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Baby Lessons

Welcome to Week 48 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

If you check out the Instagram accounts of celebrity parents, you’re bound to see some pretty insane pictures of 1-year old birthday parties. Petting zoos, moon bounces, Disney characters, and over-the-top birthday cakes are just the tip of the iceberg for celebrity tykes turning 1. What these pictures don’t often show is the birthday boy or birthday girl, behind-the-scenes, having no idea what’s going on or being totally overwhelmed by the crowd. 

Remember Stranger Anxiety? Yup, that’s still a thing at this age.  

Get Wise Below about How to Make Your Baby’s First B-Day Party Fun for Everyone Involved.

Sleep:

The American Academy of Pediatrics (the AAP) recommends a total of 12-15 hours of sleep per day until 1 year of age.

Feeding:

Continue to give your baby solid foods plus breast milk or formula. Your little one can get their first taste of whole milk when they turn 1. Only a few more weeks to go!

As a Reminder, the Hot Topic for This Week Is: Tips for Managing the Birthday Party Madness. Get Wise(r) About Them Below.

Tips for Managing the Birthday Party Madness 

There’s no doubt that parents have ramped up the birthday party expectations over the years. In the past, parents stuck a candle in a potato and called it a day. Although your baby’s first birthday is an exciting milestone, don’t feel like you have to throw a lavish party that your baby won’t remember or that they may even be too freaked out to enjoy.

Here are 5 Tips to Help You Make Your Baby’s First Birthday Celebration a Success:

1. Pare Down the Guest List: Remember, this is your child’s first birthday party, not their wedding. You don’t have to invite everyone and their mother. Keep the party small. One tip is to have the number of “kid” guests equal the age of your child. For example, a 1-year-old would have 1 “friend” there, a 2-year-old, 2 “friends,” and so on.

2. Don’t Listen to the Noise: Just because your friend down the street hired a traveling circus for her child’s birthday, doesn’t mean you have to do the same. You’re not a “lesser” parent for having a chill b-day party or no b-day party at all. 

3. Keep the Party Short and Sweet: Birthday parties, even intimate ones, can be overwhelming for babies. Therefore, wrap things up after an hour or so or put your baby down for a nap while the party continues. In addition, schedule the party at a time when your child tends to be well-rested and in a good mood.

4. Make the Activities Age Appropriate: 1-year-olds aren’t quite ready for Pin the Tail on the Donkey, but they appreciate birthday activities such as bubbles, a ball pit, and singing.

5. Skip the Latex Balloons: Although balloons and birthdays go together like peanut butter & jelly, uninflated or popped latex balloons are choking hazards for kids under 8 years old. 

How So? There are 2 ways that a child can choke on a latex balloon:

  • No. 1: If they suck inward and inhale the uninflated balloon while trying to blow it up,

    OR
  • No. 2: If they pick up small pieces of a popped balloon and eat them.

The Solution? Have a balloon-free party or opt for Mylar balloons which aren’t as dangerous (although your child still needs to be supervised around them).

As a Reminder, Mylar Balloons are the Shiny, Foil Balloons That Look Like This:

Bonus Tip: If You Want to Go Full Throttle, Get Some Back Up…

If you’re in the mood for a rager and want to throw a big party, go for it! You deserve it! Just know that this type of party is more for you than for your baby, so you’ll need to set some boundaries around it and may want to enlist another caregiver or two to help out. For example, you can have your baby make “an appearance” and then have someone else watch them while you mingle with the guests. You can also set up a “quiet” area where kids in meltdown mode can hang out and recenter with a designated teen or adult.

The Bottom Line

Use the tips above to help you plan your baby’s first birthday party. Do what feels authentic to your family and enjoy!

“It kills you to see them grow up.
But I guess it would kill you
quicker if they didn’t.”

 ~Barbara Kingsolver, “Animal Dreams”

This Week’s Reminders are the Same as Last Week’s…

  • Serve at Least 1 Iron-Rich Food Per Day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 47 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

At 9-months, babies typically ramp things up in the expressive language department by adding new consonants and saying “Mama” and “Dada” non-specifically (i.e. to anyone and anything that will listen).

By the 1-year mark, babies are usually able to say “Mama” and “Dada” specifically (i.e. to the proper people) plus one other word (such as “ball”). This week’s PediaGuide will focus on how to help your baby add new words to their repertoire (both verbally and through baby sign language).

Sleep:

The American Academy of Pediatrics (the AAP) continues to recommend 12-15 hours of sleep per day for this age group.

Feeding:

Keep up the solid foods plus the breast milk or formula.

As a Reminder, the Hot Topic for This Week Is: Baby Sign Language. Get Wise(r) About It Below.

Baby Sign Language

As your child enters the toddler years, you may notice that they have a lot to say but are limited by the words they know. This can be super frustrating for kids and is a major reason that temper tantrums occur. What might sound like gibberish to you is actually a full-on sentence in your toddler’s mind.

Speech therapists often recommend (to varying degrees) that parents add baby sign language to the mix to give their baby another way to communicate while they build up their vocabulary. Baby sign language is particularly helpful for kids with speech delays.

Below Is a Chart of the Top 24 Baby Sign Language Gestures.

PediaTip: My advice is to start with 3-5 signs, so you don’t get overwhelmed. Popular initial signs include “eat,” “drink,” “milk,” “more,” and “all done.” The goal is not to make your child “fluent” in baby sign language, but to teach them a handful of signs to help bridge the communication gap early on.

Image Source: BabySignLanguage.com

6 Ways to Promote Talking In Your Baby

In Addition to Baby Sign Language, Here are 6 Ways to Help You Encourage Your Baby to Learn New Words. 

1. Be a Narrator. Describe everything that you’re doing out loud. For example, if you’re folding a shirt, you can say “I’m folding your green shirt before I put it in the closet.” You may feel a little silly doing this, but trust me, your baby is listening to you.

2. Validate What Your Baby is Saying. If your baby throws a bunch of babbles at you, turn your body towards them and listen. Then respond by nodding and repeating whatever you think they were trying to say. Babies want to be “heard” even if you can’t understand a word they’re saying.

3. Act as a Translator. Babies communicate through gestures and facial expressions as well as through words. Teach your baby the words that go along with these other forms of communication. For example, if your baby raises their arms to be picked up, you can say “You’re raising your arms. Do you want me to pick you up?” Or, if your baby gets excited when you give them a food they like, you can say “You look excited to eat. I think bananas are one of your favorite foods.”

4. Sing (Even If You’re Bad At It). Singing is a great way to make language fun. Songs that rhyme and repeat help kids cement words in their minds.

5. Play Games. Children tend to love anything that’s gamified. So, play peek-a-boo and pat-a-cake and talk the entire time.

6. Keep It Light. Although parents are often eager to hear their baby say new words, babies operate on their own schedule and don’t appreciate feeling pressured to say (or do) things before they’re ready. Even though they’re young, babies can sense their parents’ energy in different situations. So be chill and keep things positive and pressure-free.

Common Question: Should I Talk “Baby Talk” to My Baby? 

We’ve all heard parents in the grocery store, on planes, and in toy stores talk to their babies in the somewhat grating sing-song voice of baby talk. We’ve probably all been that parent at one time or another too…gasp!

So, the question remains, does baby talk help or hinder language development?

Although the research is still cooking, the prevailing thought seems to be that “Yes! Babies DO benefit from baby talk.”

But How Can Something So Annoying Be So Beneficial?

Researchers believe that when parents slow the pace of their speech and use an exaggerated intonation, the vowels and consonants sound clearer and are easier to differentiate. In addition, babies are more captivated by a lilting baby talk voice than by an everyday “normal” voice. 

The Exception? Nonsense words do NOT help build a child’s language, so refrain from using them (if you can).

So, the next time you hear another parent (or yourself) engage in baby talk, know that researchers give it the thumbs up (for now).

