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Tending to Tummy Time Troubles & Going Back to Sleep

Back-sleeping and tummy time are common phrases in today’s parenting lexicon. Yet that hasn’t always been the case.

The Back to Sleep Campaign – primarily responsible for the switch to back-sleeping babies and related recommendations for tummy time while awake — was launched in the mid-1990s to educate parents, caregivers and health care providers about ways to reduce the risk for Sudden Infant Death Syndrome (SIDS).

At the time, this represented a big parenting shift. Before this public education campaign, parents had little reason to think twice about putting babies to sleep on their bellies. Generations of parents routinely did so. But with compelling evidence to support the Back to Sleep campaign’s primary message — that placing babies to sleep on their backs reduces the risk for SIDS (sometimes referred to as “crib death”) – great progress was made in helping babies sleep safer.

Just how much progress? It is estimated that since the campaign started, the percentage of infants place on their backs increased dramatically while at the same time, overall SIDS rates decreased by more than half.  As far as public health campaigns go, the Back to Sleep campaign is a hands-down success, and the benefits of raising back-sleeping babies and creating safe sleep environments are as clear as ever.

What isn’t always so clear, however, is how parents and caregivers should go about compensating for all this additional time that babies spend sleeping on their backs. By compensating, I mean tummy time. Encouraging back-sleeping babies to spend awake time on their bellies can help stave off the dreaded “positional plagiocephaly,” more understandably referred to as a flat head.

This all might sound fairly straightforward, but I am routinely asked about, interviewed on, and pressed on the subject of tummy time (and the challenges it seems to pose). How much time should babies spend on their tummies? What can one do to encourage tummy time? Is there a certain position babies should be put in? What if they don’t like it?

My first child was born right around the time that the Back to Sleep Campaign was really taking hold. As a pediatrician-in-training, I was well aware of the recommendations, and my daughter didn’t seem to have any problem following them as she established herself as a very good back sleeper. The problem was that I was far more comfortable with the recommendation for her to spend plenty of time on her tummy while awake than she was. Every time I put her on her belly, she’d squawk, cry, push off with her feet, and convince most everyone around her that she was in great distress. I managed to convince myself that her tummy time displays weren’t truly those of a distressed child, so she did get in a sufficient amount of tummy time. I find, though, many parents find tummy time troubling.

Try the following tummy time tips and tricks to help take the pressure off of you as well as your baby!

  • Tummy timing: The key here is quite simple. Just remember back while sleeping and tummy while awake. Despite what you may have been led to believe, there are actually very few rules about how much time a baby needs to spend on his tummy. There’s no need to set a timer, mark your calendar or otherwise formalize what essentially boils down to a simple concept. Just make sure your baby sleeps on his back, and then I commit to trying to make tummy time your baby’s default for hours when he’s awake.
  • Make tummy time a habit. I’m well aware that this may sound like stating the obvious, but it has been my experience – both in dealing with parents and with child care providers – that laying a baby down on her back seems to be somewhat of a force of habit. That’s great if you’re talking about a baby who’s going to sleep. But if it’s on the floor or a playmat, for example, it can take a conscious  effort to switch to the routine of placing an awake baby on her tummy.
  • Understand the benefits. There’s no magic to tummy time. Simply put, until they  learn to roll, sit and crawl, babies generally spend an impressive amount of their time laying down. If all of this down time is spent with pressure being put on the same spot(s) on the back of their skull while it’s still somewhat soft and not fully formed, it’s bound to make an impression. Tummy time not only takes the pressure off, but also allows babies the ability to strengthen their head and neck muscles.
  • Tummy time entertainment. Not all babies need to be entertained in order to be coaxed into spending time on their tummies. Some are perfectly content to lay there and look around. Feel free, however, to help your baby enjoy this new view of the world by placing toys in front of him, help him prop himself up a bit on his elbows, and even lay down facing him so you can look at, talk to, and even sing face-to-face.
  • Tummy time dissenters. If your baby is a tummy time squawker, as mine was, then don’t be discouraged. Make sure you ask yourself whether your baby’s squawks truly count as cries of distress or rather of effort. While my daughter’s cries certainly had my mother-in-law distressed, in reality my squawking little newborn really wasn’t truly upset, she managed to keep her perfect little round head and build up her tolerance for tummy time while all the while mastering the skill of scooting long before she could even roll, and I have some impressive baby videos to prove it.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Raising Healthy Kids: Reaching for the Low-Hanging Fruit of Parenthood

For good or for bad, parents today are faced with the fast paced nature of both the real world and a virtual one. Much of the virtually continuous stream of information, videos, tweets and texts we receive on a 24/7 basis relate in one way or another to what we can, should, and/or are expected to do to be good parents. And let’s face it – keeping up with all of the modern-day parenting advice would be hard enough even if all of it was fact-checked for us. Unfortunately, this is not often the case, as much of what we hear, see and read is unfiltered, potentially unfounded, and confusingly contradictory.

