Nicole Keller, D.O.

Happy New Year everyone! I know we are well into 2015, but, I am still feeling the aftershocks of the holiday season. Boy can all those holiday gatherings impact your life! I don’t know about you all, but my little guy (who is now just over 4 months old) had a hard time sleeping after all the excitement and my husband and I are still recovering from the sugar overload induced by every type of bread, cheese and candy we consumed over the last month or so. As we try to return to our everyday schedule we are also trying to remind our bodies (and our minds) what healthy eating is. So for this blog post, I want to talk about an important part of a healthy diet that often goes overlooked…your drinks!

The Illinois Chapter for the American Academy of Pediatrics (ICAAP) has recently launched a campaign to “Rethink your Drink.” Here’s what ICAAP is recommending (and what I would have to agree with!):

• “Red light” drinks – drink RARELY: regular soda, energy/sports drinks, sweetened coffee/tea, fruit drinks
• “Yellow light” drinks – drink OCCASIONALLY : diet soda, low-calorie/low-sugar drinks, 100% juice
• “Green light” drinks – drink PLENTY: water, seltzer water, skim or 1% milk

This got me thinking about how much my liquid consumption is part of my diet – and a part of all my patient’s diets! Fluids are one of the best ways to keep your body hydrated and healthy if you are choosing the right ones. In our grocery stores today, the juice and pop aisles take up a huge amount of space which points to how much we consume these items as a society. While juice and pop may seem like a good option to drink (they are fizzy, fruity and sweet of course!), they are some of the most common culprits for a lot of medical problems. Obesity, dental cavities, diabetes and other medical conditions can be brought on or worsened by what we drink.

Here are some tips to make sure your kids and your family are on the right track for choosing healthy drinks throughout the year:

• Water should be the primary drink you and your kids consume. You can offer water to infants starting at six months of age (in a bottle or preferably a sippy cup). Water should be available at all times of the day.
• Pop and juice should be reserved for special occasions. Holidays, birthdays, or other family celebrations (for example) should really be the only time these are offered to your kids.
• When offering juice, water it down. Cut the juice in half with water to make it less sugary.
• When you choose a juice, look for the 100% fruit juice label. This is still a very sugary drink and still should only be offered on occasion, but, if you are going to give it, this option would be best.
• Offer water or milk only with each meal. Remember infants one to two years old should be on whole milk (the extra fat helps their brain development) but milk in general should be limited to no more than 24 ounces in a day.
• Stay away from sports drinks. While those drinks are great for athletes who are exerting lots of energy during practices and games, they are not meant to be used on a regular basis. There are way too many carbs and sugars for frequent consumption.
• If you follow these guidelines you can easily make sure the beverage portion of your family’s healthy diet stays on track. As always, let your pediatrician know if you have any questions about healthy eating and drinking – we are always here to help!

Vrinda Kumar, M.D.

One thing I have humbly realized in the past two years and 10 months of being a parent, is that medical school and a pediatric residency do NOT fully prepare you for the role of “mommy.” It turns out most babies/kids don’t read the same textbooks we read (imagine that). I never thought I would break so many of my own rules. I also thought I knew what to expect in those first few weeks and months of motherhood. Holy moly, was I wrong about that!

Now that I am expecting my second baby, you would think I feel more prepared. In some ways, I do (I have all my baby supplies already!) but in other ways, I’m more uncertain about things than I was the first time! I am currently six months pregnant and things are already so different, probably because unlike the first time around, when I could rest and sleep, I am now also running around after a rambunctious toddler!

Things I understand and will hopefully be more relaxed about this time around: the lack of sleep, my lack of personal time – to watch my reality shows and get caught up on celebrity gossip ;-), the farewell of my pre-pregnancy body (yikes, this one was tough…hello stretch marks!), and the woes of breastfeeding (I experienced good things with breastfeeding, too, but it was the nursing difficulties that threw me for a loop and had me an emotional wreck the first few postpartum weeks), and the fact that colic, well, it really is just as awful as everyone says it is. I survived being the mom of a newborn once and I can do it again!

