Dr. Nan's Pediatric Solutions

Children and Media

Please see this recent article from Seattle Providing Anticipatory Guidance About Screen Time for Children: Q&A With Dr. Dimitri Christakis Christakis QA Bulletin Dimitri Christakis, MD, MPH Dr. Dimitri Christakis, a general pediatrician who conducts research on the impact of early childhood experiences on childrenâ??s development, addresses questions about screen time for children. Christakis is a member of the American Academy of Pediatrics (AAP) Executive Committee on Children and the Media and director of Seattle Childrenâ??s Center for Child Health, Behavior and Development. Thank you to Dr. Matt Allen, a pediatrician at Ballard Pediatric Clinic and a member of Childrenâ??s medical staff, for submitting these questions. Q. It now seems shockingly common to find a 4-year-old playing Angry Birds on a smartphone during a check-up. How much time are children currently spending on-screen, and what are the AAP recommendations? A. The amount of time varies by age, but the typical preschool child spends about 4.4 hours a day using screen media, and screen time increases to up to 7 hours a day by adolescence. Children spend more time watching screen media than doing any other activity except sleep. The recommendation from the AAP Executive Committee on Children and Media is to limit â??recreationalâ?? screen time to up to two hours per day, in addition to any screen time for academic work. However, I think two hours is too much because it doesnâ??t leave enough time for other activities that are important developmentally and physically. The recommendation also implies that children will stop one activity and start another, when most children today are multitasking. How do you count recreational screen time if an adolescent is Facebooking or iChatting while doing homework? My personal recommendation is no more than an hour of recreational screen time per day. Q. You have been on the leading edge of research regarding attention-deficit hyperactivity disorder (ADHD) and behavioral issues in children related to television. Could you summarize the current evidence? A. A child who watches two hours of TV per day before the age of 2 is 20% more likely to have attentional problems at age 7 compared to a child who watches none. Our work also suggests that it is the pacing that increases the risk, with fast-paced programs posing greater risk than slow-paced programs. Others have also found short-term attentional deficits in young school-age children immediately after watching episodes of fast-paced programs. In contrast, children who receive more cognitive stimulation before age 3 (such as having parents who read to them, take them to museums or sing to them) have a lower likelihood of attentional problems at school age. Rather than looking at a diagnosis of ADHD, I prefer to look at attentional capacity as a core part of executive function. There is a bell-shaped curve for attentional capacity, and while we draw a line at the 90th percentile for making a diagnosis of ADHD, a child who is close to the 90th percentile also has challenges. Q. There are many forms of screen time (e.g., computers, texting, smartphones, television, video games). Is there any evidence that certain forms of screen time are more concerning than others? A: Itâ??s not as important to distinguish between platforms as it is to look at content. Two hours of a violent cartoon is very different from a two-hour documentary on the Civil War in terms of the pacing of the program and the educational value. Iâ??d suggest moving away from the mantra of reducing screen time and focusing more on quality. If you watch the same program on television, a laptop or a smartphone, it has the same effects. I consider texting phone time rather than screen time. Q. Itâ??s hard to ignore the relationship between physical inactivity and obesity. Is there any data to support screen time limits as part of a weight management plan? A. There is an association between TV viewing and obesity, and, in fact, screen time reductions have been shown to reduce excess weight gain. However, there is a misconception that TVâ??s effects on obesity are mediated through sedentary behavior because youâ??re not expending calories if youâ??re watching TV. As a comparison, reading is also sedentary, but it hasnâ??t been implicated as a cause of obesity. The link between TV viewing and obesity is because of exposure to advertising for unhealthy foods and overeating while viewing. Children watch TV because they are sedentary; they are not sedentary because they watch TV. We keep our children indoors more than we should, and once indoors, there are few ways to expend significant calories. Notably, one of those ways is now with active video games like Kinect for Xbox 360. Q. What advice do you have for parents about successfully limiting screen exposure in their children? A. I encourage parents to think about their childrenâ??s media diet. Thereâ??s a healthy media diet, just like a food diet, that should consider a healthy amount and appropriate quality. But even good programming should be limited. Just as eating two bushels of carrots a day is not healthy for a child, watching a good TV program for six hours a day is too much because they are substituting media for other important activities. For more information, see presentations by Christakis at Childrenâ??s Grand Rounds (CME credit available) and TEDxRainier. References Christakis DA, Garrison MM, Herrenkohl T, Haggerty K, Rivara FP, Zhou C, Liekweg K. Modifying media content for preschool children: a randomized controlled trial. Pediatrics 2013;131(3):431â?"438 Tandon PS, Zhou C, Lozano P, Christakis DA. Preschoolersâ?? total daily screen time at home and by type of child care. J Pediatr. 2011;158(2):297â?"300 Zimmerman FJ, Christakis DA. Associations between content types of early media exposure and subsequent attentional problems. Pediatrics. 2007;120(5):986-992 Christakis DA, Zimmerman FJ. The Elephant in the Living Room: Make Television Work for Your Kids. Emmaus, PA: Rodale; 2006 Christakis DA, Zimmerman FJ, DiGiuseppe DL, McCarty CA. Early television exposure and subsequent attentional problems in children. Pediatrics. 2004;113(4):708â?"713

Learn to Recognize Common Skin Rashes

Babies and children can experience an array of skin conditions, which may necessitate different types of treatment. This video helps parents understand how to distinguish between skin rashes.

