Kids Corner

10 Ways to Foster Kindness and Empathy in Kids


The Washington Post

Several kids had been targeting Beth for weeks. Beth was sweet, absent-minded, easygoing and resigned to being mistreated. Some of her fellow eighth-grade students were using social media to call her fat and stupid, and they would drop dirty tissues on her head as they passed her desk. As her school counselor, I wanted to help, but Beth would never call out the bullies. She worried she would make the situation worse, and she insisted she was fine.

Beth’s classmate Jenna, however, was so disturbed by the mean behavior that she brought me a handwritten list of the perpetrators and pleaded with me to make them stop. Jenna — a confident, popular student — barely knew Beth, but she couldn’t stand the cruelty. Her discomfort was the one positive in a bad situation. The Jennas are rare; I can’t recall another recent situation when a student so vehemently refused to be a bystander. I knew that it would be difficult to change the kids’ behavior, and that quick solutions, such as detentions and phone calls home, would only give Beth a short-term reprieve.

While some kids, like Jenna, seem to be hard-wired for empathy, we need strategies to reach those who are not. No one sets out to raise an unkind child. To teach kids to be kind, it’s critical to start young, when they can most easily absorb fundamental lessons. The stakes get higher as kids age. There is no easy program to follow, but parents and educators can take these steps to stack the deck in favor of raising a child who shows decorum and kindness.

Remember that apples don’t fall far from trees. Model compassion by treating friends, acquaintances and colleagues with kindness. Expending energy on caring, reciprocal relationships teaches children to prioritize friendship and positivity over popularity. Children hovering at the periphery of “alpha” groups often struggle the most. Constant maneuvering for position in the social hierarchy can lead to insecurity, envy, anxiety, or competitiveness, all of which promote meanness. Children with sensitive adult role models and gentle friends tend to behave similarly.

Keep it real. Being inauthentic damages credibility with kids. Kindness doesn’t require liking or speaking positively about everyone all of the time. Validate kids’ feelings when they accurately point out that someone has been mean-spirited. Take the opportunity to talk about why a specific action was mean, and remind children that it’s possible to make bad choices but still be a good person. You don’t need to pretend that they have to be friends with everyone, but you can teach them to be respectful and polite and to avoid burning bridges. Friendships often cycle in and out as kids change and mature. Promote this social growth by praising kids when they are considerate or altruistic, even as they outgrow some friendships and move on to others.
Stop the contagion. Anyone who has spent time in a toxic environment knows that behaviors such as gossip, jockeying for power and negativity spread rapidly. Being in a mean climate can alter individual behavior. This stuff matters, and adults help set the tone for everyone, including kids in their charge. In order to establish positive social norms, school and community leaders need to understand and target systemic problems, which may include insecurity, anxiety or a sense of powerlessness. These trained adults can identify kindness catalysts who can model positive behavior and take on roles such as playground buddies or new student welcome ambassadors. Through field trips, retreats and collaborative projects, leaders also can create opportunities for kids to venture beyond their usual social groups. Familiarity, comfort and shared experiences make it easier for children to establish core values and develop a culture of respect and cooperation.

Teach compassion through mindfulness. Mindfulness can enhance attention span and reduce stress, but now researchers are finding that it can also foster empathy. In a study at Northeastern University, participants took an eight-week meditation course. When they were then faced with the option of giving up their chair to a person in visible physical discomfort, they were far more likely than control group subjects to act beneficently. And when a middle school in a poor neighborhood in San Francisco started offering twice-daily meditation periods, suspensions decreased by 79 percent.

Explore both natural and fictional worlds. Dacher Keltner, a psychology professor at the University of California at Berkeley, notes that going out into nature and experiencing “feelings of awe” appears to heighten empathy. You can also build kids’ compassion by sending them to fictional universes. When children read books and become invested in characters’ plights, they can imagine themselves in other people’s shoes.

Be a coach, not a browbeater. To teach children how to rationally consider the consequences of their harmful actions, use logical reasoning. Keltner notes that simply telling kids what is right or wrong — or reacting with strong emotions or physical punishment — produces people who are less likely to want to alleviate others’ pain. By encouraging reflective discussion, you can help children learn how to actively listen and appreciate different perspectives.

