include liking to play with others; exuding happiness for much of the day; being responsive to other people’s emotions; knowing how to enjoy independence; imitating what they see in others; being aware of themselves as separate from others. Of course there are dozens of these kinds of guideposts. The central point is that even though your child is for the most part pre-verbal, there are so many ways to develop social and emotional skills that are so vital for healthy growth.

Sucking Thumbs—The quick and skinny on sucking thumbs for infants and toddlers is that it is a normal activity. Parents and care-givers need not freak out about this natural means of self-comfort. When thumb sucking begins to look more intense and aggressive, and you notice this happening well into age three and four, that’s when you want to step in and start strategies to curtail it (and there’s plenty of strategies for accomplishing this out on the web). But for the very little ones, just know that it’s okay—the baby isn’t going to be deformed; it won’t mean massive dental bills at age six; and your baby isn’t displaying immaturity because of the thumb-sucking.

Therapies: Occupational

This is the much more common, and much more broad-based, intervention for young children. It can be done in the school setting, at home, or in a doctor’s office. The number of developmental delays requiring occupational therapy are many: language, speech, fine motor, gross motor, reflex, emotional skills, vision. This list can extend significantly. The main point is that occupational therapy at these young ages won’t hurt a child, even if misdiagnosed or mis-referred by a pediatrician. The work that occupational therapists do is often very helpful for children in ways that will extend beyond the initial concern. Preschool or daycare settings are typically not able to emulate or provide such support. If you have a hunch that your child’s development or physical functioning doesn’t seem right, then you need to check with your pediatrician and ask about whether one of these therapies would be appropriate.

Enlivenminds top sites for early childhood health information and advice:

Baby Medical Questions and Answers: http://www.baby-medical-questions-and-answers.com/

Familydoctor.org: https://familydoctor.org/family-health/infants-and-toddlers/

Momjunction: www.momjunction.com

Stanfordchildrens.org: https://www.stanfordchildrens.org/en/health-topics/childrens-health-and-wellness

Please submit your additional topics for this section and share your comments and suggestions.

AGE SPECIFIC WELLNESS TOPICS

When it comes to children and their health, there is an explosion of wellness literature and wellness resources. My aim here is to list some of the topics you may wish to learn more about, and to provide just a few tidbits of advice pulled from the experts. The content is not comprehensive with all the research and theories. My listings are only designed to offer topics relevant to the age category so that you can be aware of the many facets of child-rearing, child health and safety—ideally, you’ll search the sites for more about these topics.
To learn more about diseases, syndromes, and conditions pertaining to age-specific childhood health issues, I will point you to what I have found to be the most significant and informative sites that give you the latest from the medical field.
If you want to know about food and nutrition, I have separated these out into a topic all its own, “Feeding the Brain,” located next on my Brain & Body menu.

WELLNESS FOR INFANTS AND TODDLERS

Challenging Behaviors – Those toddlers will explore, venture, scream, cry, defy, rebel, resist, scratch, bite, pout, enrage, frustrate, and test, and whatever else they will do to aggravate… or they can be angelic sweethearts 24/7! The big advice? Patience; ease up on the restrictions; don’t panic; stay cool; don’t spank or respond with solicitous indulgence during supermarket crying fits—just let it slide, ignore it, and the attention-grabbing will stop. Recognize right behavior way more than you scold bad behavior.

Crying – This is rarely anything other than a clang-of-the-gong for attention. No need to punish or worry; just practice nonchalance, disinterest, preoccupation when in your child’s vicinity. You will know when a cry is for real. The time for attention and for flashing your joyful face is in response to the right behaviors; that’s how you’ll get more of the good stuff. Lots of crying? That happens, but check your own responses—are you rushing to the rescue at every squeak? These are years for love and support and closeness, yes, but they are also years for those tiny, but significant steps toward Independence and responsibility.

Environmental Health – I’m going to avoid the medical advice here (and refer you to the sites down below which are thorough and excellent), but the things to watch out for in terms of environmental health are: asthma (clear away dust, mold, pollen, cigarette smoke); changes in breathing patterns; exposure to lead (such as in older homes); unclean/unfiltered water supply; excessive noise levels; HVAC systems that are old and haven’t been cleaned; things they touch or put in their mouths that are dirty. We could add to these “environmental” issues relationship instability; neighborhood disorder; tempestuous households; chaos of all kinds; hysteria among those close by. Keep things clean, calm, stable, and fresh, and you’ll eliminate most of the problems.

