Welcome to my blog! I am Dr. Lauretta Stombaugh (Dr. S) and I have been part of the Hendersonville Pediatrics family for over 8 years. I have decided to share this blog because I feel that it is vital for parents and caregivers to be well-informed as well as have access to solid, accurate medical information. Your children are our children and we take pride in the excellent care we provide here at Hendersonville Pediatrics. Please join me monthly (or every two weeks if my four kids allow me time to write!) and I will in turn provide interesting, helpful and maybe even comical blogs. Please share a link to my blog! Ready, set, go!!
We are well into our winter here in North Carolina, and that means we are seeing a lot of viruses such as Influenza and Respiratory Syncytial Virus. These, among many other illnesses are filling our waiting rooms and making our kids really cranky. With crankiness comes the fevers. Many of us are sleep deprived as we battle one illness after another. In my case, that is multiplied by 4 which means I have had about 3 hours of sleep in the last 3 months. Ok, maybe 4? So this blog is dedicated to the parents or caregivers out there who are waiting for a break from the snot, coughing and middle of the night dosing of Tylenol.
Starting solids for your little one can be a time filled with questions, concerns and preconceived ideas about “the right way” to introduce these foods. In this bog, I will address some common myths surrounding a baby’s first foods and hopefully I can calm your worries.
Get ready for a mess!
Get ready to take some adorable photos!
Get ready for this new milestone - the first of many!
I hear this all of the time. Parents believe that they must feed veggies first to avoid the baby only wanting fruits. While it is true, most babies (and adults) will prefer sweeter foods, there is no research to suggest giving veggies first is beneficial. I recommend giving whatever you want first. Avocados, pears, peas, applesauce (raviolis? just kidding) are good starting points. Offer a variety of tastes/ food groups/colors in no particular order. You can start with rice….or oatmeal or barley. You can mix pears with oatmeal. Enjoy it! Remember your baby’s stomach is small (between the size of a kiwi and an orange) so no need to fill an entire bowl with cereal. Start with about two tablespoons.
Starting solids early will help the baby sleep through the night.
Eating solid food is a developmental milestone and should not play a role in sleep goals. Seriously, if this was true, I would have given my 6 week olds a pureed, 5 course meal! Most babies are simply not ready before 4 months of age. They need to have good head control and the tongue thrust reflex must be gone. This is a normal human response to something placed in the mouth - tongue thrusts outward. This usually disappears at 4-6 months which is why we recommend waiting until then to practice with solids. Practice is just what it is at first. The baby needs to figure out how to get the food off the spoon, get the food from the front to the back of the mouth and then swallow. Be realistic with this new experience and be patient. It may even take a few weeks to get your baby eating regular meals. No worries as there main source of calories is from their formula or breastmilk. They do however need some supplemental food at 6 months to prevent vitamin deficiencies (mainly iron and zinc)especially if exclusively breastfed). Always get the ok from one of us that your little is ready for solids and ask us any questions that may come up. We are always here and willing to help.
Infants cannot have dairy, nuts or any spices.
I have one rule - no honey before a year. While I would recommend keeping foods bland to start with, by the time my kiddos are 10 months old they are eating a variety of pureed adult foods (sometimes with simple spices…ehemm ehemm, garlic?) and some store bought baby food. I’d love to say that I make separate, pureed, organic, food cubes with a baby blender type thing and store them in those cute freezer containers, but let’s be real. I have no time. I briefly dabbled in making some baby food with kid #1 but the little jars in Ingles were just too tempting for me. I envy you if you make your own, make me some for my toddlers! Just be careful not to load foods with extra salt or sugar. Keep it simple. Soon they will eat nothing but chicken nuggets and waffles and then you will need to bring out the creative juices.
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I am told that one of the hottest toys this year on kids’ wish list is the Hatchimal. Honestly, this doctor mom did not know what it was, what it hatched, or why it was so popular. I did not buy one for my children- I’m on strike really. I hate toy trends. But the truth is, we must be mindful of caving at the hands of toy marketers. We must be even more careful not too overindulge our children. I write this blog for all of you who parent and for myself as well, because I am guilty of buying my kids too much “stuff”. As the holidays approach, keep this blog in mind.
It is with the best of intentions sometimes that we spoil our kids. It can be with things, experiences or with discipline. I’m going to explain why this is harmful and can potentially create more issues...other than burning a hole in your wallet!
