As if parents need another reason to worry about their kids, children spend an average of seven hours a day staring at television, tablet, computer and smart phone screens, reports The American Academy of Pediatrics (AAP).

To make matters worse, virtual violence&mdash;violence that&rsquo;s not experienced physically but still leaves a psychological impact&mdash;is staring children in the face on a regular basis. A 2017 study found that 61 percent of primetime shows the researchers exaamined contained violent scenes, and 39 percent contained gun violence.

Due in part to the prevalence of virtual violence, the AAP has released recommendations for pediatricians and parents guiding children&rsquo;s media use. They suggest, during regular well-checkup visits, pediatricians should discuss a healthy &ldquo;media diet&rdquo; with kids and discourage excessive amounts of screen time, especially games and shows with violence.

Learn more about virtual violence, why it&rsquo;s dangerous for your child and how you can protect your kids from its effects.&nbsp;&nbsp;

How does virtual violence affect kids? 
Violent games and shows make plot lines and intense action all too real for children.&nbsp;<a href="https://www.sharecare.com/health/functions-of-memory/article/risks-too-much-video-gaming">Games</a>&nbsp;and television shows with first-person shooting are especially dangerous not just for young children, but for older kids and teenagers, too, says the AAP. Some might be more affected than others by the health risks linked to virtual violence. Excessive media use&mdash;violent or non-violent&mdash;may lead to:

<ul>
	<li>Sleep problems and nightmares</li>
	<li>Eating disorders</li>
	<li>Anxiety, fear or distress</li>
	<li><a href="https://www.sharecare.com/health/kids-teens-health/article/ask-the-pediatrician-is-child-overweight">Obesity</a></li>
</ul>

Aggression is a hot topic when it comes to kids and virtual violence, too. Research suggests violent video games may increase the risk of aggressive behavior, aggressive thoughts and may make it hard for children to understand others or share their own feelings.&nbsp;

5 ways parents can enforce healthy media habits

<ul>
	<li>Talk to your pediatrician:&nbsp;As the AAP suggests, pediatricians should address a child&rsquo;s &ldquo;media diet&rdquo; during each well-visit exam. With parents present, physicians can discuss the types of games they&rsquo;re playing and how much time they&rsquo;re spending playing them.</li>
	<li>Check video games out for yourself:&nbsp;The only way to know how violent your child&rsquo;s favorite game is to take it for a spin yourself. Experts recommend that parents co-play and co-watch so they can evaluate the game and determine if it&rsquo;s appropriate. Parents cannot rely on the media industry for the proper ratings, says the AAP.</li>
	<li>Implement screen-free areas and monitor usage:&nbsp;Parents should be mindful when it comes to television and screen placement at home. It&rsquo;s best to leave televisions out of kids&rsquo; bedrooms, and to turn it off during dinner and other family events. Always make sure screen time ends one hour before bedtime.&nbsp;&nbsp;</li>
	<li>Enforce time limits:&nbsp;The AAP recommends that children ages two to five only be allowed one daily hour of high-quality entertainment media, like educational games or television shows. Children under six shouldn&rsquo;t be exposed to any type of virtual violence, even cartoon violence, because they have a hard time distinguishing the show or game from reality. If you have young children, ages 18 to 24 months, the AAP suggests limiting their screen time to high-quality programs only, and always watching with them. Kids younger than 18 months should have minimal screen time in general&mdash;this age is critical for their brain development. Children this young should only be allowed to use media for video-chatting; a quick hello to long-distance relatives or family friends on Skype is A-OK.</li>
	<li>Encourage other activities:&nbsp;With so much energy, try to get your child to head outdoors, pick up a book, get some exercise or to try a new hobby.</li>
</ul>

Medically reviewed in May 2018. Updated in August 2019.

How Virtual Violence Can Have a Lasting Impact on Your Child

These creative and nutritious bites will be a huge hit with the little ones.&nbsp;

6 Healthy Party Snacks for Kids

Pertussis, or whooping cough, is a serious respiratory infection that can jeopardize the health of babies, children and adults. Learn all about whooping cough and how vaccinations protect against this illness in this video with Dr. Oz.

What You Need To Know About Whooping Cough

Eat better in a pinch&mdash;fuel your body and boost energy during a busy shift.

A Nurse’s Guide to Eating Well at Work

Babies and toddlers can get into more trouble than you might imagine. Douglass Holtzman, MD, explains the household dangers you should watch out for and how to childproof your home.

7 Things You Haven't Childproofed, But Should

Constant caffeine, skipped workouts and other perils of the late-night worker.

7 Health Pitfalls for Night Shift Workers and How to Avoid Them

From classroom computers to bedroom televisions to the smartphones that seem stuck to their hands, screens have invaded every part of kids&#39; lives. And excessive time spent staring can be bad for their development, no matter their age.

&ldquo;Too much screen time can lead to more behavioral problems, attention problems, a sedentary lifestyle, weight gain and childhood obesity,&rdquo; says Elliot Freed, DO, a family medicine doctor from&nbsp;<a href="https://www.sharecare.com/group/lewisGale-hospital-montgomery">LewisGale Hospital Montgomery</a>&nbsp;in Pembroke, Virginia. For older kids, untold hours spent glued to a display is connected to mental health issues, as well.

Excessive screen time on electronic devices is associated with increased sedentary behavior and may interfere with kids&rsquo; sleep and eating habits&mdash;setting them on the path toward obesity, according to a scientific statement released in August 2018 by the American Heart Association (AHA). The AHA estimates that children age 8 to 18 spend a startling 7 hours or more in front of screens each day.&nbsp;

Screen time among even younger children has also surged over the past two decades. Between 1997 and 2014, daily screen time more than doubled among those younger than 2 years, according to a study published in&nbsp;JAMA Pediatrics in February 2019. In 1997, daily screen time for toddlers averaged around 1.32 hours and included TV and video viewing, video games and time spent on home computers. By 2014, however, young children were spending an average of three hours per day in front of screens as more devices&mdash;including smartphones, tablets and e-readers&mdash;became available.

Many experts are also concerned about the effects of devices on kids&rsquo; brain development. In fact, higher levels of unsupervised screen time (more than one hour per day) was associated with decreased growth of white matter in the brain, according to a study published in&nbsp;JAMA Pediatrics&nbsp;in November 2019 that looked at 3- to 5-year-old children. White matter plays a crucial role in language, literacy and cognitive abilities.

So, in a world where screens are inescapable&mdash;and often a necessary part of day-to-day life&mdash;how can parents and guardians find a happy medium? How can they balance the reasonable, potentially beneficial use of devices in a school setting with recreational use like social media and TV?

Here are some guidelines, plus tips on how to effectively manage your child&rsquo;s screen time use.

Screen time for younger children  
Experts believe screens don&#39;t have many benefits for babies and toddlers. For one thing, interaction with real-live people and objects is crucial to the development of this age group. Excessive screen exposure may detract from that and even cause delays, as well as sleep interruptions. What&#39;s more, babies simply don&#39;t understand what&#39;s happening onscreen.

According to the American Academy of Pediatrics (AAP),&nbsp;children under 18 months should not be exposed to any <a href="https://www.sharecare.com/health/toddlers-development/article/toddlers-tech-too-young">screen media</a>. One exception is video chatting, where they can interact with family members. Between 18 and 24 months, the smallest kids can be slowly introduced to &quot;high-quality&quot; shows as long as a parent or guardian is around to guide them.

Once your child hits preschool&mdash;between the ages of 2 and 5&mdash;the AAP advises no more than one hour of media per day. Since what they see matters, the focus should be on high-quality programs&mdash;think&nbsp;Sesame Street&nbsp;or&nbsp;Mister Rogers&rsquo; Neighborhood. Co-viewing with your child is one way to regulate how long they watch and to help them understand what&#39;s happening onscreen. Educational apps and games are often introduced at this age, as well. Since their efficacy is still being studied, parents should monitor their children&#39;s usage.

In April 2019, the World Health Organization (WHO) released guidelines advising that children younger than five years shouldn&rsquo;t spend more than one hour watching screens per day, stressing that less is even better. The WHO recommends that those younger than 1 year should avoid screens altogether.

Screen time for older children  
As kids get older, screen use becomes more complicated; many need to use computers for school, and the introduction of smartphones opens up a world of social interaction.

