Published on May 06, 2024
A Parent's Guide: Social Media & Kids
Social media can have positive and negative effects on children and teens. While it can contribute to spaces of community and self-expression, social media has been shown to lead to low self-esteem, disordered eating, and depression. Research shows that the effects these media exposures have on mental health are closely related to how and why they are engaging with the content they are seeing and posting.
Experts agree: the longer kids and teens can stay off social media, the better. Do some research into the different apps and websites that your children are asking to use; some are more appropriate than others.
There is no blanket age indicating when a child or teen is ready for social media. Rather, a youth’s individual maturity level and developed soft skills must be considered, such as their ability to read social cues, impulse control, and susceptibility to rejection/criticism.
Preparing your kids for social media, in addition to staying up-to-date on new technology or the latest app, is a big and necessary job.
While it will look different for each family, general steps parents can take to prepare for safer social media use include:
- Model good social media behavior. Limit screen time and engage with others in-person in front of your child. Much like we try to teach our children healthy eating habits we need to teach them healthy screen time habits, too.
- Scroll and discuss. Using your own feed, explain what is acceptable or unacceptable and why, including posted content and comments. Explain that posts represent a moment in time and most people only post positive experiences. This can give the impression that another persons’ life is better, which should be talked about.
- Use safety features. Consider turning off likes and comments, turn off geo-tags/ tracking features, and explain the risks associated with posting your location. For kids, location sharing and viewing can be dangerous, and it can also lead to feelings of loneliness or not being included.
- Set agreed-upon expectations. A family media plan, including limits on screen time, content boundaries (don’t post selfies or photos of others without consent), and protecting personal information, should be established. If the plan is not followed, a consequence of time away from screens/social media should be enforced.
May is Mental Health Awareness Month. Dr. Tracy Protell is a child psychiatrist at Barton Psychiatry in South Lake Tahoe, CA.
Why is fiber important for kids?
Fiber is a type of carbohydrate that is not broken down by our body. Fiber is classified into two types, soluble and insoluble.
Soluble fiber
Soluble fiber dissolves in water and becomes a thick gel. It can help regulate blood sugars and improve blood cholesterol. Soluble fiber also acts as a prebiotic, or food for the healthy bacteria in our colon or large intestine.
Feeding your child’s healthy bacteria can help protect them against disease and support their heart health! (1)
If you’re curious, see our article on Probiotics for Kids to learn more.
Insoluble fiber
Insoluble fiber does not dissolve in water and instead adds bulk to our stool, making it easier to pass bowel movements. (2)
Simply put, we need both types of fiber in our diet. However, while we need fiber, we also want to make sure our children are drinking enough beverages to make sure they can have a bowel movement with ease.
Another bonus: the best foods rich in vitamins and minerals are also rich in fiber!
Fiber for babies
During the first 6 months of life, babies should be exclusively breastfed or provided iron-fortified formula. (3) They do not need other sources of nutrition at this time.
Read More: From Milk to Solids: Feeding Babies 0-12 Months Old
As our babies wean from breast milk or formula, we want to help them accept a variety of foods rich in nutrients they need to grow.
You can begin introducing babies to nutrient-dense food that complements breast milk or formula around 6 months of age.
Currently, there is no recommendation for how much fiber babies need. However, by introducing fiber-rich foods after the 6-month mark, you can put them on course to accept more fiber-rich foods as they grow up.
What foods are high in fiber?
Fiber can naturally be found in a variety of foods, including:
- Whole grains
- Fruits
- Vegetables
- Nuts and seeds
- Beans, peas and lentils
If your child is not usually fond of high-fiber foods, try offering the foods in another form to get your child interested. Cook them differently, serve them at a different temperature or even on a different plate. You can also incorporate them in other dishes and meals, like smoothies and soups.
Check out some of our recipes like our 5-ingredient green smoothie or mango chia pudding to make fiber-rich foods more fun!
