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

I mean, best news ever, right? I have no doubt that it wasn&rsquo;t just the students celebrating when Texas teacher Brandy Young told her second graders that they wouldn&rsquo;t have homework this year&mdash;you know the parents were ecstatic. You would be, too.

But is it best for our kids? Should kids even have homework in the second grade? (Did you and I? I&rsquo;ll deny it, but that was a long time ago.)

Is homework bad or good?&nbsp; 
Well, that depends. On the plus side, homework teaches responsibility and time discipline, and it&rsquo;s a good way for kids to catch up on an area in which they&rsquo;re struggling. On the downside, in some cases, homework can take a long time. And let&rsquo;s be honest: if the homework is so difficult that a parent is doing the work, it&rsquo;s not benefiting anyone.&nbsp;

The bottom line? The sole act of completing homework isn&rsquo;t what will set your child up for success; it&rsquo;s how your child does homework and what else they do in their afternoon that will make a difference.&nbsp;

What exactly makes the difference? Here&rsquo;s what to do:

<ul>
	<li>Prioritize homework: If your child does come home with homework, get it done early. Come home, have a quick snack and get the homework out of the way.&nbsp;</li>
	<li>Incorporate physical activity and, if possible, some free play. Structured club sports are a great way to get in physical activity and camaraderie, free play is also a great outlet. Both&nbsp;<a href="https://www.cdc.gov/healthyschools/physicalactivity/facts.htm" target="_blank">benefit their academic performance, from better grades, to concentration and attentiveness</a>.</li>
	<li>Allowing a child to read books they choose has been shown to correlate with school performance. In fact, <a href="https://www.aappublications.org/content/early/2014/06/24/aapnews.20140624-2" target="_blank">3rd grade reading proficiency is one of the most significant predictors of high school graduation and success in a career</a>, according to the American Academy of Pediatrics.&nbsp;</li>
	<li>Do you sit down together at night for dinner? Some nights, I know that it&rsquo;s just impossible, especially with working parents&rsquo; schedules. Eating family dinner together, even if that&rsquo;s just three to four nights a week, <a href="https://www.healthychildren.org/English/family-life/family-dynamics/Pages/Mealtime-as-Family-Time.aspx" target="_blank">teaches your child healthy food choices</a> to prevent obesity, reduces eating disorders and even yields better social and emotional health. No time? Don&rsquo;t underestimate the value of heating leftovers, using a slow cooker, or cooking and freezing on Sunday!</li>
	<li>Kids&mdash;and parents&mdash;need their sleep. Having devices in their rooms impacts that. One study showed that kids who had a smartphone in their room fell asleep up to four hours later than those who kept phones out of the room. Have a plug-in place and time that&rsquo;s outside of the bedroom and ends an hour or so before bedtime.</li>
</ul>

Medically reviewed in December 2018.

No More Homework!

&quot;Knowing kids -- and parents -- need to eat healthy food is one thing. Getting them to do it is another. For starters, kids of all ages tend to hate at least one thing -- say, green beans -- and devour tons of another, like grapes. Don&#39;t worry about a few extremes; if your child&#39;s diet over the course of a week, for most weeks, is balanced overall, that&#39;s fine,&quot; says pediatrician Jennifer Trachtenberg, MD, mom of three and author of the book, The Smart Parent&#39;s Guide to Getting Your Kids Through Checkups, Illnesses, and Accidents and Good Kids, Bad Habits: The RealAge Guide to Raising Healthy Children.

&quot;That said, the more fun food is, the more likely kids are to eat it, especially when it comes to veggies and breakfast, two things they often resist,&quot; adds Dr. Jen. &quot;Here are some super easy recipes that can get even teens to eat smarter.&quot;

