Use a birdbath. Fresh water can be even more of an attraction that the best-stocked feeder. Any type of birdbath will do, as long as it’s kept clean and full of fresh water.

Offer seeds. No need to buy a pricey specialty mix; millet and sunflower seeds do the trick.

Make food visible. Place birdseed in a large, open tray that’s easy for birds flying overhead to see. Once a few birds stop by to snack, more will take note and flock to the food.

It’s May, which means it’s time to get your family outside and enjoy the warmer temperatures. It also means the sun’s rays are getting stronger as we head into summer months, so now’s a good time to think about skin cancer prevention. To raise awareness about melanoma, the deadliest form of skin cancer, and to encourage self-examinations, the American Academy of Dermatology has declared May Melanoma Awareness Month.

According to the AAD, 2 million people are diagnosed with skin cancer each year, with one in five people in the U.S. expected to receive a skin cancer diagnosis sometime in their life. Fortunately, skin cancer can be detected early, since it’s the only cancer that can be seen on the surface of the skin. Not sure how to spot what could be a cancerous mark or mole? The AAD recommends talking to your doctor about how often you should check your skin, then using their body mole map during your self-exams to know what to look for when checking your spots.

During your exam, keep an eye out for any of the five characteristics that can make for a suspicious mole, known as the ABCDE’s:

Asymmetry: The mole is not round, and both halves don’t match

Border: The edges of the spot are uneven

Color: Different colors or shades throughout the mole

Diameter: Melanomas are typically larger than 6mm (about the size of a pencil eraser) when diagnosed, though they can be smaller

Evolving: Any sort of change in the shape, size, or color of the mole

For more tips on how to detect and prevent skin cancer, visit aad.org/spot-skin-cancer/.

Pediatricians fed up with parents who refuse to vaccinate their children out of concern it can cause autism or other problems increasingly are “firing” such families from their practices, raising questions about a doctor’s responsibility to these patients.  Medical associations don’t recommend such patient bans, but the practice appears to be growing, according to vaccine researchers.  In a study of Connecticut pediatricians published last year, some 30% of 133 doctors said they had asked a family to leave their practice for vaccine refusal, and a recent survey of 909 Midwestern pediatricians found that 21% reported discharging families for the same reason. By comparison, in 2001 and 2006 about 6% of physicians said they “routinely” stopped working with families due to parents’ continued vaccine refusal and 16% “sometimes” dismissed them, according to surveys conducted then by the American Academy of Pediatrics.

In fact, the AAP policy on vaccine refusal is quite clear, and the excerpts below are well worth reading closely.

What is the pediatrician to do when faced with a parent who refuses immunization for his or her child? First and most important, the pediatrician should listen carefully and respectfully to the parent’s concerns, recognizing that some parents may not use the same decision criteria as the physician and may weigh evidence very differently than the physician does.  Vaccines are very safe, but they are not risk free; nor are they 100% effective.  This poses a dilemma for many parents and should not be minimized. The pediatrician should share honestly what is and is not known about the risks and benefits of the vaccine in question, attempt to understand the parent’s concerns about immunization, and attempt to correct any misperceptions and misinformation.

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For all cases in which parents refuse vaccine administration, pediatricians should take advantage of their ongoing relationship with the family and revisit the immunization discussion on each subsequent visit. As respect, communication, and information build over time in a professional relationship, parents may be willing to reconsider previous vaccine refusals.

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In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child.

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I have highlighted this last sentence. I strongly believe that the right of a parent to make health care decisions should be respected unless the child’s health is in immediate and grave danger. The ethical principles involved in these decisions are complex and vary from case-to-case. To have a blanket policy dismissing all families who refuse vaccination, I believe, is not the right choice.  I know my view on this differs from many other pediatricians—we have families seeking to join our practice simply in order to have a conversation about the risks and benefits of vaccination.  Most—I’d estimate well over 75 percent—decide after our conversations to begin immunizing their children. What would they have done otherwise? Check out of the medical system entirely? That might seem drastic, but I’ve seen this happening more lately. I have seen children who have not been to a pediatrician in years because the parents are afraid they’ll be chastised for their beliefs. Is this what’s best for their children? Talk about throwing the baby out with the bath water.

