When expectant parents come in to see me just before their baby is born, they often are a cross between excitement and fear of the unknown. The task of raising a baby to be a healthy, productive and happy adult can seem daunting and, I admit, it is. I often joke that it would be best to have the second child before the fi rst, because then everything would be so much calmer! Parents ask me for tips on what they need to know and I reassure them that this is a journey that will educate them along the way. But I began to wonder if there are some tips that I uniformly dispense that I should share, and indeed there are.
It is recommended that children in pre-school sleep between 11 to 13 hours a night and school-aged children between 10 to 11 hours a night. A recent study out of Harvard showed that children between six months to two years who slept less than 12 hours, by age three had a higher body mass index (BMI) than their counterparts who slept more than 12 hours a day. We know that in all age groups, those who do not sleep enough can have an alteration in hormones that increases hunger. Daytime sleepiness translates to less energy to do more exercise, and being awake more translates into more time to eat. Another study from the University of London showed that children who slept less had greater anxiety and depression scores when older. Sleep hygiene initiated in childhood can only be the patterns that your adolescents will follow. Establish a consistent bedtime routine that encourages adequate time to get ready for sleep. Avoid caffeinated beverages and food, sleep in a dark and cool room and get up around the same time every morning (yes, even on the weekends).
2 HEALTHY EATING HABITS
Promoting great nutrition and healthy eating habits is critical for children of all ages. If healthy eating habits are established when children are young, they will become their life-long eating habits. Canada’s Food Guide remains the cornerstone of basic nutrition messages. Teaching your children to eat a variety of healthy foods in all the food groups will lead to a well-balanced diet. Remember, as a parent you are the role model. If you eat well, your children will follow your lead.
3 BMI REBOUND AND OBESITY
When your child sees the doctor, we measure their height and weight to track growth and development. The BMI is calculated from these measurements. Somewhere in childhood your child will be at the lowest BMI they will ever be in their lifetime, and as your child puts on more weight in relation to height their BMI accelerates upwards. This moment is called the ‘BMI rebound age’. Studies have found the younger the BMI rebound, the more likely children will have higher BMIs, higher blood pressures and larger heart volumes and size. This study speaks to the fact that it is crucial to monitor growth and development from the get go. What is fondly called baby fat may translate into risk factors in later life. Make sure your doctor is giving you feedback on your child’s growth.
Although vaccines cannot offer 100 percent immunity, they can protect against serious illness. Before vaccinations, we saw up to 20,000 cases per year of diseases such as polio (which is essentially eradicated in the Americas post vaccine). In Canada, we saw 300,000 to 400,000 cases of measles a year. Now there are less than 400. Primary prevention is our best tool against many of our most debilitating infectious childhood illnesses.
5 GET MOVING
The Canadian Paediatric Society points out that physical inactivity among our children and youth is reaching an epidemic proportion. As with eating, parents are role models for fitness and exercise. If you are a couch potato, then chances are your children will be too. Get moving as a family. From walks and cycling to organized sports; from skiing and skating to swimming, there is not a season that you cannot find a sport and activity for you to do as a family. Choose fun, age-appropriate activities. Children, as we know, will model their parents’ behaviour. Limit television, video game and computer time. These are sedentary activities that replace activities that get you moving. They also encourage increased food intake. Recent studies have shown that children who reduce their television and computer time – compared to those who do not – have a lower BMI without necessarily increasing their physical activity. It speaks to the fact that sedentary activity encourages eating…a bad combination!
6 USE EFFECTIVE DISCIPLINE
While discipline depends on the age and stage of development, discipline used effectively and lovingly is an important tool. It helps our children learn limits, self control and develop responsible behaviour. It can instil a sense of values and help our children stay away from dangerous situations.
7 AVOID RISKY BEHAVIOURS
From car seats to sun safety to insect repellent to safety in the bath… the list can be endless of all those things we can do asparents to keep our children safe. We teach our children about bike safety, helmet use and sports, seasonal safety such as frost bite or heat stroke and safety by the water. And, in so doing, we hope that will translate into them avoiding risky behaviour as they get older. It is important to have age-appropriate discussions about sexual health, alcohol and drug use and peer pressure as they get older.
8 MENTAL HEALTH
The prevalence of depressive disorders is one to two percent in children and pre-pubertal youth. It jumps to three to eight percent in adolescents. It is critical to recognize that children, and even older kids, might have either limited ability or difficulty in expressing their emotions. Be aware of kids with physical complaints, school refusal and separation anxiety. Our kids have a lot of stress to deal with and it is important to be an aware parent and keep the lines of communication open. Social anxiety disorder, the anxiety that happens in social situations, has a mean onset of age 14 to 16. Situations such as public speaking, going to a party or hanging out with friends can cause an anxiety response that, without diagnosis and treatment, can limit your child’s future.
9 RESILIENT SELF -ESTEEM
Respect of others and the belief in one’s self is one of the most valuable tools you can teach your children. The American Academy of Pediatrics talks about the ‘7 Cs’ of resilience, which include competence, confidence and character. Children given these valuable tools from the very beginning are more likely to have better self-esteem and personal body image. Those who have a connection to friends and family are more likely to develop a sense of security and know that they can make a contribution to the world. Children who learn to cope with whatever challenges life might give and who know they can control their own behaviour and decisions become reslient adults.
10 AND THEN THERE IS YOU
Yes, don’t forget to take care of you! A healthy and happy parent who
fosters open communication is best equipped to parent effectively. As
parents, we are often challenged to balance our family and work along
with ourselves. It is critical to remember to invest in one’s self. You
can’t give anything unless you remember to refuel your own personal
sense of self. It’s much like the airlines tell us, “Be sure to put your
own oxygen mask on before your child’s.”
7 C’s of Resilience
The ability to handle situations effectively.
The solid belief in one’s own abilities.
Close ties to family, friends and community give children a sense of security and the values that prevent them from seeking
destructive alternatives to love and attention.
A fundamental sense of right and wrong that helps children make wise choices, contribute to the world and become stable adults.
children realize that the world is a better place because they are in
it, they will take actions and make choices that improve the world. They
will also develop a sense of purpose to carry them through future
Children who learn to cope effectively with stress are better prepared to overcome life’s challenges.
children realize that they can control their decisions and actions,
they’re more likely to know that they have what it takes to bounce back.
SOURCE: Helping Your Child Cope With Life American Society of Pediatrics, 2006