The basics of RSV

RSV is most common during October to April, which coincides with flu season. This can make it tough to tell which illness your child has, and your pediatric provider can order a nasal swab to test for both. Commonly, kids will have:

• Runny nose
• Decreased appetite
• Cough
• Wheezing
• Fever
• Fast breathing
• Tiredness or fatigue

The biggest worry with RSV is that it can make it hard for people to breathe. This video shows what to look for when it comes to RSV and breathing. Call your pediatric provider or seek emergent care if you notice any of these symptoms – even one. Babies under age one, children born prematurely, and any child with a high-risk condition are at greatest risk for complications. Older people are also at higher risk of hospitalization and complications from RSV. Encourage the grandparents and other older adults in your life to get vaccinated to protect the whole family.

What now?

If your child has been diagnosed with RSV, or it’s strongly suspected, try not to panic. Most children recover well and only need rest, hydration and maybe medication for fever. Keep a close eye out for severe symptoms and breathing difficulties, and alert your pediatric provider if your child is high-risk or having trouble eating or drinking. 

For young children and babies, it can be hard to eat and drink while sick with RSV. Signs of dehydration can be found here, but try to offer lots of fluids or water-rich foods, like fruit or popsicles, often throughout the day. Babies under age one don’t need additional water, just breastmilk and/or formula. Breastfed babies may want to breastfeed all day or find it tough to stay latched – both are common experiences. On the other end, it can be helpful to track wet diapers again in the Ovia Parenting app – even if it’s been a while! 

Because RSV spreads so easily, your child should not go back to daycare or preschool until their symptoms have resolved. Your family may also want to consider limiting contact with other high-risk family members, like grandparents.

Preventing RSV

Preventing RSV is similar to preventing other respiratory illnesses like the flu or Covid-19. Hand washing, masking and avoiding large indoor groups during RSV season can all help. Preventative treatment is approved for babies entering their first RSV season or high-risk children entering their second RSV season. 

In addition, there are currently two ways to protect your baby from the risk of getting RSV that you may want to consider. 

Nirsevimab (Beyfortus) for infants

• The RSV antibody is available for babies and some young children to protect against severe RSV.
• Recommended for infants under eight months of age born during RSV season or about to enter RSV season, especially those who are at an increased risk, such as infants:
  • Children born prematurely
  • Those with a severely compromised immune system
  • Children with cystic fibrosis
  • American Indian and Alaska Native children
• If the birthing parent gives birth 14 or more days after being vaccinated against RSV, except in rare circumstances, most infants younger than 8 months of age do not need to receive the Nirsevimab vaccine.

RSV Vaccine (Pfizer ABRYSVO) for those who are pregnant and people over 60

• An RSV maternal vaccine for the pregnant parent to pass on protection to their babies. 
• Individuals in their third trimester, from September through January, should receive the vaccine, specifically during weeks 32-36 of pregnancy. 
• Taking the vaccine will pass on valuable antibodies to your newborn baby. 
• RSV Vaccine is also approved for people over 60. If you have close family members who may live with you or care for your children, discussing vaccination may be a good idea to help protect both the baby and family members.

It’s important to explore these options with your OB provider and family to determine what’s best for your baby. It’s a big step forward in protecting those most vulnerable to severe RSV infection and hospitalization.

Reviewed by the Ovia Health Clinical Team

Sources:

• Signs & Symptoms of RSV in Babies. American Academy of Pediatrics, AAP. Oct 26, 2022 https://www.youtube.com/watch?v=_2qh31Wndls
• Signs of Dehydration in Infants & Children, HealthyChildren.org. Healthy Children. Last Updated 9/24/2019 https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/dehydration.aspx
• RSV in Infants and Young Children, CDC, Center for Disease Control, Last sourced: July 17, 2024 https://www.cdc.gov/rsv/high-risk/infants-young-children.html
• RSV Immunizations to Protect Infants. CDC, Center for Disease Control, Last Reviewed: July 17, 2024 https://www.cdc.gov/rsv/vaccines/?CDC_AAref_Val=https://www.cdc.gov/rsv/about/prevention.html

Kids’ holiday food: Consider the big picture

The holidays are a special time to make memories and strengthen relationships while having lots of fun. Food is a common centerpiece for many traditions and celebrations. It’s part of your family culture — and the smells and tastes can bring back memories from years past. These are important anchors your child will develop over years to come. 

Helping your child listen to their body signals during these gatherings will set them up for a lifetime of success in not only choosing the foods they eat and how much, but also paying attention to how they feel and what comes up for them at the holiday table. Also, part of helping your child be happy at the dinner table will give you the time and space to enjoy a meal with the other adults there!

Prepping for the gathering 

If you know your child has a hard time sitting down to eat when their cousins are around, it may help to go into the gathering feeling rested. Depending on your kiddo’s age, allowing them to get some good zzzs in before heading into a more chaotic environment can help. 

Another common concern is that they won’t like Aunt Judy’s green beans. It can be really helpful to present familiar foods alongside the new ones. Allow your little one to explore and try new things while having the security of foods they know they enjoy on their plate as well. If they’re able to help you or other family members prepare food in the kitchen, this can be a lasting positive memory and even encourage them to try something new!

