Megan Muscia, D.O.

One of the most common questions I get asked about as a pediatrician is infant sleep. Infant and childhood sleep is a huge topic and there are lots of books about it. I am going to focus on just one aspect of sleep though — getting your baby to sleep in their crib or bassinet. I am by no means a sleep guru, but I hope some of these tips will help many of you and your baby get a better night sleep.

“My two-week old will fall asleep in by arms, but as soon as I put him down in the crib he wakes up!”

First, let me say this is so common in the newborn and infant period. If you are experiencing this, you are not alone! As a pediatrician I know this is hard for any parent, but it is extremely important topic for me. When babies don’t sleep in their own beds, it may lead to unsafe sleep practices such as co-sleeping. Even if only by accident, holding your child to get them to sleep and being a sleep deprived mom or dad can lead to accidents if you fall asleep while holding your child. For all of these reasons, I really encourage you to continue to work on getting your child to sleep in their own crib or bassinet. We know it is the safest place for your baby to sleep.

1) Try “swaddling” him—wrapping him snuggly in a blanket—which can be very soothing. Lots of parents tell me their baby doesn’t like to be swaddled because they want their hands out. You can swaddle with the hands up to allow your baby to be able to get to their hands to suck on them. Being wrapped still gives the baby that warm secure feeling they felt in the womb.

2) Stay with him and rock him, sing, or stroke his face or hand until he settles down. At this age babies can’t soothe themselves, so they still depend on us.

3) Put your baby down drowsy but not fully asleep and then use some of the methods above while keeping your hand on them and “shush” them can help them transition into sleep.

4) Spend time in your baby’s room so they are familiar with their surroundings. Play and read in their room.

5) Start with putting your baby in their crib or bassinet at nap time, then continue to work toward night time. Nighttime sleep is often the more difficult transition. Making these changes in small increments, while making these transitions warm and nurturing experiences, will help your baby learn to connect her room with cozy, safe feelings.

6) If you are transitioning from bassinet to crib, move the bassinet into the bedroom first and try a few nights in with the bassinet in the room before then moving your baby to the crib.

7) Start a nighttime routine. Its never too early to start a nightly routine, bath, dim lights, reading to your baby, snuggle time. This night time routine can calm your baby and prepare them for sleep.

Most of all, it takes time for babies to learn to fall asleep on their own. Helping your child start to soothe themselves during the daytime will help him calm himself at night when you put him down. So, be patient, seek out help when you need it, and remember that these early days and months don’t last forever. I think as with any advice I give parents, consistency is key! Keep working on it, little by little, it will work.

For more information regarding infant and childhood sleep challenges, please see the Zero to Three website.

Eva Alessia, D.O.

Kids get rashes all the time. Some rashes can be tricky to figure out; some are straightforward. Roseola is one of those rashes.

Roseola is caused by a virus. It generally happens in children less than two years of age, but the range is six months to three years of age. The child has a fever for three to five days. After the fever breaks (which happens rapidly), the rash appears within 24 hours.

The rash is pink in color, consisting of flat or bumpy lesions, mainly on the chest, stomach and back. During the fever, the child is acting fine and besides possibly having “puffy/swollen” eyes, is otherwise not sick in any other way.

The rash lasts about one to two days. It is contagious until the rash is gone. Most older children and adults are immune.

Learn more about Roseola at http://kidshealth.org.

Nicole Keller, D.O.

Today I’m going to discuss a topic for tweens and teens, especially the athletes. Being active and involved in sports is a great way to stay healthy. But sometimes, the stress to do well in sports can encourage teens, coaches and parents to turn to supplements to optimize performance. Supplements can be part of a healthy, active lifestyle…but they have to be used in the right way. In this blog I have teamed with our sports medicine physician, Dr. Deepak Patel, to give you the background info on more commonly used supplements so you can decide what is best for your child.

Deepak Patel, M.D. is a board-certified family medicine and sports medicine physician with Rush-Copley Medical Group. He has convenient office locations in Aurora and Yorkville.

Protein supplements: Protein is taken by athletes to help enhance speed and strength and to increase muscle mass. Even so, research studies have shown that protein supplementation in general has not been shown to be of any benefit in regards to athletic performance. In addition to these findings, the majority of our everyday diets provide sufficient amount of protein for normal healthy children and adults without the need for extra supplementation regardless. This would also include athletes. Restrictive diets such as vegan or vegetarian may require some slight protein supplementation but only under certain circumstances. In athletes who are vegetarian or vegan and wish to gain muscle mass, Dr. Patel encourages consuming a plant based or some other dietary protein rather than a supplement. Protein intake just after weight lifting may aid in some slight increase muscle mass, but, that is a small benefit. Considering this, Dr. Patel typically encourages athletes who are not wishing to gain mass to avoid taking extra protein supplements especially shortly after strengthening workouts. Beyond the lack of benefit from these supplements, many protein supplements available contain added chemicals and nutrients, for which the safety and long-term effects may not be known. In regards to excessive protein intake, you can cause harm as well. For example, excessive amounts of protein can affect kidney function. Taking all of this into account, both Dr. Patel and I would encourage everyone to only take protein supplements with caution and under supervision (of a doctor or other health professional) and only if absolutely needed.

