Starting November 1st every year, most children begin their countdown to the next Halloween. And why wouldn’t they? Costumes! Candy! Late bedtimes! While there’s so much fun to be had, there are also safety concerns. Read on for safety reminders to ensure your Halloween night is delightful, not frightful.
Trick-or-treat in groups or individually with a
Be sure drivers can see you walking or crossing
the street, Wear glow sticks or add some reflective tape to the costume.
Bring a flashlight along, so you can see where
you’re going and avoid falling.
Walk. Don’t run.
Look both ways when crossing the street and use
crosswalks when possible.
If you’re driving, go slow and keep your eyes
open for trick-or-treaters.
An adult should look over the candy haul before
anyone digs in. Factory wrapped treats are the safest. Homemade treats from
strangers are not safe. Pay close attention to any ingredients that may trigger
an allergic reaction.
Approach well-lit homes only, and never enter a
Do not accept a ride from stranger. Ever.
If heading out in a group, plan the route ahead
of time, and share it with a trusted adult.
Pumpkins are hard to carve, even for adults. Use
a knife with a rounded tip and be sure a grown-up does the carving or oversees
Use caution if candles are part of your décor.
Look for fire-resistant costumes and place open flames in a safe spot (away
from little hands, claws, paws…) Battery operated, or LED candles are the safest
Accessories can make or break the costume. Be
sure they are short, soft and flexible.
If makeup or face paint is part of you or your
child’s costume, test it on a small part of your skin, especially if you have
sensitive skin, before applying it on Halloween night.
If you’re faced with a Halloween boo boo or illness, don’t go batty. IHA Urgent Care locations are open late and are ready to treat you and your pumpkins.
Wait in line at home, click below to save your spot in an IHA Urgent Care close to you.
Receiving the flu vaccines reduces flu illnesses, sick
appointments or hospital stays, and missed time from work or school. It can
also be life-saving for high risk patients like children or seniors.
Can the flu vaccine
give me the flu?
The viruses in the flu shot are killed (inactivated), so you
cannot get the flu from a flu shot. However, you may experience some minor side
effects like, soreness, redness or swelling at the shot site, a low grade
fever, and some aches.
For those that receive the nasal spray, the viruses are
weakened and do not cause severe symptoms often associated with influenza
illness. Side effects from the nasal spray may include, runny nose, sore
throat, cough, wheezing, headache, vomiting, muscle aches, or fever.
Who should get vaccinated
Everyone six months of age and older should receive a flu
vaccine at the beginning of the flu season, typically every fall.
Who should not be
vaccinated against seasonal flu?
A patients age, health or allergies may determine they should
not receive the flu vaccine. Talk with your physician to ensure you or your
children should receive the flu vaccine.
Why should I get my
The flu is dangerous for all people, but children under five
years old are at an especially high risk when they get sick with the seasonal
flu. The flu vaccine is your and your children’s best defense against
contracted and spreading the flu.
When should I get a
For people receiving one dose of the flu vaccine, the
Centers for Disease Control recommends that people get the flu vaccine by the
end of October. If your child requires two doses, they will need to be given
four weeks apart, so chat with your pediatrician on the best time to give the
first dose. Getting the vaccine in the summer months may result is reduced
protection later in the flu season, especially for high risk patients. There are benefits to receiving the flu
vaccine later in the season, so it’s never too late to be vaccinated!
How effective is the
The patient’s age and health status will determine the
effectiveness of the flu vaccine, as well as how well the flu in the vaccine
matches the flu circulating in your community. The CDC estimates that the flu
vaccine reduces the risk of flu illness by between 40% and 60% among the
overall population, when the seasonal flu circulating is well-matched with the
how can people protect themselves against the flu?
Getting the flu vaccine every year is your best defense
against the flu. People should also take preventive actions every day. These
include, frequently washing hands, covering coughs using the inside of your
elbow, not your hand, and avoid having contact with people who are sick (even
if they haven’t been diagnosed with the flu).
Where can I get the
This year’s flu shot is available at IHA Primary Care practices and pediatric doses are available at IHA Pediatric practices. Adults and children may receive the flu shot at any IHA Urgent Care location. Click below to schedule your flu shot.
