Language Milestones: Birth to 6 Months

Monika Pis, PhD, CPNP

Developing language skills and the growth of cognitive abilities allow children to interact with the surrounding world. 

Language development begins before birth as the baby perceives the sounds of the womb. There is evidence that the baby possesses receptive language ability well before birth. She can hear and respond to environmental sounds and start to develop memories of them.

Expressive language development also begins early. Cooing, which is when the baby produces vowel sounds, begins in the first two months of life. Increased volume in cooing begins to develop around one month of age, and pitch variability can be noticed between two and four months of age. During that time, when you converse with your infant, you should notice some variation in tone. These “conversations” are a great exercise that teaches your baby the art of conversing.

By six months of age infants should start to babble. The ability to babble requires coordination of muscles on the pharynx. When babbling begins these muscles get exercised, and your infant discovers her ability to talk. By nine months of age you should hear your baby say “mama" or "dada." Often “dada” is heard first, because the nasal sound “m” is harder to produce than the “d” sound. But don’t worry, she will say “mama” pretty soon--especially if you practice with her!

Between 9 and 12 months your baby will start to point to objects. This is a very important language milestone, as it proceeds the naming of objects. By the age of one year, a child usually has learned one other word besides “mama” and “dada” and is able to follow one-step commands.

AGE Newborn: By 3 months: By 6 months: By 9 months: By 12 months:

LANGUAGE MILESTONES The baby turns to soft voices, especially the voices of his/her parents. The baby produces cooing sounds and smiles responsively. The baby turns to familiar sounds, laughs, and coos. The baby babbles "mamama," "bababa," and knows his/her name, and turns when called. The child has learned one word other than “mama” and “dada” and follows one-step commands.

Unexpected GMO Products

Monika Pis, PhD, CPNP

The term GM foods or GMOs (genetically-modified organisms) is most commonly used to refer to crop plants created for human or animal consumption using the latest molecular biology techniques. These plants have been modified in the laboratory to enhance desired traits, such as increased resistance to herbicides or improved nutritional content. The enhancement of desired traits has traditionally been undertaken through breeding, but conventional plant breeding methods can be very time consuming and are often not very accurate  (www.csa.com).

Genetically modifying food leads to changes of a plant’s DNA and may lead to unintended and undesirable health effects.

Corn is one of the top genetically modified (GM) crops. Research shows that GM giant Monsanto corn is linked to organ failure in rats.  Researches wrote:

"Effects were mostly concentrated in kidney and liver function, the two major diet detoxification organs, but in detail differed with each GM type. In addition, some effects on heart, adrenal, spleen and blood cells were also frequently noted. As there normally exists sex differences in liver and kidney metabolism, the highly statistically significant disturbances in the function of these organs, seen between male and female rats, cannot be dismissed as biologically insignificant as has been proposed by others. We therefore conclude that our data strongly suggests that these GM maize varieties induce a state of hepatorenal toxicity.... These substances have never before been an integral part of the human or animal diet and therefore their health consequences for those who consume them, especially over long time periods are currently unknown."

Other varieties of GM corn may also pose health risk.

Considering that corn can be a hidden ingredient of many of the foods we consume everyday, we must be vigilant about ingredient list as well as do our own research.

Did you know that table salt, baking powder, and even medications could contain GM corn?

1. Table salt: Iodized salt contains cornstarch to help iodine particles adhere to salt crystals. You don’t even see cornstarch on the ingredient list…


2. Baking powder: It contains cornstarch! You may find baking soda with potato or wheat starch in a local specialty store.


3. Medications: Yes, even medicines contain corn derivatives. If you want an alternative, inquire at your local compounding pharmacy and be ready to pay the price.

Recipe for cornstarch-free homemade baking powder

Ingredients:

1 teaspoon baking soda
2 teaspoons cream of tartar
1 teaspoon potato starch

Mix all ingredients until well combined. Use immediately or store in an air-tight container.

