Kids and Vegetarianism

Kids and Vegetarianism: When Kids Don’t Like Meat

Vegetarianism poses a special nutritional challenge in the young

Kids and vegetarianism – Of the 15 million (or so) Americans who consider themselves vegetarians, no one knows how many have yet to celebrate their 21st birthday. Experts say, however, that adolescents make up the fastest-growing group of peopue who shun meat. But the nutritional needs of young people, particularly during growth spurts, may not be adequately addressed by some vegetarian diets. So what’s appropriate nutritionally and what’s not?

Is vegetarianism safe for children?

Well-planed vegetarian diets can be healthful for children over the age of two if they are carefully planned. These diet tend to be low in saturated fat, total fat, and cholesterol and tend to be high i fiber and comlex carbohydrates, as well as high in fruits and vegetables for iron.

What precautions are needed for primary- school-aged children who are vegetarian?

Preschool-age vegetarian children on lacto-ovo (eggs and dairy products are allowed) diets, lacto-vegetarian (dairy products are allowed) diets, and semi-vegetarian (no red meat) diets rarely have problems, except occasionally for the lack of iron. The children more likely to have problems are vegans; they don’t eat any animal products at all, including milk or eggs. Nutrient supplement can help prevent these problems, though.

What about teen vegetarians?

Vegetarian adolescents who drink milk and/or eat eggs have few problems if they follow basic nutrition guidelines. Vegetarian diets also seem to have little effect on age of menarche. There may be some effect on the menstrual cycle of female vegans, although these findings have not been substantiated. A vegetarian adolescent may benefit from iron and, possibly, zinc and calcium supplements. All adolescents should keep their ascorbic acid and iron intakes high via whole-grain and fortified cereals to prevent iron-deficiency anemia.

Churchill Park in Toronto, dogyard. Photo by Elena

Do teenage girls who are vegetarians need to take special precautions?

Once again, there may be problems with iron or calcium. When weights are very low, menstrual cycling may be abnormal or absent. Calcium needs are very high, and they are very difficult to meet on vegan diets. It is also very difficult to plan vegan diets that meed the RDA for zinc.

Can, like, greasy food cause acne?

Recent medical research has refuted years of received adolescent wisdom that a diet rich in chocolate and other greasy foods guaranteed a horrific acne eruption. The research shows no evidence to support a link between diet and pimples, except in people allergic to certain food. The true cause is increased production of sebum (and oily secretion) by the skin – a natural response to increased hormone levels during puberty. But doctors caution that even though candy bars and other greasy foods won’t cause acne, they are still high in fat and shouldn’t be eaten in excess.

Physical Development in Adolescents

Physical Development: The Body’s Wonder Years

Most teens will probably tell you that “normal adolescent development” is an oxymoron. But despite the awkwardness that goes with the change from child to adult, the transition is usually a predictable one.

Physical development in adolescent girls

Age noticeable change usually begins and stops:

Increase in rate of growth – begins at 10 to 11 and stops at 15 to 16. If noticeable growth fails to begin by 15, see your doctor.

Breast development – begins at 10 to 11 and stops at 13 to 14. Noticeable development of breasts (one of which may begin to grow before the other) is usually the first sign of puberty. If change doesn’t begin by 16, see your doctor.

Emergence of body hair begins – Pubic: 10 to 11, underarm – 12 to 13. Stops at 13 – 14 (pubic) and 15 – 16 (underarm). Development of body hair is extremely variable and largely dependant on heredity. Pubic hair usually darkens and thickens as puberty progresses.

Development of sweat glands under arms and in groin: Begins at 12 or 13. Stops at 15 or 16. Sweat glands are responsible for increased sweating, which causes underarm odor, a type of body odor not present in younger children.

Menstruation: The change begins at 11 to 14 and stops at 15 to 17. Menstruation often begins with extremely irregular periods but by age 17, a regular cycle (3 to 7 days every 28 days) usually becomes evident. If menstruation begins before 10 or has not begun by 17, talk to your physician.

