Food Fight: Is your toddler a picky eater?

Food Fight: Is your toddler a picky eater?

It happens to parents of toddlers all the time: you prepare your child’s favorite meal, and place it lovingly in front of them only to watch them hurl the plate to the floor. They loved this meal yesterday, how could they refuse it today? Simply put: toddlers tend to be picky eaters. For parents, this can generate a lot of anxiety about the well being of their child. I’m sharing the advice I give moms and dads in my practice to help avoid a daily food fight around the kitchen table.

Don’t sweat it.

Toddlers are developing their food preferences. What they like today they may dislike tomorrow and vice versa. For a week straight, they may request (or demand) only one or two of their preferred menu items. That’s normal. And exasperating. Try to be patient, and avoid getting frustrated. Otherwise, mealtime will turn into a power struggle between you and your toddler, and no one wins. Try to include one or two of your toddler’s preferred menu items for each meal, and offer foods to your child more than once. Today may be the day they decide to love something new!

Think big picture.

Ensuring your toddler gets the nutrition they need is one of the biggest concerns when dealing with a picky eater. Consider your child’s food intake throughout the week, not just day to day or meal to meal. They may gobble up a huge breakfast and then nibble here and there for lunch. They may eat great some days and next to nothing on others. Generally, if your child is consistently growing, they are most likely getting enough calories and protein. If they’re easily moving their bowels on a daily basis, there’s enough fiber in their diet. A hungry toddler will consume more at mealtime, so make it easier on yourself by avoiding snacks and lots of liquids prior to a sit-down meal.

Work together in the kitchen.

Including toddlers in the meal planning and preparation may give them more incentive to try something new, and give them an outlet for their desire to control which foods they are eating. Invite your toddler to help you choose healthy items at the grocery store, pick new recipes or ask them to choose the side dishes for your next meal. Toddlers are eager to help, so allowing them to safely assist in the kitchen with stirring, scooping, sifting, counting and adding ingredients can grow their interest in mealtime. You may even want to surprise them with their own apron and chef’s hat!

Don’t give up!

Very few toddlers eat five servings of fruits and vegetables each day. When they exclaim “all done!” at the end of their meal, you’ll often find the serving of veggies exactly as you placed it on their plate – untouched. Again, that’s normal. Continue to offer them healthy choices at each meal, and set an example by making healthy choices yourself. Eventually, they will be open to trying new things, and may even come to enjoy those vegetables!

If you are feeling concerned about your child’s diet, make an appointment with your pediatric provider. They can help navigate this stage of life to ensure your little one is getting the nutrition they need to grow and develop. It’s easy to schedule an appointment with your pediatric provider – simply visit our online appointment tool, scroll to find your pediatric provider, and click to schedule an appointment at a time that works for your family!

It’s easy to schedule an appointment with your pediatric provider – simply visit our online appointment tool, scroll to find your pediatric provider, and click to schedule an appointment at a time that works for your family!

Make An Appointment

Your Baby’s Best Shot: FAQs About Vaccines

Your Baby's Best Shot

 

Parents today have no shortage of information and input on raising a child. It’s easy to get overwhelmed, especially for new parents. We want to ensure our children have all that they need to grow and develop normally, but sorting through the mountains of recommendations can be daunting, to say the least. For parents of newborns, a frequent topic of discussion during well visits centers around vaccines. Which vaccines does your child need and when should they receive them? Let’s breakdown the most frequently asked questions around vaccines for our littlest patients.

There are a lot of vaccines out there, does my child need all of them?

Just because a vaccine exists, doesn’t mean it is recommended for your child. Your doctor will discuss with you the routine vaccination schedule, which is based on current recommendations from the American Council on Immunization Practices. This schedule applies for all children living in the U.S. Additional recommended vaccines based on travel, disease outbreaks, or other unique circumstances, can be discussed with your doctor on an individualized basis.

Watch for these common differentiators between a cough caused by a virus and one caused by asthma.

Why does my baby get so many vaccines before they are two?

