Boston Parent Your Family's Health

2016 Edition BostonParentsPaper.com

FAMILY’S HEALTH

YOUR

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Pregnancy • IInfants P f t tto T Teens • FFood d & Fit Fitness • M Mental t lH Health lth

Boston Parent’s Paper published by Parenting, LLC., a division of

The Ultimate Guide to Everyday Wellness

Plan ✼ Choosing a Health Decay ✼ Brush Away Tooth Smarts ✼ Teaching Kids Swim f ✼ Honey’s Sweet Relie ✼ The Press of Stress ✼ And Much More!

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Your Family’s Health 2016

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639 Granite St., Suite 25 Braintree, MA 02184 boston.parentspaper@bostonparentspaper.com Tel: 617-522-1515 / Fax: 617-522-7121 Visit us online at BostonParentsPaper.com PUBLISHER Jean Greco EDITORIAL Senior Editor: Cheryl Crosby Associate Editor: Kelly Bryant Calendar Editor: Jennifer Sammons Proofreader: Jeanne Washington Intern: Rebecca Schwartz ADVERTISING SALES Senior Account Executive: Lisa Braun Account Executive: Susan Hamilton NATIONAL SALES DIRECTOR Cate Sanderson 914-381-7474 PRODUCTION Senior Graphic Designer: Angela Rosa Graphic Designer: Staci Stedman-Morris CIRCULATION & EVENTS COORDINATOR Caitlin Dougherty DOMINION PARENTING MEDIA A Division of Dominion Enterprises

Department 5 F.Y.I.

Pregnancy 6 Upping the Odds for Pregnancy

Family Health 8 Choose a Family-Friendly Health Plan

on the cover

11 Brush Away Tooth Decay

Food & Fitness 15 Liquid Gold 18 Swim Smarts

Mental Health 21 The Press of Stress 4

Your Family’s Health | 2016

©ISTOCKPHOTO/THINKSTOCK

13 Be Burn Aware

Boston Parents Paper (ISSN 1059-1710) is published monthly by Parenting, LLC., a division of Dominion Enterprises. Please note that the advertisements in this magazine are paid for by the advertisers, which allows this magazine to be free to the consumer. Limit of one free copy per reader. Additional copies may be purchased for $5.00 per issue. Call 617-522-1515 to request additional copies. Unless specifically noted, no advertisers, products or services are endorsed by the publisher. All real estate advertised herein is subject to the Federal Fair Housing Act, which makes it illegal to advertise any preference, limitation, or discrimination because of race, color, religion, sex, handicap, familial status, or national origin or intention to make any such preference, limitation, or discrimination. We will not knowingly accept any advertising for real estate which is in violation of the law. All persons are hereby informed that all dwellings advertising are available on an equal opportunity basis. Editorial submissions are welcome. Boston Parents Paper copyright 2016 by Dominion Enterprises. All rights reserved. Reproduction in whole or part without written permission is prohibited.

f.y.i.

Advocating for Avocados The secret is out that avocados are a healthy fat – a monounsaturated fat. That may be why they’re popping up more and more on restaurant menus. Avocados have vitamin E and plenty of other nutrients.

Try making guacamole for a family snack, or spread some avocado on sandwiches. You might also add avocado to a smoothie for texture and fiber.

Eye Care and Sports While contact lenses might be convenient for young athletes to wear when playing sports, they don’t provide eye protection like special sports glasses or goggles, which are shatterproof and designed to withstand impact. A prescription correction can also be put in swim goggles. For more eye care advice, visit BostonParentsPaper.com/eyehealth101.

Speak Up A recent study shows preemies may benefit from hearing their mother’s voice just three hours a day. Published in the Proceedings of the National Academy of Sciences, researchers discovered preemies who were exposed to recordings of their mothers singing, reading or chatting while in the NICU developed larger auditory cortices (which helps in hearing and processing sounds) than those who heard only standard hospital sounds.

Avoid Tick Troubles Yippee, we can get outside and play! Yikes, we need to think about ticks! ✼ Wear light-colored clothing covering exposed areas. ✼ Tuck pants into socks or boots and be sure wrist

cuffs are snug. ✼ Put clothes in the dryer for one hour on

high after being out in the woods. ✼ Shower after coming inside and check

under arms, in and around ears, inside the belly button, the back of knees, and around the waist and hairline. ✼ For kids, use repellents with 10-14 percent DEET. Apply to clothing not skin.

Preventing Falls from Windows As we begin opening the house to let in the fresh springtime air, keep in mind the dangers of open windows. Now is the time to make sure all windows in your home are properly fitted with window guards or window locks. Window guards should be installed on any window greater than 12 feet from the ground.

Be aware that screens are not made to keep kids in, only to keep bugs out. The average window screen is easily pushed out by a child leaning against or running into it, whereas window guards are made to withstand up to 150 pounds of direct pressure.

Permanent window guards are not recommended. Instead, for windows associated with fire escape, guards should be installed that can easily be removed by an adult.

Other tips: ✼ Keep all unopened windows locked. ✼ Open windows from the top down if possible. ✼ Install window guards on any window that opens more than four inches. ✼ Make sure there’s no furniture (or anything a child can climb) near a window. ✼ Take a tour to identify potential problems, then take proper steps to give yourself peace of mind.

– Chinwendu Onwubiko, M.D., Ph.D. Boston Children’s Hospital Injury Prevention Program, 617-355-7332 2016 | BostonParentsPaper.com

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Pregnancy

UPPING THE ODDS FOR PREGNANCY A Closer Look at the Fertility Diet

By Georgia Orcutt

W

WILL SWITCHING FROM LOW-FAT MILK TO WHOLE MILK INCREASE A woman’s chances of becoming pregnant? Maybe. It’s one of the recommendations in The Fertility Diet (McGraw Hill, 2009), a book by Jorge Chavarro, M.D., and Walter C. Willett, M.D. The book, which has garnered a good deal of press since its release, offers dietary changes a woman can make to help her chances of conceiving. But it’s important to note that those changes won’t solve most infertility cases.

