Daily Dose

Babies Do Not Need Water?

1.00 to read

With the temperatures sizzling across the country, I have started to get the question, “how much water does my baby need to drink during the hotter months?” 

I have to admit, I am still confused as to where this medical myth was started?  Babies, even in warm to hot weather can stay hydrated just by their breast milk or formula intake. An infant does not “need/require” extra water in order to stay hydrated during spring and summer months. Many young moms tell me that the grandparents are asking about more water. 

An infant can get all of the hydration they need from their mom’s breast milk or formula intake as there is free water in the milk.  The best source of hydration for a healthy baby is via their milk intake. This is true for babies who are eating baby foods but are still taking a bottle or getting breast fed as well.  

I know that when the weather warms up we may drink more water with exercise or when out in the heat. But a baby is not an athlete (yet) and they are not really losing more water via sweating etc like our older children do. 

It is okay to offer a baby a bottle of water, but they don’t “need” extra water. In many cases an infant won’t even drink plain water as they prefer their mother’s milk or formula and the water just dribbles out of their mouth as you try to get them to drink it. Don’t think that they “need” 8 12 ounces of extra water a day. Someone started this little rumor. 

The bottom line? If you think you need to change your baby’s fluid intake for the warmer weather you can cross that one off your worry list! But, if you have children who are going outside and playing, or adolescents who are participating in outdoor sports, it will soon be time to start thinking about keeping them hydrated during the heat.  More on hydrating your active kids and athletes to come.  Stay tuned! 

That’s your daily dose for today.  We’ll chat again tomorrow. 

Daily Dose

Are Parents Too Connected?

1.30 to read

Has your spouse, babysitter or other child care provider ever called you to come home “because the baby is crying”?  It seems that technology, which is readily at our finger tips 24/7, has created yet another dilemma - what to do if a baby is crying? 

Pre-cell phone days, there really was not much to do if you the parent left home and your baby/child started crying.  Outside of calling the restaurant, store, movie theater (directly), and asking them to page a parent, most of us just muddled through a crying child.  I also think that in most cases, said child eventually stopped crying (unless there was an obvious reason that could be “fixed”) and by the time you the parent returned home, all was typically well.  

But now, with a cell phone in every hand, it only takes one call to summon the parent of a crying child.  I think this is a good news/bad news dilemma.  The good news is: parents may feel more comfortable leaving their child with a babysitter, knowing that they may be reached in the event of an emergency.  The bad news is:  is a baby or child who is only crying, typically an emergency?  Depends on your definition. 

The reason I bring this up is that I often hear young parents, and especially mothers, tell me that during the first several months of their infant’s life, they cannot leave the house for more than minutes, before being called home....because the baby is crying.  Some of these mothers are really “stressed out and exhausted” and need a bit of a get-away to “re-boot”. I am not talking about a trip to the day spa. I am simply talking about an hour or 2 to go to the store or meet a friend for lunch or just sit alone in the park and read a book.  Just a bit of quiet after being home with a baby day in and day out for the first 4 weeks of their newborn’s life.  If you have been there you understand. 

But, now that they have a cell phone, there is CONSTANT communication.  The minute the baby cries, the cell phone rings....”the baby is CRYING, come home.”  My husband would tell you that his best parenting started the first time I left him alone with our first son and I actually went away for the weekend.  (I believe the baby was 6 or 7 weeks old and off I went breast pump in hand to a reunion.)  No cell phones then, and guess what, he did a great job!!!!  He told me how after the first 24 hours he figured out that he really didn’t have to have the baby in the bathroom with him in order to take a shower. He later told me that the first shower he took, not only was our son in the room in his “bouncy” chair, but he left the shower door open as the door got steamy and he couldn’t see the baby!! How cute is that. 

Technology, as wonderful as it is, may also enable us to “cop out” when things get a bit difficult.  That goes for parenting as well. 

Turnoff your phone off sometime and let the “other parent” or babysitter handle it for awhile. Being disconnected is NOT always a bad thing!

Daily Dose

Start the Back-to-School Sleep Routine Now

2.00 to read

Getting back into the routine of school days also means getting back to good bedtime routines.How can it be that school is just around the corner? Getting back into the routine of school days also means getting back to good bedtime routines. With that being said, you have to start the process now to ensure plenty of time to slowly get bedtimes re-adjusted. By starting early you can avoid the battles that some parent’s talk about when discussing bedtimes.

