But, at what cost?

Physicians, psychologists and child development experts have warned of the dangers of too much screen time for years as studies show that it can negatively impact everything from a child’s eyesight, to weight, to sleep and to mental and behavioral health.

“The reality is kids are spending way too much time on screens,” said Lisa Elliott, PhD, licensed psychologist and manager of Cook Children’s Denton Behavioral Health Clinic. “There are a lot of studies now that show that too much internet gaming and too much social media causes structural and functional changes in the brain. But there’s also a chemical response, too, just like an addictive reaction to a drug.”

In 2015, the National Institutes of Health launched a multi-year research project called the Adolescent Brain Cognitive Development (ABCD) study to examine the impact of a number of childhood experiences—screen time included—on the social, emotional, mental, behavioral and academic health of youth. The study partners with leading adolescent development and neuroscience researchers all over the country as they follow 10,000 children from pre-adolescence into adulthood. It’s the largest long-term study of brain development and child health in the United States, according to the study’s website.

Early data from ABCD research released in 2018 demonstrates a correlation between screen time and premature thinning of the cerebral cortex, or the outermost layer of the brain that processes information from the five senses. While maturation of the cortex is normal with age, research indicates it’s happening faster in kids glued to screens versus those who are not, although more investigation is needed to determine why and to understand what it means for the cognitive health of children, according to articles linked on abcd.org.

So what is a parent to do, especially in 2020 when online learning became every kid’s virtual reality and exponentially increased their exposure to screens?

“We have got to control our kids’ time in front of screens as much as possible and take part in activities that promote deep, close family interaction,” Dr. Elliott said. “I am a huge believer in family dinners and making them fun. One idea is to appoint a family king or queen of dinner each night and that person gets to pick the meal idea and help prepare it.”

Dr. Elliott also believes in sparking communication with your kids by sharing the highs and lows of the day.

“This helps kids open up and talk about their daily experiences, challenges and feelings and how to work through them,” she said.

The upcoming holiday break gives kids the perfect opportunity to walk away from their screens as both online and in-person learning come to a halt for a few weeks. We asked Lauren Lasrich, a Cook Children’s child life specialist, to help generate ideas for parents on how to set the stage for a screen-free winter break.

“As child life specialists, we use play for kids to express their emotions and feel a sense of control over their environment,” Lasrich said. “In uncertain times like now, it’s important to help kids express their emotions through creativity and connection with others. These ideas not only help kids feel in control, but also helps them express their feelings about their experience and understanding about what’s going on in the world.”

Screen Free Family Time

• Set aside time on a beautiful day to take a walk, have a picnic, ride bikes or play an outdoor game together.
• Make a gratitude list together with your child to generate discussion on life’s blessings, big and small. Hang the list somewhere each family member can see as a daily reminder for thankfulness.
• Kids love board games. Pull out your family’s favorite for a weekly game night.
• Let each person in the family choose a recipe and help cook/bake it together each evening.
• Make slime or kinetic sand together.
• Create a family kindness jar that includes ideas for acts of kindness. Every day or week, have each family member draw an act of kindness from the jar and complete the act for a parent, sibling or friend.
• Go camping in your backyard.
• Have a scavenger hunt. This can be done indoors or outdoors. It can be as easy as hunting for certain household or outdoor items in a particular color, or writing your own unique clues. Have each child write one clue of their own to stoke their creativity.
• Decorate the house as a family for the holidays or bake and decorate Christmas cookies together.
• Have a holiday music family sing along.
• Read a story as a family every night.
• Create and bury a time capsule. This year has been full of history-making circumstances. Have each child write a letter about the year and its impact on them as individuals or as a family and what they hope for the future.
• Throw on your favorite festive jammies and drive thru neighborhoods to look at holiday lights. Don’t forget to take along a cup of hot cocoa!

Need a few quiet, kid-free minutes to yourself? Here are some screen-free activities kids can do on their own.

• If you’re doing any online holiday shopping you probably have an abundance of empty cardboard boxes. Give them to your child to make it into something creative. A cardboard gingerbread house? A train? A car? Give them some supplies and let them loose with their imagination.
• Draw pictures or write letters to someone special. Think about who might be alone for the holidays, or who could use some cheering up. Not only does this occupy your child, but allows them to brighten the day of someone else through their creativity and thoughtfulness.
• Write in a journal. If your child isn’t sure how to begin, give them a writing prompt. One idea is to write out their goals for 2021 and their plans for how they can be accomplished. This will help keep their writing skills sharp while on break, too.
• Create an “okay to get messy” area where your child can play freely with the slime you made together.
• Encourage reading by having them build a reading den or fort where they can cuddle up with a good book.
• Make a homemade board game. Another use for those empty cardboard boxes!
• Listen to music and dance. This keeps them occupied and gets them moving.
• Play hide and seek. It’s an oldie but goodie!
• Make up a story and share it with someone special. Put together props and costumes and act it out for the family.
• Create a comic strip.