The Bottom Line

Use the tips above to support your child’s speech and language development.

Celebrities are Just Like Us!

“Having a baby dragged me, kicking
and screaming, from the world
of self-absorption.”

~Paul Reiser 

This Week’s Reminders are the Same as Last Week’s…

  • Serve at Least 1 Iron-Rich Food Per Day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 46 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

As your baby nears their first birthday, it’s time to look for a pediatric dentist (if they haven’t seen one already). Remember, both the American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend that babies see a dentist by 1 year of age (but ideally when their first tooth comes in).1. We’ll talk about what you can expect at the first dental visit below.

Sleep:

12-15 hours is recommended (including naps).

Feeding:

Continue to give your baby solid foods plus breast milk or formula.

As a Reminder, the Hot Topic for This Week Is: The 411 on the First Dental Visit. Get Wise(r) About It Below.

The 411 on the First Dental Visit

The purpose of the first dental visit at (or before) 1 year is to make sure that your baby’s teeth look healthy and are coming in properly. Additional goals include getting your child accustomed to going to the dentist and answering any questions that you may have.

Insider Info: Back in the day, the first dental visit wasn’t until age 3. Most dentists are on board with seeing babies at 1 year of age (or before), but some old-school dentists prefer to wait and see kids when they’re 3 years of age. Find out what your chosen dentist’s policy is when you make your child’s appointment.

What Happens During the First Dental Appointment?

Not much. The dentist will take a look inside your child’s mouth, do a brief cleaning, and maybe paint the teeth with fluoride (if your baby has any teeth). There’s no scraping of the teeth, etc. The first real cleaning probably won’t happen until your child is about 2 years old.

Insider Info:

  • Today’s pediatric dental visits are a lot more fun than the ones YOU probably had as a child. Kids are given goodie bags filled with toys, stickers, and toothbrushes and they often get to wear cool sunglasses during the exam. There are a ton of fancy fluoride flavor options now, too, including birthday cake. I even know of a pediatric dentist who offers manicures during the teeth cleanings. Our kids don’t know how good they have it.
  • Because it’s notoriously hard to get 1-year-olds to open their mouths, dentists have all sorts of tricks up their sleeves to get them to comply. One such trick is to have the child lie face-up on the parent’s thighs with their feet facing the parent and their head hanging off the parent’s knees (like in the pic below). This position gives the dentist a better angle and makes it more likely that the baby will open their mouth.

    PediaTip: Try this at home if you need to look in your child’s mouth OR if they need to take an oral medication.

How Much Fluoride Toothpaste Should I Put On the Toothbrush Again?

The pediatric fluoride guidelines have been a moving target over the years. The current recommendation is to use the following amounts based on your child’s age:

  • For 0-3 Year-Olds: A “smear” of fluoride toothpaste (the size of a grain of rice).
  • For 3-6 Year-Olds: A pea-sized amount.
  • For 6+ Years: An adult-sized amount (i.e. no more than a one-inch strip).

PediaTrivia:

In 2019, the CDC Shared the Results of a Survey That Focused on Toothbrushing Practices in Kids 3-15 Years in the U.S. The Report Showed the Following:

  • 80% of the parents questioned in the survey did NOT brush their child’s teeth before 1 year of age.2
  • 1/3 of the kids brushed their teeth only once a day (rather than the recommended twice a day).
  • Approximately 40% of 3-to-6 year-olds used too much toothpaste.

What’s the Problem With Using Too Much Toothpaste?

Too much fluoride can lead to something called “dental fluorosis” (permanent white streaks and small pits on the child’s teeth). For this reason, you don’t want to overdo it with the fluoride. 

Before you freak out, though, know that it’s okay if your baby swallows a little bit of toothpaste during brushing (which they inevitably will). Just try to put the right-ish amount of toothpaste on the toothbrush to start so they don’t swallow too much. In addition, show your child how to spit out the toothpaste.

Reality Check: Kids don’t usually get the hang of spitting the toothpaste out until about 3 years of age. Still, it doesn’t hurt to show them how to do it early on.

The Bottom Line

Have your child visit the dentist by 1 year (at the latest) and be mindful of how much toothpaste you put on the toothbrush.

“Parenting without a sense of humor is like
being an accountant who sucks at math.”

~Amber Dusick 

This Week’s Reminders are the Same as Last Week’s…

  • Serve at Least 1 Iron-Rich Food Per Day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 45 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

Last week’s PediaGuide focused on Fifth Disease (aka “Slapped Cheek” Disease). In this week’s PediaGuide, we’ll discuss Sixth Disease, better known as Roseola. Roseola is an infection that everyone and their mother has had. Get Wise about it below.

Sleep:

Yup, nothing new here. Your baby still needs 12-15 hours of sleep (total) per day.

Feeding:

Continue to feed your baby solid foods plus breast milk or formula. Whole milk is on the horizon, but not until 1 year of age.

As a Reminder, the Hot Topic for This Week Is: Roseola. Get Wise(r) About It Below.

Roseola (aka Exanthem Subitum or Sixth Disease)

Roseola is a classic childhood illness. It’s most prevalent in kids 6 months-2 years of age and peaks between 6-9 months.

Babies under 6 months of age are usually protected from Roseola because of their Mom’s antibodies (which are passed to them in the womb). Once the antibodies wear off, however, the gloves come off and Roseola does its thing. Luckily, Roseola tends to be a mild and self-limiting disease.

What Causes Roseola? 

Roseola is caused by the virus, human herpesvirus 6 (HHV-6) and occasionally by its cousin, human herpesvirus 7 (aka HHV-7). 

Nearly 100% of people in the U.S. are infected by HHV-6 by age 3, although only a fraction of them (about 20%) develop roseola.1 As you may remember, herpes viruses stay in the human body forever, and can reactivate down the road. HHV-6 and HHV-7 are most likely to reactivate in patients with weakened immune systems.

What are the Symptoms of Roseola?

Roseola starts off with a high fever (that’s often greater than 103°F), a runny nose, and a mild cough. These symptoms are then followed (3-5 days later) by a rash that breaks out all over the body. The rash starts on the torso, then spreads outwards to the legs, arms, back, and face. It looks like small pink dots that are either flat or raised (as in the pics below).

Kids are usually pretty happy-go-lucky with roseola except for when they have the high fever. Sometimes, children will experience a febrile seizure because of their fast-rising temperature, but this is definitely not the norm. Although febrile seizures sound scary and look even scarier, they’re fairly benign and don’t typically cause lasting issues.

Here’s a Common Roseola Scenario: 

A child has a high fever without a clear source for a few days. The fever stresses the child’s parents out and they start to get antsy, wondering what’s causing it. Just when the parents are about to take their child to the doctor’s office, the rash appears. Everyone breathes a sigh of relief because the diagnosis has become clear.

Insider Info: When the rash appears, the patient is no longer contagious and can resume their normal activities (including daycare).

Note: Some parents elect to keep their child home until after the rash has cleared. Why? Because the rash looks kind of freaky and tends to draw sketched-out stares from other parents.

How is Roseola Managed?

Because Roseola is caused by a virus, antibiotics can’t be used to treat it. Instead, it’s managed with supportive care (think: fever reducers, fluids, and rest).

The Bottom Line

Roseola is such a common infection that it’s basically a childhood rite of passage. Even though Roseola produces an elevated temperature and a full body rash, most kids have a relatively mild case of it. If your child develops a high fever, let the doctor know, and be on the lookout for the telltale rash.

“Motherhood means understanding why
Mama Bear’s porridge went cold.”

~Unknown

This Week’s Reminders are the Same as Last Week’s…

  • Serve at Least 1 Iron-Rich Food Per Day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 43 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

Your baby is about to turn 11 months old. At this age, babies are doing a variety of things in terms of gross motor movement. Some early birds are taking their first steps while others are pulling themselves up to stand or cruising around furniture.

