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Your Teen

90% of High School Kids Need More Exercise

1:30

Nine out of ten high school students are not exercising enough to stay healthy and fit, setting up a pattern that often continues after they graduate, according to a new study published in the journal Pediatrics.

Researchers followed students at 44 high schools for four years, and found that only 9 percent met current exercise recommendations throughout that time. For the most part, those habits held steady after high school -- though college students were more active than non-students.

For students that continued to college, those living on campus exercised more than those living at home.

It's not clear why those students were more active. They might have been more involved in sports, for example, or simply walked more -- running from classes to dorms and other campus buildings, said lead researcher Kaigang Li.

"The walkability of your environment is important," said Li, an assistant professor of health and exercise science at Colorado State University, in Fort Collins.

This is not the first study to look at the physical condition of high school and college students.  Several other studies have found that these two groups struggle with getting enough meaningful exercise. 

According to Peter Katzmarzyk, a professor at Louisiana State University's Pennington Biomedical Research Center, in Baton Rouge, "This study really confirms the low levels of physical activity in adolescents, which appear to be maintained over time as they transition into young adulthood."

The strength of this study, he said, is that it objectively measured teens' activity levels: Students wore devices called accelerometers, which tracked how much they moved over the course of a week.

Katzmarzyk, who was not involved in the study, conducts research on child exercise patterns, obesity and health.

According to the U.S. Centers for Disease Control and Prevention (CDC), teenagers should get at least one hour of physical activity each day that includes exercise that boosts the heart rate, such as running. Kids should also try some strength-building activities -- for example, push-ups or lifting light-weights.

The CDC noted that a lack of physical education in U.S. schools may be a contributing factor in students’ understanding of exercise and how it can improve their health. 

At one time, PE was a part of every student’s daily school activities, today, according to the CDC, only 29 percent of high school students have gym class every day.

The evidence from this new research and other studies makes a good argument for more physical education, according to Katzmarzyk.

"Any way that we can increase physical activity levels in adolescence might translate into maintaining higher levels of physical activity in young adulthood," he said. "So physical education in high school is certainly an important outlet for this."

Still, Li said, there are probably numerous reasons for teenagers' low exercise levels.

He noted that in elementary school, most U.S. kids do get enough physical activity. But there is a steep drop-off after that. According to Li, that could be related to many factors -- including heavier homework loads starting in middle school, and more time on cellphones and computers.

While schools and communities can advance opportunities for kids to be more physically fit, families that put a high priority on exercise and a healthy lifestyle give their children the ability to independently remain physically fit for a lifetime.

Story source: Amy Norton, https://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/9-of-10-teens-don-t-get-enough-exercise-study-shows-715167.html

Your Teen

Smoking and Drinking Rates Among Teens Dropping

1:30

There’s good news to report on teens’ use of alcohol and cigarettes. According to new government data, smoking and drinking among teenagers fell to new lows in 2015.

According to the data gathered, just 9.6 percent of adolescents, ages 12 to 17, reported using alcohol in 2015, down from 17.6 percent in 2002.

Far fewer adolescents smoke every day: about 20 percent in 2015, down from 32 percent in 2002.

The numbers came from the Substance Abuse and Mental Health Services Administration, a federal agency that tracks addiction and mental health issues in the United States.

It appears that today’s teens are choosing not to follow in their parent’s footsteps, which had much higher rates of smoking and drinking when they were adolescents.

Kana Enomoto, principal deputy administrator at the agency, said the new numbers showed that rigorous public health efforts to reduce smoking and drinking among teenagers were paying off.

The survey also tracked prescription drug use and abuse, as well as the use of illegal drugs like heroin. While the trend is still down, the difference was not statistically significant from 2014, but headed in the right direction. Heroin deaths have been increasing rapidly across the country, health experts are hoping the data showing a decline in use could be an early indicator that the trend is reversing.

Prescription drug abuse is still very high in the United States. The survey found that about 119 million Americans 12 and older, or about 44 percent of that population, used prescription psychotherapeutic drugs in the past year. Of those, the vast majority — about 98 million — used pain relievers.

In all, about 19 million people age 12 and older, or about 7 percent of that population, misused prescription drugs in the past year, including about 12.5 million people who misused pain relievers.

