Saturday, October 30, 2010

Halloween Candy

How does Halloween candy fit into my obesity prevention strategy?

Well, it doesn't. Really, it's disgusting when you think about it. The epitome of American excess, in the extreme. Fat, sugar, and no nutritional value makes for rotten teeth, hyper kids, and added pounds. What could be worse?

But I think Halloween is fun! It's a little nostalgic for me, remembering all the pumpkins my siblings and I designed (and my Dad carved) lighting up my sister's 16 pane bedroom window in our little cape cod style house. Yes, there were 16 pumpkins carved every year. And I loved almost all of the candy. Remember wax lips? There were, and still are, some candies I don't like. For example, I hated the Boston Baked Bean candy. I always tried to trade that one. I still have some of the Halloween costumes my Mom made for me, and once in a while I can get one of my kids to wear one. This year one of my high school prom dresses has been incorporated into a Queen of Hearts costume for my eleven-year-old. And there was a lot of Daddy/daughter bonding time this month making matching robot costumes out of cardboard boxes.

So, what to do about the candy? I've tried different ideas to deal with it. First, I don't want the supply of candy to last forever. As a kid I can remember still having Halloween candy to eat in the car on the way to Florida for Spring Break! Yuck! I say be done with it in a week, maybe two, but don't let it last. You could have a little splurge of candy eating on the night of trick-or-treating, and just get it over with, then share the rest with Mom and Dad, and their friends at work. You can have kids trade in candy for a different reward--a movie night, laser tag, Bounce Land, a water park, a trip to the mall. You can keep the candy in a public area (not your child's bedroom), and reduce its visibility (start putting it in the cupboard)--lots of kids will forget about it.

Just have some kind of plan that doesn't involve daily candy eating from now until the New Year. Make candy be a little splurge that happens as a special treat. Consider it a privilege, not a right. Incorporate your child's favorite treats into the plan, but discourage them from eating the stuff they don't love. Encourage sharing. Emphasize teeth brushing. Require an apple, banana, or something GREEN be eaten in addition to the treat. Don't put candy in a packed lunch.

Have a parent "tax" on candy. Use this as an opportunity to explain how income taxes work--if your child collects 10 pieces of candy they have to give you one piece, but if they collect 100 pieces of candy they have to give you 30 pieces! I haven't tried this one yet, but my husband is an economist, so I'm sure this is going to happen some time at our house.

Here is an interesting idea--talk to your child before they trick-or treat about what they think is a good way to handle all the candy. You might be surprised at the ideas they have, and you can review good nutrition at the same time.

You can also intervene by limiting the amount of candy your child collects. Go trick-or-treating with your child. Start a little late. Relax, don't run. Have them use a small bag to collect candy, not a pillow case. Stop to socialize with others along the way. Take your time! Insist on good trick-or-treat manners (I think the rules of trick-or-treating are to wear a costume, say "trick-or-treat" and then say "thank you"). Let your child stop and take time to choose and eat a few pieces along the way. Show off your costumes, take pictures. Spend some time decorating your house that night. Maybe your kids would like to pass out candy to others for a while. Do anything you can to slow down the candy collection process and emphasize the fun and fantasy of the night.

Most of all I would suggest having some kind of plan that cuts off the candy after a week (or two). Think about it before you trick-or-treat. Tomorrow I'll be angling for my share of Heath Bars, Almond Joy, Starbursts, and Dots. Then we'll eat a bunch of candy that night, and keep the rest in the kitchen for about a week. And that will be it for Halloween candy at our house.

Good luck to you, and remember to have fun!

Tuesday, October 12, 2010

Flu and Flu Shots

Hey, I got my flu shot today! Tina (one of Trestlewood's nurses) gave it to me in my left arm about an hour and a half ago. I feel fine. I could hardly tell the needle went in, and my arm doesn't hurt a bit. I don't ache, I don't have a fever, I didn't catch flu from the vaccine, and I am so happy to be protected from this season's flu viruses. I am sure to be exposed to them many times this year.

My girls had their flu vaccines on Sunday, just two days ago. They prefer the FluMist (a flu vaccine that is given via drops squirted in the nose). My husband will probably drop by my office soon and surprise one of Trestlewood's nurses to get his vaccine. Everyone in my family gets a flu vaccine every year. We started this tradition after my oldest got the flu in first grade. It was quickly followed by pneumonia, and then in her weakened state, strep throat. It was awful, and I never wanted a child of mine to go through that again. Unfortunately, my middle daughter had the flu a few years ago. She was coughing, had fevers upwards of 104, and was utterly miserable for a week.

I also take flu shots to Indiana to give to my parents and my mother-in-law. I think giving out flu shots each year is one of the biggest contributions I can make to the health of my community and my loved ones. The other big impact I have on public and individual preventive health is the rest of the recommended childhood vaccines--but that's for another blog.