There are few things more irritating than a capable child or young adult expecting things to be done for them, rules to be broken for them, life to mold “like Play-doh” around their problems. Yet many parents create this by doing too much for their kids. Some parents do their kid’s projects from start to finish. Others rescue their children when they forget a deadline, allow them to miss school and work because of the sniffles, pay for everything without expecting any hard work. This creates a sense of entitlement on the part of the kids. Disappointment as they realize not everyone will praise them for doing what they should be doing as a responsible person. Frustration as they realize they must work hard and the true benefits are not monetary gains but self-worth and rich experiences. Feelings of inadequacy can be overwhelming for these children as they are thrust into a world that does not cater to them. If they are capable, let them do. Natural consequences can be powerful. Let them feel empowered. If they don’t take the initiative, let them fail. This is really hard to do. It feels good to care for our kids and uncomfortable to watch them stumble.
Here are some scenarios to think about:
your 5 year old refuses to wear the proper school tights. she wants to wear the yellow ones with the blue bows. do you force her to follow the dress code or do you allow her to wear the wrong tights and get reprimanded at school? natural consequences, you may be embarrassed but if you put it in perspective, it may just prove to be a memorable lesson.
your 7 year old leaves her book report to the last minute. it’s 9:00 pm at night and she is tired and whining like Calliou. do you complete it for her? do you give her the choice to get up early and complete it? do you watch her get a lower grade because she rushed it or even an incomplete.
your teenager is a big spender. she has a job but spends most of her money on clothes. she wants to go on the senior trip to a ski resort. she asks you to pay for the trip. do you pay up because it is potentially a good experience and yu don’t want her to miss out? do you pay and have her pay you back with a summer job? do you explain that she knew about this trip all along and now she cannot go?
The littles...toys, toys, and more toys. At my house it is like they are alive, creeping out of the woodwork when I’m not looking, setting themselves up just in my path only to be stepped on, thrown in the toy box or kicked down the stairs (doesn’t everyone do that?) I do break out the big black garbage bag occasionally after the kids go to bed. Must be big for all of the plastic toys that do nothing. Must be black because if the kids see through it in the garage, it is all over. I can hear it now, “I need that small, yellow, plastic chip” that is part of a long lost game that will never be played again. “I love that stuffed animal I won at the fair! It’s my favorite.” Seriously, all fair stuffed animals should be banned. So, why do we do this? Buy more of what we have already? Buy the same thing in different colors? Buy that trendy Hatchimal? Could we be filling some gap from our childhood? Could we be modeling our childhood? Could we be wanting to please our children so much so that we lose sight of what is important? You can say no to that toy even if you can afford it. You can limit holiday gifts and shift the focus away from the stuff. What really matters is time spent with family and your health. Remind your kids of this. Model it. Expose them to those less fortunate. Your kids will appreciate their belongings if they have less of them. I’m challenging myself in the months and years that follow. Join me. Put down the Hatchimal. You’ll have less to clean up, more money to spend on experiences and more appreciative kids.
“It's A Big World”
I first introduced my oldest child to music when she was about 3 months old. It was a song called " It's A Big World" by Renee and Jeremy. I found it on YouTube while desperately searching for lullabies to soothe her. Since then, it has quieted my own kids and many of my patients. Infants, toddlers and even younger children seem to calm down when listening to this lullaby (usually in the car). Parents on the other hand likely feel bittersweet as it can be irritating at best, but halts the piercing screams. Music can often change our moods, bring us back to past experiences and instantly allow us to connect with our current mood. Even for those of us who are not thought of as music lovers we can easily assimilate it into our lives and our children's lives with a positive impact. Music should be a part of our kids' lives just as reading, outside time and pretend play should be. Whether it be a mommy and me music class, instrumental music during nap time, singing with mom or dad, try to make music a part of your days with your littles. It can help develop language skills, listening skills and creates a time to bond. It can also help to develop their neural connections.
Now, the question many of you may have is " when do I introduce formal music instruction to my kiddos?" There are various opinions out there, but most of what I've read says around 4. It also varies depending on which instrument. For example, piano lessons should start no earlier than 5y. At this age, their fingers are large enough to navigate the piano and they have a longer (albeit still short) attention span. Piano is a great starting point because the finger movements on the piano are easier than say the guitar. Guitar playing requires a fair amount of fingertip pressure so they say 8 y is a good age to start learning. Voice lessons at around 13 y bc of proper breathing techniques and vocal cord development. Another important consideration is the interest of the child in a particular area. If they aren’t at least a bit interested they will easily become overwhelmed. Similarly, if they start formal instruction too early, they may become overwhelmed. On a positive note, even if they do not stick with the one instrument, the principles that they learn with one will likely translate to the next.
So remember to sing even if you can’t carry a tune (our kids never care)….just another way to engage your kids. Dance too. It's good for the soul.