Yield: 1 tablespoon of baking powder

Practicing Healthy Discipline

Monika Pis, PhD, CPNP

The emotional health of the whole family depends on understanding, respect, and good relationships among family members. To develop good relationships, parents need to instruct their children (from infancy) how to control their behaviors to assure family harmony. This system of instruction is called discipline. To some people, discipline is the same as punishment but that is not the case. In fact, punishment plays a very small role in discipline. 

Parents must always encourage good behaviors--this should start from infancy. Since newborns are learning to trust and to be loved, always respond to your crying baby. Then, after she turns 2 months old, you need to teach her how to self-soothe. To do so, you must establish a healthy sleep routine. Place your baby in her crib when she is drowsy, but still alert, and let her learn to fall asleep on her own. If you keep a regular routine, you’ll teach your baby how to fit in with the family's existing schedule.

For a mobile infant, safety is the most important discipline matter. You need to set a safe stage for your child’s exploration and learning: put safety plugs in electrical outlets and latches on cabinets, and place chemicals, hazardous substances, and fragile and valuable items out of reach. Set your water heater to less than 120 degrees F to prevent accidental burns. When your child approaches a dangerous situation, such as a hot stove, your job is to remove her from the area right away.

As children mature, their personalities become more complex. They seek independence and control, and constantly test their limits. Parents need to decide what those limits are, and what behaviors are followed by what consequences. If a child clearly understands what is expected of her, she will be less likely to test her limits.

Another very important component of discipline is positive reinforcement--praising your child for acceptable behaviors. Most children do not want to get in trouble with their parents. If they get rewarded with praise and love for certain behaviors, they are more likely to repeat those behaviors again.

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Discipline vs. Punishment

Discipline consists of: 

Consistency

Positive reinforcement

Consequences

Punishment is a part of discipline and consists of: 

Natural consequences

Consequences

Withholding privileges

Time outs

When punishment is appropriate, here are some suggestions for strategies to implement:

Natural consequences

Natural consequences are what a child experiences as a direct result of her actions. For example, if a child sitting in a highchair throws her toy on the floor, she should not get that toy back. The trick is to be consistent and to resist temptation of giving the toy back to her. Before you know it, she will learn not to throw toys on the floor.

Consequences

Consequences are tightly connected to behaviors. For example, you set a rule that your child must clean her room before watching a movie. If she does not follow the rule, the consequence is that she will not watch the movie.

Withholding privileges

Sometimes it is difficult to come up with a consequence for a behavior. When that happens, you may want to tell your child that if she does not cooperate, she will have to give up something that she likes (i.e. television, going out with friends, bike riding, etc.). Whatever it is that you decide to take away for a period of time, make sure it is never anything essential to your child’s well being (i.e. food, bedding, etc.)

Time out

Time outs work only if they are implemented immediately after an undesired behavior took place. Make sure that the place for time outs offers no distractions, such as a chair in the corner of a room. The purpose of the time out is to remove your child from the activity and persons connected to the unacceptable behavior. When deciding on the length of time outs, use this rule of thumb: one minute for each year of life (i.e. a 3-year-old should spend 3 minutes in a time out). If your child does not want to sit in the time out chair, give her a time out bear hug. After setting a timer, sit in the chair with your child in your lap. Hold her in place gently until the timer goes off and the time out is over. If she tries to get away, tighten the “bear hug,” and tell her that you will only let her go when the timer goes off.

For older children, set the timer for an appropriate amount of time. If she argues or fusses, reset the timer to start the time out again. Do it over and over until she stops protesting. After the time out is over, let your child return to her activity. No comments are necessary after the time out, as she was already punished for the unacceptable behavior.

Summary 

Effective discipline should be reinforced all the time. Remember that discipline consists of consistency, positive reinforcement, and consequences. Role modeling is also crucial. Show your child how she should behave and she will follow in your footsteps. When your child feels encouraged to behave in an acceptable way, you are more likely to elicit desired behaviors, and your child is more likely to listen to you and learn.