Flu, at least the flu we vaccinate for, is NOT the stomach flu! I am told daily how this or that family had "the flu" last week, or last month, or last year. Or how they never get "the flu." Or, how the flu vaccine didn't work for them because they still got "the flu." When pressed for details it is clear that most people mean gastroenteritis when they say "the flu." Gastroenteritis is an illness that is very contagious, lasts a day or two, and involves vomiting and diarrhea. The flu I am talking about is influenza, a RESPIRATORY illness.

The symptoms of influenza are fever, severe muscle aches, coughing, sore throat, runny nose, extreme fatigue, chills, with occasionally some stomach symptoms. It lasts for about a week. It is also very contagious. Flu weakens and can kill its victims, especially those who are already debilitated. It can lead to complications, such as pneumonia. At the very least it is a miserable week to spend in bed with a box of tissues, cough drops, and other cough/cold/anti-fever medicines.

Flu vaccine is recommended yearly for everyone who is six months or older who does not have an allergy or other contraindication to the vaccine. While it is especially important for people with chronic illnesses such as asthma or diabetes, it is recommended for all of us. We can all benefit from a yearly flu vaccine.

Have you and your children had your yearly seasonal flu vaccine? Get yours as soon as you can!

The following are some links to reliable information about the flu and flu vaccine. This year's vaccine includes the H1N1 subtype, so a separate shot for that one isn't necessary. Children under age nine who are getting the flu vaccine for the first time, or who have not had at least two previous seasonal flu vaccines plus one of last year's H1N1 vaccines, will need two doses of flu vaccine spaced one month apart to be completely immunized.

Croup and a Croupy Cough

It's easy to be scared when you wake up in the middle of the night to hear your baby or young child coughing with a deep, loud, barky cough and making raspy sounds when she breathes. Chances are this is croup!

It's important to hear what croup sounds like. The following videos are from YouTube. All give a pretty good idea of the distinct barky, croupy cough. It sounds like a barking seal.

A croupy cough sounds loud and barking, like a seal's bark:

Raspy breathing, also known as stridor, is another characteristic of croup:

This next link is to a video that demonstrates a significant case of stridor, just click on the link to go to YouTube (the video did not allow itself to be embedded):

Croup is usually caused by a virus (a common one is parainfluenza virus). It causes cold symptoms (runny nose, stuffy nose, cough, fever) and it likes to settle in the upper airway. It causes swelling in the upper airway and vocal cords, giving the funny sounding cough, causing raspy breathing, and a hoarse voice (laryngitis). The barky cough and raspy breathing are always worse at night.

Croup often sounds much worse than it is. In two of the videos above, the ones demonstrating stridor, you can see completely happy babies who have raspy breathing. They look pink, are smiling or talking, and are not bothered by the "trouble" they are having with their breathing. Croup can be serious, and require a trip to the emergency room. However, usually it is manageable at home.

For a croup attack, first sit your child up, and then calm him down. Sitting up usually helps the airway stay open. Crying and panicking tend to make the airway close even more. Take your child into a steamy bathroom. To do this--run the hot water in your shower and don't turn on the fan. Sit in the bathroom and sing to your child, rock her, read to her. Try this for about fifteen minutes at a time. If it works, you can put your child back to bed--then repeat the treatment as needed through the night.

Another home treatment is taking your child outside into the cold night air (assuming it is cold outdoors!). The point is to try the opposite of hot steam, if the steam wasn't working for her. You can also put a cool mist vaporizer into your child's room.

If a croup attack is very severe, your child can't breathe despite home treatments, or is looking quite pale, bluish, or lethargic, you should go to the emergency room. There your child can receive breathing treatments (to temporarily open the airway), oxygen (if required), and steroids (to reduce swelling in the airway). Remember, however, that croup can look and sound much worse than it really is--so if your child is happy and playful, able to nurse or drink from a bottle or sippy cup pretty well, it's unlikely that you need to go to the emergency room for croup.

If you make it through the night, but had a rough time getting to morning (needing recurring steam or outdoor treatments) you should bring your child to the office the next morning. Symptoms may appear to be gone in the daytime, but croup comes back each night for a few nights before it turns into a regular cold.

After a few days of the croupy stage the cough will change into a phlegmy, wet cough. This almost always happens with croup, and is a sign that the croup is starting to clear up. However, when the cough changes into something else, every parent worries that it is turning into something more serious. When it changes, watch your child closely. If she is sleeping better, is more playful, more hungry, and the fever is mostly gone, then your child IS improving and you can handle the rest of the croup illness at home, like you would for the average cold virus.

Croup is contagious in the way a regular cold is contagious. It is spread by respiratory droplets (mucous, cough, sneezing), and is most contagious in the first 2 to 3 days of the illness. If there is no fever, and the child is sleeping pretty well at night, croup is not a reason to keep kids out of daycare or school.

As always, my blog is designed to give you general information about your child's health and illness. One of the main reasons I posted this topic is to provide the links to videos of a croupy cough and stridor. My advice here is not meant to replace the more personal advice you can receive from your child's own pediatrician.

Lots of information about croup is available on the web. Here are some possible links, if you want more information:

Post updated 1/26/2014 (a new video added to replace one no longer available, two links replaced with embedded videos).