Early Children Development education and child care

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Nutrition & Healthy Meal Plans

How to Handle Biting

Oral Health and Learning

Swine Flu Prevention and Treatment

Tips for kids during a visit to the doctor’s office or trip to the ER


kid, child, nutrition, meal, health, calorie, age, 2, 3, 4, 5

  1000 Calorie Meal Plan A       1400 Calorie Meal Plan A 

1000 Calorie Meal Plan B       1400 Calorie Meal Plan B

1200 Calorie Meal Plan A       1600 Calorie Meal Plan A

1200 Calorie Meal Plan B       1600 Calorie Meal Plan B

Information provided courtesy of the United States Department of Agriculture.

How to Handle Biting

Several factors need to be taken into account when dealing with children and biting. Children bite because they are curious, copying the behavior of others, angry, trying to get what they want, teething, frustrated or even just trying to establish social contact. One of the first considerations in dealing with a biter is the age of the child.

Children under 2.5 years of age are notorious for biting. Biting is an age appropriate response for children this age, who usually do not have the socialization and verbal skills to indicate their needs in more acceptable ways. A toddler may bite just to see what biting feels like.

The preschooler generally bites due to total frustration at a situation. The preschooler usually feels quite defensive about the bite and justified in this action. "I had the truck first!," or "It's my turn," are reasons enough for a bite.

A school age biter is usually frustrated beyond control at a specific situation and feels very guilty about the bite. A school age child who is a habitual biter needs professional help.

Whatever the cause or the age, biting by any child cannot be tolerated. It is not safe, socially acceptable or conducive to positive interaction. Biting hurts, and it is not okay to hurt others.

Be alert to possible biting situations. Anger, frustration and grabbing among children can easily develop into biting. Intervention techniques may include redirection, standing next to an upset child, and helping children verbalize their feelings. Let children know biting hurts and you will not tolerate biting. "I know you are angry, but I won't let you bite anyone, and I won't let anyone bite you."

Encourage and promote appropriate behavior. Talk with children about appropriate ways to express feelings. Give children opportunities for practicing socialization skills through dramatic play, helping each other with tasks and talking together about their experiences. Give children positive reinforcement with smiles, hugs, and statements such as, "I'm glad to see you today," and "I like the way you used your words to tell Jenny you are angry," or "You are so smart, you figured out how to use the blocks together."

Provide activities such as Playdough, painting, water play, outside play that let children express and work out their feelings.

When tempers seem to be rising or behavior becoming out of bounds, change the environment. Go outside, play some music and have everyone dance, read a story, get out the Playdough or paints, do something different. Provide some "private spaces" where a child may play alone if they want.

Dealing with the bite:
1. Keep the events around biting from becoming too interesting. Lavish attention on the victim. If the victim will allow it, have the biter help wash the bite and put ice on it. Tell the victim, "I'm sorry that happened to you," so that the biter realizes you are upset.

2. Separate the biter from the rest of the group, if necessary, to let the child calm down but still be able to observe what is going on. If separation is used, 1 minute for each year of age with a maximum of 5 minutes is the recommended time.

3. Talk with the children about the cause for the biting and what the biter could have done instead of biting.

4. Inform the parents of the bitten child of the bite before they see teeth marks or hear about it from their child. Biting is an emotionally charged issue with parents. Let the parents know what you plan to do so their child will not be bitten again.

5. Tell the parents of the biter about the incident and what you plan do to help alleviate any recurrence. Parents of the biter need to be reassured they do not have a monster in their family and also given information for preventing further biting.

Article provided by permission of Child Care Links.

Oral Health and Learning

“What amounts to a silent epidemic of dental and oral diseases is affecting some population groups. This burden of disease restricts activities in schools, work, and home, and often significantly diminishes the quality of life.” -Surgeon General David Satcher, Ph.D., M.D.

