Saturday, December 19, 2009

Amazingly,,,I Actually had a Haircut

Never though before that I have to haircut by someone else besides my Dad... He usually cut my hair while I was sleep lately night or even early morning. It took my Dad more than hour just just to cut my hair. My Dad did that since I was a little baby...of course I just a toddler right now, but I mean that my Dad begin to haircut me since I was 6 months old...

I always scared to go to the barber or salon to have haircut, the "tools" that can "loose"(cut) the hair make me worry. Imagine the hair fell from the head,,, it always make me nervous to see that things. There were an experience while my Dad took me to his barber shop,,, stood like a fool and all can I do was asked my my Dad when we can go home...

Today,,, is a big story for me, and my parents. Somehow, I didn't refuse when my Mom asked me to go to salon and get haircut. It was a major experience to me and I don't think I can do that any more in the future. You can imagine, I just sit and almost not breath while the electric things cut my hair... My mom cheer me up ... she said that I have to keep my promise to her about to go to saloon to get haircut. That's it....why should I have to promised her such a thing...

Anyway.... it is good to have a nice hair style.., no matter you avoid your haircut,,,, you shoul go for it... (of course to all toddler friends,,,)

I will give you a tips from a toddler stylist;

As a stylist, the toddler haircut is not unfamiliar to me. They come in regularly and there many ways the experience can go, ranging from both good and very bad extremes. I have even written before about when to just say no to the toddler haircut. There really are times when it just isn't worth it. If your child is screaming and terrified this is one of those times to stop. Normally I refuse to give into tantrums, but listen people, we use sharp instruments. Safety is an issue. A big issue. I have been holding the clippers away from a child waiting for him to stop flailing, the child then flailed into my clippers and ended up bleeding. That being said, there are a few other things I would like to recommend to help you and your child get the best toddler haircut experience possible.

Do NOT come when your child is tired. Besides just being cranky and irritable about the haircut it causes another danger issue. A moving target is a dangerous target, tired children bob their heads and, on a occasion, nearly fall out of the chair. I have had to grab more then one child as they tumble to the floor completely asleep. You try to safely grab a child while you have laser sharpened scissors in your hand. If your child starts to fall asleep I will send you home. I reserve the right to safely cut your child's hair.

Please, please comb your children's hair. I am going to charge you extra to comb out matted hair. It takes a long time to get those out. By the time I do, your child is now cranky and irritated with me for hurting them, because it does hurt, and because they have already been sitting for a long time. Avoid heartache and comb your child's hair every day.

If your child has a sensory issue You Need To Tell Me. I can not stress this enough. Lots of children have mild Autism or sensory issues that touching makes worse. I understand that you may not feel comfortable going around and broadcasting this. You can discreetly tell me, I will not make a big deal about it. I will make adjustments for it. It will change the way I shampoo as well as the way I go about preforming the toddler haircut as well as just making a hastier effort so the child doesn't have to endure a prolonged experience. I routinely touch kids to keep them in the chair, lift their chin, or keep their head straight. If I know you child will suffer from this I can avoid it. I can do nothing if I don't know.

A lot of things can make a toddler haircut go better for you, your child and for me. Please remember how dangerous a salon is. It is not a place to play or a place let your guard down. A little preparation is going to go a long way.

source: What to expect

Other tips for parents:

When I had kids, I expected to change diapers, have midnight feedings and potty train. But it's what I didn't account for that really challenged me: the haircuts.
Toddler Getting Haircut

Stay away?

For Will's first few -- or six -- haircuts, I stayed as far away as possible. I paid for the cuts but sent my mother or my husband along. It was beyond my willingness. Then everyone else got busy. If he needed a cut, it needed to be me taking him. So I waited. And waited some more.

Unfortunately, the six-month rule doesn't work for little boys. He looked all ... messy. Then I thought about growing it long, but it didn't suit him.

Ultimately though, I was simply delaying the inevitable. Eventually, I really would have to buck up and take my own son for that haircut. I am the mommy, afterall. Still, I remember when my stepson was Will's age. Haircuts were major to-dos. He would scream and cry and whine. Bad. Experience.

Doing the deed

Finally, I caved and went -- with my mother -- for the much awaited haircut. Sometimes, just swallowing the worries and fear and just going helps. You kind of have to turn your worries off, hard as it may sound.

You know what? Ultimately, it wasn't that bad. At all. Apparently with his prior experience and all of my talking about the impending cut, he was ready and willing to sit still while the barber snipped, buzzed and tweaked his new shorter 'do. No tears, whines or otherwise. Just my happy boy getting a cool new 'do. And now, I am hooked. His cut transformed him from my little toddler into a little boy ready for preschool.

Planning a good haircut trip

Are you dreading your toddler's hair cutting? Fear not. Here are some simple tips to help make your trip to the beauty parlor a success.

1. Prepare them: One of the best things you can do is to talk with your child about what happens when they get their haircut. That way the scissors, clippers and razors won't be a surprise -- or scary -- to the littler people. Plus, if it's not a surprise, then they are less likely to freak about it.

2. Don't be afraid to bribe: There is a reason that little kids get lollypops after a trip to the beauty salon. It's bribery. The good kind of bribery that gets little boys and girls to behave and do as they are supposed to. See? Sometimes bribery is a good thing!

3. Stand firm with boundaries: Whatever rules of behavior you have need to apply everywhere -- at home, in the barber shop or wherever. Keeping things consistent is half the battle to having happy, well-behaved kids.

source: Sheknows Parenting


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Sunday, December 13, 2009

How to Find A Great Baby Sitter

Maybe your sister and niece were always your babysitters in the past, but they've moved away. Perhaps your old babysitter is going off to college. Or maybe you're new in town.

The day you've dreaded has arrived. It's time to find a highly qualified babysitter. How do people do this? Ask family, friends, neighbors and co-workers to recommend some babysitters.

Do they have a babysitter that they trust implicitly with their children? Is the babysitter kind? Does the babysitter follow parental rules? When the parents leave, do they feel confident about the safety of their kids? When the parents return home from a night out, are the children happy? Is your home a disaster, or tidy?

You know all the concerns, now you just need to find a great babysitter. If you've asked around and still come up short, don't despair. You can put an ad in the paper, or even go online.

When you write your ad, know what you're looking for, and make it clear. Be prepared to set up several appointments. Ask the prospective babysitter(s) for references from satisfied parents, and call them.

