Babysitting your grandkids can be one of the most rewarding experiences of being a grandparent, but a fun trip can quickly take a turn if the little one gets hurt. Good thing this isn&#39;t your first rodeo! Bumps, bruises, fevers, a choking fit or two&mdash;you&#39;ve seen it all. Or have you?

These days, kids can get into a number of new hazards. In 2013, nearly one in five U.S. children went to an emergency room at least once. Some of those ER trips were likely for the obvious stuff. But here are 6 other health problems that you need to keep on your radar, too.

Breathing problem: You can probably spot a breathing problem, right? Their tummy is moving in and out with each breath, or their muscles and skin between the ribs are sucking in. But watch out for this, too: If your grandchild is having coughing fits or making a high-pitched whooping sound, they may have <a href="https://www.sharecare.com/health/adult-vaccination/article/why-you-probably-need-the-tdap-shot">whooping cough</a>. This disease has made a major comeback in recent years, so be on the lookout. Also, a swollen tongue, throat or lip -- along with trouble breathing -- could mean they&#39;re having an allergic reaction to food or insects, even if they&#39;ve never had one before.&nbsp;

Tummy aches: While you might be tempted to just chalk it up to food sensitivity, stomach pains can point to several potential sicknesses. Call the doctor if your grandchild complains about their tummy and also has a fever, vomiting, diarrhea or lack of appetite. Beeline for the ER if there are signs of drowsiness, a bloated or tender belly, bloody stool, or inability to walk.

Rashes: A harmless rash, say from laundry detergent, will normally clear up on its own in a few days. You should start to worry if it doesn&#39;t, or if your grandchild also has a headache, joint pain, blistering, bleeding, trouble breathing or a fever. Watch out for red, bumpy blotches on the face and behind the ears that come with a fever&mdash;which could be measles. A 2015 measles outbreak that began at Disneyland lasted four months and infected 147 people in several states.

Neck pain: A stiff neck with a high fever could mean your grandchild has meningitis, a sometimes deadly infection that affects the brain and spinal cord. The symptoms can vary, depending on your grandchild&#39;s age, but take them to the ER if there are signs of sensitivity to light, extreme irritability, drowsiness, severe headache, vomiting or difficulty eating. If neck stiffness appears a month or so after a tick bite and comes with flu-like symptoms and a rash, it could be a sign of Lyme disease.

Ingestion: It can be hard to remember just how curious little ones are when you&#39;re not constantly around them. They can find a way to get into bottles of bleach, cleaners or medicine (like from your bag or purse). Call poison control (800-222-1222) and tell them what was swallowed. They&#39;ll be able to tell you if the ER is necessary.

Head injuries: It&#39;s probably time to call 911 if your grandchild is dizzy, sleepy, disoriented or vomiting after any head injury. Tests or CT scans may be needed. 
 
When in doubt, it&#39;s better to be safe than sorry. Talk to the kid&#39;s parents beforehand and find out what they&#39;d like you to do in the case of a medical emergency. Have the pediatrician&#39;s phone number handy, map out the nearest preferred ER, and <a href="https://www.sharecare.com/health/parenting/article/when-parents-are-away-info-every-caregiver-must-have">fill out a consent form</a> with the parents that says you can make medical decisions for the child.

To prevent mishaps during your next weekend together, be sure to put child locks on lower cabinets and place pills out of reach. And always stay up to date on the <a href="https://www.sharecare.com/health/safety-preparedness/article/many-grandparents-dont-have-recent-child-safety-information">latest safety information for kids</a>.

Medically reviewed in December 2018.

6 Reasons Your Grandkid May Need the ER

<a href="https://www.sharecare.com/health/childhood-obesity/help-overweight-children?myAttribute=yay">Healthier weight</a>, greater self-confidence, higher grades, better blood pressure, a quicker brain -- the perks of exercise are as vital for kids as for adults. Too bad so many 8- to 18-year-olds aren&#39;t getting those benefits. Instead, tweens and early teens average nearly 9 hours a day staring at screens, mainly TV or video games. But before you pull the plug, here&#39;s what researchers have found to be the best and worst ways to get kids moving . . . and loving it.

The 4 Best

1. Get that puppy. Kids with <a href="https://www.sharecare.com/video/health-topics-a-z/weight-loss/how-your-dog-helps-you-lose-weight-lower-blood-pressure">dogs</a> watch less TV and are more physically active than those whose families don&#39;t include a canine.

2. Act like they&#39;re the next LeBron James or Mia Hamm. Parents who believe their offspring have athletic ability are more likely to have kids who are physically active. And that belief-to-reality transition starts early: The researchers who found this connection were looking at preschoolers at home, not high school soccer jocks.

3. Be a role model. According to one large study, kids with active parents are five to six times more physical than kids with couch-potato moms and dads.

4. Limit screen time. Don&#39;t put a TV in kids&#39; bedrooms or leave one on when no one is watching. Children whose parents set rules about <a href="https://www.sharecare.com/health/kids-teens-health/limit-child-television-tim">screen time</a> spend about 3 hours less staring at electronics each day than do kids with lenient parents.

The 3 Worst

1. Don&#39;t depend on team sports. Only 24% of kids on soccer, baseball, and softball teams get a full hour of activity -- the recommended minimum -- during practice. Most are inactive for 30 minutes or so.

2. Don&#39;t send small fry to school in fussy outfits or flip-flops. It&#39;ll keep them from zooming around the playground and swinging on the monkey bars. Follow school rules for recess-approved gear.

3. Don&#39;t expect kids to work out like you do. Young minds and muscles are built for stop-and-start action, not a long, steady jog. Think tag, kick the can, or activities with lots of variety, such as walking on a trail dotted with exercise equipment or organizing a game of kickball or Frisbee. That holds until kids are tweens or teens, when rising sex hormones (testosterone, estradiol) prime muscles for sustained activities, such as hikes, swimming laps, or long bike rides.

