Health Education

What is ADHD in children?
Attention-deficit/hyperactivity disorder (ADHD) is a brain-based, or neurodevelopmental, disorder. It's also called attention deficit disorder. It's often first diagnosed in childhood. There are 3 types:

• ADHD, combined. This is the most common type. A child with this type is impulsive and hyperactive. They also have trouble paying attention and are easily distracted.
• ADHD, impulsive/hyperactive. This is the least common type of ADHD. A child with this type is impulsive and hyperactive. But they don't have trouble paying attention.
• ADHD, inattentive and distractible. A child with this type is mostly inattentive and easily distracted.
  

What are the symptoms of ADHD in a child?
Each child with ADHD may have different symptoms. They may have trouble paying attention. A child may also be impulsive and hyperactive. These symptoms most often happen together. But one may happen without the others. Below are the most common symptoms of ADHD.

• Inattention
• Impulsivity
• Hyperactivity

How can I help prevent ADHD in my child?
Experts don’t know how to prevent ADHD in children. But spotting and treating it early can lessen symptoms and enhance your child’s normal development. It can also improve your child’s quality of life.

How can I help my child live with ADHD?
Here are things you can do to help your child:

• Keep all appointments with your child’s healthcare provider.
• Talk with your child’s healthcare provider about other providers who will be involved in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, school psychologists, school counselors, teachers, and psychiatrists. Your child’s care team will depend on your child’s needs and how severe the symptoms of ADHD are.
• Adhere to behavioral and educational treatment plans. Work with your team to adjust the plan if it's not working.
• Give medicines as prescribed
• Tell others about your child’s ADHD. Work with your child’s healthcare provider and schools to develop a treatment plan.
• Reach out for support from local community services. ADHD can be stressful. Being in touch with other parents who have a child with ADHD may be helpful
  

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

What is generalized anxiety disorder in children and teens?

Generalized anxiety disorder (GAD) is a mental health problem. A child with GAD has a lot of worry and fear that seems to have no real cause. The worry may be more intense than the situation calls for. Children or teens with GAD often worry about many things, such as:

• Physical appearance
• Future events
• Past behaviors
• Social acceptance
• Family matters
• Failing to meet parents' expectations
• Their personal abilities
• School performance

All children and teens have some anxiety. It's a normal part of growing up. But sometimes worries and fears don’t go away and get worse over time. They may interfere with a child’s normal activities. In these cases, an anxiety disorder may be present.

What are the symptoms of GAD in a child or teen?

Unlike adults with GAD, children and teens often don’t realize that their anxiety is more intense than the situation calls for. Children and teens with GAD often need a lot of reassurance from the adults in their life.
Symptoms may be a bit different for each child. But the most common symptoms of GAD are:

• Many worries about things before they happen
• Many worries about friends, school, or activities
• Almost constant thoughts and fears about the child’s safety or the parents’ safety
• Refusal to go to school
• Frequent stomachaches, headaches, or other physical complaints
• Muscle aches or tension
• Sleep problems
• Lots of worry about sleeping away from home
• Clingy behavior with family members
• Feeling as though there is a lump in the throat
• Extreme tiredness (fatigue)
• Lack of concentration
• Being easily startled
• Being grouchy or irritated
• Inability to relax

The symptoms of GAD may seem like other health problems. Make sure your child sees their doctor for a diagnosis.

How can I help prevent GAD in my child or teen?

Experts don’t know how to prevent GAD in children. If you see signs of GAD in your child, you can help by getting an evaluation as soon as possible. Remember that the symptoms are not attention seeking, but a sign of a serious problem. Early treatment can ease symptoms. It can also improve your child’s normal development. It can also improve their quality of life.

How can I help my child or teen live with GAD?

As a parent, you play a key role in your child’s treatment. Here are things you can do to help:

• Keep all appointments with your child’s health care provider. If medicine is prescribed, make sure it's taken as directed. Alert your child's provider if there are any signs of side effects.
• Reassure your child. With GAD, your child may not realize their worry is bigger than the situation calls for. Your child will need more comforting from you and other adults.
• Listen to your child. Find out about school, activity on social media, and relationships. Bullying, both in person and on social media, is a serious problem many children face. Let your child know that they can talk to you about anything, especially if they are so anxious or sad that self-harm is being considered.
• Spend enjoyable, stress-free time with your child. Go for a walk, dinner, or out to a movie.
• Talk with your child’s doctor about other providers who will be included in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, teachers, and psychiatrists. Your child’s care team will depend on their needs and how serious GAD is.
• Tell others about your child’s GAD. Work with your child’s doctor and school to create a treatment plan. Remind teachers that your child will need extra reassurance.
• If GAD greatly interferes with your child’s ability to succeed in school, they may be eligible for specific protections and reasonable accommodations under the Americans with Disabilities Act or Section 504 of the Civil Rights Act. Ask your school's principal or your child’s teacher for more information.
• Reach out for support from local community services. Being in touch with other parents who have a child with GAD may be helpful.

When should I call my child’s health care provider?

Call the health care provider or get medical care right away if your child:

• Feels extreme depression, fear, anxiety, or anger toward themself or others
• Feels out of control
• Hears voices that others don’t hear
• Sees things that others don’t see
• Can’t sleep or eat for 3 days in a row
• Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to get help

GAD may increase a child’s risk for suicide. Threats of suicide are a cry for help. Always take such statements, thoughts, behaviors, or plans very seriously. Any child who expresses thoughts of suicide should be evaluated right away.

Call 988 in a crisis

Call or text 988 if your child has thoughts or plans of harming themself or others and the means to carry out the plan. You will be connected to trained crisis counselors at the 988 Suicide & Crisis Lifeline . The 988 Lifeline is free and available 24/7.

If your child is older, make sure they have emergency numbers in their phone. These would include parents, other trusted adults, their doctor, and the Suicide & Crisis Lifeline . Help your child understand that reaching out for help is the most important thing to do if self-harm is being considered.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• 988 Suicide & Crisis Lifeline - it’s like 911, but it’s 988. Dial 988 for confidential, free, 24/7/365 support from a trained counselor for mental health, substance use or suicidal crisis. You can also text 988 for support (English only).
• SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders. Call 1-800-662-HELP (1-800-662- 4357).
• NAMI HelpLine is available Monday through Friday from 10 a.m. to 10 p.m. Eastern. Connect by phone at 1-800-950-6264 or text "Helpline" to 62640. For more information, visit Nami.org/help.
• The Trevor Project (hotline for LGBT youth): 1-866-488-7386
• Chat is available 24/7: SuicidePreventionLifeline.org/chat
• Trans Lifeline: 1-877-565-8860. Hotline for transgender people (volunteers and staff are transgender, as well.)
• Crisis Text Line: 741-741. Trained crisis counselor replies within minutes.
• National Crisis Text Line for the Deaf: Text HAND to 839863
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

What is asthma in children?

