Parents must be sure that their child’s car seat is being used correctly…we all have precious cargo!
I read an study recently in the Journal of Pediatrics which really shocked me.
A total of 291 families (81% of those eligible) participated. Nearly all (95%) CSSs were misused, with 1 or more errors in positioning (86%) and/or installation (77%). Serious CSS misuse occurred for 91% of all infants. Frequent misuses included harness and chest clip errors, incorrect recline angle, and seat belt/lower anchor use errors. https://www.jpeds.com/article/S0022-3476(15)01459-6/fulltext
95% had errors in car seat installation of positioning! That is such a scary thought since car accidents are the leading cause of death for children. But to be honest, car seats are not easy to install correctly! The manuals are long and sometimes confusing, there are different recommendations by auto manufacturers, and I know the installation of a car seat has caused many an argument between Moms and Dads!
The newest recommendations from the American Academy of Pediatrics state that until at least age 2 your child should sit in a rear facing seat and preferably a child should be rear facing until they reach the highest weight or height allowed by the car seat manufacturer (that means your child most likely will be older than age 2 and still rear facing). Children over the age of 2 may sit in a front facing seat with a 5 point harness until their weight and height exceeds the car seat’s recommendation for the seat. A booster seat should be used until a child is 57 inches tall, which is the average height of an 11-year-old (wow…bet you didn’t realize that!) No child should sit in the front seat until age 13! www.healthychildren.org
Types of car seats:
- Rear facing only
This seat is used for infants up to 22 to 40 pounds depending on the seat. They are small and have handles to carry the seat. Some have a base that can be left in the car.
- Convertible seats that can be used for rear facing
These seats can be used rear facing and then “converted” to forward facing when your child is older. They are bigger than infant seats and do not have handles or a separate base. They often have a higher rear facing weight and height limits which is great for larger babies. They should have a 5 point harness.
- 3 in 1 seats
These seats can be used rear facing, forward facing and as a booster. They may be used longer by your child. (But remember every seat has an expiration date…about 5-6 years)
Installation for rear facing
- The shoulder straps should be at or below your baby’s shoulders.
- The straps should be snug (you shouldn’t be able to pinch any slack) and the chest clip should be at the nipple line.
- The seat should be tight in the car. You should not be able to move it more than an inch side to side or front to back.
- Never put a rear facing seat in the front seat of a car!
- Make sure the seat is at the correct angle so your baby’s head does not flop down. Many seats have an angle indicator or adjusters that can help with this.
- I recommend having a certified car seat technician help install the car seat. This will help with the many questions parents have and may even prevent Mom and Dad from having an argument! 🙂 Check out this website for great information on car seats, car seat recommendations and locations of car seat technicians in your area. It is an excellent resource! http://www.nhtsa.gov/cps/cpsfitting/index.cfm
Common questions parents have about car seats:
Rear Facing Seats
- What if my child’s feet touch the back of the car seat?
No problem…your baby will cross his legs and find a comfortable position. There are few reports of leg injuries from a crash with a baby in this position, but a leg injury is a much less severe injury than a head and neck injury which you are helping to prevent by keeping your child backward facing until age 2 or older.
- What do I do if my baby is slouching in the seat?
You may put blanket rolls on both sides of your baby and a small cloth diaper or blanket between the crotch strap and your baby for a while until your baby grows a bit. Do not ever put padding or blankets or anything behind your baby or add any car seat insert unless it came with the seat or was made by the manufacturer of the car seat. Any additions to a seat may make it work a bit differently and provide less protection for your baby!
- What do I do about winter coats?
Remember that thick winter coats, blankets, or clothing should not be put under the car seat harness or straps. Dress your baby in thin layers and then tuck a blanket around your baby over the harness straps if necessary.
Installation of forward facing seats
- Always know the restrictions of your model. Know the maximum weight and height limits for your seat!
- The shoulder straps should be in the slots that are at or above your child’s shoulders. (This is the opposite from the rear facing position)
- You may need to adjust the angle of the seat when you turn it to forward facing, check your car seat manual.
- Choose to use the LATCH system if your car or van has it OR the seat belt. Do not use both. Check your car or van manual and your car seat manual for proper installation with the LATCH or seat belt. Latch does have a weight limit of 65 lbs total, meaning the weight of the car seat plus your child. If the car seat and your child together weighs over 65 lbs, then you must use the seat belt to secure the seat.
- Use a tether strap. This is a strap that attaches to the top of the seat. It is often on the seat back of the car or van. This gives extra protection by not allowing the car seat and your child’s head to move too far forward in a crash. All vehicles manufactured from 2000 on have them. Check the weight limit for the use of the tether anchor.
