Can Childcare Providers Tell You When Your Kid Has to Be Potty Trained?

Dr. Jana quoted in article by Maressa Brown – Parents Magazine

(posted online 8/29/19)

Given how stressful potty training can be for parents and kids, the last thing either needs is to contend with discrimination from a daycare or preschool that refuses to accept a child who isn’t yet trained. And yet, every now and then, families face this very ordeal.

In 2011, a child was told not to return to her Arlington, Virginia, preschool until she stopped wetting her pants. Five years later……continue reading

Toddlers and Furniture Tip-Over Risk

The combination of toddlers and furniture such as dressers and bookshelves that are not properly secured can make for a particularly concerning and potentially dangerous combination. That’s why I was more than happy to share some parenting and “toddler brain” insights with Consumer Reports’ Rachel Rabkin Peachman about this very important safety topic.

Nov 5, 2018 by Rachel Rabkin Peachman

After her 2-year-old son, Shane, died from a furniture tip-over in 2011, Lisa Siefert started attending health fairs and other events to hand out furniture wall anchor kits – delicate-looking hardware packaged like picture hooks that are meant to secure furniture to walls.

She was tormented by the idea that families with small children didn’t know about this hidden tip-over danger in their homes. So spreading the word became her life’s work. Now, six years after……(read more)

School-Readiness: Send Kindergarteners to School with These Key Social and Emotional Skills

Originally posted on my US News & World Report parenting blog (Aug 3)

FOR ALL PARENTS OF soon-to-be kindergarteners, by now, you’re well-acquainted with all the work that goes into preparing a child for school. Kindergarten readiness has long been associated with the ABCs and 123s, and understandably so. Mastering skills such as being able to count and recite the alphabet, and knowing one’s shapes and colors all serve to lay a strong foundation for reading, writing and arithmetic.

That said, it’s worth noting that an ability to develop and maintain relationships has recently been added to this list of so-called IQ skills. Its addition makes clear that social and emotional skills, along with several other skills often misleadingly described as “soft” and “non-cognitive,” are now being acknowledged as critical when it comes to school readiness.

Honing the ability to focus and pay attention, be a good listener, share, take turns and play nice with others may seem like common sense. Yet these types of “other” skills are now collectively being recognized to be of equal, if not greater importance, than IQ skills by everyone from educators, pediatricians and neuroscientists to economists, entrepreneurs and business leaders.

With that in mind, it’s important as the new school year begins that parents integrate teaching kids what I like to refer to as QI (think positive “life force”) skills as well, while helping them develop as students. This is something that you’ll want to do, of course, not just before their first day, but as they continue to grow and develop, both in the classroom and outside of it. Here’s a breakdown of QI skills – which I’ve also outlined in my book “The Toddler Brain” and my children’s book, “Jumping Into Kindergarten you’ll want to be sure to encourage and cultivate: ….

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Shedding light on a common sleep problem: The problem with light sleepers

“Lights out” is a very common phrase meant simply to imply that it’s time to go to sleep. In days past, our ancestors lived their lives according to what was a naturally determined version of “lights out” – typically rising with the sun and turning in when it set. Over the last century, however, we have been given far more control – now able to not only artificially and technologically manipulate our light exposure, but prolong it to such an extent that some of us live our lives in a state of nearly 24/7 light exposure. Given this fact, along with all we now know about what it takes to get a good night’s sleep, it occurs to me that it’s high time for “lights out” to be seen in a new light.

The fact of the matter is a whole lot is known about light’s impact on our likelihood of getting a good night’s sleep. The potential problems and pitfalls of living in a world of electronic devices and ubiquitous screens give new meaning to the description, “light sleeper.”

