Showing posts with label toddler. Show all posts
Showing posts with label toddler. Show all posts

Monday, October 4, 2010

Milk and Your Toddler

Many parents ask me questions about transitioning their child from mom's milk/formula to cow's milk. Here are some tips that you should remember as you and your child make the switch:

Milk should be stored in a refrigerator that is cooler than 40 deg F. Once milk temperature reaches 45 deg or higher, bacterial growth can occur. Milk temperature can go up fairly rapidly, especially in warm weather. Generally speaking, milk should be used within 1 hour of taking it out of the refrigerator and should never be re-refrigerated.

Milk should be served at meal or snack times, but remember that toddlers should not walk around with a cup or constantly sip throughout the day. Those who constantly snack or sip their drinks give acid-producing bacteria a longer time to create damage/cavities.

In order for milk to be classified as "USDA organic," farms must meet the following criteria: cows are exclusively given feed grown without the use of pesticides or commercial fertilizers; cows are given periodic access to pasture and direct sunlight; cows are not treated with supplemental hormones and cows have not been given certain medications to treat illness. If you choose to give your toddler organic milk, make sure that it is treated with the conventional pasteurization process. Raw, unpasteurized milk may contain a wide variety of harmful bacteria including Salmonella, E. coli, Listeria, Campylobacter, and Brucella. These can cause illness and possibly death. Raw milk-related illnesses can be especially severe in infants and young children.

A toddler generally needs about 3 cups (24 oz) of total dairy, including milk and yogurt, daily. In general, toddler's tend to be picky and it can sometimes be hard to get them to accept a well-balanced variety of foods. Drinking too much milk may fill them up and make it more difficult to get them to eat other foods. Drinking excessive amounts of milk (more than 40 0z daily) can also lead to Iron deficiency anemia in some children, because milk can interfere with iron absorption in the intestines and can cause irritation in the GI tract leading to microscopic blood loss.

Dr. Sumita Ram
Pediatrician
Meriter Middleton Pediatrics
meriterkids.com

Monday, May 10, 2010

Fears in Toddlers


I was recently asked about a toddler who was afraid of her own shadow. Fears are common in toddlers, so I have included my response on our blog.

Developmentally, toddlers are becoming much more aware of what is around them and becaue of this, parts of everyday life that they didn’t notice before can become terrifying. In addition, toddlers are starting to develop a wonderful sense of imagination. They often struggle to distinguish between what is real and make-believe and they are still learning the concept of cause and effect. As a result, fears are quite common and normal in the toddler and preschool years. They become abnormal only if they develop into persistent and irrational fears that interfere with the child's normal activities. Some common fears in toddlers include fear of being separated from their parents, the vacuum cleaner or other loud noises, the bathroom drain, the dark, and yes ... even their own shadow.

For most common toddler fears, it is gentle reassurance and basic, truthful information that most successfully assuages a toddler's anxiety. For example, if he or she is afraid of shadows, don't bend over backward to avoid going outside. Make sure you acknowledge your toddler’s fear by mirroring their emotions, e.g. “the shadow is scary for you." In the case of shadows, expose him/her slowly to what he/she fears; some contact with what shadows (in a controlled setting with you right next to him/her or holding her while providing lots of reassurance will probably help). Gradually increase his/her exposure to shadows. Talk about the shadows in simple terms. Read books about shadows. You could do puppet shows on the wall. Silliness often helps. For example, you could make your shadows do silly dances. As she starts feeling more comfortable, you could play a game of “shadow tag” trying to “tag” each others shadows.

Chances are that once you have acknowledged your toddler’s fear and once your toddler senses that you are not afraid, they will follow suit.

Dr. Sumita Ram
Pediatrician
Meriter Pediatrics
2275 Deming Way, Suite 220
Middleton, WI 53562
608.417.8388
meriterkids.com

Monday, April 5, 2010

To fly or not to fly … with a toddler

A number of years ago, my wife and I decided to take a trip to California with our 22-month old daughter, Sophia. We reserved a hotel, arranged for a rental car, and booked the 4 hour flight to San Diego. Like anyone else, I was looking forward to vacation. I imagined showing Sophia the ocean, visiting the zoo, and just getting away from the every day routine. It was all good until a friend questioned my sanity, saying to me “Flying with a toddler is crazy. She’ll probably cry the whole flight.”