Government funded treatment programs for drug abuse continue to lack congressional approval, frustrating mental health and drug abuse service providers.

“There’s no other condition for which we would accept the fact that less than 10 percent of people are treated,” Ms. Enomoto said.

A decrease in the numbers of teens drinking alcohol and smoking cigarettes is really a welcomed change. Smoking is the largest cause of preventable death in the United States, with illnesses linked to it taking more than 480,000 lives a year.

Research indicates that alcohol use during the teenage years could interfere with normal adolescent brain development and increase the risk of developing an Alcohol Use Disorder (AUD.) In addition, underage drinking contributes to a range of acute consequences, including injuries, sexual assaults, and even deaths—including those from car crashes.

No one wants to see his or her son or daughter become one more sad statistic.  Family support and treatment availability are key in helping our young people live healthier and happier lives.

Story source: Sabrina Tavernise,

http://www.nytimes.com/2016/09/09/science/smoking-and-drinking-rates-among-us-teenagers-fall-to-new-lows.html

https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

 

Your Teen

“See it before you sign it”. Fire Safety for Off College Campus Living

1:45

Whether it’s in the spring, fall, winter or summer, many college kids will eventually move to off campus living quarters. Parents and students typically have time to do research on the areas around campus that are for rent. However, there are some fire prevention safety tips that you might not have thought about.

The best advice to help keep your college student safe is… don’t sign on the dotted line until you’ve actually seen the apartment or house.

Why? Because about seven people every year, die in fires in dorms, fraternities, sororities and off-campus housing.

Since 2000, nearly 120 people have died in campus fires, according to a U.S. Fire Administration (USFA).

Off-campus housing tops the list for fires.

Most (94 percent) fatal campus fires took place in off-campus housing, according to incidents examined by USFA between 2000 and 2015.

The U.S. Consumer Product Safety Commission (CPSC) has teamed up with USFA, the National Fire Protection Association (NFPA) and Campus Firewatch to help get this warning out. Don’t sign a contract for housing until you see it yourself. That goes for Mom and Dad too. See it, take a housing tour and make sure you look for:

#1 Working smoke alarms

Make sure there are working smoke alarms on every level and inside each bedroom. Smoke alarms save lives. Fire sprinklers add lifesaving protection too.

USFA found that smoke alarms were missing or did not have batteries in 58 percent of fatal campus fires. None of the fatal fire locations had fire sprinklers.

#2 Two ways out of each room for a safe escape. Make sure all windows and doors open easily. You need to be able to get out if there is a fire. Two ways out are best.

#3 Campus or off-campus housing that can handle today’s electric power needs.

Laptop computers, phones, televisions and coffee makers take a lot of power. Some older homes may not be able to handle all the electrical demand by today’s students. USFA found that electrical issues caused 11 percent of the fires.

#4 Be in the know.

Make sure that your college student knows how to be responsible around alcohol and smoking. The USFA study found these two things involved in the majority of the fires.

Also, if your child is going to be cooking his or her own meals, a discussion about keeping an eye on the food when it is cooking and avoiding distractions is a necessity.

College is a time of new and exciting beginnings. Be sure to “See it before you sign it” for off-campus housing so that an overlooked danger doesn’t have a chance to bring precious college years to an abrupt and devastating end.

Story source: http://onsafety.cpsc.gov/blog/2016/04/04/see-it-before-you-sign-it/

Your Teen

Keep Teen Drivers Safe

Firm parents keep teen drivers safe. No more texting in the car while driving.Your parenting style can make a huge difference in your teen's safety once he or she gets behind the wheel of a car.