More than 6 million women – or one in seven couples – in America today struggle with infertility, a word they inherit after trying, unsuccessfully, to become pregnant for one year. (The number includes women who’ve had one child but face “secondary infertility” in trying to have another.) Approximately 30 percent of these women have issues caused by irregular ovulation, and it is this group the book studies and sets out to help. Dietary changes won’t boost the fertility of the 70 percent of infertile women who have anatomical problems, such as fibroid blockages in the fallopian tubes or other issues.

The book is based on part of the eight-year Nurses’

6

Your Family’s Health | 2016

Health Study II – researchers asked 18,000 nurses who were trying to become pregnant to provide information on what they ate, their lifestyles, and personal and medical histories. Nurses were chosen for their training and skill in providing accurate information, and were asked to supply information every two years. (To learn more about this part of the study, visit nurseshealthstudy.org.)

What Chavarro and Willett found were some surprising connections. “Going into the study, we had no strong reason to believe there was a relationship between dairy and fertility,” says Chavarro, a research fellow who is studying the role of diet and lifestyle on reproductive function at the Harvard School of Public Health. “The benefit of high-fat was a big surprise.” He’s quick to point out that for everyone outside the fertility issue it’s best to stick to low-fat dairy for heart health.

The Big 10 When it comes to irregular ovulation and infertility, diet matters, say Chavarro and Willett. And weight is also an important consideration. To women who suffer from ovulatory infertility, the book offers 10 basic recommendations: 1 Avoid trans fats, found in fast foods and many commercial products. Check package labels for amounts of trans fats and avoid anything that contains a “partially hydrogenated” ingredient.

2 Cut back on saturated fat from red meat and palm and coconut oils, and use unsaturated oils, such as olive and canola.

3 Eat less animal protein and more vegetable protein, such as beans and nuts.

4 Choose whole grains, which have lower, slower effects on blood sugar, over highly refined carbohydrates, which boost blood sugar and insulin production.

5 Temporarily trade skim or low-fat dairy products for their full-fat counterparts – one glass of whole milk or one serving of full-fat yogurt or ice cream daily.

6 Take a multivitamin that contains folic acid and other B vitamins.

7 Get plenty of iron from fruits, vegetables, beans and supplements, not from red meat.

8 Drink water; have coffee, tea and alcohol in moderation. Avoid sugared sodas.

9 If you are overweight, lose between 5 percent and 10 percent of your weight.

10 If you aren’t physically active, start a daily exercise plan; if you’re quite lean, don’t overdo exercise.

With the exception of full-fat dairy and vitamins containing folic acid, the above advice was the basis for Walter Willett’s earlier book, Eat, Drink and Be Healthy (Free Press, 2003), which stressed the importance of eating well and controlling weight for all men and women. Willett, who chairs the Department of Nutrition at the Harvard School of Public Health, outlined a diet to inspire readers to weigh what they did in their early 20s, give or take a few pounds.

Will it bring on pregnancy?

“Women who have issues with ovulatory fertility who follow five or more of these recommendations have a substantial chance of getting pregnant,” Chavarro says. “In two out of three cases, women

Pregnancy

The other surprise, Chavarro says, was the magnitude of the relationship between diet and infertility.

can get pregnant by moderate changes to diet and lifestyle.”

Weight Affects Both Sexes Willett and Chavarro say weight is an important fertility factor for men, as well as women. New research indicates that overweight men have a lower sperm count than men of healthy weight.

As for women, while being too thin to sustain an ovulatory cycle is also a problem, more women are at risk for infertility because they are overweight. Body fat can contribute to insulin resistance and disrupt ovulation. While Willett and Chavarro recommend that overweight women lose 5 percent to 10 percent of their starting weight, to make that goal more reachable, their book suggests the 7.5 percent solution: “12 pounds for a women starting at 160 pounds, 15 pounds for one starting at 200 pounds, and 19 pounds for one starting at 250 pounds. Although such goals are a challenge, they are far less daunting than ‘aiming for a healthy weight,’ the advice usually offered by health-care professionals.”

Older Mothers Many women worry about the increased risk of infertility as they age. Citing American Society for Reproductive Medicine statistics, Willett and Chavarro write that fewer than 10 percent of women in their early 20s have issues with infertility, compared to nearly 30 percent of those in their early 40s, and 50 percent or more of those over age 45.

Here again, dietary changes can help with infertility at a wide range of ages.

“In our study, the relation between diet and infertility did not differ by a woman’s age,” Chavarro says. “Women in their 20s were as likely to benefit from the diet as women in their 30s. And increases in body weight with age can add to the effects of age itself.”

But Chavarro has this caveat: “We know that fertility decreases with age, and there is a trend now toward later child bearing. Many women get the mistaken impression that they can delay the age they get pregnant and rely on fertility treatments later.”

The national Centers for Disease Control and Prevention (CDC) tracks the success rates for fertility clinics across the country. Most recently, the CDC reported that the rate of infertile couples finally able to have a baby is around 20 to 29 percent overall.

“Biologically, younger women have a better capacity to get pregnant,” Chavarro says. “But it’s a difficult issue. They have to consider their personal goals.” ■ Georgia Orcutt is a former associate editor of the Boston Parents Paper.

2016 | BostonParentsPaper.com

7

Family Health

Choose a Family-Friendly

HEALTH PLAN

By Sandra Gordon

A

IF YOU’RE SHOPPING FOR YOUR OWN HEALTH INSURANCE, THE PATIENT Protection and Affordable Care Act (ACA) helps make it more affordable. Still, that doesn’t mean picking the right plan is easy. In fact, it’s trickier than ever because the ACA has turned health care into a consumer product, with the onus on you to select the plan that offers the best value. “Be prepared to spend as much time on your health care decision as you would if you were buying a new car or making a major purchase for your household,” says Carolyn Kelly, vice president and public exchange strategy leader for United Healthcare.

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Your Family’s Health | 2016

1

Talk the talk. Like most industries, health insurance has its own lingo, such as deductible, copay, coinsurance and network. If you’re not sure what these terms mean, get familiar with them. “Shopping for health insurance without knowing the language is like learning how to ask where a museum is in French when you’re traveling in France, then not having enough vocabulary to understand the response,” says Robin Gelburd, president of FairHEALTH, a nonprofit organization with a mission to bring fairness and transparency to health insurance information.

