Baby 411 & Toddler 411 Blog

New blog home debuts today! Please update your bookmarks!

Hi everyone! We've debuted a new blog home for BABY 411: be sure to change your bookmarks!

Here is the new address:

http://windsorpeak.com/sites/baby411/blog/

This site will be closed. Please visit our new site for the latest news from BABY 411!

 

When is too big or too old for a stroller?

It was meant to be a joke, but TooBigForStroller.com is causing quite a stir in the mommy social media world. Like the recent Suri Cruise-too-old-for-binky-debate, some parents are taking this as a personal affront to their parenting skills.

Reality check moment: there are MUCH bigger parenting offenses that have potential lifelong consequences on a child than carting a kindergartner around in a stroller. So, put this in perspective!

That said, I agree that some parents use strollers for children who are clearly capable of walking a decent distance. Yes, it is convenient. Yes, it adds an element of pedestrian safety when going across a crowded city street. And yes, a parent could probably get an extra hour or two in at Disney World with a tired kid if the child doesn't have to walk from one attraction to the next. (Adults aren't immune to this behavior either— Disney rents scooters for non-handicapped people who simply aren't in the mood to take a walk in the park!)

But, there are both short and long term health benefits to walking and that is why my worried doctor radar goes off here.

Walking is a form of exercise, people. And that's something many American kids don't get enough of. We've all heard the stats about our obesity epidemic. As a pediatrician, I am deeply concerned about our sedentary culture.  In our media-rich world, kids (and adults) spend several hours a day sitting in front of a screen. That's several hours too many.

Why would an able-bodied child prefer to walk when he gets a free ride from the chauffeur driven limosine? When the convenience of a stroller trumps physical activity for your child, that's when it becomes a poor parenting choice.

So when is a child "too big" or "too old" for a stroller?

1. Too big? Typical strollers on the market have a maximum weight capacity of 40 lbs. Most kids will reach that by 4-5 years of age at the latest. But if you have to squeeze your child into the seat or his feet touch the ground, he's definitely too big!

2. Too old? Ask yourself the following questions. If you answer YES to all 3, it's time to ditch the stroller.

• Can my child walk easily and confidently?
• Does my child follow directions/hold hands while walking without making a break for it?
• Is my child old enough to unstrap the restraints in a stroller and potentially create a safety risk? (Same rules apply for putting a child in a shopping cart.)

If your child gets tired at Disney (or any other family vacation destination), that means it is time to take a break. And, if your child isn't old enough to walk around Disney World, you are probably wasting your money going there in the first place!

 

Expecting 411, Baby 411, Toddler 411 on ELLEN Today!

Ellen's Mother's Day show airs today, with an audience full of moms-to-be. Expecting 411, Baby 411, and Toddler 411 were selected as audience giveaways! Wishing you were in the audience? Well, Ellen has a big surprise for her audience viewing at home. Check out the ELLEN website for details!

 

Happy Mother's Day to all!

Pregnancy myth busting on EXTRA!

We're busting the Top 5 pregnancy myths on this weekend's EXTRA show. Check it out!

Shots for tots

 It's National Infant Immunization Week....an annual reminder that to protect our youngest and most vulnerable from vaccine-preventable diseases. The current childhood vaccination schedule protects against 14 different nasty diseases, that I guarantee you wouldn't wish on your worst enemy!

This year, I've teamed up with the American Academy of Pediatrics to let parents know that as a pediatrician and a mom, I vaccinated my own children to protect them, and I wouldn't advise anything differently for your kids. Really.

Learn about vaccines. Learn about vaccine-preventable diseases. Talk to your pediatrician. But let's protect all our kids. This requires a group effort, people!

Ode to Oak Pollen: How to find relief!

This is a picture of my patio table. It’s usually brown. But my patio table, like my entire town, is covered in a lovely blanket of yellow as the oak trees have turned their reproductive instincts into high gear. Those oak trees will be happily making lots of acorns. Meanwhile, we humans are suffering the consequences!

About 40% of kids (usually age five and up) and 10-30% of adults (usually young adults) suffer from seasonal allergies. A person’s body is irritated by the pollen, resulting in an itchy nose/eyes/throat, watery eye drainage, watery runny nose, a drip down the back of the throat, a hacking cough, and a feeling of being tired or fatigued. People who are extremely sensitive can have significant eyelid swelling, a flare up of eczema, or wheezing from it. In short: misery!

