Highly Contagious: Measles

Friday, January 23, 2015 2:02 PM comments (0)

measlesMeasles is extremely contagious, infecting nearly 90 percent of unvaccinated people who come into contact with it. Why is it so contagious? It’s spread through the air (via coughing/sneezing).  People standing in the airspace around the infected person can become infected by breathing in these respiratory droplets; they do not need to be sneezed or coughed on directly.  Those infected with measles are at their most contagious the four days prior to the appearance of the rash, meaning they are extremely contagious before they themselves are aware of the virus. 

Measles symptoms develop approximately 8-12 days after exposure but the measles rash will not develop until 3 -5 days after symptoms first appear. The first symptoms are similar to a severe cold:

  • High fever
  • Runny nose
  • Cough
  • Red eyes (conjunctivitis)
  • And white-to-bluish spots may appear in the mouth immediately following the above symptoms

The measles rash begins on the face but quickly spreads downward, covering the body. Fever may be at its highest—topping 104 degrees Fahrenheit—at the appearance of the rash.  

Before the measles vaccine, more than three to four million people in the U.S. would contract the virus each year. Infected individuals can develop mild-to-severe complications including pneumonia, blindness, deafness, brain swelling, permanent neurological damage and even death. 

Julie Holland, MD, Head of General Pediatrics at NorthShore, discusses who should receive the MMR (measles, mumps and rubella) vaccine and when: 

Everyone should be vaccinated. Vaccines like MMR are a safe and effective way to prevent the spread of the virus. While there have been small outbreaks in the U.S., measles is very common in other parts of the world and can spread easily to the unvaccinated and under-vaccinated in the U.S. 

  • Children. The CDC recommends two doses of the MMR vaccine in childhood: the first dose between 12 and 15 months and the second at four to six years.
  • Teens and young adults. For unvaccinated individuals, two doses of the MMR vaccine are recommended for individuals in this age group: The first dose is given and then followed with a second dose a minimum of 28 days after the first.
  • Adults. For those born after 1957, the CDC recommends two doses of the MMR vaccine. 

Make an appointment or call your doctor or your child’s pediatrician to ensure you and your children are adequately vaccinated.

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Managing the Meltdown: How to Handle Tantrums in Children

Monday, December 29, 2014 12:02 PM comments (0)

tantrumsEvery parent has been there at one point or another—at the mercy of his or her child’s tantrum in the checkout line at the grocery store, in a crowded restaurant or at home.  In a matter of minutes, your child goes from quiet and well-behaved to completely inconsolable. 

The good news is that temper tantrums are entirely normal, especially in toddlers. For toddlers, tantrums are often brought on by a young child’s inability to understand and cope with his/her emotions, emotions related to hunger, tiredness or feeling overwhelmed and over-stimulated. 

While it’s not possible to prevent every single emotional meltdown, there are ways to manage them. Leslie Deitch Noble, MD, Pediatrician at NorthShore, discusses some of the best techniques for approaching tantrums:

Don’t overschedule. Try not to overexert your child by packing too much into the daily schedule. This is not to say that every day needs to be the same, but when possible try not to push your child to the limits with errand running. A hungry or tired child is much more likely to act out. If you know you have a long day ahead, let your child know in advance so he or she will be better prepared for the change of pace.

Be consistent with your approach. Try your best to manage your child’s behavior during every tantrum. Encourage communication during a tantrum. Say, “Use your words” or ask clear questions to better understand what might be causing your child’s frustration. Lastly, do not give in. Letting your child have his or her way during a tantrum won’t help break the cycle, even if it ends the immediate tantrum. Ideally, you don’t want to give your child any attention—positive or negative—while he or she is having a tantrum. So, as long as you are not in public and your child is not going to hurt him or herself, the best approach is to completely ignore your child until the tantrum stops.