Lost School Time and Restricted-Activity Days

  • An estimated 51 million school hours per year are lost because of dental-related illness.
  • Students ages 5 to 17 years missed 1,611,000 school days in 1996 due to acute dental problems—an average of 3.1days per 100 students.
  • Children from families with low incomes had nearly 12 times as many restricted-activity days (e.g., days of missed school) because of dental problems as did children from families with higher incomes.

Oral health and Learning

  • Children are often unable to verbalize their dental pain. But may display difficulty attending to tasks or demonstrate the effects of pain—anxiety, fatigue, irritability, depression, and withdrawal from normal activities.
  • Students with chronic dental concerns, untreated health and development problems may develop permanent disabilities that affect their ability to learn and grow, have trouble concentrating and learning, frequent absences from school, decreased school performance, poor social relationships, and become easily distracted and unable to concentrate on schoolwork all negatively impacting their self-esteem.
  • Left untreated, the pain and infection caused by tooth decay can lead to problems in eating, speaking, and learning.
  • Early tooth loss caused by dental decay can result in failure to thrive, impaired speech development, absence from and inability to concentrate in school, and reduced self-esteem.
  • When children’s acute dental problems are treated and they are not experiencing pain, their learning and school-attendance records improve.

Nutrition and Learning

  • People who are missing teeth have to limit their food choices because of chewing problems, which may result in nutritionally inadequate diets.
  • Inadequate nutrition during childhood can have detrimental effects on children’s cognitive development and on productivity in adulthood.
  • Nutritional deficiencies negatively affect children’s school performance/readiness, their ability to concentrate and perform complex tasks, and their behavior.

Article provided by permission of National Maternal and Child Oral Health Resource Center; readers are to receive permission for duplication of any cited materials from the Oral Health Resource Center.

H1N1, or "Swine Flu"

Prevention & Treatment

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against novel H1N1 virus.  However, a novel H1N1 vaccine is currently in production and may be ready for the public in the fall. As always, a vaccine will be available to protect against
seasonal influenza.

There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Take these everyday steps to protect your health:

children development child care health wash hands boy
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners* are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread this way.
  • Try to avoid close contact with sick people.
  • If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.

Other important actions that you can take are:

  • Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
  • Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs,* tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious. children development child care girl sneeze sick

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
Keep away from others as much as possible. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.

If I have a family member at home who is sick with novel H1N1 flu, should I go to work?
Employees who are well but who have an ill family member at home with novel H1N1 flu can go to work asusual. These employees should monitor their health every day, and take everyday precautions including washing their hands often with soap and water, especially after they cough or sneeze. Alcohol-based hand cleaners are also effective.* If they become ill, they should notify their supervisor and stay home. Employees who have an underlying medical condition or who are pregnant should call their health care provider for advice, because they might need to receive influenza antiviral drugs to prevent illness. For more information please see General Business and Workplace Guidance for the Prevention of Novel Influenza A (H1N1) Flu in Workers.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water or clean with
alcohol-based hand cleaner*. CDC recommends that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

What should I do if I get sick?
If you live in areas where people have been identified with novel H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people. CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Stay away from others as much as possible to keep from making others sick. Staying at home means that you should not leave your home except to seek medical care. This means avoiding normal activities, including work, school, travel, shopping, social events, and public gatherings.

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed.

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

  • Fast breathing or trouble breathing
  • Bluish or gray skin color
  • Not drinking enough fluids
  • Severe or persistent vomiting
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting
  • Flu-like symptoms improve but then return with fever and worse cough

Are there medicines to treat novel H1N1 infection?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with novel H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current pandemic, the priority use for influenza antiviral drugs during is to treat severe influenza illness (for example hospitalized patients) and people who are sick who have a condition that places them at high risk for serious flu-related complications.

What is CDC’s recommendation regarding "swine flu parties"?
"Swine flu parties" are gatherings during which people have close contact with a person who has novel H1N1 flu in order to become infected with the virus. The intent of these parties is for a person to become infected with what for many people has been a mild disease, in the hope of having natural immunity novel H1N1 flu virus that might circulate later and cause more severe disease.