Most of all, enjoy the holidays and time connecting as a family. Be together away from the screens and take a moment to decompress from the stress of this year.

How long should I breastfeed?

It seems like a simple question, but not one I feel I can answer with an exact time frame.

The World Health Organization and UNICEF recommend breastfeeding for two years, while the American Academy of Pediatrics (AAP) suggest “one year or longer.” Though these seem slightly varied, all agree that exclusive breastfeeding is best practiced until 6 months when solids are added. None offer an upper limit to the duration stated.

A recent study in Pediatrics states, “increased duration of breastfeeding… protects against infections requiring hospitalization in the first year of life but not hospitalizations or symptoms of infection at home beyond the first year.”

But this duration of breastfeeding may not be possible or sustainable for some families.

So how long do I recommend?

Short answer: For as long as you can... until you no longer feel served, available, able, or mutually fulfilled. Until you’re done.

Breastfeeding is certainly a labor. It doesn’t come easy to everyone. Some actually hate it and look forward to the day they can close the chapter and move on.

For those moms, the time may be now, because in the U.S., we do have alternative-milk options that do a great job in growing our kids.

But it is important to understand that breastfeeding doesn’t have to be all or nothing. Any is better than none. A week is better than a day. And there are benefits to two years that will exceed the benefits of a year.

So on the other end, when should we call it quits?

The answer for me is the same: For as long as you can... until you no longer feel served, available, able, or mutually fulfilled. Until you’re done.

And if it feels like you have to stand up for your feeding journey, because you buck the cultural norm here in America, the AAP has your back:

“Data on the scientific foundation for an age above which is appropriate or harmful to the child to continue breastfeeding do not exist. Nor are there reported risks to this method of social/nutritional interactions.”

Breastfeeding a toddler isn’t weird.

As always, I stand firm in my word.

If the baby is growing, if the momma is happy, and if the baby is happy then we are doing things right-breastfeeding, formula feeding, some of both.

Please reach out to me for coaching, encouragement, and ongoing support, so I can help you to meet whatever goal you have made to feed your child.

“September of 2020 has been the highest month ever that we've seen suicidal patients admitted to our medical center,” said Kia Carter, M.D., medical director of Psychiatry at Cook Children’s. “We've seen this number rising year after year, so it's not surprising that it's this high. Suicide has become the second leading cause of death for kids and adolescents in the last year, versus two years ago when it was the third leading cause of death.”

This news comes after a near-record month in August when 29 patients were admitted for intentional suicide attempts. The patients admitted to Cook Children’s in September were between the ages of 6 and 18 years old. Dr. Carter says she feels the pandemic has played a moderate role in the increase, but that we typically see higher numbers in the fall months when kids return to school. In September of 2019, for example, Cook Children’s admitted 32 patients for suicide attempts.

“We've definitely seen this number rising in the last five years, but I do think that the amount of stress that we as a society have experienced in the last six months has caused some of our kids and adults to struggle more,” said Dr. Carter.

Virtual school may also be playing a role in mental health of kids. The Rees-Jones Behavioral Health Center at Cook Children’s has become a resource for children and teens who report feeling hopeless and not knowing how to cope with the isolation the pandemic has caused.

“I think everything in proportion is good, but when something is to this extent where some kids have had to do 100% virtual since March, it’s been very difficult,” Dr. Carter explained. “When kids have school, they have an outlet. They have other people to talk to. They have friends and social activities. Now, it’s just them, their parents and siblings.”

She says it’s important to know that some kids do very well with virtual learning, but it’s up to parents to know what works best for their child. Also, some families may have to choose virtual learning if the child or another family member falls into the high-risk category for COVID-19. In that case, parents should remember to ask for help when they need it. School counselors, nurses, teachers and their pediatrician are all great resources.

Warning Signs

Dr. Carter says the biggest thing to look for is a change in your child’s behavior, which she acknowledges can be difficult during the pandemic. She says little things like sleeping more than usual or not wanting to engage or interact in activities they used to enjoy can be signs of depression.

“Start engaging a little more and check in, like ‘Hey, are you feeling okay? I noticed you were getting a little angry at us for no reason,'” she said.

While it’s easy to write off irritation as a side effect of being a teenager, it is one of the primary symptoms of depression in children and adolescents.

