911 Basics for Your Child

One of the challenges of being a parent is arming your kids with the skills to handle the obstacles life presents. Teaching them how to use 911 in an emergency could be one of the simplest — and most important — lessons you'll ever share.

Talking About 911 With Kids

Not that long ago, there was a separate telephone number for each type of emergency agency. For a fire, you called the fire department number; for a crime, you called the police; for a medical situation, you called an ambulance or doctor.

But now 911 is a central number for all types of emergencies. An emergency dispatch operator quickly takes information from the caller and puts the caller in direct contact with whatever emergency personnel are needed, thus making response time quicker.

According to the National Emergency Number Association, 911 covers nearly all of the population of the United States, but check your phone book to be sure that 911 is the emergency number to use in your area.

Everyone needs to know about calling 911 in an emergency. But kids also need to know the specifics about what an emergency is. Asking them questions like "What would you do if we had a fire in our house?" or "What would you do if you saw someone trying to break in?" gives you a chance to discuss what constitutes an emergency and what to do if one occurs. Role playing is an especially good way to address various emergency scenarios and give your kids the confidence they'll need to handle them.

For younger children, it might also help to talk about who the emergency workers are in your community — police officers, firefighters, paramedics, doctors, nurses, and so on — and what kinds of things they do to help people who are in trouble. This will clarify not only what types of emergencies can occur, but also who can help.

When to Call 911

Part of understanding what is an emergency is knowing what is not. A fire, an intruder in the home, an unconscious family member — these are all things that would require a call to 911. A skinned knee, a stolen bicycle, or a lost pet wouldn't. Still, teach your child that if ever in doubt and there's no adult around to ask, make the call. It's much better to be safe than sorry.

Make sure your kids understand that calling 911 as a joke is a crime in many places. In some cities, officials estimate that as much as 75% of the calls made to 911 are non-emergency calls. These are not all pranks. Some people accidentally push the emergency button on their cell phones. Others don't realize that 911 is for true emergencies only (not for such things as a flat tire or even about a theft that occurred the week before).

Stress that whenever an unnecessary call is made to 911, it can delay a response to someone who actually needs it. Most areas now have what is called enhanced 911, which enables a call to be traced to the location from which it was made. So if someone dials 911 as a prank, emergency personnel could be dispatched directly to that location. Not only could this mean life or death for someone having a real emergency on the other side of town, it also means that it's very likely the prank caller will be caught and punished.

How to Use 911

Although most 911 calls are now traced, it's still important for your kids to have your street address and phone number memorized. They'll need to give that information to the operator as a confirmation so time isn't lost sending emergency workers to the wrong address.

Make sure your kids know that even though they shouldn't give personal information to strangers, it's OK to trust the 911 operator. Walk them through some of the questions the operator will ask, including:

• Where are you calling from? (Where do you live?)
• What type of emergency is this?
• Who needs help?
• Is the person awake and breathing?

Explain that it's OK to be frightened in an emergency, but it's important to stay calm, speak slowly and clearly, and give as much detail to the 911 operator as possible. If they're old enough to understand, also explain that the emergency dispatcher may give first-aid instructions before emergency workers arrive at the scene.

Make it clear that your child should not hang up until the person on the other end says it's OK, otherwise important instructions or information could be missed.

More Safety Tips

Here are some additional safety tips to keep in mind:

• Always refer to the emergency number as "nine-one-one" not "nine-eleven." In an emergency, a child may not know how to dial the number correctly because of trying to find the "eleven" button on the phone.
• Make sure your house number is clearly visible from the street so that police, fire, or ambulance workers can easily locate your address.
• If you live in an apartment building, make sure your child knows the apartment number and floor you live on.
• Keep a list of emergency phone numbers handy near each phone for your kids or babysitter. This should include police, fire, and medical numbers (particularly important if you live in one of the few areas where 911 is not in effect), as well as a number where you can be reached, such as your cell phone, pager, or work number. In the confusion of an emergency, calling from a printed list is simpler than looking in the phone book or figuring out which is the correct speed-dial number. The list should also include known allergies, especially to any medication, medical conditions, and insurance information.
• If you have special circumstances in your house, such as an elderly grandparent or a person with a heart condition, epilepsy, or diabetes living in your home, prepare your child by discussing specific emergencies that could occur and how to spot them.
• Keep a first-aid kit handy and make sure your kids and babysitters know where to find it. When kids are old enough, teach them basic first aid.

Washing Your Hands, Is it Important?

A delicious mud pie, a good-luck rock, or a friendly frog are the types of goodies kids love to bring home. But these adorable gifts can also bring millions of germs with them.

Kids don't always listen when you tell them to wash their hands before eating, after using the bathroom, or when they come inside from playing. But it's a message worth repeating — hand washing is by far the best way to prevent germs from spreading and to keep your kids from getting sick.

First Line of Defense Against Germs

Germs can be transmitted many ways, including:

• touching dirty hands
• changing dirty diapers
• through contaminated water and food
• through droplets released during a cough or a sneeze
• via contaminated surfaces
• through contact with a sick person's body fluids

When kids come into contact with germs, they can unknowingly become infected simply by touching their eyes, nose, or mouth. And once they're infected, it's usually just a matter of time before the whole family comes down with the same illness.

Good hand washing is the first line of defense against the spread of many illnesses, from the common cold to more serious illnesses such as meningitis, bronchiolitis, influenza, hepatitis A, and most types of infectious diarrhea.

Washing Hands Correctly

Here's how to scrub those germs away. Demonstrate this routine to your kids — or better yet, wash your hands together often so they learn how important this good habit is:

1. Wash your hands in warm water. Make sure the water isn't too hot for little hands.
2. Use soap and lather up for about 20 seconds (antibacterial soap isn't necessary — any soap will do). Make sure you get in between the fingers and under the nails where uninvited germs like to hang out. And don't forget the wrists!
3. Rinse and dry well with a clean towel.

To minimize the germs passed around your family, make frequent hand washing a rule for everyone, especially:

• before eating and cooking
• after using the bathroom
• after cleaning around the house
• after touching animals, including family pets
• before and after visiting or taking care of any sick friends or relatives
• after blowing one's nose, coughing, or sneezing
• after being outside (playing, gardening, walking the dog, etc.)

Don't underestimate the power of hand washing! The few seconds you spend at the sink could save you trips to the doctor's office.

Concussions

The term concussion conjures up the image of someone knocked unconscious while playing sports. But concussions — temporary loss of brain function — can happen with any head injury, often without any loss of consciousness.

A concussion is also known as a mild traumatic brain injury. Although we usually hear about head injuries in athletes, many occur off the playing field in car and bicycle accidents, in fights, and even minor falls.

Kids who sustain concussions usually recover within a week or two without lasting health problems by following certain precautions and taking a breather from sports.

But a child with an undiagnosed concussion can be at risk for brain damage and even disability.

Anyone who sustains a head injury should stop participating and be removed from the activity or sport. Even 

without a loss of consciousness, it's important to watch for symptoms of a concussion.

