CHARACTERISTICS OF QUALITY CHILD CARE

Quality Child Care:

1.  Is appropriately licensed or registered as required by the state in which it is located

2.  Does not have serious/numerous licensing violations or complaints

If the above two conditions are met, the assumption is that the following are also true of the child care program.  However, this may not always be the case and you need to make sure that in your experience with the program it:

3.  Is neat and clean

4.  Has curriculum/activities that are appropriate for the age of the children

5.  Is safe

6.  Is well-staffed and the children are well supervised (check what your state's staff to child ratio requirement are)

7.  Leaves you feeling comfortable about dropping off your child and your child should feel comfortable being dropped off

See the article  "Steps to finding good child care"  for ideas on how to find a child care provider that meets these requirements.

STEPS TO FINDING GOOD CHILD CARE

1. Compile a list of child care centers that you think may work for your child(ren).  The easiest way to do this is to use Childcare Central, of course!!

2. Call the centers and get some basic information.  Find out if they have any openings, what age of children they serve, how much they cost, what their hours are, and any other critical information. (You may be able to find some of this information on Childcare Central as well.)

3. Eliminate any child care centers that won't work for you (aren't open the hours you need them, etc.)

4. Call back the 5-10 centers/home daycares you think would likely best suit your needs and arrange a time to visit.

5. If possible, don't bring your child along on the first visit so you can ask questions, be observant, and focus on finding out what you need to know. (See the article "Characteristics of good child care" to get a list of things you should look for).

6. Ask for the center's policy book or parent handbook, brochures, or any additional written information they have.  Thank them for their time.

7. Review the information from the centers you visited and narrow down your list to the top 3-5.

8. Visit these centers again, but this time bring your child along and see which one he/she seems to feel most comfortable at.

9. Ask any additional questions you have.

10. Call the agency in your state that licenses daycares and make sure that the child care arrangements you are favoring are appropriately licensed and don't have any complaints or pending investigations against them.

11. Call the daycare you like the best and register your child!  *(Instead of calling, you could go to the daycare to register your child.  If you show up unannounced, you can see how the daycare is run when they aren't expecting a prospective parent.  If you like what you see, you can then register your child.)

12. Continue to monitor the care arrangement you have chosen and make sure it continues to provide your child quality care.

Colic Soothers

A colicky baby cries and whimpers all the time and parents are often at their wit's end on how to soothe their child. Colic babies cause severe sleep deprivation, frustration and exhaustion in parents as they worry constantly try to quiet the infant. It becomes difficult for them to understand that what is hurting their baby so. Colic crying consists of frequent and prolonged outbursts. According to experts, the most common reason for colic is abdominal pain in babies and the two most common reasons that cause tummy ache in infants are discussed here along with their symptoms and cures:

• Reflux or Gastro-esophageal Reflux Disease (GERD): Since the circular band of muscle where the esophagus joins the stomach in babies is not fully matured yet, it allows stomach acid to flow into the esophagus and this causes heartburn and irritation in the lining.
• Symptoms: Babies cry a lot and are inconsolable. They spit up after feeding, writhe in pain, have frequent wet or sour burps and cannot sleep properly.
• Cure: Breast milk easier to digest and will reduce the chances of reflux, hence, nurse as long as possible. For colic babies, give half the amount at once but twice as often. Especially in bottle-feeding, it helps to digest milk better. After feeding, keep the baby upright elevating his head for about 30 to 45 degrees for at least half an hour. If your baby still remains colicky, the doctor may prescribe medication to reduce stomach acid.
• Allergy: A component of a formula or something in a mother’s diet who is still breastfeeding may act as an allergen for the baby.
• Symptoms: Apart from symptoms of GERD, the other symptoms of allergy may include diarrhea and raised rashes on the face and body of the baby.
• Cure: Feed your baby more frequently and in smaller amounts. If you are bottle-feeding for the baby, try a hypoallergenic formula. Cow’s milk is the most common infant allergen, so you can eliminate it for a week from a breastfeeding mother’s or baby’s diet and see whether it improves the condition of your baby. Other things that may act as allergens for the baby are soy, wheat, eggs and nuts.

However, there are other things too that can cause colic, so it is not necessary that all babies will respond to the above-mentioned methods. Yet, most babies outgrow the condition at the age of about three to six months.

Handling Crib Climbers

Is your toddler always on the look out of escaping from the crib? Around 18 to 24 months of age, most toddlers develop enough physical skills to enable them to climb. While some use their stuffed animals or pillows to climb out their climbers, there are others who would climb out of the crib, without the help of the toys. Infants around this time are so keen on exploring things that they become fearless. Even heights do not matter much to them. They even overlook the risk and the danger involved in climbing out of the crib. Infants, at this age, are constantly in search of opportunities, when their parents are no around. 