Common questions about forward facing car seats
- Where is the safest spot for the car seat in the back?
The safest spot is where the seat can be installed properly, it is convenient for you to use safely every time. Some LATCH systems are only on the sides of the back seat. Some car seats only fit well in the middle. It depends on your car seat, your vehicle and the number of children you have on where is best for the car seat!
- Should we use a car seat on a plane?
Most infant and convertible car seats can be used on planes. The seat must have a FAA (Federal Aviation Administration) approval label on it. The FAA and the AAP recommend that children use car seats when flying until age 4. This keeps your child safer during takeoff and landing and in turbulence.
So much information…but so important to keep your child safe. We will continue the conversation over the next few days with more tips. What car seat do you use? Why do you like it?
Take a breath, enjoy the joyful moments of each day, and remember you don’t have to be perfect to be the perfect parent.
So many questions over the last few days. How can we do better? How do we make things different for our children?
Children are not born harboring prejudice or knowing how to bully or how to hurt another physically or emotionally. These are behaviors that are unfortunately learned. About age 2, children will start to notice differences. Children will innocently ask “Why does he have brown skin?” “Why can’t she walk?” “Why does her hair look funny?” Questions like these can result in a parent shushing their child, saying that is not a nice thing to say and never talking about the questions.
The preschool years are a wonderful time to talk with your child about differences that often divide people…skin color, gender, physical challenges, culture, and religious beliefs. This is the perfect time to have true impact on your child’s understanding of what is different and what is similar in all human beings. The way you answer these very honest observations and questions your child has will provide the basis for your child’s decisions, behaviors, and development of core beliefs about people. Children learn…who YOU think is beautiful, who YOU think is smart, who YOU think is good, who YOU thing is bad, who YOU think is strong, who YOU think is weak, who YOU think is scary and who YOU think is not. Your response to your child’s natural curiousity about what is different will result in your child’s development in judgement of others.
Your child learns by what they hear, see and even perceive in your behavior. Children’s questions are not impolite, they are moments of learning opportunities. We must learn how to counter-act the everyday influences on your child that result in prejudice and bias. Parents must answer children with real-life age appropriate honesty.
- Don’t deny differences. Discuss differences openly. Be diverse in the books you read, the videos you watch. Choose wisely so that children see many different people in many different roles.
- Don’t ignore your child’s questions or become upset. Children are curious without any intent to be cruel; they are simply observing and then questioning. If you react embarrassed or don’t respond, you send the message that different is negative.
- Be proud of your family heritage and our country. Teach your child about their family history and our country’s history, celebrate different cultures, talk about leaders from all races, genders, and ethnicities. Embrace the diversity around them.
- Expand your child’s circle. Be sure that your child has the benefit of knowing people of different backgrounds, cultures and experiences. This allows your child to see how similar we of the human race are….not how different.
- Empower your child to do what is right. Root your child in moral values. By age 3 children begin to learn about empathy and feelings. By age 7 children know what is right and what is wrong. Embrace the opportunity to speak to your child about how they impact those around them, how they can make a person feel with a simple word or action.
We as parents have the ability to change the world by raising our children in a way that embraces the very differences that currently divide us.
Take a breath, enjoy the joyful moments of each day, and remember you don’t have to be perfect to be the perfect parent.
Vaccines do work! Don’t wait…vaccinate!
How Can a Parent Decide if Vaccines are Safe?
Every day parents are bombarded with information from doctors, nurses, TV hosts, books and the list goes on. Parents are best served by listening to a team of experts. We must trust the health care system that has given us the tools to prevent diseases that were so prevalent in children just a few years ago. Committees of expert scientists, clinicians and health care providers serve on the CDC (Center for Disease Control and Prevention), AAP (American Academy of Pediatrics), the Infectious Diseases Society of America and other groups. These experts look at scientific studies to see if they are performed carefully, are published in reputable journals and can be reproduced. Studies that do not meet these standards are not considered reliable. These groups have pulled vaccines in the past that have been determined to have unsafe side effects or side effects that outweigh the benefit of the vaccine. The groups have also repeatedly looked at studies regarding vaccines and asthma, diabetes, multiple sclerosis, SIDS and autism. No studies have shown a reliable causal relationship between vaccines and these illnesses. Be careful what you read…be sure it is reliable!
How vaccines work:
- A vaccine is usually given by a shot. At this time, there is one oral vaccine for rotavirus.
- The vaccine contains a dead or weakened germ that will NOT cause the disease.
