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Tips of the Week for November, 2015

A Message for Dads
11-30-2015

It is easy to say that the significant other is important in the lives of the newborn and partner, but it can be hard at times to see how to participate— especially during the early months. It may help to keep in mind that little things mean a great deal at this time: a word of encouragement for your partner as she adjusts to her new routine, an offer to help with the housework or care for the baby while she takes a nap, or a confident defense when a friend or relative questions her decision to breastfeed on demand. These small acts let your partner know that you firmly support her decision to breastfeed and that you’ll continue to support her.

Many studies have shown the support of a loving partner is the most important deciding factor in whether or not a woman chooses to initiate and continue breastfeeding. After all, you are the baby’s other parent and perhaps your partner’s closest friend. By seconding the decision to give your child the best possible nourishment, your actions can have a decisive and immediate impact on your baby’s life.

First Steps

One of the first steps you can take as the partner of a breastfeeding mother is to educate yourself regarding breastfeeding’s many benefits. You might also ask your baby’s pediatrician to discuss the advantages of breast milk over formula and give you an idea what to expect in practical terms during your baby’s first few months of life. If at all possible, attend breastfeeding classes with your partner. By understanding how breastfeeding is accomplished, you can better help your partner after the birth as she learns such techniques as positioning your baby for proper latch-on. Remember that many people still are not aware of the tremendous benefits of breastfeeding and have not been part of a breastfeeding relationship.

Immediately after birth you can support your partner’s decision to begin breastfeeding by helping to make her comfortable in the delivery room. While in the hospital, you can take turns holding, rocking, and changing diapers so she can sleep between feedings. Also, you can support your mutual decision that the baby is not to receive a pacifier, a bottle, or supplemental formula without a clear medical reason. If your baby is unable to breastfeed due to an illness, you can ask to have a breast pump for your partner and help her get it ready for use.

Once you are all home from the hospital and family life has begun, your role as the partner of a breastfeeding mother will take on a new importance. As your baby’s mother concentrates on establishing her breastfeeding routine, you can focus on keeping the household running efficiently and acting as a buffer for possible distractions to successful breastfeeding. If possible, take some time off work to prepare meals, keep up with the laundry, keep older children entertained, and otherwise allow mother and new baby to concentrate on learning to breastfeed and getting the rest they need.

Offer your partner food and drink while she’s nursing, bring her pillows if she needs them to position the baby, and provide her with a book, telephone, diapers, or whatever else she likes to have near at hand. If you see that she’s having trouble nursing— if she experiences discomfort with breastfeeding or she worries that the baby’s not getting enough milk—use your own observations and insights to help her make adjustments in the feeding technique. If you see that she’s still struggling but is reluctant to ask for help, assist her to seek outside professional help, and tell her that you are there to assist in any way possible. She will appreciate your concern and steadfast support.

Your Time With Baby

As you and your partner become more familiar with the routines of parenting, you can help with diaper changes, baths, and playtimes so your partner can sleep between feedings and perhaps enjoy a little time to herself. These interactions withyour newborn are excellent opportunities for you to create your own unique relationship with him. In the beginning, your baby will have less “awake time,” but as the baby gets older, you will find that the baby has more time to play.

After feeding, a content baby is usually happy to snuggle up against your chest for a nap or may be ready to play. Make the most of these moments—smiling and talking with your baby as you change his diaper, playfully splashing him in the bathtub if he enjoys getting splashed, holding and rocking him when he cries, and making up fun little games that he plays only with you. Babies also love to be part of such “grown-up” activities as taking a walk outside and “reading” books and magazines. As your child regularly experiences these times with you, he will understand that you are your own special parent and not just a substitute for Mommy.

Last Updated

11/21/2015

Source

New Mother's Guide to Breastfeeding, 2nd Edition (Copyright © 2011 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

 

All information provided by HealthyChildren.org.  For additional information including audio and links, please go to https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/A-Message-for-Dads.aspx

 

12 Tips for Teaching Children Gratitude
11-23-2015


By: Kathleen Berchelmann M.D., FAAP

Tired of bickering, jealousy, and selfishness? Kids are naturally materialistic and self-serving– but the good news is that gratitude can be taught. And from gratitude flows joy. 