Does your child pull their backpack off as soon as they step
off the bus or out of school, and request that you carry it for them? As a
rule, a child’s backpack should not weigh more than 10% – 15% of their body
weight, but many kids are carrying bags much heavier than that. If your child
is complaining of a sore back, they struggle to put their backpack on or they
learn forward to walk once they get it on, their backpack is most likely too
heavy. Read on for some tips to ensure they have the right backpack for their
needs and their body type, and they are packing light.
Get the right
Discuss what will need to go in the backpack to
ensure you get the right size
Your child’s backpack should not be wider than
The backpack should not hang more than 4 inches
below your child’s waist
Padded shoulder straps are a necessity
A padded back will help prevent objects from
poking your child in the back
Waist and chest straps will help your child
distribute the load of their backpack when it’s packed
Consider the weight of the backpack itself and
choose one made of a lightweight material
Two straps distribute the weight of the backpack
evenly, be sure your child is using both
Adjust the straps to ensure a good fit for your
child (remember the backpack should not hang more than 4 inches below the
Help decide what should come home every day, and
what can be left in their locker
When they must bring home a full pack, encourage
your child to use their chest and waist straps
Pack the heaviest items on the bottom, and make
use of the multiple compartments to better distribute the load
To ensure you child is carrying a sensible weight, pick up
their backpack once in a while, or weigh it on the bathroom scale. Make
adjustments as needed to help keep your child’s back in great shape!
If your child is complaining of pain that doesn’t go away, make an appointment with your child’s pediatric provider. They’ve got your back!
It’s easy to schedule an appointment with your pediatric provider – simply visit our online appointment tool, scroll to find your pediatric provider, and click to schedule an appointment at a time that works for your family!
Don’t let the cooler weather fool you, mosquito season is not over. More than a pest, these buzzing insects can carry and spread dangerous diseases to both humans and animals. Here in Michigan, health officials are advising residents to take precautions after several residents became infected with the mosquito-borne virus, Eastern Equine Encephalitis (EEE). The only way to prevent mosquito-borne illnesses is to avoid being bitten by them.
Until the nighttime temperatures consistently fall below freezing, The Michigan Department of Health and Human Services has issued the following recommendations to protect yourself and your family against mosquito bites:
Avoid being outdoors at dusk and dawn when mosquitoes are most active
Wear light-colored, long-sleeved shirts and long pants when outdoors
Apply insect repellents that contain the active ingredient DEET or other EPA- approved product to exposed skin or clothing, always following the manufacturer’s directions for use
Use nets and/or fans over outdoor eating areas
Maintain window and door screening to help keep mosquitoes out of buildings
Empty water from mosquito breeding sites such as buckets, unused kiddie pools, old tires or similar sites where mosquitoes lay eggs For those that work outdoors or cannot avoid being outdoors at dusk or dawn, be diligent about using insect repellent, and cover as much of your skin as possible.
If you’re concerned about or experiencing symptoms from a mosquito bite, reach out to your primary care physician: Make An Appointment
Finding a balance between work and life is one thing. Throw school in there, sports team practice, a science fair project, a growth spurt that requires new shoes that are only available at the store across town, and you have a perfect recipe for physical and mental burnout. Burnout can leave you feeling exhausted, drained, or even physically ill. You can’t always eliminate the stress from a busy schedule or workday, but you can learn to manage it.
Start by asking yourself: What needs to be done? Look at your task list and separate what truly must be done from less critical tasks. Things like work tasks, school events and appointments are not negotiable, while others may be. Sort through your to-do list and eliminate low-priority tasks where you can.
Create a shared family calendar. Whether you like a paper calendar stuck to the fridge, or you’re a digital family, there are templates and tools for everyone. Get upcoming events listed in one place, so everyone knows where they are supposed to be.
Wherever you are, be there. “Be present” is a trendy phrase that we hear a lot these days. But, it’s hard not to look at the 5 notifications that just popped up on your phone. When possible, set your device aside and focus your attention on what is happening around you. Maybe it’s dedicated time to play with your child or have a conversation with your spouse or a good friend. Making a conscious effort to focus on one task or person at a time will help clear the clouds of stress.
Make time for your family. So many evenings are spent rushing to practices, classes or events, and dinners are consumed during the car ride. Try to find time each week to eat together as a family. Institute a family game night, a bike ride, or maybe a family meeting. Find ways that your family can be together enjoying each other without interruption or distraction (see point above). Ultimately those closest to you will be your front lines of support, so a weekly check-in will help catch when anyone is starting to succumb to stress.