If you want to encourage your baby to walk, place objects they’re interested in, just out of reach. Don’t force it, though. Babies are less enthusiastic about walking if they feel pressured to do it.

Important Info: When it comes to walking, toy walkers are OUT because they’re dangerous. Bare feet, on the other hand, are IN (so the baby can feel the floor beneath them).

Sleep:

12-15 total hours per day is what the doctor ordered.

Feeding:

Continue the chunky (Stage 3) solid foods & finger foods in addition to breast milk or formula.

As a Reminder, the Hot Topic for This Week Is: What To Do If Your Baby Goes on a Hunger Strike. Get Wise(r) About It Below.

My Baby Has Gone on a Hunger Strike and I’m at My Wit’s End. What Should I Do?

Ah, let the games begin! Babies and toddlers can be finicky when it comes to eating. When kids refuse to eat, they may not be hungry OR they may be trying to get a big reaction out of their parents.

Here are 5 Tips to Help You Navigate the Food Refusal Waters:

1. Follow Ellyn Satter’s “Division of Responsibility Plan”: Ellyn Satter is a legend in the world of pediatric nutrition and has written several books on the topic. She believes parents and children have separate “jobs” when it comes to food. The parent’s job is to prepare nutritious meals and to offer them at regularly scheduled times. The child’s job is to decide which foods to eat and how much of them to consume.

Translation: Parents should stay in their lane at mealtimes and should NOT force their kiddos to eat.

2. Play it Cool: Babies can sense when their parents are stressed about their eating. Follow Ellyn Satter’s advice and try not to freak out (even internally) if your child pushes their plate away or rejects a particular food. Let it be and try again the next meal. And remember, it can take kids a whopping 10-15 tries to like a new food. 

3. Don’t Be a Short-Order Cook: Avoid falling into the trap of becoming a short-order cook and whipping up another meal just to please your child.

Why? Because this a habit that you do NOT want to get into. 

That being said, it’s important to serve at least 1 option that your child likes. For example, offer 1 new food, 1 known favorite, and a smattering of in-between options. 

4. Pay Attention to Patterns: Kids typically get the calories they need even if they graze throughout the day or skip a few meals. Therefore, evaluate your baby’s food intake over a week-long period rather than over the course of a day.

5. If the Pattern Continues, Let the Doctor Know: If food refusal becomes a habit over several weeks and you’re worried about your child’s weight, schedule an appointment with the pediatrician. At the visit, the doctor will probably do a “weight check” and look for medical reasons behind the food refusal.

PediaTip: You may also want to take a quick look in your baby’s mouth to see if there’s anything that could be causing them to be less interested in eating (such as mouth ulcers or new teeth coming in).

A Word About the Bottle & the Breast:

It’s not uncommon for babies to start weaning themselves off breast milk or formula before 1 year of age. This can be frustrating for parents because it’s too soon to start whole milk (even if you kind of want to).

Tips to Get Around This Problem Include:

1. Give Your Baby Pumped Breast Milk In a Bottle If They No Longer Want to Nurse.

2. Offer the Breast Milk or Formula in a Sippy Cup.

Why? Just in case your child is rejecting the container the milk is in (vs. the milk itself). 

3. Continue to Offer the Breast or Bottle at Regular Intervals to See If the Refusal Was Just a Phase. Rome wasn’t built (or, in this case, rebuilt) in a day.

4. Make Sure Your Baby is Hungry When You Offer Them the Breast or the Bottle (i.e. don’t let them fill up on solid foods beforehand).

5. Mix Pureed Food with Breast Milk or Formula to Remind Your Baby of the Milk Flavors They Used to Love.

A Word of Caution: This trick can backfire if your baby figures out what you’re doing.

Bonus Tip: If all else fails, make an appointment with the doctor so the two of you can come up with a plan. In addition, resist the temptation to give whole milk prematurely (before 1 year of age).

Why? Because whole milk lacks several important nutrients that infants need and the early introduction of whole milk can cause babies to develop iron-deficiency anemia (a low number of healthy red blood cells in the body due to low iron levels). Moreover, the GI tracts and kidneys of babies under 1 year aren’t mature enough to handle the cow’s milk.  

The Bottom Line

Most children become a bit more headstrong as they get older. They crave control and power plays become a thing. Offer your child an array of foods at set times throughout the day but let them decide which foods to consume and how much of them to eat. This approach will teach your child to naturally regulate their food intake by listening to their internal hunger and fullness cues.

“You know you’re a mom when you wish
there was a drive thru for EVERYTHING.”

~Anonymous

This Week’s Reminders are the Same as Last Week’s…

  • Serve at Least 1 Iron-Rich Food Per Day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 42 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

Laughing, crawling, pulling to stand, cruising, babbling and calling the dog or cat “Mama” or “Dada” may be part of your baby’s repertoire now. Enjoy this time. Your little one has come a long way!

Sleep:

Your baby has hopefully settled into a predictable pattern of 2 naps a day and is sleeping through the night. If this isn’t the case, let the doctor know and refer back to our Sleep Training Primer.

Feeding:

Your baby is probably showing off their pincer grasp by picking up table foods that have been cut into small pieces. Continue the solid foods plus breast milk or formula. It’s okay to give your baby water with meals, too. That being said, you don’t want your baby to fill up on water (which has no calories), especially if they’re lagging behind on the growth chart.

As a Reminder, the Hot Topic for This Week Is: Tips for Surviving the Parenting Circus. Get Wise(r) About These Tips Below.

Tips for Surviving the Parenting Circus

As a parent, you may feel like you’re being pulled in a million different directions. You may also feel like you’re failing in all areas of life. Both working and stay-at-home parents often talk about the search for “balance.” Unfortunately, the idea of balance may be a mirage, as I have yet to find a parent who says they’ve mastered it. If you have, email us and tell us how you did it!

Here are Some Tips For “Balancing” It All:

1. Forget About Balance. The idea of balance suggests that everything is in perfect harmony and that you’re at peace. Parents who’ve been suddenly vomited on by their baby as they tried to get out the door know that “balance” is hard to come by, and that peace and parenting often mix like oil and water. 

Instead of fixating on balance, decide how you want to divide up your energy based on what’s important to you. Do you want to raise an empathetic child? Make homemade baby food? Spend more time in nature with your family? Get a promotion at work? Pick 3-4 priorities and try to stick with them. Reevaluate them as you go, since parenting is always changing. 

2. Avoid the Comparison Trap. It’s human nature to see another parent do something spectacular and feel like you’re falling short by comparison. 

The comparison game is one we’ll always lose, though, because we can always find someone who’s doing something “better” and cooler than we are. Stick to what matters most to YOU and be proud of yourself for making those things a priority.

3. Know When You Need a Break. Parents tend to go hard until they burn out and have a meltdown. We’ve all been there. When you start feeling impatient, irritable, or overwhelmed, remind yourself that these are signs that you need a break (not that you’re a flawed human being).

4. Delegate. Parents often want to do it all because they think they can do it best. Delegate the things you care less about so that you can focus on the few things you care deeply about.

5. Put Down the “Busy Badge” of Honor and Opt for a Participation Award Instead. Being “busy” has become a status symbol in our society — so much so that many of us become anxious when we have a rare unscheduled moment to ourselves. Opt out of the “busy” game or, if you like being busy, own it and try to be at peace with moving at a faster pace.

The Bottom Line

Take a moment to determine what matters most to you and let your TOP priorities be your guide. This will allow you to cut through the “noise” and simplify your life as a parent.

“I’d love to be a Pinterest mom.
But it turns out I’m more of an
Amazon Prime mom.”

~Anonymous 

This Week’s Reminders are the Same as Last Week’s…

  • Serve at Least 1 Iron-Rich Food Per Day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 40 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

You’re now about 2 months away from your child’s first birthday and their 1-year checkup. Although breast milk and/or formula remain a key part of your baby’s diet, solid foods are starting to move up in the ranks. By the 1-year mark, solid foods will take over as your child’s main source of nutrition. The whole milk that they start at this point will be relegated to a beverage and limited to 16-24 ounces per day.