<a href="https://www.sharecare.com/health/everyday-activities-fitness/how-child-active-school-out">Check out these tips on keeping your kids active while school is out.</a>

Medically reviewed in January 2020.

4 Best—and 3 Worst—Ways to Get Kids Fit

Soccer in 20 minutes? Marching band in 30? Shuttling kids between doctor appointments, play dates and music lessons sometimes means everybody&#39;s gotta eat on the run or not at all. That&#39;s when your no-fast-food promise to yourself usually flies out the car window. No worries. A now-and-then fast-food meal can be had without a humongous overload of fat, sugar, sodium and empty calories. We promise.

The trouble with most pit-stop food isn&#39;t just the fat, salt and calories. It&#39;s what&#39;s missing. Think about it. When was the last time you had a meal to go that included whole grains, fruit and vegetables? In a recent survey of 3,000 children&#39;s meals at chain restaurants, over 95 percent didn&#39;t meet the basic nutritional guidelines for preschool and school-aged kids.

But the good stuff&#39;s out there if you pause for a moment and order smart. One caveat: Excess sodium seems to be a fast-food given. Even in kids&#39; meals, sodium may amount to nearly half or more of their daily limit. So watch how much salt they are eating throughout the day, knowing they&#39;re likely to get more than you like when eating on the run.&nbsp;

Here are six busy-night dinner options that give kids food they like and nutrition they need, minus the junk. They&#39;re listed in order, starting with the healthiest.

1. Subway: Roast Beef Kids Meal; the sandwich (hold the cheese) on whole-wheat bread; apple slices; 100 percent juice 
Calories: 335 (9 from sat fat); sodium: 515; healthy stuff: whole grains, fruit, calcium

2. Burger King: Kids macaroni and cheese, apple fries (skip the caramel sauce), fat-free milk 
Calories: 285 (14 from sat fat); sodium: 490 mg; healthy stuff: calcium, fruit

3. KFC: Grilled chicken drumstick, corn on the cob, unsweetened tea, string cheese 
Calories: 270 (23 from sat fat); sodium: 545 mg; healthy stuff: vegetables, calcium

4. Sonic: Corn dog, apple slices, low-fat milk 
Calories: 355 (45 from sat fat); sodium: 660 mg; healthy stuff: fruit, calcium

5. McDonald&#39;s: Plain hamburger, apple dippers (without the caramel sauce), low-fat milk 
Calories: 385 (45 from sat fat); sodium: 645 mg; healthy stuff: fruit, calcium

6. Panera: Kids Roast Beef Sandwich on whole grain bread (no cheese), fresh apple, reduced-fat milk 
Calories: 450 (45 from sat fat); sodium: 650 mg; healthy stuff: whole grains, fruit, calcium

Get more health tips:

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	<li><a href="https://www.sharecare.com/health/smoking-treatment/how-can-i-quit-smoking">Thinking of quitting? Read this first.</a></li>
	<li><a href="https://www.sharecare.com/health/back-pain/what-exercises-relieve-back-pain">Help your back feel better in no time with these exercises.</a></li>
	<li><a href="https://www.sharecare.com/health/weight-loss/good-weight-loss-plan">Here&#39;s how to start losing weight today.</a></li>
	<li><a href="https://www.sharecare.com/health/high-blood-pressure/what-causes-hypertension">Unravel the mysteries of high blood pressure.</a></li>
</ul>

Medically reviewed in January 2020.

6 Healthy Fast-Food Meals for Kids

In recent years, people all over the world have been assailed by images of tragedy, and the latest American mass shooting brings catastrophe to the forefront of the news yet again. Thanks to hyper-responsive TV coverage and the omnipresence of social media, graphic photos and video taken at these kinds of scenes can be viewed by millions in a matter of seconds. It&#39;s a lot to take, for anyone.

But for kids, who might not fully understand what&#39;s happening, or who could feel they&#39;re in danger themselves, it can be especially challenging. They may be confused or angry. They may be concerned. And they may be really, really scared.

&quot;I know, as a parent myself, that our natural instinct is to want to protect our kids,&quot; says Mehmet Oz, MD, a cardiothoracic surgeon and host of The Dr. Oz Show. &quot;And that includes protecting them from finding out about horrible events in the news. But it&#39;s best that they find out about these things from you and not at school or online.&quot;

How you speak to children after a tragedy depends on a few things: their age, your relationship and of course, the incident itself. With that in mind, here are a few strategies for answering kids&#39; questions, helping them understand, and hopefully, calming their fears.

How to talk to young children 
In the aftermath of a tragedy, though they may not comprehend the details, even the littlest kids are often aware something bad has happened&mdash;and many fear the same could happen to them. So, in a calm voice, explain the event simply, in a way they understand. Be honest, but don&#39;t offer unnecessary or violent details. Let them ask questions, and answer as best and as clearly as you can.

Limit exposure to TV or social media; if you must watch, do it when they&#39;re already in bed.&nbsp;&quot;Repeated exposure to the same event can worsen the stress&mdash;especially for children,&quot; says Dr. Oz. &quot;When talking about the tragedy to other adults be cognizant of kids who may be listening.&quot;

Most importantly, let children know that they&#39;re safe&mdash;and their family and friends are, too. Acknowledge their feelings of sadness or fear, and comfort them with hugs and affection. Let them know you love them.

How to talk to older kids and tweens 
Once kids are in elementary or junior high school, they&#39;re more keyed into world and national events. At the same time, they&#39;re prone to misinformation, thanks to friends and social media. When a shooting or natural disaster happens, do your best to give accurate&mdash;though again, not gory&mdash;details. Encourage questions, and answer them simply, straightforwardly and with facts on your side. If there are questions about the news, the American Association of Pediatrics suggests recording it in advance and watching it together, taking care to pause and discuss.