Prevent Tooth Decay in Children

Monika Pis, PhD, CPNP

You have probably heard about the importance of establishing good dental care for your children early on, as the health of their teeth and gums reflects their overall well-being.

Tooth decay remains one of the most common diseases of childhood. It’s five times as widespread as asthma and seven times as common as hay fever.

The mouth is full of bacteria, most of them harmless. They can be kept under control by the body’s natural defenses coupled with routine dental care. However, if harmful bacteria get out of control, health problems — such as tooth decay and gum disease — may begin. Gum disease, dental procedures that cut the gums or vigorous tooth brushing may allow bacteria to enter the bloodstream, and then travel to various organs and cause disease.

Research suggests that heart disease and stroke might result from chronic inflammation caused by the bacteria of gum disease. In addition, scientists suggest that tooth loss before age 35 may be a risk factor for Alzheimer’s disease. Therefore, teaching your children to take care of their teeth from the start is in their best interest!

When to Begin

From the time of the first tooth eruption, you need to take care of your children’s teeth to keep them healthy. Preventing tooth decay should start right after birth. Here are tips for keeping your baby’s mouth healthy:

❉ During bottle feedings, hold your infant and the bottle instead of letting the baby hold the bottle.

❉ Avoid bathing your baby’s teeth in formula by not letting him fall asleep when drinking a bottle.

❉ Never try to encourage sucking by dipping pacifiers in sugar or in other sweet substances.

❉ Introduce your baby to a sippy cup at six months old, and wean her off the bottle right after her first birthday.

When the first tooth erupts, clean it with a wet washcloth or a soft toothbrush and water or baby toothpaste after each feeding. Adult toothpastes contain fluoride, and they are not recommended for children until they learn to spit them out. Avoid letting your child use your toothpaste, because swallowing the fluoride will cause permanent white spots on the teeth.

Teach your child to floss as soon as she is able to understand directions and has adequate fine motor skills to begin flossing. Studies show that brushing teeth alone removes only about 40 percent of food that sticks to them. Without daily flossing, your child’s teeth will succumb to cavities and bad breath fairly quickly.

Brushing teeth twice daily and flossing regularly are crucial to maintaining a cavity-free mouth. However, experts say that doing so may not be enough. Dentists caution that diets full of carbonated beverages and juice contribute to acid erosion of tooth enamel. Even healthy diets can be full of acidic foods high in ascorbic acid — such as citrus fruits, berries and juice — that softens enamel.

An acidic environment in the mouth is a breeding ground for the bacteria responsible for breaking down carbohydrates. When the mouth remains acidic for longer than two hours, the tooth enamel starts to corrode, leading to cavities. Dr. Jessica Meeske, Pediatric Dentist, Diplomat, American Board of Pediatric Dentistry, says: “Parents need to minimize the risk of acid erosion in their children, because once tooth enamel is gone, it’s gone for good.”

Dr. Meeske stresses that “contrary to the popular advice that it’s best to brush right after every meal, children should avoid brushing teeth immediately after consuming acidic foods or drinks because this is when the enamel is still soft. Parents can also give their children a foundation for acid erosion protection by having them brush twice daily with a toothpaste recommended for children. Over-the-counter pediatric toothpaste can help re-harden softened enamel and protect against further acid attacks.” Remember that children should not avoid healthy acidic foods, but should be taught proper tooth care to prevent acid tooth erosion!

Your child should see a dentist twice a year. The American Academy of Pediatrics recommends that every child should have the first dental appointment right after the first birthday. Many dentists don’t feel comfortable seeing such young children because of their fidgeting and inability to follow directions and recommend the first visit around the second birthday. Ask your health care provider for a list of pediatric dentists in your area. Or to locate a pediatric dentist, visit:

http://www.aapd.org/finddentist/ 
or http://www.dentists4kids.com/.

