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橇腕涴跺※What you need to know§掀誕妗蚚ㄛ尕樓淕燴眳綴煦撓棒泂堤懂迵JMs僕砅陛ㄐ

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♂ Childhood Ages and Stages
♂ Normal Growth of Young Children
♂ Childhood Transitions
♂ Developmental Milestones
♂ Checklist of developmental milestones
♂ Could It Be Autism?
♂ Early Signs of Autism
♂ Guide Review - Could It Be Autism?
♂ Over-the-Counter Medicine for Kids
♂ Pediatric Health Supervision Guidelines
♂ Infant Well Child Checklist
♂ Sick Visit Checklist
♂ Emergency Information Checklist
♂ Common Pediatric and Parenting Myths

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Childhood Ages and Stages

General definitions for the ages and stages of a child include:

♂ Newborn or Neonate - birth to 28 days
♂ Infant - 1 to 12 months
♂ Toddler - 1 to 3 years
♂ Preschooler - 3 to 5 years
♂ School Age - 5 to 11 years
♂ Preteen or Tween - 11 to 12 years
♂ Teen - 13 and older

These are not universal definitions though. The State of Texas actually defines an infant as 'a child from birth through 17 months' and a toddler as being from 'from 18 months through 35 months,' so those are likely the definitions that you should use.

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Normal Growth of Young Children

Regular measurements of your child's height, weight and head circumference and plotting them on a growth chart are a good way to see if your child is growing normally. Although many parents are preoccupied by where their child is on the growth charts and often worry if their child is small or near the bottom of the growth chart, it is your child's rate of growth that is the most important factor to consider when evaluating if your child is growing and developing normally. If your child is following his growth curve, then he is likely growing normally.

Also keep in mind that some children can normally move up or down on their growth curves when they are 6-18 months old. As long as they are not actually losing weight, and they have no other symptoms, such as persistent diarrhea, vomiting, poor appetite or having frequent infections, then it may be normal to move down on your growth percentiles. Older children should stick to their growth curves fairly closely though.

General guidelines for your younger child's growth rates include:

Weight:
♂ 2 weeks - regains birth weight and then gains about 1 1/2 - 2 pounds a month
♂ 3 months - gains about 1 pound a month
♂ 5 months - doubles birth weight
♂ 1 year - triples birth weight and then gains about 1/2 pound a month
♂ 2 years - quadruples birth weight and then gains about 4-5 pounds a year
♂ 9-10 years - increased weight gain as puberty approaches, often about 10 pounds a year

Height:
♂ 0-12 months - grows about 10 inches (25 cm)
♂ 1-2 years - grows about 5 inches (13 cm)
♂ 2-3 years - grows about 3 1/2 inches a year most children will double their birth height by 3-4 years of age
♂ 3 years to puberty - grows about 2 inches (5cm) a year

Head Circumference:
♂ 0-3 months - 2 centimeters a month
♂ 4-6 months - 1 centimeters a month
♂ 6-12 months - 1/2 centimeter a month
♂ 1-2 years - 2 centimeters a year

Remember that these are general guidelines though. Your child may grow a little more or a little less than this each year. If you have concerns about your child's growth, especially if you think that he has failure to thrive (poor weight gain) or short stature (poor growth in height), be sure to talk to your Pediatrician.

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Childhood Transitions

When you ask parents which age was the most difficult when raising their kids, it is often whatever age their kids are now...

While that may seem like a simple way to look at the demands of parenting, when you look at parenting more objectively, you usually do find that each age does have its own challenges.

Many of these difficult times revolve around transitions, such as when your baby weans from the breast, moves from a crib to a bed, gives up his naps, and starts kindergarten, etc.
Learning about and anticipating these childhood transitions can make parenting a little easier.

Naps

The transition of moving from two naps to one and then finally giving up a nap altogether can be very difficult. For a few weeks or months, until they get used to their new sleep schedule, kids can be very tired, extra sensitive, and irritable, especially in the late afternoon and early evening.

Make sure your kids get enough sleep, including daytime sleep from their naps and don't give up their naps before they are supposed to. Keep in mind that most 2 and 3 year olds won't take a nap if you give them a choice...

If your older toddler has given up taking naps, but then quickly falls asleep in his car seat or his fussy late in the day, then you likely let him give up his nap too soon. You might have to change the time of when you were putting him down for the nap, be more consistent in you daytime routine, or simply have some afternoon quite time if you still aren't able to get your toddler or preschool age child to take a nap and you think he needs one.

Eating Habits

Many parents also encounter problems when their child's diet transitions from that of a baby to a toddler and then to a diet that resembles the rest of the family, which is hopefully a healthy diet.

Reviewing the 'normal' times that infants start baby food, finger food, and table food, can make feeding your baby much easier, especially for new parents. It can be just as important to understand that many toddlers have a big slowdown in their eating, like to feed themselves, and can become very picky.

Common Childhood Transitions

Other common childhood transitions that parents should, or will eventually, be familiar with include:
♂ moving your baby to a crib from a bassinet (around 3 months of age)
♂ teething and getting a first baby tooth (between 3 to 15 months)
♂ sleeping through the night (around 4 to 5 months)
♂ starting baby food (around 4 to 6 months)
♂ starting finger foods and table foods (around 8 to 9 months)
♂ weaning from infant formula to whole milk (12 months)
♂ changing from a bottle to a sippie cup (around 12 to 15 months)
♂ moving from 2 naps (a morning and afternoon nap) to 1 afternoon nap (age 12 to 18 months)
♂ weaning your infant or toddler from breast milk to infant formula or whole milk, depending on his age
♂ temper tantrums and the terrible twos
♂ starting potty training (age 18 months to 3 years)
♂ moving your child to a toddler bed (age 2 to 3 years, once your toddler is climbing out of his crib, or he is 36 inches tall)
♂ finishing potty training (age 2 1/2 to 3 1/2 years)
♂ giving up the afternoon nap (around age 3 to 5 years, but typically closer to when they start kindergarten)
♂ first day of school
♂ staying dry at night (age 4 to 5 years or even later for some kids and very often much later then when they are fully potty trained)
♂ losing a first baby tooth (age 6 to 7 years)
♂ starting puberty - girls (age 8 to 13 years)
♂ starting puberty - boys (age 9 to 14 years)
♂ learning to drive
♂ graduating from high school
♂ moving out of the house
♂ going to college
♂ getting a job

Of course, those last few can happen in a different order...

Transition Rules???

There are no hard and fast rules when dealing with childhood transitions, except that you should likely be suspicious that something could be wrong if your child is way outside the typical range for when something should occur. For example, if your 18 month has already given up naps altogether or your 8 year old still needs a daytime nap, then that could be pointing to a medical problem.

On the other hand, knowing that most kids don't start staying dry until they are 5 to 8 years old will help you to know that a 3 or 4 year old is normal if he is still wetting the bed, even after he is potty trained.

The only other 'rule' about childhood transitions is that kids with different temperaments handle them very differently. While an easy going child might be able to both switch to whole milk and a sippie cup and the same time, another child who is much more resistant to change might have to be slowly changed to whole milk and then again slowly changed to a sippie cup a few months later.

