It's a question I'm often asked by parents in my practice: does my baby need to be on a schedule?
And as with so much in medicine and parenting, the answer is a resounding...maybe.
Babies do have and need schedules of sorts. They need to eat regularly (usually around every 2-4 hours, depending on whether they are breast-or formula-fed) and sleep (around 16-18 hours a day sometimes). In between and around those, they need diaper changes. And when they are awake and alert, it's good to interact with them--and get in some tummy time.
There are definitely upsides to schedules--they give a certain order and predictability to life and can make it easier to plan your day (those baby nap times can be pretty darn crucial if you want to get anything done at all!). And there are some babies--and some parents--that really do need that predictability; they get very cranky without it.
There are downsides, though. I've seen families become slaves to schedules. They miss out on things they might like to do, and people they might like to see, because they need to be home for a feeding or a nap time. It can leave parents feeling constrained and isolated. And when something happens that throws the schedule off--like an appointment that runs late or an unexpected plumbing problem--it can be very stressful.
My husband and I are raising five kids. Poor Liam, our youngest, had no hope of having a set schedule. Sometimes naps were catnaps and meals were divided up into snacks. There were long days at swim meets or marching band competitions when he was toted around in a sling for hours. Some days went well, some less well. But he survived just fine.
I do think that it's good to build some routine into your day. It's helpful to you, and having some predictable routines is good for kids mentally and physically. Personally, I like the idea of morning and nighttime routines.
In the morning, it's good to build in some snuggling, a good breakfast, and regular getting dressed and organized routines; having a good start to the day makes a big difference and will make it easier for going to childcare or when your child starts school. And at night, I love family dinner, a bath with some playtime, and some more snuggling (with books, once baby is 6 months old or so) with a consistent bedtime. That also sets the stage for healthy habits as your child grows--and builds in rituals of togetherness.
But in between...I vote for flexibility. Yes, you need to be sure your baby eats and sleeps enough. But give yourself some wiggle room. Don't turn down an invitation or give up a chance for something you'd love to do because it would get in the way of a nap or meal. It's good for your baby to learn to nap in a stroller or sling or in the car--and meals can be portable. If you're happy, Baby is likely to be happy--and especially in that second half of the first year, babies often really enjoy seeing and doing new things.
The thing is, the best moments in life are often unscheduled. It all goes by so fast. Enjoy it.
- If your child is bitten by a dog (or other pet) you don't know, talk to the animal's owner (if possible). Find out if the pet has been vaccinated, and get the owner's name and number. I can't tell you how many times I've had to give rabies shots to a patient because we couldn't track down the animal or its owner.
- Provoked bites--ones that happen because someone was trying to pet or otherwise touch an animal--worry us less than unprovoked ones (attacking for no reason is a sign of rabies)
- Vaccinating their pets against rabies
- Keeping their pets away from wildlife (as much as possible)
- Spaying/neutering their pets, so there are fewer stray animals around
Want to keep your high school student from getting fat? Make sure they play at least two sports during the school year.
That's the message of a study just released in the journal Pediatrics. Researchers interviewed about 1700 high school students and their parents, asking about how the kids ate and spent their time (and about their height and weight). Of everything, playing on at least two sports teams each year was what made the biggest difference when it came to keeping kids at a healthy weight (walking or biking to school helped too). The authors said that if every student played on two teams,it could cut the prevalence of overweight and obesity by 26 percent.
I think it's a great idea. After all, we are in the midst of an obesity epidemic, with a third of US kids overweight or obese. Exercise helps, but the problem has been getting kids to exercise. This idea uses something that is available to the vast majority of high school students. Sounds really straightforward--and it's not like there are a whole lot of better ideas out there.
There are, however, a couple of obstacles.
Cost is clearly an obstacle. All over the country schools are having to make cuts in their budgets, and adding a whole lot of new athletes (with the coaching and other expenses that would entail) could be tough. It could also be tough for some families, as many schools charge a fee to be on a team (I paid around $200 for my kids). We'd have to figure out how to pay.