At the appointment, scrutinize your prospect carefully. Is the babysitter courteous? Ask the babysitter personal questions. Discuss rate of pay to make sure you're both on the same page. If the babysitter passes the first hurdle, you may want a second appointment. Have the potential babysitter come over and spend time with the children, while you're at home. It's important to take the time to determine if said babysitter will mesh with your family.

Hopefully you will have many applicants to choose from, and hopefully there will be one or two who stand out head and shoulders above the others in terms of desirability. It's a good idea to have multiple babysitters, so if one is busy on a given day, you have other quality options.

There! You have run the process, and gotten yourself some childcare. Be good to your babysitter, and you can expect her to be good to you and your children.

source: EBabysister

More on Babysitter : Half the Sky


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Friday, December 4, 2009

Samuel Gultom - Preschool

The three or four-year-old who is outgoing takes to preschool like a duck to water and doesn’t need any gentle introduction. It may be quite different with a sensitive three-year-old who still feels closely attached to his parents.

If a parent leaves him at preschool the first day, he might not make a fuss right away. After a while he might miss his parent. He might become frightened. The next day he might not want to leave home.

Introduce preschool gradually

Most preschools introduce children to their programs gradually. This is particularly helpful for the shy or sensitive child. Parents can stay with their children for as long as they wish. For several days a parent might stay nearby while their child plays and then take her home again after a time. Each day the parent can stay for a longer period. Meanwhile, your child is building up attachments to the teacher and other children. These will give her a sense of security when her parent no longer stays.

Sometimes a child seems quite happy for several days, even after his parent has left him. Then he gets hurt and suddenly wants his mummy or daddy. In that case, the teacher can help the parents decide if one of them should come back for a number of days.

If you are staying around the preschool, it’s best to remain in the background. The idea is to let your child develop her own desire to enter the group, so that she forgets her need for you.

Think about your own feelings

Sometimes your anxiety is greater than your child’s. If you say goodbye three times over, with a worried expression, your child might think, ‘It looks as if something awful might happen if I stay here alone’.

It's natural for a tenderhearted parent to worry about leaving a small child for the first time. Let the preschool teacher, who often has a lot of experience, advise you.

Be firm

A child who starts with some genuine anxiety about separating from the parent can learn that protesting allows him to avoid the situation.

She might then progressively use this to avoid preschool. When a child becomes reluctant or fearful about returning to a preschool with understanding teachers, it is usually better for the parents to act quite confident and firm and explain that the teacher will look after her and that she will be fine.

It can sometimes help to have someone different take a reluctant child to preschool. In any case, the child should not be deceived. He should be told that he has become friends with the teacher and the other children. Tomorrow his parent will not be staying at preschool. The parent should say goodbye once, cheerfully, then leave.

In the long run, it’s better for children to outgrow their dependence than to give in to it. If a child’s terror is extreme, the situation should be discussed with a child mental health professional.

Here are some tips to help you and your child ease into the day-to-day practicalities of preschool.

Arrival and departure

Children’s Services regulations require parents and guardians to sign the child’s name and arrival time in a supplied book when children are dropped off. Parents also need to sign that they have picked up their child and at what time. This is a legal requirement for preschool.


Comfortable, loose fitting clothing that doesn’t restrict your child’s movement is best for preschool. He'll need a hat for playing outside. It’s a good idea to check your child can handle zips and buttons so he can go to the toilet. See Dressing your toddler for more information.


Some preschools ask you to bring fruit to share with the group; others prefer your child to eat their own snack. Some long-day care programs may ask parents to supply the child's lunch, other programs supply lunch. Ask your preschool for details. See How to pack a lunchbox for more information.

Illness record

Preschools must keep a formal written record of any medication your child needs. You will need to provide a written authority for this.

It’s a good idea to speak with preschool staff if any problems arise. Working things out quickly can prevent bigger issues.

Safety rules

All preschools have safety rules which parents need to know. These will include:

* who has permission to collect your child
* any out-of-bounds areas for children
* traffic issues, such as parking.


Sick children are best kept at home, for their own benefit and so they don’t pass germs on to other children. If your child has an infectious illness it’s a good idea to let your preschool know so they can inform other parents.


You need to supply a hat, because your child’s skin is more sensitive to UV radiation than adult skin. Preschools are responsible for providing shaded play areas and making sure children use sunscreen and hats.

It's best to avoid outdoor activities between 11 am and 3 pm in hot weather (and 4 pm in daylight savings). See Sun care for more information.
Toys from home

Each preschool has its own policy on whether children can bring toys from home. It’s best to check before your child packs his favourite teddy in his bag.

Parent participation

Preschools rely heavily on parents helping out. If you are able to help out, there are lots of opportunities to take part in the day-to-day activities or to be involved with preschool management.

Educational programs

Your preschool’s philosophy will be outlined in their information booklet. Details of the educational program will be displayed in the building and you can discuss this further with staff. You will also get a regular newsletter keeping you up-to-date with the current program.

Your preschool will have policies to deal with issues such as:

* fee payment
* managing behaviour
* asthma
* allergies.

This information should be on display within the preschool.


Fees and the way in which they are collected will vary from preschool to preschool. It’s a good idea to ask about your preschool’s policy ahead of time. Parents who hold a Commonwealth Health Care Card are eligible for a $250 annual preschool fee subsidy.

source: By Dr Benjamin Spock updated by Dr Robert Needlman


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Saturday, November 7, 2009

I Think - I've Got Pneumonia

Couples months ago I've got flue and bad fever. The fever is so high, and it happened for a whole night. My parents was so terrificly worried about my condition. The next morning, they took me to the hospital. The Doctor said that I have to take a blood test in according to find out what was happen with my body.

In short word, my blood test show that I have to much L.E.D in my lung.... I have to take the antibiotic treatment for about the whole month. Now, I am still have a treatment... I think, I've got pneumonia...... Bless me God

Pneumonia is a general term that refers to an infection of the lungs, which can be caused by a variety of microorganisms, including viruses, bacteria, fungi, and parasites.

Often pneumonia begins after an upper respiratory tract infection (an infection of the nose and throat). When this happens, symptoms of pneumonia begin after 2 or 3 days of a cold or sore throat.

