Peninsula Pediatrics

Category: Preventive Care

Water Safety for Kids

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Water activities are a fun part of childhood, especially during warmer months. Whether your family enjoys swimming pools, lakes, rivers, beaches, or even backyard water play, it’s important to remember that water can pose serious risks. Drowning is one of the leading causes of injury-related deaths in children, but many tragedies can be prevented with the right safety measures. Understanding how water safety needs change as children grow can help keep your family safe.

Quick answer: Drowning can happen quickly and quietly, often without splashing or noise, so close supervision is a child’s best protection near any water. Layer in pool fencing, swim lessons, U.S. Coast Guard-approved life jackets for boating, and CPR training. Even strong swimmers still need supervision, since swim lessons alone do not make a child drown-proof.

Why is active supervision so important around water?

Drowning often occurs without splashing, yelling, or obvious signs of distress, which is why active supervision is essential whenever children are near water. For infants and young children, supervision should be constant and uninterrupted. Babies can drown in very small amounts of water, including bathtubs, buckets, kiddie pools, and other containers. Parents and caregivers should stay within arm’s reach of infants and toddlers in or near water, avoid distractions like phones or conversations, and take their child with them if they need to leave the area.

When can my child start swim lessons?

Children can typically begin learning water survival skills as early as age one, depending on their developmental readiness and individual circumstances. It’s important to remember that swim lessons do not make a child “drown-proof.” Even children who know how to swim require close supervision around water.

What pool safety measures should we have at home?

Having multiple layers of protection is extremely important. A home pool should be surrounded by a four-sided fence that separates the pool from the house and yard, with a self-closing, self-latching gate that children cannot easily open. Pool covers, alarms, and locked doors can provide additional protection, but they should never replace proper fencing and supervision. Remove toys from the pool area when swimming is finished, since toys left in or near the water may attract young children who could wander in unsupervised.

How does water safety change as kids grow older?

As children grow older and become stronger swimmers, families can sometimes become less vigilant. However, water safety remains important throughout childhood and adolescence. School-age children should continue to be supervised when swimming, especially in natural bodies of water where conditions can change quickly. Currents, waves, underwater hazards, and sudden drop-offs can make lakes, rivers, and oceans more dangerous than pools.

What water safety rules should I teach my child?

Kids should never swim alone and should always use the buddy system. Teach them to ask permission before entering the water and to follow pool rules at all times. Running near pools and diving into unknown depths can increase the risk of injury.

Do life jackets matter, and which ones are safe?

Children should wear a properly fitted, U.S. Coast Guard-approved life jacket when boating or participating in water activities where there is a risk of falling into deep water. Water wings, inflatable toys, and pool noodles may be fun, but they are not safety devices and should never be relied on to prevent drowning.

How does water safety change for teens?

For teenagers, water safety conversations should include discussions about risk-taking. Teens may overestimate their swimming abilities or participate in unsafe activities around water, such as swimming in unsupervised locations, diving into unfamiliar water, or engaging in dangerous stunts. Parents should reinforce the importance of making responsible decisions and respecting water safety rules. Learning CPR is another valuable step for families, since it can help save a life while waiting for emergency responders to arrive.

Frequently asked questions

Can a child drown even if they know how to swim?

Yes. Swimming lessons are valuable, but they do not make a child “drown-proof.” Even strong swimmers still need close supervision, since drowning can happen quickly and quietly.

When can my child start swimming lessons?

Children can typically begin learning water survival skills as early as age one, depending on their developmental readiness and individual circumstances.

Are pool floaties a safe substitute for supervision?

No. Water wings, inflatable toys, and pool noodles may be fun, but they are not safety devices and should never be relied on to prevent drowning.

What should home pool fencing look like?

A four-sided fence that separates the pool from the house and yard, with a self-closing, self-latching gate that children cannot easily open, provides the strongest layer of protection.

If you have questions about swimming readiness, water safety, or swim lessons for your child, please call our office. Peninsula Pediatrics proudly cares for families across the Rockaways.

Vitamin D for Children

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Vitamin D is an essential nutrient that plays a significant role in helping children grow and stay healthy. It helps the body absorb calcium, which is needed to build strong bones and teeth. Without enough vitamin D, children can develop weak or soft bones, including a condition called rickets. Vitamin D also supports muscle function and overall health from infancy through the teen years.