Try to let go of your own baggage around food

If you’ve ever struggled with your relationship with food or your body, do your best to take care of yourself during this time too. And if you need a little extra support, reach out to your provider to see if there’s someone they might be able to recommend you speaking with. 

We tend to place our own unhealthy thoughts about food on our kids. By challenging our beliefs about food, we can protect our kids from our own negative connotations.

In general, kids tend to be good at self-regulating — eating when they’re hungry and stopping when they’re full. By letting your kids have control over what they eat and how much, they learn to build their instincts and form good habits.

Manage outside comments

The holidays bring out the best in lots of us. For some, though, it can bring out a lot of food anxiety, which can show up as invasive, judgmental comments about what you and/or your children are eating. Not only are these offensive and unhelpful, but research has shown that negative talk about bodies/dieting actually increases the risk of children gaining excess weight in unhealthy ways and developing eating disorders. 

Responding directly to comments from family members is an important way to teach your children how to set healthy boundaries as well as how to shut down negative body/food talk. It’s okay to say for example, “We don’t police food and we are teaching our kids to listen to their bodies,” or “We don’t comment on what other people eat at our house, please refrain from doing so anymore today.” If you anticipate unhelpful commentary from a certain family member — on how your child looks or what they choose to eat — addressing these challenges before you arrive can help. A quick text can encourage supportive actions from family, and set the tone for what you expect. 

Focus on joy

As parents, we want the holidays to be a warm and special time to spend together and remember for a lifetime. Family gathering and meals create traditions, recipes, games, and laughter that our children will never forget — and may even pass on to the next generation. The contagious joy of celebrating and eating can be a positive outcome of this season to carry forward for the whole family.

Reviewed by the Ovia Health Clinical Team

Sources

• Jill Castle. “How to Help Your Child Eat Well and Be a Good Guest at Holiday Meals.” U.S. News & World Report. November 25, 2019. https://health.usnews.com/wellness/for-parents/articles/holiday-meals-and-kids-helping-them-to-eat-well-and-be-a-good-guest. 
• Kaitlyn Kamleiter. “Avoiding picky eating during holiday meals.” Children’s Minnesota. November 25, 2019.
• https://www.childrensmn.org/2019/11/25/avoiding-picky-eating-holiday-meals/. 
• Sally Kuzemchak, M.S., R.D. “Don’t Micromanage What Your Kids Eat At Holiday Parties.” Real Mom Nutrition. December 5, 2019.
• https://www.realmomnutrition.com/holiday-parties/. 
• Sandra G. Hassink, MD, FAAP. “Avoiding Food Traps.” HealthyChildren. American Academy of Pediatrics. August 20, 2020. https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Avoiding-Food-Traps.aspx. 

To raise body-confident kids in a world filled with harmful messaging about body type and image is certainly a challenge. Kids, like adults, are pressured to look a certain way from an early age in our culture. This leads many to be critical of themselves when they don’t, leading to a lack of overall confidence. 

While you can’t change the way all this messaging might pop up in your kid’s life, with some mindful messaging, you can help your child cultivate a positive self-image and embrace others in the process. 

Model healthy behavior and self-talk

Our children pick up on so much of what we say, do, and believe. That’s why one of the best things we can do is model healthy talk about our own bodies. But for many, this is easier said than done. 

The first step is to pay attention to how you’re feeling about your body. If you’ve been struggling with body image, take some small steps to address how you’re feeling. A small step might look like speaking with a mental health provider, talking to a trusted friend, or finding a weight inclusive physician. 

When you talk to your kids, do your best to focus on what your body can do rather than how it looks. For example, rather than making a negative comment about how you feel in a swimsuit, focus what you say to your kids on how excited we are to jump in the waves with them. 

Focusing on positive messaging helps our kids to appreciate and accept their own bodies and helps us rewire the ways we talk about and to ourselves. 

Talk about body diversity

While it might be tempting to avoid the subject of bodies altogether, this can make the topic feel taboo to kids and can leave them with unanswered questions. Instead, have conversations with your kids about how everyone’s bodies are different for many reasons beyond an individual’s control. Looking any way doesn’t increase or decrease one’s value as a person. Appearance isn’t linked with health and you cannot tell how much someone exercises or eats by the size of their body. Nor can you identify their contribution to this world by looking at their body. This is the age-old “never judge a book by its cover” concept. Teaching children to value people for who they are, not what they look like, is a gift they will benefit from throughout their entire lives.

Focus on health versus appearance

The conversations we have about what we eat and how we exercise should be geared around our health, wellbeing, and fun, not our body size. Move away from labeling foods as good and bad — and body sizes as healthy or unhealthy.

When you’re talking about exercise with your kids, try to frame exercise as a way to feel energized, strong, and healthy — not to achieve a certain look or body weight. Discuss how foods fuel our bodies to be strong and keep our minds sharp. For example, you might explain how vegetables give us strength and help us fight illness. Or that cookies can bring us joy and some short-term energy. Educating our kids about these topics can reduce anxiety and prevent food restrictions.

Never make critical comments about their body

You may worry that your child will get bullied for their body type or weight, and it’s natural to want to protect them. But sometimes our own fears lead us to say things that could cause our kids to be self-conscious and self-critical. Focus instead on conversation around emotional health. If you’re concerned, check in with your child about their body image, the pressure to be thin, or other body-related issues. Validating the very real feelings of inadequacy people in bigger bodies can feel is important. This type of conversation can also help you identify if your child is experiencing body dysmorphia, a different issue than body image. Body dysmorphia is a warped sense of one’s appearance. This can lead to an unhealthy relationship with food or even an eating disorder. 

