Health and Family Magazine 006 September 2008

DONALD ROCKHEAD

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En esta edición... ● Salud Infantil Cómo Ejercer la Crianza Consciente Mindful Parenting P4▼

School Time and Immunizations El Regreso a la Escuela y las Vacunas P5▼ ● Mejor Prevenir Detectando el Cáncer de Mama Breast Cancer Exams P6/P7▼ ● Salud Dental Healthy Start, Healthy Teeth Dientes Sanos para una Niñez Sana P9/P10▼ ● Historias saludables Bárbara Ferrer Bárbara Ferrer P11/P14▼ ● Estilo de Vida Special Education Educación Especial P16▼ Preventing Childhood Obesity Cómo Prevenir la Obesidad Infantil P17▼

EDITORIAL EDITORIAL COORDINATOR Marcela García

CONTRIBUTORS Dr. Matthew A. Hersh Kristie DiSalvo Eduardo A. de Oliveira Virginia Gómez Alicia Vivas GRAPHIC DESIGN Luis F. Pacheco Zhaidett Martínez HEALTH & FAMILY IS PUBLISHED BY Hispanic News Press PUBLISHER Javier Marín SALES Jullie Gordon, LICSW Jullieg@hnpmedia.com 617-232-0996 Ext. 22 MARKETING Raúl Medina raulm@hnpmedia.com (617) 232-0996 Ext. 19 SUBSCRIPTIONS 617-2320996 Ext 30 HISPANIC NEWS PRESS INC. 1318 Beacon Street, Suite 15 Brookline, MA 02446 Phone: 617-232-0996 Fax: 617-933-7677

www.hispanicnewspress.com www.healthandfamilymagazine.com

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Mindful parenting Reduce your stress while enhancing the relationship with your children Dr. Matthew A. Hersh While we always want the best for our children, it is often difficult to realize the dreams we have for them on a daily basis. We may feel as though we are too stressed to be the parent we would like to be, that there is not enough time in the day to accomplish our goals, and that our relationship with our children might be tenser than we would like.

One way to live less stressed and more harmonious lives is through the practice of mindful parenting. Mindfulness, a quality that we all possess, involves moment-by-moment awareness of what is actually happening right now in our internal (e.g., feelings, thoughts, bodily sensations) and external (e.g., our child begging us for something we already said he can't have) environments.

Suppose your child is very slow to get ready in the morning. Our impatience begins to grow as images fill our mind of how late we will be for work if she does not hurry up and move faster. This scenario, probably common for

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many parents, shows us how quickly and automatically our minds and bodies cascade with thoughts, feelings, and behavior that might unintentionally end up stressing us out - and our children - even more.

If we applied a mindful parenting perspective to this scenario, we might be able to make a series of healthy intentional choices along the way to reduce our stress. At the first sight of our child moving "too" slowly, we might try to accept the situation for exactly what it is. In doing this, we acknowledge that we actually are feeling frustrated. By doing this, we let go of some of the frustrated feelings and thoughts.

The next step might involve taking a moment for ourselves, breathing deeply, and looking at the situation with a fresh perspective. That is, we could view this as if it never happened before.

The most empowering thing about mindful parenting is that every moment can be considered as another opportunity to make a healthy intentional choice. If a certain moment is too difficult, we simply look to the next moment to help ourselves and our children live as peaceful and healthy as possible.

Dr. Matthew A. Hersh is a postdoctoral fellow in Psychology at Children's Hospital Boston.

Una crianza consciente

Siempre queremos lo mejor para nuestros hijos, y a veces nos podemos sentir tan estresados que se no siempre podemos ser el tipo de padres que quisiéramos.

Vivir armoniosamente y menos estresados se puede lograr a través de una crianza consciente. La consciencia involucra el poder reconocer lo que nos pasa internamente (emociones, pensamientos) y a nuestro alrededor.

Imaginemos que nuestro niño es bastante lento alistándose en las mañanas. Nuestra impaciencia crece porque sabemos que vamos a llegar tarde al trabajo y de manera involuntaria reaccionamos equivocadamente, sin lograr nada excepto aumentar nuestro estrés y el del niño.

Al aplicar el enfoque de una crianza sensata, pudiésemos tomar una serie de decisiones que reducen el estrés. Cuando recién nos damos cuenta de la lentitud del niño en la mañana, podemos aceptar la situación por lo que es y dejar ir los sentimientos que nos inquietan, y en lugar de ello tomar la situación como si fuera la primera vez que la enfrentamos.

