Download 3 Year Packet - Piedmont Pediatrics

**** Please note NEW acetaminophen oral suspension dosing below, this will
replace the OLD infant concentrated drops. There may be a time when both
preparations will be sold or you still have them in your cabinet. It is OK to use either
preparation, just verify which preparation you have and be sure to administer the
correct dose according to the chart below.**** July 2011
Tylenol Dosage Table
Acetaminophen (Tylenol) may be given every 4 hours. Weight (pounds) Chewable Tablets (80mg/tablet) 6‐11 12‐17 18‐23 24‐35 36‐47 48‐59 60‐71 72‐95 1 ½ tablets 2 3 4 5 6 Children’s/Infant Oral Suspension (160mg/teaspoon) “NEW” CONCENTRATION
¼ tsp or 1.25ml ½ tsp or 2.5ml ¾ tsp or 3.75ml 1 tsp or 5ml 1 ½ or 7.5 ml 2 tsp or 10 ml 2 ½ tsp or 12.5ml 3 tsp or 15 ml Drops (80mg/0.8ml) “OLD” CONCENTRATION 0.4ml 0.8ml 1.2ml 1.6ml Ibuprofen (Advil/Motrin) Dosage Table
Ibuprofen may be given every 6 hours.
We do not recommend alternating Tylenol and Ibuprofen drops because of potential confusion in
dosing.
We do not recommend Ibuprofen for children under 6 months of age. Weight Chewable Tablets
(50mg/tablet) 12‐17 18‐23 24‐35 36‐47 48‐59 60‐71 72‐95 Over 96 2 3 4 5 6 8 Infant’s Oral Childrens Suspension Suspension (100mg/5ml) (50mg/1.25ml)
1.25 ml ½ tsp or 2.5ml 1.875 ml 3/4 tsp or 3.75ml ‐ 1 tsp or 5 ml ‐ 1 ½ tsp or 7.5ml ‐ 2 tsp or 10ml ‐ 2 ½ tsp or 12.5ml ‐ 3 tsp or 15 ml ‐ 4 tsp or 20 ml 2 to 4 Years
2 TO 4 YEARS
Safety for Your Child
Did you know that injuries are the leading cause of death of children younger than 4 years in the United
States? Most of these injuries can be prevented.
Often, injuries happen because parents are not aware of what their children can do. Children learn
fast, and before you know it your child will be jumping, running, riding a tricycle, and using tools. Your
child is at special risk for injuries from falls, drowning, poisons, burns, and car crashes. Your child
doesn’t understand dangers or remember “no” while playing and exploring.
Falls
Because your child’s abilities are so great now, he or she will find an endless variety
of dangerous situations at home and in the neighborhood.
Your child can fall off play equipment, out of windows, down stairs, off a bike or tricycle,
and off anything that can be climbed on. Be sure the surface under play equipment
is soft enough to absorb a fall. Use safety-tested mats or loose-fill materials (shredded
rubber, sand, wood chips, or bark) maintained to a depth of at least 9 inches underneath
play equipment. Install the protective surface at least 6 feet (more for swings and
slides) in all directions from the equipment.
Lock the doors to any dangerous areas. Use gates on stairways and install operable
window guards above the first floor. Fence in the play yard. If your child has a serious
fall or does not act normally after a fall, call your doctor.
Firearm Hazards
Children in homes where guns are present are in more danger of being shot by
themselves, their friends, or family members than of being injured by an intruder.
It is best to keep all guns out of the home. If you choose to keep a gun, keep it
unloaded and in a locked place, with the ammunition locked separately. Handguns
are especially dangerous. Ask if the homes where your child visits or is cared for
have guns and how they are stored.
Burns
The kitchen can be a dangerous place for your child, especially when you are
cooking. If your child is underfoot, hot liquids, grease, and hot foods can spill
on him or her and cause serious burns. Find something safe for your child to
do while you are cooking.
Remember that kitchen appliances and other hot surfaces such as irons, ovens, wall
heaters, and outdoor grills can burn your child long after you have finished using them.
(over)
If your child does get burned, immediately put cold water on the burned area. Keep the burned area in cold
water for a few minutes to cool it off. Then cover the burn loosely with a dry bandage or clean cloth. Call
your doctor for all burns. To protect your child from tap water scalds, the hottest temperature at the faucet
should be no more than 120˚F. In many cases you can adjust your water heater.
Make sure you have a working smoke alarm on every level of your home, especially in furnace and sleeping areas.