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Developmental Milestones

1﹜Younger Infants Child Development

eview the physical, mental and social abilities and interests for younger infants aged 0-6 months. Note that these lists indicate average development - the age range at which the 'average' child can he expected to achieve a particular skill or develop a specific interest. The ages in the text are only approximate. Children develop skills at uneven rates - any one child may be 'above average' in one skill and 'below average' in another skill. For an individual child, the parent is the best judge of the child's abilities and interests at any point in his or her development. Be sure to talk to your pediatrician or an early childhood development expert if you have any concerns about your child's development.

Physical Development
♂ visual focus matures - follows objects with eyes.
♂ learns to localize sounds and turns to see.
♂ gains control of hands - learns to bat, then reach and grasp objects.
♂ discovers feet - brings feet to mouth and explores with feet.
♂ begins to sit with support.
♂ large muscle play may include rolling, scooting, rocking, bouncing.

Mental Development
♂ explores world with eyes and ears and begins to explore with hands and feet and mouth.
♂ enjoys creating effects in the environment by own actions.
♂ begins to recognize familiar people, objects and even events - then to anticipate them.
♂ becomes aware of novelty and strangeness in people, objects and events.
♂ develops definite preferences for certain people, objects and events.
♂ may imitate simple movements if in own repertoire.
♂ does one thing at a time.

Social Development
♂ special interest in people (faces and voices especially).
♂ begins to smile at faces, voices and mirror image.
♂ quits crying when sees face or hears voice.
♂ begins to seek attention and contact with people.
♂ distinguishes among familiar people and has preferences.
♂ begins to coo and gurgle, babble and laugh aloud, play with sounds.
♂ listens to voices and may imitate sounds already in own repertoire.

2﹜Older Infants Child Development

Review the physical, mental and social abilities and interests for older infants aged 7-12 months. Note that these lists indicate average development - the age range at which the 'average' child can he expected to achieve a particular skill or develop a specific interest. The ages in the text are only approximate. Children develop skills at uneven rates - any one child may be 'above average' in one skill and 'below average' in another skill. For an individual child, the parent is the best judge of the child's abilities and interests at any point in his or her development. Be sure to talk to your pediatrician or an early childhood development expert if you have any concerns about your child's development.

Physical Development
♂ begins to sit alone.
♂ begins to creep and crawl onto or into things.
♂ begins to pull to a stand, cruise (walk holding furniture), and walk alone (10-16 months).
♂ interest in moving about and practicing motor skills.
♂ develops "pincer" (thumb and finger) grasp and begins to hold objects with one hand while manipulating them with the other.
♂ with objects wants to bang, insert, poke, twist, squeeze, drop, shake, bite, throw, open/shut, push/pull, empty/fill, drag along.
♂ enjoys bath play - kicking and splashing.

Mental Development
♂ interest in appearing and disappearing (objects and people) - develops 'object permanence' (looks for object out of sight at approximately 11 months).
♂ interest in container/contained relationship likes to empty cupboards, drawers, and containers of objects.
♂ interest in letting go and dropping objects (will use string to pull back vanished objects).
♂ interest in exploration and likes many objects to explore.
♂ likes to operate simple mechanisms (open/shut, push/pull) and create effects.
♂ remembers people, objects, games, actions with toys - shows persistence and interest in novelty.
♂ beginning interest in picture books.

Social Development
♂ may fear strangers or react to change - plays best with familiar person nearby.
♂ watches and may imitate others.
♂ sensitive to social approval and disapproval.
♂ interest in getting attention and creating social effects.
♂ enjoys simple social games 'peek-a-boo,' 'bye-bye'
♂ babbles and plays with language - may try to imitate sounds.
♂ recognizes own name and may begin to point to named objects or obey simple commands.

3﹜Younger Toddlers Child Development

Review the physical, mental and social abilities and interests for younger toddlers aged 12-23 months. Note that these lists indicate average development - the age range at which the 'average' child can he expected to achieve a particular skill or develop a specific interest. The ages in the text are only approximate. Children develop skills at uneven rates - any one child may be 'above average' in one skill and 'below average' in another skill. For an individual child, the parent is the best judge of the child's abilities and interests at any point in his or her development. Be sure to talk to your pediatrician or an early childhood development expert if you have any concerns about your child's development.

Toddler Physical Development
♂ endless exercise of physical skills.
♂ likes to lug, dump, push, pull, pile, knock down, empty and till.
♂ likes to climb - can manage small indoor steps.
♂ manipulation is more exploratory than skillful.
♂ active interest in multiple small objects.
♂ by 2 years, can kick, catch a large ball.
♂ by 2 years, can string large heads, turn knob, use screw motion. (All beads given to this age gioup should be at least 1-3/4 niches (44 mm) in diameter, however, if any object appeais to hi easily in the child's mouth, keep it away from the child.)

Toddler Mental Development
♂ interest in causing effects.
♂ interest in mechanisms and objects that move or can he moved-prefers action toys.
♂ combines objects with other objects - makes simple block structures, uses simple stacking toys, does simple puzzles.
♂ very curious - constant experimentation with objects.
♂ interest in hidden-object toys.
♂ at 1 1/2 to 2 years, groups/matches similar objects - enjoys simple sorting toys.
♂ identifies objects by pointing - can identify pictures in book.
♂ enjoys water, sand play.
♂ makes marks on paper, scribbles spontaneously.
♂ first imitative play - imitation of adult tasks, especially caretaking and housekeeping tasks.

Toddler Social Development
♂ most solitary play - relates to adults better than to children.
♂ tries to do adult tasks.
♂ expresses affection for others - shows preference for certain soft toys, dolls.
♂ likes being read to, looking at picture books, likes nursery rhymes.
♂ by 1 1/2, enjoys interactive games such as tag.

4﹜Older Toddlers Child Development

Review the physical, mental and social abilities and interests for younger toddlers aged 24-35 months. Note that these lists indicate average development - the age range at which the 'average' child can he expected to achieve a particular skill or develop a specific interest. The ages in the text are only approximate. Children develop skills at uneven rates - any one child may be 'above average' in one skill and 'below average' in another skill. For an individual child, the parent is the best judge of the child's abilities and interests at any point in his or her development. Be sure to talk to your pediatrician or an early childhood development expert if you have any concerns about your child's development.

Toddler Physical Development
♂ skilled at most simple large muscle skills.
♂ lots of physical testing - jumping from heights, climbing, hanging by arms, rolling, galloping, somersaults, rough-and-tumble play.
♂ throws and retrieves all kinds of objects
♂ pushes self on wheeled objects with good steering.
♂ by 2 1/2 to 3 years, good hand and finger coordination.
♂ lots of active play with small objects - explores different qualities of play materials.

Toddler Mental Development
♂ interested in attributes of objects - texture, shape, size, color.
♂ can match a group of similar objects.
♂ plays with pattern, sequence, order of size.
♂ first counting skills.
♂ first creative activities (drawing, construction, clay) - process still more important than final product.
♂ beginning to solve problems in head.
♂ imaginative fantasy play increases - continued interest in domestic imitation.
♂ fantasy play alone or with adult - child also makes toys carry out actions on other toys.