Distract. Distract. Distract. If you can, try to divert your child’s attention away from what may have prompted the tantrum in the first place. Be sure that you recognize that he or she maybe be upset by a situation, but then offer different options or new activities. For example, if your child has a tantrum over wanting a new toy or treat at the store, you can suggest that you find the “new” toy she got most recently when you go home. A similar approach can be tried with treats. If necessary, try to avoid going down aisles at stores that might prompt meltdowns.

Celebrate (and embrace) the good times. Let your children know when they are behaving well and encourage this type of behavior. Tell them how happy it makes you when they listen and follow the rules. Along with acknowledging good behavior (and even rewarding it), be sure your children know how much you love and care for them. Much of what triggers tantrums is children wanting to express their emotions and wanting attention.

Have questions about tantrums? Get answers from other parents and our team of experts in our new online community The Parent 'Hood. Find out more here: The Parent 'Hood

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From Crib to Bed: Ensuring a Smooth Transition

Friday, December 12, 2014 3:04 PM comments (0)

cribThere is no magic age for when it’s best to transition your toddler from a crib to the “big-kid” bed. Much of the timing depends on your child’s readiness as well the need to free up the crib for a new little brother or sister. In most cases, toddlers transition to a bed between the ages of 18 months to 3 years.

Whether you are mid-transition or only in the planning stages, Susan Roth, MD, Pediatrician at NorthShore, offers helpful tips to make the change a smoother one:

  • Maintain consistency with a bedtime routine. A big-kid bed shouldn’t mean a new bedtime hour or a different routine. Keep the bed the only significant change. Also, try to put your child’s new bed in the same place as the crib.
  • Make it fun! Get your child involved with this “big girl”/“big boy” step. For instance, let him or her choose new sheets for the bed. If you will be purchasing a new bed, let your child help out with this decision as well.
  • Start with naps. Make the new bed the naptime bed to start. If your child can’t manage to stay in his or her bed for the duration of an afternoon nap, it might be too early to make the transition. 
  • Keep safety in mind. Depending on the type of bed that you select, be sure that you are providing a safe sleeping environment for your toddler. If you transition straight to a twin bed, it may be best to place the mattress on the floor for a while. If this isn’t an option, consider installing guard rails so your child does not roll out of bed. Padding the floor with blankets and/or pillows can also help reduce the chance of injury.

    This is also a good time to rethink and revisit your overall household childproofing. Now that your child may get out of bed and walk around at night consider removing or safety-proofing other household hazards. If needed, consider installing a gate in your child’s doorway so he or she cannot exit the bedroom. This may be especially important in homes with an accessible staircase.
  • Be supportive, yet firm. Your toddler may not adjust to this new bed immediately. The newfound freedom may lead to him or her getting up more frequently or even trying to get out of bed. Try to stay calm and reinforce that it’s time for sleeping. 
  • Reward positive behavior. Don’t expect this transition to be without its hiccups. Be sure to positively reinforce a job well done throughout this transition period.

Have questions about transitioning your toddler from a crib to a bed? Join NorthShore's new online community, The Parent 'Hood, to ask and answer questions as well as connect with our team of medical experts. Check it out here

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Sick Days: What Are Hand, Foot and Mouth Disease and Herpangina?

Tuesday, November 11, 2014 12:56 PM comments (0)

hand foot and mouthHand, foot and mouth disease (HFMD) is a typically mild but highly contagious viral infection most common in children under seven years of age. The illness is characterized by mouth or throat pain (due to sores), fever and a rash (typically involving the hands, feet, buttocks, arms and legs). The infection is caused by enteroviruses—most often coxsackie virus A16—which are transmitted from person-to-person by oral contact with stool, saliva, fluid from skin lesions or respiratory fluids via coughs or sneezes. Herpangina, also caused by enteroviruses, is a cluster of symptoms characterized by fever and mouth lesions (but no rash).  These illnesses are particularly common in child-care settings because of the frequency of contact and germ sharing between children and inadequate handwashing—especially after diaper changes or toilet use. The viruses can also be transmitted by contact with contaminated surfaces or objects, like toys.