Make time for yourself. The best way to work time for yourself into your schedule? Schedule it! Be creative (Paint! Garden! Journal!), eat a healthy diet avoiding sugar, caffeine, and carbs, have dinner with friends. Think about what truly brings joy into your life and make time for it. Feel the burn! (Not the burnout). Exercise is one of the best ways to eliminate stress. That doesn’t mean you have to make it to a 5 AM barre class. A 10-minute walk can boost your mood and outlook for 2 hours! Find ways to work exercise into your daily routine, even if it means stretching on the sidelines at soccer practice.
Know when it’s time to ask for help. Burnout can happen at home or at work. Learn to recognize when stress is taking over, and you need help. Then ask for it. Burnout isn’t one size fits all. It can look and feel different for everyone. You may start to feel exhausted, moody or withdrawn. You may not remember what you had for lunch or where you are going when you leave the house. You may start to notice muscle pain from clenching or grinding your teeth. If you are feeling the symptoms of burnout, seek support from those around you before you reach your breaking point. We’re here to help, too. Reach out to your primary care provider, they will help you extinguish burnout and feel like yourself again.
It’s easy to schedule an appointment with your primary care provider – simply visit our online appointment tool, scroll to find your provider, and click to schedule an appointment at a time that works for you!
Sometimes school lunches can get boring – both for parents to make and for kids to eat. It’s pretty easy to fall into a lunch rut when packing lunch is just one of many tasks to check-off every morning. As you get ready to kick-off another school year, we’ve got the recipe to keep boring lunches at bay.
Include a note. Who doesn’t love a surprise? Wish your child good luck on a test, give them a pat on the back for a recent accomplishment, a note of encouragement or send a sweet message just because!
Use a fun lunch box. If the lunch box features your child’s favorite character or color they will enjoy bringing it to the table each day. Individual plastic containers are fun to fill and are a great tool to teach portion control, and keep things separated – Bento Box containers are a great option.
Ditch the same old PB&J and try something new. We’re not suggesting rolling sushi in the wee hours of the morning. Keep it simple. Here are some of our lunch-time favorites: • Hummus with pita bread and veggies for dipping • Turkey slices rolled around a red pepper strip and cheese stick • Whole grain mini bagel with cream cheese and sliced strawberries • Tuna (with the pop-off lid) with cucumber slices and whole grain crackers • Kebabs: o Meat (cooked) with cheese and veggies o Pieces of granola bar with fruit o Waffles and fried chicken o Grape tomatoes with mozzarella and basil leaves (don’t forget the balsamic vinegar drizzle!) • Whole grain cereal, yogurt and blueberries • A sliced hard-boiled egg, Canadian bacon and cheese on a whole grain English muffin • Leftovers from dinner or soup in a thermal container
Be cool. Use a cold pack to keep food fresh and safe. They even come in fun colors!
Create a weekly meal plan. Have your child help plan their lunches each week. The planning process will help understand healthy eating by including a variety of food groups as well as encourage your child to try new foods (fingers crossed!). Get your weekly school lunch planner template here.
If you have any concerns around your child’s eating habits, connect with your pediatric provider. They’ll give you some food for thought.
You’ve heard about the benefits of breastfeeding your baby. You know breast milk is best for your baby (the antibodies!). But let’s face it, returning to work after weeks of cozy breastfeeding sessions creates a lot of anxiety and pressure (pun intended) for mom. There’s so much information out there online and from every woman you know that’s ever had a baby. We’re here to breakdown some of the most common concerns around returning to work and continuing to provide breastmilk for your baby. Read on to learn how some common myths around breastfeeding while working are, well, busted.
Myth: Nursing less often will create more milk when I do nurse. Actually, the more you nurse (or pump), the more milk you will produce. Your body is creating your milk supply based on demand. Feed your baby when they ask (in their own way), and your body will produce the milk they need. If you are returning to work, this will help in ensuring you are producing what your baby needs while pumping.
Myth: My baby won’t breastfeed once they get used to bottles. You will always be your baby’s favorite way to get their milk. When your baby is with you, they will expect to be breastfeed. If your baby has a predictable feeding schedule, when you return to work ask your caregiver to hold-off on giving them a bottle close to your arrival, so you can breastfeed your baby when you return home. Also, be sure you drink plenty of fluids, avoiding caffeine and alcohol. Staying hydrated is important in general, but especially while breastfeeding.