Children need a good night’s sleep to wake up happy, rested and ready to learn. Numerous studies have shown that elementary age kids need about 10 hours of sleep a night while tweens and teens still need a good 8 – 9 hours of sleep. I wonder how many children really get the recommended amount of sleep? I think too few. Unfortunately, I know from my own experience that teens seem to operate on a different sleep schedule and rarely are in bed as early as they should be. Most of us have relaxed bedtime a little during the summer and children are staying up later and sleeping longer in the mornings. This is great during the lazy summer months, when schedules are also different. But within a few weeks the morning alarms will ring forcing everyone to get up earlier to get to school. In order to try and minimize grouchy and tired children (and parents too) during those first days of school, going to bed on time will be a necessity. Working on re-adjusting betimes now will also make the transition from summer schedule to school schedule a little easier. If your children have been staying up later than usual, try pushing the bedtime back by 15 minutes each night and gradually shifting the bedtime to the “normal” hour. At the same time, especially for older children, you will need to awaken them a little earlier each day to re-set their clocks for early morning awakening. Why is it that pre-school children want to get up early, no matter what, while school-aged children are happy to sleep through alarms?  Such is life. Also, make sure that you are not only ensuring that you children get a good night’s sleep during the school year, but they also awaken in time for breakfast! Just like my mother used to say, “breakfast is the most important meal of the day’” and that adage is still true. A good night’s sleep followed by a healthy breakfast has been shown to improve mood, attention, focus and over all school performance, as well as even helping to prevent obesity. Start off the school year on the right foot. It is easier to begin with good habits than to try and break bad ones. That’s your daily dose, we’ll chat again tomorrow.

Daily Dose

Toddler Behavior

1.30 to read

Do you have a toddler? If so you are in the throes of some difficult, albeit sometimes funny, yet inappropriate behavior. It happens to every parent...suddenly their precious child turns into Dr. Jekyll and Mr. Hyde.  Somewhere around 15-18 months, you will most likely see this change in behavior. Although most books refer to the “terrible twos” I really think it is the “me no wanna” 18-30 month old. 

“Me no wanna” is the phrase we often used around our house, and it was coined when the boys were toddlers. It just seemed like the best line when our sweet toddler would rather have a tantrum than do the simple task that we wanted him to do. Example: please put your toy back in the box. “Me no wanna”, I would prefer to fall to the floor and scream.   

How is it that your typically sweet 20 month old child can be in middle of playing nicely and then suddenly seems possessed as they fling themselves to the floor kicking and screaming?  What is the matter?  Are they having a seizure? Or is it that “something” just didn’t seem right to them and they are angry and frustrated???  How can they change behavior so quickly.?   (hint, foreshadowing for those teen years). 

You never know with a toddler what kind of answer you will get when you say something as easy as “let’s get on your shoes to go outside”. Sometimes they happily run get the shoes, bring them to you, sit down and the shoes go on licitly split.  The next time they get the shoes, throw them across the room, lay on the floor and look at you like “me no wanna”. 

Trust me, you are not a “bad” parent, you are just living through some really challenging parenting. It is exhausting at times, but while this age is typically difficult it is some of your most important parenting. This is really the beginning of behavior modification.  Your brilliant toddler is testing you, this may be the first time you the parents understand why everyone talks about boundaries and consequences. 

Some children also express their “me no wanna” by acting out with hitting, biting and kicking. Again, very inappropriate behavior. Your job is to change that behavior by using time out, or taking away a toy or even putting the child to bed early.. There are so many ways to start letting your toddler know that there are consequences for misbehaving, and that tantrums don’t work. 

I am in throes of “me no wanna” again, only this time it is with a puppy! Seems very similar to me.

Daily Dose

Farmer's Marker: Family Fun!

1.15 to read

I was lucky to get a few weeks away and to travel this summer and came back with a renewed energy to cook even healthier meals.  If I could, I would plant a garden with a lot more than my few “scraggly” tomato plants, but Texas weather along with my less than green thumb seem to limit me. One of my new passions is going to one of my local farmer’s markets to buy local and fresh produce.  

What I have discovered is that the Farmer’s Market is a fun family excursion, it is free and what a great learning experience. Along the way you also get to buy fresh produce and commit to some healthier eating habits. Win, win, win!