As parents, you need to figure out the climbing age of the child. You need to be careful, when children have learnt how to climb and reach new heights, as the ability to judge danger is still not developed in them. Children, who can control their upper body and its movements, such as bending over to pick up something and can jump on both feet, may also try to escape the confinements of the crib. The result can be too painful both for your kid and you. Fast developing motor skills makes your kid a little adventurer. Once a kid learns to walk and bend on his own, he/she would engage himself/.herself in activities which can be very hard to control. 

Just when your toddler becomes a crib climber, it is better to switch from crib to toddler's bed or a mattress on the floor for safety purposes. Even if the children do not try to climb out of the crib, it is advisable to move them to toddler bed or mattress on ground when they are as tall as 35 inches or about two years of age. Also, you need to keep a constant check on the child. Kids are susceptible to getting hurt and harming themselves mostly at this time. They would put their fingers into an electric board or pick up dirty things and put them in mouth or fall into a large container, while exploring it.

Safety Tips

• The furniture used must be with rounded corners.
• Pedestal fans are a strict no-no. Chances are the infant would insert his/her fingers in it.
• Always keep all kinds of sharp objects and tools out of reach
• Never allow your child run with something in his/her mouth.
• Do not give your child something sharp to hold. Baby skin is very sensitive. The sharp edges may cut the skin.
• Keep matches and lighters out of reach. Chances are your kid would try to replicate you.
• Make sure you keep containers with hot drinks or food items away from the reach of the infant.

How to Care Your Child with Chicken Pox

Caused by varicella-zoster virus, chickenpox is a contagious infection that is most common to children below 12 years of age. The disease starts with a fever and slight headache followed by the appearance of rashes that eventually turn into small and itchy blisters.

Although the illness is considered by many to be mild, infected children may find dealing with the itch to be very uncomfortable. Unfortunately, there is no specific cure for the illness and it is usually not treated. Thus, the challenge now for the parents of children infected with chickenpox is helping them to feel comfortable. And here are ways to do so.

Control Temperature

Fever is chickenpox's major symptom. It is therefore important to closely monitor the child's temperature.

Give the infected child acetaminophen will to reduce the fever and assuage headaches and pains. Be sure to give the correct dosage which should be according to the child's age. In relation to this, parents should never offer their kids aspirin. Chickenpox combined with aspirin has been associated with a high risk of Reye's syndrome; a rare condition that harms the liver and the brain.

Using a cool compress will also help to reduce body temperature.

Reduce Itch

The itchy feeling brought by chickenpox is one of the infected child's biggest problems. Reducing this will make them feel better. To relieve the itch, bathe the child with water mixed with a small amount of oatmeal and/or sodium bicarbonate (commonly known as baking soda) every three hours. Parents can also apply calamine lotion to the child's skin or give an antihistamine to alleviate the itch (be sure to use in moderation since regular use of antihistamines can make children feel edgy).

It is also advised to encourage children not to scratch as this will just worsen the situation. If doing this is impossible for the child, keep their fingernails short to prevent deep scratching which may leave wounds and scars.

Address Mouth Sores

When blisters are also in the child's mouth, it is important to pay close attention to the food and drinks you serve them. Do not give them anything that has a lot of acid (i.e. orange or apple juice) as this will just worsen their pain. If possible, apply an ointment to reduce the pain.

The use of saltwater gargle will also help soothe the mouth's soreness.

 Give Plenty of Water

 Making sure that the child drinks enough water will not just keep them hydrated but will also help in reducing their pain and eventually lead to their fast recovery.

If none of these methods seem to make your children feel better (i.e. fever lasting longer than two days, swelling lumps), it is best to bring them to your doctor for a check-up.  

Chickenpox may be a common disease that is not life threatening, however, it still requires proper care. Parents who know how to handle chickenpox will help their children feel more comfortable as it runs its course.

How To Manage Separation Anxiety In Children

Dealing with separation anxiety can be harrowing for parents. The wails and tears elicit guilt and anxiety, as parents worry both about their child's emotional state and the caregiver's ability to handle the situation. Here are some pointers to help parents and caregivers work through the challenges of separation anxiety.

·         Remember that the behavior is normal. Although some kids never experience separation anxiety, for most, separation anxiety typically emerges around 9 to 12 months,and sometimes as early as 6 months, and can come and go through a child's early years. After babyhood, bouts of separation anxiety tend to crop up in the presence of other life stressors, such as moving, travel, divorce, or a new caregiver or classroom.