Can kids have too much fiber?
While fiber is an important nutrient and there is no Tolerable Upper Intake Level set, it’s still possible for your child to get too much too quickly. This can lead to gastrointestinal issues like gas, bloating and stomach cramps. Introducing fiber slowly and aiming for a consistent amount daily will help to minimize symptoms. Sticking to the recommended intake for your child’s age group will help you avoid giving them too much.
Water & fiber
Water plays an important role in the digestion of fiber. If your child doesn’t drink enough water while eating high-fiber foods, they can experience constipation. This happens because soluble fiber needs fluid to dissolve and move along the gastrointestinal tract.
Here are baseline ranges of water requirements across age groups (6):
Age Group Daily Recommendation of Water
Babies (7 to 12 months):
3 cups breast milk or infant formula and complementary food and water
Please note: Babies nutritional needs are primarily met through breast milk or formula. Per 2020-2025 Dietary Guidelines, babies should not have more than 4-8 oz. of water per day.
Toddlers (1 – 3 years): 4 cups
Young children (4 – 8 years):5 cups
Preadolescence (9 – 13 years)
Female: 7 cups
Male: 8 cups
Adolescents (14 – 18 years)
Female: 8 cups
Male: 11 cups
The total amount of water they need may change based on activity levels and their environment, such as if they are very active or in hot climates.
Your child’s urine color can also be a good indicator of whether they’ve had too much or too little water. The lighter the color, the more hydrated your child is. The darker the color, the more dehydrated they are.
How to avoid giving too much fiber
To avoid giving too much fiber to your child, consider:
- Increasing fiber slowly so your child’s body can adapt to the changes.
- Ensure your child increases their water intake as their fiber intake increases.
- Provide a consistent schedule of high-fiber foods to promote bowel movements. In other words, try including high-fiber foods at each meal and snack, rather than at one meal each day.
In some plant-based eating patterns, too much fiber may be a concern for young children. Too much fiber for these young ones can lead to reduced appetite and early satiety which may prevent them from getting enough of other nutrients they need for growth like protein and fat.
If your child starts making too many trips to the bathroom, or has gas, bloating and an upset stomach, consider speaking to your child’s health care provider.
Should I consider fiber supplements?
“I see fiber supplements in the supplement aisle advertised for kids. Are they any good?”
While fiber supplements or gummies may catch your eye, a balanced diet will provide enough fiber for your child. However, if you are considering supplements, make sure to consult your child’s qualified health care provider.
How to help a picky eater get enough fiber
If your child is a picky eater, know you are not alone. Picky eating can be stressful for parents, especially because kids need food to grow.
We may feel pressured to make every bite count, but did you know it may take our babies and toddlers up to 8 to 10 exposures to accept new foods? (3) We have several tips to help you with this challenge!
Please visit Expert Tips for Parents of Picky Eaters for more.
References
1. McRae MP. Dietary Fiber Is Beneficial for the Prevention of Cardiovascular Disease: An Umbrella Review of Meta-analyses. J Chiropr Med. 2017;16(4):289-299. doi:10.1016/j.jcm.2017.05.005.
2. Gropper S, Smith J. Advanced Nutrition and Human Metabolism. Belmont, CA: Wadsworth Cengage Learning, 2017. 7th ed. 
ISBN: 9781305627857.
3. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.
4. Institute of Medicine. 2001. Dietary Reference Intakes: Proposed Definition of Dietary Fiber. Washington, DC: The National Academies Press. https://doi.org/10.17226/10161.
5. U.S. Department of Agriculture, Agricultural Research Service. Food Data Central, 2019. Fdc.nal.usda.gov.
6. Institute of Medicine. 2006. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements.
Antibiotic Overuse in Children: What Parents Need to Keep in Mind
Antibiotics are effective medications that work against bacterial infection. However, many use it without understanding its functions. Here’s how it can affect kids…
Antibiotics are a popular range of medications that are used to treat bacterial infections. They work by disrupting the bacteria's ability to multiply and survive. One of the important things to note about antibiotics is that they are not effective against viral infections, which include the common cold, flu, or even COVID-19.