Vaccines are given based on a thoughtfully developed schedule to ensure children are protected when they are most vulnerable or likely to be exposed to an illness. Pertussis (whooping cough), for instance, can be life threating to an infant, so three doses of the vaccine are given in the first year of life. For illnesses that may not impact a child until adolescence, the vaccine is delivered at a later time.

Is it safe to give my baby several vaccines at one time?

Safety is of the utmost concern when giving a young child vaccines. That’s where the Centers for Disease Control’s Recommended Vaccine Schedule comes in. Extensive study and analysis have demonstrated conclusively that there is no risk or harm in giving multiple vaccines at once. Specifically, the Recommended Child and Adolescent Immunization Schedule in the U.S. has been carefully examined and has been proven to be safe and effective.

Does my child need vaccines?

Definitely. In addition to protecting our own children from serious, life-threatening illnesses, we all need to be mindful of the risks we pose to others to when we don’t vaccinate. We’re constantly interacting with others in public (for example at school, playgroups, parks) and there are many people that are not able to receive vaccines. These individuals include infants or those with compromised immune systems from chemotherapy or other conditions, are at mich greater risk of severe illness or death when exposed to some of these diseases. When you have your child vaccinated, you are helping to eliminate the risk of a harmful disease resurfacing. This not only protects your child, but also helps to protect others who are vulnerable to the spread of vaccine-preventable diseases.

How do I know which vaccines my child will receive for the first two years of their life and beyond?

Your baby’s provider can discuss the vaccine schedule which is right for your child. Talk with your pediatric provider about which vaccines your child needs, and when he or she should receive them.

  

It’s easy to schedule an appointment with your pediatric provider – simply visit our online appointment tool, scroll to find your pediatric provider, and click to schedule an appointment at a time that works for your family!

 

Make An Appointment

 

Toddler Sleep 101

New Parents and Sleep Deprivation

 

There’s nothing magical about the pitter patter of little feet at two o’clock in the morning. When a toddler isn’t sleeping well, it affects the whole household. Toddlers ages 1 to 3 years require 12 to 15 hours of sleep per day, and that sleep happens both during the day and at night. Oftentimes, a good night’s sleep will setup daytime sleep nicely, so that your child will be able to take their regular nap. So, how do you get a toddler to achieve a good night’s sleep? Start with these 3 steps:

1. Consistency is key for toddlers.

Create a bedtime routine, and follow it. Every. Single. Time. Start your routine at the same time every night and for every nap. Follow the same order of events, for example: bath, brush teeth, books, sip of water, song, lights out. Once this is a regular routine in your home, your child will come to expect each step and know when it’s time for bed.

2. A child’s bedroom should make them feel safe and comfortable.

Your child may benefit from a night light or some other ambient light that allows them to feel more at ease in their bedroom. Some calming music on a timer may also help them transition to sleep. Lastly, make sure the temperature in their bedroom is nice and cool. You don’t want them waking up from feeling hot.

3. Make a plan for the inevitable: at some point your toddler will show up in your bedroom in the middle of the night.

Parenting is hard, and doing it in the middle of the night doesn’t make it easier. Create a plan around how you will approach a toddler asking to come into your bed at night, and stick to it (see point number 1). Start by reassuring your child, and then place them back in their bed. Your middle of the night encounters should be brief and to the point – it is time to sleep. Avoid encouraging them to exit their room by playing with them or fulfilling requests for a glass of milk.

If you’re struggling with your toddler’s sleep schedule, there may be other sleep problems affecting your child. Make an appointment to discuss your concerns with your pediatric provider.

It’s easy to schedule an appointment with your pediatric provider – simply visit our online appointment tool, scroll to find your pediatric provider, and click to schedule an appointment at a time that works for your family!

 

Make An Appointment

 

New Parents and Sleep Deprivation: A to ZZZs

New Parents and Sleep Deprivation

 

Before a mother gives birth, she’s likely to hear the advice “sleep while the baby is sleeping.” Maybe more than once. Sleep deprivation is one of the greatest challenges for new parents. A newborn is on their own schedule for sleeping and eating, and it’s a 24-hour cycle. New parents will find themselves exhausted from getting up with their little bundle every two to three hours throughout the night. A foggy, scattered feeling sets in and memory lapses become a daily nuisance. Did I turn off the coffee pot? Many don’t take the advice to sleep when you can. It’s tempting to try to catch up on housework, answer an email or text or fit in the newest episode of their favorite show. Plus, when exhaustion sets in, it’s hard to believe an hour of sleep will make a noticeable difference.

