Similac Recalls Infant Formula
9/24/10 Yesterday, as some of our patients are aware, Similac recalled some lots of infant formula. This occurred because an infestation of small beetles was found at one of their plants, and insect parts were detected in some of their powdered formula. According to Abbott Nutrition, who makes Similac, the “Ready to Feed” liquid was not involved. Abbott assures the public, that no infant has become ill from ingesting formula, and the problem is being remedied. The amount of formula affected is less than 0.5% of the current formula stocked on shelves.
To read more about the recall, and problem, click here: http://similac.com/Recall/?utm_source=ppc
Does my baby weigh too much?
OVERWEIGHT: PREVENTION IN INFANTS
DEFINITION
An overweight baby is one with a weight gain far out of
proportion to height gain. An overweight baby looks fat.
Such- a baby is not necessarily a healthy one. The infants
who continue to be overweight as children and adults
usually have parents, siblings, or grandparents who are
overweight. Any infant with a strong family tendency
toward obesity needs help. Overfeeding teaches a child
to overeat. Some physicians wait until such a child shows
signs of being overweight before making any alterations
in the diet, but prevention is easier than treatment.
DIETARY PRECAUTIONS TO PREVENT
AN EXCESSIVE WEIGHT GAIN IN
INFANTS
If someone in your family has a problem with easy weight
gain, consider the following dietary precautions to pre-
vent your baby from becoming overweight. If your child
is already overweight, these guidelines will also be help-
ful. The goal for growing children is always slowing the
rate of weight gain (not weight loss).
- From the beginning, try to teach your child to stop
eating before she reaches a point of satiation. Help
her stop before she has a sense of complete fullness
and a reluctance to eat another bite. When she
closes her mouth, turns her head, or wants to play,
she’s losing interest in feeding.
- Try to breast-feed. Breast-fed babies tend to be lighter
in weight.
-If you are breast-feeding, avoid grazing. Grazing is
nursing at frequent intervals, sometimes hourly.
Such infants learn to eat when they are upset and
to use food as a stress reliever.
- If you are bottle-feeding, don’t allow your child to
keep a bottle as a companion during the day or
night. Children who are allowed to carry a bottle
around with them learn to eat frequently and use
food as a comforting device.
- Don’t feed your baby every time he cries. Most crying
babies want to be held and cuddled or may be
thirsty and just need some water.
-Also teach your infant to use human contact (rather
than food) to relieve stress and discomfort.
- Don’t assume a sucking baby is hungry. Your baby
may just want a pacifier or help with finding her
thumb. Also, don’t use teething biscuits or other
foods in place of a teething ring.
-Don’t insist that your baby finish every bottle. Unless
your baby is underweight, he knows how much for-
mula he needs.
- Don’t enlarge the hole in the nipple of a baby bottle.
The formula will come out of the bottle too fast.
- Feed your infant no more often than every 2 hours at
birth and no more often than every 3 hours from 2
to 6 months of age.
- Feed your child slowly rather than rapidly. Don’t do
anything to hurry your child’s pace of eating. It takes
15 to 20 minutes for the sensation of fullness to
develop. The rapid-eating habit in adults has been
associated with obestity.
-Avoid solids until your child is 4 months old (6 months
old in breast-fed babies).
-Change to three meals daily by 6 months of age.
-Don’t insist that your child clean his plate or finish a
jar of baby food.
-Don’t encourage your child to eat more after she sig-
nals she is full, by turning her head or not opening
her mouth.
-Discontinue breast- and bottle-feeding by 12 months
of age. A recent study found that
delayed weaning was associated with more obesity.
-Avoid sweets until at least 12 months of age.
-Don’t give your child food as a way to distract him or
keep him occupied. Instead, give him something to
play with when you need some free time.
- Use praise and physical contact instead of food as a
reward for good behavior.
CAUTION: Also don’t underfeed your infant. Don’t
put your baby on low fat milk or skim milk before 2 years
of age. Your baby’s brain is growing rapidly and needs
the fat content of whole milk. While overfeeding is more
common than underfeeding in infancy, underfeeding is
more harmful.
RECALL of Children’s Tylenol and Motrin
Many our patients have read the recent news that McNeil, the makers of Tylenol and Motrin, have temporarily recalled their product.