Toddler Social Development
♂ main interest still in parents, but begins to play cooperatively with other children (especially 30 to 36 months).
♂ uses language to express wishes to others.
♂ engages in games - likes interactions with others - also some pretend play with others.
♂ enjoys hearing simple stories read from picture books, especially stories with repetition.
♂ strong desire for independence - shows pride in accomplishment.

5﹜Preschoolers Child Development

Review the physical, mental and social abilities and interests for younger toddlers aged 3, 4 and 5 years. Note that these lists indicate average development - the age range at which the 'average' child can he expected to achieve a particular skill or develop a specific interest. The ages in the text are only approximate. Children develop skills at uneven rates - any one child may be 'above average' in one skill and 'below average' in another skill. For an individual child, the parent is the best judge of the child's abilities and interests at any point in his or her development. Be sure to talk to your pediatrician or an early childhood development expert if you have any concerns about your child's development.

Preschool Physical Development
♂ runs, jumps, climbs, balances with assurance - by 5, gross motor skills are well developed.
♂ likes risks, tests of physical strength and skill - loves acrobatics and outdoor equipment.
♂ increasing finger control - can pick up small objects, cut on a line with scissors, hold pencil in adult grasp, string small beads (Most children in this age group can begin using toys with smaller components. If child is still mouthing objects, select toys without small parts.)
♂ expert builder - loves small construction materials and also vigorous activity with big blocks, large construction materials.
♂ by 5, rudimentary interest in ball games with simple rules and scoring.

Preschool Mental Development
♂ familiar with common shapes, primary colors.
♂ interest in simple number activities, alphabet play, copying letters, matching/sorting.
♂ by 5, sorts and matches using more than one quality at a time.
♂ around 4, begins to be purposeful and goal directed, to make use of a plan.
♂ interest in producing designs, including puzzles, and in constructing play worlds.
♂ first representational pictures.
♂ prefers realism.
♂ interest in nature, science, animals, time, how things work.
♂ peak interest in dramatic play - recreates adult occupations, uses costumes and props.

Preschool Social Development
♂ beginning to share and take turns, learning concept of fair play.
♂ by 5, play is cooperative, practical, conforming.
♂ interested in group pretend play.
♂ not ready for competitive play because hates to lose.
♂ enjoys simple board games based on chance, not strategy.
♂ more sex differentiation in play roles, interests.
♂ enjoys looking at books and listening to stories from books.

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Checklist of developmental milestones

Does Your Baby...
At 4 Months:

♂ Follow and react to bright colors, movement, and objects?
♂ Turn toward sounds?
♂ Show interest in watching people*s faces?
♂ Smile back when you smile?

At 6 Months:

♂ Relate to you with real joy?
♂ Smile often while playing with you?
♂ Coo or babble when happy?
♂ Cry when unhappy?

At 9 Months:

♂ Smile and laugh while looking at you?
♂ Exchange back-and-forth smiles, loving faces, and other expressions with you?
♂ Exchange back-and-forth sounds with you?
♂ Exchange back-and-forth gestures with you, such as giving, taking, and reaching?

At 12 Months:

♂ Use a few gestures, one after another, to get needs met, like giving, showing, reaching, waving, and pointing?
♂ Play peek-a-boo, patty cake, or other social games?
♂ Make sounds, like ※ma,§ ※ba,§ ※na,§ ※da,§ and ※ga?§
♂ Turn to the person speaking when his/her name is called?

At 15 Months:

♂ Exchange with you many back-and-forth smiles, sounds, and gestures in a row?
♂ Use pointing or other ※showing§ gestures to draw attention to something of interest?
♂ Use different sounds to get needs met and draw attention to something of interest?
♂ Use and understand at least three words, such as ※mama,§ ※dada,§ ※bottle,§ or bye-bye?

At 18 Months:

♂ Use lots of gestures with words to get needs met, like pointing or taking you by the hand and saying, ※want juice§?
♂ Use at least four different consonants in babbling or words, such as m, n, p, b, t, and d?
♂ Use and understand at least 10 words?
♂ Show that he or she knows the names of familiar people or body parts by pointing to or looking at them when they are named?
♂ Do simple pretend play, like feeding a doll or stuffed animal, and attracting your attention by looking up at you?

At 24 Months:

♂ Do pretend play with you with more than one action, like feeding the doll and then putting the doll to sleep?
♂ Use and understand at least 50 words?
♂ Use at least two words together (without imitating or repeating) and in a way that makes sense, like ※want juice§?
♂ Enjoy being next to children of the same age and show interest in playing with them, perhaps giving a toy to another child?
♂ Look for familiar objects out of sight when asked?

At 36 Months:

♂ Enjoy pretending to play different characters with you or talking for dolls or action figures?
♂ Enjoy playing with children of the same age, perhaps showing and telling another child about a favorite toy?
♂ Use thoughts and actions together in speech and in play in a way that makes sense, like ※sleepy, go take nap§ and ※baby hungry, feed bottle§?
♂ Answer ※what,§ ※where,§ and ※who§ questions easily?
♂ Talk about interests and feelings about the past and the future?

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Could It Be Autism?

The Bottom Line

Could It Be Autism?, is a great resource for parents to help them recognize the first signs of autism, know what further testing should be done when a developmental problem is suspected, and understand what treatments are available.

It should be required reading by any parents that are concerned about their child's development.

Although written for parents, Pediatricians will also find it useful so that they aren't so quick to say "let's just wait and see" when a parent reports a problem.

Pros
♂ Teaches you to assess your child's development and look for red flags that may indicate a problem.
♂ Offers steps to get further testing and a diagnosis for your child with a developmental delay.
♂ Gives the support you will need once your child is diagnosed with a developmental delay.

Cons
♂ May worry some parents who focus on just one problem and not on their child's overall development.
♂ Seems to take a tone that you have to fight your Pediatrician to get help.
Description
♂ A 'first step' book to help parents and health professionals recognize the early signs of autism.
♂ Includes 'stories' from parents of children with autism that will help others cope with a diagnosis.
♂ Teaches key social, emotional, and language milestones that many people overlook.
♂ Includes information on how you can talk to your doctor when you think your child has a problem.
♂ Provides descriptions of key screening tools that could detect developmental problems in your child.
♂ Describes specialists who can provide more help testing and treating your child.
♂ Learn how to get help and support once your child gets a diagnosis of autism.
♂ And review what treatments are available that might help kids with autism.

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Early Signs of Autism

Q: I am concerned that my 11 week old is showing early signs of autism. She arches her back in her sleep and sleeps with her nose pointing straight up in the air. She also arches her back when you pick her up sometimes. She is constantly stretching her arms and body and when she sleeps she often holds her arms straight up in the air in front of her. Does this sound like normal baby behavior or should I be concerned. Lea, Annapolis, Maryland

A: If your baby otherwise seems to be growing and developing normally, then that is probably not a sign of autism. Among other normal developmental milestones that you would expect at this age include that your baby smiles, is usually comforted or soothed when she is picked up, follows objects past the midline of her face, make 'ooo' and 'aah' type cooing noises, and maybe has begun laughing. You should definitely discuss it with your Pediatrician if you don't think your baby's behavior is normal though.

The symptoms you describe could also be seen in infants with high muscle tone, especially if her muscles usually seem extra stiff. This is something that you should also discuss with your Pediatrician, but it isn't really related to autism at all.

