Healthy Pregnancy

Click For Fitness Newsletter

Healthy Pregnancy

Christopher D. Sacks: Posted on Sunday, July 24, 2011 10:52 AM


Welcome to our 4th Newsletter in July.

We realized there is a lot of information available on Pregnancy and Prenatal care, but relatively little information by comparison from a Teens perspective concerning these topics.

Click For Fitness and Click Mother continue the journey into Motherhood with having a:

Healthy Pregnancy

If you have decided to have a baby, the most important thing you can do is to take good care of yourself so that you and your baby will be healthy. Teens who get the proper care and make the right choices have a very good chance of having healthy babies.

Prenatal Care
See a doctor as soon as possible after you find out you are pregnant to begin getting prenatal care (medical care during pregnancy). The sooner you start to get medical care, the better your chances that you and your baby will be healthy.

If you cannot afford to go to a doctor or clinic for prenatal care, social service organizations can help you. Ask your parent, school counselor, or another trusted adult to help you locate resources in your community.

During your first visit, the doctor will ask you lots of questions, including the date of your last period. This helps the doctor estimate how long you have been pregnant and your due date.

Doctors measure pregnancies in weeks. A baby's due date is only an estimate: Most babies are born between 38 and 42 weeks after the first day of a woman's last menstrual period, or 36 to 40 weeks after conception (when the sperm fertilizes the egg). Only a small percentage of women actually deliver exactly on their due dates.

Timelines
A pregnancy is divided into three phases, or trimesters. The first trimester is from conception to the end of week 13. The second trimester is from week 14 to the end of week 26. The third trimester is from week 27 to the end of the pregnancy.

The doctor will examine you and perform a pelvic exam. He or she may also perform blood tests, a urine test, and tests for sexually transmitted diseases (STDs), including a test for HIV, which is on the rise in teens. (Some STDs can cause serious medical problems in newborns, so it is important to get treatment to protect the baby.)

The doctor will explain the types of physical and emotional changes you can expect during pregnancy. He or she will also teach you to how to recognize the signs of possible problems during pregnancy (called complications). This is especially important because teens are more at risk for certain complications, such as anemia, high blood pressure, and delivering a baby earlier than usual (called premature delivery).

Your doctor will want you to start taking prenatal vitamins that contain folic acid, calcium, and iron as soon as possible. The doctor may prescribe the vitamins or recommend a brand that you can buy over the counter. These vitamins and minerals help ensure the baby's and mother's health as well as prevent some types of birth defects.

Ideally, you should see your doctor once each month for the first 28 weeks of your pregnancy, then every 2 weeks until 36 weeks, then once a week until you deliver the baby. If you have a medical condition such as diabetes that needs careful monitoring during your pregnancy, your doctor will probably want to see you more often.

During visits, your doctor will check your weight, blood pressure, and urine, and will measure your abdomen to keep track of the baby's growth. Once the baby's heartbeat can be heard with a special device, the doctor will listen for it at each visit. Your doctor will probably also send you for some other tests during the pregnancy, such as an ultrasound, to make sure that everything is OK with your baby.

One part of prenatal care is attending classes where expectant mothers can learn about having a healthy pregnancy and delivery and the basics of caring for a new baby. These classes may be offered at hospitals, medical centers, schools, and colleges in your area.

It can be difficult for adults to talk to their doctors about their bodies and even more difficult for teens to do so. Your doctor is there to help you stay healthy during pregnancy and have a healthy baby and there is probably not much he or she hasn't heard from expectant mothers! So don't be afraid to ask questions.

Be upfront when your doctor asks questions, even if they seem embarrassing. A lot of the issues the doctor brings up could affect your baby's health. Think of your doctor both as a resource and a friend who you can confide in about what's happening to you.

Changes to Expect in Your Body
Pregnancy causes lots of physical changes in the body. Here are some examples:

Breast Growth
An increase in breast size is one of the first signs of pregnancy, and the breasts may continue to grow throughout the pregnancy. You may go up several bra sizes during the course of your pregnancy.

