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Ensuring a healthier and more inclusive future for LGBTQIA+ children and teens is of utmost importance to health systems in our community, especially Renown. Supporting the physical and mental health of youth in this community is key to those efforts, especially as they face unique challenges in terms of identity acceptance and social integration.   Dr. Caroline Barangan, Adolescent Medicine Physician with Renown Children’s Pediatric Specialty Care, discusses what you as a parent, caregiver, friend or support system can do to be a safe space for children and teens who identify as LGBTQIA+. 1.  Create a Safe Space at Home The most important action you can take for your LGBTQIA+ teen or child is to accept and support them for who they are, regardless of how they identify. “Being a teenager is already difficult enough, especially within the LGBTQIA+ community, which puts them at risk of being stigmatized, rejected and targets for bullying,” said Dr. Barangan.  Your supportive words and actions can make a huge difference as a profound expression of love and understanding. Being patient and willing to learn are the foundations to a healthy and loving relationship with your LGBTQIA+ teen or child.  2.  Encourage Regular Check-Ups with a Primary Care Provider (PCP)  Establishing your child or teen with a PCP is not only important when an illness occurs but also for annual preventative visits and regular check-ups. “A primary care provider can screen for high-risk behaviors that would put a patient’s health in jeopardy, such as sexual experience, substance use, suicidality and self-harm,” said. Dr Barangan. “These screenings are an opportunity to provide the education and support these kids and teens need to stay healthy.”  One of the main concerns LGBTQIA+ youth often have is that they will experience judgment from their provider, or the PCP will disclose sensitive information, including their sexuality or gender identity to their parents, when they are not ready to do so. Dr. Barangan emphatically reminds us that this legally cannot happen. “If a patient asks me to keep something confidential, unless they disclose that they have plans to harm themselves or others, I am legally not allowed to share that information with anyone without their permission,” said Dr. Barangan.  3.  Locate Local Resources  Northern Nevada is home to a variety of resources for the LGBTQIA+ community at large, including youth members of this community. "Finding resources to help them develop in a positive way and provide them with the information they need, whether it be in school, the household, the community or through a medical or mental health provider, is incredibly important,” said Dr. Barangan.  Below is a list of local LGBTQIA+ community resources open to you and your children:  Our Center LGBTQIA+ Health Services at Northern Nevada HOPES Northern Nevada Pride Festival & Community Parade (happens every July in Reno) Sassabration (happens every September in Carson City) Lake Tahoe Pride (events and resources shared on Facebook)

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The back-to-school season is here, and ensuring your child's successful transition involves more than just school supplies and schedules. At Renown Children’s Hospital, and in collaboration with Nevada Pediatric Psychiatry Solutions, we understand the vital role that mental health plays in a child's overall well-being and academic performance. Below we'll guide you through essential tips for a smooth back-to-school experience, with a special focus on nurturing your child's mental health. How to Support Your Child’s Mental Health from Home Remember, the below strategies can be adapted to align with your child's personality, learning style and household dynamics. Flexibility and understanding are key in tailoring these tips to suit your child's unique needs. 1. Be Open to Communication: Recognize that effective communication is the cornerstone of understanding your child's feelings and concerns. Create a safe space where your child feels comfortable expressing their thoughts. Listen to learn, without judgment. Make it a point to validate their emotions and ensure they are heard. Encourage sharing experiences,worries, friends and challenges they may be facing. Having open conversations about sensitive topics opens the door for discussion and understanding. Make yourself available. 2. Establish a Routine: A consistent routine can offer a sense of stability and predictability for your child, and anticipation helps to decrease anxiety and establish a sense of control. Join forces and design a daily schedule that includes time for schoolwork, play, physical activity, meals and relaxation. Be flexible about the structure to allow room for last-minute changes including extra activities based on that day’s needs as well. Always add time for play and bonding. 3. Practice Compassion: Back-to-school can come with big emotions. Listening reflexively and acknowledging these feelings can help you and your child act positively on these big emotions. 4. Get Involved: Actively engage in your child's school life by participating in school events, meetings and discussions. Show interest in their educational journey, ask about their experiences and provide guidance when needed. Being present in their academic pursuits not only boosts their confidence but also strengthens the parent-child bond. 5. Use Positive Reinforcement: Celebrate your child's achievements, no matter how small they may seem. This allows for a sense of accomplishment and boosts self-esteem. Praise efforts, progress and perseverance, whether it's completing an assignment, making a new friend or overcoming a challenge. This positivity encourages a growth mindset and resilience. 6. Organize a Schoolwork Zone: Create a comfortable workspace at home dedicated to school-related tasks. Customize the area based on your child's preferences and needs. Having a designated space for studying and completing assignments promotes focus, reduces distractions and enhances their overall learning experience.