Sleep:

Your child is still (hopefully) crushing 12-15 hours of sleep per day (including naps).

Feeding:

Continue the breast milk or formula plus solid foods (in the form of chunky Stage 3 purees or table foods that have been cut up into tiny pieces). 

As a Reminder, the Hot Topic For This Week Is: Babies & Screen Time. Get Wise(r) About It Below.

When Can My Baby Start Watching TV?

Babies are often mesmerized by the lights given off by TV screens, computer screens, and smartphone screens. If you’ve ever seen your baby stare wide-eyed at one of these screens, you may be wondering when they can start watching TV or when you can start showing them cute videos on your phone.

Here’s What the American Academy of Pediatrics (the AAP) Says About Screen Time in Babies and Young Children:

The AAP discourages the use of screens in children under 18 months.1 

Exception:

The AAP gives video-chatting the thumbs-up because it’s a good way for kids to connect with long-distance relatives and family friends.

Sneak Peek: 

  • For Children 18-24 Months of Age: The AAP says kids in this age group can get “limited” amounts of screen time, but parents should choose high-quality programs (like PBS Kids) and view them with their child.

    Reality Check: Despite the AAP’s recommendation, 90% of children under 2 years watch some form of electronic media.2 
  • For Children 2-5 Years: The AAP advises limiting screen time to 1 hour or less per day and choosing legit programs. Again, it’s best if you watch the programs with your child so you can monitor the content and make the experience more interactive. 

The Bottom Line

Although it can be super tempting to flip on the TV when you need a break and are looking for a way to entertain your baby, do your best to avoid introducing screen time until your child is at least 18 months of age. If you need a moment to yourself, stick your baby in a confined space (such as a playpen) with a bunch of toys and baby board books.

“A baby changes your dinner party
conversation from politics to poops.”

~Maurice Johnston

This Week’s Reminders are the Same as Last Week’s…

  • Serve at Least 1 Iron-Rich Food Per Day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 39 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

As your baby nears the 10-month mark, their personality will continue to take shape. Observe how your little one responds to different situations but avoid labeling them as one type of person or another. Over time, new personality traits will appear, while others will fade.

Sleep:

Your baby still needs 12-15 hours of sleep per day, including naps.

Feeding:

Keep offering your baby breast milk or formula plus solid foods. Hold off on whole milk until 1 year of age.

As a Reminder, the Hot Topic for This Week Is: Meningitis. Get Wise(r) About It Below.

Disease Spotlight: Meningitis

You may have heard about meningitis in the context of college dorm rooms. Luckily, meningitis isn’t all that common in children (or in general). Still, it doesn’t hurt to know the classic signs of meningitis, just in case.

What is Meningitis Anyway?

Meningitis means there’s inflammation of the tissues (the meninges) surrounding the brain and spinal cord.

Who Gets Meningitis?

Meningitis can occur in anyone, but it’s most prevalent in children under 5, college students, and people with weakened immune systems.

What Causes Meningitis?

Answer: Viruses, bacteria, and (in rare cases) fungi.

  • Viruses are the No. 1 cause of meningitis.
  • Although bacterial meningitis is less common than viral meningitis, it tends to produce more severe symptoms.

Bacteria Infamous for Causing Meningitis Include:

  • Group B streptococcus (GBS): As you may remember, pregnant women are tested for this bacterium (with vaginal and rectal swabs) between 35-37 weeks of pregnancy. GBS meningitis is mostly seen in babies.
  • Streptococcus pneumoniae: This bacterium is also known to cause sinus infections, ear infections, and pneumonia.
  • Hib (haemophilus influenzae B).
  • Neisseria meningitidis. Meningitis due to Neisseria meningitidis is most prevalent in teens.

Some Good News: Over the years, there’s been a sharp decline in the number of meningitis cases caused by the bacteria mentioned above. Why? Because pregnant women are now tested for Group B strep and there are vaccines that protect kids against Streptococcus pneumoniae, Hib, and Neisseria meningitidis. 

What are the Symptoms of Meningitis?

The Symptoms of Both Bacterial and Viral Meningitis Include:

  • A High Fever.
  • A Headache.
  • Blurry Vision.
  • Nausea & Vomiting.
  • A Bulging Anterior Fontanelle (the soft spot on the top of the head) in infants and young toddlers. As you may remember, the anterior fontanelle closes around 2 years of age.
  • Increased Fussiness.
  • Sensitivity to Light.
  • A Stiff Neck.

    Note: If your child can comfortably look up at the ceiling and back down at the floor, they probably don’t have meningitis. This can be difficult to assess in babies, however. And because nothing is ever 100% certain, always check with the pediatrician if your child exhibits any of the symptoms of meningitis discussed above (with or without neck stiffness).

Insider Info: Doctors Will Often Use the Following 2 Maneuvers (the Kernig and Brudzinski Signs) to Help Them Determine If a Child (Over 6 Months) Has Neck Stiffness:

Disclaimer: There’s conflicting info about how useful these maneuvers are in the diagnosis of meningitis, but many docs do them anyway.

Kernig’s Sign: During the Kernig’s test, the doctor first bends the patient’s leg at a 90-degree angle at the knee. Then, they fully extend the patient’s leg upward (so the bottom of the foot points towards the ceiling). The Kernig’s Sign is positive (aka suspicious for meningitis) if the patient resists the extension of the leg or cries out during the maneuver (due to pain).

Brudzinski’s Sign: To perform the Brudzinski’s test, the doctor flexes the patient’s neck (i.e. bends it to the chest). If the patient involuntarily bends their knees and hips when the neck is flexed, the Brudzinski’s Sign is positive for meningeal irritation.

Bonus Symptom: Bacterial Meningitis May Also Produce a Telltale Rash.

The rash of bacterial meningitis (which is often seen in advanced cases) is characterized by petechiae (little purple dots) and/or purpura (large purple lesions).

Here’s an Example of a Petechial Rash (See the Tiny Purple Dots?):

Making the Meningitis Diagnosis

If the doctor suspects meningitis based on the child’s symptoms and physical exam, they’ll order a lumbar puncture (aka a spinal tap) to confirm the diagnosis.

Tell Me More About Lumbar Punctures:

A lumbar puncture isn’t a fun test to get, but it provides doctors with a lot of information. During this procedure, the doctor inserts a needle into the child’s back (into the space between their vertebrae – the bones making up their spine). The doctor then extracts a sample of spinal fluid to be sent to the lab for testing. After the procedure, there may be pain and soreness at the injection site and some minimal bleeding.

Wait, Won’t the Needle Injure the Spinal Cord? 

No – it shouldn’t. Doctors are trained to go below the spinal cord to avoid poking it with a needle.

How is Meningitis Treated?

The Short Answer: It depends on what’s causing it.

The Longer Answer:

  • Bacterial meningitis is a medical emergency. Children with bacterial meningitis need to be treated in the hospital with IV antibiotics.
  • Viral meningitis, on the other hand, cannot be treated with antibiotics and is managed with “supportive care” (keeping the patient hydrated and comfortable) either at home or in the hospital (depending on the severity of the case).

The Bottom Line

Kids with meningitis look sick, especially those with bacterial meningitis. If your child has a high fever, is super fussy, seems sensitive to light, or appears to have a stiff neck, call the doctor or go straight to the ER.

“Enjoy the little things,
for one day you may look back and realize
they were the big things.”

~Robert Brault

This Week’s Reminders are the Same as Last Week’s…

  • Serve at Least 1 Iron-Rich Food Per Day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 38 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

At this stage in your baby’s development, they may be able to pull themselves up to a stand with the help of a coffee table, a sofa, or a chair. In addition, your child may start to “cruise” (i.e. walk around while holding on furniture).

