Seattle Mama Doc 101

All Articles in the Category ‘Seattle Mama Doc 101’

Reassuring Infant And Toddler Communication: When Not To Worry About Autism

Many parents worry about their child’s development at one point in time. With each of my boys, I had worries about their communication and thought their language delays or behaviors signaled something serious. That might just be the “worrier” in me, but it might just be the “mom” in me, too. Competitive parenting makes us all a little nuts…

Here’s a few signs that your child is developing great communication skills on time. However, if at any time you worry that your child isn’t expressing joy, communicating thoughts, or reflecting an understanding of your language, visual cues, and behavior talk with your child’s doctor. If you don’t feel heard or continue to worry, schedule another visit. If you still worry, contact another doctor for a second opinion. Instincts serve us very well when it comes to parenthood. Further, find some peace of mind if your child is doing many of the behaviors listed below!

Reassuring Developmental Milestones For Infants & Children

  • Responds to her name between 9-12 months of age.
  • Smiles by 2 months, laughs and giggle around 4-5 months, expresses great joy to your humor around 6 months.
  • Plays and thinks peek-a-boo is funny around 9 months of age.
  • Makes eye contact with people during infancy.
  • Tries to say words you say between 12 and 18 months of age.
  • Your toddler uses 5 words by 18 months of age.
  • Copies your gestures like pointing, clapping, or waving.
  • Imitates you — ie pretends to stir a bowl of pancake mix when you give them a spoon and bowl or pretends to talk on the phone with a play cell phone.
  • Shakes head “no.”
  • Waves “bye-bye” by 15 months of age.
  • Points to show you something interesting or points to get your attention by 18 months of age.

Flying With Toddlers: Tips For Distraction, Tips For Tantrums

Flying with toddlers is far more difficult than flying with an infant in my opinion. It’s the need to get up, run the aisles, move around, have another snack, read a different book, take an abbreviated nap, go pee, and that minute-attention span that makes it not only exhausting but nerve-racking for most of us. Although the challenge is real, success comes with having a good plan, allowing extra time, and packing the right snacks, toys, and books to keep your toddler occupied. That 3,000 mile flight at 30,000 feet can be a ton of fun! The above tip came from a friend years ago. Prepare for the worst and expect the best when flying with toddlers–hopefully this blue tape idea sticks. (ha)

Now dealing with tantrums while up in the air is another challenge in and of itself. Many of us heard about the toddler kicked off an airplane, and have also heard about the opinion for commercial airline children-free flights. Although I wholeheartedly disagree that we should segregate flights by age, I do think these stories in the news media elevate our anxiety for flying with our children. Don’t let it. You’re always the best one to support and help your child on the ground or up in the air. Don’t let the public shake that truth. My tips for dealing with tantrums at 35,000 feet aren’t very different from those on the ground: provide consistency, provide distraction, and provide comfort. But more, set yourself up for success by clearing the tension with passengers sitting next to you ahead of time. Acknowledge the challenge. I’ve found it not only decreases my own anxiety, it allows for a much better reception when things don’t go as planned.  Click to read full post for my additional 1-minute video explanation and a few ideas. What are yours? Read full post »

When Is It Okay To Fly With My Newborn Baby?

I think it’s okay to fly with your newborn baby straight away. After 1 week of age the Federal Aviation Association (FAA) says it’s okay, as does the AAP, but always recommends a separate seat for your infant whenever possible.

The biggest risk flying with a healthy newborn is exposure to infection. So, like any decision in life, you have to weigh the risks and benefits of a decision. Because we take fever very seriously in babies under 3 months of age, we want to avoid infections when possible. Take precautions, wash your hands frequently, and wipe down seat backs, tray tables, and seatbelts on board.

All that being said, I flew with O when he was just 6 weeks old. It was important for us to travel to see family in California for the holidays. I took precautions, loaded up on hand sanitzer, and backed extra diapers. It was a wonderful Christmas…

For more on traveling with children, check out:

TSA Tips For Traveling With Children

Is Air Travel Safe For an Infant (the short answer is “yes”)

Sudden Cardiac Death: What Parents Can Do

As a parent and pediatrician, any mention of sudden cardiac death leaves me feeling uneasy. The stories of young athletes dying or falling on the field are agonizing. All of us here on earth would like to do something to prevent these deaths.