Tricks for Teaching Children Gratitude and Creating a More Joyful Home:

  1. Surprise them! Avoid too many choices: Surprises help children see something as a gift, not an entitlement. Having too many choices breeds unhappiness– you are always wondering if you could have something better. One night, we tried to have a conversation with our children about where we might go for our summer vacation. Within five minutes, Disney World was not good enough. Everyone had a better idea, and no one was going to be happy with whatever we came up with. I put a prompt end to that conversation, and about a week later, I announced that I had a big surprise– we were going to Mt. Rushmore! I showed off my plans for our national park camping vacation, and they couldn't have been more excited. Our low-budget road trip turned out to be a fabulous success. 
  2. Talk about the best parts of your day: Find some time each day to talk about what you are thankful for– perhaps at the dinner table, before bed, or while you are driving in the car. Ask your children, "What was the best part of your day?" 
    • For older children, try keeping a gratitude journal. Gratitude journals have been shown to be an effective approach to helping children be happier: One study had 221 sixth- and seventh-graders write down five things they were grateful for every day for two weeks. Three weeks later, these students had a better outlook on school and greater life satisfaction compared with kids assigned to list five hassles.
  3. Teach your children their past: What are your family stories of hardship and perseverance? My husband's great-grandmother ironed for a living– her iron is now a bookend in our house, reminding our children what hard work really means. As a child, my grandmother washed dishes for ten cents per week during the depression. We keep her picture in our study, and tell our children her story. Not sure of your past? Just take a family trip to the history museum, a battlefield, or other historic site. You will return home grateful.
  4. Help your children serve someone who does not "need" charity: It's great for kids to participate in scout food collections and other community charity programs, but these events only occur a few times per year and you rarely meet the people you are serving. Find someone in your everyday life for your children to serve regularly, even if this person doesn't really need charity. We have a neighbor who lives alone and appreciates our left-overs so she doesn't have to cook for one person. Our kids love to bring her food. One night they were all griping about how they didn't like the dinner I made, until I asked them to bring a plate to our neighbor. Suddenly all the complaining stopped and they were out the door with her food, eager to have the opportunity to serve her.
  5. Focus on the positive, all day: I tell my children several times each day, "Attitude is a choice." Choosing to have a positive attitude is actually our #1 house rule. It's an all-day effort to constantly turn around the whining, jealousy, and complaining and instead focus on positive. "I'm thirsty!" needs to become, "Mommy, may I please have a drink?" "Where are my shoes?!" has to change to "Daddy, can you please help me find my shoes?"
  6. Say "Thank you:" Teach young children to say "thank you" as part of a full sentence, for example, "Thank you, Daddy, for making dinner." Encourage school-aged kids to say thank you throughout the day, especially when you help them get ready for school or drive them to activities. Have them thank coaches for practice and music teachers for lessons. 
    • Struggling to get your children to say "thank you" without reminders? For ten years I reminded my children to say "thank you" when they were served at a restaurant, but I just couldn't get them to do it without prompting. Now, if they forget to say "thank-you" they have to seek out their server and personally thank them before leaving. No more reminders necessary…
  7. Lead by example: How many times per day do you say "thank you"? Have you told your children what you are thankful for today? Our children are watching our every waking move. We can't ask them to be grateful if we are not. Come home and talk about the happy parts of your day, making a conscious choice not to complain. See Offering Boundaries & Being Role Models (Video).
  8. Teach "'Tis better to give than to receive." Even toddlers can buy or make gifts for others: Take young children holiday shopping at the dollar store. Challenge them to pick out gifts for others without buying something for themselves. It's hard! See How to Inspire Generosity in Children.
  9. Make time for chores: Most children have about four hours between the time they get home from school and bedtime. During those four hours, they have to accomplish homework, extracurricular activities, dinner, bath, and bedtime. It's hard to find time for chores. Without chores, children just can't understand what it takes to run a household– they will take clean laundry and dishes for granted. Find age-appropriate chores for your children, even just 5-10 minutes per day. Consider leaving time-intensive chores for the weekend, such as yard work, bathroom cleaning, and linen changing.
  10. Let big kids take care of little kids: They say you can't really understand what it takes to raise a child until you have your own children. Perhaps, but giving big kids responsibilities for little kids will start to help them have an attitude of gratitude towards their parents. Pair up big kids with little kids to get chores done or get through homework. 
    • School aged children can read books to toddlers or help them get dressed. Your older children will gain self-confidence and a sense of responsibility, and the relationship they build with their younger siblings will last a lifetime.
  11. Give experiential gifts, not stuff: Too many toys? How about gifting a membership to the children's museum, a soccer registration fee, or a camping trip? Experiential gifts build relationships, not materialism.
  12. Monitor your children's media: Our children are bombarded with age-targeted marketing that they are too young to resist or understand. Media fuels materialism. It is our job to carefully monitor their media so that they aren't dragged into marketing and made to feel incomplete or unfulfilled. 

