The secret to rolling over: an unpredictable milestone

Posted by on 9:58 pm in Babies, Milestones, Normal or Not? | 0 comments

The secret to rolling over: an unpredictable milestone

When and how should a normal baby roll-over and what does it mean? Rolling over is the most mysterious of the milestones. Some babies roll from front-to-back before they roll back-to-front and others choose the opposite order. Some babies roll over once and never again, and some babies log roll to get around rather than crawl. And all of the above are perfectly normal. Four months is the most typical age to start rolling, but anytime between 4 and 6 months is in the normal range. The age when your baby starts rolling over depends on a bunch of things: First, a baby has to develop their leg, neck, back, and arm muscles enough to twist their torso around. That’s why your plump infant might have a harder time rolling her cute little mass over. You can help develop her muscles by providing plenty of tummy time. And speaking of tummy time: babies enjoy it more when you give them some “belly bait.” Place an incentive like a mirror, toy, or your own face nearby to encourage your baby to reach out, arch his back, and exercise his torso. So the second ingredient to encourage rolling over is to keep that bait far enough away that he has to figure out a way to move towards it. Lastly, rolling over can be scary. Plenty of babies scare the poop out of themselves when they suddenly flip over and the entire room changes. It’s like time travel to them. And the scariest experience is when a baby rolls off a piece of furniture. So, whether you have seen your child roll over or not, once they hit about 2 ½ months, be extra careful about leaving a child on a raised flat surface. Babies love to surprise their parents with their first roll when it is most dangerous. And if their first roll is frightening they may avoid the motion altogether. Conditions have to be just right for a baby to roll over, and to keep doing it. So don’t worry if your child rolled over once and then stopped. And also don’t fret over which direction they rolled, or how old they were when they started. Whether your baby rolls over, wiggles, scoots, or jigs, as long as your child is trying to move their body towards objects in some manner they are developing normally . It is very common for a baby who can roll to stop rolling over. Usually non-rollers are busy working on another motor skill and most babies can only work on one skill at a time. So ask yourself what else she’s working on. It might be scooting or even just babbling a lot more. Learning to eat takes a lot of brain-power too, so her intellectual capacity may just be occupied by food. And don’t freak out that your baby will roll over and suffocate during sleep. If she has developed the ability to roll, she has also developed the ability to sense trouble when she’s sound asleep and will move her head to avoid being caught in a blanket. When should you worry? Tell your pediatrician if your child has not rolled over by 6 months and isn’t scooting, sitting, or locomoting in some other way. Another worrisome sign is if your child...

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The bright side of dark chocolate

Posted by on 6:40 pm in Babies, Eating, School-Age Child, Toddlers | 1 comment

The bright side of dark chocolate

Looking for the perfect Valentine’s gift or Easter surprise? Introduce your kids to the taste of dark chocolate and you’ll improve their health for eternity. Dark chocolate has many beneficial health effects on adults including improved cardiovascular health, cholesterol, insulin levels, and it even improves mood. Few studies have looked at these effects on children. However since it is scientifically proven that children grow up to be adults, introducing kids to the unique flavor of dark chocolate is great preventive medicine. Dark chocolate is loaded with nutrients, healthy fats and anti-oxidants. One class of compounds found in chocolate, the alkaloids, include caffeine and phenlyethylamine (PEA). PEA is the same chemical that your brain makes when you are falling in love. PEA releases endorphins, serotonin and dopamine, all of which make you feel happy and relaxed. The powerful antioxidants in dark chocolate are anti-inflammatory and have such effects as protecting blood vessels and improving blood flow in the brain as well as increasing “good” HDL cholesterol and lowering “bad” LDL cholesterol. Finally, dark chocolate is full of minerals like potassium, zinc, iron and selenium that the body needs to maintain basic metabolic processes. The details of many of these positive effects are pretty well studied in adults with high blood pressure, and even Alzheimer’s disease. Though kids’ bodies are a little different, so these effects may not be as relevant. However, there are a few effects that we know are beneficial in children. The flavonoids in dark chocolate actually protect the skin from sun damage. Eating dark chocolate regularly before sun exposure reduced the redness from ultraviolet radiation by up to 25% in one study. The chemicals in chocolate increased the skin’s density and provided better skin hydration. You’ll still need sun block, but every bit of protection helps. Chocolate also helps regulate your appetite. Melting a small square of dark chocolate on your tongue 20 minutes before a meal triggers hormones in the brain to signal that you’re full. Subjects in one study were brought to an all-you-can-eat buffet and ate far less after they had a square of dark chocolate. And a square after dinner prevents snacking later. There is a direct correlation between a country’s annual per capita chocolate consumption and the number of Nobel laureates. And for you pregnant moms who are avoiding sushi, soft cheese, wine and practically every other indulgence: Go ahead and eat dark chocolate! In one study dark chocolate reduced stress in pregnant moms and their babies smiled more than babies of non-chocolate eating parents. With so many important nutrients and health benefits, I advise you skip your child’s multivitamin and replace it with a square of dark chocolate every day! Be sure to look for chocolate with more than 70% cocoa for the most benefits. The darker the chocolate, the less sugar it contains and the greater the positive effects. Happy Valentine’s Day!  ...