Among the early signs and symptoms that parents and Pediatricians look for to alert them that a child needs further evaluation for autism include:

♂ not smiling by six months of age
♂ not babbling, pointing or using other gestures by 12 months
♂ not using single words by age 16 months
♂ not using two word phrases by 24 months
♂ having a regression in development, with any loss of language or social skills

Infants with autism might also avoid eye contact, and as they get older, act as if they are unaware of when people come and go around them, as you can see in this autism screening quiz.

Keep in mind that autism usually isn't diagnosed until about age 3, although some experts believe that some children begin to show subtle signs as early as six months of age.

There is also an autism study that showed that some children with autism had abnormal brain growth. Specifically, they had a smaller than average head size at birth (at the 25th percentile), but then had a period of rapid head growth during which their head size moved up to the 84th percentile by age 6-14 months. But rapid head growth is not a sign in all kids with autism.

In general, if you are concerned about your child's development, especially if you think that they might have autism, you should talk to your Pediatrician and consider a more formal developmental evaluation.

And keep in mind that when a child arches her back a lot, it can be a sign of gastroesophageal reflux (Sandifer Syndrome), although you would usually expect other symptoms, like spitting up and being fussy.

Getting An Evaluation

One of the frustrating things that occurs when parents think something is wrong with their child's development is that they may be told 'not to worry' or that they 'should just wait.' Experts think that it is better for parents to trust their instincts and get their child evaluated if they think that they aren't developing normally. This guide from First Signs is a good resource for parents trying to share their concerns with their Pediatrician.

Your local early childhood development program may also be able to do an evaluation if you are concerned about your child's development.

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Guide Review - Could It Be Autism?

Worrying that their child has autism or another developmental problem is often one of the biggest fears that parents of young children have.

Unfortunately, parents often feel like they have nowhere to turn when they have concerns about their child's development. What about their Pediatrician? While Nancy D. Wiseman, in her book Could It Be Autism?, is a little tough on Pediatricians, she is right that they don't often address parental concerns about developmental problems.

First Signs Developmental Milestones Checklist

The developmental milestones checklist is one of the best features of Could It Be Autism?. Parents will find it useful to get a good idea as to whether their child is or isn't following key milestones.

Red Flags

The red flags of child development are perhaps even better than the developmental milestones checklist. These red flags include things like not smiling by 6 months or not babbling by 12 months and some other things for which you should seek an immediate evaluation by a developmental specialist.

Autism Myths

Many parents and Pediatricians will find the little tips about autism myths particularly helpful. These are little things that often delay people from seeking for evaluation for autism, such as that a child couldn't possibly have autism if they are happy and affectionate.

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Over-the-Counter Medicine for Kids

An increasing number of reports about injuries and deaths from over-the-counter medicine has raised awareness that these OTC products can be dangerous.

Many more over-the-counter medicines can be helpful though -- as long as you use them at the correct dosages and at the proper times.

Over-the-Counter Medicine for Pain and Fever

Pain and fever reducers are perhaps some of the more useful over-the counter medicines. These include Tylenol (acetaminophen) and Motrin or Advil (ibuprofen).

Remember that aspirin isn't usually given to children or teens because of the risk of Reye's Syndrome. Parents should also avoid medicines like Maalox, Pepto Bismol, and Kaopectate, which may contain Bismuth Subsalicylate.

Over-the-Counter Medicine for Colds and Coughs

A large variety of cold and cough medicines are available for kids, but remember that the FDA warns that they should not be used for infants and toddlers under age two years. Most manufacturers have gone even further and have stopped marketing them to children under age four and some experts wonder if they are even useful for older kids.

Major brands of over-the-counter cold and cough medicines for older children include:
♂ Children's Advil
♂ Delsym
♂ Dimetapp
♂ Little Noses
♂ Children's Motrin
♂ Mucinex
♂ Pediacare
♂ Robitussin
♂ Sudafed
♂ Triaminic
♂ Children's Tylenol
♂ Vicks

Over-the-Counter Medicine for Babies

Few products are approved for use by babies and younger infants, so only use those that are or get the advise of your pediatrician before using other products off-label that are intended for older children. Commonly used over-the-counter medicines for babies include:
♂ Mylicon Infants' Gas Relief Drops
♂ Gas-X Baby Antigas Infant Drops
♂ Baby Orajel Teething Swabs
♂ Little Teethers Oral Pain Relief Gel
♂ Enfamil Fer-In-Sol Iron Supplement Drops
♂ Enfamil Poly-Vi-Sol Multivitamin Supplement Drops
♂ Gerber Grins & Giggles Infant Tooth & Gum Cleanser
♂ Aquaphor Baby Healing Ointment and other moisturizers
♂ Desitin Creamy and other diaper rash creams and ointments
♂ Ocean Premium Saline Nasal Spray

Over-the-Counter Medicine for Itching

Anti-itch creams and lotions are essential over-the-counter medicines to have in your medicine cabinet if your kids spend any time outside, as they will likely often have insect bites, poison ivy, and other itchy rashes.

In addition to oral Benadryl (diphenhydramine), some good choices to treat itching include:
♂ Hydrocortisone cream 1%
♂ Calamine Lotion
♂ Natural Colloidal Oatmeal Cream or Lotion
♂ Gold Bond Maximum Strength Medicated Anti-Itch Cream
♂ Sarna Original Anti-Itch Lotion
♂ Caladryl Clear
♂ Itch-X Anti-Itch Spray
♂ Domeboro Astringent Solution
♂ Benadryl Extra Strength Itch Relief Gel or Spray - not to be used on large areas though or with oral Benadryl

Over-the-Counter Medicine for Rashes

In addition to anti-itch creams and lotions and moisturizers, other over-the-counter medicines for rashes you may want to have include:
♂ Neosporin First Aid Antibiotic Ointment
♂ Polysporin First Aid Antibiotic Ointment
♂ Wartner Cryogenic Wart Removal System
♂ CompoundW Freeze Off Wart Removal System
♂ Dr. Scholl's Clear Away One Step, Salicylic Acid Wart Remover
♂ Lotrimin AF Antifungal Athlete's Foot Cream - often used for ringworm too
♂ Lamisil AT - for athlete's foot, jock itch, and ringworm
♂ Tinactin Antifungal Cream - for athlete's foot and ringworm
♂ Benzoyl Peroxide cream, pads, or gel - for acne

Over-the-Counter Medicine for Constipation

Preventing constipation with a healthy diet that is high in fiber is best for children, but when they do get constipated, these medicines are often helpful:
♂ Miralax - Polyethylene Glycol laxative for adults, but often used off-label by pediatricians for younger children
♂ Fleet Pedia-Lax Liquid Stool Softener - Docusate sodium oral laxative (2y)
♂ Fleet Pedia-Lax Quick Dissolve Strips - Senna oral laxative (2y)
♂ Fleet - Children's Pedia-Lax Chewable Tablets - Magnesium Hydroxide laxative (2y)
♂ Phillips Milk of Magnesia
♂ Fletcher's Laxative For Kids - Senna laxative (2y)

Over-the-Counter Medicine for Stomach Issues

Stomachaches, in addition to those that are caused by constipation, are a common problem for many kids. These over-the-counter medicines are sometimes useful:
♂ Culturelle for Kids - probiotic supplement
♂ Digestive Advantage Children's Lactose Intolerance Therapy - for children with lactose intolerance (3y)
♂ Children's Pepto - a calcium carbonate antacid to help relieve heartburn in children (2y)
♂ Emetrol for Nausea - may help nausea in children (2y)
♂ Dramamine Chewable Formula - prevents motion sickness in children (2y)
♂ Fiber Choice Sugar Free Fiber Supplement - chewable, fruit flavored fiber supplements for children (6y)

Since the cause of stomachaches are sometimes difficult to sort out, it usually best to see your pediatrician before giving your child an over-the-counter treatment on your own though.