According to the National Sleep Foundation, 90 percent of people in the US admit to using an array of technological devices – from TVs and tablets to smartphones and laptops – during the hour before they go to sleep. The problem with this tech-heavy approach, simply put, is that darkness matters. Insufficient darkness not only delays the onset of sleep, but also leads to more frequent and prolonged wakenings. Light exposure is one of the most powerful signals in our environment when it comes to setting the body’s internal clock – a biological “clock” responsible for determining our sleep-wake cycles (also referred to as circadian rhythms). Keeping in mind this simple concept, the reasons for the following common sleep-enhancing tips should become both more obvious and enlightening.

  • Rise and shine. Like “lights out,” rise and shine is an expression – as well as a piece of advice – that comes with plenty of supporting evidence. Exposure to sunlight (or bright, blue light) in the morning and during daytime hours is known to reinforce your body’s natural sleep-wake cycle and signal that it’s time to be awake. 
  • Face (smart)phone facts. The screens on smartphone typically give off bright blue light – a design feature meant to help make them easier to see even in bright sunshine, but one that unfortunately comes with potential sleep consequences. Designed to mimic sunlight, this blue light is considered worst with respect to throwing off your body’s sense of day and night. The solution? Reduce your exposure to bright and blue-rich light in the evenings (generally recommended 1 to 2 hours before bedtime). If you find yourself unable to set aside your phone altogether, the iPhone added a new feature (in iOS 9.3) called Night Shift that allows you to shift to “warmer” and less eye-opening hues by cutting down your exposure to the harsher blue light at bedtime.
  • Electronic-free bedrooms. Smartphones aren’t the only offenders when it comes to devices that interfere with getting a good night’s sleep. Common sleep-enhancing recommendations also routinely include turning off and/or keeping all close-range electronic devices (ie those which emit blue light) out of the bedroom. While phones, tablets and other screens definitely fall into this category, don’t forget to consider (and remove) chargers, sound machines, and other blue-light electronics and accessories as well.
  • Choosing the right nightlight. Nightlights have increasingly become the subject of scrutiny in light of what we now know about sleep/wake cycle disruptors. This seems to be especially true for parents wondering whether or not to install nightlights in their bedrooms. Clearly, blue-emitting nightlights are not a good idea. But apparently, white light isn’t so great either. For those committed to using a nightlight, it seems that red light might be your best choice. From a practical parenting standpoint, however, I will point out that newborns enter into the world already well-accustomed to sleeping in the dark. As much as possible, it would seem best to keep it this way, rather than introducing them to artificial light at night.

The bottom line is that sleep is something we all do, and that we all need. It is also one of those key aspects of our everyday lives that all too often gets too little attention…that is, until we find ourselves fatigued. Representing much more than a casual expression, “lights out” now represents a succinct yet valuable piece of advice that, firmly supported by the latest in sleep science. It is my hope that by shedding some light on this important issue, you will see the value of turning out the lights, shutting off the screens, pulling the shutters and, at least in this particular instance, choosing to remain in the dark.

Car Seat Directions: Don’t Rush Switching Your Child to a Forward-Facing Car Seat

Originally posted on my US News & World Report parenting blog (March 19)

IN THE WORLD OF parenting, we’re conditioned to treat anticipated transitions as cause for celebration – like when a child reaches a new developmental milestone or advances to the next grade. And we’re led to believe that sooner is usually better (think potty training). But this way of thinking has its limits and it’s particularly problematic when it comes to car seats, where the safest approach is to take time with each transition.

Whether you’re moving a child from a rear-facing seat to one that’s forward-facing or a child is “graduating” from a five-point harness to a booster seat and ultimately to vehicle seat belt use – it’s best to make these changes as late as possible. The same holds true, by the way, for moving older children from the back seat to the front – which, in case you’re wondering, isn’t generally recommended before age 13.

With respect to transitioning from rear-facing to forward-facing, the consensus of the American Academy of Pediatrics, Safe Kids Worldwide and the National Highway Traffic Safety Administration is that children are safest when kept rear-facing as long as possible within the height and weight limits of their rear-facing car seat, which typically translates to age 2 if not older. As with most aspects of parenting, however, actually committing to keep toddlers rear-facing longer and following through is easier said than done.

