Ensure school-age children know when to wash - before eating and after playing on a playground at recess, using the restroom, and coming into contact wiht friends and classmates. Teach kids that it's important not to chew their fingernails or touch their faces.

"Hand-to-mouth transmission is a major way children are infected by viruses," said Vanessa Charette, M.D., a Cook Children's pediatrician in Fort Worth. "Keeping hands out of the mouth is a difficult behavior for certain children to master, but it's important that they do."

Little hands can pick up a lot of germs. At any given time, you have close to 150 different bacteria living on your hands, and 80 percent of illnesses are spread by direct human contact. For kids, stomach bugs, strep throat and other bacterial illnesses can spread quickly, particularly in environments such as schools and day cares.

"I also tell young children to keep their hands below their neck. They don't rub their eyes, such their fingers or pick their nose," said Kim Mangham, M.D. a Cook Children's pediatrician in Keller. "Kids can have all the germs in the world living on their hands, but they don't put their hands in their mouth, nose or eyes, they won't get sick."

Having trouble convincing your children to get with the hand hygiene program? Let them know that fighting the spread of germs can be pretty cool. A recent study published in the American Journal of Infection Control concluded that fist bumping transmits far few bacteria than handshaking.

It is so interesting to note that maternal food preferences (what moms eat, why we eat, and how much we eat) strongly influences the eating behavior of our children. Like so many areas of parenting, our kids will do what we do way more readily than they will do what we say.

As we approach the Thanksgiving holiday, it is a great time to give thanks for our own health and for the health or our children. It is a great time to reflect on the self-care we model for our own children. Studies suggest that toddlers may need to taste a food 10-15 times before they decide it is something they want to eat. Maybe, just maybe, as grown-ups we should try some new foods as well.

Here are some healthy Thanksgiving ideas from Theresa Nash, director of Food and Nutrition Services at Cook Children’s:

1. A sweet potato casserole can be prepared in a healthy manner, and because of their sweetness may be enjoyed by children.

2. Disguising a vegetable in a mixture of children's other well accepted food is a way to get them to later choose them prepared in other ways: ex: broccoli and rice or yellow squash casserole.

3. Try something more unique and unexpected like Brussel sprouts.

As for me, I will work on giving lima beans another 8-10 chances …

After she gave us her tips. Theresa gave us a fun Brussel sprouts’ recipe. She said this is one she loves and she’s still making for her “grown” kids today:

Roasted Brussels Sprouts-Kids “and Parents” will Enjoy

• 1 pound fresh brussels sprouts
• 3 Tbsp olive oil
• 3 Tbsp honey
• 1 tsp garlic powder
• Salt & Pepper to taste: optional
• 1/4 cup dried cranberries or golden raisins
• 1/4 cup grated Parmesan cheese

1. Preheat oven to 450 degree F.
2. Cut the ends of the brussels sprouts and cut each in half.
3. Whisk olive oil, honey, garlic, (salt and black pepper) in a bowl. Toss in Brussels sprouts and stir to coat.
4. Spread on a baking sheet and sprinkle with dried fruit and Parmesan cheese.

Bake for 15-20 minutes until golden brown. Enjoy!

About the author

Kim Mangham, M.D., is a Cook Children's pediatrician at 1601 Keller Parkway in Keller, Texas. She earned her medical degree at University of Texas Southwestern Medical School in Dallas. She completed the pediatric residency program at University of Oklahoma Health Sciences Center in Oklahoma City. Her interests include breastfeeding education as well as disease and injury prevention. Dr. Mangham is board certified in pediatrics.

I order a kid’s meal for my son at a seafood restaurant in Galveston, Texas. I tell the waiter to hold the fries. He gets a very odd look on his face and replies “But they come free with the meal." My response. “I understand that, but we don’t want them.”  

There is good evidence that meals eaten at home are healthier. One way we can improve the nutrition choices we make when we eat out is to avoid the pitfall of accepting the free choices that come with a meal and worse – encouraging our kids to finish them. 

I know I’ve had the experience of wanting only the sandwich at a restaurant, yet ordering the entire meal is actually cheaper. This comes with chips or fries and a drink that I don’t even really want, yet I end up picking a soft drink instead of a water because it is “free,” and also eating the chips that I didn’t plan to order.

I heard a news clip on the radio the other day about all inclusive restaurants and how many calories we tend to consume on these trips. I think we definitely get caught trying to get our money’s worth at all you can eat buffets. 

The excess calories consumed and the subsequent health consequences for ourselves and for our children can be quite costly in terms of our overall health. So the next time we try to find the best value in our meals while eating out – it might be in saying no to the free extras.

About the author

Kim Mangham, M.D., is a Cook Children's pediatrician at 1601 Keller Parkway in Keller, Texas. She earned her medical degree at University of Texas Southwestern Medical School in Dallas. She completed the pediatric residency program at University of Oklahoma Health Sciences Center in Oklahoma City. Her interests include breastfeeding education as well as disease and injury prevention. Dr. Mangham is board certified in pediatrics.