Give back to the community. Meaningful volunteer engagement can widen children’s worldview, teach them gratitude and build their awareness of and sensitivity to others’ struggles. Placing children in unfamiliar settings or uncomfortable situations heightens their ability to empathize with anyone who feels like an outsider or lacks a sense of belonging. When families and schools prioritize this kind of service learning, children are more likely to be altruistic.
Talk about the importance of diversity. Teach children that their lives are enriched when they encounter and befriend people from different racial, ethnic or socioeconomic backgrounds, or who face different learning or physical challenges. Remind kids that everyone is an individual and that it is dehumanizing to label groups. When kids are self-aware and self-accepting, they are less likely to be judgmental or prejudiced. Promote self-discovery by sharing personal journeys and helping kids understand that everyone has a story.

Get moving. Researchers at the University of Michigan studied middle school children and found that those who were more physically active and involved in team sports scored highest in leadership skills and empathy. Exercise also can have a calming influence.

Impart the art of making amends. Everyone makes mistakes. Kids in particular are still learning, and developmentally they may be self-centered. Encourage children to do their best to behave kindly and ethically, but to recognize when their efforts fall short. Explain that there is tremendous power in an apology, even when the harm caused was unintentional.

In the end, Beth gave Jenna permission to confront the kids who were bothering her. Beth had resisted adult intervention, and her instincts were on the mark. Jenna’s forceful and self-assured approach stopped the tormentors. Beth felt enormously comforted by having a supportive ally. She also shared that Jenna’s rare and generous move had empowered her, and made her more likely to stand up for herself and others in the future. If meanness is like a tsunami, washing over and eroding a child’s self-image, kindness is like a molecule of water slowly rippling outward. That first drop may have a subtle effect, but with persistence, its force can become a current, strong enough to cut through steel, sculpt mountains and change lives.

Phyllis L. Fagell is a licensed clinical counselor at the Chrysalis Group and a school counselor in Bethesda. She tweets @pfagell.

10 Things for Parents to Know About the 2016-2017 Flu Vaccine

By: Kathleen Berchelmann MD, FAAP

Pediatrician giving a girl a shot

Here are 10 things you need to know about the 2016-2017 influenza vaccine

1. The flu vaccine is essential for children.
The flu virus is common and unpredictable, and it can cause serious complications and death, even in healthy children. Immunization each year is the best way to protect children.

Each year, on average, 5% to 20% of the U.S. population gets the flu and more than 200,000 people are hospitalized from complications. At least 77 children died from the flu in the 2015-2016 season, although the actual number is probably much higher since many flu deaths aren’t reported and are caused by secondary flu complications such as pneumonia. If you choose not to vaccinate your child, you not only endanger your own child but also others.

Although influenza can be treated with antiviral medications, these drugs are less effective if not started early, can be expensive, and may have bothersome side effects.

The American Academy of Pediatrics (AAP) and the Center for Disease Control and Prevention (CDC) strongly recommends annual influenza immunization for all people ages 6 months and older, including children and adolescents. In addition, household contacts and out-of-home caregivers of children with high risk conditions and all children under the age of 5 especially should be vaccinated.

Young children, people with asthma, heart disease, diabetes, weakened immune systems, and pregnant women are at high risk for complications of influenza, such as pneumonia.

About half of all Americans get vaccinated against the flu each year, including 50% of pregnant women. This number needs to get better. Ask your child’s school, child care center, or sports coach, “How are we promoting the flu vaccine for these children?”

2. Now is the time to get vaccinated.
Influenza vaccine shipments have already begun, and will continue through the fall and winter. Call your pediatrician to ask when the vaccine will be available.

Infants and children up to 8 years of age receiving the flu shot for the first time may need two doses of the vaccine, administered four weeks apart. It is important that these children get their first dose as soon as possible to be sure they can complete both doses before the flu season begins.

3. This year’s flu vaccine is only available as a shot.
The inactivated influenza vaccine (IIV) is given by intramuscular injection and is approved for children 6 months of age and older. Depending on the number of flu strains it contains, it is available in both trivalent (IIV3 – two A and one B virus) and quadrivalent (IIV4 – two A and two B viruses) forms.

During the last three flu seasons, the nasal spray vaccine (the live attenuated quadrivalent influenza vaccine, or LAIV) did not offer protection against the predominant strain of influenza virus, and therefore it is not recommended for use this season.

4. It doesn’t matter which form of the vaccine you get.
The quadrivalent influenza vaccines for the 2016-2017 season contain the same three strains as the trivalent vaccine, plus an additional B strain. Although this may offer improved protection, the AAP does not give preference for one type of flu vaccine over another.

