Pearls of Wisdom: Sleep Disorders in Children

Most children have nightly rituals before going to bed, whether it’s reading a story, cuddling with a special blanket or toy, turning on their own night light or battling their parents about bedtime. We know you’ve been there at least once before!

Kids may struggle with nighttime sleep and may be transient, intermittent, or chronic in nature. Babies who have difficulty establishing normal sleep patterns may be fussy and irritable as part of their temperamental characteristic. Sometimes parental anxiety or strife could also contribute to sleep disorders. Older children may have temporary fears of loud noises like thunder and lightning, being hurt by intruder, or of monsters under the bed. Your child may be able to express their fears overtly, or disguise them in the form of delaying tactics at bedtime. Therefore, it takes an astute parent to detect the problem and encourage their child to share and express these fears with them.

NightmaresSome children equate sleep as a time when they are removed from parental love and care, may it be unconsciously or symbolically. Separation anxiety such as child’s first day of school or a divorce can lead to bedtime fears. As growing children mature and become more aware of death, they may have fear of not waking up from sleep. Stress and depression related to any area of her life such as family, friends and school performance can cause sleep disorders.

About 7-15 % of children have reported problems with nightmares. These “anxiety dreams” happen during REM (rapid eye movement) sleep; the child immediately wakes up lucid and remembers part or the entire dream. Nightmares usually begin before the age of 10, and affect girls more than boys. These are also commonly seen in children with anxiety and effective disorders.

“Night terrors” are another nighttime occurrence in children that usually begins during pre-school years. The exact cause is unknown, but it does run within families. This occurs at the beginning of the sleep cycle with arousal from stage IV (non-REM) sleep. Your preschooler will be lying in bed, appearing to be awake while looking confused, disoriented and upset. He may also have labored breathing, sweating and complain of a strange visual phenomenon. She also may point to imaginary objects; appear extremely frightened and generally inconsolable.

Night terrors are often self-limited and may be related to a precipitating traumatic event that the child experienced.Bedtime Story Incidences of night terrors are about 2-5 % and seen more commonly in boys than girls. The upside is that although these events are more disturbing and unsettling for the parents who witness them, children who experience night terrors usually settle down after a few minutes, go back to sleep and remember nothing the next day. The only thing a parent or caregiver can do is to hold the child, trying to calm him during the episode and making sure he is protected from possibly hurting himself.

A period of sleepwalking may also occur which can pose a more serious risk to the child. Sleepwalking usually happens during stage 3 or 4 of non-REM sleep in 10-15% of children. The condition usually remits by early adolescence, but a history of sleepwalking throughout the family is common and can be associated with bed wetting. Treatment, therapy, and relaxation techniques are supportive and ensuring that the child is safe.

Establishing a healthy sleep routine such as a consistent time for a warm bath, reading a story, or keeping the house quiet after a certain hour is helpful for both parents and children. Forming an early bedtime to make sure she gets a sufficient amount of sleep is vital for mental and physical growth and the best preventative method for crankiness and fatigue. In time, all these nighttime woes will disappear as your child matures. Leaving everyone well rested, especially you!

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All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

Dr. Pearl CenonDr. Pearl

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Pearls of Wisdom: Child Safety Seats

As a parent or caregiver, your number one job is to keep your children safe in all circumstances, especially while riding in a vehicle. Unfortunately, even the best, most responsible drivers cannot always protect from others on the road. There are more children harmed and killed in car crashes every day than any other type of accident. The risk of a crash exists every time you pull out of your driveway, that’s why using child safety seats and using them correctly is crucial to keeping your child protected as much as possible.

With today’s technology, branding, and baby market, there are endless lists of diverse car seats that offer this, that and other features. It can be overwhelming and confusing! There is no one kind or brand that is the “best” or the “safest”, and quality is not determined by a high price tag! The most secure car seat is one that fits your child’s weight, height and exact age. Before choosing a child safety seat for your child, check the age and weight limits, because these limits are different for every car seat available.

Once you have decided on which car seat to buy, make sure to install it correctly. Read the instruction manual carefully and test and adjust the harness straps and buckles while your child is buckled in to familiarize yourself. Keep the manual in the car for future reference. Also, make sure you fill out the registration card that comes with the seat so the manufacturer can notify you for any possible recalls.

If you decide to borrow or buy a used child safety seat, please do your homework on that seat! Make sure no parts are missing, there are no recalls on it and it’s no more than six years old. Check for the Federal Motor Vehicle Safety standard sticker which certifies that it has met or exceeded safety standards.

