Caring Steps News

Medical experts repeatedly confirm what most parents already suspect--that outdoor play benefits children physically and emotionally.
Harvard faculty member, Claire McCarthy, M.D., offers these six reasons children need to play outside.

1. Sunshine. Our bodies work best when they get some sunshine every day. Sunlight boosts the body’s vitamin D supply, which helps in bone development, neuromuscular health, improving our immune system and regulating our mood.
2. Exercise. Playing outdoors, especially with something like a ball or a bike, encourages active play, which is an important form of exercise for children.
3. Executive function. Unstructured time outdoors allows children to make up their own games, problem-solve and amuse themselves. Executive function and self-regulation are an important part of human development, and children need to practice the mental processes that enable us to plan, focus attention, remember instructions, be creative and juggle multiple tasks.
4. Taking risks. Although it sometimes makes parents anxious, it is important for children to have confidence to take some risks physically and socially. Whether they try to climb a tree, ride a bike, or make a new friend, it is important for children to learn from their success and failures.
5. Socialization. Children need to learn how to work together, share and cooperate. If they only interact in structured settings, they can’t experience everything they need to learn.
6. Appreciation of nature. Dr. McCarthy feels that children need to grow up walking in the woods, digging in soil, and playing in streams to appreciate the importance of their natural surroundings.

The Caring Steps staff understands the importance of the outdoor environment on learning and development. We are proud that our students play outside every day, except in extremely harsh weather conditions. We are committed to helping our students remain happy and healthy.
Let’s go out and play!
 
Source: “6 reasons children need to play outside,” Harvard Health Publishing

As children grow, their car seat safety needs change. Resources are available to clear up confusion so parents can keep their children protected.    
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The National Highway Traffic Safety Administration (NHTSA) reminds parents how critical it is to make sure children are buckled in a properly sized and correctly installed car seat every time they are in a vehicle. For a convenient calculator that allows you to enter your child’s age, height and weight to determine the safest seat, click this NHTSA link.
 
There are several types of car seats and all have size and age recommendations. Infants begin in rear-facing seats, then transition to forward-facing seats with a harness and tether between ages 1 and 7, before growing into booster seats. Because the back seat is the safest place to sit, children should ride there through at least age 12, regardless of their size.
 
For maximum safety, the Mayo Clinic offers these NINE COMMON CAR SEAT SAFETY MISTAKES THAT PARENTS SHOULD AVOID.

1. Avoid getting a used car seat without doing your homework – Make sure a used car seat has instructions and a label showing the manufacture date and model number; hasn’t been recalled; isn’t expired; has no visible damage or missing parts; and has never been in a moderate or severe crash.
2. Avoid placing the car seat in the wrong spot – The safest place for a car seat is the back seat, away from active air bags. If proper installation is possible in the center of the back seat, away from doors, that is preferable.
3. Avoid incorrectly installing the seat or buckling a child – Manufacturer instructions should be followed to make sure the seat is tightly secured and facing the proper direction. For rear-facing seats, use the harness slots at or below the child’s shoulders, with the chest clip even with the child’s armpits, with no slack. If necessary, use small, tightly rolled blankets to provide head and neck support.
4. Avoid reclining the seat at the incorrect angle – Consult the owner’s manual to make sure babies are semi-reclined to keep their airways open, and that the angle is correct so the child’s head doesn’t flop forward.
5. Avoid moving to a forward-facing seat too soon – Resist the urge to rush into the next stage of seating. Wait until the child reaches the highest weight or height allowed for the seat. When the time is right to face forward, install the seat using either the seat belt or the LATCH system (lower anchors and tethers for children) for stability.
6. Avoid not removing heavy outerwear – Bulky outerwear and blankets can hinder a snug, secure fit. Buckle the harness first, and place a blanket on top for warmth.
7. Avoid moving to a booster seat too soon – Booster seats allow safety belts to fit children correctly. Don’t move until a child tops the highest recommended height and weight for the seat, typically 40-80 pounds.
8. Avoid incorrectly using a booster seat – Never use a booster seat with only a lap belt. Use both the lap and shoulder belt.
9. Avoid transitioning to a safety belt too soon – Most children can safely use an adult seat belt sometime between ages 8 and 12, and when the child is 4 feet 9 inches tall. The child should be able to sit comfortably against the back of the seat with knees bent comfortably at the edge of the seat. The lap belt should lie across the child’s hips and pelvis, and the shoulder belt should rest on the middle of the chest and shoulder, not on the neck or face.

 
For information about child passenger safety laws or car seat installation, the NHTSA provides a car seat inspection station locator with certified technicians who will inspect your car seat free of charge.
 
Safety first!

Families love the outdoor experiences that summer brings, but preventing minor mishaps like bug bites can be a concern. Here are some tips for parents.
 