​Additional Information:

 

About Dr. Berchelmann:

Kathleen Berchelmann, MD, FAAP, is a pediatrician at St. Louis Children's Hospital, Assistant Professor of Pediatrics at Washington University School of Medicine, and an official spokesperson for the American Academy of Pediatrics. Kathleen is the co-founder and director of ChildrensMD.org, a blog written by five dynamic mom-pediatricians who share their true confessions of trying to apply science and medicine to motherhood. Kathleen and her husband are raising five children.

Last Updated

11/23/2015

Source

Copyright © 2015 Kathleen Berchelmann M.D., FAAP

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

 

All information provided by HealthyChildren.org.  For additional information including links and audio, please go to https://www.healthychildren.org/English/family-life/Community/Pages/12-Tips-for-Teaching-Children-Gratitude.aspx

 

Talking To Children About Tragedies and Other News Events
11-16-2015

After any disaster, parents and other adults struggle with what they should say and share with children and what not to say or share with them.

The American Academy of Pediatrics (AAP) encourages parents, teachers, child care providers, and others who work closely with children to filter information about the crisis and present it in a way that their child can accommodate, adjust to, and cope with.

Where to Start – All Ages

No matter what age or developmental stage the child is, parents can start by asking a child what they’ve already heard. Most children will have heard something, no matter how old they are. After you ask them what they’ve heard, ask what questions they have.

Older children, teens, and young adults might ask more questions and may request and benefit more from additional information. But no matter what age the child is, it’s best to keep the dialogue straightforward and direct.

Avoiding Graphic Details & Exposure to Media

In general, it is best to share basic information with children, not graphic details, or unnecessary details about tragic circumstances. Children and adults alike want to be able to understand enough so they know what’s going on. Graphic information and images should be avoided.

Keep young children away from repetitive graphic images and sounds that may appear on television, radio, social media, computers, etc.

With older children, if you do want them to watch the news, record it ahead of time. That allows you to preview it and evaluate its contents before you sit down with them to watch it. Then, as you watch it with them, you can stop, pause, and have a discussion when you need to.

Children will generally follow good advice, but you have to give them some latitude to make decisions about what they’re ready for. You can block them from seeing the newspaper that comes to the door, for example, but not the one on the newsstand. Today, most older children will have access to the news and graphic images through social media and other applications right from their cell phone. You need to be aware of what’s out there and take steps in advance to talk to children about what they might hear or see.

Talking to Very Young Children

The reality is that even children as young as 4 years old will hear about major crisis events. It’s best that they hear about it from a parent or caregiver, as opposed to another child or in the media.

Even the youngest child needs accurate information, but you don’t want to be too vague. Simply saying, “Something happened in a faraway town and some people got hurt,” doesn’t tell the child enough about what happened. The child may not understand why this is so different from people getting hurt every day and why so much is being said about it. The underlying message for a parent to convey is, “It’s okay if these things bother you. We are here to support each other.”