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4 vaccines you need before you visit the baby

Posted by on 6:34 pm in Babies, Featured, Immunizations | 0 comments

4 vaccines you need before you visit the baby

Washing your hands isn’t enough. Anyone who will be in close contact with your new baby needs to be vaccinated to prevent transmitting these deadly infections.  Pertussis Also known as whooping cough, this disease is perhaps the most dangerous and easily preventable. Mom’s doctor will make sure she has the vaccine, and most will recommend the Tdap (Tetanus, Diptheria, and acellular Pertussis) for the other parent. But don’t forget the nanny, grandparents and other children at home. Tdap needs to be updated every 10 years, but some adult doctors will repeat the immunization as early as 2 years from the most recent shot to ensure good protection. And if you can’t remember when you had your last vaccine it is safe to get it again. If you’re getting pushback from family or friends, blame the doctor. Tell your skeptical brother that your obstetrician or pediatrician insisted on protecting your baby (we don’t mind taking the flack). Or show your family the CDC Vaccine Information sheet that says “anyone having close contact with a baby younger than 12 months” needs the vaccine. How deadly is whooping cough? Before the pertussis vaccine was available, 200,000 children were sick and 9,000 died every year. Since the vaccine’s introduction in the 1940s, up to 40,000 people still get whooping cough every year, but we’ve only seen 10-20 deaths a year. Increasing the number of people who are immunized can eliminate pertussis deaths.   Influenza It’s a good idea to get this vaccine every year. You can’t give a baby an illness that you don’t have. And don’t think you can get away with avoiding the baby if you’re sick. You can be quite contagious the day before you start experiencing symptoms.   Zoster This vaccine protects against shingles (a re-activation of the chicken pox virus) that causes painful blisters in adults. An adult with shingles can cause chicken pox in unvaccinated babies. Grandparents over age 60 should have this vaccine. Rumors abound that this live-virus vaccine can be contagious, but you do not need to avoid seeing the baby after the vaccine. There has not been a single case of the disease after close contact with someone recently immunized. But there are plenty of cases of babies getting very sick from chicken pox from contact with a grandparent with shingles.   Pneumococcus The pneumococcal vaccine is recommended for older caregivers and grandparents over age 65. Pneumococcus causes pneumonia, meningitis and blood infection. Babies receive this vaccine starting at 2 months and reach their best immunity when they finish the vaccine series after they turn 1. The best way to protect your newborn is to make sure that they are surrounded by vaccinated people. Asking your friends and family to check their vaccinations before visiting is one of the most important things you can do to protect the baby. As an added benefit, you may prevent your loved ones from serious diseases they weren’t even aware they were at risk...

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Pulling on Ears is Super-Fun According to Kids

Posted by on 1:00 pm in Normal or Not?, Toddlers | 2 comments

Pulling on Ears is Super-Fun According to Kids

Every parent (including myself) has suspected that their child has an ear infection when in fact they don’t. How does such deception occur?  According to my two-year old source, it is very cool to play with your ears. This 21 month-old patient I saw in the ER admitted to me that she discovered that when she puts her fingers in her ears it sounds really cool.  And the sound is even more interesting when she chews!  Thanks to this exceptionally verbal child, I was given a peek into the toddler’s world. My colleague’s 24 month-old patient similarly was thought to be pulling on her ears, but really was just pretending to talk on an invisible phone. Fooled again! I see at least one patient every day with the concern of an ear infection, when in fact their ear drums look fine. So don’t be embarrassed if you bring your child to their pediatrician for an ear-infection false alarm. There are tons of reasons kids pull on their ears. For example, ear-pulling is very popular among 4-6 month-old babies. If they could talk well enough to tell you why they pull on their ears they’d say “I just found these things on my head, aren’t they cool”? Soon enough they’ll grab your ears too: “Oh, hey! You’ve got those things too!” It’s easy to think your child has an ear infection if they can’t speak well enough to tell you their ear hurts. But the bottom line is if your child has a fever or is very fussy you should have them examined. But if they are just pulling on their ears, you can ignore it. Or stick your fingers in your ears and hum. It does sound kinda cool. Wanna learn about other baby fake-outs? Read: It’s not a seizure. Weird movements and other baby tricks. More information about ear-pulling at...