Después reflexionar: respirar profundamente para ver la situación desde otra perspectiva.

Dr. Matthew A. Hersh es un asociado en Psicología en el Departamento de Psiquiatría del Children's Hospital Boston.

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School is starting

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With children heading back to school, now is a good time to ensure that they are fully immunized ● Centers for Disease Control and Prevention Making sure that children receive all of their vaccinations on time is one of the most important things parents can do to ensure their kids' long-term health, as well as the health of their friends and classmates. Not only do vaccines protect children against common seasonal diseases like influenza, they also help prevent much rarer diseases.

Parents can find out what vaccines their children need and when the doses should be applied by consulting the nationally recommended Childhood Immunization Schedules, available on the

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Centers for Disease Control website (www.cdc.gov).

If a child falls behind schedule on vaccinations, it can sometimes be difficult to determine the best way to catch up. To help, CDC and its partners developed the CatchUp Immunization Scheduler, a new online tool that shows parents and healthcare providers the best options for getting children six years of age and younger back on schedule.

De regreso a la escuela: las vacunas

1. ¿Qué enfermedades evitan las vacunas?

Sarampión, parotiditis (paperas), polio, rubéola, pertussis (tos ferina), difteria, tétanos, haemophilus influenzae tipo b (meningoencefalitis), hepatitis B, varicela 2. ¿Cuántas vacunas necesita mi hijo?

Se recomienda administrar las siguientes vacunas antes de cumplir los dos años. Se pueden administrar durante cinco visitas al consultorio médico o a una clínica: 1 vacuna contra el sarampión/parotiditis/rubéola 4 vacunas contra la Hib (una de las causas principales de la meningitis espinal) 3 vacunas contra la polio 4 vacunas contra la difteria, tétanos y pertussis (DTP) 3 vacunas contra la hepatitis B 1 vacuna contra la varicela 3. ¿Por qué no puedo esperar hasta que mi hijo empiece el colegio para ponerle las vacunas?

Las vacunas deben empezar al momento del nacimiento y haber terminado en su mayor parte a la edad de dos años.

4. ¿Dónde puedo obtener más información?

Llame al 1-800-232-0233 (español) Fuente: www.cdc.gov/spanish

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Mejor Prevenir El hospital Faulkner ofrece programa gratuito para prevenir y tratar el cáncer de pecho El de mama es el tipo de cáncer que causó más muertes entre las latinas de Boston en 2005 y 2006 ● Virginia Gómez El cáncer es una de las principales causas de muerte en Boston. En 2006, fallecieron 944 personas debido a la enfermedad, 47 de ellas latinas. Si bien los hispanos integran uno de los grupos étnicos menos sacudidos por el cáncer, el número de casos aumenta cada año en esta comunidad, según datos del Departamento de Salud Pública de Massachusetts.

En los años 2005 y 2006, el de pecho fue el tipo de cáncer que más muertes causó entre la población latina en la ciudad. A la vista de las cifras, el hospital Faulkner ofrece a todas las mujeres de 40

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años en adelante un programa gratuito para prevenir y tratar esta enfermedad.

Gracias a él, pueden realizarse una mamografía anualmente y, en caso de necesitarlo, recibir tratamiento y cirugía. Cada año, alrededor del 16% de las mujeres que acuden a hacerse la mamografía en este complejo debe volver para recibir tratamiento.

"El programa está dirigido a mujeres con o sin papeles, con seguro médico o sin él, el único requisito es que tengan 40 años o más, aunque si notan que tienen un bulto, pueden pedir cita también las mujeres menores de esa edad", explica Tracy Sylven, la directora del Departa-

Faulkner Hospital

mento de Salud y Beneficios Comunitarios del hospital.

En el Faulkner, cada año sólo acuden a pasar la mamografía unas 200 mujeres.

Según Sylven, "hay inmigrantes ilegales

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Mejor que no quieren realizársela porque creen que sus datos serán después utilizados para deportarlas". En este sentido, aseguró que la información con la que trabaja el hospital es totalmente confidencial.

Para solicitar una cita, las interesadas tendrán que contactar con Tracy Sylven al teléfono (617) 983-7451. Existe flexibilidad de horarios, de manera que las pacientes tienen posibilidad de ser atendidas desde las 6:30am hasta las 7:00pm de lunes a viernes; además, si se solicita, la revisión puede pasarse también los sábados.