Here are the guidelines posted on HealthyChildren.org by the American Academy of Pediatrics:

Car Seat SafetyA great resource offered by the National Highway Traffic Safety Administration (NHTSA) are the Child Car Seat Inspection Stations that offer FREE in-person guidance, given by certified technicians, on the correct installation and proper use of car seats.  Just go to www.nhtsa.gov/cps/cpsfitting/index.cfm to find the inspection station nearest you.

Although there may be variables or discrepancies in guidelines (from one manufacturer to another, for example); recommendations are general in nature. Your own child’s height/weight, or any special needs and circumstance could impact your decision on the right seat.  Please consult as many resources as possible while making choices.

For parents of older kids, you may hear your pre-teen complaining and the need to feel like a big kid but all children below 13 years old are safest in the back seat of the car. Head on collision car crashes are the most common type of car accident.

Parents must be good role models and always wear seat belts. Your children follow your every move and habit. Being responsible and consistent with car safety will encourage your little one to do the same and form a lifelong habit of buckling up. It’s also good parenting, reduces fussing and most of all, can save your baby’s life.

Lastly, but certainly not least, never leave your child alone in or around cars. An unattended child in a hot vehicle can lead to heat stroke and strangulation from retracting seat belts. Drive safely – Click it, Don’t Risk it!

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All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

Dr. Pearl CenonDr. Pearl

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Time Flies

Time flies…

I think of you BabyLeggers every day, and I truly know how blissful it is to hold your little ones. My own babies are now 12 and 10 years old, and it seems like long ago and far away that they were tiny, like so many of yours.

Rita & MichaelThough I’m not one to dispense advice or get overly-sentimental, I want to reach out to all of you who have kids in your lives.  Why?  Well, here at BabyLegs, we feel intimately connected to you because you care enough to protect your children with BabyLegs.  When I think of your daily routines and all of the joys and challenges of raising children, I’m reminded of days that seemed like an endless chain of diaper-changes, crying, feeding, laundry, chores, and yes, even bouts of loneliness.

When the kids were small, my neighbor was an elderly woman named Sally. She would see me in the yard with the kids, slathering them with sunscreen on hot days, entertaining them with the garden hose, cutting up snacks, reading to them, laughing at their antics, and getting frustrated if they bickered. As if she could read my thoughts, she’d say: “Every day seems like a year for you now.  But later on, the years will have flown by like days.”  She was right.Rita & Michael

The pictures that you BabyLeggers send to us, of your little ones playing or even napping, remind me that we often wish our lives away. We wish that the hard days would hurry into night, we can’t wait until the babies walk and talk, we hurry toward a finish line at the end of every goal.  And then suddenly, your babies are teenagers.  The years passed as quickly as days.

So here’s a little Tuesday reminder to cherish every moment, hold the babies without thinking that you might spoil them (you CAN’T!), and make every effort to engrave every these moments in your hearts.

BabyLegs loves your babies!

xRita

Pearls of Wisdom: Childproofing Your Home

Children are explorers by nature and are naturally curious about the world around them. They can’t wait to explore by putting objects in their mouths. The minute they become ambulatory, parents need to take extra attention to childproofing their homes, making sure harmful items are out of reach, and locked up .

Some of the items that have to be put away from their reach are cleaning products such as bleach, detergents, drain openers, toilet bowl cleaners and  furniture polish. Detergents in single-use packets are very concentrated and can be toxic even if a small amount is ingested causing eye irritation, stomach problems or problems breathing. Remember to seal the container and store this in a locked cabinet after use. Even better, keep this container out of sight and reach. It is best to store items such as antifreeze, windshield wiper fluids, kerosene, and insecticides in the basement or garage, preferably in a high shelf that is out of your child’s reach. Even cosmetics, mouthwash, nail polish removers and perfumes should be stored in a cabinet that has a lock. Certain plants are harmful and you may want to do without houseplants for a while. The poison control hotline (1800-222-1222) can provide you with a list of description of plants that may pose a risk to your toddler.

Child ProofMost poisonings occur when parents, babysitters or caregivers are home but not paying attention. Keep products in their original packaging. Install a safety latch  on child accessible cabinets. Also keep in mind that children may get into trash containers. Usually, these contain spoiled food, sharp objects such as discarded used razor blades, or batteries therefore buy a trash can with a child-resistant cover or keep the trash out of your child’s reach.

Purses and pocketbooks that hold potential hazards, especially medications should also be kept out of child’s reach. Purchase and keep medicine in their original bottles with safety caps. When administering medications, always check the label multiple times to ensure proper dosage. Keep in mind that even simple Acetaminophen (or Tylenol) if given in the wrong dose could pose serious damage to your child’s liver. Alcohol can also be very poisonous to a young child. Just remember to empty out any unfinished drinks right away.

