Women+ Family FEBRUARY 2019
HEALTH GUIDE
Winter safety at home and play PAGE 2
Warning signs for mental-health problems PAGE 4
Breastfeeding for a great start PAGE 8
Finding fertility the second time around PAGE 10
WOMEN + FAMILY HEALTH GUIDE
Winter wonderland safety Make this winter safe at home and at play
W
hether your family is at home cozying up to a warm fire or out enjoying all the activities winter brings, Safe Kids reminds you to keep safety in check. AT HOME “Families today are better at understanding the importance of having working smoke alarms in every sleeping area, and most recently carbon monoxide (CO) alarms,” says Alison, Safe Kids Larimer County coordinator. “Carbon monoxide is dangerous because it is odorless, invisible, and it can kill. CO can make a child seriously ill in small doses that might not noticeably affect an adult.” According to a recent study, children younger than 5 years old have the highest estimated rate of CO-related visits to the emergency room among all age groups in the United States. More than 25 kids die from CO poisoning every year. Important safety tips to protect your families from CO poisoning:
• Prevent CO buildup in the first place—make sure heating appliances are in good working order and used only in well-ventilated areas. • Don’t run a car engine in the garage, even to warm it up; move the car outside first. • Install a CO alarm outside every sleeping area, on every level of your home and at least 15 feet away from every fuel-burning appliance. • When you test your smoke alarm each month, check the batteries on your CO alarms at the same time—replace the batteries twice a year. • Never use a stove for heating. Have all gas, oil or coal burning appliances inspected every year to ensure they’re working correctly and are properly ventilated.
If a CO leak is suspected, call 9-1-1 immediately. Get out of the house into fresh air. Do not open doors or windows. Fire personnel will want to verify a leak and identify the source so it can be fixed. Symptoms of CO poisoning include headache, fatigue, nausea, vomiting, or confusion. 2 | RMPARENT
“CO alarms are available at hardware stores for about $20,” adds Weston. “That is a small price to pay to help detect odorless, poisonous gases in the home before it’s too late.” AT PLAY Don’t leave safety at home when headed out to enjoy winter sports! Parents are reminded to use proper safety equipment, training and supervision when it comes to themselves and their children. Nationwide, more than a quarter million children a year are injured while participating in winter sports. Safe Kids Larimer County offers a few simple precautions:
• Kids need to be dressed appropriately, take lessons, be actively supervised and stick to safe terrain. For most winter activities, protective headgear is recommended. • Helmets are a must for anyone skiing, snowboarding, sledding or ice skating. According to the US Consumer Product Safety Commission, ski helmets could prevent or reduce the effects of 53 percent of the head injuries suffered by children younger than15 while skiing or snowboarding.
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• Did you know? Roughly 3,000 kids a year suffer serious head injuries from sledding. A good sledding hill does not lead to a street, a body of water or a crowded gathering place. In addition, the CPSC reminds parents and kids to inspect sleds regularly for worn, damaged or loose parts that could break or snag at high speed. • Children under 6 should not be riding a snowmobile, and nobody under 16 should be driving one. All snowmobile drivers and passengers should be wearing helmets designed for high-speed motor sport —a bike helmet isn’t sufficient for going up to 90 miles per hour. • Dress in layers. Wear sunscreen. Stay hydrated. Kids—or caregivers—who become distracted or irritable, or begin to hyperventilate, may be suffering from hypothermia or altitude sickness, or they may be too tired to participate safely in winter sports. They need to go indoors, rest and warm up.
Remember that even though winter is not ‘trauma season,’ parents should never take vacation from safety. For more information, please visit www.safekids.org or contact Safe Kids Larimer County at 970.495.7502.
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Because
WOMEN + FAMILY HEALTH GUIDE
grey matter
Learn to recognize warning signs for mental-health problems
matters
One out of four people—adults and children—suffer from some form of mental illness or emotional disorder.