Please don’t delay vaccination in order to wait for a specific vaccine. Influenza virus is unpredictable. What’s most important is that people receive the vaccine as soon as possible.

5. You can’t get the flu from the flu vaccine.
Flu vaccines are made from killed viruses. Mildsymptoms, such as nausea, sleepiness, headache, muscle aches, and chills, can occur.

The side effects of the flu vaccine are mild (and nothing compared to having the flu). The most common side effects are pain and tenderness at the site of injection. Fever is also seen within 24 hours after immunization in approximately 10% to 35% of children younger than 2 years of age but rarely in older children and adults. These symptoms are usually mild and resolve on their own in a couple of days.

6. If you catch the flu and are vaccinated, you will get a milder form of the disease.
We know that flu vaccines are about 60% effective–yes, we all wish that number were higher. The good news is that vaccinated people who get the flu usually get a mild form of the disease, just the sniffles, according to a recent study. People who are not vaccinated will be in bed with fever and miserable.

7. There should be plenty of vaccine for everyone this year.
For the 2016-2017 season, manufacturers have projected that they will produce between up to 170 million doses of flu vaccine.

8. The influenza vaccine doesn’t cause autism.
A robust body of research continues to show that the influenza vaccine is safe and is not associated with autism.

9. The flu vaccine can be given at the same time as other vaccines.
The flu vaccine may be given at the same time as other vaccines, but at a different place on the body. It is also important to note that children 6 months through 8 years of age may need two doses spaced one month apart to be fully protected. These children should receive their first dose as soon as the vaccine is available in their community. Live vaccines (like the MMR and chickenpox vaccines) may be given together or at least 4 weeks apart.

10. Children with egg allergy can still get the flu vaccine.
Children with an egg allergy can safely get the flu shot from their pediatrician without going to an allergy specialist. For children with a history of severe egg allergy, your pediatrician may recommend you see an allergy specialist.

Helping Your Child Develop A Healthy Sense of Self Esteem

Happy active children jumping

How can we help our child develop a healthy sense of self-esteem?  By definition, self-esteem is the way in which an individual perceives herself-in other words, her own thoughts and feelings about herself and her ability to achieve in ways that are important to her. This self-esteem is shaped not only by a child’s own perceptions and expectations, but also by the perceptions and expectations of significant people in her life-how she is thought of and treated by parents, teachers and friends. The closer her perceived self (how she sees herself) comes to her ideal self (how she would like to be), the higher her self-esteem.

For healthy self-esteem, children need to develop or acquire some or all of the following characteristics:

A sense of security.
Your child must feel secure about herself and her future. (“What will become of me?”)

A sense of belonging.
Your youngster needs to feel accepted and loved by others, beginning with the family and then extending to groups such as friends, schoolmates, sports teams, a church or temple and even a neighborhood or community. Without this acceptance or group identity, she may feel rejected, lonely, and adrift without a “home,” “family” or “group.”

A sense of purpose.
Your child should have goals that give her purpose and direction and an avenue for channeling her energy toward achievement and self-expression. If she lacks a sense of purpose, she may feel bored, aimless, even resentful at being pushed in certain directions by you or others.

A sense of personal competence and pride.
Your child should feel confident in her ability to meet the challenges in her life. This sense of personal power evolves from having successful life experiences in solving problems independently, being creative and getting results for her efforts. Setting appropriate expectations, not too low and not too high, is critical to developing competence and confidence. If you are overprotecting her, and if she is too dependent on you, or if expectations are so high she never succeeds, she may feel powerless and incapable of controlling the circumstances in her life.

A sense of trust.
Your child needs to feel trust in you and in herself. Toward this goal, you should keep promises, be supportive and give your child opportunities to be trustworthy. This means believing your child, and treating her as an honest person.

A sense of responsibility.
Give your child a chance to show what she is capable of doing. Allow her to take on tasks without being checked on all the time. This shows trust on your part, a sort of “letting go” with a sense of faith.

A sense of contribution.
Your child will develop a sense of importance and commitment if you give her opportunities to participate and contribute in a meaningful way to an activity. Let her know that she really counts.

A sense of making real choices and decisions.
Your child will feel empowered and in control of events when she is able to make or influence decisions that she considers important. These choices and decisions need to be appropriate for her age and abilities, and for the family’s values.

