Sleep training your baby

Null

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

Null

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

Null

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.

Talking to children about tragedies

Null

After a horrific event like a mass shooting or terrorist attack, parents find themselves trying to make sense of the event, all while trying to figure out what, if anything, they tell their children. Each child has unique needs in a crisis. Often, it will depend on their age, if they knew anyone affected by the crisis and how much they have been exposed to the news. Allow your child to give you clues about how to meet their needs, and remember that all children are different. One may ask you many, many questions, whereas another may only want extra hugs and to watch a movie. Both of these reactions are OK!

Ask your child what they’ve heard. Allow them to tell you what, if anything, they heard. Once they’ve told you, ask them if they have any questions. Keep your answers straightforward and direct. In general, it is best to share basic information, no graphic or unnecessary details. It’s important to understand that they’re asking you questions because they need someone they trust to listen to their questions, accept their feelings and be there to support them while they work through their emotions. Staying silent on the issue won’t protect them from these events, as much as we’d prefer for them to not have to hear about what’s happened.

While it may be possible to limit your child’s exposure to media within your home, it is difficult when you’re not within your own home, or if your child is older and has access to a cell phone, social media or news accounts.

Even your youngest child will hear about tragic events, and it’s better for them to hear information from a parent or caregiver than another child or general media. Additionally, younger children may respond with forms of dependence, like acting clingy, refusing to sleep alone and experiencing separation anxiety. They may also throw temper tantrums or wet the bed. An older child may respond with anxiety, sadness, risky behavior or outbursts at school.

Feelings of sadness, fear and confusion are normal reactions. However, if your child seems very upset and unable to recover from fear, starts having trouble in school or home, or isn’t able to get up and go to school, you may want to contact your child’s doctor for additional advice. Additionally, if you are concerned they need more information or support than you’re able to provide, you can reach out to their teacher, school counselors or doctor for additional support.

Car seats: why do they expire and can I recycle them?

Null

As all parents and caretakers know, a car seat is mandatory for young children and infants. But what do you do when your child has outgrown their seat, or it’s expired or been in an accident? There are approximately 12 million car seats purchased in the US every year, many of those ending up in landfills once they’ve been retired.

90% of the materials, by weight, can be recycled. There are two locations in Ann Arbor that accept retired car seats for recycling, which are listed below.

Why does a car seat expire or become unusable after a car accident? They expire because the plastic materials they’re made of degrades over time from ultraviolet light, which weakens the effectiveness of the frame to withstand impact in a crash.

They’re unusable after an accident, even if they look fine, for similar reasons. Think of the car seat like an airbag- it’s there to save your child’s life. You have to replace your airbag after a crash because it can no longer withstand impact and help save your life- it’s only useful for one crash. A car seat is the same. It may look like it hasn’t sustained any damage, but there could be cracks or fractures in the plastic that puts your baby’s life at risk in the event of another crash.

To properly dispose of a car seat, you should strip the entire seat of the cover, the straps, disassemble everything and cut the straps. It’s also recommended you write all over the plastic base something like “EXPIRED” or “CRASHED” in permanent marker, to stop someone from trying to use it. There are two locations in Ann Arbor that accept car seats for recycling: Drop-off station on East Ellsworth, and the recovery yard on Jackson Road. For more information visit Recycle Ann Arbor.

Talking to Your Teen About Underage Drinking

Null

By the time they reach 8th grade, nearly 50% of all adolescents have had at least one alcoholic drink with over 20% report having been drunk. In addition to being illegal, underage drinking poses high risks. While your child is young, there are significant changes in the body, including rapid hormonal changes and the formation of new networks in the brain. Young adults are extremely vulnerable to alcohol-related brain damage. The immediate and long-term risks associated with underage drinking continue to show the need for prevention and treatment programs.

The 2013 Youth Risk Behavior Survey (link) of more than 13,000 high school students nationwide found that in the past 30 days:

  • 35% drank at least one drink containing alcohol
  • 21% drank five or more drinks containing alcohol
  • 6% drank 10 or more drinks containing alcohol in a row
  • 10% drove after drinking alcohol
  • 22% rode with a driver who have been drinking alcohol

As a parent, you should feel comfortable talking to your children about underage drinking, the risks and the consequences. Often, teens do not consider consequences when making choices like to drink underage, because they do not believe they could get in an accident, or drink so much they pass out. However, alcohol related crashes are greater for drivers aged 16-20 than drivers 21 and older.

Peer pressure plays a huge role in underage drinking, as well as how alcohol is portrayed in the media. Your relationship with your children, how you discipline them, how you communicate with them and your involvement in their life are all huge influences in their choice to drink underage – or not. Communicate with your children, be involved in their lives. Encourage their growing independence, but set appropriate limits. Make it easy for them to share information about their lives, and share information about yours. Perhaps you engaged in risky behavior as a teen that you would like to make sure they do not repeat. You could be open about your teenage years and experiences. But do not glamourize any underage drinking you may have done, and be sure to tell them about the great experiences you had without drinking.