Skin Changes
Don't be surprised if people tell you your skin is "glowing" when you are pregnant. Pregnancy causes an increase in blood volume, which can make your cheeks a little pinker than usual. Hormonal changes increase oil gland secretion, which can give your skin a shinier appearance. Acne is also common during pregnancy for the same reason.

Other skin changes caused by pregnancy hormones may include brownish or yellowish patches on the face called chloasma and a dark line on the midline of the lower abdomen, known as the linea nigra.

areola, the area around the nipples, becomes darker. Stretch marks are thin pink or purplish lines that can appear on your abdomen, breasts, or thighs.

Except for the darkening of the areola, which can last, these skin changes will usually disappear after you give birth.

Mood Swings
It's very common to have mood swings during pregnancy. Some women may also experience depression during pregnancy or after delivery. If you have symptoms of depression such as sadness, changes in sleep patterns, thoughts of hurting yourself, or bad feelings about yourself or your life, tell your doctor so he or she can help you to get treatment.

Pregnancy Discomforts
Pregnancy can cause some uncomfortable side effects. These include:

• nausea and vomiting (especially early in the pregnancy)
• leg swelling
• varicose veins in the legs and the area around the vaginal opening
• hemorrhoids
• heartburn and constipation
• backache
• fatigue
• sleep loss

If you have one or more of these side effects, keep in mind that you are not alone! Ask your doctor for advice on how to deal with these common problems.

If you are pregnant and have bleeding or pain, call the doctor immediately.

Things to Avoid
Smoking, drinking alcohol, and taking drugs when you are pregnant put you and your baby at risk for a number of serious problems.

Alcohol
Doctors now believe that it is not safe to drink any amount of alcohol when you are pregnant. Drinking can harm a developing fetus, putting a baby at risk for birth defects and mental problems.

Smoking
The risks of smoking during pregnancy include stillbirths (when a baby dies while inside the mother), low birth weight (which increases a baby's risk for health problems), prematurity (when babies are born earlier than 37 weeks), and sudden infant death syndrome (SIDS). SIDS is the sudden, unexplained death of an infant who is younger than 1 year old.

Drugs
Using illegal drugs such as cocaine or marijuana during pregnancy can cause miscarriage, prematurity, and other medical problems. Babies can also be born addicted to certain drugs.

Ask your doctor for help if you are having trouble quitting smoking, drinking, or drugs. Check with your doctor before taking any medication while you are pregnant, including over-the-counter medications, herbal remedies and supplements, and vitamins.

Unsafe Sex
Talk to your doctor about sex during pregnancy. If your doctor says it's OK to have sex while you are pregnant, you must use a condom to help prevent getting an STD. Some STDs can cause blindness, pneumonia, or meningitis in newborns, so it's important to protect yourself and your baby.

Taking Care of Yourself During Pregnancy Eating
Many teens worry about how their bodies look and are afraid to gain weight during pregnancy. But now that you are eating for two, this is not a good time to cut calories or go on a diet. Both you and your baby need certain nutrients so the baby can grow properly. Eating a variety of healthy foods, drinking plenty of water, and cutting back on high-fat junk foods will help you and your developing baby to be healthy.

Doctors generally recommend adding about 300 calories a day to your diet to provide adequate nourishment for the developing fetus. You should gain about 25 to 35 pounds during pregnancy, most of this during the last 6 months, although how much you should gain depends on how much you weighed before the pregnancy. Your doctor will advise you based on your individual situation.

Eating additional fiber - 25 to 30 grams a day, and drinking plenty of water can help to prevent common problems such as constipation. Good sources of fiber are fresh fruits, vegetables, breads, cereals, or muffins that have lots of whole grain in them.

You will need to avoid eating or drinking certain things during pregnancy, such as:

• certain types of fish, such as swordfish, canned tuna, and other fish that may be high in mercury
• foods that contain raw eggs, such as mousse or Caesar salad
• raw or undercooked meat and fish
• processed meats, such as hot dogs and deli meats
• soft, unpasteurized cheeses, such as feta, brie, blue, and goat cheese
• unpasteurized milk, juice, or cider

It's also a good idea to limit artificial sweeteners, and drinks that contain caffeine and artificial sweeteners.