Myth: An hour nap won’t make a difference.

In reality, frequent naps throughout the day really do add up, just like they do for infants. If parents can adjust their schedule to grab some ZZZs while the baby is getting their required amount of sleep, it can improve the quality of life for everyone in the house.

If you’re struggling with nodding off on demand, try setting the mood for sleep. Darkening shades can help create a dark space for a mid-day snooze. Turn off the TV and face bright devices away from you. And that sound machine in your baby’s room? It may also provide some much-needed distraction from the noises of the day.

This sleep schedule can present new challenges when it’s time to return to work. Most offices don’t feature napping pods. Work with your pediatric provider on sleep training your infant, so you and your little bundle are getting the most rest possible during the night by the time maternity leave comes to an end.

Adjusting to a new baby can be difficult. If you are worried about your newborn’s routine, your pediatric provider can help. 

It’s easy to schedule an appointment with your pediatric provider – simply visit our online appointment tool, scroll to find your pediatric provider, and click to schedule an appointment at a time that works for your family!

 

Make An Appointment

 

Asthma or Cough?

Asthma or Cough?

 

Does my child have a cough or asthma?

A cough is one of the most common symptoms of both asthma and a cold. Understanding when a cough is related to a virus and when it’s asthma will help you get the right treatment for your child quickly.

Watch for these common differentiators between a cough caused by a virus and one caused by asthma.

Timing of the cough.

In asthma patients, a cough is going to be worst in the morning and at night. When a cold is the cause of the cough, symptoms may worsen slightly at night, but your child will cough consistently throughout the day and night.

Type of cough.

Dry and brassy coughs are common with asthma, while a cold will produce a wet, and more productive cough.

Secondary signs of asthma.

A child suffering from asthma may feel a tightness in their chest or shortness of breath. You may even hear some wheezing.

 

Coughs can be tricky to diagnose. If you are worried about your child’s cough, your pediatric provider can help.

It’s easy to schedule an appointment with your pediatric provider at IHA – simply visit our online appointment tool, scroll to find your pediatric provider, and click to schedule an appointment at a time that works for your family!

Make An Appointment

Sleep tips for children and teens

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Sleep has a number of key health benefits for children and is important for their growth and overall development. Sleep is important for muscle growth, tissue repair and growth hormone release. Sleep is also critical for learning and memory consolidation, making sleep important for children to perform their best in school. Sleep is necessary for maintaining the overall health of our immune system and our metabolism.

The amount of sleep a child needs really depends on the age of the child. Newborns typically require the most sleep, which can be up to 14-17 hours per day. As children get older, their sleep requirements decrease so that by adolescence their sleep needs are similar to adults.

The National Sleep Foundation recommends that toddlers get 12-15 hours of sleep and preschoolers 10-13 hours of sleep per day, including their daytime nap. The National Sleep Foundation recommends 9-11 hours of sleep per night for school-aged children, 8-10 hours of sleep for teenagers and 7-9 hours of sleep per night for adults between 18 and 64. Adults aged 65+ need 7-8 hours of sleep.

Unfortunately, we know that many children and adults do not get the recommended amount of sleep each night. A 2004 National Sleep Foundation poll found that children of all ages got less than the recommended amount of sleep. Our sleep deprivation gets worse as children get older, with teenagers usually being the most sleep deprived age group.

A 2006 National Sleep Foundation poll found that 45% of adolescents got less than 8 hours of sleep per night, with high school seniors averaging only 6.9 hours of sleep on school nights. Adults do not usually fare much better, with about 40% of adults getting less than 7 hours of sleep each night.

Insufficient sleep is associated with daytime consequences, in which children can be very different than in adults. Most adults will present with symptoms of sleepiness such as falling asleep at work, while reading or watching TV. Children, on the other hand, can present with increased energy (hyperactivity) or problems with focus/concentration. They can sometimes look very similar to children with ADHD. In fact, children are sometimes misdiagnosed with ADHD when in the symptoms are really due to poor sleep.