Happy visions of strolling along the beach were replaced with nightmare-ish visions of my daughter screaming the entire flight, or throwing sippy cups and toys at the heads of the passengers in front of us. Determined to get our vacation off to a good start, my wife and I came up with a plan. We made lists of what we needed to bring on the plane and armed ourselves with books, toys, games, food and plenty of diapers.

Finally the day came. Sophia ran from window to window looking at all the airplanes. I boarded first and installed the car seat, and my wife waited until the end to board, letting Sophia burn off a little extra energy. At first, things were great. Sophia sat happily in her car seat, drank some juice and ate cheerios. Then, about an hour in, she got squirmy and we read some books and colored. Two hours in, the fussiness started. We got out the toys and she played happily for a while. About three hours into the flight, we reached the level of desperation and brought out...the finger puppets. Yes, one for each finger. My wife sang songs and I made the finger puppets dance. Sophia laughed and all was right in the world. Of course, she fell asleep just as the pilot started the descent.

Overall, it was a successful flight—minimal ear pain for Sophia, minimal angry looks from fellow passengers (people around us were very nice) and minimal tears. Truly, flying with a child does not have to be stressful, especially if you set realistic expectations and plan ahead.

Here are a few tips on flying with babies and young children:
  • Dealing with ear pain: Babies and young children may cry in response to the sudden change in cabin pressure, which can cause ear discomfort. Usually this occurs during take-off and landing. The act of sucking, by nursing, bottle feeding, or using a pacifier, may help alleviate some of this pain.

  • Do not use Benadryl or cough and cold remedies: I often get asked about giving Benadryl or cough and cold medications prior to flying. I usually do not recommend them because 1) they are not approved for children under two years of age and 2) some children actually have the reverse effect and become “hyper.” Also, even if it does make your child sleepy, it may make them more irritable after they wake up. I highly recommend talking with your child’s doctor if you have questions about this.

  • Separate seat vs. lap child: If at all possible, purchase a seat for your infant or child (children under 2 years of age fly free as a “lap child” on most airlines). You’ll have more room to move, and more importantly, your child will be safer. When turbulence kicks in or an emergency landing takes place, it can be very difficult to keep the child safely in your lap, regardless of how tightly you hold them. According to the American Academy of Pediatrics, “Preventable injuries and deaths have occurred in children younger than 2 years who were unrestrained in aircraft during survivable crashes and conditions of turbulence.” Also, check with your airlines for discounted seats for infants. You can use a car seat on the airplane. Just make sure that is an FAA approved car seat.

  • Wait to board the plane: While many airlines allow families with small children to board first, this often means that your child will be sitting in the seat for quite a while before the plane actually departs. If you are flying with another adult, one can board first and get everything settled (including car seat installation), and the second can follow later with the child.

  • Keeping the seat belt on: For older children who have not flown before who will not be using a car seat, have a few play sessions at home, pretending to be on a flight . Use an old belt, or anything you have that can be buckled. Have a few discussion prior to the trip about the importance of keeping the belt on, and stress that the plane will not take off unless everyone is buckled up.

  • Be prepared. Flights are often delayed, so bring plenty of food and drinks (check the TSA Web site to see what is allowed), plenty of extra diapers and several changes of clothes (including a spare short for each parent in case of “accidents”). Also, bring familiar and favorite toys or games. While new toys might be a good distraction for older children, babies and younger children often prefer playing with the toys they use everyday.

  • Allow ample time: The process from checking in your bags to the arriving at your gate may be long. Allow yourself enough time to get through the security screening process as well. If you have older children, it is important to talk about the screening process ahead of time. Their personal belongings such as dolls, toys and games, will be placed under an x-ray screen, but will return to them after they walk through the security screen themselves.

  • Have realistic expectations: Your child will probably cry at some point during the flight. Accidents and spills may happen. You probably won’t have much time to read that magazine you picked up at the airport. But, with a little preparation and planning, you can make flying a great experience for the whole family!

  • More than 7 years later, my daughter is a seasoned traveler. She even packs her own carry on bag and entertains herself on flights by reading or drawing. I’ll admit, it’s nice to have some time to myself to catch up on reading during the flight, but there is a part of me that misses the songs and the finger puppets.

    Safe travels……
    Viren Bavishi, D.O.
    Pediatrician
    Meriter Pediatrics
    2275 Deming Way, Suite 220
    Middleton, WI 53562
    608.417.8388
    meriter.com/pediatrics