Help develop a positive self-image and confidence

Encourage your child to see their strengths and beauties, both physical and non-physical. Comment on how their strong legs help them climb a tree or how their fingers play the piano beautifully. Talk about their internal qualities, too, such as their kindness or curiosity.

When we share specific and positive feedback with our kids, they’re more likely to see their unique value and beauty beyond their body’s appearance. They’ll learn that their worth isn’t based on how they look, what they eat, or how much they weigh. They’ll know they’re wonderful and loved no matter their appearance.

Sources

Ana Reisdorf. “How to Teach Your Child Body Positivity.” Mental Health America. Mental Health America, Inc. 2022. https://mhanational.org/blog/how-teach-your-child-body-positivity 

Kaitlyn Kamleiter. “Avoiding picky eating during holiday meals.” Children’s Minnesota. November 25, 2019. https://www.childrensmn.org/2019/11/25/avoiding-picky-eating-holiday-meals/.

Sumner Brooks, MPH, RDN. “How to Raise a Kid Who Is Satisfied With Their Body, According to a Registered Dietitian.” Good Housekeeping. Hearst Digital Media. December 9, 2021. https://www.goodhousekeeping.com/life/parenting/a38029229/positive-body-image-for-kids/

Cultural influence

It’s not news that U.S. society has long been thin-obsessed. The extreme societal pressure that many of us feel has an impact on our kids as well and can affect the way they feel about their bodies and their value. When kids feel less valuable because of the size of their body it impacts their confidence and overall emotional wellbeing. 

According to NEDA, “By age 6, girls especially start to express concerns about their own weight or shape. 40-60% of elementary school girls (ages 6-12) are concerned about their weight or about becoming too fat. This concern endures through life.”

There are several steps you can take as a parent to change the messages within your own home and help your child cope with the messages they’re getting outside of your control.

Model healthy behaviors and language

How we talk about bodies impacts what our kids think about theirs (and other peoples’) both now and in the future. It may take a lot of time and effort to retrain your own way of considering and speaking about bodies, but by shifting the way you think and talk about your own body to be more accepting, you are modeling healthy body image for your children. 

A helpful exercise for your entire family is to practice not commenting on bodies in general. Focus compliments on the qualities that draw you to someone. For example, “You are one of the funniest people I know” or “I love the time we spend together, you offer me such reassurance.” Even a simple, “You’re a beautiful person.” Teaching ourselves and our children not to speak about other people’s bodies can help us not judge or focus on someone’s outward appearance. In the end, you don’t choose your friends and loved ones because they’re physically attractive. You want to be around people because you feel good around them. None of that is based upon how they look or what size they are. 

It will be normal for questions about different-looking bodies to come up. Try to focus on fact, not judgment in these moments. For example, a very tall person walks by and your child is awe-struck. You can talk about the differences in your bodies and how that might impact your perspective on the world! Or if your child sees a larger person and comments, “They’re fat!” A common response to this is, “That’s rude.” But perhaps another more constructive response could be, “Yes, they are bigger than you are. What does that mean to you?” Fat doesn’t have to be a negative term. It can be a descriptor just as are “tall,” “loud,” “funny,” etc. 

Adjust your media sources

Expose your kids to books, art, and movies that celebrate a variety of body shapes, sizes, and abilities. Inclusive images and messages help children have a healthy, well-rounded view of their own bodies within a diverse world. When we step away from skinny-focused, white-centered, able-bodied media and recognize that all body types are valuable, kids see that too. Noticing and celebrating our differences can help people of all ages to strive for goals that are based on their personal values and not on their outward appearance.

Social media is well known as a source of unrealistic and pervasive messaging about ideal appearances. Filters and editing are hard for younger adolescents to fully understand. They generally believe what they see. It’s easy for these literally unreal images to quickly become a goal for young minds, and the link between use of social media and body dissatisfaction increases with the amount of time spent on various platforms. Any reduction or use of other more positive media or activity can help protect your child.

Refrain from critical remarks

Kids can internalize statements that make them feel self-conscious, for example, a comment about eating too many sweets or how they look in a dress. Negative messages can stick with kids for a long time and damage their self-esteem. Instead, pay attention to what they enjoy and keep it positive: “You run so fast, you must have very strong legs!” 

Learning about exercise and what our bodies can do

When teaching your children about exercise, celebrating the physical feats they can accomplish is a great way to help your child feel empowered and energized. Helping them to explore team sports, participating in races, playing at the playground, or pushing themselves to reach a new goal they set for themselves are all ways you can encourage your child to enjoy their body and celebrate what it can do. Exercise is never a punishment for eating.

Get personal

Kids love to hear about how we often struggle with the same things they do. Why? Because our own stories can help them feel less alone and know that what they feel is normal. You might share a story about how you struggled as a child to feel like you were pretty or fashionable enough. Maybe you have a physical difference that was challenging to grow to accept or love. Maybe you’re still working on recognizing your own self-worth outside of your physical appearance. Sharing your own insecurities to a certain extent can open up space for your child to share how they’re feeling with you. 

