The recipe for strong bones for life

Bone health is a bit like saving for your pension: hard to get excited about when you’re young but the sooner you start, the better.

Taking care of your bones is a lifelong investment that will pay dividends by helping you to stay fit and independent later in life.

Like pensions, it’s never too late to start. There’s plenty you can do to keep your bones fit for purpose, whatever your age.

Let’s be clear: bone health isn’t just about bones. “It’s about your quality of life as you get older,” says Ruthe Isden of charity Age UK.

“Bone health is about staying fit and well as we get older so we can continue to do the things we enjoy,” she says.

As we live longer, more and more of us will become vulnerable to weak bones (osteoporosis) and breaking bones from falls.

Life-changing fracture

About one in three people over 65, and half of people over 80, fall each year in the UK. One in two women, and one in five men over 50, will break a bone, typically in the wrist, hip and spine, as a result of osteoporosis.

A fall later in life can be life-changing, leading to distress, pain, injury, loss of confidence, loss of independence and death.

Half of older people never regain their former level of function after a hip fracture and one in five dies within three months.

“Falls are the number one precipitating factor for a person losing independence and going into long-term care,” wrote Professor Kevin Fenton, Public Health England National Director for Health and Wellbeing in a blog post.

What you can do

But it doesn’t have to be this way, says leading bone and joint expert Professor Anthony Woolf, a rheumatologist at the Royal Cornwall Hospitals NHS Trust. “Osteoporosis and falls are not an inevitable part of ageing and much can be done to prevent them,” he says.

Preventing osteoporosis starts in childhood, if not earlier, when our bones are growing, and continues throughout life. “Building healthy bones actually starts in the womb where the baby’s skeleton is developing,” says Prof Woolf. “A real life course approach is needed to help people have bones fit for purpose as they age.”

The recipe for lifelong strong bones is a healthy balanced diet that includes calcium, exposure to summer sunlight for most of our vitamin D, and regular exercise as well as avoiding certain risk factors, including smoking and too much alcohol.

The same lifestyle advice applies to people with the menopause, osteoporosis or at risk of fracture as it will help reduce the rate of bone loss and their risk of falling.

Get diet advice and exercise tips to help people of all ages build and maintain strong bones.

Bone-building years

The key bone-building years are those up to our mid-20s, when the skeleton is growing. For example, the bone accumulated in girls aged 11 to 13 is about the same amount lost during the 30 years following the menopause. Research has shown that gymnasts aged 10 have much stronger bones than inactive youngsters of the same age.

The gains achieved during youth put the skeleton in a better position to withstand the bone loss that occurs with age. Get tips on boosting your child's bone health. After about 35, bone loss gradually increases as part of the natural ageing process.

Work out if you’re at risk of developing osteoporosis and breaking a bone in the next 10 years. Get tips on maintaing strong bones as you get older. Read how Judi Paxton beat osteoporosis by making some simple changes to her lifestyle.

Preventing falls

People with osteoporosis have weak bones, but it’s falls that break bones. Work out if you’re at risk of falling.

While it is impossible to prevent all falls, there are lifestyle and practical measures that can reduce their occurrence.

The most effective measures to prevent falls among people considered at risk involve:

• strength and balance exercises
• checking the home for trip and other hazards
• checking eyesight
• reviewing medication, which may affect balance

Get more tips on avoiding falls at home.

“Physical activity and exercise can turn back the clock on some of the losses in bone strength caused by age and disease,” says Prof Woolf.

Research suggests that a programme of strength and balance exercises tailored to the individual can reduce the risk of falls by 35% to 54% (PDF, 309kb).

Age UK says that fall prevention exercises could prevent 7,000 unnecessary deaths a year – 19 a day – from hip fractures.

How to involve your child in being healthy

Children are more likely to keep to a healthy lifestyle if it's made fun for them. Here are some ideas for how to help them prepare, and even cook, their own meals and choose activities they enjoy.

Recommended physical activity levels

• Children aged under 5 should do 3 hours every day
• Older children (5-18) should do 1 hour every day

As a general rule, children should aim to include in their daily diet:

• at least five portions of a variety of fruit and vegetables (5 A DAY)
• meals based on starchy foods, such as potatoes, bread, pasta and rice (choose wholegrain varieties when possible)
• some milk and dairy products (choose low-fat options where you can)
• some foods that are good sources of protein, such as meat, fish, eggs and beans and lentils

Educate your children about food

Whether your child is in reception or year 6, it’s always a good time to teach them how to take care of their bodies by fighting fat.

• Take your child grocery shopping with you and help them prepare a meal by themselves.
• Get your children used to cooking healthy food by letting them help with this simple recipe for smiley salmon fishcakes.
• Explain to your child how to get the balance of their diet right using the eatwell plate. It shows how much you should eat from each food group.
• Show your child how to read food labels, for example to check the sugar and fat in snacks. Even small children can understand the traffic light coding on some food packs.
• Eating advice on Change4Life includes shopping tips, cooking ideas, how to cut back on salt and fat, and sugar swaps.
• Young children (aged 5-6), can make their own cookbook, choosing their favourite healthy recipes, getting tips on being a top chef and even making a shopping list.

Make physical activity fun

Physical activity is an important part of achieving a healthy weight. It's recommended that children have at least 60 minutes of physical activity a day.

For more on how much activity children should do, and what counts as activity:

• If your child is under 5 read Physical activity guidelines for children.
• If your child is aged 5-18 read Physical activity guidelines for children and young people.

If your child isn’t used to being active, encourage them to start with what they can do and build up to 60 minutes a day. They’re more likely to stick to their new activity levels if you let them choose the type of activity they’re comfortable with.

