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My 10-year-old daughter is passionate about gymnastics. She has been training since she was six and tells me everyday that she’s going to the Olympics. I’m pleased with her focus and discipline, but I also don’t want her to suffer from injuries, over-training, or even an eating disorder. What’s the best way to guide her?
 You are absolutely on target to monitor your daughter for over-training. Recently, I have seen an increase in referrals due to concerns with weight management and diet. It may come as a surprise to parents that food restriction and injuries are often related, and result from a combination of factors known as the Female Athlete Triad.
The Female Athlete Triad can cause both short and long-term problems to the developing body of a young athlete. It often begins with a desire to become as “fit” or lean as possible. Athletes sometimes believe that the less they weigh, the stronger, faster, or more powerful their performances will be. Unfortunately, the opposite is more often true. The results are often a decrease in performance and an increase in depression and anxiety. Here are the conditions of the Female Athlete Triad:
1. Disordered Eating: Restriction of food intake or purging of food to lose weight. Athletes will often consume far less calories than their developing bodies need to support the exercise they are participating in.
2. Amenorrhea: The absence of menstrual cycles for longer than six months is caused by having a very low percentage of body fat, leading to a drop in estrogen.
3. Osteoporosis: Critical bone development and building of bone mass/density occurs during a woman’s teenage years. When a young athlete restricts her food intake, her bones are weakened and the risk of injury is high.
Here are some warning signs that your athlete may be in danger: weight loss, irregular periods or a delay in menstruation, fainting or chronic fatigue, stress fractures and a preoccupation with food.
What should you do if you are concerned that your child may be suffering from the Female Athlete Triad? Schedule a visit with a physician. Your doctor will help you and your daughter determine what is contributing to her symptoms and if she is safe to continue athletic training and at what intensity level. Also, a Sports Psychologist is trained to work collectively with your doctor, family, coaches, dietician, trainers, and most importantly, your child athlete during talk therapy treatment. The goal is to establish and maintain a healthy weight that can support the physical demands of sports training and competition. With proper treatment, sports participation should continue to be a positive, healthy, and fulfilling activity for your family. —Dr. Casey Cooper
My 6-year-old son thinks it’s hilarious to burp at the dinner table. I keep asking him not to, but I think my nagging is just encouraging him. How do I teach him it’s not OK?
I think most parents of boys can resonate with the issue that you are having. Boys tend to find their bodily functions hilarious when societal norms do not make it acceptable. Having a conversation about table manners and the rules/expectations of your 6-year-old at the dinner table might be a good place to start.
 I would take a look at your dinner time routine. Do you involve your son in the dinnertime topics? Do you tend to notice his burping increases when he is not included in the conversation? Is your son getting a positive reaction (laughing) from other family members at the dinner table?
Since you believe your nagging has encouraged his burping behavior more, try these things:
- Set up clear house rules that are short and simple, including table
manners. Make those rules/expectations the same for all family
members (including parents).
- Praise your son for showing good table manners.
- Make a reward/game out of good table manners for example, give“manner dollars” when your child has not burped at the dinner
table for which he can use to earn dessert or other small rewards.
- Find a book about manners that you can read together and have an
open dialogue about the expectations in your home. Be firm and
stick to your expectations. Assign your son the job of being the“manner police.” Have him reward other members of the family
with “manner dollars” when he witnesses good manners.
- Use a warning system. First warning, “Let’s try and not burp so we
can show that you are well behaved at the dinner table.” Next
warning, “You will need to leave the table and sit in a designated
area if you cannot show me that you can have good table manners.” Final warning, remove your son from the dinner table.
Consistency is the key in eliminating a behavior. Instead of nagging, try to reframe your child’s unruly behavior by saying positive things like, “I know you have such good manners, I know you can be a role model for your sister.” If you have applied these suggestions, and believe you and your family need additional advice, I recommend seeking professional help. To locate a California Licensed Therapist, visit www.TherapistFinder.com. —Lori Breeden-Gomez
I am going to fly cross-country with my toddler and I’m totally dreading it. How can I ensure a smooth flight for everyone involved: myself, my son, and all the passengers on board?