Test the alarms every month. It is best to use smoke alarms that use long-life batteries, but if you do not, change
the batteries at least once a year.
Poisonings
Your child will be able to open any drawer and climb anywhere curiosity leads. Your child may swallow anything
he or she finds. Use only household products and medicines that are absolutely necessary and keep them
safely capped and out of sight and reach. Keep all products in their original containers.
If your child does put something poisonous in his or her mouth, call the Poison Help Line
immediately. Attach the Poison Help Line number (1-800-222-1222) to your phone. Do not
make your child vomit.
And Remember Car Safety
Car crashes are the greatest danger to your child’s life and health. The crushing forces to your
child’s brain and body in a collision or sudden stop, even at low speeds, can cause injuries or death.
To prevent these injuries, correctly USE a car safety seat EVERY TIME your child is in the car. If your
child weighs more than the highest weight allowed by the seat or if his or her ears come to the top of the
car safety seat, use a belt-positioning booster seat.
The safest place for all children to ride is in the back seat. In an emergency, if a child must ride in the
front seat, move the vehicle seat back as far as it can go, away from the air bag.
Do not allow your child to play or ride a tricycle in the street. Your child should play in a fenced yard or
playground. Driveways are also dangerous. Walk behind your car before you back out of your driveway
to be sure your child is not behind your car. You may not see your child through the rearview mirror.
Remember, the biggest threat to your child’s life and health is an injury.
From Your Doctor
The information in this publication should not be used as a substitute for the medical care and
advice of your pediatrician. There may be variations in treatment that your pediatrician may
recommend based on the individual facts and circumstances.
TIPP®—The Injury Prevention Program
© 1994 American Academy of Pediatrics
HE0021-D
3-42/rev0805
HealthyChildren.org - Developmental Milestones: 3 to 4 Year Olds
http://www.healthychildren.org/English/ages-stages/toddler/Pages/Deve...
Healthy Children > Ages & Stages > Toddler > Developmental Milestones: 3 to 4 Year Olds
Ages & Stages
Like
5
Developmental Milestones: 3 to 4 Year Olds
What are some of the developmental milestones my child
should reach by three to four years of age?
With your child’s third birthday, the “terrible twos” are officially over and the “magic years” of
three and four begin—a time when your child’s world will be dominated by fantasy and vivid
imagination. During the next two years, he’ll mature in many areas.
Here are some milestones to look for.
Movement milestones
Hops and stands on one foot up to five seconds
Goes upstairs and downstairs without support
Kicks ball forward
Throws ball overhand
Catches bounced ball most of the time
Moves forward and backward with agility
Milestones in hand and finger skills
Copies square shapes
Draws a person with two to four body parts
Uses scissors
Draws circles and squares
Begins to copy some capital letters
Language milestones
Understands the concepts of “same” and “different”
Has mastered some basic rules of grammar
Speaks in sentences of five to six words
Speaks clearly enough for strangers to understand
Tells stories
Cognitive milestones
Correctly names some colors
Understands the concept of counting and may know a few numbers
Approaches problems from a single point of view
Begins to have a clearer sense of time
Follows three-part commands
Recalls parts of a story
Understands the concept of same/different
1 of 2
4/19/2012 2:47 PM
HealthyChildren.org - Developmental Milestones: 3 to 4 Year Olds
http://www.healthychildren.org/English/ages-stages/toddler/Pages/Deve...
Engages in fantasy play
Social and emotional milestones
Interested in new experiences
Cooperates with other children
Plays “Mom” or “Dad”
Increasingly inventive in fantasy play
Dresses and undresses
Negotiates solutions to conflicts
More independent
Imagines that many unfamiliar images may be “monsters”
Views self as a whole person involving body, mind, and feelings
Often cannot distinguish between fantasy and reality
Developmental health watch
Because each child develops in his own particular manner, it’s impossible to tell exactly when or how he’ll perfect a
given skill. The developmental milestones listed in this book will give you a general idea of the changes you can
expect as your child gets older, but don’t be alarmed if his development takes a slightly different course. Alert your
pediatrician, however, if your child displays any of the following signs of possible developmental delay for this age
range.