• Children under 5 might like this LazyTown game to get them active.
• Older children might prefer to use their smartphone. There are lots of great fitness apps. Map My Walk is a free app that counts your steps when going for a walk (or jog) and counts the calories used too. Or, they could use a pedometer or step counter to keep track of how many steps they’re taking.
• Look for little ways throughout the day to get your child moving, such as playing hide-and-seek and tag (for younger children), and walking or scootering to school.
• Be sensitive to your child’s needs. If they feel uncomfortable participating in sports, help them find an activity that they will enjoy without feeling embarrassed, such as dancing, skipping or cycling. Some will prefer to take part in a team activity, rather than solo pursuits.

How the school can help

The school your child attends should provide opportunities for physical activity and healthy food at lunchtime.

Some schools will help to ensure that your child does not bring unhealthy foods to school, by working with parents to set guidelines on healthy packed lunches.

Schools also often offer a range of after-school activity clubs in football, netball, dancing, martial arts, gymnastics and so on, and these are a great way for your child to boost their activity levels.

• Check with your school exactly how much time your child spends on physical activity each day so you have an idea of the shortfall, if any, that they need to make up on school days.
• Read about dancing for fitness and find out more about cycling for beginners.
• Join Change4Life for free and your child will get their own personalised activity plan full of good ideas for getting moving.

Healthy weight children: advice for parents

If your child is a healthy weight, there's lots you can do as a parent to help them stay a healthy size as they grow.

Weight checks

Read more about your child's BMI (body mass index) and how it is measured.

Research shows that children who stay a healthy weight tend to be fitter, healthier, better able to learn, and more self-confident. They're also much less likely to have health problems in later life.

Children whose parents encourage them to be active and eat well are more likely to stay a healthy weight and grow up healthy.

Check their BMI every now and then using using our BMI calculator to make sure they stay in the healthy range.

Steps for success

Here are five key ways you can help your child maintain a healthy weight. You can read this whole page or click on the links below to go directly to the topic you want to know about:

• Be a good role model
• Encourage 60 minutes of physical activity a day
• Keep to child-size portions
• Eat healthy meals, drinks and snacks
• Less screen time and more sleep!

Be a good role model

One of the best ways to instil good habits in your child is for you to be a good role model. Children learn by example. One of the most powerful ways to encourage your child to be active and eat well is to do so yourself.

Set a good example by going for a walk or bike ride instead of watching TV, or surfing the internet. Playing in the park or swimming with your children shows them that being active is fun. It's also a great opportunity for you all to spend time together.

• Any changes you make to your child's diet and lifestyle are much more likely to be accepted if the changes are small and involve the whole family. Here are 10 ways to get healthy as a family.
• Get inspiration with these 10 ways to get active with your kids.
• If you're not sure what activities you'd like to try as a family, use this What's your sport? tool to find out what you're best suited to.

Get active

Children need about 60 minutes of physical activity a day for good health, but it doesn’t need to be all at once. Several short 10-minute or even 5-minute bursts of activity throughout the day can be just as good as an hour-long stretch.

For younger children, it can take the form of active play, such as ball games, chasing games like "it" and "tag", riding a scooter, and using playground swings, climbing frames and see-saws.

For older children it could include riding a bike, skateboarding, walking to school, skipping, swimming, dancing and martial arts.

Walking or cycling short distances instead of using the car or bus is a great way to be active together as a family – and you'll save money too.

• Find out the amount and type of physical activity recommended for under-5s
• Find out the amount and type of physical activity recommended for children and young people aged 5-18
• Join Change4Life for free and your child will get their own personalised activity plan full of good ideas for getting moving
• Watch this short video to see how playing can help all aspects of a child's development and improve their health

Child-size portions

Try to avoid feeding your child over-sized portions.

There's very little official guidance on precisely how much food children require so you'll need to use your own judgement.

A good rule of thumb is to start meals with small servings and let your child ask for more if they are still hungry.

Try not to make your child finish everything on the plate or eat more than they want to. And avoid using adult-size plates for younger children as it encourages them to eat oversized portions.

It may also help if you encourage your child to eat slowly and have set mealtimes. You can use mealtimes as an opportunity to catch up on what's happened during the day.

• Explain to your child how to get the balance of their diet right using the eatwell plate. It shows how much they should eat from each food group
• Read more about what counts as a balanced diet
• Get ideas for healthier school packed lunches
• Ideas for getting children involved in switching to a healthier lifestyle

Eat healthy meals

Children, just like adults, should aim to eat five or more portions of fruit and vegetables everyday. They're a great source of vitamins, minerals and fibre.

Getting 5 A DAY shouldn't be too difficult. Almost all fruit and vegetables count towards your child’s 5 A DAY including fresh, tinned, frozen and dried. Juices, smoothies, beans and pulses also count.

Discourage your child from having sugary or high-fat foods like sweets, cakes, biscuits, some sugary cereals and sugar-sweetened soft and fizzy drinks. These foods and drinks tend to be high in calories and low in nutrients.

Aim for your child to get most of their calories from healthier foods such as fruit and vegetables, and starchy foods such as bread, potatoes, pasta and rice (preferably wholemeal). And switch sweetened soft drinks for water.

• Fussy eater? Not a problem with these tips to help your kids enjoy their 5 A DAY
• Tasty 5 A DAY family-friendly recipes
• Find out more about healthy drinks for children
• Try these sugar swaps – healthier swaps for breakfast, snacks and puddings
• Ideas for sugar swaps when you shop

Less screen time and more sleep!

Help your children to avoid sitting and lying around too much, as it makes it more likely for them to put on weight.

