Dealing with Loss

By: Jenn Ripepi, MD, The Choosy Pediatrician 

The loss I am referring to is not small losses but eventual big losses. But how we handle small loss can be building blocks to bigger losses. Resiliency is the catch word I'm talking about and there is more research about how important resiliency is to become well-adjusted adults.

Let's Start With a "Little" Thing Like a Lost Toy

What we say to our children is important for them getting prepared for larger disappointments. For example, if we downplay the loss by calling the child's concern unimportant, we are not showing empathy for their attachment to the object. Conversely, if we spend an inordinate amount of time looking for the object or, worse yet, replacing the lost toy whatever the cost, then we may give more importance to the object rather than to the feelings about the object. Tricky, huh?

So How Do We Go About This Task? 

One way is to ask children to try to express their feelings about the loss. Maybe using an example of your own. Using words like sad, lonely or worried may help. Ask about what children think they can do to help get over those feelings or what you can do to help. Older children may be able to imagine what they can do to recover from the toy being gone from their daily life. Maybe they could draw a picture of themselves playing with that toy as a reminder of the fun they had. Or maybe it wasn't really that important and they move on quickly. No need to fret that they have not dealt with it. They have moved past it. They have shown resilience!

Now Something a Bit Bigger Like a Pet

Whoa! That's pretty big to some families. Or maybe it's not a pet but a bird or bug which you notice on a walk. Sometimes that can be a powerful encounter. Again, consider asking questions of children or telling them your feelings of sadness, emptiness or loneliness for the death or physical loss of an animal. These feelings of grief may go on a while if your pet was deeply involved in your family life. Let children know that whatever they feel is OK. Sometimes recalling memories or looking at pictures of your pet and telling happy stories about how the pet enriched your lives is helpful. Stating gratitude for having known your pet whether it is a fish or cat or dog or horse shows children that you accept that sometimes animals are in our lives for just a brief time or a long time.

Now On To People

Heavy subject. Maybe it's not people who have died but people who have moved away or who we've moved away from. Sometimes the person is still with us physically but is unreachable emotionally--like the loss of a friendship. These are very difficult topics and many of us have trouble discussing them at all. But giving voice to these concerns is the way that children learn how to express those whirling churning feelings inside themselves. Saying things like "Mommy is crying because she feels achy inside since Gramma is gone." or "Sometimes I get frustrated because I can't understand why my friend Pete won't talk to me anymore." Apologizing for our feelings does not show resiliency. Denying what we feel inside is not a healthy adjustment. Expressing those emotions and showing our children healthy ways to deal with them like taking a break for vigorous exercise when we feel frustrated, a walk when we feel overwhelmed or helping someone else out when we feel detached from others are great ways to deal with strong emotions. Drawing, writing, pretending and physical activity are ways children can begin to deal with these. Overeating is not a good way to deal with emotions. It can be difficult to lose sight of that sometimes.

Healthy Responses is Key

Teaching children to deal with loss by not trying to "fix" it, overreact to it or blame it on others does not help them to become resilient. Using healthy responses, giving voice to our emotions and supporting children to find their way through loss can go a long way to them becoming healthy, adjusted adults.

Has your family had to deal with a loss of any kind? I’d love to hear your story so we can all help each other with healthy responses.

About the Author: I have been a pediatrician for over 25 years. My husband and I have been privileged to raise 4 bright and healthy children. I have tried to gather wisdom from the families I have been blessed to meet during my journey. I believe in practical and flexible parenting to help raise healthy adults. I love to garden, hike, travel and cook and I am looking forward to hearing from Choosy followers.

In 2016, Let’s Go With 5, 2, 1, 0

By: Dr. Linda Carson

When I was in college I had a professor of early childhood who lectured that “children grow predictably, but their development depends.” In other words, growth (or maturation) will unfold inevitably, but development depends on life experiences. This is a very powerful statement worth reflecting on by adults. Healthy child development depends on the living and learning environments that are created and nurtured by grownups. It is awe-inspiring to be reminded that child development actually depends on the many decisions made on behalf of children by parents, grandparents, teachers, or other significant adults in the life of a young person. We are literally responsible for helping a child develop preferences, resiliency, decision-making, self esteem, social skills, respect for others, healthy habits, and the list goes on and on.

