Beware sugary drinks!

A study by the University of Glasgow has reported that people hugely underestimate the amount of sugar in drinks that are perceived to be 'healthy' such as juices and smoothies. This included not only fizzy drinks but also regular drinks such as apple juice and orange juice. They suggest that the average person in the UK consumes around 450 calories a day in (non alcoholic) drinks. That's amazing, that's roughly 2 chocolate bars worth of calories. 

I remember buying a bottle of 'water' in a garage once to discover that it was 'flavoured mineral water'. It was  made with mineral water and looked like mineral water but contained flavourings including sugar…so, er colourless squash then? Rather than 'water'.

On a serious note, we do have an epidemic of obesity in the UK, mainly affecting adults, but increasingly being seen in children. (Sadly with complications of obesity now being seen in children, like type 2 diabetes). Generally, the eating habits that you develop in childhood will continue into adulthood. So, if your child drinks water and eats healthily, they are likely to continue to do so as an adult. Equally, if they drink lots of sugary drinks and unhealthy snacks as a child, they will as an adult. I'm not saying that children should never have sugary drinks and treats, but that mostly they should eat healthily and have treats as treats.

Another thing to consider is their teeth. Brushing twice a day is great, but their diet also contributes to dental health. There is an increasing epidemic of dental decay in children (especially in Scotland, where the research was done.) Sugary drinks are among the worst culprits, along with sweets, particularly those that you suck. Once you have your second set of teeth, that's it, there are no more.

So, as Dr Seuss says "Don't gobble junk like Billy Billings. They say his teeth have fifty fillings!"

And don't be a sop, drink water instead of juice or squash or pop….

University of Glasgow

In praise of reward charts

When bringing up children, parents quickly realise that the maxim 'reward good behaviour and ignore bad' only goes so far. Apart from anything children need to be told that bad behaviour IS bad behaviour, it's not as if they're born knowing. So, inspired by supernanny, I have frequently fallen to the reward chart to try and improve my children's behaviour.

A few weeks ago, my 3 year old was quite unwell for a few days with high temperatures. He had to have 3 days off school and lay either asleep or languidly watching the TV. When he was well enough to go back to school he was much improved, but not his normal self. He had tantrums and generally his behaviour wasn't great.

Time to pull out another reward chart. My reward charts are generally quite simple and I let him choose what theme he wants. This time it was 'rockets' so we drew a big moon with 7 rockets surrounding it. Each rocket had to get 6 stars to reach the moon. So 6 stars and then he can have a reward (normally a couple of sweets). I have to say I arrange it so that he can generally get one reward a day. Reward charts don't have to be pictures on paper, we once had a reward 'treasure chest' that we had to put 'treasures' in.

You can use reward charts for specific things such as 'keeping your room tidy', 'brushing your teeth', 'getting dressed by yourself'. But I also find them useful just for 'good behaviour' i.e. no tantrums and no snatching toys from your younger brother. That way, I am constantly reminding him what is considered good behaviour. So, a star for eating your breakfast nicely (and behaving well around that time), a star for eating lunch and dinner nicely, a star for behaving well at bath time and another for going to bed nicely. Plus a bonus star for 'something that I want to reward', generally being nice to his brother. (Not at all contrived!)

Supernanny says that you can also take away stars for bad behaviour. I sometimes threaten it, but rarely do, perhaps my children are a little young for that.

The main problem that I have with star charts is finishing them. After a few days, we all seem to get a bit bored of them and forget to stick the stars down. But that must be a good sign that whatever bad behaviour was the issue is now resolved. I think they're really effective. And if all else fails, as a friend recently joked, you can always roll them up and use them to swat your child...

Check out what super nanny has to say on reward charts.

Why kids always have colds and snotty noses.

My cousin wrote to me recently saying that she was worried that her 17 month old son gets so many coughs and colds. So, I thought I'd write a blog busting some of the myths surrounding children and infection.

The first thing to say is that children get ill...lots. Mostly coughs, colds and snotty noses, with the occasionally vomiting and/or diarrhoea bug thrown in for variety. As upsetting as it is, this is all part of their immune systems maturing and learning to cope on their own. When they are born, they borrow an immune system from their mother. They have lots of antibodies (things that fight infection) swimming round their bodies. Antibodies can recognise specific illnesses if they have been exposed to them before (which is how vaccinations work). Because the mother's immune system is mature, i.e. has seen lots of bugs, the baby has help fighting off illnesses. If they are breast fed, this affect is increased because there are antibodies in breast milk.