Fever—When checking for fever, a lot of thermometers out there, but taking temperatures rectally (in the bottom) is probably best. Don’t use mercury thermometers. That’s poison. Just remember that there is nothing intrinsically wrong with little kids having fevers—the fever emerges to fight off bacteria, infections, and viruses. But definitely move quickly to make them feel comfortable. Acetaminophen, rather than aspirin, would be the fever-reducer of choice. Rest and fluids are best responses to fevers. Don’t force your child to eat if they don’t want to when a fever sets in. Light blankets are okay, but don’t overdo it. Little children can heat up quickly if you start to swaddle them in blankets, which can be dangerous. Vaccinations can cause fevers, too, but here again you can administer the fever-reducers.  The whole controversy over vaccinations is something I’ll address in one of my future blogs—lots of misplaced hysteria out there.

Inner Strength—This sounds like a topic for adults, I know, and a topic for those adults ready for some spiritual or wellness overhauling. But the whole quest for growing confident, vibrant children who will pursue their talents and navigate the world around them with maturity is all about teaching resilience at these very young ages. Cultivating resilience and maturity all stems from teaching young children to anticipate what’s happening next in their day and how best to prepare for what is next. In other words, teaching resilience and inner strength is about anticipating and preparing for change—even tiny changes in what will be happening in the child’s day. Preparing children properly for what is about to happen, even preparing for the mundane and repetitive elements of the day (like, it’s bath time; or it’s meal time; or, it’s time to greet daddy coming home…) will go a long way toward moderating stress and anxiety in children, and will help them confront issues and face challenges with confidence down the road.

Pacifiers—Are pacifiers good for kids? Are they merely objects to muzzle kids and thus quiet the room so that adults can proceed with their own activity needing some quiet? Are children stymied in their development when they have a pacifier shoved into their mouths? We know that kids are soothed by sucking. A pacifier can be helpful in certain situations—like air travel, or when it’s time to take a nap or fall asleep. But watch out for dependency, and there can also be dental problems associated with pacifier use. Just know that you need to have a clean pacifier, and start weening children away from them if they are being used near the age of four.

WELLNESS TOPICS FOR PRESCHOOLERS/ELEMENTARY

Attention Deficit—This is perhaps the most topical, talked about, or suspected condition surrounding upper preschool children and early elementary ages (ages three to six or seven years old). You can read the literature and research on ADD or ADHD non-stop for months on end and you won’t find the definitive causes or the agreed-upon remedies. The current pattern of research is generally focusing on neurological issues, such as the brain’s inability to regulate neurotransmitters. But what causes that? No telling. What’s key is to watch for prolonged and repetitive patterns of disrupted focus or distraction in your children during these years; unresponsiveness to communication from others; lots of fidgeting; difficulty playing quietly and alone. It’s always okay to visit with the pediatrician to discuss these behaviors—your doctor will know how to size up the situation and whether to make a referral to a psychologist, who will then conduct the appropriate testing to determine what’s up. Medication may be in the picture down the road some years, but behavioral strategies should be attempted and exhausted first, before turning to medication.

Backpacks—The problem with overweight and asymmetrically worn backpacks is not just that lower back or dorsal pain is the likely outcome. The dragging around of heavy backpacks throughout the school day, especially when it’s happening in the younger elementary years, is highly problematic when it comes to teaching good student behavior, proper classroom routines, and many other matters related to organization of one’s belongings and schoolwork. This latter point can be a far more pernicious outcome of backpack usage in schools. While I’m a believer in handwriting, real books, and the postponement of daily laptop or iPad usage until the upper elementary or middle school years, there are definitely advantages to a school’s going virtual when delivering their curriculum. Lightening the load on one’s back, the clean organization of material that computer usage allows, and the ease of transition between home and school when not being burdened by backpacks all have to be factored into a school’s decision as to what extent backpacks will be encouraged or accommodated. IMHO: I’m not a fan of backpacks—they collect garbage and chaos; they are a tripping hazard in schools; and they can be injurious.