Perhaps because of this, the AAP does not set a specific limit on how much children age 6 and above should interact with media. They&nbsp;do, however,&nbsp;say that parents should place limits to ensure kids are not choosing media at the expense of their health. Kids should be sleeping well and getting enough physical activity, and too much time with devices can lead to deficiencies in both areas. While there&rsquo;s plenty of research suggesting that too much time in front of a screen can increase a <a href="https://www.sharecare.com/health/kids-teens-health/article/ask-the-pediatrician-is-child-overweight">child&#39;s risk of obesity</a>, the odds are even higher if they have a TV in their own bedroom.

Too much screen use may contribute to mental health issues, as well. A study published in&nbsp;Cyberpsychology, Behavior and Social Networking&nbsp;in July 2015 showed that children who used devices to check social media for longer than two hours a day had increased psychological problems and increased levels of suicidal thoughts.

How to manage your child&#39;s screen time  
The best solution? &ldquo;Everything in moderation,&rdquo; says Freed. Parents have the ability and responsibility to influence how and when their children interact with media. Here&rsquo;s how:

Create media-free zones:&nbsp;Face-to-face interactions with family members and friends are essential for your child&rsquo;s development. So, designate times and areas of your house that will remain media-free, such as the dinner table, the study area and bedrooms. You can either verbally agree on these hours and places, or they can be written down in what the AAP calls a &ldquo;family media plan.&rdquo; Sites like&nbsp;<a href="https://www.healthychildren.org/English/media/Pages/default.aspx" target="_blank">HealthyChildren.org</a>&nbsp;can help you create these documents and specify restricted and unrestricted media use within your home.

Limit tech use before bed:&nbsp;Freed believes using a phone before bed can stimulate children and cause insomnia or&nbsp;<a href="https://www.sharecare.com/health/sleep-health/slideshow/simple-habits-sleep-soundly">worsened sleep quality&nbsp;</a>in general. He suggests cutting off screen time 30 to 60 minutes prior to bedtime.

Limit extra screen time:&nbsp;Screens have become an integral part of classrooms, as many teachers encourage students to take notes on computers, and many programs or books are only available online. If your high schooler is already spending two to three hours on a screen for class or to complete their homework, you may want to cut down on anything beyond that. &ldquo;Limit extra screen time for the older children who might, out of necessity, need increased screen time,&rdquo; says Freed.

Monitor media use:&nbsp;What your child watches matters, especially when they&#39;re younger. Co-viewing can help, since you can explain what they see.&nbsp;<a href="https://www.commonsensemedia.org/" target="_blank">Common Sense Media</a>&nbsp;is a good resource for parents looking for high-quality programming, or reviews of the shows your kids are already watching.

Encourage exercise:&nbsp;Limiting screen time is important, but exercise is also essential. The U.S. Department of Health and Human Services&rsquo;&nbsp;<a href="https://www.sharecare.com/health/types-exercise/article/health-experts-urge-move-more-sit-less">physical activity guidelines</a>&nbsp;recommend that children older than 6 years of age participate in moderate activity for at least 60 minutes each day, and the activity should be vigorous at least three days a week. Kids and teenagers between 6 and 17 should also incorporate muscle-building and bone-strengthening activities at least three days per week.

Moderate exercise includes brisk walking, hiking and games like baseball, softball and catch, while vigorous activity comprises activities like jumping rope, biking and games like soccer, basketball or flag football.

Young children&mdash;infants, toddlers or preschoolers&mdash;should be allowed unlimited active playtime, as long as they are in a safe environment. Following these recommendations could help reduce your child&rsquo;s risk of heart disease, type 2 diabetes and many more short and long-term health conditions.

Talk about touchy subjects:&nbsp;Whatever your kids&#39; ages, as a parent, you can make sure they&#39;re using media safely, and not engaging in online bullying or interacting with sexually explicit material. Discuss the dangers that online harassment can pose to your child and to other people.

As an adult, it&rsquo;s ultimately up to you to model good tech behavior. In addition to monitoring how your child interacts with media, limiting your own screen time&mdash;while using media wisely&mdash;may be the most effective thing you can do.

Medically reviewed in April 2019. Updated in November 2019.

How Much Screen Time Is Too Much for Kids?

When I was growing up, PB &amp; J was a lunch box staple. But&nbsp;due to the increase in peanut allergies (which&nbsp;have&nbsp;quadrupled&nbsp;in recent&nbsp;years), many schools don&rsquo;t allow children to take peanut products to school anymore for fear of anaphylaxis&mdash;a severe, potentially life-threatening allergic reaction.&nbsp;

But the results from a&nbsp;2015&nbsp;study&nbsp;published in the&nbsp;New England Journal of Medicine&nbsp;found that exposure to peanut products may actually help decrease future&nbsp;<a href="https://www.sharecare.com/health/food-allergies-intolerance/article/what-you-need-to-know-about-peanut-allergies">peanut allergies</a>&mdash;and bring PB &amp; J sandwiches back as a lunchtime&nbsp;standard.&nbsp;

What the research found&nbsp; 
The LEAP (Learning About Peanut Allergy) study released its groundbreaking data showing that introducing peanut butter to babies who were at least 4 months but less than 11 months of age decreased their chance of developing a peanut allergy. In the study, researchers found that kids who avoided peanuts until they were age 5 were up to seven times more likely to wind up with a peanut allergy than kids who ate peanuts at least three times a week.&nbsp;

This helps shed light on the question&nbsp;of&nbsp;when&nbsp;to&nbsp;introduce peanut butter and peanut products to&nbsp;babies and&nbsp;children.&nbsp;

Previously it was recommended that parents hold off on giving kids peanuts and peanut products until they reached 1 to 3 years of age. But as the number of cases of peanut allergies&nbsp;in children continued to grow, we&nbsp;doctors&nbsp;began to wonder if we were creating food allergies by holding off on potentially allergic foods. One striking example:&nbsp;In Israel,&nbsp;where babies and young children&nbsp;often&nbsp;eat a peanut snack called Bamba,&nbsp;the prevalence of peanut allergies was low.&nbsp;

The LEAP study included just over 600 infants at high risk for peanut allergy, determined by whether they were already allergic to eggs or had eczema, which causes skin to become red and itchy. The researchers randomly assigned the children to either receive a peanut protein powder mixed with water three times a week, or to avoid peanut protein completely. They also tested the infants to see if their skin prick test to peanut was negative (not allergic) or mild.&nbsp;

The results were shocking.&nbsp;&nbsp;

In the children who were initially negative (did not have a peanut allergy), 13.7 percent of those who avoided peanut protein developed a peanut allergy. But only 1.9 percent of those given peanut protein three times a week developed a peanut allergy. In&nbsp;those children&nbsp;who initially had a mild allergy, 35 percent in the avoidance group developed a peanut allergy, compared to 10.6 percent in a mildly allergic group who ate a peanut protein. &nbsp;

Introducing peanuts to baby&nbsp; 
This study clearly&nbsp;suggested&nbsp;that&nbsp;introducing&nbsp;peanuts to babies dramatically decreased&nbsp;the risk of developing a peanut allergy.&nbsp;So,&nbsp;in&nbsp;2017&nbsp;the National Institute of Allergy and Infectious Diseases&nbsp;came up with a set of guidelines for introducing peanuts to babies, which was endorsed by the American Academy of Pediatrics&nbsp;(AAP). Their recommendations&nbsp;are:&nbsp;

<ul>
	<li>Babies with a known egg allergy or severe eczema should be tested early for a peanut allergy.&nbsp;When they&rsquo;re between 2 and 4 months old,&nbsp;speak to a pediatrician.&nbsp;Your physician may also request introducing&nbsp;peanuts in a&nbsp;medical&nbsp;office&mdash;as early as 4 to 6 months of age, says the AAP.&nbsp;</li>
	<li>Parents of babies with mild to moderate eczema should speak with a pediatrician first, but&nbsp;their children&nbsp;can generally try peanuts around 6 months old.&nbsp;</li>
	<li>Then there are babies with no eczema or&nbsp;existing&nbsp;food allergy&mdash;and&nbsp;who don&rsquo;t have a raised risk for an allergy. Based on family preference and culture, they&nbsp;can be introduced&nbsp;to peanuts&nbsp;at any time&nbsp;after they&rsquo;ve had a few other solid foods with no allergic reaction.</li>
</ul>

What you need to know&nbsp; 
What I tell my patients is this: Introducing peanut products to your baby starting at around age 6 months is a good idea, but you must be extremely careful. Do not give any child under&nbsp;4&nbsp;years old&nbsp;whole peanuts, as they can be a choking hazard. In terms of peanut butter, it may be difficult (and dangerous) for an infant or toddler to move a glob of peanut butter around his mouth and swallow.  &nbsp;