If you do not have dental insurance, contact your local dental society to inquire about community dental assistance plans and programs. To locate the dental society in your state, go to: http://www.animated-teeth.com/dental_insurance/t5_dental_insurance.htm.

*First published in Fall 2011/Winter 2012 of Ready, Set, Grow! magazine http://www.readysetgrowmag.com

Infant Eye Color

Monika Pis, PhD, CPNP

Have you ever wondered what eye color your child will have? Many parents, seeing their newborn’s blue eyes, hope they retain that deep blue hue forever. But they might be in for a surprise!

Eye color is determined by the brown pigment, melanin. Depending on the concentration of melanin in the iris, your child ends up with blue, green, or brown eyes. All newborns have blue eyes because at the time of birth, their irises have not started producing melanin. The real eye color settles in between 6-9 months of age and is mainly determined by genetics.

Research has identified many genes that are responsible for our permanent eye color, but there are two that are best understood. I'll call them gene A and gene B. Each of these genes has 2 variants: A-brown and A-blue, and B-green and B-blue. Our eye color depends on which combination we inherit from our parents. This model provides the best understanding of how eye color is inherited, but it does not provide an explanation for the occurrence of gray eyes, or shades of blue, green, or brown. So these eye colors still remain a mystery.

Brown is the most common eye color in the world. In many populations, brown is the only eye color present. Brown eyes contain the most amount of melanin, and they are common in Africa, Americas, and Asia. Brown eye color is rare in countries such as Germany, Poland, Finland, or Sweden.

Green eyes are among the rarest eye color, and they are common in Northern and Eastern Europe. A study published in Preventive Medicine reports that almost 90% of the Icelandic population has either green or blue eyes. Another study of Icelander and Dutch adults found that green eyes are much more prevalent in women than in men. 

A geneticist wrote a program, called the eye color calculator, founded on the principle of probability. This program allows you to predict your child’s eye color based on the closest approximation of the eye color of people in your family tree. You can check it out here: Eye Color Calculator. Since we don't yet know how eye color is exactly determined, use this eye color calculator only for fun.

Whether your child ends up with blue or brown eyes, remember to love them for who they are. Eye color does not determine personality or inner beauty!

Diaper Rash or Yeast Infection?

Monika pis, PhD, CPNP

The diaper area is dark, moist, and warm. Therefore, by the virtue of wearing diapers, infants are prone to develop diaper rashes and even yeast infections in the diaper area. It's important to learn how to prevent diaper rashes, as well as how to tell a diaper rash from a yeast infection, to protect your baby’s skin integrity.

Prevention Is Key
You can keep your infant’s diaper area healthy by frequently changing her wet and soiled diapers, applying barrier ointments, such as petroleum jelly (Vaseline) or A & D ointment, and allowing the area to air out after every diaper change. Using cloth diapers decreases your infant’s risk for diaper rashes, because the air can circulate better through cloth than though a synthetic diaper.

Diaper Rash
If you notice redness or pinkish red pimples in the diaper area, your infant has developed a diaper rash. You need to reach for over-the-counter zinc oxide cream like Desitin. Apply a thin layer to the diaper area 3-4 times daily, and then cover it with a thin layer of a barrier ointment. Continue to air out the area after each diaper change.

Yeast Infection
If the redness in the diaper area has spread to the bends of the legs and looks very red and shiny, most likely it is a yeast infection. You might have already tried the zinc oxide cream at this point without any results, so it is the time to consult with your infant’s health care provider. The best treatment for yeast infections in the diaper area is an anti-fungal cream applied 3-4 times a day for 7-10 days.

Contact your child’s health care provider if your infant has a rash and develops a fever, the rash is spreading, or you are concerned in any way with how the diaper area looks.

Lactose Intolerance

Monika Pis, PhD, CPNP

Lactose intolerance is the body’s inability to digest lactose-containing foods, such as milk and milk-products. There are three types of lactose intolerance:

 Primary lactose intolerance: It is experienced when the body decreases production of lactase with age.

