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Safe indoor and outdoor activities for families in the time of Coronavirus

From The Center for Discovery

As more and more school systems close and families across the country follow mandates and start to socially distance themselves in order to help stop the spread of the coronavirus, parents are scrambling for ideas on how to occupy their children – off the grid. So, if you want to keep the phones, tablets, computers and gaming systems to a minimum – other than for the purposes of online learning – we’ve complied some great ideas for you and your children of all ages and complexities.


The first rule of thumb is to set and keep a predictable schedule – for all children of all ages. Since school, leisure time and all activities are now at home, perhaps consider a white board or chalkboard or simply type up a basic schedule in big, bold letters and hang on the refrigerator for everyone to see. Here at The Center for Discovery, we know that predictability in schedules helps end confusion and eases anxiety and fear in children and adults with complex conditions.


The Great Outdoors – Fresh Air and Fun


If you have access to the great outdoors, even just a backyard, here’s a few ideas to enjoy the fresh air:


‍        • Decorate a shoebox and go on an adventure collecting favorite rocks, acorns, twigs, pinecones. You can even make animals from the treasured pinecones and acorns with pompoms, googly eyes, construction paper, feathers, pipe cleaners, and more.

‍        • Go on a botany adventure! With a notebook and crayons/pencils in hand, try to draw local plants and observe what’s already budding.

‍        • Collect rocks and categorize or paint them! Here at TCFD, we have a painted rock garden with inspirational pictures and sayings.

‍    • Play balloon tennis. No racquets? No problem. Use your hands, which is great for hand-eye coordination.

‍    • Ball Challenges. In partners, try bouncing a small ball right hand-to-right hand, and left-to-left.

‍   • Obstacle  courses are a fan favorite! The skies the limit – use hula hoops, sidewalk chalk, tunnels, paper circles for markers, sturdy tape.

‍     • Preparing the garden for planting – rake, weed and plant a vegetable garden.

‍    • Build a slackline! Got two trees? Look around the garage for tubular webbing, carabineers and an old piece of carpet and voila – hours of fun trying to balance!         

‍    • Start a weeklong fitness challenge – indoors and out – jump rope, sit-ups, pushups, etc. Team up – kids versus adults to see who has the muscle!

‍    • Potato sack races: an old game with a few old pillowcases equals endless fun.

‍    • Three-legged races: team up adult and child and see who wins!

‍        Bubbles, Bubbles, Bubbles! Everyone loves bubbles. 


Too Cold to Head Outdoors? Check out these Ideas for Tons of Indoor Fun!


‍     • Go camping! Build tents with blankets and pillows, and decorate with favorite stuffed animals, plastic figurines, flashlights, etc. Snuggle inside and read books and tell stories!

‍    • Hunt for Treasure! Hide “treasure” all over your home and devise cleaver clues to bring your treasure-hunters closer or farther away from the cache.

‍    • Cook, cook, cook! It’s a perfect time to spread your love for food and nutrition. You can have a bake-off challenge between siblings, or even mom vs. child!

‍    • Smoothie Challenge. Find out who’s got the perfect recipe!

‍    • Bag puppets! Remember them? A paper bag – construction paper and crayons? Bits and pieces of material and imagination and you are on your way to a fantastic puppet show.

‍    • It’s all about art! Plan an art show by challenging your children to draw a picture and then make it come alive with materials from your house or backyard. Recently, students and residents from TCFD won a statewide competition making this amazing mixed-media work (link to blog post).

‍    • Feeling silly? How about a dance party? It’s a great way to expel some energy, while also having tons of fun – great from the heart and soul.

‍    • The Voice…at home! You don’t need a karaoke machine to get this going, just lyrics from your favorite songs – on your phone or on a Bluetooth speaker.

‍    • The Wow Factor! Bring science right to the kitchen table. Make corn dance or homemade lava lamps. Who doesn’t love a fizzy baking soda-vinegar reaction? Here’s a great resource: https://littlebinsforlittlehands.com/dancing-corn-thanksgiving-science-activity/.

‍    • Don’t have a lot of space? Try some simple kid-based yoga videos on YouTube and meditation Apps. In fact, even if you have space – try the yoga and meditation with your children. It’s a great break from your day!


Slow it Down

‍    • Remember all those pictures saved on your phone? Start organizing them into digital albums.

‍    • Books! Books! Books! Designate an hour each afternoon or evening to sit together and read aloud a picture book. Kids too old? Just cozy up on the couch and read. TV – off!

‍    • Game Night (or day)! Get those competitive juices going and play some board games – or even simple card games.

‍    • Movie Night! Grab some snacks (healthy, of course) and head to the couch for some old family favorites. Make a calendar with each family member’s choice and day of “showing.”




Yes, we ARE seeing sick kids …

And yes, we DO Covid swabs!


Contrary to some recent Facebook posts, we are seeing sick children in our office, including those with fever. We do this in separate rooms from those we use for well-care visits and vaccines, and we do it with safety in mind - both patient safety and our safety. Certain high-risk patients, such as those with severe cough and high fever, are sent to urgicenters, but these are the exceptions, rather than the rules. Again, we are seeing sick kids in our office.


