I’m 9 Years Old – Do I Really Still Need a Booster Seat?

My son doesn’t want to use a booster seat anymore. I can see his perspective: none of his friends use one any longer and he thinks the seat belts in our cars fit him just fine. So why bother?? Because he’s just nine. And because crash studies and child safety guidelines from experts like the American Academy of Pediatrics indicate that  he still needs to be using one. Although he thinks he’s so smart and grown up, he’s just a kid – and I’m the parent. And I actually know what it feels like to be injured in a car crash.

Guidelines issued by the American Academy of Pediatrics in 2011 recommend that kids use a booster seat until they are at least 4’9” tall (57 inches) and weigh between 80 and 100 pounds. This will likely be around the ages of 8-12 years. But it’s the physical dimensions that matter most. Kids need to be large enough to fit properly in the seatbelt – and mature enough to ride without slouching down and defeating the whole purpose of the belts. Focusing on the age of the child to guide booster seat decisions can be misleading. Last spring – at 9-years of age – my son measured in the 75th percentile for both weight and height at his annual pediatric visit (meaning he was taller and heavier than 75% of other nine-year olds)….and he STILL DIDN’T meet the criteria for graduating from a booster seat – he’s not yet 4’9” and weighs only just over 80 lbs. So why are we in the minority in our community in still using a booster seat?

The problem is that many state laws – and therefore local communications about what constitutes safe car travel for older kids – haven’t caught up to these recommendations (click here for a summary of state laws on child passenger safety). Many states – like Alabama, Colorado, Iowa and Nebraska (to name just a few) focus exclusively on age – without the all-important height and weight requirements. This list includes my state of Indiana which allows children over age seven to shelve the booster seat, no matter how big they are. My son’s best friend – also nine – stopped using a booster seat last year. He’s fully THREE INCHES shorter than my son. How can he possibly be safely restrained by an adult seat belt during a crash? And this isn’t just a theoretical issue. Safe Kids USA reports that children seated in a booster seat in the rear of the car are 45% less likely to be injured in a crash as compared to those using a seat belt alone.

While this is bad enough, some states – like Florida, Arizona and South Dakota don’t even have booster seat laws. In these states it is legally permissible for children as young as age 4 and 5 to use adult seat belts. Is there some reason why the children in these states are less likely to be involved in a traffic accident – or that they are somehow more resilient in a car crash?

Let’s face it – the process of proposing and passing laws is complicated and time-consuming. Hopefully all these states will eventually get on par with the guidelines, joining states like Georgia and Maine. However, in the meantime it’s our children riding in the back seat and I would rather base my car safety approach on best-practice guidelines than rely on the timeline and politics of my state judicial process.

So, in our house the 4’9” rule prevails. We even got out the measuring tape recently and determined my son has an inch to go. He’s counting down every day. And he understands that I’m following new expert recommendations to keep him safe – and that his friends’ parents probably just aren’t aware of these guidelines, which is too bad.

Children, Follow My (Healthy Eating) Cues

Feeding behaviors are solidified early in life. In general, children are wonderful examples of listening to their hunger and satiety cues. Both of my children are great examples. My son is a really big eater in the morning and into lunch time and then has a tendency to pick the rest of the day. While other days, he eats very little. My daughter, on the other hand, eats a small amount at breakfast and then slowly picks up throughout the day. Some days, she seems to eat the amount a grown woman would eat! But I trust she is accurately listening to her own body as she remains active and her weight is following a healthy growth curve.

Unfortunately, many parents confuse children when they tell them to eat because it is meal time. Parents think, “Surely they should be hungry because they haven’t eaten in several hours.” And not only do some parents make children eat, some make them clean their plates. I recently wrote a letter to a well-known, elite school here in Dallas when the mother of one of my pediatric patients (who happens to be a physician) told me they still practice the clean plate club at their school. Really?! I thought everyone has figured out by now that this is not a good thing to do if we want to encourage healthy eating. The clean plate club trains the body to “untrust” its physiological signals to eat or not to eat. This approach may have started back in the Depression when food was scarce, but I see many adult patients that are still trying to unlearn what they were taught by their parents. “Do not get up from this table until your plate is clean.” Or, “If you want that dessert, you better eat everything on that plate.” Dietitians cringe at the thought, although I truly believe parents are very well-intentioned.

One of the best food behavior gifts we can give our children is the gift of trusting in their own hunger and fullness cues. I credit my own mother for allowing me and my siblings to make our own decisions to eat or not, and I firmly believe this has been one of the foundations to my healthy relationship with food. We ate as a family at the table without distractions (this is key), which helped us in listening to our individual cues. Because of mom, I can have my favorite food under my nose and if I am not hungry, I have no desire to eat it.