Limit the amount of time your child spends on inactive pastimes such as watching television, playing video games and playing on electronic devices.

There's no hard and fast advice on how much is too much, but experts advise that children should watch no more than two hours of television each day – and remove all screens (including mobile phones) from their bedroom at night.

It also helps children stay trim if they sleep well. It's been shown that children who don't have the recommended amount of sleep are more likely to be overweight. The less children sleep, the greater the risk of them becoming obese. Lack of sleep can also affect their mood and behaviour.

• Find out how much sleep children need according to their age
• How screens impair children's sleep
• Sleep tips for children

Teaching your child good eating skills

Children with special needs can take longer to learn how to eat independently. Read these top tips for mealtimes.

'Learning how to eat neatly is crucial to helping our children to integrate'

Deborah French

Eating a meal can be particularly challenging for children who have disabilities. A lack of fine motor skills (like finding it hard to hold a fork), sensory restrictions (like being paralysed or unable to see) and co-ordination difficulties are some of the many reasons that may delay the learning process. This can be frustrating for you and your child.

Author Deborah French has four children, two of whom have special needs. Her eldest daughter, Amariah, has Down's syndrome and her son, Henry, has autism spectrum disorder. "Socialising with others generally includes eating together," she says. "So learning how to eat neatly is crucial to helping our children to integrate."

Deborah, who also runs cookery classes for children with special needs, came to realise that nagging her children about their table manners wasn't working. Instead, she developed practical solutions to help them learn, with rapid results.

Deborah's top tips for happy mealtimes

1. Be patient

"When stress or frustration controls your reactions while trying to teach your child, they will reflect your mood and act accordingly. They will fear your reaction to their mistakes, and as a result will not be able to give their best efforts. Give instructions calmly, with positive reinforcement."

2. Invest in a funky child-sized apron

"As your child gets older, even though it may still be necessary for them to wear a bib to protect their clothing, this can also be demoralising and embarrassing in front of other family members or peers. An apron is more discreet and will help eliminate any negative feelings your child may harbour before mealtime has even begun."

3. Encourage your child to help lay the table

"Irrespective of the nature of your child's disability, take the time to involve them in preparing the table for dinner. Even watching you collect cutlery, cups and napkins helps your child to feel they have participated. During this process, talk your child through what you are doing and why. For example: 'We use a fork to pick up pieces of food on our plate instead of our fingers. That way, the fork gets dirty and not our fingers'."

4. Use heavy cutlery and solid crockery

"As parents, we instinctively opt for plastic or disposable utensils to avoid breakage and to make cleaning up easier. But for a child who has either low or high muscle tone or difficulty with their fine motor skills, a plastic fork simply feels like air. These children need to be able to feel the cutlery they are holding. The same is true for plastic plates and cups, which are unstable and easily knocked over. Solid cutlery and crockery will make it easier to teach your child how to eat."

Read about other eating equipment that can help.

5. Take the time to eat with your child

"If you eat your evening meal later than your child, compromise by ensuring that during your child's mealtime, you too are seated at the table. Even if you enjoy your coffee or a smaller version of what your child is eating, they will be encouraged by your presence. You can then talk about your food and how you eat with your cutlery. Take note of how quickly your child imitates your actions."

6. Keep a standalone mirror and wet cloth handy

"The most effective way of teaching self-awareness to a child is to let them view themselves. Even as adults, how often after enjoying a meal with friends have we been unaware that a chunk of food, usually green in colour, has become wedged between our front teeth?

"Apply this theory when helping your child to understand food residue on their face after eating. Before they leave the table, place the mirror in front of them and encourage them to look at their reflection and clean themselves using the wet cloth."

7. Encourage your child to clear their place

"Again, irrespective of your child's disability, teach them how to participate in the cleaning up process after eating according to their ability. This may involve them handing their plate to you or taking it to the side to be washed; alternatively wiping their place clean as best they can. Any level of participation helps to develop their self-awareness and obligations at mealtimes.

"It's important to remember that everyone likes to feel valued and needed. When you give your child responsibilities, they feel important to you and the family. This in turn boosts their self-confidence and speeds up the learning process."

Read our interview with Deborah about parenting children with special needs.

Specialist eating and drinking equipment

To help your child learn good eating skills, you may find that specialist eating or drinking equipment will make a real difference. The Caroline Walker Trust, a food charity, recommends a number of helpful aids to eating that parents of children with learning disabilities may find useful for their child.

These include:

• Different shaped cups, with one or two handles, of different weights, materials, transparencies and designs. The cups should be designed not to shatter or break if they are bitten.
• A transparent cup can be helpful when helping someone to drink, because you can see how much liquid they're taking.
• Cutlery of differing shapes, sizes, depths and materials. Again, the cutlery shouldn't shatter if it is bitten. Solid plastic cutlery or plastic-coated metal might be better for people who have a bite reflex when cutlery is placed in their mouth. Shorter-handled cutlery is easier to manage, and hand grips or irregularly shaped handles may help someone in using a utensil.
• Plates and bowls that do not slip, have higher sides to prevent spillage, or are angled to make access to food easier.
• Insulated crockery that keeps food hot if mealtimes are lengthy.
• Non-slip mats that support crockery.
• Straws, which can help those with a weaker suck and can have different widths.
• Feeding systems that deliver food to the diner's mouth through, for example, a rotating plate and a mechanical or electronically controlled spoon. Some systems are powered, others are hand- or foot-operated.

For more information and details of suppliers, read this factsheet from the Disabled Living Foundation.