·         Time your departure strategically. If possible, time your departure with a fun distraction for your child. We have found departures to be easier when we leave in time for the sitter to break out a new toy or offer a fun snack or fruit dessert we have prepared.

·         Allocate extra time. Whether during day care dropoff or once the sitter arrives at your home, prepare to spend a little more time to help your child get engaged in an activity before you leave.

·         Talk it out. As you prepare to leave, tell your child, for example, that you will be back after their fun day of playing with friends, doing art activities, reading books, and eating snacks. These reminders can help get kids excited about being at school.

·         Keep departures brief. Parents often want to run back and offer consolation when their child cries, but every time you do this you train your child to keep crying so you come back. It's easiest for everyone if you keep your goodbyes short and sweet. Children typically recover soon after you leave.

·         Get your game face on. Your child is well attuned to your emotions. If you exude calm and confidence, they will feel more trusting of their caregiver, whereas if you look anxious and worried, they will mirror your emotions. Say your goodbyes with a confident smile and wave to help your child get off to a better start.

·         Don't ask if it's OK to leave. Remember that you are in charge. Do not ask permission to leave; your child will likely say no!

·         Do not sneak out. Resist the urge to sneak out to avoid a painful separation. Sneaking out will only cause your child confusion when they turn around and discover that you are gone, and repeated sneak outs will erode their trust.

·         Use a transition object. Transition objects can be very helpful for kids experiencing separation anxiety. Younger kids often find comfort in a favorite blankie or stuffed animal. Older kids may find it comforting to keep a small reminder of mom or dad in their pocket, such as an inexpensive pendant or a small smooth stone from a recent family beach trip.

·         Caregiver consistency. Kids like consistency, so whenever possible, try to book the same sitter, or opt for a family member or teacher from the day care. This will also help you feel more comfortable leaving. If you are confident in the way the caregiver distracts and handles the separation anxiety, you'll feel more comfortable leaving.

·         Trust your caregiver. Make it clear to your caregiver that it is OK to call you if there are problems. If you know the caregiver will call you if they need you, you won't feel guilty and compelled to call in every 30 minutes, which can break the rhythm the caregiver has established with your child.

·         Trust your instincts. The degree and length of separation anxiety varies from child to child, but if the separation anxiety is prolonged, think about whether a change needs to be made. This could be related to factors such as the caregiver arrangement or stress in the home.

·         Drop off solo. Separation invariably is more difficult with both parents present. Have one parent do drop off, or if both parents commute together, have one parent say their goodbyes in the car, and the other take the child in to handle drop off.

Separation anxiety can be stressful, but it is a normal developmental experience that will pass. And while separation anxiety can be difficult to work through, the upside is that it reflects that you have established a firm bond with your child.

 

How to Create a Kind Kid

Let's face it, bullying has become a national crisis.  The "mean girl" mentality starts as early as age 4, and cyber-bullying is scarily terrorizing elementary students in their own homes.  

As parents, it keeps us up at night.  Is my child getting teased and not telling me?  Would I know if she was the bully?  Would he tell me if there was a problem?  Is she really as kind as I think she is?

As the place where our children spend the most time, schools are now stepping in.  Teaching empathy - the ability to relate to another person's feelings and the motivation to act kindly toward that person - is become increasingly common as parents and schools look for ways to deal with issues such as bullying and school violence.  "More and more schools are implementing programs that teach the ability to read and to address others' emotions appropriately," says Tonia Caselman, Ph.D., associate professor at the University of Oklahoma School of Social Work in Tulsa and author of Teaching Children Empathy, The Social Emotion (Youthlight, 2007).  These programs go by different names  -- character education, pro-social curriculum and bullying prevention, among them -- but the goal is the same: To get kids thinking about the feelings of others and acting in a caring way.

Why Empathy Matters

"Empathy is an essential skill for building and maintaining relationships," says Eileen Kennedy-Moore, Ph.D., a Princeton, New Jersey-based psychologist and coauthor of Smart Parenting for Smart Kids (Jossey-Bass, 2011).  "It allows us to recognize and share in the joys, worries, sorrows and frustrations of others and to respond in caring ways.  It also helps us to judge the impact of our actions on others so we can adjust our behaviors as needed."  An added bonus: people with higher levels of empathy tend to have better grades in school, more friendships and stronger relationships.

What You Can Do

"Some people tend to naturally be more empathic than others but empathy can be learned," says Dr. Caselman.  "In fact, parents can do a lot to help their child's empathy development."  Try these strategies in your family.

• Be responsive.  "Research shows that kids who have sensitive parents grow up to have more empathy toward others," says Dr. Caselman.  Responding to your baby's cries, your toddler's boo-boos and acknowledging your child's feelings builds a stable emotional base that boosts your child's ability to feel for others.