Exercise
Exercising during pregnancy is good for you as long as you are having an uncomplicated pregnancy and choose appropriate activities. Doctors generally recommend low-impact activities such as walking, swimming, and yoga. Contact sports and high-impact aerobic activities that pose a greater risk of injury should generally be avoided. Working at a job that involves heavy lifting is not recommended for women during pregnancy. Talk to your doctor if you have questions about whether particular types of exercise are safe for you and your baby.

Sleep
It's important to get plenty of rest while you are pregnant. Early in your pregnancy, try to get into the habit of sleeping on your side. Lying on your side with your knees bent is likely to be the most comfortable position as your pregnancy progresses. Also, it makes your heart's job easier because it keeps the baby's weight from applying pressure to the large vein that carries blood back to the heart from your feet and legs.

Some doctors recommend that girls who are pregnant sleep on the left side. Because of where some of your major blood vessels are, lying on your left side helps keep the uterus from pressing on them. Ask what your doctor recommends - in most cases, lying on either side should do the trick and help take some pressure off your back.

Throughout your pregnancy, but especially toward the end, you may wake up often at night to go to the bathroom. While it is important to drink enough water while you're pregnant, try to drink most of it during the day rather than at night. Use the bathroom right before going to bed. As you get further along in your pregnancy, you might have a difficult time getting comfortable in bed. Try positioning pillows around and under your belly, back, or legs to get more comfortable.

Stress can also interfere with sleep. Maybe you're worried about your baby's health, about delivery, or about what your new role as a parent. All of these feelings are normal, but they may keep you up at night. Talk to your doctor if you are having problems sleeping during your pregnancy.

Emotional Health
It is common for pregnant teens to feel a range of emotions, such as fear, anger, guilt, confusion, and sadness. It may take a while to adjust to the fact that you are going to have a baby. It is a huge change, and it's natural for pregnant teens to wonder whether they are ready to handle the responsibilities that come with being a parent.

How a woman feels often depends on how much support she has from the baby's father, from her family, the baby's father's family, and from friends. Each situation is different. Depending on your situation, you may need to seek more support from people outside your family. It is important to talk to the people who can support and guide you and help you share and sort through your feelings. Your school counselor or nurse can refer you to resources in your community that can help.

Sometimes women who are pregnant have miscarriages and lose the pregnancy. This can be very upsetting and difficult to go through, although it may bring feelings of relief for others. It is important to talk about these feelings and to get support from friends and family - or if that's not possible, from people such as counselors or teachers.

School and the Future
Some teens plan to raise their babies themselves. Sometimes grandparents or other family members help. Some teens decide to give their babies up for adoption. It takes a great deal of courage and concern for the baby to make these difficult decisions.

Teens who complete high school are more likely to have good jobs and enjoy more success in their lives. If possible, finish high school now rather than trying to return later. Ask your school counselor or an adult you trust for information about programs and classes in your community for pregnant teens.

Some communities have support groups especially for teen parents. Some high schools have child-care centers on campus. Perhaps a family member or friend can care for your baby while you are in school.

You can learn more about what to expect in becoming a parent by reading books, attending classes, or checking out reputable websites on child raising. Your baby's doctor, your parents, family members, or other adults can all help guide you while you are pregnant and after the baby is born.

(information and statistics are provided in part by Kids Health, the Mayo Clinic and reviewed by Larissa Hirsch, MD)

Fitness Basics

Click For Fitness Newsletter

Fitness Basics

Welcome to July and our first Newsletter of the month.

We are proud to announce the launch of two new Clicks, Click Kid and Click Teen.

Click Kid: Health, Fitness, Nutrition and Lifestyle education for kids.

Click Teen: Health, Fitness, Nutrition and Lifestyle education for teens.

This newsletter is about getting back to basics, "FITNESS BASICS". A step by step guide for you and your family to get started.

Fitness Basics

Starting a fitness program may be one of the best things you can do for your health. After all, physical activity can reduce your risk of chronic disease, improve your balance and coordination, help you lose weight - even boost your self-esteem. The benefits are yours for the taking, regardless of age, sex or physical ability.