A sense of self-discipline and self-control.
As your child is striving to achieve and gain more independence, she needs and wants to feel that she can make it on her own. Once you give her expectations, guidelines, and opportunities in which to test herself, she can reflect, reason, problem-solve and consider the consequences of the actions she may choose. This kind of self-awareness is critical for her future growth.

A sense of encouragement, support and reward.
Not only does your child need to achieve, but she also needs positive feedback and recognition – a real message that she is doing well, pleasing others and “making it.” Encourage and praise her, not only for achieving a set goal but also for her efforts, and for even small increments of change and improvement. (“I like the way you waited for your turn,” “Good try; you’re working harder,” “Good girl!”) Give her feedback as soon as possible to reinforce her self-esteem and to help her connect your comments to the activity involved.

A sense of accepting mistakes and failure.
Your child needs to feel comfortable, not defeated, when she makes mistakes or fails. Explain that these hurdles or setbacks are a normal part of living and learning, and that she can learn or benefit from them. Let your supportive, constructive feedback and your recognition of her effort overpower any sense of failure, guilt, or shame she might be feeling, giving her renewed motivation and hope. Again, make your feedback specific (“If you throw the ball like this, it might help”) and not negative and personal (“You are so clumsy,” “You’ll never make it”).

A sense of family self-esteem.
Your child’s self-esteem initially develops within the family and thus is influenced greatly by the feelings and perceptions that a family has of itself. Some of the preceding comments apply to the family in building its self-esteem. Also, bear in mind that family pride is essential to self-esteem and can be nourished and maintained in many ways, including participation or involvement in community activities, tracing a family’s heritage and ancestors, or caring for extended family members. Families fare better when members focus on each other’s strengths, avoid excessive criticism and stick up for one another outside the family setting. Family members believe in and trust each other, respect their individual differences and show their affection for each other. They make time for being together, whether to share holidays, special events or just to have fun.

When Do You Worry About a Picky Eater?Asian child close his mouth by hand between having lunch

By PERRI KLASS, M.D. OCT. 10, 2016

The New York Times

I saw one of the white-food kids a couple of weeks ago — a 9-year-old boy who lives on French fries, chicken fingers, white rice and white bread. Some white-food kids are so strict that their parents have to warn the restaurant that if there’s a little ceremonial dusting of parsley on the French fries, the child won’t eat them.

My patient’s mother was despairing: He won’t touch a vegetable, she said. He isn’t getting any healthy food at all. Some picky eaters are scrawny, but this one was chunky. In fact, it’s surprising to me how often a parent tells me, if I express some concern about the rapid rate of weight gain, that the child hardly eats anything, the child has no appetite, the child is incredibly, heartbreakingly, picky. And though I could tell you a perfectly true story about a mother who said just that as her child sat in the exam room, munching his way through a large bag of pizza-flavored Doritos, the truth is that it can be genuinely painful for parents to watch their children refuse food, and worry that they are somehow failing to provide the necessary vitamins, protein and vegetables.

People are often pretty judgmental about picky eaters, disapproving strongly of the children themselves (“So unadventurous, so fearful of new tastes!”); of their parents (“Don’t they know it’s their responsibility to make the rules!”); and, inevitably, of our degenerate and too-permissive times (“Why, when I was a child, we ate what was put in front of us, and no nonsense!”).

Dr. Natalie Muth, a pediatrician in Vista, Calif., near San Diego, who is also a registered dietitian and the co-author with Sally Sampson of “The Picky Eater Project,” to be published by the American Academy of Pediatrics next month, told me that it’s important to expose children to different flavors even through what the mother eats during pregnancy and breast-feeding. (The techniques used in the book were explained in more detail last year in a series of posts on the Motherlode blog.)

She said many children become comparatively picky around the age of 2, so it’s important to expose younger children to many foods, many times. They are more open to trying new things in that first year of eating solid foods, between 6 and 18 months, and multiple exposures help them learn to like different flavors.

“I talk about training your taste buds; it can take a lot of tries to like something,” Dr. Muth said. “You don’t even have to chew and swallow, just take it on your tongue.”

And that 2-year-old who may be developmentally more neophobic — nervous about new things — also is developmentally ready for all the struggles of separation and independence. “We’re all born liking sweet and salty, and a 2-year-old is no exception,” said Dr. Muth. “But also, a 2-year-old is trying to assert himself.”