Cannot throw a ball overhand
Cannot jump in place
Cannot ride a tricycle
Cannot grasp a crayon between thumb and fingers
Has difficulty scribbling
Cannot stack four blocks
Still clings or cries whenever his parents leave him
Shows no interest in interactive games
Ignores other children
Doesn’t respond to people outside the family
Doesn’t engage in fantasy play
Resists dressing, sleeping, using the toilet
Lashes out without any self-control when angry or upset
Cannot copy a circle
Doesn’t use sentences of more than three words
Doesn’t use “me” and “you” appropriately
Last Updated 12/29/2011
Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of
Pediatrics)
topic landing page
2 of 2
4/19/2012 2:47 PM
C
M
Y
CM
MY
CY CMY
K
Sample Menus for Your Child
Day 1
Breakfast
1 scrambled egg
1 slice toast
1/2 cup milk
1/2 apple, sliced
Lunch
peanut butter sandwich
(2 slices bread,
2 tablespoons peanut butter)
1/3 cup peas
1 ounce small cheese pieces
water
3/4
3/4
1/2
1 slice toast with
2 tablespoons peanut butter
water
How can I make mealtimes happy?
◆
◆
◆
◆
◆
◆
◆
Make mealtime a family time. Children like to eat with other people.
Sit down and eat meals with your child.
Try to have meals and snacks at about the same time every day.
Do not bribe, play games, or force your child to eat. Children need
to control their own eating.
Expect your child to spill sometimes. Your child can use a child spoon
or fork. You can start to teach your child good table manners.
Relax and enjoy your meal. Do not make your child’s eating the
center of attention.
Keep the TV off during meals. Make mealtime a quiet time for talking.
Set a good example. Eat many different kinds of food. Your child will
want to eat what you eat.
Snack
cup dry cereal
cup juice
Dinner
3 tablespoons baked chicken
1/3 cup mashed potatoes
1/3 cup broccoli
1/2 cup milk
Snack
4 graham cracker squares
1/2 cup milk
How can I get my child interested in eating healthy foods?
◆
◆
◆
◆
Kids like to help plan meals and shop. Let your child help pick out
fruits and vegetables at the store. Try to go when your child is not
tired or hungry.
Kids also like to help in the kitchen. Even a 4 year old can wash fruits
and vegetables, tear lettuce for a salad, cut up soft fruits with
a plastic knife, or stir batter for muffins.
Your child can set the table and help clean up. Your child will be
proud to help!
Your child can help you fix fun, healthy lunches for preschool or
kindergarten.
◆ Kids love to learn about how foods are grown
and made. Here are some ideas:
◆ plant a garden or even a few plants in pots
◆ visit a farm or fruit stand
◆ pick fruit
◆ tour a bakery or dairy
Day 2
1/2
1/2
1/2
Always wash hands
before and after eating.
cup cereal
banana
cup milk
Feeding Your
3 to 5 Year Old
cup vegetable beef soup
1 tortilla or 4 crackers
1/2 cup yogurt
water
soft taco with beans and
meat (1 tortilla,
1/4 cup beans,
3 tablespoons meat)
1/3 cup rice
1/3 cup cooked carrots
1/2 orange, sliced
1/2 cup milk
8 animal crackers
cup milk
1/2
Children this age only need 4 to 6 small servings of
milk or milk products every day. No more than 24
ounces (710 milliliters) of milk per day. All milk has the
same vitamins and minerals, whether it is nonfat, 2%
or whole milk. Limit juice to 1/2 cup (120 milliliters) per
day. Serve fruit instead of juice when you can. If your
child is thirsty at other times, offer your child water
instead of sweet drinks. Sweet drinks like pop, KoolAid®, and juice drinks can make your child feel full.
Warning: Children under age 4 can choke on foods like hot dogs,
popcorn, nuts, raw carrots, grapes, jelly beans, gum, and hard
candy. Avoid these foods. Cut hot dogs into very small pieces.
This is my goal:
Washington State Department of
Health
DOH Pub 961-188 9/2005
Adapted from California Department of Health, WIC Supplemental Nutrition Branch.
Printed by Washington State Department of Health WIC Program. WIC is an equal
opportunity program. For persons with disabilities this document is available on
request in other formats. To submit a request please call 1-800-525-0127 (TDD/TTY
1-800-833-6388).
C
M
Y
CM
MY
CY CMY
K
Food Guide Pyramid
One Serving Is About...
6 to 11
servings
each day
Feeding your
3 to 5 year
old
3 to 5
servings
each day
Fats, Oils,
and Sweets
2 to 4
C
hildren know how much they
need to eat. But they do not know
what kinds of foods they need.
Milk Products
4 to 6 servings
Protein Foods
When it is time to eat, offer your
child healthy foods. You decide
what to serve and when to serve it.