Paula Ryan, MS, author of the Healthiest Regards Blog, posted a great hunger and satiety scale that I wanted to share with readers. It’s one of the best I have seen because it also lists the consequences of waiting too long eat, or not stopping when the body says it has had enough. If you find yourself eating in the absence of hunger or waiting way too long to eat, consider printing this scale off and going back to the basics. Many people eat for reasons other than hunger –  like when they are stressed, mad or sad. Deal with those issues directly instead of turning to food. It may be easier said than done for some, but this can be a start to a healthier YOU in 2012. And a healthier you means a healthier family because the children are watching – and doing what you do.

8 Ways to Help a Shy Child

Being a shy child isn’t easy – and for many parents, neither is raising one. You want your child to be happy and make friends, and when you see her hang back, your tendency is to push her into social situations. But pushing won’t give her the skills to control her shyness, according to Bernardo J. Carducci, Ph.D., director of The Shyness Research Institute at Indiana University Southeast.

“Adults think that being outgoing should be naturally occurring, but this is not something you grow out of,” says Dr. Carducci, who has also written The Shyness Breakthrough: A Stress-Free Plan to Help Your Shy Child Warm Up, Open Up, and Join the Fun.

Here are Dr. Carducci’s tips for teaching your child to overcome insecurity and succeed in social situations.

1. Love your child for who she is, not who you want her to be.

A child who undergoes social pressure doesn’t need the added stress of feeling like a disappointment. “You don’t want her to think that because she’s a little different you don’t like her,” says Dr. Carducci.

2. Show up early and give your child a chance to warm up.

Be one of the first ones at the party so your child can acclimate slowly as guests arrive. Allow her to just sit back and observe – even if it’s uncomfortable for you. While you’re waiting, prepare her for action by helping her think of ways to approach the other kids.

3. Help build your child’s confidence one step at a time.

Invite a school friend over to your home – a comfortable environment. Next time, take them to the park or invite a third child over. The key is to build on your child’s success by introducing new social elements one by one.

4. Remind your child of past strategies and successes.

Before your child enters a social situation, look for similarities to situations he’s faced before. Remind him how he handled things that time, and show him how this upcoming encounter is not an entirely new situation.

5. Use family time to discuss and practice social skills at home.

Over dinner, talk about what your child can expect from a certain social experience in advance. Do play-date post-mortems to remind your child of her strengths and problem-solving techniques. Be sure to include her in conversation and save adult-only discussions for later.

6. Give your child a diversity of social experience.

Bring him to different public places – the supermarket, library, post office – where he can engage with other people. Have him hand over the cash or the library card. Ask him to give the mail to the postal worker instead of dropping it in the box.

7. Be involved in the lives of others where sharing occurs.

Join a volunteer project and bring your shy child with you. That way she can see people with common goals and values working together. Help out an elderly neighbor together so your child participates in acts of kindness.

8. Be social too.

“Let your child see you be outgoing – talking to people, inviting people over,” says Dr. Carducci. Just like reading in front of children helps them become readers, socializing in front of a shy child helps her overcome her insecurities and learn the social skills she needs.

Daycare vs. Babysitter – Is There a Right Choice?

So I am about to do something I never ever thought that I would do…Hire a babysitter to watch # 3 in my house – Gasp! I am a big, big proponent of daycare and I am famous for standing on my soap box and telling anyone who will listen why to choose day care over a babysitter. And here I am seriously considering a sitter. So let me tell you why I’m torn. For my 1st child I absolutely was sending her to daycare. In a nutshell I prefer it. Let me say generally when I say day care I am referring to one that you have thoroughly researched and are sure it is licensed and has no violations against it and one that is NOT in someone’s house.

I can honestly go on and on about daycare but I don’t have the space here so I’ll put my top two reasons.

1. Socialization…the socialization children receive in a daycare setting is priceless. Your child will learn how to share, play with other children and wait their turn and wash their hands and eat together at a table and …the learning is endless.
2. Accountability… chances are your child will never be alone with an adult in day care, it’s pretty difficulty, most daycares have open bathrooms for the little ones (no doors) so there’s no privacy. In all the years I have been a prosecutor in child abuse and sex crimes I have handled thousands of cases, I personally have never had a physical or sexual abuse case where the child was victimized at day care. My office has handled a handful of physical abuse case against a daycare worker but that is the exception not to rule. However, and this is huge, in most of my cases (when I say most I mean 100%)… where there is an allegation of sexual or physical abuse of a child the accused is a family member or a close friend. The accused is NOT a stranger. Unless you have a nanny cam there is no accountability for your sitter.