Aquellas personas que tengan proble-

mas para trasladarse hasta el hospital podrán beneficiarse del servicio gratuito de taxi que se ofrece junto con el programa. El estacionamiento del complejo es, además, libre para pacientes.

Asimismo, existe un servicio de intérpretes para facilitar la sesión.

La supervivencia al cáncer de mama en una detección temprana ronda en el 90%, de ahí la importancia de realizarse chequeos de manera regular. La enfermedad se da normalmente en mujeres mayores de 55 años, pero ya se ha empezado a detectar en féminas incluso menores de 35.

EXAMEN DE CÁNCER GRATUITO DÓNDE Hospital Faulkner. Belkin House, primer piso.1153 Centre Street, Jamaica Plain.

CUÁNDO Horario flexible de lunes a viernes. Sábado bajo cita previa.

CITAS (617) 983-7451 (Tracy Sylven).

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Prevenir

Faulkner Hospital provides free breast health care Worldwide, breast cancer is by far the most common cancer amongst women. In 2005 and 2006, it was the leading cause of cancer mortality among Boston Latino residents.

Looking at those numbers, Faulkner Hospital provides women over 40 years of age a free program to prevent and treat the illness.

With this program, women receive mammograms and follow-up breast care at no cost. "It is for women, with or without papers, with or without insurance; however, if they notice a lump, women under 40 can also make an appointment", says Tracy Sylven, director of the Community Health and Benefits Department.

To make an appointment, you must contact Tracy Sylven (617) 983-7451. Faulkner Hospital provides free transportation and parking for patients.

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A healthy start begins with healthy teeth

Dental

From the day your baby is born, you take every possible step to give him or her a healthy life. You schedule checkups with the doctor, cook healthy meals, and make sure baby gets enough sleep.

Parents also need to protect their babies from the most common, chronic disease of childhood: dental disease (cavities).

Because a cavity in a child's tooth isn't as immediately obvious as a bruise or cut from the playground, it can be overlooked. Cavities start in the same way as many other illnesses - from bacteria.

Untreated cavities can slow your child's ability to learn, to speak and eat, and this can lead to poor nutrition and learning problems in school.

The good news is that cavities are almost entirely preventable. By taking several simple steps, parents can make sure that their babies have healthy mouths

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â—? Doyle Williams

as well as healthy bodies.

By 6 months, your baby has four front teeth. Use a soft washcloth with a small amount of water to clean the teeth twice

a day. This helps get rid of the bacteria that cause decay. Avoid putting baby to bed with a bottle filled with juice or milk.

Sugar from these stays in the mouth while

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your baby sleeps and can lead to cavities. Healthy teeth are all one color.

Between 7 to 11 months, your baby begins eating soft foods.

It is important to include healthy foods such as fruits and vegetables. Now you can try using a soft toothbrush to clean the teeth twice a day. Encourage your baby to learn to drink from a cup. Try to dilute juices with water and avoid sugary or sticky items like candy. Make water available.

At about 18 months, the molars begin to grow in. Keep up with nutritious foods and continue to limit sugary drinks and starchy snack foods. Be sure to brush all your baby's teeth, including the new ones at the back of the mouth. You want to keep the enamel surface of the teeth clean and strong. Strong enamel helps prevent cavities.

Between 25 and 36 months, the last of baby's teeth will develop. From now on, schedule a visit to the dentist every six months. Ask about fluoride toothpaste and supplements if your home water is not fluoridated. Fluoride is proven to reduce cavities by up to 50 percent. Teach your children how to brush their teeth. Dentists recommend brushing for two minutes to get rid of food and bacteria. Replace the toothbrush every two months. Help your child floss their teeth. Flossing removes food and bacteria that a toothbrush might miss.

It is never too early to start taking care of your baby's teeth.

A daily oral health routine may save your child from a lifetime of cavities and pain.

Doyle Williams is Chief Dental Officer at Delta Dental of Massachusetts

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Un sano comienzo empieza con dientes sanos Desde el día en que un bebé nace, sus padres hacen todo lo posible por mantenerlo sano. Una de las cosas por las cuales deben preocuparse son las caries.

Como no son tan obvias o aparatosas como un raspón o una cortada, las caries pasan desapercibidas. Aparecen igual que cualquier enfermedad: se originan por una bacteria. Y una caries mal tratada puede retrasar la habilidad de aprender, comer y hablar de sus hijos.