As the baby gets older, the maternal antibodies wear off and the baby starts to make them for themselves. However, this doesn't happen overnight so young children are more vulnerable than adults to infections. Each time they get an illness or a bug, their immune system increases its ability to recognise things as bugs. However, there are so many bugs around that just as they are getting over one, another comes along and they have to start over again. (Sometimes it feels as if a child has been ill with the same bug for weeks and weeks, but probably it is several different bugs in a row.)

Children are 'allowed' to have (as a rule of thumb) 10 coughs and colds a year before a doctor would even consider doing tests to see if there were any other problems. (And even then the doctors wouldn't really get excited unless they had 'significant' illnesses, for example, needing to be admitted to hospital.) Given that most of these 10 coughs and colds occur in the winter months, it can feel like your child has a snotty nose all winter.

Children who are exposed to more bugs (go to nursery or have older siblings in nursery or school) will get ill more often. Washing hands is a very good way of preventing illnesses as a lot of bugs are spread by touch. 

The (nearly) last thing to point out is that colds are viral infections. Most infections are caused by bugs that are either viruses or bacteria (fungi can also cause infections.) Antibiotics only work on bacteria, they don't do anything to viruses. (It is possible to get antiviral medicines, but generally they are used for very severe infections.) The vast majority of coughs, colds and tonsillitis are causes by viruses. Antibiotics won't help at all. So mostly children don't need antibiotics when they have coughs, colds and tonsillitis. (If they have 'bactierial tonsilitis' they will benefit from antibiotics.)

Finally, children who have asthma may be more affected by coughs and colds because it can trigger the asthma. If you are worried about your child's breathing when they have a cold, you should go and see your doctor. 

Quite a lot of information in one blog but I hope it has given you some insight into why children always have snotty noses.

Check out snotty-noses.com for more information on breathing problems and fever.

Children carrying heavy back packs causes back pain.

A recent study in Spain showed that children aged 12-17 were carrying backpacks to and from school that were so heavy that they caused the children back pain. Over 60% of the 1403 children studied were carrying bags that were over 10% of their body weight. The authors say that this could lead to back pathology.

This is surely not a new problem. I remember lugging heavy bags to and from school. In fact, some days it was school bag, sports kit, instrument, basket full of cooking stuff and huge folder of arts stuff. Anyhow, that was a very long time ago! It seems like things haven't changed much (and the poor Spanish children have to do the trip twice as many times as those in the UK as they have morning school and then afternoon school.)

Back pain is a huge problem. 80% of people will suffer from back pain at some stage of their life. (Having heavy children who need 'hoking' in and out of car seats and cots and who aren't quite up to walking in the right direction when required is definitely a source of back pain.)

I'm not quite sure what the answer is to this problem, but it does seem to me that we should be addressing it at an early age. Perhaps schools could add 'back education' to the sex education classes. Or perhaps we should exchange all those heavy school books for a sleek, light-weight iPad.

Here's a link to the article, but you'll need an athens password to access it. 

To share or not to share (a bedroom)

When we moved to Spain, nearly a year ago, my husband announced to me that our 2 young sons, then just 1 and 3 were going to share a room. I think my first response was "are you as mad as a goat?" (Spanish saying). We had recently spent a rather sleepless week in Spain, with them sharing a room, albeit a very small room. However, I could see my husband's point of view, the children's bedroom was very large and if they didn't share a room, one would have to take up the spare room and they wouldn't have much space as there is a large unmovable double bed in it.

So, they went into the same room with reasonably good results. Occasionally the oldest wakes up screaming and by the time I've hot-footed it downstairs, he has already woken up the youngest (who is the more 'fragile sleeper'). More often, the youngest wakes up. He is going through one of those 'phases' of waking up, apparently it won't last forever. In the meantime, he can cry for some time. (I keep meaning to dig out my ear plugs). If left in his own room, he will eventually wake up his older brother who surprisingly manages to sleep through quite a lot of crying. Normally, I put him in the travel cot in the spare room. The door in the spare room closes properly which means that his cries are muted somewhat. (I would happily have him in bed with us which is, I think, what he wants, but after about half an hour, he starts playing and singing and more to the point, I know it means he'll wake up again the next night.)

On the whole, I would say putting them in the same room has been a good move. They clearly like being in the same room together. Some times the little one cries because the oldest has already gone to sleep and he doesn't have anyone to amuse him. Last night one of them was blowing raspberries to the huge amusement of the other. They talk to each other and sing before going to sleep. And in the morning occasionally they entertain each other before I've made it downstairs. 