Children can also present with more behavior problems or poorer school performance. Daytime sleepiness is also seen in children. For example, children may have a harder time getting up in the morning and may even be late for school as a result. They can also be more likely to fall asleep in the car or on the bus ride to school. Or, they can even fall asleep in the classroom, which can affect their ability to learn.

The National Sleep Foundation estimates that about 25% of teens fall asleep in the classroom at least once per week. Some children who are chronically sleep deprived will try to catch up on their sleep at home either through an after school nap or “sleeping in” on the weekends. If your child takes regular naps, especially if they are 45 minutes or longer, or if they “sleep in” more than 2 hours on the weekends, then your child may not be getting enough sleep.

If you have any concerns about your child’s sleep patterns, particularly if your child snores, pauses in their breathing during sleep, gasps for air, has mouth breathing, has frequent night awakenings or restless/sweaty sleep it is important that you talk to your child’s doctor as these could all be signs of obstructive sleep apnea. Difficulty falling asleep or staying asleep could also be signs of other sleep problems that you should discuss with your child’s doctor.

The importance of yearly physicals

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As pediatricians, we are frequently asked why a child needs a yearly physical, even if they seem perfectly healthy. At each well visit, your provider will ask questions, examine your child and discuss any recommended vaccines. At each age milestone, different screening tools and tests may be recommended in addition to the traditional physical exam.

Children are constantly growing and a lot can change in a year. We measure height and weight to ensure adequate growth. We plot these measurements on a growth curve which shows projected growth patterns. Variations in this curve can indicate nutritional deficiencies, hormone deficiencies, as well as other major medical problems.

Between two and six-years-old, children grow at a faster rate than almost any other time during their development. During this time, we can monitor their growth rate, size, weight and blood pressure to help determine if early action is needed to combat issues that may arise later in adolescence. Children who are overweight at age five have a much higher percentage of being obese in adolescence and later in life.

When your child hits the “tween” age, around eight to 12-years-old, growth patterns and timelines for development can vary. Because your child is starting toward puberty, getting a yearly physical can help us prepare them (and you!) for hormonal changes as well as other physical and emotional changes that occur during these times.

These yearly physicals allow us an opportunity to address important topics such as ways to ensure your child’s safety, healthy sleep habits, goals for adequate nutrition and more. Through these visits, we work to identify any physical, emotional, developmental or social concerns and begin to address them. The “sick visit” is a time to address an acute illness or check in on an ongoing specific condition. In contrast, the well visit (or physical) is a time for the provider to do a more thorough evaluation. It also gives the patient, family and provider an opportunity to work together to ensure quality overall health.

Additionally, if your child plays a sport, the state of Michigan (MHSAA) requires that students receive a physical AFTER April 15, 2017 in order to play sports in the 2017-2018 school year. Act now to schedule your child’s physical for this spring/summer. You can schedule online or by calling your child’s office. We look forward to seeing you!

Sleep training your baby

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Typically, when your baby is about six-months-old, their circadian rhythms stabilize and they start to wake up less and less during the night. This is a great time to work on sleep-training, or trying to get them to learn to fall asleep on their own and stay asleep during the night. There are a variety of commonly used methods, however, one that worked for your friend or coworker may not work for your baby.

 

The most common are:

Pick-up-put-down: this is a gentle technique that is exactly what it sounds like. When a baby is fussy and it’s time to go to sleep, pick them up and comfort them until they’re calm and drowsy, but not yet asleep. Put them back in their crib to sleep, and repeat until they’re finally asleep. This requires a lot of patience, and not every baby will like this method. For some, it’s overstimulating and can make them fussier, rather than coax them to sleep.

Fading sleep: this method consists of helping your baby fall asleep by rocking or feeding, but shortening the amount of time you rock/feed each night, which allows your baby to do more to get themselves to fall asleep. This also requires a lot of patience, but this works very well for families who want to minimize crying.