Parents who set firm rules, but do so in a helpful, supportive way, can reduce the likelihood of their teen getting into an auto accident by half and decrease rates of drinking and driving, two new studies find. Positive rule-setting can also increase the odds a teen will wear a seatbelt and lessen the likelihood of talking or texting on a cell phone while driving. "Parent involvement really matters. Active parenting can save teenagers' lives," said Dr. Kenneth Ginsburg, an adolescent medicine specialist at the Center for Injury Research and Prevention at the Children's Hospital of Philadelphia. "Parents who give rules, set boundaries and monitor those boundaries with warmth and support can have a really dramatic effect on teen driving safety." Ginsburg is the lead author of two studies published online in Pediatric. Both studies were sponsored by State Farm Insurance. The first study looked at the association between parenting styles and teen driving behaviors and attitudes, while the second assessed teen behavior based on their access to a vehicle. It included a nationally representative sample of 5,665 teens in 9th through 11th grades. Parenting style was reported by the teens and fell into one of four categories: authoritative (high support along with rules and monitoring); authoritarian (low support with rules and monitoring), permissive (high support with low rules and monitoring), and uninvolved (low support and low rules). Teens who had authoritative or authoritarian parents wore seatbelts twice as often as teens with uninvolved parents. Teens with parents in these groups were also half as likely to speed as those with uninvolved parents. Teens with authoritative parents -- high support and rules -- were half as likely to get into a car accident, 71 percent less likely to drink and drive, and 29 percent less likely to talk or text on their cell phones while driving compared to teens with uninvolved parents. The second study included 2,167 teens and found that 70 percent had "primary access" to a vehicle. That didn't necessarily mean that the teens had their own cars, Ginsburg said, but it could mean they had easy access to the keys and didn't need to ask permission to take a family car. After controlling the data to account for the extra hours these teens likely spent behind the wheel, the researchers found that teens with easy access to a vehicle were more than twice as likely to crash, about 25 percent more likely to use a cell phone while driving and about 25 percent more likely to speed than teens who had to ask permission to use a car. Why the difference? Ginsburg said he suspects it's because teens with easy access to a car don't necessarily feel as accountable. They don't have anyone asking where they're going or whom they'll be with. "They miss out on that conversation and appropriate monitoring," he said. Parents should control the keys to the car for at least the first six to 12 months of driving, he added. Ginsburg said there are clear rules that must always be followed, and rules that will change as your teen gains experience and demonstrates responsibility. Those rules include:

  • Always wear your seatbelt.
  • Never speed.
  • Never drink and drive.
  • Never drive fatigued.
  • Never use your cell phone or text while driving.

Rules that can change as your child gains experience and skill include having passengers, driving at night, increased access to the car and driving in bad weather. Ginsburg said it's important to make sure there's a reward for your teen for good driving behavior. "There has to be something in it for them," he said. Most parents worry more about sex, drugs and drinking than they do about driving, but car crashes are the biggest threat to teen safety, Ginsburg added. "The great news is that parents really matter. And, when you stay involved and do so in a way that promotes safety, not control, driving becomes the greatest opportunity to promote their children's safety.

Your Teen

Alcohol-Branded Clothing & Accessories Linked to Youth Alcohol Use

2:00

The T-shirts, handbags, backpacks, hats, jackets and sunglasses we wear and carry all say a little something about who we think we are or would like to be. Clothing with slogans and photos, accessories with name –brands or specific designs help express, at least a small way, how we connect with others and want others to connect with us.

From politics to religion to music and movies – we’re not likely to wear something that we philosophically disagree with. That’s pretty much true in all age groups.

So, what does it mean when teens proudly wear clothing and carry products with alcohol-brands up front and center?

According to a large review of different studies on the topic, teens that own caps, shirts, and other merchandise displaying alcohol logos are more likely to drink.

Australian researchers reviewed results from 13 studies looking at alcohol-branded merchandise and teen alcohol use. The research included more than 26,000 kids and teens, mostly from the United States.

Four studies looked specifically at young people who hadn't started drinking alcohol. Those who owned alcohol-branded merchandise were more likely to start drinking a year later, the researchers said.

While the study doesn’t prove causation (teens will drink if they own alcohol-branded items), it does show an association between the two activities.

"It is possible that owning the merchandise makes young people more likely to drink, or that young people who drink are more likely to want to own the merchandise, or a combination of these effects," explained study leader Sandra Jones. She's director of the Centre for Health and Social Research at Australian Catholic University in Melbourne.

Dr. Victor Strasburger, lead author of the American Academy of Pediatrics' Children, Adolescents, and Advertising policy statement, said, "The studies showed that this ownership contributes to onset of drinking, not the amount of drinking.”

“But we know that when teenagers begin drinking, they tend to binge drink, not use good judgment, and drive when drunk or intoxicated," he added.

Because of the study’s findings, Jones believes that promotional alcohol-branded products encourage drinking among adolescents.

"As they transition through adolescence, young people are developing their sense of identity," she said.