 Secondary lactose intolerance: It is experienced as a result of illness.

 Congenital lactose intolerance: It is hereditary and very rare when a baby is born with lactose intolerance

This article will focus on primary lactose intolerance resulting from a decreased production of lactase. This decrease in lactase production appears to be genetically programmed. For example, although all Asian people are lactose intolerant, they may tolerate to dairy products in childhood. However, they begin to develop symptoms of lactose intolerance by 5 years of age. In African American children, lactose intolerance develops by 10 years of age, and in Caucasian people by young adulthood. 

Approximately 70% of the world’s population has primary lactase deficiency. The prevalence varies according to ethnicity, as well as the availability of dairy products in the diet. In populations with an abundance of milk products in the diet, especially among people of Northern Europe, the incidence of lactose intolerance may be as low as 2%, while 100% of the Asian population, 80% of Native Americans, and 70% of Blacks are lactose intolerant.

Lactase is an enzyme produced in the small intestine and is responsible for the breakdown of lactose, the major milk sugar. As the undigested lactose passes from the small intestine into the colon, certain bacteria found there break it down, releasing hydrogen and/or methane in the process. These gases are responsible for the uncomfortable symptoms that lactose intolerant sufferers may experience after eating dairy products:

Abdominal pain
Bloating
Cramps
Diarrhea
Gas
Nausea

The severity of symptoms of lactose intolerance vary, depending on the amount of lactose in the diet and the amount of lactase in an individual’s digestive system. Everyone can respond differently to lactose.

How is it diagnosed?
Symptoms of lactose intolerance are common to other digestive system disorders. Therefore, if you suspect that you might have lactose intolerance, talk to your health care provider. She or he may order lab work to rule out a serious Irritable Bowel disease. To confirm the diagnosis of lactose intolerance, your health care provider may suggest the lactose tolerance test, the hydrogen breath test, or the stool acidity test.

The Lactose Tolerance Test 
Fasting before this test is required. At the beginning of the test, the patient drinks liquid containing the equivalent of lactose in two cups of milk. Over a period of 2 hours, blood samples are drawn to assess how well the body digests lactose. 

In healthy people, when lactose reaches the small intestine, lactase breaks it down into glucose and galactose. The liver breaks down galactose into glucose that enters the bloodstream. Hence, after ingestion of lactose, there should be an elevation of glucose in the bloodstream. However, if lactose is not completely broken down, a rise in blood glucose level does not occur. This finding serves as a confirmation of lactose intolerance.

The Hydrogen Breath Test
This test measures levels of hydrogen in a person’s breath. Healthy people do not exhale large amounts of hydrogen. In people with lactose intolerance, as lactose passes from the small intestine into the colon and bacteria begin breaking it down, hydrogen and/or methane are produced. Those gases are absorbed by the bloodstream and carried to the lungs.

The patient drinks liquid containing lactose, and their breath is analyzed at regular intervals. Higher levels of hydrogen and/or methane in the breath confirm the diagnosis of lactose intolerance. 

The Stool Acidity Test
This test can be performed on infants and children, because the previous two tests require ingestion of large amounts of lactose that may lead to diarrhea and thus dehydration. The stool acidity test measures the amount of acid in the stool. When undigested lactose passes the digestive system, lactic acid is released into the stool. Therefore, the stool’s acidity increases.

How is it managed? 
Lactose intolerance is easily managed through dietary manipulation. Avoidance of foods with lactose will result in symptom resolution. To assure appropriate amount of calcium in the diet, it is crucial to include in the diet calcium-rich products, such as calcium-fortified lactose-free milk, soymilk, or calcium-fortified juice. Most lactose intolerant people can tolerate some lactose in their diet. Therefore, they should find out through trial and error the acceptable amount of dairy and include it in their diet. Studies show that dietary lactose enhances calcium absorption, and conversely, lactose-free diets result in lower calcium absorption. Thus, daily consumption of the tolerable amount of dairy is crucial to the optimal bone health.

