CHaD Experts Share Tips for a Healthy and Safe Year!

Cartoon image of a family exercising

Experts from across CHaD and Dartmouth-Hitchcock offer these tips for keeping your family health throughout the year.

HPV Vaccine - Rebecca Evans, MD, Staff Physician, Obstetrics and Gynecology

  • The Human Papillomavirus (HPV) vaccine is a great first step for adolescent cancer prevention.
  • The HPV vaccine series is recommended for boys and girls ages 11-12 years old for prevention of cervical and potentially oropharyngeal cancer.
  • Since the invention of the vaccine, the rates of genital warts and cervical pre-cancers have dropped significantly.
  • Over 10 years of monitoring and research have proved this vaccine is very safe.
  • Ask your pediatrician, gynecologist and/or primary care provider for more information.


Mental Health / Age of First Screening - Julie Balaban, MD, Child and Adolescent Psychiatry Team, CHaD

Here are three guidelines for addressing concerns about a child’s mental health:

  • Always check it out - Talk with family members, friends and your child’s school representatives about age-appropriate behavior and how your child compares to others. It’s important to understand the wide range of typical behaviors for your child’s developmental stage.
  • Determine the level of impairment caused by the child’s behavior - Evaluate how disruptive your child’s behavior is, and if it is upsetting normal development. If it keeps your child from participating in activities or the behavior continues with age—your child likely needs help.
  • Pay attention to your instincts - Parents are the experts of their own children, and if you have a feeling something isn’t right, it should always be taken seriously. Express your concerns with your pediatrician.

Sleep in Early Childhood - Nina Sand-Loud, MD, Developmental Behavioral Pediatrician, CHaD

Sleep is not a luxury—it is important for children to get the required amount of sleep each night for proper growth and development. Having a regular bedtime schedule (a set time children get into bed) and routine assists children in getting enough sleep each night and helps them fall asleep more easily. A bedtime routine should consist of some special activities the child associates with going to sleep, such as reading stories or singing songs together. It should not include screen time. Watching a show or movie makes it more difficult to fall asleep due to the content and the light emanating from the screen. The routine is also helped by continuing naps at least until 3-years-old (although many children continue to benefit from naps until they are 5-years-old) and having a regular “wake up” time.

Immunizations - Peter Wright, MD, Infectious Disease and International Health Specialist, CHaD

  • As children approach school age, their vaccines include boosters to many of the infant vaccines, and at age 11, they should receive meningococcal and Human Papillomavirus (HPV) vaccines.

Bike Safety - Stephanie White, MD, General Pediatrics, CHaD

Riding a bicycle is a great way to enjoy spring in New England. Here are a few tips to keep you safe:

  • Make sure to wear your helmet whenever you’re riding.
  • If you are riding on a road, ride on the right side, traveling with traffic.
  • Make sure you can see–and be seen.

Enjoy your ride!

Skin Care/Sunscreen Ingredients - Nicole Pace, MD, Pediatric Dermatology, CHaD

  • Make sunscreen a healthy habit!
  • Apply sunscreen daily–regardless of the weather or season. The face and neck, and any exposed skin, should be covered with a broad-spectrum sunscreen. Add it to your morning teeth brushing routine to remember.

Ticks - Antonia Altomare, DO, MPH, Hospital Epidemiologist, Infectious Disease and International Health, D-H

Complete daily tick checks. Look at every nook and cranny of your body from top to bottom. Ticks love to hide! Showering within two hours of coming indoors will helps wash off unattached ticks, and clothes placed in the dryer on high for 10 minutes will kill ticks. Insect repellent can greatly reduce the risk of getting a tick bite. Avoid wooded and bushy areas with high grass and walk in the center of trails.

Sports/Preseason - Keith Loud, MD, Physician-in-Chief, Adolescent and Sports Medicine Specialist, CHaD

Children should start any new activity gradually, increasing their training volume by no more than 10 percent each week. If your child is playing a sport where you can count the total time of physical activity and they are participating five hours per week, they should increase their time by half an hour each week. Drinking 16 ounces of water or a sports drink is recommended one hour before exertion. Hydration should continue with 4 to 8 ounces of fluid every 15 to 20 minutes as long as exertion continues.

Backpacks - Jim Esdon, Program Coordinator, Injury Prevention Center, CHaD

Lighten the load! Backpacks should never weigh more than 10 to 20 percent of a child’s body weight.

Distracted Driving - Christopher Bishop, Youth Operator Injury Prevention Specialist, Injury Prevention Center, CHaD

  • Distracted driving is one of the leading causes of all crashes in New Hampshire each year. It means having your attention occupied by anything other than driving. Some examples of distraction include: talking on the phone (this includes using a Bluetooth device), changing music on the radio or cell phone, texting, eating, putting on makeup, scrolling Facebook or Snapchatting, having a pet on your lap, turning to speak to the front or backseat passengers and being worried about an exam or presentation.
  • Teens are more at risk for distraction due to inexperience behind the wheel and social pressure. Challenge your teen to just drive when they are behind the wheel and to speak up as passengers even if it’s not “cool.” Make a plan with your teen that while driving, he or she won’t text or call you until they reach their destination.

Nutrition - Tara Efstathiou, MS, RD, LD, is the lead clinical dietitian for Dartmouth-Hitchcock’s Weight and Wellness Center

Getting your family involved in making healthy food choices and preparing family meals encourages the whole family to choose well. One approach can be to ask, “What vegetable would you like with dinner tonight?” Involving children in making decisions gives them a sense of control and encourages your child to be open to trying new foods.

Handwashing/Flu Prevention - Erik M. Shessler, MD, Associate Medical Director, Pediatrics, CHaD

  • Handwashing is one of the critical steps we can all take to help prevent the spread of illnesses. It involves five simple and effective steps: wet, lather, scrub, rinse and dry.
  • Be sure to lather the backs of your hands, between your fingers and under your nails. Scrub for at least 20 seconds, about the length of the “Happy Birthday” song.
  • If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol—but remember hand sanitizers are not as effective when hands are visibly dirty or greasy.
  • To help prevent the flu, get a flu shot every year. They are safe and effective, and provide the single best way to prevent the flu.