Guiding Daughters Toward Lifelong Breast Health Habits

Originally appeared in: TOGETHER – Every Woman’s Guide to Preventing Breast Cancer.

Health is a strange thing. It is something that is both very personal and very communal. As individuals, of course, we ultimately have control over the choices we make when it comes to what we eat, how much TV we watch, and how much we exercise. And, of course, if we get sick – or don’t get sick – that’s about as personal as it gets. It affects only our bodies, and no one else’s.

Yet, as we’ve discussed throughout much of Together, good health is also something we can each help others realize. Our surroundings and the people around us can have a profound influence on the health choices we make. This influence is never stronger than in our own homes and within our own families.

Think back to your childhood and how much the habits of your immediate family had on what you ate and the things you did. With early life being a key period in determining later breast health, this means that family can have a large impact on the long-term breast health of the girls and young women in our families.

As with most chronic diseases, it’s almost never too early or too late to take steps to lower the risk of breast cancer. But unlike diseases like heart disease or diabetes, age can have an important impact on the steps that actually lower risk.

Growing evidence shows that youth and young adulthood is a key time for preventing breast cancer later in life. In fact, between a woman’s first period and the time she has her first child, breast cancer risk accumulates quicker than any other time in her life. Growth and development during this period can make breast tissue particularly susceptible to damage, and certain behaviors can have important and lasting impact on risk, both positively and negatively.

Healthy behaviors started in childhood and continued through adulthood could prevent over 60 percent of all breast cancers. Yet, midlife and later life remain important, particularly because it’s a period of time when women become more aware of breast cancer and are often motivated to make healthy changes to lower risk. Even with the later start, half of all breast cancers could still be prevented with healthy behaviors started at age 50.

In this section of Together, we build on the nine steps listed in the previous section, tailoring specific breast health tips for various family members and for women based on their stage in life.

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Mothers

There is little more unique than the relationship between mothers and daughters. It is a relationship that is certainly not always easy, but it is almost always marked by a deep understanding – of the meaning of family, of the issues that surround being female in today’s world, and of the importance of well-being and good health both now and well into the future.

Studies show that the best things mothers can do for daughters when it comes to their long-term breast health is to guide them toward healthy lifestyle choices both as young girls and then as young women. The earlier healthy behaviors start, the greater impact they’ll have on a child’s long-term health, and the more likely they are to become behaviors sustained life-long.

These behaviors, which we’ve talked about before, aren’t unique to breast health. Most will also boost heart health and help lower the risk of many other diseases, like diabetes, stroke, colon cancer, and osteoporosis. They’re simply great choices across the board, but with added breast health benefits because they can begin at a time in early life when breast tissue is particular susceptible to harm from certain risk factors.

In addition to guiding your daughter down a healthy path, it’s also important as a mother to be good role model and make healthy choices for yourself. As you know very well, if you do it, your children are more likely to do it, too.

Young daughters (2 years – 10 years)

As challenging as the period between the ages of 2 years old and 10 years old can be for a parent, it does offer some sense of control and the ability to steer your children in positive directions.

Within reason, the food you put on the table is the food they will eat and likely come to enjoy – even if it can take some struggling, pouting, and tears along the way, from them, and you. Similarly, if you’re a family that plays at parks and goes for walks throughout the week, that’s something that will become ingrained in a child as well and something they’ll likely wind up doing throughout their lives and eventually with their own children.

With young daughters, there are three simple things to focus on: healthy activity, healthy food, and healthy weight. Pretty straightforward stuff, but in today’s busy world where both parents often work and have very little time to think about such things, they can be much easier said than done.

Luckily, creating a healthy environment for our children isn’t very complicated or time-consuming – with a little planning and a little effort.

Let little legs move
We can easily get caught up in all the detailed recommendations we read about physical activity: moderate intensity, vigorous intensity, aerobic fitness, strength, and X-number of minutes a week. And, yes, those can be important, but when it comes to young kids, it’s really less about making our kids reach some time targets for activity than it is about simply giving kids the opportunity to be kids. Because being active is really their natural state. Just let those little legs move, and if you happen to want a daily goal to shoot for, it’s: a total of 60 minutes, which can be gathered throughout the day in pretty much any way that gets kids moving.

Be physically active as a family, every day if possible. Go on walks, ride bikes, shoot hoops, dance – whatever gets everyone moving.
Encourage children to play outside (when it’s safe) and to take part in organized activities, including soccer, gymnastics and dancing.
Walk or ride bikes with your kids to school in the morning.
Find safe places for children to play when weather is really bad: indoor playgrounds, YMCA, shopping malls.