Over-the-Counter Medicine for Allergies

Like cold and cough medicines, parents often turn to over-the-counter allergy medicines to treat their children's allergy symptoms. This is even more common now that Claritin and Zyrtec are available over the counter.
♂ Children's Benadryl
♂ Claritin (loratadine) syrup (2y)
♂ Claritin (loratadine) RediTabs or tablets (6y)
♂ Claritin D 12 hour (12y)
♂ Claritin D 24 hour (12y)
♂ Zyrtec (cetirizine) syrup (2y)
♂ Zyrtec (cetirizine) chewable tablets or tablets (6y)
♂ Zyrtec D 12 hour (12y)
♂ Opcon-A Allergy Relief Eye Drops - for allergic conjunctivitis (6y)
♂ Naphcon A Eye Drops - for allergic conjunctivitis (6y)
♂ Zaditor Eye Itch Relief - for allergic conjunctivitis (3y)

Other Over-the-Counter Medicines

Some other over-the-counter medicines that can be useful include:
♂ Reese's Pinworm Medicine - pinworm treatment (2y)
♂ Neo-Synephrine Regular Strength Nasal Decongestant Spray - can temporarily relieve stuffy noses for teens
♂ Ayr Saline Nasal Gel - helps moisturize dry noses and may prevent nose bleeds
♂ Hibiclens Antiseptic / Antimicrobial Skin Cleanser - can be useful if your child gets recurrent skin infections

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Pediatric Health Supervision Guidelines
Part 1: Introduction

You child will be making frequent visits to your pediatrician, especially in his first few years.

In addition to giving immunizations, these well child visits are an important way to monitor your child's growth and development. Specific health supervision topics for each visit vary depending on the age and developmental stage of your child.

In general, you can expect the following topics to be covered at each visit:
♂ Examination of your child's growth and development.
♂ Review of feeding and sleep schedules.
♂ Screening height, weight, head circumference and/or blood pressure.
♂ Counseling for proper discipline, injury prevention, dental health, and a healthy diet.

AAP Preventative Health Care Guidelines
Infants Children Adolescents
Newborn Fifteen Months Eleven Years
Two Weeks Eighteen Months Twelve Years
Two Months Two Years Thirteen Years
Four Months Three Years Fourteen Years
Six Months Four Years Fifteen Years
Nine Months Five Years Sixteen Years
Twelve Months Six Years Seventeen Years
Fifteen Months Eight Years Eighteen Years
Eighteen Months Ten Years Nineteen Years
Twenty Years
Twenty One Years

Remember to write down any questions you may have for your doctor before you child's checkups.

Part 2: Infants

You will be making frequent visits to your Pediatrician now.

For newborns discharged in less than 48 hours, the first visit should be within two to four days of life, especially for mothers breastfeeding for the first time.

Age specific topics that should be discussed at well child visits include toilet training (eighteen months) and dealing with temper tantrums (toddlers).

In general, you can expect the following topics to be covered at each visit:
♂ Examination of your infant's growth and development.
♂ Review of feeding and sleep schedules.
♂ Screening height, weight, and head circumference.
♂ Counseling for effective discipline, injury prevention, dental health (first visit to the dentist by age three unless high risk), and diet.
♂ Immunizations: by eighteen months your child will have completed the Hepatitis B, Prevnar, and Hib immunizations. He will also have received the primary series of Polio, DTaP, and MMR vaccines and the Chickenpox vaccine.
♂ Screening test: newborn screen according to state law, subjective tests of vision and hearing, blood level to check for anemia (by nine months), screening questionnaire for lead poisoning risk (routinely at nine months and two years), tuberculosis test if high risk.

Remember to write down any questions you may have for your doctor before you child's checkups.

Part 3: Children

You will be making less frequent visits to your Pediatrician now.

Age specific topics that should be discussed at well child visits include toilet training (eighteen months to three years), school readiness in preschool age children, and school performance in school age children. Remember that by the middle childhood years, it is important to talk about avoiding drugs and alcohol and to begin sexuality education.

In general, you can expect the following topics to be covered at each visit:
♂ Examination of your child's growth and development.
♂ Review of feeding and sleep schedules.
♂ Screening height, weight, head circumference (up to age three) and/or blood pressure (usually routine after age three years).
♂ Counseling for effective discipline, injury prevention, dental health (first visit to the dentist by age three unless high risk), and diet.
♂ Immunizations: MMR, DTaP and IPV boosters at the four to six year checkup.
♂ Screening test: vision (formal test by three years), hearing (formal test by four years), blood level to check for anemia (at two years), screening questionnaire for lead poisoning risk (routinely at nine months and two years), tuberculosis test if high risk.

Remember to write down any questions you may have for your doctor before you child's checkups.

Part 4: Adolescents

The American Academy of Pediatrics recommends yearly visits for children over the age of eleven, at which your Pediatrician will provide an:
♂ Examination of your teen's growth, development, and pubertal stage.
♂ Screening height, weight and blood pressure.
♂ Review of school performance.
♂ Counseling for effective discipline, injury prevention, substance abuse, sexual behavior, dental health, diet and exercise.
♂ Immunizations: Tetanus (Td) booster, Hepatitis B series if not already given
♂ Screening tests: scoliosis, anemia (for menstruating teens), urinalysis, vision and hearing test (if not already passed), tuberculosis test if high risk.
♂ Sexually active teenagers should have yearly checks for sexually transmitted diseases and a pelvic exam (females).

Remember to write down any questions you may have for your doctor before you teenager's checkups.

Schedule for Well Child Visits

Your pediatrician will probably want to see your baby for what is known as a well baby check or well child care. These visits are spaced periodically throughout your baby's first year of life. They may include things like:

♂ weight check
♂ head circumference
♂ length
♂ breastfeeding question/issues
♂ general developmental assessment depending on baby's age
♂ discussions of vaccinations or immunizations
♂ other parenting questions

A typical well baby visit schedule may look like this:

1. Two-three days from discharge
2. Two weeks
3. One month
4. Two months
5. Three months
6. Four months
7. Six months
8. Nine months
9. One year

You can also schedule visits sooner if needed and you should never hesitate to call your pediatrician for questions. These visits may be rearranged depending on what your baby's specific needs are at that time.

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Infant Well Child Checklist

Visits to the doctor often go a little faster than parents and pediatricians would like.
And even when you have plenty of time in your visit, parents often forget the questions they have.
Preparing our infant well child visit checklist in advance of your visit to your pediatrician can help to make sure you don't forget any questions or concerns you have about your child.

