The secret to getting your kids to eat better

Posted by on 8:10 am in Babies, Eating, Featured, Milestones, School-Age Child, Toddlers | 0 comments

The secret to getting your kids to eat better

Kids’ sense of taste is pre-programmed from birth to like sweets and to reject plant-based foods. However, their palates really are surprisingly malleable. The secret to raising a healthy eater is simple: you have to teach kids to choose healthy foods. Here are a few tips: Limit foods you don’t want them to like Kids start developing their tastes very early in life. When a baby starts eating solid foods, you’ll notice that they take quite naturally to sweet foods (like squash and carrots). However, studies show that you actually have to develop a taste for salt. Kids learn to like and crave salt, which means you can also be raised to appreciate foods without a lot of salt. So try to avoid salty snack foods when kids are toddlers and check baby food ingredients for the salt content. The same goes for high fat foods or white bread without fiber. If you want them to like whole wheat bread, don’t give them PB&J on Wonder bread. Let kids see you eat your veggies  While we adults know that fruits and veggies are healthy, kids may be wary of eating their broccoli. Generations of parents have been frustrated that their kids just don’t seem to like fruits and veggies. And now scientists have confirmed the reason for their dislike. In a series of experiments they observed young kids’ reactions to fruits and veggies and discovered that humans don’t instinctively “like” foods that come from plants. Evolutionary biologists suspect that humans are naturally picky because it protected our ancestors from eating poisonous plants when they were foraging in the forest. Further studies of children’s predilection to avoid fruits and veggies have shown that young children actually need to watch other people to determine which plants are safe to eat. Makes sense, right? If you eat that tomato and don’t die, maybe it’s safe for me too. That means you need to eat a variety of healthy foods while your kids are watching. Save the salt ‘n vinegar potato chips and cookie dough to eat in private. Breast milk, unlike formula, changes flavor with every feeding – and develops a baby’s sense of taste. Don’t give up on foods they don’t like You need to offer the same food many, many, many times. When baby spits out pureed spinach, it may appear that she doesn’t like it; but in baby body language it just means she questions whether this green leaf really is meant to be food. (It makes sense, although I still don’t understand why my son spit out bacon but would swallow carpet lint.) Very young infants only have to try a new food a few times before they will incorporate it into their diet. But once they are over age 2, they will need to see a food 5-10 times before they will eat it and you’ll have to offer up to 15 times to convince a 3-4 year-old. So offer a variety of foods in the first 2 years. And go ahead and take your toddler out for sushi. However, I must warn you from personal experience, that a 1 year-old who likes salmon sashimi grows up to be a 15 year-old with an expensive salmon habit.   Let them play with their food If all else fails with your...

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To vaccinate for flu or not?

Posted by on 9:00 am in Babies, Blogs by Age, By Topic, Featured, Illness, Immunizations, School-Age Child, Toddlers | 1 comment

To vaccinate for flu or not?