While every community’s pollen season varies a bit, it takes several weeks for a particular pollen to blow through once it arrives. So my town, unfortunately, will be enduring this “yellow haze” for a couple more weeks.

Here are some things you can do if you or your child has an oak pollen allergy (or any other seasonal pollen issue):

 

1. Stay indoors and keep your windows closed! If your school-aged child suffers significantly from seasonal allergies, get a note from her doctor to excuse her from recess or other outdoor activities.
2. Clean yourself and your pet after being outside. The pollen will come right in with you on your shoes, clothes, and in your hair. And, your dog will be covered in it-especially if he likes to roll around in the grass.
3. Try an over the counter antihistamine for relief. There are various products on the market (examples of brand names: Benadryl, Claritin, Zyrtec, Allegra). I usually recommend the non-sedating antihistamines (i.e. Claritin, Zyrtec) to my patients because they won’t make a child sleepy or zoned out and only need to be dosed once a day.
4. Get a prescription. If the over the counter stuff isn’t providing enough relief, there are a variety of other medications your child’s doctor can prescribe. These include eye drops (if your child is that miserable, he will probably let you put them in), nose sprays, and other medications taken by mouth.

 

Happy Spring!

Colic: The Unhappy Hour(s)

It's the “C word” in new parent circles. While many parents are forewarned about colic and worry that their baby might have it, many don’t even know what colic is. So, this post explains what colic is, and what (if anything) you can do about it.

Q. What is colic, anyway?

It is known as the Rule of Three’s. It starts around three weeks of age. The baby cries for about three hours straight (beginning right around “happy hour” —ironic, right?). And, it lasts until the baby is three months old. About 15% of all babies are afflicted with this malady.

Q. What causes colic?

Although scientists have been studying colic for years, no one knows exactly what causes it. Many experts think the problem is due to immaturity of the gastrointestinal or digestive system. So over the years, doctors have tried treating it with medications to reduce gas, relax the intestinal muscles, or cause sedation. None of these medications really help. The best treatment for colic is time….all babies eventually outgrow colic.

Some babies who seem “colicky” actually have a medical diagnosis. So, it is important to check in with your baby’s doctor if you've got a chronically fussy baby on your hands. Some babies have heartburn (gastroesophageal reflux disease or GERD). Those babies are usually miserable all day and night or around feedings—not just for a three hour period everyday. Other babies may have a cow’s milk protein allergy and don’t start to show signs of discomfort until several weeks of being exposed to the milk protein going through mom’s breast milk or in standard cow’s milk-based formula.

Q. What can I do to help my baby with colic?

What’s a parent to do? (Because, of course, we are all compelled to do something to help our babies feel better even when the doc tells you there is no treatment but time.) After browsing the net, you’ll no doubt find many colic treatments that make miraculous (and unregulated) claims.

My advice before starting any treatment is to ask yourself this question: Am I treating my child to make myself feel better (because I feel I am doing something), or does the therapy really work?

Q. Are there any new studies on treating colic?

A study published today in the journal, Pediatrics examines the scientific evidence supporting the most popular complementary and alternative therapies for colic. So, there isn't any breakthrough research here...it just puts this issue into perspective. Here’s what they found: Of 1764 studies done between 1991-2008, 15 were considered reasonable enough to review. Of those, only 8 of them were well designed. And here’s a key point: most of the purported treatments and effectiveness reported in a study have not been independently verified by other studies. Good science is like a good recipe—it can be repeated with the same results.

That said, let’s take a look at the therapies:

 

1. Spinal manipulation—Four studies were reviewed. Some parents reported improvement in the studies, but all the studies had methodical weaknesses. One study on chiropractic treatment showed no improvement in the number of hours a baby cried.
2. Herbal remedies—Herbs included chamomile/fennel/licorice/vervain/balm mint tea or fennel seed oil*. Three studies were reviewed. The small number of children enrolled in the studies limited the strength of the findings. But, parents noted a significant reduction in colic symptoms compared to the untreated group. Fennel is thought to work by having a relaxing (antispasmodic) effect on the gut and increasing the gut’s motility.
3. Sugar remedies—Babies were given either a glucose or sucrose* solution. Five studies were reviewed. Both sugary supplements seemed to help reduce colic symptoms.
4. Probiotics—Two studies were reviewed. In one study, one group of babies received a probiotic (L reuteri) and the other group received anti-gas drops (simethicone). 95% of parents reported improvement with the probiotic, compared to just 7% with the anti-gas drops.
5. Massage therapy—One study showed conflicting results. 93% of parents reported improvement in symptoms, yet 21% said there was no effect after the treatment itself. This calls into question if symptoms just improved with time.
6. Reflexology—There was no difference between targeted and nontargeted therapies which suggests that there is just some healing power of touch!