Having spent much of my professional career as a pediatrician increasingly committed to making sense of pediatric and parenting advice in both of these worlds, I have found that what parents often want to know from me is simply how to filter the good from the bad and separate fact from fiction.

Knowing that you all are probably as busy as I am, I decided that this week I would distill down to as few words as possible the handful of things I consider to be some of the most well-founded, important things you can do as parents can do to make your kids smarter, safer and healthier. In other words, the following is my list of the “low-hanging fruit” of parenting.

Move more. I feel the need to say this because it’s painfully obvious that it has become incredibly easy for our children (and for us) to barely move in the course of any given day. Whether it’s walking instead of driving to school (or work) or taking an evening walk around the block, getting out of the car instead of rolling your way through drive-thrus, or signing up for organized sports, joining a gym, or participating in more vigorous daily exercise regimens – every step counts towards an healthier life style.

Use restraint. Literally speaking, I’m simply referring to the use of car seats and seat belts in motor vehicles. With motor vehicle crashes clearly identified as the number one cause of death in children, and the correct use of car seats and seatbelts clearly shown to have a huge impact on reducing motor vehicle-related injuries and deaths, taking the time to buckle up comes with a huge return on your parenting investment.

Read. For every parent who has ever asked my opinion on what they can do to help their children become smarter, excel in school, or head down a path of success, reading always factors in to my answer. Reading aloud to babies, toddlers, young children and teens alike not only fosters improved language skills, but also a love of reading that will serve children well for their lifetime. One of my favorite sayings to emphasize this point is that children spend the first few years of school learning to read, and the rest of their lives reading to learn.

Sleep. For parents of infants and young children, this conversation usually focuses on getting children to fall asleep, stay asleep, sleep in their own room, and do so without requiring repeated interventions. For parents of teens, the conversation often shifts to too little and too late. But regardless of your child’s age, it is becoming convincingly clear that instilling your child with good sleep habits is not only a good thing for your own chances of getting a good night’s sleep, but your child’s overall health and well-being.

Wash your hands…and while you’re at it, remember to cover your cough (preferably with your arm rather than your hand) and vaccinate. The fact of the matter is that while modern day science and research is continually coming up with new medicines, treatments and technologies to improve our families’ health and more effectively treat disease, the simple act of teaching our children to wash their hands (which includes committing to consistently doing so ourselves) remains one of the single most effective things we can do to limit the spread of disease. So is protecting against all of the vaccine preventable diseases.

Originally posted on Omaha World Herald’s Live Well Nebraska

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I would like to start this commentary by assuring you that I really am a fun parent. I’m not a germaphobe despite the fact that I majored in cellular molecular biology, I don’t wrap my children in bubble wrap or tell them not to run for fear that they’ll get hurt and their bedroom walls are not padded despite my ongoing commitment to injury prevention.

Okay, so now that I’ve gotten that out of the way, I’ll also tell you that my husband is convinced that all of you who read my column are going to start thinking of me as Debbie Downer if I keep writing about all of the dangers of childhood – a concern I fully understand. The problem is that I just can’t help it. Not when I know that unintentional injuries have long been and continue to be the leading cause of death for children under the age of fourteen, and that there’s a lot that we, as parents, can do to prevent these injuries from happening.

While I could take my pick of summertime safety topics to write about (and probably will over the upcoming weeks, since there’s no shortage of them), right now I think it’s well worth the time to focus on the fact that there’s going to be a whole lot of fireworks on the horizon in the not too distant future. In fact, in my west Omaha neighborhood, they’re already a nightly event.

Each year, without fail, I cringe at the thought of the potential dangers of fireworks. And just saying that makes me sound like my mother. As a kid, I admit I had a very hard time listening to my pediatrician mother explain the dangers of fireworks. And not just the “dangerous” kind, but essentially all of the fireworks that every other neighborhood child got to light and enjoy in peace without hearing about how many people lose eyes and limbs to fireworks. Back then, my siblings and I weren’t allowed to light anything but sparklers.