To get the gist of standard health insurance terms, check out the glossaries on fairhealthconsumer.org and healthcare.gov. Print a cheat sheet of insurance definitions for your reference.

2

Pick a metal. Healthcare.gov offers four health plan types from which to choose: Bronze, in which 60 percent of health care costs are covered by an insurance company and 40 percent is paid by you, the consumer, with the lowest monthly premium; Silver (70 percent covered/30 percent paid for by you); Gold (80 percent/20 percent paid for by you);

Family Health

Open enrollment, the period when the federal government allows you to choose a health plan or to select a different plan if you already have health insurance, runs from November 1, 2016, through January 31, 2017. But you can enroll at other times of the year if you get married, have a baby or lose coverage. Medical care continues to be expensive, with lots of potential costs at risk. To pick the right plan for you and your family, take these healthy steps.

and Platinum (90 percent of costs covered, with 10 percent paid for by you, with the highest monthly premium). There’s also catastrophic coverage, which pays less than 60 percent of the total cost of care on average. It’s only available to those under 30 or who have a hardship exemption. “Focus on the cost of the monthly premium to select a metal level plan you can afford,” Kelly says. Buying health insurance that’s beyond your budget is a deal breaker. If you can’t keep up with the monthly payments, you’re not going to keep it. Note: The Silver level plan is the only one that subsidizes your health insurance expenses. If you qualify based on your income, it can reduce your out-of-pocket costs.

3

Next, choose a plan with providers you currently use. Once you’ve picked the metal level plan you can afford, ask yourself: Do my current providers accept this health insurance?

In other words, are the physicians and hospitals you like and use in the health plan’s network of providers and facilities? If you’re having a baby and anticipate needing an epidural or a C-section, you also want to know the anesthesiologist you end up with is in-network too. Bottom line? To keep medical costs low, it pays to stay in-network with all of your providers.

4

Do the math. As you’re narrowing the field, compare the products and services that each contender health plan offers. What will you pay for a medical service? When you visit the doctor, what will your copayment be? What’s the deductible? To estimate your health care expenses with any potential carrier, go online to your current carrier and look at last year’s claims for medical tests, doctor’s visits and prescriptions. Last year’s medical expenses are a good indication of what this year’s will be. If you went to the doctor five times last year, plug in what it would cost in each contender plan if you went to the doctor five times this year, and so on. “Arm yourself with the information you need to make a good decision,” Kelly says.

5

Check your work. At this point, you have enough information to pick a decent health plan for your family. Still, your health insurance is only as good as the carrier. If you’re going to need a medical service that’s specific to you, call the carrier’s 800 number before you sign on and ask if they typically cover that procedure. The last thing you want is for the carrier to tell you the service wasn’t medically 2016 | BostonParentsPaper.com

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necessary and refuse to pay for it after the fact. Another smart thing to do before signing on with a plan: “Call your State’s health insurance department and ask if they’ve received any complaints about the insurer,” Gelburd says.

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Phone a friend. If all this feels overwhelming or if you’d like to compare notes, consider working with a health insurance broker. This licensed and certified professional has gone through federal training to understand the ACA and the financial implications of the various choices. “Brokers represent all carriers and can look across all plans to find the best one to meet your needs,” says Todd Titsworth, a health insurance broker. A health insurance broker can help you compare your best options, determine if you’re eligible for a tax credit and even complete the health insurance application process for you. Agents receive a commission from insurance companies for their services, which are free to consumers. “There’s no discount by skipping an agent, so you might as well take advantage of the expertise,” says Katherine Woodfield, a health insurance consumer advocate and owner of healthcare-insurance-education.com. To find a licensed health insurance broker in your area, visit healthmarkets.com or healthcare.gov.

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Your Family’s Health | 2016

Consider signing up for a health savings account. If you ultimately choose a low monthly premium and a high deductible, which may make the most financial sense if no one in your family uses the medical system often, consider opening a health savings account (HSA). It’s a fund you create that must be used for qualified medical expenses. You can use it to pay for health care as you go, just like you do for groceries or gas and you don’t have to spend it down every year like you do a flexible spending account.

The IRS deems what’s an acceptable medical expense for an HSA, but its list is much more comprehensive than the services a health insurance company will cover, which is an added bonus. For example, “The IRS allows you to deduct acupuncture, chiropractic care, and orthodontic care,” Woodfield says. Many health insurance plans don’t cover these services. For more information about health savings accounts, visit the website for the IRS: irs.gov/publications/p969/index.html. If you’re not eligible for an HSA, a personal savings account designated for medical expenses will do. ■

Sandra Gordon is an award-winning freelance writer who delivers expert advice and the latest developments in health, nutrition, parenting and consumer issues.

By Anthony Giamberardino, D.M.D.

I

IF YOU’VE NOTICED A BIGGER emphasis on dental health over the last few years, you aren’t alone. While just a decade ago, children may not have visited a dentist for the first time until age 3 or 4, pediatricians and dentists now recommend a first dental visit by age 1.

Oral health is vital to overall physical health. The national Centers for Disease Control and Prevention (CDC) lists tooth decay as the most common chronic childhood disease, and cautions that untreated cavities and gum disease can lead to infection and more serious complications, such as diabetes and respiratory diseases.

Regular reinforcement of good oral health habits translates into better overall health throughout a child’s entire life. Yes, that means brushing twice a day for two minutes and flossing at least once daily. It also means delving deeper into what causes tooth decay in children, because what they put into their mouths affects their oral health just as much as how well they keep their teeth clean.

Soda, sugary beverages and sports drinks are contributing to an increase in tooth decay. Even with regular brushing and flossing, both diet soda and regular soda can break down the enamel of teeth.

2016 | BostonParentsPaper.com

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Family Health

Brush Away Tooth Decay

Family Health

Parents should take heed. Children between the ages of 8 and 17 are at the greatest risk for tooth decay from consuming acidic, sugar-rich soft drinks because the enamel protecting their teeth hasn’t yet fully developed. In fact, tooth decay is the single most common chronic childhood disease according to the CDC. Nationally, more than 51 million school hours are lost by children each year due to dental-related problems – many that are preventable.