One extremely common condition in babies is diaper rash. Though not a pressing health concern, it can be irritating to children. To alleviate diaper rash, be sure to keep diapered skin clean and dry at all times. Scarlet fever is another childhood condition that produces a red, bumpy rash on skin. Because scarlet fever can pass from child to child and cause more severe health problems, it’s important to get antibiotics from your pediatrician.

If your child is exhibiting signs of a rash, contact Dr. Nanette Nuessle in Independence, Kansas. Dr. Nan’s Pediatric Solutions can see to it that your child receives the care he or she needs to feel better as soon as possible.

Natural Easter Egg Dyes

http://buff.ly/12YPxsP via HealthyChildren.org at the AAP

When Should Your Child Be Developing His or Her Language Skills?

Along with smiling and walking, talking is considered a major developmental milestone for children. Parents anxiously await their baby’s first words, which they often take as a sign that their child is advancing according to normal pediatric standards. It’s important to remember, though, that children do not all adhere to the same developmental timetable. Some children will begin speaking sooner than others. To better understand the general progression of childhood language skills, the following article provides an overview of common early life speech markers.

The First Year Many children are vocal from birth, though the sounds they make are incoherent. For the first 12 months of life, it’s common for babies to produce gurgling or cooing noises, which may become multi-syllabic as they develop. Children of this age may also indicate a connection between words and the items they represent. For instance, if you say ask your baby about his stuffed bear, his eyes may gravitate toward the object you are referencing.

The Second Year During the second 12 months of your toddler’s life, you should see a rapid development of language skills. When you speak to your child, he may attempt to mimic simple words. He may also begin to vocalize words on his own, such as “dada” or “mama.” Children of this age can also process simple sentences, although they may not initially respond in kind. By his second birthday, your child may connect single nouns and verbs and speak short phrases.

The Third Year and Beyond Once your child is 24 months old, you may see an exponential increase in his vocabulary development. Though his ability to construct formal sentences will still be limited for some time, he will likely be able to verbally demonstrate his knowledge of objects, colors, and commands.

Do you have more questions about your child’s language capabilities? Dr. Nan’s Pediatric Solutions can help. Dr. Nanette Nuessle’s general pediatrics practice in Independence, Kansas offers friendly professional guidance and treatment for your child’s needs.

A Look at the Most Common Skin Problems in Children and How a Pediatrician Can Help

Your child is fine in the morning, but by evening, he’s covered in red bumps or scales. If this sounds like an all too familiar scenario in your home, you’re not alone. Babies and children are prone to a wide variety of dermatological problems, but many of them can be resolved with general pediatric care. The key to helping your child heal from his skin problem is to know the cause behind it. The following conditions constitute some of the more common childhood skin issues.

Diaper Rash No matter how well they claim to whisk away moisture, diapers can quickly create a damp environment for delicate infant skin, which encourages the growth of the fungus Candida. As a result, your baby gets diaper rash. The most common signs of diaper rash are bright red bumps on the skin directly under the diaper. To treat diaper rash, your pediatrician may recommend making frequent diaper changes and cleaning the skin thoroughly. In some cases, an ointment may also relief symptoms.

Cradle Cap Babies are also susceptible to cradle cap, which pediatric physicians believe develops from a yeast infection. Cradle cap often appears as red skin or scales on the skin, but it typically presents no discomfort for infants. To alleviate cradle cap, consult your pediatrician. You may need to use a baby shampoo to remove flakes and keep the area clean and dry.

Scarlet Fever As its name indicates, scarlet fever presents itself as a reddish rash on the body. Most children first show signs of scarlet fever on their faces and necks, but symptoms can quickly spread to the extremities. This condition is caused by a bacterial infection, which is contagious. If your child has a fever or exhibits other flu-like symptoms along with a rash, contact a pediatrician for antibiotics.

Dr. Nanette Nuessle can address all your childhood skin condition questions. To make an appointment at Dr. Nan’s Pediatric Solutions, or to learn more about our pediatric services for Independence, Kansas families, visit our website.