Five Ways to Keep Your Family Healthy This Winter

Winter FunIt may be cold outside but winter needn’t be the unhealthiest time of year for you and your family.

Here are five ways to make sure that even when your body is telling you to hibernate you can keep healthy and fit, no matter what the weather’s like:

1. Eliminate your sleep debt

“On average we sleep six-and-a-half hours a night, much less than the seven to nine hours recommended,” says Jessica Alexander, spokesperson at the Sleep Council, which aims to raise awareness of the importance of a good night’s sleep to health and wellbeing. But in winter, we naturally sleep more, due to the longer nights. “It’s perfectly natural to adopt hibernating habits when the weather turns cold,” says Jessica. “Use the time to catch up.”

Read more about how to get a good night’s sleep.

2. Drink more milk

You are 80% more likely to get a cold in winter so making sure your immune system is in tip-top condition is important. Milk and dairy products such as cheese, yoghurt and fromage frais are great sources of protein and vitamins A and B12. They’re also an important source of calcium, which helps keep our bones strong. Try to go for semi-skimmed or skimmed milk, rather than full fat, and low-fat yoghurts.

Read more about healthy eating.

3. Eat more fruit and veg

When it’s cold and dark outside it can be tempting to fill up on unhealthy comfort food, but it’s important to ensure that you still keep your diet healthy and include five portions of fruit and veg a day. If you find yourself craving a sugary treat, try a juicy clementine or satsuma instead, or sweet dried fruits such as dates or raisins.

Winter vegetables such as carrots, parsnips, swede (rutabaga*) and turnips can be roasted, mashed or made into soup for a comforting winter meal for the whole family. Explore varieties of fruit and veg that you may not normally eat.

Read more about how to get your 5 A DAY.

4. Try new activities for the whole family

Don’t use the cold winter months as an excuse to stay in and lounge around. Instead, get out with the whole family to try out a new activity, maybe ice-skating or taking a bracing winter walk on the beach. Regular exercise helps to control your weight, boost your immune system and is a good way to break the tension that can build if the family is constantly cooped up inside the house.

Read more about different types of exercise for your and your family.

5. Have a hearty breakfast

Winter is the perfect season for porridge (oatmeal*). Eating a warm bowlful on a cold morning isn’t just a delicious way to start your day, it also helps you to boost your intake of starchy foods and fibre, which give you energy and help you to feel fuller for longer, stopping the temptation to snack mid-morning. Oats also contain lots of vital vitamins and minerals.

Make your porridge with semi-skimmed (2%*) or skimmed milk or water, and don’t add sugar or salt. Add a few dried apricots, some raisins, a sliced banana or other fruit for extra flavour and to help you hit the five-a-day target.

Read more about healthy breakfasts.

Editor’s Note: * translation provided for our U.S. audience

Child Health & Safety News Roundup: 12-22-2014 to 12-28-2014

twitter thumbWelcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use Twitter and Facebook to communicate relevant and timely health and safety information to the parents, medical professionals and other caregivers who follow us. Occasionally we may miss something, but we think overall we’re doing a pretty good job of keeping you informed. But for our friends and colleagues not on Twitter or FB (or who are but may have missed something), we offer you a recap of the past week’s top 10 events & stories.

PedSafe Child Health & Safety Headline of the Week:
If Your Son Has Been Sexually Assaulted – 5 Things You Must Do
Information we hope we never need – but important to have

Parents, When Does Your Child Really Need A Life Jacket?

Wearing-a-life-jacketWhen you think of a life jacket, that sturdy vest that keeps you afloat, you probably think of large boats. While it is true that you should ALWAYS wear a life jacket when you are on a boat, a life jacket has far more uses for keeping you and your children safer around water. Today we are going to talk about when to wear a lifejacket, what constitutes a real life jacket, and how to convince the (usually male) disbelievers to wear a lifejacket.

Let’s start with the obvious, wearing a life jacket on a boat, because too many people still leave the life jacket sitting next to them ‘in case I need it’. 70% of boating fatalities result from drowning, and 85% of those who drown are not wearing a life jacket. It doesn’t matter if you have a little Sunfish sailboat for tooling around a small lake, a ski boat, a fishing boat, or a 90 foot ocean-going Oyster, if you end up in the water unexpectedly because you trip, are hit by the boom, get knocked by a wave, are dizzy from sunstroke, or any other unexpected accident, your odds of drowning are really high. Even if you see the person go in, think for a minute how hard it is to see a wet head in the water if they aren’t also wearing a life jacket, much less how difficult it is to retrieve the person when they are shocked, cold, and maybe injured. Even if you can get back to them and haul them onboard in a matter of minutes, they may already have started the process of drowning. My mom rule is that if you are above deck, you have a life jacket on, even docked or at anchor. And if it’s rough weather, it stays on, period. The new life jackets are light and comfortable, it’s not a hardship. Granted, if you are on one of those huge passenger ferries or a cruise ship, no one expect you to parade around all day in a lifejacket, but do know where they are kept and if you have a child, know where the child-sized jackets are stored. For your own recreational boating, click here to learn about Coast Guard approved lifejackets, the only type of lifejacket you should ever trust with your child’s life, and your own life. If you are traveling, call ahead and ask, many places have life jacket loaner programs, so you don’t necessarily have to invest yourself.

