May 2019
News From Cornerstone Pediatrics
Closing the Gap
In May, we are focusing on CLOSING THE GAP. Closing the Gap means amping up the welcome we extend to families when they come to the office. We will work to identify families before greeting them, so we can use their names. And we are going to physically close the gap by walking into the waiting area to escort families back, rather than waiting by the door.
We hope you notice that you are VERY welcome at Cornerstone Pediatrics.
Limit the Sugar
Limiting added sugar is really important for keeping kids healthy. Unfortunately added sugar seems to be EVERYWHERE! What's a parent to do? Here are some tips:
Read nutrition facts labels carefully. Many foods now list added sugar separately. You also can find added sugar by reading the ingredients. Aim for less than 25 grams (about 6 teaspoons) of added sugar per day for children 2 years of age and older. Avoid serving foods and drinks with added sugar to children under 2 years of age.
Serve water and milk.
Avoid soda, sports drinks, sweet tea, sweetened coffee, and fruit drinks. Milk contains natural sugar (lactose) and provides calcium, protein, vitamin D, and other nutrients children need.
Limit   fruit juice .
It has more sugar per serving than whole fruit. The AAP recommends no more than 4 ounces of 100% fruit juice a day for children ages 1 through 3 years; 4 to 6 ounces for children ages 4 through 6; and 8 ounces for children ages 7 through 14. Do not give fruit juice to infants under 1 year old.
Go fresh and limit processed, pre-packed food and drinks.
Sugar is often added to them while they are being made or at the table. For example, there are hidden sources of added sugar in processed foods like ketchup, dried cranberries, salad dressing, and baked beans.
Satisfy your child's  sweet tooth  with whole fruit. 
Peanut Introduction

Current guidelines for introducing peanuts divide children into three groups:
  • Those with severe eczema (persistent or recurrent eczema who need prescription creams frequently) and/or egg allergy
  • Those with mild to moderate eczema
  • Those who don't have any eczema or food allergy
For the first group, those with severe eczema and/or egg allergy, testing for peanut allergy is recommended—and parents should talk with their doctors about how and when to give peanut products. If testing shows an allergy, it may be a good idea to do that first taste of peanut product in the doctor's office. Parents of babies in this group should talk to their doctor early, like at the 2 or 4-month checkup, because the recommendation is that these babies should get peanut products between 4 and 6 months.
There is no testing needed for babies with mild to moderate eczema, although they should still talk with their doctors about their child's situation and needs. These babies should try peanut products at around 6 months of age.
The babies who don't have any eczema or food allergy can have peanut products along with other foods based on their family's preferences and cultural practices. It's not so important to do it early, but it's fine if parents do.
It's very important that parents not give babies whole peanuts or chunks of them (or chunky peanut butter) because babies could choke. Smooth peanut butter mixed into a puree is better, as are snacks or foods made with peanut butter.

Drowning Prevention
After birth defects, drowning is the NUMBER ONE cause of death for children ages 1-4 years.
In South Texas, with our HOT weather, pools are everywhere. Here are some tips to keep your child safe:
Assign a water watcher.  
His or her job is to watch all children swimming or playing in or NEAR water―such as on a backyard swing set―even if they know how to swim. This person should:
  • not be under the influence of drugs or alcohol
  • put down his or her cell phone
  • avoid other activies 
  • supervise even if there are lifeguards 
  • switch off with another adult for breaks 
Life jackets.
Put your child in a properly fitted US Coast Guard approved  life jacket  when around or near water, such as when visiting a home with a pool. 
Swim lessons.  
The AAP recommends  swim lessons  as a layer of protection against drowning that can begin for many children starting at age 1.
CPR training.
Parents, caregivers, and pool owners should know  CPR  and how to get emergency help . Keep life jackets poolside.
Check the water first.  
If a child is  missing , look for him or her in the pool or spa first. This is especially important if your child is prone to  wandering
Considering Swim Lesson? Good Idea!

Here are a few tips on what to look for. A quality swim program should:
Have experienced, qualified instructors .
Swim instructors should be trained and certified through a nationally recognized learn-to-swim curriculum. There should also be lifeguards on duty who have current CPR and First Aid certification.
Teach good safety habits in, on, and near water.
Children should learn to never swim alone or without adult supervision. Instructors should teach children to always ask for permission from parents, lifeguards, or swimming instructors before they get into a pool or natural bodies of water like a lake.
Teach what to do if they end up in the water unexpectedly.
This includes practicing water competency skills such as self-rescue. Lessons should provide training with a variety of realistic conditions, such as falling in and swimming in clothes. Older children also should learn what to do if they see someone else in the water who is struggling, and how to get help.
Let you watch a class first to see first-hand if it is right for your child. Not all swim lessons are created equal, and parents should investigate options to choose the best fit. Are they swimming most of the time, or are there long periods of inactivity where they are waiting for their turn? Do children get one-on-one attention? Are the instructors friendly and knowledgeable?
Require multiple sessions. Once children start lessons, you should be able to see gradual but consistent progress in their abilities over time.
Continue lessons at least until your they master basic water competency skills.