Those who react to small amounts of lactose may try a lactase enzyme available over-the-counter. It is available in tablets and drops and is taken with the first bite of the lactose-rich food. 

Hidden sources of lactose
Bread, pastries, and other baked goods
Breakfast cereals
Margarine
Soups
Salad dressings
Breakfast drinks
Snacks
Baking mixes
Instant potatoes, soups 

Consider these tips to limit the effects of lactose intolerance and enhance your quality of life:

 If you continue to drink real milk, drink less, but more often. Also, drink real milk with your meals, as it slows the digestive process and you reduce the chance for symptoms.
 Not all dairy products are created equal! The amount of lactose in dairy products vary. For example, Swiss and cheddar cheese have small amounts of lactose and they generally do not cause symptoms
 Buy lactose-free products
 Watch out for hidden lactose! 
 Seek alternative sources of calcium 
 Use lactase enzyme drops or tablets before meals to help with digestion of lactose
 Try probiotics – bacteria that help to maintain health intestinal flora

Changing Unhealthy Habits a Step at a Time

Cheryl Tallman

We have the power to influence young children to make healthy food choices. Children develop their behaviors and habits from observing ours. If you’re like a majority of Americans, your eating habits could probably use a little polishing. Many of us know what the good eating habits are, but sometimes eating healthy can be difficult to maintain in our busy lives.

If changing your eating habits seems insurmountable, try making changes gradually. Just as there are no easy answers to a healthy diet, don't expect to totally revamp your eating habits overnight. In fact, changing too much, too fast can get in the way of success.

Start out by making a list of your poor habits and set a goal for a healthy one. Select one habit at a time to work on, and pick the one you think will be the easiest to start with. Set your goal and develop an approach to making modest changes that add up to achieving your goal. Here are a few examples that may help explain this approach:

Goal: Build a Healthier Plate

Approach: Eating a healthy meal includes vegetables, fruits, proteins, whole grains and calcium—rich dairy (or non-dairy foods). For a week, take note of the how many food groups are represented on your plate at each meal. Over the next 2-3 weeks, slowly begin to add the missing groups, while reducing the over-represented foods on your plate.

Here is a simple tip: When you sit down for a meal, draw 2 imaginary lines through the center of your plate to divide it into 4 parts.

• Fill one of the four sections with grains or starchy foods such as rice, pasta, potatoes, bread, or corn.
• Fill another section with protein — foods like meat, fish, poultry, or tofu.
• Fill the remaining 2 sections (half of the plate) with vegetables and fruits like broccoli, carrots, cauliflower, cucumbers, tomatoes, bananas, oranges and apples.
• Then, add a small glass of non-fat milk (or calcium-fortified non-dairy milk, such as soy)

Goal: Eliminate soda and sugary drinks

Approach: Count the number of sodas you have in a day. Set a goal that, say, in five days, you will reduce that number by half. Keep track of your progress. Over the next five days, cut the number in half again, and in a few weeks, you will be down to nearly none. Then, tell yourself you can have a soda when you go out to eat, as long as you don’t go out to eat too often.

Goal: Eating slower at meals
Approach: For three days, write your start and stop time for meals. Identify the meals that you eat the fastest and ones where you can find a little more time to eat. Start out by adding two to three minutes at each of these meals. Work up to 10-15 minutes over time. Plan a topic of conversation, or a series of questions that stimulate conversation to fill the time between chewing. Put your fork down between bites, food, and drink a glass of water with your meal. Before you know it, you will be enjoying a nice slow meal and good conversation with your family.

This is just the tip of the iceberg. There are so many goals we can set for ourselves, but if they become lofty, we tend to stop striving to reach them. Take baby steps to be a good role model for your babies, and in no time, you and your family will be on a steady trek down the path to healthful living.

