Pearls of Wisdom: Your Baby and Ear Infections

At some point or another, most babies and children will suffer through the pain and discomfort of an ear infection. The telltale signs may be all you need to know what’s happening… crying, tugging at her ear(s), and temperature are all indicators. In children that have learned to talk, you may hear complaints of throbbing pain or that your child is having trouble hearing. You’ll need to get baby to the pediatrician for treatment and relief of an ear infection.

Middle ear infections, or “otitis media,” is the most prevalent disease of childhood, second only to respiratory infections. There are an estimated 25 million yearly visits to the pediatrician resulting from ear infections.  Accurate diagnosis and treatment of otitis media are important not only because it affects a lot of our children but also because left untreated, it can lead to serious complications like meningitis or brain abscess. Middle ear infections that lead to fluid in the middle ear, known as effusions, could also affect a child’s hearing and subsequently, his speech and language development.

Nearly 86% of children have at least one episode of otitis media by 3 years of age, with peaks occurring from 6-36 months and 4-6 years of age. Available medical data shows that the occurrence of ear infections tends to decrease with age but is higher in the following groups: male children; kids belonging to lower socioeconomic groups; black children, and among those with craniofacial anomalies. Incidence is also higher during winter months and early spring.

Ear InfectionWhen an ear is infected, the “eustachian tube” or the canal connecting the middle ear and the back of the throat gets clogged. During healthy periods, this canal is filled with air; however, during cold weather, when other respiratory infections are present, or when a child also has allergies, this tube can get blocked. When the eustachian tube is blocked, fluid accumulates in the middle ear and attracts bacteria that thrives. As this condition progresses, pressure increases on the eardrum, impeding its ability to vibrate properly. This can affect hearing and cause a great deal of pain.

It is wise to see your pediatrician so he can examine your child’s ear with an instrument called and “otoscope.” After diagnosing him with an ear infection, he may prescribe an antibiotic such as amoxicillin to kill the bacteria and prevent more fluid accumulation. Many times, an antibiotic is not necessary and relief can be attained just by giving acetaminophen or ibuprofen. Antihistamines and decongestants may also be prescribed depending on your child’s symptoms and a physical exam. However, in instances where fever persists and pain worsens despite these medications, he should be re-examined to rule out any other serious concurrent infections. Occasionally, if a child has recurrent ear infections, your doctor may suggest insertion of ear tubes to aid in draining trapped fluid from the middle ear.

It’s important to note that ear infections are not contagious and oftentimes, a child may return to school or daycare after the symptoms abate; however, it is always important to finish the course of antibiotics prescribed. All patients should be re-evaluated 2 weeks after the start of treatment to ensure that inflammation has resolved and the mobility of the tympanic membrane is back to normal.

Periodic follow up is highly recommended for patients with recurrent ear infections. Your pediatrician will also perform a hearing test on your child to ensure that there are no residual effects on his hearing after the infection.

Recurring medical conditions can be very trying for both children and parents. Trust me, I know it sometimes seems as though you see your pediatrician more than you see your best friend! But hang in there… some of my best friends today are parents that were in my office with their kids once a month of more ;)    Silver linings, friends. Silver linings!

I hope you are all having a wonderful, safe, and happy summer!


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: 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.

Avoiding Poisonous Houseplants

Poison control centers nationwide receive many calls yearly regarding children ingesting houseplants. And with summer ending, many people are bringing their prized plants inside. Most plants are safe and beneficial, helping to purify our stale indoor air. However, some plants contain toxins and should not be in reach of children and pets.

Angel's Trumpet

Angel's Trumpet smells heavenly but keep it away from children.

Do you know which plants are toxic? Many lists are available on-line that name toxic houseplants and tell you which parts of the plants are toxic; however, you need to familiarize yourself with what they look like. The best way to avoid toxic plants is to brush up on your plant identification. Don’t bring plants inside that are known to be toxic. Or better yet, don’t grow them. If you do have a toxic houseplant in your home, keep it out of children’s reach and label it. It is recommend that you tie a label on the plant’s branches. Include the botanical name of the plant and label it at toxic and name which parts of the plant are toxic (roots, leaves, berries, etc.) Ask others to do the same in their home (grandparents, family members, friends).

It is also important to teach your children to not consume plants and berries found outside or inside that are not edible. However, we know that children learn about the world through oral exploration. Children at this stage will stick things in their mouths and it is our job to make sure harmful items are out of their reach. For children old enough, The American Association of Poison Control Centers have tips for poison control for children. Their site also has a section of Poison Control Tips for Children with a short educational video.

Families should have the number to their local poison centers handy in case of accidental ingestion. You can find the number on the American Association of Poison Control Centers website. There is also a standard 1-800 number that will work anywhere (great for when you travel to grandma’s or if you’re on vacation). Put this number in your phone. Share this number with your babysitter, family member, anyone that watches your child while you are away.

