Pearls of Wisdom: Dr. Pearl’s Bookshelf

With warmer weather springing up in most states around the country, it’s a good time to stroll to your local library and introduce your children to new stories and/or picture books. My patients’ waiting room often echoes with children repeating their parents’ recitals of “One Fish, Two Fish, Red Fish, Blue Fish…”  This brings back memories of reading aloud with my own two children, now ages 15 and 12, so I thought I’d share with you BabyLeggers some of our favorite children’s books.

Parents also frequently ask for recommendations of clinical books that offer developmental, practical and medical information.  Such basic reference guides are well worth keeping on hand and I bet you will find yourself consulting them again and again as your children grow. So today, I present to you the first installment of “Dr. Pearl’s Bookshelf.”

Happy reading!

—————————-

Children’s Books:

Children

Charlotte’s Web, Goodnight Moon, The Very Hungry Caterpillar, The Cat in the Hat, The Lion, the Witch and the Wardrobe, The Secret Garden, Madeline, Chicka Chicka Boom Boom, The Tale of Peter Rabbit, Are You My Mother, Little Bear and A Wrinkle in Time

Clinical Books for Parents:

Most of the clinical books are available on the American Academy of Pediatrics’ website — www.aap.org — in their bookstore.

Parents

Building Resilience in Children and Teens, Patient Education for Children, Teens and Parents, Managing Infectious Diseases in Child Care and Schools, Caring for Our Children, Nutrition: What Every Parent Needs to Know, Home Strength Training for Young Athletes and Nelson Textbook of Pediatrics.

Please go to the BabyLegs Facebook post about books for parents and children and tell everyone what books you and your children love!

 

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

 

Dr. Pearl Cenon

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: Emotional Bonding Part 2- The Toddler Years

shutterstock_113693497Social and Emotional Development in Toddler Years

I can’t count how many times a mother comes to the office in tears because she feels that she has run out of tricks in her bag to deal with her toddler. Feelings of frustration, bewilderment and guilt come hand in hand with surviving the toddler years.  One of the major dilemmas for parents is how to balance discipline with freedom, and create limits. Parents are left to follow their hearts, gut feelings and of course, their children’s cues to guide them.

Social and emotional development involves three major areas: the home, school/daycare, and the neighborhood. Of all of these, the home is the most influential in a child’s life: it is here that parents and children establish a secure foundation from which to venture forth confidently. The challenges that face a toddler include acceptance of limits while maintaining autonomy. Toddlers learn how to rein in aggressive impulses and interact with a growing circle of playmates and adults. Success in attaining this goal is based on prior emotional development, occasionally using images of trusted adults to give them security in times of adversity or stress.

Many parents find their toddler perplexing and difficult to understand and children of this age have rapid, frequent shifts between clinging dependence and defiant independence; between sophisticated-sounding language and infantile helplessness, and between pure joy and uncontrollable rage. These confusing behaviors can put a toll on the parents’ confidence and patience. Your pediatrician can offer you guidance emphasizing realistic expectations for behavioral and emotional development as well as acknowledging parents’ feelings of guilt, anger and confusion. A lot of moms and dads are hesitant to raise such concerns during their doctor’s visit because they feel embarrassed or assume that this is not an appropriate topic for discussion.

Toddlers, in general, need leadership. They need clear, realistic, firm but gentle guidance as well as praise and support when they are due. Sometimes, the best way to lead is simply to serves as a good example. Watching parents clean up spilled food or, even better, allowing him to help (when old enough) is an effective teaching tool. The old-fashioned message of “do as I say, not as I do,” is being rejected by many modern parents with whom I speak. Modeling the behavior that you hope to elicit from your child is the best way to teach the lesson. And remember that your commitment to establishing order, discipline, and responsibility should be modeled with or without your toddler’s participation. In other words, even before your toddler is old enough to clean up after herself, she will watch YOU creating an environment that is orderly and has limits. Eventually, she will want to mimic this herself.