Common initial symptoms include:

• a change in level of alertness
• extreme sleepiness
• a bad headache
• confusion
• repeated vomiting
• seizure

Someone with these symptoms should be taken to the emergency room.

About Concussions

The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. The brain can move around inside the skull and even bang against it. If the brain does bang against the skull — for example, due to a fall on a sidewalk or a whiplash-type of injury — it can be bruised, blood vessels can be torn, and the nerves inside the brain can be injured. These injuries can lead to a concussion.

Many different systems have been used to grade or describe concussions. The severity of a concussion is determined by how long signs and symptoms last and so can only be known after someone has recovered. The longer the symptoms of changes in brain function, the more severe the concussion.

Signs and Symptoms of a Concussion

Someone with a concussion may lose consciousness, but this doesn't happen in every case. In fact, a brief loss of consciousness or "blacking out" isn't a factor in determining concussion severity.

Other signs of a concussion include:

• headache
• sleepiness or difficulty falling asleep
• feeling confused and dazed
• difficulty concentrating, thinking, or making decisions
• dizziness
• difficulty with coordination or balance (such as being able to catch a ball or other easy tasks)
• trouble remembering things, such as what happened right before or after the injury
• blurred vision
• slurred speech or saying things that don't make sense
• nausea and vomiting
• feeling anxious or irritable for no apparent reason

Concussion symptoms may not appear initially and can develop over the first 24-72 hours. Anyone showing any of these signs should be seen by a doctor. Young kids can have the same concussion symptoms as older kids and adults, but changes in mood and behavior may be more subtle.

Call an ambulance or go to the ER right away if, after a head injury, your child:

• can't be awakened
• has one pupil — the dark part of the eye — that's larger than the other
• has convulsions or seizures
• has slurred speech
• seems to be getting more confused, restless, or agitated

Though most kids recover quickly from concussions, some symptoms — including memory loss, headaches, and problems with concentration — may linger for several weeks or months. Nearly 15% of kids age 5 and older have symptoms and/or changes in functioning lasting 3 months or longer. It's important to watch for these symptoms and contact your doctor if they persist.

Diagnosis

If a concussion is suspected, the doctor will ask about how the head injury happened, when, and its symptoms. The doctor also may ask basic questions to gauge your child's consciousness, memory, and concentration ("Who are you?"/"Where are you?"/"What day is it?").

The diagnosis of a concussion is made by health care provider based on history and physical exam. The doctor will perform a thorough examination of the nervous system, including testing balance, coordination, nerve function, and reflexes.

Sometimes a doctor may order a CT scan of the brain (a detailed brain X-ray) or an MRI (a non-X-ray brain image) to rule out bleeding or other serious brain injury. Concussions can change the way the brain works, but in most cases, imaging tests will show normal results.

Treatment

If the concussion is not serious enough to require hospitalization, the doctor will provide instructions on how to take care of your child at home. The doctor may have you wake your child up at least once during the night.

If your child cannot be easily awakened, becomes increasingly confused, or has other symptoms (such as continued vomiting), it may mean there is a more serious problem that requires contacting the doctor again.

The primary treatments for a concussion include both physical and mental rest. While your child has symptoms, he or she should not:

• attend school or have a normal workload
• take any high-stakes testing (for example, state testing, PSATs, SATs, etc.)
• participate in physical activity including gym class, recess, and sports
• participate in wheel activities (for example, biking, rollerblading, scootering, or skateboarding)
• drive or operate heavy machinery
• return to work

After a concussion, the brain needs time to heal. Recovery time will depend on how long the symptoms last. It's very important for kids to wait until all symptoms have ended before resuming normal activities. Physical symptoms, balance and coordination, and thinking and personality all should return to the pre-injury level.

Be sure to get the OK from the doctor before your child resumes sports or other physical activities. Sometimes kids feel better even though their thinking, behavior, and/or balance have not yet returned to normal. Even if your child pleads that he or she feels fine or a competitive coach or school official urges you to go against medical instructions, it's essential to wait until the doctor has given the OK.

Healthy kids can usually resume their normal activities within a few weeks, but each situation is different. The doctor will monitor your child closely to ensure that recovery is going well and might recommend acetaminophen, ibuprofen, or other aspirin-free medications for headaches.

Even mild concussions require a player to sit out for the remainder of the game. People are much more likely to sustain a concussion if they've had one previously. And evidence shows that repeated concussions can result in lasting brain damage, even when the injuries occur months or years apart.

Kids who have resumed normal activities and no longer have symptoms might be allowed to slowly return to sports. This is a gradual process that can take anywhere from a few days to weeks. A person should never return to play or other strenuous activities on the same day of the injury and should see a doctor.

Preventing Concussions

All kids should wear properly fitting, appropriate headgear and safety equipment when biking, rollerblading, skateboarding, snowboarding or skiing, and playing contact sports. Safety gear has been shown to reduce the occurrence of severe head trauma.

Childproofing your home will go a long way toward keeping an infant or toddler safe from concussions and other injuries. Babies reach, grasp, roll, sit, and eventually crawl, pull up, "cruise" along furniture, and walk. Toddlers may pull themselves up using table legs; they'll use bureaus and dressers as jungle gyms; they'll reach for whatever they can see.

All of these activities can result in a head injury that leads to a concussion. Be sure your child has a safe place to play and explore, and never leave a baby or toddler unattended.

The time you spend taking these safety precautions — and getting your kids into the habit of abiding by your safety rules and regulations — will help keep your family safe and sound!

Leaving you Kid Home Alone

Whether it's a snow day home from school, an unexpected business appointment, or a childcare arrangement that fell through, situations are likely to arise where you feel you have little choice but to leave your child home alone.

It's natural for parents to be a bit anxious when first leaving kids without supervision. But you can feel prepared and confident with some planning and a couple of trial runs. And handled well, staying home alone can be a positive experience for kids, too, helping them gain a sense of self-assurance and independence.

Factors to Consider

It's obvious that a 5-year-old can't go it alone but that a 16-year-old probably can. But what about those school-aged kids in the middle? It can be difficult to know when kids are ready to handle being home alone. Ultimately, it comes down to your judgment about what your child is ready for.

You'll want to know how your child feels about the idea, of course. But kids often insist that they'll be fine long before parents feel comfortable with it. And then there are older kids who seem afraid even when you're pretty confident that they'd be just fine. So how do you know?

In general, it's not a good idea to leave kids younger than 10 years old home alone. Every child is different, but at that age, most kids don't have the maturity and skills to respond to an emergency if they're alone.

Think about the area where you live. Are there neighbors nearby you know and trust to help your child in case of an emergency? Or are they mostly strangers? Do you live on a busy street with lots of traffic? Or is it a quiet area? Is there a lot of crime in or near your neighborhood?

Whether it's a snow day home from school, an unexpected business appointment, or a childcare arrangement that fell through, situations are likely to arise where you feel you have little choice but to leave your child home alone.

It's natural for parents to be a bit anxious when first leaving kids without supervision. But you can feel prepared and confident with some planning and a couple of trial runs. And handled well, staying home alone can be a positive experience for kids, too, helping them gain a sense of self-assurance and independence.