The good news (being optimistic here) is that very large quantities of consumption of toxic plants will cause a severe reaction. Small quantities may only cause mild irritation and discomfort. Most children that are exposed to toxic plants usually consume a small amount and suffer only from mild irritation.

Do you have more tips regarding toxic houseplants? If so, please share.


*Beautiful Angel’s trumpet pic from Ewa in the Garden.

Baby Sign Language

When I first started my job 7 years ago, I had a co-worker that was learning sign language. I’d always thought it would be neat to know sign language but never learned how. I then found out that she was learning in order to communicate with her 6 month old grandson. I found that very interesting and researched baby sign language.  One day she brought her grandson to work with her and showed us how he would sign “milk” for a bottle, “dirty” if he had a dirty diaper, and even “more” if he wanted more. She told me that it was so easy to communicate with him and that he didn’t cry much because he was able to tell his parents what he wanted. At that moment, I decided when I had children that I wanted to teach them sign language.

Fast forward 5 years to when I had my first child…I’d forgotten about the sign language until a friend of mine told me of a website called “” (the same awesome site that introduced me to BabyLegs). One day I saw the “steal” was a DVD/CD set called Baby Signing Time and I immediately ordered it!  My daughter was about 13 months old and she was just beginning to talk and I could NOT wait to get her started on signing. Once we received the set I put the DVD in and my daughter was captivated by the children on the screen signing. My husband and I sat and watched as well. The host, Rachel, shows the sign, explains how to properly do it, and then sings a song while various children repeat the sign. My husband and I made sure to use signs when talking to our daughter to teach her. After about a month of watching the DVDs every night, our daughter showed us her first sign. We were walking out of the grocery store one rainy day and our daughter signed “rain”. We were so surprised and happy that we stopped right in the middle of the parking lot in the rain and praised her.

Rain Sign Language

It has been about a year since we started using sign language and our daughter knows about 75 or more signs and her communication is extremely advanced for her age. Our pediatrician was impressed with the way my daughter could sign and thought it was great that we were teaching her at such a young age. We have seen a decrease in temper tantrums even though she is only 2 years old because she can communicate with us better. We started later with her but plan on starting with our son when he is about 3 months old.

Have you used sign language with your baby? What type of results did you see?

About the Blogger:

My name is Stephanie. My husband and I have been married 3 years.  We have a two year old daughter and a little boy.

*Flashcard from BabySignLanguage.

Living On Limited Income

My family of four has been living with a limited income for over three years (ever since I had kids) and I would like to think I’ve become a bit of a pro at it. On our single income we have managed to pay off all my medical bill debt, buy a new house, a new car, and take the family on a nice vacation each year. It was hard work, but these days it seems so simple. Prior to becoming a one income family my boyfriend and I were both working full time and had no debt whatsoever.  Daytrips to Seattle and Portland were normal, and buying new clothes for myself with each paycheck was a must.

The hardest thing for us was building a savings account for emergencies.  We are still adding to that fund, but we have a full mortgage payment, and car payment saved up. Most importantly we need some extra money for medical bills. We are not married, so I am not covered on his insurance. Thankfully I’ve only had to go to the doctor once, but for strep throat it was $120, plus another $40 for the prescription!

 I started out couponing when my son was first born. I was completely overwhelmed with all the coupons, and had no clue what I was doing. It took me a year before I mastered it. I’m no “extreme” couponer, but most things I buy are on coupons. I found it easiest to find a few blogs that follow coupon deals and every few days check in on them to see if there are new deals posted. I’ve managed to cut our grocery bill in half this way. We started shopping at the bread outlets, and buy a few loaves at a time and stick them in the freezer. I buy meat when it’s reduced for quick sale and package it up for the freezer when we get home.

One thing that took me a long time to understand was just because it’s a really good deal, doesn’t mean you should buy it. Do my kids need every single little people play set just because I can get them for $5 at a consignment store? No.  I am just now getting rid of all the unnecessary toys in my house. It’s hard! I have made lists of what the kids will need, and how many presents they will get for Christmas, and I stick to it. I shop the Target toy clearance, usually in August, and in late January/early Feb.  I buy clothes a season ahead of time when stores are starting to clear out merchandise for the next season.

Since we have become a one income family my priorities have really changed a lot. No more fancy coffees for me.  If I don’t need new clothes I don’t buy them.  We cut down our cable bill by getting rid of the extra add on package we don’t need.  We switched to a pay as you go cell phone, since we don’t really use it on a regular basis. This has allowed me to use the extra cash on more important things such as: Preschool for my son, Tee Ball, and our family vacations.

Living on a limited income has been a challenge, but I’ve managed to control my spending, and budget the important things in with a little work.  Anyone can do it, it’s hard to get started but I think it’s important.

About the Blogger:

I’m Renea P. I’m a stay at home mommy to a one year old girl and three year old boy. I love spending time with my family, couponing, crafting, and doing fun activities with my kids.