The relationship that parents share with their children has lifelong impact. Studies show that the benefits of sustained parental involvement affect all areas of a child's life, including health, academic progress, and life choices. More “family time” is associated with fewer high-risk behaviors such as substance abuse and delinquency, and lower rates of depression, eating disorders, and antisocial behavior. Other studies have shown that family rituals and traditions are associated with positive mental health outcomes.

So I’d like to suggest a healthy family ritual for 2016 that can impact the quality of life for all family members and have impact for years to come. Let’s embrace the 5, 2, 1, 0 campaign advocated by American Academy of Pediatrics and the Head Start National Center on Early Childhood Health and Wellness. The 5, 2, 1, 0 messages encourage:

• 5 or more fruits and veggies a day: A diet (meals and snacks) rich in fruits and veggies is associated with lower rates of chronic disease and may help prevent weight gain
• 2 hours or less screen time per day: Screen time promotes sedentary behavior, attention problems, and takes away from important and influential family time
• 1 hour or more of physical activity daily: Move more! Children and adults will experience health benefits by increasing and enjoying physical activity each day.
• 0 sugary beverages: Consumption of soda pop, fruit drinks, sports and energy drinks, powdered drinks, and even bottled sweetened tea is associated with cavities and excessive weight gain.

The American Academy of Pediatrics and the Head Start National Center on Early Childhood Health and Wellness have created Growing Healthy resource materials to help us. I especially like the family goal setting worksheet that will help us get started in 2016 with the 5, 2, 1, 0 approach to developing healthy habits. The Family Goal Setting worksheet also has great ideas for getting started. Print copies after downloading it here.

If you have children in your home, use this goal setting approach as a new family ritual and consider downloading our monthly calendars for more ideas for family fun. If you work with families share this information with them. If you do not have children in your home, use this goal setting worksheet for beginning to plan and document a new personal ritual. Be sure that your goals are small and achievable. If five fruits and veggies are unachievable to start, then challenge yourself with a number that can be do-able and increase as you adjust and enjoy. I suggest making your goals visible around your home on the fridge door, bathroom mirror, or a home bulletin board. Maybe you’ll decide to focus on just one of the messages and gradually add each of the others as you make progress. You can decide how to get started and how to use this information to reap health benefits that you will never regret.

So in 2016, let’s remember that children grow predictably, but their development depends---on YOU! And if health is wealth, let’s invest wisely. Happy, healthy New Year from your friends at Choosy Kids!

About the Author: Linda Carson, Ed. D, is the founder and CEO of Choosy Kids, LLC, and the Ware Distinguished Professor Emerita at West Virginia University. An award winning, nationally recognized expert, Dr. Carson has devoted her career to promoting healthy preferences for young children and the adults who make decisions on their behalf. Click here to learn more about Linda.

If You Can: Trash the Stash!

By: Jamie Jeffrey, M.D., FAAP

The nights are cooler and fall is on its way. For a lot of families this is a perfect time to increase their outside physical activity. The cool breeze is perfect for a family walk or trip to a nearby park. That is the good news. But… Fall also brings a flurry of holidays and celebrations. For health conscious families, this can be a tough time to keep the little ones (and ourselves!) on track with nutritious choices.

We start with Halloween followed by Thanksgiving and Christmas. More than ever, these holidays seem to revolve around food, food and more food to celebrate the holiday. The traditional Thanksgiving and Christmas holiday are loaded with food choices saturated with fat, sugar and salt. It makes it really tough to stay healthy. But one of the worse holidays for our kids is Halloween. Candy.  Candy. Candy. Candy at school, candy at Grandma’s house and treat-or-treat at the mall AND in their own neighborhood. Every kid knows which neighbor hands out full size candy bars. Most kids now are seen carrying pillow cases. This is a “supersized” plastic pumpkin. Like a whole pumpkin full of candy isn’t enough for our kids!