2 to 3 servings
Vegetables
servings
each day
4 to 6
servings
each day
Your child will decide how much
to eat from the foods you serve.
3 to 5 servings
◆
Serve your child 3 meals and 2
snacks every day.
◆
Serve a variety of healthy foods
every day.
Fruits
2 to 4 servings
◆
Breads, Grains
and Cereals
6 to 11 servings
◆
Children eat more on some days
than others.
What your child eats in one day
may not match the food guide.
Think about all the foods your
child eats over several days.
2 to 3
servings
each day
Breads, Grains, Cereals
Bread slice, tortilla, roll, muffin, pancake, waffle...............................1/2
Dry cereal .....................................................1/3–1/2 cup or 80–120 mL
Noodles, rice, cooked cereal..........................1/4–1/2 cup or 60–120 mL
Crackers ....................................................................................2 small
Offer your child some whole grain foods every day.
Vegetables
Cooked .........................................................1/4–1/2 cup or 60–120 mL
Raw ..............................................................1/4–1/2 cup or 60–120 mL
Offer your child a dark green or yellow vegetable every day, like carrots,
broccoli, spinach, sweet potato, or squash.
Fruits
Fresh ...................................................................................1/2–1 small
Canned or frozen ..........................................1/4–1/2 cup or 60–120 mL
Juice ...........................................................................1/4 cup or 60 mL
Offer your child a good vitamin C fruit every day, like orange, strawberries,
melon, mango, papaya, or juices.
Milk Products
Milk or breast milk....................................................1/2 cup or 120 mL
Cheese .......................................................................3/4 ounce or 20 g
Cottage cheese .........................................................3/4 cup or 180 mL
Yogurt, pudding or custard made with milk ..............1/2 cup or 120 mL
Frozen yogurt, ice cream ..........................................3/4 cup or 180 mL
Give your child whole milk up to age 2, then lowfat milk.
Protein Foods
Animal Protein
Meat, chicken, turkey, fish ...............................2 tablespoons or 30 mL
Eggs ..................................................................................................1
Vegetable Protein
Cooked dry beans, lentils .........................................1/2 cup or 120 mL
Peanut butter...................................................2 tablespoons or 30 mL
Tofu ..........................................................................1/2 cup or 120 mL
Meat and beans have the most iron!
Fats, Oils, and Sweets
Give your child these foods once in a while.
Start with small servings. Give about 1 tablespoon (15 mL) of each food
for each year of your child’s age. For example, if your child is 4 years
old, serve your child 4 tablespoons (60 mL) of vegetables and 4 tablespoons
of rice. Let your child ask for more.
Peeka-
When rEading or teiling a familiar story
for bedtime, stop and leave out a
I word. ~Jait for your child to "fill in the
I blank.
do two or three fun or unusuel things
in a ruw. FQr example, ask him to
"TQuch yQur elbow and then run in a
Circle" or "Find a book and out it on
your head."
Practice follcwing directiQns. Playa
I silly game where you ask your child to
Make long scarves out of fabric
scraps, old dresses, Qr Qld shirts by
tearing or cutting long pieces. Use
material that is lightweight. Hold on to
the edge of the scarf, twirl around,
run, and jump.
Listen alld dance to music willl your
child. You can stop the music for a
moment and play the '~reeze" game
where everyone "freezes;' or stands
perfectly still, until you start the music
"nain. Try to "freeze" in unusual posi­
tions for fun.
www.agesandstages.com
____ ___--.------J Make an adventure path Qutside.
a garden hose, rope, or piece of chalk
and make a "path" that goes under the
bench, around the tree, and along the
wall. Walk your child through the path
first, using these words. After she
do it, make a new path or have your
child ma ke a path.
Put out several objects that are famil­
iar to your child (brush, coat, banana,
spoon, book).l\sk your child to show
you which one you can eat or which
one you wear outside. Help your child
put the objects in groups that go
together, such as '~hings that we eat"
and "things that we wear:'
Playa matching game. Find two sets
of 10 or more pictures. You can use
pictures from two copies Qf
same
I magazine or a deck of playing cards.
Lay the pictures face up and ask your
child to. find two that are the same.
Start with two picture sets and gradu­
ally adel more.
Listen for sounds. Find a cozy SPQt,
and sit with your child. Listen and
identify
the sounds hat ycu hear.