Despite these statistics, more and more children and teens have come to consider drinking soda and other soft drinks to be a regular part of their daily routine.

The average American child consumes approximately two 12-ounce cans of soft drinks every day, according to a study published in Pediatrics, the journal of the American Academy of Pediatrics. This amounts to 20 teaspoons of sugar each day. That’s nearly twice the recommended limit a child should consume.

When you eat anything, especially foods rich in sugar like soft drinks, the bacteria already present in your mouth convert the sugar in food into acids.

Those acids attack enamel on your teeth, which can cause permanent damage. The more you eat or drink sugary foods and beverages, and the longer sugars remain in your mouth before you brush your teeth, the greater your risk for tooth decay. It takes as little as 20 minutes for these acids to begin to form and do damage. The carbonation and acid in these drinks alone can weaken and permanently destroy enamel as well, resulting in discoloration, sensitivity and cracks or chips. So sugar-free and diet sodas aren’t necessarily a better choice overall.

It’s not just the sugar and acid content in soft drinks that are negatively impacting children’s teeth.

It’s the frequency in which little bicuspids and canines are exposed to the beverages throughout the day. Sipping a bottle of soda or sports drink over several hours leaves little time for the mouth to correct its pH level with saliva, which is important for protecting teeth against decay. Since most kids do not typically brush or rinse their mouths during school hours, nursing these types of drinks throughout classes allows them to do what they do best to teeth – break down enamel and cause cavities.

Despite the ubiquity of soda and sport drinks in our lives, there are a few concerted efforts that parents can make to help kids maintain a healthy mouth.

First, make water, milk and 100-percent juice the beverages of choice in your home. It’s true that fruit juice and milk contain natural sugars, but they are also nutritious. Accompanied with good brushing habits, it’s fine to drink both within recommended amounts.

It’s also a good idea to follow up a glass of milk or juice 12

Your Family’s Health | 2016

with a drink or rinse of water to flush excess sugars out of the mouth. If consuming sugar-rich drinks is unavoidable, make a small investment in straws. Straws direct beverages to the back of the mouth, limiting the amount of time the beverage is in contact with a child’s teeth. Not only are straws healthful tools, they’re fun!

Parents should also consider sending children to school with a durable water bottle. Kids can fill it up throughout the day and won’t need to purchase an additional beverage at the vending machine. Water is the all-around best choice, not only for your mouth, but for the whole body, with benefits ranging from regulating body temperature, losing weight and staying alert and energized.

The oral health of your kids should be a priority all year long, so teach your kids about how the beverages they drink and foods they eat affect their teeth. Take this opportunity to inject some fun into home dental hygiene habits and renew a true commitment to regular dental checkups. ■ Anthony Giamberardino, D.M.D., a general dentist, is the president of the Massachusetts Dental Society. To learn more about issues affecting children’s dental health, visit massdental.org.

Did You Know… ?

Your Teeth Have Stem Cells Most parents know about cord blood banking, which is the storage of stem cells from an infant’s umbilical cord for potential use in the treatment of certain diseases later in life.

A newer option involves the storage of stem cells derived from teeth. These cells can come from a child’s primary (baby) teeth or adult teeth that are being extracted, such as wisdom teeth or teeth being pulled to make room for braces. A dental practice offering access to this service would place a removed tooth in a special storage device and transporter kit, which is then sent overnight to the storage lab, where the tooth’s stem cells are collected and stored.

Dental stem cells are found in the soft pulp tissue inside a tooth. Ongoing research has indicated that these cells may be helpful in treating illnesses, such as diabetes, heart disease, Alzheimer’s disease and multiple sclerosis.

Among the dental stem-cell storage laboratories are Store-A-Tooth (storeatooth.com), a service of Provia Labs in Lexington, and the National Dental Pulp Laboratory (ndpl.net), a subsidiary of the New England Cryogenic Center and sister company to New England Cord Blood Bank. Learn more by visiting these companies’ websites.

Family Health

Be Burn

Aware What to Do If Your Child Suffers a Burn Injury

By Robert Sheridan, M.D., and Elizabeth Fisher

C

CHILDHOOD INJURIES ARE INEVITABLE. NO MATTER HOW much padding or childproofing you install, there will be bumps, bruises, scrapes and maybe even a broken bone or two. Most parents are equipped with basic first aid training to take care of minor injuries or manage them until a medical professional can take over. One area where parents might want a first aid refresher is in burn care.

2016 | BostonParentsPaper.com

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Family Health

According to the Centers for Disease Control and Prevention (CDC), more than 300 children with a burn injury are seen at emergency departments around the country every single day. While fire prevention education has had a tremendous impact on reducing the number of burn injuries in the United States, they still happen, and many burn injuries are not caused by an open flame. Scald burns (burns caused by hot liquids) are the most common type of burn among children 4 and under.

What to Do in a Burn Emergency In all cases of severe burns, call 911 immediately.

When burns are really serious, you’ll want trained help quickly. However, there are ways to be proactive, limiting exposure and reducing injury, during the vital period when you are waiting for the ambulance to arrive.

Flame burns treatment – Smother the flames using a heavy blanket or carpet, or using the “stop, drop and roll” technique. Cool the burn with lukewarm or cool water.

Scald burns treatment – Immediately remove the affected clothing (which traps heat and prolongs exposure) and cool the area with lukewarm or cool water.

Chemical burns treatment – Flush with large quantities of water to dilute the chemical and remove it from the skin. Eyes should be flushed with water or saline for at least 20 minutes.

Electrical burns treatment – Do not touch the child with bare hands if he or she is still in contact with the current source. Turn off the current immediately. If this is not an option, use an insulated pad or clothing to gently push the child off the source.

Frostbite treatment – Warm the skin using lukewarm water.