You can get sick with the flu even if you are vaccinated, so why bother getting the vaccine? It’s true that the flu vaccine does not completely prevent influenza. In 2013-14 it prevented illness in 61% of people who were vaccinated. So if you are already a little nervous about giving your child yet another vaccine, knowing this fact might make you forego the vaccine altogether. But there is no reason not to get the flu vaccine and plenty of reasons to protect your family by getting immunized this year. The flu vaccine does not cause the flu First, be assured that the vaccine is completely safe. You cannot get influenza from the vaccine. On rare occasion you can have a low-grade fever and muscle aches, which is actually a sign that your body is reacting appropriately to the vaccine and is making antibodies to fight off flu when you are exposed.   Even if you get the flu, you will be less sick The immunity you get from the vaccine only lasts about 4 months, which is why you need an annual shot. The strains included in the vaccine are updated each year to correlate with the strains that are expected to circulate during the coming flu season. Most of the time the vaccine experts guess correctly and the vaccine is extremely effective. Unfortunately, last year the predominant strains mutated and were slightly different from the form in the vaccine. However, the strain of flu last year was similar enough to the strain in the vaccine, so vaccinated people who caught the flu had a milder illness than people who weren’t vaccinated. Nice people get their flu shot You perform a true humanitarian act when you get vaccinated. If everyone who can be vaccinated gets their flu vaccine, there are fewer infected people walking around the planet, so everyone is less likely to get sick. And for babies under age 6 months who can’t have the vaccine yet, vaccinating everyone around them is like building a cocoon. Parents, grandparents and siblings around a new baby can easily bring home both whooping cough and influenza. And while these diseases cause missed school days and general misery for older children, they can be deadly to a young infant. Do you want your kids sick at home for an entire week?! Finally, you might regret not getting the flu shot if your family gets influenza this season. It is a completely annoying, long-lasting illness and often is followed by a second infection, like an ear infection or pneumonia. So you will be sick a long time and it is very disruptive to life. Don’t kick yourself when your little one gets sick; immunize them now and you will have done your best to protect them. What is Influenza? Influenza is an acute respiratory illness caused by influenza A or B viruses, which occurs in outbreaks worldwide every year. Influenza is not like the typical adenoviruses and rhinoviruses that cause the common cold. Influenza causes more body aches and general misery, tends to last longer and causes far more complications, including death and severe illness. If you choose not to immunize against flu, I’m very disappointed in you. Be sure to teach your unvaccinated children not to touch their face, eyes, or rub their nose. The best...

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Why does fever cause a fast heart beat and rapid breathing?

Posted by on 5:06 pm in Babies, Featured, Illness, Normal or Not?, School-Age Child, Toddlers | 1 comment

Why does fever cause a fast heart beat and rapid breathing?

Have you freaked out about a high fever and fast breathing or rapid heart rate only to find a dose of Tylenol turns a floppy mess of a toddler back into her usual playful self? You check on your little darling and find she is burning up with fever, breathing really fast and looks simply terrible. If you haven’t rushed off to see a doctor under such circumstances, the thought certainly has crossed your mind. Usually sometime around midnight on my overnight shifts in the pediatric ER parents arrive with their feverish children worried about their fast heart rate and difficulty breathing only to find their child looks great an hour later. Kids have a unique physiology that fools parents into thinking they are sicker than they really are. Are we witnessing an evolutionary adaptation to make parents pay closer attention when their offspring are ill? Perhaps, but we can’t prove it. Even when they are healthy kids have faster heart rates and breathe more rapidly than adults. And kids seem to be more sensitive to factors that raise these rates, such as temperature, pain, fear and anxiety. When a child has fever, they breathe faster and their heart beats faster for many reasons that are not entirely understood. What we do know is that it is a normal response to fever and is caused in part by blood vessels opening up making the heart pump harder to circulate more blood. Fever also increases the metabolic rate making every process in the body work harder. In the early 1900s scientists discovered there is a linear relationship between pulse and body temperature. Our pulse increases 4-17 beats per minute for every 1°C (1.8°F) increase in temperature depending on age and a few other individual factors. Among kids, the data from many modern studies show that the general rule of thumb is that the heart rate increases by about 10 beats per minute for every 1°C change in temperature. However, babies under 2 months don’t follow this rule. Young infants have an immature nervous system and haven’t yet developed the mechanisms for an appropriate response to fever. I can only speculate that it is one of the reasons that young infants can go from looking fine, to becoming quite ill without their parent noticing. They may not have that “I’m super ill” appearance that an older baby or child gets when they have fever. Fever also causes kids to breathe fast. Breathing fast allows heat to be released through pulmonary gas convection. In kids under 2 years-old respiratory rate changed by 5-7 breaths per minute for each 1°C change in temperature. Under 12 months the correction was 7-11 breaths per minute. No wonder fever can make a child look like they have pneumonia! A child with fever will look like they are having difficulty breathing because fever stimulates the respiratory muscles to increase both the rate and depth of breathing. In animals this looks like panting. Heat and SIDS risk Animal studies and some observations in human babies have shown that the immature nervous system response to heat in young infants can lead to episodes of apnea (breathing pauses). Based on observations associating temperature and breathing, there is a presumptive correlation with one possible cause of SIDS (sudden infant death syndrome) which is still under investigation....