• Does your child show signs of responsibility with things like homework, household chores, and following directions?
• How does your child handle unexpected situations? How calm does your child stay when things don't go as planned?
• Does your child understand and follow rules?
• Can your child understand and follow safety measures?
• Does your child make good judgments or is he or she prone to taking risks?
• Does your child know basic first-aid procedures?
• Does your child follow your instructions about staying away from strangers?

Make A "Practice Run"

Even if you're confident about your child's maturity, it's wise to make some practice runs, or home-alone trials, before the big day. Let your child stay home alone for 30 minutes to an hour while you remain nearby and easily reachable. When you return, discuss how it went and talk about things that you might want to change or skills that your child might need to learn for the next time.

Handling the Unexpected

You can feel more confident about your absence if your child learns some basic skills that might come in handy during an emergency. Organizations such as the American Red Cross offer courses in first aid and cardiopulmonary resuscitation (CPR) in local places like schools, hospitals, and community centers.

Before being left home alone home alone, your child should be able to complete certain tasks and safety precautions, such as:

• knowing when and how to call 911 and what address information to give the dispatcher
• knowing how to work the home security system, if you have one, and what to do if the alarm is accidentally set off
• locking and unlocking doors
• working the phone/cell phone (in some areas, you have to dial 1 or the area code to dial out)
• turning lights off and on
• operating the microwave
• knowing what to do if:
  • there's a small fire in the kitchen
  • the smoke alarm goes off
  • there's a tornado or other severe weather
  • a stranger comes to the door
  • someone calls for a parent who isn't home
  • there's a power outage

Regularly discuss some emergency scenarios — ask what your child would do if, for example, he or she smelled smoke, a stranger knocked at the door, or someone called for you while you're gone.

Before You Leave

Even after you decide that your child is ready to stay home alone, you're bound to feel a little anxious when the time comes. Taking these practical steps can make it easier for you both:

• Schedule time to get in touch. Set up a schedule for calling. You might have your child call right away if he or she is coming home to an empty house, or set up a time when you'll call home to check in. Figure out something that's convenient for both of you. Make sure your child understands when you're readily available and when you might not be able to answer a call.
  
  
• Set ground rules. Establish some special rules for when you're away and make sure that your child knows and understands them. Consider rules about:
  • having a friend or friends over while you're not there
  • rooms of the house that are off limits, especially with friends
  • TV time and types of shows
  • Internet and computer rules
  • kitchen and cooking (you might want to make the oven and utensils like sharp knives off limits)
  • not opening the door for strangers
  • answering the phone
  • getting along with siblings
  • not telling anyone he or she is alone
    
    
• Stock up. Make sure your house has everyday goods and emergency supplies. Stock the kitchen with healthy foods for snacking. Leave a precise dose of any medication that your child needs to take, but don't leave medication bottles out as this could lead to an accidental overdose or ingestion, especially if younger siblings are also present.
  
  In addition, leave flashlights in an accessible place in case of a power outage. Post important phone numbers — yours and those of friends, family members, the doctor, police, and fire department — that your child might need in an emergency.
  
  
• Be sure that you:
  • Create a list of friends your child can call or things your child can do if lonely.
  • Leave a snack or a note so your child knows you're thinking of him or her.
  • Make up a schedule for your child to follow while you're away.
  • Make sure the parental controls and filtering systems, if you have any, are programmed for the Internet on your computer and on your TV.
    
    
• Childproof your home. No matter how well your child follows rules, be sure to secure anything that could be a health or safety risk. Lock them up and put them in a place where kids can't get to them or, when possible, remove them from your home. These items include:
  • alcohol
  • prescription medications
  • over-the-counter medications that could cause problems if taken in excess: sleeping pills, cough medicine, etc.
  • guns (if you do keep one, make sure it is locked up and leave it unloaded and stored away from ammunition)
  • tobacco
  • car keys
  • lighters and matches

Ready to Go

When you're ready to leave your child home alone for the first time, a few other steps can help both of you manage the transition.
You might have an older teen or a friend of the family come over to stay with your child. Don't call that person a "babysitter" — tell your child that the person is there to keep him or her company. You might also want to let your child invite a trusted friend of the same age to come over, and propose this as a trial run for later solo stays. Be sure to let the friend's parents know that you won't be home.
And don't forget that pets can be great company for kids who are home alone. Many kids feel safer with a pet around — even a small one, like a hamster, can make them feel like they have a companion.
So cover your bases and relax. With the right preparation and some practice, you and your child will get comfortable with home-alone days in no time!

January Jones Pregnant in Sheer Top: New Trend for Mamas?

We know expectant mothers are proud of their little packages, but is donning a sheer top just TMI?

First Charlotte Gainsbourg wore a black see-through blouse over her baby bump in Cannes, and now January Jones has been spotted rocking the same look while walking her dog with a friend in L.A. Are sheer tops a new trend for mothers-to-be?

We think the "Mad Men" star looks kinda cool in hers. It's an improvement over Charlotte's attempt, so we're excited to see how far this motherhood fad can go. And while we've never been pregnant ourselves, we can only imagine that it gets pretty hot carrying around the extra poundage. Sheer fabric probably gives mom a cool breeze, no?

Maybe seven-months-pregnant Victoria Beckham will be next to jump on the sheer-top train. She could probably afford some more stylish yet functional maternity wear. Remember those sky-high heels she wore to the royal wedding? Ouch.

Paula Patton's Russian Baby??

When recent pictures of Jumping the Broom actress Paula Patton's son with hubby Robin Thicke emerged, the web went crazy with everyone buzzing about the adorable 1-year-old's blonde hair and blue eyes.

But in an appearance on Chelsea Lately, Paula assured fans that no, the couple did not adopt a Russian baby, and yes, she is in fact Julian's biological mother.

"Blackness takes time," joked Patton, who said that people often mistake her for the nanny when she's out in public with her son.

Though she says -- in jest -- that she's threatened to cover the tot in baby oil and sit him out in the sun, Paula's certain that little Julian will start to look more like his mother in due time adding, "A tan is coming in, the hair's curlier....."

So, it's okay. In the case of Julian Thicke, Paula Patton is the baby's mother!

Alicia Silverstone Welcomes Bear Blu Jarecki

Alicia Silverstone has welcomed her first child with husband Christopher Jarecki on Thursday (May 5). Son Bear Blu Jarecki weighed in at 7 lbs., 15 oz., PEOPLE reports.

"Mom and Dad are completely in love" with their "beautiful baby boy," Alicia's rep said in a statement.

It sounds like congratulations may be in order for Alicia Silverstone and her husband Christopher Jarecki!

Though the former Clueless star has yet to confirm the news, X17online.com is reporting that the couple have welcomed their first baby, writing that the 34-year-old actress and author “had a water birth at an LA-area birthing center on Friday” and is already back at home.

Married for 5 years, Alicia and her hubby announced the pregnancy back in January.

“I've been wanting to have a baby since I was 2 years old,” she said in an interview just last year. “I'm destined 

to be a mother.”