Preventing tick bites
Nature trails, gardening, or even walking your dog can put you in close contact with ticks, which are most active during warmer spring and summer months. Ticks can live in grassy, brushy and wooded areas, right where children are likely to be playing.
                                           
If you can’t avoid these areas, parents may want to consider treating clothing and gear with child-safe insect repellent. Remember that when exercising this option, please use all products as directed. According to the Centers for Disease Control (CDC) and Prevention, it is not recommended that insect repellent be used on babies younger than two months old, and it is not recommended that Oil of Lemon Eucalyptus (OLE) or para-menthane-diol (PMD) be used on children under 3 years old.  
 
Wearing long-sleeved shirts and long pants can be helpful if you are in highly wooded areas. You may even tuck pants into socks and shoes to limit skin exposure, and avoid going barefoot or wearing open-toe sandals.
 
It’s a good idea to shower within two hours after coming indoors. Check your body for ticks, especially under the arms, in and around the ears, inside the belly button, behind the knees, in and around hair, between legs and around the waist.
 
Check all clothing for ticks. Tumble-drying garments on high heat for 10 minutes will kill ticks, and hot water is recommended for washing. Don’t forget to check your pets, who could unknowingly carry pests into the house.
 
Outdoor pesticides can help reduce the number of ticks in an area, but they must be used carefully according to specified instructions. Simple landscaping techniques can also create a safer yard. These include:

• Remove leaf litter.
• Clear tall grasses and brush around buildings and at the edge of lawns.
• Place a 3-ft wide barrier of wood chips or gravel between lawns and wooded areas to prevent migration into recreational areas.
• Mow the lawn frequently.
• Stack wood neatly and in a dry area.
• Keep playground equipment, decks and patios away from yard edges and trees.
• Construct fences to discourage unwelcome animals such as deer, raccoons and stray dogs.
• Remove old furniture, mattresses and trash.

 
The CDC shared this information on tick prevention and what to do if you find one attached.
 
Preventing mosquito bites
In most cases, a mosquito bite is simply an itchy nuisance, but it may also spread viruses that can make you sick. Mosquito season starts in the summer and continues into fall, when the insects may hibernate in warm places like garages or sheds. Pesky mosquitoes can live indoors and outdoors, and although they are most active from dusk to dawn, they bite anytime during the day and night.
 
Controlling mosquitoes begins with paying attention to the places where they lay eggs—particularly near water, which is needed for larvae to survive. Homeowners can remove standing water that may accumulate in tires, buckets, planters, toys, pools, birdbaths, clogged gutters and trash containers. These items should be emptied, scrubbed, turned over, covered or thrown away. It is important to keep mosquitoes outside by using screens on windows and doors and using air conditioning when available.
 
West Nile virus is the most common virus spread by mosquitoes in the United States. Health officials in Oakland County have found West Nile samples in the mosquito pool recently and residents are asked to exercise caution. Other areas of the world are at risk for other illnesses and problems. Travelers are advised to take necessary steps and learn more about the areas they plan to visit.
 
The Oakland County Health Department offers these mosquito prevention tips.
 
A combination of bug prevention tactics may help you enjoy your summer safely. Pesticides, repellents, structural barriers and attention to surroundings can help you and your family avoid bug bites and stay healthy!
 

Measles is a serious respiratory illness that is highly contagious. Thankfully, no cases have been reported in the Rochester Community School District or the Caring Steps community. With the current measles outbreak in the Metro Detroit area, however, parents may have questions about protecting their families.
 
The Michigan Department of Health and Human Services (MDHHS) has confirmed more than 40 cases in Oakland, Washtenaw and Wayne counties. Infected individuals range in age from 8 months to 63 years, according to health officials.
 
Measles is a highly contagious, vaccine-preventable disease that is spread by direct person-to-person contact, and through the air. The Centers for Disease Control and Prevention (CDC) reports measles is so contagious that if one person has it, 9 out of 10 people around him or her will also become infected if they are not protected. Your child can get measles just by being in a room where a person with measles has been, even up to two hours after that person has left. An infected person can spread measles to others even before knowing he/she has the disease—from four days before developing the measles rash through four days afterward.
 
Parents are urged to review this information provided by the Oakland County Health Division to help address many of your concerns. If you have questions, please contact the Oakland County Health Division’s Nurse On Call at 800-848-5533 or noc@oakgov.com. For information about the measles outbreak, visit www.oakgov.com/health or Michigan.gov/MeaslesOutbreak.
 
What is measles?
Measles is a respiratory illness with rash caused by the rubeola virus.
 
Who can get measles?
Anyone who has not received two documented doses of MMR or has not had a confirmed case of measles can get measles. If exposed, approximately 90 percent of people who have not been vaccinated or previously had measles will develop the disease.
 
What are the symptoms of measles?
Measles starts with a fever and at least one of the "three Cs": cough, coryza and conjunctivitis. It's followed by a rash that starts on the face and spreads over the body.

