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Featured Articles

The holidays are upon us and with them often come big, holiday meals.   These meals typically include long standing family traditions and often times the food can be a source of a major break down for a picky eater. We know that Thanksgiving can be extra challenging for parents of picky eaters.  In order to prevent dinner from turning into a battle zone, check out these tips below to keep your Thanksgiving dinner fun for all!

 

Prepare something your picky eater eat will.  Choose at least one food you know your child will like and make enough to imply that anyone can eat it, even if it’s unlikely that they actually will.  This allows you to have something your child will eat without sending a message that he or she has their own special food.   This way, your child is guaranteed to eat something during the meal and it also shows your child you care about his or her preferences when planning meals. 

 

Prepare your child.  Let your child know that you plan to offer at least one protein, grain, vegetable and fruit and tell them about any foods you are definitely planning on including (such as a turkey as a protein and stuffing as a grain).  Make a few dishes ahead of time that your child will see Thanksgiving day on the table one at a time and let them try them during a normal family dinner.

 

Involve your child in meal planning.  Kids are much more likely to eat foods that they have helped planned themselves.  Ask your child if he or she has any ideas for the other food groups.  For example, “What type of vegetable do you think we should include?”  Then together, find recipes that use those foods as ingredients.  

 

Invite your child to help with meal prep.  When kids help to cook food, they will often sample what they are preparing which helps to make them more likely to eat their masterpieces later.   Ask your picky eater to help you work behind the scenes washing vegetables, mixing ingredients or putting together a fancy cheese tray. 

 

Use food bridges.  Once a food is accepted by your picky eater, find similarly colored, flavored or textured “food bridges” to expand the variety of foods your child is willing to eat.  For example, if your child likes pumpkin pie, try including mashed sweet potatoes on his or her Thanksgiving plate.  

 

Give holiday foods fun names and make the food smell, taste and look delicious.  We know it sounds silly, but studies have shown that kids are much more likely to eat “Magical Mashed Potatoes” or “Superpower Sweet Potatoes” over plain-old mashed potatoes.  Many times, kids have made up their mind about a food before actually trying it.  By adding a “cool” name and making the dish smell, takes, and look delicious, you’re already increasing the odds that your child will try it.  For example, when preparing a veggie tray, try arranging the veggies in the shape of a turkey. 

 

Don’t make it a battle.  Focus on enjoying your time together with family or friends.  Try not to worry if and what your child is eating, you have done your job.  Go easy on yourself and your child and celebrate this day of gratitude.  

 

As natural as we are all told breast feeding is, it is important to remember that it doesn't always come easy for a new mom or baby.  Here are the top 5 most common problems mothers face with breast feeding and tips from our Lactation Counselor, Susan Cohen.

Engorgement

Pain swollen breasts, happen to most women when their milk "comes in" which is typically three to five days after birth.  Engorgement typically lasts for a day or two and then subsides.  

We are commonly asked what mothers can do to help with the discomfort they often experience during these early days:

  1. Use heat and massage before pumping or nursing followed by ice or cool cabbage leaves afterwards
  2. Take warm showers or do warm baths to help relax the breast and then massage them to allow the milk to flow. 
  3. Ibuprofen can help with pain relief as well
Know that even though your breasts may feel full, it is normal for breast production to be low during the first few days and then increase.  If you start to experience flu-like symptoms, please call your provider.  
 

Low Milk Supply

One concern we hear from parents a lot is, is my baby getting enough milk?  Here are some indications your baby is eating enough:
  1. You are breast feeding on demand 8-10 times/day or pumping 7-8 times/day (or a combination of pumping and breastfeeding)
  2. Your baby is making 6-8 wet diapers per day, having yellow, curdy stools and gaining weight
  3. Moms who pump breast milk can expect 1 oz total at each pump session by the end of the first week post-partum and 2-3 oz per session after 2-3 weeks. 
If you do not pump or nurse at night or if you offer bottles and don't pump at that time to keep up your supply, your supply may decrease.  As a rule of thumb: the more you pump or breastfeed, the more milk you will make.  Some things that can affect your milk supply are: decongestants, breast reductions, PCOS or thyroid disease. 
 