• Name emotions.  "Helping your child develop a good 'feelings vocabulary' will enable her to identify feelings within herself and others," says Dr. Caselman.  One way to do this is to let her hear you use feeling words.  For example, you might note, "I feel disappointed because my friend cancelled our lunch plans" or "I'm proud of myself for finishing my project early."

• Use books and movies to spark conversations.  "Discussing the feelings of characters is a nonthreatening way to help children learn to observe feelings," says Dr. Kennedy-Moore.  You can pose questions such as "How do you think he felt when that happened?  How can you tell?" and "Has something like that ever happened to you?"

• Practice picking up nonverbal cues.  "A lot of  emotional communication is nonverbal, so being empathic means we need to be able to interpret facial expressions, body language and tone of voice," explains Dr. Kennedy-Moore.  Her suggestion: Turn off the sound on a TV show or movie and challenge your child to figure out what's happening by observing the characters' facial expressions and body language.

• Look for opportunities to reach out to others.  If another family loses a loved one or is celebrating an accomplishment, have your child help you send a card.  "The ritual of recognizing other people's pain and celebrations helps kids develop empathy," says Dr. Caselman.

• Encourage volunteering.  Getting out in the community and helping others is a great way to develop understanding for other people's situations.

• Take advantage of teachable moments.  The next time your child displays some less than kind behavior (hey, it happens!), seize the opportunity.  "Instead of talking about how a behavior was bad, help your child see what the experience was like for the other person," says Dr. Caselman.  For example, you might ask, "How do you think Emma felt when you said she couldn't play with you?" to get a discussion rolling.

• Be on the lookout for acts of kindness.  "When your child does something kind or helpful point out the impact of his act on others," says Dr. Kennedy-Moore.  "This allows your child to feel healthy pride and also encourages awareness of others' feelings."  Be sure to speak up the next time your child includes a sibling in a playdate or helps out at home.

Once you have the tools to teach your child empathy, the best time to start is now!  "Like any other skill, the earlier one begins, the better developed that skill will be," says Dr. Caselman.  And don't be surprised if teaching your little compassion pays off in the form of a tighter bond between the two of you.  Acknowledging your child's perspective, making her feel safe to share her feelings and modeling kindness and caring - all things you'll do while teaching empathy - can add up to a better relationship as your child grows.

Teenage Mothers In Canada At Greater Risk Of Abuse, Depression Than Older Mothers

Teen mothers are far more likely to suffer abuse and postpartum depression than older moms, according to a study of Canadian women's maternity experiences by a University of Alberta researcher. 

Dawn Kingston, an assistant professor in the Faculty of Nursing, analyzed data from the Maternity Experiences Survey, which asked more than 6,400 new mothers about their experiences with stress, violence, pre- and postnatal care, breastfeeding and risky behaviour like smoking and drug use before, during and after pregnancy. 

Kingston said the survey offers the first nationwide view of maternity experiences and many risk factors affecting maternal and infant health. Knowing that teens are most at risk of abuse and depression, for example, helps public health policy makers and providers target care and support where it's needed most, she said. 

"If we don't intervene early, the abuse and depression can continue into the postpartum period and the child's early developmental years," she said. "Women that have mental health issues in pregnancy and postpartum have children that are at greater risk of having mental health problems and developmental problems." 

The study, published in the May issue of Pediatrics, compared maternity experiences of women at various ages: teens (15 to 19 years), young adults (20 to 24) and adults (25 and older).

The data showed that 41 per cent of teen moms had experienced physical abuse in the previous two years - double the rate among women in their early 20s and five times that among adult women.

"We had no idea that the risk was as high as it is in adolescents," Kingston said.

Nearly a quarter of teens indicated they had been abused more than three times during that span. One-fifth said they'd been abused by a family member, compared with 14 per cent of young adults and 9.5 per cent of adult women.

Some 14 per cent of teens experienced symptoms of postpartum depression, compared with 9.3 per cent of women in their early 20s and 6.9 per cent of adult women.

Such results suggest a need for screening for depression and violence among pregnant women, Kingston said. Few pregnant and postpartum women are routinely screened for violence at present in Canada, something that is mandatory in Australia and the U.K.

"Women often don't tell their provider they're suffering, whether it's depression or domestic abuse," she said. "That's why there needs to be a routine screening process. If you don't screen, the need may not be identified and women are not linked to resources like counselling and other help that's available."

Teens later to start prenatal care

The data also showed that teen moms were more likely to start prenatal care late, more likely to engage in risky behaviour like smoking, and less likely to breastfeed.