Outbreaks occur most often in summer and fall but can happen anytime, especially if your child is in daycare. Kenneth Fox, MD, Pediatrician at NorthShore, shares symptoms parents should watch for and outlines ways you can make your child more comfortable while the virus runs its course: 

Symptoms of Hand, Foot and Mouth Disease:

  • Small, painful sores in the throat or mouth, including cheeks, tongue and gums 
  • These lesions cause pain and difficulty swallowing
  • Small blisters or red spots classically located on hands, soles of the feet and between fingers and toes 
  • Fever
  • Decreased energy and appetite
  • Diarrhea and vomiting
  • Respiratory symptoms like congestion, cough and “pink eye” (conjunctivitis)

Symptoms of Herpangina:

  • Fever
  • Painful red sores in mouth/throat (as above)
  • Vomiting
  • Abdominal pain
  • Headache

Fever and mouth/throat pain usually last three to five days. Other symptoms, like mouth sores and rash (with HFMD) can last up to seven to ten days. The virus is shed orally for one to three weeks and in stool for two to three months after infection. While there are no cures for HFMD or herpangina, there are things you can do to make your child more comfortable during those first few days, as well as reduce the risk for dehydration which can occur because of pain and difficulty swallowing. 

What can parents do?

Keep little ones hydrated. Try Pedialyte or Gatorade to keep their electrolytes up. Also popsicles, ice chips and other frozen treats can replenish fluids while also helping with pain. 

Reduce pain or fever. Use Acetaminophen or Ibuprofen but check age-appropriate dosages before administering. 

Make swallowing easier. Eliminate salty, spicy or acidic foods to avoid further irritating mouth sores. Consider providing a variety of soft foods, like yogurt, pudding and rice. And always rinse mouth after meals. 

While it is not always possible to prevent your child from contracting hand, foot and mouth disease, you can reduce his or her risk, and your own. Here are some ways to keep your kids healthy and prevent the spread of HFMD in your home:

  • Wash hands with soap and water for 15-30 seconds and dry with disposable towel after using the toilet, changing diapers; after touching another child, the floor or contaminated surfaces; before eating meals or snacks; after coming in from outdoor play; after sneezing, coughing or wiping nose or eyes 
  • Clean and disinfect contaminated surfaces and toys more than once a day
  • Avoid or prevent close contact like kissing, hugging, sharing utensils or cups 

If your child does get hand, foot and mouth disease, watch for these signs of complications:

  • Dehydration (dry mouth, pale skin and nails, no tears or urine, lethargy)
  • Breathing difficulty
  • Chest pain
  • Stiff neck
  • Mental status changes (inconsolable crying, confusion, poor balance, difficulty walking)

Have questions about hand, foot and mouth disease or any other pediatric illness? NorthShore's new online community, The Parent 'Hood, has answers. Join today to connect with other parents in the community as well as our expert physicans.  Click here to start now

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Pediatric Orthopaedics: Dr. David Roberts on the Rewards of His Unique Specialty

Friday, October 17, 2014 7:00 AM comments (0)

dr. robertsFor David Roberts, MD, Pediatric Orthopaedics at NorthShore, helping people was always the goal on the horizon, which is what ultimately brought him to medicine. Once there, it was the challenge and the enjoyment of treating children that brought him to pediatric orthopaedics.

Here, he explains the ins and outs of his unique specialty and how his experience as a father has informed the way he treats his patients and their parents:

What first attracted to you medicine? Was there something that inspired you to go into the field?
I chose a career in medicine because I wanted to help people. There wasn’t one specific moment of realization; it was always what I wanted to do with my life.  

Why did you decide to pursue pediatric orthopaedics as a specialty?

I decided to become a pediatric orthopaedist during the middle of my orthopaedic surgery residency.  During my training, I enjoyed all different areas of orthopaedics so it was hard to pick just one area! Pediatric orthopaedics is unique in that you take care of a variety of conditions affecting all areas of the body, from fractures and congenital anomalies, to scoliosis and spine conditions. It also covers a wide age range, from newborns to young adults.  The diverse nature of pediatric orthopaedics is challenging but that’s also what I enjoy most about it.  And, of course, kids are fun.