Infant Well Child Checklist
Among the information you should record include:
♂ your child's diet and feeding schedule, including what and when your infant is eating
♂ your child's sleep schedule, including naps and nighttime sleep
♂ your child's development, including new milestones your child has met since your last visit
♂ any problems or concerns you have had since your last visit

Questions for Your Pediatrician

Your pediatrician will likely answer a lot of your questions during the course of each well-child visit, but it can be helpful to make sure you know the answer to the following questions about your infant:
♂ Does your child need Vitamin D supplements?
♂ When can you start using insect repellents and sunscreen?
♂ When can you start solid baby food, like cereal and then vegetables and fruits?
♂ When can you start finger foods and table foods?
♂ How long should you breastfeed your baby?
♂ When can you introduce water and juice?
♂ When can you switch from formula or breastmilk to whole cow's milk?
♂ When can you turn you child's car seat around?

Our infant well child visit checklist makes it easy to record all of this information and bring it to your visit with your pediatrician, whether it is the 2 week or 2-, 4-, 6-, 9-, or 12-month checkup. It also includes a handy spot to record your child's height and weight and any vaccines he was given.

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Sick Visit Checklist

Visits to the doctor often go a little faster than parents and pediatricians would like.
And even when you have plenty of time in your visit, parents often forget the questions they have.

Preparing our sick visit checklist in advance of your visit to your pediatrician can help to make sure you don't forget any questions or concerns you have about your child.

Sick Visit Checklist
Among the information you should record include:
♂ the 'chief complaint' or main reason that your brought your child to the doctor, which can include something like a cough, runny nose, fever, vomiting, diarrhea, etc. This is usually the most bothersome or worrisome symptom that your child has.
♂ details about when your child began to get sick and how long he has been sick. It is important to try to be as clear as you can about this, as some people say that their child has had a cough for 2 or 3 months, for example, when they really mean that he was sick a few months ago, got better, and is now sick again.
♂ all of the symptoms that your child is having
♂ any medications that you have been giving your child, including prescription, over-the-counter, herbal remedies, etc. Including some details about whether these treatments have made your child's symptoms better or worse can also be helpful.
♂ information about sick contacts and any other reasons that your child might be sick, such as exposure to other sick kids at daycare, a recent visit to a petting zoo, recent travel history, or a recent tick bite, etc. A family history of similar symptoms would also be important to mention to your doctor.

Ask Your Pediatrician

At your visit with your doctor, it is important to ask questions to make sure that your understand what is wrong with your child.

Be sure to ask about:
♂ when your child will no longer be contagious and can go back to daycare or school
♂ when you can expect your child to get better
♂ what signs or symptoms to look for that might mean that your child is getting worse
♂ when you should make an appointment for a recheck
♂ what treatments are being prescribed or recommended for your child
And if there is anything you don't understand, be sure to ask before you leave the office.

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Emergency Information Checklist

Complete emergency medical information can be very handy for babysitters and other caregivers or simply for your own use in case of an emergency with your children.

If your child swallows a medicine or poison, are you going to remember the number for Poison Control?

Or will you remember the number for your pediatrician in the middle of the night if your newborn has a fever?

If you have more than one child and they have food or medication allergies, will you remember who is allergic to what in an emergency situation?

Collecting the following information and keeping it in a handy place, such as by the phone, will help to make sure you are prepared with the right information in case of an emergency.

Emergency Information

You should always make sure that you and any one that is caring for your kids knows the following information in case of an emergency:
♂ how to activate your area's emergency medical services, especially if it isn't done by calling 911
♂ the number for Poison Control - (800) 222-1222
♂ your emergency contact information, including work and cell phone numbers and a few alternative numbers and contacts
♂ your child's doctor's name and phone number
♂ your child's dentist's name and phone number
♂ health insurance information, including your plan and policy number
♂ your child's full name and date of birth
♂ your child's medical history, including all allergies, food allergies, medications he is taking, and any medical problems he has, especially chronic medical problems such as asthma, seizures, diabetes, etc.
♂ any special instructions you have
♂ any other emergency information you think is important, including the address and number for your home

Our Emergency Information Checklist makes it easy to collect this information and post it by your phone and provide it to your child's babysitter or other caregivers.

Authorization for Medical Care

To be complete, especially if you are going to be away overnight or in another city, you might also authorize your child's caregiver to seek medical attention if your child gets sick. Keep in mind that your child can be treated without any authorization in an emergency situation, but it often has to be a true life-threatening emergency. And to be sure that your wishes are followed, be sure to have the letter notarized.

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Common Pediatric and Parenting Myths

There are many myths that are spread to new parents by family members, friends and sometimes even their pediatrician. Many of these myths are just 'old wives tales,' and while they are generally not harmful, they can be confusing to a new parent who is trying to learn to do the right thing for their children.

Myth 1: A green or yellow runny nose means that your child has a sinus infection and needs antibiotics.

This is usually not true. A sinus infection is commonly defined as having a green or yellow runny nose that lasts for more than 10-14 days without improvement. Many other infections caused by viruses can also cause a green runny nose, but unlike a sinus infection, these infections will not respond to an antibiotic.

I think most parents understand the difference between an infection caused by a virus and an infection caused by a bacteria, and that only bacterial infections respond to antibiotics. But many believe the myth that a green runny nose means a sinus infection, which can lead to your child taking antibiotics unnecessarily. So remember that while a green or yellow runny nose does mean that your child has an infection, unless it has been lasting for more than 10-14 days, then it is probably just a cold that will get better on its own. And it is not because your child will likely get better on his own that antibiotics aren't used for viral infections, instead it is because they just don't work on these types of infections.

Myth 2: A fever is bad for you.

Fever by itself is not harmful or dangerous, and unless it is very high (over 106 or 107 F), then it is unlikely to cause brain damage or other problems. Even febrile seizures (a seizure triggered by a fever) aren't usually dangerous. Fever is not a disease, instead, it is a symptom that can accompany many childhood illnesses, especially infections. In general, you should call your pediatrician if your infant under three months of age has a rectal temperature above 100.4 F, if your infant aged 3-6 months has a temperature above 101 F, or if an infant above 6 months has a temperature above 103 F.

For most older children, it is not so much the number, but rather how your child is acting that is concerning. If your older child is alert, active and playful, is not having difficulty breathing, and is eating and sleeping well, or if the temperature comes down quickly with home treatments (and he is feeling well), then you don't necessarily need to call your doctor immediately.

However, it is important to keep in mind that a fever is not the only sign of a serious illness. While some children are fine with a temperature of 104, others can be deathly ill with a temperature of 101 or even without a fever or a low temperature. Whether or not your child has a fever, if he is very irritable, confused, lethargic (doesn't easily wake up), has difficulty breathing, has a rapid and weak pulse, is refusing to eat or drink, is still ill-appearing even after the fever is brought down, has a severe headache or other specific complaint (burning with urination, if he is limping, etc.), or if he has a fever and it is persistent for more than 24 to 48 hours, then you should call your pediatrician or seek medical attention immediately.

Myth 3: A fever is good for you.