Researchers and cardiologists are working tirelessly to understand predictors for sudden cardiac death in children alongside techniques to improve screening and prevention for young athletes. Dr Nicolas Madsen talked with me about recent work here in Washington State. There’s a video at the end of this post from the interview. I’m lucky, I met Dr Madsen when he was a medical student and now he’s an old friend. He’s one of those bright lights: a compassionate physician and father of three who just gets it and wants to solve big problems. He’s about to finish his fellowship here in Seattle and while completing his training, he’s uncovered some holes in the system. He’s helped me understand how to screen children better. As a parent, there are some simple things you can do to improve the screening your child receives prior to athletic participation.

“Sudden Cardiac Death is a needle in a haystack, but a very sharp one.” Read full post »

18 Months: Seattle Mama Doc 101

18 month-olds are extremely determined,  constantly challenging, tenacious, adorable, witty, and ever-aware. By 18 months, most babies have really figured out how to get and hold a parent’s attention! As they explore their widening world, an 18 month-old’s curiosity leads while their judgment lags well behind. Providing your child with a safe and consistent environment is paramount. Development in all areas (gross motor, personal and social, fine motor, etc) is highly variable but the video reviews typical milestones your baby’s clinician will review around 18 months of age.

What Should My Baby Do At 18 Months?

In general by 18 months, your toddler will be very curious. They will be demanding. They will be communicating wants and needs through words, motions, and imitations. They will be pointing out objects in the sky. They will be calling you by a name just as they run the opposite way…

 18 month milestones

“Mr No” — I found this extensive list of milestones and observations both very entertaining and educational

What Parents Can Do For 18 Month-Olds:

  • Give your 18 month-old their space. As they crave more and more autonomy, provide them times for a bit of freedom.
  • Let your child mimic you. Give them toys or safe objects you use in the house so that they can pretend to be an adult.
  • Let them help. Start finding daily or weekly “chores” for your 18 month-old (ie bringing napkins to the table or moving stuffed animals to a bin). They’ll love their role!
  • Offer puzzles, matching, and sorting games.
  • Read to your 18 month-old every single day. Point out objects in the book. Ask your toddler to tell you the names of animals or toys in the book. Get them involved. And get ready to read the same book over and over and over again!
  • Keep rules to a minimum. Rather, define “right” from “wrong” for your child and remember to praise your 18 month-old for doing things right. Catch them when they are being good!

Reading A Growth Chart: Mama Doc 101

Parents, pediatricians, and nurses have been using growth charts since the late 1970’s to track growth in their infants and children. The charts were revised back in the year 2000 as the data for the first charts (from a small study in Ohio) that didn’t accurately reflect the cultural and ethnic diversity of our communities.

The hallmark of a well child check is the review of a child’s growth. Growth can be a reflection of a child’s overall health, nutrition, and/or tolerance of possible underlying medical conditions. So understanding what your doctor or nurse practitioner says about your child’s growth should be a priority.

Watch the video to learn more about interpreting growth charts.

If your doc doesn’t have a computer in the room, ask to see the chart (on paper) or on a computer in their office. It will not only inform you, I suspect it will delight you to see what your child has done since the last time they have been seen.

The human body really is a fine-tuned machine and growth is simply astounding if you really stop to think of it.

If you have a challenge understanding how your child is growing or how the growth chart is presented, demand clarification. It’s okay if you don’t understand the presentation of facts on these grids; have confidence to speak up and ask for the doctor or nurse practitioner to explain it.

Revisions to the growth charts in 2000

Understanding growth charts

Pacifiers: A Love Affair Worth Having?

Pacifiers, a love affair worth having? It’s up to you, of course. Pacifiers are hotly debated among some parents, some pediatricians, some lactation consultants, and some dentists. I say some, as I believe not all clinicians have strong impressions/judgments. That’s because pacifiers don’t cause excessive harm. Yet most parents agree on one thing: they all have an opinion about what to do with one. Some hate them, others adore them. Just like babies. Silicon pacifiers can be all the rage, or none of it…

At our house, we had a love affair with a pacifier. Twice. Without even trying. And it all happened by accident.

Although the American Academy of Pediatrics and National Institute of Child Health and Human Development recommend using a pacifier at night to decrease the risk of SIDS, if your infant doesn’t like one, you certainly DON’T need to force it upon your content baby. Don’t over-think or over-value the pacifier, either.

With F (our first born), I waited, held off, and withheld the pacifier hoping to improve my changes of successful breastfeeding. We had a few sleepless weeks (with the fussing and crying normal for a newborn) until a couple weeks of age when we realize it really was the “plug” he was looking for. F’s crankiness improved, and we had another tool to help support him when holding, rocking, feeding, changing diapers, or swaddling didn’t soothe him entirely. The pacifier was just something he loved.