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Latch-on: Simple solutions to common breastfeeding problems

Posted by on 10:39 am in Babies, Breastfeeding, Eating, Milestones, Normal or Not? | 0 comments

Latch-on: Simple solutions to common breastfeeding problems

Any mom who says breastfeeding is easy just doesn’t remember the first few weeks! At some point every new mother has difficulty breastfeeding. If you have been advised to supplement with formula, don’t give up on breastfeeding entirely. Every ounce of breast milk a baby gets will help them grow and thrive in ways that formula manufacturers will never be able to match. Fortunately, the two most common breastfeeding problems, insufficient milk supply and pain, are relatively easy to address: Check baby’s latch and suck Making a good milk supply almost entirely depends on baby latching on well.  All other factors combined like maternal age, breast shape and mom’s health status don’t add up to the effect that a proper latch has on both milk production and prevention of nipple pain. If baby doesn’t latch well, mom’s hormonal system won’t receive the proper signals to increase milk production – and nursing will be far more painful. The nipple needs to go deeper into the baby’s mouth than you would ever guess. When you first learn to help baby latch you basically have to shove their head on at just the right moment when their mouth is wide open. This takes practice. Then listen for the rhythmic train-like sound of suck-swallow. If you aren’t absolutely sure you are doing it right, have your pediatrician or lactation consultant observe you feeding the baby. What are signs of a good latch? Good latch: An angle of about 120 degrees between the top and bottom lip The lower lip (and, to a lesser extent, the upper lip) turned outward against the breast The chin and nose in close proximity to the breast Full cheeks Tongue extended over the lower dental ridge and in visible contact with the breast if the lower lip is pulled away Bad latch: Contact between the upper and lower lip at the corners of the mouth Tongue not visible below the nipple when the lower lip is pulled down Creased nipple following nursing   What about supplements to increase milk supply? Galactagogues are medications or herbal substances that are thought to increase milk production. No medications or supplements have been shown to be effective in research studies. Fenugreek is the most common herbal supplement used and there is no evidence that it works. There is some evidence that it causes diarrhea and flatulence. It’s tempting to think that taking fenugreek is worth a try, however, it isn’t known whether it crosses into the milk and is probably not worth the minuscule risk to the baby. Plus, who needs more gas? Even the most commonly prescribed galactagogue, metoclopramide, was not more effective than placebo in research trials. Honestly, a relaxing cup of herbal tea may be more helpful.   Put baby to the breast A LOT The honest truth is that not making enough milk is expected. Every baby will have days when they act like they are starving which leads any caring mom to assume she isn’t making enough milk – and she’s probably correct. Babies have growth spurts and need more calories. These spurts often occur around 2-3 weeks, 6 weeks and 3 months. But they can happen anytime. The solution is for the baby to spend more time breastfeeding. Like all high-end luxury goods, breast milk is...

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Blue lips, hands and feet mean a warm heart

