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Past editions of the Arkansas Healthy Childrena€™s Handbook were coordinated and produced by the Child & Adolescent Health Team at the Arkansas Department of Health with funding provided by the Arkansas Department of Health and the Arkansas Department of Human Servicesa€™ Division of Child Care and Early Childhood Education. This 2012 version has been coordinated and produced by the Arkansas Department of Human Servicesa€™ Division of Child Care and Early Childhood Education, Health and Nutrition Unit with funding provided by the Arkansas Early Childhood Comprehensive Systems Initiative Grant. As child care providers and educators, you are the front line in protecting and promoting the health of our children.
Division of Child Care and Early Childhood EducationNote: While several Arkansas agencies and medical doctors provided information for this handbook, some of the material in this handbook is excerpted from a similar handbook produced by the Lincoln- Lancaster County Health Department in Nebraska. You will find useful, important information throughout this guide, but I ask that you pay close attention to the section on nutrition and physical activity.
At the simplest level, preventing obesity is about balancing the energy taken in through food and beverage with the energy expended through physical activity. Because childhood obesity is so prevalent these days it is sometimes difficult for parents to recognize when a childa€™s weight becomes unhealthy.
Many researchers and health professionals agree that if we dona€™t reverse the obesity epidemic, the current generation of young people could be the first in U.S. On behalf of the Arkanas Childhood Comprehensive System Initiative, the Medical Homework group would like to thank the following for generously giving of time and resources to make the Sixth Edition of the Arkansas Healthy Children Handbok (2012) a great success.
The Arkansas Healthy Children logo represents the intersection of four components of wellness: healthcare, nutrition, physical activity and safety. If something is wrong with your health or your childa€™s health, you should see your doctor. Medicaid and most other insurance programs pay for children to see the doctor even when theya€™re not sick.
Your doctor asks you about what your child needs and works with you and others to meet those needs.
Someone at your doctora€™s office helps you if your child needs a specialist or other services. The doctor makes sure everyone who helps take care of your child has the information they need. The people at your doctora€™s office help you if your child gets sick or has a special need.
The Patient-Centered Medical Home in Arkansas is an approach to providing comprehensive primary care for children, youth and adults. The following information describes normal growth and development and ways to encourage development in children.
Growth refers to the body getting larger in size and development to the body becoming more skilled or mature. Environment (living conditions) a€“ The most important environmental factor affecting growth is good nutrition (eating a balanced diet).
Gross motor skills a€“ the overall tone, strength and coordination of a child; how well a child is able to roll, sit and walk. Fine motor skills a€“ hand-eye coordination and the ability of a child to grab and release small objects. Cognitive, linguistic and communication skills a€“ how a child receives the information, thinks and expresses it. Since rates of growth and development vary in each child, use the following information as a general guide. They gain 3 a€‘ 4 ounces a week from 6 months to 1 year, tripling their birth weight by 1 year (7 pounds at birth = 21 pounds at 1 year).
By their first birthday, babies have increased their birth length by half of their birth length. Put on stomach and place brightly colored toys 8 a€‘ 10 inches in front of face, or make soft noises in front of head to encourage lifting of head. When an infant cries, check to see if he or she is hungry, wet, too cold or hot, or uncomfortable. If these measures dona€™t work after about two minutes, pick up baby, swaddle (wrap snugly with a blanket), and hold close or rock or walk; this gives a feeling of closeness and warmth. Stares at objects held about 8 a€‘ 10 inches in front of him or her (likes human faces and bright colors best). Cries to let you know needs a€“ calms down when needs are met (food, dryness, warmth and loving). Provide lots of time for sitting up (support head and back until good head control is complete). Have the same person care for the same babies as much as possible; this helps them learn to trust and develop relationships with others. Reaches for object, holds object in hand and can bring hands together (like clapping); looks for object that goes out of sight.
