الحمى عند الأطفالFever in children (Arabic)-

 

الحمى عند الأطفال

• النقاط الرئيسية (Key points)

  • الحمى هي عندما ترتفع درجة حرارة الجسم إلى 38 درجة مئوية أو أكثر - عادة بسبب عدوى.
  • الحمى شائعة عند الأطفال. إنها علامة على أن جهاز المناعة في الجسم يعمل.
  • ليست هناك حاجة لعلاج حمى الطفل إذا بدا جيدًا ومرتاحًا.
  • راجع الطبيب أو اختصاصي الصحة إذا كنت قلقًا بشأن طفلك وتعتقد أنه يبدو مريضًا للغاية.
  • إذا كان عمر طفلك أقل من ثلاثة أشهر ويعاني من حمى أعلى من 38 درجة مئوية، فيجب عليك اصطحابه إلى الطبيب في أسرع وقت ممكن.

  ما هي الحمى؟ (?What is a fever)

  الحمى هي عندما ترتفع درجة حرارة الجسم إلى 38 درجة مئوية أو أكثر. الحمى شائعة عند الأطفال وهي استجابة طبيعية للعدوى. في الواقع، قد تساعد جهاز المناعة على مكافحة العدوى.

  عادة ما يركز الأطباء على سبب الحمى، وليس درجة الحرارة الفعلية. إذا كان طفلك يعاني من الحمى، فمن المهم مراقبته بحثًا عن أعراض أخرى، بدلًا من فحص درجة حرارته بشكل متكرر. على سبيل المثال، إذا كان الطفل يعاني من الحمى مع سيلان الأنف أو السعال، فمن المهم مراقبة تنفسه.

  في حين أن الحمى ليست دائمًا مدعاة للقلق، إلا أنه يجب أن تظل متنبهًا. إذا بدا الطفل مريضًا بشكل غير عادي، فمن الأفضل التحدث مع طبيب أو اختصاصي صحي.

  علامات الحمى وأعراضها (Signs and symptoms of fever)

  يعاني الطفل من الحمى إذا كانت درجة حرارته 38 درجة مئوية أو أكثر.

  قد يمكن أيضًا:

  • أن يكون غير سعيد وغير مرتاح
  • أن تشعر بالحرارة عند لمسه
  • أن يكون سريع الانفعال أو يبكي
  • أن يكون لديه صداع
  • أن يكون أكثر نعسًا من المعتاد
  • أن يتعرّق
  • أن يكون لديه طفح جلدي أو تغير في لون الجلد
  • أن يرتجف أو يشعر بقشعريرة.

  قياس درجة حرارة طفلك (Taking your child’s temperature)

  هناك عدة طرق لقياس درجة حرارة الطفل. يقيس كل واحد درجة الحرارة بشكل مختلف، ويمكن أن تختلف النتائج حسب نوع مقياس الحرارة الذي تستخدمه.

  أفضل الطرق للتحقق من درجة حرارة الطفل هي:

  • تحت الإبط باستخدام مقياس حرارة رقمي أو كحولي
  • في الأذن باستخدام ميزان حرارة للأذن (ويسمى أيضًا مقياس الحرارة الطبلي) - لا ينصح به لأقل من ستة أشهر من العمر.

  
  الشكل الأول: نوعان مختلفان من موازين الحرارة - ميزان حرارة تحت الإبط (يسار) وميزان حرارة داخل الأذن (يمين).

  
  اتبع دائمًا التعليمات الخاصة بميزان الحرارة للحصول على قراءة دقيقة لدرجة الحرارة.

  قد يكون لمس جبين الطفل طريقة سريعة للتحقق من الحمى المحتملة، ولكن يجب عليك التحقق من ميزان الحرارة إذا كنت بحاجة إلى التأكد.

  قد تكون موازين الحرارة بالأشعة تحت الحمراء والشريط البلاستيكي للجبهة غير دقيقة في قياس درجات حرارة الأطفال.

  كيفية العناية بالحمى في المنزل (How to care for a fever at home)

  يمكن أن تسبب العديد من الأمراض المختلفة الحمى؛ العدوى الفيروسية هي الأكثر شيوعًا.

  عادة ما تختفي الحمى مع توفير الراحة والدعم.

  لن يؤدي خفض حمى طفلك إلى اختفاء العدوى بشكل أسرع أو منع نوبات الحمى التشنجية.

  ليست هناك حاجة لعلاج حمى طفلك إذا بدا مرتاحًا ويشرب السوائل. ومع ذلك، هناك بعض الأشياء التي يمكنك القيام بها لمساعدته على الشعور بالتحسن:

