August 2010

Hello to all our readers

Welcome to our first Newsletter as Frontier Kids Care. There have been many changes since our move in April 2008, and we continue to explore new ways of helping you to unlock your child’s full potential

———————————————————————————————————————

New at Frontier Kids Care

We have a new welcoming face at our front desk. Her name is Dominique Rodrigues and she has already become an essential part of our team in delivering quality care to you.

As we all face difficulties in these financially challenging times, we at FKC are doing our best to give an affordable service. The good news is that the visit fees remain the same but there has been a slight increase in costs of immunizations and procedures in the office.

We have expanded our Learning Not Waiting menu to include information on 100 calorie snacks. Perfect for packing in lunch kits for camp or even for keeping at home during the holidays. Some of the snacks are available for purchase at the office while you wait, along with 100cal pure juices and water.

———————————————————————————————————————

Vacation Health Information

Here at FKC we have observed many children put on an average of 5 lbs during holiday time.

This is usually due to less physical activity than during school time and more leisure time to eat snacks. This extra weight is difficult to lose!

To lose 1 lb, you must eat 500 calories less a day = 3500 calories less a week.

What can you do to help?

1. Weigh children at the beginning of the holiday and monitor to keep them from gaining too much. If you are challenged in this way, come in for a visit.
2. Keep children active by walking, doing outdoor activities or enrolling in a camp with exercise as a major part of the schedule.
3. Limit TV and computer time to less than 2 hours/day. This also decreases the associated mindless eating.
4. Keep healthy snacks such as fruit available, but limit to 2/day, plus normal balanced meals. Don’t forget water!
5. Read labels when buying food and snacks, paying special attention to serving size and calorie values.

Did you know that only 15 almonds or 10 gummy bears = 100calories?!

For more information, ask when you bring your child in for the annual visit

———————————————————————————————————————

TIBS News

TIBS is holding their annual walk and breakfast

When:            Saturday 7^th August, 2010

Where:          Starting opposite All Saints Church on the Queens Park Savannah

Time:             7.30am

Cost:  $40.00

Breakfast will be served from 8-10am at All Saints Hall, Marli Street.

Tickets are on sale at all TIBS offices as well as at Frontier Kids Care

———————————————————————————————————————

Vacation Working Times

Dr Thomas will be on vacation from August 13^th – 18^th, 2010. Emergencies will be covered. So please call Dominique to arrange your annual check ups and school boosters early to avoid the last minute rush at the end of August.

Please don’t forget to call the office if you are unable to keep your appointment, so that we can book someone else in your place.

It affects our ability to maintain an affordable service, if we have excessive missed appointments.

———————————————————————————————————————

And Finally…

In an effort to go green, we have cut down on our paper use. We now send our appointment reminders through email.

Please keep us informed of any changes in your contact information so we can keep you up to date on health and FKC events.

Don’t forget to visit us at www.frontierkidscare.com for our new updates!

-        Can cause diarrhoea (frequent, watery stools) and sometimes vomiting.

-        Usually caused by a virus, most commonly the rotavirus.

-        Most children get better without medicine in a few days but soft stools may persist for a week or more.

-        It is spread mostly by droplet infection (like the cold) or putting dirty hands, toys, bottles or other objects around the mouth.

Signs and Symptoms:

-        Loose frequent stools and sometimes vomiting

-        Cramping abdominal pain. Occasionally fever.

What to do:

-        Babies: Continue breastfeeding, replacing each stool with an extra feed, or if formula fed, give smaller amounts, slowly

-        Child:  Older child may continue regular diet but increase fluids.

-        Replace stool lost with an equal volume of fluids – juice, coconut water. If diarrhoea excessive, use oral rehydration fluids to replace salts lost in diarrhoea.

-        Drinks can be put in the freezer to make them slushy and then sip or eat with a spoon.

-        If there is vomiting, give fluids slowly, a few tsps at a time every 10 mins. If that is tolerated, increase fluids. Light diet such as crackers or light soups, crix, jam, applesauce, banana, watermelon.

Stay away from:

-        Milk drinks as these may not be well digested at this time.

-        Fatty foods and high sugar drinks as these may make the diarrhoea worse.

Medical treatment:

-        Antidiarrhoeals or antiemetics are not used as the virus needs to work itself out of the body

-        Antibiotics are not usually used.

Be concerned if:

-        Your child is younger than 6 mths old or has a high fever.

-        Has severe or prolonged diarrhoea, or has diarrhoea that contains blood or mucous

-        Vomits repeatedly and refuses to drink fluids.