But older infants, around 8 or 9 months of age, may be able to handle a thin smear of creamy peanut butter to lick off of a parent&rsquo;s finger or on a thin piece of soft bread. Alternatively, you could mix peanut butter into a pureed food (such as oatmeal) that you are already feeding your infant, or mix a small amount into muffins. Be sure to ask your pediatrician or pediatric allergist&nbsp;before&nbsp;introducing&nbsp;peanut products&nbsp;to your baby.&nbsp;

While it&rsquo;s difficult to know exactly how much&nbsp;to give&nbsp;your child (to replicate the amounts in the study), giving your child a taste is a good idea since peanuts are a healthy food. &nbsp;

You may be wondering if you can cause your child to become allergic by introducing peanuts at a young age. The answer is no: The study results show that it can actually decrease the possibility. If your child should develop an allergy after this exposure, it would likely have happened anyway.&nbsp;

And one final note:&nbsp;<a href="https://www.sharecare.com/health/food-allergies-intolerance/article/everything-you-need-to-know-about-food-allergies">Allergic reactions</a>&nbsp;can vary from mild&mdash;such as dry, itchy skin&mdash;to hives, facial or lip swelling or trouble breathing. If there is swelling or trouble breathing seek medical help immediately.&nbsp;

Meanwhile, I&rsquo;m mixing some peanut butter into my 6-month-old&rsquo;s oatmeal. Yum! &nbsp;

Medically&nbsp;reviewed&nbsp;in March 2021.&nbsp;

Sources:&nbsp;

FARE. &ldquo;Facts and Statistics.&rdquo; 2021. Accessed March 5, 2021.&nbsp; 
G&nbsp;DuToit, G Roberts, et al. &ldquo;Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy.&rdquo; New England Journal of Medicine. February 26, 2015.&nbsp;372:803-813.&nbsp; 
Sarah&nbsp;DeWeerdt. &ldquo;The peanut snack that triggered a fresh approach to allergy prevention.&rdquo; Nature. December 2, 2020.&nbsp;Accessed March 5, 2021.&nbsp; 
Claire McCarthy. &ldquo;Peanut Allergies: What You Should Know About the Latest Research &amp; Guidelines.&rdquo; American Academy of Pediatrics. January 17, 2020.&nbsp; 
Amanda Cox. &ldquo;When can I start giving my baby peanut butter?&rdquo; American Academy of Pediatrics. March 17, 2019.&nbsp; 
American Academy of Pediatrics. &ldquo;AAP Clinical Report Highlights Early Introduction of Peanut-based Foods to Prevent Allergies.&rdquo; March 18, 2019. Accessed March 5, 2021.&nbsp;

Exposing Kids to Peanuts Early May Prevent Allergy Later

It can sometimes be tempting to shake off schoolyard bullying, saying, &ldquo;Oh, they&rsquo;re just kids, they&rsquo;ll grow out of it.&rdquo; But while it may be widespread, being bullied isn&rsquo;t a childhood rite of passage.

A growing pile of research also suggests that the trauma resulting from all those childhood taunts, social snubs and nasty texts can add up and have lingering effects on victims&rsquo; mental and physical health.

&ldquo;The emotional and physical trauma from being bullied can make people more prone to feelings of anxiety and panic attacks,&rdquo; says Yevgeniy Gelfand, MD, a psychiatrist at <a href="https://www.sharecare.com/group/trident-medical-center">Trident Medical Center</a>, in Charleston, South Carolina. And those reactions don&rsquo;t automatically go away when you graduate from high school.

In the short term, we know that bullying can cause stomachaches, social isolation, trouble sleeping and poor performance in school. A 2017 review of existing bullying studies published in the Harvard Review of Psychiatry suggests, however, that childhood bullying, which occurs during a critical stage of development, raises concerns about some long-term consequences, ranging from poor self-esteem to chronic health issues.

Lasting health effects 
Being bullied is associated with greater odds for a range of chronic health issues&mdash;possibly resulting from the chronic stress victims face, the 2017 review found. Over time, ongoing stress, researchers theorize, could trigger inflammation and alter metabolism, which could even influence gene expression and play a role in the development of certain diseases, such as diabetes and heart disease.

Teens who are bullied may face a greater risk for depression and anxiety disorders, including panic disorder and agoraphobia, a condition characterized by fear and avoidance of anxiety-provoking places or situations, research shows. There is also evidence that some kids who were targeted by bullies may also be at higher risk for <a href="https://www.sharecare.com/health/kids-teens-health/article/words-weapons-bullycide-how-concerned">suicidal thoughts or behaviors</a>, experience more body aches and pains, take longer to recover from illnesses and have trouble dealing with everyday life stressors.&nbsp;&nbsp;

Victims&rsquo; confidence may suffer 
Bullying also can cause long-term damage to victims&rsquo; self-esteem. Students who are tormented in school may drop out before graduation, which could have rippling effects on their future ability to find a job or earn a good living. Even if they stay in school, they may be less likely to participate in extracurricular activities, speak up in class or do well on standardized tests.

This may be partly due to the fact that the victims of bullies may internalize all the abuse that was hurled their way when they were growing up, Dr. Gelfand explains. &ldquo;When someone has low self-esteem and feels that the world is not their oyster, that it&#39;s a scary and dangerous place, they tend to lead very secluded lives or they don&#39;t engage in certain activities and they shy away from experiences that could be beneficial for them,&rdquo; he says.

If they were excluded from friend groups, bullying victims may not have been able to fully develop important social skills, Gelfand adds, and their misguided notion that they are unlikeable may persist for years to come.

Ongoing bullying linked to PTSD 
Kids who experience chronic bullying can experience the same kind of <a href="https://www.sharecare.com/health/post-traumatic-stress-disorder/article/post-traumatic-stress-disorder-ptsd-what-you-need-to-know">post-traumatic stress disorder</a> (PTSD) that survivors of other types of abuse suffer, according to Gelfand. &ldquo;When someone feels like they are in danger all the time, that can result in PTSD,&rdquo; he says.

Over time, children and teens who are constantly bullied may feel weak or helpless. This loss of empowerment, which is often associated with trauma, can chip away at victims&rsquo; sense of self. PTSD in children can become a chronic health issue, which is also associated with depression, anxiety and substance abuse.

Research conducted by the National Institute of Childhood Health and Human Development supports the link between being bullied&mdash;and bullying others&mdash;and an increased risk for depression.

Your past does not have to determine your future 
Whether or not childhood bullying leads to a long-term mental or physical health issue also depends on the severity and duration of the abuse, the resilience of the victims and whether or not they have the support of friends and family.

Not every person who has been bullied is destined to lead a life of quiet desperation, however. Success stories include pop star Rihanna, entrepreneur Elon Musk and Olympian Michael Phelps, who have all spoken publicly about being bullied as children.

Getting the help you need to work through your trauma can help you take your life back from the bullies who tormented you years ago, says Gelfand. He advises those struggling with the long-term effects of bullying to take some proactive steps, such as the following.

Ask your doctor to recommend a therapist. <a href="https://www.sharecare.com/health/mental-health-therapies/slideshow/therapy-work-psychiatrist-breaks-down-facts">Cognitive behavioral therapy</a> (CBT) can be an extremely helpful tool for working through fears and anxieties, says Gelfand. &nbsp;&ldquo;CBT teaches people very important skills, such as to how to evaluate their own fears, how to address cognitive distortions and &lsquo;all or nothing&rsquo; statements, like &lsquo;I will never be good for anybody.&rsquo; It can really help rewrite any negative beliefs, or at least help you notice when these negative beliefs are triggered and to learn not to let that dictate your actions,&rdquo; he says.

Find a support group. Talking about your trauma with others can help you feel less alone, says Gelfand, who runs a group-therapy program for adults in Charleston. &ldquo;Even people who are suffering from social anxiety as a result of their childhood experience with bullying can little by little begin to engage with the group,&rdquo; he says. &ldquo;They warm up and do really well, so a group venue is also valuable for this.&rdquo;

Consider medication. In some more extreme cases, if the trauma from bullying has left such deep emotional scars that it has caused severe depression or anxiety, antidepressants or anti-anxiety medications can be a game-changer, says Gelfand.