Posted by on 1:54 pm in Babies, Normal or Not? | 0 comments

Blue lips, hands and feet mean a warm heart

Babies can be colorful – literally. A young mother noticed that after she nursed her six-week-old baby boy the skin around the baby’s lips was always blue. He didn’t seem in distress, and would lay peacefully afterward in her arms, content and relaxed in a “milk coma.” The mom finally mentioned the color change around the baby’s mouth to her husband when he came home from work. He was alarmed that it was a sign that the baby was not getting enough oxygen, so they rushed into the emergency room in a panic. I examined the baby and he was completely normal. I watched as the infant nursed, and the mother was correct; the skin around the lips did have a bluish hue afterward. However, he was not cyanotic. When babies nurse, the veins in their lips become engorged, producing a weird blue-white shade. Babies have thin, minimally pigmented skin and an immature circulatory system. So you may see several weird color changes. Another common circulatory oddity is that a baby’s hands or feet turn blue. Sometimes they need the heat from those outer regions of their body to warm up their head and core, so their body closes off the vessels in the hands and feet to bring that warm blood to the center of their body. But sometimes their hands and feet turn blue just out of lack of coordination of the vessels. The most bizarre example of this lack of coordination is a “harlequin color change.”⁠ Occasionally and for no apparent reason, one side of a baby’s torso may simply turn blushing red and the other pale white. This harmless phenomenon seems to be caused by uncoordinated nervous system circuitry that controls blood vessel constriction and dilation. One side of the baby’s body may randomly decide to dilate its blood vessels, creating a blush; and the other side may constrict the vessels, producing paleness. While some weird circulatory phenomena are apparent, other baby oddities can’t be directly observed. For example all babies develop anemia (low red blood cell count) around three months of age. Babies use a fetal form of hemoglobin—the blood’s oxygen-carrying molecule – because it grabs oxygen more tightly than does the adult form. In the womb, the fetus needs this “super hemoglobin” to pull oxygen from the mother’s blood. But, the baby loses this form of hemoglobin over the first few months, replacing it with the adult form.⁠ And the time between when the fetal hemoglobin has stopped being produced, and when the adult form starts being made in larger quantities will mean the baby has fewer red blood cells. Babies hands and feet also turn blue when they get a fever. Read more References Harlequin colour change: unilateral erythema in a newborn Chamley, et al, Developmental Anatomy and Physiology of Children, p...

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How to decorate a smart baby’s nursery

Posted by on 12:22 pm in Babies, Sleep | 0 comments

How to decorate a smart baby’s nursery

Decorating the nursery isn’t just fun – it’s also important for a baby’s development. According to baby vision researchers you can enhance a child’s visual development by giving her a rich and interesting environment and tailoring it to the stage of her development.  So, go ahead and get that expensive wall hanging or fuzzy rug.   Mobiles Slow moving mobiles help your baby practice following objects with her eyes. You may sometimes see your very young infant stare at an object for some time before she grabs it because newborns “reach-to-grasp” machinery is primitive. But with experience from that awesome, slowly-rotating toy you hung, she will not even have to look at it as she reaches, because her vision, touch, and motor coordination machinery will have wired itself together.⁠1 Especially if the toy is made of narwhals or snazzy unicorn-dinosaur hybrids. Night light Don’t worry about keeping the room dark in the first few months. A one month-old baby needs fifty times more illumination to detect the presence of light than an adult needs. The photoreceptors in their retina haven’t developed. So, it doesn’t really help your baby sleep to keep the lights low in the nursery. The only thing you’ll likely accomplish is stubbing your toes and bruising your shins. Even at three months, babies still need ten times as much light to see properly. So you have some time to shop for the perfect night light. Stuff with shapes Babies love to look at the edges of stuff. They rely on the borders of objects and high contrast areas of 2-dimensional patterns to identify things. In fact, when looking at a human face, a newborn looks at the hairline. In one experiment, French scientists showed four-day-old infants pictures of their mother’s face and those of strangers. This experiment was especially cool because by using photos it eliminated the possibility that the baby was using smell or sound to identify Mom. The researchers found that the newborns looked longer at the photo of Mom than of a stranger. Researchers then put head scarves on the subjects and discovered that babies couldn’t distinguish their mom from a stranger.⁠2 However, once they were about 2 months old they start to pay more attention to facial features. So older infants are not fooled by such minor alterations in Mom’s appearance. The lesson here? If you want your newborn to recognize you – no head scarves, fake beards, rubber noses, etc. But you should choose edgy nursery decor with patterns and shapes that have distinct edges for them to inspect. Babies develop their vision through experience. The brain’s pre-wired visual pathways need exposure to light and moving objects to create the complex sense that we call vision. What babies “see” is very different from what parents see. We take for granted that we can synthesize color and the movement of objects to keep track of what is around us. Babies on the other hand are very nearsighted and they don’t always see something if it is moving too quickly. Researchers say babies have a visual “speed limit”. So, newborns need experience seeing stuff to become less nearsighted, be able to see moving objects and for their brains to learn the very complex task of combining color, movement, and timing into a single...