Signs and Symptoms

Symptoms of pneumonia vary, depending on the age of the child and the cause of the pneumonia. Common symptoms include:

  • fever
  • chills
  • cough
  • unusually rapid breathing
  • breathing with grunting or wheezing sounds
  • labored breathing that makes a child's rib muscles retract (when muscles under the rib cage or between ribs draw inward with each breath)
  • vomiting
  • chest pain
  • abdominal pain
  • decreased activity
  • loss of appetite (in older kids) or poor feeding (in infants)
  • in extreme cases, bluish or gray color of the lips and fingernails

Sometimes a child's only symptom is rapid breathing. Sometimes when the pneumonia is in the lower part of the lungs near the abdomen, there may be no breathing problems, but there may be fever and abdominal pain or vomiting.

When pneumonia is caused by bacteria, an infected child usually becomes sick relatively quickly and experiences the sudden onset of high fever and unusually rapid breathing. When pneumonia is caused by viruses, symptoms tend to appear more gradually and are often less severe than in bacterial pneumonia. Wheezing may be more common in viral pneumonia.

Some types of pneumonia cause symptoms that give important clues about which germ is causing the illness. For example, in older kids and adolescents, pneumonia due to Mycoplasma (also called walking pneumonia) is notorious for causing a sore throat and headache in addition to the usual symptoms of pneumonia.

In infants, pneumonia due to chlamydia may cause conjunctivitis (pinkeye) with only mild illness and no fever. When pneumonia is due to whooping cough (pertussis), the child may have long coughing spells, turn blue from lack of air, or make a classic "whoop" sound when trying to take a breath.


Pneumonia is a lung infection that can be caused by different types of germs, including bacteria, viruses, fungi, and parasites. Although different types of pneumonia tend to affect children in different age groups, pneumonia is most commonly caused by viruses. Viruses that cause pneumonia include adenoviruses, rhinovirus, influenza virus (flu), respiratory syncytial virus (RSV), and parainfluenza virus (which causes croup).


The incubation period for pneumonia varies, depending on the type of virus or bacteria causing the infection (for instance, respiratory syncytial virus, 4 to 6 days; influenza, 18 to 72 hours).


With treatment, most types of bacterial pneumonia can be cured within 1 to 2 weeks. Viral pneumonia may last longer. Mycoplasmal pneumonia may take 4 to 6 weeks to resolve completely.


The viruses and bacteria that cause pneumonia are contagious and are usually found in fluid from the mouth or nose of an infected person. Illness can spread when an infected person coughs or sneezes on a person, by sharing drinking glasses and eating utensils, and when a person touches the used tissues or handkerchiefs of an infected person.


Vaccines can prevent infections by viruses or bacteria that cause some types of pneumonia. Kids usually receive routine immunizations against Haemophilus influenzae and pertussis (whooping cough) beginning at 2 months of age. (The pertussis immunization is the "P" part of the routine DTaP injection.) Vaccines are now also given against the pneumococcus organism (PCV), a common cause of bacterial pneumonia.

Children with chronic illnesses, who are at special risk for other types of pneumonia, may receive additional vaccines or protective immune medication. The flu vaccine is strongly recommended for kids with chronic illnesses such as chronic heart or lung disorders or asthma, as well as otherwise healthy children ages 6 months through 19 years.

Because they're at higher risk for serious complications, infants who were born prematurely may be given treatments that temporarily protect against RSV, which can lead to pneumonia in younger children.

Doctors may give prophylactic (disease-preventing) antibiotics to prevent pneumonia in kids who have been exposed to someone with certain types of pneumonia, such as pertussis. Those with HIV infection may also receive prophylactic antibiotics to prevent pneumonia caused by Pneumocystis carinii.

Antiviral medication is now available, too, and can be used to prevent some types of viral pneumonia or to make symptoms less severe.

In addition, regular tuberculosis screening is performed yearly in some high-risk areas because early detection will prevent active tuberculosis infection including pneumonia.

In general, pneumonia is not contagious, but the upper respiratory viruses that lead to it are, so it is best to keep your child away from anyone who has an upper respiratory tract infection. If someone in your home has a respiratory infection or throat infection, keep his or her drinking glass and eating utensils separate from those of other family members, and wash your hands frequently, especially if you are handling used tissues or dirty handkerchiefs.

When to Call the Doctor

Call your doctor immediately if your child has any of the signs and symptoms of pneumonia, but especially if your child:

  • is having trouble breathing or is breathing abnormally fast
  • has a bluish or gray color to the fingernails or lips
  • has a fever of 102° Fahrenheit (38.9° Celsius), or above 100.4° Fahrenheit (38° Celsius) in infants under 6 months of age

Professional Treatment

Doctors usually make the diagnosis of pneumonia after a physical examination. The doctor may possibly use a chest X-ray, blood tests, and (sometimes) bacterial cultures of mucus produced by coughing when making a diagnosis.

In most cases, pneumonia can be treated with oral antibiotics given to your child at home. The type of antibiotic used depends on the type of pneumonia.

Children may be hospitalized for treatment if they have pneumonia caused by pertussis or other bacterial pneumonia that causes high fevers and respiratory distress. They may also be hospitalized if:

  • supplemental oxygen is needed
  • they have lung infections that may have spread into the bloodstream
  • they have chronic illnesses that affect the immune system
  • they are vomiting so much that they cannot take medicine by mouth
  • if they have recurrent episodes of pneumonia

Home Treatment

If your doctor has prescribed antibiotics for bacterial pneumonia, give the medicine on schedule for as long as directed. This will help your child recover faster and will decrease the chance that infection will spread to other household members.

Don't force a child who's not feeling well to eat, but encourage drinking of fluids, especially if fever is present. Ask the doctor before you use a medicine to treat your child's cough because cough suppressants stop the lungs from clearing mucus, which may not be helpful in some types of pneumonia.

If your child has chest pain, try a heating pad or warm compress on the chest area. Take your child's temperature at least once each morning and each evening, and call the doctor if it goes above 102° Fahrenheit (38.9° Celsius) in an older infant or child, or above 100.4° Fahrenheit (38° Celsius) in an infant under 6 months of age.

Check your child's lips and fingernails to make sure that they are rosy and pink, not bluish or gray, which is a sign that the lungs are not getting enough oxygen.