If this isn’t happening yet, don’t worry. As long as your baby is showing signs of progress in the motor skills department, that’s reassuring. If you have any concerns, though, don’t hesitate to bring them up to your baby’s doctor. 

Sleep:

The American Academy of Pediatrics (the AAP) continues to recommend a total of 12-15 hours per day (including naps).

Feeding:

Keep up the solid foods plus breast milk or formula. Remember, whole milk should not be introduced until your baby is 1-year-old.

Why’s That Again? Because research shows that babies who receive whole milk before 1 year are prone to iron deficiency anemia (a low number of healthy red blood cells in the body due to low iron levels).  

In addition, the GI tracts and kidneys of infants aren’t mature enough to handle the cow’s milk. Moreover, the milk, itself, lacks several important nutrients that babies under 1 year need.

Rashes and other skin findings are common in babies and older kids. Most skin problems are benign and can be easily treated, while others (like eczema) are harder to get rid of. This week we’ll Get Wise (Again) about Eczema, and take a look at Impetigo and Cellulitis, two bacterial skin infections. In addition, we’ll say a quick word about MRSA Infections and everyone’s least favorite topic, Flesh-Eating Bacteria.

Jeez, Why Go There? Because flesh-eating bacteria is a topic that you may hear about in the news. Plus, the disease caused by flesh-eating bacteria progresses quickly, so it helps to know what signs to look out for. But, don’t worry, it’s rare and isn’t worth wasting too much mental energy on.

Get Wise(r) About All of These Topics Below…

Eczema

Eczema, as you may remember, is a chronic inflammatory skin condition that’s commonly seen in children (and in some adults as well). It’s characterized by dry, itchy and scaly red patches on the skin. These patches tend to congregate on “flexor surfaces” (such as the back of the knees and the inside of the arms).

Eczema runs in families and can be a pain to manage. Fortunately, most kids outgrow it.  

Get Wise about Eczema and its Management here.

Impetigo

Impetigo is a superficial skin infection that’s typically caused by one of two bacteria – Staphylococcus aureus or Group A Strep.

What Does Impetigo Look Like?

Impetigo initially causes red bumps on the face, arms, or legs. These bumps turn into blisters, then rupture, and scab over. The scabs form a yellow crust and are often described as “honey-crusted.”  If you’re not particularly squeamish check out this pic of an intense case of impetigo.

Who Gets Impetigo? Is It Contagious?

Impetigo tends to occur in warm and humid conditions. It’s primarily seen in kids ages 2-5 years but can affect children of all ages. Impetigo is contagious and can be passed between people in close contact (e.g. in families, daycares, and schools).

Can Impetigo Be Treated?

Yes. If your child develops impetigo, their pediatrician can prescribe a topical antibiotic (e.g. Mupirocin, aka Bactroban) to rub on the affected skin. If the lesions don’t get better or if your child has a bad case of impetigo, they may need oral antibiotics.

Cellulitis

Cellulitis is a skin infection caused by various bacteria (i.e. different types of staphylococcus and streptococcus)

The most common culprit is Group A Streptococcus (Fancy Name: Streptococcus Pyogenes).

PediaTrivia:

Group A Streptococcus, affectionately known as GAS, is the same bacterium that causes strep throat.

How Does Cellulitis Develop? 

Cellulitis typically starts off innocently with a small break in the skin (such as a cut or an insect bite), that often goes unnoticed. Bacteria then slip through this breech in the skin, causing an infection. 

What Does Cellulitis Look Like?

In cellulitis, the infected skin (surrounding the cut or bug bite) becomes red, warm, swollen, and tender to the touch.

In the pic below, we see redness and swelling of the hand.

And in this pic we see a poorly-defined patch of redness on the leg. (This infection started off as a mosquito bite.)

Cellulitis can spread across the affected body part fairly quickly. Therefore, caregivers need to be on their toes and call the doctor if the redness starts to expand. 

PediaTip: If your child has cellulitis and you notice that the red area is enlarging, outline the redness with a pen. This is what doctors do in the clinic and in the hospital.

Why? Because it’s easier to “show” the doctor how the redness has spread, than it is to describe it or measure it with a ruler.

How is Cellulitis Treated?

  • Oral antibiotics are the treatment of choice for mild to moderate cases of cellulitis. More severe cases require IV antibiotics.
  • At times, an abscess will form at the site of the infection. An abscess is a collection of pus beneath the skin’s surface. Because antibiotics aren’t always able to penetrate the walls of an abscess, some abscesses need to be surgically drained at a hospital. Children are awake for the procedure and, if squirmy, may be given an anti-anxiety medication to take the edge off.

Rare Complications of Cellulitis Include Sepsis and Necrotizing fasciitis (Flesh-Eating Disease). Get Wise(r) About These Conditions Below.

Sepsis

In rare cases, the bacteria responsible for the cellulitis make their way into the child’s bloodstream, causing a blood infection called “sepsis.” This is an unlikely complication of cellulitis but it’s something to be on the lookout for if your child has cellulitis and then spikes a fever. The bloodstream infection can be treated with antibiotics, but the antibiotics need to be given through an IV in the hospital. 

Flesh-Eating Disease (Fancy Name: Necrotizing Fasciitis)

I don’t even like to bring up the topic of flesh-eating disease because the name alone sends shivers down everyone’s spines. It’s worth mentioning, however, because it’s a subject that you may hear about in the news, every now and then.

What the Heck is Flesh-Eating Disease? Flesh-eating disease is the hair-raising non-medical term for a nasty condition called necrotizing fasciitis. Necrotizing fasciitis is essentially cellulitis on steroids. Not only do the bacteria attack the skin in necrotizing fasciitis, but they attack the tissues below the skin as well.

One of the telltale initial signs of necrotizing fasciitis is “pain out of proportion to the skin findings” (i.e. the patient seems to be in a lot of pain even though the cellulitis doesn’t look all that bad at first). Other signs include the rapid development of red streaks, blisters, and ulcers on the skin. Areas of dead skin may turn black (ugh!). The patient may also develop a fever, chills, dizziness, weakness, and confusion.

Flesh-eating bacteria are the bacteria that cause necrotizing fasciitis. There isn’t one bacterium that causes this condition. Vibrio vulnificus, a bacterium found in saltwater, brackish water, and seafood is often described as THE flesh-eating bacterium. It’s pretty rare, though, despite the publicity that it garners. Group A Streptococcus (GAS), a more common bacteria, is actually thought to be the No. 1 cause of necrotizing fasciitis.1

Before you start stressing out about flesh-eating disease, know that it’s super rare and isn’t something that you or your child are likely to experience. If you want to learn more about the symptoms of flesh-eating disease and its management, Get Wise(r) about it here.

A Word About MRSA

As mentioned above, different types of staphylococcus bacteria can cause cellulitis. Not all staph is created equal, however. The type of staph that docs worry most about is MRSA. MRSA stands for methicillin-resistant Staphylococcus aureus. You may have heard about MRSA in the context of boys’ locker rooms (particularly locker rooms where football players and wrestlers hang out).

  • MRSA is a worrisome bacterium because it’s resistant to commonly used antibiotics, like methicillin. Bigger-gun antibiotics are therefore needed to treat it.
  • MRSA lives on the skin and in the noses of some people, waiting for its moment to slip into a cut or a scrape, and cause an infection.
  • Some families have multiple members who are “colonized” by MRSA and who are, therefore, prone to recurrent MRSA infections. This can be a real pain in the you-know-what. If your family is known to be colonized by MRSA, there are steps that you can take to take to get rid of it once and for all. Get Wise about these steps here.