Creatine supplements: This is a common supplement taken by athletes and weight-lifters. It has been shown to produce a slight benefit in rapid short duration movements such as power lifting. Therefore for endurance athletes, such as runners, swimmers or soccer players, it is of little value. It has also been thought to increase muscle size and muscle gains for with weight lifting. Studies have shown that most of the weight gain is likely related to water weight than true muscle mass gained. In younger athletes there have been a few cases reported of muscle tears and ruptures which have been linked to creatine use. Once again, the risks of this supplement may outweigh the benefits in most athletes. Because of this, Dr. Patel and I would encourage you to use creatine with caution and to have it be taken only in specific athletes with a focused benefit in mind.

Supplemental vitamins and minerals: Many parents ask about taking a multi-vitamin or a specific vitamin in supplemental quantities. As mentioned when discussing protein, the typical American diet does offer us most of the vitamins and minerals that our bodies need to function properly. Eating a healthy, well-balance diet is the best way to assure you are getting enough of these micronutrients as well. New studies are starting to come out saying that many of us are over-doing vitamins, too. For the most part, if you get too much of a certain vitamin or mineral, your body will get rid of it (usually in urine). But, you can get too much of a good thing. With this in mind, I would recommend talking to your health care professional before starting a regimen of vitamins or minerals for your child. Calcium and vitamin D are both vitamins that typically are safe and healthy to take extra of, but, not every supplemental vitamin is this way. This also goes for the more natural supplements like ginseng and glucosamine. Many of these supplements are poorly studied and not as closely regulated which also questions their safety for everyday use.

If you or your child hear about a supplement that you think may be of benefit to them, come talk to us! We’d love to help your family stay healthy and educate you on the best vitamins, minerals, and supplements that may be good for you. Remember, a healthy balanced diet with five servings of fruits and vegetables each day is one of the best ways to give your body what it needs – without any need for additional pills or powders! I hope this helped clear some things up – thanks for reading!

Vrinda Kumar, M.D

Some of you may remember that I posted a blog entry when I was six months pregnant with my second child. I had expressed my anxieties and excitement about having another baby when my older daughter was three years old. Well, now the baby is seven months old, and it’s hard to believe that a year has flown by! I promised to post an update on life with two kids, so here it is.

Well, let me say the transition was hard, but easier than anticipated. My three year old immediately took to “her baby” and wanted to snuggle and kiss her IMMEDIATELY. When we brought the baby home from the hospital, we gave our toddler a “gift from baby sister.” That way, she didn’t feel left out when the baby was receiving gifts. It is natural to be so busy with the baby (especially for me, since I am breastfeeding), so it really does take a solid, conscious effort to make sure we are giving our older daughter the attention she needs. I try to make sure I set aside time when she and I can do things together, just the two of us. My husband does the same. We also allow our toddler to help us take care of the baby. She wants to help and allowing her to do so makes her feel included.

I do sometimes feel because we are sleep deprived and still in “baby mode,” our fatigues and frustrations sometimes become directed towards our often stubborn three year old during her whiny moments or momentous meltdowns. During these times, I’ve realized I have to stop and take a deep breath so I don’t get short and snappy with her (when you are tired and busy, it’s easy to get that way!) I have to realize that much of her behavior is NORMAL for a three year old, especially for one that is trying to get her parents’ attention when they are focused on a new baby. When she is “misbehaving” or having a tantrum, I either ignore her and walk away from her (as long as she is safe!) because I do not want to perpetuate that kind of behavior by giving it attention, and  I have to remember to be sweet in my words because she is not actually doing anything deserving of punishment but rather just trying to play and interact with her mommy.

The baby LOVES her older sister, and follows her with her gaze everywhere she goes. We let them be physically affectionate as much as possible because it’s good for both of them. Sometimes, we have to remind our daughter than her baby sister is a baby and she needs to be GENTLE (i.e., “don’t pinch her cheeks and squeeze her too hard”) but if that’s our biggest concern, I think we have it pretty good. I’m just enjoying this time before they start bickering with each other!

The logistics of having a baby and toddler is hard if it’s just one person at home (and that one person is also breastfeeding) but it has been manageable. It’s important to remember that if one child needs something urgently, it’s okay to let the other one cry a little (again, as long as they are in a safe place). Crying never hurt anyone. But when there are two of us at home, it’s basically one on one defense, especially during dinner and bed time.