What do you like most about your job?
Seeing my patients get better.  Often my patients are in pain or recovering from an injury when we first meet. Seeing them recover and get back to normal, being a part of that, is what I like best about my practice. 

What do you find most challenging?
Encountering overuse injuries in young athletes is difficult.  Young kids are increasingly involved in sports at "elite" levels, playing harder and longer than ever before. Overuse inevitably can lead to chronic and recurrent injuries of various types.  Generally, the cure is simple—rest—but these are some of the hardest conditions to treat given the pressure from coaches, teammates, parents and even the children themselves.  Fortunately with time, rest and realistic expectations, these conditions typically resolve and permit the child to fully return to activities.

What do you think is an essential skill of a pediatric orthopaedic surgeon?
You have to really enjoy working with children.  Treating children is very different from treating adults. Children of different ages require different approaches at interview and examination, which represents the "art" of medicine.  To be truly good at it this, you really have to like working with kids, and this is what I like most about my job.

How is treating orthopaedic cases in children different from adults?
Kids are not just little adults.  From an orthopaedic perspective, treatment of children's conditions can be drastically different than in adults, and not just because we have more cast colors to choose from.

Unlike adults, children's bones are still growing, which means they require special respect and consideration during treatment for orthopaedic conditions.  For example, fractures that typically require surgery for an adult may be treated without surgery in a child because of the ability to correct bone alignment over time with growth.  Other injuries can potentially affect growth and require close monitoring over time for years after injury.  Very young children also may require different treatment for the same type of injury in an adult because a child may be too young to follow treatment instructions.

Within pediatric orthopaedics, you specialize in scoliosis. What inspired this interest?
I specialized in scoliosis because of the positive impact surgery for this condition has on a patient's life.  For many patients with severe scoliosis, the condition is more than just a curvature of the spine.  Severe curves negatively affects self-esteem and body image, which are already vulnerable during the teenage years even for those without scoliosis.  After surgery for scoliosis, these patients literally and figuratively stand taller and straighter. It can make a difference to the rest of their lives.

What are some of the biggest influences on the way you treat your patients?
My own experience as a parent has really informed my practice.  Having a child gives you practical experience working with children but also the perspective of a parent.  I believe it is my duty to care for your child as I would my own.

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Childhood Asthma: Risk, Triggers and Symptoms

Friday, October 10, 2014 10:58 AM comments (0)

asthmaAsthma is one of the most common chronic disorders in children, and, for unknown reasons, is on the rise.  Asthma is a reversible lung disease that inflames and narrows airways, causing chest tightness, shortness of breath, wheezing and coughing. While there is no cure for asthma, with modern knowledge and proper treatment, you and your child can take an active role in managing this disease. If diagnosed, your child can live an active life and sleep through the night without ever experiencing asthma symptoms.

Leslie Noble, MD, Pediatrician at NorthShore, discusses risk factors for and signs of pediatric asthma:

What are the risk factors for developing childhood asthma?

  • Family history. If there is a family history of allergies, eczema or asthma, there is an increased risk for developing asthma in childhood. 
  • Personal history of allergies. This includes both food allergies and seasonal/environmental allergies
  • Personal history of eczema.
  • Exposure to tobacco smoke. Whether during pregnancy or after birth, exposure to cigarette smoke or any tobacco product can significantly increase risk. 
  • Higher exposure to pollution. Children living in urban settings have increased exposure to air pollution, which can increase their risk. 
  • Respiratory infections and sinus issues. Children with frequent respiratory tract infections, pneumonia, chronic runny/stuffy noses and other sinus issues have been shown to have a higher risk for childhood asthma. 
  • Being male. Boys have a higher incidence of pediatric asthma than girls. 
  • Possibly low birth weight. 

What are common triggers that can cause a child with asthma to have “flare-ups” or asthma “attacks”?