Source : Kids Health

Reviewed by: Joel Klein, MD
Date reviewed: November 2008


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Wednesday, October 21, 2009

Complimentary and Alternative Medicine


There are many terms used to describe approaches to health care that are outside the realm of conventional medicineMedicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals such as physical therapists, psychologists, and registered nurses. as practiced in the United States. This fact sheet explains how the National Center for Complementary and Alternative Medicine (NCCAM), a component of the National Institutes of Health, defines some of the key terms used in the field of complementary and alternative medicine (CAM)A group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine.. Terms that are underlined in the text are defined at the end of this fact sheet.

What is CAM?

CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine. While scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered through well-designed scientific studies—questions such as whether these therapies are safe and whether they work for the purposes for which they are used.

Are complementary medicine and alternative medicine different from each other?

Yes, they are different.

What is integrative medicine?

Integrative medicine combines treatments from conventional medicine and CAM for which there is evidence of safety and effectiveness. It is also called integrated medicineAn approach to medicine that combines treatments from conventional medicine and CAM for which there is some high-quality scientific evidence of safety and effectiveness..

What are the major types of complementary and alternative medicine?

NCCAM groups CAM practices into four domains, recognizing there can be some overlap. In addition, NCCAM studies CAM whole medical systems, which cut across all domains.

Whole Medical Systems

Whole medical systems are built upon complete systems of theory and practice. Often, these systems have evolved apart from and earlier than the conventional medical approach used in the United States. Examples of whole medical systems that have developed in Western cultures include homeopathic medicineA whole medical system that originated in Europe. Homeopathy seeks to stimulate the body's ability to heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness or symptoms (an approach called "like cures like"). and naturopathic medicineA whole medical system that originated in Europe. Naturopathy aims to support the body's ability to heal itself through the use of dietary and lifestyle changes together with CAM therapies such as herbs, massage, and joint manipulation.. Examples of systems that have developed in non-Western cultures include traditional traditional Chinese medicineA whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi. and AyurvedaA whole medical system that originated in India. It aims to integrate the body, mind, and spirit to prevent and treat disease. Therapies used include herbs, massage, and yoga..

Mind-Body Medicine

Mind-body medicine uses a variety of techniques designed to enhance the mind's capacity to affect bodily function and symptoms. Some techniques that were considered CAM in the past have become mainstream (for example, patient support groups and cognitive-behavioral therapy). Other mind-body techniques are still considered CAM, including meditationA conscious mental process using certain techniques—such as focusing attention or maintaining a specific posture—to suspend the stream of thoughts and relax the body and mind., prayer, mental healing, and therapies that use creative outlets such as art, music, or dance.

Biologically Based Practices

Biologically based practices in CAM use substances found in nature, such as herbs, foods, and vitamins. Some examples include dietary supplements, herbal products, and the use of other so-called natural but as yet scientifically unproven therapies (for example, using shark cartilage to treat cancer).

Manipulative and Body-Based Practices

Manipulative and body-based practices in CAM are based on manipulationThe application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health. Manipulation may be performed as a part of other therapies or whole medical systems, including chiropractic medicine, massage, and naturopathy. and/or movement of one or more parts of the body. Some examples include chiropractic or osteopathic manipulationA type of manipulation practiced by osteopathic physicians. It is combined with physical therapy and instruction in proper posture., and massagePressing, rubbing, and moving muscles and other soft tissues of the body, primarily by using the hands and fingers. The aim is to increase the flow of blood and oxygen to the massaged area..

Energy Medicine

Energy therapies involve the use of energy fields. They are of two types:

What is NCCAM's role in the field of CAM?

NCCAM is the Federal Government's lead agency for scientific research on CAM. . NCCAM's mission is to explore complementary and alternative healing practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals.

For More Information

Sources of NCCAM Information

NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications and searches of Federal databases of scientific and medical literature. Examples of publications include "Selecting a CAM Practitioner" and "Are You Considering Using CAM?" The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

A wide range of complementary and alternative medicine (CAM) therapies are used in children, including herbs and dietary supplements, massagePressing, rubbing, and moving muscles and other soft tissues of the body, primarily by using the hands and fingers. The aim is to increase the flow of blood and oxygen to the massaged area., acupunctureA family of procedures that originated in traditional Chinese medicine. Acupuncture is the stimulation of specific points on the body by a variety of techniques, including the insertion of thin metal needles though the skin. It is intended to remove blockages in the flow of qi and restore and maintain health., chiropractic care, naturopathyA whole medical system that originated in Europe. Naturopathy aims to support the body's ability to heal itself through the use of dietary and lifestyle changes together with CAM therapies such as herbs, massage, and joint manipulation., and homeopathyA whole medical system that originated in Europe. Homeopathy seeks to stimulate the body's ability to heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness or symptoms (an approach called "like cures like").. This fact sheet from the National Center for Complementary and Alternative Medicine (NCCAM) offers information for parents who are thinking about using a CAM therapy for their child.

Key Points

  • CAM is used by American children, including adolescents.
  • Children are not small adults. Their bodies can react differently from adults' bodies to medical therapies, including CAM.
  • In general, CAM therapies have not been well studied in children.
  • Tell your child's health care providers about any CAM therapy you are considering or using for your child. This helps to ensure coordinated and safe care.

Patterns of CAM Use in Children

The 2007 National Health Interview Survey gathered information on CAM use among more than 9,000 children aged 17 and under. Nearly 12 percent of the children had used some form of CAM during the past 12 months. CAM use was much more likely among children whose parents also used CAM. Adolescents aged 12–17, children with multiple health conditions, and those whose families delayed or did not use conventional medical care because of cost were also more likely to use CAM. The accompanying figures show survey findings on CAM use by children, including top therapies and diseases/conditions.

In addition, a 2001 survey of 745 members of the American Academy of Pediatrics found that 87 percent of pediatricians had been asked about CAM therapies by a patient or a parent in the 3 months prior to the survey. The pediatricians were asked most often about herbs and dietary supplements.

10 Most Common Therapies Among Children-2007: follow link for full description

Diseases/Conditions for Which CAM Is Most Frequently Used Among Children-2007: follow link for full description

Safety of Childhood CAM Use

Few high-quality studies have examined how CAM therapies may affect young people, and results from studies in adults do not necessarily apply to children. Children are not small adults. Their immune and central nervous systems are not fully developed, which can make them respond to treatments differently from adults. This is especially true for infants and young children.