As with young children, you should assure older kids they&#39;re safe, and let them express their feelings. &quot;Don&#39;t tell your children it&#39;s silly to be afraid,&quot; says Dr. Oz. &quot;You can validate their fears but still stress that the chances of something like this happening to them are rare.&quot;&nbsp;

Older children want to help the victims, as well, in which case you can work together to take action. Remember: in the wake of tragedy, it&#39;s best to give to established philanthropic organizations or verified funds; the organizers often have experience, and can direct aid accordingly.

How to talk to teens 
With more sophisticated worldviews and a better understanding of news, teenagers may not need as much comforting and as many explanations as littler kids. Then again, they might. Tell them the truth. Let them ask questions, and ask them questions in return&mdash;about what they think, how their friends are feeling, and whether they want to help. Provide detailed information, and be prepared for passionate opinions. Look out for signs of depression or an inability to cope, especially in teens who tend toward mental illness, as these events can evoke strong feelings.

What to avoid 
Media can be vital in helping us fully comprehend tragedy, but unending footage of death and destruction can also wear us down, upset and scare us, whatever our age. When children are in the house&mdash;particularly young children&mdash;limit your consumption. It&#39;ll help everyone keep a better head.

Finally, while the discussion may be difficult or uncomfortable, don&#39;t skip talking about tragedy with your kids. A fact-based discussion rooted in comfort and concern goes a long way to addressing kids&#39; fears&mdash;and it&#39;s best that it&#39;s coming from someone who loves them.

Medically reviewed in December 2018.&nbsp;Updated in August 2019.

How to Talk to Your Kids About Tragic Events

No question that <a href="https://www.sharecare.com/health/parenting/how-common-temper-tantrums-kids?myAttribute=yay">tantrums</a> (especially the public ones) can be some of the most frustrating times we have as parents and grandparents. The easiest thing is to give in; to do anything that stops the insanity. Intellectually, we know that&#39;s not good because it reinforces bad behavior. Practically speaking, it&#39;s much harder to stand your ground. Harder, but not impossible. These six strategies should help:

1. Practice <a href="https://www.sharecare.com/health/parenting/how-common-temper-tantrums-kids?myAttribute=yay">prevention</a>. If you can learn to predict the times when your child may be more likely to lose his cool, you can either avoid public situations or perform a timely intervention. The truth is that tantrums are surprisingly predictable; they often happen when kids are overtired, overstimulated, or hungry. These explosive moments are typically preceded by a sullen or quiet period; the proverbial calm before the storm. Then, when he tries to do something he can&#39;t do or is denied something, it&#39;s not long before whining morphs into a category 5 hurricane.

Once he gets sucked into this storm, there&#39;s often little you can do except ride it out. But if you can learn to identify the signs of an impending meltdown, you can try to distract your child before he gets sucked into the black hole. First, feed him a healthy snack if there&#39;s a chance he&#39;s losing it because of low blood sugar. If that doesn&#39;t work, break into a silly song, start a game of chase, or try the tickle technique (below).

2. Laugh it away. Laughing with someone at a situation can be a powerful coping tool. Example: Junior is about to pitch his best tantrum, but instead you tickle him until he can&#39;t help but laugh. Or make your silliest face. Or try balancing a spoon on your nose. Wrapped in a hug, he receives the message, &quot;I love you, and we laugh together.&quot; It doesn&#39;t always work, but it&#39;s worth a try from time to time.

3. Find different ways to say NO. You shouldn&#39;t let a child&#39;s habit of throwing tantrums deter you from saying no. Kids need boundaries for many reasons, and they need to know the word no. However, you may find that it&#39;s more effective to avoid directly using the word no. Changing the way you tell your child that you&#39;re denying him something can be a good way to diffuse a volatile situation. Maybe you explain briefly why today&#39;s not the day he gets to jump puddles. Or maybe you deflect the reason for saying no off of him and onto you.

4. Ignore it. If you&#39;re in a place where you can ignore a tantrum comfortably (say, your own home as opposed to church), then go ahead and ignore it. No response from you eventually means he won&#39;t lash out to get one. For a child, drama without an audience is like a glass without wine -- there&#39;s nothing to it. But beware: If you&#39;re going to ignore it, you have to stick to that. If he learns that your ignoring it for 30 minutes eventually leads to a great display from you, he will work even harder to overcome the ignoring phase to get that delayed reward.

5. Wrap him up. Boys and girls respond differently to anger, stress, and <a href="https://www.sharecare.com/video/health-topics-a-z/parenting/what-are-the-best-methods-for-disciplining-a-toddler">discipline</a>. Girls, who tend to have more advanced language skills, will use their words, whereas boys may feel like hitting. One of the strategies that we have found effective is this: When a boy is reacting emotionally or physically, go ahead and wrestle a bit with him (playfully, not WWE-like). This gives him a chance to vent physically without actually hitting anything, and it also helps diffuse the situation. When kids don&#39;t have the language to vent frustration, roughhousing can help. Plus, think of all the subconscious cues going on: Yes, you may be restraining him, but the physicality also means that you&#39;re hugging and comforting him at the same time.

Note: If your daughter sounds more like the boy in the description above and needs a good wrestle rather than just a hug, this is not a cause for alarm. The above is a generalization, and individual temperaments vary tremendously.

6. Be understanding. Sometimes, kids kick and scream because they are overwhelmed or tired, need to release tension (often after being picked up from preschool or day care), or are having trouble dealing with something they can&#39;t articulate. They&#39;re not trying to outmuscle you or win a power game; a tantrum may simply be the only means available for expressing pent-up emotion. Sometimes, they just need to &quot;talk&quot; things out. A hug, with some close talking and reassurance, can help, too.

