When speaking with families about ways to combat childhood obesity, I sometimes struggle to find the right level of advice.  It is possible to be too simple ("Eat Less, Exercise More") or too complicated (a long list of "do this" and "don't do that").  The Wall Street Journal reports on "Let's Go!", a community initiative in Portland, Maine that increased awareness about healthy eating and exercise habits.  Since they started the program five years ago, they have seen some modest success in reducing the numbers of overweight and obese kids.  Their concept is simple enough to grasp and remember, but sophisticated enough to make a difference.  5-2-1-0 represents a daily scorecard of do's and don'ts:

5 servings of fruits or vegetables per day

2 hours or less of screen time per day (TV, computer, video games, etc.)

1 hour of exercise per day

0 sugary drinks (sodas, processed fruit juice, kool-aid, sports drinks, etc.)

 

See if these rules of thumb can help you set specific goals for your day!

 

The safety data have been accumulating for several years now, but this week the American Academy of Pediatrics changed their official recommendation to state that children should remain rear-facing in their car seats until age 2, or until they have reached the rear-facing weight and height limits for their car seat.  Additionally, older kids should remain in a belt-positioning booster seat until they are 4 feet 9 inches tall and are at least 8 years old.  The bottom line is that kids are safer in the rear-facing position:  under age 2, they are 75% less likely to die or be severely injured in a collision if they are rear-facing.  For every excuse that you can think of as to why your child would really rather face forward, please refer back to this statistic for your answer:  75% less likely to die or be severely injured.  The New York Times summarizes these recommendations nicely here, and the AAP provides more advice and specific car-seat information.

If you ask any pediatrician the most common reason for a middle-of-the-night call, I am sure it would be fever.  For obstetricians, the answer must surely be a mother in labor.  With fever, we do our best to identify the source of the fever, help with the child's comfort, and reassure parents that fever is not harmful.  In fact, fever is the body's natural, appropriate response to an illness.  This week, the American Academy of Pediatrics released helpful guidlines to educate physicians and families about "Fever Phobia," and the Wall Street Journal presents a nice summary here.

In modern times, obstetricians have managed some of their middle-of-the-night issues by recommending induction of labor during daylight hours.  The "discomforts of pregnancy" are admittedly substantial, so many moms are relieved to consider this option.  Induction of labor prior to 39 weeks gestation has proven to have some drawbacks, however, so there is a current push to limit these pre-term inductions.  The Journal summarizes this issue here.  An induction before 39 weeks increases the rate of complications for the baby, and also increases the rate of a "failed induction," leading to more C-Sections.  Ultimately, the Good Lord and Mother Nature know best, and they figured out this "40-week pregnancy" thing for a reason.  Waiting until the baby is good and ready ends up being better for both mom and baby.

Although many of my posts tend to focus on younger children, a trio of recent New York Times articles caught my eye regarding our young adults.

The first article analyzes the stress high school students experience in the race to do everything.  The article was spawned by the release of a new documentary on this subject, "Race to Nowhere."  When considered along with "Waiting for Superman," another recent documentary which addresses the failures of our educational system, there seems to be a great deal of current interest in improving our high school educational system.  It looks like the only local screening of "Race to Nowhere" will be on January 20 in Fort Worth, so if you are interested, try to track it down.  "Waiting for Superman" will be available on DVD on February 15.

The next article, entitled "Is Going to an Elite College Worth the Cost?" , has been stuck in my brain over the past week.  I faced this issue in high school, choosing to go to Texas A&M instead of piling up a large debt of school loans to attend a private university.  I like to think that I turned out okay, and ultimately A&M was a great fit for me.  Since that time, college tuitions have skyrocketed further, raising further the question of whether the return on the investment of an elite private institution is worth it.

Lastly, at whatever college your child does attend, this article looks at the issue of grade inflation.  My brother-in-law and his wife are professors at an expensive private university, and there is frequently a sense of entitlement along the lines of, "My parents are paying a lot of money for me to come here, so you better give me an 'A'."  I am reminded of a quote I heard recently from Jason Garrett, interim head coach of your Dallas Cowboys -- (paraphrasing) -- "I was a mediocre quarterback.  The coaches who told me I was great weren't doing me any favors."

In summary, to all my young adult patients out there:  good luck surviving high school, getting into the affordable college of your dreams, and learning for the sake of intellectual curiosity and self-improvement.  Oh, and I hope you truly earn an "A"!!!

