Successful Traveling with Your Children
Elisabeth Winterkorn, MD

Traveling for the holidays?    
As you head out to visit family or take a trip together this holiday season, we at CMO want you to stay safe and healthy! Amid all the excitement and change in routine, it is important to remember that preserving routine in an unfamiliar situation will make the experience even more enjoyable for everyone -- home rules should be travel rules. Vacation can be fun even if you limit media to 2 hours per day, wear your helmet, go to sleep on time, and read a book!
Travel is fun and educational
      Encourage kids to look up your destination on a map, read a book about somewhere you plan to visit; older kids should look at guidebooks and suggest their own side-trips to get excited about the process.   For toddlers and school-age kids, travel can be fun but frightening. Reassure them that you will be with them, that there will be a bed/car/food/toys when you arrive. Spend some time talking about the trip beforehand and let them be part of the planning process. Talk to them about security at airports, and let them know that bags (backpack, dolls, etc.) must be put in the X ray machine but will come out the other end and be returned to them.    
Chronic illness and daily medications
Make sure to pack your regular medications and check to see that you have enough to last your entire trip. If your child has asthma, take your nebulizer or MDI with spacer even if they haven't had an attack in a few months. Remember to also take your EpiPen twin pack.
Traveling Overseas
We recommend some vaccines (or boosters) and medications based on where you are traveling. It is best to get any new vaccines at least one month prior to travel. Please schedule a visit with us to discuss any necessary vaccines as soon as you plan your trip. You can check the CDC website for more specific information.  
Jet lag is more significant when traveling overseas. If possible, try to schedule your trip to allow for a few days to readjust when you return home.

Road travel can be extremely dangerous in developing countries. Make sure to use appropriate restraints and car seats even if not "required" in that country. In countries where they drive on the "wrong side of the road" there is the extra concern of looking RIGHT before crossing.
Traveler's diarrhea is the most common illness when abroad. Bacteria that cause this illness are carried in water and on foods. Make sure to drink bottled or boiled water, and remember that fresh fruits should be peeled or cooked before eating.
Traveling within the USA
Children are not just little adults! If your child gets sick while you are away from home, please try to find a   Children's Hospital whenever possible.
We are also available to you at our regular call-in and on-call times.    
Air Travel Tips
 Getting through security with children can take even longer than when traveling alone. Make sure to plan some extra time especially if you are traveling with infants and strollers.
Have your child wear layers of clothing that can be quickly and easily removed both for security and because airplane temperatures are widely variable.  
Children under two can travel on a parent's lap, but will need their own seat if older than two. It is recommended that children less than 40 pounds sit in a car seat on the airplane -- you will need to remember car seats and boosters for when you arrive at the other end anyway.   Always remember a "bag of tricks" especially for younger children -- toys, quiet games, snacks, coloring books -- an occupied child is a quiet child. Toddlers may need to stretch their legs on the trip but shouldn't be allowed to run up and down the aisles. Bring a snack and water bottle as well, plane-food is not always "kid-friendly."   Ear pain during take-off and landing can be reduced in infants by having them nurse, take a bottle, or suck on a pacifier; older children can drink through a straw or chew gum.   We do not routinely recommend using Benadryl or other antihistamines before travel on an airplane because it can increase the risk of dehydration. However, speak with your provider individually if you have specific needs and concerns for a child.     


Automobile Travel Tips
As for car travel, plan for activities to do while driving. Kids should have a backpack full of crayons, coloring books, magnetic puzzles, and other in-car games. You can even get a book-on-CD for the whole family to listen to on long trips. Short movies and video games are fine, but even on the road, keep your media time less than two hours. If you are planning a long car trip, look for fun pit-stops along the way. And bring a water-bottle and a few healthy snacks.   For children who get carsick, you want to have them sit by the window and look as far in the distance as possible. Do not allow reading in the car (including kindle/nook/iPad), also, restrict video games or movies as this will focus their attention on the interior of the car and make the nausea worse. Play family games that encourage kids to look out the window (the alphabet game, counting red cars, find all the state license plates). If none of these is working, pull over safely to the side of the road and allow your child to lie flat for 5-10 minutes in open air to resolve the symptoms.     If your child has recurrent and severe episodes of carsick, contact your primary provider to talk about possible over-the-counter medications to prevent the symptoms.

Healthy Holiday Eating Tips

During the holidays, yummy food and tasty treats are everywhere. It would be easy to let healthy eating habits slide, but holidays can still be healthy. Here are some tips to help you and your family stay on track with good eating habits:

  • Nibble on healthy snacks like whole grain crackers, fruit, or raw vegetables before the big feast. You will eat less.  
  • When you are at a party or having a holiday meal, look for the foods that are healthier, like veggies or fruits, and make sure to eat some of those.  
  • It takes your brain some time to signal you are full. Wait 10-15 minutes before eating seconds. This may keep you from overeating!  
  • It's not rude to say no to food. Don't be pressured to eat, if you aren't hungry.  
  • Eating holiday goodies like fudge, peanut brittle, cookies, and other baked goods is fine, but eat them in small portions.
  • You can help make healthy holiday food with your children. Look for low-fat recipes that substitute butter and oil with non-fat ingredients like applesauce or pumpkin.

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 CMO CLOSING AT 4:30 PM Wednesday November 27
will be 
Thanksgiving Day 

Our providers remain available for urgent clinical matters

Open normal   office hours  
all other days.

As always, our providers remain available 
24 hours a day, 
7 days a week, 
365 days a year. 
CALL US FIRST For urgent clinical questions by calling 978.975.3355. 

We also encourage you to use our  Acute Illness Guide    to help determine the urgency in which your child needs to be seen.

CMO wishes you and your family a safe and happy holiday season!

Don't Ignore Your Child's Tummy Ache
| Child Anxiety

"Mom, my tummy hurts." This is a classic excuse children use to get out of going to school. But...is it an excuse? Or is it a sign of something more serious?

Tummy Aches and Child Anxiety
Anxiety often manifests as physical symptoms. This can happen long before a person realizes he or she is anxious. For instance, you may have a hard time sleeping before the start of the work week. The struggle could be from subconscious stress you feel about work.
Most children do not understand their emotions enough to understand when they're feeling anxious. Instead, they may get upset, emotional, or defiant. They may also experience physical effects, such as a tummy ache or headache. If your child is complaining about an upset stomach, he or she may be dealing with anxiety.

Does This Mean My Child Should Skip School?
Anxiety isn't necessarily a reason to skip school. Rather, it is an issue that requires a solution. Try to figure out why your child is anxious about school. Is there a test coming up? Is there a child at school that is being mean? Is your child struggling in a certain subject?
Once you know why your child is anxious, you can find a solution for that issue. For instance, if your child is struggling with a certain subject, you might as the teacher for extra study work you can do at home. When your child feels comfortable in school, those stomach aches are liable to go away.

How to Treat Child Anxiety
If you believe your child has anxiety, a child therapist can help. These professionals have unique training in how to communicate with children. The therapist can get to the root of your child's anxiety and determine which solutions will work best for him or her. You can also work with the therapist to learn how to improve matters at home.

What If Child Anxiety Isn't the Issue?
Anxiety is not always the reason for tummy aches in children. If you think this is an issue with your child's physical health, talk to your primary care provider about treatment options.

Family Counseling Associates  provides counseling services for patients of CMO right in our office. Contact your provider through MyChart if you think this may be beneficial for your child.