• High fever (over 101˚ F)
• Cough
• Coryza (runny nose)
• Conjunctivitis (red, watery eyes)
• Tiny white spots on the inner cheeks, gums, and roof of the mouth (Koplik Spots) 2-3 days after symptoms begin
• A rash that is red, raised, blotchy; usually starts on face, spreads to trunk, arms, and legs 3-5 days after symptoms begin

 
How long after exposure do symptoms begin?
Symptoms usually begin 7-14 days after exposure, but can appear as long as 21 days after exposure. If symptoms develop, call ahead before you visit your doctor, urgent care or emergency room so they can take precautions to prevent exposure to other individuals.
 
How is measles spread?
Measles is a very contagious disease that is easily spread by person-to-person direct contact and airborne spread of droplets from the nose, throat, and mouth through sneezing, coughing, and speaking. It is spread through even minimal air exposure and contact with contaminated surfaces.
 
How long is a person contagious?
Measles can be spread four days before developing the rash through four days after the rash appears. Measles is highly contagious. A person can be infected with measles just by being in a room with an infected person, even up to two hours after the infected person has left.
 
I have been exposed to someone with measles, what do I do?

• Unvaccinated individuals need to get vaccinated within 72 hours of exposure. If you do not have a record of receiving two measles (MMR) vaccines, unsure if you have been vaccinated, or unsure if you have had measles in the past, contact your healthcare provider.
• Immune Globulin (IG) treatment is effective within six days of exposure for high-risk individuals including those who are unvaccinated or unsure about vaccination status, pregnant women, and those with a weakened immune system due to illness and diseases like HIV, malnutrition, and/or medications.
• If symptoms develop, call ahead before you visit your doctor or emergency room so they can take precautions to prevent exposure to other individuals.
• Stay home if you are sick and don't allow visitors in your home as measles is highly contagious.
• Watch for symptoms for 21 days after potential exposure. Call your preferred healthcare provider if symptoms develop and you believe you were exposed.

 
Are there complications from measles?
Measles can make individuals very ill. Encephalitis (inflammation of the brain) is a serious complication of measles. A more common complication of measles is an ear infection or pneumonia. During pregnancy, measles may cause preterm birth or the baby being born at a low birthweight. Death due to measles is rare in the U.S.
 
Is there a treatment for measles?
If exposed to someone with measles, unvaccinated individuals or those without evidence of immunity can be vaccinated within 72 hours of exposure to help prevent disease. Immune Globulin (IG) treatment is effective within six days of exposure for high-risk individuals.
Bed rest at home for at least four days after the appearance of the rash is necessary to not infect others. Supportive care can be given to relieve symptoms and address complications.
 
How can measles be prevented?

• Measles is preventable by vaccination.
• If you do not have a record of two documented measles (MMR) vaccines from a doctor or in the Michigan Care Improvement Registry (MCIR), unsure if you were vaccinated, or unsure if you had measles in the past, contact your healthcare provider about getting vaccinated.
• Measles vaccine is a two-dose series. If you have two documented doses of the MMR vaccine you do not need another dose.
• All healthy children should be vaccinated at 12 - 15 months with the combination shot for measles, mumps, rubella (MMR).
• A second MMR vaccine is usually given at 4 - 6 years of age, but can be given earlier if it is at least four weeks after the first dose. Children who receive two MMR vaccines at least four weeks apart at any time after the age of 12 months are considered to have completed the MMR series. 
• Some infants under 12 months should get a dose of MMR if they are in an area with ongoing transmission or are traveling out of the country. This dose will not count toward their routine series, so these children would still need to receive two MMR vaccines after 12 months of age. Contact your healthcare provider to determine if your infant should get a dose of MMR.
• Adults born in 1957 or later should receive at least one dose of MMR vaccine unless they have other acceptable evidence of immunity. A second dose of MMR vaccine is needed for adults who may have been exposed to a measles case, or those who are students in colleges/universities, work in health care, or plan to travel internationally. Check with your health care provider to see if you need to be vaccinated.
• In an outbreak situation: potentially exposed individuals without documentation of two MMR doses should receive a dose of MMR.
• Pregnant women should not get vaccinated as this is a live viral vaccine.
• All women of childbearing age should avoid contact with those who have measles.
• Be sure to keep a record of all immunizations. Write down when the shots were received.

 
What if measles occurs at school or a day care center?
All cases must be reported to your local health department within 24 hours. People born in 1957 or later who cannot prove that they either have had: laboratory evidence of immunity to measles, or measles vaccine after 12 months of age and a second dose at least four weeks later, should get a measles vaccine. Otherwise, they will be excluded from school/day care for at least 21 days after the beginning of the last measles case.
 
The Caring Steps staff is cautious in protecting the health and wellness of our children and families. If you suspect you may have a contagious condition, you are urged to stay home and seek medical attention to prevent infecting others.
 
The following information is available from reputable sources.
 
Downloadable fact sheets are available here:
Measles, What You Need to Know, Oakland County Health Division
Top 4 Things Parents Need to Know About Measles, Center for Disease Control and Prevention
 
Sources with links: Oakland County Health Division, Centers for Disease Control and Prevention, Michigan Department of Health and Human Services, HealthyChildren.Org