Behavior and Wellness for the Family

Healthy Sleep

A sleep problem lasting longer than 30 days could mean you've joined the ranks of millions already suffering from sleep disorders.

A sleep deficit shouldn't be merely a nuisance that makes people feel bad. Insufficient sleep has been linked to the development and management of chronic diseases and conditions, such as diabetes, cardiovascular disease, obesity, and depression.

According to the Centers for Disease Control and Prevention, chronic sleep problems caused by a sleep disorder or poor sleep hygiene affect an estimated 70 million Americans. National Sleep Awareness week, an annual public education and awareness campaign to promote the importance of sleep, takes place the week before Daylight Savings Time has these recommendations:

Adults:

• Go to bed at the same time each night and rise at the same time each morning.
• Make sure your bedroom is a quiet, dark, and relaxing environment.
• Make sure your bed is comfortable and use it only for sleeping and not for other activities, such as reading, watching TV, or listening to music
• Physical activity may help promote sleep, but not within a few hours of bedtime.
• Avoid large meals before bedtime.

Adolescents/Young Adults:

• Avoid caffeinated drinks after lunch.
• Avoid bright light in the evening.
• Avoid arousing activities around bedtime, such as heavy study, text messaging and prolonged conversations.
• Expose yourself to bright light upon awakening in the morning.
• While sleeping in on weekends is permissible, it should not be more than 2 to 3 hours past your usual wake time, to avoid disrupting your circadian rhythm governing sleepiness and wakefulness.
• Avoid pulling an "all-nighter" to study.

Follow this link to learn more about sleep disorders and Texas Health's sleep medicine services. 

Asthma and Allergy Tips

Seasonal allergies affect more than 35 million people in the United States, according to the American Academy of Allergy, Asthma and Immunology.

In the early spring, the major cause is wind-borne pollen from trees. In late spring, grasses start to cause trouble. The worst springtime allergy signs and symptoms occur during hot, dry or windy days when there's a lot of pollen and mold in the air.

The best way to avoid allergies is to avoid what triggers them. But if symptoms reoccur, you should speak with your doctor.

Most people can't completely avoid springtime allergies, but there are a few things to remember to lessen exposure to the pollens or molds that trigger allergy symptoms.

The American Academy of Allergy, Asthma and Immunology recommends that people suffering from allergies:

• Visit a doctor before allergy season gets into full swing to discuss what medications can be taken proactively.
• Keep windows and doors shut at home because screens will not keep out tiny pollens and molds.
• Keep the car windows up and adjust the vent to re-circulate the air.
• Time outdoor activities to avoid outdoor activities in the early and mid-morning hours. Pollen counts tend to be higher in the morning.
• Take antihistamines before venturing outside. If yard work is unavoidable, take an antihistamine at least two hours before going out. Consider wearing a dust mask and glasses while working.
• Wash clothes and shower immediately after coming inside from an outdoor activity.
• Know which allergens affect each individual. Knowing if indoor or outdoor allergens are a trigger will make it easier to manage allergies.
• A saline wash two or three times a day can help when allergy symptoms are more active.
• Spring clean the home.  Clean out ducts and vents.  Replace air filters and replace your vacuum bag.

Consider seeing a physician if allergies continue to affect day-to-day activities.

To learn more, visit www.aaaai.org.

Immunizations

Today's children receive 11 or 12 vaccinations by the time they reach age 2. A schedule of immunizations is required to ensure community health and must be administered before a child attends childcare programs or starts school. Your child's doctor knows the most current, most effective and safest immunizations to give your child at the most appropriate age.

Parents can take comfort in knowing that vaccines are developed, tested, re-tested and determined to be safe and effective by the U.S. Food and Drug Administration. Important physician organizations — including the Advisory Committee on Immunization Practices (part of the Centers for Disease Control and Prevention), American Academy of Pediatrics and the American Academy of Family Physicians — decide which of these safe and effective vaccines will be useful for children.

Some children experience a mild or moderate reaction to vaccinations at the injection site. Your child's doctor will give you specific information regarding reactions, including signs to watch for and how to minimize your child's discomfort.

These charts illustrate the recommended schedule of immunizations for infants, children and adolescents. Your pediatrician or family physician will provide a record of immunizations for you to keep and furnish to childcare providers or schools as needed.

Bullying

As you and your child check off back-to-school supplies, don't forget to add one thing to the emotional toolkit — how to deal with a bully.

In recent years there have been a number of sad cases across the nation and here close to home of tragic consequences of bullying. Yet many children are still afraid to share the information with their parents.

Taking an active interest in children's friendships and activities can make a difference in spotting signs of bullying early. Monitoring your child's behaviors and noticing subtle behavior shifts can be among the first signs of problems at school.

The U.S. Department of Health & Human Services has identified possible warning signs that a child is being bullied. Those signs include:

• Unexplained cuts and bruises;
• Few friends;
• Lost interest in school;
• Trouble sleeping;
• Frequent complaints of headaches, stomachaches or other pains;
• Low self esteem; and
• Loss of appetite.

The agency recommends that parents talk to their children first, asking subtle questions such as:

• Who do you sit with at lunch?
• Are there children at school you don't like?

In the meantime, parents should watch for signs of other problems, such as depression, and share concerns with school counselors or administrators.

For more information, visit stopbullyingnow.hrsa.gov.