Biting—As much as it is alarming for many parents to learn that their child may be biting others at the day care center, this behavior is normal and very common in toddlers. Of course this doesn’t mean that it is okay—the point is that parents and caregivers need to respond promptly, firmly, and calmly, with a simple “no biting” command (and not by way of punitive measures such as biting the child in an effort to demonstrate what they are doing to others). Being punitive is the wrong approach. Realize that biting among toddles is a manner of communication, of demonstrating curiosity, of socializing in terms of seeking a response from others. If you issue a too-harsh tone that is punitive, berating or scolding, the child will learn that being mean to others is what is expected. When biting activity persists at age three or four, however, that’s when partnership with school teachers and professionals will be necessary. There could be more complex reasons, even physiological reasons, for the persistent biting—and this can be ferreted out by those in the know.

 

Soft Drinks and Sodas—As far as what drinks down the colored drink aisle are good for you—forget it. Nothing is on this aisle in the store. The food dyes in most colored drinks have been linked with hyperactivity in numerous studies (though, of course, nothing conclusive—so no labelling to be found on the bottles); the rest of the drinks are jacked with sugar and artificial sweeteners. Even the juices—bypass these, or perhaps dilute them with soda water when you get home. Take a look at the sugar content in orange juice—unbelievably high in sugar, which for young children is just slow-acting brain poison. Skip the happy meals at MacDonald’s and always buy your fast food a la carte (be sure to bring water with you in the car, always). Whole milk is certainly okay, but skim milk and 1%? There is literature out there that kids who drink skim and 1% are heavier than kids who drink milk, and it’s because those “slim” milks are heavily processed. Keep it simple with water as much as you can. Smoothies, too. Birthday parties in other homes will be difficult to manage, but maintain the standards at home and you’ll steer clear of the unfortunate impact those colored drinks have on children.

Fast Foods

—Very difficult here in this marvelous first world of ours keeping your children away from fast foods. Unless you’re a super strict tiger mom, you frequently fumble on this one and thus let loose on the standards of healthy foods that are dear to your heart. While there is no such thing as farm-to-table-fast-food joints serving happy sprouts and wheat grass fries, you can find some healthy options in such places as Panera Bread, Jason’s Deli, Corner Bakery, Chipotle, Einstein Bros. Bagles, and Taco Del Mar. I’m sure there are many more not mentioned here—I’ll be happy to add to this list in a future blog or onto these wellness pages. Here’s the 101 on fast foods: These foods are extremely high in sodium, saturated fat, trans fat, and cholesterol. The list of additives can last pages, but essentially they are just weird chemical stuff thrown in to bolster taste, preserve the food, and to enhance addictiveness. The health consequences are disturbing: mental illnesses, hyperactivity, heart failure vulnerability, cancer risks, and of course there is obesity. Much of the research linking fast foods with these health problems are teting those who partake in fast food just once or twice a week. Get on the health bandwagon when kids are young—dial it down on the fast food activity—and chances are good your children will be less hyperactive, less moody, and more cooperative

Language Disorders—It’s possible these can be detected at a young age—4 or 5. Expressive language disorders refer to problems children have in getting their meaning across to others; whereas receptive language disorders occur when children have trouble understanding when others are communicating with them. There can be any number of causes for these disorders, and when there is no originating cause (such as caused by damage to the central nervous system, or aphasia) they are referred to as developmental language disorders. One thing researchers and specialists do know—language disorders do not reflect lack of intelligence. Be careful not to mix these disorders with “delayed language,” which is basically normally developing language but occurring slower or later than others. The language disorders I’m referring to mean abnormal development of language. If your child is having a hard time understanding others, has difficulty following directions, finds it challenge to organize thoughts, can’t put words into sentences, struggles to find the right word when talking, leaves words out when talking, messes up on verb tenses a lot, or repeats phrases frequently—these are indicators that it is time to see a specialist. When these disorders go un-addressed, the difficulties can mount, including problems with social interaction or poor academic performance.

Oppositional Defiance Disorder—Expect all children, even the best-behaved children, to exhibit mean and angry and defiant behavior toward you and other adult figures like teachers from time to time. But the ODD determination will be clear if such bellicosity persists over time, and it’s happening with no known or obvious trigger. No need to fret when opposition or defiance shows its ugly face once or twice, then dissipates and doesn’t emerge again for many weeks or months. It’s the frequency and the hours-long tantrum that will indicate the seriousness of the condition. Typically, this dark and aggressive tone will show up in the preschool years, although it can emerge later in the elementary school ages. You’ll know when it is happening to a serious degree. That’s when it’s time to check with your pediatrician and/or a pediatric psychiatrist. There will likely be no known cause for ODD behavior, but certainly if there is abuse and a aggressive, punitive tone around the house, the child who exhibits ODD traits is probably echoing the harsh tone in the environment. Still, the vast majority of cases aren’t stemming from such households. The key here is early intervention—when these characteristics are brushed off or just tolerated over time, the condition can be cemented in the psyche of the child, making it difficult to find solutions down the road.