Ask your child if It is a loud Qr soft
sound. Try this activity inside and outyour home,
Talk about the number 3. Read stories
that have 3 in them (The Three Billy
Goats Gruff, Three Little Pigs, 7he
Three Bears). Encourage your child to
count to 3 using similar objects (rocks,
cards, blocks). Talk about being 3
years old. After your child gets the
idea, move up to the nwnbers 4, 5,
and so forth as long as your child is
interested.
Before bedtime, look at a magazine or
children's book together, Ask your
child to point to. pictures as yoa name
them, such as "Where is the truck?"
Bo silly and ask him to
his
elbow or foot. Ask him show you
something that is round or something
thnt goes fast.
~-,-- ______I____ -
Make necklace you cun eat by
stringing Cheerios or Froot Loops on a
piece of yarn or string. Wrap short
p,ece of tape around Ihe end of the
string to make a firm tip lor stringing.
Encourage ycur child's "sharing skills'
by making a play CQrner in your home.
Include only rNC children to start (a
brQther, sister, or friend) and have a
few of the same type of toys available
the children don't have te share
the time. Puppets or blocks are good
because they encourage playing
together. If needed, use an egg or
oven timer with a bell to allow the chil­
toys,
dren equal time with
During bath time, play Simon Says to
teach your child names of body parts.
First, you can
"Simon" and help
yQur child wash the part of his body
that "Simon says," Let your child have
turn ile "Simon," toc. Be sure to
name each body part as it is washed
and give your child a chance to wash
himself.
Grow a plant. Choose seeds that
sprQut quickly (beans or peas), and
together with your child place Ihe
seeds in a paper cup, filling almQst to
top with dirt. "lace the seeds
'I, inch under tile SQil. Put the cup in a
sunny windowsill and encourage your
watch the piant
c'rild to water
grow.
The ASQ User's GUide, Second Edition, Squires, Potter, and Brioker. @ 1999 Paul H. Brookes Publishing
___ l
Find large pieces ct oaper cr card­
board for your child to draw on. Using
crayons, penCils, or markers. play
drawing game where yQU lcllow his
lead by copying exactly what he
draws. Next. encourage him to copy
yQur drawings, such as circles or
, straight lines.
I down" the track.
is a choo-choo train going "up and
boo to show her how buttons go
I. through
the holes. Pretend the zipper
and zippers. Playa game
your child is gctting dresscd,
I When
encourage her to practice with buttons
I
Make a bird feeder using peanut butter
and bird seed. Help your child find a
pine cone or piece wocd to
spread peanut butter on. Roll in or
sprinkle with seeds and hang in a
or outside a window. While your chiid
watches the birds, ask her about the
number, size, and color of the differtmt
birds that visit.
Cut out some large paper circles and
show them to your child. Talk with your
ohild. Ask who has more "polaloeo"
child about things in her world that are
and who has less. Try this using same­ I "round" (a ball, the moon). Cut the cir­
ele in half, and ask her if she can
size glasses or cups, filled with juice
or milk.
make it round again. Next, cut the
I cle into three pieces, and soforth.
c~oki~g or eating dinner, play
I~Vhile
the "more or less" game with your
Make a book "about me" for your child.
Save family pictures. loaves, maga­
zine pictures of a favorite food, and
drawings your child makes. Put them
a photo album, or glue oole sheets
of paper and staple together to make
a book.
ACTIVITIES FOR CHILDREN 36 - 48 MONTHS OLD
CALCIUM
The Bone Builder
Calcium is a builder and a helper mineral:
• 99% of the calcium in your body builds and maintains bones and teeth.
• the other 1 % helps your heart beat, helps your muscles contract and relax, helps
clot your blood when necessary and helps your nerves send messages.
"As an adult,
it is important
The need for calcium starts when you are an infant. Your greatest need for calcium comes during
the pre-teens to the mid-twenties when bones become the strongest they will ever be. This is the
time to build your bone bank for the adult years ahead. Beginning at age 30-35 the calcium
balance in your bone bank will begin a slow, natural decrease. As an adult, it is important to
replace calcium through your diet every day to keep your calcium balance as high as possible.
to replace
If your diet is too low in calcium, this vital mineral will be withdrawn from your bone bank
for the other important functions that require calcium. Over time, if the calcium taken from
your bones is not replaced, your bones may become porous, brittle and weak. That's why it is
so important to get enough calcium in your diet each day.
calcium
How much calcium do you need?