Emergencies and Illness

If you spend some time planning and preparing to respond to your children's accidents and illnesses, you'll benefit from a calm, clear head when an emergency happens. Your best preparation may include taking infant/child CPR classes, which usually include training in the Heimlich Maneuver for choking. Here are some further recommendations:

Print or type a quick reference for emergency information. Include:

• Emergency - 911
• Poison Control Center - 1-800-222-1222
• Child's doctor - name and office phone, after-hours phone (if different)
• Child's allergies and chronic conditions - include medication, food and/or latex allergies
• Child's immunization record
• Child's medication record - daily or regular medicines
• Child's surgeries
• Mom contact information
• Dad contact information

Make sure your babysitter, grandparents and older children know where your list is posted. It will be handy for your family and critical for emergency services personnel if you are not available.

Always discuss emergency procedures with your child's physician before an actual emergency. Find out where to go, when to transport your child and when to call 911 for an ambulance. In case of poisoning, call Poison Control EVERY TIME - whether your child is showing symptoms or not.

Assemble a First-Aid Kit

Prepackaged first-aid kits are available in many pharmacies, retail stores and online. Some are designed especially for children's needs. If you purchase a packaged kit, be sure to go through the contents and become familiar with what is included. Add other items you think you might need. Or, make your own first-aid kit starting with the following list of essentials.

Use a durable bag or box with compartments or pockets to organize the contents. Some parents use a tool kit, a fishing tackle box or a plastic storage bin with small compartments. Choose something you like, and then store it out of reach of your young children, but in a place that's handy for adults to access.

Kit contents

• First-aid manual - try to review this book before you need it.
• Bandages
• Different sizes and shapes, self-adhesive
• Sterile gauze pads in medium and large sizes
• Elastic, wrap bandage
• Bandage tape
• Wound care
• Antiseptic or alcohol wipes
• Antiseptic solutions (alcohol or hydrogen peroxide)
• Liquid antibacterial soap
• Antibiotic ointment or cream
• 1 percent hydrocortisone cream or ointment
• Calamine lotion
• Tweezers
• Scissors
• Instant cold packs
• At least one pair of sterile gloves (plastic)
• Fever and pain control
• Acetaminophen and ibuprofen
• Thermometer
• Miscellaneous
• Flashlight with extra batteries
• CPR emergency guide
• Heimlich maneuver guide (choking)
• Emergency contact information for child's doctor, parents, grandparents
• Blanket (can be stored near the kit)

NOTE: The American Academy of Pediatrics (AAP) no longer recommends syrup of Ipecac to induce vomiting

Remember to check kit contents periodically and replace items that have been used or that have reached expiration dates.

When to go to the Emergency Room

Most pediatricians and family physicians agree that it's rare for a child to become seriously ill without warning. Keep in touch with the doctor's office when your child has fever, coughing, sore throat, diarrhea, vomiting, intense pain, rashes, swollen glands or ear pain. For the most part, you can trust your experience. You already know your child and what is usually safe to take care of at home, and you have a good idea when you need to call the doctor for advice or to schedule an office visit. The AAP encourages parents to prevent an illness or minor injury from getting worse, or turning into an emergency, by recognizing and treating symptoms early.

Get immediate, emergency help if your child shows any of these signs, symptoms or behaviors:

• Acting strangely or becoming more withdrawn and less alert
• Unconsciousness or no response when you talk to your child
• Rhythmic jerking and loss of consciousness (a seizure)
• Increasing effort or trouble with breathing
• Skin or lips that look blue, purple or gray
• Neck stiffness
• Rash with fever
• Increasing or severe persistent pain
• A cut that is large, deep or involves the head, chest or abdomen
• Bleeding that does not stop after applying pressure for 5 minutes
• A burn that is large or involves the hands, feet, groin, chest or face
• Any loss of consciousness, confusion, headache or vomiting after a head injury

Get immediate, emergency help if your child is injured by:

• Bicycle or car crashes
• Falls
• Burns or smoke inhalation
• Choking
• Near drowning
• Firearms or other weapons
• Electric shocks
• Poisoning

In an emergency, remember to:

• Stay calm
• Start rescue breathing or CPR if your child is not breathing
• Call 911
• Apply continuous pressure to the site of bleeding with a clean cloth
• During a seizure, place your child on the floor with head and body turned to the side. DO NOT put anything in the child's mouth
• Do not move your injured child unless he or she is in immediate danger (such as a fire, or on a busy street)
• Stay with your child until help arrives

Home Accidents

According to the Centers for Disease Control and Prevention (CDC), home accidents usually involve:

• Water - in the bathroom, kitchen, swimming pool or hot tub
• Heat or flames - kitchen, fireplace, candles or outdoor grill
• Toxic substances - cleaners under the kitchen sink, detergents/bleach in laundry, medications (prescription and over-the-counter) in the medicine cabinet, lawn and garden chemicals outdoors or paints/solvents/oil/gasoline in the garage
• Anywhere a fall can happen - on stairs, slippery floors, backyard or playground equipment or from high windows

Take precautions to make these places as safe as possible; however, it's best to keep your children away from these areas unless an adult is close.

SOURCES: The American Academy of Pediatrics (American Medical Association); The American Academy of Family Physicians (American Medical Association); Centers for Disease Control and Prevention; www.kidshealth.org; National Highway Transportation and Safety Administration; www.safekids.org. Note: This information is not intended to replace advice from your physician.