Whatever the cause of the tantrum, figure out what works to pull your child out of it, and stick with that. Often, kids just want to be heard. If a 2-year-old is saying, &quot;I want my tricycle,&quot; it may be enough just to reinforce that you hear and understand him. &quot;Yes, I understand, you want your tricycle.&quot; Speak back to him in his manner. And when a child eventually does pull himself out of a tantrum, it&#39;s a good time to use positive reinforcement. &quot;You did a good job calming yourself down.&quot;

Medically reviewed in January 2020.

How to Deal with Toddler Tantrums

Which pain reliever do you reach for when your child has a <a href="https://www.sharecare.com/health/infectious-disease/should-i-give-child-medicine-for-fever">fever</a> or an earache or a headache? There&#39;s a good chance it&#39;s the same one your parents gave you. Most contain either ibuprofen (its familiar brand name is Motrin) or acetaminophen (yes, that&#39;s Tylenol). While there&#39;s no shame in brand loyalty, it may not be the best strategy. Here are my six tips for giving children ibuprofen or acetaminophen:

1. Never give your child any kind of aspirin (I cannot stress this enough) -- not even baby aspirin, which is not for babies. Aspirin can cause Reye&#39;s syndrome. Many of you might remember taking baby aspirin in your own childhood, but that was before anyone knew better. Let me repeat: Baby aspirin is not for babies or kids under 16.

2. Always treat your child, not the fever. If your child has a mild fever but appears happy and playful, it is not necessary to give your child a fever reducer. Germs don&#39;t like higher body temperatures, so if your child is fighting an infection and does not seem uncomfortable, I&#39;d skip the meds. The immune system has warmed up and is doing its work.

3. Do not give ibuprofen to infants under 6 months old or to kids who are dehydrated or vomiting. It can cause gastritis and stomach pains.

4. Don&#39;t give your child acetaminophen unless you&#39;re certain of the dose, and never give it for more than 5 days in a row. With care, acetaminophen can usually be given to young kids, even infants, but always check with your pediatrician first. Acetaminophen is used to treat mild to moderate pain and fever. It does have the benefit of coming in a suppository form, which can be helpful if your child is vomiting or refusing to take medications by mouth. It doesn&#39;t have any anti-inflammatory properties, so it&#39;s not the best choice for treating infections or sports injuries.

5. As always, be very <a href="https://www.sharecare.com/health/health-care-basics/how-safely-give-medicine-child">careful with dosing</a>. If you give your child medicine on your own, always follow the dosing instructions on the label. In certain situations, your pediatrician might recommend a different dose of ibuprofen or acetaminophen than what the label recommends, depending on your child&#39;s condition. In that case, follow your doctor&#39;s instructions to the letter.

If your pediatrician recommends either Concentrated Tylenol Infants&#39; Drops or Children&#39;s Tylenol Suspension Liquid (both are acetaminophen), pay special attention to which product you&#39;re using and what the dose is -- and, as always, use only the dispenser that&#39;s made for that product. The Infants&#39; Drops come with a little dropper for dispensing and are much more concentrated than the Children&#39;s Tylenol Suspension Liquid, which comes with a little cup. Don&#39;t mix up the meds or the dispensers. Overdosing can be toxic to the liver, which is one of the most frequent causes of medication-related death in children.

6. Don&#39;t mix acetaminophen and ibuprofen. It can be risky to alternate them -- especially if your child is dehydrated or has other medical problems. The drugs can react with each other to cause serious side effects, including kidney damage. If you&#39;ve already given your child ibuprofen for fever and want to add acetaminophen for pain, check with your pediatrician first. If your doctor okays alternating the two, keep a written schedule so that you give the right one at the right time.

Medically reviewed in January 2020.

Pain and Fever Reducers: Which Is Right for Your Child?

More and more parents are reverting to <a href="https://www.sharecare.com/video/sharecare-experts/samantha-heller/what-are-some-ideas-for-packing-a-healthy-school-lunch-for-my-child">packing lunches</a> until school cafeterias clean up their junk-food acts -- but here&#39;s the catch: It&#39;s easy to sabotage your own good intentions. Avoid these lunch-box fillers like the measles -- they&#39;re not good for your kids&#39; health or their waistlines!

1. Juice drinks: We all know that soda is as nutritious as sugar water, but drinks &quot;made with real juice&quot; aren&#39;t much better. Just 1 ounce of raspberry or peach punch, iced tea, and other sweetened fruit drinks can contain over a teaspoon of high-fructose corn syrup -- and it&#39;s about as healthy as trans fat. Among other things, the syrup seems to throw off the body&#39;s weight-regulating mechanisms. If you wouldn&#39;t feed your children pure sugar, think twice about dropping these drinks into their lunch bags. 
Better choices: Water, low-fat milk, V8 juice, one of the fruit-veggie juice blends (Vruit, Juice Plus+), or a small container of 100% fruit juice. Real fruit juice is better than juice drinks, but it&#39;s still high in sugar and calories, so watch quantities.

2. Cold cuts: Meat sandwiches, although they are the most common lunch-box entr&eacute;e for elementary school kids, shouldn&#39;t be everyday fare. Bologna and other processed meats -- yes, even turkey Lunchables -- are brimming with saturated fat (9 grams, nearly half the recommended daily value), sodium (1140 milligrams, about half the daily max), and preservatives. 
Great replacements: Check out these easy, <a href="https://www.sharecare.com/health/healthy-eating-children-and-teens/how-pack-lunches-child-eat" target="_blank">kid-friendly lunch ideas</a>.

3. Fruit-topped whole-milk yogurt: Although yogurt is filled with protein, calcium, and vitamins D and B12, whole-milk yogurt has lots of fat, too -- much of it saturated. What&#39;s more, yogurt that&#39;s topped (or bottomed) with a jam-like fruit mix can pack almost as much sugar as a candy bar! 
Far smarter: Choose low-fat yogurts and pack a container of berries or fresh fruit chunks for your child to dunk or stir in.