One thing that I have found to be much harder after having a second baby is finding time to spend with my husband. We rarely spend any quality time during the week (we are both working and tired), but we do make an effort to go on a date night one to two times a month. Sometimes I think we are so focused on being such a great parent, that we sometimes neglect being a great partner to our spouses…marriage and parenthood is hard work! But it’s also the most rewarding and joyous gift in life! Even though life with two small kids is busy and tiring, one thing I think we should all remember is sometimes we have to stop, take a deep breath, look around, and really appreciate the joys in our life…including our beautiful, amazing children.

Nicole Keller, D.O.

Recently I’ve had a lot of families come to the office with sleep woes. Whether it is the six-month old who is still waking up every 2 to 3 hours, the nine-month old with sleep regression, or the toddler who doesn’t want to stay asleep, all of these situations can run a family ragged! I myself didn’t get a full night’s sleep until my son was 10- months old (and that was just until 3 to 4 a.m.!) and didn’t sleep until past 4 a.m. until he was 14-months old. So, I have full appreciation for how hard it is when your child isn’t sleeping. Some kids are just not good sleepers to start – but that doesn’t mean that they (or you) won’t ever get good sleep! Beyond this, there is no “one size fits all” for sleep – every family and household is different. If you ask me, getting good sleep is finding a set of healthy and safe routines that works in YOUR house for YOUR family and YOUR schedule. Below are some tips and tricks that hopefully you can make work for your unique child and family.

1. Get a good routine. This is key! By keeping a consistent routine, your child will start to associate the SAME book, the SAME sounds, the SAME lullaby, (etc) with sleep. This can take time, so, don’t get discouraged. Make sure you put them to bed at roughly the same time of day each night as well. Good bed times to shoot for are: 0-2 months: 8-9 p.m., 3-6 months: 7-8 p.m., 7-12 months: 6:30-8 p.m., older than 1 year: 7-8 p.m. This routine will serve you well when life gets hectic too. For example when you are on vacation, when your child is sick, or at hectic times of the year. Your kids will already be programmed to be ready for sleep no matter their location, illness, or busy day. My son’s sleep routine goes as follows (feel free to use this if it works for you!): 5:30 p.m. dinner, 6:30 p.m. bath and brush teeth, 7 p.m. read same 3 to 4 books, turn on his fan, say goodnight and turn off lights together, “I love you” and down in his crib (by 7:15ish) with his horsey thumbie blanket. He’s so used to this that once we are getting towards the end of the last books he is pointing to his crib. He even puts his arms out to hold his thumbie blanket after being put down – it is so sweet! *Of note, no stuffed toys, blankets or pillows should be in your child’s bed until they are 9 to 15 months old. Safe sleep first!*
2. Put your child down drowsy, but awake. This is a hard rule to follow. Let me explain why this is important. If you put your little one down asleep (after nursing, bottle, rocking, etc), they learn to need you to fall asleep. If they are put down awake (but drowsy), they then teach themselves to fall asleep on their own. Sometimes this involves a little crying (which is really hard to hear!), but, try to think of it as you teaching them to learn to fall asleep. You don’t ever have to let your child cry it out, but, I do feel that sometimes those short periods of crying are helpful in giving your child the opportunity to figure things out for themselves. In addition, try to not have feeding be the last thing you do before putting your child down. Rearrange the bedtime routine to have feeding be at the beginning followed by bath, book, then bed. This way they don’t associate needing a bottle or nursing with bedtime – it will really help you wean off bottles and nursing when the time comes!
3. Keep visits during middle of the night wakings non-existent or as short as possible. Kids are smart. They know if they cry for mommy, mommy will come. They then expect this. If they get fed, their body learns to be hungry. Considering this, try to keep the middle of the night visits short and boring. After four months old, babies can self soothe. You can allow them to fuss/whine/cry in their crib for a little to see if they’ll fall asleep on their own. If you have to go to them, try to keep them in their crib, offer a short pat on the back and be gone within a minute. If you are already feeding them when they wake up, wean that slowly – one minute at a time every 3 to 5 days. That way you know hunger isn’t the reason they are waking. Most of these middle of the night waking are behavioral – a bad habit really. It’s no one’s fault that they began, but, you can work to slowly eliminate them to help you and your little one get more restful sleep at night. Plus, the older they get, the harder it is to stop these frequent night time disturbances.

These tips are brief but I feel are the most important when trying to get sleep back on track in your household. There will always be good nights and “less good” nights too…but hopefully by getting some good habits in place you’ll be able to get more good nights on a regular basis. If you need more help, you can always look to a sleep book, sleep consultants, or of course your pediatrician. There are lots of different ways to work sleep – you just need to find what works for you! Many times it is a blending of several sleep styles and recommendations.

Here are some of the references I found helpful and I hope that help you too:

Healthy Sleep Habits, Happy Child (By Dr. Marc Weissbluth)

The Happiest Baby: Guide to Great Sleep (By Dr. Harvey Karp)

The Sleep Sense Program (online program by Dana Obleman)

I wish you all lots of zzz’s! Cheers! Thanks for reading!