On average, each piece of bite sized candy treat contains about two teaspoons of sugar. Multiple sources estimate an average kid will eat 10-15 treats before they get home from the trick-or-treat festivities. Do the math. That would be 20-30 teaspoons of sugar. Hmmm. No wonder they can’t seem to settle down and get to sleep. Can you say, “the energizer bunny?” No wonder my waiting room is full of kids with tummy aches the morning after trick-or-treat. I am always surprised that parents seem “shocked” and have an “ah-ha” moment when I mention that the belly ache could be from too much candy.

So how can Choosy help? Choosy teaches kids to move to music and use movement vocabulary. Halloween could be such a fun and creative time for costumes and fun games and activities. I say TRASH the STASH. Candy corn and bite size candy bars will be everywhere! Preschool, school and family parties should be based on movement and fun…the way Choosy would like it! Plus, a typical child will have to walk 11 miles to stay energy neutral for all the calories and sugar they consume.

I also can offer the following advice for parents to keep their kid’s safe and healthy during the holiday:

• Pick safe, comfortable and brightly colored costumes. Make sure kids can safely walk in their costumes and can adequately see if the costume has a wig or mask. 
• Carry a flash light and add reflective tape to the costume or trick-or-treat bag. 
• An adult should always accompany their children and go to fully lite houses of neighbors that you know.
• Eat a full, healthy dinner with lots of veggie options and lean protein like grilled chicken, turkey or seafood before trick-or-treating activities. Serve water with dinner to make sure everyone is well hydrated. 
• Make a family rule of eating candy only after inspection at home or only 1-2 items until you get home. 
• Try to ration treats and consider swapping for cash or other non-food rewards. You could also donate the candy to a local charity (even though I sometimes feel guilty about this one!).

So think of the song, “Girls Just Want to Have Fun” and substitute the word kids for girls and focus on fun activities that include movement for Halloween and all other holidays as well.

About the Author: Dr. Jamie Jeffrey, M.D., FAAP
Medical Director, CAMC Medical Center
Director of Healthy Kids Pediatric Weight Management Program
Director, KEYS

Dr. Jeffrey is a pediatrician and Clinical Associate Professor of Pediatrics at WVU School of Medicine-Charleston Division. She is also the Medical Director of HealthyKids Wellness and Weight Management Program (HealthyKids) at CAMC. She received her medical degree from Marshall University School of Medicine and completed a pediatric residency at Akron Children’s Hospital in Akron, Ohio. She supervised pediatric residents for the past 20 years. She lives in Charleston with her husband and four fantastic children, ages 10,15,19, and 21.

As Director for KEYS 4 HealthyKids, she works with the community to meet the mission to reverse the childhood obesity epidemic by focusing on policy, system and environmental strategies to enable more sustainable change. This will hopefully provide the system and landscape improvements where the HEALTHY choice is the EASY choice.

Look behind the white coat and you’ll see more than a pediatrician in Dr. Jamie Jeffrey.
“I’m a fixer,” she says. “I love to find problems because then I can go to work on fixing them.”

Why Enforcing Rules Makes a Difference

By: Emily Murphy, Ph.D.

When I reflect on my childhood, I remember certain instances that I would say to myself, “I will never turn into my mother.”  Well guess what, I was wrong.  Don’t be mistaken, I love my mom more than the world itself, but as a head-strong child and adolescent there were certain things that I was convinced that my mom (and dad for that matter) had no clue about.  Below are a few examples of some of these things.

As a very involved and active child, my parents had a rule that both my sister and I were only allowed to be enrolled in a maximum of two organized activities at any one time.  So I was tasked with deciding between field hockey, cello, piano, softball, etc. At the time, I did not see any purpose for this parental decision being forced upon me. The only explanation that I could see through my child lens was that my parents were being mean and selfish.  Boy was I wrong.  Fast forward 15 years to the time when I became a parent myself and the reasons behind that rule now appear crystal clear. My parents developed and enforced this rule because they knew that family time was equally, if not more important than, a multitude of structured activities.