Adolescent Girl. Photo by Elena

Physical development in adolescent boys

Age noticeable change usually begins and stops:

Increase in rate of growth – begins at 12 to 13 and stops at 17 to 18. If noticeable growth fails to begin by 15, see your doctor.

Enlargement of genitals: Testicles and scrotum – change begins at 11 to 12 and stops at 16 to 17. Penis – 12 to 13 and 15 to 16. As testicles grow, the skin of the scrotum darkens. The penis usually lengthens before it broadens. Ability to ejaculate seminal fluid usually begins about a year after the penis starts to lengthen.

Emergence of body hair begins – Pubic: 11 to 12, underarm – 12 to 13. Stops at 15 – 16 (pubic) and 16 – 18 (underarm). Development of body hair is extremely variable and largely dependent on heredity. Development of hair on the abdomen and chest usually continues into adulthood.

Development of sweat glands under arms and in groin: Begins at 13 or 15. Stops at 17 or 18. Sweat glands are responsible for increased sweating, which causes underarm odor, a type of body odor not present in younger children.

Voice change: begins at 13 to 14. Stops at 16 to 17. Enlargement of the larynx, of voice box, may make the Adam’s apple more prominent. The voice deepens at 14 to 15, and may change rapidly or gradually. If childlike voice persists after 16, see your doctor.

(Source: American Medical Association Family Medical Guide, Random House).

Calendar for Kid’s Shots

Calendar for Kid’s Shots

The experts finally agree on an immunization schedule

For years, federal health officials at the Centers for Disease Control recommended a childhood immunization schedule that was followed in public health clinics, while the American Academy of Pediatrics put out a different one that was used widely by private practitioners. Now the two groups have finally issued a uniform timetable for vaccinating children (see below). The schedule clears up discrepancies over when to administer oral polio, diphtheria, pertussis, and tetanus (DPT); measles, mumps, and rubella (MMR); and infant hepatitis B vaccines.

Since the late 1980s the number of vaccine doses recommended for children has increased from 9 to 15. What’s more, federal health officials recently approved a vaccine for chicken pox. The vaccine is reported to be only 90 percent effictive in preventing the childhood disease, but in nearly every case, says Food and Drug Administration Commissioner, “almost all of the vaccinated patients who got chicken pox had a milder form of the disease.”

The vaccine is expected to be administrated to children 12 to 15 months old and to people over 13 years old who have not had the disease already.

To promote universal childhood vaccination, the Clinton administration persuaded the Congress to pay for immunizing children who are uninsured, poor, or of Native American or Native Alaskan ancestry. Much of the states had elected to make vaccines available free through public health clinics while the other states are working through private physicians and reimbursing them. State Medicaid programs remain responsible for supplying vaccines to children enrolled inn Medicaid. For the situation in your state, contact your state health department’ immunization program.

Recommended Childhood Immunization Schedule

The Centers for Disease Control and the American Academy of Pediatrics are America’s leading authorities on childhood immunization. But until recently they disagreed about when children should be immunized. Below is their unified immunization schedule.

Vaccine, First Dose, Second Dose, Third Dose, Fourth Dose, Fifth Dose, Sixth Dose

Hepatitis B – Before 2 months, 1 – 4 months (1), 6 – 18 months.

Diphtheria, Pertussis, Tetanus (DPT) – 2 months, 4 months, 6 months (1), 12-18, 4-6 years (booster) (2) 11-16 years.

H. influenza type B – 2 months, 4 months, 6 months, 12-15 months (booster). (3).

Polio – 2 months, 4 months, 6-8 months, 4-6 years.

MMR – 12-15 months, 4-6 years or 11-12 years. (4)

(1) – Allow at least one month after previous dose before administering next.

(2) – Allow at least five years after previous dose before administering next.

(3) – Children who get an H. Influenza vaccine known as PRP-OMP do not require a dose at 6 months, but still require the booster.