Physical Activity

One of the main brain feeders in a child’s early years is sufficient, and proper, physical activity. The classic image of the kid couch genius—the tubby kid who happens to be gifted and therefore untouchable or unmovable—is neither a cute, nor a precious image to be celebrated or revered. Don’t be suckered by this archetype. Physical activity is crucial for activating the neurons in the brain and for establishing healthy brain growth. Make sure your preschools and elementary schools are taking kids outside to run around and play, every day. Also, when selecting a school, know what playthings and play stations are out in the recess yard—you’ll want to see swings, tire swings, spring riders, tunnels, climbers, bridges, ramps with ropes, trolley sliders, seesaws, and any number of other pieces of play equipment that will exercise and develop balance, core muscles, upper/lower body, and motion stamina just to name a few of the main body activities that will contribute to mind/body coordination and connection. One of the best benefits of physical activity? Following physical activity, and with a teacher who understands how to guide successful transitions back to the classroom, there is a much better chance for moderating stress and anxiety, and even for achieving mindfulness, calmness, stamina, focus—all the attributes necessary for academic success.

Teeth Health

It may be surprising to know that tooth decay is the most common chronic disease in children. Nearly 20% of children, age 5-17 have tooth decay. Certain foods and the absence of fluoridated water can quickly translate into bacteria breaking through teeth or producing acids that will create cavities. Untreated, cavities can lead to all sorts of learning and functional difficulties. Of course, when they do need to be treated with significant dental work, the anesthesia experience at such an early age, especially if nascent health conditions warrant repeated use of anesthesia, can harm normal brain development in children. Many of the dental care sites for infants and young children will recommend taking a brush to the gums at the time teeth are beginning to push through. These are crucial years to be habitual about proper oral hygiene as neglect in this area can cause serious complications later on. And as far as foods and drinks are concerned, for goodness sake limit and eliminate wherever possible the consumption of sugar, being especially aware of the juices that are packaged for children, which contain alarming amounts of sugar.

Oppositional Defiance Disorder—Expect all children, even the best-behaved children, to exhibit mean and angry and defiant behavior toward you and other adult figures like teachers from time to time. But the ODD determination will be clear if such bellicosity persists over time, and it’s happening with no known or obvious trigger. No need to fret when opposition or defiance shows its ugly face once or twice, then dissipates and doesn’t emerge again for many weeks or months. It’s the frequency and the hours-long tantrum that will indicate the seriousness of the condition. Typically, this dark and aggressive tone will show up in the preschool years, although it can emerge later in the elementary school ages. You’ll know when it is happening to a serious degree. That’s when it’s time to check with your pediatrician and/or a pediatric psychiatrist. There will likely be no known cause for ODD behavior, but certainly if there is abuse and a aggressive, punitive tone around the house, the child who exhibits ODD traits is probably echoing the harsh tone in the environment. Still, the vast majority of cases aren’t stemming from such households. The key here is early intervention—when these characteristics are brushed off or just tolerated over time, the condition can be cemented in the psyche of the child, making it difficult to find solutions down the road.

WELLNESS TOPICS FOR ADOLESCENCE/TEENS

Eating Disorders—The medical sites report that eating disorders is the third most common chronic illness. Early intervention is critical, as prolonged disorders—whether anorexia nervosa or bulimia nervosa—can lead to serious illnesses and conditions of a lasting nature well into adulthood. Often these symptoms cannot be observed superficially, and they may require nutritional professionals to collaborate with pediatricians in assuring proper balance of vitamins and minerals, alongside monitoring protein and calorie intake. Predominantly a situation with young girls, eating disorders should not be regarded as some passing fad or some “thing they are just going through.” Undetected and untreated, these disorders can quickly become dangerous and life threatening. Watch out for the obsession with weight, figure, and even exercise as what can sometimes seem benign and healthy to the casual onlooker is masking a disastrous health problem in the making. Don’t hesitate to engage the doctor and a counselor if necessary before these troubling eating trends or habits become cemented in the child’s psyche. The best approach is prevention in the form of parenting your child toward healthy food choices, and this should be systematic around the house beginning in the early childhood years.