During routine check ups I love to ask kids about their eating habits.  I usually ask “what is your favorite vegetable?”  I laugh at some of the responses, but I am impressed that some children really do love broccoli and spinach and I am convinced it is due to early exposure.  I also ask about favorite fruits and I also like to ask what they have for a favorite dinner and who cooks it.....a subtle way of getting some good information on family meals.

A trip to the market is a great teaching experience too - as children can learn what an eggplant looks like, or that there are so many different kinds of lettuce. Seeing the veggie in “real time” rather than on an I-pad is also important.  Who knew that there are round and long squash and that some looks like spaghetti on the inside?

So as you start back to school and hopefully cooler temperatures in the next month, let’s all try to be healthier.  More fruits, veggies and lots of color on the plate.....I may just try to plant a cucumber, I hear they are easy to grow?  I’ll keep you posted :)

Daily Dose

Foods You Can Eat When Breast Feeding

1.30 to read

Should breast feeding moms avoid certain foods?I was making hospital rounds today and talking to all of the new moms (and dads) about their newborns.  I love talking to new parents about the importance of having healthy meals to support breast feeding! I even had a young dad asking “what foods should I avoid cooking for my wife while breast feeding?”  How cute is that! Can we clone him?!

After breast feeding my 3 children, I have decided that you can really eat whatever you want!  I know some people swear that certain foods you eat will cause a breast fed baby to have gas. But think about it, bottle fed babies and breast fed infants all have GAS!  None of the formulas contain broccoli, or cauliflower or beans or tomatoes and bottle fed babies have gas too. It is just a fact, newborn babies are gassy for the first several months as their digestive tracts mature. And yes, it is stinky too! So… I told this dad, “good for you for cooking for your wife.  Make her healthy, well balanced meals and throw in a few of her favorite foods.”  I would not change anything unless you can definitely correlate that a food ALWAYS makes your baby more uncomfortable (and that is so hard to keep track of). Eat what you want (in moderation) to be healthy and happy.  I have no data but feel certain that happier mothers must in some way have an effect on a  baby, so at least enjoy mealtime. When I had a colicky baby (previous post), I tried eating only broth and bland foods, and with me equally miserable and starving…this stressful situation only got worse. Final words, if I was going to try eliminating anything from my diet while breastfeeding to try and help “relieve “a gassy baby, it would be excessive dairy, as there has been some data on this. Remember, everything in moderation. I’m willing to bet that by the time your baby is 4 months old (the magic age) you are not even worried about what you are eating, as you are having too much fun laughing with your baby! What foods (if any) bothered your baby while breast feeding? I would love your comments.  Leave them below. That’s your daily dose for today. We’ll chat again tomorrow.

baby, breast feeding, Daily Dose, mom
Daily Dose

Kids Need Vitamin D!

1.15 to read

During all of my check ups I discuss the importance of dairy products in a child’s diet to provide adequate calcium and vitamin D for bone growth and long term bone health.  It doesn’t seem that the little ones are difficult to get  to drink milk, eat string cheese, have a yogurt, but the older kids are definitely more challenging. 

Teenage girls seem to be one of the biggest problems when it comes to calcium intake. When I ask them if they drink milk, a typical response is “Uh, no”, then if I ask about other dairy they may say they drink the milk out of the cereal bowl, or they grab a frozen yogurt at lunch or have a slice of cheese on occasion.  When I ask them if they know how much calcium and viamin D they need during the tween and teen years I also get a blank look  but they do know how many texts they have on their cell phone plan!).  Answer is 1300 mg/day once you hit the teen years. 

With that being said, I am always encouraging more dairy products, milk and then a calcium/vitamin D supplement as well. Interestingly, they usually don’t balk at the idea of a vitamin, but the issue is getting them to stay on the supplement for more than a few days/weeks when they typically start to “forget”. 

So, I was seeing a family with two teenage daughters who had heard my calcium talk before. They were both non milk drinkers, competitive cheerleaders who needed strong bones and who by now could answer my calcium questions. When I asked if they were taking their calcium supplements the mother said, “they have access to calcium and vitamins” everyday......what a great line. Well put by a mom of teens! 

In fact, despite having “access” the girls readily admitted they “rarely” remembered to take them and might be more likely to up their dairy products everyday. 