(4) Depends on state school requirements.

Newborn's Weight

Sizing Up the New Arrival

A newborn’s weight cannot be used to predict a child’s future size.

Ask any parent what she or he remembers from the birth of a first child and one of the first details likely to be recalled is the baby’s birth weight and height. What is to be made of these vital statistics that are so proudly reported? 80% of all infants born in the United States fall between 5 pounds 11 1/2 ounces and 8 pounds 5 3/4 ounces at birth. About 1 in 10 newborns weighs in above the range; an equivalent number is below the low end of this zone.

Where your child is on this continuum may depend on a number of factors. For instance, the longer a pregnancy goes on, the larger the infant is likely to be, while an unborn baby’s growth may be limited by poor nutrition or other complications during pregnancy. Smoking, drinking, or drug use by the mother during pregnancy can also stunt development.

Heredity also plays a part, though it’s no guarantee of how large an infant will grow up to be. While babies whose parents are unusually large or small may reflect their parents’ size at birth, an infant’s birth size should not be taken as a predictor of a child’s eventual size, according to the American Academy of Pediatrics.

Babies whose birth size is larger or smaller than average may find life beyond the womb difficult at first. Large babies sometimes experience trouble with their blood-sugar levels and need extra feedings to avoid hypoglycemia. Small babies may find feeding difficult or have trouble maintaining proper body temperature.

A newborn’s birth size can be a tip-off to doctors and nurses that a baby will require special attention for a few days. But more often than not, these stats will be used mainly as benchmarks by parents and pediatricians in following an infant’s advance through childhood.

God`s Garden. The Kiss of the Sun for Pardon. The song of the birds for Mirth. One is nearer to God in a Garden than anywhere else on Earth (Dorothy Frances Gurney, dedicated to the Glory of God by friends of the St. James Park). Photo by Elena

Rating a Newborn’s Health

Within a minute of delivering a baby, the obstetrics team will check the newborn’s heart rate, respiration, muscle tone, reflexes, and coloration and record a score designed to reflect how that baby came through the delivery process. That rating, known as an Apgar score, is compiled by issuing a ranking between zero and two for each of the vital signs and indicators listed above, and then adding each of the numbers together to arrive at a single score. The process is then repeated five minutes after birth and the two sets of observations are compared to gauge the baby’s progress in adjusting to his or her new environment. But Apgar scores are not intended as a reliable predictor of a baby’s long-term health prospects, only of how the newborn is adapting to life outside a mother’s womb.

Component and Apgar Score

    Heart Rate Absent – Slow (less than 100 beats/minute) – More that 100 beats/min.

    Respiration – Absent – Weak; hypoventilation – Good, Strong cry.

    Muscle Tone – Limp – Some Flexion – Active Motion.

    Reflex Irritability – No response – Grimace – Cough or sneeze.

    Color – Blue or Pale – Body Pink; extremities blue – Complete pink.

When the Stork is a Midwife

When the Stork is a Midwife

Nurse midwives are better-trained and increasingly common today

The image of the midwife from medieval and pioneer times was not one to inspire confidence. But much has happened in recent years to professionalize the role of midwives in assisting childbirth, and today almost 1 in 20 births are attended by a registered nurse trained as a midwife. Kimberly Pool of the American College of Nurse-Midwives explains what a certified nurse-midwife can – and can’t – do.

What types of midwives are there? – The two basic categories are nurse-midwives and lay midwifes. Lay midwives are people who help women deliver their babies but are not necessarily nurses and differ widely in their level of education and experience.

Nurse-midwives are registered nurses who have completed additional training in obstetrics and gynecology. Often they are certified by passing a national exam administered by the American College of Nurse-Midwives. To qualify for the exam, they must spend a minimum of 18 months learning clinical midwifery skills and advanced obstetrics and gynecology for normal women, as well as newborn care and family planning.