  • Exposure to substances that the child is allergic to. The most common of which are: mold, pollen, dust mites, animal dander and cockroaches.
  • Respiratory infections. Examples of such respiratory infections are: viral infections of the nose and throat (i.e., “colds”), pneumonia, sinus infections.
  • Irritants in the air that the child breathes. Depending on the child’s particular sensitivities, these can include: tobacco and other smoke, air pollution, cold/dry air, perfumes, fumes from cleaning products.
  • Exercise.
  • Stress.

How can you tell if your child has asthma? Symptoms are not the same for every child and symptoms may even vary from one attack to another in the same child, so diagnosis can be difficult. Here are common symptoms to watch out for and discuss with your child’s pediatrician:

  • Frequent coughing spells that occur most commonly at night or early in the morning.
  • Coughing that occurs during physical activity, play or laughter.
  • Less energy during play, feelings of weakness or tiredness.
  • Rapid breathing, shortness of breath, wheezing.
  • Chest pain, chest congestion and tightness.
  • Fatigue.
  • Breathing issues that may prevent play.

If your child has prolonged experience with any of these symptoms, take them to their doctor immediately for evaluation. 

Have questions about pediatric asthma or any other pediatric concern? Join NorthShore's new online community, The Parent 'Hood, to connect with other new and expecting parents, as well as our expert physicians. Find support, ask questions and share your stories. Click The Parent 'Hood to start now! 

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Tips for Handling Back-to-School Jitters with Kindergarten and Elementary Students

Friday, August 15, 2014 6:37 AM comments (0)

back-to-school

Nervousness on the first day of school is perfectly normal both for parents and young students. New routines, new people, new information: it’s a time of transition. But “transition” doesn’t have to be a bad word. 

Nancy Zinaman, LCSW, shares some simple back-to-school preparation tips that will make the first day easier on the entire family:

For kindergartners try not to make the first day over emotional. If parents are anxious they need to be aware of their own feelings so as not to make their children more nervous.

Children who have made a smooth transition into preschool may have a harder time transitioning into Kindergarten. You can help make this transition easier by playing on the school playground with your child before classes begin. Visit the school when it is empty or schedule a tour. If time allows, visit or arrange a one-on-one meeting with the teacher and staff. Familiar faces and places will make the first day so much easier.

For children with special needs it’s important for parents to connect with teachers prior to the first day of class to make sure they are aware of separation anxiety, ADHD or any other family challenges

Find out the best way to communicate with your child’s teacher. Ask your child’s teacher what he or she would prefer: email, phone, etc. This will foster a positive, productive relationship from the start. 

Prepare for the new routine early. Don’t wait until the first day to start implementing your new routine. Put the school day structure in place one or two weeks before: establish a back-to-school bedtime; get up early; give kids a fun school-day task like packing their own lunch or backpack. Don’t over-schedule after school activities the first couple of weeks because your children will be tired after a long day of school.

Talk to your children. Find out how your children really feel about starting a new school year. Is there something in particular that is causing nervousness or dread? Give yourself time to address it or talk to the school about it if it’s something the school can address. Let your children know their feelings are normal and that they are not alone.

How does your family prepare for the first day of school?

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Q&A: Pediatric Food Allergies and GI Issues

Friday, August 01, 2014 3:19 PM comments (0)

tummy acheAre stomachaches and messy potty breaks frequent occurrences for little ones in your home? “Stomach problems” happen to everyone, and children are no exception. Sometimes an upset tummy is just an upset tummy, but children, just like adults, can suffer from food allergies and sensitivities, and just like adults these allergies and sensitivities can and should be addressed.