Some 15.5 per cent of teen moms started prenatal care late, double the rate for moms in their 20s and nearly four times that for adult mothers.

Fewer teens reported initiating breastfeeding than older women. Just 19 per cent breastfed for three months or more, compared with 30 per cent of moms in their 20s and 41 per cent of adult women.

Teens were also far more likely to smoke during and after pregnancy (29 per cent and 50.9 per cent, respectively) than women in their 20s (23.6 per cent and 33.9 per cent) and adult women (7.8 per cent and 12.7 per cent).

Such results might not be surprising given the nature of unplanned teen pregnancies, but the high smoking rates among young adults was a surprise, Kingston said, as was the decision of moms to continue smoking after delivery.

"That suggests there's considerable opportunity for teaching, identifying needs and linking women to services they need through prenatal and postpartum care." 

How to Protect Your Child Against Respiratory Infection Linked To Asthma From Dog-Associated House Dust

House dust from homes with dogs appears to protect against infection with a common respiratory virus that is associated with the development of asthma in children. Researchers from the University of California, San Francisco, present their findings today at the 2012 General Meeting of the American Society for Microbiology.

            "In this study we found that feeding mice house dust from homes that have dogs present protected them against a childhood airway infectious agent, respiratory syncytial virus (RSV). RSV infection is common in infants and can manifest as mild to severe respiratory symptoms. Severe infection in infancy is associated with a higher risk of developing childhood asthma," says Kei Fujimura, a researcher on the study.

                            In the study Fujimura and her colleagues compared three groups of animals: Mice fed house dust from homes with dogs before being infected with RSV, mice infected with RSV without exposure to dust and a control group of mice not infected with RSV.

          "Mice fed dust did not exhibit symptoms associated with RSV-mediated airway infection, such as inflammation and mucus production. They also possessed a distinct gastrointestinal bacterial composition compared to animals not fed dust," says Fujimura.

Pet ownership, in particular dogs, has previously been associated with protection against childhood asthma development, says Fujimura. Recently she and her colleagues demonstrated that the collection of bacterial communities (the microbiome) in house dust from homes that possess a cat or dog is compositionally distinct from house dust from homes with no pets.

"This led us to speculate that microbes within dog-associated house dust may colonize the gastrointestinal tract, modulate immune responses and protect the host against the asthmagenic pathogen RSV," says Fujimura. "This study represents the first step towards determining the identity of the microbial species which confer protection against this respiratory pathogen."

Identification of the specific species and mechanisms underlying this protective effect represents a crucial step towards understanding the critical role of microbes in defining allergic disease outcomes and could lead to development of microbial-based therapies to protect against RSV and ultimately reduce the risk of childhood asthma development, says Fujimura

Helping a Stressed Child Become Self Aware of Stress

Children who suffer from stress disorders often have lived for so long with their stress symptoms and behaviors that they do not realize that they are different from other children. They take their extreme level of stress and resulting behaviors as a fact of life. One step in treating stress behaviors in children is to help them to become self-aware of their stress, how the stress is cued and triggered, and the levels of their stress.

The first step, of course, is for the adult caregivers to be able to make a list of the stress behaviors that are seen regularly in the child. If you do have a clear idea of what "stress signs in children" looks like, you can read the companion article to this one entitled: "Stress Cluster Descriptions". You should also consult with your treatment specialist to help you make the list.

Once the signs and behaviors have been identified, caregivers can gently make observations to the child about the behaviors once the child has clamed down from the stress episode (upset, or acting out). These observation might be something like: "I notice you seem to get very upset when you are told that you cannot have a food treat...your face gets red, and then you begin to yell and say that I am unfair..."

Children in foster care who have stress disorders often have an increase in stress and stress related behaviors before and after contact with biological family members. When signs are seen prior to a visit, a caregiver can comment on this to the child, once again, very gently: "You seem to be a little bit nervous or worried, I see you pacing around and you can't seem to stay still...I wonder if I am right, are you worried?"

The phrase: "I wonder...", followed by a reflection of what the caregiver thinks the child might be feeling, thinking, or what the cause of the behavior is a very useful phrase. By saying "I wonder...", you are not making a definitive statement or accusation, but leave room for the child to correct you if you are wrong. If you are right, you have just helped the child to recognize their stress source and level, and if you are wrong, the child will likely correct you, and then still become self aware of their stress.

For many children with stress disorders, there are many, many things, people, and situations that may trigger stressful memories of the traumas in their past. When a caregiver gets a clue that something, someone, or a particular kind of situation is triggering to a child, they should ask the child directly about it: "After you saw that big dog, you seemed to get very anxious...I wonder why?" It is important not to lead the child by saying something like: "I wonder if it because something bad happened to you that involved a big dog?" If a child is led in this way, you could very well get a false agreement by the child, because children want to please adults.