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Need to find a new pediatrician NOW?

Posted by on 4:39 pm in Babies, School-Age Child, Toddlers | 0 comments

Need to find a new pediatrician NOW?

Does the New Year mean a new health insurance company for your family? Or maybe your 14 year-old daughter asked if she could possibly see a female pediatrician. Whatever the reason you are searching for a new health care provider these guidelines may help you find the right practice:   Choose an office located near home/work/daycare Ask other moms or your local pharmacist for recommendations Check out how easy it is to make an appointment: call and see how long you are on hold to speak to the office staff Make sure the office has separate waiting rooms for well and sick visits Look for an office that will grow with your family. They should have male and female clinicians for when your kids are older (and more modest). Size matters: offices with more than one doctor always have coverage, but you may not see the same provider in a large practice. Weekend hours are a huge plus! Also, ask whether the practice has convenient radiology and lab facilities. Ask about how the office approaches alternative treatments: do they stay up-to-date on the latest alternative treatments so they can offer sound advice, or do they ignore them?   The pharmacists all recommended the same practice and I couldn’t be happier with it!                                                                                            – a BabyScience...

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Best gift EVER? Play with your kids

Posted by on 4:13 pm in Babies, School-Age Child, Toddlers | 0 comments

Best gift EVER? Play with your kids

What single thing develops every aspect of a child’s health? A. Giving them LOTS of gifts B. Giving in when your child whines C. Roughhousing The answer is C. Roughhousing seems an easy way to get hurt. But I assure you that I’ve seen hundreds of kids with broken bones from jumping on trampolines and slipping in socks on wood floors; but never a roughhousing injury. What I do see are kids who take life way too seriously, so that every bump in the road (or to the head) seems a catastrophe. Playing with your children, and even wrestling with them is one of the best ways to raise a great kid. The physical benefits of play may be obvious; children develop coordination through physical play. And getting out of breath is healthy for the heart and lungs. But roughhousing also improves social graces, morality, and even intelligence. When children roughhouse with their parents, or other kids, they learn to adapt to unpredictable situations, deal with minor discomfort and see first-hand that failure is temporary. There really is no better way for children to start practicing these important life skills than through rough play. Wrestling with your kids teaches them to read body language, to practice give-and-take and helps them develop self-control. And the spontaneous nature of roughhousing teaches them to be a more flexible thinker – in fact, the unpredictability of roughhousing actually wires connections between neurons that help with being a more flexible thinker in other situations. Some studies have shown that the brain releases a growth chemical that affects memory, logic and language development during rough play. Even very young kids benefit. Go ahead and toss your baby in the air and catch him. It builds trust! Non-contact play like pretending and joking with your kids is also beneficial. The give and take between you and your child when you are playing with toy ponies or action figures teaches creativity. And knowing how to joke is a learned skill that helps kids make friends, be creative and solve problems. So make time to play with your kids, and joke around with them. And if grandma is yelling at the kids to stop wrestling in the living room, tell her it’s okay. They are developing their emotional health and wiring their brains for...

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Uncovered: The Mysteries of changing diapers