3 Tempting Breakfasts

<ul>
	<li>Oatmeal-Cookie Pancakes: Every kid loves these. To regular pancake batter, add oats, raisins, chopped walnuts -- all excellent fiber and nutrition boosters -- plus some cinnamon and a bit of brown sugar. Pour into fun shapes like snowmen, turtles, or Mickey Mouse. To beat the morning rush, make the batter the night before and refrigerate it.</li>
	<li>Breakfast Tacos: Teenagers who turn down everything else will often eat these. Spoon scrambled eggs into warm whole-wheat tortillas, top with shredded low-fat cheese, a dollop of low-fat yogurt or sour cream, and salsa.</li>
	<li>Smoothies for Two: These are a treat on hot summer mornings and are filled with enough protein, fiber, and nutrients to keep kids fueled for hours. Just combine 2 frozen bananas, 1 cup frozen strawberries, 1 cup low-fat vanilla yogurt, and 3/4 cup juice in a blender.</li>
</ul>

3 Fun Snacks

<ul>
	<li>Graham Sandwiches: When your child wants something sweet, here&#39;s a delicious cheesecake-like treat that&#39;s healthier than kids realize. Spread half a graham cracker with low-fat cream cheese; top with a little raspberry puree and the other cracker half. Yummy!</li>
	<li>A Feast for Giants: Broccoli &quot;trees&quot; and carrot &quot;logs&quot; are even more fun when you can dunk them in a yogurt-based dip. Mix up to 8 ounces of plain low-fat yogurt with some chopped dill, a little Dijon mustard, and a dash of soy sauce. Try dipping bell-pepper-strip &quot;canoes,&quot; cherry-tomato &quot;boulders,&quot; and cucumber-slice &quot;bridges,&quot; too.</li>
	<li>Creepy-Crawly Crackers: Spread peanut butter between two round whole-wheat crackers, add pretzel sticks for legs, and raisins for eyes and you&#39;ve got one fun, spidery snack.</li>
</ul>

6 Fast, Healthy Recipes for Frazzled Parents

When your child is in the hospital, it helps to think of the key staff members as new friends who can play a critical role in your child&#39;s well-being. They can also magically smooth out bumps and delays that plague less savvy parents and patients. Use these tips to reap strategic benefits:

1. Ask staffers what they do. It&#39;s hard to tell who&#39;s who based on their clothing&mdash;that impressive gentleman in the tie might be there to fix a broken dialysis machine. If you&#39;re not sure, just ask. Is the person a resident, intern, doctor, nurse, or <a href="https://www.sharecare.com/health/nursing/what-is-certified-nurses-aide">nurse&#39;s aide</a>? Any staffers who enter your child&#39;s room should have an ID badge on and say why they&#39;re there. (Refrain from yelling, &quot;Halt! State your business!&quot;) By the way, to make sure they have the right patient, staffers should also check your child&#39;s ID bracelet.

2. Be extra nice to the nurses. They are the workhorses, and they can make life for you and your child a whole lot easier, whether you need a washcloth, more pain medication, or face time with the doctor. <a href="https://www.sharecare.com/health/nursing/what-nurses-do-hospitalized-child">Nurses</a> get the brunt of abuse from angry patients and frustrated family members. Try saying &quot;please,&quot; &quot;thank you,&quot; and &quot;I appreciate your help.&quot; You might be amazed by the attention you get.

3. Be there when the nurses change shifts. Nurses generally work 12-hour shifts, and shift changes are often when mistakes get made in the hospital. Learn who the next nurse on duty is, and personally relay any important information about your child. Yes, the new nurse should read the previous nurse&#39;s notes, but don&#39;t rely only on that. Remember that the nurse may have more patients to care for than just your child.

4. Know the shortcuts. Get friendly with the resident or intern so you can get quick answers to relatively basic questions. Both should have access to the attending physician and will likely get back to you with an answer in less time than it would take for you to track down the attending physician. Of course, for important questions, ask to see the attending.

5. If an intern explains test results, and you have questions, it&#39;s fine to ask a resident, fellow, or attending physician how they interpret the results. Some findings are very clear, such as, &quot;Your test results are normal.&quot; But others may require lengthier discussions, so it&#39;s always okay to ask.

6. Start every day nudging. Every morning, your first question for the attending physician or resident should be, &quot;What&#39;s the specific plan for today?&quot; This can subtly prod them to keep things moving. You don&#39;t want to wait 5 days for tests that could be completed in 2.