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Don’t blame teething for baby’s ills

Posted by on 4:43 pm in Babies, Illness, Milestones, Normal or Not?, Sleep | 0 comments

Don’t blame teething for baby’s ills

Teething has had a bad reputation for over 5000 years. Hippocrates, Homer, and Aristotle associated teething with serious diseases1. Since then teething has been blamed for ailments from seizures, to infections like cholera, meningitis, tetanus and even penile discharge. In 18th century France, about half of all infant deaths were attributed to teething. Obviously, it’s ridiculous to blame the eruption of a new tooth for life-threatening disease, but teething is still widely thought to cause fever, diarrhea, irritability, poor sleep and drooling. Teething is uncomfortable. But it’s mostly coincidence that kids are a mess when they are teething. First of all, they cut new teeth from about 6 months, until sometime around 3 years. So there is virtually never a time when they are sleeping poorly, have a fever or diarrhea, when they aren’t ALSO getting a new tooth. They are always teething, so their symptoms aren’t necessarily due to a new tooth. Second, babies’ first tooth erupts in the center of their lower jaw at the same age when kids really start to explore their environment. They put their hands on everything they can grab and then shove them in their mouth because they just learned how to do that. And they probably do have some amount of gingival discomfort with those new teeth coming in, so they like to chew on the grocery cart handle, their friend’s toy, and frankly, anything they can find that is covered in infectious virus particles. And they haven’t quite built up their grown-up immune system, so they get sick. I’m not just making this up. Research supports this germ theory of teething-related fever and diarrhea. A summary of 10 studies on teething (a “meta-analysis”) 2 showed that teething absolutely does not cause fever. The most common teething-related symptoms were gum irritation in 86% of kids, and irritability in 68%. One of the studies3 included in this analysis compared 236 toothdays (days when new teeth were erupting) to 895 non-toothdays in 21 babies at a daycare center. They examined the babies mouths, took their temperatures and asked parents and daycare workers about symptoms. They found that fever, sleep disturbance, drooling, diarrhea, and rashes were not at all related to the timing of baby tooth eruption. It’s time to exonerate teething. Despite the evidence, both parents and physicians still hold incorrect beliefs about teething. And placing the blame for fever, diarrhea and even fussiness on teething prevents parents from addressing poor sleep and fussiness. Just as a child with language delay might benefit from early intervention, so would a child with poor sleep benefit from sleep training more than pain medication or teething tablets. Besides, using teething remedies can be dangerous. The AAP (American Academy of Pediatrics) recently advised against using homeopathic teething remedies when a lab analysis of some homeopathic teething pills found greater amounts of deadly nightshade (belladonna) than were on the label. Symptoms of belladonna include seizures, difficulty breathing, muscle weakness, skin flushing and agitation. Similarly, topical pain relievers with benzocaine (e.g. Orajel) have long been known to cause serious side effects. So, what should you do for teething? During the day, a baby can easily be distracted from the minor discomfort so just show them a new toy or tickle them. Or try cold fruit inside a Fresh Food Feeder....