It&rsquo;s important to know the <a href="https://www.sharecare.com/health/depression/article/depression-symptoms-shouldnt-ignore">warning signs of depression</a>, which can manifest in a variety of ways. Someone with depression may experience one or more of the following symptoms:

<ul>
	<li>Feeling sad, hopeless or &ldquo;empty&rdquo; for a prolonged period of time</li>
	<li>Loss of interest or pleasure in hobbies and once enjoyable activities</li>
	<li>Being irritable and less social or withdrawn</li>
	<li>Changes in appetite or sleep habits</li>
	<li>Feeling guilty, worthless or helpless</li>
	<li>Loss of energy</li>
	<li>Moving less quickly or talking more slowly</li>
	<li>Memory problems</li>
	<li>Difficulty concentrating or making decisions</li>
</ul>

If you start to recognize any of these behaviors, it&rsquo;s important to reach out to a healthcare provider (HCP) for help.

Medically reviewed in December 2019.

Sources: 
Pablo Patricio Zarate-Garza, MD; Bridget K. Biggs, PhD; et al. &ldquo;How Well Do We Understand the Long-Term Health Implications of Childhood Bullying?&rdquo; Harvard Review of Psychiatry. March/April 2017. 
Randy A. Sansone, MD and Lori A. Sansone, MD. &ldquo;Bully Victims: Psychological and Somatic Aftermaths.&rdquo; Psychiatry. 2008 Jun; 5(6): 62&ndash;64. 
Boston&rsquo;s Children&rsquo;s Hospital. &ldquo;Bullying | Symptoms &amp; Causes.&rdquo; 
William E. Copeland, PhD; Dieter Wolke, PhD; Adrian Angold, MRC Psych; et al. &ldquo;Adult Psychiatric Outcomes of Bullying and Being Bullied by Peers in Childhood and Adolescence.&rdquo; JAMA Psychiatry. 2013;70(4):419-426. 
Mayo Clinic. &ldquo;Agoraphobia.&rdquo; 
Dieter Wolke and Suzet Tanya Lereya. &ldquo;Long-term effects of bullying.&rdquo; Archives of Disease in Childhood. 2015 Sep; 100(9): 879&ndash;885. 
National Institute of Child Health and Human Development. &ldquo;How does bullying affect health and well-being?&rdquo; 
Stopbullying.gov. &ldquo;Effects of Bullying.&rdquo; 
Stefanos Stylianos Plexousakis, Elias Kourkoutas, Theodoros Giovazolias et al. &ldquo;School Bullying and Post-traumatic Stress Disorder Symptoms: The Role of Parental Bonding.&rdquo; Front Public Health. 2019; 7: 75. 
Stanford Children&rsquo;s Health. &ldquo;Posttraumatic Stress Disorder (PTSD) in Children.&rdquo; 
National Institute of Mental Health. &ldquo;Depression.&rdquo;

Childhood Bullying Has Lasting Health Consequences

When you get on the road with your children, there are lots of things that you probably view as the biggest threats to your safety: traffic conditions, the weather, other drivers swerving in front of you or changing lanes like maniacs. But there&rsquo;s another thing that poses a major threat -- and you may be surprised to learn that if you drive when you&rsquo;re distracted, it&rsquo;s you.

A recent study in the journal Academic Pediatrics found that of the parents interviewed with children ages 1 to 12, 90% admitted to having one or more distractions while driving in the past month, including <a href="https://www.sharecare.com/health/safety-preparedness/dangerous-drive-talking-cell-phone">talking on a cell phone</a>, changing a DVD, giving food to a child, picking up a toy or game, brushing hair and using an electronic navigation system.

The fact that parents are taking their eyes off the road (it&rsquo;s not all about <a href="https://www.sharecare.com/health/parenting-teens/what-dangers-texting-while-driving-teens">texting teens!</a>) is frightening, and so are the statistics. According to the National Highway Traffic Safety Administration, distracted driving has caused 27,000 deaths since 2009, with 448,000 people injured in motor vehicle collisions involving a distracted driver in 2009. While statistics for children are not separately broken out, they are most definitely included.

So what to do? Other than never take your children in the car until they&rsquo;re 18 (hmmmm &hellip; duly noted but highly impractical), <a href="https://www.sharecare.com/health/safety-preparedness/what-is-distracted-driving">recognition of the danger</a> is the crucial first step. While many drivers are aware of the grim statistics, they think they don&rsquo;t apply to them (part of that magical thinking we all give into from time-to-time&mdash;it won&rsquo;t happen to me!).

But it can. Here are four &ldquo;musts&rdquo; to follow when you&rsquo;re behind the wheel:

<ol>
	<li>Avoid &ldquo;distraction overload&rdquo;: When the baby&rsquo;s screaming as I&rsquo;m driving down the highway there&rsquo;s not much I can do to prevent her screaming from distracting me. I&rsquo;m distracted! But I can avoid adding more distractions by using my phone (to tell hubby to hurry up and heat her food!) or reaching back to try to appease her.&nbsp;</li>
	<li>Pull over: Often, a quick pull-off can address the problem (dirty diaper? Dropped passy? Needs a sippy cup?). I know it&rsquo;s annoying to further delay the trip (especially when you&rsquo;re already 90 minutes late because it takes an hour to get out of the house with a baby). But in this case it&rsquo;s better to be late(r) than sorry.</li>
	<li>Let it be: Sometimes it&rsquo;s best to just let them cry/be thirsty/live without their favorite toy for a few moment &ndash; I promise, it won&rsquo;t permanently damage their psyche. Or harass their sister (hey, I was once a harassed sister so I don&rsquo;t take this lightly.) Turning around and taking your eyes off the road for even a few seconds to avoid a minor catastrophe only puts you at risk for a major one.</li>
	<li>Set a good example. Worried about your soon-to-be-driving teen talking and texting while she&rsquo;s driving? Then give her a good example to emulate. And that means NOT checking your phone at stop signs and red lights or <a href="https://www.sharecare.com/health/safety-preparedness/text-while-driving">texting and driving</a> yourself. In fact, to be truly safe and resist the temptation, mute it or turn it off until you reach your destination.</li>
</ol>

As an ER doctor, I know too well what it&rsquo;s like to treat traffic accident victims -- and to share terrible news with family members. For everyone&rsquo;s sake, let&rsquo;s all take a vow to keep our eyes on the road and our hands on the wheel. It&rsquo;s the only way to go!

Medically reviewed in January 2020.

The Latest Road Risk? Parents Who Drive Distracted

Every summer, news stories trend about children dying after being left in hot cars. Upon reading these, many parents have a similar reaction&mdash;how could anyone forget their child in that way? Unfortunately, the death of a child due to vehicular heatstroke happens to even the most responsible caregivers, during any time of the year.

According to data compiled by Noheatstroke.org, an initiative from the Department of Meteorology and Climate Science at San Jose State University, an average of 37 children die from vehicular heatstroke annually. More than half are under 2 years old. It&rsquo;s the leading cause of non-crash related vehicular deaths in kids 14 and under.

At some point, every driver becomes distracted and stressed. Instead of thinking that this could never happen to your family, take a moment to consider how children can be left in vehicles and ways to prevent it.

Ways kids get trapped in cars 
Over half of vehicular heatstroke cases occur when a parent or caregiver forgets that a child is in the car. These cases&mdash;which are labeled as unintentional&mdash;happen when routines are changed, a driver is distracted, or a different caregiver is in charge of a drop-off. Once they reach their destination and park the car, these drivers can leave without realizing anyone is still in the vehicle.

Still, there are other ways children can be unintentionally left in a car. According to the National Highway Traffic Safety Administration (NHTSA), nearly 3 in 10 heatstroke deaths in children occur when they gain access to a parked vehicle left unlocked. Kids may climb in to play or retrieve something but may not be able to get themselves out of the car.

Finally, many parents and caregivers are simply misinformed about the danger of leaving a child in a vehicle. Cars can heat up very quickly, even when outside temperatures are in the high 50s or low 60s. A car&rsquo;s internal temperature can increase by 20 degrees in just 10 minutes. Cracking windows or running the air conditioner while the engine is turned off in a parked vehicle is not enough to cool it down. Youngsters should never be left unattended, even for trips that you think could take a minute. A short errand can always become delayed, causing them to be unattended longer than anticipated.

How heat affects young kids 
While <a href="https://www.sharecare.com/health/injuries-wound-trauma/article/headache-clammy-skin-signs-overheating">extreme heat</a> can be dangerous for people of any age, younger children tend to have high risk for heatstroke. Their bodies can absorb heat quicker, and they don&rsquo;t sweat at the same rate as adults, making them unable to cool their skin as rapidly. Their metabolisms also function more quickly than those of adults, producing more body heat.

