Parents Page

Sleep in Kids: How to Help Your Child (and you) Get More Sleep

Thu, 20 Apr 2023 20:16:41 GMT

Tips for Sleep Success

Restful sleep and good sleep hygiene is crucial for us all. It is important for your child's brain development and important for your mental health as a parent. So let's discuss how to help everyone stay happy (and sane) by helping your baby or child get better sleep.

Let's break it down since sleep can be slightly different for babies versus older children. I will talk about babies in this section and later about older children.

HELPING YOUR BABY SLEEP

A word on sleep training.

"Sleep training" is a term that you may have heard that generally refers to different methods that are meant to help your baby become an independent sleeper. These methods involve helping your baby fall sleep without excessive rocking or a feeding and teaches your baby to self-soothe. This can also help with nighttime awakenings by helping your baby get back to sleep on their if they awaken, without you having to respond to them.

Remember that sleep training and weaning from nighttime feeds do not necessarily go hand-in-hand. Your baby may still need to feed once or twice during the night, even once they are old enough to fall asleep and get back to sleep independently.

Some experts and parents swear by one method or another of sleep training and you can try some of these methods as early as 4 to 6 months of age. However, sleep training can be effective no matter what age you start and even for older children. Some methods require more "tough love" than others and may involve lots of crying but promise a quick improvement over only days. Other methods allow for less crying and more bonding and comforting but may take weeks to help your child sleep independently. You can read more about the different methods of sleep training here https://www.todaysparent.com/baby/baby-sleep/most-popular-sleep-training-methods-explained/ .

Regardless of how you decide to help your child sleep more independently, there are a few guidelines that will make the journey smoother for everyone involved and are helpful for a child at any age.

Ensure their own sleeping space

The first rule of sleep hygiene is that your baby should have their own sleeping space whenever possible. This should be a crib or bassinet in your room or in their own room.

While there may be other reasons that you decide to co-sleep, if your baby is sleeping in your bed, it will be extremely difficult to encourage good sleep habits. Your child will likely get in the habit of needing you to fall asleep and to get back to sleep if awoken during the night. Not to mention, every movement you make during the night will likely wake your baby and every movement your baby makes will likely wake you, resulting in less sleep for everyone.

Recognize signs of sleepiness

Watch for signs of sleepiness, such as yawning, rubbing eyes, or becoming more fussy. It helps to put your baby to sleep when they start to show signs of sleepiness rather than when they are already overly tired and extremely cranky. This will help your child go to sleep more smoothly and stay asleep longer. It also helps to lay your child down when still awake but sleepy, rather than trying to place them down ever-so-gently once already sleep, only to awaken them again and having to start all over.

Establish a bedtime routine

Create a consistent routine around bedtime, ideally at the same time every day, to help signal your baby and your baby's body to get ready for sleep. This routine may involve bathtime or reading a book just before bed. Avoid using a feeding to help your baby fall asleep. Instead, give your baby's last feeding just before you start their bedtime routine. This will help to prevent your baby needing a feed in order to fall asleep.

Avoid stimulating activities

Avoid any activities that may overstimulate your baby just before bedtime, usually for at least 30 minutes prior to bedtime. This means no electronics and avoiding any rambunctious play just before bedtime.

Use calming activities to your advantage

Read your baby a book, play some lullaby or other soft music, or give your baby a calming bath before bedtime. These calming activities help relax your baby's mind to prepare for sleep.

Keep the room dark

A nightlight may be helpful so you can see your baby at night in case you need to check on or respond to them. However, otherwise keeping the room fairly dark will actually help your child sleep. This helps to eliminate distractions and things that your child may see around the room that may stimulate them to want to play or engage.

Wait to respond

Try not to rush to your baby as soon as you hear their first whimper or cry. Babies may make noises and toss and turn a bit in their sleep but may fall back asleep on their own if you just give them time. Even if your baby is fully awake but is not crying, you can give them time to drift back off to sleep if it is still sleeping time. If your baby has been crying for more than 30 seconds (may feel like a long time for parents), then you may respond, unless you have chosen a method of sleep training that advises against it.

Avoid late naps

While your baby will still need naps during the day, try to avoid having your baby nap too close to bedtime, unless absolutely necessary. This can disrupt their ability to sleep at their desired bedtime. Try to end naps at least 2 hours before bedtime by waking your child up if they happen to fall asleep close to this time, as long as they have had at least 30 minutes of sleep for their nap.

HELPING YOUR CHILD SLEEP

Ensure their own sleeping space

The first rule of sleep hygiene is that your child should have their own sleeping space whenever possible. Once your child is 12 to 18 months of age, this should ideally be a crib or bed in your child's own room.

If your child is sleeping in your bed, it will be extremely difficult to encourage good sleep habits. Your child will likely get in the habit of needing you to fall asleep and to get back to sleep if awoken during the night. Not to mention, every movement you make during the night will likely wake your child and every movement your child makes will likely wake you, resulting in less sleep for everyone.

Recognize signs of sleepiness

Watch for signs of sleepiness, such as yawning, decreased activity, or becoming cranky. It helps to help or encourage your child to go to bed when they start to show signs of sleepiness rather than when they are already overly tired. This will help your child go to sleep more smoothly and stay asleep longer.

Establish a bedtime routine

Create a consistent routine around bedtime, ideally at the same time every day, to help signal your child and your child's body to get ready for sleep. This routine may involve bathtime or reading a book just before bed.

Avoid stimulating activities

Avoid any activities that may overstimulate your child just before bedtime, usually for at least 30 minutes prior to bedtime. This means no electronics, such as TV, cell phones, tablets, and video games. Your child should never have a TV in their room, regardless of age. You should also avoid or have your child avoid any rambunctious playing and/or exercise just before bedtime as this can overly stimulate their mind and derail being able to get to sleep.

Use calming activities to your advantage

Have your child engage in more soothing activities that actually help relax their mind and help them to drift off to sleep easier. This may include reading them a book or encouraging them to read on their own. Listening to soft or calming music or bathtime before bed can also help.

Keep the room dark

A nightlight may be helpful, especially for toddlers and preschoolers, to curtail fears of being in the dark alone. However, otherwise keeping the room fairly dark will actually help your child sleep. This helps to eliminate distractions and things that your child may see around the room and want to play or engage with. Studies have shown that it is much easier to fall asleep in a dark room.

Avoid late naps

While toddlers or preschoolers may still need a nap during the day, try to avoid naps too close to bedtime for all ages, unless absolutely necessary. This can disrupt your child's ability to sleep at their desired bedtime. Try to end any naps at least 2 hours before bedtime by waking your child up if they happen to fall asleep close to this time, as long as they have had at least 30 minutes of sleep for their nap.

Don't rely on sleep aids or medications

Sleep aids and medications are not generally recommended for children to help with sleep. While not addictive, some of these medications can be habit-forming, meaning your child develops a habit of not being able to sleep without them.

How To Get Your Child To Eat Veggies (even if they don't know it)

Thu, 20 Apr 2023 17:19:06 GMT

Making eating vegetables easy and fun

Are you having trouble getting your child to eat vegetables? Here are some ways to get your child to expand their palate to include these nutritious morsels, regardless of age.

Encourage them to keep trying foods.