"The things that they wear, carry, and consume help to create and convey their desired identity. There is increasing evidence that brands facilitate this by allowing the young person to take on and project the desirable characteristics that are associated with that brand. These characteristics and brands then become a part of their sense of self, as well as the way that others see them," Jones said.

In addition to hats, caps and T-shirts, other examples of alcohol-related products include accessories, such as bags, backpacks, belts, lighters, sunglasses, wallets and key rings. Other promotional items include drinking glasses, utensils, cooler bags, bottle openers and coffee cups, the researchers said.

Depending on the study, ownership of such items ranged from 11 percent to 59 percent of the young participants. Ownership was higher among older children and males, the researchers said.

Most of the studies didn't find any gender differences. But two studies did find that the association between branded merchandise and drinking issues was actually stronger for girls.

Jones noted that company policies and regulations could help prevent the availability of such products for teens. She recommended restricting the sale of alcohol promotional products where the sale of alcohol is allowed, that alcohol-branded clothing not be made in children’s sizes and toys and gimmicks that appeal to children be discontinued.

Jones also noted that it’s not only up to businesses and government to regulate the availability of these products to kids, but parents as well.

"Many of these items are given away for free at promotional events or as gifts with purchase, and parents may hand them on to their children -- or allow others to do so -- without processing the fact that they are providing their child with extended exposure to an advertisement for an alcohol brand," she said.

Strasburger said the media are often irresponsible when it comes to alcohol. "They depict alcohol use as normative behavior, or a solution for complex problems, or show being drunk as funny," he said. "We spend something like $5 million on alcohol advertising every year, then we wonder why so many teenagers drink. It's not rocket science."

The findings were publised online in the April 1st edition of the journal Pediatrics. 

Story source: Don Rauf, http://consumer.healthday.com/kids-health-information-23/kids-and-alcohol-health-news-11/booze-branded-merchandise-may-spur-teen-drinking-709478.html

 

 

 

Your Teen

Acne

Teenage acne can be a traumatic experience for your child. It’s a very common condition, one that impacts over an estimated 17 million people. Dr. Robin Carder, chief of pediatric dermatology at Children’s Medical Center Dallas says acne can be due to a number of things. “Their follicles make more skin cells and that, combined with oil in our skin forms plugs. Once skin is plugged, you get a pimple.”

Dr. Carder says oil is stimulated more in skin during puberty which is sometimes why teens seem to be more impacted. Typically boys get more severe acne than girls. Parents can help their child by encouraging them to gently wash their face twice a day. Dr. Carder says to resist the temptation to scrub as that can aggravate the skin. Teens that have more oily skin should use a wash that contains salicylic acid, which will dry the skin out some. Teens with sensitive skin should use something more gentle like Cetaphil or a Neutrogena glycerin bar. She also says that if your child doesn’t see results from an over-the-counter product within three to four months they should see their pediatrician for a more aggressive treatment. Dr. Carder offers her teenage patients one final tip: “Squeezing and picking is probably the worst thing you can do and it’s probably the fastest way to reach scarring. They heal faster if you leave them alone.”

Your Teen

Acetaminophen, No Threat To Child's Liver

2.00 to read

With more than eight million American kids taking the drug every week, acetaminophen is the nation's most popular drug in children. It's toxic to the liver in high doses, and can be fatal if taken in excess. Very rarely, adults may also get liver damage at normal doses, so doctors had worried if the same was true for kids. Concerns about liver injuries in children who take the common painkiller acetaminophen, sold as Tylenol in the U.S. are unfounded, researchers said on Monday. "None of the 32,000 children in this study were reported to have symptoms of obvious liver disease," said Dr. Eric Lavonas of the Rocky Mountain Poison and Drug Center in Denver. "The only hint of harm we found was some lab abnormalities." With more than eight million American kids taking the drug every week, acetaminophen is the nation's most popular drug in children. It's toxic to the liver in high doses, and can be fatal if taken in excess. Very rarely, adults may also get liver damage at normal doses, so doctors had worried if the same was true for kids. "This drug is used so commonly that even a very rare safety concern is a big concern," said Lavonas, whose findings appear in the journal Pediatrics. Some researchers suspect there is a link between long-term use of acetaminophen and the global rise in asthma and allergies, but the evidence is far from clear at this point. For the new report, researchers pooled earlier studies that followed kids who had been given acetaminophen for at least 24 hours. There were no reports of liver injuries leading to symptoms such as stomachache, nausea or vomiting, in the 62 reports they found. Ten kids, or about three in 10,000, had high levels of liver enzymes in their blood, which usually means their livers have been damaged. In most cases, however, those elevations were unrelated to acetaminophen. And even if they were caused by the drug, they don't indicate lasting damage, according to Lavonas. "Acetaminophen is extremely safe for children when given correctly," he said. "Parents should not be afraid to give acetaminophen to their children when they need it, but they should be very careful about giving the right dose." "If you suspect that you have given a child an overdose, call your state's poison center," he added. The Rocky Mountain Poison and Drug Center receives funding from McNeil Consumer Healthcare, the Johnson & Johnson subsidiary that sells Tylenol, but the researchers said the company did not support this study.