The Bottom Line

Skin rashes and skin infections are common in kids and are usually not a big deal. Eczema can be stubborn to manage but many children outgrow it by 4-5 years of age. Impetigo can usually be treated with topical antibiotics, but tough cases require oral antibiotics. Cellulitis often resolves with oral antibiotics, but severe cases call for IV antibiotics. Call the doctor if you’re concerned that your child has a skin infection or if they struggle with hard-to-control eczema.

And…Breathe

“No animal is so inexhaustible as
an excited infant.”

 ~Amy Leslie

This Week’s Reminders are the Same as Last Week’s…

  • Serve at Least 1 Iron-Rich Food Per Day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 31 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

Your little one is almost 8 months old. At this stage, babies are curious explorers seeking adventure. This may take the form of commando crawling to the nearest electrical outlet or scanning the carpet for nearly microscopic pieces of lint to put in their mouths. Whatever your baby’s style is, they’re no longer a sedentary lump on a log, which, unfortunately, means that you can’t be one either. 

Get Wise (Again) about babyproofing for this age group.

Sleep:

Your baby sleeps 12-15 hours per day, including naps.

Feeding:

Continue to give your baby breast milk or formula plus pureed solids.

As a Reminder, the Hot Topic for This Week Is: Developmental Delays & How to Manage Them. Get Wise(r) About This Topic Below…

Developmental Delays

Most parents (especially first-time parents) wonder, at some point, whether their child is developing “normally.” It’s human nature to check out other kids’ development at the park, at the grocery store, and on the street for comparison’s sake. The problem with this is that you don’t know the exact age of the child you’re eyeballing. In addition, you don’t know their history or the full picture of how they’re developing.

You may also find yourself comparing your child’s development to that of an older sibling or to a friend’s kid (whose age you do know). Again, this can be risky business because every child is different and parents often forget when their older child reached their developmental milestones. Moreover, other parents (even those who are friends) tend to exaggerate their kids’ abilities.

The Bottom Line: There’s a fairly wide range of “normal” when it comes to development.

Below, We’ll Discuss:

How Doctors Identify Developmental Delays:

At every checkup, the pediatrician will examine your child and ask you a bunch of questions to make sure your little one’s development is on track.

Doctors Look for Growth in the Following 6 Areas:

1. Gross Motor Skills: These are skills that require large muscle groups to work together (think: crawling).

2. Fine Motor Skills: Fine motor skills require small muscle groups to work together (for example, holding a spoon).

3. Oral Motor Skills: Oral motor skills require children to move their mouths and tongue muscles together. Examples include swallowing and expressive language (making sounds & talking).

4. Receptive Language: This is the ability to understand language (i.e. to follow commands).

5. Social-Emotional Skills: These are skills that enable a child to interact with the world around them.

Think: Smiling in response to another person’s smile – aka the “social smile”.

6. Cognitive/Intellectual Ability: This refers to how well a child understands what’s going on around them. An example of cognitive ability is “object permanence” – the understanding that an object still exists even when it’s hidden from view.

As kids get older, school performance and teacher feedback become important markers for how a child is doing developmentally.

Get Wise About the Developmental Milestones for the First Three Years of Life.

PediaTip: When it comes to developmental milestones, remember that doctors look for forward progress and don’t expect kids to hit every milestone at exactly the “right” time. 

A Word About Walking:

Doctors usually take notice when a child isn’t walking by 15-months of age, but will often wait until they’re 18 months before intervening.

A Word About Talking:

Three Red Flags That Suggest a Speech Delay Include (But Aren’t Limited To):

1. No babbling, pointing, or gesturing by 1 year of age. (Doctors hope for 1 word plus “Mama” and “Dada” at 12 months).

2. No words by 15 months of age.

3. Not being able to follow simple (one-step) commands by 18 months.

Get Wise(r) About Speech Delays here.

PediaTip – Trust Your Gut: If you’re concerned that your child has a developmental delay, let their doctor know. It can be hard for doctors to pick up on subtle delays during a short visit. You, on the other hand, see your child day in and day out and know them best. If you want to do a deep dive into your concerns, schedule a separate visit with the pediatrician to discuss them in more detail (vs. tacking them onto the end of a routine checkup).

What are the Next Steps If a Developmental Delay Is Suspected?

  • If the developmental delay seems mild (i.e. just outside the realm of normal) and it’s the only delay found, your child’s doctor may choose to take a “watch and wait” approach to see if your baby “catches up.” 
  • If the delay seems moderate to severe or there are global delays (delays in multiple areas), the pediatrician will refer your child to one or more developmental specialists (such as a speech-language pathologist, a physical therapist, or an occupational therapist). Note: Doctors tend to get more amped up about global delays (vs. single, isolated delays).
  • Insider Info: If the doctor is concerned about a language delay, they’ll order a hearing test, too.

    Why? Because a child needs to hear well for their receptive and expressive language to develop properly.

    Note: I typically provide a referral to a speech-language pathologist along with the referral for the hearing test.

    Why Both? Because even if the hearing screen is abnormal and we’ve identified the cause of the speech delay, speech therapy is still needed. 

Tell Me More About the Different Types of Developmental Specialists:

  • “Developmental-Behavioral Pediatricians”: As the name implies, “developmental-behavioral pediatricians” specialize in pediatric developmental and behavioral issues. They do a super in-depth developmental evaluation to see if a delay exists. If one (or more) does, they direct the child to the appropriate specialists.  
  • Physical Therapists, Occupational Therapists, and Speech-Language Pathologists work directly with children with developmental delays.

    Physical therapists primarily focus on strength & getting the body to move properly, whereas occupational therapists assist kids with their “activities of daily living” (such as dressing and feeding themselves). 

    Speech-language pathologists, on the other hand, help children with speech delays and/or feeding issues.

    Physical therapists, occupational therapists, and speech-language pathologists work in private settings AND through Early Childhood Intervention Programs.

What are Early Childhood Intervention Programs?

Early Childhood Intervention Programs help kids under age 3 with developmental delays. They’re great because they’re funded by the government (read: free) and the specialists will usually come to the child’s home. 

To Find an Early Childhood Intervention Program Near You, You Can Either:

  • Call your child’s doctor and ask them for the number.
  • Check out the CDC’s list of Early Intervention Programs in the U.S. (and their contact info).
  • Google your ZIP Code and the term “Early Childhood Intervention.” 

Insider Info: Easterseals is an early childhood intervention program that has child development centers nationwide.

Think: High quality daycare and education for children with developmental delays (who are 6 weeks to 6 years of age). If interested, go to the Easterseals website or call 1-800-221-6827. 

PediaTips:

  • If the pediatrician refers your child to a developmental-behavioral pediatrician, make an appointment ASAP.

    Why? Because developmental-behavioral pediatricians tend to be popular people with booked schedules. If there’s a long waitlist, ask the doctor for names of other developmental-behavioral specialists in the area. If there aren’t any, see if the pediatrician can pull some strings to get your child an earlier appointment. 
  • If the pediatrician recommends that your child see both a developmental-behavioral pediatrician and a developmental therapist (such as a speech therapist, a physical therapist, or an occupational therapist), don’t postpone your appointment with the developmental therapist while you wait for your appointment with the developmental-behavioral pediatrician. Call the Early Intervention Program or a private developmental therapist right away.

    Why? Because you don’t need an exact diagnosis to start therapy and the early intervention specialist can evaluate your child and start working on the areas of concern. Early intervention is the most important thing you can do to help your child reach their developmental milestones.

    Why’s That? Because children’s brains are super plastic (i.e. they have a large capacity for growth and change).
  • If your child has multiple delays (i.e. global delays), you may want them to see a private speech therapist, physical therapist, or occupational therapist in addition to an Early Childhood Intervention therapist.

    Why? To maximize your child’s services and to help them reach their developmental potential. If the cost is prohibitive, though, don’t worry about it. Just ask the Early Intervention Program specialist to provide you with exercises to do with your child at home.