About the author: Cheryl Tallman is the co-founder of Fresh Baby, creators of the award-winning So Easy Baby Food Kit, and author of the So Easy Baby Food Basics and So Easy Toddler Food. Learn more about the Fresh Baby MyPlate for adult portions sizes at www.FreshBaby.com.

Winter Projects

Cabin fever anyone?  When I get restless during winter because of the weather, I concentrate on indoor projects, such as painting or redecorating my house.  I recently came across these wonderful books that I would like to share with you, because they include a multitude of ideas that anyone can use to shake off the winter boredom and beautify his or her living space.

100+ paint projects: Fresh ideas for your home 

Whether you want to paint walls, furniture, fabric, or tiles, this book will give you inspiration for creative and affordable redecorating.  Just look inside the book and roll up your sleeves!

New Decorating Book

This book provides a modern approach to creative home decorating.  It offers a room-by-room design guide, whole house tours, and a comprehensive workroom section full of ideas and resources.

Studio Spaces

Want to turn a boring and chaotic work space into inspirational and organized place?  Then this book is for you!  You will find here ideas on how to transform your work space to reflect your creativity and personality, how to declutter, organize, and spruce up your studio.

Have fun!

Introducing Solid Foods to Infants

Monika Pis, PhD, CPNP

When an infant doubles her birth weight, weighs over 13 pounds, lifts and supports her head, may seem to be hungry after 8-10 breast-feedings, or ingests over 40 ounces of formula a day, she may be ready to start eating solid foods. Typically, the readiness to begin eating stage 1 baby foods takes place between 4 and 6 months of age.

Always talk to your health care provider before starting solid foods, as she may recommend waiting. For example, physicians may recommend a delay in solid foods for infants with an extensive family history of food allergies.

When you and your health care provider come to an agreement that it is safe to start solid foods, start slowly and enjoy the process! Start with single-grain cereals (rice, then oatmeal, and then barley), then move to vegetables and fruits. Introduce one new food at the time. Preferably, offer a new food to your baby 4-5 days in a row, so that you can observe her for allergic reactions (i.e. hives, abdominal pain, vomiting, etc.). Once you establish that the new food is safe, add a new one to your baby’s menu and repeat the steps.

After introducing cereals, you can start vegetables. Begin with green vegetables, as they are not as sweet as the yellow ones, and your infant may learn to like them faster. Remember that it may take several tries before your baby accepts new food, so don’t give up after the first rejection!

At about 6 months of age, you may start to feed your child meats and introduce juice (only for flavor!). Remember that juices are full of sugar (empty calories); therefore, it is a good idea to dilute them with water, and offer no more than 2-4 ounces per day.

Guidelines to introducing solid foods to infants

Infants are ready for stage 2 foods when they can sit independently, roll over, and can hold a small object in their hands. These milestones occur around 6-7 months of age.

Some sources recommend moving on to stage 3 foods when infants begin to crawl and pull themselves up to stand (at approximately 9 months of age). However, I never recommend that. Stage 3 foods can be tricky, as they are a mixture of smooth and chunky textures. Since it takes a coordination of several muscles in the mouth to chew and swallow foods, and your baby is learning the process, stage 3 foods may increase your baby’s risk for choking. To keep that risk as low as possible (prevention is the best medicine!), when your child begins to crawl and pull herself up to stand, start her on table foods. At that point, she can eat almost everything you are eating with some small exceptions and baby food is no longer necessary.

Foods to avoid in the 1^st year of life

Honey
Karo Syrup
Cow’s milk
Peanuts
Peanut butter
Strawberries
Citrus products
Tortilla chips
Popcorn
Hard candy

Avoid honey and Karo syrup before your child’s 1st birthday, as they may contain spores of botulism (see below). Feed your baby breast milk or formula until she turns one. Afterwards, you may introduce cow’s milk. All she will need is 16-24 oz. per day. Until the second birthday, whole milk is preferred, as it contains just the right amount of fatty acids that are necessary for the proper development of the nervous system. After the second birthday, you can switch to whatever milk the rest of the family drinks. Also, do not rush your child into eating highly allergenic foods, such as peanut butter and citrus products. By delaying their introduction until your child’s immune system is a little stronger, you decrease your child’s chance to develop allergic reactions.