Another way you can help a child become aware of their stress is by modeling: talk about your own stress and stressors (when appropriate), and describe how the stress feels to you, such as where in your body you feel the stress, the level of stress, etc. You then can in turn ask the child how and where they feel their stress.

Once it has been established with the child that they have stress problems, a caregiver and child can make a creative chart that will help both the child and caregiver to graphically symbolize the stress level. This could be a big poster of thermometer, with a sliding red line to indicate how high the child feels their stress level is. Finally, children can be taught healthy self-comforting and stress reducing techniques. When the child experiences genuine relaxation, safety, and security, they are better able to come to a better self awareness of their debilitating stress and stress behaviors.

Dealing With Nighttime Enuresis in Children

Dealing With Nighttime Enuresis in Children

Many children have occasional enuresis, or wetting at nighttime, even though they have been toilet trained for years. Quite a few children who have been traumatized by interpersonal violence will have nighttime (and even day time) wetting that is often not effectively treated by medication or restriction of liquids. Even older children may have nighttime wetting; it is not uncommon for the problem to continue to occur in children who are victims of PTSD even into their teen years.

If medication and liquid restrictions do not help, what should you do? The first step is to accept that the wetting issue may not go away quickly or easily. The second thing to remember is that even though it is a frustrating problem, you should refrain from becoming punitive with the child when they wet. Giving consequences will likely only make the situation worse, and begin to erode and damage your relationship with the child. Once you have accepted these basic ideas, you can move on to the practical coping strategies listed below.

If the child is clearly in control of their bladder in the daytime, and the child is above the age of three or four, resist putting nighttime diapers or 'pull-ups' on the child. The reason for this is that when diapers are used, the child is being behaviorally shaped to depend on them. In other words, the longer they wear the diapers, the longer they will wear the diapers. As the child gets older, this is a social embarrassment as bad as wetting the bed. Diapers do not solve the wetting problem. For children to learn how to avoid wetting, they need to be able to feel the wetness on their skin!

Your next step is to get a cover for the child's mattress. Not just a top cover, but an all encasing, heavy plastic cover. In most cases, new mattresses are sealed in a plastic that is perfect. You can find some waterproof encasement covers in mattress stores or on the Internet. Then, be sure to have at least two or three sets of fitted bottom and top sheets, as well as a n extra blanket for the child's bed, so that there will always be a change of sheets available. You can take a regular top sheet and fold into quarters and place it under the area where the child's bottom lies, then put the regular fitted bottom sheet over this. Of course, if the child moves around the bed a lot, this measure may not have the intended absorption effect. It is a good idea to encase the child's pillow in the same fashion, because pillows can get wet too!

If the child wakes in the middle of the night to tell you they are wet, you should help the child first to take a quick shower, not just clean up with wet wipes and change clothes and sheets. The child should strip the bed following the shower, and take the wet sheets to the laundry area to be washed later. The reason for these measures is to make the wetting incidents a bit uncomfortable, not to mention press home to the child that wetting clean up is their responsibility. All of these procedures should be done in a matter of fact manner; try to hide the fact that you are tired and irritated by the problem. By the same token, if the child discovers they are wet in the morning, the same procedure should be done.

If the child sleeps through their wetting and it is not discovered till morning, you might want to try to ascertain when they usually wet. In most cases, this is either during their dreaming (intrusive nightmares about their abuse) or in deep sleep. You can check at intervals throughout the night to try and ascertain a pattern. If a pattern is found, you have a shot at being able to wake the child about thirty to sixty minutes before the known wetting time to use the toilet.

Last of all, there are devices on the market that sound an alarm when the child begins to urinate at night. Some are pads under the bottom sheet, while others clip to the inside of the child's underwear. The child will still wet themselves, but the idea is that the alarm begins to teach the child's sleeping mind how to pay attention to their full bladder, and to wake themselves up, instead of having an annoying alarm do this. Some of these alarms can be fairly costly, and have varying degrees of claimed success.

Off the Menu: How to Create a Healthier Kids Meal

My kids have eaten their share of kids’ meals at restaurants.  As a mother, I am cognizant of what they eat and do my best to provide them with healthy choices at every meal.  It’s my responsibility to teach them to make smart choices and prepare them for the times when I won’t be there to control their diet.

But for now, I am the boss.  And my kids know that.  They are used to my questioning of servers when we order a meal at a restaurant and don’t get too embarrassed when I send back food that is less than desirable.  My expectations are high, whether it’s fast food or fine dining.  