Gorgeous Alyssa Milano Expecting a Son

Gorgeous mom-to-be Alyssa Milano radiated the red carpet in polka dots at the premiere of The Hangover Part II in Los Angeles on Thursday (May 19).

Expecting a son with husband David Bugliari in early fall, the actress recently talked about loving her first pregnancy: "I've had such a great time being pregnant that you're probably going to see me more pregnant than not in the next few years because I'm really digging it."

The 38-year-old actress went on to say, "We have five names picked out because we aren't going to name him until we see him."

Jennifer Garner on Motherhood

Mom-of-two Jennifer Garner seemed happy and relaxed and she took time sign autographs for fans on the way into The Late Show With David Letterman yesterday.

The Ghosts of Girlfriends Past star reports that home life with her husband Ben Affleck and their kids Violet, 3, and Seraphina, 3 months, is chaotic - but in a good way!

"It's crazy, it's like having 10 kids," she says of life since the arrival of Seraphina. "You have one and you think you start to know what you're doing and you have it under control. And then you have the other one and it all just goes to hell in a hand basket!"

Jennifer says that she's in mommy mode 24/7 these days. "People say, 'How was your night? How was the baby last night?' But I feel like, What's night? It just means that I put on sweatpants and took a couple of naps."

Despite the sleep-deprivation, she insists that she is finding motherhood much easier the second time, saying, "If we could all just be second-time parents the first time around!"

It sounds as though Ben has also found his fatherhood groove - Jen says that he's not as nervous with Seraphina as he was with her big sister Violet.

"When our oldest was a baby he was so careful with her, and delicate, but with the second he's just flinging her around," she laughs.

Ali Larter Hates Leaving Baby!

NEW YORK, N.Y. --

Former “Heroes” star Ali Larter may be a famous actress, but she hates leaving her baby just like the rest of us!

Access Hollywood caught up with Ali at the launch of Reebok’s RealFlex footwear in New York City on Thursday where the new mom spoke opened up about leaving her baby for the first time and maintaining a work-out schedule.

“I think it’s a challenge for all new moms to get back to their pre-baby weight,” Ali told Access.

When asked about leaving her baby, 4-month-old Theodore Hayes MacArthur, for the first time, Ali admitted it was “absolutely traumatic in every way.”

“I feel like all the working moms out there know how difficult it is and I think it’s the great equalizer in life once you have a child,” she said.

Ali mentioned that she thinks its important to work and wants her son to be proud of her, but admitted “at the same time, I just want to be home!”

Ali also shared with Access how she keeps her svelte shape, and how she tricks herself into working out when she doesn’t want to!

“I’m doing pilates a couple days a week, and I’m trying to hike or run a couple days a week,” she said.

“The pressures of life can be a lot for everyone, and instead of going ‘Oh, I don’t want to to work out,’ I try to flip that switch in my brain, and go ‘This is your time to get rid of the problems, let your stress go,’” she explained.

For new moms out there, Ali has some advice on how to get moving and begin a workout routine.

“If you don’t have someone to watch the baby, just put him in a stroller and walk for a couple of hours. It just really gives you the positive endorphins,” she said.

Child Custody Battles - Charlie Sheen

The parents: Charlie Sheen and Denise Richards
 
The offspring: Their daughters, Sam (born in 2004) and Lola (born in 2005)
 
The scandal: Richards accused Sheen of being addicted to prescription drugs, gambling, prostitutes and porn, including having a fascination with underage girls. Sheen denied the allegations. In September 2007, Richards filed court papers requesting that Sheen not be alone with their children while the kids visit him. In February 2008, Sheen publicly blasted Richards for including their daughters in her reality show, and he asked people to boycott the show.
 
The outcome: In March 2008, Sheen and Richards announced that they reached a custody agreement. The specific terms of the agreement remain undisclosed.

Child Custody Battles - Alec Baldwin

The parents: Alec Baldwin and Kim Basinger
 
The offspring: Their daughter, Ireland (born in 1995), who also goes by the nickname Addie
 
The scandal: After Basinger and Baldwin split up in 2000, they accused each other of being unfit parents. She said he was emotionally abusive, and he claimed she was mentally unstable. Their legal warfare resulted in a 2004 court judgment of shared custody on the condition that they not violate a gag order that prevents them from publicly talking about the case. In April 2007, an angry voice-mail recording of Alec Baldwin was leaked to the media. In the recording, Baldwin called Ireland “a thoughtless little pig.” As a result of the scandal, his visitation rights were temporarily suspended.
 
The outcome: After Baldwin publicly apologized for his outburst, his visitation rights were restored. His legal team accused Basinger of violating the gag order by leaking the recording, but the allegation was unproven in a court of law. Although the ex-couple has shared custody, the animosity between the two clearly remains.

Child Custody Battles - Britney Spears

The parents: Britney Spears and Kevin Federline

 

The offspring: Their sons, Sean Preston (born in 2005) and Jayden James (born in 2006)

 

The scandal: The bitter custody battle between Spears and ex-husband Federline included explosive accusations that she’s a drug and alcohol abuser who frequently puts her kids in danger.

 

The outcome: In October 2007, Spears made headlines around the world (again) when she became the first major female celebrity in years to lose custody of her children. She lost custody because she reportedly failed to follow a court order that required her not to drive without a valid license, and to undergo random drug testing and parental counseling.

Kids and Alcohol

As much as parents may not like to think about it, the truth is that many kids and teens try alcohol during their high school and college years, long before it's legal for them to drink it. Research has shown that nearly 80% of high school kids have tried alcohol.

Although experimentation with alcohol may be common among kids, it's not safe or legal. So it's important to start discussing alcohol use and abuse with your kids at an early age and keep talking about it as they grow up.

The Effects of Alcohol Abuse

Alcohol interferes with a person's perception of reality and ability to make good decisions. This can be particularly hazardous for kids and teens who have less problem-solving and decision-making experience.

Short-term effects of drinking include:

• distorted vision, hearing, and coordination
• altered perceptions and emotions
• impaired judgment, which can lead to accidents, drowning, and other risky behaviors like unsafe sex and drug use
• bad breath
• hangovers

Long-term effects include:

• cirrhosis and cancer of the liver
• loss of appetite
• serious vitamin deficiencies
• stomach ailments
• heart and central nervous system damage
• memory loss
• an increased risk of impotence
• high risk for overdosing

Talking to Kids About Alcohol

Long before your kids are presented with a chance to drink alcohol, you can increase the chances that they'll just say "no."

Childhood is a time of learning and discovery, so it's important to encourage kids to ask questions, even ones that might be hard to answer. Open, honest, age-appropriate communication now sets the stage for your kids to come to you later with other difficult topics or problems.

Preschoolers

Although 3- and 4-year-olds aren't ready to learn the facts about alcohol or other drugs, they start to develop the decision-making and problem-solving skills they will need later on. You can help them develop those skills in some simple ways.
For instance, let toddlers choose their own clothing and don't worry if the choices don't match. This lets them know you think they're capable of making good decisions. Assign simple tasks and let kids know what a big help they are.
And set a good example of the behavior that you want your kids to demonstrate. This is especially true in the preschool years when kids tend to imitate adults' actions as a way of learning. So, by being active, eating healthy, and drinking responsibly, parents teach their kids important lessons early on.