In children, antibiotics help treat bacterial infections, such as strep throat or bacterial ear infections. It's crucial that parents administer antibiotics exactly as prescribed by the pediatrician, completing the full course even if symptoms improve.
On the occasion of World Antimicrobial Awareness Week 2023, we spoke to Dr Tushar Tayal, Consultant-Internal Medicine, CK Birla Hospital, Gurugram, to understand the harmful effects of antibiotic overuse and how it can affect children.
Also Read: Viral Versus Bacterial Infection: Why You Need to Know the Difference
What Is Antibiotic Overuse?
Dr Tayal said, “Antibiotic overuse means the usage of antibiotics in illnesses where they are not required or the usage of high-end antibiotics in outpatient or inpatient department (OPD or IPD) settings where a low-end antibiotic is recommended.”
He added, “It also includes prolonged usage of high-end antibiotics in hospital settings without de-escalation.”
According to the US Centers for Disease Control and Prevention (CDC), at least 28% of antibiotics prescribed in an outpatient setting are unnecessary, meaning that no antibiotic was needed at all.
Antibiotic Resistance and Other Harmful Effects of Antibiotic Overuse in Children
In a 2015 study published in the Journal of Clinical and Diagnostic Research, researchers established that around one in every four (28%) parents correctly identified the use of antibiotics against bacterial infections, whereas only 15.5% of parents knew the meaning of the term antibiotic resistance.
Unfortunately, there is a lack of awareness associated with antibiotic use. Many fail to understand that antibiotics do not work on viruses.
The Mayo Clinic explains, "If you take an antibiotic when you have a viral infection, the antibiotic attacks bacteria in your body. These are bacteria that are helpful or are not causing disease. This incorrect treatment can then promote antibiotic-resistant properties in harmless bacteria that can be shared with other bacteria. Or it can create an opportunity for potentially harmful bacteria to replace the harmless ones."
In such cases, high-end antibiotics are required to treat simpler bacterial infections because low-end antibiotics stop working because bacteria have become resistant to them, said Dr Tayal.
As per a study published in the European Journal of Pharmaceutical Sciences, if the current trend of inappropriate and excessive use of antibiotics continues, antibiotic resistance could cause one crore deaths worldwide by the year 2050.
In addition, Dr Tayal listed a few other side effects that could occur with antibiotic overuse
- Alteration of gut bacteria, which can affect overall immunity and health
- Increased risk of C. difficile infection, which can cause hospitalization and even death
- Increased risk of photosensitivity
- Elimination of good bacteria in the body, which protect against fungal infection
- Increased risk of kidney damage
- Severe allergic reactions, known as anaphylaxis, in rare cases
- Reactions with pre-existing medications
What Parents Need to Know
According to Dr Tayal, antibiotics should only be given under the guidance of a doctor.
It should only be taken once a bacterial cause of infection has been established after thorough clinical examination and necessary testing,” he advised.
In addition, when it comes to administering antibiotics to children, they should be given for the prescribed duration and should not be stopped as per your convenience.
Childhood Vaccine Safety
Vaccinating children is one of the most effective ways to protect against serious diseases which can cause severe illness or even death. For example, the measles vaccine has prevented an estimated 57 million deaths from measles between 2000-2022. Declining vaccination rates increase the risk of serious outbreaks. Unfortunately, there has been a significant increase in measles outbreaks across the country. As of November 21, 2024, there have been 280 cases of measles in 32 states and jurisdictions in the United States. Children under five represent 41% of these cases, and more than half of these children required hospitalization.