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How to rehydrate kids with stomach flu

Posted by on 10:03 am in Babies, Illness, Poop, School-Age Child, Toddlers | 0 comments

How to rehydrate kids with stomach flu

Most kids don’t need intravenous (IV) fluids to get back on their feet after a bout of vomiting or diarrhea. Here’s what you need to know to get through the stomach flu: Give frequent, small sips of fluids. Offer a drink even if your child is vomiting every 5-10 minutes — which is common during the first few hours of being sick. Their stomach will absorb enough of the fluid before they vomit again and you can prevent dehydration if you get a head start on replacing lost fluids. You can’t make an infant drink if they don’t want to. So if a baby (or grouchy toddler) won’t drink willingly, use a medicine dropper or syringe to squirt fluids into their mouth. Start with 1 teaspoon (5ml) every 5 minutes and then increase the amount slowly when the child stops vomiting. Try 15ml every 15 minutes, and if they don’t vomit that amount, offer an ounce (30ml). If they keep down an ounce, then you can let them drink as much as they want. The goal is to not stretch out the stomach with a large volume of fluid that will just make them vomit again. Slow and steady wins the race here. Your choice of drink is important. Drinks that are too sugary, like sports drinks and juice, will actually cause diarrhea. And chicken broth has too much sodium and isn’t absorbed well. What about water? That’s the worst choice. The lining of the intestine has tiny passages that carry fluid into the blood stream. These passages are unlocked by a specific combination of sugar and sodium. That’s why there are ready-made rehydration drinks. Pedialyte and other commercially available electrolyte drinks have the optimal ratio, but some kids don’t like the taste. A recent study showed that watered-down apple juice (1:1 ratio) is extremely effective at preventing dehydration in kids with the stomach flu. I also love popsicles because kids can’t drink them fast. See my post that explains why popsicles are a legit stomach flu treatment. Why juice, soda and broth aren't the best choices The high sugar concentration in fruit juice and soda holds water in the intestine. Instead of being absorbed into the bloodstream the liquid will continue to travel through your intestine and come out the other end as diarrhea. Fluids with far more sodium than sugar (chicken broth) have insufficient sugar to make the intestinal water pump function properly to bring water from the intestines into the blood stream. That’s why the World Health Organization (WHO) has worked for decades to determine just the right formula for rehydration fluid. Even if a child is moderately dehydrated, drinking liquids has been shown in many studies to be equally effective to an IV. If your child won’t take Pedialyte offer them any other fluid you think they will drink. Any drink is better than nothing. Once a child becomes dehydrated they will feel awful and it will be even harder to get them to take fluids. Baby got a fever? If they vomit their fever medicine, rectal acetaminophen is an ideal option. Let me tell you why!  ...

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What’s autism, what’s not?

Posted by on 5:05 pm in Babies, Language, Milestones, Normal or Not?, School-Age Child, Toddlers | 0 comments

What’s autism, what’s not?

Don’t freak out if you catch your child head-banging, echoing others words’ or hand flapping. Yes, those are symptoms of autism, but they don’t define your child as having an autism spectrum disorder (ASD). Every regular developing kid will do many of the same things that autistic kids do at some point. Many “autistic” behaviors are part of normal development and are simply stages kids go through as their nervous system wires itself for adulthood. People with autism just stick with some of these behaviors for too long or do them too often. Kids with ASD have a different operating system than other children. What’s even more complicated is that children with autism can be vastly different from one another, which is why its’ called a “spectrum”. But at the very heart of autism, all kids on the spectrum have a few things in common: they have abnormal social interaction and restricted, repetitive patterns of interests. Parents with 16-30 month old toddlers can screen for ASD using the 20-question M-Chat screening tool. If your child tests positive on this questionnaire, 95% of kids will eventually be diagnosed with some developmental disorder. However, only about 45% will actually be diagnosed with autism. That’s because lots of other diagnoses have symptoms that look like autism, but are nothing more than a similar looking manifestation with an entirely different root cause. For example, ADHD can look like autism because ADHD symptoms include inattentiveness and impulsiveness. So if a child is inattentive to language and other social cues, they may seem to have autism. But really they have attention problems. Getting an accurate diagnosis is essential, because the treatments are so different. Kids who have a suspected diagnosis of autism often turn out to have anxiety, a language delay, or selective mutism (the inability to speak in certain situations, but able to speak in comfortable environments). Parents are extremely accurate when they have concerns about their child’s development. So if you are worried, your concern is probably valid. However, the issue is most likely not what you fear. So talk to your pediatrician. In the meantime, your child probably does NOT have autism if he or she: Looks at an object when you point at it Pretends to talk on the phone, or pretends to feed a doll Points to show you something that they want you to see also Smiles back when you smile at her Tries to copy you (claps when you clap, makes a funny noise when you make a funny noise) Tries to get you to watch them do something, looks at you for praise or wants your attention Looks at you to see your reaction if something surprising or new happens Follows your directions – like “put the book on the chair” or “bring me a diaper”...