Ages 4 to 7

Kids this age still think and learn mostly by experience and don't have a good understanding of things that will happen in the future. So keep discussions about alcohol in the present tense and relate them to things that kids know and understand. For example, watching TV with your child can provide a chance to talk about advertising messages. Ask about the ads you see and encourage kids to ask questions too.
Kids are interested in how their bodies work, so this is a good time to talk about maintaining good health and avoiding substances that might harm the body. Talk about how alcohol hurts a person's ability to see, hear, and walk without tripping; it alters the way people feel; and it makes it hard to judge things like whether the water is too deep or if there's a car coming too close. And it gives people bad breath and a headache!

Ages 8 to 11

The later elementary school years are a crucial time in which you can influence your child's decisions about alcohol use. Kids at this age tend to love to learn facts, especially strange ones, and are eager to learn how things work and what sources of information are available to them.
So it's a good time to openly discuss facts about alcohol: its long- and short-term effects and consequences, its physical effects, and why it's especially dangerous for growing bodies.
Kids also can be heavily influenced by friends now. Their interests may be determined by what their peers think. So teach your child to say "no" to peer pressure, and discuss the importance of thinking and acting as an individual.

Casual discussions about alcohol and friends can take place at the dinner table as part of your normal conversation: "I've been reading about young kids using alcohol. Do you ever hear about kids using alcohol or other drugs in your school?"

Ages 12 to 17

By the teen years, your kids should know the facts about alcohol and your attitudes and beliefs about substance abuse. So use this time to reinforce what you've already taught them and focus on keeping the lines of communication open.
Teens are more likely to engage in risky behaviors, and their increasing need for independence may make them want to defy their parents' wishes or instructions. But if you make your teen feel accepted and respected as an individual, you increase the chances that your child will try to be open with you.
Kids want to be liked and accepted by their peers, and they need a certain degree of privacy and trust. Avoid excessive preaching and threats, and instead, emphasize your love and concern. Even when they're annoyed by parental interest and questions, teens still recognize that it comes with the territory.

Teaching Kids to Say "No"

Teach kids a variety of approaches to deal with offers of alcohol:

• Encourage them to ask questions. If a drink of any kind is offered, they should ask, "What is it?" and "Where did you get it?"
• Teach them to say "no, thanks" when the drink offered is an alcoholic one.
• Remind them to leave any uncomfortable situation. Make sure they have money for transportation or a phone number where you or another responsible adult can be reached.
• Teach kids never to accept a ride from someone who has been drinking. Some parents find that offering to pick up their kids from an uncomfortable situation — no questions asked — helps encourage kids to be honest and call when they need help.

Risk Factors

Times of transition, such as the onset of puberty or a parents' divorce, can lead kids to alcohol use. So teach your kids that even when life is upsetting or stressful, drinking alcohol as an escape can make a bad situation much worse.

Kids who have problems with self-control or low self-esteem are more likely to abuse alcohol. They may not believe that they can handle their problems and frustrations without using something to make them feel better.
Kids without a sense of connectedness with their families or who feel different in some way (appearance, economic circumstances, etc.) may also be at risk. Those who find it hard to believe in themselves desperately need the love and support of parents or other family members.
In fact, not wanting to harm the relationships between themselves and the adults who care about them is the most common reason that young people give for not using alcohol and other drugs.

General Tips

Fortunately, parents can do much to protect their kids from using and abusing alcohol:

• Be a good role model. Consider how your use of alcohol or medications may influence your kids. Consider offering only nonalcoholic beverages at parties and other social events to show your kids that you don't need to drink to have fun.
• Educate yourself about alcohol so you can be a better teacher. Read and collect information that you can share with kids and other parents.
• Try to be conscious of how you can help build your child's self-esteem. For example, kids are more likely to feel good about themselves if you emphasize their strengths and positively reinforce healthy behaviors.
• Teach kids to manage stress in healthy ways, such as by seeking help from a trusted adult or engaging in a favorite activity.

Recognizing the Signs

Despite your efforts, your child may still use — and abuse — alcohol. How can you tell? Here are some common warning signs:

• the odor of alcohol
• sudden change in mood or attitude
• change in attendance or performance at school
• loss of interest in school, sports, or other activities
• discipline problems at school
• withdrawal from family and friends
• secrecy
• association with a new group of friends and reluctance to introduce them to you
• alcohol disappearing from your home
• depression and developmental difficulties

It's important not to jump to conclusions based on only one or two signs. Adolescence is a time of change — physically, socially, emotionally, and intellectually. This can lead to erratic behavior and mood swings as kids try to cope with all of these changes.
If your child is using alcohol, there will usually be a cluster of these signs, like changes in friends, behavior, dress, attitude, mood, and grades. If you see a number of changes, look for all explanations by talking to your kids, but don't overlook substance abuse as a possibility.
Other tips to try:

• Keep tabs on where your kids go.
• Know the parents of your child's friends.
• Always make sure you have a phone number where you can reach your child.
• Have kids check in regularly when they're away from home.
• When spending an extended length of time away from you, your child should check in periodically with a phone call, e-mail, or visit home.

For teens, especially those old enough to drive, consider negotiating and signing a behavioral contract. This contract should spell out the way you expect your child to behave and state the consequences if your teen drives under the influence. Follow through and take the keys away, if necessary.

Make part of the deal with your teen that you and the rest of your family also agree never to drink and drive.
Also encourage responsible behaviors, such as planning for a designated driver or calling an adult for help rather than driving under the influence.

It's important to keep communication open and expectations reasonable. Tying responsible actions to freedoms such as a later curfew or a driver's license can be a powerful motivator. Teach your kids that freedom only comes with responsibility — a lesson that should last a lifetime.

KIds and Smoking

The health risks of tobacco are well known, but kids and teens continue to smoke and use chewing tobacco. Many young people pick up these habits every year — in fact, 90% of all adult smokers started when they were kids. Each day, more than 3,900 kids become regular smokers.

So it's important to make sure kids understand the dangers of tobacco use. Smoking is the leading cause of preventable deaths in the United States, and can cause cancer, heart disease, and lung disease. Chewing tobacco (smokeless or spit tobacco) can lead to nicotine addiction, oral cancer, gum disease, and an increased risk of cardiovascular disease, including heart attacks.

Giving kids information about the risks of smoking and chewing tobacco, and establishing clear rules and your reasons for them, can help protect them from these unhealthy habits.

You also should know the warning signs of tobacco use and constructive ways to help someone kick the habit.

The Facts About Tobacco

One of the major problems with smoking and chewing tobacco has to do with the chemical nicotine. Someone can get addicted to nicotine within days of first using it. In fact, the nicotine in tobacco can be as addictive as cocaine or heroine. Nicotine affects mood as well as the heart, lungs, stomach, and nervous system.