Soon perhaps they'll be making me breakfast in bed!

Children and tummy aches.

Children of all ages often complain about having tummy aches. Frequently it's just one of those things that disappears by itself. (When my 3 year old complains of having a tummy ache, it's normally because he needs to do a poo.) But how do you know if it's something serious?  Or, what most people want to know is, why? What is causing my child's tummy ache?

Well, the interesting thing about medical science is that it may be able to do amazing things like face transplants and brain surgery, but often it can't tell you why your child has a tummy ache. Even if children are admitted to hospital and lots of tests done on them, often we don't find out what the cause is. What you as a parent wants to know is 'what is it' but what your doctor wants to know is 'is it serious'? Two slightly different questions.

So, let's start by thinking about things that might make us think it's serious. Firstly, how is your child? Are they well or unwell? If they're unwell, fever, not eating, vomiting, that sort of thing, your doctor will want to know if they have appendicitis. Appendicitis is an infection of a little bit of your gut that sits in the lower right hand bit of your tummy (in the majority of people). The appendix isn't really thought to be used for much in humans, apparently rabbits have large appendices, something to do with digesting all that grass but don't quote me on that.  Anyhow, the point is it can get inflamed and infected and then it needs to be removed with an operation. Your doctor will do lots of prodding and poking your child's tummy to help them decide if they may have appendicitis.

What else would make your doctor concerned? If the tummy pain had been going on for a long time, if your child wasn't eating or growing well. If it was associated with symptoms such as diarrhoea (over a long period of time, not just for a day or two) or blood in your poo.

There are lots and lots of causes of tummy ache and some are easily diagnosed. For example, constipation, urinary tract infections and diarrhoea are all common causes of tummy ache. Sometimes children get inflamed lymph nodes in their tummy when they have an infection somewhere else ('abdominal lymphadenitis'). But sometimes it has to be put down to 'one of those things' and hope that it doesn't last too long.

Getting children to eat fruit and vegetables.

Most parents wonder how to give their children a healthy diet, how to make them eat fruit and vegetables and how to reduce the amount of cake, crisps and biscuits that they eat. Well, help is at hand. Recent studies by City University and the School Food Trust has found that cooking clubs and classes has a positive effect on children's eating habits. They found that more children ate fruit and vegetables after the classes and were able to recognise healthy food.

Given the growing epidemic of childhood obesity this is fantastic news. Getting children involved in cooking is a 'fablious' idea, as my 3 year old son says. The up sides are huge, learning what goes into food, how long it takes to prepare, giving them skills for later life (not just being able to cook but impressing the fairer sex according to my husband who claims I fell for him thanks to his amazing risotto.) Let's not mention the mess and the amount of extra time needed! When they're old enough, they might even cook the meal by themselves.

From a personal point of view, I find that my children are much more likely to eat something new if they've helped make it. I use the word 'helped' in the loosest sense. My 3 year old 'helped' me to cook mussels the other day. I de-bearded them, passed them to him, he dabbed a few of them with a sponge and put them into a colander. Anyhow, he ate the mussels and was very proud to have helped. A few weeks later I cooked mussels again, this time he was watching tele. He wouldn't touch them. Yuk yuk, I'm not eating those! This 'helping' tactic has also worked with curry and other new and unknown foods. 

In my clinics, I often recommend that children get involved with cooking, especially those who are slightly over weight and constipated (a frequent flyer in many paediatric clinics.) Many parents try to hide vegetables in dishes and this is certainly one way of getting children to eat vegetables in the short term. But I wonder whether it is a good tactic for the long term, when the child is able to decide themselves what they want to eat (which happens very quickly). If they are used to eating fruit and vegetables they will often opt to have a healthy piece of fruit as a snack instead of a piece of cake or a biscuit. (Not all the time I grant you.) I leave bowls of fruit on the kitchen table and both my 1 and 3 year old will help themselves to it. "Norange, norange" grunts my 1 year old.

Feeding children, of what ever age is not easy. Just when you think you've got it nailed, your perfect eater turns into a fussy eater overnight. They don't have to have a perfect diet. Cakes, biscuits and other treats are fine in small quantities. However, it is important that they eat fruit and vegetables, not just today but as they grow and continue into adulthood. If you're having problems getting your child to eat healthily it may feel like a steep slope to climb, but take it one step at a time. Get them involved, don't loose heart and keep presenting them with healthy options.