Helping your child see that you’re a human too and that you’re there for them in the tougher moments, allows you to connect with them on a deeper level. It also paves the way for them to open up more to you and see you as a resource.

Reviewed by the Ovia Health Clinical Team 

Sources

• Ana Reisdorf. “How to Teach Your Child Body Positivity.” Mental Health America. Mental Health America, Inc. 2022. https://mhanational.org/blog/how-teach-your-child-body-positivity. 
• D’Arcy Lyness, PhD. “Encouraging a Healthy Body Image.” KidsHealth. Nemours. June 2018. https://kidshealth.org/en/parents/body-image.html.
• Erica Lamberg. “6 Lessons in Body Positivity to Teach Your Child by Age 5.” Parents. Dotdash Meredith. January 12, 2021. https://www.parents.com/kids/problems/body-issues/lessons-in-body-positivity-to-teach-your-child-by-age-5/.
• Ragan Chastain. “Raising Body Positive Kids in a Body Negative World.” Dances with Fat. September 24, 2016. https://danceswithfat.org/2016/09/24/raising-body-positive-kids-in-a-body-negative-world/.
• Sumner Brooks, MPH, RDN. “How to Raise a Kid Who Is Satisfied With Their Body, According to a Registered Dietitian.” Good Housekeeping. Hearst Digital Media. December 9, 2021. https://www.goodhousekeeping.com/life/parenting/a38029229/positive-body-image-for-kids/.
• “Body image and eating disorders.” National Eating Disorder Organization. National Eating Disorder Organization. https://www.nationaleatingdisorders.org/body-image-eating-disorders. 

Be mindful of your own thoughts and beliefs

Being aware of your own mindset around food is the first step to ensure you don’t pass down negative associations to your kids. Notice how you think or talk about certain foods, whether it’s desserts, bread, or vegetables. Stay curious about your food beliefs and be mindful of what you say in front of your children.

If you’re noticing you have a lot of negative associations with foods, or you feel compelled to diet or restrict food regularly, it may be beneficial for you to seek help in healing your own relationship with food. The work you do to heal your own relationship with food will have positive rippling effects on everyone in your life, especially your kids. 

Intuitive Eating can be a great place to start when exploring how you relate to the foods you do and don’t eat. It is a way of eating that helps you to identify which foods make you feel your best and which don’t agree with you, or leave you wanting for more.

If you’re struggling with your own body image, consider finding a therapist who specializes in body image or a community you can learn from. And there are some pretty amazing leaders on social media having these conversations about positive food associations, too.

Talk about what food does for the body

Rather than categorizing a particular food as “bad” or “good,” describe what the food offers the body. Make it fun and educational, rather than about restriction. For example, you could say, “Chicken has protein and helps build the cells that make up your body.” or “Cookies give you short-term energy.” When kids learn how food fuels their bodies, they can start making their own healthy choices. 

Aim for family meals

According to research, eating meals together as a family is associated with less disordered eating and better self-esteem for children and adolescents. It also helps generate healthy habits and enjoyment around eating. Plus, this time gives your children a safe and comfortable space to playfully try something new on their plate.

Avoid pushing certain foods

Forcing kids to eat particular foods can dull the internal cues they have about what they like, what their body needs, and when they’re full. Mealtime battles often backfire anyway, leading them to resist the vegetables or protein on their plates. 

Pressuring kids to eat certain foods can even lead to a negative association with mealtime, with them feeling anxious about even sitting down to eat. Instead, serve well-rounded meals but allow them to have some voice and decision. Giving them choices about what they eat helps build long-term habits where they feel confident and in control of their nutrition.

Notice changes in your child’s eating

If your child’s eating habits change noticeably, it could be a sign of a deeper problem, such as depression, anxiety, or even an eating disorder (no matter their body type). Consider talking with your child or getting help from a trusted therapist or pediatrician. 

Reviewed by the Ovia Health Clinical Team

Sources

• Jennifer Anderson MSPH RDN. “Kids Eat in Color.” Kids Eat in Color. 2022. https://kidseatincolor.com/links/ 
• Kaitlyn Kamleiter. “Avoiding picky eating during holiday meals.” Children’s Minnesota. November 25, 2019. https://www.childrensmn.org/2019/11/25/avoiding-picky-eating-holiday-meals/.
• Sumner Brooks, MPH, RDN. “How to Raise a Kid Who Is Satisfied With Their Body, According to a Registered Dietitian.” Good Housekeeping. Hearst Digital Media. December 9, 2021. https://www.goodhousekeeping.com/life/parenting/a38029229/positive-body-image-for-kids/

Recognize that it’s not going to be one conversation

Often, parents think they have to cram all the facts of life into “the talk”. In reality, most discussions about big topics should happen over and over as a child grows, with increasing depth. You don’t need to try to squeeze everything into one conversation and, in fact, kids learn more when you break things down into smaller pieces. 

Use real life to open the conversation

You don’t have to sit face to face with a PowerPoint presentation to clue your kid into how their body will soon be changing. Use things that happen in everyday life to spark the conversation instead. Next time you’re walking through the mall with your daughter and pass the bra section, have a quick chat about how she might notice her body changing soon and it’s completely normal. Or, when your son sees you putting on deodorant, use the opportunity to talk about why he’ll soon add it to his everyday routine. 