Calcium and vitamin D metabolism is a hot topic and “banking calcium” during childhood is so important.....even with access to the supplement you have to swallow it to make a deposit. 

Daily Dose

New RSV Policy

1.30 to read

The American Academy of Pediatrics (AAP) released a new policy statement Monday concerning RSV infections and the use of the medication Palivizumab (Synagis), which is a monoclonal antibody.  

Synagis has been used since 1998 in preterm infants as prophylaxis against serious RSV (respiratory syncytial virus) infections. RSV is one of the most prevalent respiratory infections during the winter months and causes the infection known as bronchiolitis.  Bronchiolitis causes cold like symptoms in all ages but has been associated with wheezing and at times respiratory distress requiring hospitalization and supplemental oxygen in infants. The majority of children will have had RSV by the time they are 2 years of age.  

For years it has been the standard of care to give preterm infants born at less than 32 weeks gestation (or 35 weeks with certain risk factors) a shot of Palivizumab every month during RSV season in hopes of preventing serious RSV infections and subsequent hospitalizations. Palivizumab is also not an inexpensive medication and dosing is based upon a child’s weight so cost went up as the babies weighed more each month.  

But multiple studies are now showing that palivizumab prophylaxis really provided limited benefits in terms of total RSV hospitalizations, effect on wheezing and no measurable effect on mortality.  Overall, about 2-3% of infants in the first 12 months of life are hospitalized with RSV infection each year.  More than 80% of RSV hospitalizations in the U.S. occur among full-term previously healthy infants in their first 3 months of life.  These healthy children were never recommended to receive the prophylactic medication. 

So, based on newer data the recommendations will change and palivizumab prophylaxis will now be recommended for infants born before 29 weeks of gestation during their first year of life.( as well as for certain other groups at high risk).  

The good news is that the care of premature infants has improved dramatically which has helped to prevent chronic lung disease. There are now fewer than 100 deaths a year due to complications of RSV.  With that being said, the best way to prevent RSV infections in all infants, especially those born at preterm is by promoting breast feeding, practicing good hand and cough hygiene, avoiding smoke exposure,immunizing household contacts with flu vaccine and limiting attendance in large group child care during the first winter season if at all possible.   

With temperatures across the country now in the “sweltering” range it is hard to think about winter respiratory infections, but these changes are important for both the medical community and new parents as well. 

Daily Dose

Over The Top Birthday parties

1.15 to read

Birthday parties are getting to be quite a big deal...even for a one year old. I have had several parents in with their children for their 1 year old check up and they often bring along birthday party pictures. WOW!

Some of these bashes look like they could be a swee” sixteen or a wedding.  No kidding. I thought I had hit the jackpot when I started printing birthday invitations on my color printer....but these days some of the invitations are printed and delivered to other “1 year olds” who I assume cannot read yet. Thankfully their parents are also included as +2. 

These parents are very clever and most of the parties had themes....with the invitation, cake and party favors all coordinating. Looked like a ton of work for the parents to put this all together. If anything, this is not a “last minute” event...lots of planning and executing. I wonder if second or third children have such elaborate “bashes”.

I know I seemed to be able to throw together a birthday party at the last minute when necessary, but I am sure that was for child number 2 or 3. My husband did remind me of our first child’s 1st birthday when we had many friends and their toddlers over. He also reminded me that it was about 110 degrees in June, and that we had a plastic baby pool that we put a bunch of hot sweaty kids in, with parents who wished that they could have fit as well.  Not sure where those pictures are.

But it seems that petting zoos, bounce houses (maybe for the adults), magicians, and even super heroes arrive to celebrate this latest group of 1 year olds.  There are themed cakes with a miniature one for the birthday child too so that they may fully indulge in their “first sweet” A few of my moms had gluten free cakes made, just because. There are often tons of gifts as well, but many parents are opting to then donate them to one of our local children’s hospitals....a wonderful idea.

Lastly, with all of the fancy new apps and iPhone photos, many of the parties look like they have been professionally photographed (some of course had been).  Some of the precious 1 year old birthday children even had several wardrobe changes to celebrate the big day (yes, those were mostly little girls), I guess to get an early start on future occasions like the wedding.

What do you think about first birthday parties... I just think it might be worth waiting till your child can appreciate it as well?

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DR SUE'S DAILY DOSE

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