Knowing what I know now, even sparklers concern me. Of course, saying that alone makes me a bit of a social outcast, given that most families I know are out buying hundreds (if not thousands) of dollars worth of fireworks that they fully intend to fire off together in the front driveway. Now that non-profits are allowed to sell them right here in Nebraska, I can only imagine how many more amateur fireworks we stand to witness in the next few days and weeks. I only hope this increased availability doesn’t translate into an increase in fireworks related injuries.

For my part, I figured it might help if I shared a couple of commonly used expressions that I think are particularly relevant to the Fourth of July weekend celebrations. It is my sincere hope that they will give you pause, and then set you up to enjoy a fun-filled and safer family holiday weekend.

It’s all fun and games until someone loses an eye…and people actually do. According to my mother, it was the experience of being on call on the Fourth of July in the pediatric emergency room in Boston and seeing a child brought in who had been blinded by an exploding firework that shaped her future opinions of them. According to the Consumer Product Safety Commission, somewhere on the order of seven to nine thousand people a year are treated in hospital emergency rooms for fireworks-related injuries.

You’re playing with fire….literally. While you’d like to think that this would be obvious – akin to letting children stick their hands in the oven, for example – this particular burn risk seems to be lost on some otherwise safety-minded parents as soon as their children start begging to go out and join the fun of lighting explosives. And if you think I’m just talking about the more obviously dangerous explosive kinds of fireworks, consider the fact that even good old, presumably benign sparklers burn at temperatures of about 2000 degrees and are responsible for an estimated one third of fireworks-related injuries to children under age 5.

You’re throwing caution to the wind – definitely in a figurative sense, but also in a very literal sense. It makes absolutely no sense to me that one of the most well-accepted rituals involved in celebrating our country’s independence is the liberation of lit explosives into the wind in the hopes that they entertain rather than fall on a neighbors roof, tree, or other highly flammable objects.

And finally, knowing full well that there will still be lots of families lighting lots of fireworks in the upcoming days, I’ll leave you with some important fireworks safety tips from the Consumer Product Safety Commission:

  • Never allow young children to play with or ignite fireworks.
  • Avoid buying fireworks that are packaged in brown paper because this is often a sign that the fireworks were made for professional displays and that they could pose a danger to consumers.
  • Always have an adult supervise fireworks activities. Parents don’t realize that young children suffer injuries from from sparklers, [which are] hot enough to melt some metals.
  • Never place any part of your body directly over a fireworks device when lighting the fuse. Back up to a safe distance immediately after lighting fireworks.
  • Never try to re-light or pick up fireworks that have not ignited fully.
  • Never point or throw fireworks at another person.
  • Keep a bucket of water or a garden hose handy in case of fire or other mishap.
  • Light fireworks one at a time, then move back quickly.
  • Never carry fireworks in a pocket or shoot them off in metal or glass containers.
  • After fireworks complete their burning, douse the spent device with plenty of water from a bucket or hose before discarding it to prevent a trash fire.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Kids & Cars: Keeping Your Child Safe In and Around Cars

I spent most of last week on the road – first in Orlando at the International Reading Association Conference and then in Chicago participating in a Twitter Party where I was graciously allotted 140 characters per answer to address the challenges of feeding babies. Given that I routinely scan the Omaha World Herald each morning in search of current, locally-relevant parenting topics to blog about, by mid-week I was feeling more than a bit removed and had all but decided to focus on the benefits of early literacy or feeding babies.

That is, until I picked up last Wednesday’s USAToday. What scant details I found condensed into a tiny little paragraph about a baby in Omaha recovering after being rescued from a hot car left me cringing at what might have happened right here in my home town. After returning to Omaha, I not only picked up additional details of this narrowly averted tragedy, but also learned of another child who was recently and inadvertently left in a car while family members went to church.

Even though this isn’t Child Passenger Safety Week (which, for future reference, is planned for the week of September 18th this year), and even though I just wrote about important safety considerations related to teen driving last week, this is as good a time as any to discuss additional risks associated with kids and cars. Because the fact of the matter is that although last week’s two incidents both occurred right here in Omaha, incidents like these can happen anywhere and to anyone. It is my hope that they (along with this blog) will serve as a powerful reminder to everyone of just how important it is to protect against these known dangers involving kids and cars.