Chair method: This method doesn’t involve picking up your baby at all. Begin with your normal bedtime routine and put a chair very close to the crib while your baby falls asleep. The goal is to reassure baby that you’re nearby, but you don’t help them calm down or give them any attention after you’ve put them to bed. Each night, you move your chair farther and farther away until you’re right outside the door and no longer need the chair at all. This method can be very difficult on parents and baby, but for some, it can work well.

Ferberizing (check and console): This technique allows you to check the baby at timed intervals while allowing them to learn to console themselves. Your goal is to reassure baby that you’re nearby while reassuring yourself that they’re ok. When you check on baby, don’t pick them up, simply tell them that they’re ok and pat or rub their back for two-three minutes before leaving. Over time, increase the amount of time between checks. Start with 10 minutes between checks and increase by five minutes each night. This method helps baby learn to fall back asleep in the same environment they wake up in each night.

Cry it out (sleep extinction): This is the most commonly known method. The idea is you do your normal bedtime routine and put the baby to bed, but do not check on them again, instead of letting them fall asleep on their own. This can be hard for parents to not console their child when they’re crying, but the idea is that if you go in after a certain amount of time, your child will expect you to do that every night.

There is no “one-size-fits-all” method of sleep training. You may find a hybrid of these methods works best for you, or something that’s not listed here at all. If you need help finding a way to sleep train your baby, or talking through some of the ideas listed here, talk to your pediatrician. They can offer some helpful suggestions about what to try and what might work for you and your baby.

 

 

Making Halloween safe and inclusive for kids with allergies

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When a child has food allergies, Halloween can be a scary time. The small candy wrappers often do not contain lists of ingredient, making it nearly impossible to make sure your little one is eating a treat that’s safe for them. When your child has an egg, milk, nut or soy allergy, how do you make sure they’re safe and can have a fun Halloween experience?

The Food Allergy Research & Education (FARE) organization started the Teal Pumpkin Project, which encourages people to place a teal painted pumpkin outside their door if they’re offering non-food treats, such as stickers or small toys, to trick-or-treaters.

It’s a small step to make sure all children can be a part of the fun on Halloween, and it allows the parent to know their children will be safe without a bag full of candy they may or may not be able to eat safely.

If you’re interested in participating, it’s very simple! Place a teal painted pumpkin outside your door to let trick-or-treaters and their parents know you have non-food items, and pass them out like you normally would. Some kids may ask for them knowing they can’t have dairy, soy or nuts. It’s best to keep the non-food treats in a separate bowl or container, so extra safety from cross-contamination. FARE has printable materials available for you to display to let others know there are non-food items available at your home.

This article was originally published on September 30, 2015, and was updated on September 7, 2016.

Heatstroke prevention

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July 31 is national heatstroke prevention day. On average, 37 children die in hot cars every year in the US. 87% of those are ages 3 and younger. Vehicular heat stroke is largely misunderstood, with the majority of parents believing they could never forget their child in the backseat of a car. Even the most cautious parent can be thrown off by a change in routine, lack of sleep, stress or fatigue.

2/3 of the increase in temperature happens within the first 20 minutes, and a child’s body overheats 3-5 times faster than that of an adults. Even with windows cracked, the temperature inside a car can reach 125 degrees in minutes.

To help make sure you keep your child safe, we’d like to give you some ideas to always check for baby.

Make it a routine to open the back door of your car every time you park (at work, home, grocery, etc.) to make sure no one has been left behind. Put your purse, bag, cell phone or something else important you always need in the backseat to remind yourself to check every day, every time. Send your significant other a photo of your child inside daycare every day when you’ve dropped them off, or send them a photo at home once you’ve picked them up and have them inside the house.

Additionally, make sure your child cannot get into a parked car. Keep vehicles locked at all times, even if they’re parked in the garage or driveway. Keep car keys and garage remotes up and out of reach of your children. Ask your neighbors, friends, family and guests to do the same.

If your child goes missing, immediately check all vehicles- inside the trunk and front and back seats carefully, even if they’re locked. A child may lock the doors after entering on their own and may not be able to unlock them.

If you see a child alone in a vehicle, get involved. Call 911 immediately. If the child seems hot or sick, get them out of the vehicle as soon as possible.