You shouldn't expect your child to eat every vegetable or to love all the foods that you love. But you do want to encourage them to keep trying new foods. Once a child reaches toddler age and has learned the art of refusal, you may notice that they don't seem to love all the vegetables they used to eat. At this stage (or any stage), research shows that it can take a person 10 times to taste the same food before they develop a taste for it.

Here's where I like to create a rule or bargain between child and parent. The child's rule or part of the bargain is that they have to taste the vegetable or food any time it is available or offered (a healthy spoonful or bite, not just a teensy nibble). Then the parent's part of the bargain is that, if the child decides they don't like the taste of the vegetable or food, they should not be forced to continue eating it during that particular meal.

Forcing your child to eat foods that they have expressed they don't like may create for them a negative association with vegetables and healthier foods. However, the next time that particular vegetable or food is available for your child, the rule starts over, so the child can decide if they truly do not like a particular vegetable or food.

My rule growing up was that you couldn't leave the table until your plate was clean. So whenever my most-hated vegetable, overly cooked squash, was served, I would come up with everything from feeding it to the cat, to hiding it in the crevices of the table, to faking vomiting, to strategically going to the bathroom with squash in napkin to be flushed. It took me years to realize that I actually like squash, when it's not soggy and overcooked.

Keep their favorites available. If your child has a few vegetables that they will always eat, keep these well-stocked while you work on broadening their palate. This way, even if they refuse the asparagus they tried today, you can still get some great nutrition in with their usual broccoli, peas, or green beans (common favorites).

Add some flavor. Try to make sure the vegetables you are offering your child actually TASTE good. Don't be afraid to add some butter (or margarine), salt, or other herbs and flavorings. You generally want to stay away from spicy seasonings, like a lot of black or red pepper or curry seasoning, unless your child is a lover of spicy foods, but most young children are not. But kids can handle and may enjoy lemon, basil, garlic, cumin, and other mild seasonings.

You might also add a sauce or dip to make their vegetables more tasty. You can add a flavorful sauce, such as a tomato sauce, ketchup, a cheese sauce, barbecue sauce, or salad dressing. Or you can let your little one dip their vegetables into these sauces. Dipping always makes things more fun!

Make sure the vegetables are cooked well and taste good to you too (flashbacks again of soggy squash). Don't expect your child to eat vegetables that you wouldn't enjoy either.

Let them help you cook. Let your child get involved with cooking. Your child will be more likely to try foods that they helped prepare and this makes eating healthy more fun for your child. Be sure to keep your young child away from sharp knives and the hot stove or oven. But young children love cooking activities such as peeling garlic or onions, snapping peas, dropping fruits and veggies into the blender cup, and mixing things with a spoon. Think of other creative and safe ways to allow your child to help you with cooking.

Getting your child to eat more vegetables make take some creativity but it can be done! Try one or more of these tips and in time, your child can become a veggie lover.

Sneak them in. If all else fails, you can sneak your child's vegetables into their food by blending or mixing them in. Incorporate the vegetables in a way that it tastes good and can't be picked out or eaten around. For example, you can blend up spinach, kale, or broccoli and mix into any soups, sauces, stews, or ground meat dishes that you are already making. This works great with spaghetti sauce (another common favorite), hamburgers, or meatballs.

Here are a couple more creative ideas. Blend spinach, broccoli, or kale and mix it into eggs and serve it as "green eggs and ham" (or other preferred breakfast meat) to make it fun. Or cook butternut squash until soft, blend it, and use as a healthy "cheese" sauce for macaroni and cheese or any other cheesy dishes. You can even add some cheese if you want but it tastes pretty good, and surprisingly "cheesy" even without.

Make fruit (and veggie) smoothies. Make smoothies by blending tasty, sweet fruits with or without yogurt and with or without ice to make a delicious smoothie. Just don't forget to add the veggies! Lots of vegetables mix well into smoothies, such as broccoli, leafy greens, celery, sweet peppers, and carrots. This way the veggies taste great and can't be picked out.

All content on this website, including medical opinion and any other health-related information is for informational purposes only and should not be considered a specific diagnosis or treatment plan for any individual situation. Use of this website and the information contained does not create a doctor-patient relationship. Always seek the direct advice of your own doctor before starting any specific treatment plan.

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4 Month Milestones Checklist

Wed, 30 Nov 2022 15:09:54 GMT

My Baby is 4 Months Old: What should he/she be able to do?

Your baby is now almost 4 months old and makes you smile more and more every day. Here are the things you should expect your child to do by 4 month of age.

By 4 months of age, your child should be able to:

Gross Motor/Physical Movement

Hold his/her head up on their own
Lift up onto his/her elbows when lying on their tummy
Bear weight (and may bounce) on legs when his/her feet are placed on a flat surface
Roll in one direction (usually from tummy to back)

Fine Motor/Hand-Eye Coordination

Reach for toys
Bring toys to his/her mouth

Social/Emotional

Smile spontaneously, especially at people, and may begin to laugh
May copy some movements and facial expressions, like smiling or frowning
Respond to affection (by smiling back or making vocalizations)

Language/Communication

Begin to babble (make vocalizations that sound like conversation)
May experiment with and copy sounds he/she hears (grunting, yelling, coughing)
Have different cries for different things (like being hungry, being tired, or being in pain)

Cognitive/ Learning & Problem-solving

Follow moving things with eyes side to side (people, toys, colorful objects)
Watch faces closely
Recognize familiar people and objects from a distance (Mommy, Daddy, bottle, favorite toy, etc)

If your child is 4 months old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 4 Month Milestones

Tummy time: Set your child on top of a blanket/playmat on the floor for “tummy time” once or twice a day.
Toys: Introduce colorful toys for your child to play with. Now your child will begin to reach for and engage with toys and will be interested in colorful items or things that make noise.
Talk and respond: Talk to your baby as much as possible and respond when he/she talks or makes baby sounds while looking directly at you. Showing your baby that their vocalizations will get a response helps to foster social skills and conversational skills and encourages your baby to continue "talking"
Smile and play: Smile at and play with your child often. Make lots of facial expressions. Your child is studying and starting to learn the differences in the tone of your voice and the facial expressions you make. And, sometimes, silly faces, just give your baby a delight.
Read: Read simple books to your child. Reading is fundamental at all stages of learning and helps your child to be exposed to and absorb as much information as possible. Your baby may look at the book a little more as you are reading and can distinguish more color now, so colorful books will catch their attention.

When to Be Worried

If your child is already 4 months of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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6 Month Milestones Checklist

Wed, 30 Nov 2022 15:05:19 GMT

My Baby is 6 Months Old: What should he/she be able to do?

Your baby is now approaching 6 months of age and continues to surprise you day by day with his/her new skills. Here are the things you should expect your child to do by 6 months of age.