  • قدم للطفل كميات صغيرة للشرب بانتظام. كثير من الأطفال يمتنعون عن تناول الطعام عندما يصابون بالحمى. هذه ليست مشكلة بشكل عام، طالما أنهم يشربون سوائل.
    • إذا كان عمر طفلك أقل من ستة أشهر، فاعرض عليه الرضاعة الطبيعية مرات أكثر من المعتاد أو رضعات زجاجية بشكل أكثر تكرارًا.
    • إذا كان عمر طفلك أكثر من ستة أشهر، يمكنك أن تقدم له الماء أو عصير التفاح الممزوج بالماء أو محلول الجفاف الفموي.
  • أعطِ طفلك الباراسيتامول و/أو الإيبوبروفين إذا كانت الحمى تجعله متألمًا بشدة أو كان لديه أعراض أخرى، مثل التهاب الحلق. اتبع بعناية تعليمات الجرعة على العبوة. لا تعطِ الأسبرين للأطفال أبدا ما لم يصفه الطبيب.
  • لا تضع الطفل في حوض الاستحمام البارد أو الدش. قد يجعله الماء البارد غير مرتاح ويجعله يرتجف أكثر.
  • ألبس الطفل ملابس خفيفة حتى لا يشعر بالسخونة أو البرودة كثيرًا. لا تحتاج إلى إلباسه ملابس دافئة إذا كان يرتجف من الحمى - فقد يؤدي ذلك إلى ارتفاع درجة حرارته.

  نوبات الحمى التشنجية (Febrile seizures)

  يمكن أن يصاب بعض الأطفال بنوبات (تشنجات) عندما يصابون بالحمى. وتسمى هذه نوبات الحمى التشنجية. قد يصاب طفلك بنوبة حمى تشنجية إذا ارتفعت درجة حرارته فجأة. في بعض الأحيان، تكون نوبة الحمى التشنجية هي أول علامة على الحمى.

  قد يكون من المخيف مشاهدة نوبات الحمى التشنجية، لكنها شائعة ونادرًا ما تسبب أي آثار صحية طويلة المدى.

  إذا كان طفلك يعاني من نوبة حمى تشنجية وكانت أول نوبة له، واستمرت لأكثر من خمس دقائق، أو إذا لم يستيقظ بعد توقفها، فاتصل بالإسعاف (000) على الفور. خلاف ذلك، اصطحب الطفل لزيارة الطبيب أو اختصاصي الصحة.

  متى تحصل على المساعدة (When to get help)

  اتصل بسيارة الإسعاف (000) إذا:

  كان طفلك يعاني من صعوبة في التنفس، لونه أزرق أو شاحب جدًا. لم تستطع إيقاظ الطفل. أُصيب طفلك بنوبة تشنجية لأول مرة. أُصيب طفلك بنوبة تشنجية تستمر لأكثر من خمس دقائق. أُصيب طفلك بنوبة تشنجية ولا يستيقظ عندما تتوقف.

  اذهب إلى المستشفى إذا:

  كان طفلك عمره أقل من شهر واحد ويعاني من حمى أعلى من 38 درجة مئوية. كان طفلك يعاني من ضعف في جهاز المناعة (نقص المناعة) وحمى أعلى من 38 درجة مئوية. كان طفلك يعاني من تيبس الرقبة أو الضوء يؤذي عينيه. كان طفلك يعاني من صداع مستمر. كان طفلك يعاني من طفح جلدي ولا يتحول إلى لون الجلد الطبيعي عند الضغط عليه (غير مبيض).

  راجع الطبيب أو الاختصاصي الصحي إذا:

  كان طفلك عمره أقل من ثلاثة أشهر ويعاني من حمى أعلى من 38 درجة مئوية. كان يبدو أن طفلك يزداد مرضًا. لم يتحسن طفلك بعد يومين. كان طفلك يعاني أيضًا من الأعراض التالية: قيء وعدم الاحتفاظ بأي طعام أو مشروبات أو أدوية طفح جلدي يتحول إلى لون الجلد الطبيعي عند الضغط عليه (مبيض) صعوبة في التنفس تفاقم الخمول مع عدم وجود دفعات من الطاقة. طفلك عادة ما يمشي ولكنه توقف و/أو لم يعد قادرًا على المشي. استمرت نوبة الطفل لأقل من خمس دقائق، ولست متأكدًا من سبب الحمى (درجة حرارة 38 درجة مئوية أو أكثر). كنت قلقًا بشأن طفلك وتعتقد أنه يبدو مريضًا جدًا.

  اعتنِ بالطفل في المنزل إذا:

  شعر بتحسن ولديه مستويات طاقة جيدة بين نوبات الحمى، أو بعد تناول الباراسيتامول و/أو الإيبوبروفين. كان يشرب ما يكفي من السوائل. كان يتنفس بشكل مريح. كان يبدو أنه يتحسن.

  الأسئلة الشائعة حول الحمى عند الأطفال (Common questions about fever in children)

  هل يجب أن أقلق بشأن حمى طفلي؟ (?Should I be worried about my child’s fever)

  من الطبيعي أن تقلق إذا كان الطفل يعاني من الحمى. ومع ذلك، فإن معظم الحمى ناتجة عن العدوى التي تتحسن من تلقاء نفسها ولا تحتاج إلى علاج محدد. الاستثناء للأطفال الصغار جدًا. إذا كان عمر طفلك أقل من شهر واحد ومصابًا بالحمى، فيجب عليك نقله إلى المستشفى. إذا كان عمر الطفل أقل من ثلاثة أشهر ومصابًا بالحمى، فاستشر الطبيب أو اختصاصي الصحة.