- The body makes antibodies to fight the weak or dead germs in the vaccine.
- These antibodies practice on the weak germs so when the real strong disease germs, which are still out there, enter the child’s body the ready antibodies will know how to destroy them and the child will not become sick.
- Antibodies fight infectious diseases and usually stay in a person’s system even after the disease is gone to protect him or her from getting sick again–that is immunity.
- Newborn babies are immune to many diseases because they have antibodies from their mothers—this only lasts about a year. The timing of the vaccine schedule is such that a child will develop immunity to a disease before he or she is most vulnerable.
- Immunizations protect your child and the community—herd immunity. Herd immunity protects unborn children, the elderly whose immunity may have waned and babies that are not yet fully immunized.
- When you choose to immunize your child and follow the recommended guidelines, your child is protected from diseases that can cause death, disability, or severe illness and even though we don’t often see these diseases; they are still out there today!
What About Side Effects?
If your definition of safety is something that does not have any side effects–then a vaccine is not 100% safe. All vaccines have side effects, but most of them are very mild. This might include a fever, soreness, redness or swelling at the vaccine site, and fussiness. Some side effects are more severe, but these are much rarer. Some parents ask if it would be safer to avoid the vaccine and the possible side effects. This is a choice that also has side effects, ones that are much more serious. The risk of your child being infected with the disease the vaccine prevents is greater than the risk of the serious side effects.
I Never See These Diseases, Why Get a Vaccine?
Many of the diseases that vaccines prevent are common. Pertussis or whooping cough is a very common disease that if your child is not immunized against–they are very likely to become ill with the disease. This is a serious disease especially in infants and the elderly. Last year in the Indianapolis area, there were large pockets of whooping cough outbreaks in several schools.
Many of the diseases could become common again. H-flu diseases such as meningitis and measles mumps and rubella have all “popped up” in areas where the immunization rates have fallen. A measles outbreak in the Indianapolis area during the Super Bowl a few winters ago and a more recent outbreak beginning in Disneyland both demonstrated how contagious this disease is and how quickly the disease can spread among children and adults who are not fully immunized.
Some diseases such as polio and diphtheria have essentially been eliminated from this country, but still occur in other countries. We are a small world with many people traveling internationally; your child can be exposed to these diseases by traveling or by people who have entered this country.
Following the recommended immunization schedule is one of the best decisions you can make for your child’s health. Here is the most recent approved vaccine schedule. Don’t wait, vaccinate!
Take a breath, enjoy the joyful moments of each day, and remember you don’t have to be perfect to be the perfect parent.
This cute little smile cost us several thousand dollars later to straighten it out….but worth it!
There is nothing cuter than a toothless grin of a baby. Next the cute little pearly whites that erupt create a darling smile, then there is a toothless grin again as the tooth fairy starts to make visits to your home, and then soon your child will have two big front teeth that look way too big for their mouth. As your child grows, their dental needs change too. Why is dental health so important for children? Dental decay is the most common chronic childhood illness. There are at least 4 million preschoolers who have had at least one cavity. Forty to fifty percent of children will have cavities before the age of five. 51 million school hours are lost each year due to dental health problems. The American diet is high in sugar, and we are using more and more non-fluoridated bottled water for drinking. This all adds up to an increase in dental cavities, and a decrease in dental health of our children. Children with cavities in their primary or “baby” teeth have more problems with poor weight gain, iron deficiency, speech problems and poor dental health as adults. Taking care of our children’s teeth is part of good health care!
I. When do baby teeth form and erupt?
- The primary teeth or baby teeth begin to form before your baby is born at about the 14th 19th week of pregnancy. The crown, or the white part of the tooth that is seen, continues to develop until several weeks to several months after your child is born.
- Total of 20 baby teeth, 10 on top and 10 on the bottom by about age 3.
- The first tooth to appear usually is the lower central incisors (the bottom two teeth) around 6 months of age. Don’t panic if your baby’s first tooth isn’t the lower two teeth…some baby’s teeth erupt to the beat of their own drummer!
- Teething can be painful for infants. Babies explore their world with their mouths, and during teething this can be uncomfortable. There can be redness, swelling in the gums, drooling, increase in finger sucking, and the need to bite and chew on any object. Some babies will pull at ears or rub their jaw line, teething pain is often referred to the ear area.
- Sometimes parents will see a “blister” where the tooth is about to erupt, this is normal.
- Many babies like a clean teething ring, frozen wash cloth, frozen fruit in a mesh feeder, frozen bagel or mom’s fingers to rub the gums.