Check the box that lists your calcium needs:
I need this much calcium each day:
(in milligrams of calcium)
through
Infants 0-6 months
7-12 months
2100 2700 · ... "
your dret
Children 1-3 years
4-8 years
5000 8000 Pre-Teens and Teens 9-18 years
13000 Adults 19-50 years
51 years and older
10000 12000 Pregnant / Lactating Up to 18 years
19-50 years
13000 10000 Source: Institute of Medicine, Food and Nutrition Board, Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, 1997.
See "Crank up Your Calcium" on next page
W
see if you are rea~hing your calcium goal.
CRANK UP YOUR CALCIUM Foods or medications or lifestyle habits can make a difference in how your body uses calcium. The following tips
can help you decide how to get the most benefit from the calcium in your diet.
CALCIUM BOOSTERS
Vitamin D is a must for calcium absorption. Sources of dietary vitamin D are few: vitamin D-fortified milk, cod
liver oil and fatty fish. Besides food, vitamin D also comes from exposure to sunlight--even for a short period of
time. People who live in cloudy or dark climates or who rarely get outdoors need to make sure their daily diet
includes adequate vitamin D. The recommended amounts of Vitamin D are: ages 1 to 50 - 200 IU, ages 51 to 70
- 400 IU, and over age 70 - 600 IU.
CALCIUM BUSTERS
• Too much protein or sodium in the diet causes your body to excrete calcium in the urine. Eating a balanced
Qiet, using the Food Guide Pyramid as a guide, can prevent this problem.
• Heavy alcohol use is linked with low bone mass. If you drink alcohol, do so in moderation.
• Too much caffeine from coffee, tea or soda pop, coupled with a low calcium intake, can cause bone loss.
COPING WITH LACTOSE INTOLERANCE
About 75% of the calcium in our food supply comes from dairy foods. But these high calcium foods also contain
the milk sugar, lactose. If you have lactose intolerance (experience gas, bloating, cramps and/or diarrhea after
consuming lactose), here are some tips that may help you enjoy high calcium dairy foods:
• try smaller, but more frequent servings ofdairy foods throughout the day--enough to equal 2-3 servings.
• drink milk with meals and snacks.
• eat aged cheeses like Swiss and cheddar; these cheeses have very little lactose.
• enjoy yogurt; the active cultures in yogurt have the necessary enzymes to break down lactose.
• use lactase enzyme (available over-the-counter at pharmacies) or lactase-treated milk/dairy products (available in many supermarkets). Which calcium-rich foods do you enjoy eating? Fill in the three blanks with the high calcium foods from the list
below that you will eat to help meet your daily calcium needs.
1. ________________________________________
2.______________________________________
3._________________________________________
Write in the amount of calcium you need each day.
(See chart on previous page)
mg
FOOD
SERVING SIIE
CALCIUM
FOOD
SERVING SIIE CALCIUM
Custard, baked
Pudding
Frozen yogurt
Tofu
1/2 cup
1/2 cup
1/2 cup
4 ounces
(In milligrams)
(In milligrams)
Lowfat or nonfat yogurt, plain
Lowfat or nonfat yogurt, with fruit
Pannesan or Romano cheese
Milk: skim, lowfat or whole
Calcium-fortified orange juice
Buttermilk
Swiss cheese
Canned sardines, with bones
Cheese pizza
Canned salmon with bones
Mozzarella cheese
Macaroni & cheese, home recipe
Kale, cooked
American cheese
Washington State Dairy Council, 1999
1 cup
1 cup
1 ounce
1 cup
1 cup
1 cup
1 ounce
3 ounces
2 slices
3 ounces
1 ounce
1/2 cup
1 cup
1 ounce
450
393
318
290-300
300
285
271
260
232
195
182
180
180
152
152
135
80-140
*(check label for
calcium content)
*(If the label shows 10% Daily Value for calcium, this means that one
serving contains 10% of the recommended 1000 milligrams of calcium per
day. To calculate milligrams: 10% x 1000 mg = 100 mg).
Broccoli
1 cup
Ice milk
1/2 cup
Ice cream
1/2 cup
Macaroni & cheese (frozen dinner) 1/2 cup
1/2 cup
Cottage cheese
94
92
85
81
69
May be duplicated for educational purposes.
YOUR CHILD'S FEARS Understanding Your Child's Fears
Children have fears - they're a normal part of growing up. Young children from birth to school
age have many new experiences, and they are frightened by some of them.
Carrie, at 18 months of age , doesn't know that she won't go down the drain with the bath water.
Kenny, at age 3 years , meets the neighbor's big German shepherd for the first time.