I was recently reminded of the additional practical challenges involved when a senator in my home state of Nebraska introduced new and improved car seat legislation requiring appropriate child safety seat use up until the age of 8 (instead of 6), rear-facing until the age of 2, and keeping children under the age of 13 in the back seat. In the spirit of helping this important bill become law, I made my way to the state capitol a couple of weeks ago armed with nearly two decades worth of professional insights and information about the life-saving benefits of the proposed changes.

Read more…..

Flu & You: Protecting Your Family During the Flu Season

Originally posted on my US News & World Report parenting blog (Feb 16)

THIS YEAR’S flu season is officially reaching its peak, and this year’s strain of influenza virus is cause for considerable concern, striking with a vengeance not seen in decades. It’s causing more severe illness, more hospitalizations and even more children’s deaths, as parents do what they can to try to protect their kids.

In reality, the strategies being recommended to combat this year’s flu are essentially the same as those employed in years past. While you’re likely to have heard about many of these strategies before, it’s nevertheless useful to remind ourselves of the importance of washing our hands and covering our coughs; getting everyone in the family who is 6 months or older vaccinated; and being on alert for and recognizing early the signs of the flu – such as fatigue, body aches, cough, sore throat and fever – and it’s potential complications, from sinus infections and pneumonia to heart problems, particularly in more vulnerable individuals, like the very young and very old or those with compromised immune systems.

Now that’s easy to say, and it sounds like easy enough advice to follow. Yet each year I’m left wondering why it is that, as parents, we don’t always feel confident in our approach to fighting the flu. In large part, it’s the fault of the virus responsible for causing the flu. The influenza virus is cunning in its ability to change from year to year, which makes it all the more difficult to protect against.

But I would also suggest that there are some parenting practices and commonly held parenting beliefs that, despite our best intentions, stand to get in the way when it comes to protecting our children, and ourselves, from flu’s wrath.

It’s useful to start with a clear understanding of what “the flu” actually is, and what it isn’t….

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Taking Baby Brain Science to the Streets

There certainly seems to be a lot of encouraging activity taking place in the world of early childhood these days – from campaigns such as Let’s Move to efforts dedicated to identifying high quality child care and insuring that it is both accessible and affordable for all. As a pediatrician trained in the so-called “hard” sciences, one of the most intriguing aspects of this activity, in my opinion, is the movement to effectively and impactfully take early brain science to the streets.

Before jumping ahead to some of the exciting and innovative work that’s now being done, it’s worth reviewing (in admittedly oversimplified terms) how we got here. The 1990’s were characterized by a “concerted effort to enhance public awareness of the benefits to be derived from brain research,” earning it its recognition as the “decade of the brain.” In 2000, the IOM released a galvanizing consensus report on the science of early childhood development – representing both a rallying cry and a very big next step in the brain-building movement. Aptly titled From Neurons to Neighborhoods, it served as a broad and firm, evidence-informed foundation for what we are increasingly seeing: direct connections being forged between the burgeoning brain science and what’s being done to directly promote healthy experiences and environments for all young children…on our “streets” and in our neighborhoods, our communities and across the country.

I have found that on the brain science side of the equation, nowhere is the large and growing body of early brain-based research more accessible, compelling and clearly articulated than Harvard University’s Center on the Developing Child, under the leadership of Neurons to Neighborhoods editor, Dr. Jack Shonkoff. Based on a firm believe that the science of early childhood – right down to the developing brain architecture – can be used to develop more effective policies and services focused on building resilience, developing executive function and self regulation skills, and ultimately preventing the potentially neurotoxic effects of poverty, adversity and toxic stress for those most at risk.