Shows signs of attachment to important caregiver(s) (father, mother or usual child care provider). Give toys such as: spoons, plastic containers and cups, balls, large blocks, and pots and pans.
Begin using simple commands and show child what your words mean (for example: a€?sit downa€? or a€?come herea€? and use hand gestures at the same time).
Provide toys that are age-appropriate and challenge the child to learn (like ina€‘anda€‘out toys, pusha€‘pull toys, stacking cones, music boxes and jacka€‘ina€‘thea€‘boxes). Pulls self up to a standing position; may be able to stand alone and may take several steps while holding on. Have safe play area outdoors and indoors for using large muscles (running, climbing, throwing and jumping).
Let children begin to play with each other a€“ expect mostly individual play, but they do enjoy being near one another.
Children play side by side not really interacting with each other a€“ may do the same activity near others a€“ no real concept of sharing. Continues to develop independence a€“ begins to say a€?noa€? when asked to do things or asked questions. Good toys and games are blocks, toys to climb on, dressa€‘up clothes, items to play house with, and colorful picture books. Develop classification skills by making collections of similar objects for children to sort and compare: buttons, small plastic objects, spools, lids, etc.
Encourage selfa€‘expression through creative activities, such as drawing, painting and dramatic play.
Encourage positive peer support by using the a€?buddy systema€? a€“ pairing more outgoing child with shy child.
Provide simple, honest answers to their why, what, where questions.Continue to teach problem-solving skills through stories, games and actual situational opportunities.


Tries out silly words and sounds; trying a€?four-lettera€? words (curse words) is typical and should be dealt with calmly.
Present relevant problems or use actual situations to let children provide possible solutions.
Babies are born with the ability to feel pleasure in their genitals and other erogenous zones.
By the time they begin to speak (18 months to 2 years), children know whether they are male or female.
Children of both sexes may experience sex play with other children, especially samea€‘sex friends. Children begin to learn how to make and keep friends, and may go through a period of disliking opposite-sex children. Sex play among children is common and, like other play, is a normal expression of curiosity. If children exhibit frequent aggressive behavior, overt sex act behavior or seem preoccupied with sex over a period of time, particularly toward children significantly younger (a two-year difference), consult with your public health nurse or other health professional.
Never allow an infant to fall asleep with a bottle that contains milk, formula, juice or any sweetened liquid. Please note: When you look at the tooth chart, you are looking into a persona€™s mouth with the jaws open. A national campaign (the a€?Back to Sleepa€? campaign) was launched in 1994 to promote supine (lying on back) positioning during sleep.
Although the recommendation appears simple (most babies should be put to sleep on their backs), a variety of questions have arisen about the practicalities of implementation.
Recent reports indicate that the risk of SIDS is greater for babies placed on their sides versus those placed truly supine.
Since the initiation of the national campaign, some parents have misinterpreted the recommendation to say that babies should never be placed prone.
There have been studies showing that preterm babies who have active respiratory disease have improved oxygenation if they are prone. We are unsure of the level of risk associated with prone positioning at specific ages during the first year of life, although there are some data that suggest that the greatest decrease in SIDS incidence in those countries that have changed to mostly non-prone sleeping has been seen in the younger infants (2 to 6 months). Therefore, the first 6 months, when babies are forming sleeping habits, are probably the most important time to focus on. Do I need to keep checking on my baby after laying him or her down for sleep in a non-prone position? We recommend that parents do not keep checking on their baby after he or she is laid down to sleep. While this has been a significant concern to health professionals and parents, there is no evidence that healthy babies are more likely to experience serious or fatal aspiration episodes when they are supine. In addition, indirect reassurance of the safety of the supine position for infants comes from the knowledge that this position has been standard in China, India and other Asian countries for many years. There is some suggestion that the incidence of babies developing a flat spot on their occiputs (back part of head or skull) may have increased since the incidence of prone sleeping has decreased. Change the direction that the baby is lying in the crib on a regular basis to ensure he or she is not always resting on the same part of the head. Frequently get a€?cuddle timea€? during the day by holding the baby upright over one shoulder.