It is a huge step to trust someone with your child especially your first because chances are you have never seen the sitter take care of a child before. So you may ask why would I go against my own advice now and choose a sitter for #3? Convenience, that’s why. I am all ready to go back to work (not really but I must) and I have no child care lined up for #3. I was considering a few daycares and discussing this dilemma with my cleaning lady/ occasional babysitter/friend when she said “I’ll watch the baby!” WOO HOO really I thought? I love, love, LOVE this woman and so do my kids. I never even thought about having a babysitter until she suggested it. And you know what she said to me? “You can’t send #3 to daycare, you need someone here to clean up for you and to cook dinner for you!” REALLY? Yes I do actually. I really trust this woman and I have seen her with my kids. I have been to her house and know her family. Sometimes she even stops by unexpectedly on a Saturday and plays with my kids.

Returning to work with 3 kids will be a lot. And the less I have to do when I get home the easier my life is. My job is tremendously stressful and I don’t want to worry about all the extras when I get home from work. I want to come home and play with the kids and hear all that I missed while I was at work. All of my worries went out the window with a 3 minute conversation with a friend. I know my kids will be safe and happy with the sitter … still, that’s not to say there won’t be a camera in this house.

Where Do Children Drown?

In the U.S., a disproportionate amount of press is given to children drowning in swimming pools, and while it’s true that children ages 1-5 are most likely to drown in swimming pools, it’s not the whole story, and I think it gives parents a false sense of security about water safety. It’s important to know the different dangers, and how to teach your children to navigate the dangers at any age.

So, let’s look at where children are most likely to drown at different ages and what you need to know:

Age: For infants, birth to one year, bathtubs pose the greatest danger. The statistics don’t break it down by months, but I’d guess it’s as soon as your baby can sit upright unsupported that you feel you can dash out of the bathroom to grab clean jammies, answer the phone, or stop a fight between your older kids. Or maybe you think they are safe in that bath seat with the suction cups on the bottom. Or you put the baby in with an older sibling who, you are sure, will raise the alarm if necessary.

Solution: Never, ever leave your child alone in the bathtub until they can swim the length of a 25m pool. Young children reach for toys and fall over. Those seats tip over – never trust them unless you are in the room, or don’t buy them in the first place. As for older siblings, well, they may feel a bit conflicted about your new bundle of joy and give a gentle push or not call if the baby falls over, but then know they did something wrong and not want to get in trouble. It takes one minute of submersion for brain damage to begin and two minutes to die.

Age: 1 to 5 – swimming pools.

Solution: Check out www.poolsafely.gov for great trips on keeping your pool safe. The best rule of all, tell your children to ALWAYS have an adult with them when they go near water. When I had a pool, the rule was no one could even go down the steps to where the fenced pool was without me. Period. This is one limit you need to set and stick to diligently. When your child is in the pool, you need to watch them, constantly. The lifeguard is not there to babysit and since I know you understand how hard it is to keep an eye on one child, imagine a lifeguard trying to watch 200 children. The most important strategy is to talk to your child regularly about how to act around water – no horseplay (dunking isn’t fun, it’s scary and dangerous), always have an adult nearby, and KNOW YOUR LIMITS!

Age: 6 to 12 – open water

Solution: Lifejackets in boats. Again, a non-negotiable rule. But beyond that, again, talk to your child, have them in regular swimming lessons, and help them to KNOW THEIR LIMITS. A tranquil pool is radically different from the wave pool at a water park or the surf off Santa Monica. For complete guidelines, Seattle Children’s Hospital is cutting edge. (insert link: http://www.seattlechildrens.org/classes-community/community-programs/drowning-prevention/open-water-guidelines/ )

Age: 13 to 18 – alcohol

Solution: It’s not just drinking and driving you need to be worried about, it’s drinking and drowning. Alcohol is the greatest contributing factor in drowning deaths for teenagers. By now, hopefully, you’ve been talking to your teenagers about the dangers of mixing alcohol and heavy machinery, you need to add in what happens when you mix with water. And again, teach them to KNOW THEIR LIMITS around water because teenage bravado, alcohol and water are an unforgiving combination.

All fairly dismal statistics, but as you know, I’m all about JOY! in the water. If you are teaching your child, from birth, to navigate water respectfully and safely, while they have fun, you have given them the greatest gift of all, you have taught them to navigate their environment independently and intelligently – and isn’t that what parenting is all about?

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