By 6 months of age, your child should be able to:

Gross Motor/Physical Movement

Roll in both directions (tummy to back and back to tummy)
Sit with support (with something behind his/her back or with his/her hands down for support)
Bear weight on legs and may bounce when feet are on flat surface
May get up on all fours and rock back and forth (usually not crawling yet)

Fine Motor/Hand-Eye Coordination

Pass toys from one hand to the other

Social/Emotional

Recognizes familiar faces and may begin to show stranger anxiety
Likes to play with others, especially parents and siblings
React to other people’s emotions and often seems happy
Likes to look at self in mirror

Language/Communication

Respond to sounds by making sounds and likes to take turns making sounds
Respond to his/her own name (by turning his/her head or looking at you)
Make different sounds to show joy and displeasure
Babble using long vowel sounds (“aaah,” “eee,” “ooo”)

Cognitive/Learning & Problem-solving

Look around at things nearby
Bring toys to mouth
Show curiosity about things and try to get things that are out of reach (may roll, squiggle, or wiggle, to try to get to something out of reach)

If your child is 6 months old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 6 Month Milestones

Play time: Create time each day for your child to play with toys and let them explore (a playmat on the floor is a great place to do this).
Talk and respond: Talk to your baby as much as possible and respond when he/she talks or makes sounds. Showing your baby that their vocalizations will get a response helps to foster social and conversational skills and encourages your baby to continue "talking".
Smile and play: Smile at and play with your child often. Make lots of facial expressions. Your child is still studying and learning the differences in the tone of your voice and the facial expressions you make.
Read: Read simple books to your child and use a lot of expression in your storytelling. This will help to keep your child engaged and they will likely smile and giggle along if they see you are enjoying it too.

When to Be Worried

If your child is already 6 months of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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9 Month Milestones Checklist

Wed, 30 Nov 2022 15:00:35 GMT

My Baby is 9 Months Old: What should he/she be able to do?

Your baby is almost 9 months old and has probably become an explorer of sorts. Here are the things you should expect your child to do by 9 months of age.

By 9 months of age, your child should be able to:

Gross Motor/Physical Movement

Pull up on the couch, a chair, or your legs to a standing position
Stand and takes steps while holding on (“cruising”)
Sit up on his/her own without support
Crawl

Fine Motor/Hand-Eye Coordination

Move things smoothly from one hand to the other
Pick up small things between thumb and index finger, like “puffs” or other finger foods

Social/Emotional

Shows stranger and separation anxiety
May be clingy with familiar adults

Language/Communication

Seem to understands “no” or other simple words
Copies sounds and gestures
Says the words “dada” and maybe “mama” or "baba", but not yet specific to parents or objects
Can make many other sounds and string sounds together

Cognitive/ Learning & Problem-solving)

Will drop things intentionally to see them fall
Will Look for things he/she sees you hide
Can play peek-a-boo

If your child is 9 months old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 9 Month Milestones

Play time: Create time each day for your child to play with toys and let them explore (a playmat on the floor is a great place to do this).
Sitting tools: Allow your child to sit with support in appropriate sitting devices (high chair, bouncy chair, “bumble” chair, etc)
Talk and respond: Talk to your baby as much as possible and respond when he/she talks or makes sounds. Showing your baby that their vocalizations will get a response helps to foster social and conversational skills and encourages your baby to continue "talking". The more language your child hears, the more he/she will pick up as they begin to learn to talk.
Smile and play: Smile at and play with your child often. Make lots of facial expressions. Your child is still studying and learning the differences in the tone of your voice and the facial expressions you make. Play is how your child learns best at this stage.
Read: Read simple books to your child and use a lot of expression in your storytelling. This will help to keep your child engaged and they will likely smile and giggle along if they see you are enjoying it too.

When to Be Worried

If your child is already 9 months of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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12 Month Milestones Checklist

Wed, 30 Nov 2022 14:57:34 GMT

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It's been a full year with your bundle of joy and he/she is growing up before your eyes! Here are the things you should expect your child to do by 12 months of age.

By 12 months of age, your child should be able to:

Gross Motor/Physical Movement

May take his/her first steps (but really has up until 18 months to walk)
If not walking just yet, should be able to stand alone
Get to a sitting position without help

Fine Motor/Hand-Eye Coordination

Point to things with his/her index (pointer) finger
Feed him/herself finger foods

Social/Emotional

Show stranger and separation anxiety
Has preferred toys

Language/Communication

Use simple gestures, like shaking head “no” or waving “bye-bye”
Make sounds with changes in tone (sounds more like real speech)
Says at least 3 words you can understand, often “mama” and “dada” and one other
Use “mama” and “dada appropriately
Try to repeat words/sounds he/she hears (similar sound even if you still can't really understand the word)

Cognitive/ Learning & Problem-solving)

Explore things by shaking, banging, throwing, etc
Find hidden things easily
Copy gestures he/she sees (clapping, pat-a-cake, etc)
Play peek-a-boo and pat-a-cake
Hand you a book or toy when wants to hear a story or wants to play
Follow one-step commands with gestures, like pointing and saying “pick up the toy”

If your child is 12 months old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 12 Month Milestones

Play time: Create time each day for your child to play with toys and let them explore indoors and outdoors. Engage with your child by explaining things in simple terms and showing them how things work. Encourage them to try things on their own and let them explore a little on their own (while keeping a close eye on them).
Walking practice: Encourage and help your child to practice walking by:
holding their hands and letting them walk
letting them use a baby walker (always supervised and away from any stairs or ledges)
placing them a few steps away from you or a favorite toy and encouraging them to take steps toward you or the toy
Talk and respond: Talk to your baby as much as possible in plain language (no more "baby" talk) and encourage others not to use "baby" talk either. The more language your child hears, the more he/she will pick up as they begin to learn to talk. Respond when your child talks to continue to encourage social and conversational skills.
Read: Continue to read simple books to your child. Your child may now be more engaged in the story, especially if there are bright colors and lots of pictures (and funny voices can help too to make the story fun).

When to Be Worried

If your child is already 12 months of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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15 Month Milestones Checklist

Wed, 30 Nov 2022 14:54:09 GMT

My Baby is 15 Months Old: What should he/she be able to do?

Time is flying and your baby is officially a toddler! Here are the things you should expect your child to do by 15 months of age.

By 15 months of age, your child should be able to:

Gross Motor/Physical Movement

Walk (but really has up until 18 months to walk)
If not walking just yet, should be able to stand alone
Climb up stairs and onto couch or chairs

Fine Motor/Hand-Eye Coordination

Put things into and takes things out of a container
Attempt to use tools appropriately (such as drinking from a cup, brushing hair, or using a fork/spoon)

Social/Emotional

Show stranger and separation anxiety (and cling to familiar people)
Have preferred toys

Language/Communication

Say 3-5 words you can understand
Try to repeat words he/she hears (similar sound even if you still can't understand the word)
Use simple gestures, like shaking head “no” or waving “bye-bye”
Make sounds with changes in tone (sounds more and more like real speech)

Cognitive/ Learning & Problem-solving)

Recognize some objects or pictures when named
Copy gestures he/she sees (like clapping or waving)
Hand you a book or toy when wants to hear a story or wants to play
Follow one-step commands with gestures, like pointing and saying “pick up the toy” or "put it in the trash"

If your child is 15 months old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 15 Month Milestones

Play time: Create time each day for your child to play with toys and let them explore indoors and outdoors. Engage with your child by explaining things in simple terms and showing them how things work. Encourage them to try things on their own and let them explore a little on their own (while keeping a close eye on them).
Talk and respond: Talk to your baby as much as possible in plain language (no more "baby" talk) and encourage others not to use "baby" talk either. The more language your child hears, the more he/she will pick up as they begin to learn to talk. Respond when your child talks to continue to encourage social and conversational skills.
Read: Continue to read simple books to your child. Your child may now be more engaged in the story, especially if there are bright colors and lots of pictures (and funny voices can help too to make the story fun).