For full info on the recall see this link: http://www.mcneilproductrecall.com/
If your child has had recalled medicine, don’t panic!
The medicines were recalled because some had a “moldy smell” , also because there may have been insufficient quantities of the active ingredient.
If your child needs fever reducer, or pain medication, use a CVS or pharmacy brand. It will work the same.
Ask The Doctor – Sir Cough A Lot!
Question
When do I need to call the doctors about a cough?
Answer
This is one of our most asked questions. Coughs can be caused by many reasons but usually not serious ones. The most common cause of cough is the common cold brought on by the Rhinoviurs. This nasty virus can cause nasal congestion, runny nose, cough, fever and malaise. Luckily symptoms usually resolve in 5-7 days.
If a cough is constant, causes breathing problems, or is associated with fever for more than 2 days, it is time to call the doctor. A simple cough should resolve within 7-10 days, if cough persists, you should also call the office and consult with the doctor.
Ask The Doctor – Kids on a Plane!
Question
I was wondering. Every time my kids go on an airplane, they wind up sick for vacation. Since the air on planes is just recycled, I assume they pick up the germs that way. Is there anything I can do to prevent this…mega doses of Vitamin-C or Echinacea before the trip? Do you have any suggestions?
Answer
It’s true that airplanes recycle the on-board air and that infectious diseases can theoretically spread this way. Although no clinical studies have proven that airplane passengers infect each other to a great degree, it makes sense that they are at risk.
Touching objects with your hands is a common way to transmit illness. We recommend the use of hand sanitizer (Purel or Dial), or frequent washing. Taking Echinacea or Vitamins has not been proven to prevent illness, but you cannot harm yourself with these medicines if used in the usual doses
Talking To Your Children About Death
People who accept the inevitable end of physical life can enjoy and respect life here and now. Death is a great teacher, but talking about death is difficult.
The Importance of Listening
Listening, and being available to listen, is one of the best ways we can help friends whose loved ones die. Many bereaved people, both children and adults, need to talk about their loss with a friend who cares for them.
Not only must we comfort our friends, but sooner or later, we must also talk about death with our own children. Doing so openly, calmly, and kindly can help your children a they grow. If they know you accept both life and death, they will too.
Expressing Sympathy to Adults
The worst trial a parent can face is the death of a child. Most parents in our society never face this ultimate pain, but many of us know people who have. When a friend loses a child or a pregnancy, we want to express sympathy, give comfort and help, but we often don’t know what to do or say. We fear saying "the wrong thing" and making the pain worse.
Many people feel helpless at the sight of a mother or father whose child has died. usually, adults are confident and successful in keeping children safe-we feel powerful. But when a child dies, we all become children insofar as we are forced to remember that we can’t control nature. For a time, we lose our sense of power: All our technology and skill can’t control the forces of nature, or reclaim the dead to life.
Each person deals with grief differently. Often, mothers express their pain more openly than fathers. Some parents may seem to be unnaturally calm, others too vocal, but all need and appreciate having our sympathy.
Sometimes we avoid saying anything to a grieving parent a well known pediatrician whose daughter committed suicide recently wrote about how isolated he felt when friends and colleagues stopped talking to him, not because they didn’t care but because they didn’t know what to say. When a friend’s loved one dies, we need to communicate across the chasm of grief, if only be a single statement such as "I hope you’re OK," or "I’ll be here when ever you need me," or a simple touch.
There is no right or wrong way to express sympathy. If you share a religious faith with a grieving parent, you can participate in religious rituals. Attending a funeral or memorial service can be a great comfort, both for family and friends. Cards and letters express sympathy in a way that allows the recipient to decide when he or she wants to have it. Bereaved parents need someone to listen to them. Having their child’s name, even years later, on birthdays and special occasions.
Parents whose own children have died have courage to speak words that may be less than perfect but that come from sincere compassion. The Compassionate Friends* is an international organization of support groups for families who have lost a child. And in grief workshops, roomfuls of strangers describe their losses and share their pain. Such sharing has a wonderful effect: It shows people that grief is normal, and that they are not alone.
Especially at times of death, we can be awakened to the great wonder of everyday life and the power of human connections. death can shock us into focusing on what we have, rather than what is gone, and help us be more grateful for all living beings.