Help your children practice ways to say no to their friends: “No thank you, I’m fine,” or “I’d rather be sober,” are great places to start. Set clear rules about alcohol use and enforce the rules you set.

You need to be a positive role model for your children as well. If you drink, drink responsibly. That means not too much or too often. Do not drive when you have been drinking. Get help if you think you have a problem. And do not give alcohol to your children.

If you have any questions about how to start the conversation with your children, ask their pediatrician. They may have suggestions or resources that will help you along the way.

 

Talking to Your Teen About Smoking

Null

Did you know that every day nearly 3,800 people younger than 18 smoke their first cigarette? According to the Department of Health and Human Services 2,100 youth who are occasional smokers become daily smokers every single day.

The harmful effects of nicotine in teenagers and young adults creates an important call to action for parents. Don’t wait to start the conversation about the hazards of smoking. If you yourself are a smoker, seek help to quit. 5.6 million children alive today (or 1 in every 13 children) will die early from smoking if we do not do more to reduce current smoking rates.

It may be a tough topic to talk about but it’s an important topic. Teens may be more concerned with the immediate impact smoking has on their lives than they are with their health in the future. Emphasize the immediate negative impacts. Remind them that:

  • Smoking around friends or siblings can be damaging, as secondhand smoke is known to be harmful. (Half of all children between ages 3 and 18 are exposed to cigarette smoke regularly).
  • Teens who smoke tend to be sick more often than their non-smoking peers, and may develop lung problems or have more asthma attacks. If your child is an athlete, this can harm their athletic performance.
  • Smoking has a negative effect on their personal appearance (bad breath, yellow teeth, wrinkly skin).
  • Smoking may lead to the use of alcohol and other drugs.

 

On the positive end, there are healthier ways to shine within a peer group, by saying no or through unique interests or hobbies. Also remind them about the long-term effects:

  • Tobacco use is the single most preventable cause of death in the US and in the world.
  • Smoking is well-known to cause heart disease, cancers and stroke.
  • Smoking decreases life expectancy.
  • Nicotine has negative effects on brain development which could have lasting effects on memory and attention.

 

Remind your child that smoking includes e-cigarettes and hookahs. Both have some of the same dangerous effects as cigarettes. Starting the discussion about smoking when your children are young and continuing it through their high school years is important. You, as the parent, are a role model and the greatest influence on your children’s lives. Set a positive example by quitting smoking if you currently smoke.

They will need consistent reinforcement, support and guidance. Knowing if your children’s friends smoke is important. You may be able to help them practice ways to say no. For example “No thanks – I’m good” or “Gross! Those things stink!”

Help your children understand that TV shows and movies may make smoking look “cool” when in reality it’s very harmful. Remind them it’s much harder to quit smoking than it is to start in the first place. Tell them stories about family members with health problems related to smoking, make it real.

Talking about smoking with your children may seem challenging, but it’s important. If you have questions, ask your child’s doctor for information that may help kick-start or continue the conversation.

Breastfeeding: When and How Much Does My Baby Need to Eat?

The first few days your body will make colostrum- a thick yellow/orange colored liquid that is VERY important for your baby to eat. It is nutritious and will help protect your baby from sickness. There may only be a tiny amount and that is OK and normal.

Between days 2-5 your milk will come in and will start to change to a creamy yellow to milky white color and there will be much more. The most wonderful thing is that your body will make milk according to your baby’s needs both in quantity and in nutrition!

To make sure you have enough milk, feed your baby when they ask to be fed or “on demand” feeding. There is no need to wait a certain amount of time before feeding and it could be less than an hour before your baby wants to feed again. It is normal for a newborn not to have a pattern for when they would like to eat and it is important for you to feed them often for both their health and to make sure you have enough milk for them.

Look for signs your baby is ready to eat such as:

  • Making soft sounds, whimpering- don’t wait for a full-blown cry to try!
  • Mouth movements- licking lips, sticking tongue out
  • Trying to put hands/fingers in mouth
  • Turning head toward breast or chest (this is called rooting)
  • They are awake and looking alert

The most important thing is to feed your baby when they ask to be fed and to make sure they are feeding every 2-3 hours for the first 2-3 weeks.

Don’t let your baby sleep through the night at first, if needed wake your baby at least every 3 hours. This will ensure that your baby is getting enough to eat and that your body makes enough milk.

This will be at least 8-12 feedings in a day and it may be more that is OK and normal.

Once your baby is older and stronger, they may not eat as many times each day and will be able to sleep for more hours at night.

How do I know if the feeding is good?