Las caries pueden ser prevenidas siguiendo los próximos pasos: Entre los: 6 meses, su bebé tiene los cuatro dientes frontales. Utilice un pañuelo suave mojado en agua para limpiarlos dos veces por semana. No dejé a su bebé dormido con el biberón en la boca al darle leche o jugos, pues el azúcar en tales líquidos crea caries. Los dientes sanos tienen un solo color, así que avise al doctor si cambian.

7 y 11 meses, su hijo ya come comidas suaves. Incluya frutas y vegetales.

Ya puede utilizar en él un cepillo de dientes suave dos veces al día. Dele agua de beber. Llévelo al dentista al cumplir el primer año.

18 meses, comienzan a salir los molares. Siga alimentando a su bebé con comidas saludables sin muchas bebidas azucaradas y golosinas. Asegúrese de limpiar bien todos sus dientes para mantener los esmaltes fuertes.

25 y 36 meses, los últimos dientes se desarrollan. Llévelo cada 6 meses al dentista y pregúntele por los métodos de cuidado. Enséñele al nene a cepillarse (se recomienda por dos minutos) y a utilizar frecuentemente el hilo dental.

Nunca es prematuro inculcarle a sus hijos una rutina de limpieza diaria, pues ésta podrá evitar que ellos sufran de caries y dolores de muela cuando crezcan.

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Bárbara Ferrer, working to improve your health

In the face of financial hardship, the head of the Boston Public Health Commission wants everybody to use the agency's free health services

Next month, Lucio Hernández will take an unconventional step to halt the $190 weekly withdrawal from his paycheck that has paid his family's health insurance expenses: he'll move to New Hampshire.

The dilemma for Hernández was either maintaining the Blue Cross Blue Shield coverage or finishing the construction of a house in Panama he started building five years ago. He chose the latter, and will move from Acton, Mass., because New Hampshire residents are not obligated by law to have insurance.

"I still ponder if [my decision is] what's best for our family, but I can't afford paying almost $800 per month for an insurance we use every two months," said Hernández, a document courier who drives 75,000 miles per year.

Hernández says he was willing to spend the $60 per month that would have paid for his two kids, ages 4 and 1½, to have MassHealth, a public health insurance program for eligible low and medium-income residents.

But he was told that MassHealth covers only visits to the doctor, and not expenses such as prescription drugs, surgical procedures, and X-rays.

A legal immigrant from Panama, Hernández applied for a number of more-affordable insurance options.

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● Eduardo A. de Oliveira / EthnicNewz.org

Bárbara Ferrer speaks the BPHC's 4th Annual School Book Bag Giveaway, one of the events the commission holds to help Boston families Although, earning about $45,000 a year his family falls under the 300 percent of federal poverty line about $63,000 for a family of four, they did not qualify to receive any government subsidies.

On the other hand, many workers, regardless of their immigration status, are enjoying free health services (not to be confused with free health insurance) provided by government agencies like the Boston Public Health Commission, the city's arm of the state's Department of Public Health.

Parenting-skills workshops and substance-abuse programs, two of the services of the Boston commission, are all filled or overenrolled. But at least

one program is under-used, executive director Bárbara Ferrer says, referring to the nine school-based health centers.

"Only between 30 to 60 percent of the school children are using these health centers," said Ferrer.

The health centers, which are mostly concentrated in the city's public high schools, offer all of types of routine care that means children don't have to miss a day of school because they're sick.

To reach immigrant communities and offer all of its free services, the commission has used various tactics, such as placing ads in ethnic newspapers, making church visits, and

Cortesia: Circo Ringling Bros.

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participating in health fairs.

But nothing has proven more effective than a diverse staff, with people from immigrant communities educating their own people.

"We use the knowledge of immigrants' peers in 16 Boston neighborhoods for HIV prevention," says Ferrer, who is originally from Puerto Rico.

Even though funding is allocated in categories, with state and federal resources going to specific programs, such as infant mortality or obesity education, sometimes services overlap.

"When you're working on HIV prevention, you have to act [also] on substance-

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abuse education. We know the educational work is never done, because we have new immigrant populations coming into the city," says Ferrer.