Quick answer: Babies under 12 months need 400 IU of vitamin D daily and older children and teens need 600 IU. Since breast milk and diet alone often fall short, supplements are sometimes needed. More is not always better, so follow your pediatrician’s guidance.

Why do children need vitamin D?

Vitamin D helps the body absorb calcium to build strong bones and teeth, and it supports muscle function and overall health. Without enough, children can develop weak or soft bones, including rickets. It remains important throughout childhood and adolescence.

How much vitamin D do children need?

According to the American Academy of Pediatrics, babies younger than 12 months need 400 IU of vitamin D daily, while toddlers, older children, and teens need 600 IU each day. Breast milk alone usually does not provide enough vitamin D, so it is recommended to give breastfed babies a supplement shortly after birth. Babies who drink at least 32 ounces of vitamin D-fortified formula each day do not need extra, but those drinking less may still need supplementation.

How can children get enough vitamin D?

Children get vitamin D from a combination of food, supplements, and sunlight. Food sources include fatty fish, egg yolks, shiitake mushrooms, milk, and some cereals and juices. Sunlight also helps the body make vitamin D, but the amount depends on skin tone, sunscreen use, clothing, weather, season, and time outdoors. Because excessive sun exposure can damage skin, babies younger than six months should be kept out of direct sunlight, and older children should continue practicing sun safety.

Why does vitamin D matter for teens?

Teens experience rapid growth and bone development during puberty, but many do not get enough vitamin D. Spending more time indoors, using sunscreen regularly, or drinking less fortified milk can lower levels. Teens who are deficient may feel fatigue, muscle weakness, or bone discomfort. Encourage a well-balanced diet and a daily supplement if recommended by the pediatrician.

Can a child get too much vitamin D?

While vitamin D is needed, more is not always better. Taking excessive amounts of supplements can lead to problems such as kidney stones or other complications. Always follow dosing instructions and talk with your pediatrician before starting supplements beyond the recommended amounts. Remember that many foods and multivitamins already contain vitamin D, so consider the total amount your child receives each day.

Frequently asked questions

How much vitamin D do children need?

According to the American Academy of Pediatrics, babies younger than 12 months need 400 IU of vitamin D daily, while toddlers, older children, and teens need 600 IU each day.

Do breastfed babies need a vitamin D supplement?

Breast milk alone usually does not provide enough vitamin D, so it is recommended to give breastfed babies a vitamin D supplement shortly after birth. Partially breastfed babies may also need supplementation.

How can children get enough vitamin D?

Children get vitamin D from a combination of food, supplements, and sunlight. Food sources include fatty fish, egg yolks, shiitake mushrooms, milk, and some fortified cereals and juices. Because few foods naturally contain it, supplements are sometimes needed.

Can a child get too much vitamin D?

Yes. More is not always better. Taking excessive amounts can lead to problems such as kidney stones, so always follow dosing instructions and talk with your pediatrician before starting supplements beyond the recommended amounts.

If you have questions about whether your child is getting enough vitamin D or whether supplementation may be appropriate, please call our office. Peninsula Pediatrics proudly cares for families across the Rockaways.

Why We Don’t Routinely Test for MTHFR Gene Variants or Heavy Metals

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Quick answer: Pediatricians at Peninsula Pediatrics do not routinely recommend MTHFR gene variant or heavy metal testing in children. MTHFR variants are common, usually cause no symptoms, have no specific treatment, and knowing your status does not change medical care. Following AAP guidance, these tests are not recommended for most kids.

