Teething do’s and don’ts

Teething do’s and don’ts

As a pediatrician, I hear a great deal of questions and concerns about teeth and teething: “Can you see if my baby has any teeth coming in?” “I think my baby is teething; her hands are always in her mouth.” “My baby is not sleeping, not eating, is more fussy, and has a fever – could this be from teething?” Teething is the process of teeth erupting through the gums. It can start as early as 3 months and continue until as late as 30 months, when all 20 of the primary teeth are in. Most commonly, parents can expect that first tooth to peek through around 4-7 months of age. Usually the middle two bottom teeth appear first and are followed by the four upper teeth, then the lower lateral incisors. Next, families can expect the first set of molars, then finally the canine (eye) teeth. Some babies can even be born with one or two teeth. As children begin teething, they may drool more and want to chew on things. However, this can be confused with normal developmental milestones. At around 3 months of age, babies put their hands to their mouths, then hold toys and bring them to their mouths. So not all drooling and hands in the mouth is related to teething. Some babies are a little more irritable with teething, and the most discomfort occurs during the few days before the tooth breaks through the gum. The gums may appear a bit swollen and a little more red. Sometimes the gums can even look a little purple or bruised. Some babies may feed a...
What does it mean to be school ready?

What does it mean to be school ready?

The playground can be a tough place…especially for parents!​ You may meet parents who boast about their 3 year old who reads independently. Others ​swoon​ about ​their​​ 4 year old who can count to 50 with ease. All of this may leave you wondering if your child is school ready. What does it mean for a child to be “school ready”? What indicators​ can ​tell you if your child is going to thrive when he/she walks through those doors on the first day of school? ​It’s helpful to be guided by two principles when thinking about school and your child’s ​abilities: (1) ​​Every child​ is​ unique ​and there can be no “one size fits all” definition of school readiness​; and (2) You are the most valuable resource for your child’s ​readiness. — for more tips, check out our Parenting Advice section — You may be surprised to learn that school readiness has less to do with what your child can already do, ​and more about how prepared he/she is to learn it.  Is your child ready physically, socially, emotionally, and cognitively to function in a classroom​?​ ​It is not about what they already know to “be ahead” or “keep up” in school. It is important to ​differentiate between the behavioral skills (collaboration, patience, ​listening​)​ you want your child to have, and ​content knowledge (counting, reading, writing).​ Preparedness happens when you are mindful of your child’s learning, patient when challenges arise and thoughtful about how you can support and nurture their growth. ​There are many school readiness traits developed and studied by top educators,​ ​​and based on the research, and my own experience, I have identified seven​ “School Readiness Indicators​”​ which ​will...
Ways to praise

Ways to praise

When you attend to and acknowledge your child for their efforts and accomplishments, your child will feel good about him or herself because you are focusing on their strengths. Using praise improves relationships between adults and children and increases children’s self-esteem. There are effective ways to this, and based on the psychological effects of how praise is received by children, here are 3 tips on the best ways to praise your child: 1) Be specific Praise works best when you specifically describe the thing for which your child is being acknowledged. For example, it’s better to say “Great job – you worked hard picking up the toys!”  than saying “Great job!” It is best to praise children by focusing on the behavior rather than the person. For example, saying “I’m proud of you for tasting those carrots” puts the emphasis on the behavior (tasting a new food) whereas saying “you are a good girl for tasting those carrots” puts the emphasis on the child (being a good person). This may seem subtle, but we do not want children to think they are “good” or “bad” because of the behavior they display. We do want children to know what behaviors we expect from them and praising their positive actions accomplishes that.   2) Be sincere When your child does something that makes you happy or proud of him let him know by acknowledging the thing he did that made you proud. When praise is genuine and sincere, you should use it liberally. It increases children’s motivation and their self-esteem.  And no, you don’t need to worry about this kind of praise “going to his head”. Related, be careful not to give backhanded praise....
Music to support learning

