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Parenting MD: Guide to Baby’s First Year

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This book, written exclusively for e-readers, is filled with straightforward and up to date information to guide you from preparing for your baby’s birth to celebrating her first birthday.

The ebook format includes links to useful resources within the book and online.

Quickly access helpful information about feeding, sleeping, development, and common ailments, as well
as a glossary of terms and conditions.

Every day, research continues to expand our knowledge about keeping our children safe, healthy, and thriving. The information and recommendations contained in this book are based on the most current evidence available. Printed books can take years to get to publication, and medical knowledge and safety recommendations often change before the book even hits the shelves. This electronic format allows the reader to have access to the information within days of the final edit. Dr.Raja will also provide periodic updates to the ebook for free. Subscribe to ParentingMD.com and follow Dr.Raja on Facebook to find out more.

10% of proceeds will be going to St. Jude Children’s Research Hospital

 

13 Things You Should Do When Your Baby Starts Crawling

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Baby Crawling

Photo by Douglas LeMoine, Flickr Creative Commons

I must admit I am a completely neurotic mom when it comes to safety. If my girls are sick, I am actually pretty relaxed. A sick child usually takes a while to get to the point of hospitalization, and I am very well versed on every red flag for a sick child; but injuries happen in a fraction of a second. They are preventable, but in the real world no one can predict every move of a very unpredictable baby or toddler. There are moments when you will gasp or scream as you realize that your baby is in danger, and you can’t stop it. These moments happen to all of us, and we never forget them even when the outcome was just a few tears. The safety things I have listed below are the most common causes of serious injuries, causing hospitalizations or death, in crawling infants and toddlers. If your baby is crawling or even scooting across the room then you need to read this.

1- Put up baby gates at the top AND the bottom of any stairs. About 100,000 kids under 5 visit an Emergency Room in the U.S. each year after falling down stairs. More than a third of these are babies under a year old.

2- Crawl yourself! Everyday you should get down on the floor and make sure there are no hazards within his reach. Look for hidden items under the couch that he can (and will) stick in his mouth, or electric cords that he may pull (along with the lamp attached to it), or an outlet that is unprotected. If your baby were to swallow a button battery, magnets, or a push pin, he could be dead in a few hours. Remote controls, key fobs, calculators, hearing aids, thermometers, and holiday ornaments often have button batteries in them. Be sure to always keep these out of reach.

3- Drain any ditches, ponds or fountains that she could get into, or cover them with a heavy grate. If your baby is going to have access to a bathroom while you are out of the room or even showering, you should also consider a toilet lock. Over 100 children drown in the U.S. each year in bathtubs, buckets, toilets, spas, hot tubs and other containers of water.

4- Strap down large furniture, TVs and appliances that your crawler-soon-to-be-climber can pull onto  himself. Every 3 seconds a child in the U.S. will have one of these items topple on them, and every 2 weeks one is killed. Even the most stable dresser becomes very unstable once your child figures out how to pull the drawers out and use them to climb to the top.

5- Make sure any medications, cleaning agents, or chemicals are placed in a cabinet out of your child’s reach and locked. I have cared for countless numbers of little ones who got hold of grandma’s pills and ended up on my pediatric unit or ICU to monitor or resuscitate. Little boys seem to be the most common offenders- something about that Y chromosome!

6- Remove any furniture that has sharp edges and cover any sharp corners like the hearth on a fireplace. Crawling will soon become cruising, and babies have very large heads that usually make contact with the floor before any of their limbs. A sharp corner can turn that little fall into a lot of tears, hours in the ER, stitches and a not-so-small bill from the hospital.

7- Don’t use a baby walker. These walkers can actually delay when a baby starts to walk and they are ridiculously dangerous. The AAP (American Academy of Pediatrics) has tried to have these banned for sale for over a decade now. Babies can move 3 feet in 1 second in a walker. They can fall down stairs (in a way that will almost guarantee a severe head or neck injury), flip on the edge of a carpet, and even reach hot stoves or table tops that would normally be out of reach.

8- Tie up any cords that may be in reach. Cords from things like window shades or baby monitors can entangle and strangle an infant or young child.