Other signs to watch for include:

• Declining grades
• Lack of concern about appearance and hygiene
• Changes in eating and/or sleep
• Self-injury such as cutting
• Less motivation
• Alcohol/drug use
• Acting highly anxious or agitated
• Recklessness

Dr. Carter says girls are more likely to be hospitalized for attempting suicide, but boys tend to make more lethal attempts. As for age, Cook Children’s data shows 14 to 15 years old is the average for suicide attempt admissions, but more recently, the majority of patients have been around 12 to 13 years of age.

With many kids at home alone due to COVID-19, increased access to things like medication, firearms and the internet may also be contributing to the increase in patients. Dr. Carter says her team has also seen more patients participating in social media challenges where kids are hurting themselves.

“We have seen a rise in cutting behaviors, which are a form of self-injury. This is not always considered a suicide attempt but more of a maladaptive behavioral response to stress.”

She says these are things often picked up on social media, reinforcing the importance of knowing what your child is looking at and who they are talking to on the internet.

What Can Parents Do?

Get help.

If you’re concerned for the immediate safety of your child, take them to an emergency room. Trained professionals will evaluate your child to see what next steps need to be taken.

If you’re concerned about your child’s mental health (but not that they will harm themselves), you can contact your pediatrician, school nurse or counselor for a list of outpatient resources in your area.

If you feel your child may need a higher level of care (but it’s not an emergency), you can call Cook Children’s Behavioral Health Intake Department at 682-885-3917. Our team will help arrange referral for outpatient therapy and medication management, partial hospitalization day treatment options or inpatient treatment if needed.

Partial hospitalization allows children to receive treatment including medication management, family and group therapy at the Rees-Jones Behavioral Health Center during the day, while allowing them to go home at night. Children who are deemed an immediate danger to themselves may be admitted to the inpatient unit for 24/7 monitoring and treatment. The Rees-Jones Behavioral Health Center, is one of the few places in North Texas that offers inpatient psychiatric care for children between the ages of 2 and 12.

“Our biggest hope is that we can help families find the support and resources they need, and that we can educate our school systems about warning signs and screenings because they are hopefully going to come in contact with those kids before we do,” said Dr. Carter. “We don't want the numbers to continue to rise and we continue to lose our children. Remember that suicide is preventable.”

In the following video, our team answers the questions they hear most frequently, including how COVID-19 has impacted the program.

Learn more on our website.

Whichever decision or situation you choose for your student, the start of this school year will be like no other. I thought I would review a few recommendations the CDC (Center for Disease Control) has made that will help you and your family get ready for the start of the new school year.

For parents who have a child starting school in person, it’s normal to have some anxiety about the entire process, staying informed and connected may reduce these feelings and can give you a way to express concerns that you have regarding practices at your child’s school.

Consider the following if your child is set to start in-person learning and or will eventually be transitioning from virtual at-home learning to in-person learning:

Get organized and stay informed: Make sure you are aware of the safety guidelines that your school will be taking when students are back in the classroom.

Will face coverings be required for ALL children? If so ensure you have taken the last few weeks of summer to have child practice wearing their face covering or mask and encourage minimizing touching the face while putting the mask on or taking it off. Other things to consider regarding masks/face coverings:

• Ensure the mask/face covering you choose fits snugly yet comfortably against the face, covers the nose and mouth completely, and if its design is “re-usable” ensure the material allows washing and drying without damage to shape or build of the mask.
• Once you have found the type/style of mask your child is comfortable in ensure you have several available as backups.
• Tips on practice for wearing a mask (gathered from several different expert pediatricians)
• Have the child wear the mask/face covering during times likes watching a movie or playing a game. Allow them to take breaks but also praise them when they have successfully worn the mask or covering for a significant amount of time.
• For younger children needing help with wearing a mask use a favorite stuffed animal to demonstrate proper mask wearing, or find pictures of children or their favorite cartoons wearing masks.
• Modeling is very important. As a family model wearing masks/face coverings, children learn by example and this is one of the best ways to teach a child the importance of wearing a mask.
• Get in the habit of checking in with your child each morning for signs of illness. If there is ANY concern at all take the child’s temperature (if the child has a temperature of 100.4F or higher even without any other symptoms the child should NOT go to school).
• Thereafter monitor for any other symptoms: ensure your child does NOT have sore throat, cough, diarrhea/vomiting, headache or body aches.

Even if symptoms seem mild they should be recognized and taken into account in order to avoid potential spread of any infectious illness. This will remain important as the cooler weather and fall season are typical for other respiratory illnesses to arise such as influenza.