When to Be Worried

If your child is already 15 months of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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18 Month Milestones Checklist

Wed, 30 Nov 2022 14:50:55 GMT

My Baby is 18 Months Old: What should he/she be able to do?

Can you believe your little newborn baby...is almost 2 years old now and is growing and changing every day!?!? Here are the things you should expect your child to do by 18 months of age.

By 18 months of age, your child should be able to:

Gross Motor/Physical Movement

Walk (every child should be walking by this age)
If your child has already been walking for months, should have improved walking and may run
May try to kick a ball
Can pulls toy behind while walking
Can drink from a sippy cup and begins to drink from a cup with no top (or a water bottle)
Begin to eat correctly (but still making mess) with a spoon/fork

Fine Motor/Hand-Eye Coordination

Can help get themselves dressed (arms in, legs in)
May be able to remove some clothing on their own (especially socks and diapers)
Can scribble with a crayon (or other writing tool)

Social/Emotional

Play next to, but not necessarily with, peers
Hand things to others during play or points to show others something interesting
May have temper tantrums
May still be afraid of strangers or cling to familiar people
Show affection to familiar people (kisses and hugs)

Language/Communication

Say 5-20 words that you can understand and is adding at least one (understandable) new word a week to their vocabulary
Can say and shake head “no”
Can point to show someone what they want

Cognitive/ Learning & Problem-solving)

Play simple pretend games, such as talking on the phone or feeding a doll
Explore alone (if parent still nearby)
Follow one-step commands without gestures, like “sit down” or "come here"
Point to one body part

If your child is 18 months old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 18 Month Milestones

Play time: Continue to let your child to play with toys and explore indoors and outdoors as regularly as possible. Engage with your child by explaining things in simple terms and showing them how things work. Encourage them to try things on their own and let them explore more and more on their own (while still keeping a close eye on them).
Talk and respond: Talk to your baby as much as possible in plain language. The more language your child hears, the more he/she will pick up as they begin to learn to talk. Respond when your child talks to continue to encourage social and conversational skills. Help to expand your child's vocabulary by pointing to things and stating what the object is and by explaining the world around them, in general.
Read: Continue to read simple books to your child. Your child should be more engaged in the story, especially if there are bright colors, lots of pictures, and funny voices/actions to help tell the story.

When to Be Worried

If your child is already 18 months of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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2 Year Old Milestones Checklist

Wed, 30 Nov 2022 14:45:51 GMT

My Child is 2 Years Old: What should he/she be able to do?

Your little one continues to grow up SO fast and has now been in your life for 2 whole years! Here are the things you should expect your child to do by 2 years of age.

By 2 years of age, your child should be able to:

Gross Motor/Physical Movement

Stand on his/her tiptoes for a few seconds
Kick a ball
Walk up and down stairs while holding on to the rails (not yet completely independently)

Fine Motor/Hand-Eye Coordination

Can copy straight lines or (imperfect) circles
Build a tower of 4 or more blocks

Social/Emotional

Play next to, but not yet with peers, but may be excited to be around other children
Show defiant behavior (testing boundaries and temper tantrums)
Copy others
Want to do things independently (and want less and less help)

Language/Communication

Say several words (more than you can count)
You can understand about half (50%) of what he/she says
Speak in some short 2-3 word sentences
Repeat words overheard in others’ conversations

Cognitive/ Learning & Problem-solving)

Begin to sort shapes and colors
Sing songs and rhymes
May start to show left- or right-handedness
Can points to things or pictures when they are named
Know names of familiar people and several body parts

If your child is 2 years old and is doing all of these things, great!

Tips to Help Your Child Reach Their 2 Year Milestones

Play time: Continue to let your child to play with toys and explore indoors and outdoors as regularly as possible. Engage with your child by explaining things around them and showing them how things work. Encourage them to try things on their own more and more and let them explore on their own (while still supervising).
New activities: Children are still mostly learning through play at this age. Try new activities with your child, such as painting, water play, or tactile play (can be as simple as playing with clay, sand, or letting them play with and mix flour in a bowl with a spoon). Get creative and choose things that you and your child will enjoy. Don't be afraid to let them get a little messy (or take the activity outdoors or in a contained area with a dropcloth or inside of a box/play area), this only adds to their fun.
Talk and respond: Talk to your child as much as possible in plain language. The more language your child hears, the more he/she will pick up as they begin to learn to talk. Respond when your child talks to continue to encourage social and conversational skills. Help to expand your child's vocabulary by pointing to things and stating what the object is and by explaining the world around them, in general.
Read: Continue to read books to your child. Your child will be more engaged in the story now and may have some favorites. Indulge your child a little in reading the same book a couple or times or daily to encourage their delight in reading, storytime, and learning

When to Be Worried

If your child is already 2 years of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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2 1/2 Year Old (30 Month) Milestones Checklist

Wed, 30 Nov 2022 14:42:01 GMT

My Child is 2 1/2 Years (30 Months) Old: What should he/she be able to do?

Your little human is blossoming before your eyes and it has you full of bittersweet emotions! Here are the things you should expect your child to do by 2 1/2 years of age.

By 2 1/2 years of age, your child should be able to:

Gross Motor/Physical Movement

Can walk up and down stairs while holding on to the rails (not yet completely independently)

Fine Motor/Hand-Eye Coordination

Can draw straight lines or (imperfect) circles
Can remove some of his/her own clothing
Can build a tower of 4 or more blocks

Social/Emotional

Excited to be around other children and may begin to play with familiar children
Continue to shows defiant behaviors and test boundaries
Want to do things independently ("I can do it")

Language/Communication

Say several words (more than you can count)
You can understand more and more of what they say and can understand a little more than half of what he/she says
Speak in 2-3 word sentences
Repeat words overheard

Cognitive/ Learning & Problem-solving)

Sing songs and rhymes
Can name several pictures and objects
Know names of familiar people and several body parts
Show interest in potty training

If your child is 2 1/2 years old and is doing all of these things, great!

Tips to Help Your Child Reach Their 2 1/2 Year Milestones

Play time: Continue to let your child to play with toys and explore indoors and outdoors as regularly as possible. Engage with your child by explaining things around them and showing them how things work. Encourage them to try things on their own more and more and let them explore on their own (while still supervising).
New activities: Children are still mostly learning through play at this age. Try new activities with your child, such as painting, water play, or tactile play (can be as simple as playing with clay, sand, or letting them play with and mix flour in a bowl with a spoon). Get creative and choose things that you and your child will enjoy. Don't be afraid to let them get a little messy (or take the activity outdoors or in a contained area with a dropcloth or inside of a box/play area), this only adds to their fun.
Talk and respond: Talk to your child as much as possible in plain language. The more language your child hears, the more he/she will pick up as they begin to learn to talk. Respond when your child talks to continue to encourage social and conversational skills. Help to expand your child's vocabulary by pointing to things and stating what the object is and by explaining the world around them, in general.
Read: Continue to read books to your child. Your child will be more engaged in the story now and may have some favorites. Indulge your child a little in reading the same book a couple or times or daily to encourage their delight in reading, storytime, and learning.

When to Be Worried

If your child is already 2 1/2 years of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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3 Year Old Milestones Checklist

Wed, 30 Nov 2022 14:33:51 GMT

My Child is 3 Years Old: What should he/she be able to do?

All of a sudden you have a 3 year old and now may be starting to think about school for your child...where has the time gone? Here are the things you should expect your child to do by 3 years of age.