shutterstock_10029688The first step in emotionally bonding with your toddler is to acknowledge, understand, respect, and meet their needs. Toddlers love to play and experiment and they need their parents’ votes of confidence. For instance, allowing a child to occasionally make a “mess” within acceptable boundaries during playtime allows him to feel worthy as well as trust your leadership and guidance. When limits are set, children respond, not out of fear or because they were  threatened with punishment, but because they want to reciprocate the care and love that’s been given.  Again, there must be a healthy balance between empowering your child by allowing him free expression, and saying” no” when the child wants something that may pose harm to himself and others, or is unhealthy or simply not feasible.  Your toddler can handle accepting the limits of reality as long as he knows that you understand his feelings and love him unconditionally.  Another pearl of wisdom I share with parents is that toddlers are not much different than we are in many respects; after all, what adult doesn’t like to have their feelings acknowledged and accepted, even if they are irrational?

It’s wise for parents to master the art of ”trusting and waiting.”  Try to trust your ability to teach and lead and wait for your children to model your behavior at their own pace. Children respond best to modeling and following leaders as opposed to control. Look at the long-term goal for your child’s sense of self over momentary convenience. Enjoying your toddler for who he is and not what you want him to be is key. Parents have to separate their own emotional needs from what their child feels and needs. Lastly, embrace your child’s uniqueness as well as your own.  Your toddler is his own person with his own motives and individual qualities. Every stage in a child’s life has its own purpose and we simply need to acknowledge and respect their needs fully during every stage, allowing them to mature and move on to the next phase.

*The views expressed in this blog are solely those of the writer.

———–

Dr. Pearl

 

Dr. Pearl Cenon

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: Emotional Bonding- Part 1: Birth to 12 Months

We hear the term “bonding” so often in modern culture that it’s easy to minimize its importance and impact. But the bond between parents and children is so critical that immediately after delivering a baby, barring complications, a mother will be given some time to spend holding, stroking and looking at her baby. During this sensitive period when the newborn is very alert and responsive, the very first exchanges of touch, eye contact and sounds between a mother will occur; these first interactions are all part of the bonding process.

Many of the basic core emotions you feel for your child will begin during the period right after birth. Watching your baby look back at you, mirroring your facial expressions and following your movements, you will feel a wonderful surge of awe, protectiveness, and limitless love. This initiates what is called the attachment process. Moms who are sedated or who have babies requiring immediate medical attention may not be able to spend this time but should not worry. This will have no long-term repercussions on their relationship since bonding has no time limit. Once your baby is stable and you have recovered from the stress of labor, you will have this opportunity and achieve the same heightened connection.

shutterstock_78150679Parents have an active role in the infant’s state regulation, by alternately offering stimulation or soothing to lengthen the social interaction. Likewise, the parents are regulated by the baby’s signals, responding, for instance with a bottle or breast to answer cries of hunger. These interactions comprise a system directed toward developing the infant’s normal physiologic homeostasis and physical growth. This also forms the foundation for the budding relationship between parent and child. Your baby learns that you as the primary caregiver can alleviate her stress or tension by feeding and shows this preference by calming down quicker for the mom or dad than for a stranger. In turn, this gives Mom a sense of validation and strong connection with her infant. Breastfeeding is a wonderful means by which mothers feel fulfillment and joy from the physical and emotional connection they experience while nursing. These warm feelings are augmented by the release of the hormone prolactin, producing relaxation and the hormone oxytocin, which promotes the sense of love and attachment between mother and infant.

Babies learn basic trust when they realize that their urgent needs are met. The presence of an adult who provides consistency creates the scenario for a secure attachment. Studies show that infants who are consistently picked up and held in response to distress cry less at 1 year and show less aggressive behavior at 2 years.

shutterstock_130586048By the age of 2 months, infants have their first voluntary social smiles and their amount of eye contact increases, marking a change in the parent-child bonding and also giving the parents a sense of being loved back. The baby interacts with increasing sophistication and range, expressing varied emotions of joy, anger, fear, interest and surprise by different facial expressions. When interacting with a trusted adult, the infant and the caregiver have matching expressions about 30% of the time; the eye-widening, laughing and lip-puckering rises and falls together. If the parent turns away, the baby leans forward and reaches out to get the adult involved again. Infants of depressed parents have a different pattern and spend noticeably less time in coordinated movement with their parents, and make less effort to re-engage. They show sadness, apathy and a loss of energy when the parents are not available. This face- to- face behavior demonstrates a baby’s ability to share emotion and expectation from the relationships, which is the initial step in communication.