• If your child is sick and develops symptoms of COVID make sure you are aware of where you child can be tested. Also make sure you know who the school’s point of contact is for reporting illness. Find out what options for instruction/learning will be available for the child if quarantine is required. Make sure you are familiar with the school’s plan of communicating with families when a positive case or exposure to COVID-19 have occurred.
• Ensure your child is up to date on ALL recommended vaccines including the flu vaccine when it becomes available this year. We do not know how these two respiratory illness will affect severity of illness if a child or adult is co-infected.
• Review and practice proper hand washing techniques with your child at home and ensure they are aware of the options available at school for hand hygiene.
• Adjust daily before and after school routines to include the following if you had not been doing them already: remember to pack hand sanitizer and extra face coverings/masks. Have children change out of school clothes into clean set of clothes and wash hands as soon as they return home.
• Make sure the school has up to date contact information including emergency contacts as well as individuals authorized to pick up your child. If the list includes anyone who is considered high risk for developing severe illness for COVID-19 consider choosing an alternate person.
• Plan for potential school closures or quarantine periods. Consider if you will be able to take time off work should the child require quarantine at home. If the parent is unable to work from home or take time off work it is important to identify an adult who would be able to supervise the child during this time.

Stay alert: We know these times of significant change and decreased social interactions can contribute to stress and anxiety in children as well as adults.

Talk to your child about what to expect regarding how school will look different from before. For example desks may be set far apart for distancing purposes, teachers and staff will likely be using masks/face coverings and in some instances eye protection or googles, lunch time may occur at staggered times in smaller groups. Sports and other outside activities may involve different precautions than before. Be alert to changes in your child’s behavior that may indicate they are struggling with stress, anxiety or depression.

These include excessive crying or irritation, excessive worry or sadness, change in eating habits or sleep habits or difficulties concentrating among other changes in their typical behavior.

Remember there has already been a lot of stress with handling the many unknowns and issues the COVID pandemic has brought, it is important for children and adults to take breaks when necessary, get plenty of sleep, exercise and eat well and stay socially connected during this time.

As the fall semester approaches we know how hard it has been for parents and families to decide the mode of learning for their children. Some school districts have opted for a hybrid model in which the school year will start with ALL students in the remote/virtual setting gradually transitioning and providing opportunities in-person instruction.

Whichever decision or situation you choose for your student, the start of this school year will be like no other. I thought I would review a few recommendations the CDC (Center for Disease Control) has made that will help you and your family get ready for the start of the new school year.

 For those in virtual at-home instruction:

• Talk to your child about how school is going (even if they are home and involved in virtual learning), ask them about their day and about how they are feeling regarding this form of learning. It’s normal for children who are extroverts to struggle with the lack of in-person interaction while natural introverts may be more comfortable in this setting. Regardless of the situation it’s important to find out how they feel and work through the things they are struggling with.
• If you do identify behavior changes which worry you that your child may be experiencing difficulties reach out to your pediatrician to discuss these. Also find out if school has set up a plan to provide counseling or other support services during periods of virtual learning.
• Be a role model: Practice self-care. If your job or other responsibilities have you worried about how you will handle supporting your child’s learning during virtual at-home learning time seek out resources to help you find that balance (there are webinars out there currently covering this very topic).
• Consider the following to get prepared for Virtual or At-home learning:
• Get organized: Make sure you are aware of any registration deadlines, including submitting preference forms that your school districts may need. These forms will help how staff will need to prepare for when they will be offering in-person learning as well as ongoing virtual learning options.
• Review your families schedule and identify times for learning or instruction if your school has not provided a schedule for the student. Also don’t forget to schedule “recess” times in which the child can spend doing activities outside. Make sure to include breaks, waking/bedtimes, and unstructured “free time.”
• Attempt to schedule family oriented physical activity as your schedule allows (such as walks in the evening, water activities outside)
• A family calendar if you don’t use one yet may help keep everyone organized especially if you are keeping track of multiple assignments and deadlines for more than one child.
• Find a space in your home that is free of distractions and noise and designate this area as the area for learning. Avoid choosing rooms or areas that have easy access to toys or distractions such as TVs. Make sure the area is well lit and has access to electrical outlets for access to charging devices if necessary.
• Identify activities that will allow your child to remain socially engaged with peers or family virtually and if in person ensure you know the proper precautions that should still be taken.
• Stay informed: The information coming from school districts is immense. Make sure you are reading any communications that your school is putting out. Consider attending any virtual meetings which are discussing the preparations the school has made for the start of school year. Keep up with the constant changes that occur as new guidelines are made for school districts to consider.

