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The Best Ways to Say NO

Saying "No!" packs a powerful punch. We use it often -- sometimes too often...

Posted by Tanya Altmann, MD, FAAP

Saying "No!" packs a powerful punch. We use it often -- sometimes too often -- without even realizing it. To our children, we say, "No. Don't touch that! No. You can't have a cookie before dinner. No. You don't need another (insert child's favorite toy here)."

As children get older, we teach them to say no if asked to do something they don't feel comfortable with. And as adults we say no to avoid adding more tasks to our already hectic schedules. With young children, it's very important to say no when appropriate -- specifically when you mean it and in ways that will not discourage your children from communicating with you as parents.

With Infants, Know Your "No"
The art of saying no as a parent develops when your child is still a baby. Initially, most parents are yes-parents. You give your baby what she needs and what she demands at this age. It's fairly simple and routine. At around 9 months of age, your baby may begin to recognize your no's. You may see her stop and hesitate while playing when she hears you say no. This is around the time when children become mobile. So at this time, parents often transition from saying yes in cute and loving tones, to saying no, initially in sweeter tones, but later more matter-of-factly.

For Your Toddler, Make Every "No" Matter
Try to avoid cluttering your home with no's. Keep things that you don't want your child to touch out of his reach and safeguard potential dangers, such as electric sockets and stair ways. Setting up your home in a manner where you aren't constantly saying no makes your no's more powerful and allows your toddler to explore freely and safely. And your toddler can learn about their environments without being disciplined and discouraged every step of the way.

At this age, your child will quickly learn to say no, too. So be creative and use substitutes for "no", such as "Not safe" or "Put that down". Also, turn no-statements into positive ones. Instead of saying "No. We don't throw toys" try saying something like "We throw balls outside."

When You Say No to Your Preschooler, Mean It
Consistency is key. So don't give in. If your preschooler learns that throwing a tantrum will turn your no into a yes, your no's lose power. You can only reason so much with a preschooler. But remember, every moment can be a teaching moment. So explain your no's and offer better choices, such as "No. It's not TV time. It's a beautiful day and Mommy would love to take a walk with you and get some exercise. Let's go count bugs!"

Be mindful of your no's. Enjoy more yes-days with your kids than no-days. Save the no's for when you really need them.

Have any no-stories to share? How do you say no to your children and model the use of the word for your children?View Thread

Posted byTanya Altmann, MD, FAAP

0 Replies | Reply | Watch This DiscussionReport This| Share this:The Best Ways to Say NO Saying "No!" packs a powerful punch. We use it often -- sometimes too often...

Making Sure Your Child's School Meets His Needs

As a mother to 2 boys and a pediatrician with patients in many different...

Posted by Tanya Altmann, MD, FAAP

As a mother to 2 boys and a pediatrician with patients in many different schools, I know how important it is for your children's schools to fulfill their needs. As a parent, you are your child's best advocate when it comes to ensuring that he is receiving the best education possible. Although no school is a perfect fit for each child, the more you research and prepare, the better equipped you and your child can be for handling the school year. Here are 7 tips to help get your kids off to a good start and to sustain positive results throughout the year.

Tip # 1: Before admitting your child to any school, become familiar with the schools from which you can choose. Depending on where you live, you may have several choices concerning which schools you can send your children to. In addition to local public schools, there may also be magnet or charter schools available in your area. Or you may have a selection of private or parochial schools to consider. Take tours. Talk to staff members. Talk to families of children that attend those schools.

Tip # 2: Get to know the adults who are in charge of your child during the day. Early on, establish a relationship with your child's teachers -- and school administrators if possible -- rather than waiting until there are important issues to discuss. Teachers may vary in the way they communicate with parents, whether it's through emails, phone calls, or face-to-face meetings. If you have trouble reaching your child's teacher -- and your child is old enough -- send a note to school with your child asking the teacher to please contact you. Or alternatively, contact the school office.

Tip # 3: Get involved at your child's school. Become active in a parent/teacher organization. Volunteer whenever possible. Spend time in the classroom, the library, on the school yard, or helping serve lunch. This can give you a good view of what is going on.

Tip # 4: Pay attention to your child's temperament toward being at school and doing her school work. One of the most important indicators that your child's school is meeting her needs is her attitude about school. Is she excited to see her teachers and friends? Does she enjoy learning new things? Does she come home from school happy? Talk to your child every day. Have conversations and ask open ended questions about her day.