Posted by on 2:03 pm in Babies, Pee, Poop | 0 comments

Uncovered: The Mysteries of changing diapers

Diaper irritation leads to an irritated baby. Follow these steps to ensure a smooth, soft, irritation-free bottom. Diapers and wipes are just tools for keeping moisture away from the skin. Here’s what you need to know to use them to your advantage. (And pay attention; many of these principles apply to caring for our sensitive adult faces too!)   Keep wetness away Cloth or disposable diapers? The choice of diaper is probably not as important as keeping moisture away from the skin. Modern diapers are the ants of the baby product world – they can carry 80 times the moisture of a cloth diaper. Their incredible wicking power keeps water and irritating substances  away from the skin. Exposure to wetness dries out the skin and enzymes and acids in urine and poop disrupt the outer skin layer by breaking down skin proteins and altering the pH which causes inflammation. So the most important function of any diaper is to quickly absorb baby’s waste and confine it away from the skin. So a cloth diaper can do a fine job, you just may need to change the diaper more often. If you feel compelled to use cloth diapers because of the significant environmental impact of disposable diapers, go for it. Most babies’ skin does just fine. If you have trouble with diaper rashes, then try switching to disposables. As far as sizing goes, go up a size when the diaper is leaking or if the diaper fits too close to the skin. You want some space between the skin and the diaper to hold the wetness away from the skin, but not enough to cause a gap between the elastic around the legs. See What to Expect for a good pro/con list comparing cloth and disposable diapers.   Avoid friction Always pat the diaper area dry rather than rubbing which causes mechanical shear force and can damage the upper skin layer. The same advice goes for your own face – never rub your face, especially for acne-prone skin, or you will create micro-tears in the skin and shove bacteria into them. Store bought wipes are great. While sensible adults use them for practical reasons, good research shows that they are gentler than water and a washcloth. In studies of preemies and normal babies, soft wipes containing an oil-based cleanser removed more diaper schmutz and led to decreased skin irritation. The cleansers in wipes are far superior at dissolving and removing pee and poop than water. Wipes should contain only the essential materials, and be free of alcohol (mild alcohols such as benzyl alcohol are okay). Definitely avoid wipes with added fragrance and the preservative methylisothiazolinone, a common allergen.   Protect skin Applying lotions and oils to baby’s bottom is common in many cultures. Oil massage is common in India, and it turns out that sunflower, safflower, sesame and apricot oils contain fatty acids (like linoleic acid) with anti-inflammatory properties. Creams with petrolatum and olive oil-lanolin helped protect skin as well. In premature babies, diaper cream actually prevented blood infections in a study in developing countries! A few studies even looked at applying breast milk to the diaper area and it had good anti-bacterial and protective effects. So it is a great practice to keep the skin protected with a barrier cream....

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How kids would run reading time

Posted by on 12:34 pm in Babies, Language, School-Age Child, Toddlers | 0 comments

How kids would run reading time

Why bother reading when skipping a page sets off a tantrum and Olivia won’t sit still long enough to conquer even one page? Listening to a story literally builds kids’ brain cells. Only seconds after reading to a toddler, thousands of cells in their growing brains respond. So you have to read books to help develop well-rounded language skills. In fact, children are exposed to fifty percent more unique words in books than in television shows or even college students’ conversations! Here are a few tips to help you choose good books and maybe keep your child’s attention for a few pages:   1.Don’t Read You don’t have to read the actual words on the page. According to research, two components of reading are particularly beneficial and don’t involve reading the words at all. Reading experts discovered that describing pictures and actions, and asking questions about the story teach language skills very effectively. So it’s perfectly fine to turn pages, look at pictures together and tell a story about what you see. 2. Rhyme Rhymes are a great way to develop language skills. Since I rarely speak like Dr. Seuss at home I make it a point to choose rhyming books because the rhythm and repetitive sounds are optimal for developing early language skills like listening and sound recognition. 3. Read the same book Kids learn new words better when they are familiar with the story. They hear and understand unfamiliar words better each time you run through the book because they aren’t distracted by the action. So don’t resist repeating The Very Hungry Caterpillar for the 100th time. That might just be when they learn the word cocoon!   Reading obviously builds vocabulary, but it also develops curiosity and memory and has other positive effects. From elementary school age kids through adulthood, reading literature with engaging characters improves empathy! So, let kids choose books they like. And be a good role model by letting your kids see you take time to read for yourself!   For more information about the research: Reading aloud to children: the evidence. Arch Dis Child. 2008...

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Growing pains caused by living life