-        Is urinating less than usual or has no tears when crying – Signs of dehydration

Think Prevention:

-        Breastfeeding is preventative.

-        Use proper hand washing techniques at all times.

-        Clean bottles and pacifiers well.

Article from local Love and Logic website

Pushing Against Firm Boundaries

By Barry Ebert

Recently, a woman in a parenting workshop expressed a problem I have heard many times from parents who are struggling with their toddlers. “When my husband and I had our first child, we never wanted him to hear the word no. We changed our language and did a lot of distracting and diverting of his attention so that we wouldn’t have to tell him no. Now we have a four year old with absolutely no boundaries and he’s impossible to live with. What should we do?”

First of all, we have to decide if we think healthy boundaries are a good thing for children to have. We often confuse our desire to encourage a free spirit of creativity with giving a kid open license to be a brat. A proper response to authority is crucial to a person who must become a part of society.

The relationship between toddlers and their parents lays the foundation for most future moral behavior. Children learn how a loving authority figure operates by watching their parents. Setting firm boundaries on toddlers gives us the opportunity to continuously move these boundaries out as our children grow. If we try to shrink boundaries when our kids reach adolescence, we are in for a battle.

I’ve heard the boundary concept explained this way once. Imagine waking up in total darkness. You’re sitting in a chair, but it is impossible for you to tell where you are. After overcoming your fears, you would eventually have to move off the chair and begin searching about in your new, unfamiliar surroundings. What would you be looking for? You would be looking for boundaries. Where am I? Where does the space end? Are there any danger spots? What can I count on here that’s solid? Will I fall if I go too far in this direction?

This is what our toddlers are doing during their time of “autonomy and independence” that is often called “the terrible two’s”. They are searching for something solid to push against: something they can count on that will not fall no matter how hard they push. And this is what we as parents must provide for them. In this magical time of early childhood, when the urge for exploration is so strong, we can give our children a priceless gift by providing them consistent, loving boundaries. We are telling them: “Here is a safe place for you to operate. I will treat you with respect, and it is my expectation that you will treat me with respect as well.”

Thomas Edison said “Restlessness is discontent, and discontent is the first necessity of progress.” Restlessness is an important aspect of human nature, and toddlers bring a powerful mixture of restlessness and discontent into a home. They want to get moving and see what’s around the next corner, they want to know what’s inside all of the cupboards, and they want to know what they can get away with.

Ironically, teenagers look at the world in much the same way. The cupboards they are peeking into are different and the things they are trying to get away with have changed, but the impulse to explore and be autonomous is much the same. That’s why we have to remember that there are only two kinds of kids: teenagers, and those that are going to become teenagers. When we are dealing with our toddlers, we are laying the foundation for a relationship that will last as long as parent and child are alive. If a respect for healthy boundaries is a cornerstone of this relationship, the rest of the building process will go a lot more smoothly.

One of the most common areas of questions during a Love and Logic parenting workshop concerns the “timeout” issue. When should a toddler be put into a timeout area and for how long? How much explanation is necessary for a child to understand why they were put into timeout? What kind of a message are we delivering when we send a child to their room for being disrespectful? Are we damaging their self-esteem?

Dr. Foster Cline, co-author of Parenting With Love and Logic, puts it this way: “When a loving parent puts a child into timeout for being disrespectful, they are teaching them a very valuable lesson: ‘When I act like a jerk, people don’t want to be around me’. We either learn this from loving parents or our first spouse, but eventually everybody learns this one.”

We don’t come to earth with an understanding of healthy boundaries. A child gets the impression during their first year or two that they are the center of the universe, and that the rest of life revolves around them Loving parents are the most qualified and the best equipped to set their toddlers straight on this one, while the price tag is just a little bedroom time.

Guidelines for Introducing Solids:

Birth to 6 months:

¨       The World Health Organization and the American Academy of Pediatrics, both recommend as the gold standard, exclusive breast-feeding to age 6 months. No extra water needed.

¨       If not breast, an infant formula that contains iron [not low iron] should be used.  Baby’s stomach doesn’t have the enzymes to digest anything but lactose [the sugar in milk]. The iron in breast milk or iron-fortified formulas is needed for brain growth.

Introduction of solids

Ideally solids should be started at 6 mths if baby is breastfed. Can be started at 4 mths if baby is bottle fed and has lost the tongue pushing reflex.

¨       Start cereal: Cereal in a bowl with breast milk or formula. Cereal should not be added to the milk as it prevents the baby from learning to advance to an adult type diet, and one may overfeed, and encourage obesity.