Of course, children don't need to be afraid when the bath water drains out, and they do need to be
careful when they meet a strange dog. But young children can't tell the difference between these kinds
of experiences.
Fears commonly occur at certain ages in a child's life. For example, an 8-month-old is likely to
be afraid of strangers, and a 2-year-old is scared by loud noises. These fears often appear when children
are taking major steps in development, like learning to walk or to make choices for themselves. But
they are still young children. Being afraid shows that they still depend a: great deal on theircparents,
despite their new abilities and independence. So, at these fearful times, young children need extra love,
comfort, and guidance from their parents and other adults.
Sometimes, a child has fears that the parents e211't find a reason for - he or she has nightmares,
fears of strange things in the bedroom at night, or fear of a gentle dog that wasn't frightening just fast
week. Sometimes these fears are expressions of strong feelings within a child that he or she can't
handle.
Three year old Melissa, for example, was afraid of the "lion" behind the curtains in her bedroom.
This fear was a way of managing the anger she felt toward her father, who had said that noon, "No,
Melissa, you can't have candy now. It's too close to lunch." Melissa couldn't express her anger
without risking the loss of her father's love - and that was unthinkable.
Understanding you child's fears is important because then you can help your child make sense of
the world - and learn to manage fearful feelings and situations.
"How Can I Tell When My Child Is Afraid?"
Not all children fear the same things. Some are highly imaginative and sensitive and may adjust
less quickly than others to new and potentially frightening situations. And children don't all show fear
in the same way:
. jlJ
.•
Some cry and look afraid.
Some say "smart" remarks or act silly - just,like some adults do when they're afraid.
. ..
', '
~
Some bite their nails or such their thumb a lot.
When you leave, your child has no sense of time and no way of knowing you will return. But the
following hints may make a situation like this a little easier:
Talk about the separation ahead of time, if possible, and plan to have your child visit you in the
hospital.
Have your child stay in you home, if possible, and with someone he or she know well and likes.
Phone at regular times while you are away.
Be prepared for your child to be upset with you or to ignore you when you return . Your child may
be trying to give you a taste of how it felt to be left.
Talk with your child about how much you missed one another.
Bring something special home to your child, especially if you have a new baby who will be showed
with gifts and attention.
Extra hugs and encouragement at these times give your child comfort and security. Then he or she
can have the confidence to try to understand and deal with the unpredictable world.
"Will My Child's Fears Change Over Time?"
Some fears are common at certain ages or during specific stages of development. · Here are some
ways to help your child at those important times.
Babies, from birth to 15 months. Some very young babies are fearful of loud noises and sudden
movements.
If your baby is frightened by the nose of, say, the hair dryer, first "introduce" him or her to it when
it is turned off. Then gradually let your baby 'get used to the noise by standing some distance away
when you run the dryer, on low at first.
' . ,~~,
By 5 or 6 months of age, most babies are frightened by strange people, places and things. Try the
following when your baby is afraid of strangers:
Try to leave your baby only with familiar adults during this stage.
Have strangers approach slowly , at first focusing their attention on a toy or some other object,
rather than on the child.
An important fear common to all babies appears around 8 months of age - fear of separation. At
this age, a baby is afraid than when loved ones leave his or her sight, they won't return. Because of
this, the baby may be unwilling to stay with familiar baby sitters or even other relatives.
As times goes on - up to about 15 months - babies can show even more anxiety over separation
from a parent. Even good-natured, even-tempered babies may seem upset and cry if the parent leaves
the room. Babies who have always gone to sleep easily and been quiet through the night suddenly refuse
to go to sleep and·;then wake up over and over and cry. The baby is not spoiled or "bad, ~just afraid
the parent won't return.
Knowing that these fears of babyhood are-common and normal, you can understand you'r.~,baby' s - .
behavior and be sympathetic and patient. The· foHowi I).g are some ways to help your baby - and yourself
through this stage.
Your
Play "peekaboo" to teach your baby that separations from you are temporary.
"disappearance" is short, and watch how delighted your baby is when you come back in view!
Always tell your baby that you are leaving, and emphasize that you will be back. It's harder on
a baby if parents sneak out.
Tell your baby that you know how hard it is for both of you when you're away. When you get
back, ask "Was it hard while I was gone?" (Children are relived that an adult recognizes their
feelings and puts them into words.)
Encourage caregivers to be sensitive to your child's feelings about missing you and to accept those
feelings.