- You can give acetaminophen, or ibuprofen (after 6 months of age) to help with the pain. Ibuprofen is a bit more effective for inflammation of the gums, but wait until your baby is at least 6 months to use this!
- Do NOT place oral numbing ointments on your baby’s gums. These over the counter remedies contain benzocaine. These treatments have little or no benefit and can cause a serious and sometimes fatal decrease in oxygen carried in your child’s bloodstream. Benzocaine is an ingredient in common treatments like Orajel, Baby Orajel, Anbesol and Orabase.
- Do NOT use homeopathic teething tablets. The FDA found there was inconsistent amounts of the toxic substance belladonna in these teething tablets.
- Teething pain usually occurs for 3 to 4 days prior to the tooth breaking through the gum. Pain should decrease once the tooth breaks through the gum line. There may still be some discomfort for a few days after. It is not a month-long process unless your baby is cutting multiple teeth one after the other.
- Teething does NOT cause a fever, vomiting, diarrhea or cold symptoms. If your baby has any of these symptoms with teething, he or she is probably ill too.
- Teething can cause an increase in drooling which can lead to a rash or irritation around the mouth and on a baby’s chest. Keep the area dry by changing shirts frequently, using absorbent bibs, and “water proofing” the skin with ointments.
II. When is the first dental visit?
- The first dental visit should be after the first tooth and/or by age 1. It is important to have your child’s first teeth examined. Dental problems can begin early. Children with healthy teeth can eat better, develop better speech, and dental cavities can cause a permanent state of infection in your child.
- Usually the first visit is just a visual exam—usually on mom of dad’s lap. Going to the dentist is just like a well child exam at your child’s doctor. We want to be sure we support healthy teeth, not just see the dentist when there is a problem!
III. How do you care for the first teeth?
- Wipe your baby’s first teeth using a wash cloth or gauze or a soft bristled baby toothbrush. Ideally, your baby’s teeth should be wiped or brushed twice a day. Once in the morning and once before bed. The earlier your child becomes accustomed to wiping or brushing their teeth, the easier it will be.
- You can use a small smear (about the size of a grain of rice) of fluoride toothpaste on your child’s tooth or teeth until age 3 and then a pea size amount after age 3. Fluoride is important! It helps strengthen your child’s teeth and prevent decay.
- You should help your child brush teeth until at least age 6. Children are not coordinated enough to brush teeth well before that. Sometimes this will be a battle, but it is worth the battle. We want to form good dental hygiene habits early! Do what you have to do to get teeth brushed. Check out these tooth brushing songs published by the American Dental Association (ADA). https://www.mouthhealthy.org/en/kids-brushing-playlist
- Have your child sit on your lap facing out, or you sit on the floor and lean your child back into your lap to brush.
- Let your child brush after you brush. Use circular motions on the teeth and brush along the gum line.
- Use stickers, games, songs, whatever it takes to get the tooth brushing done. If your child cries, brush quickly…but at least the mouth will be open!
- Never put your baby to bed with a bottle of formula or breast milk. This will result in decay in your baby’s first teeth!
- Never put juice or any other sugared drink in a bottle. The American Academy of Pediatrics recommends NO juice in the first year of life and limited amounts of juice in older children.
- Do not allow your child to walk around with a sippy cup of juice or milk all day long. This will leave a continual coating of sugars on your child’s teeth.
- You can begin to floss your child’s teeth when they start to touch. Again, this is a good habit to start young!
- As your child begins to eat table food, try to avoid high sugar snacks. Sticky snacks are the worst. Fruit snacks, dried fruit like raisins and any other sticky food must be brushed out of your child’s teeth.
IV. When do I worry about thumb sucking, finger sucking and pacifiers?
- It is perfectly normal for infants and young children to need to suck. Sucking decreases stress in young children and makes for a happier child!
- It should be discouraged starting at about age 18 months. Parents should limit pacifier use to bedtime and nap time.
- All thumb sucking and pacifier use should be discouraged after age 3.
- Most children stop on their own, but some need help. Most will then quit with encouragement from the dentist and parents. Do not use negative reinforcement like hot sauce on a thumb, taping fingers, or putting mittens on your child.
- Prolonged sucking can create crowded, crooked teeth or bite problem. The fingers, thumb and pacifier all affect the teeth the same way.
VI. My child grinds his teeth, is this bad?
- Teeth grinding happens in many toddlers. The toddler’s molars are very smooth, and children will often grind.
- Most children outgrow the habit by about age 6.
- If teeth grinding continues after permanent teeth arrive, then speak with your child’s dentist.