Asthma is a long-term (chronic) lung disease that causes your child's airways to become sensitive to certain things (triggers). Several things happen to the airways when a child is exposed to triggers:

• The lining around the airways swells.
• The muscles around the airways tighten.
• The airways make more thick mucus than normal.

All of these things will cause the airways to narrow. This makes it hard for air to go in and out of your child’s lungs and causes asthma symptoms.

What causes asthma in a child?

Experts don't know the exact cause of asthma. They think it's partly passed down through families. But it can also be caused by many other things, such as the environment, infections, and chemicals.

Which children are at risk for asthma?

A child is more likely to get asthma if they:

• Have family members with asthma.
• Have environmental allergies, food allergies, or eczema.
• Are around tobacco smoke.
• Are around air pollution.
• Have another health problem, such as sinus problems or being overweight.

What are the symptoms of asthma in a child?

Symptoms can be different in each child. Children with asthma have times when they have few, if any, symptoms. They also have times when symptoms flare up. Symptoms may include:

• Cough that is either constant or comes and goes.
• Wheezing or whistling sound that is heard while your child breathes.
• Trouble breathing or shortness of breath while your child is active.
• Chest tightness.
• Tiredness.
• Cough at night.
• Noisy breathing.

The symptoms of asthma can look like other health conditions. Have your child see their health care provider for a diagnosis.

What can you do to prevent asthma in your child?

Asthma can’t be completely prevented. There are steps you can take to reduce the chance of your child having asthma. They include:

• Not being around secondhand smoke.
• Staying away from air pollution.

In most children, asthma flare-ups can be prevented by:

• Staying away from known triggers.
• Carefully managing symptoms.
• Taking medicines as directed.

How can you help your child live with asthma?

You can help manage your child’s asthma by:

• Finding out your child’s triggers and keeping them away from those triggers.
• Not letting people smoke in your car, home, or anywhere near your child.
• Not letting your child smoke or use e-cigarettes.
• Giving your child medicine as directed to prevent symptoms.
• Keeping your child up-to-date on vaccines as directed by their health care provider.
• Creating and keeping an Asthma Action Plan.
  • The Asthma Action Plan has information on your child’s medicines. It also says what to do when symptoms occur, and what to do in an emergency.
  • Your child's provider can help you fill it out and update it as needed at each office visit.
  • You can share it with family, babysitters, and school officials.
• Closely watching asthma symptoms to know when they are getting worse.
• Knowing what to do when asthma gets worse.
• Keeping scheduled follow-up appointments.
• Letting school officials or child care providers know about your child's asthma and their Asthma Action Plan.

Work with your child’s provider to find the best way to take care of your child’s asthma. There are guidelines for children from newborn to age 4, ages 5 to 11, and ages 12 and older. Your child should wear a medical alert bracelet or necklace so help can be provided in an emergency.

The more information a person with asthma has, the better the asthma can be controlled.

When should you contact your child’s doctor?

Call your child’s health care provide if your child’s symptoms are not well controlled. For example, your child is waking at night with symptoms or is having trouble with daily activities. Or your child needs their rescue medicine more often. Also talk to your provider if your child shows any signs of emotional distress, such as sadness, anger, or isolation, and refuses to talk to you. These emotions may be related to coping with the asthma symptoms. Bring your Asthma Action Plan to appointments so it can be updated if treatment plans or medicines change.

Call your child’s provider or get medical help right away if your child has severe symptoms. These severe symptoms can include:

• Trouble breathing.
• Trouble sleeping.
• Trouble walking.
• Trouble talking.
• Trouble doing usual activities, such as getting dressed, playing, or getting ready for school.
• Coughing that won’t go away.
• Wheezing when breathing in and out.
• Wheezing that gets worse after medicine should be working (most quick-relief medicines work within 15 minutes).
• Feeling faint, dizzy, or weak.

Call 911

Call 911 right away if your child has any of these:

• Symptoms or conditions as directed by your Asthma Action Plan
• Lips or nails are turning blue
• Nostrils flare each time they inhale
• Can't talk or walk at a normal pace
• Rapid breathing (30 or more breaths per minute)
• The skin between your child's ribs or under their neck sinks in when they breathe

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Asthma and Allergy Foundation of America: Free, online community for asthma and allergic diseases. Post in support forums, follow topics, connect with other members and more. Free. Available in English and Spanish.
• American Lung Association: Free, online community offering peer-to-peer support for people living with asthma. Search for specific topics to find other members who share your interests.
• American Lung Association Lung Helpline: Speak to a lung health expert about your asthma questions. They can educate, coach and counsel on a range of topics and connect you to local and online education systems, support groups, providers and medical equipment resources. Call 1-800-586-4872. Spanish interpreters available onsite, and phone interpretation service provided for more than 240 languages.
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

What is autism spectrum disorder in children?

Autism spectrum disorder (ASD) is a problem that affects a child’s nervous system and growth and development. It often shows up during a child’s first 3 years of life.

Some children with ASD seem to live in their own world. They are not interested in other children and lack social awareness. A child with ASD focuses on following a routine that may include normal behaviors. A child with the disorder also often has problems communicating with others. They may not start speaking as soon as other children. They may not want to make eye contact with other people.

ASD can keep a child from developing social skills. This is in part because a child with ASD may not be able to understand facial expressions or emotions in other people. A child with ASD may:

• Not want to be touched
• Want to play alone
• Not want to change routines

A child with ASD may also repeat movements. This might be flapping their hands or rocking. They may also have abnormal attachments to objects. But a child with ASD may also do certain mental tasks very well. For example, the child may be able to count or measure better than other children. Children with ASD may do well in art or music, or be able to remember certain things very well.

What are the symptoms of ASD in a child?

Each child may have different symptoms. Below are the most common symptoms of ASD.

Social symptoms

• Has problems making eye contact with others
• Has problems making friends or interacting well with other children

Communication symptoms

• Does not communicate well with others
• Starts speaking at a later age than other children or doesn’t speak at all
• When the child is able to speak, doesn’t use speech in social settings
• Repeats words or phrases (echolalia) or repeats parts of dialogue from TV or movies

Behavior symptoms

• Does repeated movements, such as rocking or flapping fingers or hands
• May be too sensitive or less sensitive to certain things around them, such as lights, sounds, touch, or taste
• Has rituals
• Needs routines

The symptoms of ASD may look like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

How can I help prevent ASD in my child?