4. Fruity roll-ups: Two problems here, unfortunately. First, many brands have only a smidgen of fruit and maybe some fiber. A puree of apples or pears from concentrate makes up about one-third of a roll-up; the other two-thirds are additives and sugar. Second, these stretchy fruit strips are so sugary and sticky that they cling to teeth long after they&#39;re eaten, creating the perfect environment for cavities -- especially if your child doesn&#39;t brush after lunch. (Do you know one who does?) 
Better bet: If your child loves roll-ups, buy all-natural brands, and reserve them for after-school treats -- followed by a brushing.

5. The obvious (or maybe not) potato chips: No matter how much we wish that potato chips counted as a serving of veggies and cheese puffs were a form of dairy, these snacks are as bad as it gets. Consisting mostly of fat and sodium, they&#39;re actually worse than empty calories. But that&#39;s not the surprise. This is: Potato chips are the #1 lunch-box snack among little kids -- they&#39;re given to 55% of K&ndash;5 students. 
Savvy substitute: Try a new, crispy-thin snack we just taste-tested called Garden Harvest Toasted Chips. Made by Nabisco, these have a satisfying chip-like crunch, are made from whole grains, and have the equivalent of a half serving of veggies or fruit. So why would kids go near them? Because they don&#39;t taste, you know . . . healthy.

Your reward for making all those lunches? Kids who get into the habit of eating fiber-rich foods now -- which include all fruits and veggies -- are likely to stick with this healthy habit as adults. If they do, by age 32 their RealAge could be only 29.

Medically reviewed in January 2020.

Keep Out! Five Foods to Ban from Your Kid's Lunch Box

Surgery can scare the heck out of kids, just as it can scare adults. These four strategies can reduce fear and ease the journey for both you and your child.

1. Put on your game face. For some parents, the hardest part of their child&#39;s surgery is trying not to fall apart. But your child will be looking to you to see how you&#39;re doing, so you&#39;ve got to be supportive, loving, sympathetic, and, above all, calm. Even if you&#39;re a basket case, put on a happy face, hold hands with your child, and show him that you&#39;re confident the outcome will be positive and everything will go as expected. If you need help getting yourself through this, contact the hospital&#39;s social worker and ask for tips. <a href="https://www.sharecare.com/health/breathing-exercises/can-deep-breathing-reduce-stress">Taking deep breaths can help you relieve some stress.</a>

2. Banish any misplaced guilt. Young children sometimes secretly believe that their medical problem and the operation is a form of punishment for being bad. Reassure your child that this problem is not the result of anything he did. Even if the problem might have been prevented -- say, a bike accident when your son wasn&#39;t wearing his helmet -- lay off the lectures until well after his surgery. Say, in a week or two. He doesn&#39;t need the extra stress of feeling guilty when he&#39;s having an operation and trying to recover.

3. Take a tour. Many hospitals have preop tours for children so they can try on a surgical mask, dress up in a hospital gown, handle a stethoscope, and see the kind of bed they will be in. Getting a glimpse of the hospital can take away the fear of the unknown. Your child will see that the staff is friendly and that there are other kids in the hospital who are coming and going.

4. Practice coping skills. The day you arrive, a child specialist or social worker may teach your child calming skills, such as deep breathing and positive mental imagery, but you can practice those at home before you arrive, too. Provide lots of praise and support. During recovery, your child may feel pain or discomfort, and it helps to have ways to offset those feelings and even reduce the need for pain medications.

Medically reviewed in January 2020.

4 Strategies to Make Surgery Easier for Your Child

In 2017, the American Academy of Pediatrics updated its schedule of the preventive screenings children and adolescents need. The most notable changes involve testing kids for serious illnesses such as high cholesterol, depression and HIV, depending on their age. But is universal screening really necessary? We caught up with Sharecare Advisory Board Member <a href="https://www.sharecare.com/user/dr-tanya-altmann">Tanya Altmann, MD,&nbsp;FAAP</a>, for her take. For a summary of what&rsquo;s new in the guidelines, see the list at the end.

Several of the new recommended screenings used to be targeted to kids at risk. Why screen everybody instead? 
Dr. Altmann: We used to do targeted screening and we found we were missing a lot of children and teenagers. Often the risk factors aren&#39;t apparent. With targeted screening you may miss some things, like depression or cholesterol.&nbsp;

The guidelines call for cholesterol tests for kids between ages 9 and 11. Do many 9-year-olds have high cholesterol, and how do you manage it?&nbsp; 
Dr. Altmann: One of the interesting things is that these guidelines were actually approved back in 2014, so many doctors have already been following them. I&#39;ve been doing cholesterol screening in my office for the last five years, and I&#39;ve seen firsthand how many children are affected. They&#39;re not always overweight and they don&#39;t always have a family history of high cholesterol -- instead, their condition is due to the good ol&#39; American diet. With screening, we&#39;re able to intervene at a young age and hopefully prevent some of the serious problems, such as heart disease, that can develop as these kids get older. Sometimes it&#39;s about making small changes: changing from fast food, switching to low-fat milk, increasing fruits and vegetables, adding exercise. But small changes like these can make a big difference.

Did any of the changes in the guidelines surprise you? 
Dr.&nbsp;Altmann: The one that I found most surprising was the universal HIV screening. For my practice this will be the most challenging to sell to parents. Many kids aren&#39;t at risk -- or the parents don&#39;t think they are -- so the screening is going to take a little while to get used to. But the reality is that 60% of teens and young adults who have HIV don&#39;t know it, and one in four new HIV infections are in 13- to 24-year-olds. While many parents may be uncomfortable with having their child screened, based on these stats it is a good idea.

What are the recommendations for depression screening? 
Dr.&nbsp;Altmann:&nbsp;Routine depression screening is officially now recommended. In the past pediatricians asked questions and sort of &quot;read the faces&rdquo; of their teen and young adult patients, and now a more standard test exists. Suicide is the leading cause of death in adolescents, so it&#39;s important to pick up those cues so we can get them help.