Myth: I need a freezer full of milk to return to work. Just when a new mom or dad feels like they are adjusting to life as parents, it’s typically time to return to work. For a mother who is breastfeeding, this transition can be especially difficult. A few weeks before your re-entry into the working world, start mixing some pumping and bottle feeding into your baby’s routine. This will help in two ways; your baby will get some practice with and be more willing to take a bottle and you will have some milk stored for backup. We recommend a minimum supply of two days’ worth of breastmilk for a smooth transition. As you pump at work, you will get into a rhythm of producing what your little one needs. You don’t need a freezer stocked full of milk in order to return to work.
Myth: I can’t breastfeed and pump at the same time. There’s a balance between pumping and breastfeeding. Once you find it, your body will respond and produce the milk required. To start working pumping into your feeding schedule, pump between breastfeeding your baby. Pump about an hour AFTER you feed, and at least an hour BEFORE your baby’s next feeding. If you are returning to work, take note of when your baby typically eats, and pump based on that schedule. Continue to demand milk consistently and your body will get the signal to produce enough breast milk for your little one.
Myth: I will have to stop breastfeeding when I return to work. Every mother has a legal right to take breaks from work to pump. That said, many women may still be anxious about taking this time. While you are pregnant and before you go on maternity leave, chat with your boss about a pumping schedule. That way, your boss will know what to expect upon your return and you will have some peace of mind knowing there is a plan in place to ensure you can continue to provide breast milk for your baby. Also, be sure to understand the accommodations available to you in the work place for pumping. Where is the room? Where will you store the milk you pump throughout the day? To get your questions answered, chat with a human resources rep or a colleague that recently transitioned from maternity leave and pumped at your office, to get your questions answered.
Myth: I won’t be successful at work if I have to stop and pump. For a mother that wants to continue providing breast milk for her baby, taking the time to pump will create peace of mind, and allow you to be more focused when at your desk. You may even want to use the time you spend pumping to catch up on some emails, or read through an article or report that you can’t seem to work into your day while sitting at your desk. Some of your colleagues will understand when you excuse yourself a few times a day to pump, and others may not. The fact is, it’s your right to take time to pump during the work day, so try to focus on your baby and not the opinions of those around you. If you have concerns, talk to a manager or supervisor.
Breastfeeding is a wonderful way to take care of your baby, but it can be a struggle too. If you are feeling stressed about producing milk for your baby, make an appointment to chat with a provider. There is no “one size fits all” when it comes to breastfeeding, and they can provide the support you need as you work through challenges that come with being a new mom.
It’s easy to schedule an appointment with your pediatric provider – simply visit our online appointment tool, scroll to find your provider, and click to schedule an appointment at a time that works for your family!
For those that suffer with Eczema, or the parent of a child
that suffers with it, it’s a constant struggle to keep it under control. There
are several types of irritating skin conditions known more broadly as “Eczema”.
Children may be impacted as early as 6 months old, and symptoms include dry,
itchy and inflamed skin. While there is no cure for Eczema, it can be treated.
Here are some tips for daily skincare and managing unpleasant flare-ups:
Hydrate the skin 2 -3 times per day using a plain petroleum or glycerin-based cream. For busy hands and feet, light-weight cotton gloves or socks may be worn to hold the cream on the skin.
Include a shower or bath, followed by moisturizer into your routine when possible. Follow the 3 minute rule after applying lotion to Eczema-prone skin: wait 3 minutes before dressing your child to give their skin a chance to absorb the moisturizer.
Frequent washing of hands can strip the much-needed oils from the skin. Place a bottle of your favorite moisturizer next to the sink to help replace some of the oils that keep the skin from cracking and are so important for Eczema sufferers.
Flare-ups are inevitable, and when they occur your child’s doctor may prescribe a steroid for relief. Typically, steroids are applied once or twice a day for up to a week to knock-out those flare-ups. When you see the skin getting red, dry, cracked or inflamed, contact your pediatric provider right away to get started on treatment.
Understand what triggers your child’s Eczema. There are several types of Eczema, each with their own triggers and symptoms. These triggers may include sweat and/or drool on the skin, dry skin that goes untreated, heat or allergens. Know when your child is vulnerable to a flare-up and help them avoid exposure to triggers.