Experts don’t know how to prevent ASD in children. They do know that it is not caused by what a parent does to raise a child, nor is it linked to childhood vaccines. Spotting and treating ASD early can reduce symptoms and enhance your child’s normal development. It can also improve your child’s quality of life.

How can I help my child live with ASD?

ASD is a lifelong condition that can put great stress on both the person with ASD and their family. Your child’s primary care provider will play a key role in supporting you and your child. They will help you understand treatment and how to care for your child. You play a critical part in your child’s treatment and well-being. Here are things you can do to help your child:

• Keep all appointments with your child’s healthcare provider.
• Talk with your child’s healthcare provider about other providers who will be included in your child’s care. Your child may get care from a team that may include neurologists, speech-language pathologists, occupational and physical therapists, social workers, psychologists, and psychiatrists. Your child’s care team will depend on your child’s needs and how severe the symptoms of ASD are.
• Tell others about your child’s ASD. Work with your child’s healthcare provider and schools to create a treatment plan.
• Check for school resources for your child. Many times a child’s ASD seriously interferes with their ability to manage regular school settings. The Americans with Disabilities Act (ADA) and Section 504 of the Civil Rights Act can help protect children with special educational needs. Talk with your child's teacher or school principal for more information.
• Have your child wear a medical alert bracelet or necklace if they wander or have communication problems. Also think about having them carry an emergency form with contact information and communication symbols.
• Reach out for support from local community services. ASD can be stressful. Being in touch with other parents who have a child with ASD may be helpful.
• Take care of yourself and watch for signs of stress in you or your family members. The physical and emotional demands of caregiving can be overwhelming. Let family and friends help and provide respite care. A break can be helpful for both you and your child. Get additional professional support if needed.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Autism Source from Autism Society of America: Get help finding resources in your area using this national call center. Staff can help connect you with services, government agencies, providers, support systems and more. Call 1-800-328-8476 or email info@autism-society.org for more info.
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

Most pediatric dentists agree that regular dental care should begin by 1 year of age, with a dental checkup at least twice each year after for most children. Some children may need more frequent evaluations and care. The American Academy of Pediatric Dentistry (AAPD) recommends the following:

Birth to 6 months old

• Clean your baby’s mouth with gauze or use a soft infant toothbrush after feedings and at bedtime.
• Ask your child's health care provider or pediatric dentist about fluoride supplements if you live in an area without fluoridated water.
• Also ask about fluoride varnish, which is applied to the teeth.
• Breastfeed your baby, if possible. Breastfeeding can be challenging for many reasons. Talk with your health care team for support if needed.

6 to 12 months old

• During this time, the first tooth should appear. See a pediatric dentist for an exam.
• Brush teeth after each feeding and at bedtime. Use a small, soft-bristled brush and a very small amount of fluoride toothpaste, about the size of a grain of rice.
• As your child begins to walk, stay alert for possible dental or facial injuries.
• The American Academy of Pediatrics recommends giving only breastmilk for at least 6 months. The AAPD recommends breastfeeding for at least 1 year if possible. At about 1 year, continue to breastfeed or begin weaning as you and your baby are ready. Talk with your child's provider about adding other types of food to your baby's diet.
• You can start offering your child small amounts of water around 6 months. If you live in a place with fluoridated water, this will help prevent tooth decay. Ask your child's provider how much water to give your child.

1 to 3 years old

• Most kids have a full set of 20 baby teeth by the time they are 3 years old.
• Follow the schedule of dental exams and cleanings, as recommended by your child's pediatric dentist. Generally, dental exams and cleanings are recommended every 6 months for children and adults.
• At about age 3, as your child learns to rinse and spit, brushing with a pea-sized portion of fluoridated toothpaste is appropriate, in most cases. Always supervise your child to make sure they don't swallow toothpaste.

Diet and dental care for children

The AAPD recommends the following to make sure that your child eats correctly to maintain a healthy body and teeth:

• Ask your child's dentist to help you assess your child's diet.
• Don't routinely stock your pantry with sugary or starchy snacks. Buy "fun foods" just for special times.
• Limit the number of snacks and choose nutritious snacks.
• Provide a balanced diet. Serve age-appropriate foods to your child, including fruits, vegetables, whole grains, low-fat dairy, and lean protein. Stay away from sugary drinks and juices.
• Don't put your young child to bed with a bottle of milk, formula, or juice. This increases the risk of tooth decay.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

What is major depression in teens?

Major depression is a serious type of mood disorder. It’s also known as clinical depression or unipolar depression. There are different types of depression, including:

• Major depression (clinical depression)
• Bipolar disorder (manic depression)
• Persistent depressive disorder (dysthymia)

Major depression goes beyond the day’s normal ups and downs. It affects a person’s body, mood, and thoughts. It can affect and disrupt eating, sleeping, or thinking patterns.

Depression is not the same as being unhappy or in a blue mood. It's also not a sign of personal weakness. It can’t be willed or wished away. Teens with depression can’t merely pull themselves together and get better. Treatment is often needed.

What causes major depression in a teen?

Depression has no single cause. Many factors, such as genetics and the environment, play a role.

What are the symptoms of major depression in a teen?

Each teen with major depression may have different symptoms. A teen often needs to have several of these symptoms during the same 2-week period to be diagnosed with major depression.

• Lasting feelings of sadness
• Feelings of despair, helplessness, or guilt
• Low self-esteem
• Feelings of not being good enough
• Feelings of wanting to die or wishing to already be dead
• Loss of interest in usual activities or activities once enjoyed
• Trouble with relationships
• Sleep problems, such as insomnia
• Changes in appetite or weight
• A drop in energy
• Problems concentrating or making decisions
• Suicidal thoughts. Always take self-harm comments seriously. Get help right away.
• Suicide attempts. A suicide attempt is a self-harm behavior that is meant to cause death, but results in the person surviving. This is an emergency situation and needs immediate help.
• Frequent physical complaints, such as headache, stomachache, or severe tiredness (fatigue)
• Running away or threats of running away from home
• Sensitivity to failure or rejection
• Irritability, hostility, aggression

Symptoms of major depression may look like other mental health problems. Make sure your teen sees their healthcare provider for a diagnosis.

How can I help my teen live with major depression?