Talking to Gradeschool Children & Teens

After asking your child what they have heard and if they have questions about what occurred during a school shooting, community bombing, natural disaster, or even a disaster in an international country, a parent can say something such as:

“Yes. In [city], [state]” (and here you might need to give some context, depending on whether it’s nearby or far away, for example, ‘That’s a city/state that’s pretty far from/close to here’), there was disaster and many people were hurt. The police and the government are doing their jobs so they can try to make sure that it doesn’t happen again.”

A parent can follow-up as needed based on the child’s reactions and questions.

Talking to Children with Developmental Delays or Disabilities

Parents who have a child with a developmental delay or disability should gear their responses to their child’s developmental level or abilities, rather than their physical, age. If you have a teenage child whose level of intellectual functioning is more similar to a 7 year old, for instance, gear your response toward her developmental level. Start by giving less information. Provide details or information in the most appropriate and clear way you can.

Talking to Children with an Autism Spectrum Disorder (ASD)

What’s helpful to a child with an ASD may be different. For instance, the child may find less comfort in cuddling than some other children. Parents should try something else that does calm and comfort their child on other occasions. Ask yourself, “Given who my child is, his personality, temperament, and developmental abilities, what might work for him?”

Signs a Child Might Not Be Coping Well

If children don’t have a chance to practice healthy coping, a parent may see signs that they’re having difficulty adjusting. Some of things to look for are:

  • Sleep problems: Watch for trouble falling asleep or staying asleep, difficulty waking, nightmares, or other sleep disturbances.
  • Physical complaints: Children may complain of feeling tired, having a headache, or generally feeling unwell. You may notice your child eating too much or less than usual.
  • Changes in behavior: Look for signs of regressive behavior, including social regression, acting more immature, or becoming less patient and more demanding. A child who once separated easily from her parents may become clingy. Teens may begin or change current patterns of tobacco, alcohol, or substance use.
  • Emotional problems: Children may experience undue sadness, depression, anxiety, or fears.

Sometimes it can be hard to tell if a child is reacting in a typical way to an unusual event or whether they are having real problems coping, and might need extra support. If you are concerned, talk to your child’s pediatrician or a mental health professional or counselor.

Don’t wait for the signs. Start the discussion early, and keep the dialogue going.

Additional Resources: 

 

 

Last Updated

8/20/2015

Source

Adapted from an eHealthMD interview with David Schonfeld, MD, FAAP, Director of the National Center for School Crisis and Bereavement and member of the AAP Disaster Preparedness Advisory Council

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

 

All information provided by HealthyChildren.org.  For additional information including links and audio, please go to the following website.  https://www.healthychildren.org/English/family-life/Media/Pages/Talking-To-Children-About-Tragedies-and-Other-News-Events.aspx

 

Caring for a Premature Baby: What Parents Need to Know
11-09-2015

Fast Facts

  • Premature birth occurs in about 11 to 13 percent of pregnancies in the US.
  • Almost 60 percent of twins, triplets, and other multiple deliveries result in preterm births.
  • A birth is considered "preterm" when a child is born before 37 weeks of pregnancy have been completed. Other categories of preterm birth include late preterm (34–36 weeks), moderately preterm (32–36 weeks), and very preterm (less than 32 weeks).

It is important to recognize that preterm deliveries, even if late preterm, should never be done for the convenience of the mother or obstetrician. Research has shown that late preterm babies have significantly greater risk for negative outcomes, and all efforts should be made to have babies reach full term. See Let Baby Set the Delivery Date: Wait until 39 Weeks if You Can.

Characteristics of Babies Born Premature

If your baby is born prematurely, she may neither look nor behave like a full-term infant. While the average full-term baby weighs about 7 pounds (3.17 kg) at birth, a premature newborn might weigh 5 pounds (2.26 kg) or even considerably less. But thanks to medical advances, children born after twenty-eight weeks of pregnancy, and weighing more than 2 pounds 3 ounces (1 kg), have almost a full chance of survival; eight out of ten of those born after the thirtieth week have minimal long-term health or developmental problems, while those preterm babies born before twenty-eight weeks have more complications, and require intensive treatment and support in a neonatal intensive care unit (NICU).