Sunburn treatment – Prevention is the best treatment. Wear protective clothing, sunglasses and sunscreen when appropriate. Avoid exposure during the sunniest times of the day in the hours before and after mid-day. If sunburn does occur, apply cool, damp towels to skin for comfort. In some cases, a moisturizer may provide comfort in the following hours. Blisters are best left alone if they occur. Drinking extra fluid will reduce symptoms of dehydration. In some cases acetaminophen or a nonsteroidal anti-inflammatory agent may be useful for comfort. It’s rare, but sun exposure has been enough to cause systemic illness, with lightheadedness, vomiting and swelling. Medical care should be sought in such situations. It’s important to prevent 14

Your Family’s Health | 2016

exposure to intense sun in the days and weeks after suffering a sunburn.

For even the most minor burn, your first instinct might be to grab ice to cool the injury. Burns should be treated with lukewarm or cool water, not cold water or ice. Ice and extremely cold water can slow the flow of blood to the burned area, potentially doing further damage. If a small portion of the skin has been affected, you can immerse the burned area in still water. Do not immerse a large burn in cool water, as it could cause hypothermia.

In some cases, a blister may form quickly. It is not recommended to break blisters until your child is seen by a medical provider. It is also ideal to avoid ointments and creams unless advised to use them.

Burns that will be seen by a provider are best simply covered with a clean, dry dressing.

Do not hesitate at any point to seek medical help, keeping in mind that it is very common for burns to appear minor initially but worsen in the following days. Burns that are larger than three inches in diameter or wrap completely around an extremity should be seen immediately by a medical provider.

Burns that occur on the hands, feet, face, groin or buttocks should be evaluated regardless of size.

Be Burn Aware at Home While accidents do happen, there are precautions you can take around the home to prevent burn injuries, including: ✼ Set the water heater temperature no higher than 120 degrees Fahrenheit. ✼ Turn pot handles to the back of the stove. ✼ Fill the bathtub with cold water first, then warm water until a comfortable temperature is reached.

Always test the bath water first, before allowing a child to enter the tub. Keep in mind children’s skin burns at a lower temperature than teens and adults.

What may not be too hot for you, may be too hot for your child. ✼ Children should face away from the faucet in the bathtub. ✼ Do not hold a hot beverage when carrying your child. ✼ Do not place hot beverages in stroller cup holders. ✼ Avoid using table cloths because small children are prone to pulling on them, bringing hot dishes crashing down. ■ Dr. Robert Sheridan is the medical director of the acute burn service at Shriners Hospitals for Children – Boston. Elizabeth Fisher is the hospital’s public relations manager.

Food & Fitness

iquid LGold The Health Benefits of Honey

By Mary Alice Cookson

H

HERE’S THE THING ABOUT

honey – it’s sweet, it’s gooey, it goes with just about everything and it makes an incredible nickname for those you adore most in life, but aside from its seemingly superficial benefits, it really does have an important place in our diets.

For Gretel Clark of Hamilton, a naturalist who has painstakingly tended bees for more than 30 years, honey production is both a hobby and a labor of love. “It takes a good two or three months once spring arrives to have enough seasoned honey for me to even think about harvesting it,” says Clark. “Bees need the food they bring in to the hive for their young and to sustain them through the winter.”

Clark says she waits until the bees have an ample surplus. As they accumulate more honey, she adds more boxes, which are like the bees’ storage rooms.

She then harvests, spins out and jars the “extra” honey and sells it from her home, often allowing customers the benefit of paying by “the honor system.”

As summertime flowers blossom, bees become increasingly more active in gathering nectar that they turn into honey. Healthy colonies consist of about 60,000 bees, Clark explains, and each bee survives only about six weeks. The queen, who lays 1,500 to 2,000 eggs a day, lives up to three years. The industrious colony feeds and grooms her, heats the hive (which needs to be maintained at more than 90 2016 | BostonParentsPaper.com

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degrees) and fans off moisture from the nectar they have collected with the movement of their wings – an amazing process.

Why Do Bees Make Honey?

Bees make honey to heat the hive during the winter, to provide energy for their flight muscles and as protein for their brood, according to the National Honey Board, a non-regulatory board appointed by the U.S. Secretary of Agriculture that supplies research and information. Honey consists of natural sugars and trace enzymes, minerals, vitamins and amino acids. Its color and taste are determined by the blossoms from which it is made.

Best When Not Heated “Raw” honey is an unofficial term meaning honey that has not been heated or filtered, and therefore, contains trace amounts of pollen. With processed honey, typically found in supermarkets, these traces are removed.

Charles Frederic Andros, owner of Linden Apiaries in Walpole, N.H., is a full-time producer of honey and other bee products, and a keeper of 50 two-queen bee colonies. He is also a former New Hampshire and Vermont apiary inspector. Like many people, Andros admits he puts honey in his tea, but he and other beekeepers stress that it’s not good to heat honey because it kills the nutrients.

“I keep my honey and pollen in freezers. Neither is ever heated to preserve the enzymes and apitherapeutic activity,” Andros says. “All the bee products are immune system stimulators.”

If honey “sugars up,” Clark advises boiling some water in a saucepan then removing the pan from the stove and setting the jar in the hot water until its content is liquefied. Don’t boil the honey directly or boil the water with the jar in it, she says.

Health Benefits of Honey Aside from making a delicious addition to tea and toast, honey has been prized over the centuries for its healing qualities. Some health-related uses: ✼ As a natural sweetener, which is one- to-oneand-a-half times sweeter than sugar but with about 20 percent less carbohydrates. Andros says it provides a more sustained energy boost than the shorter burst one gets from cane sugar. ✼ For

relief from cold and flu symptoms.

Honey is well known as a natural cough suppressant. It also soothes sore throats by coating the throat and reducing irritation. “Take a teaspoon 16

Your Family’s Health | 2016

and swallow it slowly,” Clark advises.

Experts warn, though, that honey should never be given to babies under 1, and that raw honey should not be consumed by pregnant women or people with immune deficiencies because of a risk of botulism.