Vincent Biank, MD, Pediatric Gastroenterology at NorthShore, answers some common questions about GI food allergies and sensitivities in children: 

 Is there an easy, relatively non-invasive test to see which foods a child is allergic or sensitive to?
There are several simple blood tests for allergies but unfortunately we do not have simple tests for sensitivities that are accurate in children; therefore, we will commonly have to do an elimination diet.  We will remove one food item at a time for two weeks and then replace that food item after those two weeks, carefully documenting any changes in the symptoms. The two most common sensitivities are lactose and gluten. I would not recommend removing gluten from a child’s diet until they have been properly tested for Celiac disease otherwise you will just need to add it back in for one to two months before it can be accurately checked in the blood.

What foods are typically off-limits for child with soy and dairy allergies? Is it possible to eliminate these foods entirely from a child’s diet?
Soy and diary are in almost everything, so eliminating them is difficult. For this reason, we will have our pediatric dieticians work with families to make sure no soy or dairy in getting into a patient’s diet. Until then, check labels! Anything that has soy, soy protein, milk, milk protein, casein or whey in its label should be avoided.

Are children with GI food allergies more likely to develop other GI-related issues as young adults and adults? 
Unfortunately we don't have enough data to answer this question at this time. Although food allergy with typical symptoms of anaphylaxis, hives, trouble breathing etc. has been diagnosed and treated for many years, the majority of the GI manifestations of food allergy are recent in their discovery. For example it wasn't until 1995 that Eosinophilic Esophagitis was even considered a diagnosis and now we are diagnosing it one to two times per week. The result is we still don't have a clear idea of the natural history of GI food allergies over time.

Should children with stomach “issues” be given probiotics, as well as brought in for testing? 
The short answer is to go ahead and try probiotics prior to the visit. The long answer is that unfortunately we are only at the beginning of our understanding of what probiotics do, such as which varieties are best, how much to give and how long they should be taken.

What are some of the warning signs of GI issues in toddlers/children? Should a parent be concerned about frequent loose stools?
The biggest sign of GI issues is poor weight gain. Diarrhea can be a symptom of an underlying GI disorder but not always. We frequently see toddlers with loose stools with no additional systemic signs of disease, like poor weight gain; therefore, we will typically rule out some common GI-related problems. If tests are negative, we will then discuss how to thicken the stool.

Are the foods known to cause GI allergic reactions in kids the same as those that cause skin or more severe allergic reactions? What are the common foods for GI allergies?
Yes, for some individuals the foods that cause GI allergic symptoms could also cause skin and the typically more severe allergic reaction; however, this is not the case for everyone. Some individuals will only have GI symptoms and others will only have skin or respiratory symptoms. The most common foods for GI allergies are the “Big Six:” milk, soy, wheat, eggs, nuts and fish.

Does your child have a food allergy or sensitive that results in GI issues?

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Kid-Friendly Home Remedies for the Common Cold

Monday, December 23, 2013 9:00 AM comments (0)

common cold

It’s cold and flu season. There’s no way around it. If it hasn’t happened already, it won’t be long before the common cold and the flu start making the rounds at your child’s school. And kids in school are particularly susceptible because regular hand-washing probably isn’t at the top of their to-do lists. 

Parents, it’s the perfect time to prepare for the sick days ahead. Susan Roth, MD, Pediatrician at NorthShore, shares some effective home remedies for parents with little ones stuck at home with a bad cold.

What home remedies have worked for you?

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The Tough Stuff: When Eating and Sleeping Don’t Come Easily for Your Child

Thursday, December 05, 2013 1:55 PM comments (0)

veggie haterAre your kids getting the sleep they need each night? Is your picky eater turning down fruits and vegetables at every meal? Are bedtimes and mealtimes a daily struggle in your home? This is the “tough stuff.”

Lindsay Uzunlar, MD, Pediatrician at NorthShore, answers these tough questions, sharing bedtime and mealtime solutions and tips to ensure every member of the family—large and small—is getting the sleep and nutrition they need to thrive.  

When should your child start to regularly sleep through the night? When should you be worried that they aren’t sleeping through the night or are waking up too frequently? 
Your child is biologically able to sleep through the night around 3-4 months, so with your help they should be able to sleep through the night by six months—meaning sleeping between 6-7 hours without waking up. If your baby is still waking up frequently at nine months, talk with your pediatrician about some possible sleep-training strategies. Consider talking to your pediatrician about sleep-training techniques earlier than six months, or even during pregnancy. 