6 Tips on Hospital Etiquette

These are excerpted from a patient tip sheet published by the U.S. government. While all the info in it is useful, using this little hospital checklist from Uncle Sam can go a long way toward <a href="https://www.sharecare.com/health/parenting/article/preventing-medical-errors">keeping your kid out of medical trouble</a>.&nbsp;

1. If you have a choice, pick a hospital at which many children have the procedure your child needs. As previously mentioned, all patients, young and old, tend to do better in hospitals that have a great deal of experience treating their condition. Ask how many of the procedures have been performed at the hospital.

2. Make sure you know who is in charge of your child&#39;s care at the hospital. This will be the attending physician -- most likely a surgeon or specialist, not your pediatrician. Identifying this person is especially important if your child has many health problems.

3. Make sure that all health professionals involved in your child&#39;s care have important medical information about him. Do not assume that everyone knows everything they need to.

4. If you don&#39;t trust yourself to speak up, bring along someone you do trust. Ask a vocal family member or friend to help be your child&#39;s advocate. This person can also help you remember instructions during what can be an overwhelmingly stressful period. Time to call in a few favors! <a href="https://www.sharecare.com/health/parenting/article/preventing-medical-errors">Read more on why this is so important.</a>

5. Ask why each test or procedure is being done. It is a good idea to find out why a test or treatment is needed and how it can help. Sometimes a test is optional, and your child could be better off without it.

6. When your child is being discharged from the hospital, go over the home treatment plan twice. Research shows that at discharge time, doctors think people understand more than they really do about what they should and should not do when they return home.

Source: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.

Medically reviewed in January 2020.

6 Ways to Protect Your Child From Medical Mistakes

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

1. Stay Calm. If you freak out, so will your child.

2. If your child is unresponsive, <a href="https://www.sharecare.com/health/critical-care/when-should-call-911-child">call 9-1-1</a> and do the &quot;ABC&quot; check:

<ul>
	<li>Check the Airway to make sure it&#39;s not blocked.</li>
	<li>Check for Breathing -- sounds of inhaled and exhaled air.</li>
	<li>Check for Circulation -- your child&#39;s pulse. If you need to start CPR or do the Heimlich maneuver, the dispatcher can walk you through the steps while the paramedics are en route. Better yet, be prepared by taking a CPR class or refresher course.</li>
</ul>

3. Stop any bleeding by applying pressure to the wound. Remember to keep holding it (don&#39;t peek). Every time you relieve the pressure, the bleeding will restart. So hold on, and apply pressure for at least 10 minutes. (Be prepared: Scalp and tongue wounds are especially bloody, so try not to overreact. Follow the same steps for these wounds.)

4. Don&#39;t move your child if you suspect a head, neck, or back injury. With any serious head injury, assume your child also has a broken neck, just in case. Cover him with a blanket and wait for the paramedics.

5. <a href="https://www.sharecare.com/health/injuries-wound-trauma/what-childs-finger-toe-cut">If a finger or toe has been cut off</a> (gruesome, but it happens), apply pressure to the wound, then place a cloth, towel, or plastic bag around the body part and ice it. Make sure it isn&#39;t directly touching the ice and is protected. The body part can probably be reattached if the surgery&#39;s done within 6 hours.

6.&nbsp;On the chance that your child will need emergency surgery, don&#39;t give him anything to eat or drink. It&#39;s much safer to get anesthesia on an empty stomach.

Medically reviewed in January 2020.

Pediatric Emergencies: 6 Commandments of ER Care

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

If you have children, you&rsquo;re probably all too familiar with temper tantrums: the crying, the kicking, the screaming. (Oh, my!) These emotional outbursts occur frequently in children between 12 and 18 months of age, typically worsening between ages 2 and 3 before tapering off after age 3.

Adults and children process feelings differently. When adults are frustrated, they have a range of productive outlets to which they can direct excess emotional energy. They can talk it out, go for a walk or pound a punching bag. Young children, on the other hand, have a limited ability to express their desires and aversions, so they resort to what they know: screams and tears.