First kid, we read the books about how to have a good sleeper. Second kid, we read the parenting books. Have you visited the online parenting sites? Have your relatives added their opinions about how to raise your children? The bad news is, I have no magic plan to pass on to you, as I do not know each of your children the way that you do. The good news is that there IS a way to discipline your children without screaming, shaming, spanking or spoiling:) I promise to help you learn some of these ways. Check out the end of this blog entry for some specific techniques or download the app “Positive Discipline Parenting Tool Cards” by Jane Nelson.
Most of us strive to raise competent, capable and confident children. We can do this by empowering them to do things for themselves depending on their developmental level. Also, by sticking to routines so that expectations are set. If you are like me, your kids act up at the most embarrassing times and when you are doing 5 other things (like changing diapers, wiping snot, putting shoes back on, trying to drink your cold coffee). I like to tell my patients' caregivers to try and remain “kind and firm” (an approach similar to that mentioned in Jane Nelson's Positive Discipline series). It is not necessary to " punish" for successful child rearing and better “to guide" children. I believe in thoughtful parenting, not permissive parenting. So this does not mean we are best friends with our children. It means teaching them in a way many of us might find foreign. Most of what we know is rooted in our experiences. The truth is, on paper the “kind and firm” approach seems fluffy, almost corny. But, if you have screamed, shamed, spanked or spoiled, is this consistently working for you? Yes, your child may briefly stop the behavior, however, do they have repeated offenses? Mine certainly do. Plus, the conflicts escalate until we are both more angry and not listening to each other. Definitely not a win win. So give it a try. Experiment with being “kind and firm”.
Remember that although you may favor one discipline technique over another, it will depend on the personality and developmental level of the child. For example, let’s talk about teeth brushing. If a 15 mo resists brushing their teeth, you are not going to kindly and firmly explain about cavities and plaque. You may distract, sing, speak in a calm voice, involve the toddler. If you are dealing with a 3 yo, kindly explain that we do this before bed so we can keep our teeth from getting yucky. Involve him/her and pick your battles. Is it really necessary to have a wrestling match ending in tears (the child’s not ours…usually) just before bed? Lastly, the older child, you can be “kind and firm”…ask them what they need to do to get ready for bed. How can they show you that they can do it on their own? Do they want healthy teeth or cavities?
It’s ok to be flexible during summertime/ school breaks. Bedtime can be a little later as long as overall the child is sleeping close to the recommended number of hours per day. Maybe there is more time for play, but be sure to encourage continued learning through reading often, educational activities and monitored screen time. You should expect some resistance during times of transition like the start of summer break or the start of a new school year. If you have a strong foundation these times will prove to be short lived.
The basic framework should be set early on as to what is acceptable in an individual family. Some families eat dinner together, while others order takeout and eat separately. Some families watch TV, while others do not own a single TV. Some are structured, others dance with the wind! My house seems to be a mix among all of these. Yes, this pediatrician’s kids watch tv. I was secretly ecstatic when the American Academy of Pediatrics recently updated their take on screen time (insert bells and whistles). Old recommendation: no screens under 2. New one: limited screen time under 2 with an adult present in the room engaging the child. So I am not ruining my toddler’s ability to think after all if I allow some screen time? Yeah! Oh the things that make me excited these days. Along with double gas points Tuesday at Ingles. I could have fabulous Tuesdays!
Here are some helpful tips I have learned/modeled after the positive discipline approach:
ask don’t tell. say, “What do you need to do to get ready for bed?” instead of “please brush your teeth” “brush your teeth” “brush your teeth!!!!!” set expectations ahead of time. say “we are going into the yogurt store. i expect that you will be calm and use your manners. if you misbehave we will leave and go home” (so painful I know, but be consistent and always follow through - and grab your own yogurt before you leave!)don’t pamper (Jane Nelson has a card addressing this). if you coddle a child, they expect it from everyone else. they become my worst nightmare - the entitled young adult! if you allow them to develop and experience, they learn to be self-reliant and confident even when things aren’t going as planned.encourage them. don’t praise them. geez, i had this all wrong at least through kid #1 (of 4). avoid saying “good job” “excellent artwork” and be specific. “good job finishing your homework on your own. you must be very proud.” “excellent picture - you chose some really pretty colors. you are very creative”.
Parenting is hard. You’ve got this. Remember that some limit setting is a necessary part of discipline. Figure out what best fits your family and your individual child. You are the loving parent, not the cool friend.
(your friendly pediatrician with an angry 3 yo at home- mad because I put milk in his chocolate milk)