For most dining experiences, these are 5 questions I ask before we order:

What drink options are available besides soft drinks?  Ask the server for soda water with a splash or two of fruit juice or lemonade.  This is perfect alternative to a sugary soda and gives kids the fizzy, soft drink feel without the added sugar. Cutting soft drinks in half (1/2 soft drink and ½ soda water) is a smarter choice as well.  Be creative! My daughter is a milk drinker, so this is her drink of choice when we dine out. However, many restaurants only serve whole milk, so I always ask if there is 2% or less available and discourage the chocolate option.

Can we get the chicken (shrimp, fish) grilled?  Most casual dining restaurants have a grilled option available on the adult menu, so ask your server if that option is available on the kids’ menu. You would be surprised at how many will make the accommodation.

Do you have side choices other than French fries?  Side salad, fruit, some type of vegetable.  Look at the side choices available for adults and ask for a substitution. Many restaurants offer a steamed vegetable option, and it may be worth the $0.50 up charge.  My daughter will often ask for raw broccoli and tomatoes, and I’ve had servers prepare this in lieu of an iceberg lettuce salad.

Can you tell me about the portions?  4 large chicken fingers in a kids’ meal is too much food.  If you have 2 kids, have them share a kids’ meal and perhaps order an additional side.

Can I have an extra plate?  I’m all about sharing meals with my children or having my kids share an adult entrée. My kids like food – good food.  Just as an adult would, they get tired of chicken fingers, hot dogs, and hamburgers; they want choices!

Kids will eat when they are hungry, and if French fries (or other unhealthy choices) are available, that’s what they will have.  Offer healthier sides, and kids will gradually make those choices on their own.  It’s unreasonable to expect children who eat unhealthy food regularly to make healthy choices on own.  They practice what their parents teach them.

Talk to your kids often about their food choices and make healthy choices available.  Children can learn what is “good” for them from an early age and need to be encouraged to make these choices when dining out.

Knowledge is power, and when we know the questions to ask, it’s easier to make positive choices for our kids…particularly ones that will help prepare them for the future.

Excellent Early Childhood Care Is Crucial In Child Development

Making sure that your children receive top class early childhood care is one of the best things a parent can do. And if a parent isn't in a position to provide full time care for their children through the first five years of life, then a quality early childhood centre can be an excellent option. Many parents these days would love to have their toddlers at home with them full time, but the economic situation means that isn't feasible. More and more parents these days find it impossible to make ends meet without at least working part time. And when you have young children to think about as well, it's important to make the right choices.

Experts agree that the first few years of life are crucial for optimum child development. Well resourced and well staffed early childhood centres can play an important role in that development. The key is to choose a centre that has the best interests of your child as a central part of its philosophy. Early childhood education can also be a fantastic preparation for school. It makes a big difference when it comes to transitioning children from being at home with mum and dad to spending a large part of the day in a classroom environment when they get to school age.

When considering early childhood care, it can be hard to choose the best place to ensure your child's developmental potential, but quality child care centres have several points of difference. One of the best ways to find a good centre is to ask other parents who live nearby. They'll be more than happy to tell you the pros and cons of the early childhood centres they have used. You can also feel free to visit as many centres as you choose. You and your child can immerse yourselves in the culture and spirit of the centre for a morning and get a feel for whether it's the sort of place that will bring out the best in you both. Ask yourself if you and your child feel comfortable there. Are you made to feel welcome? Do the other children and adults around you seem genuinely happy, involved and in good relationships with each other? Is there a good range of modern equipment that is clean and well maintained?

Leaving your child in early childhood care involves developing a bond of trust with the people who will be there in your place. A good quality early childhood centre employs staff members who are well trained and well suited to the role, so that the children in their care receive the very best informal education as they play. For a child's development, they need to form strong attachment bonds with the people around them, trusting them and feeling comfortable in their presence.

Don't feel guilty about putting your children in quality early childhood care. It can be beneficial to children socially and cognitively. But the keys to making it a good environment include quality interactions between staff and children, access to an array of wonderful books and other literacy materials and a wide selection of learning activities.

How to Teach Children to Take Care of Their Belongings

Children are prone to scatter things around the house. Anywhere you go, if you have kids at home, you are surely to see something scattered at the place where they have been for only two minutes. This is actually a very normal behavior of children as they still don't have the notion of what's neatly arranged and what is not. However, by teaching children to take care of their belongings at a young age, they would be able to integrate this behavior until they get older, and you would surely be thankful for it.

When children start going to preschool, like in nursery, it is the best time to start teaching them on how to take care of their belongings.