When those struggles persist around food, and parents find themselves faced with that picky eater, the idea is to go on offering foods, go on encouraging repeated tastes, go on letting the child see other family members eat different foods — to do all that but to let the child make the actual decisions about what to eat. “There’s a division of responsibility, which was first described by the dietitian Ellyn Satter,” Dr. Muth said, “parents choosing what’s offered and when, the child choosing what to eat of what’s offered.”

As a pediatrician, I worry when children don’t gain weight — or sometimes, when they gain too much, like some white-food eaters. We start with the assumption that picky eaters are just picky, and studies have shown that while they may not eat many vegetables, they generally take in about the same amount of food as other children.

Parents may find it helpful — and reassuring — to give multivitamins to children whose diets are very limited, even as they are encouraging them to expand their range.

“A hungry child will eventually eat,” Dr. Muth said. “Your best shot is having your child hungry at mealtimes when there is a variety of food.”

And though it can be a long process, Dr. Muth says, she encourages parents to keep trying, and not to give way to the temptation to create parallel meals. “One family, one meal,” she said. “Maybe include something that your child will eat, but don’t cater to the picky preference by making a second meal or making some alternative always available.”

The child will either come around or else learn to cook, she said, and children who do learn to cook have been shown to be more interested in trying new foods.

This can be a long process, and very distressing for parents; pediatricians can help make sure that the child is, in fact, growing normally, and help address the question of whether something else might be going on.

In those rare cases when a child doesn’t grow properly, you have to consider more serious issues, from food allergies and GI problems to autism and other developmental issues.

I have a pediatrician friend whose own baby wouldn’t eat. He did fine on breast milk and formula, but when it came time to make the transition to solid foods, he just didn’t seem to have any appetite. It was impossible to get food into him, and his growth failure was significant enough that his pediatrician began diagnostic tests for some of the many possible syndromes and chronic illnesses that can cause what we call failure to thrive.

The child was also slow to start talking, and it was his speech therapist who suggested that there might be a connection to his difficulties with eating. He needed specialized occupational therapy to help his mouth do its various jobs; when he got better at chewing and swallowing, he began to gain weight and grow.

But most children don’t have a serious medical problem. Yet despite a parent’s best efforts to offer a variety of foods, some children are pretty resistant. I know that the mother of that 9-year-old in my exam room thought that she was failing her son, and she probably worried that I was judging her for his weight gain, and for giving him all that white food, which was the only food he would eat.
Those were not the messages I intended to send, but the emotional overtones of eating and feeding continue to be powerful for parents, as their children grow up. We feel directly responsible for what our children eat — and what they don’t eat — but the negotiations around autonomy and responsibility are more complicated than that.

“It’s not a lost cause,” Dr. Muth said. “We can help kids be more healthy and adventurous eaters, but it takes time.”

Vaccines and Side Effects: The Facts

bottle of medicines close-up

What about serious side effects? How often do they occur, and should you worry about them? This is an issue that has been studied repeatedly and intensively. Here are some facts that should help put your mind at ease.

Yes, there are reports of serious side effects that have been blamed on vaccines. But proving that the vaccine caused these side effects is often hard to do. In many cases, children simply develop illnesses around the time they’ve received a vaccine, and the immunizations get blamed unfairly. Don’t forget that infants and children are given vaccinations at a time in life when certain health conditions begin and become apparent to both parent and doctor. In most cases, the evidence just isn’t there to support a cause-and-effect link with vaccines.

That’s the case with the myth linking the diphtheria-tetanus-pertussis (DTP) vaccine with sudden infant death syndrome (SIDS). The first dose of the vaccine is administered when a baby is 2 months old, which coincides with the time of life when the risk of SIDS is highest. Thus, you would expect some SIDS deaths to occur in this age group, whether children receive the immunization. In fact, a number of studies dating back to the 1980s looked at the incidence of SIDS deaths occurring at the time of the DTP vaccine. The researchers concluded that the number of deaths was at a level about equal to the number that would be expected to take place by chance. In short, there just isn’t any scientific evidence linking the vaccine with SIDS. Even so, many of the myths surrounding vaccines seem to have a life of their own. Below, you’ll find a description of some of these unfounded claims, as well as a look at what the scientific evidence shows.