The Department of Health and Human Services recommends that healthy adults include aerobic exercise and strength training in their fitness plans, specifically:

• At least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week

• Strength training exercises at least twice a week

Regular exercise can help you control your weight, reduce your risk of heart disease, and strengthen your bones and muscles. But if you haven't exercised for some time and you have health concerns, you may want to talk to your doctor before starting a new fitness routine.

When you are designing your personal fitness program, consider your fitness goals. Think about your fitness likes and dislikes, and note your personal barriers to fitness. Then consider practical strategies for keeping your fitness program on track.

Starting a fitness program is an important decision, but it does not have to be an overwhelming one. By planning carefully and pacing yourself, you can make fitness a healthy habit that lasts a lifetime.

Stretching and Flexibility

Stretching is a powerful part of any exercise program. Most aerobic and strength training programs inherently cause your muscles to contract and flex. Stretching after you exercise promotes equal balance. Stretching also increases flexibility, improves range of motion of your joints and boosts circulation. Stretching can even promote better posture and relieve stress.

As a general rule, stretch whenever you exercise. If you don't exercise regularly, you might want to stretch at least three times a week to maintain flexibility. When you're stretching, keep it gentle. Breathe freely as you hold each stretch. Try not to hold your breath. Do not bounce or hold a painful stretch. Expect to feel tension while you're stretching. If you feel pain, you've gone too far.

Aerobic Exercise

Regular aerobic exercise can help you live longer and healthier. After all, aerobic exercise reduces health risks, keeps excess pounds at bay, strengthens your heart and boosts your mood. Healthy adults should aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week. That doesn't have to be all at one time, though. Aerobic exercise can even be done in 10-minute increments. So what are you waiting for?

For many people, walking is a great choice for aerobic exercise. In fact, walking is one of the most natural forms of exercise. It's safe, it's simple and all it takes to get started is a good pair of walking shoes and a commitment to include aerobic exercise in your daily routine.

Of course, there's more to aerobic exercise than walking. Other popular choices include swimming, bicycling and jogging. Activities such as dancing and jumping rope count. Get creative!

Strength Training

Strength training can help you tone your muscles and improve your appearance. With a regular strength training program, you can reduce your body fat, increase your lean muscle mass and burn calories more efficiently. Better yet, strength training does not have to take as long as you might think. For most people, one set of strength exercises for major muscle groups performed two to three times a week is sufficient.

Strength training can be done at home or in the gym. Free weights and weight machines are popular strength training tools, but they are not the only options. You can do strength training with inexpensive resistance tubing or even your own body weight. With proper technique, you may enjoy noticeable improvements in your strength and stamina in just a few weeks.

Sports Nutrition

How much do you know about sports nutrition? What and when you eat can affect your performance and how you feel while you are exercising. Brushing up on sports nutrition basics can help you make the most of your exercise routine.

Sports nutrition often focuses on carbohydrates. For example, athletes training for endurance events may load up on carbohydrates in the days before the event to boost their performance. Protein for muscle repair and growth is another important aspect of sports nutrition.

Of course, sports nutrition goes beyond simply what you eat. When you eat counts as well. To maximize your workouts, coordinate your meals, snacks and drinks.

-Starting and maintaining a comprehensive fitness program is an important decision that can change your life, but it does not have to be an overwhelming one. By planning carefully and pacing yourself, you can make health and fitness a healthy habit that lasts a lifetime.

Take The First Click!

-Christopher D. Sacks

(Information and statistics provided in part by the Mayo Clinic and it's staff)

Midwives

Click For Fitness Newsletter
Midwives

Welcome to our third Newsletter in July.

This Newsletter will be the first in a new series utilizing our contacts and information from Click Mother. We will be exploring the beautiful world of motherhood.

We start the journey with:

Midwives

You are Pregnant
Let the decision-making begin. Choosing a health care provider to care for you and your baby during your pregnancy is one of the biggest decisions you will make.

In the United States, women's choices once were limited to an obstetrician or a knowledgeable family doctor. But in recent years midwives became another alternative for women with low-risk, uncomplicated pregnancies.

In Europe, midwives assist at more than 70% of normal vaginal births. Though midwives delivered only 7% of American babies in 2003, that percentage has been increasing since 1975. But most Americans aren't sure what midwives do, how they are trained, or if they are even available. Is a midwife a viable option for you?