Talking to Children
When should you tell a child about death? When the child asks about it, or first experiences it-usually when a pet dies. If a close friend or family member dies, telling a child can be very difficult. The books listed below can help. But-as always-openness, honesty, and having permission to share both good and painful feelings within the family are extremely important.
"White lies" or euphemisms can be dangerous: Telling a child that a loved one was so good that God wanted another angel in heaven, can make the child fear God, heaven, and being good; talking about death as "sleep" can make the child fearful of bedtime. Telling a boy whose father dies, "You can be the man of the house now" (once a common way to express sympathy) also frightens the child and can add insult to his mother’s grief.
A child who has suffered a loss can be encouraged to talk or draw pictures: A gift of a large pad of newsprint and a new box of crayons can help.
The books listed below, written for children and recommended for anyone who is suffering grief, deal with death honestly while affirming life. These and many other excellent books are available at most public libraries:
- When a Pet Dies, by Fred Rogers
- The Tenth Good thing About Barney, by Judith Viorst
- The dead Bird, by Margaret Wise Brown
- I Had A Friend Named Peter, by Janice Cohn
- A taste of Blackberries, by Doris Buchanan Smith
- Nana Upstairs, Nana Downstairs by Tomie Depaola
- Learning to Say Good-Bye When A Parent Dies, by Eda LeShan
The following books can help parents:
- The Bereaved Parent, by Harriet Sarnoff Schiff
- Explaining Death to Children, edited by Earl Grollman
*The Compassionate Friends has over 600 groups in the US meeting within 30 minutes travel time of most homes. They also have national and local news-letters and a resource list to help bereaved families. Contact:
The Compassionate Friends PO BOX 3696 Oak Brook, IL 60522 Tel: 708-990-0010Does Your Child Have A Stuttering Problem
The Problem
Many children repeat words and phrases or mispronounce words as they learn to talk. Most of these difficulties are normal and disappear with time, although they are naturally of concern to parents.
When children are learning to speak, between 18 months and 5 years of age, they normally repeat words and phrases. This repetition is called "dysfluency" or "pseudostuttering." Normal dysfluency occurs in about 90% of children because the child’s mind is able to form words faster than the tongue can produce them. if handled correctly, it lasts for only two or three months.
Many children who are learning to talk also have trouble pronouncing words correctly. "Normal dysarthria" and "mispronunciation" are terms used to describe incorrect pronunciation. Once again, this is not true, stuttering. Sounds are substituted or left out, so that some words become hard to identify. Normal dysarthria affects about 30% of children between 1 and 4 years of age, causing them to say words that their parents and others cannot comprehend. The cause is usually hereditary. Unlike normal dysfluency, normal dysarthria, speech becomes completely understandable by 4 years of age. By 5 or 6 years, 95% of children can speak intelligibly.
True stuttering, which affects around 1% of children, involves repetitions of sounds, syllables, words, or phrases; hesitations and pauses in speech; absence of smooth speech flow; and fear of talking. It occurs more often when the child is tired, excited, or stressed and is four times more common in boys than girls.
In most cases, true stuttering develops when a child with normal dysfluency or dysarthria is pressured to improve and in the process becomes sensitive to his inadequacies. Soon the child begins to anticipate speaking poorly and struggles to correct it. the child becomes tense when he speaks, and the more he attempts to control his speech, the worse it becomes. Hereditary factors also play a role in stuttering. Without treatment by a speech therapist, true stuttering will be come worse and persist into adulthood.
The Solution
The following suggestions for helping your child cope with normal dysfluency and dysarthria should prevent these conditions from progressing to true stuttering.
Encourage conversation. Sit down and talk with your child at least once a day. Keep the subject matter pleasant and enjoyable. Avoid asking your child to recite or otherwise perform verbally. Keep speaking time low-key and fun.
Don’t correct your child’s speech. Avoid expressing disapproval. Don’t use phrases such as, "Stop that stuttering" or "Think before your speak." Remember that this is your child’s normal speech for her age and is not controllable. Don’t try to improve your child’s grammar or pronunciation. Also, avoid praising her for good speech because it implies that her pervious speech wasn’t up to standard.
Don’t interrupt your child. Give your child ample time to finish what he is saying. Don’t complete sentences for him, and don’t let siblings do so, either. Try to leave a pause of two seconds between the end of your child’s sentence and the beginning of yours.