Things that I am nervous about: feeling overwhelmed (because I already feel like one kid is keeping me REALLY busy), feeling like I am not spending enough time with one child (this is definitely going to happen, but I think it’s healthy for kids to realize they are not the only person in your universe), the birthing process (because births are like fingerprints…no two are ever exactly the same) but my biggest worry right now is how my little soon to be three-year-old will adjust to having a sibling!

I am expecting some “acting out,” some jealousy, and possibly some regression but in reality, I don’t think I can really anticipate how things will actually go. I have been keeping a running list of suggestions experienced moms have given me to make the transition easier for my little one, my husband and for me too! Below are some of these suggestions (I think these are all great ideas!):

• Tell big-sibling-to-be that the baby will be bringing a gift.  This gives them something to look forward to when the baby comes. Also, after baby first arrives, they are going to feel like he/she is “taking” a lot from them, so it will be nice to feel like baby is also “giving” something.
• Keep several wrapped small gifts aside at home for your older child. When visitors come with a gift only for the baby and not something for older sibling, you can pull one of these gifts out to give to the older child so he/she do not feel left out or jealous.
• Take several minutes aside per day that you can do something with your older child, just the two of you.
• Take your older child for an outing, just the two of you, once a week (ice cream, anyone?)
• Have the older sibling participate in the baby’s care. Older siblings love feeling like they are helping.
• Give the sibling-to-be a doll to carry around BEFORE the real baby comes along. This way, they feel like they also “have a baby” and are sharing the experience with you.

I will certainly be doing all these things when the baby arrives. Thanks to the contributors of the above suggestions, and if anyone else has any great suggestions on how to make the transition from one child to two children easier, please share! I will write a follow-up post a few months after baby #2 comes to let you know how it all goes. Wish me luck!

A diagnosis that we make a lot during the winter months is Bronchiolitis. Bronchiolitis is an infection or inflammation of the smaller airways in our lungs, called bronchioles.  It usually caused by a virus.  Any virus can cause bronchiolitis, but the most common is RSV.  Bronchiolitis occurs in the Northern Illinois area between November and April and is a disease of children ages two years or younger.  

Symptoms include wheezing, a coarse cough that can sound like rice krispies crackling in milk, vomiting after coughing hard, fever, stuffy and/or runny nose, nostrils flaring, decreased appetite and pulling in of the skin of the chest or stomach while breathing (retractions).  Usually, it starts like a cold and then goes to the chest.

Treatment may be as simple as suctioning the nose/mouth frequently and using a humidifier.  Some children need nebulizer treatments, using albuterol with or without a steroid, to help open up their airways.  Other children need admission to the hospital, because they need oxygen or they are becoming dehydrated (due to difficulty eating and drinking). 

Prevention includes good hand hygiene and limiting exposure to large groups of people who may be sick.  Some preemie babies can receive a shot to help prevent RSV infection.  This shot is given monthly throughout the RSV season.  Call your doctor if your child is struggling to breathe, breathing rapidly, taking shallow breaths, looks dusky around the mouth, etc.  Breathe easy this winter!

The Christmas season is here, and that can mean a lot of toys under the tree.  Here are 10 tips from the American Academy of Pediatrics to help you choose safe and appropriate toys for your child.

Eva Alessia, D.O.

Read the label.  Warning labels give important information about how to use a toy and what ages the toy is safe for.  Be sure to show your child how to use the toy the right way.

Think LARGE.  Make sure all toys and parts are larger than your child’s mouth to prevent choking.

Avoid toys that shoot objects into the air.  They can cause serious eye injuries or choking.

Avoid toys that are loud to prevent damage to your child’s hearing.

Look for stuffed toys that are well made.  Make sure all the parts are on tight and seams and edges are secure. It should also be machine washable.  Take off any loose ribbons or strings to avoid strangulation.  Avoid toys that have small bean-like pellets or stuffing that can cause choking or suffocation if swallowed.