The History of Midwives
The word "midwife" comes from Old English and means "with woman." Midwives have helped women deliver babies since the beginning of history. References to midwives are found in ancient Hindu records, in Greek and Roman manuscripts, and even in the Bible.

As early as 1560, Parisian midwives had to pass a licensing examination and abide by regulations to practice. Not all midwives had this level of education, however. English midwives received little formal training and were not licensed until 1902. America inherited the English model of midwifery.

Early American midwives usually learned their craft through apprenticeship and tradition. They were not educated about scientific advances in fighting infection through hygiene and drugs such as penicillin. By the early 20th century, women and their babies were more likely to die under the care of midwives than under the care of doctors.

Around this time, American medical doctors began a campaign against midwifery in the press, the courts, and Congress. They cited the poor outcomes for mothers and babies under the care of midwives. Doctors might also have viewed midwives as competition.

The Foundation of Certification

Whatever the doctors' motivations, the rate of midwife-attended births dropped during and after the campaign. But the widespread criticism from the medical establishment prompted the foundation of the first certified American nurse-midwifery school in 1932. It aimed to incorporate the necessary medical training into midwifery's traditional approach to pregnancy and labor.
What Kind of Training Does a Midwife Have?
Midwives today come from a variety of backgrounds. The subtitle a midwife uses will indicate the level of education and training. Most American midwives are certified nurse-midwives (CNMs) who:

• have at least a bachelor's degree and may have a master's or doctoral degree
• have completed both nursing and midwifery training 
• have passed national and state licensing exams to become certified 
• are licensed in every state 
• may work in conjunction with doctors

About 96% of births assisted by certified nurse-midwives occur in hospitals.

A certified midwife (CM) is not a registered nurse but otherwise meets the same qualifications as a certified nurse-midwife. Because this certification has only existed since 1996, there are few CMs. Currently, only some states recognize this certification as sufficient for licensing.

A lay or direct-entry midwife may or may not have a college degree or a certification. Direct-entry midwives may have trained through apprenticeship, workshops, formal instruction, or a combination of these. Not all states require them to work in conjunction with doctors, and they usually practice in homes or non-hospital birth centers. Not every state regulates direct-entry midwives or allows them to practice.

A certified professional midwife (CPM) is certified by the North American Registry of Midwives after passing written exams and hands-on skill evaluations. Direct-entry midwives and certified nurse-midwives can apply for this certification. They are required to have out-of-hospital birth experience, and usually practice in homes and birth centers. Their legal status varies according to state law.

What is the Midwife's Philosophy?
A midwife's education stresses that pregnancy and birth are normal, healthy events until proven otherwise. Midwives view their role as supporting the pregnant woman while letting nature takes its course.

Midwives also focus on the psychological aspects of how the mother-to-be feels about her pregnancy and the actual birth experience. They encourage women to trust their own instincts and seek the information they need to make their own valuable decisions about pregnancy, birth, and parenthood.

Of course, many medical doctors (MDs) share the same values. But an MD may be more likely to use preventive testing and medical technology, such as ultrasound, continuous fetal monitoring, and the option of pain medications during birth as a standard part of care during pregnancy and labor.

High-risk pregnancies undoubtedly require this approach. But many midwives find it unnecessary for most uncomplicated pregnancies.

What Does a Midwife Do?
Midwives generally spend a lot of time during prenatal visits addressing a woman's individual concerns and needs, and will stay with her as much as possible throughout labor. They sometimes encourage physical positioning during labor such as walking around, showering, rocking, or leaning on birthing balls. Midwives also usually allow women to eat and drink during labor.

Certified nurse-midwives, like doctors, may use some medical interventions, such as electronic fetal monitoring, labor-inducing drugs, pain medications, epidurals, and episiotomies, if the need arises. However, a certified midwife, certified professional midwife, or direct-entry midwife may not legally be allowed to use these techniques without a doctor's supervision and birthing centers may or may not be equipped for these procedures.

Cesarean Sections
Midwives of any licensing degree cannot perform cesarean sections (C-sections). If one were required, an obstetrician would have to perform your delivery. If any potentially life-threatening complications suddenly arose during delivery, midwives should also involve an obstetrician.