As a parent, you play a key role in your teen’s treatment. Here are things you can do to help:

• Talk to your teen, especially about what's going on in school and on social media. Bullying is a major contributor to mental health problems among teens.
• Give medicines as prescribed. Don't increase or decrease the dose without talking to your child's healthcare provider. Don't share your child's medicines or give them someone else's, even if it is the same medicine and dose.
• Focus on your teen's strengths and talk to them with love and support. Let your teen know you are ready to listen, especially if they are so sad they are thinking of self-harm.
• To prevent self-harm, lock up all guns, knives, prescription and over-the-counter medicines, and alcohol.
• Keep all appointments with your teen’s healthcare provider.
• Work to find a balance between your teen's safety and mental health needs and their concern for privacy. Talk about who needs to know about the depression and why. Emphasize the fact that depression is a serious illness, not a lifestyle choice. Explain that many concerned people are ready to help them manage the condition.
• Talk with your teen’s healthcare provider about other providers who will be involved in your teen’s care. Your teen may get care from a team that may include counselors, therapists, social workers, psychologists, school staff, and psychiatrists. Your teen’s care team will depend on your teen's needs and how severe the depression is.
• Reach out for support from local community services. Being in touch with other parents who have a teen with depression may be helpful.
• Take all symptoms of depression and suicide very seriously. Get treatment right away. Suicide is a health emergency. Talk with your teen’s healthcare provider for more information on suicide including whom to call and what to do (for example never leaving the teen alone). Have a written emergency plan. Remove guns and other weapons, alcohol, medicines, and harmful household chemicals. If you can’t remove these items, store them safely in a lockbox.

For several reasons, many parents never look for the right treatment for their teen with depression. This is true even though many people with major depression who get treatment get better. They often improve within weeks. Continued treatment may help keep symptoms from coming back.

When should I call my teen’s healthcare provider?

Call your healthcare provider right away if your teen:

• Expresses thoughts of self-harm
• Feels extreme depression, fear, anxiety, or anger toward themselves or others
• Feels out of control
• Hears voices that others don’t hear
• Sees things that others don’t see
• Can’t sleep or eat for 3 days in a row
• Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to get help

Give your teen a list of emergency numbers and have them put the numbers in their phone. These numbers can include your teen's healthcare provider, trusted family members or adults, and the 988 Suicide & Crisis Lifeline .

Call or text 988 if your teen has thoughts of harming themselves or others. When you call or text 988, you will be connected to a trained crisis counselor at the 988 Suicide & Crisis Lifeline .

Key points about major depression in teens

• Major depression is a serious type of mood disorder. It's not the same as being unhappy or in a blue mood. It's not a lifestyle choice.
• Depression can be treated with a combination of medicine and psychotherapy.
• Let you child know it will take a few weeks to start feeling better, but things will change.
• Depression is caused by a combination of factors, such as genetics and the environment.
• A teen may have a higher risk for depression if they have a family history of it. Trauma, stress, and abuse can also make a teen prone to it.
• Symptoms include feelings of sadness, despair, and guilt. A teen may lose interest in activities and have problems sleeping and eating.
• A mental health professional can diagnose major depression after a mental health evaluation.
• Talk therapy and certain medicines can help treat depression.
• Major depression is linked to a higher risk for suicide.
• A team including health professionals, family members, and school personnel may be needed to help your teen get better.
• An emergency plan should be discussed, put in writing, and shared with significant others. Ask your teen to enter emergency numbers in their phone for easy access.
• Be clear with your teen that you can be approached on any subject, especially if they are so sad they are thinking of harming themselves.
• Get immediate help for a teen expressing thoughts of self-harm.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• 988 Suicide & Crisis Lifeline - it’s like 911, but it’s 988. Dial 988 for confidential, free, 24/7/365 support from a trained counselor for mental health, substance use or suicidal crisis. You can also text 988 for support (English only).
• SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders. Call 1-800-662-HELP (1-800-662- 4357).
• NAMI HelpLine is available Monday through Friday from 10 a.m. to 10 p.m. Eastern. Connect by phone at 1-800-950-6264 or text "Helpline" to 62640. For more information, visit Nami.org/help.
• The Trevor Project (hotline for LGBT youth): 1-866-488-7386
• Chat is available 24/7: SuicidePreventionLifeline.org/chat
• Trans Lifeline: 1-877-565-8860. Hotline for transgender people (volunteers and staff are transgender, as well.)
• Crisis Text Line: 741-741. Trained crisis counselor replies within minutes.
• National Crisis Text Line for the Deaf: Text HAND to 839863
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

Diabetes management and meal planning for children

It's important to learn about correct meal planning when your child has diabetes. The type and amount of food your child eats affects their blood sugar levels. If your child eats too much, their blood sugar may go up too high. If your child skips meals or is more active than normal, their blood sugar may go too low. Good blood sugar control needs a balance of food, exercise, and medicine. Healthy meals include foods that contain carbohydrates, protein, and fat.

What are carbohydrates?

Carbohydrates (carbs) are an important source of energy for children. Carbs in foods affect the body's blood sugar the most. The body turns carbs into blood sugar. If your child eats too many foods with carbs, then their blood sugar can go too high. A dietitian can help you decide how many carbs your child needs each day. About half the calories your child eats should come from carbs. Carbohydrate foods should be part of each meal and snack. Sources of carbs include:

• Breads, crackers, and cereals.
• Pasta, rice, and grains.
• Vegetables.
• Milk and milk products.
• Fruit and fruit juice.
• Sugar, honey, jelly, and syrup.

Your child can eat limited sweets and sugars if they are counted as part of the daily carb intake. Sweets and sugar don't have many vitamins or minerals. So they should be eaten in small amounts.

Are proteins and fats important?

Protein and fat don't affect the body's blood sugar level as much as carbs. But the amount of protein and fat in your child's diet may need to be counted. That's because it is important for your child to eat the right amount of protein and fat. Too much fat can increase your child's risk for heart disease. And it may make it hard for your child to stay at a healthy weight. Your child's dietitian can help you decide how much protein and fat your child needs. Also, some fats are good for you. But some are not as healthy. A dietitian can help you figure out which fats are better for your child. And they can help you find which ones to stay away from.

Sources of protein include:

• Beef, pork, and lamb.
• Fish and seafood.
• Chicken and turkey.
• Cheese.
• Eggs.
• Peanut butter.
• Nuts and seeds.

Sources of fat include:

• Salad dressing.
• Olives.
• Avocado.
• Butter and margarine.
• Oils and shortening.
• Mayonnaise.
• Sour cream and cream cheese.
• Bacon and other cured meats. 
• Beef, pork, and poultry without the skin removed.
• Ice cream, cheese, and other high-fat dairy products.
• Sauces.