As parents, it’s natural to want the best for your child’s health. You may have heard about MTHFR gene variants or heavy metal testing and wondered whether your child should be tested. There is a lot of information online and in adult medicine, sometimes parents are tested, and it can be confusing.  As pediatricians, we do not routinely recommend these tests, and here’s why.   Understanding MTHFR Gene Variants   MTHFR (methylenetetrahydrofolate reductase) is a gene that helps the body process folate (Vitamin B9), which is essential for cell growth and metabolism. Everyone has two copies of this gene, and variations in the gene are common—about 40% of people have one. A variant may slightly decrease the body’s ability to process folate, but in most cases, the body still processes enough for normal function.   Most people with an MTHFR variant do not experience any symptoms or health issues, which is why routine testing is not useful. There is no specific treatment for having an MTHFR variant, and knowing your status does not change medical care. The more meaningful test, if someone has concerning symptoms, is a homocysteine level, as MTHFR-related issues only become relevant if homocysteine is elevated. However, this is still very rare in children.   Should my child be tested for MTHFR Gene Variants? Based on guidance from the American Academy of Pediatrics (AAP), MTHFR testing is not recommended in children because it does not provide useful or actionable medical information for children. Variations in the MTHFR gene are very common in the general population and, by themselves, do not cause disease. Knowing whether a child has an MTHFR variant does not change medical management, does not predict health problems, and does not guide treatment. Research in pediatrics has shown that MTHFR variants are not a cause of developmental delays, behavioral concerns, anxiety, ADHD, autism, or most other medical symptoms. They also do not reliably predict blood clot risk in children. Because of this, testing can create unnecessary worry without providing any information to help a child. We specifically recommend not testing for MTHFR in children, even when parents have been tested or when there is a family history and instead we focus on symptoms that a child does have and things we can test or do that are helpful and guide us to decisions that can benefit children. Additionally, even when an MTHFR variant is present, children with a normal diet do not need special supplements or treatment beyond standard age-appropriate nutrition. Should I Give My Child More Folate?   If your child has no symptoms or folate deficiency, there is no need to supplement with extra folate as a precaution. A well-balanced diet that includes vegetables, fruits, whole grains, lentils, beans, and fortified cereals provides enough folate for healthy development. If your child is ever found to be deficient, your pediatrician will guide you on the right approach.   Heavy Metals and Children’s Health   Heavy metal exposure can be concerning, but routine testing for metals like mercury, arsenic, and cadmium is not recommended unless there is a clear risk factor or symptoms. These exposures are rare, and our daily environment contains only trace amounts that the body naturally eliminates.   To reduce unnecessary exposure, parents can take simple precautions:  
  • Wash fruits and vegetables thoroughly.  
  • Avoid excessive fruit juice consumption, as some juices have been found to contain small amounts of heavy metals.  
  • Provide a variety of foods to prevent overexposure to any single source.  
  • Ensure your drinking water is safe by checking with your local health department.  
  Heavy Metals in Vaccines   Some parents worry about heavy metals in vaccines, but routine childhood vaccines do not contain harmful levels of heavy metals. Thimerosal, a mercury-based preservative, was removed from most vaccines in the early 2000s, and the trace amounts used in some multi-dose flu vaccines (our office uses single dose prefilled syringes) have not been shown to cause harm. The benefits of vaccines in preventing serious diseases far outweigh any theoretical risks from minimal exposure.   Lead Exposure and Testing   Unlike other heavy metals, lead exposure remains a real concern in certain situations. Children are routinely tested for lead exposure at 1 and 2 years old, or later if they are at risk. Risk factors include:  
  • Living in a home built before 1978 with chipping or peeling paint.  
  • Using imported pots, pans, or toys that may contain lead-based coatings.  
  • Having a caregiver who works in jobs with lead exposure, such as construction or battery manufacturing. 
If you are concerned about lead in your home, talk to your pediatrician about testing and prevention strategies.   Final Thoughts   We understand that navigating health information can be overwhelming, and we are here to support you. While MTHFR variants and heavy metals are widely discussed online, routine testing is not needed in most cases. If you ever have concerns about your child’s health, we encourage you to reach out. We are always happy to discuss evidence-based guidance to help your child grow up healthy and strong.

Frequently asked questions

What is the MTHFR gene?

MTHFR (methylenetetrahydrofolate reductase) is a gene that helps the body process folate, or vitamin B9, which is essential for cell growth and metabolism. Everyone has two copies, and variations are common, with about 40 percent of people having one.

Should my child be tested for MTHFR gene variants?

Based on guidance from the American Academy of Pediatrics, routine MTHFR testing is not recommended. Most people with a variant have no symptoms, there is no specific treatment, and knowing your status does not change medical care.

Is there a more meaningful test?

If someone has concerning symptoms, a homocysteine level is the more meaningful test, since MTHFR-related issues only become relevant if homocysteine is elevated, which is still very rare in children.

Related reading: What to Know About Tylenol, contact our office. Peninsula Pediatrics proudly cares for families across the Rockaways.