Consider the following and ask questions regarding the following to ensure you are well prepared:

• Will your student be expected to be logged in at certain times of the day for live video instruction? Will the access to recorded lessons?
• How will attendance be taken each day?
• Will the school offer any sort of physical activity opportunities? If not remember it’s important to come up with your own to include in your kid’s daily routine.
• If your student participates in the school’s meal program, does your school plan to make meals available while students are learning online, if so how will you be able to access these?
• If your child has an IEP (Individual Education Program) or 504 Plan or receives other support services (PT,OT, Speech) from your school, how will your school provide these during the virtual at-home learning period?
• If you anticipate any technological barriers (we all experience these at some point), does your school offer support such as allowing students to borrow a laptop? Will they help with internet connectivity if this is an issue? Make sure you know how to access the school’s IT department for questions or issues.

Remember there has already been a lot of stress with handling the many unknowns and issues the COVID pandemic has brought, it is important for children and adults to take breaks when necessary, get plenty of sleep, exercise and eat well and stay socially connected during this time.

Related Content:

• Regreso a la escuela durante la pandemia de COVID: Planificación para el aprendizaje en persona
• Regreso a la escuela durante la pandemia de COVID-19: Planificación para el aprendizaje virtual

As the fall semester approaches we know how hard it has been for parents and families to decide the mode of learning for their children. Some school districts have opted for a hybrid model in which the school year will start with ALL students in the remote/virtual setting gradually transitioning and providing opportunities in-person instruction.

Whichever decision or situation you choose for your student, the start of this school year will be like no other. I thought I would review a few recommendations the CDC (Center for Disease Control) has made that will help you and your family get ready for the start of the new school year.

 For those in virtual at-home instruction:

• Talk to your child about how school is going (even if they are home and involved in virtual learning), ask them about their day and about how they are feeling regarding this form of learning. It’s normal for children who are extroverts to struggle with the lack of in-person interaction while natural introverts may be more comfortable in this setting. Regardless of the situation it’s important to find out how they feel and work through the things they are struggling with.
• If you do identify behavior changes which worry you that your child may be experiencing difficulties reach out to your pediatrician to discuss these. Also find out if school has set up a plan to provide counseling or other support services during periods of virtual learning.
• Be a role model: Practice self-care. If your job or other responsibilities have you worried about how you will handle supporting your child’s learning during virtual at-home learning time seek out resources to help you find that balance (there are webinars out there currently covering this very topic).
• Consider the following to get prepared for Virtual or At-home learning:
• Get organized: Make sure you are aware of any registration deadlines, including submitting preference forms that your school districts may need. These forms will help how staff will need to prepare for when they will be offering in-person learning as well as ongoing virtual learning options.
• Review your families schedule and identify times for learning or instruction if your school has not provided a schedule for the student. Also don’t forget to schedule “recess” times in which the child can spend doing activities outside. Make sure to include breaks, waking/bedtimes, and unstructured “free time.”
• Attempt to schedule family oriented physical activity as your schedule allows (such as walks in the evening, water activities outside)
• A family calendar if you don’t use one yet may help keep everyone organized especially if you are keeping track of multiple assignments and deadlines for more than one child.
• Find a space in your home that is free of distractions and noise and designate this area as the area for learning. Avoid choosing rooms or areas that have easy access to toys or distractions such as TVs. Make sure the area is well lit and has access to electrical outlets for access to charging devices if necessary.
• Identify activities that will allow your child to remain socially engaged with peers or family virtually and if in person ensure you know the proper precautions that should still be taken.
• Stay informed: The information coming from school districts is immense. Make sure you are reading any communications that your school is putting out. Consider attending any virtual meetings which are discussing the preparations the school has made for the start of school year. Keep up with the constant changes that occur as new guidelines are made for school districts to consider.

Consider the following and ask questions regarding the following to ensure you are well prepared:

• Will your student be expected to be logged in at certain times of the day for live video instruction? Will the access to recorded lessons?
• How will attendance be taken each day?
• Will the school offer any sort of physical activity opportunities? If not remember it’s important to come up with your own to include in your kid’s daily routine.
• If your student participates in the school’s meal program, does your school plan to make meals available while students are learning online, if so how will you be able to access these?
• If your child has an IEP (Individual Education Program) or 504 Plan or receives other support services (PT,OT, Speech) from your school, how will your school provide these during the virtual at-home learning period?
• If you anticipate any technological barriers (we all experience these at some point), does your school offer support such as allowing students to borrow a laptop? Will they help with internet connectivity if this is an issue? Make sure you know how to access the school’s IT department for questions or issues.

Remember there has already been a lot of stress with handling the many unknowns and issues the COVID pandemic has brought, it is important for children and adults to take breaks when necessary, get plenty of sleep, exercise and eat well and stay socially connected during this time.