Babies 6-12 months old show advances in cognitive understanding and communication ability, with new tensions around themes of attachment and separation. Babies look back and forth between a stranger and a parent, as if to contrast a familiar versus an unfamiliar, and may cling or cry. At the same time, there is an emergence of asserting independence; hence, they attempt self-feeding and refuse to take the spoon from the caregiver. This is when temper tantrums arise as the desire for autonomy comes into conflict with parental control.

The unique emotional relationship that forms between you and your baby is key to him feeling safe, and also influences your child’s social, emotional, intellectual and physical development. A secure bond ensures that your baby will have a firm foundation for life, which includes a healthy sense of self-awareness, eagerness to explore and learn, and trust and respect for others. When babies develop a secure attachment bond, they are better able to enjoy interacting with others, develop confidence, handle disappointment, loss or stress, form mature intimate relationships and maintain emotional balance.

How do you bond with your children? Share your stories in the comments or on our Facebook page!

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

 

Dr. Pearl Cenon

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: Potty Time

PottyTrainingOne of the most challenging tasks that parents face is toilet training their child. Every mom and dad who has bought, changed and disposed of stinky and wet diapers appreciates and celebrates this monumental milestone. No parent has a built-in GPS to help navigate the road to “potty town” and even the experienced parents will see variations in readiness from one child to the next.  Remember, too, that forcing little ones to pee/poo using the toilet or potty chair before they are ready can lead to difficulties. Although as parents we anticipate each new stage with eagerness, some things must come naturally.

Though many creative strategies have been developed and tested (star charts, prizes, songs, help from siblings, even talking toilets!), realistic parenting is all about setting developmentally appropriate expectations for children and offering praise and positive reinforcement when it’s due.  Trust me, approaching this sensitive subject with optimism and encouragement is far better than resorting to negativity, regardless of how challenging potty training becomes.

Many children show interest in using a potty between 18-24 months of age. However, some children may not be ready until after 2 ½ years old, so it’s best to let your child’s behavior and actions guide you. Just like speech, motor skills, and cognitive development, toilet training will happen when your toddler is ready. Once he is able to sense the urge to go — or does a noticeable jig — and verbalizes the need go to the toilet or potty chair, you’re on the right track to successful potty training. Another factor to remember: the process can be affected if there are stressors at home like illness, death, divorce or separation, moving, or any other crisis that impacts the family.

The Academy of Pediatrics recommends the following tactics to facilitate successful toilet training:

  • Decide what words to use to describe body parts, urine and bowel movements. Use terms that will not offend, confuse or embarrass anyone.
  • Pick a potty chair that a child can easily get onto with feet touching the floor. If you use a child-size seat attached to an adult toilet, place a stepstool beneath to support her feet so that she can bear down with ease.
  • Help your child recognize signs of using the potty and encourage him to inform you before, not after, the fact.
  • Make trips to the potty part of a routine. Once you see telltale signs, take your child to the potty and explain what you want to happen.
  • Encourage the use of training pants to make him proud, as this is a sign of being a “big kid.” Don’t get upset when accidents happen since it may take weeks, even months, before toilet training is completed.  Frustration is normal, but try not to let your child sense your frustration.
  • Last and most importantly, give loads of encouragement and positive reinforcement during the whole process to keep your child interested in being diaper-free. Be their cheerleader! Showing lots of excitement when the toddler uses the potty properly will ensure a healthy transition.

Awareness of your own tone and approach is what truly guides toddlers into a success story. Children try very hard to make their parents happy and proud of them, so try your best to applaud your child’s efforts and keep a sense of humor as she tries to master this new skill. It’s just like riding a bike, and once your child gets the hang of it, they’ll never forget how!

Do you have any methods of your own? Post in the comments below, or head over to BabyLegs’ Facebook page and look for today’s post on potty training. Share your wisdom with other BabyLeggers for helpful tips.