  أنت تعرف طفلك بشكل أفضل. بغض النظر عن عمره، إذا بدا مريضَا وكنت قلقًا، فمن الأفضل التحدث إلى الطبيب.

  طفلي لا يأكل أو يشرب بوجود الحمى. ما الذي ينبغي عليّ فعله؟ (?My child is not eating or drinking with a fever. What should I do)

  من الشائع أن يفقد الأطفال شهيتهم عندما يصابون بالحمى. عادةََ لا يُعدّ ذلك مشكلة، طالما استمروا في شرب السوائل حتى لا يصابوا بالجفاف. إذا كان عمر طفلك أقل من ستة أشهر، فقدم له رضاعة طبيعية إضافية أو رضعات زجاجية متكررة. يمكن أيضًا إعطائه محاليل الإماهة الفموية. إذا كان عمر طفلك أكثر من ستة أشهر، فاعطه الماء أو محلول الإماهة الفموية أو الحليب أو عصير التفاح الممزوج بالماء.

  إذا كان طفلك يشرب الماء فقط، فيجب أن تعطيه بعض الأطعمة البسيطة مثل الفاكهة أو البسكويت الجاف. هذا سيمنحه المزيد من الطاقة.

  تحدث مع طبيب أو اختصاصي صحي إذا لم يشرب أو لا يستطيع الاحتفاظ بأي شيء بسبب القيء.

  ما المدة المعتادة لاستمرار الحمى؟ (?How long does a fever typically last)

  تتحسن معظم الحمى في غضون أسبوع، اعتمادًا على السبب. ومع ذلك، غالبًا ما يوصي المهنيون الصحيون بالتحدث إلى الطبيب إذا كان طفلك يعاني من الحمى لمدة تزيد عن يومين - خاصة إذا ظهرت عليه أعراض أخرى مقلقة.

  هل صحيح أنه يجب تجويع الحمى؟ (?Is it true that you should starve a fever)

  القول القديم القائل بأنه يجب عليك "تجويع الحمى" هو خرافة. من المهم التركيز على السوائل عندما يصاب طفلك بالحمى، ولكن لا بأس في أن يأكل أيضًا.

  هل يمكنني إعطاء طفلي الباراسيتامول والإيبوبروفين في نفس الوقت؟ (?Can I give my child paracetamol and ibuprofen at the same time)

  عادة ما يكون إما الباراسيتامول أو الإيبوبروفين كافيًا لمساعدة الطفل المصاب بالحمى. ومع ذلك، فمن الآمن إعطاء كليهما في نفس الوقت، أو إعطاء أحدهما ثم الآخر وفقًا لتعليمات عبوة الدواء، إذا لزم الأمر. إذا كنت ستعطي طفلك كلًا من الباراسيتامول والإيبوبروفين، فتأكد من تتبع الجرعات ومتى تعطيها. قد يساعد أيضًا ضبط مؤقت على الهاتف لتذكيرك بموعد الجرعات التالية.

  هل يمكن أن يسبب التسنين الحمى؟ (?Can teething cause a fever)

  قد تصل درجة حرارة الأطفال الذين يعانون من التسنين إلى 38 درجة مئوية. درجة حرارة أعلى من 38 درجة مئوية لا تنتج عن التسنين. من المحتمل أن يكون طفلك مصابًا بعدوى. قد يكون من قبيل المصادفة أن يكون الطفل في مرحلة التسنين ويصاب بعدوى في نفس الوقت، حيث أن كلاهما شائع جدًا عند الأطفال الصغار.

  لا يزال طفلي يعاني من الحمى بعد الدواء المسكن. هل يجب أن أشعر بالقلق؟

  (?My child still has a fever after pain relief medicine. Should I be worried)

  إذا كان طفلك يشعر بتحسن وتحسنت أعراضه الأخرى، فلا داعي للقلق بشأن الحمى. قد لا يؤدي الباراسيتامول والإيبوبروفين إلى زوال الحمى؛ سبب إعطاء هذه الأدوية هو لجعل الطفل يشعر بتحسن.

  يجب عليك التحدث إلى طبيب الطفل إذا استمرت الحمى لأكثر من يومين دون أن تتحسن، أو إذا كنت قلقًا من أنه يبدو مريضًا للغاية.

  هل يمكنني إعطاء طفلي الأسبرين للمساعدة في علاج الحمى؟ (?Can I give my child aspirin to help with a fever)

  لا تعطي الأسبرين للطفل أبدًا ما لم يصفه طبيبه خصيصًا له. يمكن أن يؤدي إلى الإصابة بحالة خطيرة ولكنها نادرة تسمى متلازمة راي.

  ما هي العلاجات الطبيعية التي يمكنني تقديمها لطفلي لمساعدته على الشعور بالتحسن؟

  (?What natural remedies can I give my child to help them feel better)

  لا ينصح بالعلاجات الطبيعية للأطفال دون استشارة الطبيب. لا يحتاج طفلك إلى الفيتامينات ليتحسن بسرعة أكبر.