Adding to our increasingly deep and detailed understanding of the baby brain is interdisciplinary research being done at places like the University of Washington’s Institute for Learning & Brain Sciences (I-LABS). Headed up by renowned baby brain researchers Patricia Kuhl and Andy Meltzoff, I-LABS is using intriguing modes of dynamic neuro-imaging such as MEG (magnetoencephalography) to not only provide compelling new insights, data and images about the connecting of neurons and the mechanisms for early learning, but also collaborating with people and organizations who can quickly translate this work into real-world applications.

With respect to these “real-world” applications, The First 1000 Days author Roger Thurow captures the importance of translating this science when he states, “If we want to shape the future…we have 1000 days to do it, mother by mother, child by child.” For anyone dedicated to doing just that, it’s heartening to see just how wide a range of brain-building efforts there are now in place across the country – all dedicated to helping all children reach their full potential by directly offering parents and caregivers evidence-based brain-building information, activities and support. Whether bringing the message to families where they live – on their phones, in their inboxes, on their screens or on their doorsteps – the following are a sampling of these brain-building efforts.

Vroom. Vroom’s brain-building message is clear: Shared everyday moments, from mealtime to bathtime, can easily be turned into brain building moments, and that parents have what it takes to become master brain builders. Suggestions for fun, everyday age-specific activities meant to “spark connections” are made easily available via the free Vroom app, along with practical tips, videos and even badges of encouragement. As for future efforts, watch for everyday brain-building messages to make their way on to the packaging of trusted brands. Supported by the Bezos Family Foundation, one look at the Brain Trust behind Vroom and it leaves no doubt that the best in early brain science is at its core.

Thirty Million Words Initiative. With a name based on the 1995 landmark findings of Hart & Risley, who found that preschoolers from families on welfare were exposed to a full 30 million fewer words than their high-income counterparts, Thirty Million Words Initiative is a Chicago-based, parent-directed program that employs the power of home visitation, one-on-one and group interactions, social media, and the use of the LENA word pedometer to study, build relationships, educate and support powerful parent-child interactions and children’s early language development.

Too Small To Fail. Given the foundational importance of early language development and exposure to words, Too Small’s to Fail’s parent-directed Talking is Teaching efforts include direct-to-parent tips and resources focused on talking, reading and singing with young children that are delivered via email and also available on Twitter (@TooSmallToFail). This is a partnership between the Clinton Foundation and The Opportunity Institute meant to improve the health & well-being of America’s children ages 0 to 5 years.

Text4Baby. Text4baby is a free mobile messaging service provided by Zero to Three – an organization dedicated to advancing the proven power of early connections – in partnership with Voxiva. Text4baby provides personalized, evidence-based health information in the form of text messages for moms and babies throughout the critical period of pregnancy and the first year.

Sesame Street. That’s right…when it comes to taking early brain science – complete with its implications for both cognitive and social emotional development – “to the street,” one needs look no further than the beloved Sesame Street. Founded on helping reach all children with life-changing opportunities to learn, a Sesame Workshop – RWJF collaboration is allowing the Sesame Workshop team to study how best to create and directly deliver the brain-building resources we now know are so fundamentally important for young children’s healthy cognitive and social-emotional development. If you aren’t familiar with past contributions of Sesame to this realm, just take a look at what they can endearingly do with key concepts such as self-control (a core component of executive functions skill development) and empathy.

Biting: What To Do When Toddlers Bite

Originally posted on my US News & World Report parenting blog (Dec 11)

A CONCERNED MOTHER recently reached out to a large virtual support group of fellow moms to seek advice regarding a distressing incident involving her young child. She described all sorts of challenges that commonly face working moms today, from the adjustment involved in heading back to work to all-important considerations regarding child care. But at the heart of this particular discussion was a subject that I have long found to be of universal interest to parents and others who take care of young kids: biting.

The virtual response this mom got to her tale of woe was impressive: Hundreds of other moms weighed in, sharing their own biting experiences, insights and frustrations. As I’ve found over several decades interacting with young children and their caregivers, biting can become the bane of a parent’s existence – whether you’re upset your child has been bitten, or the frustrated parent of a biter.