Other health risks include short-term effects of smoking such as coughing and throat irritation. Over time, more serious conditions may develop, including increases in heart rate and blood pressure, bronchitis, and emphysema.

Finally, numerous studies indicate that young smokers are more likely to experiment with marijuana, cocaine, heroin, or other illicit drugs.

The Attraction for Kids

Kids might be drawn to smoking and chewing tobacco for any number of reasons — to look cool, act older, lose weight, win cool merchandise, seem tough, or feel independent.

But parents can combat those draws and keep kids from trying — and getting addicted to — tobacco. Establish a good foundation of communication with your kids early on to make it easier to work through tricky issues like tobacco use.

Prevention Tips

To help prevent your kids from using tobacco, keep these guidelines in mind:

• Discuss it in a way that doesn't make kids fear punishment or judgment.
• It's important to keep talking to kids about the dangers of tobacco use over the years. Even the youngest child can understand that smoking is bad for the body.
• Ask what kids find appealing — or unappealing — about smoking. Be a patient listener.
• Read, watch TV, and go to the movies with your kids. Compare media images with what happens in reality.
• Encourage kids to get involved in activities that prohibit smoking, such as sports.
• Show that you value your kids' opinions and ideas.
• Discuss ways to respond to peer pressure to smoke. Your child may feel confident simply saying "no." But also offer alternative responses such as "It will make my clothes and breath smell bad" or "I hate the way it makes me look."
• Emphasize what kids do right rather than wrong. Self-confidence is a child's best protection against peer pressure.
• Encourage kids to walk away from friends who don't respect their reasons for not smoking.
• Explain how much smoking governs the daily life of kids who start doing it. How do they afford the cigarettes? How do they have money to pay for other things they want? How does it affect their friendships?
• Establish firm rules that exclude smoking and chewing tobacco from your house and explain why: Smokers smell bad, look bad, and feel bad, and it's bad for everyone's health.

What to Watch For

If you smell smoke on your child's clothing, try not to overreact. Ask about it first — maybe he or she has been hanging around with friends who smoke or just tried one cigarette. Many kids do try a cigarette at one time or another but don't go on to become regular smokers.

Additional signs of tobacco use include:

• coughing
• throat irritation
• hoarseness
• bad breath
• decreased athletic performance
• greater susceptibility to colds
• stained teeth and clothing (also signs of chewing tobacco use)
• shortness of breath

Getting Through to Kids

Sometimes even the best foundation isn't enough to stop kids from experimenting with tobacco. It may be tempting to get angry, but it's more productive to focus on communicating with your child.

Here are some tips that may help:

• Resist lecturing or turning your advice into a sermon.
• Uncover what appeals to your child about smoking and talk about it honestly.
• Many times, kids aren't able to appreciate how their current behaviors can affect their future health. So talk about the immediate downsides to smoking: less money to spend on other pursuits, shortness of breath, bad breath, yellow teeth, and smelly clothes.
• Stick to the smoking rules you've set up. And don't let a child smoke at home to keep the peace.
• If you hear, "I can quit any time I want," ask your child to show you by quitting cold turkey for a week.
• Try not to nag. Ultimately, quitting is the smoker's decision.
• Help your child develop a quitting plan and offer information and resources, and reinforce the decision to quit with praise.
• Stress the natural rewards that come with quitting: freedom from addiction, improved fitness, better athletic performance, and improved appearance.
• Encourage a meeting with your doctor, who can be supportive and may have treatment plans.

If You Smoke

Kids are quick to observe any contradiction between what their parents say and what they do. Despite what you might think, most kids say that the adult whom they most want to be like when they grow up is a parent.

If you're a smoker:

• First, admit to that you made a mistake by starting to smoke and that if you had it to do over again, you'd never start.
• Second, quit. It's not simple and it may take a few attempts and the extra help of a program or support group. But your kids will be encouraged as they see you overcome your addiction to tobacco.

Soiling (Encopresis)

If your child who has bowel movements (BMs) in places other than the toilet, you know how frustrating it can be. Many parents assume that kids who soil their pants are simply misbehaving or that they're too lazy to use the bathroom when they have the urge to go.

The truth is that many kids beyond the age of toilet teaching (generally older than 4 years) who frequently soil their underwear have a condition known as encopresis. They have a problem with their bowels that dulls the normal urge to go to the bathroom — and they can't control the accidents that typically follow.
Although encopresis is estimated to affect 1% to 2% of kids under the age of 10, problems with encopresis and constipation account for more than 25% of all visits to pediatric gastroenterologists (doctors who specialize in disorders of the stomach and intestines).

Most encopresis cases (90%) are due to functional constipation — that is, constipation that has no medical cause. The stool (or BM) is hard, dry, and difficult to pass when a person is constipated. Many kids "hold" their BMs to avoid the pain of constipation, which sets the stage for having a poop accident.
Well-intentioned advice from family members and friends isn't always helpful because many people mistakenly believe that encopresis is a behavioral issue — a simple lack of self-control. Frustrated parents, grandparents, and caregivers may advocate various punishments and consequences for the soiling — which only leaves the child feeling even more alone, angry, depressed, or humiliated. Up to 20% of kids with encopresis experience feelings of low self-esteem that require the intervention of a psychologist or counselor.

Punishing or humiliating a child with encopresis will only make matters worse. Instead, talk to your doctor, who can help you and your child through this challenging but treatable problem.

Encopresis and Its Causes

Three to six times more common in boys, encopresis isn't a disease, but rather a symptom that may have different causes. To understand encopresis, it's important to understand constipation.
There's a wide range of normal when it comes to having a BM. The frequency of BMs varies with a person's age and individual nature. "Normal" pooping might range from one or two BMs per day to only three or four per week. Some kids don't poop on a regular basis, but a child who passes a soft BM without difficulty every 3 days is not constipated. However, a child who passes a hard BM (small or large) every other day is. Other kids may go every day, but they only release little, hard balls and there's always poop left behind in the colon.

So, what causes the hard poop in the first place? Any number of things, including diet, illness, decreased fluid intake, fear of the toilet during toilet teaching, or limited access to a toilet or a toilet that's not private (like at school). Some kids may develop chronic constipation after stressful life events such as a divorce or the death of a close relative. Whatever the cause, once a child begins to hold his or her BMs, the poop begins to accumulate in the colon and a vicious cycle begins.

The colon's job is to remove water from the poop before it's passed. The longer the poop is stuck there, the more water is removed — and the harder it is to push the large, dry poop out. The large poop also stretches out the colon, weakening the muscles there and affecting the nerves that tell a child when it's time to go to the bathroom. Because the flabby colon can't push the hard poop out, and it's painful to pass, the child continues to avoid having a BM, often by dancing, crossing the legs, making faces, or walking on tiptoes.

Eventually, the lower part of the colon becomes so full that it's difficult for the sphincter (the muscular valve that controls the passage of feces out of the anus) to hold the poop in. Partial BMs may pass through, causing the child to soil his or her pants. Softer poop may also leak out around the large mass of feces and stain the child's underwear when the sphincter relaxes. The child can't prevent the soiling — nor does he or she have any idea it's happening — because the nerves aren't sending the signals that regulate defecation (or pooping).