'Our adopted children need more support'

Sally Donovan and her husband Rob adopted their two children 10 years ago. She has since written a book, No Matter What, about their adoption journey. Here she opens up about some of the emotional health issues they experienced along the way.

Sally and Rob Donovan decided they wanted to start a family in their early thirties. But after years of trying, they were told that they couldn’t conceive naturally, a fact which took a long time for them to get used to.

“Infertility is horrible, and the effects of it are underestimated by those who haven’t experienced it,” says Sally, now 45. At first the couple felt very isolated, but they were able to turn to each other for support. “We dealt with it together by talking and giving each other space when we needed it.”

In time, Sally and Rob began to explore IVF, surrogacy and adoption. The nurse at Sally’s GP surgery put them in touch with parents who had adopted and other parents who conceived through IVF, so they could ask questions. After much reflecting, they chose to adopt, as Sally explains:

“It wasn’t important for us to have children who were genetically connected to us, and I wasn’t sure that I wanted a lot of medical intervention in order to conceive. As there are many children in care who can benefit from being part of a stable and loving family, it felt like the obvious choice.”

"Our children have taught us so much and we are better people for having been their parents."

Sally Donovan, mother of two adopted children

After being approved as adopters, Sally and Rob were thrilled to be matched with a sibling group: their son Jamie, then four years old, and daughter Rose, then aged one.

Adopted children with complex emotional needs

Like many children who are taken into care, Jamie and Rose’s early traumatic experiences of neglect and abuse have led to ongoing difficulties around their emotional development and health.

“Learning to be the parents that our children need has been both rewarding and extremely challenging,” says Sally.

Anxiety as a result of traumatic experiences

The children spent their early months and years in a state of fear and isolation, and had to develop survival skills that equipped them well at that time. Although now in a safe environment with Sally and Rob, Jamie and Rose have high levels of anxiety and are on high alert for potential danger, even though they no longer need to be. This can make life at school particularly challenging, as sitting still to focus on something can make them feel under threat.

Issues around food due to neglect

Long periods of neglect – including being deprived of food – before they were taken into care, left both children with deep and long-lasting issues around food. They constantly need Sally and Rob to reassure them that they will always have plenty of food in their lives.

Learning difficulties resulting from neglect

Jamie and Rose also have a range of cognitive difficulties, which can include problems with learning, understanding and remembering things. Sally believes the reasons for this are due to their early brain development being interrupted by high levels of fear, and a lack of nurture. At times they display feelings of anger, which Sally feels is a delayed reaction to their early trauma. “It’s a release of fear and sadness which has been held in,” she says.

Access to post-adoption support

In the early years after the adoption, Sally felt the support the family received, from social services, health services and their GP, was generally poor. For example, she feels the children would have benefited from much better speech therapy early on, “before they experienced difficulties talking to other children at school”.

Some support eventually came from a social worker who started a clinic carrying out therapeutic family therapy, based at the Child and Adolescent Mental Health Service (CAMHS). “It was fantastic, and has been instrumental in shaping our children’s progress,” says Sally, who wants more NHS support for children who have experienced developmental trauma.

“Children like ours deserve treatment, just like anyone else with any other health need. Effective treatment can significantly improve a child’s chances of achieving a happy family, social life, an education and future career.”

Fortunately, the family’s support network has improved in recent years. The post-adoption support team within Sally’s local authority are more experienced at supporting adoptive families. “Although they currently have no budget to cover therapeutic services, they provide advice and training on therapeutic parenting, will go into the children’s school to give advice, and are there to listen when we need them,” says Sally.

Find out more about post-adoption support.

Finding the right school for children who have been in care

“School is often the part of life that adoptive children struggle with the most and if it isn’t going well it can risk having dire consequences for family life,” says Sally. “So it is important to get it right.”

Her advice to other adopters is to visit as many schools as possible and ask specific questions. “Ask questions of relevant staff around trauma and attachment issues and see if they have any knowledge or feel for them. Particularly test for empathy and compassion if you can and a readiness to learn, with you, about what works and what doesn’t.”

Sally also highlights concerns around how a school disciplines children who have been in care. “I would also be enquiring about what behaviour system a school uses. If it is very strict and involves shame [by deliberately drawing attention to the child in a negative way] then I would be very careful.

"Our children learn and are calm when they feel safe and liked.” Sally points out that it is common for adopted children to have low self-esteem. “Branding them as ‘naughty’ plays into the hands of the narrative they have of themselves (‘I am bad’),” she says.

Children adopted from care under the Adoption and Children Act 2002 have priority access to schools, which means that your child should be able to attend whichever school you think best meets their needs. From September 2014, they will also be entitled to free early education from the age of two.

Sally and Rob’s own mental health and wellbeing

Any parent can relate to the emotional highs and lows involved in bringing up children. But children who have been traumatised, as many adopted children have, can behave in a much more challenging way. For their parents, this can be hard to cope with and to explain.

Despite support from friends and family, Sally feels there is a lack of awareness about the impact upon a child of early neglect and abuse.

“There was a time when it felt as though there was very little support available, and that few people around us, including professionals, understood what we were experiencing,” she says.

“We read what we could about therapeutic parenting methods but it was only when our new support worker came into post that things improved. She helped us to find a more appropriate school that not only supported our children much more effectively, but us too. She also allowed us to share our feelings and frustrations and hopes and fears with honesty. This alone made a big difference.”

In addition, Rob experienced a bereavement just after the children were placed with them, when somebody close to him died. In order to cope, his grief was “put on hold”, but returned later on when life had settled down. “He didn’t seek any medical help and I believe he should have,” recalls Sally, who saw signs of depression developing in her husband. “But he is much better now.”