The Bottom Line

Most kids fall within the normal range when it comes to development. That being said, your child’s pediatrician will be on the lookout for developmental delays at every checkup. Avoid comparing your child to other kids and speak up if you have any concerns. If a delay is suspected, contact the Early Childhood Program (or a private therapist) right away even if the diagnosis isn’t 100% clear.

“We can’t all look good at the same time.
It’s either me, the kids, or the house.
The struggle is real.”

~Unknown

This Week’s Reminders are the Same as Last Week’s…

  • For the Solid-Foodies: Serve at least 1 iron-rich food per day. Examples include baby cereal, pureed spinach, and pureed broccoli.
  • For Breastfeeding Mamas and Those Giving Less Than 32 Ounces of Formula Per Day. Continue to give your baby their daily dose of vitamin D (400 international units per day) even if they’re eating solid foods that contain vitamin D.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).

And…That’s a Wrap!

Welcome to Week 23 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All, Below…

The 6-month-visit and the introduction of solid foods (if they haven’t been started already) are just around the corner.  

Sleep:

Your baby is still crushing 12-15 hours of sleep per day, including naps. Hopefully, sleeping through the night has become a “thing” in your household. If not, don’t despair, many babies have FOMO at this age and like to fight sleep. 

If You Need a Sleep Training Refresher, Go Here.

Feeding:

Continue to feed your baby breast milk and/or formula. And remember to avoid giving your baby water until they’re at least 6-months-old. Both breast milk and formula have a ton of water in them, so you don’t have to worry about your baby getting dehydrated.

As a Reminder, the Hot Topics for This Week Are:

Get Wise(r) About These Topics Below…

The 6-Month Vaccines

The 6-month vaccines are basically a repeat of the 2- and 4-month vaccines except for a couple of minor changes. These changes include:

1. The Flu Shot: The biggest new development at the 6-month visit is that your baby becomes eligible for the flu shot during flu season. You, your partner, your baby’s siblings, and additional caregivers should get the flu shot as well, for extra protection. 

Insider Info: Children 8 years & under who get the flu vaccine for the first time, need a flu “booster” 4 weeks later (but no sooner than 28 days later).

Get Wise(r) about the flu vaccine here.

Note: Your baby can also get the COVID-19 vaccine, for the first time, at 6-months.

2. Kicking the Rotavirus Vaccine to the Curb (For Some): 

As you may recall, there are 2 forms of the oral Rotavirus vaccine: Rotarix and RotaTeq. 

  • Only 2 doses of Rotarix are required to complete the vaccine series, whereas 3 doses of RotaTeq are needed.
  • Therefore, babies who received Rotarix at the 2-month and 4-month visits have completed their Rotavirus vaccine requirement and don’t need another dose of Rotarix at the 6-month visit.
  • However, babies who have been getting RotaTeq need a 3rd (and final) dose of this vaccine at the 6-month visit.

Here’s a List of the Routine 6-Month Vaccines:

  • The Diphtheria, Tetanus, and Pertussis (DTaP) Vaccine.
  • The “Inactivated” Polio Vaccine (aka the IPV Vaccine).
  • The Hepatitis B Vaccine.
  • The Haemophilus influenzae type B (Hib) Vaccine (as long as the doctor isn’t using a version of the vaccine – like PedvaxHIB – which requires only 2 doses).
  • The Prevnar-13 (Pneumococcal) Vaccine.
  • RotaTeq (the 3rd dose).
  • The Flu & COVID-19 Shots (if it’s cold & flu season).

Common Vaccine Combos Given at the 6-Month Visit Include:

1. Pediarix + Prevnar-13 + Hib + Rotateq (3rd dose) + the Flu & COVID-19 Shots

Note: If your baby has been receiving the combo vaccine, Pediarix, then this will be their 4th dose of the Hepatitis B vaccine. It’s OK for them to get this extra 4th dose.

2. Pentacel + Prevnar-13 + Hepatitis B (3rd dose) + Rotateq (3rd dose) + the Flu & COVID-19 Shots

Get Wise (Again) about what the different vaccines protect against.

A Word About Ibuprofen (e.g. Motrin and Advil)

When your baby reaches 6-months of age, you can add ibuprofen (e.g. Motrin and Advil) to your fever-reducer arsenal.

This means that if your baby spikes a fever after receiving their 6-month vaccines, you can give them Tylenol OR ibuprofen to manage it. Here are the links to the Tylenol and ibuprofen dosing charts (if you need them).

When giving your baby ibuprofen, make sure to note the concentration on the bottle. The “infant drops” have a concentration of 50mg/1.25mL, whereas “children’s ibuprofen” has a concentration of 100mg/5mL. Mixing up the two could cause an overdose, so make sure that you have the correct concentration when you’re looking at the dosing chart and administering the medication.

Insider Info: Infant Tylenol and Children’s Tylenol have the same concentration, so you don’t have to worry about this issue with Tylenol.

The Bottom Line

The 6-month vaccines are nearly identical to the 2-month and 4-month vaccines except for some minor variations (including the addition of the flu/COVID-19 shots). As with prior checkups, vital signs will be taken at the 6-month visit, a physical exam will be done, questions will be asked, and your baby’s developmental milestones will be evaluated. We’ll talk more about the 6-month developmental milestones in next week’s PediaGuide.

“Being a [parent] is learning about strengths
you didn’t know you had and dealing with
fears you didn’t know existed.”

~Linda Wooten 

The Reminders for This Week are the Same as Last Week’s (With an Additional Reminder to Book Your Baby’s 6-Month Checkup).

  • Make Sure to Get Your Baby’s 6-Month Checkup on the Calendar (If You Haven’t Already).
  • Remember to Give Your Baby a Daily Vitamin D Supplement (That Contains 400 International Units Per Day) If You’re (Exclusively) Breastfeeding OR If They’re Taking Less Than 32 Ounces of Formula Per Day.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • For Formula-Feeding Parents: Make sure you’re mixing the formula correctly and that it has iron in it (which it probably does). Get Wise about How to Mix Formula.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Don’t Give Water to Babies Under 6 Months of Age (Except For What’s in the Formula, If Your Baby is Taking Formula).

    Why? Because extra water can lead to electrolyte abnormalities (such as low sodium levels), which can, in turn, lead to seizures. 
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).
  • Don’t Give Ibuprofen to Babies Under 6 Months of Age. Aspirin Is Off Limits For Kids Under 18 Years (Unless It’s Prescribed by the Child’s Doctor).

And…That’s a Wrap!

Welcome to Week 22 of Parenting Your Baby!

In This Week’s PediaGuide, We’ll Discuss:

Get Wise About It All Below…

Your baby is developing their own personality. You may see glimpses of it in their coos, smiles, facial expressions, and shrieks of laughter. As time goes on, new traits will emerge while others may fade into the background.

Reality Check: If you have a “fussy baby” with colic or reflux, and you’re worried they’ll turn out to be a major whiner or an unhappy kid, don’t despair. Once they outgrow the colic or reflux, you’ll get a better sense of their true personality.

Sleep Recommendation (on Repeat):

12-15 hours per day, including naps.

Feeding: 

Continue to give your baby breast milk and/or formula. If you’re twiddling your thumbs waiting to start solid foods at 6 months, Get Wise (Again) about how to introduce them.

As a Reminder, the Hot Topic for This Week Is: Food Allergies in Babies. Get Wise(r) About Them, Below.

Food Allergies in Babies

When parents first offer solid foods to their babies, they often worry about food allergies, especially if there’s a family history of one. 

Doctors have this in the back of their minds as well, which is why they typically recommend introducing single-ingredient foods, one at a time, to start. This makes it easier to pinpoint the food responsible for the allergic reaction, if one occurs.