Measles-Mumps-Rubella Vaccine and Autism
Autism is made up of many chronic developmental disorders and is often first diagnosed in toddlers. The number of cases of autism is reportedly on the rise, and some critics insist that the measles-mumps-rubella (MMR) vaccine is to blame. Others say the increase can be attributed to better reporting of autism cases by doctors. In 2001 and again in 2004, the Institute of Medicine (IOM) Immunization Safety Review Committee, an independent body of experts who have no conflict of interest with pharmaceutical companies or organizations that make vaccine recommendations, studied a possible MMR-autism link and found no evidence supporting such a connection. A panel of experts brought together by the AAP reached the same conclusion. Most of the authors of the original study linking MMR to autism have retracted their support of the study.

Risks of Thimerosal?
Since the 1930s, some vaccines have included a mercury-containing preservative called thimerosal. It has been used as an additive to vaccines because of its ability to prevent contamination by bacteria or fungi. Critics have argued that thimerosal-containing vaccines are the cause of a number of neurologic and developmental disorders, ranging from autism to attention-deficit/hyperactivity disorder and speech and language delays. The IOM safety committee studied this issue and concluded that the evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism. Since the end of 2001, most of the vaccines recommended by the AAP are available in thimerosal-free formulations. Some vaccines, such as the MMR, polio, and chickenpox vaccines, have never contained thimerosal.

Multiple Immunizations and Immune Disorders
Because some immunizations are given together, parents are often concerned that multiple vaccines might trigger health problems associated with the immune system. Can they increase your child’s risk of infections? Can they lead to the development of type 1 diabetes or various allergic diseases including asthma? After looking at this issue, the IOM committee concluded that there is no evidence of a cause-and-effect relationship between multiple immunizations and a greater risk of infections and/or type 1 diabetes. As for a link with asthma and other allergic disorders, there simply isn’t enough evidence to either accept or reject a connection with multiple vaccinations given together.

Hepatitis B Vaccines and Multiple Sclerosis
Although critics have claimed that hepatitis B immunizations can cause or trigger a relapse of multiple sclerosis, the IOM safety committee could find no scientific support for this theory. The same report also concluded that there is no evidence that the hepatitis B vaccine causes other types of nervous system problems, including Guillain-Barre

Why are preservative ingredients in vaccines?

Each ingredient has a specific function in a vaccine. These ingredients have been studied and are safe for humans in the amount used in vaccines. This amount is much less than children encounter in their environment, food and water.

Aluminum salts – Aluminum salts help your body create a better immune response to vaccines. Aluminum salts are necessary to make some of the vaccines we use more effective. Without an adjuvant like aluminum, people could need more doses of shots to be protected. Everyone is exposed to aluminum because there is much aluminum in the earth’s crust. It’s present in our food, air and water, including breast milk and formula. The amount of aluminum in vaccines is similar to that found in 33 ounces of infant formula. Aluminum has been used and studied in vaccines for 75 years and is safe.

Formaldehyde – Formaldehyde is used to detoxify diphtheria and tetanus toxins or to inactivate a virus. The tiny amount which may be left in these vaccines is safe. Vaccines are not the only source of formaldehyde your baby is exposed to. Formaldehyde is also in products like paper towels, mascara and carpeting. Our bodies normally have formaldehyde in the blood stream and at levels higher than in vaccines.

Antibiotics – Antibiotics, such as neomycin, are present in some vaccines to prevent bacterial contamination when the vaccine is made. Trace amounts of antibiotics in vaccines rarely, if ever, cause allergic reactions.

Egg protein –  Influenza and yellow fever vaccines are produced in eggs, so egg proteins are present in the final product and can cause allergic reaction. Measles and mumps vaccines are made in chick embryo cells in culture, not in eggs. The much smaller amount of remaining egg proteins found in the MMR (measles, mumps, rubella) vaccine does not usually cause a reaction in egg allergic children.

For more info on vaccine studies:

‘Mindful Eating’ – Promoting Healthy Habits in Kids

An apple and a paper bag with lunch. Vintage Style.

How schools are using ‘mindful eating’ to help prevent eating disorders

By Juli Fraga
At Waddell Language Academy, a K-8 School in North Carolina, Monica Mitchell-Giraudo, a French immersion middle school teacher, instructs 19 sixth-graders to gather into a circle.

