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Gone are the days of soggy PB&Js on white bread: Today’s school lunch is your chance to create a healthy, colorful midday meal! Here are a few simple tips, a week of lunch ideas and a shopping list to help you pack a lunch that won’t be offered up for trade during tomorrow’s lunch hour. While school lunches are getting healthier, packing and taking a lunch to school will ensure that your child is getting a healthy, well-balanced meal. Making lunches should be a team effort. Your kids can help pack their lunches by spreading on condiments or putting food in containers. To save time in the morning, pack lunches the night before. The following are a few suggested items you can use to ensure your child is eating a tasty but nutritious lunch: Main dishes Lunch meat and lowfat cheese roll ups English muffin pizzas Sandwich wraps – meat, cheese and veggies in a whole grain tortilla Pita pockets stuffed with grilled chicken and vegetables Soup Chef salad with spinach, veggies, cheese, lunch meat and dressing Tuna or chicken salad on a mini bagel Snacks and sides Fresh or dried fruit Natural apple sauce Baked tortilla chips and salsa Veggie sticks and hummus Cheese slices or string cheese with whole grain crackers Homemade trail mix with nuts, seeds and raisins Pudding Homemade fruit roll ups Popcorn (add different toppings such as salt, garlic, cinnamon, sugar or cayenne pepper) Drinks Water If you child doesn’t like plain water, try adding a few slices of fresh fruit (strawberries, lime, lemon) for more flavor. School Lunch Menu: Day-By-Day We’ve put together a week’s worth of colorful, fun and healthy school lunch ideas your kids will love. And we’ve also created a shopping list to help you easily locate all the ingredients on your weekend shopping trip. Monday: Turkey BLTA Roll-ups Roll-up Ingredients Turkey, cold cuts Bacon Avocado Tomatoes Side Dish Choices Blueberries Cucumbers Carrot sticks Tuesday: Bacon & Cucumber Sandwich Sandwich Ingredients Whole wheat English muffin Cucumber Bacon Side Dish Choices Apples slices Strawberries Vanilla yogurt mixed with sprinkled cinnamon Wednesday: DIY Lunchables Lunchables Ingredients Crackers Turkey, cold cuts Cheese Side Dish Choices Blueberries Carrots Cucumber Thursday: Veggie Grilled Cheese Veggie Grilled Cheese Ingredients English muffin Cheese Tomato Spinach leaves Avocado Side Dish Choices Apples slices Strawberries Vanilla yogurt mixed with sprinkled cinnamon Tomatoes Friday: DIY Pizzas DIY Pizza Ingredients 2 toasted English muffins Pizza sauce Cheese Turkey pepperoni Side Dish Choices Celery Black olives Shopping List (under 20 items) Cold section: Dairy 1 large container of vanilla yogurt 1 package of your favorite cheese  Cold section: Deli meats 1 package of turkey pepperoni 1 package bacon 1 package turkey cold cuts Inside aisles Whole wheat English muffins 1 can of whole black olives 1 jar of pizza sauce 1 box of whole wheat or multigrain crackers  Produce department 1 cucumber 1 stalk of celery 2 apples 1 container of strawberries 1 avocado 2 tomatoes 1 bunch of spinach leaves 1 container of blueberries 2 carrots  For more healthy school lunch box options, visit our Kids Health & Nutrition board on Pinterest.