How Your Premature Baby Looks

  • The earlier your baby arrives, the smaller she will be, the larger her head will seem in relation to the rest of her body, and the less fat she will have.
  • With so little fat, her skin will seem thinner and more transparent, allowing you actually to see the blood vessels beneath it. She also may have fine hair, called lanugo, on her back and shoulders.
  • Her features will appear sharper and less rounded than they would at term, and she probably won't have any of the white, cheesy vernix protecting her at birth, because it isn't produced until late in pregnancy. Don't worry, however; in time she'll begin to look like a typical newborn.
  • Because she has no protective fat, your premature baby will get cold in normal room temperatures. For that reason, she'll be placed immediately after birth in an incubator (often called an isolette) or under a special heating device called a radiant warmer. Here the temperature can be adjusted to keep her warm.
  • After a quick examination in the delivery room, she'll probably be moved to the NICU.

How Your Premature Baby Acts

  • You also may notice that your premature baby will cry only softly, if at all, and may have trouble breathing. This is because her respiratory system is still immature.
  • If she's more than two months early, her breathing difficulties can cause serious health problems, because the other immature organs in her body may not get enough oxygen. To make sure this doesn't happen, doctors will keep her under close observation, watching her breathing and heart rate with equipment called a cardio-respiratory monitor.
  • If she needs help breathing, she may be given extra oxygen, or special equipment such as a ventilator; or another breathing assistance technique called CPAP (continued positive airway pressure) may be used temporarily to support her breathing.

Preemie Parents: How to Cope with the Stress

As important as this care is for your baby's survival, her move to the special-care nursery may be wrenching for you. On top of all the worry about her health, you may miss the experience of holding, breastfeeding, and bonding with her right after delivery. You won't be able to hold or touch her whenever you want, and you can't have her with you in your room.

To deal with the stress of this experience, ask to see your baby as soon as possible after delivery, and become as active as you can in caring for her. See How You Can Participate in the Care of Your Baby in the NICU.

  • Spend as much time with her in the special-care nursery as your condition—and hers—permit. Even if you can't hold her yet (until she's stable), touch her often. Many intensive care units allow parents to do "kangaroo care"—or skin-to-skin care—for their babies once the infants don't require major support to their organ systems.
  • You can also feed her as soon as your doctor says it's OK. The nurses will instruct you on either breast-or bottle-feeding techniques, whichever is appropriate for the baby's needs and your desires.
    • Some premature babies may initially require fluids given intravenously or through a feeding tube that passes through the mouth or nose into the stomach. But your breast milk is the best possible nutrition, and provides antibodies and other substances which enhance her immune response and help her resist infection.
    • In some cases, if it's too difficult for your premature baby to nurse at the breast, you can pump breast milk for feeding through a tube or bottle. Once you are able to start breastfeeding directly, your baby should nurse frequently to increase your milk supply. Even so, mothers of premature babies sometimes find it necessary to continue using a breast pump in addition to feeding frequently to maintain a good milk supply. See Providing Breastmilk for Premature and Ill Newborns.
  • You may be ready to return home before your newborn is, which can be very difficult, but remember that your baby is in good hands, and you can visit her as often as you'd like. You can use your time away from the hospital to get some needed rest and prepare your home and family for your baby's homecoming, and read a book for parents on caring for preterm babies. Even after you've returned home, if you participate in your infant's recovery and have plenty of contact with her during this time, the better you'll feel about the situation and the easier it will be for you to care for her when she leaves the special care nursery.
  • As soon as your doctor says it's OK, gently touch, hold, and cradle your newborn.
  • Your own pediatrician may participate in, or at least will be informed about, your infant's immediate care. Because of this, he will be able to answer most of your questions.

Your baby will be ready to come home once she's breathing on her own, able to maintain her body temperature, able to be fed by breast or bottle, and gaining weight steadily.

Additional Information on HealthyChildren.org:

 

Last Updated

11/2/2015

Source

Caring for Your Baby and Young Child: Birth to Age 5, 6th Edition (Copyright © 2015 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

 

All information provided by HealthyChildren.org.  For additional information including links and audio, please go to the following website:  https://www.healthychildren.org/English/ages-stages/baby/preemie/Pages/Caring-For-A-Premature-Baby.aspx

 

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