By 3 years of age, your child should be able to:

Gross Motor/Physical Movement

Can climb well and run easily
Can ride a tricycle or bike with training wheels
Can walk up and down stairs one foot at a time (with less and less use of the rail)

Fine Motor/Hand-Eye Coordination

Can get themselves dressed with a little help
Can work toys with buttons, levers, and moving parts
Can draw a circle with pencil or crayon (although still not a perfect circle)
Can turn book pages one at a time
Can build a tower of more than 6 blocks
Can open easy packages (plastic bags) or turn door handles

Social/Emotional

Copy adults and friends
Show affection toward friends
Play with friends, share, and take turns in games
Show concern for a crying sibling, friend, or familiar person
Show a wide range of emotions
Separate easily from parents (but may still get upset with major changes in routine)

Language/Communication

Can name a friend and most familiar things
Know first name, age, and sex
Use words like “I,” “we,” and “you” appropriately, most of the time
Talk well enough for strangers to understand most of what they say
Have a conversation using 2-3 word sentences

Cognitive/ Learning & Problem-solving)

Understand “mine” and “his” or “hers”
Can follow 2-3 step commands ("pick up the toy and put in the box" or "get your shoes and bring them to me")
Can complete puzzles with 3 or 4 pieces

If your child is 3 years old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 3 Year Milestones

Play time: Continue to let your child to play with toys and explore indoors and outdoors as regularly as possible. Engage with your child by explaining things around them and showing them how things work. Encourage them to try things on their own more and more and let them explore on their own (while still supervising).
New activities: Children are still mostly learning through play at this age. Try new activities with your child, such as painting, water play, or tactile play (can be as simple as playing with clay, sand, or letting them play with and mix flour in a bowl with a spoon). Get creative and choose things that you and your child will enjoy. Don't be afraid to let them get a little messy (or take the activity outdoors or in a contained area with a dropcloth or inside of a box/play area), this only adds to their fun.
Talk and respond: Talk to your child as much as possible in plain language. The more language your child hears, the more he/she will pick up as they begin to learn to talk. Respond when your child talks to continue to encourage social and conversational skills. Help to expand your child's vocabulary by pointing to things and stating what the object is and by explaining the world around them, in general.
Read: Continue to read books to your child. Your child will be more engaged in the story now and may have some favorites. Indulge your child a little in reading the same book a couple or times or daily to encourage their delight in reading, storytime, and learning.

When to Be Worried

If your child is already 3 years of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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4 Year Old Milestones Checklist

Wed, 30 Nov 2022 14:24:49 GMT

My Child is 4 Years Old: What should he/she be able to do?

You have a preschooler who is growing up before your eyes!?! When and how did that happen so fast? Here are the things you should expect your child to do by 4 years of age.

By 4 years of age, your child should be able to:

Gross Motor/Physical Movement

Hop and stand on one foot for a few seconds
Catch a bounced ball most of the time

Fine Motor/Hand-Eye Coordination

Cut with scissors with supervision
Pour a drink with supervision (may spill a little)
Draw a square and copy some letters
Draw a person with 4 body parts (may be a stick figure)

Social/Emotional

Enjoy doing new things
Is creative with imaginary play (plays house and pretends to be “Mommy” and “Daddy” or plays superheros, pirates, princesses, etc)
Would rather play with other children than by themselves
Can talk about what he/she likes or is interested in

Language/Communication

Knows more basic rules of grammar, such as correctly using “he” and “she”
Can sing an entire song from memory such as the “The Itsy Bitsy Spider” or “The ABC Song”
Tell a story
Say first and last name

Cognitive/ Learning & Problem-solving)

Can name most colors and can count to 20 or higher
Understands the concept of counting objects
Starts to understand the concept of time
Can remember parts of a story or (recent) past events
Can play simple board or card games

If your child is 4 years old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 4 Year Milestones

Play time: Continue to let your child to play with toys indoors and explore outdoors as much as possible. Continue to explain things to your child, now with more detail. At this age, your child is a sponge and will soak up everything you teach them about things that interest them.
New activities: Children are still mostly learning through play and through things that interest them at this age. Continue to expose your child to new things and/or the things they have grown to love. Get creative and let your child be involved in choosing activities.
Talk and explain: This is the age of LOTS OF QUESTIONS! Try to respond to your child and answer their questions as much as possible as this is just their way of learning more and more about the world around them. It is ok to set limits and ask for quiet every now and then but try not to stifle your child's interests and eagerness to learn and explore.
Read: Continue to read books with your child. Your child is now in the pre-reading stage and may now be able to recite their favorite parts of books and start to recognize sight words and some letter sounds. Start to practice identifying letters, their sounds, and some sight words with your child.

When to Be Worried

If your child is already 4 years of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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5 Year Old Milestones Checklist

Wed, 30 Nov 2022 14:16:36 GMT

My Child is 5 Years Old: What should he/she be able to do?

Now you all of a sudden you have a kindergartner and school and ensuring your child's learning and continued development will be a whole new world for both you and your child to navigate? Here are the things you should expect your child to do by 5 years of age.

By 5 years of age, your child should be able to:

Gross Motor/Physical Movement

Stand on one foot for 10 seconds or longer
Hop and may be able to skip
Can do a simple forward roll/somersault
Can use the toilet completely on his/her own

Fine Motor/Hand-Eye Coordination

Can use a fork and spoon well
Can write some letters (especially in their name) and numbers
Can copy a triangle and other geometric shapes
Can draw a person with at least 6 body parts

Social/Emotional

Wants to please friends
More likely to agree with rules
Likes to sing and dance
Shows more independence

Language/Communication

Speaks very clearly
Tells a more elaborate story using full sentences
Uses tenses, such as “yesterday” or “grandma is coming tomorrow”
Can say name and address

Cognitive/ Learning & Problem-solving)

Is aware of gender
Can count 10 or more objects
Knows about things used every day, like money and food
Starts kindergarten

If your child is 5 years old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 5 Year Milestones

Play time: Continue to let your child to play with toys indoors and explore outdoors as much as possible. Continue to explain things to your child, now with more detail. At this age, your child is a sponge and will soak up everything you teach them about things that interest them. Let your child play with and spend time around other children as there will be lots of learning, both socially, and otherwise, to be had.
New activities: Children are still mostly learning through play and through things that interest them at this age. Continue to expose your child to new things and/or the things they have grown to love. Get creative and let your child be involved in choosing activities.
Talk and explain: Your child will still have lots of question about the world around them and things they see and do. Try to respond to your child and answer their questions as much as possible as this is just their way of learning more and more. It is okay to set limits and ask for quiet every now and then but try not to stifle your child's interests and eagerness to learn and explore.
Read: Continue to read books with your child. Continue to work on identifying letters, letter sounds, and sight words. Your child may be able to begin working on sounding out small words now as well.

When to Be Worried

If your child is already 5 years of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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6 Years & Beyond Milestones Checklist

Wed, 30 Nov 2022 14:12:35 GMT

My Child is 6 Years or Older: What should he/she be able to do?

Once your child is 6 years of age or older and is in school, the best way to keep track of how they are doing developmentally is to monitor their school performance.