9- Be careful when placing your infant in a shopping cart. It is safest to wear your infant in a carrier if you are shopping. If you do put her in a cart be sure that you strap her in correctly, never step away from the cart, never let another child push or climb on the cart, and never use an infant carrier or car seat in a shopping cart. I can tell you first hand, a toppling shopping cart with your child in it is one of the most terrifying moments a parent can witness.

10- Your baby is no longer safe in his bassinet or bouncy seat once he can sit up on his own (or exceeds the weight limit). He may also be too big for his baby swing now. Most crawling infants are too big and too strong to safely remain in these momma-really-needs-a-shower gadgets.

11- Make sure he is always strapped properly in his high chair. There are almost 10,000 Emergency Room visits each year from high chair injuries.

12- Take an infant CPR class, and make sure anyone caring for your child is CPR certified too.

13- Keep the number for Poison Control on your fridge and telephone. 1-800-222-1222

 

You can click on the links below to access more information:

Button batteries

Magnets

Shopping cart safety

Bouncer seats

Infant swings

High chairs

CPR classes

The Runt of my Litter. Why I Worry About my Smallest Child and When You Should Worry about Yours.

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CharlottesWebEvery day in the office at least one parent expresses concern over their smallest child: “His siblings were so much bigger at this age”; “Why is she sick all the time?”.

I can completely relate to their concerns. My 4 year old daughter is a runt1. Like Wilbur the pig2,3, she is sweet and brilliant, but small and often sickly. My husband and I are both tall, athletic people. Her sister has always been in the 95th percentile for her height and weight. Little E is taller than average, but she is scrawny, and she gets sick… a lot. Her sister didn’t have a cold until she was 2 years old. E had her first cold at a few weeks of life and seemed to be sick constantly for her first 3 years.

Why do I worry? Since I first entered medical school 18 years ago I have studied everything that can go right with a child’s health and everything that can go wrong. I have seen innumerable children who have suffered from accidents, cancer, infections, genetic disorders, and autoimmune diseases. When I was in training we used to say “the sweeter the child, the more horrific the diagnosis will be”. There was no truth in our statement. It was just a reaction to the heartbreak we felt; time after time we had to share devastating news about a child to the family that cherished him.

Unfortunately I have kept that superstition with me. My little E is a cup-half-full kind of girl. She dances around the house singing “Let It Go”, yells “wheeeee” the whole time she is flying down the trail on her bike, and shows more determination and grit than almost any child or adult I know. She is also prone to covering me with thousands of kisses and 10 second bear hugs on a daily basis. I have tears in my eyes when I write this because my overwhelming love and admiration for this child is matched by my overwhelming fear that something bad will happen to her. I try to reassure myself by remembering that many of my friends, and parents I see in the office, share my neurosis about their littlest child.

So when do we really need to worry?

  1. Is my child continuing to grow? Your child may be in the 3rd or 30th percentile on her growth curve. What really matters is if she is continuing to follow that percentile (normal) or if she is continuing to drop off the curve (concerning).
  2. Is my child reaching his developmental milestones appropriately (or is he doing well academically)? Check here for more information on developmental milestones.
  3. Does my child get frequent infections requiring antibiotics or hospitalizations? Frequent ear infections in the first year of life are often due to anatomy (small, flat eustachian tubes that don’t drain the middle ear space well), but frequent ear infections are unusual after the age of 2. Recurring bacterial pneumonia, frequent skin infections, or blood infections are more concerning for an immune deficiency.
  4. Does my child have bloody stools or frequent cramping and diarrhea? These can be signs of inflammatory bowel disease or celiac disease.

So how do you protect your runt? Fortunately there are a few great things you can do to keep your children healthier: good hand washing, proper nutrition, consistent sleep schedules, limiting screen/TV time, regular exercise, and vaccines. We do all of these things in our home but my baby still get sick. If your child is in daycare or preschool (or his older sibling attends school) then he may get 10-12 viral respiratory infections per year. Exposure to second-hand smoke will also significantly increase his risk of frequent infections.