Another good example of the importance of vaccination is the recent increase in cases of pertussis, or whooping cough. Pertussis is one of the diseases that we routinely vaccinate children against as part of their regularly scheduled vaccines. Children who are fully vaccinated against pertussis can still be infected, but their symptoms are usually much milder than in someone who has not been vaccinated. Also, vaccinating healthy children helps to slow outbreaks of disease from spreading and protect other children who are too young or otherwise not able to receive vaccinations.
There is a lot of vaccine misinformation on the internet which can cause parents to worry. Here are a few answers to common vaccine concerns:
- The Measles, Mumps, Rubella (MMR) vaccine is NOT associated with the development of autism. The safety of the MMR vaccine has been shown in many well-designed research studies over many years.
- Another common myth is that vaccines contain high levels of harmful ingredients such as aluminum or formaldehyde. In fact, these ingredients are found in much higher levels in common foods and drinks. For example, aluminum is found in both formula and breast milk in much higher levels than is found in vaccines. One pear contains FIFTY times more formaldehyde than is found in any vaccine.
- Parents may worry that receiving more than one vaccine at once can cause their child’s immune system to be overwhelmed. But our immune systems can fight off thousands of potential threats every day and are capable of handling multiple vaccines at one time.
Here are a few common questions I get asked by my parents regarding childhood vaccines.
What are the most common side effects of receiving one or more vaccines?
Fever is one of the most common side effects after receiving a vaccine. Since fever is part of the body’s immune response, fever after a vaccine indicates that the vaccine is doing its job to prepare the immune system to fight the virus or bacteria in the future. (It is important to note, however, that not everyone will develop a fever after vaccination – not to worry, the vaccine is still working). Other common side effects include arm soreness where the vaccine was administered, as well as fatigue or fussiness. More serious adverse events can occur, but these are extremely rare.How many vaccines are safe to receive in one visit?
Multiple studies have shown that it is definitely safe to receive all of the recommended vaccines in one visit. The body’s immune system can manage exposures to thousands of germs in a day, so the vaccines do not overload or weaken the immune system. In general, the routine childhood vaccinations are scheduled for the age when a child is most vulnerable to the effects of that disease. Also, many of these vaccinations require multiple doses in order to give full protection. As a result, a child may need to receive multiple vaccines in one visit, but this is safe and important to fully protect the child.
What about alternative vaccine schedules?
Spacing out the timing of vaccines beyond the recommended schedule is not recommended because it leaves children exposed to potentially harmful diseases for longer. Alternative schedules have not been shown to be beneficial to children. The CDC and American Academy of Pediatrics recommend that children receive all routine childhood vaccinations as scheduled instead of spreading them out, to ensure that they are protected against dangerous diseases as soon as possible.
Is there any child who should NOT receive a certain vaccine?
Some children may not be eligible to receive one or more of their vaccines. For example, your child may not be eligible to receive one or more of their vaccines if they:
- Had a true allergic reaction to that vaccine in the past, or a very rare but serious immune reaction after a vaccine, like Guillain-Barre syndrome.
- Are taking (or have recently taken) medications that affect the immune system, such as chemotherapy medications.
- Have been diagnosed with certain disorders of the immune system.
If you have concerns about your child’s eligibility for one or more vaccines, you should discuss them with your pediatrician.
By vaccinating their children, parents are not only protecting their families from serious illness but also contributing to the health of the whole community. Pediatricians are happy to help by providing accurate information for parents to make informed choices about vaccination. In this way, we can work together to protect vulnerable populations and prevent dangerous diseases, to build a healthier future for all children.
About The Author:
Perry Dinardo, MD, MA is a primary care pediatrician at Atrius Health in Somerville. She obtained her BA in Psychology from Duke University, then completed medical school at the Cleveland Clinic Lerner College of Medicine (CCLCM). While at CCLCM, she also obtained a master's degree in Bioethics & Medical Humanities at Case Western Reserve University. She completed Pediatrics internship and residency at Massachusetts General Hospital