Posted by on 12:33 pm in Normal or Not?, School-Age Child, Toddlers | 0 comments

Growing pains caused by living life

Growing pains cause real pain, but it’s not from growing. If your child has arm or leg pain at night, without warmth or redness of the joints, and the pain is gone the next day, they have growing pains. You don’t need to worry your child has some dangerous, mysterious disease (like cancer or an infection). They do have a mysterious disease, but it’s a common, benign one. Nobody knows exactly what causes growing pains, and many studies have tried to correlate them to growth spurts but have not found a link. However, scientists have found a connection between growth spurts and increased sleep. see: Kids can grow overnight. Growing pains are leg pains (but can occasionally occur in the arms at the same time), they occur at night and can wake a child from sleep. They are almost always on both sides of the body and are gone by morning.   Researchers1 used ultrasound to look at the leg bones in children with growing pains and were surprised to find that the bone structure was nearly identical to what they saw in patients with pain from being overly active. So it appears that growing pains are caused by overuse. Other studies support this idea. For example, when parents were asked to record their child’s daily activity, the records showed that growing pains happen more often after a day when their child was more active than usual. And even if your child has growing pains one night and you don’t think they were particularly active, the truth is that you don’t really know what your child did all day. Perhaps they were fighting crime and jumped down from a high ledge 150 times. More recent research2  has found a link between low vitamin D levels and growing pains. But researchers still need to confirm that kids without growing pains have normal vitamin D levels before we can start considering this as a cause of the condition. They also need to test whether vitamin D supplements cure growing pains. So don’t start a vitamin supplement just yet. From my experience with growing pains, both having had them myself and among my patients, I suspect we will find several factors that contribute. Vitamin D may play a role. More likely, a combination of factors are involved including an individual child’s pain sensitivity, and activity level. Growing pains are most likely more muscle pain than bone pain. Bone pain doesn’t go away overnight. Also, daily muscle stretching in children with frequent growing pains decreases how often a child has the pains and can cure them completely. We know that children’s bones grow fairly rapidly in length, but their muscles don’t always keep up. Kids’ muscles become just a little bit tighter as they are stretched along the growing bone. If you pay attention, you will notice that children lose some of their flexibility as their limbs grow longer. This unequal growth in length between bones and muscles probably contributes to growing pains. Nevertheless, “growing pains” is not a great name for the condition. Doctors have tried to more correctly name them something like ‘non-inflammatory, non-rheumatologic recurrent benign limb pain in children (NINRRBLPC)’ but the term just hasn’t caught on. Perhaps we should call them “life pains.” For more information about Growing Pains at the Mayo Clinic Website Stretching Exercises Quadriceps (front of thighs) Lie...

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Unclog a stuffy nose (the right way)

Posted by on 8:31 am in Babies, Illness, School-Age Child, Toddlers | 1 comment

Unclog a stuffy nose (the right way)

What are you supposed to do you when your little one is congested? Cough and cold medicines are potentially dangerous for children under two years old and are ineffective anyway.  A study in 2010 showed that good old vapor rub improved kids cough and congestion symptoms, and most importantly improved their sleep. So now I recommend Vicks VapoRub. But again, the camphor in VapoRub is not supposed to be given to children younger than two. So what can be done for a congested little one? Do medications improve congestion? A lot of pediatricians recommend diphenhydramine (Benadryl), an anti-histamine. This is a great choice if you know your child’s congestion is a reaction to an allergen. Pollen and other allergens cause your body to release histamine. Body tissues respond to histamine by swelling and becoming itchy.  Anti-histamine medications block this release and therefore prevent swelling. But this isn’t what is happening when your child has a cold. Mucolytics (guaifenesin or Mucinex) are supposed to thin mucus and theoretically should help it drain out better, but no studies have shown this helps. Similarly, decongestant medications have not been better than placebo in studies. And decongestants can be dangerous for a young child. My recommendation for all kids and adults is even older than VapoRub – which was originally introduced as Vicks Magic Croup Salve in 1905. The ancient Ayurvedic technique of nasal irrigation actually may be the optimal way to moisturize the nasal passages and clear thick mucus. Mechanically-speaking, washing out the nasal passages makes sense. All the holes in your head are connected: the sinuses, the ear canals, the tear ducts and the nostrils. The sinuses inside your face have little doorways to your nasal passages. These tiny little doorways can become blocked by thick mucus when you have a cold so pressure can build up inside the sinuses. The maxillary sinuses are behind your cheeks, and the ethmoid sinus is behind the bridge of your nose, so depending on which sinuses are blocked, you can feel pressure anywhere on your face and forehead. Sinuses aren’t filled with air when a baby is born. They develop during the first 3 to 5 years of life, so a baby can’t really have a sinus infection since they don’t technically have sinuses yet. When you irrigate through the nose, you are washing out the mucus that is blocking all of those connections and every part of your head is going to feel better. Still not convinced? The passage from your nostrils all the way to the back of your throat are lined with little brooms (ciliated epithelium) that sweep mucus along. They get all gummed up with mucus when you are sick and don’t function effectively. When you irrigate your nose, you clean out those bristles and they work better. Think your child is going to resist nasal washing? I thought my son would fight me on this when he was 4 years old and I was surprised at how cooperative he was. But even if your child does put up a fight initially, give this a try. Be persistent. Nasal irrigation is the most effective way to make them feel better. So grab a nasal saline rinse kit or bottle of nasal saline drops at your pharmacy and plan to use it this winter....

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