Fluoride varnish is recommended for kids ages 6 months to 5 years. Why is that important, since those baby teeth are just going to fall out anyway? 
Dr.&nbsp;Altmann: Cavities in young children are a big problem nationwide. Even though they&#39;re just baby teeth, having damage early on can mean damage to permanent teeth. Applying the fluoride varnish to toddlers twice a year can decrease the rate of cavities and serious dental consequences later. It&#39;s simple to do -- it comes on a little swab and you just rub it across their teeth and gums. It kind of tastes like a toothpaste or mouthwash.

A summary of guidelines:

<ul>
	<li>Anemia screening for toddlers at 15 and 30 months, plus additional testing at other ages based on risk assessment</li>
	<li>Autism screening at 18 and 24 months</li>
	<li>Blood pressure screening at every checkup, beginning at 3 years</li>
	<li>BMI check at every checkup, beginning at 24 months</li>
	<li>Cholesterol screening for children ages 9 to 11, and again between 17 and 21</li>
	<li>Congenital heart disease testing in all newborns</li>
	<li>Fluoride varnish treatments for children ages 6 months through 5 years</li>
	<li>HIV testing in teens ages 15 to 18</li>
	<li>Annual screening for depression in young people ages 12 to 21</li>
	<li>Drug and alcohol risk assessment (not a drug test) for all adolescents ages 11 to 21</li>
	<li>Pap testing for pre-cancerous cells (cervical dysplasia) to be done in young women at age 21 (previous guidelines called for risk assessment every year from ages 11 to 21)</li>
	<li>Screening for sexually transmitted infections from 11 to 21, based on risk</li>
</ul>

Medically reviewed in May 2019.

New Screening Guidelines for Kids: What Parents Should Know

It&#39;s a bad idea to fib about or downplay the possibility of pain your child may experience when unpleasant tests or procedures need to be done. After all, you wouldn&#39;t be in the ER if there wasn&#39;t something really wrong. Kids are pretty smart creatures. You know your kid best, but you shouldn&#39;t try to trick your child into thinking that getting his arm reset, for example, isn&#39;t going to hurt. It&#39;s best to be honest and tell him that it will hurt for a moment, but then everything will be okay. Of course, that may not be completely honest, but it&#39;s honest enough. Don&#39;t lie and say it won&#39;t hurt in order to assuage his fear or give him hope. That will only work once, and he&#39;ll then be certain that every subsequent procedure will be agonizing, no matter what you say.

Young kids will be helped by a simple explanation and maybe even a drawing of what is going to happen, while older kids may appreciate more information. Making comparisons to other ouches can be helpful. For example, if your child is afraid of a shot, you can say it will hurt for a second, just like a pinch or a bug bite, but then it&#39;ll stop. The pediatrician may ask him to yell &quot;Ouch!&quot; or use <a href="https://www.sharecare.com/health/kids-teens-health/what-help-child-frequent-shots">another tactic to distract your child from the pain.</a> Do your best to get him some real pain relief whenever possible, too. If your child needs to get a shot, have blood drawn, or get stitches, ask about &quot;ouchless&quot; options. For example, there&#39;s a numbing cream the doctor can apply to his skin through a patch, but it takes about 1 hour to work. For minor lacerations, you can ask the doctor if skin tape (called Steri-Strips) or skin glue might work instead of stitches.

Medically reviewed in January 2020.

How to Help Your Child Handle Pain

Every child is unique, with unique DNA, unique fingerprints, a unique personality, and a unique path to adulthood. Although you can&#39;t smooth all the bumps, anticipate all the challenges, or defuse all the bombs your children will encounter along the way, you can make their journeys and their lives as adults a little bit easier and much healthier!

1. Get Stuck in a Rut 
<a href="https://www.sharecare.com/health/preschool-age-child-development/why-important-establish-routines-child">Children thrive on routines.</a> Rituals and routines provide them with a sense of identity, stability, and consistency as they strive to figure out their roles, relationships, responsibilities, and even their own personalities. Routines also help them understand the importance of setting limits. Involve your children in organizing your family&#39;s daily schedule, such as setting regular times for meals, homework, cleanup, leisure time, and bedtime.

2. Gross Them Out 
How the human body functions is often a mystery to kids. Take time to explain how the body works when it&#39;s healthy and what happens when it breaks down. For example, explain the short-term and long-term effects of taking care of their health and of overindulging or neglecting it. By providing kids with this information, they&#39;ll be more aware of the specific benefits and consequences their actions have on their bodies.

RealAge Projection: Learning to be proactive about health issues will benefit kids indefinitely. If they keep it up in adulthood, at 50 they could look and feel closer to 38.

3. Question Them 
Parents play an essential role in building their children&#39;s communication skills. That&#39;s why it&#39;s important to ask plenty of questions and listen with interest, attention, and patience. It often takes kids longer than adults to express themselves. Skip the yes or no questions. <a href="https://www.sharecare.com/health/relationship-challenges/communicate-better-with-my-children" target="_blank">Ask questions that require explanation or description.</a> Listen for details that may be missing and ask for clarification. This allows you to keep tabs on what your kids are thinking, feeling, and doing, which is crucial in keeping them safe, healthy, and out of trouble.

4. Show Off 
Children learn by observing and imitating behavior, especially yours. Be a day-to-day example of how you want your child to behave. Studies show that parents with the healthiest lifestyles raise the healthiest children who in turn grow up to be healthier adults.

5. Crack Them Up 
Life can get crazy and stressful for kids; laughing can help them cope. Encourage generous amounts of giggling and silliness in your home, and help kids see the humor in everyday events and mishaps. This will help them learn to put things in perspective and better handle the constant stresses of daily life. Laughter will be medicine that kids can carry with them for years to come.