For the most part, temper tantrums are completely normal. They can crop up when children don&rsquo;t get their way, or when they&rsquo;re hungry, sleepy or just plain irritable. And although tantrums are common, that doesn&rsquo;t mean they&rsquo;re inevitable. Here&rsquo;s how to peacefully handle your child&rsquo;s emotional outbursts, plus some signs to look for that may indicate a more serious problem.

Can you prevent a temper tantrum? 
Many children have temper tantrums simply because they want to exert control over their circumstances or express their individuality. Try letting your child have some control in situations where the outcome isn&rsquo;t important. For example, you might let them choose the type of snack they wish to eat or the movie they want to watch. Giving them a few options allows them to feel a sense of agency. If they&rsquo;re allowed to exercise control in some circumstances, they may be more likely to cooperate in other cases when choices have to be made for them.

The way you speak to your child and your tone of voice also makes a difference. Try asking your child to do something instead of ordering them to do something. Another way to create conditions that reduce the likelihood of tantrums: Make sure your child&rsquo;s physical needs are met. That means setting&mdash;and sticking to&mdash;regular bed times and nap times, keeping a predictable schedule for daily activities, serving nutritious and filling meals, and keeping healthy snacks on hand in case of flare-ups.

What to do if your child has a tantrum 
If your child starts wailing, remember that it does not reflect poorly on you as a parent or on your child. Tantrums come and go like the weather, but what matters is how you handle the situation when it arises:

Stay calm: If your child has a temper tantrum, <a href="https://www.sharecare.com/health/parenting/article/parenting-style-could-cause-problems" target="_self">don&rsquo;t resort to hitting, spanking or shouting</a>. Punishing a child in this way when they express frustration or anger can set a negative example for how one deals with normal emotions. Take a few deep breaths and get your own emotions in check. Remaining calm will teach your little one to stay calm, too, because children model their parents&rsquo; behavior.

Use a distraction: If your child can&rsquo;t stop crying, distracting them with a book, toy or coloring book is a good bet. If you&rsquo;re at home, offer up an activity that they enjoy, like Legos, a doll or a game, especially if you know it will change their focus. If you&rsquo;re out in public, distraction is a good first resort, but if that fails, try to remove them from the situation at hand.

Do not give in: Abide by your own rules. If you say no to candy, stick to it. Caving in to a tantrum to make it go away quickly can reward your child&rsquo;s uncooperative behavior, giving them the green light to use tantrums to get their way in the future. Another strategy: Try ignoring your child&rsquo;s tantrum. This can help demonstrate that crying and screaming are ineffective.

Offer praise: When the tantrum finally passes, praise them for calming down. Explain exactly what they did right. This positive reinforcement will motivate them to react differently the next time they feel frustrated.

How to tell if it&rsquo;s something more serious 
The occasional squall is nothing to worry about, unless your child&rsquo;s tantrums last longer than 15 minutes, or if they continue or worsen after age 4. Another red flag to seek professional guidance is if your child hurts himself or others. Some children, when upset, forget to breathe and end up holding their breath to the point of almost fainting, while others may refuse daily necessities such as sleeping or eating. Issues such as <a href="https://www.sharecare.com/health/anxiety/article/expert-ways-help-someone-anxiety?partnerid=HCA-EFLA-BROW" target="_self">anxiety</a>, headaches, stomachaches or nightmares that accompany tantrums should also be checked out, as these might be evidence of a more serious underlying condition.

And remember: If your child&rsquo;s tantrums are causing you distress, making you anxious or aggressive, that&rsquo;s a sign you should take your child see a pediatrician&mdash;and that you may want to seek professional help, such as from a therapist, for your own peace of mind.

Medically reviewed in March 2018.

Help, My Kid Won't Stop Crying! How to Solve Temper Tantrums Now

If pediatricians prescribed only drugs approved for kids, we&#39;d have a lot of sick kids. So it&#39;s extremely common for doctors to prescribe medications off-label for children.

Off-label is the term used when a doctor prescribes a medication for a purpose or age group that the Food and Drug Administration (FDA) has not approved&mdash;in other words, that&#39;s not spelled out on the label. Yet, off-label prescribing is very common, totally legal and often excellent medicine.