Here are some tips to help them continue to perform well:

Stay engaged: Talk to your child about school and what they like or don’t like about school. Ask them if they need help and teach them to ask for help when they need it.
Talk regularly with your child’s teacher(s): Talk regularly to and develop a relationship with your child's teacher(s) so you can stay updated on know how your child is behaving and performing in school. Keep the line of communication open so your child’s teacher can easily make you aware of any problems or concerns.
Ask for a curriculum or syllabus: Ask your child's school or teacher(s) for a curriculum, syllabus, and/or class schedule so you know what things your child will be learning this quarter, semester, or year.
Check your child’s homework: Look at your child's homework before and/or after they complete it. Ask them if they need help even if they don’t ask you first. This way you will know what they are working on and what they may be struggling with so you can give help or find help if needed. You can also help them with any tools they may need to stay organized and make sure they are completing and turning their homework in on time. Allow your child more and more autonomy and self-responsibility as they get older but always be there as a resource to help them develop the skills that they need to succeed.
Ask your child’s school about tutors: Ask if your child's school has tutors or recommends a tutoring program, in the event that your child needs it. You may also ask other parents about their experiences with tutoring to make sure you get the right resources for your child, if needed.

What to Do If Your Child Is Having Issues in School

If your child is not performing well in school or you are getting a lot of calls home or complaints from teacher(s), here’s what you can do.

Talk with your child’s teachers . Find out what their major concerns are with your child and what suggestions they have for helping. Try to stay open-minded and non-judgmental in communication with teachers. Remember that they may see a different child in their classroom than what you see at home and that most teachers are just trying to advocate for your child.
If your child seems to have difficulty learning in general or difficulty in particular subjects , talk to your child’s school about doing psychoeducational testing . This can often help determine what specific areas your child is struggling in and will prompt the school to provide additional services and help for your child.
If your child’s problems are mainly behavioral , talk to your child’s pediatrician. They may be able to help determine if your child has any medical, developmental, or psychosocial issues that can be addressed in other ways. They can also help to initiate and evaluation for ADD (attention deficit disorder) or ADHD (attention deficit hyperactivity disorder), if appropriate.

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2 Month Milestones Checklist

Wed, 30 Nov 2022 14:08:36 GMT

My Baby is 2 Months Old: What should he/she be able to do?

Your baby is now almost 2 months old and has changed your life for the better. Here are the things you should expect your child to do by 2 month of age.

By 2 months of age, your child should be able to:

Gross Motor/Physical Movement

Hold his/her head up a little higher and more steadily when lying on his/her tummy or when sitting on your lap
Make smoother movements with his/her arms and legs

Social/Emotional

Smile at you when you are looking or smiling at him/her
Make better eye contact with you (even when you're standing a little farther away)

Language/Communication

Coo and make gurgling sounds
Turn his/her head toward sounds

Cognitive/Learning & Problem-solving

Pay attention and may stare at faces
Track your movement with his/her eyes, now following you all the way across the room with his/her eyes

If your child is 2 months old and is doing all of these things, great!!

Tips to Help Your Child Reach Their 2 Month Milestones

Tummy time: Set your child on top of a blanket/playmat on the floor for “tummy time” at least once a day. Don't worry if your baby seems to hate "tummy time". Some babies do. If your baby is fussing and crying while in "tummy time", it's okay to pick your baby up and try again later or on another day. Try not to do tummy time right after your baby has eaten as this may result in stomach discomfort and spit-ups.
Talk: Talk to your baby as much as possible. You may not realize it, but their little baby brain is absorbing everything you do and say. Your baby may look at you and listen intently, staring at and absorbing the sound of your voice, the inflection in your tone, and the facial expressions you make.
Smile and play: Smile at and play with your child often. This helps to develop your child socially and reminds him/her constantly that they are loved and cared for.
Read: Read simple books to your child. Reading is fundamental at all stages of learning and helps your child to be exposed to and absorb as much information as possible. Don't worry if your baby doesn't look at the book as you're reading at this age but know that they are still listening to you. Books with high contrast colors are best at this age, as your baby's vision can distinguish these type of colors/pictures best.

When to Be Worried

If your child is already 2 months of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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1 Month Milestones Checklist

Wed, 30 Nov 2022 14:00:35 GMT

My Baby is 1 Month Old: What should he/she be able to do?

So your baby is approaching 1 month old and has been the center of your world for almost 30 days. Here are the things you should expect your child to do by 1 month of age.

By 1 month of age, your child should be able to:

Gross Motor/Physical Movement

Hold his/her head up when lying on your chest or lying on his/her tummy
Move his/her arms and legs equally on both sides

Social/Emotional

Smile in his/her sleep
Make eye contact with you

Language/Communication

Begin to coo and make baby sounds

Cognitive/Learning & Problem-solving

Follow your movement with his/her eyes for short stretches (not all the way across the room yet)

If your child is 1 month old is doing all of these things, great!!

Tips to Help Your Child Reach Their 1 Month Milestones

Tummy time: Set your child on top of a blanket/playmat on the floor for “tummy time” at least once a day. Don't worry if your baby seems to hate "tummy time". Some babies do. If your baby is fussing and crying while in "tummy time", it's okay to pick your baby up and try again later or on another day. Try not to do tummy time right after your baby has eaten as this may result in stomach discomfort and spit-ups.
Talk: Talk to your baby as much as possible. You may not realize it, but their little baby brain is absorbing everything you do and say. Your baby may look at you and listen intently, staring at and absorbing the sound of your voice, the inflection in your tone, and the facial expressions you make.
Smile and play: Smile at and play with your child often. This helps to develop your child socially and reminds him/her constantly that they are loved and cared for.
Read: Read simple books to your child. Reading is fundamental at all stages of learning and helps your child to be exposed to and absorb as much information as possible. Don't worry if your baby doesn't look at the book as you're reading at this age but know that they are still listening to you. Books with high contrast colors are best at this age, as your baby's vision can distinguish these type of colors/pictures best.

When to Be Worried

If your child is already 1 month of age and is not meeting these milestones, talk to your child’s pediatrician. You know your child better than anyone else. If you are concerned your child may have a delay in his/her development, it is better to intervene sooner rather than later. This gives your child the best chance of catching up to his/her peers by the time he or she reaches school age.

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Newborn Basics 101

Mon, 24 Oct 2022 20:05:06 GMT

Congratulations! You're a parent! Let's talk about babies!

Your new baby is finally here and you're officially a Mom or Dad! You did it! Now let's get to know all about your baby.

Feeding

Your baby will feed at least every 2-3 hours during the first several weeks of life, and sometimes more often, particularly if you are breastfeeding your baby. If your baby does not wake up to feed within 3 hours, you should wake him/her up to feed. This is extremely important for his/her growth and overall health. Your baby's doctor will talk to you about how your baby is feeding, check your baby's weight, and make recommendations for any changes in feeding if needed.

Breastfeeding

You will be given the opportunity to breastfeed within the first few hours after birth if you desire to do so as long as there are no major health issues with you or your baby. This helps you to begin bonding with your baby and establish breastfeeding as early as possible.

However, know that your milk will not come in immediately! Before your milk comes in, you will express small amounts of a yellowish or golden-colored fluid, called colostrum , from your breasts. Colostrum is full of antibodies to help your baby begin building their immune system.

Your breastmilk will take 2-5 days to come in. When it comes in, you will feel a heaviness in your breasts and sometimes pain (if your breasts are engorged). This is often a time that babies will "cluster feed" or feed very frequently now that these rich nutrients are finally available to them.