Once a child&rsquo;s internal body temperature reaches 104 degrees Fahrenheit, organs begin to fail. At 107 degrees, they could die. If left in a hot car, it does not take long for their body to reach these extreme temperatures.

If your child has been trapped in a hot vehicle, look for warning signs of heat illness, including hot skin, feeling faint, nausea, vomiting, fever, intense thirst, not urinating, headache, confusion and muscle spasms and cramps. If you observe any of these symptoms, call your pediatrician immediately.

Steps to prevent vehicular heatstroke 
There are precautions any parent or caregiver can take to assure that this type of tragedy does not happen to their family.

Always lock your car at home. Once you&rsquo;re inside your home, keep your keys in a secure location that children cannot reach. This prevents kids from finding their way into a parked car to play, accidentally trapping themselves inside. Let them know that cars should not be used for games.

Take your child out of the car at every stop. Even if you plan to dash in and out of a store, unbuckle your kid and carry them in with you. Even a minute in a car alone could be deadly.

Be alert when leaving your vehicle. End all phone conversations before you step out of your car. Make it a habit of looking into your windows instead of rushing off to work. The stress of starting the day can make us forgetful, so practice a routine that allows you to be mindful of your surroundings and responsibilities.

Keep your belongings in the backseat. Whether it&rsquo;s your bag, a cell phone, or even a shoe, keep an essential item that you wouldn&rsquo;t leave without behind your seat. If your car has remote start, consider putting the key in the backseat too. The NHTSA suggest placing a stuffed animal in the front seat when your child is in the back as a reminder.

Use technology and motion sensors. Some new car models and car seats now come equipped with technology that alerts parents when a child is left in a vehicle. Other cars may also have alarms that will go off if any motion is detected around or inside the automobile. Technology is not foolproof though, and a sleeping kid often doesn&rsquo;t set off an alarm.

Have your daycare or caregiver call if your child is late. This may trigger a reminder if your child is left in a perilous situation. If you are tasked with dropping off your child when it&rsquo;s not normally part of your routine, have a spouse, parent or friend text you that morning to make sure everything went according to plan. If someone else is taking your kid to school, check in with them.

Finally, take action if you see a child in a car. Call 911 if you suspect a child may be in danger and wait until help arrives. Many people don&rsquo;t want to meddle, but quick action could be the key to saving a child&rsquo;s life.

Medically reviewed in July 2018.

Why So Many Children Are Left in Hot Cars—and How to Prevent It

About 1 in every 700 babies in the US is born with this chromosomal disorder every year.

7 Things You Should Know About Down Syndrome

Physical punishment&mdash;punishment that involves spanking, slapping, hitting or pulling, also known as corporal punishment&mdash;is one way parents discipline their kids. But spanking and other physical forms of discipline may have lasting consequences for children&rsquo;s health and wellbeing.

A 2018 study published in the Journal of Pediatrics found that kids who were spanked, slapped or struck with an object as a form of punishment were more likely to have recently committed <a href="https://www.sharecare.com/health/relationship-abuse/slideshow/lasting-impact-physical-abuse">dating violence</a>.&nbsp;The study&rsquo;s authors surveyed 758 young people between the ages of 19 and 20-years old to draw that conclusion.

Other studies suggest that physical punishment is not even effective, and could take a toll on children&rsquo;s development. Physical discipline may also be associated with certain mood and anxiety disorders, substance abuse and personality disorders, according to the American Academy of Pediatrics. A 2019 study, published in JAMA Network Open, supports this view. For the study, researchers analyzed data on 36,309 adults from the National Survey on Alcohol and Related Conditions. They found those who were subjected to child maltreatment, such as physical, emotional and sexual abuse or neglect, were more likely to exhibit antisocial behavior later in life. The same was true however, for those who weren&rsquo;t abused or neglected as kids but experienced harsh physical punishment, such as pushing, grabbing, shoving, slapping or hitting. The study&rsquo;s authors speculate that child abuse, physical punishment or both could account for nearly half of all antisocial behaviors among men and women in the United States.

So why are some parents still using this form of punishment and how bad is it really?

We talked to Felicia Nevarez, LCSW, a social worker at <a href="https://www.sharecare.com/group/medical-city-healthcare">Medical City Green Oaks Hospital</a> in Irving, Texas, to understand more about how physical punishment impacts a child, and the ways she recommends parents approach discipline instead.

Physical punishment: What is it exactly, and why exactly do parents use it? 
Physical punishment can be described as a type of punishment used to correct a child&rsquo;s behavior by way of physical force meant to cause pain or discomfort, says Nevarez. Spanking is one of the most common forms of physical punishment, but here are some of the others:

<ul>
	<li>Slapping, pinching or pulling</li>
	<li>Striking with an object like a paddle, belt, hairbrush, whip or stick</li>
	<li>Forcing a child to eat soap, hot sauce or any other unpleasant ingredients</li>
</ul>

Why do some parents choose to discipline their children this way? The answer to this question isn&rsquo;t a simple one. According to the 2015 Parenting in America report from the Pew Research Center, one out of six parents admit to using spanking as a form of discipline some of the time.

There are many factors at play when we talk about just how many parents are still using physical punishment&mdash;race, geographical location, college education and a history of physical punishment are all factors. According to the report, African American parents are more likely to spank than white, Asian Americans or Latino parents and those without a college education are more like than those with a bachelor&rsquo;s degree or graduate degree.

Choosing to physically punish your child may seem like the only option, especially if that&rsquo;s how you were punished as a child.

Nevarez hears comments like, &ldquo;I was spanked and I turned out fine&rdquo; all the time&mdash;but the fact of the matter is, it can have long-lasting effects. And, even parents who have tried to steer away from physically punishing their children may revert back to spanking or slapping when they get angry.

Negative impacts of physical punishment 
Over the years, there have been many studies intending to prove physical punishment can have short and long-term health effects on children. And it was in the 1990s when the connection between physical punishment and developmental problems first began.

In 2012, the Canadian Medical Association Journal published the report, Physical Punishment of Children: Lessons from 20 Years of Research, and the general consensus was that physical punishment:

<ul>
	<li>May increase the risk of developmental issues</li>
	<li>Cause aggression, especially towards parents, siblings or other children</li>
	<li>May prevent them from learning how to deal with anger or discomfort, so they revert to physical aggression in stressful situations</li>
	<li>Can confuse them&mdash;they may have trouble understanding why their caretaker is hurting them</li>
	<li>May lead to spousal violence and aggression later in life</li>
</ul>

And the 2019 study suggests that physical punishment and child maltreatment, occurring either separately or in conjunction with one another as a child, are associated with symptoms of antisocial personality disorder such as:

<ul>
	<li>Failure to conform to social norms; repeated commitment of unlawful behaviors resulting in arrests</li>
	<li>Deceitfulness, including repetitive lying, use of aliases or conning others for personal profit or pleasure</li>
	<li>Impulsivity or failure to plan ahead</li>
	<li>Irritability and aggressiveness, as indicated in repeated physical fights and assaults</li>
	<li>Reckless disregard for safety of self or others</li>
	<li>Consistent irresponsibility when it comes to work and financial obligations</li>
</ul>

The bottom line? Research shows that physical punishment does not provide positive benefits related to development or upbringing. In fact, it may even have negative effects during childhood, as well as adulthood.

You have to find the parenting style that&rsquo;s right for you 
Every parent has a different <a href="https://www.sharecare.com/health/mental-health-kids-safety/article/6-tips-for-parenting-a-troubled-child">parenting</a> style&mdash;and every child is completely different (different ages, different personalities and different stages of life) so a parenting style that works for your family, may not work with your neighbor&rsquo;s.

Here are some of the ways Nevarez recommends you approach discipline with your child:

Communicate about rules and expectations: Communicating effectively about what you want your child to do (or not do) is key. Talking through <a href="https://www.sharecare.com/health/family-relationships/rules-should-develop-for-family">family rules</a> (with a positive tone of voice) and why you&rsquo;ve established these rules will help them understand the correct behavior and the reasons you expect it.

Use positive reinforcement: In almost every parenting book, online resource or study, you&rsquo;ll read about the effects of positive reinforcement&mdash;that is, giving your child verbal praise for good behavior.

