their children's health.

The number
of illnesses that can be prevented is
growing at a remarkable pace, and
with all the vaccines now being rec-
ommended, it can be difficult to keep
track of which ones should be given
at a particular age. To help, we're
enclosing with this issue of CHILD
HEALTH ALERT a flyer entitled
"When do children and teens need
vaccinations?". Produced by the non-
profit Immunization Action Coalition,
this guide provides a simple outline
ofthe recommended vaccines and
when they should be given, from
birth to adolescence. We invite read-
ers to share it with friends and col-
leagues, and hope you find it useful. D
CHILD DEVELOPMENT
Babies Need Exercise...
Babies like to move around a lot,
but too many times they're confined
for long periods in strollers, baby
seats, or playpens. Also, TV and
video games keep a lot of pre-
schoolers from being physically
active for longer periods of time
than parents might realize. So the
National Association for Sport and
Physical Activity is recommending
simple but targeted daily activities
for babies, toddlers, and preschoolers.
The goal isn't to develop baby gym
classes, but rather to provide com-
monsense, fun activities that make
exercise a part of normal everyday
life in the hope that children will
grow up to be active rather than
contribute to the growing problem
of obesity that can result from lack
of exercise.
Among the guidelines, the group
recommends:
-As part of each day. an infant should
have a structured activity (such as
patty-cake, being carried to and
exploring a new environment)
-Each day, toddlers should have at
least 30 minutes of structured physi-
cal activity and preschoolers should
have at least an hour. Examples for
toddlers include follow-along songs
or chasing a ball, and for older chil-
dren, balancing games or tumbling.
-Each day, toddlers and preschoolers
should spend at least one hour in free
playexploring, experimenting, imi-
tating. Caregivers should provide safe
objects to ride, push, pull, balance on,
and climb.
-Avoid keeping infants and toddlers
in restrictive settings (such as baby
seats) for long periods of time.
-Except when they're sleeping, toddlers
and preschoolers shouldn't be seden-
tary for more than an hour at a time.
Finally, they point out that physical
activity shouldn't be forced or used as
punishment, but rather should be a
routine part of daily lifeand parents
should join in, not just sit on the side-
lines and watch their children romp.
(Associated Press, February 7, 2002)
...And Children
Need Sleep
Many reports have pointed out
that many adults may not get enough
sleep, and this can lead to difficulties
staying awake and problems with
job performance. But the National
Association of Elementary School
Principals is campaigning to get
"equal time" for children. Sleep
problems can be caused by some-
thing as simple as staying up late or
as complicated as biologic problems.
Whatever the cause, it's impor-
tant to be able to identify when chil-
dren aren't getting enough sleep.
While some signs might be obvious,
such as yawning and daytime sleepi-
ness, children who don't get enough
sleep can have a wide range of prob-
lems that may not seem related.
They may not concentrate well on
school work, or their symptoms can
mimic some attention deficit disor-
ders as well as learning and behavior
problems. As one expen noted,
"Sleepy kids may move around a lot.
They may appear hyperactive but
what they're doing is trying to keep
themselves alert and awake." (New
York Times News Service, January
30, 2002)
COMMENT: It's important to
recognize that when they don't get
enough sleep, children may react
very differently from adults, and that
in many cases their behaviors look
very much like symptoms of atten-
tion deficit hyperactivity disorder
(ADHD). While no one has yet said
how often sleepiness might be con-
fused with ADHD, parents, teachers,
and others can make a real differ-
ence by recognizing that in some
children with learning and behavior
problems, the problem just might be
something as simple as their getting
too little sleep. CI
Child Health ALERT March 2002