Car Safety Rules/Recommendations
Introduction to Solid Foods
What is a check-up?
Children and Disasters
Car Safety Rules/Recommendations
- The AAP recommends that all infants and toddlers should ride in a rear facing carseat until the age of two years .
- All children who are age 2 and older, who have outgrown the rear facing seat (by height or weight), should use a forward facing car safety seat .
- The forward car safety seat should be used with a harness as long as possible, up to the height and weight allowed by the manufacturer of the seat .
- It is best to ride in a seat with a harness until at least 4 years of age .
- Booster seats are for older children who have outgrown their forward facing car safety seat. The booster seat should be used until the seat belt fits properly over their lap and shoulder. This typically occurs around 4 feet 9 inches in height and around 8-12 years of age.
- All children younger than age 13 should be restrained in the back seat of the car
More than 44 million Americans own 192 million firearms. Of this total of firearms, 65 million are handguns. Most handgun owners say that self-protection is the reason for having a gun. However, research shows that guns in homes are a serious risk to families:
- A gun kept in the home is 43 times more likely to kill someone known to the family than to kill someone in self-defense.
- A gun kept in the home triples the risk of homicide.
- The risk of suicide is five times more likely if a gun is kept in the home.
Advice to parents:
The best way to keep your children safe from injury or death from guns is to NEVER have a gun in the home.
- Do not purchase a gun, especially a handgun.
- Remove all guns present in the home.
- Talk to your children about the dangers of guns, and tell them to stay away from guns.
- Find out if there are guns in the homes where your children play. If so, talk to the adults in the house about the dangers of guns to their families and all young people.
For those who know of the dangers of guns but still keep a gun in the home:
- Always keep the gun unloaded and locked up.
- Lock and store the bullets in a separate place.
- Make sure to hide the keys to the locked boxes.
In Pediatrics, prevention = protection. Don’t delay…Do it today!
Introduction to Solid Foods
Introducing solid foods – When, What, How
The introduction of solid foods should be a fun and exciting new chapter for you and your baby. Oftentimes, this excitement is overshadowed by uncertainty over what foods to offer, potential allergies, and possible emergencies such as choking. There is an abundance of information out there, and depending on who you ask or what you read, much of it is contradictory and confusing. We hope that our guide helps you to navigate a little more easily and confidently.
Most babies are ready to start solids sometime between 4 and 6 months. However, we would recommend waiting to start solids until closer to 6 months of age. Breastmilk or formula are adequate nutrition up until 6 months of age, and there is no particular need for other sources of food. Even more important than a specific age in months, are the cues that you are receiving from your baby. Next time you eat a meal, take notice of what your baby is doing. Is he looking at you intently? Does she seem interested in what you are eating, in the movement of your mouth, and the motions of your hands on your utensils? Does he salivate or make any subtle movements with his mouth while he watches you chew your food? In addition to these factors, your baby should also be able to hold her head up in a steady position. He should also sit with support. If many of these factors are present, then your baby is telling you that you can start thinking about introducing solids foods.
Most babies need to “learn” how to eat from a spoon. Breastfeeding or bottlefeeding requires that the tongue is thrust out and is curved around the nipple. Spoonfeeding requires that your baby reverse this motion and draw the tongue into the mouth with the food. It can take a little while, but practice makes perfect.
How to start:
Continue giving breastmilk or formula as you have always done (this will be the staple of your baby’s nutrition up until one year of age)
1. Cereal – the perfect introductory solid food. Start with a single grain, iron fortified baby cereal. It isn’t an exact science, but to offer some guidance, try mixing about 1 tablespoon of cereal with about 4-5 tablespoons of breastmilk or formula. This “mixture” will seem very liquidy and less like a solid. Resist the urge to thicken it up…..as it will be viewed as a solid by your baby. Do not put this mixture in a bottle. Rather, sit your baby upright, and offer little bits on a spoon. Many parents start with either rice cereal or oatmeal cereal. If your baby tends towards constipation, you might be more successful with the oatmeal cereal (which is less binding). Some babies love cereal, and others are less enthused. Don’t be discouraged right away if your baby rejects this. Keep trying. You can try cereal once a day at the beginning and move on to twice a day in the coming weeks/months if your baby likes it. Breastfed babies should continue cereal until 12 months since this is an important source of iron for them.
2. Other foods – After your baby gets the hang of eating cereal, you can begin to introduce other foods. Years ago, we were much more strict about the directions we would give to parents concerning solid foods. We would suggest which veggies to start first, we also recommended starting veggies before fruits (to avoid a sweettooth), etc. Nowadays, there are fewer rules and regulations. The main guideline is to offer single ingredient foods first and to wait 3-5 days before introducing a new food. By waiting 3-5 days before introducing new foods, you will know right away which food was responsible if your baby has a reaction (rash, vomiting, etc.).