Hot cars. Within a mere matter of minutes, the temperature inside a car can be twenty degrees higher than the outside temperature. Within an half an hour, that number can reach 30 degrees higher than outside. That means that even a 70 degree spring day can quickly become dangerous for children left in cars. It also explains why an average of 38 children die each year from heat stroke after being left unattended. That thought alone should be enough to make all parents break into a cold sweat. Now factor in that children can’t control their core body temperatures nearly as well as adults, and it puts them at risk three to five times faster.

Last week’s incident, however, did not tell the whole story. While it is my understanding that that infant was intentionally left in the vehicle, this is not always the case. In many instances, parents or caregivers simply forget that there is an infant in the back, especially when they are off routine, tired, and/or in a hurry. I have yet to meet a parent who isn’t off routine, tired, and/or in a hurry at least on occasion. To help safeguard yourself from ever having this happen to you, always check the back seat of your car. Consider putting a small reminder, such as a stuffed animal, on the front seat whenever you put a child in the back, or put your purse (or some other easily remembered object) safely secured in the back seat along with your child. I also recommend that you read the Pulitzer Prize winning Washington Post article, Fatal Distraction.

Children left unattended in cars. Power windows, trunk entrapment, and accidentally shifted gears are but a few of the lurking dangers when children are left unattended in cars. Regardless of whether you’re talking about children playing in parked cars in the driveway or being left in a car while you run into a store – you’re talking trouble. While a child left alone in a car doesn’t guarantee a disastrous outcome, it certainly has all the makings of one – even when the temperature is not a factor.

With three children of my own, believe me when I say that I am well aware of just how tempting it can be to run in and out of a store without unbuckling, unloading, re-loading and re-buckling up young kids. Yet I never allowed myself to do so, and neither should you – especially if you happen to have children under the age of 7. While there are currently only 18 states with laws against leaving a child unattended, Nebraska happens to be one of them, with a penalty of up to three months of prison time or $500 or both.

Backovers. Young kids and big cars certainly seem to be commonplace these days, but this combination of convenience can quickly turn lethal when small children behind vehicles aren’t visible to those behind the wheel. The result is an estimated 50 children being backed over each week in the United States, with at least 2 of them dying from their injuries. While the death of any child is tragic, even more tragic is the fact that a vast majority of the time backovers occur when a parent or close family member is behind the wheel.

One of the most publicly heartbreaking examples occurred two years ago, when Grammy-winning Christian music singer Steven Curtis Chapman’s youngest daughter was run over and killed by her brother as he backed the family SUV out of the driveway.

So what’s a parent to do? First, be aware of the risks. Every car has a blind spot that stands to make anything behind it – including a child – out of sight to the driver. The higher, bigger and/or longer the vehicle, the bigger it’s blind spot. Regardless of the size of your car, you should therefore always walk around it before backing up, and even then back up slowly. Although there are no current regulations requiring a baseline amount of rear view visibility, also be aware that there are cars (my minivan included) that now come equipped (or can be equipped) with a rear-view camera. My advice would be to rank this added feature at the top of your wish list.

Additional Resources:

Originally posted on Omaha World Herald’s Live Well Nebraska

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Kids and Cars: Teen Driver Safety

News of teen car crash victims invariably get me choked up, but I have recently found myself thinking even more than usual about teenage drivers. I’m sure this is in large part due to the fact that my oldest child has now started talking about what car she hopes to drive in the not-too-distant future. I’m pretty sure it’s also because of the recent news detailing the incredibly sad local story about teenage sisters involved in a fatal crash.

But to be honest, this time of year always makes me think about the risks involved in newly licensed teens getting behind the wheel. I’m not sure why the time of year should make a difference – since the premature death of a teenager is without exception an horribly sad occasion in any season. But there’s apparently something even more devastatingly newsworthy about covering the senseless loss of life when it happens on prom night or just after graduation when teens should be excitedly preparing to embark on their future, not being laid to rest.

Needless to say, my heart always goes out to the families and friends of the more than 3000 teens who die in motor vehicle crashes each year. At the same time, my thoughts also turn immediately towards helping make sure you and every other parent (myself included) know what parents can do to protect our own children from such a tragedy.

It’s important to start by being aware of just how common it is for teenagers to be involved in motor vehicle crashes. Not only do car crashes continue to rank as the number one cause of death for teens, but 16 to 19 year olds are four times more likely to be fatally injured than 25 to 69 year olds.