We also do Covid swab testing in our office, both PCR testing (4-5 days) and antigen testing (15 minutes).



We have some new faces!


We’re really excited to have added some wonderful clinicians to the Kidfixer line-up, and we’d like you to meet them. They will be seeing patients and taking some of your phone calls and Telehealth “visits” as well. We think you’ll really enjoy meeting them. Here’s a quick rundown:


Lauren Brunn, MD …

… Is a Brooklyn native, and graduate of CUNY Brooklyn College and SUNY Downstate College of Medicine. Dr. Lauren completed her pediatric residency at North Shore-Manhasset. We “recruited” Lauren from another Long Island practice and are thrilled to have her (partly because she’s a champion cake-baker). Lauren will be starting in December. We can’t wait for you to meet her!






Brittany Andriano, NP...

… Graduated from the University of Massachusetts and practiced as a pediatric registered intensive care nurse for 7 years before completing her Nurse Practitioner degree from Stony Brook University. Until January “NP Britt” is on maternity leave, binging on Netflix shows with her BRAND NEW baby, Vinnie!






Pamela Bacani, NP...

… Has over a decade of varied pediatric experience. She originally focused on intensive/critical care, including baby heart (cardiothoracic) surgical management, then earned a Pediatric Nurse Practitioner degree from NYU. Since moving to LI, her kid-fixing involves primary and urgent care management. When not working or taking care of her two kids, Pam loves working out while eating breakfast (sounds messy, no?)





Kids Healthy Eating Plate

From the Harvard Nutrition Department

The Kid’s Healthy Eating Plate is a visual guide to help educate and encourage children to eat well and keep moving. At a glance, the graphic features examples of best-choice foods to inspire the selection of healthy meals and snacks, and it emphasizes physical activity as part of the equation for staying healthy.


Building a healthy and balanced diet


Eating a variety of foods keeps our meals interesting and flavorful. It’s also the key to a healthy and balanced diet because each food has a unique mix of nutrients—both macronutrients (carbohydrates, protein, fat) and micronutrients (vitamins and minerals). The Kid’s Healthy Eating Plate provides a blueprint to help us make the best eating choices.


Along with filling half of our plate with colorful vegetables and fruits (and choosing them as snacks), split the other half between whole grains and healthy protein:


Veggies


• The more veggies – and the greater the variety – the better. 


• Potatoes and French fries don’t count as vegetables because of their negative impact on blood sugar.



Fruits


• Eat plenty of fruits of all colors.


• Choose whole fruits or sliced fruits (rather than fruit juices; limit fruit juice to one small glass per day).


Grains


• Go for whole grains or foods made with minimally processed whole grains. The less processed the grains, the better.


• Whole grains—whole wheat, brown rice, quinoa, and foods made with them, such as whole-grain pasta and 100% whole-wheat bread—have a gentler effect on blood sugar and insulin than white rice, bread, pizza crust, pasta, and other refined grains.


Protein


• Choose beans and peas, nuts, seeds, and other plant-based healthy protein options, as well as fish, eggs, and poultry.


• Limit red meat (beef, pork, lamb) and avoid processed meats (bacon, deli meats, hot dogs, sausages).


Fats


• It’s also important to remember that fat is a necessary part of our diet, and what matters most is the type of fat we eat.We should regularly choose foods with healthy unsaturated fats (such as fish, nuts, seeds, and healthy oils from plants), limit foods high in saturated fat (especially red meat), and avoid unhealthy trans fats (from partially hydrogenated oils):


• Use healthy oils from plants like extra virgin olive, canola, corn, sunflower, and peanut oil in cooking, on salads and vegetables, and at the table.


• Limit butter to occasional use.


Dairy


• Dairy foods are needed in smaller amounts than other foods on our plate.


• Choose unflavored milk, plain yogurt, small amounts of 

cheese, and other unsweetened dairy foods.


• Milk and other dairy products are a convenient source of calcium and vitamin D, but the optimal intake of dairy products has yet to be determined and the research is still developing.For children consuming little or no milk, ask a doctor about possible calcium and vitamin D supplementation.


Water


• Water should be the drink of choice with every meal and snack, as well as when we are active:


• Water is the best choice for quenching our thirst. It’s also sugar-free, and as easy to find as the nearest tap.


• Limit juice—which can have as much sugar as soda—to one small glass per day, and avoid sugary drinks like sodas, fruit drinks, and sports drinks, which provide a lot of calories and virtually no other nutrients. Over time, drinking sugary drinks can lead to weight gain and increase the risk of type 2 diabetes, heart disease, and other problems.


Stay active!


• Finally, just like choosing the right foods, incorporating physical activity into our day by staying active is part of the recipe for keeping healthy:


• Trade inactive “sit-time” for “fit-time.”


• Children and adolescents should aim for at least one hour of physical activity per day, and they don’t need fancy equipment or a gym—The Physical Activity Guidelines for Americans suggest choosing unstructured activities for children such as playing tug-of-war, or having fun using playground equipment.