When feeding your baby, remember that she learns from you. If you want her to eat a certain food, do not wrinkle your nose! She will learn very quickly that you do not like that food and think that she should do the same. Also, respect your infant's ability to know when she is full. When she is done eating, she may turn her head away, cover her face with her hands, or simply spit the food out of her mouth. Watch for these clues and do not force her to eat more. Overfeeding may lead to overweight later in life, and we all know that it is easier to prevent it than to deal with it.

Overall, have fun introducing solid foods to your baby. It is a good way to interact and learn about each another.

What is infant botulism?

Botulism is rare but a very serious disease. It is caused by toxins released by a bacterium called Clostridium botulinum. Signs and symptoms begin after 18-36 hour after ingestion and may lead to death. The first sign of infant botulism is often constipation. Other signs and symptoms include: floppy movements due to muscle weakness, droopy eyelids, trouble breathing, weak cry, tiredness, difficulty sucking and feeding, and paralysis. Paralysis and other symptoms are caused by the toxins ability to disrupt the nerve function.

Encouraging High Self-Esteem

Monika Pis, PhD, CPNP

Self-esteem is an integral part of your child’s development, as well as the basis for healthy social skills.

Self-esteem is defined as a person’s feeling of self-worth, or a person’s view of his or her competency. Children with high self-esteem feel substantial worth, and believe themselves to be good and capable. On the other hand, children with low self-esteem think they are useless and that others do not care how they behave and perform.

The role of healthy self-esteem cannot be stressed enough. How your child views his/her worth will play a role in how he/she performs in school, deals with mistakes and failures, motivates self, and interacts with peers.

In adolescence, your child’s self-esteem will influence his or her resistance to risky behaviors, such as alcohol consumption, cigarette smoking, drug use, and sex. While high self-esteem is associated with an overall sense of well-being during adolescence, low self-esteem is related to risk behaviors and negative developmental outcomes. For example, adolescents with low self-esteem are at high risk for attempting suicide. Studies have shown that adolescents with low self-esteem have elevated levels of suicidal ideation and negative expectations of the future.

According to research at the Florida State University, parents who have boys with low self-esteem at age 11 were 1.6 times more likely to meet the criteria for drug dependence nine years later than other children. These findings are a wake up call to parents and other adults who interact with children.

Characteristics of children with HIGH self-esteem:

 Make friends easily

 Show enthusiasm for new activities

 Are cooperative and follow age-appropriate rules

 Control their behavior

 Play by themselves and with other children

 Like to be creative and have their own ideas

 Are happy

Characteristics of children with LOW self-esteem:

 Don’t believe they can do things well

 Fear interactions with other children

 Don’t share ideas

 Are sad

Parents can help their children to build high self-esteem from a very early age. The simplest ways include: praising your child’s efforts and successes however small, providing warmth and affection, being supportive, showing interest in your child’s activities, using positive enforcement, and being patient when your child learns new skills.

Robert Brooks, PhD, assistant professor of psychology at the Harvard Medical School, offers these strategies to parents to foster a healthy self-esteem:

1. Provide opportunities to make choices, decisions, and solve problems.

A belief that one has some control of their environment leads to high self-esteem.

2. Help develop responsibility and make a contribution.

Assuming responsibility that makes one feel capable and making a contribution boosts self-esteem.

3. Offer encouragement and positive feedback.

Self-esteem is nurtured when adults communicate appreciation and encouragement to children.

4. Help establish self-discipline.

Ability to reason and reflect on one’s behavior and its impact on others helps in developing a high self-esteem.

5. Teach to deal with mistakes and failure.

The fear of making mistakes and feeling embarrassed is a potent obstacle to challenges and taking appropriate risks, and thus achieving positive self-esteem.