Instead of tossing families aside, maybe we should be asking why more and more are questioning vaccines and whether our modes of inquiry and communication regarding vaccine safety should be adjusted. As with so many of our American institutions designed to protect public good (CDC, EPA, FDA, etc.), the immunization program that is often termed “the greatest medical advancement of the last century” by public health figures and most doctors, may in fact be a victim of its own success. By that, I mean we have eliminated or vastly reduced most of the vaccine-preventable diseases that plagued our country in the 20th Century. The last case of naturally occurring paralytic polio in the United States was in 1979, and in fact, 95 percent of non-naturally occurring polio cases from 1980-1999 were vaccine-associated paralytic polio affecting some who received the oral Sabin vaccine. This vaccine was discontinued in the U.S. when it was discovered that the risk of polio from vaccination outweighed the natural risk of contracting polio; now we use the inactivated injectable Salk vaccine (the original polio vaccine) exclusively in our country. In a drastically changed infectious disease environment compared to 50 years ago, parents today are similarly trying to weigh risks versus benefits regarding vaccine efficacy and safety for all immunizations.

Do you think this is a radical statement? Shouldn’t parents have a role in this decision? Isn’t vaccination a medical procedure guided by the ethical principles of informed consent? Again, I understand there are other principles in play here—for example, what takes precedence, individual health or public health? Should a parent’s right to decide if and how to immunize her child be outweighed by society’s need to protect the community at large from outbreaks, including newborns and immunocompromised children who cannot receive certain vaccines? These are complex ethical principles and deserve measured, careful debate. I don’t think parents should be ridiculed and ousted for raising questions. But as a pediatrician who has dared to consider the idea that 100% of vaccines may not be safe and effective for every child all of the time (no different than any other medical intervention, I might add), I, too, have been labeled, at times, as “anti-vaccine.”

I’m not naïve. Despite the fact that I have been visibly, publicly in favor of immunization as public health policy, it is a common-place practice to marginalize those who question authority. Although I typically vaccinate children in my practice and (as I tell my patient’s families) I have vaccinated my children, because I question the rhetorical safety and efficacy of immunizations, special interest groups with lots of political power and money would like me to shut up. After all, if a board-certified pediatrician—a Fellow of the American Academy of Pediatrics—is voicing concern, well, I guess some find that threatening. I can deal with that; after all, it is my choice to speak out on the matter. It would be much easier to carry on in silence. But to attack parents who are just trying to make the best decisions they can for their kids?  That’s not OK, and for those families, I cannot sit idly by.

In a country where we are trying to recover from one of the greatest economic debacles of all times due in part to a lack of regulatory oversight, is it wrong for parents to be cautious and skeptical? We live in a cynical age. Trust in public institutions is at an all time low. When one government regulatory agency—the CDC—is charged with both promoting vaccines and monitoring their safety, we have a big potential conflict of interest. What I have simply argued is that in order to save the vaccine program, we need transparency and open dialogue, not cloak-and-dagger policies. If parents are forced to choose between giving all currently mandatory vaccines on a strict schedule based more on insurance company recommendations and school requirements than on current scientific rationale, more are going to choose none and opt for full-scale exemptions. It is anecdotal, and I would love to study this, but it is my observation that most parents who are avoiding vaccination altogether would like to vaccinate their children against most illnesses, but have reservations about 1 or 2. In New Jersey, they are left with one option—religious exemption, and thereby effectively closing the door to any vaccines. Is this what we want?

We need to be able to ask very difficult questions—are immunizations in some way related to the epidemics of autism, food allergies, ADHD, and asthma afflicting our children? Are we trading off a reduction in acute, infectious-disease illnesses for a surge in chronic neurodevelopmental and atopic/autoimmune disorders? Even the stalwart academic vaccine advocate, the Mayo Clinic’s Dr. Gregory Poland, authored a landmark paper calling for the need to better understand the individual adverse responses to vaccine.  Dr. Poland concludes, “Clearly more comprehensive studies are needed to determine if there are associations between genetic variations among individuals and susceptibility to serious adverse events in response to vaccination.  These factors combined with technologic ability will lead to a new era in vaccinology and better, safer vaccines.” It will only be through open, scientifically-based debate that we will discover what is truly in the best interest of our public’s health. In the meantime, we must find a way to work with families who believe they are acting in their children’s best interests.