¨       Fruit: Fresh fruit such as banana/mango/watermelon/paw paw or applesauce etc. is best but fresh juices may also be given.

6 Months

A high chair is useful as baby is now sitting up, and should be having 3 meals a day. No extra sugar/salt should be used.

¨       Cereals: such as – cream of wheat, sago, oats, cornmeal all with breast milk or formula

¨       Fruits: all fruits can be given either with a spoon or allow baby to feed themselves with cut pieces.

¨       Starches: such as –  mashed potato, eddoes, dasheen, yam, sweet potato, rice, green fig

¨       Vegetables: such as - callaloo, pumpkin, melongene, zaboca, bodi, tomatoes, carrots, broccoli

¨       Peas: such as - split peas, channa, lentils – dhal consistency. Can add provision/vegetables/fresh seasonings and blend.

¨       Finger foods: such as - lightly toasted bread, crix, baby biscuits.

9 months

Eat 3 meals/day out of the family pot., seated at the table with the family. No extra sugar should be given. Can have salt

¨       Breakfast: porridge, egg, sardines, cheese, saltfish

¨       Lunch: soups with bread, sandwiches with salads, food.

¨       Dinner: pelau, roti, stew chicken, fish, callaloo, coo coo, macaroni pie, veggies, salads

¨       The volume of milk consumed will decrease; you may start offering the cup.

1 year

Milk is no longer the main food source. Baby should be having their meals at the table with other family members

¨       Should be given 3 meals a day from the family pot.

¨       Formula fed babies – stop the bottle and change to full cream milk in a cup – 2 cups a day at most.

¨       Breastfed babies should continue breastfeeding for up to 2 yrs, but less dependency.

¨       Growing up milk is not needed.

If your baby is consuming large volumes of milk in a bottle at this age, there is a risk of problems of anemia, poor growth and baby bottle tooth decay.

Come join us for Trinidad’s most practical and entertaining parent training!

“BECOMING A LOVE AND LOGIC PARENT”

This seven week parent training programme, designed by the Love and Logic Institute, Inc., teaches practical, easy to use skills for handling children and teenagers/

You can download the flyer here.

Dr. David Bratt, Paediatrician, is launching his new book  Book of Brats :Bringing up Children in the Caribbean.  This beautifully written, humorous book answers many of the health and parenting questions of Caribbean parents. It is the first time a book as been written with our unique perspectives and it is a must have for all parents. It is available for sale at Frontier Kids Care. Here are 2 chapters, one called Mother’s Kiss, and another entitled Pitfalls.

Enjoy!…

The American Academy of Pediatrics has posted a bulletin dealing with many of the questions that we are all asking. For more information, click on the following link :  http://www.aap.org/advocacy/releases/may09swineflu.htm

A couple of parents have come to us recently with babies running a fever. We’ve compiled this quick article discussing causes and remedies.

• Rectal temperature over 100.4°F (38°C)
• Oral temperature over 99.5°F (37.5°C)
• Axillary (armpit) temperature is over 99°F (37.2°C)

A body’s average temperature is 98.6°F (37°C), but it normally goes up and down during the day. A mildly higher temperature can be caused by exercise, too many clothes, a hot bath or hot water. Remember: TEETHING DOES NOT CAUSE FEVER.

When taking temperature, mercury thermometers are recommended as digital thermometers are not always accurate.

In babies under 18 mths, a rectal thermometer is used as it measures CORE TEMPERATURE.

• To take a rectal thermometer, grease the thermometer bulb with Vaseline, place ½ “ into rectum while holding baby firmly and hold for 30 seconds.

CAUSES

Fever is a symptom, not a disease. It is a normal response to infections. Fever helps fight infection by turning on the body’s immune system. Most fevers that children get are not harmful and can last anywhere from 3-5 days.

WHAT TO DO

• Bathe in tap water in the day or warm water at night. (tepid sponge)
  Limacol, alcolado or cold water may temporarily cool skin but does not affect core temperature

• Keep child cool. Light clothing (because most heat is lost through the skin) and lots of cool fluids to drink. Blankets keep heat in.
• Give paracetamol/acetaminophen (Panadol/Tylenol) every 4-6 hrs as needed. Dose is 10mgs/kg of your child’s weight. For example a 6kg child will get 60mgs. Ibuprofen may also be used except in suspected dengue cases. It is given every 6-8hrs. Avoid Aspirin as it can be harmful to your child.
• …and lastly, remember to give lots of Tender Loving Care