Sore/Cracked Nipples

Breastfeeding should not be painful and pain with breast feeding may mean that the baby is not latching properly.  The baby's mouth should cover your areola (the brown skin around your nipple), not just be latched on the nipple.  In order for milk to be released, your baby needs to pull on the ducts behind the nipple to release milk and needs a wide open mouth to get a deep latch.  To help accomplish this, remember to bring your baby to the breast, not to put your nipple in the baby's mouth. 
 
Other causes of sore nipples can include:
  1. A yeast infection on the nipple - This is a condition that can be treated by your provider
  2. Baby's tongue tie - This is a condition diagnosed by your provider
  3. Flat nipples - This can make it hard to center the breast in the baby's mouth.  A nipple shield can help as well as a manual hand pump for inverted nipples
  4. Too much pressure on a breast pump - Remember to only turn the pump pressure up as high as is comfortable and productive

Painful Breasts

When your baby latches, it may initially be painful but if the pain persists or comes back after the engorgement phase, there may be a problem.

  • Red, painful breasts may indicate mastitis -- an infection of the breast that will required antibiotics to treat.  This does not affect milk quality so it is recommended to keep pumping or nursing to ensure your supply stays up. 
  • A clogged milk duct can be relieved with warm compresses and massage while pumping of breast feeding on that breast. 
  • Avoid underwire bras as these can lead to clogged milk ducts.  Keep your breasts as empty as you can by using hand massage while you pump and by nursing early and often.

Where Can I Turn for Reliable Information on Breast Feeding?

We know that between corporate promotions, social media and blogs, it can be confusing to make sure your source for health care information is reliable.  We recommend these reliable resources for accurate and research-based information:
  • Our certified lactation counselor at Cherry Creek Pediatrics
  • Stanford University - offers helpful videos on breastfeeding in the first hour, latching, hand-expressing milk and much more
  • New Mother's Guide to Breastfeeding - a book published by the AAP
    (has up-to-date information on how to establish a breastfeeding routine, as well as troubleshooting tips)

We want you to enjoy your breastfeeding experience and help you through the process of providing the best nutrition for your infant and growing child. If you have any concerns about how your baby is feeding or are worried about your milk supply, please contact our office. 

If you would like to schedule an appointment with Susan, please contact our office at 303-756-0101

November 06, 2018
Category: Featured Articles
Tags: sleep   Lifestyle  

From infants and toddlers to school-aged children and teens, one of the most common questions we get is how much sleep should my child be getting?  While it's true that sleep needs vary from person to person, there are some very reasonable, science-based guidelines to help you determine if your child is getting the sleep he or she needs to grow, learn and play!

The American Academy of Sleep Medicine (AASM) provides some helpful guidelines regarding just how much sleep children need at different stages in their development.  Don't forget though that these numbers reflect TOTAL sleep hours in a 24-hour period, this includes naps

Do These Numbers Surprise You?

It's important to remember that all children thrive on a regular bedtime routine.  Regular sleep deprivation can result in difficult behaviors and health problems such as: irritability, difficulty concentrating, hypertension, obesity, headaches and depression.  Children who get enough sleep have a healthier immune system and better school performance, behavior, memory and mental health!!

As a parent, it’s important to encourage healthy habits, including exercise, in your youngster to help enforce that physical activity becomes as much a part of their routine as eating and sleeping.  

 

Teach your child that sports such as cycling (always with a helmet!), swimming, basketball, jogging, walking briskly, cross country skiing, dancing, aerobics, soccer and other sports when played regularly, are not only fun but also promote health.  

 

Physical activity is important for all children as it helps to:

 

1.  Increase Cardiovascular Endurance

 

Did you know that more Americans die from heart disease than any other ailment!  Physical activity can help improve your child’s fitness, make them feel better and also strengthen their cardiovascular system helping to protect against heart problems.  