Because they are choking hazards, small objects including beads, buttons, coins, pins, refrigerator magnets, small toys with screws and especially button batteries should be out of your child’s reach. Check your floors regularly for small objects especially if there are any family members  who  have a hobby that uses small items. Make sure the battery covers on musical books, greeting cards, key fobs, and remote controls are secure. Button batteries look pretty harmless but can cause serious injuries and even death if ingested.

IN CASE OF POISONING:

In case you find your child with an open or empty container of a dangerous item, assume that he has been poisoned.  Do not panic, stay calm and act quickly. Take the item away from him and check for any objects still in his mouth. You can either make him spit it out or you can remove it with your fingers in a sweeping motion. Save this item together with anything else that can help identify what your child swallowed. Do not make him vomit because this could cause more problems. If your child is unconscious, pale or blue , not breathing , or having seizures, call 911 immediately. If your child appears fine, call Poison Help and you will be assisted by a poison expert who is available 24/7. Make sure you have all the information available e.g. medications he is taking, any existing medical conditions, name of item swallowed and the time of the incident (or when you found him) . In case the poison is very toxic, you may be instructed to take him to the ER. However, if your child is not in danger, the Poison Help staff will guide you on what to do to help your child at home.

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All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

Dr. Pearl CenonDr. Pearl

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Pearls of Wisdom: Vitamin and Iron Supplements for Your Baby

New moms can feed their newborns all the formula and/or breast milk in the world and still wonder whether their baby is getting enough nutrients – and I can’t blame them! Maximum health and nourishment for newborns is at the very top tier of importance. Despite all of the nutritional facts, labels and knowledge on natural human anatomy, the question often pops up, “Doc, does my baby need more vitamins from supplements?”

Of course the answer to this question varies from baby to baby, but a regular and well- balanced diet is enough to provide all the nutrients both for nursing moms and baby. Human breast milk contains a natural balance of vitamin C, E and B, so if both mom and baby are receiving enough of those essential vitamins through sustenance, your baby does not require an additional supplement. Usually discovered through check-ups, there are some instances where babies are lacking healthy levels of certain vitamins. In these cases, doctors will determine and recommend a fixed amount of supplementation.

Vitamin DBreastfeeding moms are encouraged to continue their daily dose of prenatal vitamin supplements for optimal nutritional balance. Although breast milk contains small amounts of vitamin D, it is not sufficient to prevent rickets (a condition with weak and brittle bones) therefore breastfed infants need supplemental vitamin D. Besides milk and formula, vitamin D is naturally produced by the skin when exposed to sunlight. It’s an important recommendation that all babies should avoid direct exposure to the sun and use plenty of sunscreen; however these actions prevent the skin from producing vitamin D. The best and safest of both worlds would be taking the baby out for a short walk in the morning (avoid afternoons when the sun is hottest) or even sit by the window just so he can intake some sun.

The Academy of Pediatrics advises that all infants and children should receive a daily minimum intake of 400 IU of Vitamin D per day starting immediately after birth. Vitamin D assists in calcium absorption essential for healthy bones and teeth. Most formulas contain adequate amount of vitamin D so if your baby’s daily milk intake total is at least 32 oz. per day, she most likely does not need any vitamin D supplements. In cases when an infant is premature or has an underlying medical problem, a pediatrician may recommend vitamin drops.

Moms who are on a strict vegetarian diet and breast feeding should also take extra Vitamin D and B complex nutrients because their diets lack meat, poultry or fish products — foods that are rich in these vitamins. Babies who are deficient in vitamin B12 can lead to anemia and abnormalities in their nervous system. Formula-fed babies generally receive adequate vitamins from their daily milk intake.

Most term babies are born with sufficient iron reserves that prevent them from getting anemic. Breastfed babies usually receive enough iron from mom to give them adequate supply. At around 4-5 months of age, your breastfed baby can also receive iron from solid foods such as cereal, green vegetables and meats. For babies who are formula-fed, make sure that you give iron-fortified formula which contains 4-12 mg. of iron from birth to the first year of life. Again, premature babies may need extra iron supplements over what they receive from breast milk or formula.

Beware that megadoses of vitamins, especially A, C, or D, can produce toxic symptoms like headaches, nausea, or rashes and sometimes may lead to even more serious adverse reactions. Overcompensating is never a good idea either, so always make sure to consult a trusted professional you’re comfortable with before administering any dosage.

It’s also important to note that taking care of yourself, Mom, is just as critical for your baby’s health and your own wellness! Being mindful of your own health and taking time for yourself are essential for your family’s health overall.

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All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

Dr. Pearl CenonDr. Pearl

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.