Freeze the screens
Children grow up as digital natives these days, but that doesn’t mean that all that screen time doesn’t have health repercussions. Too much screen time takes time away from physical activity and can promote unhealthy eating.

Limit TV, tablet, computer, and other screen time to under two hours a day. The less, the better.
Keep TV, tablets, and smartphones out of children’s bedrooms.
Choose one day each week to go TV-free and tablet-free as a family. Board games and family cooking clubs are great screen-time alternatives.

Offer a lot of plant foods
When it comes to promoting breast health later in life, getting daughters to eat a lot of plant-based foods early in life is important. This means focusing on fruits, vegetables, nuts, and whole grains, and eating less full-fat dairy and meat.

Make fruits and vegetables a part of every meal. Put fruit on cereal. Cut up vegetables as a snack.
Dice vegetables into soups, sauces, even batters. It’s an easy – and tricky – way to add more vegetables to meals.
Keep fruit out where kids can see it: on the counter, on a desk, in a backpack. If they can see it, they’re more likely to eat it.
Offer whole-grain cereal, brown rice and whole-wheat bread over refined choices, like white rice and white bread.
Try a meat-free week. The family just might like it.
Make dishes made with olive or canola oil, which are high in healthy fats.
Cut back on full-fat dairy, fast food, and store-bought snacks (like cookies), which are often high in unhealthy fats.

Don’t obsess but keep track of weight
Weight is clearly a loaded issue, especially for girls. And it’s important not to create or perpetuate in your daughters – or any girls for that matter – unhealthy body image. In today’s world of photo-shopped models and selfies, females of all ages have a hard enough time comparing themselves to unreal expectations of beauty and body size.

At the same time, however, it’s important for parents to be aware of their daughter’s weight and to know whether it may be too low, too high, or in the normal range. Surprisingly, studies show that many parents have trouble knowing if their child is an unhealthy weight or not. So, simply knowing can be a victory in itself.

A good place to start if you have questions about your child’s weight is the CDC’s BMI Calculator for Child and Teen. This tool uses a special calculation of weight, height, gender, and age to estimate whether a child is underweight, normal weight, overweight, or obese. Because children are still growing and developing, these labels are not always perfectly accurate, so it’s important to bring up any concerns about your child’s weight directly with a healthcare provider.

Keep track of your child’s weight and bring up any concerns with a health care provider.
Help your daughter focus on healthy food choices and healthy activities rather than on weight and body image.
Give your children the chance to be physically active every day.
Limit sweets and processed foods, which are often high in calories as well as carbohydrates that can stimulate hunger.
Limit TV, tablet, computer, and other screen time to under two hours a day. The less, the better.
Help your children get enough sleep by setting a bed time and sticking to it every day. Keeping electronics out of the bedroom also helps.

Begin the conversation about smoking
It’s almost never too early to start to talk with kids about the importance of never smoking. Though there isn’t as much youth exposure to smoking imagery as there used to be a decade ago, there’s still plenty out there for kids to see – on TV, in magazine ads, and at sporting events. And even if they don’t voice them out loud, kids will begin early on to have questions about cigarettes and smoking. So even if this age group may be a bit too young to actually begin to experiment with smoking, it’s still an important time to help them form healthy attitudes about tobacco use that can help them avoid smoking when they’re older.

When teachable moments come up – such as seeing someone smoking on TV – talk with kids in general terms about the health risks of smoking.
Keep your house – and yourself – smoke-free. One of the best things you can do as a parent is to lead by example.

Older daughters (11 years – 17 years)

In the tween and teen years, children begin to fully explore their independence, and this translates to many of their health choices. While parents may slowly lose some of the direct influence they have on their daughters’ choices, family life remains a very strong influence on the choices girls make and the lasting habits they’ll form.

Most of the breast health messages that apply to younger daughtersapply to this age group as well. What varies slightly is the approach. It can be important in this older group to treat daughters as more independent beings who have a certain degree of control over their choices. They are little adults, or at least they think of themselves that way. And along this vein, it is also a period of time where more adult issues come into play, like alcohol.

