Over the years, I have observed that as our technology has become more sophisticated, parents are allowing their young children to interface more with their smart phones and tablet devices. I frequently see parents wanting to placate their energetic children in the waiting room by handing them mobile devices to play with.  While it may be surprising to watch a three year old child adeptly navigating through a cell phone, he is missed out on the important language, motor, and development skills that can be gained from interpersonal and even individual screen-free play time. 

Limiting screen time enables children to be inquisitive and use their mind/body interaction to make important, long lasting connections in their brain. It is important to be wary of videos that are marketed as educational and targeted towards the under two year old demographic, as evidence has not shown educational validity in such a young age group.  Physical play time is richer in the positive effects that it has on your baby’s brain. It allows them to use problem solving skills, and become stimulated by different textures, colors, and movements. Not only does limiting screen time help to improve bonding between a parent and child, but it will also prevent your child from being sedentary. According to HealthyChildren.org, a website powered by the American Academy of Pediatrics, children who are exposed to more than 2 hours of TV every day have an increased likelihood of obesity as adults. 

Instead of having your child play with your smart phone or tablet, allow them to engage in independent playtime with simple, child-proof objects. This interaction can make a tremendous impact in the road to their life-long learning.

Campaigns such as the “Let’s Move” initiative by First Lady Michelle Obama, have brought to light an important topic: there are a resounding number of American children that obtain very limited amounts of daily exercise. However, what many parents may not know is that physical activity is important even for your newborn.  Simple activities such as “tummy time”, which involves placing your newborn on his stomach while you are watching him, enables your baby to strengthen muscles in his back, neck, and arms. For instance, allowing your six month old child to bear weight on their legs while you hold her upright will help to strengthen her body so that she becomes balanced and stable when several months later she begins to cruise and then eventually to walk. These simple activities help to improve your child’s motor skills and muscle memory. The earlier these habits are introduced the greater the likelihood your child will develop a strong foundation for a healthy, active, and prosperous future.

Surveys have shown that almost one in three American children is overweight or obese, and the epidemic has more than tripled over the last thirty years. The alarming rate of obesity in our country can have lasting effects on the health and wellbeing of our children. Obesity in children has been shown to place them at risk for diabetes, liver damage, high cholesterol levels, and even sleep apnea to name a few.  Moreover, the emotional benefits of exercise through the release of endorphins are a natural way for children to increase their level of happiness. It is never too early to engage your child in healthy physical activity.  Speak with your pediatrician about helpful tips to keep your child active at every age. 

Sure, recycling is good.  But upcycling is better.  It’s not enough to use a product once and recycle it.  It’s so much better to use it again and again before heading to the recycling or compost heap.  Whether you’re a crafter or just enjoy unique artwork and decor, you might find that products made from recycled materials are just SO cool!

Take, for example, these cute fall themed items from Night Owl Paper Goods.  Made with upcycled sweaters, acorns and leftover bits from their manufacturing process of creating wooden greeting cards these cuties are great for decorating the house this season.

Of course, if you’re a crafter or want to get your kids in on sustainable crafting projects, there are plenty of great books available, such as Green Crafts for Children and Craftcycle. Find a project that’s specific for the fall, use an idea for a Halloween costume, or just find a way to use up some of the items that you might accumulate over the holiday season.  Enjoy!

The CDC issued an advisory on June 18, 2008, alerting consumers about the danger to children from lead on some (not all) synthetic turf fields – especially for young children on older fields with visible wear or dust. This advisory is still in effect. The Consumer Product Safety Commission (CPSC) speedily conducted their own evaluation of synthetic turf fields and announced on July 30, 2008 that “young children are not at risk from exposure to lead in these fields,” and that “none of these fields released amounts of lead that would be harmful to children.” While I appreciate the CPSC’s attempt to answer the lead question quickly, I vigorously disagree with the announcement they made based on the testing they did. It’s a disservice to parents of young children.

Let’s look at some of the facts. Because of serious health risks, lead paint is banned if it is more than 0.06 percent lead. The CPSC report is based on results from only six fields in use (as well as a handful of brand new samples from one firm sent to the lab for analysis – which thankfully were not a concern). From two of the six actual fields tested, only a single small sample was tested. Four of the six actual fields tested (all of those that were sampled more than once) were found to contain lead, with the lead content ranging from 0.09 percent to 0.96 percent – or from 50 percent above the amount allowed in paint to 500 percent above this amount.