There are also foods that have carbs, protein, and fat. They can affect your child's blood sugar like other foods with carbs. These foods include:

• Pizza.
• Casseroles.
• Stew and soups.
• Milk and yogurt.

A dietitian can help you create the meal plan that works best for your child. Share what you have learned about your child's nutrition needs with school staff. Be sure to include staff who supervise meals and exercise.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

Start early. Experts suggest that you start talking about drinking, smoking, and using drugs when your child is between ages 5 and 7, and that you keep the discussion going.

When possible, look for teachable moments. For example, if family members drink wine with dinner, talk about why they do and what it means to drink responsibly. Or if your younger child is watching TV and a beer commercial comes on, discuss the fact that although the people in the commercial appear to be having a good time, drinking too much alcohol can cause you to make bad decisions. It can also cause you to hurt yourself or others. Talking with your child at a young age is especially important if family members have alcohol or drug problems. Children with a family history of substance abuse are more likely to become substance abusers.

As your child gets older, continue to talk regularly about drugs, alcohol, and tobacco. But do so in a way that's right for your child's age. Make your views on the subject clear and repeat them often. If you don't approve of smoking or drinking, be sure your child knows this and the reasons for your beliefs. Your child needs to understand that under no circumstances is drug use acceptable and that there are no safe street drugs.

The more involved you are in your teen's life, the less likely they are to drink, smoke, or use drugs. Here are some ways to be supportive:

• Build your teen's self-esteem. During the teen years, the body changes, emotions run high, and moods swing. It can be a confusing time for both you and your teen. Listen to your teen, and be careful not to judge. Let your teen know that their feelings are important. This helps build self-esteem. If your teen has the confidence, assertiveness, and strength to handle tough times, they will be less likely to try drugs, alcohol, and tobacco to feel better or to please friends.

• Keep tabs on your teen. Know how much time your teen spends unsupervised. Studies show that having a lot of unsupervised time can make a teen more likely to try drugs. Help them choose healthy leisure activities.

• Know their friends. Discourage your teen from having friends that use drugs, alcohol, or tobacco. Peer pressure is a powerful influence on teens.

• Be a role model. If you smoke or use alcohol or drugs, chances are your teen will, too. If you smoke or have a problem with alcohol or drugs, get help. Call a local substance use treatment center or an organization such as Alcoholics Anonymous, Narcotics Anonymous, or Nicotine Anonymous. Let your teen see your efforts to kick a substance use habit. Or ask a relative or friend who is trying to quit smoking, drinking, or using drugs to talk with your teen about how strong the addiction is.

• Ask for help. Raising children is complicated, and you may need help. Think about taking a parenting class or going to a family counselor. Hospitals and community centers often offer such classes. Your teen's healthcare provider can help you find one.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

Types of Visual Screening Tests for Babies and Children

To evaluate your child's vision, your child's healthcare provider will do a health history and physical, including a complete eye exam. There are also many different types of vision tests that can be used to check your child's ability to see. Some of them can be used at any age, while others are used based on your child's age and understanding.

Visual screening tests for a baby

Here are some of the ways your baby's vision can be tested:

• Response to light. A baby will blink in response to a bright light.
• Pupil response. Measuring the response of the black center part of the eye (the pupil) by shining a light in the eye.
• Ability to follow a target. The most common vision acuity test in babies is a test to check the ability to look at and follow an object or toy.
• Visually evoked potential/response testing. These are tests that stimulate the eyes with either a bright light or special pattern. The baby is connected to a special monitor with attachments on the baby's head. The machine then records electrical activity in the brain as the lights and patterns are shown to the baby.
• Visual screening tests for an older baby and toddler
• Many of the above tests may be done, as well as the following:
• Cover and uncover test. This test checks the alignment of the eyes when a child is focusing on an object. One eye is covered with an opaque card while the child stares straight ahead. The examiner then observes the uncovered eye for movement.

Visual screening tests for a preschooler

Around age 3, some of the same tests that are used for a toddler may be done, as well as the following:

• Visual acuity tests. Specific tests and charts may be used to measure both near and distant vision. In a preschooler, these charts may show pictures or stories instead of letters of the alphabet.
• Color testing. This test helps find color blindness in a child.

Visual screening tests for a school-aged child

In this age group, formal vision tests can be completed with special charts or devices that aid with testing vision. Both near and far vision can be evaluated.

If your child is old enough, let them play an active role in choosing their own glasses. Think about the features below when buying eyeglasses for children:

• Shatterproof and impact-resistant lenses, especially for children who play sports
• Scratch-resistant coating on the lenses
• Spring-loaded frames that are less likely to be bent or warped
• Silicone nose pads that prevent glasses from slipping
• Earpieces that wrap around the ear (cable temples) are advised for children under 4 years. Straps may also be advised to hold the glasses in place.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
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About one-third of homes in the U.S. have some type of firearm. Access to firearms in the home raise the risk of unintentional firearm-related death and injury among children. Unintentional shootings cause a major portion of all firearm-related deaths among children ages 14 and younger.

Underestimating a child's ability to gain access to a firearm in the home and use it is a common problem. Even a 3-year-old child may have enough finger strength to pull the trigger of a handgun. Unlike adults, children can't tell the difference between a real gun and toy guns. Also, children are not able to make good judgments about how to safely handle a gun.

To keep your child safe from firearms, consider whether it is even worth the risk to keep a firearm in your home. If you choose to do so, safely store the firearm locked up, unloaded, and out of reach. Keep ammunition in a separate, locked place from the actual firearm. Also, talk with your child about the dangers of firearms. Teach your child to never touch or play with guns and to tell an adult if they find a gun.

Being aware of situations that can raise your child's risk for an unintentional firearm injury may help prevent one. High-risk situations include:

• Accessible firearms in the home. Parents often underestimate their child's ability to gain access to the firearm in the house, or even the child's ability to pull the trigger.
• Accessible firearms at another home. Even if your home does not have a firearm, your neighbor, friend, or relative may have an accessible firearm in the house.
• Teen boys. Most children killed by accident with firearms are boys. The American Academy of Pediatrics (AAP) considers homes with teen boys at a higher risk for accidental injury and death from firearms.
• Ammunition and firearms stored together. When a firearm is locked away with ammunition, or left loaded, it greatly raises the risk of accidental injury and death from firearms. About one-third to one-half of all firearm owners keep their firearms loaded and ready for use at least some of the time.
• Lack of supervision. Most accidental firearm shootings among children happen during times when children are not supervised, such as during the late afternoon, on weekends, and during summer months.
• High-risk homes. According to the AAP, homes with a higher risk of accidental injury and death from firearms include those in which someone is abusing alcohol or illegal drugs.