Thankfully now that E is 4 years old, her illnesses are less frequent and less severe. Hopefully her physical composition will eventually match her emotional one. In the meantime I will still snuggle up next to her when she has a fever, and I will hold her all night when she has a cough. It makes us both feel better.


1. runt (definition from http://dictionary.reference.com/browse/runt)

- an animal that is small or stunted as compared with others of its kind.

- the smallest or weakest of a litter, especially of pigs or puppies.

2. E.B. White, Charlotte’s Web, (New York: Harper and Bros, 1952).

3. No children or animals were harmed in the writing of this post. Both Wilbur and my 4 year old can’t read yet. If little E does read this in the future I am fairly certain she will forgive her mommy for calling her a “runt”.

5 Common Questions about Introducing Solid Foods to Your Baby

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baby led weaning, introducing solid foodsTomorrow I am speaking at a Parent Participation class about introducing solid foods to your baby. In preparation I collected the most common questions I am asked about this very fun stage in a baby’s development and I wanted to share them with you. Put down your spoon, grab your mop, and be prepared for the messy fun!

 

When is my baby ready for solid foods?

Can your baby hold his head up and sit properly in a high chair? Does your baby express interest in food? This typically happens between 4 and 6 months of age. Before this your child’s GI system is not ready to properly handle anything other than breastmilk (or formula) and he has not developed the motor skills to chew and swallow food properly. When you offer him food, if he turns his head away from you, chokes, or lets the food just dribble out of his mouth, then he is not ready. Try again in a few weeks.

Do I start with infant cereal?

Traditionally it was recommended that infant’s start with a single grain infant cereal. It is a nice option because you can mix a very small amount with breastmilk or formula when you are trying solids for the first time. Infant cereals are also fortified with iron and don’t have added sugar. Today we know that there really is not a bad first food to start with. You can choose a vegetable, fruit or even meat. The most important thing is that you are offering a single ingredient in a consistency that your baby can handle, without any added salt, sugar or chemicals. In fact there is some evidence that “baby led weaning” may be a preferable way for some families to introduce solid foods to their infants.

What is baby led weaning?

Baby led weaning is a fancy term for letting your baby feed himself, skipping the spoon feeding stage completely. This is a skill that is typically not found in infants until they are 6 or even 7 months of age, so it is best for parents who are not in a hurry to introduce solid foods. Initially your baby will get most of the food in his hair or on your floor, so it is also best for parents who are not mess-ophobic.

The goal with this method is to offer your child smushy versions of common foods that he can pick up himself (soft, steamed and peeled sweet potato wedges, steamed broccoli, scrambled eggs, etc). You want to avoid honey and anything that he could choke on. Some studies have shown that children introduced to solid foods this way may have lower rates of obesity and tend to be less picky eaters, although you may need to supplement with spoon feeding for a child who is underweight. The theory is that babies learn to pace themselves, chew their food, decide when they are done, and get a greater variety of food. How many times can you really serve your baby pureed peas anyway?

It is also nice to sit down at a table with your family and eat together, instead of spending the whole meal spoon feeding your infant. When my 4 year old looks at me at dinnertime some nights and says “feed me” I wish that we had skipped spoon feeding in her infant days! She does love being the baby some days, and I guess mommy secretly loves it too :)

What foods should we avoid?

There is increasing evidence that children introduced to a greater variety of foods before 11 months of age will have a lower risk of food allergy. This means that you should introduce eggs, seafood, meat, cheese, yogurt, wheat and nut products to your infant. You do NOT want to give your infant honey, milk, or choking hazards; no nut butters, grapes, hot dogs, large pieces of meat, hard pieces of fruits or vegetables, popcorn, candy, seeds or nuts. There is also no benefit to fruit juice unless your child’s physician has recommended it for constipation.

Exceptions: If you have severe food allergies in your family then you should not introduce any solid foods to your baby until you have discussed it with your child’s physician.

When do I start to decrease breastfeeding?

Your baby will let you know when she is getting enough solid food and will back off naturally on her frequency of breastfeeding. This shouldn’t happen before 6 months of age, and it will typically not occur until she is 10-12 months old.