“Okay, everyone, let’s take a few mindful breaths, and think about our gratitude for Amy, who brought us apples for snack today,” says Mitchell-Giraudo. “As you take these breaths, try to tune into your body. What sensations do you notice?”

“I notice my stomach is already growling,” chuckles Ben.

“My mouth is watering,” exclaims David.

Another student follows David and then another until each child has had their turn. After each of her student’s observations, Mitchell-Giraudo rings her Tibetan meditation bell. Each time the children remain still, despite the loud chimes.

[The problem with recess in the United States: We get 27 minutes. Finnish kids get 75, Japanese kids even more.]

Next, she instructs her students to hold and examine the apples. First, they pick up the fruit and roll it between their fingertips. Then, on her suggestion, they bring the apples to their noses, using their sense of smell to savor the flowery scent of their snack before taking the first succulent bites.

“Excellent, class,” says Mitchell-Giraudo. “Also, as a gentle reminder, before you eat the apple, ask yourself whether or not you’re hungry.” The students nod in recognition. “Remember, you don’t have to eat if your body isn’t giving you a hunger signal,” she says.

These students are learning a practice called “Mindful Eating,” that focuses on cultivating “present moment awareness” during meal times. Mindful eating invites participants to “pay attention” to the food in front of them and engage their five senses (sight, smell, hearing, taste and touch) before consuming a single morsel. This mindfulness practice builds the children’s awareness of important physical cues like hunger and satiety.

While mindful eating is scientifically proven to help prevent overeating and obesity, a new psychological study suggests that it may also forestall eating disorders, such as anorexia and bulimia, which affect 30 million people each year and are the deadliest of psychiatric illnesses. Surprisingly, anorexia nervosa is deadlier than major depression, schizophrenia or bipolar disorder. In fact, individuals who suffer from this severe illness are at higher risk of suicide, as well as prone to major health complications, such as cardiac arrest.

The National Eating Disorders Association states: “For young women, 15-24 years-of-age, Anorexia is twelve times more fatal than all other causes of death among this age group. Only 1 in 10 eating disorders sufferers will receive treatment for that illness, which makes prevention programs even more valuable.”

According to eating disorders researchers Michael Levine and Linda Smolak at Kenyon College, “By having children and adolescents participate in prevention programs, such as mindful eating, it can protect them from anorexia, bulimia and binge eating disorder.”

The positive life-affirming feedback from the children who participate in the program is the biggest testament to just how much these newly learned life skills are helping them.

“Mindful eating helps me respect the food that goes into my body,” asserts Jamie, a middle-school student in Mitchell-Giraudo’s class. “I can make better food choices,” she says, “because when I slow down to eat, I can tell which food is filled with fake ingredients and which foods are organic.”

“Mindful eating teaches children how to connect with their body signals, and learn how to eat intuitively,” says Kelsey Latimer, an eating disorders psychologist at the Center for Pediatric Eating Disorders and Children’s Health in Dallas. “This form of intuitive eating helps us distinguish between physical and emotional hunger and can help curtail overeating and binging.”

While Mindful Eating has been used in medical settings and eating disorder treatment centers, bringing the practice into the classroom as a preventative tool is a new concept.

“These programs buffer against eating disorder development,” suggests Latimer, “especially when administered during the late middle-school years. That’s a crucial period because it’s when students have been exposed to social the messages that “thin is in” but most have not yet manifested disordered eating habits to obtain a thinner physique.”

Mitchell-Giraudo, herself a graduate of the Mindful Schools program, echoes Latimer.

“It’s wonderful to see my students engage in 45 minutes of eating mindfully, especially since they used to scarf down their food in less than 10 minutes,” she says.

“By slowing down, my students have learned how to tell the difference between artificial and authentic flavors,” says Mitchell-Giraudo, “and this knowledge helps them make healthier food choices.”

Penelope says she is grateful that she’s learned these life skills. “Mindful eating is a great way to eat because it helps you feel good about yourself,” she says. “It’s helped me think about what I put into my body, which helps me grow stronger and do better in sports, too.”

While middle school is the ideal time to introduce eating disorders prevention programs, high school students can benefit just as much from the practice as those who are younger.

Aggie Giglio Kip, a nutritional counselor at Phillips Academy in Andover, Mass., incorporates mindful eating with her students in the dining hall.

The self-serve cafeteria bustles with activity as the students collect their food, flatware and beverages. Once they sit down to eat, Kip encourages them to unplug from other distractions, which means turning off their cellphones and powering down their computers. “Mealtimes are an opportunity to practice just eating,” she says.