Overall, this has been a fairly average cold and flu season so far.  We are seeing a number of different types of illnesses, but no major outbreaks of any particular illness.  We have not seen much Influenza yet, but historically it peaks in January and February.  We have seen quite a bit of RSV, and my youngest son was quite sick with it about a month ago (fully recovered and feeling fine now, thanks!).  RSV stands for Respiratory Syncitial Virus, and it is one of the most common wintertime viruses that we see each year.  For older kids and adults, it may just look like a common cold, but for babies it can be a much more severe illness.  For premature babies in particular, it can be very serious, many times leading to hospitalization.  Last week, I was interviewed by Channel 11 news about RSV.  The story highlights a change in the recommendations for Synagis, which is an antibody injection given to protect certain high-risk infants from RSV.  Babies who were born at less than 35 weeks gestation may qualify to receive Synagis once a month during RSV season, but now babies in the 32 to 35 week category may only qualify for 3 doses instead of 5.  Synagis is very expensive, so the recommendations have evolved over the years to best protect at-risk infants while also controlling costs.  Feel free to check out the video report on the Channel 11 website.

As Thanksgiving nears, I am grateful for many things -- first and foremost, my family, which has grown over the past year.  I am also thankful for our patients and families.  There are so many interesting topics to discuss and share, and we hope that we can enrich your childrens' lives over the years.

Two topics that I have found fascinating over the past few weeks:

This pair of articles from the New York Times discusses a wide variety of ways to make vegetables more enticing.  This is not necessarily specific for kids, but I do encourage families to share the same family meal instead of making separate "kid stuff."

Eat Your Vegetables

Learning to Love Vegetables

This week, the New York Times describes the increasing ways that our digital world changes the way our kids think and work.  "Growing Up Digital, Wired for Distraction" provides plenty of food for thought about the impact that screen time plays in the teenage years.

This weekend marks the end of Daylight Savings Time, so at 3 AM early Sunday morning, your clock can "fall back" to 2 AM.  Most people just look forward to this extra hour of sleep.  Parents of young children, however, are well aware that kids don't look at the clock and will wake up even earlier on Sunday.  So even if you can't sleep in, this is a golden opportunity to quickly adjust your child to an earlier bedtime.

I would also like to apologize for the prolonged blogging absence -- I have a pile of interesting articles and topics, so I pledge to start plowing through them for the good ol' FLP Blog.  Stay tuned, and stay healthy out there!

School has started, so that means cold and flu season is not far behind.  The flu vaccine is recommended for all persons 6 months of age and older.  Currently, we have the intranasal FluMist available for age 2 years and older, and the injection available for age 3 years and older.  We expect to have the injection available soon for infants 6 months of age and older.  Unlike last year, when there was one vaccine for seasonal influenza and a separate vaccine for H1N1 Flu, this year there will only be one vaccine.  This year's vaccine does include the 2009 H1N1 strain, as well as two other strains of influenza that are expected to be the dominant strains this year.  All kids under age 8 who are receiving the flu vaccine for the first time need two doses, given one month apart, for full protection.  In addition, children under 8 who did not get 2 doses of last year's H1N1 vaccine will need 2 doses this year.  Everyone else will only require one dose this year.  As in previous years, Forest Lane Pediatrics will provide many different opportunities for you and your family to get the flu vaccine.  The flu vaccine can be given at any doctor's visit provided that your child is feeling well enough to receive it.  We can schedule a nurse visit at any time during regular office hours in the week.  We have also scheduled several Saturday morning flu vaccine clinics for your speed and convenience.  This year, we will have flu clinics on the following dates:

Saturday, September 25

Saturday, October 9

Saturday, October 23

Saturday, November 6

Further dates may be added depending on "supply and demand."  We are happy to provide the vaccine for parents and other caregivers, too; we cannot file insurance for adults, so payment is expected at the time of service.  For further details about the 2010-2011 Influenza season, check the CDC website here.  Please call or e-mail if you have any specific questions about recommendations for your child.

Most area kids have had their first day of school now -- yesterday was the first day of kindergarten for us (*sniff-sniff*).  Three recent articles in the New York Times describe a range of school issues and should be thought-provoking, no matter how old your kids are.

The Littlest Redshirts Sit Out Kindergarten - discusses the increasing practice of delaying school entry

Students, Welcome to College; Parents, Go Home - what happens when helicopter parents land on a college campus

What Is It About 20-Somethings? - after college, more and more young adults are prolonging their youth