Engorgemen t means that your breasts are overfull with milk and this can be painful. Feeding your baby will help to relieve your engorgement. If feeding your baby does not relieve this, you can express some milk by hand or use a pump to relieve the heavy, overfull feeling, and sometimes pain, engorgement can cause.

Breastfeeding should not be painful, but it can be if your baby is not latching correctly. Check out my "Breastfeeding Basics" post for more detailed information on how to avoid this pain and other tips and tricks for breastfeeding.

Ask your nurse or doctor early on if your hospital has a lactation consultant. If so, you can request that they visit you in the hospital to help with breastfeeding. Your baby's doctor may be able to provide additional breastfeeding help at your baby's first few doctor's visits. Also, check with your insurance company for information on lactation resources and services that are covered.

Formula Feeding

If you are feeding your baby formula, it is usually best to start with a standard formula to see if your baby tolerates this well. Standard formulas will have all the nutrition that your baby needs and you will often be given samples in the hospital. You should not switch formulas too hastily or very frequently if you feel your baby is having an issue. It takes time for your baby's body to get used to a new formula and switching too quickly or too often can lead to problems for your baby. It is best to speak with your baby's doctor if your baby is having an issue to decide together if your baby needs a formula change.

When mixing your baby's formula, make sure to read the instructions on the can or bottle on how to properly mix your baby's formula to ensure they are not getting too little or too many calories. If your baby was born prematurely, was born with a low weight, or has had trouble gaining weight, your baby's doctor may have you mix your baby's formula differently to provide additional calories.

Always wash your hands before preparing your baby's bottle and use the recommended type of water. You may need to ask your baby's doctor what water sources are okay to use depending on where you live and what water sources you have access to.

Newborn (full-term) babies have a stomach only about the size of a ping-pong ball. This means that your baby will only need about 1-2 ounces (30-60 mL) in the first several days to weeks of life. Be careful not to overfeed your baby as this can lead to more spit-ups, vomiting, constipation, and even trouble breathing. It is best to start low and make small increases of half an ounce to one ounce at a time if your baby does not seem satisfied.

Signs that your baby is satisfied may include falling asleep after feeding for a period of time or stopping sucking on the bottle. Signs that your baby is not satisfied may include still seeming fussy after finishing a bottle or rooting (turning head from side to side with mouth open, looking for the nipple/bottle).

It is important to discuss feeding with your baby's doctor and to have their weight checked at routine appointments to help determine if your baby is getting enough (or too much).

Weight loss

It is normal for your baby to lose weight in the first week of life. Your baby's doctor will monitor his/her weight to make sure they are not losing more than 10% of his/her body weight. Your baby should be back to their birth weight by the time he/she is 2 weeks old, which is a time your baby's doctor will usually want to see them in the office to check.

Wet diapers

Your baby may have only a few wet diapers in the first couple of days of life. This is normal but should increase to at least 6-8 wet diapers a day during the 1st week of life as your baby eats more. This means you will be changing your baby's diaper a lot, usually at least one wet diaper with every feed.

Stool

Your baby’s first stools will be black and sticky, like tar. This is called meconium and is normal. This will change once he/she feeds more and will eventually become more yellow and seedy or grainy. Newborn stools are usually very loose and may resemble diarrhea. This is normal. It is also normal for your baby to have several poopy diapers a day, especially if your baby is breastfed.

A normal newborn stool can vary somewhat from baby to baby. Color, consistency, and frequency may be slightly different depending on whether your baby is breast- or formula-fed, among other things. What is most important is that your baby's stool is soft, even if your baby does not poop every day. Find out more on my post called "Let's Have the Poop Talk!"

You should notify your doctor if you notice blood in your baby's stool or if you are concerned that they may be constipated. Signs of constipation may include a hard belly that seems painful to touch, fussiness or crying with stooling, or hard balls for stools.

Sleep

It is normal for newborn babies to sleep most of the day in the first few weeks of life. Your baby may wake up only to feed and then go right back to sleep. As your baby gets older, he/she will begin to stay awake for longer stretches but this happens gradually.

Burping

Your baby will swallow air as he/she feeds, so you will need to burp him/her after, and sometimes during, feeds. Your baby may get fussy if he/she needs to burp and will often need help getting the burp out. Put your baby in an upright position. This is usually easiest over your shoulder. Make sure you have a good hold on your baby, then firmly pat his/her back to help air bubbles to rise so he/she can burp more easily.

Hiccups

It is normal for babies to get hiccups. Hiccups are related to the fact that your baby swallows a lot of air when he/she feeds. However, hiccups do not hurt your baby and tend to be more bothersome to us as parents, then it is to your baby. You do not have to do anything to try to stop them as they will go away on their own after several seconds to minutes. You should never give your baby water or any home remedies in an attempt to stop hiccups.

Spit-ups

Many babies spit up and this can be normal. If your baby spits up and is still happy or sleeping, this is usually nothing to worry about, especially if your baby is still gaining good weight. This means that although the spit-ups may seem large at times, your baby is holding down far more milk than they are spitting up, evident in the fact that they are still growing appropriately. If your baby seems very fussy, agitated, or very uncomfortable when he/she spits up, talk to your baby’s doctor. For more detailed information, check out my post on "Reflux vs Normal Spit-up: How to Tell the Difference & What to Do" .

Gas

Many babies will have some gas. If your baby has gas but does not seem bothered by it or fussy with it, this is nothing to worry about. If your baby is very fussy with gas and it seems painful, try these things to help improve your baby's gassiness:

- Pause every five minutes during feeds (if he/she will allow you) to frequently burp your baby. This will allow air that has been swallowed to escape through your baby's burp and create less chance of the air moving into your baby's stomach.

- Prop your baby up at a slight angle after feeds (using a baby chair, swing, or carseat, or a pillow under supervision) rather than laying them flat right away to help air bubbles move upward rather than downward.

- Remedies such as gripe water and/or gas drops may be helpful but should not be overused.

- Sometimes, changing your diet (i.e. eliminating or decreasing dairy products), if your baby is breastfed, or changing your baby's formula may help resolve or improve gassiness. However, if your baby is not bothered by his/her gas, these changes are not usually necessary. Discuss with your baby's doctor first before making these changes.

Coughing & sneezing

Your baby may occasionally cough or sneeze in the first few days to the first week of life. This is usually normal and is their body's way of clearing residual secretions from being inside the fluid in your uterus. If a cough persists past a week, talk to your baby's doctor.

Congestion

Congestion is very common in infants and is often due to slight overfeeding or overeating. If a baby's stomach is overfull, they may spit up, or some of their milk may come up just enough to sit in the back of their nose or in the back of their throat and cause them to sound congested. This type of congestion may seem like it's lingering on for weeks and months and may seem like it was present since birth or very close to birth. However, if your baby is still eating and sleeping comfortably, this is usually no cause for concern.

You can attempt to improve you baby's congestion by using saline drops and nasal suctioning with a nasal suction bulb or similar device. However, if the congestion is very far back in your baby's nose or throat, you may not be able to relieve the congestion or get anything out. Be careful not to suction too much as this can cause trauma, and sometimes bleeding, to your baby's delicate nose.

You can also run a cool mist humidifier while your baby is sleeping to help with congestion. However, remember that if your baby is still eating and sleeping comfortably, you likely do not need to do anything but know that your baby is fine. Your baby is too young for any cold or cough medicines so do not give your baby anything over-the-counter.