Your Teen

Why Do Teens Use E-Cigarettes?

2:00

Why do teenagers give e-cigarettes a try? Because these products are easy to obtain, not terribly expensive, come in lots of different flavors and their friends use them. All very adolescent associated reasons.

If they continue using e-cigarettes, it’s because of the low cost and the promise that they can help them quit smoking regular cigarettes, according to senior researcher Suchitra Krishnan-Sarin. She is a professor of psychiatry at Yale University School of Medicine in New Haven, Conn.

Teens who initially tried e-cigarettes because of their low cost had significantly stepped up their use of e-cigarettes by the time researchers checked in six months later.

In addition, teens who tried e-cigarettes to quit smoking were more than 14 times more likely to keep using e-cigarettes than those who did not consider this a reason to try the devices, the findings showed.

Unfortunately, researchers found that e-cigarettes did not help the kids quit smoking. Four out of five teens that were smokers, were still smoking regular cigarettes six months later even though they were using e-cigarettes to quit, the investigators found.

E-cigarettes don't produce tobacco smoke, but they do contain nicotine. And researchers fear they'll create a new generation of smokers, with kids hooked on nicotine turning to tobacco for a stronger fix, Krishnan-Sarin said.

"That is the huge public health debate," she said. "Are kids going to start with e-cigarettes and then move on to cigarettes? Is that going to be the start of nicotine addiction?”

As part of the study, Krishnan-Sarin and her colleagues’ surveyed 340 e-cigarette users in two middle schools and three high schools in 2013, asking them why they first tried e-cigarettes.

Most cited reasons for first trying e-cigarettes as curiosity (57 percent), good flavors (42 percent), use by friends (33 percent), healthier than cigarettes (26 percent), can be used anywhere (21 percent) and does not smell bad (21 percent).

Six months later, researchers checked in with the teens and asked if they were still vaping and if so, why. They then compared the answers to the teens’ reasons for continued use with their previous reasons for starting e-cigarettes.

Kids who cited the low cost of e-cigarettes or their potential help to quit smoking wound up vaping more days on average than those who cited other reasons, the study authors said.

Teens who cited low cost, used e-cigarettes two out of every three days during the previous month, and those who wanted to quit smoking wound up vaping nearly that often, according to the study results.

Other reasons also predicted continued use of e-cigarettes: they don't smell bad; they come in good flavors; friends use them; they can be used anywhere; they can be hidden from adults; and they are healthier than tobacco.

But for kids who kept using e-cigarettes, "the most robust predictors were the low cost and trying e-cigarettes to quit smoking," said lead researcher Krysten Bold, a postdoctoral fellow in psychiatry at Yale School of Medicine.

Krishnan-Sarin said these findings reveal several different means by which policymakers could make e-cigarettes less attractive to teenagers.

Earlier this year, The U.S. Food and Drug Administration (FDA), announced new regulations for e-cigarettes. Anyone under 18 years of age cannot purchase them and they must show a photo I.D. if they appear to be younger than 27. Retailers cannot give out samples and cannot sell them in vending machines unless the machines are in adult-only facilities. These new rules went into effect August 8th.

The Food and Drug Administration will have to approve all e-cigarette products that have been available since February 2007. That means nearly every e-cigarette product on the market must go through an application process to deem whether it can continue to be sold.

However, the FDA did not address the issue of different flavors.