Ask what they know or notice

Sometimes, as parents, we don’t know as much about what kids know as we think we do. It can be helpful to start each conversation with a quick check-in about what they know or may have experienced. A question as simple as, “What have you heard about periods” can clue you into both the practical information they’re aware of and any beliefs or attitudes they’ve picked up from peers or the media. Another simple way to start a conversation is to ask them if they’ve noticed a difference between kids and adults. For example, you might ask if they’ve noticed how men’s voices sound different than younger boys or how some teenagers have mustaches but kids their age have smooth faces.    

Keep it positive or neutral

As adults, the body changes associated with puberty can bring up some big feelings about our own experiences or the attitudes of our family of origin. Puberty doesn’t have to mean the same thing to our kids as it does to us though. Aim to convey the information you want to share in a positive or neutral way. Don’t lead with how annoying it is to get your period every month or how painful cramps can be. Instead, share the information you want to share and let them come to their own personal feelings about what’s to come. 

Focus on the emotional as well as the physical

The changes that come to mind when people think about puberty are often those that are most visible to the outside world. While it’s important to discuss what sort of physical changes will occur with puberty, it’s also important to talk about the emotional shifts as well. Let your kiddo know it’s normal to wonder about their body and the bodies of others, that they and some of their peers might begin to experience crushes, and that shifts in friendship can be confusing but normal.

Be open to questions

One of the most important things a parent can do as their child grows is to be a safe space to ask questions and have hard conversations. Let your child know that you’re always available for questions and then do your best to answer them openly and honestly when they do come to you. If they bring you a question you’re not sure how to answer, let them know you’ll think about it and get back to them soon. 

Each stage of parenting has its challenges and, during the middle elementary school years, one of the big ones can be navigating new conversations. As you think about discussing puberty with your child, remember that as long as you’re open and honest, your child will know you’re there for them in the coming years.

Read more

Should you give your child an allowance?

How to connect with your child

Take the morality out of food bravery

Sometimes, as parents, we want our kids to do things because they “should.” While a healthy, varied diet is important for kids’ growth, there’s nothing inherently good or bad about a child eating more or fewer foods. Do your best to resist pushing your child to try or like certain foods because you perceive them as “better” than others or because you worry about other people judging you by what is (or is not) on your kid’s plate. 

Take them grocery shopping

While cooking with your kid is a great way to help them get more food-curious, taking them shopping can help even the most reluctant eater get excited. Bring them to the store and invite them to select a new food each week. Even if at first they choose less “healthy” options, celebrate them for tackling new tastes and textures. As time goes on and they get more adventurous, you can start guiding them towards new foods that are more in line with what you want them to be trying.

Serve deconstructed meals

Meals with a lot of ingredients can be overwhelming to kids that are intimidated by a variety of new tastes and textures. Instead of serving a pasta dish that’s already sauced or a salad that’s filled with toppings and already dressed, try to serve meals buffet style. Allowing your child to build their own taco, create their own salad, or choose how much sauce goes on their pasta can go a long way in getting them to try new things. 

Introduce new foods, but always with a safe option

Don’t let your kid’s shy appetite keep you from prepping your favorite meals or trying out new recipes. Keep on cooking and serving what you want to cook and serve, and consider adding something familiar on the table too. You don’t want your child to feel backed into a corner or like they must eat a new food or go hungry, but consistent exposure to new dishes can spark curiosity over time. 

Dig deeper

Sometimes, picky eating is more than just picky eating. If you feel like your child’s list of acceptable foods is shrinking, that they have an extreme reaction to being around new foods, or that they’re really not getting the nutrition they need to grow, reach out to your child’s pediatrician. Sometimes, picky eating is the first sign of sensory issues or bigger-picture challenges. 

Picky eating is an ongoing challenge for many families. While the frustration and concern is real, it’s important to remember that kids are more than what they will or won’t eat. Do your best to make mealtimes fun and relaxing, even if that means you have to shut off the part of your brain that takes note of what disappears from your child’s plate. Over time, many kids learn to enjoy trying new foods or, at least, develop a longer, more varied list of their favorites. 

Read more

How to respond to your child’s crying

Teaching manners

What is eczema?

Eczema also called atopic dermatitis, is a skin condition with inflammation, itching, pain, and sometimes rashes. It is not contagious (it can’t be spread from one person to another). In infants and children, eczema typically causes dry, itchy skin patches. Your child’s healthcare provider or a specialized skin doctor (dermatologist) will diagnose your child’s eczema and help you find the best way to treat it.

How is eczema treated?

There is no cure for eczema, but a treatment plan can limit how much it impacts your child. Eczema treatments usually target four problems: dryness, itching, irritated skin (inflammation), and infection. Childhood eczema is best controlled by a regular bathing and moisturizing routine, treating flares (times when eczema worsens), and avoiding triggers (those things that cause flares). The goal of treating eczema is to reduce your child’s discomfort, help them sleep better if itching keeps them awake at night, and reduce scratching, so they don’t cause skin infections or scarring.

For several reasons, eczema can be tricky to treat, especially in infants and children. 

1. Eczema symptoms can vary from child to child.
2. It can cause severe itching, especially at night, disrupting infants’, children’s, and (let’s face it) your entire family’s sleep.
3. It can be stressful as a parent to try to stop your child from scratching the uncontrollable itch of eczema rashes. 
4. It can be frustrating and time-consuming to treat. Sometimes it can still get worse, despite treatment efforts.