Leave a safe object of yours with your baby, like an empty purse.
Try not to be~ne any longer than you have to. If your separation will be long, arrange to phone
your child.
Take your baby with you on trips, or avola 'long trips during your child's preschool years.
', ' - :
't-~
.,
All through your baby's early years, you'll want to be especially aware of gradually introducing him
or her to new places and people. Every new situation requires this careful introduction.
Toddlers, from 15 months to 3 years. Because toddlers are growing in abilities and in their
understanding of the world, they have more fears than babies. They are still afraid of separation, but
they also may become afraid of the dark, afraid of taking a bath, or afraid of animals. Toddlers are still
dependent on their parents, but they also want to let go. A great deal of conflict is going on within the
child.
Toddlers don't manage strong feelings like anger, frustration, and jealousy very well. So they may
"create" a fearful situation outside themselves in which to act out those feelings. A good example was
Melissa, who imagined a fierce lion behind the curtains in her room when she was angry at her father.
These fears aren't like ones that have an obvious reason, such as fearing dogs after getting nipped by
one.
If a toddler feels angry, he or she may think that things that make a loud noise - like a siren,
thunder, or vacuum cleaner - are angry and be afraid of them. All the technical explanations in the
world won't help.§ .•,
But the following may help:
.Recognize that your child's fears are real to him or her. It isn't fair or useful to make fun of your
child's fear of the" monster in the closet. "
• ~ .:'> • t "-• •
Don't join in the . fantasy ' ~ fodnstance,' .by pretending to chase away the monster ·in the closet.
Imagine how real it becomes· if Mom: or Dad chase it: It is much better to calmly go' with 'the child
to see that no monster is there. And a night' light may also be rea~suring. . _;(~ .
Explain that loud : noi.ses i~don: t mean, that. an object is .angry ;. and tell . your , child · you won·'t let
anything harm him or her. That 's what parents are for - to keep children safe.
Help the child get comfortable with animals or other feared objects. For example, desensitize your
child to the good-natured dog next door. Pick a calm time and gradually bring the child and dog
closer and closer together, first with the dog on the other side of the fence , then on a leash, and so
on. But if your child remains frightened, don't continue.
Encourage your child to express feelings in words.
anxious activities.
This way, fears don't have to show up in
Provide calm, predictable routines for your toddler, especially at bedtime. This gives the child a
feeling of security.
Give your child a hug: and a pat on the back for even a small act of bravery- like putting a toe in
the bath water.
Parents who are understanding and supporti~e' give-their child the message that they care.
Preschoolers, from 3 to 5 years. Nightmares, fear of the dark and of going to bed alone, and fear
of sirens and other loud noises are common to preschoolers. These fears are a sign thatsomething has
overwhelmed your child. You may also notice that he or she has trouble calming cl'0wn and following
family routines. Or your child may try to scare other children, just like he or she has been scared.
There is probably something important behind your preschooler's fears: Is it anger about a new
baby in the family? Is it sadness over the death of a grandparent? Is it jealousy over the parents being
partners and the child's being left out? Is it fear of going to school? So recently toilet trained, is the
child afraid of losing control?
Do your best to discover your child's underlying feelings. While you can't eliminate unknown
fears, you can at least provide comfort and security. You can be most helpful if you do the following:
Help your child express himself or herself and understand and accept negative, angry feelings.
Provide acceptable outlets for your child s aggressive feelings by pointing out how other family
members handle these types of feelings - for instance, by enjoyable, vigorous activities.
I
Continue to set and keep firm limits on your child appropriate to his or her age.
Speak honestly and openly about the death of a relative or pet. It is best not to tell a young child
that Grandpa is sleeping or away on a long trip: ;
, \
~.
.
.
~
"
AND GROWING will cause him or
up. If
come from,
big and
the world must look
confidence
or her
To
a
ld
if
These
Terry Berger, I Have
1 and 1
respectively.
read
to
1 Have Feelings,
Margaret Wise Brown,
Delson,
IS Remember
Ohio, 44122.
to Day
Rogers,
Group, 1985.
Simon, I Was So Mad!
Stein, About Dying: An
&
1984.
Publishing Co
Available
1979.
2666 Rocklyn Road,
First
Books.
York, Putnam
Whitman & Co, 1974.
Family Bookfor Parents and Children Together. New
Jane Werner Watson, Sometimes
Afraid. A Read Together
New York, Crown
Inc, 1986.
".
Inc,
New York,
New York,
Mist
child.
Children.