What most parents don’t think about is when lifejackets should be used off of boats. If you have an inexperienced or weak swimmer, a very young child, or anyone with physical or mental limitations, have them wear a life jacket whenever they are near water. If you are in a pool and at arm’s length, it isn’t necessary, but for a day at the beach or the lake, at one of those fabulous big resort pools, or even if you just have more than one child to watch, a life jacket adds a layer of safety and peace of mind. It is almost impossible for anyone, even vigilant lifeguards, to see beneath the surface of rough water, so better to keep the head above water in the first place. Children forget they can’t swim, they jump in or walk until they are over their heads, or just get tired, and next thing you know, they are bobbing just beneath the surface.

You may be thinking, I’m covered, I picked up a great floatation suit at the store, or always have those inflatable arm bands in our bag. First anything inflatable. If it inflates, it deflates. Those inflatable arm bands are still sold everywhere, because the water safety field hasn’t gotten the message out there, but if you have some, do me a favor, pick up the scissors and drive a hole right through them before you put them in the garbage. Not only can they deflate, especially at a beach or in rough water, but they really limit a child’s arm motion if they are trying to swim. I’m all in favor of having fun in the water, and inflatable rafts and rings and toys can be great fun, but they are for fun, not for safety. Inflatable arm bands aren’t even for fun. If you have a question about any floatation suit or vest you have, see if there is a label saying it is Coast Guard approved. Or go directly to the Coast Guard website to learn more. A true life jacket can turn an unconscious person onto their back so their face is not in the water.

There is the gray area of a child who is over-confident in the water but doesn’t have solid swimming skills, or has the skills but not the confidence. For this child, you really want them in the water practicing their skills, under your supervision, but a life jacket may be too restrictive. My go-to is still the SwimFin. It’s a shark-shaped fin that straps securely around a child’s middle. A UK-product, it has passed the European Union flotation regulations, except that it is still not a life jacket, because it won’t keep someone on their back if they are unconscious. I would never use SwimFin in the ocean or any other open water that has a current, a tide, or waves, but for a pool when you want to play more safely, it is absolutely brilliant. It changed one of our vacations from my daughter saying ‘I’m bored, I want to go back to the room’ to my having to beg to get her out of the pool at the end of the day. I still kept an eagle eye on her, but it gave her the freedom to practice her strokes and jumps. Her swimming skills and confidence improved exponentially and appropriately on that trip. Major bonus, all the kids at the pool wanted to wear one because it looks so cool.

Finally, how to you convince the ‘I’m too cool to wear a life jacket’ members of your family (statistically the males). For them, I have two videos to recommend. Both tried and tested within my family. For the younger males, have them watch this ‘Heroes Wear Life Jackets’ video that features Coast Guard Rescue Swimmers. My son said he was definitely more likely to wear a life jacket after watching – because it makes life jackets cool.

For the older males, here is an award-winning interactive video that simulates what happens when you are knocked into the water. You have to keep scrolling to stay alive. I admit I couldn’t watch for long, but the guys I work with said it got pretty graphic and frightening. But, it did convince one of the most recalcitrant non-jacket-wearing avid boaters I know to start wearing a life jacket. I didn’t push or nag, just forwarded the link in an email and said, ‘thought you might find this interesting’. Sometimes all it takes to change behavior is a slight nudge in the right direction and someone else explaining why they need to change.

Study Suggests it May be Harder to Detect Autism in Girls

Word picture about autism“Thousands of girls may have autism that has never been diagnosed because they cover-up the signs so well,” the Mail Online reports.

The headline is prompted by a study focusing on one of the key symptoms of autistic spectrum disorder (ASD): a failure to recognise the emotional states of others.

Researchers wanted to see if there was a gender difference associated with this symptom.

Children were assessed as having ASD-like traits if they scored highly on a well-validated checklist assessing social reciprocity (responding to others’ emotional states) and other verbal and nonverbal social traits.

The children were also given two tests to assess how well they could recognise emotion. The first was a test of how well they could distinguish emotions from photos of faces of other children expressing emotion such as happiness of fear.