The only sure way to keep your child safe from accidental injury and death from firearms in your home is to remove all firearms from the home. Yet, there are other ways to improve the safety of your child around firearms. These ways include:

• Store the firearm correctly. Firearms should always be stored unloaded and uncocked in a locked container.

  • The gun should be stored separate from ammunition.
  • The firearm and ammunition should both be locked away, in a place known only to the parents, and out of reach of children.
  • For a revolver, put a padlock around the top strap of the weapon. This will prevent the cylinder from closing.
  • For a pistol, use a trigger lock. Never leave a gun unattended, even for a moment. This includes when you are cleaning it.

• Educate your child. Teaching your child the dangers of guns may help prevent accidental injury and death from firearms. A parent should teach a child to do the following if they see a firearm:

  • Don't touch the firearm.
  • Leave the area.
  • Tell an adult right away.

• Check with relatives, friends, and neighbors. Even if your own home is free of firearms, your child may visit another home where firearms are kept. Always check with neighbors, friends, and relatives to make sure they safely store their firearms, out of reach of children.

• Use other safety devices. Safety devices, such as gun locks, lock boxes, and gun safes, should be used for every firearm in the house. Safety devices on firearms could prevent most accidental fatal shootings of children ages 5 and younger.

What is the flu in children?

Influenza (flu) is a very contagious viral infection that affects the air passages of the lungs. It causes a high fever, body aches, a cough, and other symptoms. It's one of the most severe and common viral illnesses of the winter season. Most children are ill with the flu for less than a week. But some children have a more serious illness and may need to be treated in the hospital. The flu may also lead to lung infection (pneumonia) or death.

Because of other illnesses such as COVID-19 and RSV, the CDC says getting a flu vaccine is more important than ever to protect yourself and the people around you from flu. Flu vaccines and other vaccines can be given at the same time. Talk with your doctor about vaccines.

A flu virus is often passed from child to child through sneezing or coughing. The virus can also live for a short time on surfaces. This includes doorknobs, toys, pens or pencils, keyboards, phones and tablets, and countertops. It can also be passed through shared eating utensils and drinking. Your child can get a flu virus by touching something that was touched by an infected person, and then touching their mouth, nose, or eyes.

People are most contagious with the flu 24 hours before symptoms start, and while symptoms are most active. The risk of infecting others often ends about day 5 to 7 of the illness. Because the flu can be spread before symptoms start, it’s easy to pick up a flu virus. This is especially true with children, who often touch many surfaces and then touch their mouth, nose, or eyes.

How can you help prevent the flu in your child?

The best way to prevent the flu is to make sure your child gets the yearly flu vaccine. Each year, a new flu vaccine is available before the flu season starts. Flu shots and nasal spray are available. Talk with your doctor if you have questions about how vaccines work and how well they prevent flu.

The flu vaccine is most often given as a shot into the muscle. For babies and young children, it's given as a shot in the thigh muscle. In older children, it's given as a shot in the upper arm muscle. It's also available as a nasal spray for healthy children over the age of 2, including teens who are not pregnant. Check with your child’s doctor to see which is the best choice for your child.

The first time a child between the ages of 6 months and 8 years gets a flu vaccine, they will need a second flu vaccine 1 month later. This is to build up protection against the flu. Get your child’s first dose as soon as the vaccine is available. Then the second dose can be given by the end of October. This will give your child the best protection for the flu season. After your child's first flu season, they'll need only one dose.

The vaccine is advised for all children 6 months and older. But for some children, it’s more important for them to get a flu shot because they are more likely to have complications from the flu. The flu shot should be given to any child who has any of these:

• A long-term heart or lung condition
• An endocrine disorder such as diabetes
• A kidney or liver disorder
• Weak immune system from HIV/AIDS or long-term use of steroids or other immune-suppressing medicines
• A blood disorder such as sickle cell disease

A flu shot should also be given to: 

• A child who has a family member with a long-term (chronic) health condition.
• A child or teen taking aspirin as long-term therapy.
• A child with parents or caregivers at high risk for complications from the flu.

Some side effects of the vaccine can seem like mild flu symptoms. But the vaccine doesn't cause the flu. Side effects can be treated with over-the-counter medicines such as acetaminophen. Never give your child aspirin without first talking with your child's doctor. Possible side effects of the flu vaccine include:

• Soreness in the arm where the shot was given.
• Short-term symptoms such as mild headache or a low-grade fever for about 1 day after the shot.

In addition to the flu vaccine, you can do other things to help reduce your child’s risk of getting the flu. You can also:

• Limit your child’s contact with infected people, if possible.
• Have your child wash their hands often.
• Have your child wear a medical mask when in contact with many others or in large groups of people.

And you can help prevent your child spreading the flu to others if you:

• Have your child cover their nose and mouth when coughing or sneezing. Teach them to use a tissue or cough or sneeze in the crook of their arm.
• Wash your hands before and after caring for your child.
• Clean surfaces in the home that others may touch.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

Eating well is an important part of a healthy lifestyle. It's something that should be taught to children at a young age. These are some general guidelines for helping your child eat healthy. It’s important to discuss your child’s diet and nutrition needs with your child’s healthcare provider before making any dietary changes:

• Provide 3 meals a day, with healthy snacks in-between.
• Increase fiber in your child’s diet.
• Decrease the use of salt and salty foods.
• Encourage your child to drink water. Try to stay away from drinks and juices that are high in sugar.
• Don’t put your child on a low-fat diet without talking to your child’s healthcare provider. Children under the age of 2 need fats in their diet to help with the growth of their nervous system.
• Serve balanced meals.
• Try to bake, grill, roast, or broil instead of frying.
• Decrease your child’s added sugar intake.
• Offer fruit or vegetables for a snack.
• Decrease your use of butter and heavy sauces and gravies.
• Serve more lean meat, chicken, fish, and beans for protein.

Don’t feel guilty about snacking. Eating small, frequent meals can help you control your weight. They can help you stay fueled all day long. Just make sure snacks for you and your kids are healthy. Find out more about healthy snacking by taking this quiz.

The importance of vaccines

Vaccines are key to preventing disease. Vaccines benefit both the people who get them and the vulnerable, unvaccinated people around them. That's because the infection is less likely to spread through the community if most people are immunized. Plus, vaccines reduce the number of deaths and disability from infections like measles, whooping cough, and chickenpox.