My bottom line?

As long as you avoid choking hazards and honey there is no right or wrong way to feed your baby. Eat together as a family and enjoy each other instead of your smartphone. The most entertaining moments of your child’s life are often at the dinner table. Have fun!

 

Please comment below if you have any questions (or funny baby feeding photos and stories to share).

For more information:

Parenting MD: Guide to Baby’s First Year

www.babyledweaning.com

www.healthychildren.org

 

References:

  1. Rapley, G. 2006. Baby-led weaning, a developmental approach to the introduction of complementNwaru BI, Takkinen HM, Niemelä O, et al. Introduction of complementary foods in infancy and atopic sensitization at the age of 5 years: Timing and food diversity in a Finnish birth cohort. Allergy 2013;68(4):507-16.
  2. Hourihane JO, Aiken R, Briggs R, et al. The impact of government advice to pregnant mothers regarding peanut avoidance on the prevalence of peanut allergy in United Kingdom children at school entry. J Allergy Clin Immunol 2007;119(5):1197-202.
  3. Du Toit G, Katz Y, Sasieni P, et al. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol 2008;122(5):984-91.
  4. Poole JA, Barriga K, Leung DY, et al. Timing of initial exposure to cereal grains and the risk of wheat allergy. Pediatrics 2006;117(6):2175-82.
  5. Brown A, Lee MD.Early influences on child satiety-responsiveness: the role of weaning style. Pediatric Obesity. Published online December 17 2013
  6. http://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2014-01-12-spoon-feeding-link-to-child-obesity-not-proven/
  7. Rapley, G. 2006. Baby-led weaning, a developmental approach to the introduction of complementary foods. In Hall Moran, V and Dykes, F. eds. Maternal and Infant Nutrition and Nurture: Controversies and Challenges. Quay Books, London. pp 275-298.

 

 

Baby Safety: The 2 Leading Causes of Death and How You Can Prevent Them

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Safe to Sleep® campaign, baby safety, SIDS

Image courtesy of the Safe to Sleep® campaign

Recently I was asked to speak at a childbirth education class at my local hospital. I love talking to expecting parents as it brings back my own memories of that time: the excitement, hopes, fears…My topic tonight was baby safety.  I want to share this information with you as well.

1- SIDS (Sudden Infant Death Syndrome) and accidental suffocation is the leading cause of death in infants in the U.S. from 1 month to 1 year old.  Your child’s sleep environment is the most important thing you can control to keep your baby safe.  It is important that your baby always sleeps on her back on a firm surface with no crib bumpers, pillows (or breastfeeding pillows), sleep positioners or soft bedding. The safest place for your baby is in a crib that is in your room for the first 6 months. Breastfeeding is also associated with a lower risk of SIDS. If you choose to have your baby sleep in bed with you it is really important to keep in mind the risks and what makes a sleep surface safe.

Our first child was a really fussy baby and we did end up sleeping with her occasionally during her fussiest months (1-3 months). It is not something I recommend to others, but it was a decision we made out of desperation and with all of the risks in mind. We have a firm mattress (pillowtop removed), we slept with no pillows or blankets, and we placed her in the middle of a king size bed. This would have been especially dangerous if there were any other risk factors for SIDS (secondhand smoke, obesity, alcohol or drug use, or pain medications). We never let her sleep on her stomach and we never slept on a couch or chair with her. Sanity trumped absolute safety in our house, but we did our best.

For more information on SIDS prevention and safe sleeping please go to Safe to Sleep.

2- The leading cause of death in infants 1 month to 1 year worldwide is respiratory infections, including pneumonia and influenza. Thankfully in the U.S. we have free access to vaccinations. Unfortunately our vaccination rates in many areas of the country are below 90% and we can’t protect our infants unless everyone they are surrounded by is fully vaccinated. We also have access to clean water. Good hand washing can be very effective in reducing the spread of disease. Unfortunately not everyone (especially young children) does a great job of washing their hands after coughing, sneezing, wiping their noses, or using the restroom.