While a fever is a sign that your body is fighting an infection, lowering the fever will not make it take longer to get over the infection. You do not necessarily need to treat your child's fever, but in most cases, fever can be treated as a comfort measure. Treating a fever, especially if it is caused by an infection, will not help your child to get better any faster either, but it may help make it feel better. If your child has a fever, especially if it is low grade, but does not feel bad, then you don't really need to give him a fever reducer.

Treatment of a fever can include using an over-the-counter fever reducer, including products that contain acetaminophen (Tylenol) or ibuprofen (Motrin or Advil). If you child has an infection, using a fever reducer will not help your child to get better any faster, but they will probably make him feel better. You should also give your child a lot of fluids when he has a fever, so that he does not get dehydrated. Keep in mind that treatment of a fever is usually to help your child feel better, so if he has a fever, but doesn't feel bad, especially if the fever is low grade, then you do not need to treat the fever.

Is it safe to alternate acetaminophen and ibuprofen? If you are using the correct dosage of each medicine at the correct times, then it is probably safe, although there is no research to prove that it helps. The problem is that it is easy to get confused and give an extra dose of one or the other medicines. If you are alternating fever reducers, then write down a schedule with the times that you are giving the medicines so that the correct medicine is always given at the correct time.

Myth 4: Teething causes ...fever, diarrhea, vomiting or diaper rashes.

Not true. Teething may cause some fussiness and nightwakenings in some children, but if your child has other symptoms, especially a high fever, then you should look for another cause, such as a viral infection, which are very common during the time that children's teeth are coming in. Your child's first teeth will begin coming in between three and sixteen months (usually around six months). The two bottom front teeth will be the first to come in and this will be followed by the four upper teeth in four to eight weeks. Your child will continue to get new teeth until he has all twenty of his primary teeth when he is three years old, with most children getting about four new teeth every four months. In most children teething only causes increased drooling and a desire to chew on hard things, but in some it does cause mild pain and irritability and the gums may become swollen and tender. To help this you can vigorously massage the area for a few minutes or let him chew on a smooth, hard teething ring. Although most children do not need teething gels or treatment with acetaminophen or ibuprofen for pain, you can use them if necessary.

Myth 5: You must boil your water before preparing your infant's bottle of formula.

This one is actually controversial. Boiling the water when preparing infant formula was universally recommended and was then thought to be unnessesary. In 1993, an outbreak of cyclosporiasis from contaminated water in Milwaukee prompted officials to again recommend that water be boiled when preparing infant formula.

If you live in a city with sanitized water and you are preparing bottles one at a time, then boiling water or sterilizing the bottles and nipples probably isn't necessary. You can use this water out of the tap and bottles can be washed in hot soapy water or in the dishwasher. If you are not convinced that your water supply is safe or if you are using well water, then you should boil the water for five minutes before preparing formula.
Myth 6: Giving your infant cereal will help him to sleep through the night.
This is one of the most common myths that just isn't true. When your child begins to sleep through the night has more to do with his development and having a good bedtime routine where he learns to fall asleep on his own, and not on how hungry or full he is. And remember that many children do not begin to sleep though the night until they are about 3-4 months old.

Breast milk or infant formula supplies all of your baby's nutritional needs for at least the first 4 to 6 months of life, so don't be in a rush to start solid baby foods. Starting solids too early can cause your baby to develop food allergies. Your baby's intestinal tract is not as fully developed during the first few months and introducing solids at this time can be too much to handle. Another reason for not giving solid foods earlier than 4 to 6 months is unintentional overfeeding, since younger babies can not offer you signals when they are full, such as turning away or showing disinterest. A third reason for holding off on solids is your baby's inability to swallow solids correctly before 4 to 6 months of age and this can potentially cause choking.

Myth 7: Colic is caused by -

It is not known what causes colic, but it is not usually thought to be from abdominal pain, formula allergies, the iron in infant formula or gas. It is known that normal babies have a fussy period toward the end of the day that begins when they are two to three weeks old and that this may be their way of 'blowing off steam' or dealing with the normal stimulus of their day. It may be that babies with colic are more sensitive to this normal everyday stimulation. It is also known that babies with colic do not have more difficult temperaments and are not more hypersensitive as they grow older.

Colic is a common problem, affecting 10-25% of all newborns. It is defined as recurrent inconsolable crying in a healthy and well-fed infant. It usually begins at about two to three weeks of age, is at its worst at six weeks of age and then gradually improves and finally resolves on its own by three to four months. The most common symptoms of colic are the sudden onset of screaming and crying that can last for more than two to three hours at a time. Babies with colic will often seem as if they are in pain and are difficult to console. While crying they will usually pass a lot of gas, draw up their legs and their abdomen may seem hard or distended. Most babies with colic have one or two episodes of this type of crying each day. In between these episodes they usually act fine.

Unless your baby has reflux or a formula allergy, there are no medicines to make colic go away. Some tips to help deal with colic until it clears up on its own include reassuring yourself and other family members that this is a benign problem that always clears up on its own without any long term effects. Some things that you may try to comfort your baby include swaddling, cuddling, rhythmic rocking, going for a walk or ride, warm baths, singing, rhythmic sounds, massages, or using a pacifier, windup swing or vibrating chair. None of these measures work for all children, but you can try one or two at a time until you find what works for your baby.

If nothing works, it is okay to just put your baby down and let him cry for short periods. Always remember that it wasn't anything that you did or didn't do that caused your baby to have colic and as a last resort try to take a break by having a family member or friend help care for your baby.

Myth 8: Your child needs a daily multi-vitamin.

It is estimated that a daily multivitamin is given to 25-50% of children in the United States, although this is generally not necessary for most children with an average diet, even if your child is a picky eater. Some children that have a poor or restricted diet, liver disease or other chronic medical problems, especially those that lead to fat malabsorption, such as cystic fibrosis, may need vitamin and mineral supplements to prevent deficiencies.

Preterm infants and children who are exclusively breastfed, with either very dark skin or limited exposure to sunlight, may also need vitamin supplements. Also, children may need fluoride supplements if they do not drink fluoridated water.

Although you may give your child an age appropriate multivitamin if you or your Pediatrician feels that your child needs one, it is probably better to try and reach his daily requirements or recommended daily allowance by providing him with a well balanced diet. Consuming a diet with the minimum number of servings suggested by the Food Guide Pyramid will provide your child with the recommended daily allowance of most vitamins and minerals.

Myth 9: A mobile infant walker will help your child learn to walk faster.

In general, you should not use a mobile baby walker, as it will not help your child learn to walk faster and they can be dangerous if they make your child too mobile. Stationary walkers are much safer. If you do use a mobile walker, make sure the area is child proofed and away from stairs, and that your child is supervised at all times.

Myth 10: You should/shouldn't let your children sleep in your bed.

There are no definite right or wrong ways to put your child to sleep and if you and your baby are happy with your current routine then you should stick to it. However, it is not good if it is a struggle to put your child to bed, if he gets overly frustrated in the process, strongly resists being put to bed or if he is waking up so much that he or other family members end up not getting adequate sleep.

Myth 11: You shouldn't give milk or other dairy products to your child when he is sick because it will increase mucus production or make it thicker.

In general this isn't true, unless your child has a milk allergy. When your child is sick, you can let him eat his usual diet as tolerated. If your child does not want to eat then you can try the typical BRAT diet (bananas, rice, applesauce and toast) with lots of fluids and then advance his diet as he will tolerate it.