Herbs and other dietary supplements may interact with medicines or other supplements, or they may cause problems during surgery, such as bleeding-related complications. In addition, "natural" does not necessarily mean "safe." CAM therapies can have side effects, and these may be different in children than in adults.

Parents should seek information from scientific studies about how safe and effective a specific CAM therapy is in children. However, since few, if any, rigorous studies in young people exist, additional scientific studies are needed. Anecdotes and testimonials (personal stories) about CAM therapies are common and can be compelling, but they are not evidence.

Discussing CAM With Your Pediatrician

Parents often do not tell pediatricians or other health care providers that their child is receiving CAM. It is important, however, that families speak with their child's health care provider about any CAM therapy being used or considered. Providing a full picture of what is being done to manage your child's health will help ensure coordinated and safe care.

For tips about talking with your health care provider about CAM, see NCCAM's Time to Talk campaign at

When seeking care from a CAM practitioner, it is important to ask about the practitioner's:

  • Education and training
  • Experience in delivering care to children
  • Experience working with other providers, including physicians, to ensure coordinated care
  • Licensing (some states have licensing requirements for certain CAM practitioners, such as chiropractors, naturopathic doctors, massage therapists, and acupuncturists).

Additional Points To Consider

In addition to asking your child's physician what is known about whether a therapy works and is safe for children, consider these points when making decisions about using CAM in children:

  • Ensure that your child has received an accurate diagnosis from a licensed health care provider and that CAM use does not replace or delay conventional medical care.
  • If you decide to use CAM for your child, do not increase the dose or length of treatment beyond what is recommended. More is not necessarily better.
  • If your child experiences an effect from a CAM therapy that concerns you, contact your child's health care provider.
  • Store herbal and other dietary supplements out of the sight and reach of children.
  • If you are a woman who is pregnant or breastfeeding, remember that some CAM therapies may affect your fetus or nursing infant.

For More Information

NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226
TTY (for deaf and hard-of-hearing callers): 1-866-464-3615
Web site:


A service of the National Library of Medicine (NLM), PubMed contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. CAM on PubMed, developed jointly by NCCAM and NLM, is a subset of the PubMed system and focuses on the topic of CAM.

Web site:
CAM on PubMed:


References are primarily recent reviews on the topic of children and adolescents and CAM in the peer-reviewed medical and scientific literature in English in the PubMed database or from Federal Government text.

  • Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. Journal of the American Medical Association. 2001;286(2):208–216.
  • Breuner CC. Complementary medicine in pediatrics: a review of acupuncture, homeopathy, massage, and chiropractic therapies. Current Problems in Pediatric and Adolescent Health Care. 2002;32(10):353–384.
  • Committee on Children with Disabilities, American Academy of Pediatrics. Counseling families who choose complementary and alternative medicine for their child with chronic illness or disability. Pediatrics. 2001;107(3):598–601.
  • Davis MP, Darden PM. Use of complementary and alternative medicine by children in the United States. Archives of Pediatrics and Adolescent Medicine. 2003;157(4):393–396.
  • Ernst E. Serious adverse effects of unconventional therapies for children and adolescents: a systematic review of recent evidence. European Journal of Pediatrics. 2003;162(2):72–80.
  • Gardiner P, Dvorkin L, Kemper KJ. Supplement use growing among children and adolescents. Pediatric Annals. 2004;33(4):227–232.
  • Kemper KJ, Cassileth B, Ferris T. Holistic pediatrics: a research agenda. Pediatrics. 1999;103(4 Pt 2):902-909.
  • Kemper KJ, O'Connor KG. Pediatricians' recommendations for complementary and alternative medical (CAM) therapies. Ambulatory Pediatrics. 2004;4(6):482–487.
  • Sawni-Sikand A, Schubiner H, Thomas RL. Use of complementary/alternative remedies among children in primary care pediatrics. Ambulatory Pediatrics. 2002;2(2):99–103.
  • Sibinga EM, Ottolini MC, Duggan AK, et al. Parent-pediatrician communication about complementary and alternative medicine use for children. Clinical Pediatrics. 2004;43(4):367–373.
  • Wilson KM, Klein JD, Sesselberg TS, et al. Use of complementary medicine and dietary supplements among U.S. adolescents. Journal of Adolescent Health. 2006;38(4):385–394.
  • Woolf AD. Herbal remedies and children: do they work? Are they harmful? Pediatrics. 2003;112(1 Pt 2):240–246.
  • Yussman SM, Ryan SA, Auinger P, et al. Visits to complementary and alternative medicine providers by children and adolescents in the United States. Ambulatory Pediatrics. 2004;4(5):429–435.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCAM.

NCCAM Publication No. D383
Created May 2007
Updated February 2009

How To Find a Good Alternative Medicine

By Katy Koontz
From Health magazine

Whether you’re getting a deep-tissue massage or trying acupuncture for the first time, picking the right alternative medicine professional is important to your health. Here’s how to pick the right one for you.

  • Ask for referrals from your doctor, local hospital, or medical school.
  • Get a recommendation from a professional organization for the type of practitioner you are looking for. The National Institutes of Health’s Directory of Health Organizations is a good place to start.
  • Call your local health department to find out if your state has a regulatory agency or licensing board for the therapy you’re interested in, and then contact that office for referrals.
  • Check on the training, certification, or other qualifications of your practitioner. See if he or she will speak with you briefly on the phone for this purpose before you make an appointment.
  • Find out how much experience the practitioner has with your health concern and how effective he or she believes this therapy may be for your condition. (Be sure to ask about scientific research, as well.)

Four Things You Didn't Know About Natural Medicine

If natural medicine still sounds too alternative for you, here are four things that may help mainstream the concept for you.

It’s not so “out there”
In addition to the 38 percent of all adults in the United States who have tried natural medicine, nearly 12 percent of children have used complementary and alternative (CAM) therapies. Veterinarians use it on pets, too. “It’s not just the fringe anymore,” says Donald B. Levy, MD, medical director of the Osher Clinical Center for Complementary and Integrative Medical Therapies at Brigham and Women’s Hospital in Boston.

“It’s more widespread.” In fact, CAM is considered standard treatment in many European countries (including Germany, which regulates herbs, and France, where hospitals widely use acupuncture), so sometimes alternative treatments new to the States have already been researched and used for years abroad.