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If you’re a parent, you’ve probably been there — the sometimes-nightly struggle to get your little ones off to bed. Elaina Lantrip, an APRN with Renown Pediatrics, offers some tips and explains how your child’s electronics may be getting in the way of a good night’s sleep. These days, kids are consuming media from a very early age on all types of devices — from tablets and phones to TVs. While they can benefit from some media use, it can have a negative impact on bedtime. We asked Elaina Lantrip, an advanced nurse practitioner with Renown Pediatrics, for some advice on downloading a better bedtime routine. What are the most important practices for parents to establish for their children’s bedtime routines? I often have parents tell me that their child won’t go to bed — or to sleep. Parents frequently ask for tips on bedtime routines that work. My first question is whether their regular bedtime routine involves television, iPad, tablet, phone or anything with a screen. It’s very important that bedtime includes a bath, reading a story, talking, singing and bonding with young ones, rather than using any devices. Why shouldn’t children have a device at bedtime? A growing body of research supports that screen time at bedtime contributes to delays in a child’s falling to sleep; overall inability to reach the important REM, or deep sleep; waking up during the night; nightmares and night terrors. For older youth, engaging with social media before bedtime can bring up stresses, emotions and relationship issues with peers that don’t exactly create peaceful bedtime thoughts. Bedtime should be a screen-free, stress-free, peaceful time of day. It’s a great time for parents to promote self-esteem, talk through things going on in the child’s life, to encourage and build them up. Children grow up fast — bedtime is a great the opportunity with younger children to cuddle up and read a story or sing a lullaby. What are other major considerations in making bedtime smooth and relaxing for kids and their parents? Another factor that contributes to positive sleep habits includes children getting enough activity during the the day so they’re genuinely tired at night. Also helpful are ambient noise makers, peaceful music, avoiding sugar two hours prior to bedtime, consistency in bedtime routine, comfortable pajamas and comfortable temperature in the home. Is it important to keep the child’s bedroom dark? Dimming the lights is important, regardless of the time of year. This is another reason to ban screens, as they emit light that stimulates wakefulness.

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Dr. Max J. Coppes, Physician-in-Chief Renown Children’s Hospital, and Nell J. Redfield Chair of Pediatrics, UNR Med, talks about how much is too much when it comes to teens and social media. Social apps (Facebook, Instagram, Twitter, WhatsApp, Snapchat, TikTok, etc.) have become an integral part of most people’s lives. In contrast to traditional media — where one source goes to many receivers — social media operates in a dialogic transmission system. Many sources interact, sometimes simultaneously, with many receivers and provide for superior interactivity between its users. Not surprisingly, it also plays a significant role in our children’s lives once they are old enough to understand how to access and use these apps. On average, children start exploring social media at around ages 10 to 12. They rapidly discover that electronic communication allows for unique and personalized ways to make and keep friendships. They also use it to develop and expand family ties, get help with homework, share music, art, and experiences, and learn and discover the world. Social Media and Teens Surveys suggest that more than 90 percent of teenagers use social media. Additionally, approximately 75 percent have at least one active profile by age 17. Access to social media is greatly facilitated because more than two-thirds of teens have their own mobile devices with internet capabilities, a substantial change relative to previous generations. The use of social apps can have many positive aspects. But we now also recognize that it can also have negative impacts. The use of hazardous sites or the inherent risks of using social media (identity theft, being hacked, cyber-bullying, etc.) are indeed damaging to children. Any use of hazardous social apps is too much and carries serious hazards. But what about the use of “normal” and/or “safe” social media? Well, data suggest that too much use of “non-hazardous” apps can indeed affect health. How Much Do Teens Use Social Media? First, some basic data. For example, how much do normal teenagers use social media? A study from Pew Research found that more than 50 percent of 13- to 17 year-olds go online several times a day. This quickly increases during the teenage years to more than 70 minutes per day. Teenage girls have the highest usage at just over 140 minutes per day. It is important to recognize that non-school related use of the internet and social media is often beheld by teenagers as important for developing their self-esteem, their acceptance among peers, and their mental health in general. As parents, we recognize that the use of social media can indeed contribute, in many positive ways, to our children’s growth. At the same time, we also worry about them spending too much time online. We worry about their ability to communicate effectively in face-to-face settings or in writing. Many of us also feel and/or worry that our children are addicted. Social Media and Addiction Recent studies suggests that the overuse of social media indeed mirrors addiction. Reports now show that teenagers and college kids experience anxiety when deprived from their connected devices and consequently feel a compulsion to access their social applications. The emotional symptoms they experience are very similar to those seen in substance abuse. In fact, the American Psychiatric Association is considering making internet addition a bonafide diagnosis. Pediatricians therefore encourage limits on the use of social media, a recommendation more easily suggested than accomplished. So when should a parent consider seeking help? Aside from unhealthy use of these apps (cyber-bullying, sexting, online users asking for sexual relations, etc.), which should always trigger concern, the use of social media for more than 120 minutes per day should trigger parental concern. If you feel unable to address the overuse of social media, contact your pediatrician for help and guidance. Renown Children’s Hospital Whether it’s seeing a pediatrician, getting a sports physical or looking for advice, our care is centered around supporting and nurturing patients and families at our many locations. We have pediatricians dedicated to children who have experience recognizing children’s illnesses. They also have knowledge about tests and treatments for young ones to ensure your child gets the best care possible. Explore Children’s Services