Which medications treat childhood eczema?

Healthcare providers treat eczema with medications called corticosteroids, applied to your child’s skin (topically). Topical steroid medications are the most effective treatment for eczema. They work because they reduce inflammation. Corticosteroids should be applied twice a day during an eczema flare. Only apply the steroids to your child’s irritated or itchy areas, avoiding other skin areas. Corticosteroids have different strengths and forms (lotions, ointments, creams, gels, and oils). When used as prescribed, topical steroids are very safe and effective — but you should speak to your provider about the right fit for your child. 

Non-steroid eczema medicines (tacrolimus ointment, pimecrolimus cream, crisaborole ointment) also help heal eczema rashes for children over 2. They have different ingredients than corticosteroids. They work well for mild eczema and delicate areas of skin, like the eyelids, armpits, and groin (between the legs).

Biologic therapies target your child’s immune system to decrease the allergic response. Dupilumab is the first biologic therapy approved by the U.S. Food & Drug Administration (FDA) to treat eczema in children ages six months and up. Dermatologists use Dupilumab to treat moderate to severe eczema that corticosteroids failed to improve.

Continuous scratching may leave your child’s skin raw, sensitive, and swollen. If their scratching has caused open areas that have become infected, your pediatric provider may prescribe antibiotics. Signs of a skin infection include oozing, crusting, pus bumps, blisters, or a worsening rash that does not improve with your usual treatments. These are important to get treatment for right away. If your child is prone to frequent infections, there are special baths that may be recommended by your healthcare provider as part of a prevention strategy. 

Antihistamine medicines like diphenhydramine (Benadryl) and hydroxyzine (Atarax, Vistaril) can help your child feel drowsy so they fall asleep instead of scratching their skin. Follow directions based on their age and weight, and talk with their pediatric provider or pharmacist if you have questions about how to give your child the correct dose of these medications. These medications should only be given exactly as directed and with the approval of your healthcare provider if your child is under age 6. 

Bathing and moisturizing: Two key pieces of your child’s eczema puzzle

Infants and children with eczema have a skin barrier that isn’t working effectively — meaning that their skin does not work as well to keep moisture inside and dries out more easily. Skin dryness is a trigger for eczema symptoms. Bathing and moisturizing help strengthen your child’s skin, making it more eczema resistant. A healthy skin barrier also keeps out bacteria, viruses, and irritants. Applying moisturizer (also called an emollient) after a bath is crucial because it provides an artificial barrier preventing water loss. Giving your child a bath and not putting moisturizer on afterward might do more harm than good, leaving their skin drier than it was before the bath. Here’s a suggested bathing and moisturizing treatment plan for eczema:

• Give your infant or child a lukewarm bath every day. Let them soak for at least 5-10 minutes (with supervision, of course). Longer than 20 minutes risks further skin drying.
• While in the bath, only wash their dirty or smelly areas with a gentle cleanser. Do not use any soap or cleanser on the skin areas with eczema.
• When they are out of the bath, gently dry them off, leaving their skin still damp and patting with the towel rather than rubbing.
• Smear a thick layer of moisturizing lotion or ointment twice daily all over your child’s skin. When the skin is very itchy, using an eczema-friendly ointment provides more relief than a cream or lotion.
• If your child uses topical corticosteroids to treat their eczema, apply them to the eczema-affected areas after your child’s bath but before the moisturizer to increase their absorption. 
• Put PJs on immediately to help seal in moisture. Use non-synthetic fabrics like cotton or bamboo. 

Remember, all soaps, shampoos, conditioners, and moisturizers should be fragrance-free, specially formulated for sensitive skin, and without dyes or other irritating chemicals. Do not use bubble baths or bath oils.

Although it seems counter-intuitive, do not use anti-itch creams or lotions. The American Academy of Dermatology says that these products do not relieve the eczema itch and can sometimes contain ingredients that cause flares.

What makes my child’s eczema worse?

Things that make your child’s eczema worse (called a flare or flare-up) are triggers. Some of the items listed below may trigger your child’s eczema:

• Dry skin
• Dry air
• Indoor heat (indoor temperatures hotter than 75 degrees F)
• Tight-fitting clothing or clothes with irritating seams or tags
• Scented laundry detergents and fabric softeners
• Soaps, shampoos, or lotions that are scented or contain irritating dyes and chemicals
• Dust mites (found in old pillows, carpets, and bedding)
• Pet dander
• Pollen
• Saliva (infants’ drool can irritate cheeks, chin, and neck)
• Sweat
• Fragrances from indoor candles, air fresheners, and incense
• Insect bites and stings
• Tobacco smoke
• Wool and synthetic fabrics

Avoiding triggers will help prevent eczema flares. Some parents and healthcare providers consider allergy testing to identify triggers better.

Can changing my child’s diet help treat my child’s eczema?

Maybe, but it’s complicated. Having eczema (AD) is closely linked with food allergies (as well as asthma and hayfever). Restrictive or fad diets are never a good plan for babies and children, who have specific nutrient needs and can also be picky. If you’ve noticed flares around certain foods, discussing this with your child’s providers is a great idea. No two cases of eczema are the same or have the same triggers. It can be so tempting to hunt a cause, but often flares are a result of many different external and internal factors.