In an article on the Mayo Clinic’s website, James M. Steckelberg, M.D., reports that studies have shown honey is as effective as dextromethorphan, a popular ingredient in over-the-counter cough syrups, in easing a child’s nighttime cough. But he notes that coughs shouldn’t necessarily be suppressed because coughing helps clear mucus from airways. ✼ As

first aid treatment for wounds and burns. Clark mixes honey with Aquaphor in equal

parts and applies this ointment to a wound before covering it with a bandage. Honey is known to have antibacterial and anti-inflammatory properties.

Andros notes, “You can actually put honey right onto a burn – the quicker, the better.” He adds that it’s particularly helpful for soothing sunburn.

Many skin care products, such as facials, lotions and shampoos, contain honey for its moisturizing effects. ✼ As

a potential therapy for seasonal allergies. Some people believe that taking a

dose of raw honey that’s locally produced works somewhat like an “allergy shot” to boost one’s resistance to seasonal allergies. The key, they say, is finding honey that’s produced in the area where you live, with traces of pollen that are the same pollens giving you trouble.

One new believer in this theory is Frank Yu Chang, a software engineer from Holliston. “I take one to two teaspoons of infused honey with two slices of toast in the morning,” he says. “The main reason is I don’t want to suffer allergy symptoms and the side effects from allergy drugs.” Chang started his regimen in March of last year and continued it for three months. During that time he says he didn’t need any allergy drugs, except for eye drops for itchy eyes, despite having taken allergy medicine previously for 10 years. His “honeyed toast therapy” has worked so well that Chang is doing it again this season and has introduced it to his two teen daughters.

Seasonal Allergy Study “There are quite a number of people who say that when hay fever starts, they eat local honey and their symptoms back off,” says Eric Mussen, Ph.D., apiculturist at the Entomology Extension at the University of California (U.C.).

In the March/April issue of U.C. Apiaries’ bi-monthly newsletter, Mussen writes about a 2013 study conducted by a hospital research team from Malaysia. Forty hay fever sufferers were given 10 mg. of the allergy medicine loratadine each day. Additionally, they were divided into two groups with half receiving a gram of honey (about one-sixth of a pound) split into four equal doses each day and the other half (the control group) being given the same amount of honey-flavored corn syrup. By the fourth week, both groups exhibited progressive improvements in their allergy symptoms, possibly due to the placebo effect, reports Mussen. But over the next four weeks, only the group fed honey demonstrated further improvements. After treatments ended, the participants’ improved state of health persisted for another month.

“This is one of the first studies I have seen that actually demonstrated, in a well-conducted, medically acceptable design, that ingestion of honey containing the right pollen grains or pollen protein extracts can affect allergic responses in humans,” said Mullen in a recent interview.

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Medical Skepticism While supportive of the idea of taking honey to relieve coughs and sore throats, the medical community remains skeptical about raw honey’s effectiveness in combating seasonal allergy symptoms. In fact, several doctors declined to be interviewed for this article, citing a lack of evidence.

“The theory’s been kicking around for a long time, but rigorous scientific studies haven’t supported it,” says Andrew Ober, M.D., a board certified allergist with Asthma & Allergy Affiliates in Salem. “It’s very tricky to desensitize people. Dosing is important. Timing is important. There really isn’t that much allergen in honey. … If I had a patient who felt better taking honey, I wouldn’t dissuade them from taking it, but I don’t think in someone who’s still having a problem that it replaces conventional therapies.” For that, Ober recommends over-the-counter antihistamines.

Andros proposes that bee pollen, which he sells and consumes himself, is much more effective than honey for that purpose. But Mussen cautions, “We know that ingesting very much allergen by an allergic person can cause problems. One has to be pretty careful when consuming pollen directly.”

As with all health-related matters, it’s best to consult your physician for sweet and sound advice. ■ Mary Alice Cookson is the former associate editor of Boston Parents Paper.

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Swim Smarts

Feel safe in the water this summer by being water wise.

I

By Kelly Bryant

IT’S THE MOMENT WE’VE ALL BEEN WAITING FOR – IT’S NEARLY TIME for swim season! All of those agonizing months of freezing temperatures and snow have led to this. But is your kiddo ready to jump in? While May marks National Water Safety Month, there’s never a wrong time for making sure your little one feels comfortable going for a swim. Here’s how to know if your child is ready to take the plunge, no matter how shallow.

“Drowning is the leading cause of death for young children ages 1 to 4, according to the Centers for Disease Control and Prevention, and one of the leading causes of death for children under the age of 13,” says Korrinn Lubarsky, aquatics director at the Leventhal-Sidman Jewish Community Center and director of the JCC’s Lenny Krayzelburg Swim Academy. “Since drowning statistics have been on the rise, it makes it imperative for children to learn what to do in the water.”

Kids aren’t the only ones who should brush up on swim safety. Parents should pause to take note as well and keep a watchful eye on pool play.

“Parents often think that once their child gets to an upper level swim class that she is safe in the water,” says Lubarsky. “Sometimes they assume the lifeguard is responsible for watching their child. Yes, lifeguards are there to watch over the pool and be proactive to

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prevent emergencies. However, ultimately the parent or caretaker should be the one solely responsible for their child while she is swimming.”

The Fear Factor If your child is struggling to get comfortable in the water, relax – pushing him will only make him more anxious.

“It is important to develop trust and comfort with fearful swimmers,” says David Witkus, assistant manager of aquatics at the Boston University Fitness and Recreation Center. “This can take more time and, as instructors, we often have to adjust our strategy. We must continue to encourage progress without pushing too hard. The last thing we want is for a child to give up swimming. Fear is why we encourage swim lessons starting at an early age. To reduce fear the swimmer must gain comfort and confidence around the water.

Basic Pool Safety Rules Witkus offers these guidelines that all children should know: ✼ Never swim alone. Swim with a buddy and with your parents’ permission. ✼ Know how to call for help. ✼ Look before you leap and jump feet first. ✼ Follow pool rules and listen to the lifeguard. ✼ Don’t eat food or chew gum while swimming; it’s a choking hazard.

Babies You don’t have to wait long to enjoy water play with your little one. In fact, there are programs available for children as early as 3 months old.