At first, parents may think their child has a simple case of diarrhea. But after repeated episodes, it becomes clear that there's another problem — especially because the soiling occurs when the child isn't sick.

Parents are often frustrated by the fact that their child seems unfazed by these accidents, which occur mostly during waking hours. Denial may be one reason for the child's nonchalance — kids just can't face the shame and guilt associated with the condition (some even try to hide their soiled underpants from their parents). Another reason may be more scientific: Because the brain eventually gets used to the smell of feces, the child may no longer notice the odor.

When to Call the Doctor

Although rectal surgery or birth defects such as Hirschsprung disease and spina bifida can cause constipation or encopresis without constipation, these are uncommon.
Call the doctor if your child shows any of the following symptoms:

• poop or liquid stool in the underwear when your child isn't ill
• hard poop or pain when having a BM
• toilet-stopping BM
• abdominal pain
• loss of appetite

Treating Encopresis

As the colon is stretched by the buildup of stool, the nerves' ability to signal to the brain that it's time for a BM is diminished. If untreated, not only will the soiling get worse, but kids with encopresis may lose their appetites or complain of stomach pain.

A large, hard poop may also cause a tear in the skin around the anus that will leave blood on the stools, the toilet paper, or in the toilet. Constipation is also associated with wetting and urinary tract infections (UTI). If you think your child has encopresis, call your doctor.

Most cases of encopresis can be managed by your doctor, but if initial efforts fail, you may be referred to a gastroenterologist.

Treatment is done in three phases:

1. The first phase involves emptying the colon of hard, retained poop. Different doctors might have different ways of helping kids with encopresis. Depending on the child's age and other factors, the doctor may recommend medicines, including a stool softener (such as mineral oil), laxatives, and/or enemas. (Laxatives and enemas should be given only under the supervision of a doctor; never give these treatments at home without first checking with your doctor.) As unpleasant as this first step sounds, it's necessary to clean out the bowels to successfully treat the constipation and end your child's soiling.
2. After the large intestine has been emptied, the doctor will help the child begin having regular BMs with the aid of stool-softening agents, most of which aren't habit-forming. At this point, it's important to continue using the stool softener to give the bowels a chance to shrink back to normal size (the muscles of the intestines have been stretched out, so they need time to be toned without the poop piling up again). Parents will also be asked to schedule potty times twice daily after meals (when the bowels are naturally stimulated), in which the child sits on the toilet for about 5 to 10 minutes. This will help the child learn to pay attention to his or her own urges. It's especially helpful for parents to keep a record of their child's daily BMs.
3. As regular BMs become established, your doctor will reduce the child's use of stool softeners.

Keep in mind that relapses are normal, so don't get discouraged if your child occasionally becomes constipated again or soils his or her pants during treatment, especially when trying to wean the child off of the medications.

A good way to keep track of your child's progress is by keeping a daily poop calendar. Make sure to note the frequency, consistency (i.e., hard, soft, dry), and size (i.e., large, small) of the BMs.
Patience is the key to treating encopresis. It may take anywhere from several months to a year for the stretched-out colon to return to its normal size and for the nerves in the colon to become effective again.

Diet and Exercise

In the meantime, diet and exercise are extremely important in keeping stools soft and BMs regular. Also, make sure your child gets plenty of fiber-rich foods such as fresh fruits, dried fruits like prunes and raisins, dried beans, vegetables, and high-fiber cereal.
Because kids often cringe at the thought of fiber, try these creative ways to incorporate it into your child's diet:

• Bake cookies or muffins using whole-wheat flour instead of regular flour. Add raisins, chopped or pureed apples, or prunes to the mix.
• Add bran to baking items such as cookies and muffins, or to meatloaf or burgers, or sprinkled on cereal. (The trick is not to add too much bran or the food will taste like sawdust.)
• Serve apples topped with peanut butter.
• Create tasty treats with peanut butter and whole-wheat crackers.
• Top ice cream, frozen yogurt, or regular yogurt with high-fiber cereal for some added crunch.
• Serve bran waffles topped with fruit.
• Make pancakes with whole-grain pancake mix and top with peaches, apricots, or grapes.
• Top high-fiber cereal with fruit.
• Sneak some raisins or pureed prunes or zucchini into whole-wheat pancakes.
• Add shredded carrots or pureed zucchini to spaghetti sauce or macaroni and cheese.
• Add lentils to soup.
• Make bean burritos with whole-grain soft-taco shells.

And don't forget to have your child drink plenty of fluids each day, including water and 100% fruit juices like pear, peach, and prune to help draw water into the colon. Try mixing prune juice with another drink to make it a little tastier. Also be sure to limit your child's total daily dairy intake (including cheese, yogurt, and ice cream) to 24 ounces or less.

Successful treatment of encopresis depends on the support the child receives. Some parents find that positive reinforcement helps to encourage the child throughout treatment. Provide a small incentive, such as a star or sticker on the poop calendar, for having a BM or even just for trying, sitting on the toilet, or taking medications.

Whatever you do, don't blame or yell — it will only make your child feel bad and it won't help manage the condition. Show lots of love and support and, assure your child that he or she isn't the only one in the world with this problem. With time and understanding, your child can overcome encopresis.

Teaching Self-Control

When kids melt down in the middle of a crowded store, at a holiday dinner with extended family, or at home, it can be extremely frustrating. 

But parents can help kids learn self-control and teach them how to respond to situations without just acting on impulse.

Teaching self-control skills is one of the most important things that parents can do for their kids because these are some of the most important skills for success later in life.

 

 

 

 

Helping Kids Learn Self-Control

By learning self-control, kids can make appropriate decisions and respond to stressful situations in ways that can yield positive outcomes.
For example, if you say that you're not serving ice cream until after dinner, your child may cry, plead, or even scream in the hopes that you will give in. But with self-control, your child can understand that a temper tantrum means you'll take away the ice cream for good and that it's wiser to wait patiently.
Here are a few suggestions on how to help kids learn to control their behavior:

Up to Age 2

Infants and toddlers get frustrated by the large gap between the things they want to do and what they're able to do. They often respond with temper tantrums. Try to prevent outbursts by distracting your little one with toys or other activities. For kids reaching the 2-year-old mark, try a brief timeout in a designated area — like a kitchen chair or bottom stair — to show the consequences for outbursts and teach that it's better to take some time alone instead of throwing a tantrum.

Ages 3 to 5

You can continue to use timeouts, but rather than enforcing a specific time limit, end timeouts once your child has calmed down. This helps kids improve their sense of self-control. And praise your child for not losing control in frustrating or difficult situations.

Ages 6 to 9

As kids enter school, they're better able to understand the idea of consequences and that they can choose good or bad behavior. It may help your child to imagine a stop sign that must be obeyed and think about a situation before responding. Encourage your child to walk away from a frustrating situation for a few minutes to cool off instead of having an outburst.