Sally and Rob agree that the most rewarding part of their adoption journey has been seeing their children develop in confidence and emotional resilience. “Adoption isn’t the easy route to raising a family, but it forces you to see the world through your child’s eyes and to learn new ways of parenting,” says Sally. “It makes you consider much more carefully both what is achievable and what is important in life.

“Our children have taught us so much and we are better people for having been their parents.”

More information

Read more about the health issues faced by children who need adopting.

Find out about adopters' own health and wellbeing.

Follow Sally’s adoption blog.

Teen aggression and arguments

Many parents find that when their child becomes a teenager, their behaviour becomes more challenging. But how do you cope if they become aggressive or even violent towards you?

Find out how to cope with heated arguments with your teen, and what to do if they become violent.

If you’re experiencing aggression or violence from your teen, you’re not alone. A recent Parentline Plus survey found that 60% of calls (between October 2007 and June 2008) included verbal aggression from a teenager, and 30% involved physical aggression, much of it aimed at the parent themselves.

It is common to keep this kind of abuse behind closed doors and not confide in anyone. Many parents feel that they have failed to control their child, or that they are responsible for the behaviour in some way. In addition, they may not know where to turn.

However, any kind of aggression can be stressful, and can cause an atmosphere of tension and fear for the entire family, not to mention the possibility of physical harm if their teen becomes violent.

No parent should feel obliged to put up with an unruly teen, and as with any type of domestic abuse, help and support is available. You can find appropriate organisations and helpline numbers in ‘Help and support’ below. There are also a number of techniques and tips that you might find helpful.

Defusing heated arguments

It’s useful to remember that your own behaviour can improve or worsen an aggressive situation, so it’s important to be a good role model for your teen.

Linda Blair, clinical psychologist working with families, advises: “Bear in mind that you are their principal role model. If you act aggressively but tell them not to, they won’t listen. It’s also helpful to remember that their anger is often based on fear – fear that they’re losing control.”

With that in mind, it is worth trying to maintain a calm and peaceful presence. You need to be strong without being threatening. Remember that your body language, as well as what you say and how you say it, should also reflect this.

Avoid staring them in the eye, and give them personal space. Allow them the opportunity to express their point of view, then respond in a reasoned way.

Breathing exercises to control anger

If an argument becomes very heated, Linda suggests that you “stop for a moment". Take a deep breath, hold it for a few seconds and then exhale. Repeat five times. This technique is very useful in intense situations.

If your teen is becoming aggressive during arguments, suggest this technique to them when they’re calm, so they too have a way of controlling their anger.

If an argument feels out of control, you can also try explaining to them that you are going to walk away, and that you’ll come back again in half an hour. Given the chance to reflect and calm down, you and your teen will both be more reasonable when you resume your discussion.

As with toddlers, if you give in to teenagers because their shouting and screaming intimidates or baffles you, you are in effect encouraging them to repeat the unreasonable behaviour as a way of getting what they want.

Counselling for teenagers

Family Lives is a charity dedicated to helping families. They suggest that if very heated arguments happen frequently, it may be worth suggesting counselling to your teen. They’ll benefit from talking to someone new and unbiased, someone who isn’t in their family and who won’t judge them.

Read more about the benefits of talking treatments.

Remember they may not know how to handle their anger, and this can leave them frustrated and even frightened. Some guidance from an outsider can be very helpful.

Dealing with violent behaviour

Sometimes, teen aggression can turn into violence. If they lash out at you, or someone or something else, put safety first.

Let your teenager know that violence is unacceptable and you will walk away from them until they’ve calmed down. If leaving the room or house isn’t helping, call the police – after all, if you feel threatened or scared, then you have the right to protect yourself.

Family Lives offer this advice for coping with, and helping, a violent teen:

• Give them space – once they have calmed down, you may want to talk to them about what has happened and suggest that they let you find them some help.
• Be clear – teenagers need to know that you will stand by the boundaries you set. They need to know that any kind of violence is unacceptable.
• Talk to their school and find out if their aggressive behaviour is happening there as well. Some schools offer counselling.
• Arrange counselling – if your teen admits they have a problem and is willing to get help, book an appointment with a counsellor or psychologist as soon as possible. Speak to your GP or their school about what help is available.

Help and support

There are many organisations that offer emotional support and practical advice. Getting some support can help you and your child. At such an important development stage, it’s important that they learn how to communicate well and express anger in a healthy way.

• You can call Family Lives' Parentline on 0808 800 2222 any time, or email parentsupport@parentlineplus.org.uk for a personalised reply within three days. They also offer i-parent modules to help you learn more about communicating better with your teen.
• You can call the Samaritans on 08457 909090 any time to talk about any type of distress and to get confidential support and advice.
• Youth Access has details about youth organisations and services offering teens counselling, advice and support.
• Young Minds is a charitable organisation supporting children and young people with mental health issues, and their parents. They provide information to help young people with anger issues. If you discuss your child’s behaviour with them and they are open to getting help, you might like to direct them to the information on the Young Minds website.

Concerned about mental health issues?

If you’re worried that your teen has a mental health problem such as depression, talk to your GP. He or she can refer them to the Child and Adolescent Mental Health Services, who in turn can refer all or some of you for Family Therapy. Or contact the Young Minds Parents’ Helpline on 0808 802 5544 for advice and support concerning mental health issues in young people.

If you are having trouble coping with your teenager, and you suspect you may have symptoms of depression or other mental health problems, discuss this with your GP. He or she can then suggest suitable treatment. You may, for example, be referred for counselling, or directed to support groups or other services in your area.

Beach safety

Every summer, lifeguards respond to thousands of incidents on UK beaches. To stay safe at the seaside, be informed about the dangers and follow these simple tips.