6. Bond with Them 
Almost all interactions in a child&#39;s life are influenced by family relationships. Kids who have close connections with parents, grandparents, siblings, and other relatives are more likely to initiate social interaction with other kids and with other adults, and are likely to be more confident in all relationships. Also, kids with <a href="https://www.sharecare.com/health/parent-child-relationship/what-good-ways-bond-child">positive family relationships</a> generally struggle less with depression and peer pressure and have higher self-esteem.

RealAge Projection: Kids who have close connections with family and friends generally struggle less with emotional issues. And as adults, these social ties can help them look and feel almost 4 years younger. Imagine that . . . your child, 40 years old but feeling 36.

7. Chase Them 
<a href="https://www.sharecare.com/health/fitness-exercise-children/physical-activity-children" target="_blank">Regular physical activity</a> develops and strengthens children&#39;s bodies and brains. Plus, it&#39;s the best way to prevent weight gain and potentially fatal diseases, such as heart disease, cancer, and stroke. Encourage your kids to be active by regularly engaging them in games and activities that get the blood pumping. Chase them -- and let them chase you -- around the yard in a game of tag. Play toss, kickball, or hide-and-seek. Take hikes together in the woods or around the neighborhood.

RealAge Projection: Kids who learn to love being active when they&#39;re young are likely to stick with this healthy habit when they&#39;re adults. And if they do keep it up -- getting a good mix of aerobic, strength, and flexibility exercise -- at 35 their RealAge will actually be 27.

8. Remind Them 
Although no parent wants to be a nag, kids need guidance and gentle reminders about rules, limits, and appropriate behaviors. Steering kids toward healthy habits, and reinforcing those habits along the way, will teach them the principles of moderation, discretion, consistency, and self-discipline. Over time, and with your help, kids will develop their own sense of self-control and self-regulation, which will allow them to set healthy limits for themselves.

9. Put Them to Work 
Research shows that involving kids in chores and projects around the house is one of the best ways to build self-esteem and help kids feel competent. Doing so lets them know that you believe they&#39;re capable of handling important tasks, which is an incredibly powerful message for kids. Children who grow up perceiving chores as a normal part of life are more likely to complete their education, get a good start on a career, develop successful relationships, and avoid risky behaviors.

These 9 ways to be a better parent may sound simple, but research shows that, when combined, they can help your sons and daughters grow in body, mind, and spirit.

Medically reviewed in January 2020.

Top 9 Ways to be an Even Better Parent

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

Shocking fact: Approximately 20.3 million people in the United States are addicted to drugs and/or alcohol, according to 2018 data from the Substance Abuse and Mental Health Services Administration (SAMHSA). That&rsquo;s about 1 in every 14 Americans age 12 or older. Among those, an estimated 916,000 kids ages 12 to 17&mdash;or 3.7 percent of all adolescents&mdash;had a substance abuse disorder in 2018.

That&rsquo;s right, even preteens struggle with addiction.

Statistics like these are a stark reminder that it&rsquo;s crucial to talk to your kids about drugs and alcohol. Pediatrician Tanya Altmann, MD, of Calabasas Pediatrics in Calabasas, California, shares some advice on how to broach the topic.

Sharecare: At what age should you start talking with your child about drugs and alcohol?

Dr. Altmann: Kids are less likely to use drugs when parents provide guidance and clear rules about not using drugs, don&rsquo;t use drugs themselves, and spend quality time having meaningful conversations. I usually recommend parents start having the conversation with their kids about drugs and the dangers of drugs during the elementary school years. Even for preschool children, it&rsquo;s not too early to teach them to take care of their bodies and make good decisions.

Sharecare: What are some things you should say when speaking to your kids about drugs and alcohol?

Dr. Altmann: Make sure you directly state what your house rules are regarding drug and alcohol use. Don&rsquo;t leave space for wiggle room. But let your kids know that you are there if they have any questions or concerns.

Also, educate your kids about the harmful effects drugs and alcohol have on their brains, bodies, and their ability to learn and play sports. Teach your kids how to say &ldquo;no.&rdquo; Give them the words to use and role-play conversations they may have with their peers. They can say things like, &ldquo;No. I&rsquo;m not into that.&rdquo; Or, &ldquo;My parents would ground me forever, so I can&rsquo;t.&rdquo;

I usually tell my families that&rsquo;s it&rsquo;s ok to blame the parents or even me, their pediatrician, if it helps. Also, remind your child that real friends will never ask them to do something that is unsafe or that makes them feel uncomfortable.

Sharecare: Anything you should never say?

Dr. Altmann: Never give your kids an out or an excuse to try drugs. Don&rsquo;t say things like, &ldquo;everyone experiments.&rdquo; Also, don&rsquo;t praise other kids as being cool or popular because you don&rsquo;t know what those kids are doing that your own children may try to emulate. Instead, praise your own kids for their hard work, good behavior, and integrity.

Sharecare: What are some clues that a child may have a drug problem?

Dr. Altmann: <a href="https://www.sharecare.com/health/substance-abuse-addiction-recovery/article/facing-up-to-addiction" style="color:#0563c1; text-decoration:underline">Warning signs of addiction</a> may include behavior and physical changes. Behavior changes may include changes in mood, sleeping, eating, friendships, and school performance. Physical signs your child may be using drugs or alcohol include having bloodshot eyes, losing or gaining weight, tremors, slurred speech, and either smelling like smoke or wearing heavy perfume to cover it.

Sharecare: What steps should you take if you suspect your child has a drug problem?

Dr. Altmann: Talk to your pediatrician or an addiction specialist if you think your child may have a drug problem. They can help you figure out the best way to confront your child, get them tested and treated. There are many <a href="https://www.sharecare.com/health/substance-abuse-addiction-recovery/article/treatment-options-for-substance-use-disorders" style="color:#0563c1; text-decoration:underline">treatment options</a> available depending on what your child needs.

Sources:

Substance Abuse and Mental Health Services Administration (SAMHSA). Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. August 2019.