  كم من الوقت يجب أن يبقى طفلي في المنزل غائبًا عن المدرسة أو رعاية الأطفال عندما يكون مصابًا بالحمى؟

  (?How long should my child stay home from school or childcare with a fever)

  يمكن لطفلك العودة إلى المدرسة بمجرد شعوره بالتحسن وتحسن أعراضه، ما لم يقل طبيبه خلاف ذلك.

   

  The Royal Children’s Hospital, Melbourne

   : 

 

High Cholesterol in Children

Medically Reviewed.Last updated on 11/12/2024.

High cholesterol isn’t just a concern for adults. Kids and teens can also have high cholesterol levels, often due to genetic factors. Making some changes to what your child eats and encouraging them to move around often can help support healthy cholesterol levels. But some kids also need medications to get their cholesterol down to a safer level.

Overview

What is high cholesterol in children?

High cholesterol in children (sometimes called pediatric high cholesterol) is when your child’s cholesterol levels are higher than they should be. It’s also possible for kids and teens to have high triglyceride levels. Cholesterol and triglycerides are fats (lipids) that circulate in our blood. We need some lipids to support our bodies’ needs, but higher-than-normal levels can lead to health problems.

So, how do you know if your child has high cholesterol or high triglycerides? Providers do a blood test called a lipid panel to check lipid levels. What’s normal or not varies by age. For example, normal cholesterol levels in adults are slightly different from normal pediatric levels.

The chart below lists normal, borderline and abnormal lipid levels for children. Note that HDL cholesterol (“good cholesterol”) is the only number that’s abnormal when it’s too low.

	Normal level	Borderline	Abnormal level
Total cholesterol	Less than 170 mg/dL	170 to 199 mg/dL	200 mg/dL or higher
Triglycerides (for kids under age 10)	Less than 75 mg/dL	75 to 99 mg/dL	100 mg/dL or higher
Triglycerides (for kids 10 to 19)	Less than 90 mg/dL	90 to 129 mg/dL	130 mg/dL or higher
HDL cholesterol	Higher than 45 mg/dL	40 to 45 mg/dL	Less than 40 mg/dL
LDL cholesterol	Less than 110 mg/dL	110 to 129 mg/dL	130 mg/dL or higher

Symptoms and Causes

What are the symptoms of pediatric high cholesterol?

Your child typically won’t have any obvious symptoms of high cholesterol. But severely high cholesterol levels, especially high levels from genetic causes, may lead your child to develop:

• Waxy, fatty plaques on their skin (xanthoma)
• Yellow bump on or near their eyelid (xanthelasma)
• White or grayish rings around the outer edges of their eyes (corneal arcus)

Why would a child’s cholesterol be high?

Many factors affect your child’s cholesterol levels, including:

• What they eat
• How much physical activity they get
• Medical conditions they have, like obesity, diabetes and nephrotic syndrome
• Medications they take
• Genes they inherited

Kids with high cholesterol commonly have a biological parent with a history of elevated cholesterol or a biological parent who needs medications to keep their cholesterol at a safe level.

Genetic causes of high cholesterol in children

Genetics play a big role in causing pediatric high cholesterol. Let’s take a closer look at how it works.

Familial hypercholesterolemia in kids

A genetic condition called familial hypercholesterolemia (FH) causes children to have high LDL cholesterol (“bad cholesterol”) from birth. This is most commonly a dominant condition, meaning that it only takes one abnormal gene from one parent to pass it on to a child.

Your child’s provider may suspect this condition if your child’s LDL level is 160 mg/dL or higher without other known causes. In children whose parents have FH, even LDL cholesterol levels that are above 130 mg/dL are concerning.

Polygenetic causes

FH isn’t the only genetic cause of high cholesterol in kids. If your child’s high cholesterol has polygenetic causes, that means they inherited multiple genes from both parents that cause them to have high LDL. Their LDL level may rise over time but not be very elevated until their late teen years or early adulthood. 

These genetic factors can lead to increased cardiovascular risk, but the risk is less severe than having FH early in life. Kids with FH typically need medications sooner than kids with polygenetic causes.

Lipoprotein (a)

Lipoprotein (a) (pronounced “lipoprotein little a”) is a specific kind of cholesterol that parents can pass down to their kids. Higher levels of lipoprotein (a) raise a person’s risk of coronary artery disease and can be associated with rare cases of stroke in childhood.

Your child’s provider may recommend a blood test to check their lipoprotein (a) levels if they have one or more of the following risk factors:

• A familial hypercholesterolemia diagnosis
• A history of an ischemic stroke without a known cause
• A biological parent with high lipoprotein (a) levels
• A biological first-degree relative (parent or sibling) who had an early heart attack

Why would a child’s triglycerides be high?

Common causes of high triglycerides in children include:

• Obesity
• Diabetes
• Certain medications

There are also genetic causes of high triglycerides, but this is less common than with FH. If your child has a fasting triglyceride level of 500 mg/dL or higher, without other causes, then providers may consider a genetic cause.

High LDL levels can contribute to plaque buildup in your child's arteries.

What are the possible complications of high cholesterol in children?

Children who have high cholesterol (LDL cholesterol) may develop health concerns as they get older. These include issues with plaque (atheroma) buildup blocking blood flow to their heart, brain or legs. You might know these conditions as:

• Heart attack
• Stroke
• Peripheral artery disease

What are the possible complications of high triglycerides in children?