So what can you do to keep your baby safe from infection?

  • Remind people to wash their hands or use hand sanitizer before touching your baby.
  • Ask people who are sick to visit another time. The first sign of many illnesses that can be dangerous to your baby is just a clear runny nose (whooping cough, measles, RSV…).
  • Make sure anyone who is around your baby is fully vaccinated. This should include a yearly influenza shot and whooping cough (pertussis) booster.
  • Avoid crowded places for the first few months. If you have to go somewhere crowded try to keep your baby in an infant carrier or stroller with a blanket thrown over the top. Carry hand sanitizer and avoid anyone that looks like a grandma! She will want to touch your baby :)

For more information go to the AAP (American Academy of Pediatrics)

So I am curious (and maybe neurotically overprotective based on my career choice): Do you ask your friends and family to stay away if they are sick? Do you ask them if they are vaccinated before they come visit your newborn? How do they react?

 

How to Make the Most of your Visit with the Pediatrician

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This is a guest blog from Sheila Cason, MD. It was previously published on her site DrCason.org. Dr. Cason is a photographer, pediatrician, and mother of three. I have great respect for her advice and incredibly compassionate nature.

Photo by Brendan Riley, Flickr Creative Commons

Photo by Brendan Riley, Flickr Creative Commons

Whew! The morning is over and I’m at lunch, preparing for a busy afternoon.

With the ever increasing time crunch, pediatricians are forced to see more patients in less time. Often we are only given 10-15 minutes to get the history, do an exam, make a diagnosis, formulate a plan and then explain the directions to the family.

This may be fine if the chief complaint is ear pain. But what if it’s chronic abdominal pain? Or a seizure? Then it’s even more important to streamline the visit so we can help your child and you get some answers.

Here are some simple ways to make your visit go smoother and get what you need:

1. First off let me know if you are running late for another appointment. I try not to run late but it’s ineveitable sometimes. There have been times when I go into a room and the family is seething! It seems they missed an incredibly important meeting. If I can I will try to adjust the schedule and see you faster. Or I’ll just cut to the nitty gritty and get you out quickly.

2. Let your doctor know what you really want. If you really want antibiotics, you’re going to be mad when you spent all that time and didn’t get it. Let them know. Often I’ll compromise. If it’s viral and they really don’t need the antibiotics, I let them know. But if it’s a cold and it has been over a week and a half and it’s tough for them to return for a recheck, then I may give them a script to take with them. I give instructions to start only if the cold hasn’t resolved by two weeks. Surprisingly most people don’t abuse this and both parties are happy.

3. Prepare your child: Tell your child where they are going. If they are old enough then let them know exactly what we are going to do. Encourage the young ones and don’t threaten shots if they don’t behave! It scares them to death and then I have to spend a lot of extra time coaxing them to let me even come close.

4.Know your history: Often I have a grandparent come in and not know anything. We have to guess and muddle through the history. This can take a lot of time. If you can’t be there, write a note or give me a number that I can call to ask you some pointed questions.

5. Don’t have the doctor tackle every thing on the same day. If your complaint is ear pain and a cold then talking about your child’s short stature might be better addressed at their well check or another appointment. You’re only going to get frustrated that the doc is rushing you.

6. If you’re still not happy let the doctor know. Some people still look at me at the end of the visit, all worried. I know something is up. Most parents who have a child with 1. Headache: worry it’s a tumor 2. Bruises: worry it’s leukemia 3. Fever and a cough: worry it’s pneumonia. Because parents have told me their fears I have learned what bothers them. I can anticipate this and talk with them about it.

I hope this helps. I think that most people who are frustrated that the doc didn’t spend a lot of time with them, didn’t get what they needed. Communication is key! A pediatrician’s number one priority is making sure your child is healthy and you’re happy!

Do you have ways that make your visit go smoother and you get what you need?

Do you have tips for the doctor that will make the visit go smoother?

Do Probiotics Help Babies Stop Crying?

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Photo by Dina, Flickr Creative Commons

Photo by Dina, Flickr Creative Commons

Do probiotics help young babies stop crying? Well my answer has changed in the past two months and this is why.