To foster regular physical activityin older daughters, follow the younger daughter activity tipsand screen time tips. You should also encourage daughters to take part in school and club sports or explore other activities, like running, hiking, and dance, independently. If they have good experience in a particular sport, they’re old enough now to also think about helping coach younger teams or activity clubs. Becoming advocates for healthy activity can also help build a lifelong love of exercise. Girls can lobby for more physical education at schools or the creation of more activity-based afterschool clubs.

Similarly, in addition to following the younger daughter healthy food tips, you should encourage your older daughters to explore healthy food choicesindependently of what the family offers at meals. They can search for healthy recipes online and at libraries and cook healthy meals for themselves as well as the family. Rating recipes and sharing these with their peers can provide added motivation. If you have sons in the house, you can also have them do the same. The key is getting everyone in the family actively engaged in healthy eating.

Body image can be an issue at any stage in life, but as girls enter middle school and high school, it can become something that feels supercharged. Just as with younger children, it’s important to be aware of any weight issues your older daughter may have but to have the focus be on healthy eating and activity habits rather than directly on weight. In addition to tips for younger daughters, it can be instructive for older girls to build some media literacy around body image – to be able to think about the portrayal of female beauty that magazines, websites, and social media help perpetuate. By helping your daughters become aware that what they often see on screen is not real life, they can develop a healthy approach to body image that will help keep them healthy and active throughout life.

Alcohol
As children get older, the issue of alcohol will almost inevitably rear its head to some degree. And unfortunately, drinking in youth and young adulthood may be particularly bad when it comes to breast cancer risk later in life.

While it’s virtually impossible as a parent to keep a strong-willed teenage daughter from drinking if she really wants to, it’s important for parents to have open discussions with their children about drinking and the associated risks, including the impact on breast health.

Have open discussions about alcohol as a family, including the short and long-term risks of drinking. A health care professional or school counselor can help if needed.
Avoid making alcohol an essential part of family gatherings.
Encourage media literacy discussion around alcohol ads on TV and in magazines.
Ask them questions, like: What are these ads saying? What do they want you to do? How do these ads mesh with reality?

Smoking
This age group is prime for experimentation. Unfortunately, when it comes to cigarettes, experimentation can have lifelong consequences. Around 90 percent of adults who regularly smoke tried their first cigarette before age 18. So, it’s important to have open discussions with your daughters very early in life about the dangers of smoking, how addictive cigarettes and nicotine are, and how hard it can be to stop smoking once started.

Though in a tween and teen’s mind there can be a big draw to smoking – it can make them feel more mature and part of a group – there’s a lot going against it, too – even within the short time horizon that youth live in. It’s expensive, and it makes clothes and breath smell. And even some of the longer-term risks can be compelling, such as wrinkles, bad teeth, and an increased risk of many serious diseases, including breast cancer.

Electronic cigarettes are also important to be aware of in these ages. Statistics show that kids are using them more and more, and though electronic cigarettes are often marketed as safe alternatives to standard cigarettes, there are a lot of possible dangers for youth who use them – from nicotine addiction to exposure to risky chemicals to a greater likelihood of taking up regular cigarettes.

As with other issues, a little media literacy can go a long way to dissuade children from falling for the allure of tobacco and electronic cigarettes. The older children get, the more they like to feel in control and independent. Helping them understand how tobacco companies try to manipulate them by constructing appealing images of tobacco in advertisements, TV shows, concerts, and movies can help them more easily resist smoking’s draw. The Truth campaign by the American Legacy Foundation is a great source of information for parents and kids about Big Tobacco’s “lies and manipulation.”

As a parent, one of the best things you can do is to lead by example and maintain a smoke-free house and be smoke-free yourself.

A great source of information for parents and teens is smokefree.gov, a federal site, which also includes smokefreewomen and smokefreeteen.

Adult daughters (18 years and older)

As much as some of our daughters might prefer it, our parenting doesn’t magically stop when they become adults. Although our outsized influence may be a bit diminished, we can still be trusted guides, helping our daughters navigate through their next stages of life, whether it’s college, marriage, or childbirth. And no matter how old or how young our daughters are, healthy choices remain an important part of their lifelong breast health and overall well-being.

Continuing to show an interest in their health and helping them make the healthiest choices possible are important in your continuing role as a mother. This can be as simple as asking whether your daughter’s recently had a clinical breast exam or setting up a time to go for a walk with her each week. Every little thing can add up over time.

And, really, the key things mothers can help their young adult daughters focus on are not that different than those for younger girls: plant-based foods, exercise, weight, and alcohol. It’s really just the context that’s different.