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Sometimes, children’s asthma masks itself in symptoms that can be similar to other common respiratory problems. Dr. Shipra Singh of Renown Medical Group – Pediatrics discusses some diagnoses and treatments for asthma in children. Adults can easily recognize when we are out of breath or struggling to breathe, but what if you noticed this regularly happening to your infant or child during their daily play? Would you think they might have asthma? It may be difficult to tell if your small child has asthma because the symptoms can be similar to other common respiratory problems (bronchitis, croup, pneumonia) or even allergies. Read on to learn how to spot and manage asthma in your infant or child with advice from Shipra Singh, M.D., MPH, Pediatric Pulmonologist at Renown Medical Group – Pediatrics. According to the Centers for Disease Control, asthma in children is a leading chronic illness and cause of school absenteeism in the U.S. Asthma is a multi-factorial disease. Smoking during pregnancy or a family history of allergies or asthma has been linked to a greater chance of developing childhood asthma. Asthma is usually on a spectrum and not a single disease. It can range from mild to severe. Because an infant’s or toddler’s airway is smaller than in older children and adults, even a slight blockage caused by mucus or a restricted airway due to swelling can make breathing hard for them. In children five and younger, one of the most common causes of asthma symptoms is a respiratory virus, which narrows the airways in the lungs. These include a cold, the flu, bronchitis, pneumonia and other illnesses. How can I tell if my child has asthma? Unfortunately small children are unable to describe their symptoms, making asthma difficult to diagnose. Your child may even be active, playing and smiling, although they are experiencing chest tightness or labored breathing. Observe your child and let the child’s doctor know if: Your child’s breathing behavior has changed (coughing, wheezing, rapid breathing) Your child’s breathing pattern changes (day vs. night, with rest or activity, inside vs. outside) You have a family history of asthma or allergies Your child’s breathing is triggered by any foods or allergies With your help, your child’s doctor can make the best diagnosis to determine if your child has asthma. A pediatric pulmonologist (lung specialist) or pediatric allergist may also have to be consulted for special testing. Tests may include lung function testing, allergy tests, blood tests and X-rays for an accurate diagnosis. What is the treatment for infants and toddlers? Young children can use many of the same medications as older children and adults, although the way they take them and the dosage will differ. A nebulizer (or breathing machine) creating a medicated mist for your child to breathe through a mask may be used. An inhaler with a small spacer tube connected to a mask is also common to help your child breath medication into their lungs. Either of these options are effective. Asthma in children is treated with both fast-acting and long-term medicines to open up airways quickly for easy breathing and also to lessen asthma symptoms over time. Communicate with your child’s medical providers to create a personalized asthma management plan for them. How can I manage my child’s asthma? Recognize your child’s breathing habits and be aware of worsening symptoms. Consult with your child’s doctor on a daily asthma action plan to recognize worsening symptoms and track medications. (Here’s an example of an asthma action plan provided by the U.S. Department of Health and Human Services’ National Institutes of Health). Be consistent with the plan and talk to your doctor before changing it. Have an emergency plan in case of a serious asthma attack. Know where the closest ER is and know who can take care of your other children. Also know what the medical treatment coverage is under your insurance plan. We asked Dr. Singh about asthma in children: “Discussing asthma with your child may be a difficult subject. Some kids find the subject frightening or confusing. Others, especially the older kids, may be resentful of the treatment and may not be interested in doing the treatment. Talk to your doctor about advice to build an open and trusting relationship regarding your child’s asthma care.” What can I do to reduce my child’s asthma? Know your child’s asthma triggers (dust, pets, pollen, etc.) Follow your asthma action plan Keep your child away from smoke Can my child outgrow their asthma? Asthma symptoms change day to day and year to year. An older child can better recognize and manage their symptoms, so asthma episodes may lessen. However asthma is a life-long condition of the airways, so it is important to always have an asthma action plan, even with occasional asthma events. Renown Health Pediatric Care | Same-Day Appointments: 775-982-KIDS Our team of pediatricians, specialists and nurse practitioners have specialized training in children’s healthcare needs. We see children from birth to age 18 for the following pediatric needs: Wellness and preventive visits Sick visits Immunizations Behavioral health Allergy Asthma Common cold Diabetes  Asthma resources for parents: Asthma and Allergy Foundation of America Centers for Disease Control and Prevention

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Parents often struggle with installing and choosing car seats for their children. Picking out a car seat for your child is a never-ending battle. Safe Kids Washoe County has made it simple for you to understand the types of car seats that will work for your child. Types of Car Seats Rear-Facing Only Seat. Your baby's first car seat is often used from 5 to 40 pounds. People usually buy this type of seat because it is portable. Convertible Car Seat. This seat is larger and stays in the car; it may be rear-facing until your child is two years or more. After that, it can change to a forward-facing seat. Forward-facing-only car seat. This type of seat is used in one direction and has a 5-point harness and top tether.  Combination seat. This is a forward-facing seat with a 5-point harness and top tether and can change into a booster seat when you remove the harness.  3-in-1 car seat. This seat also stays in the car. You can use it rear-facing, forward-facing, and then later, as a booster seat. Booster seat.  It boosts the child for a safer and more comfortable fit of the adult seat belt. Make sure your child has outgrown the weight or height limits allowed in the forward-facing car seat. The seat belt must lie flat across your child's chest, on the bony part of the shoulder, and low on the hips or upper thighs. Most children will be between the ages of 8 to 12 years old before they are ready for the seat belt alone. Have a trained car seat technician check your installation Why: 3 out of 4 car seats are installed improperly, with some studies show that the misuse rate is 90%, with the average car seat having three mistakes. Solution: Ensuring that your child's car seat is installed correctly by a certified car seat technician will ensure your child's safety.