“The best way out is always through.”
- Robert Frost, “A Servant to Servants” from “North of Boston” (1915)

When your child’s sick or in pain but you’re wary of conventional meds, you might wish there were something to give him that falls somewhere between a kiss on the forehead and a tablet of Tylenol. Fortunately, there is: a homeopathic remedy.

Developed in Germany in the late 1700s, homeopathy is based on the principle that “like cures like.” The idea is to treat pain or other symptoms with an extremely diluted version of the same kind of substance that can cause that reaction. For instance, if you were stung by a bee, your skin would burn, swell, and turn pink. So, if you have a skin rash (from a bee or not) with those symptoms, a practitioner trained in homeopathy might use an ultra-diluted dose of bee venom to treat you, causing your body to react to the tiny amount of venom and trigger its natural healing process. Other homeopathic remedies come from plants and minerals, and they’re all repeatedly diluted (usually with water) so that only the tiniest amount of the original substance is left. A homeopath then prescribes tablets, gels, or liquid mixtures containing these natural extracts.

But do they actually work? And are they safe for kids? Skeptics say that the extracts are too diluted to be effective, and any healing is the result of a placebo effect. Homeopaths and some other doctors disagree: They say that even the most diluted solutions have enough particles of the original substance left for your body to recognize it and trigger the healing system. Plus, their watered-down form makes them perfectly safe for people of all ages, says Steven Olsen, a homeopathic doctor and author of Homeopathy—Nature’s Way to Better Health. “Used in the right way, homeopathy is very, very safe.”

If you want to give homeopathy a try, treating one of these common kid health issues might be a good place to start:

Allergies: Because allergy symptoms can vary widely (sneezing, itchy eyes, congestion), it’s tricky to recommend just one remedy. Start with Boiron’s Children’s Sabadil ($11 for 160 tablets, boironusa.com), pellets that contain a variety of plant extracts, including ambrosia artemisiifolia (derived from ragweed) for coughing, and allium cepa  (derived from red onions) to relieve runny noses, says Heather Jeney, M.D., who is certified in clinical homeopathy. If your child’s not feeling better after 24 hours, it’s probably best to see a homeopath who can recommend a more specific remedy. For instance, she may prescribe drops of solidago virgaurea, a wild herb, to help with congestion, or euphrasia officinalis, from the herb eyebright, to relieve irritated eyes.

Aches and pains: Arnica, made from the arnica montana plant, has anti-inflammatory properties when diluted for homeopathic treatments; it’s the most common homeopathic medicine for relief from everyday aches and pains. Arnica can be used as a topical gel on a leg sore (but not an open wound) from a long soccer practice, for example, or taken by mouth in tablet form for bruising and swelling from a fall. If you can, treat your child’s injury within an hour of when the pain begins, Olsen says, to stimulate her body’s healing system as quickly as possible. Try Hyland’s Bumps ‘n Bruises ($8.29 for 125 tablets, hylands.com), or Newton Homeopathics for Kids Bangs and Scrapes ($14 for one ounce), newtonlabs.net.

Motion sickness: Before you choose a treatment for nausea, find out more about what makes your child feel ill (or better). If his upset stomach is further aggravated by the sight or smell of food, Jeney recommends trying cocculus, like Heel BHI Lightheaded ($14.50 for 100 tablets, heelusa.com) from the cocculus indicus plant, which works to counteract the effect of food on nausea in particular. If he feels better in fresh air, try a remedy containing tobacum, derived from the tobacco plant (but safe and not addictive). Instead of making him nauseated—the way a cigarette might!—it encourages his body to fight the nausea. Try Hyland’s Motion Sickness ($7.69 for 50 tablets, hylands.com).