Having said that, I feel the need to assure you (and my own teenagers, if they happen to read this) that my goal here isn’t to convince you that you should take away the car keys until your child reaches the age of 25. Rather, it’s to tell you that there is good evidence to support the notion that what you do as a parent, including the limits you set when it comes to your teen’s introduction to driving, is exceedingly important.

So what can you do to limit your teen’s crash risk? The good news is there’s actually a lot you can do.

  • Practice, practice, practice. Be aware that a teen’s greatest lifetime risk of crashing is in the first 6 months after getting a driver’s license – a risk that is in large part attributed to inexperience. In fact, seventy-five percent of all serious crashes involving teens have been related to three main critical errors of inexperience – lack of scanning for (and responding to) hazards, going too fast for road conditions, and distractions. Based on what we now know, however, the number of supervised hours that teens get behind the wheel before getting their driver’s licenses makes a big difference.
  • Set limits. It should come as no surprise that parents who set appropriate boundaries –– both on and off the road – have been shown to have a big impact on their children’s health and well being. Teen drivers are no exception. According to a study published in Pediatrics, teen drivers whose parents set and enforced rules were more likely to wear seat belts and less likely to speed, get in crashes, drink and drive, or use cell phones.
  • Help your teen avoid distractions. While it’s a good idea to avoid any and all distractions that stand to interfere with your teen’s undivided attention, there are 2 driving distractions in particular that have been proven to kill teens: cell phones and other teen passengers. In fact, nearly two out of three teen crash deaths for 16-year-old new drivers involve additional teen passengers.
  • Know the rules. Every state is different when it comes to laws about teen driving and learner’s permits. A majority of states – Nebraska included – place restrictions on new drivers in the first 6 to 12 months of driving. Referred to as a Graduated Driver’s License (GDL), such limits as nighttime and passenger restrictions have been proven to reduce crash risk. Nebraska’s GDL restrictions include no driving between midnight and six a.m. until the age of 17, and no passengers other than family members for the first 6 months of driving.
  • Agree upon the rules of the road. This is easiest done by printing out a Parent-Teen Driving Agreement (such as the one from the CDC or Checkpoints) and making sure you and your teen both take it seriously
  • Drive by example. Just as with every other aspect of parenthood, your teen driver will be watching you. Logging lots of supervised practice hours is definitely important for your teen’s future driving safety, but so is serving as a role model by making sure you always wear your seatbelt and put down your cell phone while driving.

For more very valuable information on teen driver safety, I recommend the following sites:

Originally posted on Omaha World Herald’s Live Well Nebraska

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I have been convinced that fish would be a perfect blog topic ever since I returned from a recent trip to San Francisco. Let me assure you that my newfound determination to focus your attention on fish was not triggered by my proximity to Fisherman’s Wharf, but rather by what was discussed in the city by the bay at a meeting of pregnancy and newborn nutrition experts. The topic, which warranted a full day of discussion, was the fact that pregnant and breastfeeding women should be eating more fish.

That’s right – I didn’t say less fish. I said most pregnant and breastfeeding women should be eating more fish. And this recommendation not only comes from an esteemed group of experts in perinatal nutrition, but from the Food and Drug Administration (FDA). Now this recommendation in and of itself wouldn’t necessarily warrant a blog post, except for the fact that just about everyone seems to believe that pregnant women should avoid eating fish altogether because of the risk of mercury exposure. More than an isolated few also (mistakenly) believe that everyone should significantly limit their fish consumption. And therein lies the problem.

You see, back in 2004, the FDA released guidelines clearly stating that “fish and shellfish are an important part of a healthy diet. Fish and shellfish contain high-quality protein and other essential nutrients, are low in saturated fat, and contain omega-3 fatty acids. A well balanced diet that includes a variety of fish can contribute to heart health and children’s proper growth and development. So, women and young children in particular should include fish or shellfish in their diets due to the many nutritional benefits.” At the same, however, the FDA also offered some cautionary advice about how to limit the risk of mercury exposure from eating fish by simply recommending that pregnant and breastfeeding women consume no more than 12 ounces of fish per week. While the American public seemed to have no problem digesting the information that fish may contain methylmercury, far too many completely missed the part about the benefits of eating fish –for pregnant and breastfeeding women, for their babies, and for all of us.