Watch a video featuring an RNLI lifeguard explaining how to stay safe on the beach

In 2014, lifeguards from the Royal National Lifeboat Institution (RNLI) responded to 17,050 incidents, helping more than 19,350 people in difficulty on some of the UK’s busiest beaches.

Most of the people they helped were children and the most common type of incident, counting people of all ages, involved rip currents that can quickly take people out of their depth.

"Rip currents cause the most incidents and can occur at any beach with waves – so that's most of the UK coast. This is why we encourage people to swim between the red and yellow flags at lifeguarded beaches. Lifeguards know their beaches and are experienced in spotting rips and other dangers. They place the flags to identify the safest areas to swim," says JoJo Mains, RNLI's beach safety manager.

Tips for beachgoers

If you see anyone in trouble, alert the lifeguards or call either 999 or 112 and ask for the coastguard

To avoid getting into difficulty at the seaside, follow these safety tips from the RNLI.

1. Swim at a beach patrolled by lifeguards

"This is the single most important message from the RNLI," says JoJo. "This is because you are far less likely to drown on a lifeguarded beach, plus first aid and other assistance is immediately available from RNLI lifeguards."

Find the red-and-yellow flags and always swim or bodyboard between them. This is the safest part of the beach, because it’s where the lifeguards patrol. Lifeguards will move the flags to adjust for changing conditions during the course of the day, as rip currents and other dangers can come and go with the tide and varying weather conditions.

Not all beaches have lifeguards. To find beaches where there are lifeguards on duty during the summer months, use the search facility on the Good Beach Guide website.

2. Look for information and follow advice

Find out about the beach before you go there, and check the weather and tide times. Ask at the local tourist information office or use the Good Beach Guide to find out about facilities at more than 500 beaches around the UK. See the bottom of this page for more information on tides.

When you get to the beach, read the safety signs at the entrance. This will help you to identify and avoid hazards, and find out about the safest areas to swim. The signs will also have specific information that you can give emergency services to help them locate you quickly.

3. Never swim alone

4. If you get into trouble in the sea, stick your hand in the air and shout for help

5. If you see someone else in trouble, tell a lifeguard

If you can’t see a lifeguard, call 999 or 112 and ask for the coastguard.

6. Never use inflatables in strong winds or rough seas

"Even a slight breeze offshore can sweep you out to sea very quickly," says JoJo.

When there is little or no wind, only use inflatables between the red-and-yellow flags, and make sure children are closely supervised.

7. Supervise children

Keep an eye on children at all times and agree on a meeting point when you arrive at the beach, in case you're separated.

8. Don’t go into the sea after drinking alcohol

Alcohol slows your reactions and can impair your ability to judge distances.

9. Know your flags

On beaches patrolled by lifeguards, different flags tell you where it’s safest to swim and which areas are designated for watersports.

The area between the red-and-yellow flags is patrolled by lifeguards. This is the safest place to swim, bodyboard and use inflatables.

The area between black-and-white chequered flags is a designated area for watersports such as surfing and kayaking. Never swim or bodyboard here.

The orange windsock means there are offshore winds. Never use an inflatable when you see the sock flying, as the wind could push you offshore very quickly.

The red flag indicates that it is dangerous to swim or get in the water. Never go in the water when the red flag is flying.

The dangers of the sea

Rip currents

Rips are strong currents that can quickly take swimmers from shallow water to water beyond their depth.

Signs of a rip include: discoloured, brown water (caused by sand being stirred up from the seabed), foam on the water's surface and debris floating out to sea.

If you’re caught in a rip, the RNLI’s advice is:

• Stay calm.
• If you can stand, wade. Don’t swim.
• Keep hold of your board or inflatable to help you float.
• Raise your hand and shout for help.
• Never try to swim directly against the rip or you’ll get exhausted.
• Swim parallel to the beach until free of the rip, then make for shore.

Tides

The tide can come in surprisingly quickly. Many lifeboat and lifeguard rescues involve people being stranded by the tide. Find out about the tides from the local tourist information office or from BBC Weather's tide tables.

When you’re on the beach, keep a lookout for the tide’s direction and be aware of how fast the water’s coming in, especially if you’re playing in rock pools.

Waves

Watch out for waves, especially if you have small children. Even a small wave can knock a child over. Dumping waves are particularly dangerous. These waves break with great force in shallow water and occur during low tide.

Tombstoning

Many people have been seriously hurt or killed by tombstoning (jumping from a height into water). Tombstoning is dangerous for several reasons:

• The water depth changes with the tide and the water may be more shallow than you think.
• Rocks or other submerged objects may not be visible.
• The water may be cold and the shock could make it difficult to swim.
• There can be strong currents that could sweep you away.

Read about tombstoning and watch two short films about the dangers of tombstoning on the RNLI website.

Other beach hazards

Sunburn

For tips on avoiding sunburn and protecting your skin and eyes from the sun’s harmful ultraviolet rays, see sun protection.

Dehydration

Make sure you have plenty of water to drink. Even on a cool day, the sun and wind can dehydrate you.

Avoid drinking alcohol at the beach. It contributes to dehydration, affects judgement and leads to greater risk-taking. Never enter the water when you’ve been drinking alcohol.

Weever fish and jellyfish stings

The weever fish is a small fish with venomous spines on its back. If you step on one, the sting can be very painful. For weever fish stings, the RNLI's advice is to place the affected area in water as hot as is comfortable, making sure you test the water first, so you don't scald the person who has been stung.

If someone has been stung by a jellyfish, do not rub the affected area, as this will make the pain worse. Lightly spray the area with seawater and apply a cold compress if it's available.