“Children should start getting orientated and comfortable with the pool environment between the ages of 6 months and 3 years,” says Witkus. “I recommend swim lesson programs that offer parent and child swim classes. This is a great way for children to have fun and get used to the pool while parents are educated on water safety. Statistics prove that when a child is in formal swimming lessons the risk of drowning is reduced by up to 88 percent.”

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We often encourage parents to take their fearful swimmers to open swim times for fun and to practice skills like blowing bubbles. Parents must also remember not to push too hard; your job is to encourage and be your child’s partner in the learning process.”

Lubarsky agrees, noting that babies are much more receptive to swim lessons than many people think.

“Some parents think they should hold off on swimming until their child is a little older because they don’t think they will learn much at that young age,” she explains. “They say, ‘How much can babies really learn when they are 3 months old?’ You would be surprised! Little ones will start by getting used to being in the water and learning to float.”

While all children respond to lessons differently, generally the milestones you’re trying to hit in the water between 6 months and 3 years are comfort in the water on the front and back sides along with feeling at ease working with a swim instructor and increased water safety knowledge, explains Witkus.

Preschoolers Even at a young age, don’t underestimate the importance of learning technique. As Kubarsky will tell you, it’s incredibly important and something she stresses to students.

“Parents have this notion that endurance is essential in learning how to swim,” she says. “Parents will push for their children to learn how to swim the whole length of the pool even when their technique is poor, just to say that they swam the length of the pool. If the foundation and technique are not taught, it doesn’t really matter how far they can swim. I would always tell my swimmers, ‘You don’t want to swim long, wrong.’”

Witkus notes that while kids’ skill levels vary greatly because some may have started swim lessons

WATER SAFETY TIPS Whether it’s the eagerly-anticipated return of sunshine and warm weather days spent in the pool or at the beach, below are some tips to help keep your family safe in the water: ✼ Basic water safety. Walk, don’t run, around pools. on what the kids are doing in and near the water. ✼ Learn how to go underwater. Not panicking when ✼ Bring sunscreen. Make sure you and your kids have inadvertently going underwater is paramount, but sunscreen on – even on cloudy days. You’ll be protected when your kids know how to hold their breath and go against painful sunburns and potential long-term risks. underwater it heightens their confidence in and around the ✼ Pack snacks and water. It’s important to make sure kids are pool, lake or ocean. staying hydrated. Yes, they’re surrounded by water while ✼ Do keep an eye on your kids and listen. Always know where swimming, but they need to drink, too! Staying fed and your kids are and how they’re doing. It’s important to hydrated helps prevent muscles from cramping up while understand that potential drowning signs may not include swimming and keeps kids’ energy up to make sure they’re a loud, splashing fit. It’s easy to silently slip under water able to stay safe in the water. while struggling to stay afloat and breathe. You may not ✼ Have life-saving equipment nearby. That may mean life hear a commotion and nearby swimmers may not even jackets, flotation devices, long poles in a pool, a first aid kit notice. It’s necessary to keep your ears open to listen for and more. You probably always have your phone nearby to sounds of anyone calling for help – or silence when there take pictures of your kids doing cute stuff while swimming – should be joyful voices in the water. Always keep one ear but you need to be ready to call 911 if needed, too.

– Sarah Kepic is a mom of two young boys and owner of Goldfish Swim School in Needham & Burlington.

2016 | BostonParentsPaper.com

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as babies while others are only just beginning, from 3 to 5 years you can generally expect a slow progression from assisted skills to independent swimming.

“In the end children will be swimming distances of 15 to 40 feet independently on their front and back along with an understanding of all water safety rules,” he says.

Elementary Schoolers Through Teens If your child is at ease in the water and has been taking lessons for some time, Witkus says children ages 6 to 14 years will generally be swimming all strokes confidently, swimming distances over 25 yards, feel comfortable diving, tread water and execute flip turns.

While diving may seem like the next logical step for a strong swimmer, it’s not imperative for a child to learn (a sigh of relief for parents who remember this somewhat traumatic rite of passage from our own childhoods).

“A child can be a great swimmer and never step foot on a diving board,” he assures. “Most swim lesson programs teach jumping and diving from the side of the pool and that covers the required skills that help children to be safe around the water. I think springboard diving is an amazing sport when taught by an experienced coaching staff and run out of a safe facility.”

You’ll probably also notice fewer diving boards around public pools these days; Kubarsky explains why.

“Diving boards are not as common as they were five to eight years ago,” she says. “Most newly built pools do not have diving boards because of the insurance liability they possess. Insurance policies required when owning a diving board are frequently prohibitive.”

Diving Dos and Don’ts If you do find yourself with a diver on your hands, be sure to instill these safety practices: ✼ One diver on the board at a time. ✼ Look before you leap. The dive well must be clear before the next diver begins their dive. ✼ One bounce only. ✼ No running on the diving board. ✼ No hanging on the board or grabbing it. ✼ Dive off the end of the board, never the sides. ✼ Do not dive from the board with loose clothing or equipment. ✼ Springboard diving should be supervised by a coach or instructor.

Now that you’re armed with swim knowledge, get out there and enjoy! You can find a plethora of pools and water parks on our website: BostonParentsPaper.com/pools. ■ Kelly Bryant is associate editor of Boston Parents Paper.

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Mental Health

How It Affects Children – and How to Help Them Cope

By Lisa Kosan

A

AS PARENTS, WE MAY NOT THINK OUR KIDS EXPERIENCE STRESS – NOT really anyway. After all, we’re the ones dealing with mortgages, threats of layoffs, orthodontist payments and global worries, such as war and terrorism.

“Ask me,” my 10-year old son says, “I know all about stress.”

So I ask.

“I get stressed when I have to do big projects for school,” Max tells me, “or when I have math that’s way too hard. Everything builds up and I can’t get it done.

I feel like I’m going to explode.”

From preschool on up, children deal with their own significant sources of stress. There’s internal stress – the kind that bubbles up from within – and external stress, the stress kids feel from family, peers

and the world at large. There’s the age-old childhood stressors of separating from parents at preschool, bullies, spelling tests, making the Little League team, a new crop of pimples, college applications, worrying about parents or friends, and more. Plus, today’s rushed lifestyles, crowded schedules and increasingly high academic expectations have added new layers of stress to kids’ lives.