Don’t ask your child to repeat herself or start over. Listen very closely when your child is speaking. If possible, guess the message. Only if you don’t understand a comment that appears to be important should you ask your child to restate it.
Don’t ask your child to practice a certain word or sound. this just makes him more self-conscious about his speech.
Don’t ask your child to slow down when she speaks. A rushed rate of speech is a temporary phase that cant’t be changed by orders from the parent. Try to convey to your child that you have plenty of time and are not in a hurry. Model a relaxed rate of speech.
Don’t label your child a stutterer. Labels tend to become self-fulfilling prophecies. Don’t discuss you child’s speech problems in this presence. Don’t allow siblings to tease or imitate your child’s stuttering.
Help your child to relax and feel accepted in general. Try tin increase the hours of fun and play your child has each day. Try to slow down the pace of your family life. Avoid situations that seem to bring on stuttering. if there are any areas in which you have been applying strict discipline, back off.
Ask other adults not to correct your child’s speech. share these guidelines with baby-sitters, teachers, relatives, neighbors, and visitors.
Call our office during regular hours if:
- Your child is over 5 years of age.
- Your child has true stuttering.
- Your child also grimaces of has facial tics.
- Your child has become self-conscious or fearful about his speech.
- Your family has a history of stuttering in adulthood.
- Your child’s speech is delayed ( no words by 18 months or no sentences by 2 1/2 years).
- Your child’s speech is totally unintelligible to others, and he is over 2 years of age.
- His speech is more than 50% unintelligible to others, and he is over 3 years of age.
- His speech is 10% unintelligible to others, and he is over 4 years of age.
- Dysfluency doesn’t improve after trying this program for two months.
- You have other questions or concerns.
Adapted from Schmitt BD: Your Child’s Health. New York, Bantam Books, Inc., 1987
Coping with the Early Riser
The Problem
Some young children awaken before their parents do, usually between 5 and 6 am. These 1 to 4 year old children are well-rested and raring to go. They are excited about the new day and want to share it with others. they call out from the crib or come out of the bedroom and want everyone to wake up. If no one responds, they make a racket. It doesn’t take parents long to figure out that their child is a "morning person."
These children do not awaken early on purpose. They have received plenty of sleep, and they are not tired. Most of them were put to bed too early the night before, took too many naps, or took naps that were too long. Early morning naps that begin with in two hours after breakfast also contribute to early morning awakening. Some of these children require less sleep than the average 10 to 12 hours a night that most children between 1 and 10 years of age need. This is often a hereditary trait. Other children begin waking up early in the springtime when sunlight streams through the window; dark shades or curtains easily solve that problem. Other children who are given a bottle in the crib, fed an early breakfast , or allowed to come into their parents’ bed early in the morning may develop a bed habit that persists after the original cause (such as too much naptime) is removed.
The Solution
Reduce naps. If your child is an early riser, assume that he is getting too much sleep during the day. many children over 1 year of age (and almost all children over 18 months of age) need only one nap, unless they are sick. If your child needs two naps, be sure the first nap doesn’t start before 9 am. If cutting back to a single two-hour nap after lunch doesn’t help, shorten the nap to a maximum of one and a half hours. Also, make sure your child gets plenty of exercise after his nap, so he’ll be tired at night.
Delay bedtime until 8 or 9pm. This step, combined with reducing naps, should cure your child of early rising unless he has a below-average sleep requirement. In that case, proceed with the following limit-setting approach:
Establish a rule: "You may not leave your bedroom until your parents are up. you may play quietly in your bedroom until breakfast." Also, tell your child, "It’s not polite to wake up someone who is sleeping. Your parents need their sleep."
If your child sleeps in a crib, leave her there until 6am. Put some toys in her crib the night before (but not ones she can stand on). If you put them in before she goes to sleep, she may play with tem for a while, fall asleep later, and sleep longer. If she cries early in the morning, go in once to reassure her and remind her of the toys. Don’t include any surprises or treats among the toys or she’ll awaken early, as children do on holiday mornings. If she makes loud noises with some toys, remove those toys. if she cries, ignore it. If the crying continues, visit her briefly every 15 minutes to reassure her that all is well. Remind her that most people are sleeping. Don’t turn on the lights, talk much, give her a bottle, remove her from the crib, or stay more than one minute.