In our busy world today, many parents think that in order for their children to be successful they must get them involved in as much as possible.  But in reality, families need quality time together to be creative, to be physically active together, and to simply enjoy time together.  I often tell parents that I encounter through the various programs that I teach, that being overscheduled does not necessarily translate into having a healthy, happy child.  Many times, being overscheduled mean that children spend a lot of their spare time in a vehicle being transported from one activity to the next, eating fast food in the back of the car, and standing on a sport field waiting for a ball to be hit to them or their turn to play.  Unstructured family time can be filled with family-friendly physical activity like walking the dog or simply playing tag in the backyard. It can be spent preparing meals together, having a family game night, or a variety of other activities. 

Another thing that my parents always made us do when I was growing up was to sit down at the kitchen table and eat dinner together as a family most, if not all, days of the week.  Compared to my closest friends and neighbors, my family was one of the only families that had this ritual.  I used to think that my friends who were allowed to make themselves something to eat, or eat their meal in their bedroom or in front of the TV were so lucky.  Yep you got it, I was wrong again. 

Family mealtimes are important for many reasons.  Family meal times allow family members to connect and talk about important things that are going on in each other’s lives.  Eating meals as a family has also been shown to improve various health outcomes like more healthful dietary patterns (Larson, Neumark-Sztainer, Hannan & Story, 2007). In a study done in 2007, families who ate dinner together every day consumed an average of 0.8 more servings of fruits and vegetables compared to families who did not eat dinner together (Rockett, 2007). These families also had higher intakes of important nutrients such as dietary fiber, calcium, folate, vitamins B₆, B₁₂, C and E, and iron, and they were less likely to eat unhealthy fried foods and drink soda (Rockett, 2007).  In addition, children from families who eat together on a regular basis are more likely to have family support, positive peer influences, and positive adult role models (Fulkerson, Neumark-Sztainer & Story, 2006). 

I am sure glad my parents were right and that I was wrong about many rules that they had as I was growing up. In fact, most of those rules, including the two examples above, are now rules in my own household.  And yes, I am sure that my kids sometimes think that I am mean when I tell them to turn off the TV and put their cell phones away when we sit down together for a meal as a family, but I also know that when they look back at their childhoods they too will realize that my husband and I had these rules because we wanted what is best for their overall well-being. 

About the Author: Emily Murphy is an Obesity Prevention Specialist with the West Virginia University Extension Service.  By trade, she is a Pediatric Exercise Physiologist and her passion is promoting physical activity for kids and families.  While her daytime job is working as a faculty member at WVU, her most important, most rewarding and hardest (at times) job is being a mom to two amazing, creative and loving children.  

A state and national leader in childhood obesity prevention, Emily has nearly 15 years of experience helping children, communities and families get active and healthy.

She holds Bachelor’s, Master’s and doctoral degrees in exercise physiology from WVU. She served as an Extension specialist with the Family Nutrition Program from 2003 – 2005. She then joined the CARDIAC Project at the WVU School of Medicine where she helped implement and gain funding for new programs, like West Virginia Games for Health.

Murphy’s approach to better understanding and helping to resolve obesity issues is to begin by looking at the barriers unique to West Virginians.

To contact Emily, e-mail emily.murphy@mail.wvu.edu, or call 304-293-8589.

My New Arch Nemesis

By: Christine Cox, The Choosy Mommy

I am going to preface this post by saying I am not the kind of parent who kept her child from fast food restaurants. They are great for meals on the go and treats but beyond that, there are other more suitable options available. However, my daughter who is almost 3, has had her fair share of fast food and now recognizes those golden arches every time she sees them. Regardless if we just had a really nice dinner out at a fancy restaurant or even if it isn’t meal time, she will say, “McDonalds! Nuggets! Fries!”

And I sigh.

Where did I go wrong? Every parent needs a break from a meal and my break is usually the drive thru. I try to make healthy choices for us both, but now I feel like I have created an arch nemesis, the fast food restaurant, because she recognizes and asks for it.

Should I feel like a bad parent because she eats fast food? Should I just stop going to fast food restaurants all together? NO! I am going to educate her on making healthy choices and being choosy when we do go to these kinds of restaurants because let’s face it…I might be a choosy mommy, but I am also a busy mommy and sometimes convenience wins.