When holding, feeding or carrying an infant, make sure that there is no undue pressure placed on the flat side of the head. Although various devices have been marketed to maintain babies in a non-prone position during sleep, the Task Force does not recommend their use. Several studies indicate that soft sleeping surfaces increase the risk of SIDS in infants who sleep prone. Until more information becomes available, a standard firm infant mattress with no more than a thin covering, such as a sheet or rubberized pad, between the infant and mattress is advised. Video Of A Male Baby Being Circumcised December, 2006 …I truly have seen little in my adult life that disturbed me as much as this. Potty Training Children With Special NeedsSince an important sign of readiness and a motivator to begin potty training involves being uncomfortable in a dirty diaper, if your child isn't bothered by a soiled or wet diaper, then you may need to change him into regular underware or training pants during daytime training. Kirsten Dunst As Becky, Julia Roberts As Becky S Mom, Robert …This precise moment, I am wearing big boy s pants and and she loves taking care of adult babies. The Musical Dimension Of The Daily Routines With Children …What is the role of the adult ? Baby Crawling Contest-09One adult will stay behind at the start line and the other at the finish.
FLOTATION SWIMWEAR ACCESSORIES ANDFlotation Swimsuits and Swim-sters™ Swim Diaper products can be adapted for those with special needs in youth and adult sizes. 3-year-old Injured In Fall From WindowA 3-year-old boy was hurt in a fall from a second-floor window at a Des Moines apartment complex Friday morning, officials said. FIESTA DAYS’ 55th ANNUAL DIAPER DERBYRug rats 24 to 30 months (girl) (boy) yellow tippy toes 31 to 36 months (girl) (boy by all rules upon entry into derby.
Joycelyn Elders, former director of the Arkansas Department of Health as well as United States Surgeon General was in Lincoln, Nebraska, in 1992 when she came across a Healthy Childrena€™s Handbook.
The information provided within this handbook should be considered the most current and up-to-date information and will be useful in making health-based decisions and developing your agency or program policies.
It is our desire that this handbook will serve as a tool in helping you and your staff protect and promote the health and safety of Arkansas children.
I applaud your dedication in using this guide to improve the health of the children under your care. With 33 percent of Arkansas children overweight or obese by the time they reach kindergarten, we must start early to reverse this deadly epidemic. Maintaining a consistent relationship with a medical home as described in Chapter One will allow your childa€™s doctor to help you monitor your childa€™s weight and general health, including making sure your child receives the shots needed to avoid illness. The logo also suggests a relationship with good health with subtle reference to the symbol of first aid. But having a medical home a€“ one doctor or clinic you call every time a€“ means you are more likely to get the best care possible.
At these visits, the doctor will make sure your child gets all the immunizations he or she needs. If you feel like you need to get care for a health problem that is not life-threatening, call your doctor first. The Patient-Centered Medical Home in Arkansas is a health care setting that facilitates partnerships between individual patients and their personal physicians and, when appropriate, the patienta€™s family. For example, tall parents tend to have taller children, and short parents have shorter children.


Although babies can vary a lot in their growth and still be healthy, watching growth is a way for you to see if they are getting good nutrition (enough to eat) and have adequate sustenance to support the processes of development.
Check all toys to be sure they do not have small pieces that babies can choke on or swallow.
Infants cannot learn to speak unless spoken to and likewise cannot learn how to love and show affection unless they are hugged, tickled and kissed. It is important to remember that this play does not acquire sexual meaning until after puberty. Undressing, a€?playing doctora€? and a€?playing housea€? are typical of preschool children.
This recommendation was based on numerous reports that babies who sleep prone (face down) have a significantly increased likelihood of dying of sudden infant death syndrome (SIDS). Periodic surveys have confirmed that the prevalence of prone sleeping among infants in the United States has decreased from approximately 75 percent in 1992 to 11 percentA  in 2002. The AAP Task Force on Infant Sleep Position and SIDS has considered these questions and prepared the following responses. The reason for this difference is that babies placed on their sides have a higher likelihood of spontaneously turning to prone.