 

How you many ask?  Aerobic activity can help the heart pump more efficiently, helping to reduce the incidence of high blood pressure.  It can also help raise the body’s level of HDL (high-density lipoprotein) cholesterol, the “good” cholesterol that removes excess fats from the bloodstream.  

 

But I thought cardiovascular diseases were thought to be illnesses of adulthood?  Fatty deposits have been detected in the arteries of children as young as three years of age and high blood pressure is present in about 5 percent of youngsters, making it important to make physical activity part of your child’s routine from the beginning!

 

How much activity should my child be getting?  It is recommended that children in their middle-years get twenty to thirty minutes of physical activity, at an increased heart rate, at least three times a week.  Make certain that each session of exercise is preceded and followed by a gradual warm-up and cool-down allowing muscles, joints and the cardiovascular system to ease into and out of vigorous activity, helping to ensure a safe workout.  

 

2.  Improve Large Muscle Strength and Endurance

 

As physical activity becomes a part of your child’s routine, your child’s muscles with become stronger and they will be able to exercise for longer periods of time, as well as help to prevent future injuries, as strong muscles provide better support for the joints.  

 

What are some exercises my child can do?

Modified sit-ups (knees bent, feet on the ground) can help build up abdominal muscles, increase lung capacity, and protect against back injuries.  

Modified pull-ups (keeping the arms flexed while hanging from a horizontal bar)

Modified push-ups (positioning the knees on the ground while extending the arms at the elbow)

 

3.  Increase Flexibility

 

In order to be well-rounded in terms of physical fitness, children need to be able to twist and bend their bodies through the full range of normal motions without overexerting themselves or causing injury.  Although most people lose flexibility as they age, this process can be repressed by maintaining suppleness throughout life, beginning in childhood.  

 

Stretching exercises are the best way to maintain or improve flexibility and should be incorporated into your child’s warm-up and cool-down routine.  

 

How should I instruct my child to stretch?  Your child should stretch to a position where they begin to feel tightness but not pain and then hold steady for twenty to thirty seconds before relaxing. Instruct your child not to bounce as they stretch as this can cause injury to the muscles or tendons.  

 

4.  Maintain a Healthy Weight

 

Did you know twelve percent of children in their pre-puberty years are overweight!  Physical activity can effectively burn calories and fat and reduce appetite.  Ask your provider to help determine whether your child has a healthy percentage of body fat for their age and sex.  

 

5.  Reduce Stress

 

Stress that is unmanaged can cause muscle tightness contributing to headaches, stomachaches and other types of discomfort.  Getting your child physically active teaches them to not only recognize stress in their body but also healthy ways to manage it.  Exercise is one of the best ways to control stress helping your child to experience less stress-related symptoms than their sedentary peers.  

 

 

Are There Any New Updates That I Should be Aware of?

The AAP is now recommending that children remain in a rear-facing car safety seat as long as possible, until they reach the highest weight or height allowed by their seat.  Previously, the AAP guideline was for children to remain rear-facing until age 2.  

 

How Do I Know my Child’s Car Seat’s Weight and Height Limits?

Check the instruction manual and the labels on a car safety seat to find the manufacturer’s weight and heights limits.

 

Why is it Important to Keep my Child Rear-Facing?

When children are rear-facing, the head, neck, and spine are all supported by the hard shell of the car safety seat, allowing the car seat to absorb most of the crash forces and protecting the most vulnerable parts of their body.  When toddlers are forward-facing, their body is held back by the straps but their heads—which are disproportionately large and heavy—are thrown forward, which can result in spine and head injuries.  

 

Remind Me, What are the Different Types of Rear-Facing Car Seats?