I am going to teach my children that:

• Fast food restaurants are for certain times. We don’t make an extra stop just to drive thru somewhere because my child says so. I make breakfast, lunch and dinner and on those “on the go” days, or when a treat is warranted (successful potty training meant a milkshake in my house!) we will drive through. No exceptions. 
• There are “healthy” choices on the menu. Many fast food restaurants now have a fruit or yogurt option available for kids and have taken sugary drinks off the menu. And it seems to me that the meal sizes are smaller than they used to be meaning your children won’t eat more than they can chew (get it?!) 
• A penny saved is a penny earned. Right now this doesn’t mean a whole lot to my soon to be 3 year old, but it can make the choice even easier for parents to not eat regularly at fast food restaurants. IT IS EXPENSIVE! Sure, the dollar menus may seem like a bargain but once you add on a side and drink, then it all adds up. You can make a full meal of food similar to what you would find at a fast food restaurant for a fraction of the cost. 

So even though fast food restaurants are my new arch nemesis, I am not going to remove them from our lives and we will still eat at them occasionally. It is a life lesson that all children need to learn as these restaurants aren’t going away any time soon. Have your children check out the "Choosy Size Me" song and let them know that Choosy says...

"So I’ve just got to use my head

When somebody comes up to me and 

says ‘Would you like a burger and fries?’

Tack on a few extra sides

A jumbo size soda to wash it all down

Is that how you want to be?

(Is that how you want to be?)

Let your brain just waste away 

Sitting home watching TV all day

No thanks. I will just Choosy size me 

(Ooh...)

Just Choosy size me (Ooh...)"

Want more? Check out this fun, printable healthy food activity for your children! Click here to access the PDF and print. 

What fast food stops have you been willing to make and why? 

About the Author: Christine Cox is the blog master and The Choosy Mommy for Choosy Kids. She has always had a passion for writing and is honored to contribute her work to this blog. Most of her writing inspiration comes from her daughter, Capri, who is fun-loving and full of energy, and newborn son Cam. Click here to learn more about Christine.

Real Life Heroes!

By: Dr. Linda Carson

As we get ready for another holiday that brings friends and families together for picnics, parades, and fireworks, let’s take just a moment to acknowledge real life heroes---those who have served or are currently serving in our military. Recognizing how busy and stressed we all feel at times, for our Fourth of July this year, let’s lift up military families with young children as our personal heroes for the stress and sacrifice that they make on behalf of us each day while trying to nurture their own families.

Forty percent of military children are under the age of five, and the unique circumstances and challenges facing military families make early childhood years even more vulnerable. Having a parent sent to an active combat zone with an undetermined return date may rank as one of the most stressful events of childhood. And the spouse back at home has to cope with the personal stress of deployment and the insecurities of the youngest children over parental separation.

So, U.S. military families everywhere, we salute you and thank you for your many sacrifices that impact your entire family.

About the Author: Linda Carson, Ed. D, is the founder and CEO of Choosy Kids, LLC, and the Ware Distinguished Professor Emerita at West Virginia University. An award winning, nationally recognized expert, Dr. Carson has devoted her career to promoting healthy preferences for young children and the adults who make decisions on their behalf. Click here to learn more about Linda.

Family Meals for Healthy Kids

By: Heather Dyson

We've all heard the saying, “a family that plays together, stays together,” but it also true that a family that eats together, stays healthy together! Studies show that kids who regularly sit down to meals with their parent(s) even as few as 3 times a week have better eating habits, do better in school and develop healthier social skills than kids who rarely have a family meal. Kids who eat with their family tend to eat a wider variety of food, mostly because they see others at the table eating different foods, including those pesky vegetables. The benefits of eating with our kids reach far beyond food, though. Sitting down to a meal encourages conversation, a rare opportunity for parents to hear what is going on in their children’s world. Frequent family meals are also associated with lower rates of smoking, alcohol and drug use among middle and high school aged kids. All from something as simple as sharing a meal!