Eczema symptoms may change as your child grows. Make an appointment with your pediatric provider to determine what type of Eczema you’re dealing with, and how-to best manage your child’s condition at every stage of life.
It’s easy to schedule an appointment with your pediatric provider – simply visit our online appointment tool, scroll to find your pediatric provider, and click to schedule an appointment at a time that works for your family!
How did anyone ever parent before smartphones? We all know the scenario: a family is sitting at a restaurant eating dinner and a young child gets restless. A parent hands over a phone or a tablet to keep them occupied while they finish their meal and have a nice conversation. This seems innocent enough, but we are learning that when we hand over screens or place a child in front of the TV, we are doing it at the expense of their language and socio-emotional development as well as physical exercise.
Time that a child spends staring at a digital device, or screen time, is time they are not interacting with other people. Learning to bond and interact with others is crucial for children starting at a very early age. Now, I’m not saying that parents need to engage in deep conversations or read books every time they interact with their child. Simple conversations with a young child, even narrating your activities helps. Screen time is a strictly passive activity. Kids are rarely, if ever interacting with a screen in a meaningful way. However, even the most basic of activities, such as building and knocking down towers of blocks, doing puzzles together or scribbling with crayons on a piece of scrap paper (or a napkin) help teach kids cause and effect, and foster human interaction. These are invaluable for stimulating language development and creating a healthy emotional foundation.
A child that has more than the recommended exposure to screens at a young age is more likely to lead a more screen-filled, sedentary lifestyle as a teenager and beyond. This often goes hand in hand with mindless, unhealthy eating. Kids playing video games all day aren’t usually reaching for apples and carrots. People with active lifestyles that include regular exercise and exposure to the outdoors tend to be more physically and mentally healthy in the long run. My recommendation to parents is to turn of the television and put handheld devices away. This is true for both kids and adults. It’s hard to ignore a TV that’s on or a phone that’s blinking with a notification. Parenting without screens is certainly more challenging, especially in the early years, but it’s definitely worth the investment in the long-run. Teaching your child to entertain him/herself without the aid of screens will benefit them throughout their childhood.
So, what are the age-based recommended limitations on screen time? Below are the recommendations from The American Academy of Pediatrics. Remember though that at ALL ages, less is more, especially in preschool/early elementary-aged kids.
Under 2 years of age: No screen time
Ages 2-5: Limit to one hour of screen time per day
Ages 5 and up*: Consistent limitations on screen time, ensuring children have healthy physical activity and sleep schedules as well as personal relationships and interactions.(*Notice this says “and up”. Screen time limitations are for everyone, not just children. It’s important for adults to limit the amount of time they spend plugged-in, not only for their own well-being, but to set a great example for children).You can start by being aware of just how much time your family is spending in front of a screen. Jot down the number of minutes per day on a piece of paper on your refrigerator, or try this tool from the American Academy of Pediatrics, to create a customized family media plan: Family Media Plan
It’s easy to schedule an appointment with your pediatric
provider – simply visit our online appointment tool, scroll to find your provider,
and click to schedule an appointment at a time that works for your family!
Fifteen minutes. According to the Center for Disease Control, that’s all it takes for the sun’s ultraviolet (UV) rays to damage your skin. When you’re on beach or pool time, 15 minutes goes by quickly. It feels great to soak up those rays, but they are harming your skin and are putting you at risk for long-term skin damage and worse, skin cancer. Before you head out into the sun for the day, take some time and precautions to keep yourself and your family safe all summer long, and you’ll be golden for some fun in the sun!
It’s one of the easiest ways to prevent skin cancer. Look for a sunscreen with broad spectrum protection against both UVA and UVB, an SPF of at least 30, and water resistant. When applying sunscreen, more is more. You want to be sure to get a thick layer of sunscreen on your skin in order for the SPF to do its job. For an average size person, remember the teaspoon rule, and adjust for all ages and body types:1 teaspoon to the face/neck/scalp1 teaspoon for each arm1 teaspoon to the chest and abdomen1 teaspoon to the back2 teaspoons for each leg
Sunblock lotions are the preferred choice, but if you are using a spray sunscreen, apply outside by holding the bottle close to the skin and spray on each area for approximately 6 seconds, or until the sunscreen is visible on the skin (typically, when it looks white). Then, rub it in. Don’t apply spray sunscreen directly to the face. Instead, spray generously into your hand and apply to your face as you would a lotion. Don’t forget to apply a lip balm with an SPF of 30, too!