We all like positive reinforcement. Knowing that our loved ones&mdash;the ones that are caring for us&mdash;are pleased with our actions, makes us feel good, even as adults, says Nevarez. And the same holds true for your career&mdash;it&rsquo;s very likely you respond well to praise, and are motivated to keep up the good work. Kids react in the same way&mdash;if they receive praise for their behavior, that helps them behave appropriately, because they want to please the care taker, she adds.

When they do a good job with something, let them know and let them know why you&rsquo;re proud of them, too. Say things like, &ldquo;I think it&rsquo;s wonderful you&rsquo;re helping your little brother learn to ride a bike.&rdquo; In turn, they&rsquo;ll start to become more aware of what constitutes good behavior.

Give choices and consequences: It can also be helpful to give them choices, explain the consequences for those choices and follow through with those consequences, says Nevarez.

For example, you can say, &ldquo;You can choose to pick up your toys and then we can go outside. Or, you can choose to leave your toys out and later on, you&rsquo;ll have to take time to put things away, which won&rsquo;t leave much time to go outside.&rdquo; This can help the child understand that the consequence occurred because of the choice they made, rather than just because you&rsquo;re giving the consequence.

Stay calm: Whether you&rsquo;re setting rules, talking through consequences or giving praise, you always want to remain calm when talking with your child.

&ldquo;A child can hear anger and frustration in your voice, so if you&rsquo;re calm, they&rsquo;re going to better understand what you&rsquo;re discussing, which will encourage them to make better decisions,&rdquo; says Nevarez.

Parenting is hard work, but you don&rsquo;t have to go at it alone. <a href="https://www.healthychildren.org/english/family-life/family-dynamics/pages/default.aspx" target="_blank">HealthyChildren.org</a>, <a href="https://kidshealth.org/" target="_blank">KidsHealth.com</a> and <a href="https://www.boystown.org/parenting/Pages/default.aspx" target="_blank">BoysTown.org</a> are all great places to connect with other parents and get discipline tips from professionals.

Spank, Slap or Hit Your Kids? Your Parenting Style Could Cause Them Problems Later On

The emergency room is not a place you go to learn about parenting. Yet, after years of working as an ER doctor, during moments ranging from tragic to the happily poignant, I&rsquo;ve picked up a few lessons. Now, as a new parent, I&rsquo;m trying to implement them in my own life and wanted to share them with you. Read on. And leave the Cheetos at home (see #4)!

1. Monkey see, monkey do. <a href="https://www.sharecare.com/health/school-age-child-emotional-health/my-stress-rub-off-children">Your child will mirror your actions</a>, not your words. When children need stitches, they look to their parents. If you&rsquo;re calm (ok, you can be entirely freaking out on the inside, but it&rsquo;s what your child sees that counts), your child has a much greater likelihood of being less terrified. Brave parent = brave munchkin!

2. The best laid plans . . . (you know the rest). Remember that lovely little arts and crafts area you set up at home? Your 4-year-old felt it was the perfect location for placing beads up his nose. So, your afternoon of domesticity is spent with . . . me. In the ER. Positive? We got the beads out. Negative? You&rsquo;ll never be able to look at beads again without nausea. Second takeaway? (This one&rsquo;s a freebie.) Watch your kids whenever they&rsquo;re playing with anything smaller than their nostril.

3. Life moves quickly. Babies and toddlers move even more quickly. Your vigilance has to be nonstop. Anyone who has a child knows that they move the fastest when they seem to be getting into trouble, whether it&rsquo;s entertaining themselves by chewing on an electrical cord or tasting your hairspray. You. Just. Turned. Around. For. One. Freaking. Second! My infant can&rsquo;t even crawl&mdash;she moves in a combination of spinning and rolling over&mdash;yet she gets around quickly when in the direction of danger. How anyone who essentially moves in a series of &ldquo;five-point turns&rdquo; gets anywhere that fast is beyond me. But so it goes.

4. Cheetos equals good prognosis&mdash;and a potentially longer ER stay. One ER where I worked had a vending machine with Cheetos. I knew two things when I walked into the room and saw a happy child with an orange mouth: 1. Their condition wasn&rsquo;t life-threatening (eating Cheetos is apparently just not something you do when your life is on the line) and 2. They were going to have a long ER stay while we waited for the Cheetos to digest before we could sedate them to stitch their cut, fix their fracture, etc. Lesson? If you&rsquo;re <a href="https://www.sharecare.com/health/critical-care/how-prepare-children-emergency-room">taking your child to the ER</a> for any reason, don&rsquo;t let them eat Cheetos or anything else while you&rsquo;re on your way or waiting in the ER!

5. It&rsquo;s all (or at least some) in your head. Who are some of the toughest people on the planet? Kids. I&rsquo;ve seen many a child leave with a cast and a popsicle while an adult with the same injury requires a prescription for Percocet and a note of absence for work. Seeing this really speaks to the power of mindset&mdash;how we view setbacks and how we respond to them.

6. If it crosses your mind that something in your home might be dangerous, fix it. I have seen too many parents who said &ldquo;I just knew that was a hazard.&rdquo; You&rsquo;ll probably never know what injury you averted, and that&rsquo;s ok.

7. No one. No one. Is more crazy protective than a mom. Don&rsquo;t. Cross. Mama. Bear. I appreciate that you would rather have me cut off your own arm than place an IV in your child or perform some other painful treatment, no matter how mild. I really do. You can be an excellent advocate for your child by remaining calm and asking questions. (See item #1.)

8. Delete &ldquo;that will never happen to me&rdquo; from your mindset. When we hear of something tragic, we tend to think that it can happen to &ldquo;other&rdquo; people&mdash;leaving a child unobserved by a swimming pool even for a minute, driving while <a href="https://www.sharecare.com/health/kids-teens-health/article/parents-driving-distracted">looking at your phone</a>. This thinking makes us feel safe. Falsely safe. I&rsquo;ve taken care of enough patients to know that these things can happen to people just like me, just like you. I don&rsquo;t say this to frighten you, but to take away a false sense of security and leave in its place an awareness that will keep you and your family safe.

Life is short. This doesn&rsquo;t require explanation. But I&rsquo;m reminded of this in ways that don&rsquo;t necessarily include the tragic. When I see a parent step up after a child&rsquo;s health scare, or even a little munchkin bounce back after an injury, I&rsquo;m reminded that it&rsquo;s never too soon to make changes, no matter how scary or hard they may be.

8 Lessons I Learned About Parenting in the ER

The classic image of a bully is the freckle-faced rascal teasing a smaller child on the way to school. The reality? Bullying can take many different forms, and kids are experts at hiding it from adults, says Yevgeniy Gelfand, MD, a psychiatrist at <a href="https://www.sharecare.com/group/trident-medical-center">Trident Medical Center</a> in Charleston, South Carolina.

Anyone can be a bully: The star student or &ldquo;teacher&rsquo;s pet&rdquo; who spreads rumors about her rival at school, even the &ldquo;nice&rdquo; boy down the street who closes his bedroom door and posts vicious comments about other kids on social media.

This may be one reason why bullying seems to be everywhere. A survey of 6,117 students in grades 6 to 12 from the National Center for Education Statistics (NCES) found that 20 percent of students ages 12 to 18 were bullied in school during the 2016-2017 school year. The survey, published in 2019, also found that 13 percent of those polled were the subject of rumors, 13 percent were called names, insulted or ridiculed and 5 percent were purposefully excluded from activities&mdash;incidents that may be more likely to go unnoticed by adults and more difficult for young people to verbalize.

But whether it&rsquo;s done in person or online&mdash;by calling names, shoving a kid into a locker or freezing a girl out of her friend group&mdash;bullying is always cruel, always intentional, always creates a power imbalance and is always repeated, adds Michele Borba, EdD, author of UnSelfie: Why Empathetic Kids Succeed In Our All-About-Me World.

Here are four of the more subtle forms of bullying, and what you can do to help your child.

Microaggressions 
Kids who are perceived as &ldquo;different&rdquo;&mdash;because of their weight, sexual orientation or gender expression, physical frailness, socioeconomic status, race or ethnicity&mdash;are more likely to be bullied. This can come across in subtle comments that might not outwardly appear menacing, but that nevertheless &ldquo;create an environment where the child feels unaccepted and put down,&rdquo; says Dr. Gelfand.

Small comments like, &ldquo;I love your sneakers, did your mom buy them at the discount store?&rdquo; or, &ldquo;Why does your lunch always smell like curry?&rdquo; might not seem like outright bullying to a teacher or an observer, but these microaggressions add up over time. &ldquo;These can be difficult to pinpoint, and the person being bullied can even question whether or not they&rsquo;ve misperceived something or ask themselves if it&rsquo;s actually happening,&rdquo; Gelfand notes.