 

Infant Car Seat (Rear-Facing Only)

 
  • Designed for newborns and small babies, the infant-only car seat is a small, portable seat that can only be used rear-facing.  Babies usually outgrow their infant car seats by eight or nine months.  When that happens, parents should purchase a convertible or all-in-one car seat and use it rear-facing

Convertible Seat

  • As a child grows, this seat can change from a rear-facing seat to a forward-facing seat with a harness and tether.  Because it can be used with children of various sizes, it allows for children to stay in the rear-facing position longer

All-In-One

  • This seat can change from a rear-facing seat to a forward-facing seat (with a harness and tether) and to a booster seat as a child grows.  Because it can be used with children of various sizes, it allows for children to stay in the rear-facing position longer

 

But What if my Toddler’s Feet Touch the Back of the Vehicle Seat?

Children can bend their legs easily and will be comfortable in a rear-facing seat.  Injuries to the legs are very rare for children facing the rear.

 

What are Other AAP Recommendations for Car Safety?

Once facing forward, children should use a forward-facing car seat with a harness for as long as possible, until children reach the height and weight limits for their seats.  Many seats can accommodate children up to 65 pounds or more.  

 

Different Types of Forward-Facing Car Safety Seats:

    

Convertible Seat

  • As a child grows, this seat can change from a rear-facing seat to a forward-facing seat with a harness and tether

Combination Seat

  • As a child grows, this seat transitions from a forward-facing seat with a harness and tether into a booster

All-In-One

  • This seat can change from a rear-facing seat to a forward facing seat (with a harness and tether) and to a booster seat as a child grown
  • When a child exceeds these limits, a belt-positioning booster seat should be used until the vehicle’s lap and shoulder seat belt fits properly.  This is often when they reach 4 feet 9 inches (57 inches) in height and children are 8-12 years of age.  Did you know that most children will not fit i a seat belt alone until 10-11 years of age?

 

Different Types of Booster Seats:

 

Booster Seat with High Back

  • This type of booster seat is designed to boost the child’s height so the seat belt fits properly.  It also provides nec
  • k and head support and is ideal for  ehicles that don’t have head rests or high seat backs

 

Backless Booster Seat

  • Designed to boost the child’s height so the seat belt fits properly.  It does not provide head and neck support.  It is ideal for vehicles that have head rests

Combination Seat

  • As a child grows, this seat transitions from a forward-facing seat with a harness into a booster seat

All-In-One

  • This seat can change from a rear-facing seat to a forward-facing seat (with a harness and tether) and to a booster seat as a child grows
 

What is the Difference Between High-Back and Backless Boosters?

Both types of boosters are designed to raise your child so seat belts fit properly, and both will reduce your child's risk of injury in a crash.  High-back boosters should be used in vehicles without head rests or with low seat backs.  Many seats that look like high-back boosters are actually combination seats.  They come with harnesses that can be used for smaller children and, later, removed for older children.  Backless boosters are usually less expensive and are easier to move from one vehicle to another.  Backless boosters can be used safely in vehicles with head rests and high seat backs.

  • Once old enough and large enough to use the vehicle seat belt alone, children should always use lap and shoulder seat belts for optimal protection.

But How do I Know When an Adult Seat Belt Fits my Child Correctly?
 

When an adult seat belt fits your child properly:

  1. The shoulder belt lies across the middle of the chest and shoulder, not the neck or throat
  2. The lap belt is low and snug across the upper thighs, not the belly
  3. Your child is tall enough to sit against the vehicle seat back with her knees bent over the edge of the seat without slouching and can comfortably stay in this position throughout the trip

    **All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection. 

Commonly Asked Questions

 

What do I do if my baby slouches down or to the side in the car seat?

  • Blanket rolls may be placed on both sides of your infant.  A small diaper or blanket may be placed between the crotch strap and your infant too.  Do not place padding under or behind your infant or use any sort of car seat inserts unless it came with the seat or was made by the manufacturer of the seat

 

Why should I dress my baby in thinner layers of clothing before strapping him or her into a car seat?