Talking to Your Kids About Drugs and Alcohol

First off, ask your pediatrician, of course. But do some detective work, too. Start by calling or stopping by the hospital to speak with the director of emergency services and asking these questions:

1. Do you have a pediatric emergency-care specialist on staff -- or at least pediatricians available 24/7? About 40% of ERs in the United States don&#39;t even have round-the-clock access to pediatricians, according to the Centers for Disease Control and Prevention. You want to be sure that your child&#39;s ER is staffed with pediatricians, pediatric nurses, and, ideally, pediatric emergency-medicine specialists (not just general emergency physicians). If it is, it&#39;s the strongest indication that they&#39;ll have the right equipment.

2. Do you have medications in doses appropriate for children? Are they available in chewable or liquid form? This is important. Many hospitals don&#39;t have <a href="https://www.sharecare.com/health/parenting/article/pediatric-pain-medication">pediatric medications</a>, and it can cause life-threatening complications.

3. Does your ER have child-sized resuscitation equipment? Are there beds, IVs, and oxygen masks made for children? They need to be well stocked in extra-smalls.

4. Do you have a separate area just for pediatric patients? A good pediatric ER will have a kid-friendly section that will look more like a Chuck E. Cheese restaurant than an acute medical care facility. You should find a TV, cartoon DVDs, a few toys, and coloring books (though try to remember to bring comforting favorites from home, too). While the distractions are helpful, here&#39;s the real benefit: Your child will be shielded from the drama in the average ER. As a bonus, so will you. When it comes to germs, stress, and sanity, this is better for everybody. Unfortunately, many hospitals don&#39;t have a special emergency area for children.

5. How many children under the age of 5 years do you treat every week? More than 50 is a good answer; 3 is not. You want an ER staff that&#39;s adept at dealing with screaming babies, frantic toddlers, and -- not that you&#39;ll need this angle of their expertise, of course -- hysterical parents.

6. Do you have a separate urgent-care satellite center? If a nearby hospital doesn&#39;t have a dedicated pediatric ER, at least you&#39;re likely to get treated faster in the satellite center than the general ER. Similarly, the ER will be less crowded with non-life-threatening cases because of the satellite center.

7. Is the hospital accredited by the Joint Commission? If so, it means the hospital has voluntarily met national health and safety standards. You don&#39;t need to interrogate an ER staffer to find this out; you can use the Joint Commission&#39;s Quality Check to see whether the hospital is accredited (as well as how it&#39;s performing in several key areas).

8. Are there translators on site? You may speak English, but -- and this is a big point that many people dangerously overlook -- does your child&#39;s nanny, babysitter, or grandparent who watches her every day speak English? Believe me, this can be critical.

Once you&#39;ve identified your best emergency option, map out how to get there, and do a couple of dry runs before you actually have a crying little one gushing blood in your backseat. In a real emergency, you might not be driving -- you might not even be in your own vehicle -- but at least you&#39;ll know how to get there. Someday, that might also help you decide whether to drive yourself and your child to the ER or to call 9-1-1. But don&#39;t throw away your list of other choices. If an emergency strikes when your daughter is at a sleepover four towns away or your son is playing Little League in a neighboring community, it may come in handy. Unfortunately, by their very nature, emergencies are unplanned. <a href="https://www.sharecare.com/health/parenting/article/8-lessons-I-learned-about-parenting-in-the-er">Be prepared</a>. Have backups.

How to Find the Best Pediatric ER Near You

Encouraging a love of learning is one of the greatest gifts you can give your children. Although your level of involvement will change often -- sometimes directing, sometimes stepping back -- enriching their environment, ensuring needs are met, supporting them through challenging periods, and applauding every success are all essential to raising lifelong learners. The seven strategies on this printable page are good guiding principles. Hang it on the fridge with the latest macaroni art from your little geniuses.

<a href="https://s.sharecare.com/newsletter/OHG/lifelong-learning.pdf" target="_blank">Print Your Seven Steps to Raising a Lifelong Learner List.</a> (PDF)

Seven Steps to Raising a Lifelong Learner

Kids hate pain. Adults aren&#39;t crazy about it either. That&#39;s one reason pain control is such a big part of any surgery or invasive procedure. Another reason is that uncontrolled pain can slow or even derail recovery; people who are in agony simply don&#39;t heal well and can suffer additional medical problems. What&#39;s more, they tend to make very unhappy patients, whether they&#39;re 3 or 90 years old. So hospital staffers go to great lengths to keep patients pain-free, or at least as comfortable as medically possible.

Use these tips to minimize your child&#39;s pain and discomfort:

&nbsp;

<ul>
	<li>
	Before surgery, a nurse will probably give your child a mild sedative to make him relaxed and sleepy. Ask the doctor if your child should also receive additional pain medication before or during the surgery, so it&#39;s already working when he wakes up in the recovery room.
	</li>
	<li>
	If your child&#39;s pain is severe, ask to speak to a pain specialist (usually a specially trained anesthesiologist).
	</li>
	<li>
	Ask about nondrug pain relief, including relaxation techniques such as deep breathing. Your doctor may also recommend heat, cold compresses, massage, rest, position changes, or simply good distractions (such as TV, video games, music, puzzles, or coloring books).
	</li>
	<li>
	If your child needs to take pain medication for a while, be certain that it&#39;s carefully monitored. Every time a nurse comes in with medication, check the drug name, dose, and schedule to make sure it&#39;s the right amount of the right drug at the right time. Keep tabs on your child&#39;s medication schedule so you can hunt down the nurse if a round gets skipped -- or keep an extra dose from being administered.
	</li>
	<li>
	Ask the doctor if your child needs a prescription pain medication or if an over-the-counter product will do the job.
	</li>
</ul>

Medically reviewed in January 2020

&nbsp;

Keep Your Child's Hospital Visit As Painless As Possible

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.