Mood Disorders—These are sometimes described as “affective disorders,” and they are much more prevalent, researchers say, in children than we commonly believe. Mental health professionals say that mood disorders can be tricky to spot in children, simply because children are not as adept at expressing their feelings like adults. Many professionals say that these mood issues are seriously under-diagnosed, as parents and teacher will skate over what appears to be just a passing mood of negativity. Whatever the disorder may be—such as depression, bipolar, or perhaps a mood disorder generated by other medication, to name just a few—if allowed to go on untreated, the result can mean additional disorders such as anxiety disorder, disruptive behavior, and suicidal ideation. Symptoms to watch for include: difficulty concentrating, trouble sleeping, diminished energy, decrease in appetite, low self-esteem, a sudden drop of interest in any number of activities like sports or school, irritability and hostility, a fear of failure or fear of falling short of perfection. This list can go on—the crucial thing to know is that children can be helped. Downward shifts in attitude should be monitored, and don’t hesitate to connect with the right expertise through your school’s resources or through your pediatrician.

Sexual Development and Attitudes

For this topic, in this space on the enlivenminds site, I want to focus on attitudes, values, and feelings—these contribute to or reflect the emotional, social and cultural world our children experience when it comes to sexuality. When kids turn twelve and thirteen, they have already amassed a significant amount of attitudes and perceptions about sexuality from their peers, social media, and popular culture. It is the rare child who receives predominantly healthy perspectives from one’s parents, but that typically stems from a lack of communication on the topic. This lack of parent-child communication on sexuality is the norm in developing and under-developed countries. The level of media/internet exposure to aggressive sexual behavior during early and middle adolescence should be of utmost concern to educators and parents as teenagers will are very vulnerable to STD’s and sexually violent behavior when their educational institutions are not partnering with parents in the area of education. How can we further the development of respect, safety, consideration, and awareness, in addition to enhancing the education of non-coital sexual activity as a means of encouraging healthy behavior? While the MeToo movement has largely focused on adult perpetrators, we are overlooking the experience of children and adolescents whose experience of sexual harassment, bullying and abuse, can cause hurt and pain that is serious and permanent. In my IDENTITY section on this site, you will find additional commentary on what provides for appropriate education prior to the adolescent years, which can prepare the child attitudinally for the rapid hormonal changes that take place during puberty and beyond.

Alcohol and Tobacco—Let’s start with smoking. The best way to ward off teen smoking, apart from establishing an absolute no smoking household, is to set the right example by not smoking or, if you do smoke, by communicating with your child how you are trying to quit and enumerating the reasons why it is a disgusting and harmful habit. Setting an example is hugely influential, but it needs to go hand in hand with communicating the hazards long before your child hits puberty and adolescence. Keeping your child productively involved in anything physical—sports, dancing, hiking, even menial jobs—will also limit the chances they will turn to smoking. Teaching, especially through role-playing, how to turn down a cigarette, and rehearsing the line as if it were your child’s sole line in the school play, “No thanks—I don’t smoke,” will give your child the tools to resist peer pressure. Throw in all the other demerits, like the expense of cigarettes, or how smelly they are for your breath and your clothes, and certainly how damaging to the lungs and how detrimental to longevity. The good news is that teen smoking has been witnessing a decline (however tiny) in the USA over the past two decades. The education is working. Underage consumption of alcohol has also seen a decline, at least in terms of teen fatalities associated with drinking, which have gone down significantly, even though it remains a startling statistic [4,600 underage drinking deaths in 2016, down almost 80% from the levels of the 1980’s]. Even while trends are moving in the right direction, health officials are still regarding underage drinking as an epidemic. Nearly 20% of teens report drinking in the past 30 days, while 12% report having engaged in binge drinking. The warning signs that your child may be drinking can be invisible for many months. Watch out for these symptoms: sudden drop in school performance, diminished interest in activities and hobbies, loss of memory, or irritable and distant behavior.  There can be more indicators, but aggressive intervention should occur immediately and an indefinite revamp of the entire parent-child relationship may be in order to turn around such behavior. One of the odd statistics you will find is that parents who include their children in modest amount of drinking at the dinner table tend to raise children with fewer drinking problems, compared with parents who restrict alcohol 100% around the house.  To learn more about intervening on your child’s alcohol problem, check the site https://www.alcoholproblemsandsolutions.org/children-alcohol-and-parenting/