*More than one study found similar results.

Bottom line: None of these treatments are truly supported by the scientific evidence we have to date. More research is in order to help these babies and their parents!

Q. Given the lack of data, what do you recommend to your patients?

If everyone in the house is miserable, I suggest trying “gripe water” (a combination of ginger and fennel) or a daily dose of L. reuteri probiotics. Both products are available in pharmacies and online. I don’t make any promises, but I have seen some scientific evidence of their benefit and safety. I’d certainly like to see more research on colic, though!

Children Act Fast...So Do Poisons

Creepy title, I know. But, it's National Poison Prevention Week, Moms and Dads, and this is the morbid motto for the 2011 campaign.

Here are the sobering stats: Every year, 2.4 million people—over half under SIX years of age—swallow or come in contact with a poisonous substance.

I know, I know, this would never happen on your watch. Unfortunately, most of these accidents happen when a child is at home and the supervising adult is distracted. So, what can you do to prevent one of these potentially deadly situations?

Here are some tips from the American Academy of Pediatrics:

• Store medicine, cleaners, paints/varnishes and pesticides in their original packaging in locked cabinets or containers, out of sight and reach of children.
• Install a safety latch – that locks when you close the door – on child-accessible cabinets containing harmful products.
• Purchase and keep all medicines in containers with safety caps. Discard unused medication.
• Never refer to medicine as “candy” or another appealing name.
• Check the label each time you give a child medicine to ensure proper dosage.
• Never place poisonous products in food or drink containers.
• Keep coal, wood or kerosene stoves in safe working order.
• Maintain working smoke and carbon monoxide detectors.

Be sure to have Poison Control on speed dial. The number is 800-222-1222. Obviously, if your child has swallowed a poison and is unconscious, having a seizure, not breathing, or is lethargic or unresponsive, the phone number to call is 911. (And start CPR until EMS arrives if your child is not breathing!) But, if your child is not having any symptoms or is not showing signs of immediate distress, Poison Control gives great advice for the next steps.

Here is some practical advice for first aid in the most common poisoning situations.

• We no longer recommend making your child vomit by using syrup of ipecac. If your child has swallowed a poison and he is able to spit it out, go for it.
• If a poison has touched your child's skin, remove your child's clothing and rinse your child off with lukewarm water for 15 minutes.
• If a poison enters your child's eyes, flush her eyes with room temperature water towards the inner part of the eyes for 15 minutes (yes, that is probably very difficult to do with a young child). Do not stick your child's head under the faucet to do the rinsing. And, don't let your child rub her eyes.
  
• If your child inhales poisonous fumes, take him outside to let him breathe fresh air.

For more tips on home safety, check out safekids.org.

 

How long does your baby need to stay rear facing in a car seat?

While the safety data was released a couple of years ago, today the American Academy of Pediatrics updated its previous policy on carseats to say: Kids should stay rear-facing in a carseat in the back seat of the car until TWO years of age. Why? It's safer for a young child's head and neck support to be rear-facing. In fact, there fatality risk in a car accident goes down by 75%!

Here are some of the highlights:

• The "rear-facing until two" is a guideline only. Young children who are very small, or born prematurely, may need to stay rear facing longer--until they outgrow the weight and height limits for the rear-facing carseat. And, kids who are big may outgrow the size limitations younger than age two and may need to be turned forward-facing earlier.
• Once a child outgrows the size limits of rear-facing, he should be forward-facing in a harness carseat until he outgrows that seat.
• You can check your carseat's size limitations on the label or in the instruction manual. In general, convertible carseats are safe for rear-facing until a child weighs 35—45 lbs. Height limitations vary as well.
• Kids need to remain in booster seats until at least EIGHT years of age, or when they exceed the size limits for a booster and they are ready for a seat belt.
• Kids should not be riding in the front seat of a vehicle until they are at least 13 years old.

 

 

 

 

 

 

 

 

 

Expecting 411 author Dr Michele Hakakha on Rachael Ray Show Friday!

 

Set your DVR's for Friday's Rachael Ray Show! Our very own Dr. Michele Hakakha is in the house, testing out products that claim to relieve morning sickness. For all those preggo gals suffering from this malady, this show's for you! Check out Rachael's website to see where and when the show airs in your hometown.