  • You can hear your baby swallowing and may see milk in their mouth when they are off the breast.
  • You feel your breasts are softer after feeding
  • You feel strong, deep pulling as your baby eats
  • Your baby nurses for about 15-20 minutes each side or 20-30 minutes on 1 side.

How do I know if they are full?

  • Your baby may become drowsy or sleepy after feeding
  • They look relaxed (hands and shoulders are relaxed)
  • Their mouth falls off your breast because they are so relaxed

How do I know if they are getting enough?

  • Your baby should have at least 6-8 wet/poopy diapers per day
  • We will check your baby’s weight when you come in for appointments to make sure they are gaining weight.

Call our office, IHA Pediatric Healthcare – Arbor Park, if you have any concerns, we are here to support you! (734) 434-3000

 

Back to School Physicals and Immunizations

With the kids going back to school soon, now is a great time to get their annual checkup by their physician or health care provider. This visit is also the best time to make sure their immunizations are up-to-date with the current recommendations and school requirements.

Most school-aged children receive several vaccines at their 4, 5, or 6-year-old checkup, and then the next set of vaccination occurs at 11 or 12 years of age. However, each year the physician will assess the child’s status of vaccines to make sure he or she is up-to-date.

Some important vaccine highlights this year include:

The meningitis vaccine: One of the newest recommendations is a second dose of the meningitis vaccine for high school students, usually at the age of 16; the first dose has been routinely given at 11 or 12 years of age. Meningitis is an infection of the lining of the brain and spinal cord that can be more easily transmitted when students are in close contact with each other. The HPV vaccine: This vaccine—which prevents genital warts in boys and girls and cervical cancer in girls—is now approved for boys ages 9 to 26 and has been approved for girls of the same age since 2006. It is a series of three vaccines, and the first dose is usually given at 11 or 12 years of age. Because the vaccine is to prevent a sexually transmitted infection from occurring, it is important that children get this vaccine before they become sexually active.

The tetanus-diptheria booster: Your child’s tetanus boosters should be up to date, especially because the booster contains the vaccine for pertussis, also known as whooping cough. Pertussis has been on the rise in Michigan recently, but the risk of this respiratory illness can be greatly reduced with the vaccine. Although immunizations are an important part of the annual checkup, the visit to the office is also an opportunity for the physician to review the child’s growth, eating habits, school performance, social interactions, and safety. The health care provider will do a complete physical exam and assess the child’s need for any testing. Additionally, he or she will be able to provide recommendations to the parent and child about topics such as healthy eating, exercise, risk reduction, and any other areas of concern that have come up during the visit.

Spring has Sprung! Seasonal Allergies and Children

This time of year seems to be appreciated by most who live in Michigan. The children can finally begin to go out to play and families can spend some quality time outdoors. Unfortunately, along with onset of spring comes the sneezing, the coughing and the itchy, watery eyes. For most parents, the hardest part is trying to distinguish these typical symptoms from a cold. Generally speaking, if your child does not have a fever and the sneezing and watery eyes occur every year around the same time, it is usually seasonal allergies. Children with seasonal allergies can also manifest signs of dark circles under their eyes called “allergic shiners” or little wrinkles in the middle of their nose because they are constantly taking the palm of their hand and wiping their nose upward, commonly referred to as the “allergic salute.”

 

 

In Michigan, different seasons sprout different allergens (substances causing allergy symptoms). In the first few weeks of spring, the pollen coming from trees (elm, maple and birch) are likely to blame. In late spring and summer, grass pollens and some weeds begin to spread throughout the air. By late summer and fall more weeds, especially ragweed, produce their strongest pollen, usually until the first frost. In the fall, some molds will also develop due to decaying leaves. Molds can be found year-round whenever conditions are damp and humid.

Allergens can irritate the body and activate what is called the histamine response. This gives children the symptoms of sneezing, itchy watery eyes and scratchy throat. If these symptoms persist they can start to cause swelling or inflammation symptoms in the nasal passages. Thick mucus can block the nasal passages, and infection can potentially develop. Other complications from seasonal allergies are that they may trigger asthma or wheezing, or they may complicate eczema. For children and adults alike, nasal saline flush is best to open blocked passages. Medication for seasonal allergies usually begins with a trial of anti-histamine oral medicines. Studies have shown, however, that nasal sprays can be more effective at treating seasonal allergic symptoms because they prevent the allergen from triggering the histamine response right at the source. There are also natural ways to combat seasonal allergies, such as air conditioners and indoor air filters. Some research has shown that citrus fruits rich in vitamin C may provide anti-histamine benefits and help reduce allergy symptoms.

If a child has repeated symptoms around the same time every year, it may be helpful to discuss with your pediatrician if your child may have seasonal allergies. If the symptoms persist, allergy testing is also an option to try to figure out exactly which allergens to avoid.

Additional Information about Seasonal Allergies

What are allergy tests?

How do allergies occur?