3. Food allergies – Allergies are a major concern for most parents. Years ago, we told parents to avoid foods such as eggs, peanut butter, and fish. It was thought that by avoiding these foods until the age of one or two, the child would develop fewer food allergies. We now know that there is no scientific evidence to prove that school of thought. Unless there is a specific food allergy that runs in the family, there are no rules against allowing your baby to try a variety of foods before age one. For more specific questions regarding your own concerns and family history of allergies, please speak to your pediatrician.
4. Foods to avoid – The only foods that should be avoided for medical reasons are cow’s milk (as a replacement for breastmilk or formula) prior to age one and honey/corn syrup. Cow’s milk does not have the appropriate nutritional value to replace breastmilk/formula before age one, and it can even cause iron deficient anemia. Honey/corn syrup that is given before age one can carry harmful spores that produce a condition called Botulism.
5. Choking hazard – Around eight months, you may notice that your baby is no longer that interested in being spooned food. He wants to pick up the food himself. Finger foods are very appropriate at this age, as long as they are the right size, shape, and consistency. Consider well cooked pasta, small pieces of soft bread, soft fruits and veggies. Cut up any circular foods into triangles or small squares. By the time that your baby is one years old, she should be eating meals that are similar to yours (perhaps cut up differently and a little softer).
6. Juice – This is not a necessary part of your child’s diet. In fact, we know that too much juice contributes to tooth decay and childhood obesity. Although we recommend avoiding or limiting juice as much as possible, parents who do want to give juice should give no more than 4-6 ounces a day (served in a cup, not a bottle).
Tricks of the Trade
- If your child is grabbing for the spoon and refuses to be spoon fed, give him his own spoon to hold.
- If your baby refuses a certain food, don’t make it a power struggle. Try something else, and then reintroduce that food a few weeks later. Babies’ tastebuds and palates change all the time.
- Unless you know that your baby is going to finish the entire jar or container of baby food, spoon out an individual serving. This will prevent bacterial growth and avoid your baby becoming ill.
- Eating is a messy affair. Resist the urge to keep you, your baby, and your kitchen clean. Allow your baby to explore with food and have fun.
- Keep your baby safely strapped into a high chair or safety seat while eating.
- You know your baby is done eating when she pushes away the spoon and/or turns her head away. Don’t force extra bites. She is letting you know that she is satisfied.
Please see the attached chart → Medication Dosages-PDF
What is a check-up?
The providers at Doctors’ Pediatric agree with the AAP recommendations that your child should receive regularly scheduled checkups.
It can often be very confusing for parents in regards to what Insurance companies will or will not cover during a checkup. As you read below, you will find a guide to help educate families about what is routinely covered at the preventative care visits and what may result in additional charges.
When you bring your child in for his/her next well check, these are the things our providers will do. These are all billed to your insurance company with a “Well Checkup” code:
During checkups, all children:
- Measure their height, weight and head circumference (depending on age) and plot them on our growth chart. A body mass index (BMI) is calculated for all children older then 3 years.
- Check their eyes, ears, nose and throat
- Listen to their breathing and their heart
- Check their abdominal area and their lymph nodes
- Look at their skin • Check their genitals and pubertal staging
- Discuss age related anticipatory guidance • Discuss safety information
- Discuss nutrition appropriate for age
- Discuss development and growth
- Discuss schooling (if age appropriate)
- Fill out forms for daycare, school and sports
- Refill medications
Other concerns that are more time involving and thought provoking such as chronic (prolonged duration) headaches, chronic stomach pains, psychological problems, or other more involved medical issues usually get coded with a separate code from our checkup. Due to this separate code, there is an additional visit charge. It is up to the insurance company, and specifically your medical plan, as to if and how they will pay these charges. Some plans completely pay, others require a separate co pay (even if there is no co pay for checkups), and others do not cover these separate charges at all, considering it a “non-covered item”. These billing issues are between you and the insurance company, and we always suggest you check with your insurer or HR department BEFORE coming to the doctor to know just what is covered and what is not covered by YOUR plan. Please make sure you know up front, so there will be no surprises. Insurance companies have many hidden costs, so it benefits parents to educate themselves upfront so that there are no unwanted surprises.
Children and Disasters
Talking to Children about Disasters
Please visit this link from the American Academy of Pediatrics for information regarding speaking to your child about disaster.