Tip # 5: If your child is having academic difficulties, don't forget to talk to his pediatrician, as well as his teachers. Of course, every day may not a bed of roses. But if too many thorns are interfering with your child's education, you must take a closer look. There may be a medical condition -- such as a vision or attention issue -- that is interfering with his ability to learn. Be open to treatment options and receiving extra help, such as tutoring and other school services that may be beneficial.

Tip # 6: If your child has special needs, find out what services are offered through your state or school district. Ask for an individualized education program (IEP) if needed. The goal should be to understand your child's individual needs and to get solutions as to how his school can best meet them.

Tip # 7: Remember, there's more to being fulfilled than just academics. It is important for students to experience a balance between academics, arts, language learning, music, and physical activity. Some schools offer more of a selection than others. What activities are most important to you and your child? Are his physical and/or creative needs being met at school? If not, consider enrolling in after-school enrichment programs.

Helping your child succeed in school requires a solid partnership between you and your child's school. What tips or personal stories do you have that may help other families thrive in their schools?View Thread

Posted byTanya Altmann, MD, FAAP

0 Replies | Reply | Watch This DiscussionReport This| Share this:Making Sure Your Child's School Meets His Needs As a mother to 2 boys and a pediatrician with patients in many different...

Starting the Day Off Right

Mornings can be hectic and hurried. And when your day gets off to a rough...

Posted by Tanya Altmann, MD, FAAP

Mornings can be hectic and hurried. And when your day gets off to a rough start, everything that follows can seem more challenging. To ensure that your family has stress-free and productive mornings, here are 9 tips to get your troop out the door on time.

1. Prepare the night before. Make lunches and pack backpacks the night before so your necessities are all set when you get ready to walk out the door.

2. Get your kids to bed on time. Sleep is essential for growing bodies and developing brains. Ideally, school age children should sleep at least 10 hours a night. So if waking your kids up in the morning is a struggle, try giving them an earlier bed time.

3. Wake up earlier. Parents, this one is for you. Waking up earlier -- before your kids wake up -- and getting yourself ready first can help you avoid feeling so rushed.

4. Wake up well. Start the day off with hugs, smiles, "Good mornings", silly songs, and other fun routines.

5. Get dressed first. It works best for kids to get up and get dressed before eating or doing anything else. Prepare two outfit choices the night before.
Exception: Young toddlers -- who may still wear more of their breakfast than they eat -- may need to eat before dressing.

6. Everyone brushes their teeth. If getting your children to brush their teeth is a struggle, have everyone in the family brush together. When parents brush with their kids, they can see the importance of good oral hygiene. And it makes the task more fun.

7. Reward them for being ready early. If your kids are ready ahead of schedule, reward them with special playtime, by reading a book, or by walking around the block. One mistake that parents can make is turning on the TV right when the family wakes up. But if the television must be part of your morning routine, use it as a reward once kids are all ready and waiting to go to school.

8. Stay calm. Calm parents = calm children. Stressed parents = stressed children. Enough said.

9. Praise your children every step of the way. For younger children who struggle in the morning, try putting stickers or stamps on their hands with each completed step. Let them show their teachers and everyone at school! Make a big deal out of their successes. After a few weeks no stickers or stamps are usually needed, since the routine will have become a normal part of your child's busy day.

How do you jump start your family in the morning? Any tricks to add to this list?
View Thread

Posted byTanya Altmann, MD, FAAP

0 Replies | Reply | Watch This DiscussionReport This| Share this:Starting the Day Off Right Mornings can be hectic and hurried. And when your day gets off to a rough...

Reading with Your Children

One of the best New Year's resolutions a family can make is to READ MORE....

Posted by Tanya Altmann, MD, FAAP

One of the best New Year's resolutions a family can make is to READ MORE. Reading is important at every age and it's never too early -- or too late -- to start. Here are a few age-appropriate tips to help increase the importance of books and reading time in your children's lives.

Infants: Reading aloud is one of the most important things you can do with your baby. Studies show that infants and toddlers who are exposed to books and reading are more interested in learning later in life.

Be sure to make reading time exciting. Your baby will love your energy; how you change your tone and exaggerate your facial expressions. Make a short story part of your infant's regular bedtime routine. Hold her so that she can see the book's illustrations. During the day, let her play with books. It's even OK if she tries to eat them. Good choices for this age are board books and books with lots of textures, colors, and shapes.

Toddlers: Let your toddler choose his books, hold them himself, and turn the pages during the story. Pick sturdy books to decrease the risk of damage, and books with large fonts and pictures that he can enjoy. Run your finger under the words as you read to show your child that the print carries the story. Stop to look at pictures and ask your child to name things he sees. Talk about how the pictures relate to the story. Begin building a children's library in your home, even if it's just a corner filled with a stack of colorful kids' books. In my own home, we collect books in a small area under our stairs. And I often find my boys snuggled there, reading books on their own.