We know that the lead in paint is released into paint dust that could get on children’s hands and then into their mouths. Is the lead in synthetic turf released in field dust? To answer this question they firmly rubbed a small wipe, about the diameter of a palm, on the field for a few seconds and then measured the lead in the wipe. All of the fields with lead in the turf also had lead on the wipes.

Was the amount enough to harm young children?

The CPSC says that blood levels less than 10mcg/dL in children are safe. THIS HAS NO BASIS IN FACT. They report that they use this level as a safe level because that is what the CDC uses, and point to the CDC’s August 2005 publication “Preventing Lead Poisoning in Young Children” as justification for this. But in this very pamphlet, the CDC says that the level of 10 is “frequently misinterpreted as a definitive toxicological threshold” or in other words, don’t imagine that below ten means safe. In fact, they go on to state, “As the accompanying review of recent studies indicates, additional evidence exists of adverse health effects in children at blood lead levels <10 mcg/dL.”

A number of studies have found lead levels below 10 to impair children’s cognitive function and lower their IQ (including studies by Bellinger in 2003, Canfield in 2003, Chiodo in 2004, Lanphear in 2000, Lanphear in 2005, Moss in 1999, Schnaas in 2006, Tellez-Rojo in 2006, and Wasserman in 2003).

And lead has also been associated with ADHD. A blood lead level as low as 2 mcg/dL is linked to a 4.1 fold increase in the risk of ADHD. Even a level of 1 mcg/dL doubles the risk. Experts estimate that an extra 290,000 children in the US have ADHD because of lead exposure (Braun 2006).

Next, the CPSC assumes that it would take exposure of 15 mcg of lead in a day to raise the blood levels above 10 mcg/dL, so exposure to levels less than 15 mcg would be safe. But the wipe samples had as much as 98.7 mcg of lead. The CPSC assumed, though, that the wipe would pick up about five times more lead than a child would pick up playing on the field for hours and getting lead on both hands, the face, the clothes. So they divided their results by five. Then they assumed that only half the persistent lead would ever make it to the child’s mouth, so they divided those results again by two. I can’t find where either of these assumptions has been adequately validated. Even so, they came up with estimated daily exposures of up to 9.9 mcg in a child’s mouth. To me, this is unacceptably high. For young children, I would pay attention to levels above 1.5 mcg.

Based on this rushed, uncertain science they made these blanket statements to the public in their video press release: “We evaluated a variety of synthetic turf products for lead and found children are not at risk. Based on the testing we did, consumers should not be concerned about using these fields.” And “We examined samples to determine the presence of lead and to test for hand-to-mouth exposure by simulating repeated skin contact. The synthetic turf either had no detectable lead or would not expose hands to levels of lead which would present a risk to children.” I don’t understand how or why they could say these things.

The CPSC did also say that they are asking manufacturers to voluntarily stop using lead in synthetic turf fields in the future and they may set a standard for new manufacturers entering the synthetic turf market. And newer synthetic turf fields already are using less lead.

As I have written elsewhere, I see synthetic turf fields as a complex issue with advantages and disadvantages for our health and for the environment. It will be a while before some of the science is sorted out. In the meantime, I believe that synthetic turf fields should be held to the same 0.06 percent maximum lead content standard that applies to other surfaces such as paint, furniture, and to toys and other items intended for use by children.

CPSC. CPSC Staff Finds Synthetic Turf Fields OK to Install, OK to Play On. July 30, 2008 press release.

CPSC. Briefing Package for Petition for Ban on Lead Toy Jewelry, Petition HP 06-1. December 4, 2006.

A fun, practical, affordable way to help overweight kids? My friend and colleague, Dana Weintraub, MD, from the Division of General Pediatrics at Stanford University School of Medicine and the Lucile Packard Children’s Hospital, led a team that studied the effect of an after school soccer team on weight. The results of SPORT (the Stanford Sports to Prevent Obesity Randomized Trial) were published in the March 2008 Archives of Pediatrics and Adolescent Medicine. Treatment for weight issues is not available for all kids. When it is, the treatment is often expensive, difficult, not very fun, and meets with limited success. Dr. Weintraub, determined to make a difference especially for disadvantaged kids, designed an innovative study that I hope will change what we do nationwide.