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Car seat technicians often find parents are moving their child to their next car seat stage too soon, as they get older. Here are a few reminders of when to transition your child from their booster seat to a seat belt. Moving to a booster seat too soon According to Safe Kids Worldwide, nearly 9 in 10 parents remove children from their booster before they’ve reached the recommended height, weight, or age of their car seat recommendations, which leaves the seat belt in a position on the child that could injure them. If the child is not the proper height, the seat belt can rise up on the belly, instead of the hips where it’s supposed to sit, which can lead to spinal cord damage or whiplash in the event of a car crash. Solution: You can switch from a car seat to a booster seat when your child has topped the weight allowed by the car seat manufacturer; typically 40 to 80 pounds (18 to 36 kilograms). Remember, however, that your child is safest remaining in a car seat with a harness for as long as possible. Booster seats must always be used with a lap and shoulder belt — never a lap-only belt.  Transitioning to a safety belt too soon Older children need booster seats to help ensure the seat belt stays properly positioned on their body. The lap belt should lie low across the child's hips and pelvis with the shoulder belt crosses the middle of the child's chest and shoulder, so that in the event of a crash, the forces are applied to the hip bones and not the abdomen. If the lap belt is not positioned properly then it could lead to injuries to the spinal cord and abdominal organs.  Solution: Most kids can safely use an adult seat belt sometime between ages 8 and 12. Always use a booster seat until the child passes the 6-step test Your child reaches a height of 4 feet, 9 inches (nearly 1.5 meters) Their back is flat against the seat back. Knees bend over the edge of the seat and feet are flat on the floor. The shoulder belt sits on their shoulder and chest (not face or neck.) The lap belt sits low on their hips and touches their upper thighs (not on their stomach.) Your child can sit comfortably this way for the entire trip.   The American Academy of Pediatrics reminds us that the back seat is the safest place for children younger than age 13.

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We’ve all been there: Your child gets sick right after urgent care closes — or worse, in the middle of the night. So do you wait it out, or do you load up and head to the Children’s ER? Pediatric Emergency Physician Joey Gassen, MD, with Northern Nevada Emergency Physicians, has insight. As parents, we often wish we had all the answers. And while a short-and-sweet comprehensive parenting guide is elusive, we can help if your questions involve whether to go to the children’s ER or wait it out. Here, a pediatric emergency physician explains when you should take your child to the Children’s ER at Renown Children’s Hospital, and what makes a children’s ER different. How do you know when it’s time to take your child to the ER? Having a sick or injured child is stressful. If you have a true emergency, you should go straight to the ER or call 911. When to go to the ER: Allergic reactions Asthma or severe shortness of breath Fever (infants less than two months old) Choking or poisoning Coughing up or vomiting blood Fainting, confusion or seizures Fractures or broken bones Head injuries Severe bleeding If you determine your child’s condition isn’t life-threatening but needs to be taken care of right away, urgent care is the best choice. Those conditions include: Cold and flu Coughs and sore throat Fevers Vomiting, diarrhea, stomach pain Cuts and severe scrapes Minor injuries and burns What is different about Renown Children’s ER compared to the adult ER? The difference starts when you first bring your child in. We have a lobby dedicated to our community’s smallest patients. The 24/7 lobby incorporates a child-friendly atmosphere with vibrant colors to help decrease anxiety that can accompany emergency situations. Our children’s ER also has equipment sized just for kids of any age. We offer a distraction machine, as well as games and movies, to help children cope with what can be a traumatic experience, like getting an IV. In addition, we have Child Life Specialists available to provide the emotional support to both children and their families. Why is it important to have an emergency room and lobby open 24/7 dedicated to children? Children aren’t just little people. They have special needs that require specialized care. Our children’s ER is staffed with skilled physicians and pediatric nurses certified in advanced pediatric emergency care to give your child the highest level of support. Renown Children’s Hospital From newborns to teens, Renown Children’s Hospital offers many different services and treatments designed specifically to take care of our community’s children. We provide a range of specialized services — from a dedicated Children’s ER and Pediatric ICU to a children’s imaging center and child’s asthma program. Explore Children’s Services

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