Diet Can Change Activity of Genes that Impact Health 

From the Tufts Nutrition Newsletter

A biological process can change the affect of our genes on health, without changing the gene itself. Called “DNA methylation,” this process can determine if a given gene is active, or not. New research from the Friedman School’s Jiantao Ma, PhD, and Alice H. Lichtenstein, DSc, found diet quality was associated with the level of DNA methylation of certain genes; the DNA methylation in turn altered the association of these genes with health outcomes. In other words, what we eat may impact our health on a genetic level. 


The researchers analyzed the diet quality of nearly 10,000 individuals using two common diet quality scores. They then looked at over 400,000 DNA methylation markers in the blood of these participants. In individuals with European ancestry, 30 methylation markers were associated with diet quality scores. Of these 30 markers, 12 were associated with mortality, and six were likely causal factors for cardiovascular risk factors (like body mass index, triglyceride levels, and type 2 diabetes). 


This research suggests that a high quality diet (one that emphasizes fruits, vegetables, nuts/seeds, legumes, whole grains, and plant oils and limits refined grains, added sugars, processed meats, and other high-saturated-fat and high-sodium foods) may alter your genetic predisposition to heart disease, regardless of your level of familial risk. 





Parental Screen Time and Effect on Children

Journal of Pediatrics


The topic of digital device usage is a growing area of importance as devices are increasingly becoming a part of daily life for people of all ages worldwide. The medical field has made recommendations on limiting screen use for young children. However, new data are emerging that goes beyond focusing on just child screen time. In this volume of The Journal, Wong et al disentangle the factors of parent screen time, distracted parenting, parent-child interactions, and child behaviors. They used data from 1254 parent-child dyads (mean child age 3.4 years) from disadvantaged backgrounds in Hong Kong and evaluated the use of parent and child electronic use, parent-child interactions, and children's psychosocial behavior.


Results showed that increased parent technology use was associated with higher levels of distracted parenting, reduced parent-child interactions, increased child screen time, and psychosocial difficulties. Additionally, children's internalizing difficulties were related to parent's high use of digital devices primarily because of the reduction in parent-child interactions. Children's externalizing behavior was related to increased problematic parental device use through reduced parent-child interactions, distracted parenting, and increased child screen time. These results suggest that limiting parental use of electronics in front of young children may be beneficial and help foster child psychosocial development.




Mask Facts

From the CDC


Wear your Mask Correctly

‍        Wash your hands before putting on your mask

‍        Put it over your nose and mouth and secure it under your chin

‍        Try to fit it snugly against the sides of your face

‍        Make sure you can breathe easily


Wear a Mask to Prevent Getting and Spreading COVID-19

‍        Wear a mask that covers your nose and mouth to help prevent the spread of COVID-19

‍        Wear a mask in public settings when around people who don’t live in your household, especially when it may be difficult for you to stay six feet apart

‍        Wear a mask correctly for maximum protection

‍        Don’t put the mask around your neck or up on your forehead

‍        Don’t touch the mask, and, if you do, wash your hands or use hand sanitizer to disinfect

‍        Stay at least 6 feet away from others

‍        Avoid contact with people who are sick

‍        Wash your hands often, with soap and water, for at least 20 seconds each time

‍        Use hand sanitizer if soap and water are not available


Take Off Your Mask Carefully, When You’re Home

‍        Untie the strings behind your head or stretch the ear loops

‍        Handle only by the ear loops or ties

‍        Fold outside corners together

‍        Place mask in the washing machine (learn more about how to wash masks)

‍        Be careful not to touch your eyes, nose, and mouth when removing and wash hands immediately after removing.


How to Store Your Mask

‍        Store your cloth mask properly and wash it regularly to keep it clean. Consider having more than one mask on hand so that you can easily replace a dirty mask with a clean one. Make sure to remove your mask correctlyandwash your handsafter touching a used mask.

‍        Store wet or dirty masks in a plastic bag

‍        If your mask is wet or dirty from sweat, saliva, make-up, or other liquids or substances, keep it in a sealed plastic bag until you can wash it. Wash wet or dirty masks as soon as possible to prevent them from becoming moldy. Wet masks can be hard to breathe through and are less effective than dry masks

‍        Store masks that are not wet or dirty in a paper bag

‍        You can store your mask temporarily to reuse later. Remove your mask correctlyandwash your handsafter touching a used mask. Keep it in a dry, breathable bag (like a paper or mesh fabric bag) to keep it clean between uses. When reusing your mask, keep the same side facing out.

‍        If you are taking off your mask to eat or drink outside of your home, you can place it somewhere safe to keep it clean, such as your pocket, purse, or paper bag. Make sure to wash or sanitize your hands after removing your mask. After eating, put the mask back on with the same side facing out. Be sure to wash or sanitize your hands again after putting your mask back on.


How to Wash Your Mask

‍        Wash your cloth mask whenever it gets dirty or at least daily. If you have a disposable face mask, throw it away after wearing it once.

‍        Using a washing machine,nclude your mask with your regular laundry.

‍        Use regular laundry detergent and the appropriate settings according to the fabric label.

‍        By hand, wash your mask with tap water and laundry detergent or soap; then rinse thoroughly with clean water to remove detergent or soap.




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The Kidfixer Newsletter            Winter, 2020