This is the title of an article about a study published in the British Medical Journal yesterday: More Evidence That Probiotics Won’t Ease Baby’s Colic, and here is the title of an article from the Wall Street Journal that I shared two months ago: Probiotic Given to Newborns Appears to Help Prevent Colic.

My first reaction to this conflicting research was to cry like a newborn. Thankfully before doing that I thought about research and why it is important to sort through good research and bad research. There is a lot of analysis that goes into deciding whether a study is good or bad. Instead of giving a Stats 101 talk I will tell you this: research results can be flawed because of the study design, number of subjects in the study, conclusions drawn, and statistical significance of the findings. For example: If you have 8 guys on a golf course and 7 are wearing pants, 1 is wearing shorts, and the guy in shorts gets hit by lightning… there is NO conclusion to be drawn. Now the good thing about that scenario is you can now come up with a question that can be researched properly: Does wearing shorts on a golf course increase your risk of being hit by lightning?

I realize I may be getting off on a bit of a tangent. Research is tricky, and unless you have taken a course or two in statistics it is best to ask your physician or favorite statistician whether a study is drawing valid conclusions or not.

So what is my take on probiotics and crying babies? The study released in January was a small study, funded by a probiotic manufacturer. It left me feeling hopeful, but not convinced. The benefit of that study was that it led to a larger study, funded by a children’s hospital, and set up in a way (double blind, placebo controlled randomised trial) that was truly free of bias.

So the bottom line once again is: babies cry. Sometimes they cry because they are hungry, sometimes they are hurt, sometimes they need a diaper change, and sometimes they just need soothing. But sometimes babies cry because it is a normal developmental phase. If you are concerned it is always a good idea to call your pediatrician. I wouldn’t spend my money on gripe water, gas drops, probiotics, or homeopathic remedies. I would save it for a good bottle of wine. You may need a glass to get through the roughest of evenings!

For more tips for crying babies you can go to my previous posts: Crying, Teething Torture, Is Swaddling Risky? and Postpartum Depression.

Finally… the Bliss of a Sunday Don’t-Cram-in-the-Fun Day

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Photo by Linda Tanner, Flickr Creative Commons

Photo by Linda Tanner, Flickr Creative Commons

Today was one of those days when the whole world seemed to slow down. As I watched my children play I was acutely aware of how quickly they are changing, growing up so very fast.

For the past 13 years my husband and I worked full time, which for me also included every other weekend and holiday. It seemed like a reasonable schedule until my first daughter was born. My reasonable schedule then became hectic. When my second daughter was born 19 months later I found that my hectic schedule then became frantic. When I actually had a weekend off did we relax? Absolutely not. Weekends were precious and few so we crammed in a month’s worth of fun into every one. By 9AM we were usually on the hiking trails, biking trails, beach, playground, or Costco! We had done laundry, made beds and picked up toys before sprinting out the door with me screaming “get in the car” so we could have “fun”.

Thankfully, a year ago I finally hit the wall and apparently that wall knocked some sense into me.  I was overworked, overextended, and exhausted. I was missing Christmas mornings and leaving my sick children at home so that I could take care of someone else’s sicker child. I was passionate about my work, but it was time to find a replacement; preferably a doctor who didn’t have a 3 and 4 year old at home and a full-time working spouse. My children needed their mommy and I needed them. We decided to downsize our lives and cut back my work hours. It took almost a year to find my replacement at the hospital but I am finally home. Almost every day I take my kids to school, I get to pick them up 3 or 4 days a week, I am here at dinnertime, I am here to tuck them in at night, and I am finally home most weekends.

Despite all of these positive changes I have found my frenetic pace hard to break. Last week we finally slowed down. My kindergartener and preschooler were off for spring break and we headed south to visit a dear friend. My friend’s kids are a few years older than mine and it was eye opening to see how much changes in those few years. They don’t need you. I mean they need you, but not in that every second of the day baby/toddler/preschooler kind of way. Our girls immediately took off with her big girls and we only saw them for brief moments throughout the day. They painted their fingernails, learned to make lip gloss from YouTube videos, watched movies, and whined-cried-fought all of zero seconds! We relaxed, they relaxed, and we all slowed down.