To tackle this issue, I’ve found it most useful for everyone involved to step away from the particular situation at hand – at least for a moment – and start with a clear understanding of what biting does, and doesn’t, represent.

The best way I’ve found to explain it is that biting happens to be the least socially acceptable of all of the predictable and developmentally normal behaviors of early childhood. The thought of one child trying to take a bite out of another child has come to be perceived as far more distasteful than, say, hitting, pinching, pushing, kicking, shrieking or any of a whole host of less-than-desirable toddler behaviors. There’s something about the discovery of a human bite mark on one’s child that parents find especially disturbing. However, a young child’s predilection to bite both friends and foes isn’t abnormal.

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Kids & Cars Seats, Why Safety Shouldn’t Take a Back Seat When You Fasten in Your Kids

Originally posted on my US News & World Report parenting blog (Sept 22)

THIS WEEK HAPPENS TO BE Child Passenger Safety Week – a week specifically dedicated to ensuring that parents, as well as anyone else who transports children, use the correct car seat and properly buckle kids in each and every time children ride in motor vehicles.

As a pediatrician with 15 years of experience being a child passenger safety technician and instructor, I am most definitely a fan of this week-long focus. That’s because the stakes are high when it comes to buckling kids in properly. Motor vehicle-related injuries continue to be a leading cause of death for children in the U.S.; and buckling up is the best way to save lives and reduce injuries. Child safety seats, when used correctly, can reduce the risk of death by as much as 71 percent, according to SafeKids.org.

Yet, despite all we know about the importance of passenger safety, nearly three-fourths of cars seats are still not being used or installed correctly.

Adding to this problem is a second challenge that’s by no means exclusive to car seats, but which stands to seriously thwart our collective efforts to keep our children safe in them. I’m talking about the culture of “mommy-shaming.”

Consider the photo that just a few months ago managed to capture the attention of the parenting world. The photo I’m referring to wasn’t just any picture shared by any mom. It was a snapshot of the then 18-month-old son of pop culture royalty Kim Kardashian and Kanye West. It also just so happened to be a shot of a not-yet-2-year-old strapped into a car seat that was facing forward, rather than rear-facing seat as generally recommended for a child of this age.

The parenting and media response was fast and furious. While the virtual dust has settled, I still feel the need to weigh in on a couple lingering aspects of this cause celebre.

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Books and Young Children – 5 Reasons You Should Read Aloud to Your Kids

Originally posted on my US News & World Report parenting blog (Aug 17)

WHAT IF I WERE TO START this blog post with the phrase, “In a great green room…,” ask you what the brown bear sees, or simply inquire as to what very hungry caterpillars eat? I’m willing to bet that most of you, as parents (not to mention grandparents, child care providers and early educators), would be able to finish the sentence and answer the questions without pause.

I imagine that for many of you, these ever-so-simple references would likely also conjure up the colorful images and happy memories that tend to go hand in hand with reading such beloved children’s books as Margaret Wise Brown’s, “Goodnight Moon;” or “Brown Bear, Brown Bear” written by Bill Martin, Jr. and illustrated by Eric Carle; and “The Very Hungry Caterpillar,” written and illustrated by Carle. Yet all too often, I find that discussions about early literacy move away from what we all know and love about the experience of reading aloud with young children, and towards the more literal, academic advantages. That includes getting kids familiar with “sight words” – or commonly used words kids are encouraged to memorize, or know on sight; teaching them the sounds of letters; and all of the various other nuts and bolts of learning to read.

That’s not to say efforts focused on promoting early literacy and helping young children make the necessary connections between sounds, letters and words are without benefit. After all, learning to read affords children the ability to spend the rest of their lives reading to learn. There is no question that reading aloud with young children can facilitate their learning their ABCs and help set them up for reading and life success.

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