Related Content:

• Returning to School During the COVID-19 Pandemic: In-person learning
• Regreso a la escuela durante la pandemia de COVID: Planificación para el aprendizaje en persona
• Regreso a la escuela durante la pandemia de COVID-19: Planificación para el aprendizaje virtual

Did you know that schools consider French fries and ketchup as vegetable servings in their cafeteria served lunches?! In just a few minutes in the evenings, you can prepare a more nutritious lunch for your kiddos.

You can prepare these meals even if you’re not sending your child off to school yet. Go ahead and get in the routine of lunch prep at night, and they can eat their “school lunch” during the noon break from virtual school. In fact, prepping lunch and snacks will limit the constant grazing we might have gotten into the bad habit of over the lockdown and summer.

 Here are my healthy takes on kid-friendly favorites.

Kids Meal Prep Ideas for school lunches:

1.“Pizza Lunchables”: 1 or 2 Wheat English muffin halves, with side of low salt pizza sauce (make your own real quick with low or no salt tomato sauce seasoned with pepper and oregano), shredded mozzarella, and turkey pepperonis. Side Veggie: sliced bell peppers. Side Fruit: fresh mandarin orange

2.“Lunchables”: Handful (approx. 12) of wheat or veggie crackers, 3 slices of low salt, no preservative deli turkey or ham cut in quarters, 3 slices of low fat cheese cut in quarters. Side Veggie: celery sticks with hummus or ranch dip. Side Fruit: No sugar added fruit cup

3.Roll Ups: Corn or wheat tortilla with sliced cheese or spreadable cheese (such as laughing cow) and low salt no preservative deli meat. Can add spinach and/or smashed avocado as well. Slice in 6 equal pieces to have cute pinwheels. Side Veggie: carrots and dip. Side Fruit: grapes

4.Egg muffins:

Recipe: 1 cup Bisquick

• 1 lb cooked turkey sausage or ground turkey
• 4 eggs, beaten
• 1 cup shredded cheddar cheese
• *Optional: 1 cup chopped veggies such as peppers and mushrooms
• Mix all ingredients and split between 12 servings in a muffin tin. Bake at 350 degrees for 20mins
•  Side Veggie: cucumber slices and cherry tomatoes. Side Fruit: berries

5. Pasta salad: Cooked whole wheat or veggie pasta with chopped grilled chicken and vegetables such as tomatoes, zucchini, and spinach. Add a little dressing to the pasta salad such as pesto or Italian dressing. Side Fruit: apple slices.

6. Quesadillas: Corn or wheat tortillas with bean & cheese or chicken & cheese. Side Veggie: broccoli and dip. Side Fruit: mango or peach slices

7.”Chicken Nuggets”:

• Recipe: Cut 1 lb chicken breasts into strips or large chunks.
• Coat in flour mixture: 1 cup or more whole wheat or oat flour mixed with ¼ cup ground flax seeds, ½ tsp salt & pepper, 1 tsp garlic powder, and 1 tsp paprika. Now dredge coated chicken in beaten eggs, and then again coat with flour mixture.
• Bake or air fry until cooked through. (Double recipe to make for dinner, then to have leftovers for next day’s lunches.)
• Side Veggie: veggie chips or sticks. Side Fruit: fruit & veggie squeeze pouch

8. Meatballs:

• Recipe: 1 lb ground beef or turkey
• ½ can pureed pumpkin
• 2 slices wheat bread, torn apart in small pieces
• ¼ cup flax seeds
• 1 egg
• ½ tsp each salt & pepper
• 1 tsp garlic powder
• 2 tbsp low sugar ketchup
• Mix all ingredient until well combined. Make 1-2 inch balls and place on greased sheet pan. Bake 15-20mins at 350 degrees until cooked through. Can serve with ketchup or bbq sauce. (Double recipe to make for dinner, then have leftovers for lunch next day.)
• Side Veggie: Cauliflower and hummus or ranch. Side Fruit: pineapple
• Extra additions to above lunch ideas, 1 per day: small individual cookie packs, all natural fruit twists (actual fruit instead of packs of fruit snacks), granola bar, fruit & nut bar such as LaraBar, ¼ cup trail mix, ½ cup honey wheat pretzels.
• No juice, soda or sports drinks; instead have water or 2% milk.

I hope you enjoy! 

Sleep, it’s important, right?!

Has your kid's new COVID-19 schedule got them going to bed after midnight and sleeping until noon?

Well it’s time NOW to start getting back into a normal sleep schedule for school, even if they are learning online.

So how much sleep does your child need? This is a good estimate, but teenagers can require up to 12 hours of sleep while they’re going through a growth spurt.