So much so, in fact, that the American Academy of Pediatrics (AAP) urged physicians to routinely assess young children for stress, anxiety and depression. The 2016 | BostonParentsPaper.com

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Mental Health

AAP acknowledged the deep toll of modern lifestyles and heavier academic loads on today’s kids and strongly advocated for more downtime.

“When pediatricians are issuing a report saying that kids are too scheduled and stressed, and that they need free time, you know something is up,” says Michael Thompson, Ph.D., author of The Pressured Child (Ballantine Books, 2005) and co-author of the best-selling book Raising Cain: Protecting the Emotional Life of Boys (Ballantine Books, 2000).

Pressure to Succeed One reason why today’s kids are likely to be more stressed than even 10 years ago, many argue, is the sense of higher stakes for academic success in an increasingly competitive world economy. Parents may convey a heightened state of anxiety about this that children feel, either consciously or subconsciously.

“We have an idea that the best-raised children are the ones whose parents are guiding their children every second of the day,” says Thompson, a clinical psychologist, consultant and parent of two teenagers.

“Aware parenting is fine. But we’re getting to a point of competitive parenting, when your children are a project that has to be constantly monitored so you can turn out the perfect child. You’re under stress, and so are they.”

Consider the mother of a little boy who told Thompson she wanted to hold her son back from kindergarten so that he could be at the top of the next year’s class. She kept saying that she wanted him to be the leader.

“What she couldn’t say was that she wasn’t satisfied with her son just being a happy student in the middle of the class,” Thompson says. “That’s competitive parenting that causes stress in children.”

Or how about the father who told Thompson that his ninth-grade son needed to be more organized?

“I asked why he was so worried and the father said, ‘globalization.’ And he meant it.”

Global competition is real, Thompson says, but so is the timing of childhood milestones. “You can scare the hell out of your children by saying they need to prepare for globalization, but that doesn’t change the arc of their development – or when boys get organized.

“So many kids have teachers everywhere,” he adds, referring to parents who are overly involved in their children’s academic lives. “It’s stressful when your mom is also your teacher, and there’s no difference between home and school.”

Certainly, children need to understand their 22

Your Family’s Health | 2016

responsibilities around school and homework, but they also need to have lots of fun, Thompson says.

“Kids need time when they’re not task-focused, when they’re not doing things that contribute to their welfare later and they are just playing in the moment.

That is the sweetest time of all, and it’s also the best for developing a child’s personality.”

Pressure to Feel Safe Children also feel their parents’ anxieties about challenges closer to home. If we’re too worried about their personal safety to let them ride their bikes to the park or walk to school on their own, our children may not become resilient enough to cope with their own stress; they won’t have the skills they need to rely on themselves.

“Kids used to grow up in communities where they know everybody on the block or in their building,” says clinical psychologist Dan Kindlon, Ph.D., author of Tough Times, Strong Children (Miramax, 2003) and co-author with Thompson of Raising Cain. “Most of us feel fairly isolated today, and isolation produces stress. Social support is the biggest protective factor in dealing with stress, but we feel more alone and our kids feel more alone.”

How to Spot Stress Just like adults, children exhibit a range of symptoms when they’re under stress. They might: ✼ look anxious or tired; ✼ complain of stomachaches and headaches; ✼ have trouble sleeping or suffer vivid nightmares; ✼ lack joy in activities that would normally make a child smile; or ✼ start biting their nails, twirling their hair, or sucking on a shirt cuff or collar to release excess energy.

Regression is another classic symptom of stress.

A toilet-trained 3-year-old, for instance, suddenly has accidents when faced with a new preschool or caregiver. A slightly older child starts clinging to parents more and talking in a more childish voice.

Some children participate in repetitive play to gain control over scary situations. For instance, a child who was momentarily locked out of her house might open and close a door repeatedly. Kids under constant stress, bordering on trauma – such as living with an abusive parent or in a violent neighborhood – might become numb to their surroundings or introverted, withdrawing from friends and family.

How to Help Extracurricular activities, from dance lessons to baseball practice, can create stressful schedules, few

opportunities for families to spend time together and more pressure at the end of the day when homework still isn’t done. Add a problem or conflict – such as fear of a bully or worrying about grades – and the stress can feel insurmountable to a child. What can parents do to help? ✼ Limit the causes of stress in your children’s lives, and make sure they have enough downtime. “If their lives and schedules get too demanding, put your foot down and say enough’s enough,” says Denise Moutafis, the mother of two grown boys and head teacher at a private day school in Massachusetts.

“Their anxiety builds when they feel like everything is going to come crashing down around them.”

Moutafis says she and her colleagues are often the first to notice signs of stress in a child. She’ll first try to assess whether the source of stress is at school, including problems with classmates or schoolwork. Then she’ll approach parents to see if there’s trouble at home.

“It makes such a difference if we know that a grandparent is ill, or a pet just died, or home causes a major meltdown every night,” Moutafis says. “When a parent talks to us first, we can anticipate how a child might act at school.” ✼ With very young children, try to take on some of the burden. That might mean hanging up a dream catcher if the nighttime starts feeling scary, or calling a teacher or another parent to resolve a conflict at school.

“Work with children to solve the problem and help them move forward,” Kindlon says. “Give them a sense that there is always something you can do, even if you don’t think it will work. Just letting them sit there feeling afraid is the worst thing you can do.” ✼ Talk with your kids about what stresses them, maintain a sense of humor and give them some perspective. Remind your middle-schooler that a bad grade or two won’t prevent her from going to college.

“You want them to work hard,” Kindlon says. “But if they give their best effort, let it fall the way it falls. And let them know you love them even if they get a C on a test.” ✼ Let your children know that you’re always available to listen and you’ll try to help. Being able to talk about the stress they’re feeling, and knowing you’re there to support them no matter what, helps tremendously.

As with any health issues, if you suspect your child is more seriously affected by stress, talk to your pediatrician about how to respond and what other steps may be needed. ■ Lisa Kosan is a writer, editor and the mother of two boys from Beverly.

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