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How to outsmart mosquitos and prevent bites

Posted by on 5:40 pm in Babies, Illness, Injury, School-Age Child, Toddlers | 0 comments

How to outsmart mosquitos and prevent bites

Yes, you should be worried about mosquitos transmitting Zika. And you should be just as worried about dengue fever, yellow fever, chikungunya, Japanese encephalitis, West Nile, and several other diseases. About 700 million people are infected every year around the world and some get really sick. Even if you don’t get sick, bug bites are easily infected by dirty kid hands scratching their itch. Plus, bug bites are just annoying. Here’s how to avoid them: Step 1: Understand the enemy Mosquitos lay their eggs in little insect “nurseries” like birdbaths, discarded cups, and old tires. Even small areas of standing water provide a soup of organisms they can feed on – it’s like mosquito Enfamil. Once they grow up, all mosquitos feed on plant nectar. However, females need protein and other nutrients found only in blood so that they can produce new eggs. So mosquito mothers-to-be have special chemical and heat sensors to help them search out carbon dioxide and octenol in our breath and sweat. Every person has a unique smell signature that make some people more fragrant to a mosquito than others. (Ooh..is that Octenol no. 5 you’re wearing?) There’s nothing you can do to change your scent – not even eating garlic, onions or other malodorous foods, so don’t bother trying.   How do bugs bite? Once a female mosquito locks on to your smell, their mouthparts bite through your skin and their hypopharynx wiggles around until it finds a capillary. It punctures through the wall of the capillary and pumps blood out and saliva in. Their saliva keeps our blood from clotting and makes most of us itch (but not everyone – some people do get bit, but they don’t react to mosquito saliva).   Step 2: Protect yourself Reduce the number of mosquitos in your area by getting rid of any standing water in your yard (tarp folds, kiddie pools). And protect your family from getting bit. Most species of mosquitos feed at dawn or dusk, so that’s when you need to stay inside or use insect repellent. For young kids, use an insect net over their stroller. Cover as much skin with clothing as is comfortable and try hats with insect screens. If you plan to be outside, there are lots of insect repellent options.   Step 3: Repel the critters Insect repellents work by blocking insects’ sense of smell; some even confuse their sensors to make your good scent smell bad. Permethrin – effective against mosquitoes, flies, ticks, and chiggers – Permethrin is not actually a repellent. It causes nervous system toxicity in insects. So they either leave or stay and die. Permethrin can only be used on clothes. DEET is very safe and the most effective repellent, it can be safely used in pregnancy and in babies after 2 months. However, DEET can damage plastic and synthetic fabrics (e.g. rayon and spandex ) so be careful around your $98 yoga pants! DEET is available in products up to 70% concentration, but 30% is plenty. If you’re worried about toxicity, there are microencapsulated formulations (e.g. 3M Ultrathon), which increase repellency while reducing skin absorption. Picaridin is plant-derived. The benefit is that it is odorless, non-sticky, and non-greasy – so kids won’t complain when you smear it on. It is available in several...

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