Healthcare providers advise against changing your child’s diet or avoiding any foods without first talking to them. The American Academy of Dermatology recommends allergy testing for foods only when a child has an immediate allergic skin reaction after eating a specific food. In addition, there is no conclusive scientific research to demonstrate any dietary supplements, including probiotics, help treat eczema. Instead, keep your child (and their skin) healthy by feeding them a complete, balanced diet

Home remedies can help break the itch-scratch cycle.

Increasing how often you apply emollients or the strength of the corticosteroid medication are usually the ways your child’s pediatrician or dermatologist will treat flare-ups. Unfortunately, the medication can take a couple of days to work. In the meantime, here are some tips from the American Academy of Dermatology to help your child itch and scratch less:

• Apply a cool compress (a cold face cloth, cold pack wrapped in a towel) to itchy areas
• Take a colloidal oatmeal bath (usually sold at pharmacies or health food stores, pick unscented, and add to running lukewarm water, then let your child soak for 10-15 minutes)
• Keep your child’s nails cut short, or have infants and toddlers sleep in pajamas with hand covers so they cannot scratch while asleep.
• Try a wet-wrap treatment if your provider recommends it. 

Can eczema be cured?

Unfortunately not. Some children outgrow eczema. For most, eczema improves with age. Others will continue to have flare-ups mixed with symptoms-free times for the rest of their lives.

The best way to manage your child’s eczema is to learn more about their symptoms and triggers to keep flare-ups under control. Treating symptoms right when they first start can help your child feel better and prevent sleep disruptions, irritable behavior, and skin infections. Working with your child’s healthcare provider to create a stepped eczema treatment plan with effective treatment options will help your entire family feel better.

Dealing with eczema can be so overwhelming for families and if you’re struggling to manage the physical and/or emotional aspects of it — please reach out to a provider to get some support.

Sources

“Baby eczema: Causes, symptoms, treatment, and more.” National Eczema Association. National Eczema Association. https://nationaleczema.org/eczema/children/

“Can food fix eczema?” American Academy of Dermatology. American Academy of Dermatology. 2022. https://www.aad.org/public/diseases/eczema/childhood/treating/food-fix

“Childhood Eczema.” American Academy of Dermatology Association. American Academy of Dermatology Association. https://www.aad.org/public/diseases/eczema/childhood

Stein, S. and S. Maguiness. “How to treat and control eczema rashes in children.” Healthychildren.org. American Academy of Pediatrics. April 19, 2021. https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/How-to-Treat-and-Control-Eczema-Rashes-in-Children.aspx

“Treating your child’s eczema can help the whole family.” Mayo Clinic. Mayo Clinic. March 21, 2019. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/treating-your-childs-eczema

So, how many hours of sleep does your child need, and what can you do to help them achieve it? Read on for tips and insight.

How many hours of sleep does your child need?

It varies by age. According to the American Academy of Pediatrics (AAP), kids at age 3 need roughly 10 hours per night and an hour-long nap.

From ages 4 through 6, kids still typically need about 10 hours of sleep a night, though most are done taking naps. Then up until the teen years, children need at least nine hours of nightly sleep.

Sleep habits and tips for kids

What can you do to help your child sleep better or longer? There’s no one-size-fits-all solution, but we outlined a few things that might work.

Winding down, powering off

Screen time before bed is stimulating. And according to Stanford Children’s Health, it can block the production of crucial sleepytime hormones, including melatonin and serotonin. Aim to power off devices at least an hour before bedtime and wind down with books, songs, and cozy lighting.

Nightlights and smart clocks

While TV, tablets, and overhead lighting should go off well before bedtime, nightlights and smart clocks can be beneficial for many kids. The Cleveland Clinic says relatively dim nightlights are no problem. And app-controlled clocks designed for younger children can be set to illuminate or change color at certain hours, helping kiddos know when it’s time to sleep and when it’s OK to get out of bed in the morning.

Sunlight

Sometimes how you start the day can reinforce a good night’s sleep. Exposure to sunlight first thing in the morning, for example while eating breakfast, can help regulate a child’s sleep hormones and circadian rhythm.

Maintaining a bedtime routine

Developing and maintaining a consistent bedtime routine is crucial for achieving healthy sleep habits. Stanford Health explains that it can be comforting for children to know what to expect at the end of the day while regulating their circadian rhythm.

Of course, push-back is to be expected at pretty much any age. But when you stick to it, your child will start getting tired around the same time each day, which can help them fall asleep faster.

Focused attention before bed

Kids who resist bedtime more often than not or have a habit of hopping out of bed after the lights go out might be craving focused attention from their parents. Raising children is exhausting, to say the least, and it’s understandable to try to rush through bedtime.

But spending just 10 extra minutes reading stories, talking about the day, or cuddling before tucking your child in could make a world of difference.

Sleep changes with puberty

Around when your child starts to experience changes related to puberty, their sleep will also be impacted. Hormones are now telling their bodies it’s not time to go to sleep for about 2 hours after their usual 8-9 pm sleep window. Working through this natural change can be tricky while helping them still get their 9 hours of daily sleep. Extra sleep on the weekends may throw their internal clock off even more, but short naps and consistent bedtime routines may be helpful.