When my twin sons were two and a half, we set out on a cross-country trip to visit their grandmother. Yes, just me and two 2-year-olds! Believe it or not, we arrived at grandmother’s house in good spirits! It took pre-planning on my part, but the extra effort was worth the boy’s contentment during the trip.
Three things you’ll need: patience, more patience, and a toddler flight kit.
The week before the trip, designate a backpack as your child’s flight kit bag. Encourage your child to put a few of his favorite books and toys in the bag as the week progresses. Having a few familiar things on board helps to lower your child’s anxiety.
Now, it’s your turn to gather a few surprises to add to his bag:
- Fill a small baggie with cheerios and a shoestring. Tie a large knot
on one end of the shoestring. Your child will enjoy stringing the
cheerios and can munch along the way, too!
- Gather a few old-fashioned comic books and include an egg of
Silly Putty. Even young children can press the silly putty on the
comic book pages to make impressions.
- Add washable crayons and a new coloring book.
- A roll of tape and a small pad of paper keep a toddler happy and still for quite a long time. I’m amazed when I watch the creativity of a three-year-old with a roll of tape and paper!
- Draw a frame on blank pieces of paper. Ask your child to create a work of art!
 I’m sure you can think of more things to add to your toddler’s flight kit. Don’t allow your child to play with any of the goodies until the flight. Build up his suspense, so he looks forward to the trip and discovering what’s in his bag!
When all else fails, be prepared to tell stories. Play “I Spy.” Find something on board for each letter of the alphabet.
Hopefully, you won’t have to worry about that unavoidable question “Are we there yet?” When wise old Papa Smurf couldn’t take it anymore, he bellowed back, “NO, we’re not there yet!” And they were hiking across the mountains in the outdoors, not crossing the country in a tiny seat being told to sit still and stay quiet for three hours!
I know we’ve all been tempted to just scream, “NO!” to our own children, but hopefully the toddler’s flight kit bag will make those long trips enjoyable for you, your children, and those around you.
—Jill Rigby
With so much talk about childhood obesity, I want to take a pre-emptive approach with my 5-year-old son. We have a history of obesity and diabetes in the family, and I’m sure my son is susceptible, just because of his genes. But I don’t want that to be an excuse. What’s the best way to approach my child’s nutrition?
 Childhood obesity is an epidemic in the United States. In the last two decades, the number of overweight children has doubled. One in five are categorized as medically overweight. Genetics play a role, but that alone does not account for this alarming increase. According to recent studies, changes in the quantity and quality of nutrition, a reduction in physical activity, an increase in sedentary lifestyle, media consumption, and lack of sleep all contribute to childhood obesity.
However, there are some simple ways parents can win the war against childhood obesity. Suggestions include:
- Do not use food as a reward or punishment.
- Involve your children in meal planning and grocery shopping. This helps them learn about food labels and nutrition, as well as gives them a role in the decision making.
- Eat balanced meals and sneak in nutrition wherever you can. Try adding ground flaxseed and vegetable purees in any of your baked breads, muffins, pancakes, cookies, brownies, etc. Add blueberries on top of non-sugar cereals or oatmeal. Use soy nut butter instead of peanut butter for sandwiches. And eat dinner at home together as a family instead of in front of the television.
- Limit juice intake and eliminate soda completely. Healthy drink options include water and 100% pure organic juice (preferably orange or others with plenty of Vitamin C).
- Keep healthy snacks on hand. Options include fresh or frozen fruits and vegetables, low-fat cheese, cottage cheese, fat-free frozen yogurt, frozen fruit juice bars, and lean protein such as grilled chicken strips or turkey breast. Another option is a healthy smoothie.
- Get your kids outside and set strict guidelines for the amount of time allowed for watching television or playing video games.
- Keep them moving. It’s well documented that children today are moving less; it has become imperative that parents play a more active role in their child’s physical activity. Plan weekend family physical activities such as hiking, family bike rides, walking the dog or going to a park. Encourage but don’t push your children to pick up a sport. It’s important they are interested in it otherwise it can become a negative experience. —Dr. Steven Chen
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