We returned home a few days ago and today I feel like I just experienced my first real Sunday since we had kids. We did YOGA. Seriously people my husband and I, with the intermittent company of our daughters, actually did yoga in our living room. It took about 1 minute of yoga for me to pull a muscle but still… we did yoga! We then hung out until the late hour of 10:30AM and had a relaxing brunch with the aunties and grandmas, took a brief walk, and then came home to do almost nothing. I actually dug out the rubberband bracelet kit that Santa had brought my eldest and we made bracelets. I realize it is nowhere near Christmas anymore but we just hadn’t made the time. Later they played in the dirt while my husband and I read the paper on the front porch, we listened to music, cooked dinner together, and only “accomplished” 1 load of laundry. For a checklist kind of girl I have to say it was a little unnerving, but fabulous.

Don’t get me wrong there were still the occasional grumpy mommy moments, but overall it was a slow pace, snuggly kind of day. It was filled with laughter, smiles, a ridiculous number of kisses and hugs, and more “I love you Mommy”’s than we typically get on our hyperactive Sundays supposedly-fun-days. I can’t promise that this will be our new normal, but as I spend more time as mommy and less time as Doctor Raja I hope we discover the beauty in slowing down. My kindergartner chose Someday by Alison McGhee as her bedtime story tonight. She knows that I can’t get through it without my voice cracking and the tears flowing. I think she knew how special today was too.

Guide to Baby’s First Year- Updated and Expanded!

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*CONTENT UPDATED AND EXPANDED IN MARCH 2014*

  • Breastfeeding section expanded to include tips for successful breastfeeding, hand expression of breast milk, and more!
  • Added glossary terms

If you purchased the book and want to receive free updated versions please go to your Amazon account > Manage Your Kindle and sign up for automatic book updates. This works for the Kindle app on an ereader or computer.

Dr.Raja Live on the Dave Congalton Show

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Natasha Raja, MD on the Dave Congalton ShowIn case you missed the live broadcast, my interview on the Dave Congalton Show is now available as a podcast. You can listen here (my interview starts 37 minutes into the broadcast).

Dave and I discussed my background and reasons for choosing a career as a pediatrician as well as my book, Parenting MD: Guide to Baby’s First Year. We also talked about why the first year of your baby’s life is so challenging, and we ended with a heated discussion on vaccines. It was a lot of fun and I hope you enjoy listening. Please comment below if you would like to continue the conversation.

Thank you Dave Congalton and KVEC for having me on your show!

5 Things You Need to Know About the New Car Seat Laws

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csl-5step-test-graphic-w-textThere has been a lot of buzz lately about new car seat laws in 2014. This is what you need to know:

1- There is no new law in place right now. There is a proposed law that car manufacturers and car seat makers get on the same page; what we want is consistency. Your child’s car seat may allow your child to be in the car seat until 65 pounds, but your child’s weight plus the weight of his car seat weight may exceed the LATCH system’s weight limit (often 65 pounds or less). In this case, the LATCH may not hold the seat in place if there is an accident.

2- If your child plus his car seat exceeds the safe weight limit for your car’s LATCH you can still secure the car seat with a seat belt. There is no maximum weight limit for the seat belt to secure a car seat.

3- You should always use the top tether on your child’s car seat. There is currently no weight limit for the top tether, and we know they significantly reduce the risk of head injuries if you are in an accident.

4- You should still have your infant or toddler in a rear-facing car seat until she is at least 2  years old or she exceeds the height and weight limit for your particular seat. Rear-facing is so much safer that we just changed our daughter’s car seat to forward-facing at 3 ½ years old!

5- Your child should switch to a booster seat after he exceeds the safe height and weight for your forward-facing seat (typically over 4 years old and over 40 pounds). The AAP still recommends that he remain in a booster until he is 8-12 years old and 4 feet 9 inches tall.

For more information and max weight limits for your vehicle go to Car Seats for the Littles and the Car Seat Lady