Children get most of the vaccines. But adults also need to be sure they are already immune to certain infections and stay up-to-date on certain vaccines, including varicella, tetanus, pertussis (whooping cough), shingles, and the flu. Childhood illnesses, such as mumps, measles, and chickenpox, can cause serious problems in adults. 

Guidelines for common childhood vaccines

Many childhood diseases can now be prevented by following these guidelines for vaccines:

• Meningococcal vaccine. It protects against meningococcal disease.
• Hep B vaccine. It protects against hepatitis B.
• Inactivated polio vaccine (IPV). It protects against polio.
• DTaP vaccine. It protects against diphtheria, tetanus (lockjaw), and pertussis (whooping cough).
• Hib vaccine. It protects against Haemophilus influenzae type b, which causes spinal meningitis and other serious infections.
• MMR vaccine. It protects against measles, mumps, and rubella (German measles).
• Pneumococcal vaccine/PCV13 (pneumococcal conjugate vaccine). It protects against certain causes of pneumonia, infection in the blood, and meningitis.
• Varicella vaccine. It protects against chickenpox.
• Rotavirus (RV) vaccine. It protects against severe vomiting and diarrhea caused by rotavirus.
• Hep A vaccine. It protects against hepatitis A.
• Human papillomavirus (HPV) vaccine. It protects against HPV, which is linked to genital warts, cervical cancer, and other cancers. 
• Seasonal influenza vaccine. It protects against different flu viruses.

A child's first vaccine is given at birth. Vaccines are scheduled throughout childhood. Many start within the first few months of life. By following a regular schedule and making sure your child is immunized at the right time, you are making sure that your child has the best defense against dangerous childhood diseases.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
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E-cigarettes have become very popular with teens, and with people who are trying to quit smoking. People who use these devices also call it vaping or Juuling. But major health concerns have been raised about e-cigarettes. And experts are advising people not to use them. This Q&A explains what’s known about e-cigarettes.

E-cigarettes are also known as electronic nicotine delivery systems. These devices are often made to look like regular cigarettes, cigars, or pipes. Some even look like flashlights, pens, or USB flash drives. This makes it easy for teens to hide these devices from their parents or teachers.

Because of health risks, experts advise people not to use e-cigarettes.

E-cigarettes have been linked to severe lung disease. The exact cause is not clear yet. But all of the people who developed these lung conditions had vaping in common. Some people have died from these illnesses. 

Some of the people who became sick after vaping had symptoms of severe lung disease. These symptoms can occur slowly over a few days or weeks. They may become so serious that you need to be hospitalized. Call your healthcare provider or get medical care right away if you use e-cigarettes and have these symptoms:

• Cough, shortness of breath, or chest pain
• Nausea, vomiting, or diarrhea
• Extreme tiredness (fatigue)
• Fever of 100.4ºF (38°C) or higher
• Belly (abdominal) pain

Nicotine and other harmful chemicals

E-cigarette users are inhaling nicotine. This is a very addictive substance. And that’s a special concern for young users. Teens who vape may become addicted to nicotine, which can harm their developing brains. They may also start smoking regular cigarettes.

At high doses, nicotine can cause dizziness and vomiting. Juul products, which are popular among teens, deliver much more nicotine than other brands. One of their pods has about the same amount of nicotine as one pack of cigarettes. And e-cigarette users who refill their own cartridges are especially at risk for unsafe levels of nicotine.

Nicotine poisoning is also a big concern in children. Children younger than age 5 have been harmed after accidentally coming into contact with the nicotine liquid.

E-cigarettes may contain other harmful substances that cause cancer. The inhaled vapor may contain chemicals such as formaldehyde, acrolein, and acetaldehyde. The chemical acrolein is used in weed killers and has been linked to severe, acute lung problems and asthma, COPD, and lung cancer. E-cigarette flavorings may also hide possible toxins. It’s also unclear if the vapor puffed into the air puts nonsmokers at risk for health problems.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
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What causes obesity in a child or teen?

In many ways, childhood obesity is a puzzling disease. Doctors do not fully understand how the body controls weight and body fat. On one hand, the cause seems simple. If a person takes in more calories than they use for energy, then they will gain weight.

But a child or teen's obesity can be caused by a combination of things. It can be linked to:

• Genes
• Socioeconomic issues
• How the body turns food into energy (metabolism)
• Not getting enough sleep
• Not getting enough exercise
• Lifestyle choices
• Emotional issues
• Too much screen time and sedentary behaviors

Some endocrine disorders, diseases, and medicines may also have a strong effect on a child’s weight.

Treatment depends on your child's symptoms, age, and health. It also depends on how severe the condition is.

Treatment for obesity may include:

• Nutrition counseling
• Changes to portion sizes and snack habits n
• More physical activity or an exercise program
• More sleep and a regular sleep routine
• Behavior changes
• Individual, group, or family therapy that focuses on changing behaviors and facing feelings linked to weight and normal developmental issues
• Support and encouragement for making changes and following recommended treatments
• Medicine
• Weight-loss surgery
• Treatment for other obesity-related conditions

Treatment often involves the help of a nutritionist, mental health professionals, an exercise specialist, and other healthcare professionals. The goal of obesity treatment should be better health. This may differ for each child. Goals can include good self-esteem, being more physically active, improved weight, or better cholesterol levels.

Ask your child's healthcare provider about enrolling in an intensive health behavior and lifestyle treatment (IHBLT) program. This may also be called intensive behavioral intervention or family healthy weight programs. IHBLT is a safe and effective treatment for childhood obesity. It's a family-centered program that focuses on nutrition, physical activity, and behavior change strategies that are for your family. If there are no IHBLT programs nearby, you can work together with your child's healthcare provider to address different lifestyle and behavior topics.

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

In the first month of life, babies often catch up and exceed their birth weight. Then they steadily continue to gain weight. A weight loss up to about 10% of birth weight is normal in the first 2 to 3 days after birth. But the baby should have gained this back and be at their birth weight by about 2 weeks old. All babies may grow at a different rate. Here is the average for boys and girls up to 1 month old:

• Weight. After the first 2 weeks, should gain about 1 ounce each day.
• Average length at birth:
  • 20 inches for boys
  • 19 3/4 inches for girls
• Average length at 1 month:
  • 21 1/2 inches for boys
  • 21 inches for girls
• Head size. Increases to slightly less than 1 inch more than birth measurement by the end of the first month.

What can my baby do at this age?

A newborn spends about 16 hours a day sleeping. But the time a baby is awake can be busy. Much of a newborn's movements and activity are reflexes or involuntary. This means the baby does not purposefully make these movements. As the nervous system begins to mature, these reflexes give way to purposeful behaviors.