The kids in the SPORT study were low-income, overweight 4th and 5th graders from ethnic minorities. Half of the kids were randomly assigned to a supportive soccer team for overweight kids, and given shin guards, uniforms, and water bottles. They practiced after school for 75 minutes 2 days a week, plus 45 minutes of homework help from the coaches. The practice time included 15 minutes of warm-up/stretching, then skills drills, then a scrimmage game. A third session each week was ‘game day’. All sessions ended with a celebratory cheer, and recognition of positive achievements. Total sessions increased to 4 days a week in month 5 of the study, at the request of kids and parents, because the team was so much fun. Medals and awards were given out at the end of 6 months. Most of these kids had not been involved with team sports before.

The other half were randomly assigned to 25 weekly sessions where the kids received state-of-the-art information about nutrition, health, and exercise. This was also enthusiastically received. All of the kids in both groups wore accelerometers to measure their physical activity. Remarkably, all of the kids in both groups completed all 6 months of the study, though they did vary widely in how many sessions they attended.

Those who played soccer, instead of learning about what to do or focusing on nutrition, had significantly better results – with medium to large improvements in their BMIs compared to the other group. They also showed significant improvement in total daily activity, moderate, and vigorous activity. When questioned afterwards, almost all of these kids requested to continue the soccer team.

This appears to be the first study of sports teams of overweight kids as a strategy for preventing and treating obesity. I hope this spurs larger, more comprehensive studies.

In the meantime, team sports with supportive coaches and other overweight kids on the team may be an inexpensive, fun way to get weight under control. Besides the increased physical activity, it might be motivating because of the supportive adult attention, friendships, and sense of accomplishment. I’d love to see this available to all kids struggling with weight, as we sort out exactly what works best.

Weintraub DL, Tirumala EC, Haydel KF, Fujimoto M, Fulto JE, Robinson TN. Team Sports for Overweight Children: The Stanford Sports to Prevent Obesity Randomized Trial (SPORT). Arch Pediatr Adolesc Med. 2008;162(3):232-237.

As summer weather is fading, many families consider taking advantage of the shorter lines at theme parks for one last family outing.  A day at the theme park often involves miles of walking without kids or parents much noticing.  What a fun way to have an active day!  I have fond memories of these trips with my family – both as a child and as a dad. 

Over the years I’ve learned some ways to make theme parks a more healthy (and happy) experience for the entire family.  When we arrive at a park, I take the lead and figure out what is available – this includes attractions and food options.  Food is especially important.  We work at keeping everyone hydrated and ahead of energy drops that come from waiting too long to eat.  By planning ahead we can select the healthiest food options available at the park.

I’m thrilled to see more and more bottled water, fresh fruit, yogurt parfaits, lean meat sandwiches and veggie-patty burgers offered at theme parks.  After our initial discussions we take turns picking the next attraction for us all to enjoy together.  This often leads to weaving our way back and forth across the park, so that we all get plenty of exercise and everyone gets to do at least some of his or her favorite things.

If there are any particularly activities that seem valuable for the body or mind, I pick them for my turn or rave about them in a way that kids will think they are cool.  While waiting in lines we play games like 20 Questions or I Spy or Boticelli.  If you can engage kids attention while waiting, time in line gives you a great time to connect.  Finally, we don’t rush to see everything.  The time together is far more important than getting in one or two additional attractions.

March 10 to 16 is Brain Awareness Week. One important way to take care of your child’s brain is to protect it from injury. Thankfully, wearing helmets has become common and cool while riding bikes. I hope helmets become just as natural during other fun activities, such as skateboarding, scootering, horseback riding, ATV or dirtbike riding, skiing, and even for those last few sled runs of the season.

As a child, I never wore a helmet while racing down a hill on a sled – or on a bike. Now I’ve seen too many serious head injuries, and too many children whose brains were saved by helmets, to ever feel comfortable seeing an un-helmeted racer again.

According to the Consumer Product Safety Commission, there are about 3 million head injuries related to activities like these treated in US emergency rooms each year. Almost half a million of them result in concussions or skull fractures.

Helmets can make all the difference. How cool is that?

Roller coasters are fun! Nevertheless, a study in the January 2002 issue of the Annals of Emergency Medicine reported a disturbing trend in the rate of thrill ride injuries.

Overall, the risk of injury is low. Of the 900 million rides taken in the US each year, about 1 in 124,000 result in a significant injury that is detected. Only about 1 in 15 million require hospitalization and 1 in 150 million rides taken results in a death. Most of the worst injuries are from internal bleeding or from brain damage.

As my own children learned while playing Roller Coaster Tycoon, the fastest rides often have the longest lines, creating a strong incentive to build them bigger, faster, scarier.

Each time the G forces are increased, the risk of injury (detected and undetected) also increases. And thus the rate of injuries is going up each year.