Read more about the potential perils of open water swimming.

Insect stings

For information on how to treat stings and how to tell if a person needs urgent medical help, read about how to treat insect stings.

Camping safety

A camping holiday can be great fun for all the family. Pitching your tent is one of the least expensive accommodation options for a holiday.

Watch a video about staying healthy at summer festivals

Kids love the freedom of staying in a tent: sleeping under the stars, eating simple meals and enjoying the great outdoors.

To ensure your holiday under canvas goes smoothly, especially if it's your first time in a tent, make sure you're aware of how to stay safe on your camping holiday.

Campsite cooking and fire safety

Fire is a significant risk when you're camping. Camp fires, barbecues, gas canisters and camping stoves all need to be handled with care.

“Cooking on a camping holiday is completely different from cooking in your own kitchen,” says Barry Norris, technical information officer for the Camping and Caravanning Club. “You are in a much more confined area than at home, especially when the weather is bad.”

Norris says that cooking is best done outside and advises campers to ensure that any gas equipment is securely supported when it's being used and kept away from children.

To reduce the risks of fire when you’re camping, the Royal Society for the Prevention of Accidents (RoSPA) advises holidaymakers to take some precautions:

• Assess the site before you pitch your tent. Ideally, be at your site before sunset so you can see what you're doing and see where other campers have made fires or set up barbecues, stoves and heaters.
• Check that tents are positioned well apart from each other to prevent the risk of a fire spreading. Check the specific rules at your campsite. Some recommend that tents are pitched at least six metres apart.
• Practise using your stove before you go on your trip.
• Cooking inside a tent is not advisable because even a fire-resistant tent can burn. There is also the risk of deadly carbon monoxide poisoning. Check out the Camping and Caravanning Club's tips on carbon monoxide safety.
• Don't change gas canisters or refuel petrol or meths-burning stoves inside a tent. Keep flammable liquids and gas cylinders outside the tent and away from children.
• Keep matches and lighters locked away and, where possible, out of the reach of children.
• Don't use naked flames such as candles and lighters inside a tent. Use a torch instead.
• Don't use oil-burning appliances in or around tents.
• Check the rules regarding open fires and barbecues at your campsite and make sure all fires, stoves, gas lamps and barbecues are out before you go to bed.
• Make sure you know about the fire-fighting arrangements on the campsite and where the nearest source of water is.
• Don't smoke inside a tent.

If there is a fire in your tent:

• Get everyone out without delay – fires in tents spread extremely quickly.
• If your clothing catches fire, don't run around as this will fan the flames and make them burn faster. Instead, lie on the ground as this makes it harder for the fire to spread. Smother the flames with heavy material (a coat or blanket for example) or roll around to smother the flames.
• Call the fire and rescue service and give as exact a location as you can. If you have a mobile phone, it may be able to give GPS co-ordinates.

Pitching your tent safely

According to RoSPA, common accidents around tents include people tripping over guy ropes or treading on tent pegs. Give tents a wide berth when you’re walking around a campsite, especially when it's dark.

RoSPA's advice to campers is:

• If possible, choose a tent with guy ropes that are a bright colour or have fluorescent tags attached to them so people can see them in the dark.
• Practise putting up your tent before you go away so you won't be stressed when you arrive at the campsite.
• Check that you've got all the equipment you need before you set off on your trip. That way, you won't be tempted to improvise with other items that might not be suitable for the task.
• Don't pitch your tent right under a tree or on the banks of a river or lake.
• Don't obstruct walkways or tracks with your tent's guy ropes.
• Supervise children at all times. Be especially careful on the first and last days of your holiday because children can easily wander off while you're busy pitching or taking down your tent.

Packing tips for camping trips

Barry Norris, from the Camping and Caravanning Club, advises people to do the following:

• Pack at least one torch.
• Organise your first aid kit.
• Buy sun cream. You spend a lot of time outdoors when you're camping so you'll need to protect your skin from sunburn. See how you can protect your skin in the sun.
• British weather is unpredictable so pack clothes for wet weather, warm weather and cold weather.
• The temperature drops at night so take a warm sleeping bag and enough bedding.

For more camping tips, especially for first-timers, see the Camping and Caravanning Club's new to camping section.

How clean is the sea?

You can avoid catching a nasty bug from swimming in polluted seawater this summer by finding out about the water quality at your favourite beaches.

“Pick a Blue Flag beach or an MCS-recommended beach.” Thomas Bell, coastal pollution officer at the Marine Conservation Society

Swimming in the sea and taking part in water sports such as surfing is invigorating and fun. But there are some health risks associated with swimming in polluted waters.

What are the health risks in seawater?

Most water-borne disease is related to faecal contamination from either humans or animals.

The main ailments caused by bathing in faecally contaminated water are gastrointestinal (digestive tract), such as dysentry, respiratory infections, and ear, nose and throat complaints.

Why are coastal waters affected by faecal contamination?

"Direct sewage discharge, sewage from stormwater overflows and sewage running off from streets and farmland (often through streams and rivers) can all affect the quality of coastal water," says Thomas Bell, coastal pollution officer for the Marine Conservation Society (MCS).

The degree of pollution from these sources varies from beach to beach, depending on the proximity of any sewage discharge and the type of sewage treatment that is used locally.

Weather also affects pollution.

"The quality of bathing water will drop 24 to 48 hours after heavy rainfall," says Andy Cummins, campaign manager for Surfers Against Sewage.

This is because combined sewage overflows (CSOs), which divert excess sewage from treatment plants into rivers and the sea to prevent flooding, are operated more frequently during storms. There is also a greater risk that the sea will be affected by polluted water draining from farmland after heavy rain.