Tight budgets are forcing many immigrants, such as the Hernรกndez, to make some tough decisions as they deal with the complexities and expense of health care and health insurance. Many in the medical and political fields have praised the 2006 Massachusetts Health Reform because more than 439,000 people became newly insured within two years of the reform's legislation.

The reform has indeed

Donald Rockhead

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Mayor Thomas Menino signs autographs at the Book Bag event, as Bรกrbara Ferrer looks on helped drain the state's Moreover, coverage of health system - but it also Latinos in Massachusetts is has helped prevent at an all-time high: 82 thousands of previouslypercent now have uninsured families from insurance, according to the using hospitals' emergency state's Department of Public rooms for treatment, instead Health. Before 2006, when of visiting primary-care the state's obligatory healthphysicians for their care. insurance law was passed,

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56 percent of Spanish speaking reported not having visited a doctor because of high costs, pointed a survey by DPH. Up until 2006, 25 percent of patients cared for at the Boston Medical Center hospital were uninsured.

Now, the figure is down to less than five percent.

But undocumented housecleaner Ana's (a fictitious name used for this story) does not qualify for any government-subsidized health plans in Massachusetts, where she has lived for 20 years.

"But if I am not covered, when I declare my taxes I have to pay a fine of $219," she says.

Actually, it's $900, up from $219, that she and other non-insured Massachusetts residents will each have to pay, for tax year 2008.

Still, while Ana's situation is worrisome, many immigrants don't even know they have the right to receive health services, regardless of their immigration status.

Dominican factory worker Carlos Herrero is one of those migrant workers who spent years on American soil without a doctors' visit.

"I take the chance [of not seeing any doctors while I'm in the US because] I go see my family every year in the Dominican Republic

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Visitors receive information on various health and family programs at the Book Bag Giveaway event and visit my doctor there."

According to Ferrer, the Boston Public Health Commission's job is "to protect, promote, and preserve the health and well-being of all Boston residents, particularly the most vulnerable." The commission offers various health programs throughout the city that "target preventable disease and injury."

To know more about the Boston Public Commission services, including a newly launched program that help families to find a primary care physician, call (617) 534-5395 or visit www.bphc.org.

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Un truco para mejorar sin costo su salud La directora de la Comisión de Salud Pública de Boston, Bárbara Ferrer, anima a beneficiarse de los numerosos servicios sanitarios gratuitos de la agencia El mes que viene, Lucio Hernández dará un paso poco habitual para ahorrarse los $190 de su sueldo que destina cada semana para pagar el seguro médico de su familia: se mudará a New Hampshire.

Para Hernández, el dilema era mantener la cobertura de la Blue Cross Blue Shield o terminar la casa que comenzó a construir en su natal Panamá hace cinco años. Eligió lo segundo, y por ello se marcha de Acton, Massachusetts, a New Hampshire, pues la ley allí no obliga a los residentes a tener seguro.

"Sigo preguntándome si fue la mejor decisión para mi familia, pero no me puedo permitir pagar casi $800 al mes

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por un seguro que utilizamos cada dos meses", explica. Hernández asegura que estaba dispuesto a gastar los $60 al mes requeridos para que sus hijos, de 1 y 4 años, tuvieran MassHealth.

Sin embargo, MassHealth no incluye costo de prescripciones, intervenciones quirúrgicas ni radiografías.

Muchos trabajadores, sin importar su estatus migratorio, están actualmente disfrutando de los servicios médicos gratuitos de la Comisión de Salud Pública de Boston, la sede local del Departamento de Salud Pública del estado.

Los talleres sobre el cuidado de los hijos y la drogadicción, dos de los

servicios de la comisión, gozan de una gran aceptación; sin embargo, al menos un programa está infrautilizado, el de los centros médicos que se han ubicado en nueve escuelas, indica la directora ejecutiva, Bárbara Ferrer.

Según apunta, sólo entre el 30 y el 60% de los alumnos hacen uso de estos centros, que se encuentran concentrados en los institutos de la ciudad y que ofrecen cuidado periódico de todo tipo, lo cual facilita que el niño no deba perder clase por estar enfermo.

Para llegar a las comunidades inmigrantes y ofrecerles sus servicios gratuitos, la comisión ha incluido anuncios en publicaciones étnicas,

visitado iglesias y participado en ferias de salud. No obstante, lo más efectivo ha sido la labor del personal, muy diverso, formado por inmigrantes.

"Utilizamos su conocimiento en 16 vecindarios de Boston para prevenir el virus del sida", dice Ferrer.