How much sleep does my child need?

• 3-6 year olds need 10-12 hours of sleep
• 7-12 year olds need 10-11 hours of sleep
• 13-18 year olds need 8-9 hours of sleep

If your child has a midnight or (gasp!) even later bedtime right now, start working on adjusting their bedtime slowly over the next few weeks. I propose the following schedule:

• Aug 1: 11:30 p.m.
• Aug 2: 11:15 p.m.
• Aug 3: 11 p.m.
• Aug 4: 10:45 p.m.
• Aug 5: 10:30 p.m.
• Aug 6: 10:15 p.m.
• Aug 7: 10 p.m.
• Aug 8: 9:45 p.m.
• Aug 9: 9:30 p.m.
• Aug 10: 9:15 p.m.
• Aug 11: 9:15 p.m.
• Aug 12: 9 p.m.*

*Early elementary children will likely need a 7 p.m. or 8 p.m. bedtime, adjust the 15-minute pattern above as needed.

Keep in mind that bedtime means lights out, no screen time. Charge your child’s phone in your room, you’d be shocked to find out the long text message conversations happening at 2 a.m.! No TV in the bedroom either. If your child is having trouble with the adjustment in bedtime, it is perfectly fine to give melatonin about 20-30 minutes before bedtime. One or 3 milligrams is appropriate for elementary age, up to 5 milligrams for teenagers. Don’t allow caffeine after noon either.

Best of luck transitioning to school this year! We’re all going to have to work nicely together to get through this, but we can and we will!

Lauren, who was diagnosed with leukemia in 2017, said Poehler was funny, encouraging and relatable. For about 40 minutes, the two talked about their families, favorite TikTok videos and staying at home during quarantine.

Since being diagnosed with cancer, avoiding germs and public places has become a part of life for Lauren. Poehler asked the teen if she had any advice for those of us who are struggling with the new changes in the world.

“You find the things that calm you down and relax you,” explained Lauren. “Spend time with your family, that’s what I do and it’s got me through some bad times.”

The teen also told Poehler about her dreams of becoming an anesthesiologist, which she attributes to her experience as a surgery patient at Cook Children’s.

“Medicine is so cool,” Poehler told Lauren during the chat. “I’ve talked to a lot of kids who have to go through a lot of procedures and they get interested in medicine because they have experience with it that a lot of young people don't, and they see how they could make a difference. It's really cool.”

Lauren asked Poehler questions about everything from her career path to what it’s like being an actress and comedian. She also asked Poehler what inspires her. Her answer: working mothers.

“Moms who have to work and raise kids, especially during these times. There’s a lot of mothers who are working hard,” Poehler said. “I’m also very inspired by health care workers who are in the trenches and can’t see their own families because they have to be safe. I’m very inspired by people who put their lives on the line, risk their lives for people.”

Last month, Children’s Miracle Network Hospitals named Poehler a CHANGEMAKER, which is an exclusive list of celebrities, influencers, corporate leaders and advocates who have positively impacted children’s health. According to the organization, the individuals and groups named have made a difference in the health and well-being of children, specifically sick and injured children treated at children’s hospitals across North America. 

“We’ve really had to change the way we do things,” said Jill Koss, director of Family Support Services and Child Life at Cook Children’s. “The goal of Child Life is to help patients and their families work through any fears and anxieties they have about being in the hospital, and giving them tools to cope with that fear. For patients that may find themselves in isolation due to Covid-19 testing, we are meeting many of those needs virtually.”

Cook Children’s Child Life Zone (CLZ) is now using its closed TV station, CLZ-TV Channel 2, to connect with patients. They’ve ramped up their broadcasting schedule, now hosting several game shows a day which allow patients to call in from their rooms to play along. CLZ is also teaming up with Hear Fort Worth, a division of Visit Fort Worth, to bring the magic of music straight to patient rooms.

“Through Hear Fort Worth, we’ve started collaborating with the local music community to bring free, virtual concerts to patients and families,” said Rayne Delgado, program coordinator for the Child Life Zone at Cook Children’s. “The response from our patients has been great. They especially enjoy being able to interact with the artists.”

Concerts are streamed via Zoom with the artist performing from their home while answering questions from the patients via Instagram or a special phone line.

“We are honored to work with the tremendous staff at Cook Children’s Medical Center,” said Mitch Whitten, executive vice president of marketing and strategy at Visit Fort Worth. “Music can inspire and bring hope during trying times and we are grateful to our local musicians for donating their time and talents. Music is an integral part of our city’s culture.”

Three concerts have occurred thus far featuring artists Jack Barksdale, Jessi England and Grady Spencer with more being planned.