Social exclusion 
Whether your teenager was left off the invite list for a sweet sixteen party (and then spent the night scrolling through everyone else&rsquo;s pictures from the bash), or your 6-year-old is told by a giggling group of classmates that there is no room for her at the lunch table, social exclusion is a common form of bullying in which a child or teen tries to manipulate other kids&rsquo; relationships.

&ldquo;When young kids are learning the ins and outs of society, there is a natural tendency to want to be on top, and sometimes that involves putting other people down or creating a group that&#39;s exclusive, so certain kids get elevated and everyone who is excluded gets pushed down,&rdquo; Gelfand explains.&rdquo; Borba points out that this kind of jockeying for position starts as young as kindergarten and peaks in middle school.

Spreading rumors 
Another insidious form of social bullying is spreading rumors, which can start with whispers in the school hallways, texts or online posts. This is actually one of the most common forms of bullying, with 17.5 percent of girls and 9 percent of boys between 12 and 18 years old suffering from rumor-mongering, the NCES survey showed.

&ldquo;A bully can start spreading vicious rumors, inside and outside of school, and the problem is you might not know who started it, who has repeated it and who has heard it,&rdquo; says Borba. &ldquo;And since no one knows who is spreading it and no one can confirm whether it&rsquo;s true or not, everyone may assume it&rsquo;s true.&rdquo;

Cyberbullying 
The fastest-growing form of bullying takes place on social media&mdash;posting mean-spirited, false or embarrassing pictures and comments about someone on Instagram, Snapchat, group texts or shared gaming sites. The NCES report revealed that 15 percent of the students surveyed were bullied online or via text.&nbsp;&nbsp;

One of the reasons cyberbullying has become so pervasive is that it&rsquo;s so easy, particularly for a bully to hide behind a screen, says Gelfand. &ldquo;You don&#39;t even need to leave the privacy of your own home to bully someone anymore,&rdquo; he says. &ldquo;And when you&rsquo;re in an online forum, you can have a different screen name that isn&rsquo;t linked directly to you, so the bully can feel like he&rsquo;s wearing a mask, and he can say whatever he wants without worrying about retaliation,&rdquo; he adds.

What can parents do? 
It&rsquo;s not always easy to recognize when your child is being bullied, advises Gelfand. &ldquo;If something&#39;s going on, it may just look like they are more withdrawn and not as cheerful as usual,&rdquo; he says. &ldquo;They may just want to stay in their room by themselves.&rdquo;

Rushing home from school to use the bathroom or raid the fridge may be a red flag. Kids who are bullied may be too fearful to use the bathroom or cafeteria at school, adds Borba. Students who are being bullied may act out and, in turn, start bullying their younger siblings.

Changes in eating or sleeping habits, dropping grades and unexplained headaches and stomachaches may also be signs that a child is being bullied. Since less than half of kids report bullying to an adult, it&rsquo;s important to be aware of these <a href="https://www.sharecare.com/health/kids-teens-health/article/words-weapons-bullycide-how-concerned">changes in habits or behaviors</a> and take action. Some steps you can take to support your child include the following.

Bring up the issue in general terms. Suggest a family movie night watching Tina Fey&rsquo;s seminal 2004 movie about bullying, Mean Girls, and use that to start a conversation about what might be going on in your teen or tween&rsquo;s school, suggests Borba. For younger kids, you can say you read an article online about bullying and ask if that kind of thing ever goes on in their school.

Listen without interrupting. Though you may be tempted to jump to express your own anger or offer suggestions right away, be sure to hear your child out, says Gelfand. &ldquo;Giving suggestions right away doesn&#39;t validate their story as much. So, sit down and really listen to what they have to say. They want to be heard and understood and know that someone cares,&rdquo; he adds.

Seek help when needed. If possible, assess the severity of the situation and determine whether or not those involved would benefit from the help of a trained professional, such as a guidance counselor or a mental health professional.

Figure out a safety plan. Pay attention to where and when physical or verbal harassment is happening and make a plan to never allow your child to be alone in those areas if possible, says Borba. &ldquo;Many students tell me they find a safe space in the school library, where they can sit near the librarian and everyone needs to be quiet,&rdquo; she says.

Keep an eye on their screens. If your child is being cyberbullied, saving screenshots of the offending content to help document the abuse and reporting it to the social media platform may help. Keep in mind, this also has the potential to backfire. If your child receives serious threats online, report it to the police.

But you could help prevent cyberbullying in the first place by teaching your children about social networking safety. Make sure they know what cyberbullying is and how it can be hurtful. Be sure that young people never share personal information on social media sites and that they keep their accounts private and never &ldquo;friend&rdquo; strangers. You can also help wean children off their reliance on social media by making a contract of when and how they can use their <a href="https://www.sharecare.com/health/kids-teens-health/article/how-screen-time-too-much-kids">phone, tablet or computer</a>.

Bring in allies. Many kids don&rsquo;t report their bullying because they are afraid of retaliation or being labeled a tattletale. But remind your child that schools have anti-bullying policies, and it is in everyone&rsquo;s best interests to maintain a safe environment. &ldquo;Encourage them to talk to an adult at school and let them know it&rsquo;s totally normal to pursue safety,&rdquo; says Gelfand. (Borba says that in extreme cases, if the school is not willing or able to help, parents should consider switching schools or moving to a new district to protect their child.)

Find a new friend. For social bullying, it may be best to encourage your child to forget about the group of friends that&rsquo;s excluding her or whispering behind her back. Once she shows she doesn&rsquo;t care about being invited to the mall, the bullies will lose their power.

&ldquo;Help your child find at least one loyal friend,&rdquo; says Borba. That may involve signing up for activities outside of school that she loves&mdash;a dance troupe, a horseback-riding club, a computer animation class&mdash;where she can find kids who will bond over a shared interest, far from the influence of the local bullies.

Sources: 
National Center for Education Statistics. &ldquo;Student Reports of Bullying: Results From the 2017 School Crime Supplement to the National Crime Victimization Survey.&rdquo; 
National Center for Education Statistics. &ldquo;Fast Facts: Bullying.&rdquo; 
Stopbullying.gov. &ldquo;Who is at risk?&rdquo; 
American Psychological Association. &ldquo;Unmasking &#39;racial micro aggressions.&#39;&rdquo; 
Stopbullying.gov. &ldquo;What is bullying?&rdquo; 
Stopbullying.gov. &ldquo;Facts About Bullying.&rdquo; 
Stopbullying.gov. &ldquo;What is Cyberbullying.&rdquo; 
Stopbullying.gov. &ldquo;Warning Signs For Bullying.&rdquo; 
Stopbullying.gov. &ldquo;Prevent Cyberbullying.&rdquo; 
Pacer&rsquo;s National Bullying Prevention Center. &ldquo;Cyberbullying.&rdquo;

4 Stealthy Forms of Bullying—and What to Do About It 

One out of four adults will have some type of foot problem in their lifetime, and we imagine that professionals who are on their feet all day (hello, nurses!) are even more likely to have aching tootsies.

Spending a lot of time on your feet can cause major foot discomfort on a daily basis, and may even cause problems like <a href="https://www.sharecare.com/health/plantar-fasciitis">plantar fasciitis</a>, <a href="https://www.sharecare.com/health/foot-and-ankle-conditions/what-are-heel-spurs">heel spurs</a>, <a href="https://www.sharecare.com/health/corns-calluses-and-bunions/what-are-calluses-corns">calluses</a>&nbsp;or <a href="https://www.sharecare.com/health/corns-calluses-and-bunions/causes-of-bunions">bunions</a> down the road. No matter how comfortable the shoe, you still might have pain if you&rsquo;ve been running around the hospital for 12-plus hours. &nbsp;&nbsp;

Prep your tootsies for long hours on your feet, or give them some lovin&rsquo; after your shift with these tips.

