Category: Infant Care
What people eat and drink have an impact on their health. The U.S. Departments of Agriculture and Health and Human Services recently released their updated reference, “Dietary Guidelines for Americans, 2020-2025”. Reflecting the current body of nutrition science, the guidelines examine the relationship between diet and health across all life stages, from infancy to older adulthood. The goal of the guidelines is to inform, based on evidence from scientific studies, how eating healthier can help reduce the risk of diet-related chronic disease including obesity, type 2 diabetes, and cardiovascular disease.
The full version of the guidelines can be found here. The guidelines cover areas that parents frequently have questions on or are concerned about. Some of these areas include:
Birth to 23 months:
- Introducing infants to nutrient-dense complementary foods at about 6 months of age
- Assessing readiness for beginning to eat solid foods
- Introducing infants to potentially allergenic foods
- Establishing a healthy diet for toddlers including recommended intake ranges of various food groups
Children and Adolescents age 2-18 years:
- Tables showing recommend food group intake ranges broken down by age
- Ages 2 through 4 years
- Ages 5 through 8 years
- Ages 9 through 13 years
- Ages 14 through 18 years
- Offering nutrient-dense foods and beverages at an early age to help children develop and maintain healthy dietary patterns
While food choice is only one part of staying healthy, this report is a welcome addition to the body of knowledge that is available in terms of approaching nutrition from infancy to young adulthood.
For generations, a host of symptoms and behaviors have been attributed to infant teething. It is not unusual for parents to wonder if crankiness, diarrhea, drooling, diaper rashes and trouble sleeping are related to teething, illness or a normal phase of development.
A recent analysis of the medical literature related to teething found that teething causes babies to rub their gums, be a little crankier and drool more. This conclusion was the result of of a meta-analysis, published in March 2016 in the journal, Pediatrics, where over one thousand citations from researchers around the world regarding teething were studied. The researches then narrowed down the citations to 22 studies from eight different countries to concentrate on. The children in the studies ranged from birth to age 3 years. The authors, led by Carla Massignan, DDS, concluded gum irritation, irritability and drooling were the main manifestations of infant teething. A key finding is that while some infants have a slight rise in their temperature, it was not up to 100.4 degrees F, the standard cut off for a fever. Based on their meta-analysis, the authors concluded teething does not cause a full-fledged fever or any other sign of actual illness. Now, based on the research, lets look at some of the myths and facts surrounding teething:
“Many parents who come to me share the fact that, well before they end up in my office, they have read a pile of sleep advice books without getting results,” says a local sleep consultant in Westport, CT. “As a result, they often worry there is no real solution for the problems they face with their child’s sleep.”
However, the specialist adds, “The good news is, with the several hundred families I’ve worked with, this has never been the case. The problem isn’t with their child – it’s with the source they’re using for help with getting a child to sleep.” Read More
All of the doctors here at Willows are parents, and we’ve all experienced the jitters and uncertainty that can be part of becoming a parent for the first time. Taking care of newborns can be nerve-racking for sure. But with a little information and good parenting practices, we can help you ensure that your little one will be healthy and happy!
That said, one of new parents’ biggest fears is often sudden infant death syndrome (SIDS). That term is applied to infant deaths that cannot be explained. Another term, sudden unexpected infant death (SUID) is used to describe any unexpected death from SIDS or causes such as suffocation, entrapment, arrhythmia and trauma. Today we want to address SIDS and the subset of SUIDs that occur during sleep.
The American Academy of Pediatrics recently revised and updated its recommendations to reduce the risk of SIDS and sleep-related suffocation, asphyxia and entrapment in infants. Some, like getting regular prenatal care and voiding smoke, alcohol and drugs during pregnancy, are applicable before the baby is born. The remaining recommendations apply to infants up to one year of age and should be used consistently until your child turns one.
Back in 2008, the Food and Drug Administration (FDA) recommended that over-the-counter (OTC) cough and coldmedication should not be used in infants and children under the age of two, and Willows Pediatrics agrees. The FDA found that these products could cause serious and potentially life-threatening side effects in young children including convulsions, rapid heart rates, decreased levels of consciousness and death. This recommendation led to a voluntary recall of these types of products marketed to children under two. Read More
Willows Talks About The Family Bed & Co-Sleeping
Many families spend their days together. Others stay together at night too! The “family bed,” or co-sleeping is a common practice in many societies, and there are advocates for it here in the U.S. too. However, there are child safety concerns related to having adults and children share a bed. So, is it an acceptable practice?
A recent blog posted on CT Now (and written by former local mom Sarah Cody), asked the same question. She’d heard about the possible benefits of co-sleeping—better nursing and enhanced emotional security—but worried about the dangers to newborns and infants, including injury and suffocation.