I
n 2016 in Larimer County, 80 people committed suicide, according to the Larimer County Coroner’s Office. The number is not final for 2016 as some cases are pending. Four of those were youth or children under the age of 18. Last year in Weld County, at least 46 lives were lost to suicide; two of those were youth ages 10-18. Twelve percent of teenagers said they have had suicidal thoughts and eight percent said they’ve attempted suicide at least once, according to the 2015 Healthy Kids Colorado Survey. These numbers and percentages scream out for attention. They emphasize that human brains are part of the human body and just as susceptible to illness as other parts, like hearts or stomachs or lungs. They underscore the fact that “mental health issues are common and nothing to be ashamed of,” says Emily Leetham, who coordinates local Mental Health First Aid (MHFA) and Youth Mental Health First Aid (YMHFA) Trainings. 4 | RMPARENT
Kim Sharpe
WHEN TO BE CONCERNED Mental health issues often are hard to detect, especially in children, because sometimes they’re written off as normal developmental phases or willful bad behavior. In teens, symptoms of mental issues often are confused with the moodiness and rebellion they sometimes display that’s related to drastic hormonal changes and trying to navigate the journey from childhood to adulthood. North Range Behavioral Health offers an extensive list of symptoms at: www.northrange.org. Symptoms that suggest a child may be struggling with mental-health issues include:
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Recurring bad dreams Headache or upset stomach that happens repeatedly, but doesn’t appear related to illness Destroying toys and other items Persistently disruptive behavior at school or home with little understanding of consequences Being very afraid of certain places, people or things
roblems with learning, including at P school or about routines at home Eating problems, both eating too much and eating too little Persistent conflict with others
Additional behaviors that suggest a form of treatment might be helpful for teenagers include:
Sadness or moodiness that lasts a week or more Overly-sexualized or promiscuous behavior Angry or assaultive behavior Persistent school problems, including truancy, failing, problems with peers Not being motivated for school, hobbies or friends Statements about not wanting to live or efforts to hurt him/herself or others Hurting animals or being deliberately mean to younger children or older adults Involvement with law enforcement, including stealing, assault, lying, or vandalism Delinquent behavior, gang involvement Running away from home or school Changes in sleeping habits Repeated lying.
GET HELP
Receive mental health, substance use or emotional support for you or someone you know… u Emergency (for police, ambulance, etc.) – 911 u National Suicide Hotline – 1-800-273-TALK (8255) u Colorado Crisis Support Line – Available 24/7/365. Call 1-844-493-TALK (8255) or Text TALK to 38255. u Colorado Crisis Services – http://coloradocrisisservices.org. Offers local care to people of all ages in behavioral health crisis: In Larimer County at 1217 Riverside Ave., Fort Collins. 970-494-4200. In Weld County at 928 12th St., Greeley. 970-347-2120. u Mobile Crisis Units are available to travel across Weld and Larimer Counties to reach people in crisis and transport them to services. Call 970-494-4200 in Larimer or 970-3472120 in Weld County to reach a local Mobile Crisis Unit.
More Local Resources u Child, Adolescents and Young Adult Connections (CAYAC) – 970-221-3308 www.mentalhealthconnections.org.
u Clear View Behavioral Health – Serving the Loveland/Johnstown are of northern Colorado. www.clearviewbh.com, 970-461-5061.
u Heart-Centered Counseling – Same day appointments in Fort Collins, Greeley and Loveland. Accepts Medicaid, Medicare and all major insurances. www.heartcenteredcounselors.com, 970-310-3406.
u Mental Health Connections – A partnership between the Health District of Northern Larimer County and SummitStone Health Partners. 525 W. Oak St. (located inside SummitStone Health Partners), Fort Collins. Walk-ins: 8am-4pm. Phone help available 24 hours: 970-221-5551. u North Range Behavioral Health – Serving Weld County communities. www.northrange.org, 970-347-2120. u SummitStone Health Partners – Serving Larimer County communities with locations in Fort Collins, Loveland and Estes Park. www.summitstonehealth.org, 970-494-4200.
“Parents and teachers are often the first adults to notice when a child is struggling with mental health, however, other family members, coaches, youth leaders, social service workers, etc., might notice issues, too,” says Leetham. That’s why she feels “anyone and everyone” should become better educated about mental health and can benefit from taking a Mental Health First Aid course. “It was created to lessen the stigma around mental health issues and to encourage people to seek care and help.” MENTAL HEALTH FIRST AID MHFA is an eight-hour course that gives people the skills to recognize warning signs for mental health or substance use problems, as well as the tools to help someone who may be developing a mental health-related problem or experiencing a mental health crisis. YMHFA is primarily designed for adults who regularly interact with young people, such as parents, family
members, caregivers, teachers, school staff, peers, neighbors, health and human services workers, and other community providers. The Health District of Northern Larimer County and Connections Mental Health and Substance Abuse Resources will offer YMHFA trainings on Friday, Feb. 24, and Thursday, March 23, 8am-5pm, at the Health District, 120 Bristlecone Drive in Fort Collins. The training is free, but space is limited. (For more information or to reserve a spot, contact Emily Leetham at 970-494-4370 or eleetham@healthdistrict.org.) Summitstone Health Partners and North Range Behavioral Health also frequently offer the trainings. Check their websites or call for upcoming training dates and details. “We all just want to make sure everybody has the opportunity to equip themselves with the tools to reach out and offer support when they see a kiddo struggling,” says Leetham.