Preschoolers: Continue to use funny voices, or even animal noises. Don't be afraid to be silly! Your enthusiasm can help your child get excited about the story and about learning to read. Start teaching your preschooler letters and the sounds they make. But don't be discouraged if they don't pick it up right away. Learning to identify letters and eventually read is a process. And research shows that reading to children teaches them the importance of communication and motivates them to become readers as they get older.

Young Children: Most children learn to read in kindergarten. Nonetheless, continue reading out loud to your child even after she learns to read for herself. A child can listen and understand more difficult stories than she would if she only read on her own.
Take advantage of your reading time to discuss themes and issues raised in her books and learn what is on her mind and what happens during her day at school.

Don't forget, as a parent you are your child's best role model. So read daily, whenever possible. Keep reading alongside your children, even when they are proficient enough to read on their own. Read the newspaper, books, magazines, whatever your family prefers, as long as you show your children the value of reading at every age.

Are there any techniques you've used or stories you've found that have kept your children excited about reading? Share your experiences with the group.View Thread

Posted byTanya Altmann, MD, FAAP

1 Reply | Reply | Watch This DiscussionReport This| Share this:Reading with Your Children One of the best New Year's resolutions a family can make is to READ MORE....

Beat Those Summertime Bug Bites

I seem to always get eaten alive on summer evenings when mosquitoes are out...

Posted by Tanya Altmann, MD, FAAP

I seem to always get eaten alive on summer evenings when mosquitoes are out looking for their next meal. I don't want my kids to suffer like I do, so I am extremely careful to protect them from bites, and keep them safe from insect-borne illnesses.

Try these tips to prevent bug bites and treat those bites that manage to sneak up on your family in spite of your best efforts.

• Keep kids covered with clothes, shoes, and socks when possible -- especially in the evening hours when mosquitoes tend to become active.
• Don't use bug-attracting scented products such as soaps, perfumes, or hair sprays.

•Avoid areas where insects congregate, such as stagnant pools and puddles of water.
•To remove a stinger, gently back it out by scraping it off the skin horizontally with a credit card or your fingernail.

When needed, use insect repellent carefully and correctly to prevent insect-related diseases such as West Nile virus and Lyme disease:

• The Centers for Disease Control and the American Academy of Pediatrics recommend using insect repellents that contain up to a 30 % concentration of the chemical DEET for children over 2 months of age. DEET should not be used on newborns. If you don't want to use products containing DEET, look for products containing picaridin, an alternative insect repellant now available in the United States.

• When possible, avoid combination sunscreen/insect repellent products because sunscreen needs to be reapplied every two hours, but insect repellent should not be reapplied.

• Use insect repellent on clothing and sparingly on exposed skin (more is not better). To avoid inhalation, apply spray-on insect repellant when you are outdoors. Have children shower or take a bath to remove insect repellant after they are indoors and the protection is no longer needed.

Signs that you should call your doctor for a bite or sting:

• Trouble breathing, swallowing or facial swelling (call 9-1-1).
• Feeling dizzy or ill.
• Hives (skin rash).
• Severe pain.
• Fever.
• Rapidly spreading redness or swelling.

It can often be difficult to tell the difference between a bite and a more serious bacterial infection called MRSA (methicillin-resistant Staphylococcus aureus). MRSA can develop quickly -- sometimes overnight, appearing as a spreading redness on the skin and a deep, painful abscess. If you're not sure if it's a bite, sting, or a serious infection, see your doctor for treatment.View Thread

Posted byTanya Altmann, MD, FAAP

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Learning to Swim: Keeping Your Child Safe

Spring is quickly turning into summer, and that means it's time for...

Posted by Tanya Altmann, MD, FAAP

Spring is quickly turning into summer, and that means it's time for swimming lessons! When little ones beg for some watery fun, safety-minded parents often wonder if their child is ready to learn how to swim. How do you know if a child is ready to take the plunge?

Not all children grow and develop at the same rate, and not all children will be ready to learn to swim at the same age. When advising parents, I tell them to look for a child that can follow directions, is comfortable in the water, wants to go in the pool, and enjoys playing games and being active.

Last year, the American Academy of Pediatrics released new evidence that children from ages 1 to 4 may be less likely to drown if they have had formal swimming instruction. Check with your local American Red Cross, YMCA, and community centers to find swimming lessons and programs that are appropriate for your child. It's a life-saving investment!