What do nurse-midwives do? – By education and experience, a nurse-midwife is qualified to be the main caregiver for healthy women throughout pregnancy and childbirth, and to provide gynecological and family planning care throughout a woman’s childbearing years. In most states they have the authority to write medical prescriptions.

The nurse-midwifery policy is to consult with a doctor when a condition arises in pregnancy or labor that is considered to be medically dangerous. In most cases this means that the mother is not healthy, has high blood pressure, gestational diabetes, an abnormal metabolism, infections, or an improperly developed fetus or placenta.

Midwife. Photo by Elena

Where do nurse-midwives deliver babies? – Many people envision a birth at home when they hear the word “midwife.” Bust the vast majority of nurse-midwives work in hospitals – about 85 percent. Another 11 percent work in birth centers, and the remaining 4 percent attend home births.

What kind of backup do nurse-midwifes have if something goes wrong? – Whether a problem is apparent during the first prenatal visit or does not arise until the final hour of labor, a nurse-midwife is taught to call in a doctor as soon as the woman’s condition strays outside the boundaries of a nurse-midwife’s expertise. The mother may be referred to the consulting doctor for medical care, or the physician and the nurse-midwife may co-manage the care, depending on what the complication is.

Are doctors always willing to work with nurse-midwives? – Not all doctors think highly of nurse-midwives, but as the number of certified nurse-midwives increases, this attitude is decreasing. A policy statement issued by the American College of Obstetrics and Gynecology and the American College of Nurse-Midwives states that the maternity car team should be directed by a qualified ob/gyn with written medical guidelines that define the individual and shared responsibilities of the doctor and nurse-midwife. These procedures include periodic and joint evaluation of services performed, including chart review, case review, patient evaluation, and review of data on the health of babies over time.

How do nurse-midwives differ from doctors? – Nurse-midwives are trained to treat normal, healthy women, and in that capacity they celebrate the normal. Doctors are trained to handle the emergency situation and because they have spent much more of their training on what to do if something goes wrong, they may be more likely to treat a normal pregnancy as if it were a high-risk situation waiting to happen.

Do nurse-midwives only deliver babies “naturally”? – Nurse-midwives use technology when it is needed to learn something about the pregnancy that they otherwise would not know. During labor, nurse-midwives induce labor, break waters, start intravenous lines, use fetal monitoring equipment, and prescribe analgesics when it is medically necessary, thereby minimizing side effects and often ensuring that labor progresses more quickly.

What is the record for nurse-midwives delivering babies? – Over the years nurse-midwives have maintained a superb safety record. Research shows that pregnancy, labor, and delivery for a healthy woman is as safe with a nurse-midwife as with a physician. Studies have also shown that the rate of Cesarean sections, episiotomies, infant and maternal mortality, and low birth weight are often much lower than average among women being cared for by a nurse-midwife.

In fact, government reports have called for an increased use of nurse-midwives as a safe way to improve maternity care.

How does the cost of using a nurse-midwife compare with using a doctor? – Having your baby with a nurse-midwife usually costs less than obstetrical care with a physician in a hospital. The cost of midwifery care usually varies with the setting; most costly is a nurse-midwife in private practice with a hospital birth.

The least expensive is usually a home birth, which may cost a fraction of the price of a hospital birth. Birth centers fall somewhere in the middle. These differences may be significant or minimal; it all depends on the community.

Are nurse-midwives’ fees covered by insurance? – All 50 states provide Medicaid reimbursement for nurse-midwifery care, regardless of whether the birth occurs in a hospital, birth center, or home.

In many states, insurers are required to reimburse for nurse-midwifery care, although not necessarily in all possible birth settings.

They Stand ad Deliver

A resource guide for those who are considering childbirth options

For more information on certified nurse-midwives:

• American College of Nurse-Midwives.

For information on lay midwives:

• Informed Homebirth/Informed Birth and Parenting;
• National Association of Childbearing Centers;
• Midwife Alliance of North America.

A girl. Illustration by Elena.