A COMMUNITY THAT CARES Many other groups are working to raise awareness about mental illness and the resources available to help people in need. The Child, Adolescent and Young Adult Connections (CAYAC) is a grant-funded service that helps youth and their families identify mental health and substance use concerns and get connected to proper care. It’s a partnership between Summitstone, the Health District and Poudre School District. Since its establishment in August 2016, its team has helped 300 families. “We know oftentimes families have no idea where to go for help when they have a child acting out in class, who’s labeled as stubborn or bad,” says Kristen Cochran-Ward, CAYAC coordinator. “We want parents to know resources are available to help them when they feel at their wits end. We can help connect them to those resources.”
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Breastfeeding for a great start Celebrate the beauty of breastfeeding LY N N U. N I C H O L S
C
hoose breastfeeding to give your baby a great start. Celebrate that your body not only grew a baby, it’s also providing all the food your baby needs until about six months of age. Now that’s the real beauty of breasts. If you are currently breastfeeding or you did when your kids were young, give yourself a pat on the back for providing a slew of benefits to not only your baby, but to yourself. Babies who are breastfed have fewer infections, skin diseases, allergies and digestive problems. Celebrate the literal boost you’ve given your child to start life on the right track, as breastfed babies have higher IQ scores. Finally, breastfed babies are at a lower risk of developing high blood pressure, diabetes and obesity later in life, and they have a lower incidence of some forms of cancer. You are also taking care of yourself by breastfeeding. Women who breastfeed have a lower likelihood of ovarian cancer and premenopausal breast cancer. It also lowers your risk for long-term obesity, reduces your risk for postpartum bleeding, and the biggest obvious bonus—helps you return to your prepregnancy weight faster. High five to you! SUPPORT YOURSELF BY SEEKING SUPPORT While all these perks for you and your baby sound great, you may feel unsure about your potential success with breastfeeding. All area hospitals have lactation specialists or nurses especially trained in breastfeeding available to new moms. Take advantage of them. Establishing good latch-on techniques from the start reduces the chance of sore nipples and speeds up milk production. While sore nipples, leaking and clogged milk ducts do occasionally occur, they can be worked through early on to get you on track again. Most moms experience some soreness when first starting to breastfeed. If the soreness becomes more severe, 8 | RMPARENT
seek help from a lactation specialist immediately—some insurance companies pay for home visits or call your local hospital for free- or reducedrate services. A lactation specialist can come to your home and help you learn to position yourself and your baby in your own favorite chair or couch. If your baby is born early or has health problems and ends up in the neonatal intensive care unit, your road is harder, but you can do it. There are several resources for moms in this situation. In most hospitals, moms can come in and breastfeed whenever they want and pump to provide breast milk to be fed to their child through a feeding tube or bottle. If you are looking for assistance or just camaraderie with other breastfeeding moms, try La Leche League, friends who have breastfed, and breastfeeding support groups and classes at local hospitals. BEASTFEEDING IN PUBLIC Another reason to give yourself kudos is for breastfeeding in public, even if it can feel uncomfortable at times. When you
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think about it, why should it? Your body is simply doing what it’s meant to do. In the state of Colorado, wherever a mom is allowed to be she can breastfeed. Once breastfeeding becomes second nature, you realize how wonderful it is to have a ready supply of milk with no worries of whether or not you brought a bottle and kept it safe from contamination, or having to rush home when the next feeding time comes around. If you feel funny about going out in the world with a hungry baby, here are some tips to make it easier: Practice at home in front of the mirror, avoid draping a big blanket over you as you’ll likely feel more conspicuous—try a bulky shirt instead. Or try the cape that’s available, with an opening at the neck to easily view your baby but still have some cover up. A pro-tip: Buy a front-facing baby backpack that puts your baby’s head facing your breast for easy, inconspicuous access. Breasts are beautiful! No doubt your baby thinks so and is grateful for the good nutrition, cuddles and closeness breastfeeding brings.