Music to support learning

From the day your baby is born, you watch them grow and change on a daily basis. It is amazing to see the physical, emotional and developmental changes! There are important milestones to watch for as your baby progresses and you can use music to support learning. Here are some ideas for how you can do this at every stage of your child’s development: 1 month​ ​-​-​ ​Y​our baby’s hearing is fully developed, even before his sight. During tummy time, shake an instrument such as a shaker or rattle to one side of your baby’s head. Watch as he picks up his head and turns to look towards the sound source. Not only does this exercise his muscles, it also exercises his ability to look towards and track the sound source. 3 months​ ​-​- ​Your baby will start to babble and mimic sounds. Help to shape those sounds by emphasizing your mouth and affect while singing simple sounds such as “ohhhh”, “ahhhh” and even “lalala”. Praise your baby as he attempts to mimic your sounds and affect. This also offers opportunities for vocal play between you and your baby. Have fun with it and be silly with your sounds! 4-​6​ months​ ​-​- ​By this point​,​ it is important to establish a routine for your baby. Make music part of your routine in order to create predictability. For instance, sing “row your boat” as bath time approaches or turn on a soothing lullaby CD as you are preparing your baby for bedtime. Use the same music on a daily basis and this will create predictability for your baby, cuing him that it...

What can I do when my child gets frustrated while playing?

Discuss frustration and potential cognitive delay and how to handle that as a parent. Frustration can be very difficult to see your child go though. What can you do when your child gets frustrated while playing? There may be frustration playing with a particular toy or learning a specific word or skill. You may wonder how you can help your child when they get frustrated. If it’s a toy that is causing the frustration, it may mean that the toy and level of complexity is too much at this particular point.  Brandon, an educator on our expert panel, discusses the concept of “building a scaffolding” to help your child through that frustration so that they can continue to play and learn.  ...
Developing a Bedtime Routine

Developing a Bedtime Routine

As pediatrician​s​, one of the most common concerns​ we​ hear from parents is, “My child won’t go to bed.”  At the end of a long day, the last thing parents want is bedtime drama. Often parents will try ​an “easy​”​ fix (lying down in their child’s bed, bringing the child into the parents’ bed, letting the child fall asleep anywhere and moving her later) just so everyone gets some sleep. ​These fixes may help in the short-term​, but ​often lead to long​-term ​issues. It is best to begin with a bedtime routine at a young age. And, as with all things, consistency will pay off. Most toddlers and preschoolers need 11​-​14 hours of sleep in a 24-hour period.  ​We ​recommend picking a bedtime that fits your family routine, taking into account the time you need to wake up and the ​length of time your child still needs for a nap.  Once you settle on a bedtime, decide ​what to include in your​ routine. Bath? ​Brushing teeth? ​Changing a diaper, putting on pajamas? Stories?  Choose an order for the components of your routine, and ​​stick with it. Very soon your children will expect it and enjoy it.​ ​​Some of the ​most wonderful times ​we have had with our children (Dr. Kaseta has four kids and Dr. Gannon has six kids) a​​​​re the quiet games, reading and chatting before bed. Some children will resist sleep because they feel a bit out of control. They do not really want the day and​/or​ time with you to end. ​Y​ou can give them some control by allowing them to make choices about the activity. ...
Teaching Sleep

Teaching Sleep

One of the greatest gifts you can give your children is teaching them how to sleep. Teaching sleep?​ ​Yes! Babies do not know how important good quality sleep is to their growth and healthy development,​ ​so we must teach them! The most difficult thing for new parents to understand is that often learning a new skill can be difficult for a baby and may lead to a few tears. I liken it to learning to ride a bicycle. A five-year-old will fall a few times and get a​ ​couple of​ ​scraped knees​ ​before riding independently. You cannot learn to ride a bike for another person in the same way you can’t get someone else to sleep. They need to master it on their own, but we can be there to help. So​,​ how do​ ​you do this? Here are 5 things to remember: First off, your baby needs his own place to sleep for safety reasons. We do not want any increased risk of SIDS (sudden infant death syndrome or “crib death”) or suffocation. A bassinet or crib with a tight fitting sheet is all you need. No bumpers, no blankets, no toys, and never allow your baby to sleep in bed with you. Next, ​set your routine​. I like the feed-wake-sleep routine. Most newborns and young infants are on a two-to-three hour feeding schedule depending if they are breastfed​ ​or​ ​on​ ​formula. Make a note of the time when you start to feed your baby. After feeding, the baby can stay awake for 30-60 minutes; this is when you talk to your baby, do tummy time, and play....
What To Do About Separation Anxiety