The second test was more subtle. They were shown an animation of a triangle and a circle animated in such a way as to convey emotions; such as a jaunty bouncing to convey happiness or a slow slouching movement to convey sadness.

This test, known as the Emotional Triangles Task, is designed to assess the ability to detect recognise emotion from movement (a real-world equivalent would be trying to judge somebody’s likely mood by the way they are walking).

Researchers found that girls with ASD-like traits could recognise emotion from photos of faces as well as girls without ASD-like traits. However boys with ASD-like traits performed worse than boys without ASD-like traits on this test.

But both girls and boys with ASD-like traits struggled with the Emotional Triangles Task.

The concern now is that girls with ASD may be going misdiagnosed and are not receiving the support they need. This finding may have implications on how ASD is diagnosed in girls.

Where did the story come from?

The study was carried out by researchers from University College London and was funded by the National Institute of Health research and Wellchild, a UK charity for sick children.

The study was published in the peer-reviewed Journal of the American Academy of Child and Adolescent Psychiatry.

This story was covered by the Mail Online. The majority of the research was well-reported. Although it should be noted that the assertion that untreated girls with autism may be prone to eating disorders and depression in later life was based on a quote from the National Autistic Society.

Long-term outcomes of the participants were not assessed by the study.

What kind of research was this?

This was a cross-sectional study that aimed to investigate the potential association between autistic-type traits and emotion recognition, and whether this differs in boys and girls. This is the ideal study design to investigate this question.

What did the research involve?

The researchers used data from 3,666 children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC); an on-going cohort study of children and parents.

The children were assessed using the Diagnostic Analysis of Non-Verbal Accuracy (DANVA) – the facial recognition test at 8.5 years of age and by the Emotional Triangles Task at 13.5 years.

The parents had also returned the results of the Social Communication Disorders Checklist (SCDC), a well-validated tool designed to detect for autistic-like social communication deficits at 13.5 years of age.

The SCDC measures social reciprocity, for example responding positively to positive actions such as kindness, and other verbal/nonverbal social traits.

A higher SCDC score is an indication of more deficits in social communication, and a score of nine or above is predictive of ASD. DANVA included a test assessing facial emotion recognition, by showing photographs of children expressing happiness, sadness, anger, or fear.

The Emotional Triangles Task assessed emotion recognition from the movement of objects, in this case a triangle and a circle moving around a screen during five-second animations.

The researchers compared performance on the DANVA and the Emotional Triangles task between children who scored higher or lower on the social communication disorders checklist. They then analysed boys and girls separately.

What were the basic results?

Children who scored nine or more on the SCDC had higher odds of:

  • Making at least seven errors in facial emotion recognition (all faces)
  • Making at least three errors in facial emotion recognition when shown ‘high-intensity’ faces
  • Making at least five errors in facial emotion recognition when shown ‘low-intensity’ faces
  • Making at least three errors in facial emotion recognition when shown fearful faces
  • Making a least two errors in facial emotion recognition when shown sad faces
  • Misattributing faces as happy at least four times

However, when boys and girls were analysed separately, it was found that girls scoring nine or more on the SCDC were not at increased odds of making any type of error in facial emotion recognition than girls who scored less than nine.

However, boys who scored nine or more on the SCDC had higher odds of making errors in the recognition of emotion in all types of faces compared to boys who had scores of less than nine. They also had higher odds of misattributing faces as happy.

Children with high SCDC scores performed worse on the Emotional Triangles Task, where they had to recognise emotions from the movement of objects.

Higher SCDC scores were associated with poorer emotion recognition in the happy and sad conditions. When boys and girls were analysed separately it was found that girls with high SCDC scores had poorer emotion recognition in the happy and sad conditions than girls with low scores. Boys with high SCDC scores had poor emotion recognition in the happy condition.

How did the researchers interpret the results?

The researchers conclude that “autistic-like social communication difficulties were associated with poorer recognition of emotion from social motion cures in both genders, but were associated with poorer facial emotion recognition in boys only”.

They speculate that this might be because girls learn to compensate for facial emotion recognition difficulties and it is this speculation that caught the media’s attention.

They go on to say that “the implications of this are far reaching with regard to the diagnosis of autism spectrum disorders in females, suggesting that more subtle assessment may be required to identify those individuals with difficulties”.


This was a large, interesting and useful study. It suggests that both boys and girls with defects in social communication skills suggestive of ASD have difficulties in emotion recognition from social motion, tested using the Emotional Triangles Task.

However, only boys with ASD-like social communication deficits have difficulties in recognising emotion from faces – girls with ASD-like traits perform as well as girls without ASD-like traits on this task.

This suggests that there may be differences in the characteristic traits associated with ASD between boys and girls, and implies that the criteria used to diagnose ASD may need to be gender-specific.