“The COVID-19 pandemic has created many unique challenges for Cook Children’s, including how to help kids feel like kids while social distancing in a hospital room,” said Koss. “This partnership with Hear Fort Worth gives our patients and families a chance to momentarily set aside the medical challenges they’re facing, and feel a little more connected through music.”

Musicians interested in performing may contact Child Life Zone Program Coordinator Rayne Delgado or Hear Fort Worth leads Tom Martens and Hillary Dupriest for more information. Visit www.FortWorth.com/Music to learn more about the local music community and how you can support.

"Your child is here with a sore throat. I know they haven’t had a fever, but strep has been going around."

Whelp, there goes your day. Cancel all your meetings. Call your pediatrician's office. Get an appointment in a few hours. Get your child tested and see what happens next.

But for some families in North Texas, there might be a better way to get treated for illnesses.

Through a partnership with Cook Children's, students in Keller ISD join a growing list of other local school districts who can now see a pediatric provider via telemedicine as part of our School-Based Virtual Health program. All while staying at school.

Children with qualifying conditions such as earache, sore throat, pink eye and many others who present symptoms to their school nurse, connect with either a Cook Children's board certified pediatrician or a certified nurse practitioner via a secure video connection. The school nurse can use devices to show the provider the child's ears, throat, rashes, and other physical findings as well as allow the provider to listen via a digital stethoscope. Students also can be tested for both strep and flu while right there in the office.

The virtual visits are completely covered for children who are on Medicaid. For all other patients, the price of a visit is $65 for new patients and $50 for established patients.

Keller ISD and Cook Children's started a pilot program approximately three years ago in five schools. The success of the program led to the adoption of the program to the full district last fall. Funds from the Grainger Foundation allowed for the purchase of more equipment and marketing information to be distributed.

Enrollment at Keller ISD has increased significantly over time. Although registration can be completed on the day of the visit, there are now over 1,000 students pre-registered for visits. More than 150 appointments have been completed this school year. About half of those visits have allowed the student to stay at school. Staying in school means decreasing lost educational time, faster time to diagnosis and treatment as well as prevention of many parental headaches and frustrations.

Interested in more information about Cook Children's School-Based Virtual Health program?

Click here to find out more about the program and how your school might become involved. If you would like to donate to this program, click here and type in "telemedicine" when prompted.

It took that long to outrage a country from what was seen and heard by members of Sigma Alpha Epsilon fraternity at the University of Oklahoma chanting a racial epithet on a bus.

While the video shows that we haven’t progressed as far as most of us would like as a society, it also proves once again that our children need to learn the life-changing consequences of going viral.

Jody S. Hawkins, Information Systems Security Officer at Cook Children’s, gives a presentation to children called, “The Virtual World.” He explains the permanence of everything we post to the Internet.

“Like a face tattoo, the things your child posts to the Internet in public forums could be discoverable by potential college recruiters, employers or those out to paint your child’s character in a negative way,” Hawkins said. “What does your child aspire to be when he or she grows up? Are the things your children are doing on the Internet today going to have a negative impact on that career choice?”

Considering the speed of today’s technology, it’s important for kids to understand that everything they do is permanent, even if it’s been deleted. Thanks to screen shots, a careless text message can be frozen in time and put on social networking sites, forever subject to public scrutiny.

Hawkins recommends parents talk with their kids and express the need for self-control when they interact with others, even when they aren’t speaking face-to-face. Explain the importance of cooling off before sending that angry text message, commenting on a blog or posting an aggressive Facebook status. And if someone is doing something inappropriate, walk away or don’t participate. Everyone has a recording device in their hands these days.

A study from the University of Massachusetts’ Center for Market Research found that 21 percent of college admissions offices research their applicants via social media sites. An offensive blog post could overrule a stellar SAT score and change a university’s admission invitation.

“Kids don’t think about the harms they could be causing themselves,” Hawkins said. “They tend to have this, ‘Look ma, no hands’ mentality while we watch them and freak out. But those split second decisions can have forever consequences.”

About the source

Jody S. Hawkins, Information Systems Security Officer, has been in technology for medical facilities since early 2000 and has been practicing for more than 20 years with his start in the United States Air Force. He is a part of Cook Children's Experts on Call Speakers Bureau. Hawkins specializes in privacy and technology safety and is a regular speaker at the National HIT/HIPAA Conference. He has been quoted and published in several national publications, including Health Information Management Magazine.

Hawkins' can speak on a variety of security topics facing our children & parents today, including:

• Social media
• Cyber bullying
• Sexting
• Safety online (Parents & Child)
• General home networking security
• Virtual Child (Parents)
• Internet Safety (Parents & Child)