It’s a spa thing
Our strong desire to “heal” ourselves with natural medicine has made alternative therapies hot items at spas and resorts. Some treatments may sound like a wacky mix of the scientific and the spiritual—Crystal Bowl Sound Healing (at Rancho La Puerta Fitness Resort and Spa in Baja California) claims to activate alpha waves in the brain; Spirit Flight treatment (at Miraval in Tucson, Arizona) is touted as a blend of energy medicine, full-body massage, acupuncture, craniosacral therapy, and spinal alignment, along with indigenous ceremonial rituals.

But treatments like these are very popular, and an arm of the National Institutes of Health called the National Center for Complementary and Alternative Medicine (NCCAM) is researching their validity. In fact, you may be able to take part in a clinical trial for an alt med therapy being studied at a university near you. For information, visit the NCCAM’s Web site.

Lots of MDs use it
More than half of U.S. medical schools now include at least some courses in alternative medicine. And the government is pumping more money than ever into research. The current budget for the NCCAM is $121.5 million—that’s 61 times as much as it was in 1992, the year the department was founded.

Many people turn to alt med when conventional therapy doesn’t do the trick, says Richard Nahin, PhD, senior advisor for scientific coordination and outreach at the NCCAM. The number-one concern: relief for chronic pain (in areas like the neck, joints, and lower back).

But adding complementary therapies like supplements (specifically, omega-3 fatty acids found in fish oils), Tai Chi or yoga, mind-body therapies (such as biofeedback), and even spiritual practices (including forgiveness), to conventional medications for heart disease is getting a lot of attention and can lower risk, says Victor Sierpina, MD, chairman of the Consortium of Academic Health Centers for Integrative Medicine.

Some docs use natural products along with prescription medication, Dr. Levy says. For instance, he may suggest that his patients who can’t tolerate migraine medication try Petasites hybridus (butterbur) root to ease the side effects. “It’s the perfect marriage with modern medicine,” he adds.

Insurance may pay for it
Just over 80 percent of employers’ health insurance plans cover chiropractic care, and more than 33 percent cover acupuncture or acupressure. At least 13 percent will pay for massage and nutrition therapy, and 9 percent cover biofeedback.

Contact your state’s insurance department to find out which companies in your area are most alternative-friendly. You may also be able to deduct some alt med treatments as medical expenses on your tax return if you itemize or as eligible expenses for most flexible-spending and health-savings accounts.


Samuel Gultom


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Thursday, October 8, 2009

Ten Ways To Save Green

Sure, you know that saving the earth is important, but buying "green" products can be super-expensive. But there

are affordable ways to do your part to lessen your environmental footprint — you'll even save some cash at the same


Go Shopping (for New Appliances)!

If your appliances are from the mid-'90s or before, they're probably so inefficient that it makes sense to replace

them. Look for appliances with the Energy Star label, which means that they use 10 to 50 percent less water and

energy than standard models—a substantial savings on your utility bills. (According to Department of Energy

calculations, a new clothes washer can save you up to $110 a year on your energy bills.) Find more information on

the Energy Star program.

Break Out the Baking Soda

Baking soda is a nontoxic substance that helps regulate pH, getting rid of bad odors caused by too much acidity

(food, BO) and two much base (fish and smoke). Plus, it's a gentle cleanser. Make a paste with BS and water for a

chemical-free way to shine your silver, pour it down the sink and run warm water to deodorize, or use it to scrub

the tub.

Slay (Energy) Vampires

Energy vampires are electronics (like TVs, DVD players and cell phone chargers) that still use energy even when

they're turned off. Guess what? This wasted power can add up to 20 percent to your energy bill. The best way to cut

down on energy-sucking is to unplug your appliances when they're not in use, or plug them all into a power strip and

turn that off. If all that switching is too much of a hassle (and let's face it, having the clock on your DVD player

is convenient), at least unplug your cell phone charger when it's not in use.

Pack a Bottle

According to one estimate, Americans go through more than 30 million water bottles a year. If you're drinking that

water on the go, you're probably throwing the bottle in the garbage — and that adds up to a lot of trash. Fill up a

reusable water bottle and you can stay hydrated, cut down on waste and save cash. If the bottles of water you buy in

a store are about $1 each, this baby will pay for itself in about eight uses.

Cruise in the Slow Lane

Gas mileage drops considerably when you go over 60 mph. According to the Department of Energy, you pay about 20

cents more per gallon for each 5 mph you go over 60. Over time, that's a lot of extra fuel, and cash! Excessive

accelerating and heavy breaking can also make your car less efficient, so make it a smooth ride. For more ways to

save on car expenses, go to

Plant a Tree — Seriously

Adding trees to the south, east and west side of your house shades your home, keeping it cooler. That means savings

of up to 25 percent on your home cooling costs. Get more ideas from the government's Energy Savers Web site.

Print on Both Sides

Whether you're at work or in your home office, whenever possible, print on both sides of your paper to reduce your

consumption. Or, even better, store files and emails on your computer, so you're not using any paper at all.

Go Native

Try to use plants and flowers that are native to your area in your garden. The benefit? Because they're already

adapted to the soil and water conditions, you won't have to use as much fertilizer and water to get them to grow.

For more information and lists of regional plants, go to

Say, "It's Vintage"

Shopping at thrift stores like Goodwill or buying used goods on eBay can be super-cheap, but it's also eco-friendly.

Why? There's none of the energy consumed that would be used in manufacturing and transporting something new. Plus,

you're reusing furniture and clothing that might otherwise get thrown away. No need to say it's a thrift-store find.

Just call it "vintage" or "antique."

Get Your Kids in on It

Visit The Greens at, an interactive site for teens and tweens that features animated clips, a

blog, games and more. Hosted by two cartoon middle schoolers, the show teaches kids ways they can conserve and save

the environment. Will it get your kid to do the laundry — line-drying, of course? One can only hope.

source:Everyday Health

Other Ten Ways To Go Green

How can we live lightly on the Earth and save money at the same time? Staff members at the Worldwatch Institute, a global environmental organization, share ideas on how to GO GREEN and SAVE GREEN at home and at work.

Climate change is in the news. It seems like everyone's "going green." We're glad you want to take action, too. Luckily, many of the steps we can take to stop climate change can make our lives better. Our grandchildren-and their children-will thank us for living more sustainably. Let's start now.