CDC does not recommend "swine flu parties" as a way to protect against novel H1N1 flu in the future. While the disease seen in the current novel H1N1 flu outbreak has been mild for many people, it has been severe and even fatal for others. There is no way to predict with certainty what the outcome will be for an individual or, equally important, for others to whom the intentionally infected person may spread the virus.

CDC recommends that people with novel H1N1 flu avoid contact with others as much as possible. If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Stay away from others as much as possible to keep from making others sick.

Information provided courtesy of the Centers for Disease Control and Prevention.

Kids Health

Tips for kids during a visit to the doctor’s office or trip to the ER

Going to the emergency room can be scary for a child – and his parent. A high fever, a deep cut that requires stitches, a broken leg or any of life’s unexpected traumas can cause a great amount of anxiety. And, if a child is afraid of doctors, the experience may be even more stressful.

There are some easy ways to prepare a child for a trip to the ER or for an appointment at the doctor’s office:

Avoid making the doctor out to be the ‘bad guy.’ Using threats of taking your kids to the doctor for a shot may be an unfair connection for the medical profession and for children. While shots are a regular part of appointments in the early stages of life, they become less frequent as a child gets older. Some appointments only require an assessment, such as checking your ears and throat.

Reinforce that a doctor’s job is to help you feel better. If your child is not feeling well, or if there is a situation that requires a trip to the ER, a doctor can make you feel better. Tell your child the reason for the visit is so he can get well.

Share information with your child. Be mindful of her age and share the appropriate amount of information so she’ll know what’s happening at each stage of the appointment.

Use distractions. Find ways to take your child’s mind off of the visit. Bring a favorite toy or stuffed animal. Coloring books, stickers, bubbles, a portable video game or a television show in the waiting room are also helpful.

Don’t make promises. Wait to see if a shot or procedure will be needed before telling your child anything about the treatment. If it’s necessary, be honest and tell your child there might be some discomfort or that a shot may sting a little. Make sure there are no surprises. Being honest will help build your child’s trust for future visits. Next time, they’ll know to expect pain with a shot.

Misbehaving may be a sign of fear. If your child acts out, he may be trying to tell you he’s afraid. Perhaps he’s experiencing stranger anxiety because of his age. Consider his limitations and set reasonable expectations for your child, such as being a good listener or following directions.

Reward him for a good visit. It’s perfectly acceptable to reward your child for being brave and cooperative during an appointment. However, consider the reward and the impact it may have in the future. Popsicles and stickers are effective incentives.

Pick a child-friendly ER. Look for a hospital that offers pediatric emergency services, which may shorten your wait time. Colorful walls and a kid-friendly environment can make the experience a little more soothing for a child. Also, a child-friendly ER will use “ouchless” stitches that have a topical preparation to numb the cut and reduce pain.

Remain calm. For your child’s sake, stay composed. Your child will pick up on your facial expressions and your actions. Your primary role is to be a comforter. Use a soothing voice. Offer him a hug or blanket to keep warm. Use deep breathing to keep yourself relaxed. Above all, be your child’s advocate.

Finally, most doctors encourage you to give a pain reliever such as ibuprofen or ice before coming in to the office or ER. When your child is experiencing pain, she will be miserable during the appointment, so it’s helpful to relieve some of the discomfort prior to the visit. And, it’s important to note, neither will affect the level of care or treatment.

Going to the ER or doctor’s office usually isn’t a fun experience. For many of us, the anxiety of what we expect to happen is probably worse than the experience or pain itself. Some of us may never outgrow our fear of doctors. With a little bit of reasoning and some mental preparation, we can help our children and ourselves get through the appointment and move on to healing.

George Koburov, MD, medical director of the Pediatric Emergency Department at Edward Hospital, contributed to this article.

Article provided by permission of Edward Hospital.


Communicable Disease Guidelines

Provided with permission from the Indiana Institute on Disability & Community at Indiana University