And that brings us to what has been referred to as “the fish paradox.” Once known as brain food because of its high levels of omega-3 fatty acids and other nutrients, fish has suffered an undeserved fall from grace. It is for this reason that I am committed to clarifying what we know about fish, its benefits, the issue of mercury, and what current dietary guidelines recommend when it comes to fish consumption. While you probably have heard of the mercury risk associated with eating seafood, I want to make sure to leave all of you – but especially those of you who are new or expectant moms – with a very healthy respect for the risks of not eating seafood and the following fish-food for thought.

Let them eat fish! Compelling evidence tells us that eating fish during pregnancy and while breastfeeding can improve brain development in babies, and even potentially decrease a woman’s risk of preterm labor and post-partum depression.

Simply avoid four types of fish. Instead of struggling to remember which fish contain less mercury, just make it a point to remember that there are only four higher-containing fish to avoid: Tilefish, Shark, Swordfish and King Mackerel.

Make fish a part of your weekly diet. The 2011 Dietary Guidelines reinforce the recommendation that pregnant and breastfeeding women should make an effort to eat 8 to 12 ounces of seafood a week – an amount currently being consumed by fewer than 20 percent of new and expectant mothers.

Fear not the fish. Unless you are pregnant, planning on becoming pregnant, or breastfeeding, then you should also know that the recommendation to limit seafood consumption doesn’t apply to you. What does apply to you is the fact that the 2011 Dietary Guidelines recommend we could all benefit nutritionally by increasing the amount of fish in our diets!

Originally posted on Omaha World Herald’s Live Well Nebraska

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The Benefits of Breastfeeding

There sure has been a lot of discussion about breastfeeding in Nebraska lately, and for that I’m glad. But I have to cringe every time it’s brought to my attention that Nebraska is one of only two states without legal protection for “the practice” of breast-feeding. To put it bluntly, as a pediatrician I find this quite embarrassing. Even more than embarrassing, I find it completely baffling. As much as I try to understand the opposition to LB 197 and the right to breast-feed in public, I simply can’t.

After all, you can’t convince me it’s based on concerns about over-exposed breasts. Not in this day in age. Not when Katy Perry flaunts her assets on Sesame Street, Lady Gaga’s outfits leave little to the imagination, and everything from billboards to Superbowl ads bombard us (and worse yet, our children) with nearly bare-all images of women’s breasts. Let me also point out that there’s a huge difference between the pervasive and highly sexualized imagery our society has discouragingly come to tolerate, and breast-feeding. Quite frankly, breast-feeding shouldn’t even be discussed in the same breath. Sure, it involves the breasts, but that’s as far as the connection goes.

I also think that anyone who opposes protecting the rights of women to breast-feed in public is missing the hugely important fact that promoting breast-feeding is one of the single best ways we know to improve the health and well-being of babies (and their mothers). It’s no coincidence that the U.S. Surgeon General, Dr. Regina Benjamin, recently  launched a nationwide campaign to encourage breastfeeding by removing barriers that discourage it. I applaud well-respected pediatricians Dr. Laura Wilwerding (the American Academy of Pediatrics’ breast feeding coordinator for Nebraska) and Dr. Tom Tonniges (former Associate Director at the American Academy of Pediatrics and now Medical Director at Boys Town) for their recent and ongoing efforts to insure that Nebraskans don’t lose sight of just how important breastfeeding is.

I join them in closely watching what’s happening with LB 197 and hoping Nebraska will soon catch up with the rest of the country in better supporting every new mom’s noble efforts to successfully breast-feed her baby –in the hospital, at home, and yes…even in public.

On that note, I figured it would be most compelling to leave you with a few simple but powerful reminders of just why breast-feeding and LB 197 are so important.

  • Breast milk contains infection-fighting antibodies that provide babies with protection against everything from diarrhea and the common cold to ear infections and pneumonia
  • Breastfed babies are less likely to have asthma
  • Babies who are breastfed for at least six months are less likely to become obese
  • Breastfeeding reduces the risk of Sudden Infant Death Syndrome (SIDS)
  • Moms who breastfeed not only return to their pre-pregnancy weight faster, but experience less postpartum bleeding and are at reduced risk of breast and ovarian cancer.

Obstacles such as lack of support, instruction, and accommodation to breastfeed at work and in public all contribute to the fact that while 75% of moms in the U.S. start breastfeeding, only 43% are still doing so at the end of six months (and only 13% exclusively, as recommended by the American Academy of Pediatrics).

Originally posted on Omaha World Herald’s Live Well Nebraska

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An alternative to Valentine’s Day chocolate: reasons to dance your heart out!