We've partnered with the Million Car Carbon Campaign to help you find ways to save energy and reduce your carbon footprint. This campaign is uniting conscious consumers around the world to prevent the emissions-equivalent of 1 million cars from entering the atmosphere each year.

Keep reading for 10 simple things you can do today to help reduce your environmental impact, save money, and live a happier, healthier life.

Save energy to save money.
State of the World
State of the World 2009:
Into a Warming World

* Set your thermostat a few degrees lower in the winter and a few degrees higher in the summer to save on heating and cooling costs.
* Install compact fluorescent light bulbs (CFLs) when your older incandescent bulbs burn out.
* Unplug appliances when you're not using them. Or, use a "smart" power strip that senses when appliances are off and cuts "phantom" or "vampire" energy use.
* Wash clothes in cold water whenever possible. As much as 85 percent of the energy used to machine-wash clothes goes to heating the water.
* Use a drying rack or clothesline to save the energy otherwise used during machine drying.

Save water to save money.

* Take shorter showers to reduce water use. This will lower your water and heating bills too.
* Install a low-flow showerhead. They don't cost much, and the water and energy savings can quickly pay back your investment.
* Make sure you have a faucet aerator on each faucet. These inexpensive appliances conserve heat and water, while keeping water pressure high.
* Plant drought-tolerant native plants in your garden. Many plants need minimal watering. Find out which occur naturally in your area.

Less gas = more money (and better health!).
Bicycle Commuters
World Watch Magazine

* Walk or bike to work. This saves on gas and parking costs while improving your cardiovascular health and reducing your risk of obesity.
* Consider telecommuting if you live far from your work. Or move closer. Even if this means paying more rent, it could save you money in the long term.
* Lobby your local government to increase spending on sidewalks and bike lanes. With little cost, these improvements can pay huge dividends in bettering your health and reducing traffic.

Eat smart.

* If you eat meat, add one meatless meal a week. Meat costs a lot at the store-and it's even more expensive when you consider the related environmental and health costs.
* Buy locally raised, humane, and organic meat, eggs, and dairy whenever you can. Purchasing from local farmers keeps money in the local economy.
* Watch videos about why local food and sustainable seafood are so great.
* Whatever your diet, eat low on the food chain [pdf]. This is especially true for seafood.

Skip the bottled water.

* Use a water filter to purify tap water instead of buying bottled water. Not only is bottled water expensive, but it generates large amounts of container waste.
* Bring a reusable water bottle, preferably aluminum rather than plastic, with you when traveling or at work.
* Check out this short article for the latest on bottled water trends.

Think before you buy.
Low Carbon Energy
Low Carbon Energy Report

* Go online to find new or gently used secondhand products. Whether you've just moved or are looking to redecorate, consider a service like craigslist or FreeSharing to track down furniture, appliances, and other items cheaply or for free.
* Check out garage sales, thrift stores, and consignment shops for clothing and other everyday items.
* When making purchases, make sure you know what's "Good Stuff" and what isn't.
* Watch a video about what happens when you buy things. Your purchases have a real impact, for better or worse.

Borrow instead of buying.

* Borrow from libraries instead of buying personal books and movies. This saves money, not to mention the ink and paper that goes into printing new books.
* Share power tools and other appliances. Get to know your neighbors while cutting down on the number of things cluttering your closet or garage.

Buy smart.
Climate Change Reference Guide
Climate Change Reference

* Buy in bulk. Purchasing food from bulk bins can save money and packaging.
* Wear clothes that don't need to be dry-cleaned. This saves money and cuts down on toxic chemical use.
* Invest in high-quality, long-lasting products. You might pay more now, but you'll be happy when you don't have to replace items as frequently (and this means less waste!).

Keep electronics out of the trash.

* Keep your cell phones, computers, and other electronics as long as possible.
* Donate or recycle them responsibly when the time comes. E-waste contains mercury and other toxics and is a growing environmental problem.
* Recycle your cell phone.
* Ask your local government to set up an electronics recycling and hazardous waste collection event.

Make your own cleaning supplies.
Million Car Campaign

Join the Million Car Carbon Campaign by purchasing your Earth-Aid kit today.

* The big secret: you can make very effective, non-toxic cleaning products whenever you need them. All you need are a few simple ingredients like baking soda, vinegar, lemon, and soap.
* Making your own cleaning products saves money, time, and packaging-not to mention your indoor air quality.

source:Worldwatch Organization.


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Wednesday, September 2, 2009

Back To School-Prepare For Swine Flue

Parents might be feeling more anxious than usual as they send their children back to school this fall. After all, the previous academic year ended with a wave of school closings across the country, the declaration of an influenza pandemic, and fears that H1N1 (swine flu) would return with a vengeance this season.

But here’s the good news: Health and education officials at the local, state, and federal levels have spent the summer preparing for whatever the upcoming flu season may bring. And experts believe that H1N1 (swine flu) will not be any more potent than the seasonal flu we deal with every year. “I think the swine flu is going to be much milder than the regular flu,” says Dr. Kent Holtorf, M.D., of Holtorf Medical Group in Torrance and Foster City, Calif. “Likely there’s a lot more scare than there is substance.”

For now, the Centers for Disease Control and Prevention is taking a wait-and-see approach. In a new set of guidelines released in early August, the CDC recommends that schools not rush to close their doors if some students have the flu. Rather, they are urged to carefully weigh the potential benefits of school dismissal against the social disruption it can cause. The recommendations are based on severity of the flu season — whether conditions are similar to or more severe than the conditions observed in spring 2009 H1N1 outbreak.

A vaccine for H1N1 is undergoing clinical trials and is tentatively scheduled to be available in mid-October. “I think the good news is that by the time the question really comes up in school season, there will be a vaccine out — and a large proportion of the population will have already gone through the disease,” says Dr. Stephen Berger, M.D., founder of the Global Infectious Disease and Epidemiology Network and director of geographic medicine at Tel Aviv Medical Centre in Israel. “Not all flu is susceptible to drugs, but this one is.”

In the meantime, here are a few steps you can take to help keep your children healthy and prepare for the season ahead.