Sunscreen will wear off throughout the day. Be sure to reapply every two hours and following exposure to water or sweat.
If you’re avoiding sunscreen because you don’t like how it feels on your skin or you had an allergic reaction, try another type or brand. There are a variety of choices by a variety of brands, so if you aren’t happy with one, try another until you find one that works with your skin. You may want to make an appointment with your primary care provider or dermatologist to discuss your individual needs. After all, the best sunscreen is the one you will wear!
Avoid exposure between 10 am and 4 pm
Have you heard of the shadow rule? If your shadow is shorten than you are in real life, the sun’s rays are strong. During this time, you should avoid exposure or follow precautions to protect yourself and your family. For our region in the Midwest, the sun is most intense from 10:00 a.m. to 4:00 p.m., so you’ll want to be the most vigilante in protecting your skin during this time.
Your eyes will absorb those harmful rays much like your skin does. Look for sunglasses that block and absorb UVA and UVB light. The lenses should fit close to the skin and be large enough to cover your eyes and the surrounding areas. The bigger the better! Polarized lenses will help eliminate glare, which is great for driving or days in the water or snow.
Drink more water
When you’re sweating, you are losing water. Drink plenty of water throughout the day, especially in hot weather to keep dehydration at bay. Don’t wait until you feel thirsty. Also, look for signs of heat exhaustion such as; feeling overheated, tired or weak. Nausea, headaches and dizziness are also indications that it’s time to get out of the sun, cool down and drink some water. Heat stroke is a more serious condition. If you or someone in your family stops sweating, has red and/or hot skin, a high temperature, confusion or is suddenly uncoordinated, seek medical attention right away.
Go Long!: Wear Protective Clothing
Long-sleeved shirts and long pants provide an extra layer of protection while spending time out in the sun. Look for clothing made with tightly woven fabrics. Those linen pants aren’t going to protect you from the sun, so be sure to wear sunscreen underneath. When playing the water, look for bathing suits that feature a sun shirt, especially for little ones.
Hats Off ON!: Wear a Broad Rimmed hat
Wearing a hat with a full brim is a great way to protect the scalp, ears, face and neck from exposure to the sun’s UV rays. Tightly woven fabric is the key to a good hat, straw hats are cute, but don’t provide the protection you need. When purchasing sun hats for the family, be sure to pick the correct sizes for each person. Kids will pull off a hat that slips down over their eyes.Seek the shade & avoid direct sunlight
Trees or shelters block the sun’s UV rays and provide ultimate protection. Seek out these spaces when spending time outdoors to help protect yourself and your family from painful sunburns and help reduce the risk of skin cancer. When you can’t find shade, make it! Invest in a beach umbrella or tent to shield your family from the sunlight.
Be cautious of reflections
Your exposure to the sun’s rays increases when the sun shines onto and reflects off of bright surfaces, like water, sand or house paint, for example. When spending time near a reflective surface, ensure everyone is sporting sunglasses and sunscreen or protective clothing are being used consistently.
Don’t. Tan skin is damaged skin and the impact can last or even shorten a lifetime. Tanning should not be part of a beauty regiment at any point in a person’s life.
Protection 365 Days
Skin cancer prevention is not seasonal. Sure, we wear less clothing and spend more time outside in the sun’s rays during the summer months, but protection from those rays is just as important during the winter months. UV rays reflect off snow just as they do off of sand, water and concrete. Apply sunscreen to the face and any other exposed skin, wear sunglasses and lip balm every day. When it comes to sun safety, there’s a lot of information to soak in. Download this handy checklist and keep it in your beach bag to help ensure you and your family are covered for summer skin protection.
For questions concerning dangers to your skin from the sun, consult with your dermatologist.
It’s easy to schedule an appointment with your dermatology provider – simply visit our online appointment tool, scroll to find your dermatology provider, and click to schedule an appointment at a time that works for your family!
It’s easy to schedule an appointment with your provider – simply visit our online appointment tool, scroll to find your provider, and click to schedule an appointment at a time that works for your family!