Valentine’s Day is undeniably all about love and sweethearts. It’s also defined by the heartfelt gifts of chocolates, sweets and (candy) hearts so plentiful this time of year. Now it’s not that I think we need to do away with all of these sweet gifts in lieu of a more heart-healthy approach to Valentine’s Day. But it has occurred to me that this holiday could mean so much more when it comes to finding ways for our loved ones to have happy hearts.

To get you one step closer to achieving this goal, I’d like to suggest that you, your kids, and your sweetheart all get up and dance. That’s right…dance! There are several reasons why you and your family should put your best foot forward and get up and start dancing.

It’s Fun. Regardless of age, who doesn’t like putting on some music and just letting loose? The good news is that regular physical activity throughout the day (which could easily include dancing), improves sleep, reduces stress, and overall makes people feel better about themselves. So just break out those dancing shoes (and your toddler’s skid-free socks and tutus) and start dancing. For some added fun – grab your video camera and capture the moment(s). No rules, just fun.

It’s Exercise. I imagine you don’t need me to tell you that we’re in the middle of a nationwide childhood (and adult) obesity epidemic. The beauty of dancing is that it’s not work, it doesn’t require committing to regular trips to the gym, and it doesn’t cost a thing to break a sweat. Yet don’t let this lack of requirements deceive you into thinking it’s not exercise. In fact, First Lady Michelle Obama’s national Let’s Move! Campaign actively promotes the need for kids to get 60 minutes of moderate to vigorous active play every day. After all, when they (and you) simply get moving (or dancing!), it all adds up to building and keeping healthy bones, muscles and joints and achieving a healthy body weight.

It’s Quality Family Time. Whether you opt for a daddy-daughter dance, a dance contest, or a more freestyle approach to your family’s dancing, it all adds up to the potential for quality family time. With the hectic pace of parenthood and often over-scheduled childhood that defines the times, I would argue that protected quality time with the family – at the dinner table, during conversations with your child in the car, and when sharing fun family activities like dancing together – is invaluable.

And now for my timely and heart-warming news. As many of you may already know, in addition to being a pediatrician, I also own an educational childcare center – Primrose School of Legacy – located in West Omaha. As one of over 200 franchised centers across the country, I am particularly proud to share with you that from February 1st through March 19th, all your heart-felt family dancing can be for a very worthy cause! That’s because Primrose Schools is hosting the 2nd Annual National Family Dance-off Contest. This fun family-oriented dance-contest is open to all families and benefits the Children’s Miracle Network Hospitals. By simply uploading a 30-second video of your family’s most creative, unique, or amusing dance moves at www.FamilyDanceoff.com and/or making sure that you and everyone you know votes each day for your favorite Omaha video, you could be one of 14 weekly contest winners who receive a flip video camera and up to $5000, while also winning Children’s Hospital and Medical Center a chance at receiving a $15,000, $20,000, or even $30,000 donation from Primrose Schools!

Simply put, I want to see Omaha families and children getting healthy by eating healthier, getting up and moving, and dancing. And through March 19th, I more specifically hope you all will be dancing to win, not only for yourselves, but for Omaha’s Children’s Hospital and Medical Center. I guarantee you it will do your body, your family, and your heart some good!

Originally posted on Omaha World Herald’s Live Well Nebraska

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What’s the Big Deal About Chickenpox?

I presume that many of you just received the same notification that I got in my children’s school newsletter regarding Nebraska’s new 2011-2012 School Year Immunization Law. For any parents who may have missed it: in short, the state of Nebraska will soon require all students (K-12) to have two immunizations (instead one) for Varicella (Chickenpox) unless they provide written documentation verifying prior varicella infection. In keeping with Nebraska’s current immunization laws, children won’t be allowed to attend classes in public or private school until the school has written proof of either prior chickenpox infection or the required two varicella shots.

The update in Nebraska’s Immunization Law, with its increased requirement from one to two doses of chickenpox vaccine, came as no surprise to me since I make it a point to keep current on the latest immunization recommendations. That said, I have found that parents have had many questions about the chickenpox vaccine ever since it first became available in the US over 15 years ago. I figured it might therefore be useful to address some of the questions I’m most frequently asked about chickenpox and the vaccine.