But the bigger obstacle, I think, will be changing the culture of high school sports.
When I was in high school, it never occurred to me to play sports. Back then, I was one of the last picked for kickball, if you know what I mean. I'm reasonably athletic now, but as a teen I was more one of the geeks. None of my friends were on teams, and without friends to do it with you, well, it's kind of a non-starter. Basically, as a teen if you're not good at sports, or if you don't hang out with kids who play sports, chances are you won't play sports. That's what has to change if we want to get kids moving.
We need to follow the example of my son's high school swim team. All it took to make the team was an interest in doing it--and the ability to swim 50 yards or so without drowning. The coach divided the kids up in practice and coached them according to their ability. There were a few kids who, like my son, were experienced swimmers; they helped the newbies out. The team didn't win a whole lot of meets, but the boys had a really great time--and everybody got to be a better swimmer (and got regular vigorous exercise).
We could make high school sports mandatory, I suppose. Some schools do, or do some variation on that theme. It may be the road we end up needing to take, if obesity rates keep rising. But wouldn't it be better if we could make kids actually want to do it? Wouldn't it be better if coaches and school staff and current athletes and others did outreach to the kids who don't usually play sports--and helped them not only do it but enjoy it?
We'd have to be willing to let go of the goal of winning. We'd have to be willing to celebrate teamwork, and individual goals, instead. We'd have to be willing to think of sports as exercise--and as games.
I don't know if we can do these things. But I think we should try. The health of our children is at stake.
When I heard about the deadly strain of hand-foot-and-mouth disease in Cambodia, I thought: wow, this is going to freak a lot of parents out. After all, hand-foot-and-mouth is a really common illness. Hearing that a strain of it is killing children is, well, terrifying.
Hand-foot-and-mouth is generally not a fatal illness--the vast majority of children who get it recover completely with fluids and rest and snuggling. But the reality is that any illness can take a nasty turn. So it's important to know the signs that an illness is taking a turn for the worse. That way you'll know when to worry (and take action) and when not to.
If your child has any of the following, get to medical care immediately (or call 911):
Trouble breathing. How to tell: rapid breathing (or very slow labored breathing), sucking in around the ribs or neck, trouble getting a sentence out, can't stop coughing, skin pale or blue.
Loss of consciousness--like a faint or falling asleep, only you can't shake them awake. Which is similar to but not quite the same as...
Excessive sleepiness, so that it's hard to arouse them, at a time when they aren't usually that way (i.e. if it's three am and they are otherwise fine, not so much a problem).
Seizures (if your child doesn't suffer from seizures)
A dark red or purple rash that doesn't get lighter when you press on it. The spots may be small (petechiae) or larger and more raised (purpura). If your child has fever along with the rash, it can be a sign of a dangerous infection.
Severe pain--or, in an infant or younger child, inconsolability
Hives and swelling of the face, especially if your child is dizzy or has any stomachache or vomiting--it could be a sign of a severe allergic reaction.
While not necessarily reasons to call 911, here are some reasons to get yourself to the doctor's office:
- A high fever. Notice I didn't give a temperature...because what counts as a high fever is going to depend a bit on the age of your child and whether they have any medical problems. Ask your doctor what temperature you should worry about.
- A cut that gapes open or won't stop bleeding, because it likely needs stitching.
- Weakness or dizziness that doesn't go away, especially if your child looks pale
- An injury that gets very swollen or painful, especially if your child has trouble moving the body part (it could be broken)
- Vomiting or diarrhea that won't stop, especially if you are having trouble getting plenty of fluids into your child, and especially if they are urinating much less than normal
- Blood where you don't usually see blood (vomit, poop, urine, etc). Nosebleeds are less of a big deal, unless you can't get the bleeding to stop.
- A significant change in your child's behavior (acting strangely, can't move or use a body part normally, etc)