Reflexes in newborns include:

• Root reflex. This reflex happens when the corner of the baby's mouth is stroked or touched. The baby will turn their head and open their mouth to follow and "root" in the direction of the stroking. The root reflex helps the baby find the breast or bottle.
• Suck reflex. When the roof of the baby's mouth is touched with the breast or bottle nipple, the baby will begin to suck. This reflex does not begin until about the 32nd week of pregnancy. It is not fully developed until about 36 weeks. Premature babies may have a weak or immature sucking ability. That's because they are born before this reflex develops. Babies also have a hand-to-mouth reflex that goes with rooting and sucking. They may suck on their fingers or hands.
• Moro reflex. This is often called a startle reflex. That's because it often happens when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back their head, throws out their arms and legs, and cries. Then the baby pulls their arms and legs back in. Sometimes a baby can be startled by their own cries. That also can trigger this reflex. The Moro reflex lasts until the baby is about 5 to 6 months old.
• Tonic neck reflex. When a baby's head is turned to one side, the arm on that side stretches out. And the opposite arm bends up at the elbow. This is often called the "fencing" position. The tonic neck reflex lasts until the baby is about 6 to 7 months old.
• Grasp reflex. Stroking the palm of a baby's hand causes the baby to close their fingers in a grasp. The grasp reflex lasts only a couple of months. It is stronger in premature babies.
• Babinski reflex. When the bottom of the foot is firmly stroked, the big toe bends back toward the top of the foot and the other toes fan out. This is a normal reflex until the child is about 2 years old.
• Step reflex. This is also called the walking or dance reflex. A baby seems to take steps or dance when held upright with their feet touching a solid surface.

Newborn babies also have many physical characteristics and behaviors that include:

• Head sags when lifted up, needs to be supported.
• Turns head from side to side when lying on their stomach.
• Eyes are sometimes uncoordinated, may look cross-eyed.
• First fixes eyes on a face or light, then begins to follow a moving object.
• Begins to lift head when lying on stomach.
• Jerky, erratic movements.
• Moves hands to mouth.

• Visit our Smart Smart for Your Baby webpages for resources for you and your baby!
• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. 

Sunscreens protect the skin against sunburn and play an important role in blocking the penetration of UV radiation.

Terms used on sunscreen labels can be confusing. The protection provided by a sunscreen is indicated by the SPF listed on the product label. No sunscreen blocks UV radiation 100%. A product with SPF 15 blocks about 93% of UVB radiation.

A product that physically blocks the sun (such as zinc oxide or titanium dioxide) is sometimes called a sunblock. The terms sunscreen and sunblock are often used interchangeably.

If your child gets a sunburn, these tips can help make your child more comfortable:

• Have your child take a cool bath or use cool compresses on the sunburned area.
• Give your child acetaminophen or ibuprofen for discomfort and fever. Be sure to follow the directions on the container. Never give aspirin to children.
• If your child's healthcare provider tells you to, put a moisturizer, aloe gel, hydrocortisone cream, or a topical pain reliever on the sunburned skin.
• If your child's skin has blisters, don't break them open. They can get infected.
• Keep your child out of the sun until the burn is healed.
• Give your child extra fluid for several days to prevent dehydration. 

All children can benefit from exercise, energy release, and pure enjoyment of playing sports. This includes children with special needs.

Children with special needs are sometimes not encouraged to exercise. Their parents or guardians may fear they'll get hurt. But physical activity is as important for children with special needs as it is for any child.

Participating in sports can help boost self-confidence. It can also improve skills in relationship building and working as part of a team. And it can help in managing weight. This is a common problem among today's kids.

All children and teens ages 6 to 17 should get at least 60 minutes of moderate to vigorous physical activity each day. They should also do strengthening activities at least 3 days a week. You can change how often your child does these based on their needs. You can also change the intensity and the amount of exercise.

Just about any sport or activity can be altered to give children with special needs the cardiovascular, flexibility, and strength-training benefits that allow kids to stay healthy and fit. Children in wheelchairs, for instance, can play basketball or tennis. Children who can't use their limbs or those with mental disabilities can enjoy the therapeutic benefits of horseback riding.

Sports and activities especially good for children with special needs are:

• Swimming
• Bicycling
• Soccer
• Football
• Handball
• Gymnastics
• Boccia
• Weightlifting

Some sports don't need any changes. For instance, the buoyancy felt in the water while swimming offers a sense of freedom for children who use wheelchairs. Other activities can be changed to make them a better fit. Therapeutic riding programs, for instance, can help children learn to ride a horse with correct instruction. Also, these programs use special devices to keep children safe, whatever their special needs might be. Competition-level participation is available, too. There are a variety of wheelchair sports teams and leagues. A child can also take part in the Special Olympics.

As a busy parent, you’re juggling it all―dashing from work to soccer practice to dance class, making time for birthday parties, teacher conferences, and family dinners around the kitchen table. While it may feel tough to fit it all in, here’s something you don’t want to skip: well-child visits. Recommended for infants, children, and teens, these medical appointments are the time for vaccinations, important health screenings, and a check of your child’s development. Plus, they’re an opportunity for you to ask questions and voice concerns.

By some estimates, children miss between 30% to 50% of these crucial visits. That can be risky: Kids who skip well-child visits are more likely to fall behind on the vaccines they need to stay healthy. They may also face an increased risk for hospitalizations and emergency department visits.

Heed the tips below to make scheduling and keeping well-child visits easier, and to help you make the most of them.

Know when to go. The American Academy of Pediatrics recommends well-child visits for babies and young toddlers at 3 to 5 days old, then at months 1, 2, 4, 6, 9, 12, 15, 18, 24, and 30. Starting at 3 years old, kids need one preventive-care visit every year through age 21.

Make scheduling (and remembering) a cinch. Take advantage of appointment reminders―by phone, text, or email―offered by the pediatrician’s office. Schedule well-child appointments at the same time each year, such as before the start of school, to help you remember. And always say “yes” if office staff offer to schedule the next well visit while you’re already there.

Unlike sick visits, where the focus is on diagnosing and treating illness, every well-child visit covers a wide range of health needs, depending on your child’s age. These include:

• Vaccines
• A physical exam
• Checks of vision, hearing, cholesterol, and blood pressure at recommended ages, plus autism spectrum disorder screening
• An assessment of your child’s emotional health
• For adolescents, time for confidential conversations about issues such as drinking, smoking, drugs, sexual activity, and depression

• Contact WellKids by PA Health and Wellness Member Services to find the best resources for you and your child at 1-855-445-1920 (TTY: 711).
• Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more.