Certified midwives are trained in basic life support for newborns and, in the event of sudden complications with your baby after birth, can care for the baby until a pediatrician or neonatologist (an intensive-care specialist for newborns) is available.

Is a Midwife Right for You?
Several studies have shown that midwife-supervised births produce excellent outcomes with fewer medical interventions than average. Midwives' patients use electronic fetal monitoring less often and tend to have a reduced need for epidurals, episiotomies, and C-sections for successful deliveries. To some degree, this stems from the fact that midwives see only low-risk patients with uncomplicated pregnancies. But some researchers attribute the need for a minimum of medical intervention to the midwives' natural approach to the management of labor and delivery, which may reduce a woman's fear, pain, and anxiety during birth.

Midwifery is not advisable for women with higher-risk pregnancies. Those expecting twins or multiples and those with prior pregnancy complications, gestational diabetes, high-blood pressure, or chronic health problems of any kind before pregnancy should discuss their options with their primary health care provider or an obstetrician. Certified nurse-midwives who practice in major medical centers and work very closely with obstetricians and perinatologists (specialists in high-risk pregnancy) may take patients with risk factors. But midwives in solo practice or who practice in limited medical facilities generally do not.

Surgery and Anesthesia
A major difference between doctors and midwives is the doctors' ability to intervene surgically when necessary, and to deal with complications that arise. Midwives can't perform C-sections and some cannot administer drugs or anesthesia. If you feel more comfortable having those options immediately available, a doctor may be the right choice for you.

What if Something Goes Wrong?
Midwives are trained to recognize the signs of trouble in pregnancy and labor. If a complication develops at any time, the midwife should consult a doctor. If your midwife doesn't already have a practice agreement with a doctor, be sure to find out what will be done in case of a complication.

If you plan to deliver at a non-hospital birth center or at home, an emergency back-up plan is especially critical. If you must go to the hospital, your midwife will go with you and will continue to support you throughout your labor.

It is a good idea to get answers to these questions:

• What training or equipment does your midwife have to handle emergencies?
• How far will you be from the nearest hospital?
• Do they have fail-safe transportation?

Finding a Midwife
You can decide to use a midwife at any time during your pregnancy. Women often turn to midwifery a few months before their due dates, when they begin to seriously consider their birth plans.

To evaluate your medical needs, most midwives will request that you bring your prenatal care records to your first meeting. Few midwives will accept a patient well along in pregnancy unless she has had adequate prenatal care.

Interview a prospective midwife carefully. Investigate the midwife's background, certifications, experience, and emergency procedures. Because you'll be closely involved, make sure your personalities mesh. Do you feel comfortable with the midwife? Can you talk easily?

To locate a midwife, try asking your obstetrician-gynecologist (OB/GYN), family doctor, and friends for a referral.

-Christopher D. Sacks

(Information and statistics provided in part by Kids Health, the Nemours foundation and reviewed by larissa Hirsch MD)

Keep Your Kids Active

Keep Your Kids Active

Welcome to our second Newsletter in July.

I want to take the time to thank everyone for their continued support of the Click Kitchen. The idea of Healthy, Fun and Delicious recipes for you and your family is alive and well.

Our mission statement: Click For Fitness is a San Francisco non-profit corporation dedicated to promoting fitness, preventing childhood obesity and establishing a set of health guidelines for you and your family through advocacy, education, research and service.

Healthy Families is our founding principle. This Newsletter continues our effort to keep families healthy by:

Keeping Kids Active

Anyone who's seen kids on a playground knows that most are naturally physically active and love to move around. But what might not be apparent is that climbing to the top of a slide or swinging from the monkey bars can help lead kids to a lifetime of being active.

As they get older, it can be a challenge for kids to get enough daily activity. Reasons include increasing demands of school, a feeling among some kids that they are not good at sports, a lack of active role models, and busy working families.

Even if kids have the time and the desire to be active, parents may not feel comfortable letting them freely roam the neighborhood as kids once did. So their opportunities might be limited.

Despite these barriers, parents can instill a love of activity and help kids fit it into their everyday routines. Doing so can establish healthy patterns that will last into adulthood.