The Stats:

  • Nearly 8% of children in the U.S. develop a food allergy.1
  • Most food allergies surface during the first two years of life. 
  • Common “allergenic foods” include:
    • Milk
    • Eggs
    • Peanuts (note: peanuts are technically legumes, not nuts)
    • Tree Nuts (such as walnuts, almonds, and pecans)
    • Soy
    • Wheat (note: a wheat allergy is different from the “gluten sensitivity” we see in celiac disease)
    • Fish
    • Shellfish (such as shrimp, lobster, crab, and oysters)
    • Sesame (like the sesame seeds on a hamburger bun)
  • Allergies That Typically Persist Into Adulthood Include Allergies To:
    • Peanuts
    • Tree Nuts
    • Fish
    • Shellfish
  • On the Flip Side, 80-90% of Egg, Milk, Wheat, and Soy Allergies Resolve by 5 Years of Age.2

Bonus Fact Facts About Allergies:

  • “Cross-reactivity” can occur in allergic reactions.

    What’s That? It’s when a person is allergic to substances that contain similar-looking proteins. For example, kids with a “grass pollen” allergy may also be allergic to tomatoes, melons, oranges, and figs because of cross-reactivity.3
  • Children don’t always react in the same way (and with the same intensity) to the things they’re allergic to. For example, kids with an egg allergy may have a big reaction when they eat scrambled eggs, but have no reaction when they eat foods with eggs baked into them (like muffins).

Food Allergy Risk Factors

Any Child Can Develop a Food Allergy, But There are Certain Risk Factors That Make Some Kids More Prone to Them Than Others. Such Risk Factors Include: 

  • A personal history of severe eczema, asthma, or hay fever.
  • Having a parent or a sibling with an allergic condition such as a food allergy, hay fever, eczema, or asthma. 

PediaTips:

  • Let Your Baby’s Doctor Know If Anyone in the Family Has a Food Allergy.

    Insider Info: Even if a child has a parent or a sibling with a major food allergy, that doesn’t mean they’ll be allergic to that food and have to avoid it. Nor does it mean the doctor will automatically test the child for the food allergy. Allergy testing isn’t usually warranted until a child has tried the food (under a doctor’s guidance) and shown signs of an allergy to it.

    How Do I Give My Child a Food That I’m Allergic To? In this case, you can ask a trusted relative or a friend who’s not allergic to the food to offer it to your child outside of the home (if your baby’s doctor approves). Then you can monitor your child for allergic symptoms for the rest of the day.
  • If Your Baby Has Eczema Talk to Their Doctor BEFORE You Introduce Highly Allergenic Foods Into Their Diet.

    Why?     Because babies with eczema are at a higher risk of having food allergies. In fact, it’s been shown that 30% of kids with eczema develop a food allergy.4

    In addition, food allergies can trigger eczema flares. For this reason, I often send patients who suffer from tough cases of eczema to an allergist for allergy testing.

    If your baby has bad eczema, notice when their eczema flares occur and if they’re related to certain foods. If so, you may be able to improve your baby’s eczema by eliminating the problematic food(s) from their diet. 

Insider Info: Studies show that introducing babies to allergenic foods early on helps prevent allergies.5 This is the opposite of what the medical community used to think. If interested, Get Wise about How to Safely Introduce “Allergenic” Foods to Your Baby’s Diet (After 6 Months).

How Will I Know If My Baby Has a Food Allergy?

Food allergies can declare themselves in different ways. A true food allergy is caused by the release of a substance called histamine. The body releases histamine when it encounters something “foreign” (and doesn’t like it). Allergic reactions usually occur within seconds to minutes after the allergen has been ingested. In some cases, the allergic reaction happens hours (typically within 2-6 hours) after the exposure. This isn’t the norm, though.

The Histamine Release Can Cause the Following:

  • Hives: Hives are itchy red welts with raised borders. They tend to disappear and then reappear in different places. They can last for a few days or longer (weeks). Get Wise(r) About Hives and How They’re Managed.
  • Other Non-Hive Rashes.
  • Vomiting.
  • Diarrhea.
  • Blood or Mucus in the Poop.
  • Tongue and/or Lip Swelling.
  • Trouble Breathing.

Tongue swelling, lip swelling and trouble breathing suggest a severe allergic reaction called anaphylaxis. Call 911 if your child develops any of these symptoms.

Note: Children with food allergies are often prescribed an Epi-Pen (or another form of injectable epinephrine) to administer at home, in case anaphylaxis occurs.

The Good News: Anaphylaxis doesn’t usually happen the first time a child is exposed to a food they’re allergic to.

Why? Because histamine takes time to build up in the body and trigger a big reaction. Often (but not always), the initial exposure results in milder symptoms, such as a rash, diarrhea, or vomiting.

PediaTip: If your child develops allergy symptoms, take a picture of the rash (if there is one) and call the doctor. 

Double Take:

Certain Skin Findings and GI Complaints Can Mimic the Symptoms of a Food Allergy But Are Actually Caused by Other Phenomena. 

Below are Some Examples:

  • Irritation From Acidic Foods: Acidic foods like berries, oranges, and tomatoes can cause redness around a child’s mouth. This redness is often due to irritation rather than to a food allergy.
  • Eczema Flare-Ups: Children with eczema may develop a rash on their face when food touches their skin. This rash is usually a sign of an eczema flare-up, not of a histamine-releasing allergic reaction.

    PediaTip: If your child has eczema, slather Vaseline on their cheeks and around their mouth before meals to protect their skin against irritants in the food.
  • Food Intolerances: A food “intolerance” means a child has trouble tolerating a specific food but isn’t necessarily allergic to it (i.e. no histamine is released when they ingest the food). Food intolerances can cause stomach cramps, flatulence, and bloating. For example, some kids develop a milk intolerance. They don’t feel great when they drink milk, but they’re not technically allergic to it either.

If Your Child Develops “Allergic” Symptoms, Let the Doctor Know, So They Can Help You Figure Out What’s Causing Them.

In Addition, Get Wise About How Doctors Diagnose Food Allergies Plus Tips for How to Handle a Severe Food Allergy.

The Bottom Line

Food allergies are fairly common in the pediatric population, especially in kids with a family history of food allergies or with a personal history of eczema. When your baby starts solid foods, introduce a new single-ingredient food every 3-5 days to make the detective work easier, in case an allergy develops. In addition, be on the lookout for hives, trouble breathing, or lip swelling with foods (especially with the highly allergenic ones). Call the doctor (or 911) if you see these signs.

“Mothers are basically part of a
scientific experiment to prove that
sleep is not a crucial part of human life.”

~Someecards (created by Tinamarie2944162)

The Reminders for This Week are the Same as Last Week’s.

  • Remember to Give Your Baby a Daily Vitamin D Supplement (That Contains 400 International Units Per Day) If You’re (Exclusively) Breastfeeding OR If They’re Taking Less Than 32 Ounces of Formula Per Day.

    Get Wise (Again) about the importance of vitamin D supplementation.
  • For Formula-Feeding Parents: Make sure you’re mixing the formula correctly and that it has iron in it (which it probably does). Get Wise about How to Mix Formula.
  • Put Your Baby on Their Back to Sleep, With No Pillows, Blankets, Bumpers, or Stuffed Animals in the Crib.
  • Avoid Giving Honey to Babies Under 1 Year.

    Why? Because of the concern for infant botulism. Get Wise about it here.
  • Don’t Give Water to Babies Under 6 Months of Age (Except For What’s in the Formula, If Your Baby is Taking Formula).

    Why? Because extra water can lead to electrolyte abnormalities (such as low sodium levels), which can, in turn, lead to seizures. 
  • Call the Doctor If Your Baby Spikes a Fever Above 102.2°F OR If They Develop Any Other Worrisome Symptoms (Such as Lethargy or Poor Feeding).
  • Don’t Give Ibuprofen to Babies Under 6 Months of Age. Aspirin Is Off Limits For Kids Under 18 Years (Unless It’s Prescribed by the Child’s Doctor).

And…That’s a Wrap!

Pediatric Wisdom for Parents
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