 

  • Bulky clothing, including winter coats and snowsuits, can compress in a crash and leave the straps too loose to restrain your child, leading to increased risk of injury.  Ideally, dress your baby in thinner layers and tuck a coat or blanket around your baby over the buckled harness straps if needed.

Do preemies need a special car seat?

 

  • A car seat should be approved for a baby’s weight.  Very small babies who can sit safely in a semi-reclined position usually fit better in rear-facing-only seats.  Premature infants should be tested while in the hospital to make sure they can sit safely in a semi-reclined position.  Babies who need to lie flat during travel should ride in a car bed that meets Federal Motor Vehicle Safety Standard 213.  They should be tested while in the hospital to make sure they can lie safely in the car bed.  

 

Should my child ride in a car seat on the airplane?

 

  • The FAA and the AAP recommend that children less than 40 pounds be securely fastened in certified child restrains when flying.  This will help keep them safe during takeoff and landing or in case of turbulence.  Most rear-facing, convertible, and forward-facing seats can be used on airplanes, but booster seats and travel vests cannot.
  • Look for a label on the car seat that says, “This restraint is certified for use in motor vehicles and aircraft.”  You can also consider using a restraint made only for use on airplanes and approved by the FAA.  Larger children may use the airplane seat belt or continue to use their car seat on the airplane as long as it is labeled for use on aircraft and the child has not exceeded the seat’s weight or height limit.  Remember that your child will need an appropriate car seat to use at your destination.  

 

What if my car has only lap belts in the back seat?

 

  • Lap belts work fine with rear-facing–only, convertible, and forward-facing seats but can never be used with a booster seat.  If your car has only lap belts, use a forward-facing seat that has a harness and higher weight limits.

You could also:

  • Check to see if shoulder belts can be installed in your vehicle.
  • Use a travel vest (some can be used with lap belts).
  • Consider buying another car with lap and shoulder belts in the back seat.

 

I've seen products that say they can help make the seat belt fit better.  Should we get one of these?

 

  • No, these products should not be used.  They may actually interfere with proper seat belt fit by causing the lap belt to ride too high on the stomach or making the shoulder belt too loose.  They can even damage the seat belt.  This rule applies to car seats too; do not use extra products unless they came with the seat or are specifically approved by the seat manufacturer.  These products are not covered by any federal safety standards, and the AAP does not recommend they be used.  As long as children are riding in the correct restraint for their size, they should not need to use additional devices.

 

Remember to Never Use a Car Seat That:

 

Is too old. Look on the label for the date it was made. Check with the manufacturer to find out how long it recommends using the seat.

Has any visible cracks on it.

Does not have a label with the date of manufacture and model number. Without these, you cannot check to see if the seat has been recalled.

Does not come with instructions. You need them to know how to use the seat.

Is missing parts. Used car seats often come without important parts. Check with the manufacturer to make sure you can get the right parts.

Was recalled. You can find out by calling the manufacturer or contacting the National Highway Traffic Safety Administration (NHTSA) Vehicle Safety Hotline at 888/327-4236. You can also visit the NHTSA website.

Do not use seats that have been in a moderate or severe crash. Seats that were in a minor crash may still be safe to use, but some car seat manufacturers recommend replacing the seat after any crash, even a minor one. The NHTSA considers a crash minor if all the following situations are true:

  • The vehicle could be driven away from the crash.
  • The vehicle door closest to the car seat was not damaged.
  • No one in the vehicle was injured.
  • The air bags did not go off.
  • You can't see any damage to the car seat.

If you are unsure, call the manufacturer of the seat.

 

What are some parent resources?

  1. SeatCheck (or call 866-SEATCHECK [866-732-8243])
  2. National Child Passenger Safety Certified Technicians (or call 877-366-8154)  This site also includes a list of CPSTs fluent in Spanish and other languages or with extra training in transportation of children with special needs
  3. NHTSA Parents Central  http://www.safercar.gov/parents/index.htm
     

Keep your child safe! Using the right car safety seat or booster seat lowers the risk of death or serous injury by more than 70%!!!





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