What To Do About Separation Anxiety

It’s hard to believe, but children as young as a few months old can experience anxiety. In fact, beginning around six months, a certain amount of separation anxiety is to be expected, and can be difficult for both your child and for you. Here are three quick tips to remember whenever you are worried about your child’s separation anxiety: ​1) ​Anxiety is​ completely normal Separation anxiety is ​generally ​triggered when a child becomes mobile (crawling and walking)​.​ The ability to move ‘independently’ is exciting, but also causes worry about being too far away from a care​giver​. You will notice your baby crawl or walk a little​,​ then ‘check in’ to make sure you are still there. This new push and pull feeling​ – ​wanting to explore, but still needing to feel secure​ – ​sets off the separation anxiety. Separation anxiety is most clear when you (or another primary care​giver​) leave for any amount of time. For some children, the anxiety is minor. They will cry briefly, but it will dissipate after a couple of minutes of distraction. For others, separation can be more significant​. T​hey will cry for several minutes or more after you leave, refusing to be consoled. In fact, a baby or toddler may even cry when you return​, ​simply from relief that you are back! Some children continue to experience separation anxiety into kindergarten, but almost every preschool and kindergarten teacher reports that once the moment of separation is over, the child is fine​ ​and able to enjoy their time in school. Thus, as long as your child’s separation struggles don’t interfere with her ability to...
Why music is important for your child

Why music is important for your child

Throughout our lives, most people love some type of music. It doesn’t matter our background, skills or preferences – there is music that makes everyone happy and it starts at a young age.  Do you know why music is important for your child? Music is one of the few activities that engages both sides of the brain. At a young age, it helps form neural pathways that are beneficial for motor skill development, emotional intelligence and creativity. Here are some simple ways that music can be beneficial to your child…and you! Music ​develops skills​ ​-​ ​Music is multi-modal​, which means it​ addresses ​multiple ​areas of development such as speech and language, fine and gross motor skills, social development, spatial awareness, academic skills, as well as sensory needs. The effects are endless! ​Your child ​will ​think​ they are having fun with music, ​​and at the same time are learning and developing ​their​​ brains on so many different levels​.  How do you do this? Sing a familiar song such as “baa baa black sheep” while clapping hands with your child. Emphasize the shape of your mouth as you sing “baa baa” so that your child can see and imitate the sounds that you are creating. Music is structured​ ​-​ ​In early stages of life, infants and toddlers are developing a sense of trust. They have complete dependency on the caregiver and when their needs are met​,​ that creates security. Music is structured sound. It has a predictability that meets the instinctual needs of an infant, therefore provides a sense of comfort. ​Combining emotional comfort with soothing and structured sounds ​can make...
Food Allergies in Children

Food Allergies in Children

Food allergies in children get a lot of attention from parents, especially since approximately 1 in 20 children under the age of 5 are allergic to at least one food. ​It is a common issue, and can be very concerning. ​Allergic reactions to foods can be serious, so it is​ important to educate yourself with the facts​!​ ​I have worked extensively with parents and children, talking with them about nutrition in general and helping to understand food allergies. From my experience, here are the top 5 things to know about food allergies in children: 1. Six foods are the most common​.​ In infants and children, the most common foods the cause allergic reactions are: eggs, milk, peanut, treat nuts, soy, and wheat (​these cover ​6 of the 8 major food allergens​ ​- the other two are fish and shellfish). Some children outgrow their egg, milk and soy allergies, but generally do not outgrow their allergy to peanut. 2. Symptoms are varied​.​ A food allergy occurs when a food triggers an abnormal response by the body’s immune system​, and ​this can occur in minutes or hours after ingesting the food. Symptoms include: itching of the mouth, swelling of the lips/tongue, vomiting, diarrhea, abdominal cramps/pain, hives, rash, tightening of the throat or trouble breathing. Anaphylaxis is a severe form of allergic reaction that requires immediate medical attention because it can be life-threatening. 3. Diagnosis can be confirmed​. Monitoring your child’s food intake and potential symptoms using a food diary can provide clues about a possible food allergy. If you suspect your child may have an allergy, you should consult with your pediatrician immediately....
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