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Finding fertility
…the second time around LY N N U. N I C H O L S
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t seems a no brainer that if you want a second or third child, it will happen easily, right? After all, you know you can get pregnant and carry a baby. Yet, it’s fairly common that couples have a hard time getting pregnant the second time around. Several factors play in, including the food you eat. The good news is there are things you can do to boost your fertility. CHANGE HABITS, INCREASE CHANCES According to the Cleveland Clinic, several factors make it hard to get pregnant again. The first is age—the only one you can’t control—as women in their mid to late 30s and older have fewer eggs. Being overweight is also a barrier to getting pregnant, for both you and your partner. Extra weight in women means higher levels of testosterone that can inhibit ovulation; in men, extra pounds increase estrogen levels, reducing sperm counts. Then there’s alcohol. People who have more than seven drinks a week are less fertile, because alcohol may disrupt hormones and hinder sperm production and motility. Of course, smoking is off the list as it can damage sperm and eggs. CUT BACK ON COFFEE AND ALCOHOL You know alcohol isn’t great because of what it may do to your hormones, but there’s another reason you shouldn’t drink a lot when trying to conceive— alcohol is a diuretic. In other words, it makes you pee a lot, which dehydrates you. The same is true for caffeine, so limit coffee, soft drinks, energy drinks and black tea. Also skip diet sodas, because artificial sweeteners can mess with your hormone balance. Being dehydrated makes it harder to get pregnant. Dehydration dries a woman’s cervical fluid and a man’s ejaculate fluid. Switch to herbal teas, as some are thought to increase fertility including maca, red raspberry leaf, nettle 10 | RMPARENT
and dandelion, but avoid ginseng and licorice teas. ADOPT A MEDITERRANEAN DIET Eating whole, real foods close to the source like fruits, vegetables, nuts, seeds and whole grains, along with limiting your meat intake, helps you become more fertile. A study in Spain of 2,000 women found that only 17 percent of women who ate a Mediterranean diet had problems with fertility, compared to 26 percent of women who ate a lot of fatty meats and processed foods. A Harvard School of Public Health study of over 18,000 women also found that women who ate a diet that was high in meat, carbohydrates and trans fats were more likely to have trouble with ovulation. Switch out meat for a plant-based source of protein, such as nuts or beans for better luck at getting a baby bump. SKIP THE SOY Soy is a phytoestrogen, which disturbs hormone levels for both you and your partner. You may not realize it, but energy bars are often packed with soy lecithin. Other foods that contain
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phytoestrogens are sesame seeds, wheat berries, barley and oats. When trying to conceive, it’s wise to avoid raw fish (think sushi), runny or undercooked eggs and fish that might have high mercury, including swordfish, orange roughy and yellowfin tuna. On the other hand, eating fish is important because it’s loaded with Omega-3s, an important nutrient for a developing fetus. Eat low mercury fish including catfish, shrimp and salmon. If you are actively trying to get pregnant, taking a prenatal vitamin now is wise. While you are at it, buy your partner a good multivitamin, as certain nutrients, including vitamins C and E, L-Carnitine, zinc and folic acid, boost sperm production. WEAR LOOSE SHORTS Has your husband taken up biking and does he really sweat it up in his bike shorts? If so, he’s heating up his testes and thereby reducing his sperm count. The same is true for men who take testosterone supplements. While changing your lifestyle habits isn’t easy, it is possible. Wanting to get pregnant again is great motivation to get started.
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PICKY EATING AND MEALTIME EXPLORATION By Northern Colorado Feeding Therapy Team
M
ealtimes can be hard. Getting your child to eat what we think is healthy and needed for a wholsesome diet can be a struggle. As parents, it’s one of the biggest things that we don’t compromise on. We must feed our children and if they won’t eat what we give them, we give them something else. For most children these are occasional battles, but for some this represents a difficult cycle of picky eating that in turn could lead to more problems eating down the road. By focusing on healthy and positive eating habits early on, you are laying the groundwork for a life-long successful eater. Mealtimes are not only a part of everyday routines but are a necessity for growth. They foster the development of expressive/receptive and social language, fine motor and sensory skills. Here at the Northern Colorado Feeding Therapy Team, we see a wide variety of children from the picky eater who just needs a little support to the very medically complex child. Please don’t hesitate to call us with any questions or concerns.
IDENTIFYING PICKY EATING Can you answer yes, to any of these questions about your child? If you can, a discussion with your doctor may be appropriate to determine if a feeding evaluation is needed.
Try these strategies to help make your mealtime more pleasant for all. n Integrate movement before mealtimes to get sensory systems ready to eat. This could be a few jumping jacks, animal walks, a lap around the table or a movement song. n Involve your child in preparing meals with you. Using cookie cutters to prepare foods in fun shapes increases creativity and willingness to explore new foods. n How we perceive the food on our hands is how we expect it to feel in our mouths. Talking and using descriptive words lets children know what to expect. n Children are creatures of habit. Be consistent in your mealtime routines. n Serving meals “family style” involves the entire family and makes it more fun. n Give your child a job for mealtimes. He or she could set the table, decide where people sit, describe the food, pass dishes, be the person that excuses everyone from the table, etc. n Offer new foods 10 different times to increase likelihood of acceptance. Children need multiple exposures to decide whether they like a new food.
n Does he or she eat less than 20 age appropriate foods/flavors? n Does he or she have tantrums or meltdowns at more meals than not?
n Allow a reasonable time to eat, usually 10-20 minutes. Setting a timer can help.
n Does he or she refuse to eat entire categories of foods (e.g. won’t eat puree textures or crunchy foods)? n Do you find yourself often having to make separate meals for him or her?
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