Experiment with shoe inserts. 
Shoe inserts help support the ball of your foot, and allow your toes to spread out wider in your shoe when wearing high heels, meaning less pain at the end of the day. Inserts are easy to get, too&mdash;almost any drugstore or mall has a slew of options. It&rsquo;s best to consider the type of pain and the location of the pain before choosing shoe inserts:

<ul>
	<li>Arch supports will support the foot&rsquo;s natural arch, whether your have high or low arches.</li>
	<li>Insoles slide into your shoe and offer cushion and support.</li>
	<li>Heel pads, heel liners and heel cups support and cushion your heel.</li>
	<li>Foot cushions prevent your shoes from rubbing against your heels, toes or sides of the foot.</li>
</ul>

Try orthotics. 
If foot pain is plaguing you and over-the-counter inserts aren&rsquo;t working, prescription <a href="https://www.sharecare.com/health/fitness-apparel-exercise-clothing/what-is-orthotics" style="line-height: 1.6em;">orthotics</a> may be a good fit. Orthotics are custom-made inserts that straighten irregular foot mechanics and help you move better. The devices match the contours of your feet and the way they move.

Your podiatrist will fit you for specific orthotics based on your condition and your level of pain. Functional orthotics correct abnormal structures or motion and can help ease injuries such as shin splints or tendinitis, while accommodative orthotics provide cushioning and support to help with things like foot ulcers or foot calluses. See your podiatrist if you&rsquo;re experiencing extreme pain, and over-the-counter methods aren&rsquo;t working.

Create the perfect foot bath. &nbsp; 
No matter what type of soreness you have, a <a href="https://www.sharecare.com/health/foot-and-ankle-conditions/what-home-remedy-sore-feet">relaxing foot bath</a> after a hard day&rsquo;s work can help ease your pain. Mix all ingredients together and stir the mixture into warm bath water. Let your feet soak for 10 to 15 minutes.&nbsp;

Milk and Honey Foot Bath Recipe 

<ul>
	<li>3 to 5 tbsp. honey</li>
	<li>1 tsp vanilla extract</li>
	<li>2 tsp baking soda</li>
	<li>1 tsp ground cinnamon</li>
	<li>1/2 cup orange juice</li>
	<li>1 cup whole milk</li>
</ul>

Try your hand at massaging. 
You may not be a masseuse, but giving your tootsies a foot rub is sure to help ease the pain. Here&rsquo;s an easy massage recipe that will have your feet begging for more:

<ul>
	<li>Step 1: Wash feet with warm soap and water.</li>
	<li>Step 2: Apply a small amount of sesame or almond oil mixed with lavender essential oil.</li>
	<li>Step 3: Start rubbing at the bases of your little toes.&nbsp;</li>
	<li>Step 4: Apply slight pressure on the flesh between your little toe and the next toe over.</li>
	<li>Step 5: Now move to your middle toe.</li>
	<li>Step 6: Massage, stretch and pull your middle toe in a circular motion, then do the same with your other toes.</li>
	<li>Step 7: With your fingertips or the palms of your hands, gently apply pressure to both sides of your heel just below the ankle, and then rub around your ankle clockwise.</li>
	<li>Step 8: Finally, knead and squeeze your calf muscle to release tension.</li>
	<li>Step 9: Repeat on the second foot.</li>
</ul>

Exercise your tootsies 
While it may be the last thing you want to do after a long day on your feet, you&rsquo;ll be surprised at how much relief you&rsquo;ll get from moving your feet around a bit. Here are a few exercises that will strengthen your feet and help relieve some of the pain.

<ul>
	<li>Exercise 1: Roll a tennis ball under your foot from heel to toe and back again. Keep repeating for one minute on each foot.</li>
	<li>Exercise 2: For a big-toe stretch, take a thick rubber band and place it on your two big toes, pull the toes away from each other and towards your other toes. Hold the pose for five seconds and repeat the move 10 times.</li>
	<li>Exercise 3: Put your rubber band around the toes of each foot, spread your toes apart and hold for five seconds. Repeat 10 or more times.</li>
	<li>Exercise 4: Place towel on floor, grip the towel between your toes and curl towards your body. Relax your grip, and repeat the exercise five times.</li>
	<li>Exercise 5: When you&rsquo;re at the beach, take every opportunity to walk in the sand&mdash;it&rsquo;ll massage your feet and improve your toe strength.</li>
</ul>

5 Simple Ways to Soothe Foot Pain 

Burns, car crashes, concussions and other injuries contribute most to child and teen deaths rates.

These Injuries Send 9.2 Million Kids to the Hospital Each Year

Depression can be hard on anyone, but it&rsquo;s especially tough to watch your own child go through it. And while it is a serious mental health issue that&rsquo;s affecting nearly three million American teens, ages 12 to 17, it&rsquo;s a treatable disorder if diagnosed.

It can be hard to decipher normal teenage irritability from signs of depression. However, if your teen withdraws from family or friends, shows a decline in school performance or seems unmotivated to participate in things they once enjoyed, it might be time to see your healthcare provider. Scott Adams, PhD, Director of Youth Psychology and Quality at the <a href="https://www.sharecare.com/group/the-medical-center-of-aurora">Medical Center of Aurora</a>, explains how parents can help their teens if <a href="https://www.sharecare.com/health/teenager-emotional-health/article/reasons-teen-depressed">they&#39;re showing warning signs</a>.

1. Spend time with your child. 
&ldquo;If you start to notice behavioral or emotional changes or if they&#39;re not acting the way they used to, you can&#39;t ignore it,&rdquo; says Adams. He sees a lot of parents brush off depression as a phase their child is going through, which is the number one thing you shouldn&rsquo;t do. &ldquo;If your gut is telling you that something isn&rsquo;t right or something is off, then pay attention to that,&rdquo; he adds.

An easy way to make sure you&rsquo;re in the loop when it comes to your child is to spend time with them and connect. &ldquo;Try to set aside a time each day to spend with them,&rdquo; says Adams. And the time shouldn&rsquo;t involve the internet, television, social media or any other distractions. Volunteering is a great activity you can do together.

2. Listen to them. 
If your teen is showing warning signs, listening to them is key. &ldquo;You have to ask questions, especially if you&rsquo;re seeing behavioral changes,&rdquo; says Adams. Reprimanding them for acting out probably won&rsquo;t help.

If you&rsquo;re wondering how to talk to them, a non-threating, non-lecturing tone is best. Adams says you want to access and acknowledge their feelings to really understand the stage they&rsquo;re in.

3. Help your child make physical health a priority. 
Poor health habits may make a teenager&rsquo;s mental health worse. Get your teen to make their physical health more of a priority, says Adams. Things like not enough sleep, poor hygiene or nutrition can certainly exacerbate depression symptoms, he adds.

Another tip: make sure their screen time doesn&rsquo;t exceed two hours per day because when they&rsquo;re online, they&rsquo;re not active. &ldquo;Try to make sure that you&#39;re providing them nutritious meals and that you&#39;re giving them the opportunity to get plenty of sleep,&rdquo; says Adams. Encourage them to join the local gym, get out of the house for a game of football with neighborhood friends, or take up jogging.

4. Take care of yourself, too. 
It&rsquo;s easy for parents to focus all of their energy and attention on the adolescent that may be depressed, but that can have unintended consequences, says Adams.

&ldquo;You really need to make sure you&#39;re not spending so much time and energy on the teen who&#39;s depressed that you&#39;re ignoring your own needs and the needs of the rest of your family,&rdquo; says Adams.

His biggest piece of advice? Reach out for support. &ldquo;You need to make sure that you&#39;re reaching out and getting the kind of support you need, so the whole family can make it through this,&rdquo; says Adams. &ldquo;It&#39;s not just an individual child who would be going through this. It affects everybody.&rdquo;

Parents can get help through in person or online support groups. Organizations like <a href="https://www.erikaslighthouse.org/parents/" target="_blank">Erika&rsquo;s Lighthouse</a> and the <a href="https://www.nami.org/" target="_blank">National Alliance on Mental Illness</a> will help you learn more about your child&rsquo;s condition and offer helpful communities to connect with other parents going through the same thing.

5. Reach out for help. 
If left untreated, teenage depression can escalate to self-harm or thoughts of <a href="https://www.sharecare.com/health/suicide-and-suicidal-behavior/article/suicide-warning-signs" style="line-height: 1.6em;">suicide</a>. Adams says it&rsquo;s never too early to seek out help. &ldquo;It doesn&#39;t hurt to utilize trained professionals. This is what they do. This is what they&#39;re exposed to every single day.&rdquo;

When your teen seems depressed, it can be difficult for parents to admit. &ldquo;As a parent, when you get very emotionally involved it can be hard see the forest through the trees,&rdquo; says Adams. Don&rsquo;t be afraid to seek professional help&mdash;the best thing you can do for your child is get them the treatment they need.

Child Health and Development