Try to designate a place for your child to keep his things at school such as his books, notebooks, pencils, crayons, and paper. It may be a small desk with a compartment underneath or a box that he can call his own. Explain to your child that he must place all his things in this specific location. Don't expect your child to learn it the first time around, it may take several days before your child would be used to this kind of routine. Remember that patience is always the key.

Whenever your child comes home from school, instill the discipline in him to go to this spot in your home and place his things there. Pile his things neatly, and while doing so, make sure that your child is closely observing what you are doing. By constantly doing this, you would notice your child doing it all by himself after some time. This is one way of teaching your child to take care of his belongings.

You can also teach your child to arrange his things in his bag. Doing this would instill the value of properly caring for his belongings. Whenever you would see his things in disarray, try to call his attention and explain to him that whatever thing he owns he must take care of it so that it would last for a long time. He must handle things with care all the time.

Proper care must also be rendered to his toys as well. Oftentimes, a child would just throw or destroy his toy if he feels that it is already old and is not looking good. You have to make sure that even if his toy is a little bit faded and old, he still must return it to its proper place and not break it deliberately. This way he will learn to take care of the things that belong to him.

Teaching a child to properly care for his belongings is a very rewarding experience especially when you see your child doing what you taught him. This is not an easy task but if you are patient enough, you will surely see your child becoming better at taking care of his belongings.

What Every Preemie Parent Needs to Know About Newborn Intensive Care

What prompted you to write "Newborn Intensive Care"?

I was working as the clinical nurse specialist for the Northwest Regional Perinatal Program at the University of Washington in Seattle. As the person who provided education and resources for health care professionals in the region, I fielded many phone calls from nurses, physicians, and parents who were looking for an up-to-date resource for parents about the neonatal intensive care experience. There didn't seem to be such a reference at the time, and writing and editing a book had always been a personal and professional goal. I located a publisher who was interested in my proposal, and the book was born.

Who would benefit from "Newborn Intensive Care"?

The book was written for parents who are anticipating that their baby will require special care and for parents whose baby is already born and in the intensive care unit. Many parents read parts of the book before their baby is born and I've also received comments from parents whose babies have already come home and they use the book to understand what happened. No baby has all the problems discussed in this book, so most parents read the pieces that apply to their situation as their baby progresses through hospitalization and homecoming.

It is also interesting to know that nursing students, medical students, and new doctors read this book for a quick and easy review of newborn medical problems, and to read about the challenges facing parents of babies in special care. This group, physicians in particular, appreciate the simplified language and explanations in the book that help them explain things to parents in language that parents can understand.

What advice do you have for those parenting their babies in the NICU?

Remember that this is a unique experience - it is happening to YOU, and no one else's experience will be the same as yours. Find a trusted and supportive listener who is understanding of your good days as well as your very bad days. Be kind to yourself and to your partner, and recognize that people act differently under stress. Some feel challenged and grow stronger through this journey, while others withdraw and need to be cared for by others until the crisis has passed. It is most important to take care of yourself, so that you can have energy to care for your baby.

Coping with the intensive care experience is easier if you are empowered by knowledge about what is happening to your baby. Ask many questions of your baby's care providers and continue to ask questions even after your baby comes home. From the very beginning, find out what you can do to participate in your baby's care. Establish a good working partnership with the physicians, nurses, and other people on your baby's care team and remember that everyone is working toward the same goals -- sending your baby home in the best possible shape and supporting your family through homecoming and beyond.

What can professionals do in the NICU to assist new parents in caring for their premature babies?

Taking the time to establish an honest relationship with parents is very important to developing a good partnership. Professionals need to be clear, right from the start, that they do not always have all the answers, but they are willing to listen to every question and concern. Parents need to be involved in their baby's care, and members of the baby's care team need to encourage parents to learn about their baby. Professionals need to remember that parenting is extremely important in the baby's convalescence. Babies whose parents are actively involved in care help to influence a healthier outcome for their child.

What advice do you have for parents as they prepare to bring their babies home?

If you were able to visit your baby often and participate in his care, homecoming will be less stressful than if you try to learn everything all at once right before homecoming. Try to room-in with your baby for a day or two before you bring the baby home so that you can ask questions while help is only a few steps away. Find a supportive pediatrician and make sure your community resources and follow-up appointments are lined up before you come home. Some parents find homecoming just as stressful as the first days in intensive care, so remember to simplify your life as much as possible and use your support people. A trusted friend or relative can be a lifesaver, even if it means being available for something as simple as staying with the baby for a moment while you walk around the block or take a shower.

Most important, take a moment every day for a quiet talk with your baby. Don't worry if you feel clumsy as a parent at first, or if you're not madly in love with your baby all at once. Your relationship will build as you spend time together as parent and child. Congratulate yourself for doing many things well and for learning new parenting skills everyday.