High triglyceride levels can lead to inflammation of your child’s pancreas (pancreatitis). Over long periods, high triglycerides may contribute slightly to plaque formation in your child’s arteries, but it plays far less of a role than LDL cholesterol.

Diagnosis and Tests

How do providers diagnose high cholesterol in children?

Healthcare providers can check cholesterol in school-aged children with a simple blood test. In certain situations, your child should fast (nothing to eat or drink for at least 12 hours) before getting the labs drawn. Be sure to ask your provider if this is necessary.

Doing such a test is especially important if there’s a strong biological family history of heart disease or if a parent has high cholesterol. The blood test results will show if your child’s cholesterol or triglyceride levels are too high.

Management and Treatment

How is high cholesterol in children treated?

The first step in managing high cholesterol is making changes to what your child eats and the amount of physical activity they get. Your child’s provider will advise you on what to do. If these changes aren’t enough to lower your child’s cholesterol to safe levels, their provider may recommend medication (for kids age 8 and older).

Does my child need medication?

Possibly. Providers follow the expert guidance of the National Heart, Lung and Blood Institute and the American Heart Association in deciding when to recommend medication. Here are the situations when providers may recommend medication for your child.

LDL higher than 190 mg/dL, if:

• Your child has no other risk factors for cardiovascular disease

LDL 160 mg/dL or higher, if at least one of the following is true:

• Your child has risk factors for cardiovascular disease
• One parent has a history of early heart attack or plaque in the heart arteries (coronary artery plaque)
• Changes to foods and physical activity haven’t brought their cholesterol to target levels after six months

LDL higher than 130 mg/dL, if at least one of the following is true:

• One parent has been diagnosed with FH
• Your child has cardiovascular disease risk factors like obesity, high blood pressure, cigarette smoking, low HDL, history of Kawasaki disease, kidney disease, solid organ transplant, juvenile rheumatoid arthritis, lupus or HIV

LDL higher than 100 mg/dL, if at least one of the following is true:

• Your child has type I or type II diabetes
• Your child has Kawasaki disease that caused enlarged coronary arteries (aneurysms)

Which medications do providers use to treat high cholesterol in children?

For kids with elevated LDL levels, statins are the first-choice medical treatment. These include medications like:

• Atorvastatin (Lipitor®).
• Rosuvastatin (Crestor®).
• Simvastatin (Zocor®).

Statins lower your child’s LDL by:

• Stopping their liver from making cholesterol
• Helping their body pull excess cholesterol out of their blood so their body can properly use it

Ezetimibe is the second-line medication to lower LDL levels. It works by blocking the absorption of cholesterol in your child’s gut so it can’t reach their bloodstream.

Treating high lipoprotein (a)

Lifestyle doesn’t affect lipoprotein (a) levels as much as it does LDL levels. Currently, there aren’t any medications that specifically treat elevated lipoprotein (a). But medication trials are underway. If your child’s lipoprotein (a) levels are high, their provider may recommend focusing on reducing their other risk factors for coronary artery disease by:

• Eating heart-healthy foods
• Getting enough physical activity
• Treating other cholesterol levels with medication
• Avoiding smoking

Treating high triglycerides

Your child’s provider may recommend:

• Changes to your child’s foods and physical activity
• Fish oil supplements (up to 4,000 mg per day)
• Other medications (in select cases to treat severely high triglyceride levels in children)

Outlook / Prognosis

Can high cholesterol in kids be reversed?

Yes. Treatment can help lower your child’s cholesterol to safer levels, in turn lowering their risk of serious complications down the road. Your child’s provider can give you the most accurate sense of what your child’s target cholesterol levels should be and how to get there.

Living With

How can I help lower my child’s cholesterol?

You can help lower your child’s cholesterol levels by encouraging them to do the following:

• Eat foods low in total fat. The total amount of fat your child consumes should be 30% of their daily total calories or less. A dietitian can help you calculate this number and create meal plans.
• Avoid trans fats and limit saturated fats. Saturated fat is usually solid at room temperature and comes from animal fats, coconut oil and palm oil. Saturated fat should be less than 10% of total calories. Instead, choose unsaturated fats like olive, avocado and flaxseed oils.
• Limit dietary cholesterol consumption. Your child should consume less than 300 mg of cholesterol per day.
• Avoid full-fat dairy. Kids 12 to 24 months old should consume 2% milk. Kids over 24 months should consume fat-free milk.
• Eat enough fiber. Encourage high dietary fiber intake. Foods high in fiber include vegetables, fruits, legumes, seeds and whole grains.
• Get regular physical activity. Regular aerobic activities — like biking, running, walking and swimming — can help raise HDL levels and lower your child’s risk for cardiovascular disease.
• Maintain a weight that’s healthy for them. Your child’s provider can provide a range for what that should be.

What are some examples of good foods for my child to eat?

Select a variety of foods so your child can get all the nutrients they need. Here are some examples of foods that are nutritious and can help support healthy cholesterol levels.