Reviewed by the Ovia Health Clinical Team

Sources

• Stanford Children’s Health. Healthy Sleep Habits. Stanford Medicine. 2022. Web.
• Stanford Children’s Health. Tips for better rest. Stanford Medicine. 2022. Web.
• Cleveland Clinic. Sleep in Toddlers & Preschoolers. Health Essentials. 2020. Web.
• Stanford Health. Why Bedtime Routines Matter. Fit Stanford. Web.
• American Academy of Pediatrics. Healthy Sleep Habits: How Many Hours Does Your Child Need? 2020. Healthychildren.org.
• “Sleep and Teens.” UCLA Health. UCLA. https://www.uclahealth.org/medical-services/sleep-disorders/patient-resources/patient-education/sleep-and-teens.

According to the Centers for Disease Control and Prevention (CDC), tooth decay is one of the most common chronic health problems among children. Affecting roughly 20% of kids between 5 and 11, it can be not only painful but also a potential concern when permanent teeth grow in. The good news is that the condition is totally preventable.

Keep scrolling for insight into when to start brushing your kid’s teeth and tips for developing an oral hygiene routine for children of all ages.

When to start

The American Academy of Pediatrics (AAP) and American Dental Association (ADA) both recommend starting a brushing routine around 6 months of age or when the first tooth erupts. Though tooth decay could develop soon as your child’s first teeth appear, a survey by the CDC found that 80% of kids don’t start brushing until after their first birthday.

Of course, it’s never too late to start. We compiled tips and guidance for babies, toddlers, and older kids below.

Teeth brushing for babies and toddlers

While you might be met with resistance at first, brushing your child’s teeth can be a simple, fuss-free process.

What type of toothbrush to use

A soft washcloth or a small piece of wet gauze can work when wiping down an infant’s teeth and gums. When your child’s first few teeth come in, you can graduate to a small soft-bristle toothbrush.

Then once you hit the toddler stage, consider upgrading to an electric toothbrush. Most experts consider this safe after age 3. You can also find vibrating silicone brushes with U-shaped heads that clean kids’ teeth without having to be moved around.

How much toothpaste to use

The ADA recommends using a very small smear of fluoride toothpaste from ages 0 to 3 — about the size of a single grain of rice.

Introducing concepts with books and videos

You can’t expect babies and toddlers to fully grasp the concept of oral hygiene. Still, books and videos can help introduce the idea and potentially get your child excited about brushing.

Teeth brushing for older kids

Most kids still need at least some help brushing until about age 8.

How much toothpaste to use

For children 3 and older, the ADA recommends a pea-sized amount of toothpaste. Before you start adding more to their toothbrush, make sure they can spit on command and remind them not to swallow their toothpaste.

Fun toothbrushes and toothpaste

Even with good habits in place from a young age, teeth brushing just isn’t most kids’ idea of fun. With that in mind, flavored toothpaste and toothbrushes featuring their favorite characters might encourage them to stick with it.

Time it

Brushing twice a day for two minutes is ideal, but this is easier said than done — even for adults. Kids’ electric toothbrushes often have built-in timers, sometimes with songs that play for two minutes. If not, you can use your phone, a kitchen timer, or get an hourglass for the bathroom counter.

Good habits chart

If your kiddo responds well to rewards, you can create a good habits chart for teeth brushing. Add a sticker each time, then figure out what a brushing streak will get them — maybe a new book or a few extra minutes of screen time before bed.

The importance of fluoride at every age

The ADA only recommends toothpastes containing fluoride, as it’s the only ingredient proven to prevent tooth decay. While it’s important not to swallow toothpaste, fluoride is safe to use. The mineral occurs naturally in oceans, lakes, and rivers, though some cities add extra to the municipal water.

Fluoridated water can be beneficial for infants and toddlers who are still working on their brushing skills. If your community water supply doesn’t have it, you can also ask your pediatrician to prescribe fluoride drops or chewable tablets.

What about flossing?

Children should also floss daily if possible, but we realize adding another step to the routine may seem like a tough feat. Focusing on molars, which fall out later than front teeth and are harder to brush, is a first step. Toddlers can start practicing with flosser picks. When they get used to the idea, you can show them how to work the floss between their teeth. Just bear in mind many kids don’t master flossing until about age 8, so you’ll likely need to lend a hand each night.

Regular dental visits

Regular dental visits are also important. The ADA suggests bringing your child in before their first birthday or as soon as their first tooth comes in, then every six months moving forward. This will help them get used to the process early on. If you have dental insurance, signing them up for coverage at the same time you enroll them in medical insurance can help cover these visits!

Reviewed by the Ovia Health Clinical Team

Sources

• Cleveland Clinic. Parents: You May Not Start Brushing Your Child’s Teeth As Soon As You Should ― and Yes, It’s a Big Problem! Health Essentials. 2019. Web.
• Mouth Healthy. Healthy Habits. American Dental Association. Web.
• Mark AM. Your child’s teeth. Journal of the American Dental Association. 2019. DOI:https://doi.org/10.1016/j.adaj.2018.11.009
• American Academy of Pediatrics. Good Oral Health Starts Early. 2020. Web.
• Centers for Disease Control and Prevention. Children’s Oral Health. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion. 2022.
• Thornton-Evans G, et al. Use of Toothpaste and Toothbrushing Patterns Among Children and Adolescents — United States, 2013–2016. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion. 2019.