How do you set bedtimes? How much sleep do children need?
A lot of babies need help learning when and how to sleep so this is where you can make a big difference. Observe when your child seems become naturally sleepy or when he starts to be fussier. When that time comes, put him to bed drowsy but not sleeping. 

The key to remember is that you are in charge of bedtime, from infancy until they leave your house.  Setting bedtimes is really important and can vary depending on age. Children will naturally start to go to bed later as they need less sleep. A newborn needs up to 15-17 hours of sleep; a six-month-old needs 13-14 hours; 9-24 months need about 12 hours; school age between 9-10 hours and adolescents 8-9 hours.

How long is it normal for a child to wet the bed? Is a family history of bedwetting a contributing factor? What can you do to stop it? 
It is still normal to have nighttime wetting up to the age of six, especially if there is a family history. There are different techniques that you can try. The simplest is just having scheduled wake-up times. With this technique, you set your own alarm and wake him up to take him to the bathroom. In a perfect world, you could wake him up before you go to bed (assuming you go to bed later than him) and then not worry about it for the rest of the night.

How do you wean an infant of needing a pacifier to remain asleep at night?
As you may have realized, children use pacifiers as a self-soothing object. So the key to helping them transition to good sleeping without is to replace the pacifier with something else. For instance, this is a great time for a teddy bear or blanket. Put them to sleep with both the pacifier and the new object so that they can learn to associate both with self-soothing. Then you can take away the pacifier and ideally he or she won't notice its absence too much. You can work on having the pacifier gone over the next 2-3 months. I would recommend that you take all pacifiers away at once, that way when he wants it, you can 100% truthfully say that they are "all gone."

What do you do if your child refuses meat? How do you ensure he or she gets enough protein? 
Vegetarianism is fine for kids but it is understandable to worry about protein intake. There are other sources of protein besides peanut butter and meat. Some other good sources are: eggs, milk, soy products and whole grain cereals. Try to make sure your child gets a combination of these at each meal. 

How do you handle a picky eater who won’t eat anything other than his or her favorite and probably unhealthy foods?
It takes kids about 10-15 tries of a food before they will like it. So making sure that they take a “no thank you” bite will help give them exposure to the new foods. You can also try introducing new tastes of food mixed with their favorites such as peas with macaroni and cheese. Your child should be eating the same dinner that everyone else is eating. If they don’t want it, then accept their opinion and let them know that this is the only thing that will be prepared tonight. He or she will be more likely to eat what has been prepared if they know that they don’t have other options. The key to helping instill change is consistency. So it is important that anyone who consistently cares for your child be on the same page about introducing new foods. 

What are some strategies to help children learn to explore more food types if they have texture sensitivities?
For texture sensitivities, it’s a good idea to attempt “try and try again." It can take kids awhile to get used to new things, tastes and textures, so just encourage a single bite each meal and if he or she takes it, consider that a success! If you find that this is taking longer than you think it should, speak with your pediatrician.

Are dairy and gluten considered safe for children? Are they a necessary part of a child’s diet?
Dairy-free and gluten-free diets are very popular right now; however, they are only necessary for a select number of people and otherwise are part of a healthy diet. Children who experience gastrointestinal symptoms like diarrhea, stomach cramping, vomiting or bloating after eating one or both of these may have a sensitivity. In that case, it is a good idea to see your pediatrician about safely removing these from the diet. If they don't experience these symptoms, they are fine and your children can continue eating food with dairy and gluten without issue.

When should babies start drinking animal milk? Do you have recommendations on cow vs. goat?
To help with brain growth, babies should remain on breast milk or formula until 12 months old. After that, trying cow's milk is best as it has a more complete set of nutrients. Goat's milk is an option if you feel your child may not be tolerating the cow's milk,but in that case, he should be taking a multivitamin with it.

 

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