However, these babies have not been specifically examined as a group once they are recovered from respiratory problems and are ready for hospital discharge.
Nevertheless, until more data suggest otherwise, it seems reasonable to continue to place babies down for sleep supine throughout infancy. Although the infanta€™s risk of SIDS could be increased slightly if he or she spontaneously assumes the prone position, the risk is not sufficient to outweigh the great disruption to the parents, and possibly to the infant, by frequent checking.
In fact, in the majority of the very small number of reported cases of death due to aspiration, the infanta€™s position at death, when known, was prone.
Finally, in countries such as England, Australia and New Zealand, where there has been a major change in infant sleeping position from predominantly prone to predominantly supine or side sleeping, there is no evidence of any increased number of serious or fatal episodes of aspiration of gastric contents. This is almost always a benign condition that will disappear within several months after the baby has begun to sit up. For example, have the babya€™s feet point toward one end of the crib for a few days, and then change the position so his or her feet point toward the other end of the crib. None of the studies that showed a reduction In risk when the prevalence of prone sleeping was reduced used devices. Children who learn healthy social-emotional skills in preschool will do better in kindergarten. This poster present the observations made during the diaper change, at home and at the nursery.
Care of the uncircumcised penis If you decide not to circumcise your baby, taking care of his penis is easy. She thought that Arkansasa€™ child care providers would appreciate being given the same kind of information. It is the Health and Nutrition Unita€™s intention to keep this handbook revised and updated as soon as new health or medical guidelines suggestions are made. Obesity is a top contributor to serious diseases like hypertension, diabetes, heart disease and others that rob Arkansas citizens of their ability to lead healthy, productive lives.
Provide well-balanced meals and healthy snacks in age-appropriate portions sizes as described in this guide. If you see the same doctor every time, that doctor will know what sicknesses and health care you have had. Your doctor can tell you if you need care right away, or if you can wait until the clinic opens again. If hanging toys over cribs, make sure they are high enough so the baby cannot pull them down and become strangled by the cord. Babies will touch and play with their genitals, just as they do with everything else in the world.
This helps children understand gender differences and is usually limited to peers, although young children may want to touch their parentsa€™ sexual organs. Between 1992 and 2001, there was a more than 50 percent reduction in SIDS deaths, but a slight increase in prone sleeping since 2002 may be contributing to the lack of further reduction. It should be emphasized, however, that for most of these questions there are not sufficient data to provide definitive answers. Developmental experts advise that prone positioning during the awake state is important for shoulder girdle motor development to promote head control.
There is no reason to believe that they should be treated any differently than a baby who was born at term. Also, studies have shown that it is unusual for a baby who is placed in a supine position to roll into a prone position during early infancy.
Consumer Product Safety Commission has also warned against placing any soft, plush or bulky items, such as pillows, rolls of bedding or cushions, in the babya€™s immediate sleeping environment. Your doctor should know what problems to check for and what shots or medicines you need to stay healthy. The doctor will also check for health problems and make sure your child is growing and developing as expected. The Arkansas Department of Human Services is in compliance with Titles VI and VII of the Civil Rights Act. Physical affection with babies and young children is the foundation of healthy sexual development. Children experiment with a€?dirtya€? words and slang terms for information and sometimes for shock value. Health care professionals are encouraged to read both publications for a review of the evidence that led to the recommendation. Therefore, parents should be advised that a certain amount of a€?tummy timea€? when the baby is awake and observed is good. These items can potentially come into close contact with the infanta€™s face, impeding ventilation or entrapping the infanta€™s head and causing suffocation.
Security objects and activities, such as imaginary friends, blankets, favorite toys and thumb sucking, are also normal and sources of comfort and affection for children.



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