VII. What should I do if my child injures his mouth and teeth?
- Be sure and ask your dentist when he or she would like to be contacted for a tooth injury.
- If a child knocks out a permanent tooth, keep it moist or drop it into cup of milk and call the dentist immediately or head to the ER.
- If a child is hit in the mouth–always call the dentist for an exam even if there is no obvious damage.
- If a child chips a tooth–call the dentist even if there is no sensitivity.
- Your child should use a mouth guard for sporting activities!
Start good dental habits early…find your child a dental office home where both you and your child are comfortable. Dental care should not be scary but just a part of good health. Take care of your child’s smile, it is one of the most beautiful things a parent sees!
Image courtesy of American Dental Association
I can remember that feeling of excitement when I first saw the top of a little tooth poking through our oldest child’s gum….I must admit I remember the shock the first time I felt that tooth when I was nursing too!
(Remember, children can bite only if latched incorrectly, and that is usually when they are “playing” at the end of a nursing. Put your child down and say, “that hurts!” If you put your baby down every time he or she bites or you break the nursing latch when you realize your baby is no longer sucking to eat…there will be no problems. Just because your baby is teething or has teeth is not a reason in itself to wean from the breast!)
We have always known that care of those cute little teeth was important, but the recommendations in fluoride usage has changed over the years. How we care for our child’s teeth will affect his or her health. Those baby teeth ARE important! Dental decay is an active infection in a mouth…and we want to protect those little pearly whites for the best smiles now and down the road!
Dental decay is the most common chronic disease of childhood! 24 percent of children in the U. S. have a cavity before age four! 53 percent by age 8 and 56 percent by age 15. There has been a significant increase of dental decay in children in the 2-4 year old age group. So, what are parents supposed to do to protect our little ones’ precious smiles? There is a plan! http://pediatrics.aappublications.org/content/early/2014/11/18/peds.2014-2984.full.pdf+html
- Brush with fluoridated toothpaste at the first sign of a tooth. (Yes you heard me correctly…that is a big change from several years ago. Past recommendation was to use “baby toothpaste” without fluoride until age 2!) Starting to brush teeth from moment one teaches a lifelong habit for your child. At a minimum, the recommendation is to brush twice daily, morning and night. The most important brushing is the nighttime one before bed. Parents should use a very small amount of fluoridated toothpaste (the size of a grain of rice) until age 3. (see picture above) After age 3, children and adults should use about a pea size amount of toothpaste. Parents should supervise tooth brushing until about age 8 when most children are proficient. It is not important to worry about what direction to brush on the tooth….just that all sides of the tooth and the gum line are brushed.
- Drink tap water! Many of us have become a bit of “water snobs” drinking only a certain brand of bottled water! Most bottled water does not have fluoride. Fluoridated water has been proven to prevent dental decay in children and adults! So fill up your child’s straw cup and get a glass for yourself too!
- Monitor sugar and sticky foods. We know that tooth decay increases when there is sugar on teeth for long periods of time. Children who drink sugared drinks (this includes juice!), sleep with bottles, or use a sippy cup with milk or juice in it all day are more prone to decay. Keep water in your child’s cup except at meals and stay away from a lot of sugared or sticky foods and treats.
- Prevent bacteria in the mouth. Tooth decay is caused by a bacteria called streptococcus mutans. Parents who have a history of poor dental health (lots of cavities) should be very cautious about sharing cups and cleaning those pacifiers in their own mouths! Transfer of that bacteria early on increases your child’s risk of early dental decay. Most importantly, parents should be sure that their own dental health is good…having active decay that is untreated increases the streptococcus mutans in your mouth increasing the likelihood your child’s mouth will colonize with it too. We want to be sure that the snuggles and kisses you give your child does not transfer bad bacteria…because those kisses are a necessity!!
- Find a dental home for your child. Your child should have a dental visit by age 1. Dentists are an important part of your child’s health care just like your child’s doctor! Make every 6 month visits to your child’s dentist to promote good dental health. If your child sees the dentist for preventative care, there may never be a need to develop a fear…there will be no cavities!
- Ask about fluoride varnish. Fluoride varnish is a sticky resin of highly concentrated fluoride. Your child can have two or more applications per year and it is very effective in preventing dental decay. Some pediatricians are applying this at well child visits, and often dentists are using this instead of the fluoride rinse or gel of the past. A child can eat right away after this application and it actually will stay on the teeth for a longer time and can help restore early decay.
So those are some of the best tips to prevent decay in your child’s teeth. The habits we form early in our child’s life will have long -lasting effects on their dental health and smiles in the future. Keep your child’s sweet smile bright!