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Many factors are contributing to the rise of early onset puberty in girls. Learn what they are below and how you can support your daughter. The number of girls experiencing early puberty has increased dramatically over the last few years and continues to grow. More and more girls in the U.S. are starting to show signs of development before the age of 8. Recent studies show that up to 10 percent of Caucasian girls and 23 percent of African American girls are showing signs of puberty by age 7. What’s Contributing to Early Puberty in Girls? Determining the exact cause is difficult. But experts agree that several factors may be contributing to these growing numbers. Increasing rates of childhood overweight and obesity. Excess body fat alters the levels of hormones responsible for the acceleration of pubertal timing. Physical inactivity may decrease melatonin levels, which can also trigger pubertal development. Increased animal protein intake. Higher total protein, animal protein and meat intake in children ages 3 to 7 have been associated with earlier onset of menstruation. High protein intake elevates IGF-1 levels and promotes growth, which could accelerate the onset of puberty. Poor diet. Children with lower-nutrient diets tend to enter puberty earlier. A diet rich in processed foods and meats, dairy, and fast food is disruptive to normal physical development. Exposure to EDCs (endocrine-disrupting chemicals). EDCs are synthetic chemicals found in plastics, pesticides, fuels and other industrial chemicals that inhibit or alter the action of natural hormones. Because EDCs accumulate in the fatty tissues of animals, animal foods contain higher levels of these chemicals than plant foods. Exposure to BPA (bisphenol A). BPA is an industrial petrochemical found in a variety of products including plastics, tin-can linings and even cash register receipts. Because it acts as a synthetic estrogen it may speed up pubertal development. Soy products. Soy contain isoflavones which are converted to phytoestregens in the body, and are similar to the hormone estrogen, Dr. Chelsea Wicks says. “Soy consumed from natural food sources is likely safe and will not cause abnormal hormones levels. However, when consumed in large amounts, such as with soy supplements or in more processed foods, there have been links to chronic medical problems due to elevated estrogen levels. I feel a good answer to this is to continue working on eating fresh foods and trying to avoid the processed, packaged foods as this will be best for overall general nutrition as well,” she adds. What You Can Do While some genetic factors play a role in the early onset of puberty, parents can help lessen environmental causes of the condition. Encourage and help your child to maintain a healthy weight with proper nutrition and exercise. Avoid exposure to hormones such as estrogen and testosterone that may be found in hair products, medications and nutritional supplements. Avoid exposure to EDCs and BPA. Offer your child a diet centered around whole plant foods rather than animal foods, which will help keep protein intake within a safe range and reduce consumption of EDCs. Create a supportive environment for your daughter. Avoid commenting on her appearance and instead focus on her achievements, academic successes or artistic talents. Speak to her openly and honestly about the physical changes she’s experiencing — that although these changes are normal, she’s simply developing early — and that ultimately her peers will undergo the same changes. Encourage your daughter to continue participating in social activities and pursuing her interests, and reassure her you are always open to discuss any questions or worries. If you are concerned that your child may be going through these changes before expected, speak with your pediatrician. Sources: Early Puberty: Causes and Consequences When Is Puberty Too Early? Precocious Puberty (Early Puberty) Precocious Puberty

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