Kip suggests that they “eat without judgment,” refrain from negative body talk and avoid measuring their self-esteem based on the foods they choose to eat. This is important since many of these teenagers struggle with the social and emotional changes of adolescence, including body image dissatisfaction.

For example, when Kip hears students say, “I ate the cookies — I was so bad,” a red-flag sign of negative body talk, she insists that they redefine the experience by using their senses to describe the flavors in the cookie. As an example, if a student feels guilty about eating oatmeal raisin cookies, Kip will ask her to focus and describe the scent and taste of the cinnamon, oatmeal and raisins.

Unfortunately, these kinds of courses are in short supply because many educators and school administrators believe that social and emotional programs are too expensive or time-consuming to implement. At many schools, teachers and school staff are often overwhelmed, overworked and underpaid. To save costs and reduce staffing issues, the schools bring prevention programs and/or leadership training into the schools like the Body Positive, founded by Connie Sobczak and Elizabeth Scott. The program trains educators and school staff in the principles of mindful and intuitive eating and teaches a series of self-exploration exercises that help them examine their feelings and attitudes about food and weight so that they can relay these messages to their students, too.

Kathy Laughlin, director of counseling at San Domenico High School in San Anselmo, Calif., is a fan of the Body Positive training. “The risk factors for eating disorders at my school are very high,” he says. “Since we began to incorporate this program, I have not seen as many girls with issues related to body hatred.”As the evidence demonstrates, implementing a mindful eating practice is one of the best ways to help students develop a healthy mind and body connection — one which will bolster them for years to come.

FAQ: Fluoride and Children

Girl brushing teeth

Fluoride from drinking water and other sources such as toothpaste can strengthen tooth enamel and help prevent tooth decay. Below is a list of questions that parents frequently ask about fluoride and how it can help their children.

Q: Why do children need fluoride?
A: Fluoride is an important mineral for all children. Bacteria in the mouth combine with sugars and produce acid that can harm tooth enamel and damage teeth. Fluoride protects teeth from acid damage and helps reverse early signs of decay. Make sure your children are drinking plenty of water and brushing with toothpaste that has fluoride in it.

Q: Is fluoridated water safe for my children?
A: Yes. The American Academy of Pediatrics (AAP), along with the American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC), agree that water fluoridation is a safe and effective way to prevent tooth decay.

Q: Should I mix infant formula with fluoridated water?
A: According to the ADA, it is safe to use fluoridated water to mix infant formula. The risk if mixing infant formula with fluoridated water is mild fluorosis. However, if you have concerns about this, talk with your pediatrician or dentist.

Q: What if I prefer not to use fluoridated water for infant formula?
A: If you prefer not to use fluoridated water with formula, you can:

Breastfeed your baby.
Use bottled or purified water that has no fluoride with the formula.
Use ready-to-feed formula that does not need water to be added.
Q: What if we live in a community where the water is not fluoridated? What can we do?
A: Check with your local water utility agency to find out if your water has fluoride in it. If it doesn’t, ask your pediatrician or dentist if your child is at HIGH risk for dental caries (also known as tooth decay or a cavity). He or she may recommend you buy fluoridated water or give you a prescription for fluoride drops or tablets for your child.

Q: How else can my child get fluoride?
A: There are many sources of fluoride. Fluoridated water and toothpaste are the most common. It is also found in many foods and beverages. So making sure your child eats a balanced diet with plenty of calcium and vitamin D is a great way to keep teeth healthy. Your dentist or pediatrician may also recommend a topical fluoride treatment during well child or dental visits at various stages of your child’s development.

Q: When should my child start using fluoride toothpaste?
A: The AAP and the ADA recommend using a “smear” of toothpaste on children once the first tooth appears and until your child is 3. Once your child has turned 3, a pea-sized amount can be used.

Q: What is dental fluorosis and will fluoridated water mixed with infant formula increase the risk?
A: Although using fluoridated water to prepare infant formula might increase the risk of dental fluorosis, most cases are mild.

Fluorosis usually appears as very faint white streaks on the teeth. Often it is only noticeable by a dental expert during an exam. Mild fluorosis is not painful and does not affect the function or health of the teeth.

Once your child’s adult teeth come in (usually around age 8), the risk of developing fluorosis is over.