Breakfast:

• Fruit
• Whole grain cereal
• Oatmeal
• Greek yogurt

Lunch and dinner:

Follow the USDA MyPlate model by filling your child’s plate with:

• Lean protein like chicken, fish and beans (1/4 of the plate)
• Whole grains (1/4 of the plate)
• Fruits and vegetables (1/2 of the plate)
• 1 serving low-fat dairy

Healthier cooking methods are baking, broiling, grilling and air frying. Avoid deep frying.

Snacks:

• Fruits
• Vegetables
• Nuts and seeds
• Whole grain crackers
• Low-fat dairy

Beverages:

• Choose water and low-fat milk.
• Avoid soda, sweetened milk, juice and sports drinks.

When should I take my child to see a healthcare provider?

Your child’s provider will tell you how often you should come in for appointments. Your child may need blood tests on a regular basis to monitor their cholesterol levels. They’ll also need testing after six months of dietary changes and/or after two months of a new medication.

A note from Cleveland Clinic

We’re all so used to hearing about high cholesterol in adults that it’s easy to forget kids can have this issue, too — until it happens to your child. And then it can be hard to get your mind off the topic. Rest assured your child’s providers understand your concerns and are there to support your entire family. Share your questions and get as much information as you can. Make heart-healthy living a family affair. Treating high cholesterol early in life can give your child the best chance at a healthy future.

 

 source :Cleveland Clinic 

 

ΕΠΙΣΤΡΟΦΗ ΣΤΟ ΣΧΟΛΕΙΟ ΜΙΚΡΕΣ, ΧΡΗΣΙΜΕΣ ΟΔΗΓΙΕΣ-Back-to-School Tips for Families

 

Η επιστροφή στο σχολείο δεν είναι απλώς η αρχή μιας νέας σχολικής χρονιάς, είναι η επανεκκίνηση μιας καθημερινής ρουτίνας που επηρεάζει παιδιά και γονείς. Από το πρωινό ξύπνημα μέχρι τον ύπνο, κάθε στιγμή διαμορφώνει την διάθεση, την μάθηση και την ψυχική ισορροπία του παιδιού. 

Το ξύπνημα μετά τις καλοκαιρινές διακοπές μπορεί να φανεί δύσκολο. Χρειάζεται μια  σταδιακή προσαρμογή στο σχολικό ωράριο:

• Ξυπνάμε 10–15 λεπτά νωρίτερα κάθε μέρα πριν την έναρξη των μαθημάτων.
• Ετοιμάζουμε ρούχα και τσάντα από το βράδυ.
• Δημιουργούμε ένα σταθερό και ήρεμο πρωινό τελετουργικό.

Έτσι, τα παιδιά ξεκινούν τη μέρα με περισσότερη ηρεμία και ετοιμότητα. 

 

 Η χρήση οθονών μετά το σχολείο είναι σχεδόν αναπόφευκτη μπορούμε όμως να θέσουμε όριο και περιορισμούς.

• Όριο χρόνου (π.χ. 30 λεπτά).
• Εκπαιδευτικό ή ήπιο περιεχόμενο.
• Χωρίς συσκευές πριν τον ύπνο.

Με τον τρόπο αυτό, ενισχύεται η συγκέντρωση, η χαλάρωση και ο ποιοτικός ύπνος.

ΕΠΙΣΤΡΟΦΗ ΣΤΟ ΣΧΟΛΕΙΟ-ΧΡΗΣΙΜΕΣ ΟΔΗΓΙΕΣ

·Προληπτική κλινική εξέταση του παιδιού και έλεγχος εμβολιασμών.

·Συζήτηση με τα παιδιά ότι πρέπει να περιορίσουν την χρήση των κοινωνικών δικτύων.

·Πριν το παιδί πάει σχολείο πρέπει να τρώει ένα καλό πρωϊνό –κυρίως πρωτεϊνούχο. Έτσι λειτουργεί καλύτερα.

·Τα μικρότερα παιδιά χρήζουν επίβλεψης κατά τη μεταφορά προς και από το σχολείο.

·Δημιουργία φιλικού περιβάλλοντος και χώρου μελέτης στο σπίτι.

·Απαραίτητος ο κανόνας ότι ηλεκτρονικές συσκευές και τηλεόραση δεν λειτουργούν κατά την ώρα μελέτης.

 ·Για όλα τα παιδιά απαιτείται επαρκής ύπνος που βοηθά στην καλύτερη συγκέντρωση και εκμάθηση στο σχολείο. Καλό είναι να υπάρχει σταθερή ώρα για κατάκλιση κάθε βράδυ και διακοπή κάθε ηλεκτρονικής συσκευής πριν από την κατάκλιση.

 

Back-to-School Tips for Families

Back-to-School Tips for Families

​Before it's time to head back to school, use these tips to help ensure your child has a safe, healthy and happy year.

Make the first day of school easier for kids.

• Take your child to visit the new school or classroom before the first day of school. Attend any orientations you can and take an opportunity to tour the school. Also consider taking your child to school a few days before classes start to play on the playground to help them feel comfortable. Many children get nervous about new situations, including changing to a new school, classroom or teacher. It can be helpful to rehearse heading into the new situation.