Ages 10 to 12

Older kids usually better understand their feelings. Encourage them to think about what's causing them to lose control and then analyze it. Explain that sometimes the situations that are upsetting at first don't end up being so awful. Urge kids to take time to think before responding to a situation.

Ages 13 to 17

By now kids should be able to control most of their actions. But remind teens to think about long-term consequences. Urge them to pause to evaluate upsetting situations before responding and talk through problems rather than losing control, slamming doors, or yelling. If necessary, discipline your teen by taking away certain privileges to reinforce the message that self-control is an important skill.

When Kids Are Out of Control

As difficult as it may be, resist the urge to yell when you're disciplining your kids. Instead, be firm and matter of fact. During a child's meltdown, stay calm and explain that yelling, throwing a tantrum, and slamming doors are unacceptable behaviors that have consequences — and say what those consequences are.
Your actions will show that tantrums won't get kids the upper hand. For example, if your child gets upset in the grocery store after you've explained why you won't buy candy, don't give in — thus demonstrating that the tantrum was both unacceptable and ineffective.
Also, consider speaking to your child's teachers about classroom settings and appropriate behavioral expectations. Ask if problem solving is taught or demonstrated in school.
And model good self-control yourself. If you're in an irritating situation and your kids are present, tell them why you're frustrated and then discuss the potential solutions to the problem. For example, if you've misplaced your keys, instead of getting upset, tell your kids the keys are missing and then search for them together. If they don't turn up, take the next constructive step (like retracing your steps when you last had the keys in-hand). Show that good emotional control and problem solving are the ways to deal with a difficult situation.
If you continue to have difficulties, ask your doctor if family counseling sessions might help.

Pica

Many young kids put nonfood items in their mouths at one time or another. They're naturally curious about their environment and might, for instance, eat some dirt out of the sandbox.

Kids with pica, however, go beyond this innocent exploration of their surroundings. Between 10% and 30% of kids ages of 1 to 6 years have the eating disorder pica, which is characterized by persistent and compulsive cravings (lasting 1 month or longer) to eat nonfood items.

 

 

About Pica

The word pica comes from the Latin word for magpie, a bird known for its large and indiscriminate appetite.

Pica is most common in people with developmental disabilities, including autism and mental retardation, and in children between the ages of 2 and 3. Pica also may surface in children who've had a brain injury affecting their development. It can also be a problem for some pregnant women, as well as people with epilepsy.

People with pica frequently crave and consume nonfood items such as:

• dirt
• clay
• paint chips
• plaster
• chalk
• cornstarch
• laundry starch
• baking soda
• coffee grounds
• cigarette ashes
• burnt match heads
• cigarette butts
• feces
• ice
• glue
• hair
• buttons
• paper
• sand
• toothpaste
• soap

Although consumption of some items may be harmless, pica is considered to be a serious eating disorder that can sometimes result in serious health problems such as lead poisoning and iron-deficiency anemia.

Signs of Pica

Warning signs that a child may have pica include:

• repetitive consumption of nonfood items, despite efforts to restrict it, for a period of at least 1 month or longer
• the behavior is considered inappropriate for your child's age or developmental stage (older than 18 to 24 months)
• the behavior is not part of a cultural, ethnic, or religious practice

Why Do Some People Eat Nonfood Items?

The specific causes of pica are unknown, but certain conditions and situations can increase a person's risk:

• nutritional deficiencies, such as iron or zinc, that may trigger specific cravings (however, the nonfood items craved usually don't supply the minerals lacking in the person's body)
• dieting — people who diet may attempt to ease hunger by eating nonfood substances to get a feeling of fullness
• malnutrition, especially in underdeveloped countries, where people with pica most commonly eat soil or clay
• cultural factors — in families, religions, or groups in which eating nonfood substances is a learned practice
• parental neglect, lack of supervision, or food deprivation — often seen in children living in poverty
• developmental problems, such as mental retardation, autism, other developmental disabilities, or brain abnormalities
• mental health conditions, such as obsessive-compulsive disorder (OCD) and schizophrenia
• pregnancy, but it's been suggested that pica during pregnancy occurs more frequently in women who exhibited similar practices during their childhood or before pregnancy or who have a history of pica in their family

Eating earth substances such as clay or dirt is a form of pica known as geophagia, which can cause iron deficiency. One theory to explain pica is that in some cultures, eating clay or dirt may help relieve nausea (and therefore, morning sickness), control diarrhea, increase salivation, remove toxins, and alter odor or taste perception.

Some people claim to enjoy the taste and texture of dirt or clay, and eat it as part of a daily habit (much like smoking is a daily routine for others). And some psychological theories explain pica as a behavioral response to stress or an indication that the individual has an oral fixation (is comforted by having things in his or her mouth).

Another explanation is that pica is a cultural feature of certain religious rituals, folk medicine, and magical beliefs. For example, some people in various cultures believe that eating dirt will help them incorporate magical spirits into their bodies.

None of these theories, though, explains every form of pica. A doctor must treat each case individually to try to understand what's causing the condition.

When to Call the Doctor

If your child is at risk for pica, talk to your doctor. If your child has consumed a harmful substance, seek medical care immediately. If you think your child has ingested something poisonous, call Poison Control at (800) 222-1222.

A child who continues to consume nonfood items may be at risk for serious health problems, including:

• lead poisoning (from eating paint chips in older buildings with lead-based paint)
• bowel problems (from consuming indigestible substances like hair, cloth, etc.)
• intestinal obstruction or perforation (from eating objects that could get lodged in the intestines)
• dental injury (from eating hard substances that could harm the teeth)
• parasitic infections (from eating dirt or feces)

Medical emergencies and death can occur if the craved substance is toxic or contaminated with lead or mercury, or if the item forms an indigestible mass blocking the intestines. Pica involving lead-containing substances during pregnancy may be associated with an increase in both maternal and fetal lead levels.

What Will the Doctor Do?

Your doctor will play an important role in helping you manage and prevent pica-related behaviors, educating you on teaching your child about acceptable and unacceptable food substances. The doctor will also work with you on ways to to restrict the nonfood items your child craves (i.e., using child-safety locks and high shelving, and keeping household chemicals and medications out of reach).

Some kids require behavioral intervention and families may need to work with a psychologist or other mental health professional.

Depending on a child's age and developmental stage, doctors will work with kids to teach them ways to eat more appropriately. Medication may also be prescribed if pica is associated with significant behavioral problems not responding to behavioral treatments.

Your doctor may check for anemia or other nutritional deficiencies, if indicated. A child who has ingested a potentially harmful substance, such as lead, will be screened for lead and other toxic substances and might undergo stool testing for parasites. In some cases, X-rays or other imaging may be helpful to identify what was eaten or to look for bowel problems, such as an obstruction.

Fortunately, pica is usually a temporary condition that improves as kids get older or following pregnancy. But for individuals with developmental or mental health issues, pica can be a more prolonged concern.
Following treatment, if your child's pica behavior continues beyond several weeks despite attempts to intervene, contact your doctor again for additional treatment. Remember that patience is key in treating pica because it can take time for some kids to stop wanting to eat nonfood items.