Myth 12: You can tell if a child has strep throat just by looking at him.

This is a common myth that is propagated by doctors, but it isn't true. While most parents are worried about strep throat when their child has a throat infection (tonsillitis), there are also many viruses that cause infections that look very similar to strep. If your child has a sore throat with fever and a red, swollen throat or tonsils with white pus on them, then he should be seen by his physician so that he can be tested for strep throat. If the tests for strep are negative, then your child's throat infection is caused by a virus and antibiotics will not work. Viral infections of the throat usually improve in two to three days without treatment.

Most studies have shown that doctors and other health professionals are only correct about half the time when they think a child has strep after just a physical exam. So if your child was treated everytime it looked like he had strep, then he might be overtreated or mistreated with antibiotics half the time.

Myth 13: You should begin potty training when your child is _______ months old.

Although most children show signs of readiness to begin potty training between 18 months and 3 years of age, there is no set time at which you should begin. When to start potty training has more to do with your child's developmental and physical readiness, and the time when this occurs varies in different children. Signs that your child is ready to begin potty training include staying dry for at least 2 hours at a time, having regular bowel movements, being able to follow simple instructions, being uncomfortable with dirty diapers and wanting them to be changed, asking to use the potty chair or toilet, and asking to wear regular underwear. You should also be able to tell when your child is about to urinate or have a bowel movement by his facial expressions, posture or by what he says. If your child has begun to tell you about having a dirty diaper you should praise him for telling you and encourage him to tell you in advance next time.

Myth 14: Punishment and discipline are the same thing.

Discipline is not the same as punishment. Instead, discipline has to do more with teaching, and involves teaching your child right from wrong, how to respect the rights of others, which behaviors are acceptable and which are not, with a goal of helping to develop a child who feels secure and loved, is self-confident, self-disciplined and knows how to control his impulses, and who does not get overly frustrated with the normal stresses of everyday life.

You should understand that how you behave when disciplining your child will help to determine how your child is going to behave or misbehave in the future. If you give in after your child repeatedly argues, becomes violent or has a temper tantrum, then he will learn to repeat this behavior because he knows you may eventually give in (even if it is only once in a while that you do give in). If you are firm and consistent then he will learn that it doesn't pay to fight doing what he is eventually going to have to do anyway. Some children, however, will feel like they won if they put off doing something that they didn't want to do for even a few minutes.

Be consistent in your methods of discipline and how you punish your child. This applies to all caregivers. It is normal for children to test their limits, and if you are inconsistent in what these limits are, then you will be encouraging more misbehavior.
Myth 15: If your child is doing badly in school and he has a short attention span and is easily distractable, then he has Attention Deficit Hyperactivity Disorder.

There are many reasons for teens to underperform at school, including a lack of motivation to do well, problems at home or with peers, poor work habits or study skills, emotional and behavior problems, learning disabilities (such as dyslexia), attention deficit hyperactivity disorder, mental retardation or below average intelligence and other medical problems, including anxiety and depression. It is important to find the reason for your child's poor performance, especially if she is failing, and come up with a treatment plan so that she can perform up to her full potential and to prevent the development of problems with low self-esteem, behavior problems and depression.

It is sometimes difficult to figure out if a child's problems at school are caused by their other medical problems, such as depression, or if these other problems began because of their poor school performance. Children who do poorly at school may be under a lot of stress, and will develop different ways to cope with this stress. Some may externalize their feelings, which can lead to acting out and behavior problems or becoming the class clown. Other children will internalize their feelings, and will develop almost daily complaints of headaches or stomachaches. A thorough evaluation by an experienced professional is usually needed to correctly diagnose children with complex problems. When you realize your child has a problem at school, you should schedule a meeting with her teacher to discuss the problem. Other resources that may be helpful including talking with the school psychologist or counselor or your Pediatrician.

Myth 16: Children and adolescents don't get depressed, and if they do, then they don't need treatment.

Depression in children has long been an overlooked health problem.

Depression in children can, if untreated, affect school performance and learning, social interactions and development of normal peer relationships, self-esteem and life skill acquisition, parent-child relations and a child's sense of bonding and trust, can lead to substance abuse, disruptive behaviors, violence and aggression, legal troubles, and even suicide. According to the American Academy of Pediatrics, suicide is the 3rd leading cause of death among children and adolescents, just behind accidents and violence. Moreover, depressive thinking can become part of a child's developing personality, leaving long-term effects in place for the rest of a child's life.

The most common symptoms of depression reported in children and adolescents were sadness, inability to feel pleasure, irritability, fatigue, insomnia, lack of self-esteem, and social withdrawal. Children are as well somewhat more likely than adolescents to suffer from physical symptoms (e.g., stomach aches and headaches), hallucinations, agitation, and extreme fears. On the other hand, adolescents showed more despairing thoughts, weight changes, and excessive daytime sleepiness.

Myth 17: You should force your picky eater to finish his dinner.

Not true. Forcing your child to eat when he isn't hungry is a good way to encourage feeding problems in the future.

The best way to prevent feeding problems is to teach your children to feed himself as early as possible, provide them with healthy choices and allow experimentation. Mealtimes should be enjoyable and pleasant and not a source of struggle.

Common mistakes are allowing your children to drink too much milk or juice so that they aren't hungry for solids, forcing your children to eat when they aren't hungry, or forcing them to eat foods that they don't want.

While you should provide three well-balanced meals each day, it is important to keep in mind that most children will only eat one or two full meals each day. If you child has had a good breakfast and lunch, then it is okay that he doesn't want to eat much at dinner. Although your child will probably be hesitant to try new foods, you should still offer small amounts of them once or twice a week (one tablespoon of green beans, for example). Most children will try a new food after being offered it 10-15 times.

Myth 18: Physical punishment is an effective discipline technique.

You should avoid physical punishment. Spanking has never been shown to be more effective than other forms of discipline and it will likely make your child more aggressive and angry and teach him that is sometimes acceptable to hit others.

Myth 19: You should just observe your child with speech or motor delays because he will probably eventually grow out of it.

If you think that your child is not meeting his normal speech or language developmental milestones, if he is at high risk of developing a hearing problem, or has school performance problems, then it is very important that his hearing be formally tested by a professional. Again, it is not enough that they think that your child hears because he responds to a loud clap or bell in the doctor's office or because he comes when you call him from another room.

Parents are usually the first ones to think that there is a problem with their child's speech development and/or hearing, and this parental concern should be enough to initiate furthur evaluation. In addition to a formal hearing test and developmental assessment by their Pediatrician, children with speech and language delays should be referred to an early childhood intervention program (for children under 3) or the local school district (for children over 3), so that an evaluation and treatments can be initiated by a psychologist (if indicated) and/or a speech therapist/pathologist.

Early diagnosis is also important if your child has motor delays, so that treatment can be started, and your doctor will probably refer you to an Early Childhood Intervention program if your child is not meeting age appropriate gross motor milestones, such as sitting up or walking.

Myth 20: You should always or your should never __________ .

There are very few things that you should always or you should never do when taking care of your child. In general, you should trust your instincts, and if what you are doing is working well, then you can usually stick to it. If your methods or techniques aren't working, then try something else or get some help.

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