• Remind your child that teachers know that students may be nervous about the first day of school; they will make an extra effort to make sure everyone feels as comfortable as possible. If your child seems nervous, ask them what they are worried about and help them problem-solve ways to master the new situation.

• Point out the fun aspects of school starting to help your child look forward to the first day of class. Talk about how they will see old friends and meet new ones, for example.
  

• Find another child in the neighborhood you child can walk to school or ride with on the bus. If you feel it is needed, drive your child (or walk with them) to school and pick them up on the first day. Get there early on the first day to cut down on unnecessary stress.
  

• Make sure your child is up to date on recommended immunizations. Close contact makes it easy for contagious diseases to spread quickly. That’s why most schools require routine childhood immunizations before starting school. When everyone in a school is vaccinated, it’s harder for diseases to spread. That means fewer missed school days and more fun and learning.
  

Develop a healthy sleep routine.

• Help your child adjust to earlier bedtimes a week or two before the new school year starts, just to help them ease into new routines. Set a consistent bedtime for your child and stick with it every night. Getting enough sleep is critical for kids to stay healthy and be successful in school. Not getting enough sleep is linked with lower academic achievement, as well as higher rates of absenteeism and tardiness. (See Healthy Sleep Habits: How Many Hours Does Your Child Need?)
  
  

• Create a bedtime routine that is consistent to help your child settle down and fall asleep. For example, a calming pre-bedtime routine may involve a bath/shower, reading with them, tucking them in and saying goodnight.
  

• Have your child turn off electronic devices well before bedtime. Try to have the home as quiet and calm as possible when younger children are trying to fall asleep.
  

Plan for safe travel to & from school.

Review the basic rules with your student and practice any new routes or modes of transportation:

Taking the school bus

• Remind your child to wait for the bus to stop before approaching it from the curb. Kids should always board and exit the bus at locations that provide safe access to the bus or the school building. Make sure your child walks where they can see the bus driver (which means the driver will be able to see them, too).

• Remind your student to look both ways to see that no other traffic is coming before crossing the street, just in case somebody does not stop as required. Encourage your child to actually practice how to cross the street several times before the first day of school.

• If the school bus has lap/shoulder seat belts, make sure your child uses one at all times when in the bus. (If your child's school bus does not have lap/shoulder belts, encourage the school system to buy or lease buses with lap/shoulder belts). See Where We Stand: Safety Restraints on the School Bus for more information. Your child should not move around on the bus.

• Check on the school's policy regarding food on the bus. Eating on the bus can present a problem for students with allergies and also lead to infestations of insects and vermin on the vehicles.

• If your child has a chronic condition that could result in an emergency on the bus, make sure you work with the school nurse or other school health personnel to have a bus emergency plan. If possible, do this before the first day of class.

Safe driving & carpooling to school

• All passengers should wear a seat belt or use an age- and size-appropriate car seat or booster seat. Keep your child riding in a car seat with a harness as long as possible and then put them in a belt-positioning booster seat. Your child is ready for a booster seat when they have reached the top weight or height allowed for their seat, their shoulders are above the top harness slots, or their ears have reached the top of the seat.
  

• Have your child ride in a belt-positioning booster seat until the vehicle's seat belt fits properly (usually when the child reaches about 4' 9" in height and is between 8 to 12 years of age). This means that your child is tall enough to sit against the vehicle seat back with their legs bent at the knees and feet hanging down and the shoulder belt lies across the middle of their chest and shoulder, not the neck or throat; the lap belt should be low and snug across the thighs, not the stomach.
  

• Children younger than 13 years old should ride in the rear seat of vehicles. If you must drive more children than can fit in the rear seat (when carpooling, for example), move the front passenger's seat as far back as possible and have the child ride in a booster seat if the seat belts do not fit properly without it.
  

• Remember that many crashes happen while novice teen drivers are going to and from school. Remind your teen to wear their seat belt, limit the number of teen passengers, and do not allow eating, drinking, cell phone conversations (even when using hands-free devices or speakerphone), texting or other mobile device use to prevent driver distraction. Familiarize yourself with your state's graduated driver's license law and consider the use of a parent-teen driver agreement to facilitate the early driving learning process. See here for a sample parent-teen driver agreement.
  

Biking to school

• Practice the bike route to school before the first day of school to make sure your child can manage it.

• Always wear a bicycle helmet, no matter how short or long the ride.

• Ride on the right, in the same direction as auto traffic and ride in bike lanes if they are present. Also, use appropriate hand signals.

• Make sure kids know the "rules of the road" and respect traffic lights and stop signs.
  

• Wear brightly colored clothing to increase visibility. White or light-colored clothing and reflective gear is especially important after dark.
  

Walking to school

• Make sure your child's walk to school is a safe route with well-trained adult crossing guards at every intersection. If your child will need to cross a street on the way to school, practice safe street crossing with them before the start of school.
  
  

• Be realistic about your child's pedestrian skills. Because small children are impulsive and less cautious around traffic, carefully consider whether or not your child is ready to walk to school without adult supervision. Children are generally ready to start walking to school at 9 to 11 years of age.