It's important to remember that just because your child has had some swim training, it does not mean she will be safe in the water. I often hear patients say that they taught their toddler to swim so they could relax at the lake or at grandma's house. But you can't ever relax when your children are near water. Swim lessons are just one of the layers of protection necessary to keep your children safe from drowning. Others include:

• Fencing. All swimming pools should be surrounded by a 4-sided pool fence that is at least 4 feet high and has a self-closing, self-latching gate. A 4-sided fence alone can cut drowning risk in half.

• Adult supervision. Make sure there is constant supervision by an adult who knows how to swim, perform a rescue, initiate CPR, and call for help.

• Use a designated supervisor. Use a badge or special hat to designate whose turn it is to watch the water.

• No distractions. If you're on duty, don't turn away, not even for a second. In the moment it takes to answer the phone, a little one can slip quickly and quietly under water and drown.

• Touch supervision. For infants, toddlers and weak swimmers, use a technique called "touch supervision." This phrase means that an adult should always be within an arm's reach of a child in or near the water.

• Pool floats aren't life jackets. Although air-filled floatation devices and other pool toys are cute, they can deflate or slip off, leaving a child in a dangerous situation. These items are not really designed to keep a swimmer safe, or even keep their head above water. You don't want to use them in place of life jackets.

• Safe drain covers and outlets. Be sure that your pool has special drain covers and safety vacuum-release systems to prevent a child from becoming trapped by increasing suction when a hand, foot or hair is caught in an open drain.

Swimming is a fun summer activity and a great form of exercise for all ages. Now that you know how to keep your family safe, slather on the sunblock, grab your sunglasses and a hat, and cool off with a dip in the pool.

How did you know your child was ready to learn to swim? What tips do you have for parents seeking water fun for their children?View Thread

Posted byTanya Altmann, MD, FAAP

0 Replies | Reply | Watch This DiscussionReport This| Share this:Learning to Swim: Keeping Your Child Safe Spring is quickly turning into summer, and that means it's time for...

Toys: Too Many? Wrong Type?

Do you ever feel like you can't take one step in your house without...

Posted by Tanya Altmann, MD, FAAP

Do you ever feel like you can't take one step in your house without tripping over a toy? Do you wonder if your kids really need all of them?
When should you say, "No more!"?

Play is an important factor in a child's development, and parents should encourage free play every day. That said, kids don't need to have every expensive gadget or hundreds of toys for effective play.

Have you ever bought your toddler a fancy toy and watched her cast it aside in favor of a wooden spoon and pot from the kitchen? It is often the simple things that help children to be creative and learn to imagine.

Babies learn by engaging their senses, so toys that are colorful, make sounds, have textures, and are safe for tasting are best. As your infant grows, toys can help encourage her to do new things like pulling up to stand, imitating sounds, and later learning her letters. She will eventually learn all of these skills, but a few, carefully selected toys can aid the process and make it fun.

When choosing toys, remember that every year thousands of children are injured by toys. Make sure children's toys are sturdy and safe, too large to be swallowed, and always age-appropriate.

As hard as it is when your child says, "Everyone else at school has one," try to not fall victim to marketing campaigns and commercialism. Your child doesn't need every toy from every movie. It's okay if they have different toys than their friends. Toy variety can make play dates more special for your child's visiting friends.

Remember -- you are the parent -- chant this every day! Learning to say "no" to your child's every desire is an important part of parenting. This will also teach her to appreciate what she has, work hard for a few select items she truly wants, and to take care of her belongings.

Encourage your child to spend time each day playing by kicking a ball or playing tag outside. Try to encourage your child to participate in creative play instead of sitting on the couch playing a video game.
Speaking of video games, I find that the weeks when parents take them away are the most enjoyable for everyone in the family!

Do you have a "toy strategy"? How do you select toys and encourage creative play for the children in your life? Share your experiences with children's toys and methods to encourage positive playtime with the community.View Thread

Posted byTanya Altmann, MD, FAAP

1 Reply | Reply | Watch This DiscussionReport This| Share this:Toys: Too Many? Wrong Type? Do you ever feel like you can't take one step in your house without...

Too Strict? -- Or Not Strict Enough?

Moms and Dads often worry that if they are too strict, their children won't...

Posted by Tanya Altmann, MD, FAAP

1 Reply | Reply | Watch This DiscussionReport This| Share this:Too Strict? -- Or Not Strict Enough? Moms and Dads often worry that if they are too strict, their children won't...

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