What’s the big deal about just getting chicken pox? Let me first say that I fully understand the temptation for parents to consider chickenpox a not-such-a-big-deal childhood infection. After all, it is usually mild and self-limited – known primarily for being highly contagious and causing an itchy rash, fever and maybe some accompanying fatigue. What I have found, however, is that parents are often unaware of the fact that prior to the vaccine, chickenpox was also responsible for about 11,000 hospitalizations and 100 deaths in the US every year. Young children and adults were (and still are) more likely to develop serious symptoms as chickenpox infection can lead to severe skin infection, scarring, pneumonia, and even brain damage or death. In other words, chickenpox can be a very big deal.

Does the chickenpox vaccine work? Yes. The chickenpox vaccine does work to prevent chickenpox, as most people who get the vaccine will not get chickenpox. In fact, a single shot is estimated to be 80 to 90 percent effective. That said, it is possible to get chickenpox after having been vaccinated. Less than an estimated 1 to 3 percent of vaccinated children each year develop a mild varicella-like syndrome involving fewer blisters, less likelihood of fever, and shorter duration of symptoms.

Can you get chickenpox from the shot? While most people who get the chickenpox vaccine don’t have any problems with it, according to the CDC’s Chickenpox Vaccine Information Statement approximately 1 in 25 may develop a mild rash up to a month after getting the vaccine. While it’s possible for people with this rash to infect others, it’s extremely rare.

Why are two chickenpox shots needed instead of just one? Like a majority of other vaccines, it has been determined that chickenpox requires a second shot in order to provide adequate immunity. It is true that when chickenpox vaccine was first introduced in the US in 1995, it was initially recommended as a single shot (between the ages of 12 and 15 months). In 2006, however, the Advisory Committee on Immunization Practices recommended adding a second dose (between the ages of 4 and 6) after outbreaks were seen in previously vaccinated school-age children.

While I understand the temptation to cringe at the thought of yet one more shot added to our children’s already immunization schedule, I would like to suggest that we remember to be grateful for the fact that we have available to us a chickenpox vaccine that is much safer than getting the disease itself.

Originally posted on Omaha World Herald’s Live Well Nebraska

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Preventing Carbon Monoxide Poisoning: What Every Parent Needs to Know

In an attempt to maintain my glass-half-full view of the world, I’m always relieved when I sit down to read the morning paper and come across a good tragedy-averted story interspersed amongst the doom and gloom. So believe me when I say I was particularly happy to read John Schreier’s article, Carbon monoxide sickens students. While it’s unfortunate that more than 40 UNL students recently wound up at the hospital after waking to symptoms consistent with carbon monoxide poisoning, the operative word in this description would have to be “waking.” Because the fact of the matter is that carbon monoxide is one of the leading causes of poisoning deaths in the United States. Often dubbed “the silent killer,” this toxic gas is colorless, tasteless and odorless, but has the deadly ability to disrupt the body’s use of oxygen. In other words, things could have been worse at the UNL fraternity house. Much worse.

Recognizing this, my thoughts immediately turned to the fact that this near-tragedy (with its thankfully happy ending) might momentarily grab people’s attention long enough for me to convey some very important safety information.

I certainly don’t mean to imply that no one would pay attention to information about carbon monoxide precautions except in times of tragedy. But human nature has me convinced that it’s all too easy for the out-of-sight, out-of-mind principle to take over – especially when it comes to the many hidden and/or silent dangers around the house and a not-so-subtle reminder of these dangers can go a long way towards helping focus everyone’s attention on the following simple yet potentially life-saving home safety measures.

  • Recognize the potential signs of carbon monoxide (CO) poisoning. Symptoms can admittedly be non-specific, variable and wide-ranging, but most commonly include headache, nausea, dizziness, and a general feeling of malaise that can be confused for a viral infection. See a doctor right away if everyone in the household begins to experience flu-like symptoms at the same time, especially if the symptoms seem to get better upon leaving the house.
  • Have the number to Poison Control (1-800-222-1222) posted by the phone and don’t hesitate to call it should you suspect CO poisoning.
  • Make sure to put a CO detector on each level of your home.
  • Never leave a car running in the garage, even if the garage door is open. Dangerous fumes can not only fill the garage in minutes, but also easily seep their way into the house.
  • Get household appliances that have the potential to leak carbon monoxide such as furnaces, wood stoves, fireplaces, gas water heaters, ovens, stoves and clothes dryers serviced yearly to make sure they are in good working order.
  • Refrain from using charcoal grills indoors (or in closed-in spaces) and never use a gas oven to provide heat for your home, as both can be dangerous sources of carbon monoxide gas.

Originally posted on Omaha World Herald’s Live Well Nebraska