"Es un trabajo formativo que nunca acaba, pues a la ciudad siguen llegando cada día nuevos inmigrantes", añade la directora, quien nació en Puerto Rico.

Para obtener más información sobre los servicios de la Comisión Pública de Boston, incluido el nuevo programa para ayudar a las familias a encontrar un médico de atención primaria, llame a (617) 534-5395 ó visite www.bphc.org.

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Special Education What parents should know, and can do ● Massachusetts Children's Trust Fund If your child has a learning disability or if you suspect that she might, it is important that you as a parent know how the special education system works.

Where to start. If your child is having trouble in school, start by initiating a conversation with his teacher. He might have a learning disability, or a problem at home may affect his concentration, he may have a hearing or vision problem, or something in the classroom may be bothering him. You may be able to come up with solutions to address some of the issues, such as changing seats,

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communicating more frequently with your child's teacher, or give the teacher some pointers on what you do at home to get your child to listen. If there is no improvement, then it might be time to talk to the school about initiating the special education process.

Don't give up. Learning disabilities will not go away, but your child can receive extra help through tutoring and/or special education services at the school so that her

academic skills can improve. With appropriate identification and intervention, your child can achieve the same goals as her peers.

Bright, hard-working, and motivated students with learning disabilities can graduate from high school and go to college and beyond, if they wish.

To read more on this or other topics related to school, health, discipline, and more, visit the parenting website of the Massachusetts Children's Trust Fund: www.onetoughjob.org.

Educación Especial

Lo que los padres deben saber y pueden hacer Si su hijo tiene problemas de aprendizaje o lo sospecha, es importante que sepa cómo funciona el sistema escolar de educación especial.

Si su hijo tiene problemas en la escuela, converse con sus maestros. Quizá no tenga una buena habilidad para aprender, o haya alguna situación en casa que afecte su concentración, o algún compañero que lo moleste en clase.

Manténgalo en observación junto a su maestra, y si no encuentran solución hable con la escuela para iniciarlo en el sistema de educación especial.

Ante todo, no se rinda. Su hijo puede recibir mucha ayuda. Si el problema se identifica, y con la intervención y motivación correcta y necesaria, su hijo puede cumplir las metas que se proponga.

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Preventing early childhood obesity Suggestions from a registered dietitian ● Janet Rose

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The number of obese children between the ages of 2 and 5 in the U.S. has more than doubled over the past thirty years.

During childhood, these children are at risk for bone and joint problems, diabetes, sleep apnea, and psychological issues related to poor body image and social isolation. The key to preventing obesity in the early years is in teaching habits that promote physical health.

Diet Young children do not have control over what they eat - it is therefore the responsibility of adults to offer nutritious foods and balanced meals. A young child's nutritional intake should comprise of 50-60% carbohydrate, 15-20% protein, and 25-30% fat. Portion control is important with all foods but especially with fatty ones. For snacks, rather than potato chips or cookies, a child should receive foods high in fiber and water content, such as fruits and vegetables.

Exercise Children need 60 minutes of exercise a day. Particularly in an urban setting, young children often spend an inordinate amount of sedentary time. It is up to parents and caregivers to create opportunities for physical activity, which need not take place all at once, but can be spread throughout the day.

Generally, a child under the age of 6 cannot become obese unless aided by adults caring for him or her.

Janet Rose is a registered dietitian and Director of Nutrition and Food Services at Associated Early Care and Education, a non-profit agency in Boston.

Cómo prevenir la obesidad infantil temprana

El número de niños obesos entre los 2 y 5 años en los EE.UU. se ha incrementado en más del doble en 30 años. La clave para prevenir la obesidad en temprana edad es inculcar buenos hábitos alimenticios que promuevan la salud física. Lo esencial es una buena dieta y el ejercicio.

Dieta Es responsabilidad de los padres que los niños reciban comidas nutritivas y balanceadas. Un niño pequeño debe ingerir 50-60% de carbohidratos, 15-20% de proteínas, y 2530% de grasas. Para la merienda, en vez de unas papas fritas o galletas, el niño debe ingerir alimentos altos en fibra y agua, como frutas y vegetales.

Ejercicio El niño necesita 60 minutos de ejercicio al día.

Particularmente en un ambiente urbano, el pequeño pasa mucho tiempo en un mismo sitio. Depende de los padres y de quienes lo cuidan crear actividades físicas.

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