If your child sleeps in a bed, keep him in his bedroom until 6am. tell him he may not leave his bedroom until the music comes on, but he may play quietly until then, Help him put out favorite toys or books the night before. If he comes out of his room, put up a gate or close the door. Tell him that you’ll be happy to open the door or gate as soon as he is back in his room. if this is a chronic problem, put up the gate the night before.
If you meet strong resistance, change the wakeup time gradually. Some children protest a great deal about the new rule, especially if they have been coming into your bed in the morning. In that case, move ahead a little more gradually. If you child has been awakening at 5am., help her wait until 5:15 for three days. Set the clock radio for that time. After your child has adjusted to 5:15, set the radio to 5:30. Move the wakeup time forward every three or four days.
Don’t back down on the rule. If you relent, and continue to allow the child to come into your bed, her early mourning habits will rarely improve.
Praise your child for not waking other people in the morning. a star chart or special treat at breakfast may help you child wait more cooperatively.
Change your tactics for weekends. Many parents want their child to sleep in on Saturday and Sunday mornings. if this is your preference, keep your early morning riser up and hour later the night before. If you are using a clock radio for your child, turn it off or reset the time for an hour later. As a last resort, put together a breakfast for your child the night before and allow him to watch a preselected video.
Call or office during regular hours if:
- Your child’s sleep pattern doesn’t improve after trying this approach for four weeks.
- Your child has several other behavioral problems.
- You have other questions or concerns.
Adapted from Schmitt BD: Your Child’s Health, ed 2. New York, Bantam Books, Inc., 1991
Toilet Training
Toileting is a developmental skill that must be learned. Some children take to it swiftly, others take a little more guidance. The time to master this skill does not correlate in any way with successes in other areas of development. Most toddlers take several weeks to master daytime toileting, and most have occasional relapses. The key to success is patience, praising success and ignoring failures.
How do you know your child is ready for toilet training?
Your toddler will most likely begin giving you signals that he is ready to start toilet training. Toddlers may show more interest in bodily functions, become more aware of neatness and cleanliness, may wish to join you in the bathroom, or may even express their desire to wear underpants instead of diapers.
Preparing for toilet training.
Pay attention to your toddlers regular soiling pattern. You will notice that her BMs occur at fairly predictable times of the day. You will be able to use this knowledge to your advantage when the actual training begins. Reading her children’s stories about toilet training and letting her accompany you to the bathroom may help to prepare her. Potties should be stable and not frightening to your toddler. Let him decorate it and become comfortable with sitting on it, clothes on. He should feel like he has some control over his potty.
Toilet training.
A first step in toilet training is to make sure your toddler’s bottom is readily accessible. Training pants are very helpful, as you will need to quickly remove his clothing when the time is ripe.
Toilet training includes helping your toddler gain control of his bodily functions. A first step is to recognize when a movement is imminent. You probably are already able to recognize when he is having a BM or needs to pee. This is a good time to sit them down on the potty. Letting him be naked occasionally helps him get in touch with his body’s signals. Praise your toddler when he reports that he has had a BM or when he has a wet diaper. Never criticize accidents or soiled diapers. Shame will discourage your toddler from trying.
Try to take advantage of your toddlers regular soiling pattern to schedule times on the potty. Never force her to sit on the potty. If your toddler resists sitting on the potty, she may not be ready. Having the tap run during potty time sometimes helps. Praise any successes. You may even choose to give your toddler small rewards for successes, but be sure to phase out the rewards as toileting becomes more natural. Try not to get frustrated if your toddler is always asking to sit on the potty. He may be misinterpreting her body’s signals, but will soon get the hang of it.
Teach your child about hygiene; girls should always wipe front to back. Having your toddler sink toilet paper targets (from a sitting position) will improve his aim. He will later learn to stand to urinate, after he has mastered basic toileting. Bridge the gap between the potty and the toilet by emptying the contents of the potty into the toilet in front of her. She may even wish to flush the toilet herself, but if she is frightened by the noise, wait until she is out of the room. She will learn to flush later. Your toddler may want to move the potty from room to room. As long as he feels good about using the potty, any room is ok. Eventually your toddler will graduate to using the toilet, and the potty will remain in the bathroom.