Federal officials also could ban the use of flavors in e-cigarettes, as has already been done in traditional cigarettes except for menthol, said Dr. Norman Edelman, senior scientific advisor for the American Lung Association.

"Despite recommendations from the American Lung Association and others, the final rule did not ban flavorings as they have in ordinary cigarettes," Edelman said. "We continue to believe all the measures that have been applied against ordinary cigarettes should be applied to e-cigarettes."

The study was published online in the journal Pediatrics.

Story sources: Dennis Thompson, http://www.webmd.com/parenting/news/20160808/why-teens-choose-e-cigarettes

Aamer Madhini, http://www.usatoday.com/story/news/2016/08/07/e-cigarette-regulations-set-go-into-effect/88362926/

Your Teen

Teens Using Internet for Better Health

2:00

There’s been a lot of bad news concerning teens and the Internet but finally there’s something good to report. According to a new study, many adolescents are using the Internet to research ideas on how they can improve their health.

In the first national study in more than a decade to look at how adolescents use digital tools for health information, nearly one-third of teenagers said they used online data to improve behavior — such as cutting back on drinking soda, using exercise to combat depression and trying healthier recipes — according to a study to be released Tuesday by researchers at Northwestern University.

Now that’s the kind of Internet use that makes parents let out a sigh of relief.

The study emphasizes the importance of making sure that there is accurate and easy to understand information that is available “because it’s used and acted upon,” said Ellen Wartella, director of Northwestern’s Center on Media and Human Development and lead author of the report.

While social media may be the new neighborhood community, 88 percent of the participants said they didn’t want to share their health concerns on Facebook or on one of the many other social media outlets.

“I mainly find it kind of moving, because it really illustrates that a lot of teens are grappling with very real, very important health challenges and that the Internet is empowering them with the information they need to take better care of themselves,” said Vicky Rideout, a co-author of the study.

Researchers surveyed 1,156 American teenagers between 13- and 18-years-old. Teens in English-speaking households were surveyed last fall, and those in Spanish-dominant households were surveyed in March. Eighty percent of those surveyed attended public school.

The survey explored how often teens use online tools, how much information they receive, what topics they are most concerned with, what sources they trust and whether they have changed their health behaviors as a result.

The top health topics were fitness and exercise (42 percent), diet and nutrition (36 percent), stress or anxiety (19 percent), sexually transmitted diseases (18 percent), puberty (18 percent), and depression or other mental health issues (16 percent).

While Internet health-related searchers are growing in popularity, parents are still the number one choice for teens to learn about health issues (55 percent).

The next source was health classes in school, doctors and nurses and Internet searches being the fourth most popular way to get the information they wanted.

“The Internet is not replacing parents, teachers, and doctors; it is supplementing them,” the researchers wrote.

In fact, 23 percent of teens say they have gone online to research information about a condition that affects a friend or family member. Data from the study indicates that 31 percent of low-income teens have done so, compared with 18 percent of high-income teens.

What are the top health topics teens are Googling? Fitness and exercise was number one (42 percent). Followed by diet and nutrition (36 percent). Next up was stress or anxiety (19 percent), and a few that many parents might not think of; sexually transmitted diseases (18 percent), puberty (18 percent), and depression or other mental health issues (16 percent).

The survey points out that teens may need extra attention when it comes to digital literacy skills. So many articles are wrapped in advertising that is trying to sell someone a particular weight-loss product or new diet aid. Half of teens say they usually click on the first site that comes up. Domain names that end with “.edu” are more trusted than those that end with “.com,” the survey found.

“We need to make sure there is good information for teens online,” Rideout said. Teens could be influenced by the tweets they see about e-cigarettes without realizing that a large proportion are coming from manufacturers, she said.

Still though, teens are learning a lot from the Internet; a place where they can search for answers anonymously. It’s up to parents, teachers, doctors and nurses to guide them towards websites with sound information that is based on on the kinds of websites where they can find science-centered information and helpful advice.

Source: Lena H. Sun, http://www.washingtonpost.com/national/health-science/nearly-13-of-teens-changed-health-habits-based-on-digital-search-study-finds/2015/06/01/c6679aec-0892-11e5-95fd-d580f1c5d44e_story.html

 

 

 

 

 

 

 

 

 

 

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What is baby led weaning when it comes to first foods?

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