Benefits of Being Active

• When kids are active, their bodies can do the things they want and need them to do. Why? Because regular exercise provides these benefits:
• strong muscles and bones
• weight control
• decreased risk of developing type 2 diabetes
• better sleep
• a better outlook on life

Healthy, physically active kids are more likely to be academically motivated, alert, and successful - and physical competence builds self-esteem at every age.

What Motivates Kids?
There is a lot to gain from regular physical activity, but how do you encourage kids get "get started"? The three keys are:

1. Choosing the right activities for a child's age: If you don't, the child may be bored or frustrated.

2. Giving kids plenty of opportunity to be active: Kids need parents to make activity easy by providing equipment and taking them to playgrounds and other active spots.

3. Keeping the focus on fun: Kids won't do something they don't enjoy.

When kids enjoy an activity, they want to do more of it. Practicing a skill, whether it is swimming or riding a bicycle, improves their abilities and helps them feel accomplished, especially when the effort is noticed and praised. These good feelings often make kids want to continue the activity and even try others.

Age-Appropriate Activities
The best way for kids to get physical activity is by incorporating physical activity into their daily routine. Toddlers to teens need at least 60 minutes on most (preferably all) days. This can include free play at home, active time at school, and participation in classes or organized sports.

Age-Based Advice:
Preschoolers: Preschoolers need play and exercise that helps them continue to develop important motor skills - kicking or throwing a ball, playing tag or follow the leader, hopping on one foot, riding a bike, freeze dancing, or running obstacle courses.

Although some sports leagues may be open to kids as young as 4, organized and team sports are not recommended until they are a little older. Preschoolers can not understand complex rules and often lack the attention span, skills, and coordination needed to play sports. Instead of learning to play a sport, they should work on fundamental skills.

School-age: With school-age kids spending more time on sedentary pursuits like watching TV and playing computer games, the challenge for parents is to help them find physical activities they enjoy and feel successful doing. These can range from traditional sports like baseball and basketball to biking, camping, hiking, and other outdoor pursuits.

As kids learn basic skills and simple rules in the early school-age years, there might only be a few athletic standouts. As kids get older, differences in ability and personality become more apparent. Commitment and interest level often go along with ability, which is why it is important to find an activity that is right for your child. Schedules start getting busy during these years, but do not forget to set aside some time for free play.

Teenagers: Teens have many choices when it comes to being active, from school sports to after-school interests, such as yoga or skateboarding. It is important to remember that physical activity must be planned and often has to be sandwiched between various responsibilities and commitments.

Do what you can to make it easy for your teen to exercise by providing transportation and the necessary gear or equipment (including workout clothes). In some cases, the right clothes and shoes might help a shy teen feel comfortable biking or going to the gym.

Fitness Personalities
In addition to a child's age, it is important to consider his or her fitness personality. Personality traits, genetics, and athletic ability combine to influence kids' attitudes toward participation in sports and other physical activities, particularly as they get older.

Which of these three types best describes your child?

1. The nonathlete: This child may lack athletic ability, interest in physical activity, or both.

2. The casual athlete: This child is interested in being active but is not a star player and is at risk of getting discouraged in a competitive athletic environment.

3. The athlete: This child has athletic ability, is committed to a sport or activity, and likely to ramp up practice time and intensity of competition.

If you understand the concepts of temperament and fitness types, you'll be better able to help your kids find the right activities, get enough exercise and find enjoyment in physical activity. Some kids want to pursue excellence in a sport, while others may be perfectly happy and fit as casual participants.

The athlete, for instance, will want to be on the basketball team, while the casual athlete may just enjoy shooting hoops in the playground or on the driveway. The nonathlete is likely to need a parent's help and encouragement to get and stay physically active. That's why it is important to encourage kids to remain active even though they are not top performers.

Whatever their fitness personality, all kids can be physically fit. A parent's positive attitude will help a child who is reluctant to exercise.

Be active yourself and support your kids' interests. If you start this early enough, they will come to regard activity as a normal and fun part of your family's everyday routine.

Take the first CLICK!

-Christopher D. Sacks

(Information and statistics provided in part by Kids Health, the Nemours foundation and reviewed by Mary L. Gavin, MD)