In fact, around 80 percent of medicine used for kids is prescribed off-label. In some cases, there is good research showing that a particular drug is safe and effective in children, but the pharmaceutical company only applied for FDA approval to use the drug in adults&mdash;because each separate approval (adults and kids) is a long, costly process.

For example, you probably remember hearing about Prozac being approved for treating kids with depression. Actually, doctors had been prescribing it to children off-label for years. The drug company just had not applied to the FDA for approval for kids.

Albuterol, used for asthma, is another good example. Even though it&#39;s only approved for kids over 2 years old, docs regularly prescribe albuterol for children younger than that if it is needed. Not treating asthma is a poor alternative. And albuterol has been used for so long with so much success that it&#39;s now generally considered safe.

The downside of a doctor using medications off-label is that pediatricians have to estimate the dosage for kids based on the amount that&#39;s been proved effective in adults (or, sometimes, in older children).

Pediatricians have had a lot of experience with this. But there&#39;s always some risk of a child getting too much or too little medicine if the dose isn&#39;t calculated correctly, so that&#39;s why caution is key: I always give the smallest dose possible to do the job in order to minimize the odds that the drug will cause side effects.

Medically reviewed in January 2020.

Why Pediatricians Prescribe Medications for Off-Label Use

The little boy was sitting in the ER, crying. He had fallen off his bicycle and broken his arm. And I legally wasn&rsquo;t allowed to fix it.

Why? His parents were out of town and had left him with a caregiver, but hadn&rsquo;t left any documentation on &ldquo;right to approve treatment&rdquo;. While we were legally allowed to stabilize his &ldquo;emergency conditions&rdquo; (which I did), I couldn&rsquo;t initiate procedures to take the next steps to repair it (such as sedation or arranging for surgery) without his parent&rsquo;s consent. Unfortunately, they were on a hiking trip in the backwoods of Canada. So not only was he scared and <a href="https://www.sharecare.com/health/critical-care/how-prepare-children-emergency-room">upset to be in the ER</a>, we weren&rsquo;t able to fully take care of the problem at the moment.

Do you know what paperwork you need to leave with a caregiver when you&rsquo;re away? If not, read on. With a little forethought you can make sure that &ndash; in the event of an emergency &mdash; your children can get the best and fullest care possible. And that can give you peace of mind to truly enjoy your trip. Here&#39;s what to include in your Caregiver ER Checklist.

[Note: This checklist is intended as a guide only. Additional information may be necessary to address your specific healthcare circumstances.]

Personal Info

<ul>
	<li>Your child&rsquo;s full name, date of birth, weight (of course, you&rsquo;ll need this information for every child in the house)</li>
	<li>Your full home address, including cross streets (in case a call needs to be made to 911 or other emergency responders)</li>
</ul>

Medical Info

<ul>
	<li>Medical conditions (from childbirth on, including any hospital stays, such as the NICU as an infant)</li>
	<li>Allergies</li>
	<li>Medications taken</li>
	<li>Insurance cards</li>
</ul>

Physician info

<ul>
	<li>Pediatrician&rsquo;s name, address, phone numbers and office hours</li>
	<li>Dentist&rsquo;s name, address, phone numbers and office hours</li>
	<li>Nearest ER where you&rsquo;d want your child to be taken (I like to leave directions to the ER, too)</li>
</ul>

Contact: 3-point plan 

<ol>
	<li>All phone numbers to reach you, including the name and number of your hotel and anyone else at your location who could get in contact with you</li>
	<li>Phone numbers of your closest relatives</li>
	<li>Phone numbers of your nearest reliable neighbor (who agrees to help) and their address. I also like to leave a second in-town person as backup.</li>
	<li><a href="https://www.sharecare.com/health/first-aid-safety-preparedness/information-call-poison-control-help">Poison Control Center</a> number: 1-800-222-1222</li>
</ol>

Permission to Treat Form 
This form gives a doctor permission to provide medical treatment when your child is in someone else&#39;s care, whether it&#39;s a babysitter or a relative such as a grandparent. If a child is legally considered a minor, the ER must regard the child as such. Requirements for such authorizations may vary by state and/or facilities, so be sure to check what is required in yours.

Medically reviewed in January 2020.

Parenting