If conflicting schedules make daily family dinners impossible, no need to worry! There are 21 meals each week, which means 21 opportunities for sharing a meal with your kids. Remember: you are only aiming for at least 3! Extracurricular activities got you running in the evenings? Focus on the weekends to share a family brunch. Try dedicating one morning a week to get up 15 minutes earlier to have a bowl of cereal with your youngster. Or plan one evening a week where the family can make a simple meal together, so mom or dad isn't solo in the kitchen while everyone roams off with their plates. A family pizza night is quick and easy and can be healthy if you make your own. Purchase pre-made whole grain crust, seasoned tomato or pasta sauce, mozzarella cheese, turkey pepperoni and pre-chopped veggies for a meal that can be put together in minutes and cooked in even less time! Or try something new like these pizza sauces! At the ball field 4 nights a week? Pack sandwiches, raw veggies, fruit, baked chips and bottled water to eat as a picnic after practice.

Getting into the habit of eating family meals while your children are young will make the transition easier as they get older. Just be sure to keep it a priority and remember you don’t have to be perfect and sit down to a fancy meal every night. Kids will cherish and benefit from simply sharing any meal with the most important people in their lives!

About the Author: Heather Dyson is a Licensed and Registered Dietitian who currently focuses on counseling patients with a variety of health situations, and in ages ranging from infancy to elderly. Click here to learn more about Heather.

Yoga is for Everyone

By: Kerry McKenzie

As a yoga instructor, I have had the pleasure to teach a broad range of ages. One of my favorite classes is a family yoga class where the students’ ages range from 3 to 50+. Ever wonder how children learn yoga, especially when they are so young? Imagination and a free spirit help the young learn in many ways! You can conduct your own yoga session at home by following what I did in class. You don’t even need a mat. Just use a towel or blanket so everyone involved has their own space.

At the beginning of the class, as everyone sets up their yoga mats and mingles, I play, "I Like to Move" on the ChoosyNation music CD. I encourage dancing and moving to music to get the “jitter bugs” out.

As a warm-up, I lead the class through several animal poses like giraffe, kangaroo, eagle, downward dog, upward dog, cat, cow, cobra, shark, swan, and dolphin. You can even make up your own! During each pose, I ask the participants what else they think the pose looks like. For instance, cat could also be a tiger and cow could be a howling wolf.  Within each pose, we also try to make the animal noises. Practice this especially with those who are still learning their animals and sounds!

I then walk the group through a flow of poses, moving in and out of postures using the dragon’s breath (sticking your tongue out and pretending fire is coming out your mouth on exhales). The dragon then spreads its wings, lifts its tail (one leg lifted in down dog), then surrenders as the belly is now facing up toward the sky. Finally, the dragon comes alive and flies back home with its wings wide and standing tall. The children in class love to imagine this and really get into it. I played “Puff the Magic Dragon” with this yoga flow. You could also incorporate a lion pose while playing “The Lion Sleeps Tonight.”

Another fun thing to do is play a freeze game using “Choosy Freeze" by Choosy Kids and your yoga mat, towel or blanket. Start the music and move about the room. When the music prompts everyone to freeze, jump onto a mat/towel/blanket and do your favorite yoga pose or make one up. I have learned some cool poses from young yogis.

You can also do partner yoga. For instance, the adult can do a child’s pose on the floor and then a child can climb on top of the adult and do child’s pose on top. You can see this in the picture. Children can do boat pose with their feet pressing together and holding hands and parents can try to crawl under. Then switch the roles. I renamed the pose bridge and we sang “London Bridges”. This is also in the picture! During the other partner poses the music I chose was “Lean On Me” and “Stand By Me.”

Yoga is a great way to relax, increase your strengthen and flexibility or a great partner activity! Have you tried yoga with your children? How old are they? What do you and they like best about it?

About the Author: Kerry McKenzie, B.A., M.S., has been working in education for more than 13 years. She is a Certified Health Coach, a 500 level (E-RYT500) yoga teacher and specializes in early childhood motor development. She has a passion for working with expecting moms, babies, toddlers and preschool age children and their caregivers at Greenville Health Systems pediatric clinic, child care centers and in the community. Click here to learn more about Kerry.