With O (our second), I didn’t get the choice. While in the NICU, the nurses used the pacifier to “quiet” him down. I asked that they didn’t, but when I returned to feed him, there it was again, in his mouth. And he was in love. So we continued to use it and I didn’t take it from him. As I’ve written before, I loved to see him enjoy and indulge with that pacifier. I mean, he really craved and adored the time he got with it (mostly during sleep or in the car). Weaning him from it was harder on me, it turns out. And I faltered a couple of weeks after the wean during a moment of weakness…

We used pacifiers in our homes until both the boys were just under 2 years of age. And like I said, it really was a love a affair.

The reason is simple, babies soothe by sucking and pacifiers are a perfect tool. My advice on pacifiers: follow your instincts. You’ll be able to find studies both that support use and studies that dissuade use to back up either decision. So don’t over-think this. And stop beating yourself up for using one if you are…

Mama Doc’s Cliff Notes On Pacifiers:

  1. These are things you already know: Wash the pacifier regularly (dishwasher safe are easiest) in warm soapy water, get rid of old pacifiers that show cracking or damage, and use a one-piece silicone design if possible. Don’t dip the pacifier in anything (ie sugar water, honey, etc) ever. And never tie the pacifier around your baby/toddler’s neck.
  2. As your child grows, the pacifier should, too. Don’t let toddlers have infant sized pacifiers due to choking risk. Smaller pacifiers may rest more on their front teeth as well and cause more malocclusion or “bucking” of teeth. Get the correct size pacifier if your older toddler or preschooler still uses one.
  3. When your child approaches 6 months of age, consider weaning. If neither of you are interested in breaking up with pacifier, try again at 2 years of age. By 3 years, get it out of the house or the love affair will cause a most terrible break-up.

Additional Safety Tips on Using Pacifiers:

Mayo Clinic’s Do’s & Don’ts on Pacifiers

Review article about dental problems caused by pacifiers after age 3.

Satisfying your baby’s needs: Pacifiers

What About Chores? Seattle Mama Doc 101

So what about kids and chores? My take is that it’s personal. But also I’ll hint that I think chores are a great opportunity to build community and citizenship. Research has found great lifelong reward from doing childhood chores (think: less drug use, higher self-esteem, more sound relationships, beginning a career path, less anxiety, etc). I mean with those findings, sign me up! But it’s possible not everyone agrees and research may not be what sways you. It may be a need to get things done around the house. A popular poll (done way back in 2001) found that 75% of people feel children do fewer chores today than 10 or 15 years ago. I don’t know if that’s just recall bias or pessimism or favorable historians talking. But…

A smattering of opinions about chores:

What do you think; is there controversy here at all? Do you think chores help transition our children into responsible adults?

Sleep Through The Night

Getting your baby to sleep through the night is a major milestone for baby and for you. If I had to distill down the best sleep advice I’ve ever heard it would be these 4 things:

  • Your consistency with the sleep routine is far more important than what method you choose to help get your baby to sleep. The ritual at bedtime (reading, bath, rocking, etc) is one of the most important daily activities you establish for your child from day 1 (or day 30).
  • Letting your baby learn to fall asleep all on her own at 1 to 2 months of age will serve you and your child again and again. Research shows that infants and children who are allowed to learn to self-soothe and get themselves to sleep will often be far better sleepers, even as adults. Consider letting your baby learn to self-soothe and “cry it out” in the middle of the night after 4 to 6 months of age.
  • If you’re concerned about your baby’s sleep challenges, talk directly with their doc. Recent research found that 1 in 10 children under age 3 has a sleep challenge, and often sleep trouble persists from infancy to toddlerhood.
  • Sleep needs to be a priority (for us all). Making sacrifices to support routine bedtimes and sleep routines will always be worth it.

How To Pack A Healthy Lunch: Mama Doc 101

Although you’ll see these lunch ideas don’t look exceptionally fancy, I think the point is this: you don’t have to spend a ton of time or money giving your children healthy lunch choices. But you do have to spend some. After the pizza debacle (“a slice of pizza still counts as a vegetable”) bubbled up when congress blocked proposals for changes in school lunches, I was reminded we still have to have a significant responsibility to watch over our children’s lunches. Don’t leave lunch in someone else’s hands unless you’re reviewing the menu. At our sons’ preschool we sometimes feel they do a better job than we do (!) so this is not a post to trash school lunch programs. Some schools really are doing an exceptional job. Is yours?

Trouble is, sometimes I look at example lunch ideas for parents and I feel overwhelmed. Read full post »