If your baby's congestion is new and is affecting their ability to eat or sleep comfortably or they seem more fussy than usual, talk to your baby's doctor.

Newborn rashes

It is normal for newborn babies to have peeling skin. This is dead skin that will come off with time. You do not have to put any lotions or creams on it. However, if you notice that the peeling is starting to crack the skin or you see bleeding, you can use a thick moisturizer like petroleum jelly, to help heal the skin and prevent further cracking. Otherwise, this dead skin will slowly come off each time you clean your baby's skin and especially once you can give your baby a full bath after his/her umbilical stump falls off.

There are many normal newborn rashes. Most of these rashes go away on their own over time and will not cause your baby any problems. Check out my post on " Baby Rashes. Acne & Nevi & Milia. Oh My!" for more detailed information.

Umbilical cord care

You do not need to put alcohol or anything else on your baby’s umbilical cord. This will fall off on its own in 1-3 weeks. Do not give your baby a full bath immersed in water until the umbilical cord falls off. You want to keep the area clean and dry. You can give gentle sponge baths or wipe your baby's skin with a slightly moist rag and a gentle soap until this happens.

Circumcision care

You should use petroleum jelly on your baby’s circumcision with diaper changes until it has completely healed. A “beefy” red color and some yellow drainage are normal for a well-healing circumcision. Your baby’s doctor will check to see that it is healing appropriately.

Immunizations (Vaccines)

Immunizations are extremely important to protect your baby from serious preventable diseases, diseases that can kill. Vaccines and the recommended vaccine schedule have been shown to be safe for babies and children.

Visit www.cdc.gov/vaccines/schedules for more information about vaccines. For detailed information about each vaccine and what disease it is protecting your child against, visit https://www.cdc.gov/vaccines/parents/diseases/index.html

Doctor’s appointments

Your baby’s doctor’s appointments will mostly follow the recommended immunization schedule until they are 3 years of age and old enough for yearly checkups only. In addition to vaccines, it is important to take your child in for each visit to discuss important topics, such as feeding, growth, and development, and to address any questions or concerns that you may have.

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Hand Foot Mouth Disease: What You Need to Know

Mon, 17 Oct 2022 13:26:22 GMT

Not just a summertime virus

Hand-Foot-Mouth Disease

Each year, as pediatricians, we see lots of hand-foot-and-mouth disease! We usually see this in the summertime but this year has proven to be a little different. As the weather gets cooler, hand-foot-and-mouth disease is running rampant. So, since your child may have already had, or may develop this common illness, let's explore what this virus is all about.

What is hand-foot-and-mouth disease?

Hand-foot-and-mouth disease (HFM disease) is a viral infection common in young children, usually age 5 and under, but can occur at any age. It's telltale sign is a rash on the hands and feet, and sometimes in the mouth, hence the name.

More specifically, the rash usually involves the palms of the hands and the soles of the feet, distinguishing it from many other illnesses that can cause a rash. The rash consists of red bumps that are usually not itchy, painful, or bothersome at all to the child. The rash tends to bother us, as parents, far more than it does our child(ren) due to the look of the rash.

Sometimes the bumps blister, making the skin a little itchy or irritated. If the bumps do blister, you may notice some peeling of your child's skin. This type of peeling, especially of the hands and feet, may last longer than the actual virus and can linger on for a few weeks even after the rest of the illness has resolved.

While the rash is the most classic finding, hand-foot-and-mouth disease can also cause:

Fever
Painful, red spots or sores in the mouth (usually on the tongue, gums or insides of the cheeks)
Decreased appetite in younger children or sore throat in older children, and
Increased fussiness or irritability in younger children or generally feeling unwell in older children

Fever is often the first sign of hand-foot-and-mouth disease, followed by the rash 1-2 days later. However, sometimes no fever occurs and the first sign is the rash or mouth sores.

Outbreaks of hand-foot-and-mouth disease are most common in the summer and fall seasons in the United States. In tropical climates, outbreaks occur year-round.

What causes hand-foot-and-mouth disease?

HFM disease is most commonly caused by a group of viruses called enteroviruses , and usually specifically by a virus called coxsackievirus .

How is hand-foot-and-mouth disease spread?

HFM disease is contagious and spreads from person to person. The illness spreads by contact with an infected person's:

Respiratory droplets
Saliva
Nasal secretions
Fluid from blisters, or
Stool

Hand-foot-and-mouth disease is commonly spread in childcare settings because small children are not the most hygienic and often put their hands in their mouths (and other places). However, the virus can also be passed by adults and older children who may not show signs or symptoms of the disease (usually because they have already developed an immunity to the virus) but can still spread the disease through respiratory droplets and the other means mentioned above.

Children are most contagious during the febrile stage (if fever occurs) but can remain contagious during the first week of the illness. When fever does not occur, there is no way for parents or childcare workers to know that a child has been exposed...until the rash develops.

By this time, a child may have already passed the virus to others, which is another reason why the virus is spread so easily.

Children usually develop immunity to hand-foot-and-mouth disease after exposure to the virus. However, because HFM disease is caused by a group of viruses and not just one virus, it is possible to get HFM disease again. It is also possible, but less common, for older children and adults to get the disease (if they have never been exposed before).

How do you treat hand-foot-and-mouth disease?

Since HFM disease is caused by a virus, there is no treatment that will make the illness go away faster. Fortunately, the illness is typically mild and will resolve on its own, usually within 7-10 days.

You can treat some of the symptoms of HFM disease if they are bothersome for your child. This may help them feel better while their body does the work of fighting off the virus.

For fever : You can give your child fever-reducing medications as recommended by your child's pediatrician or by following the medication label(s).
For rash :
If your child is not bothered by the rash, you don't need to do anything and there are no medications to make the rash go away faster.
If your child's rash is slightly itchy, you can apply calamine lotion to their skin to help soothe their skin. **My trick is to leave the calamine lotion in the refrigerator. The additional coolness can be very soothing for an itchy, inflamed rash.**
For mouth sores/pain or sore throat :
Cold foods and liquids will be very soothing for the mouth pain your child may be experiencing. This is the time to give them plenty of ice-cold or frozen beverages or treats . This will help soothe their mouth pain and get in some much-needed electrolytes and calories for a child who may not be eating much while ill.
Your child's doctor might prescribe medication to help with mouth pain as this can be one of the most bothersome symptoms of HFM disease.

Are there any complications of hand-foot-and-mouth disease?

The most common complication of HFM disease is dehydration since the painful mouth sores can lead to a child not eating or drinking like usual. To prevent this:

Encourage plenty of clear fluids (water and/or age-appropriate electrolyte beverages) to help your child stay well-hydrated, even if they don't want to eat solid foods.
Monitor your child's urine output to ensure that they are still having their usual amount of wet diapers or using the bathroom their usual amount.
Monitor you child's activity level to ensure your child is not becoming weak or having difficulty awakening or moving.
If you think your child may be dehydrated, call your child's doctor right away or take them to an urgent care or emergency room. Severe dehydration may require IV fluids and/or monitoring of your child in a healthcare facility.

For more information or to get your child checked, call (301) 710-0455 to schedule (for those in Maryland)

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Hand Foot Mouth Disease: What You Need to Know

Not just a summertime virus

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