Buy plastic toys that are sturdy. Toys made from thin plastic may break easily.

Avoid toys with toxic materials that could cause poisoning. Make sure the label says “nontoxic.”

Avoid hobby kits and chemistry sets for any child younger than 12 years.  They can cause fires or explosions and may contain dangerous chemicals.  Make sure your older child knows how to safely handle these kinds of toys.

Electric toys should be “UL Approved.”  Check the label to be sure.

Be careful when buying crib toys. Strings or wires that hang in a crib should be kept short to avoid strangulation.  Crib toys should be removed as soon as your child can push up on his hands and knees

Here are some additional resources to check out regarding toy safety.

Happy Holidays!

Consumer Product Safety Commission

HealthyChildren.org

Consumer Product Safety Commission Recalls

I’m back! Maternity leave is over (so sad!) and I am back in the pediatrician saddle, so to speak. It was really hard leaving my little guy for the first few days but it is getting better every day. As a new mom I have been faced with all the struggles of lack of sleep, endless physical demands of a newborn, and learning how to be “me” in a whole new way. Most of my challenges now don’t come from what I’m going to wear to work or eat for dinner but rather how I’m going to keep my son, Leo, happy and healthy. With that said, I want to talk about car seat safety today as a sometimes overlooked area of your child’s well being.

Nicole Keller, D.O.

Let me start with a story. At first Leo loved being in the car seat – or so it seemed. He would easily doze off until we arrived at our destination and not make a peep. That didn’t last long. He now will get in the car seat, be content for a short time, and then…panic. If we don’t keep the car moving, he tells us! Every stop sign or red light his eyes flash open and the whimpers (and sometimes flat out screams) begin. I was picking up a prescription at the drive-thru one day and had to wait for about 15 minutes and he screamed the entire time!! It was awful! As a parent, I want to do everything possible to not hear my baby cry. So when he started disliking his car seat, my husband and I would wait until the last minute before we tightened the car seat straps in the hope that Leo would stay content as long as possible. We thought if we kept the straps loose, he wouldn’t feel restricted and therefore stay happy.

While our intent was good, one time we forgot to tighten him and didn’t realize it until we were already on the road. Yikes! We pulled over right away and tightened those straps up but boy did that event strike fear in me – much more fear than his crying could ever scare me. What if we had gotten in a collision? Would he have been OK? Would he have stayed in his car seat? How could I ever forgive myself if he had gotten hurt just because we didn’t want to hear him cry?! I tell you this for a couple reasons; first, because I want you to know that we all make mistakes.  Secondly, because I don’t want you to make the same mistake!

Car seats are incredible items that help us run around town with our little bundles of joy as safely as possible. They are meant to be used in very specific ways to ensure safety. Here are some tips for you to remember to keep your little ones safe when in the car:

– Straps should be snug, straight and flat.

– The harness chest clip should be located at armpit level.

– Keep your child rear-facing as long as possible! The AAP recommends until at least two years of age to maximize safety.

– Know your car seats limits. Each car seat has certain weight and height restrictions that should be followed strictly.

– No bulky winter jackets under car seat straps! When kids wear winter jackets/suits under their car seat straps it is almost impossible to get them secure and tight in their seats. Keep them in a warm but thin clothing layer and then cover with blankets as needed to keep them toasty.

– Get your car seat checked out by a professional:  Visit http://cert.safekids.org/ or www.nhtsa.dot.gov or call the DOT Vehicle Safety Hotline at 888-327-4236 to find a professional car seat examiner near you. Many local fire/police stations have trained professionals ready to help you.

– Keep your kids in the back seat until at least 12 years old.

These are just a few quick tips to keep your kids safe. Visit www.nhtsa.dot.gov for more info on keeping your children as safe as possible when riding in a car. Please, buckle up and have a safe, happy and healthy holiday season!