Warm Regards,

Dr. Pearl

 

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

 

Dr. Pearl Cenon

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: Naptime

Over the years, countless parents have asked me how to get babies to sleep through regular intervals on a daily basis. Naptime is an essential part of a baby’s development and health, but it’s also good for parents, who use those hours to give more attention to other children, catch up on chores, cook, or even to nap themselves!  Here are some of my thoughts on successful snoozing.

Regardless of your child’s age, sticking to a regular routine is essential to get your baby off to a sound sleep. Very young babies will sleep through all kinds of noises and don’t necessarily need absolute quiet…think of how many times your baby has fallen asleep in his car seat while horns are honking!  If a baby grows accustomed to sleeping only when there is silence, parents can set themselves and their child up for problems later on, when siblings are noisy, the telephone rings or the television is on.

When is the best time to lay baby down in her crib for a nap?  You, and not necessarily the clock, will be the best judge of that! It’s vital that you watch for signs of fatigue such as fussiness, crying for no reason, or refusing to play, as these are clear signs that it’s time for a nap.

The average newborn may spend at least 16 hours a day sleeping!  As they mature, babies’ sleep requirements gradually decrease, averaging about 14 hours by the time they are six months old and a little less than 14 hours by the age of one.  The duration of newborns’ naps are variable, often random, and quite unpredictable depending on circumstances (noise level, distractions, discomfort, etc.)  Ideally, newborns settle into a three-nap–per-day schedule by the age of 2-3 months: an hour in the morning, two hours in early afternoon and another short nap in the evening. Moms and dads who bring their babies to a daycare or a nursery may expect their babies’ sleep patterns to be slightly different but eventually, babies adapt and will stick with a pattern that’s in synch with parents’ sleep cycles.

After two years of age, toddlers do not require that much sleep; usually, 1-2 hours in the afternoon is sufficient. This isn’t true for every child but more important is that he or she is active, playful and energetic.  Here’s something that should be kept in mind: it’s not necessary to stop daytime naps with the intention of making babies sleep better at night. Many new parents assume that eliminating naps will result in better nighttime sleep for their child, or greater willingness to go off to sleep.  Oftentimes the opposite can be true! Keep in mind that lack of sleep during the day may lead to behavioral problems and hyperactivity at night.  An overly exhausted child will be agitated, irritable and less likely to wind down for bed… same as an overly exhausted adult!

By four year of age, naptime is usually eliminated, for better or for worse. Before entering school, I suggest limiting naps to weekends only, in order to prepare your child for this big transition. Though daycare centers often include naptime in toddlers’ schedules, many preschools do not and by kindergarten, it’s virtually eliminated.

There are a few strategies that parents can practice to develop a healthy naptime routine:

1. Mom and dad can observe baby’s behavior to see when he or she exhibits signs of fatigue; making naptimes regular and based on when the baby is tired.

2. Engage your baby in active play when awake.

3. Schedule feeding times before naptime so baby will not get hungry and cut short his naps

4. Again, develop a routine around naptime like using a favorite blanket or stuffed toy to calm her down. Then move her to her crib once she’s sleepy.

5. Other effective strategies include: swaddling baby in a blanket; rocking baby in your arms or in a rocking/gliding chair; using white noise or music (singing quietly to baby or playing lullabies) to drown out jarring daytime noise; changing the baby’s diaper before his nap; taking a short walk with baby in a stroller, or even just turning down the toddler bed and telling a story.

These suggestions, combined with patience and experimentation, should provide a plan for good sleep patterns. After all, it’s a parent’s responsibility to satisfy baby’s needs and helping him or her adjust to family life. This will take time and many tears – maybe even fits and tantrums —  but with effort, you will be rewarded with a child who literally ”sleeps like a baby.”

How do you encourage naptime?  Post in the comments below, or go over to BabyLegs’ Facebook page and look for today’s post on naptime. Share your own pearls of wisdom with other BabyLeggers who might need help with this important part of baby’s daily routine.

Warm Regards,

Dr. Pearl

 

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

 

Dr. Pearl Cenon

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.