Dr. Bob: I am worried about my child’s weight. I read so much about too many children being overweight and all of the concerns about pre-diabetes. Do you have any suggestions?
Answer: You are right to be concerned. Multiple factors appear to be contributing to increased weight in too many children. Less exercise, less healthy food (fast food, processed food) and overall less attention to nutrition certainly contribute to the problem. The discussion about childhood obesity is actually quite complex and involves so many potential interventions and needs to be tailored to each child and family. Please remember that this should be considered a family problem to tackle.
Let me suggest some basic guidelines advanced by the American Academy of Pediatrics – 5-2-1-0, especially for children ages 2-9. Following these recommendations can be quite helpful.
- 5 – Consume at least 5 servings of fruits and vegetables daily. This is admittedly difficult to do but worthy of our best attempts. But let’s be honest. If the parents don’t lead the way in these attempts, children don’t stand a chance. It takes a family effort to set the stage for healthy habits to last a lifetime.
- 2 – Limit screen time to no more than 2 hours per day. Too much screen time leads to sedentary behavior, less exercise and play. This two-hour guideline does not include any instructional time or homework. This limit applies to video games, TV time or watching videos on the computer, phone or tablet. Two hours is plenty of time for video “play” time. Please substitute less screen time with play, exercise and reading.
- 1 – Attain at least 1 hour of physical activity daily. It is worthwhile for the whole family to consider some organized activity so everyone can start adopting healthy habits.
- 0 – Consume 0 sugar-sweetened beverages. Sugary beverages are one of the major culprits for childhood obesity and the increase in pre-diabetes. In the South, we consume far too much sweet tea and other sodas and fruit drinks with sugar. Choose water and sparingly use fruit juice. We really don’t know the long-term effect of diet sodas so those should be avoided if possible.
So, think 5-2-1-0 and you will be making great strides. And remember, never single out the child as having a problem. The whole family needs to work together on 5-2-1-0 and help nurture the child through these steps.
Dr. Bob: My eight-year-old daughter has been having problems with sleeping and wants to sleep with us. What should I do?
Answer: Try to talk with your child in a supportive way that allows them to be honest about the problem. Do not be judgmental as the child explains the problem and avoid a flippant “don’t worry about it” answer. It is fine to show your concern while you emphasize that you understand their fears or whatever is upsetting them.
I would discourage having her sleep with you. You will need to consider other options. Maybe you can sleep in her room for a night or two. Maybe you use an air mattress and have her sleep nearby to your room. There are multiple possibilities to consider. With support and nurturing, short-term solutions can be sought. If the problem appears more serious than a transient situation, seek the assistance of your pediatrician.
Dr. Saul is Professor of Pediatrics (Emeritus) at Prisma Health and his website is www.mychildrenschildren.com. Contact Dr. Bob at askdrbobsaul@gmail.com with more questions.