Who monitors the quality of bathing water?

The UK, in line with other European Union members, is required to identify popular bathing beaches and test the water for faecal contamination during the summer season.

The test results are reported as follows:

• "poor" or "fail", which means the water has not met the minimum standards
• "pass" or "good", which means it has met the minimum standards
• "excellent", which means the water has passed the higher guideline standards set by the EU

In 2010, 587 coastal bathing spots in the UK were monitored. Nearly all of these beaches (571) met the minimum standards (pass or good) and 421 of them also met the higher guideline standards (excellent).

To view a list of the beaches that were tested and the results of those tests, see DEFRA (for England and Wales), SEPA (for Scotland) and NIEA (for Northern Ireland).

The results of the previous summer’s environment agency tests (see above) are also used by the Blue Flag and MCS award schemes to recommend beaches.

How to avoid polluted water

Watch this video featuring a lifeguard offering advice on staying safe at the beach

"To minimise the risks of swimming in polluted water, pick a Blue Flag beach or an MCS-recommended beach," says Bell. "If it’s been raining heavily, stay out of the water for at least 24 hours."

According to Bell, if a beach meets the minimum EU mandatory standards or is rated as good, you still have a 12%-15% chance of contracting a sewage-related illness. At a beach that has met the higher EU guideline standards, this drops to 4%-5%.

Both the Blue Flag and the MCS award schemes (more details below) only include beaches that have met the higher EU standards (or in the case of the MCS recommendations, stricter criteria).

Beaches recommended by the Marine Conservation Society

The Good Beach Guide is published by the Marine Conservation Society (MCS) and indicates which UK beaches have excellent water quality.

By clicking on the guide's interactive map, you can find out about more than 1,000 beaches in the UK and Ireland. You can find out about the quality of bathing water, if the beach has lifeguards and if there are facilities such as toilets and parking available.

The MCS recommendation for bathing quality is the highest standard of any UK award for bathing water quality. It uses the government agencies' data but applies stricter criteria than those of the EU's higher guideline standards.

The Blue Flag Scheme for beaches

The Blue Flag Scheme is awarded annually to beaches that meet high standards of management, promote environmental care, and have attained high standards for water quality in the previous summer season.

All beaches awarded the Blue Flag must meet the higher EU bathing water standards. The Blue Flag is therefore another useful indicator of good quality bathing water. You can check which beaches have been awarded the Blue Flag.

How can I check the current status of bathing waters?

During the summer months, the Environment Agency posts the results of its weekly tests of bathing water quality in England and Wales on its website.

In Scotland during the summer, SEPA provides daily information on the predicted water quality at 11 of its beaches. These forecasts are available on its website and from a telephone helpline: 0845 230 3098.

Free family activities

Kids have lots of opportunities on holiday to run around and get plenty of exercise. Here are some ideas for healthy activities that cost little or nothing.

Watch a video about learning to ride a bike

Physical activity is essential for your child's health. It helps them develop strong bones and muscles, maintain a healthy weight and promotes their independence. Most of all, physical activity can be great fun for you and your children.

Wherever you live in the UK, there are plenty of opportunities for you and your family to be active in your area.

Walking, running around and playing

Make time for outings to a green space near you, such as a local park, wood or nature reserve, and get the kids walking, running and playing. If you want to try somewhere new, use the following websites to search for options near you.

Green Flag parks

The Green Flag scheme recognises parks, community gardens and nature reserves that are welcoming, clean and well maintained. Go to Green Flag Award to find your nearest award-winning parks or reserves.

Woods and forests

To find out about woods and forests near you and the activities on offer this summer, see the Woodland Trust and Forestry Commission websites.

Accessible walks

To find walks that are accessible for people pushing buggies and for wheelchair users, see Walks with Buggies and Walks with Wheelchairs.

For more information on why walking is good for you and tips for making it fun, see the Walk4Life website.

Cycling

Strictly speaking, cycling is not free, since you need a bike before you can start pedalling. However, once you have the right equipment, it's a very cheap form of exercise and one that can be enjoyed by all ages.

With more free time available in the holidays, it's a chance to go on a longer bike ride. The following websites offer suggestions for family-friendly routes.

Sustrans

Sustrans co-ordinates the National Cycle Network, which offers thousands of miles of walking and cycle routes on traffic-free paths and quiet lanes, as well as traffic-calmed minor roads across the UK. Visit the Sustrans website to find cycle routes near you.

Forestry Commission

You can use the Forestry Commission’s website to search for cycle trails in woods and forests.

Cycling tips

If you're new to cycling or haven’t cycled for a long time, take a look at our guide to cycling for beginners.

You could also consider enrolling on a cycling training course. Visit Bikeability for more information on the national standard training scheme.

For more information on why cycling is a great way to stay healthy, along with tips on buying a bike and staying safe, see the Change4Life website.

Swimming

Swimming can be a great way to get active as a family. Swim4Life has ideas for games you can play together in the pool.

Visit these websites to find somewhere near you where you can have fun with the kids.

Local swimming pools

Some local councils offer free swimming to children aged 16 and under, particularly during the school holidays. Search for your local council to find out if this is available in your area.

RNLI

A day at the seaside won't break the bank, but 7,000 visitors a year get into serious trouble at the beach. It's wise to visit a beach with trained lifeguards. Find out which beaches have RNLI lifeguards.

Outdoor Swimming Society

Open water swimming can be dangerous, but you can search for family-friendly places to swim outdoors on the Outdoor Swimming Society website. Note that not all the pools listed are free to use.