Healthy Practices to Prevent Swine Flu

  • Review good hygiene practices with your children. Remind them to wash their hands frequently and thoroughly, and to cough or sneeze into a tissue or the crook of their arm. Equip them with a travel-size bottle of hand sanitizer to take to school.
  • The CDC recommends getting your family vaccinated for both seasonal flu and H1N1(they are separate vaccines). Priority groups for the H1N1 vaccine — different than those for the seasonal flu — include people ages 6 months to 24 years and people who take care of or live with children under 6 months old. Priority groups include people ages 6 months to 24 years, as well as caretakers of children under 6 months old. NOTE: Multi-dose vials of H1N1 vaccine will contain thimerosal, an antibacterial additive that contains mercury and is believed by some to be harmful to children. Single-dose syringes and inhaler vaccine products will be thimerosal-free and are recommended for young children and pregnant women.
  • If your child is sick, keep him home for at least 24 hours after the fever has subsided without the use of fever-reducing medication.

If Flu Conditions Become More Severe

  • Keep a child sick with flu at home for at least seven days, even if he or she feels better sooner. Those who are still sick after seven days should continue to stay home until at least 24 hours after symptoms have completely disappeared.
  • If someone in your household is sick with the flu, keep all school-aged children home for five days from the time that person became sick. Monitor the children for signs of fever and other flu symptoms.

Contingency Plans in Case of School Closings

  • Stay up-to-date on your school district’s pandemic or emergency plan.
  • Determine whether your school plans to offer Web-based lessons or other forms of distance learning during an extended closure, and plan accordingly.
  • Plan activities to keep your children engaged at home in the event of school closings. Create a stockpile of games, books, DVDs, craft projects, etc.
  • Check with your employer ahead of time to find out if you will be able to stay home to care for sick family members or children who have been dismissed from school. If you can’t work from home, arrange for other child care.

source :Everyday Health

Recommended school responses for the 2009-2010 school year

Under conditions with similar severity as in spring 2009

* Stay home when sick:
Those with flu-like illness should stay home for at least 24 hours after they no longer have a fever, or signs of a fever, without the use of fever-reducing medicines. They should stay home even if they are using antiviral drugs. (For more information, see CDC Recommendations for the Amount of Time Persons with Influenza-Like Illness Should be Away from Others.)

* Separate ill students and staff:
Students and staff who appear to have flu-like illness should be sent to a room separate from others until they can be sent home. CDC recommends that they wear a surgical mask, if possible, and that those who care for ill students and staff wear protective gear such as a mask.

* Hand hygiene and respiratory etiquette:
The new recommendations emphasize the importance of the basic foundations of influenza prevention: stay home when sick, wash hands frequently with soap and water when possible, and cover noses and mouths with a tissue when coughing or sneezing (or a shirt sleeve or elbow if no tissue is available).

* Routine cleaning:
School staff should routinely clean areas that students and staff touch often with the cleaners they typically use. CDC does not believe any additional disinfection of environmental surfaces beyond the recommended routine cleaning is required.

* Early treatment of high-risk students and staff:
People at high risk for influenza complications who become ill with influenza-like illness should speak with their health care provider as soon as possible. Early treatment with antiviral medications is very important for people at high risk because it can prevent hospitalizations and deaths. People at high risk include those who are pregnant, have asthma or diabetes, have compromised immune systems, or have neuromuscular diseases.

* Consideration of selective school dismissal:
Although there are not many schools where all or most students are at high risk (for example, schools for medically fragile children or for pregnant students) a community might decide to dismiss such a school to better protect these high-risk students.

Under conditions of increased severity compared with spring 2009

CDC may recommend additional measures to help protect students and staff if global and national assessments indicate that influenza is causing more severe disease. In addition, local health and education officials may elect to implement some of these additional measures. Except for school dismissals, these strategies have not been scientifically tested. But CDC wants communities to have tools to use that may be the right measures for their community and circumstances.

* Active screening:
Schools should check students and staff for fever and other symptoms of flu when they get to school in the morning, separate those who are ill, and send them home as soon as possible. Throughout the day, staff should be vigilant in identifying students and other staff who appear ill.

* High-risk students and staff members stay home:
People at high-risk of flu complications should talk to their doctor about staying home from school when a lot of flu is circulating in the community. Schools should plan now for ways to continue educating students who stay home through instructional phone calls, homework packets, internet lessons, and other approaches.

* Students with ill household members stay home:
Students who have an ill household member should stay home for five days from the day the first household member got sick. This is the time period they are most likely to get sick themselves.

* Increase distance between people at schools:
CDC encourages schools to try innovative ways of separating students. These can be as simple as moving desks farther apart or canceling classes that bring together children from different classrooms.

* Extend the period for ill persons to stay home:
If influenza severity increases, people with flu-like illness should stay home for at least 7 days, even if they have no more symptoms. If people are still sick, they should stay home until 24 hours after they have no symptoms.

* School dismissals:
School and health officials should work closely to balance the risks of flu in their community with the disruption dismissals will cause in both education and the wider community. The length of time schools should be dismissed will vary depending on the type of dismissal as well as the severity and extent of illness. Schools that dismiss students should do so for five to seven calendar days and should reassess whether or not to resume classes after that period. Schools that dismiss students should remain open to teachers and staff so they can continue to provide instruction through other means.

Reactive dismissals might be appropriate when schools are not able to maintain normal functioning for example, when a significant number and proportion of students have documented fever while at school despite recommendations to keep ill children home.

Preemptive dismissals can be used proactively to decrease the spread of flu. CDC may recommend preemptive school dismissals if the flu starts to cause severe disease in a significantly larger proportion of those affected.
Deciding on a course of action

CDC and its partners will continuously look for changes in the severity of influenza-like illness and will share what is learned with state and local agencies. However, states and local communities can expect to see a lot of differences in disease burden across the country.

Every state and community has to balance a variety of objectives to determine their best course of action to help decrease the spread of influenza.
Decision-makers should explicitly identify and communicate their objectives which might be one or more of the following:
  1. protecting overall public health by reducing community transmission;
  2. reducing transmission in students and school staff; and
  3. protecting people with high-risk conditions.

Some strategies can have negative consequences in addition to their potential benefits. In the particular case of school dismissals, decision-makers also must consider and balance additional factors:
(a) how to ensure students continue to learn;
(2) how to provide an emotionally and physically safe place for students; and
(3) how to reduce demands on local health care services. The following questions can help begin discussions and lead to decisions at the state and local levels.

source: CDC H1N1

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