• In neighborhoods with higher levels of traffic, consider organizing a "walking school bus," in which an adult accompanies a group of neighborhood children walking to school.

• Brightly colored clothing or a visibility device, like a vest or armband with reflectors, will make your child more visible to drivers.

Provide health food options during the school day.

• Children who eat a nutritious breakfast function better. They do better in school, and have better concentration and more energy. Some schools provide breakfast for children; if yours does not, make sure they eat a breakfast that contains some protein. If your child does not have time to eat, send them to school with a grab and go snack like a granola bar.

• Many children qualify for free or reduced price food at school, including breakfast. The forms for these services can be completed at the school office. Hunger will affect a child's performance in class.

• Many school districts have plans that allow you to pay for meals through an online account. Your child can get a card to "swipe" at the register. This is a convenient way to handle school meal accounts.

• Look into what is offered inside and outside of the cafeteria, including vending machines, a la carte, school stores, snack carts and fundraisers held during the school day. They should stock healthy choices such as fresh fruit, low-fat dairy products and water. Learn about your child's school wellness policy and get involved in school groups to put it into effect. Also, consider nutrition if your child will be bringing food to eat during school.

• Choose healthier beverage options such as water to send in your child's lunch. Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child's risk of obesity by 60%.

Consider backpack safety.

• Choose a backpack with wide, padded shoulder straps and a padded back.

• Organize your child's backpack to use all of its compartments. Pack heavier items closest to the center of the back. The backpack should never weigh more than 10% to 20% of your child's body weight. Go through the pack with your child weekly, and remove unneeded items to keep it light.

• Remind your child to always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles. Adjust the pack so that the bottom sits at your child's waist.
  

Prevent bullying at school.

Bullying or cyberbullying is when one child picks on another child repeatedly. Bullying can be physical, verbal, or social. It can happen at school, on the playground, on the school bus, in the neighborhood or through mobile devices like cell phones.

When your child is bullied

• Alert school officials to the problems and work with them on solutions.

• Teach your child to be comfortable with when and how to ask a trusted adult for help. Ask them to identify who they can ask for help.

• Recognize the serious nature of bullying and acknowledge your child's feelings about being bullied.

• Help your child learn how to respond by teaching your child how to:

1. Look the bully in the eye.

2. Stand tall and stay calm in a difficult situation.

3. Walk away.
   

• Teach your child how to say in a firm voice:
  

1. "I don't like what you are doing."

2. "Please do NOT talk to me like that."

• Encourage your child to make friends with other children.

• Support outside activities that interest your child.

• Make sure an adult who knows about the bullying can watch out for your child's safety and well-being when you cannot be there.

• Monitor your child's social media or texting interactions so you can identify problems before they get out of hand.

When your child is the bully

• Be sure your child knows that bullying is never OK.

• Set firm and consistent limits on your child's aggressive behavior.

• Help your child learn empathy for other children by asking them to consider how the other child feels about the way your child treated them. Ask your child how they would feel if someone bullied them.

• Be a positive role mode. Show children they can get what they want without teasing, threatening or hurting someone.

• Use effective, non-physical discipline, such as loss of privileges.

• Focus on praising your child when they behave in positive ways such as helping or being kind to other children as opposed to bullying them.

• Develop practical solutions with the school principal, teachers, school social workers or psychologists, and parents of the children your child has bullied.

When your child is a bystander to bullying

• Encourage your child to tell a trusted adult about the bullying. Encourage your child to join with others in telling bullies to stop.

• Help your child support other children who may be bullied. Encourage your child to include these children in activities.

Secure before & after school child care.

• During early and middle childhood, children need supervision. A responsible adult should be available to get them ready and off to school in the morning and supervise them after school until you return home from work.

• If a family member will care for your child, communicate the need to follow consistent rules set by the parent regarding schedules, discipline and homework.

• Children approaching adolescence (11- and 12-year-olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age.

• If alternate adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone.

• If you choose an after-school program for your child, inquire about the training of the staff. There should be a high staff-to-child ratio, trained people to address health issues and emergencies, and the rooms and the playground should be safe.

Support good homework & study habits.

• Some children need extra help organizing their homework. Checklists, timers, and parental supervision can help overcome homework problems.

• Create an environment that is homework-friendly starting at a young age. Children need a consistent workspace in their bedroom or another part of the home that is quiet, without distractions, and promotes study.
  
  

• Schedule ample time for homework. Build this time into choices about participating in after school activities.

• Establish a household rule that the TV and other electronic distractions stay off during homework time. Supervise computer and internet use.
  

• Take steps to help ease eye fatigue, neck fatigue and brain fatigue while studying. It may be helpful to close the books for a few minutes, stretch and take a break periodically when it will not be too disruptive.
  

• If your child is struggling with a particular subject, speak with their teacher for recommendations on how to help your child at home or at school. If you have concerns about the assignments your child is receiving, talk with their teacher.
  
  

• If you believe your child would benefit from special education services, submit a request to your school for an Individualized Education Program evaluation. Your pediatrician can help draft a letter of this request.

• 
  

Last Updated

8/26/2026

Source

American Academy of Pediatrics Council on School Health (Copyright © 2025)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.