Colic: Colic can be one of the more difficult ailments to treat, since a baby can’t tell you what exactly hurts. Olsen suggests looking at how your child is handling the pain: If he’s bending forward, try a medicine that uses colocynthis, like Boiron’s Cocyntal ($6.59 for 20 unit-doses, boironusa.com). Derived from the fruit citrullus colocynthis, colocynthis works to ease the digestive tract spasms. If she won’t stop crying and can’t be comforted, try a chamomilla-based remedy, like Hyland’s Colic Tablets ($10 for 125 tablets, hylands.com). Chamomile is known for its calming effects, and is particularly helpful with restlessness and irritability.

What inspired you to start freekibble.com, and later, freekibblekat.com? 
I realized the shelter where I volunteered in Bend, Oregon, was having trouble affording pet food. Then I saw freerice.com (a website that fights world hunger by donating rice for correctly answered trivia questions), and it inspired me to start a similar site for animals!

What obstacles did you face early on?
My parents and I designed the website, but we had to hire a programmer to build it. Local pet stores agreed to donate the food, but they soon couldn’t keep up. Fortunately, Halo pet food stepped in and is now our official sponsor.

Where do you get the daily trivia questions?
Books, magazines, the Internet, newspapers–anywhere we can find them!

What advice would you give to kids who want to help animals?
You’re never too young to help. Set up a lemonade stand or start a dog-walking business with your friends, and donate the proceeds. Also, find ideas at freekibblekids.com, my new site that helps kids help animals. Little things really do add up.

You’ve already accomplished so much at such a young age! What’s next?
So far, we’ve donated more than 5 million meals. I’m going for 5 million more!

Parent (and kid!) tested

For this year’s KIWI Awards, we added a new twist: Our first-ever taste test. Five Moms Meet groups—over 100 parents and kids—sampled a selection of pretzels and chocolate sandwich cookies and weighed in on their favorites. These are the brands the groups loved most.

Best sandwich cookies

Best pretzels

The weather’s finally warming up, and nothing says spring like spending time outside. It’s also a great time to think about ways to give back. Here, a few ways to enjoy the warm weather and your community.

Celebrate National Park Week April 21-29 by taking your family outside to see what your nearest park has to offer. The best part? All 397 national parks across the country are offering free admission throughout the week! Find out more at nps.gov/npweek.

Volunteer! Spring is a great time for making new commitments, so why not find a way to volunteer in your community? If your kid’s an animal lover, check with your neighborhood shelter about becoming a dog-walker, or look into possible volunteer opportunities for older kids at a local zoo. Check out more tips for how families can volunteer together here.

Plant a tree for National Arbor Day, April 27^th. You can plant a tree yourself, get your child and her friends involved, or volunteer with a local tree-planting organization. Check out arborday.org for tips on how to get started.

National Volunteer Week is April 15–but how can you turn that into something doable for your kids, all year long? “Make it a family affair,” says Jenny Fridman, co-author of Doing Good Together and executive director of the Minneapolis-based nonprofit of the same name. Here are some fun ideas for age-appropriate activities:

Age 4: Start small, like with litter cleanup. At the park, pick up five items together before playing. This will get even little kids thinking about why helping matters—and get them in the habit of doing it every week.

Age 8: Friedman recommends starting with “kitchen table activities” that you can do right from home. For example, many shelters give guests sandwiches when they leave in the morning, so help your child throw a sandwich-making party with friends—everyone can make different kinds of sandwiches, then deliver them to the shelter in person.

Age 11: There are so many activities preteens can do, so the key is to let them decide how they want to give back, says Friedman. “The more excited they are about ideas they’ve come up with, the more invested they’ll be,” she says. Talk to your child about her interests,and brainstorm ways to help: Maybe setting up a lemonade stand whose profits go to a favorite charity, or help a homebound senior with chores.

Find more ways to get your family involved at doinggoodtogether.org.

Cool compress
Place a damp, chilled washcloth over your child’s closed eyes. The compress works to help reduce the inflammation in the eyes and surrounding skin.

Saline drops
Nix burning and redness by rinsing away airborne allergens with eyedrops. Try Similasan Allergy Eye Relief drops or Boiron Optique 1 Eye Drops.

Looking for more natural seasonal allergy remedies? Watch our webinar with green pediatrician, Dr. Lawrence Rosen.