She turned to Willows Pediatric Group physician Dr. Jeff Owens for his take on the issue. Dr. Owens rightly pointed out that ‘”The American Academy of Pediatrics still doesn’t recommend it.” He also noted that the dangers stem from two major concerns: soft bedding and impaired judgment. A baby should never sleep on a futon, couch or waterbed, and a parent should not drink, smoke or use drugs with the infant nearby. Moreover, twenty-four hour bonding can challenge a couple’s need for a healthy physical relationship and leave a mother drained and exhausted.
However, Dr. Owens did allow for some wiggle room. “If it’s a stark, firm [bed] and the baby is on his back, the baby is probably safe.” Dr. Owens believes we should also respect different cultures, some of which believe “the family bed” is the answer to peaceful nights and strong attachments.
In other words, “do what works for your family as long as it’s a safe situation.”
Recently Time magazine featured a brief article about early detection of autism. The column correctly noted that because autism’s behavioral symptoms don’t become obvious until about age 3, pediatricians have been challenged to find ways to pick up indicators of the condition at an earlier age.
“But,” as the article stated, “researchers say it may be possible to detect subtle warnings of the developmental disorder as early as 12 months—and all it takes is a simple 24-item questionnaire that parents can complete in the pediatrician’s waiting room.”
Good news for patients at Willows Pediatric Group: we routinely offer the M-CHAT, a screening test like the one referred to above, to children at their 15-month checkup. M-CHAT, which stands for Modified Checklist for Autism in Toddlers, is widely recognized and recommended by the American Academy of Pediatrics. The M-CHAT does not provide a diagnosis, but it can indicate if a child is at risk and should receive further evaluation.
In terms of insurance coverage, we submit this service to your insurance company, but as is with all services provided in this office, we do not know or guarantee that your insurance company will pay for the service. At Willows we strive to provide the best care to your child without regard to reimbursement. If you have any questions about reimbursement please feel free to call us and we will help to guide you through the insurance maze.
At Willows, we are always available to discuss your child’s health and any behavioral issues that may be of concern. Child development is an integral part of child health and we are here to answer any questions you have about your child’s speech and language or social skills. If you have any questions about M-CHAT or other child development issues, please don’t hesitate to contact us!
Last fall, we blogged about the importance of correctly using car seats and booster seats to keep babies and older children safe while driving. Just a few weeks ago, however, the AAP released new recommendations relating to car safety, and we wanted to share them with you.
The AAP issued two important revised recommendations:
(1) Parents are now advised to keep toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat.
(2) The AAP now recommends that children ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.
More detailed information on these guidelines can be found at the AAP’s website.
According to the CDC, in 2008, an average of 4 children ages 14 or younger were killed in motor vehicle crashes every day, and many more were injured. Willows Pediatrics is here to answer questions about car seats or child safety in general. In addition, most of our local communities offer car seat check services.
We hope you will take these new recommendations into consideration when putting your children in the car. Use your best judgment and try to adhere to the weight/height guidelines, even if the age guidelines might not be appropriate for your child. For example, as Dr. Czuzcka notes, “The new 4’9” advice to stay in the back booster seat would mean that my wife’s grandmother would be a in a booster seat until she died in her 80s!” In other words, while these are important safety recommendations, each child is unique and there are times when exceptions may be made. (Feel free to ask us about your own child and your specific concerns at your next appointment.)
Thanks for checking in today … and, please, drive safely!
In November 2010, the AAP issued new age-based recommendations for iron intake in infants and toddlers. Because iron deficiency can have irreversible long-term effects on children’s cognitive and behavioral development, the AAP Committee on Nutrition stated that, “It is critical to children’s health that we improve their iron intake status starting in infancy.”
Babies born healthy at full term are born with sufficient iron stores for the first 4 months of life. Therefore, full-term babies do not need iron supplements prior to four months of age. However, if the infant is breast-fed, the AAP now recommends a 1-mg/kg daily dose of oral iron starting at four months, and continuing until an infant begins eating solid iron-rich foods – typically around six months of age. (Formula-fed infants will receive sufficient iron in their formula and do not need a supplement between four and six months of age.)
There is one caveat: Preterm infants do require iron during the first four months. If they are bottle-fed, the iron-fortified formula will provide the proper amount for these infants. However, according to the AAP, preterm infants who are breast-fed should take a 2-mg/kg daily dose of iron starting at one month of age.
We’ve been saying it for years: a teaspoon in your kitchen is not a “teaspoon” in medicine dosing terms. Same goes for the tablespoon. In other words, kitchen spoons are made for eating, not for measuring medicine!