This study has one main strength in that it used data from a large number of children. However, the authors point out that it also has limitations, including that the group of children studied (from Avon, England) have been found not to be representative of the UK child population as whole.

So it is not known whether the findings are applicable to other groups across the country. Unfortunately, the study doesn’t specify how the children living in Avon were different from the general UK population but one might speculate there may be differences in ethnic diversity or socioeconomic background in this area, compared to the UK average.

They also point out that fewer girls than boys scored above the threshold of nine on the SCDC.

This may mean that the numbers of girls with scores above nine wasn’t big enough to detect a significant difference in facial emotion recognition, rather than there not being one.

It should also be noted that this study looked at autistic-type traits, but did not confirm a diagnosis of ASD.

Further research will be required to confirm the findings of the study, and to investigate if, how or why, girls might be able to compensate for facial emotion recognition difficulties.

Analysis by Bazian. Edited NHS Choices. Follow Behind the Headlines on Twitter.


“Thousands of girls may have autism that has never been diagnosed because they cover-up the signs so well,” the Mail Online reports. The headline is prompted by a study focusing on one of the key symptoms of autistic spectrum disorder.

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Child Health & Safety News Roundup: 12-15-2014 to 12-21-2014

twitter thumbWelcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use Twitter and Facebook to communicate relevant and timely health and safety information to the parents, medical professionals and other caregivers who follow us. Occasionally we may miss something, but we think overall we’re doing a pretty good job of keeping you informed. But for our friends and colleagues not on Twitter or FB (or who are but may have missed something), we offer you a recap of the past week’s top 13 events & stories.

PedSafe Child Health & Safety Headline of the Week:
5 Reasons To Rethink Santa’s Lap

Surprising Reason for Less Screen Time and More Outdoor Play

two boys running in snowWe’ve all heard it many times…. It’s important to limit the time our kids spend looking at screens, be it smartphones, tablets, TV or computers. In fact the American Academy of Pediatrics recommends avoiding ALL screen time for children under age 2 (no Elmo!!) and – for children and adolescents aged 3-18 (yes 18!) – limiting use of any screen device or TV to 1-2 hours per day, not counting online homework. But we are a long way from that, with American kids spending an average of 7 hours a day watching devices and screens.

Research shows that excessive screen time is linked with attention issues and school problems, along with physical inactivity, obesity, and lack of sleep. Even eating disorders have been associated with too much media consumption. And, of course, access to TV and the internet can lead to early exposure to age-inappropriate content (like American Dad and other shows on Adult Swim….we’ve had that problem…).

However, we parents all know that limiting screen time is VERY, VERY DIFFICULT. In fact, when the latest AAP policy statement was issued in 2013, an Associated Press reporter created a hash-tag that says it all: #goodluckwiththat. So if you are struggling with how much screen time is too much…here is another reason you probably never knew to get the kids off the internet…and GET THEM OUTSIDE:

A recent article in The Economist magazine highlighted the excessive level of myopia (short-sightedness – inability to see distant objects) among children in China and other East Asian countries. Short-sightedness is 4 times higher among Chinese elementary school children than those in the US, at 40% versus 10% here. Furthermore, levels of myopia in East Asia surge as kids move through school, with 80-90% of urban high school seniors in Singapore, South Korea and Taiwan having the condition. Short-sightedness may seem like a benign problem, but its development can increase risk of glaucoma and retinal detachment in adulthood.

Anyone familiar with the Tiger Mom phenomenon might think this has a lot to do with the intense focus on studying and academic achievement, prized in Asian cultures – and you would be partly correct. The article points out that up to the age of six, children in China and Australia have similar rates of myopia, but once they start school, the rates quickly diverge – in large part because of extensive studying, reading and use of electronic devices in Asia.

But that’s not the whole story. One of the most significant drivers of this childhood eyesight issue is lack of time spent outdoors. Apparently sunlight causes release of a chemical in the eye that prevents the eyeball from becoming too long (a common cause of short-sightedness), and Asian children, especially in urban settings, spend less time outside than their Western counterparts. However, myopia is also rising significantly here in America, perhaps due to a drop in time spent playing outside. Studies in Taiwan and Denmark have shown a link between time spent outside and development of short-sightedness, with the Taiwan study showing that a move to hold recess outdoors for elementary students (rather than the country’s usual indoor approach) reduced rates of eyesight issues.

So, another – perhaps surprising – reason to push kids to get off their phones and into the great outdoors….or at least to take their textbooks and study outside on occasion (though that might need to wait until it’s a little warmer – at least around here in the Midwest). The possibility of avoiding glasses might just be an appealing inducement for some kids!

Photo credit: Jon Rieley-Goddard; CC license