Dr. Joanne Wagner answers, “One question I get asked a lot is how to start solid foods.”

  1. The recommendations are to start spoon feeding your infant pureed foods around 6 months of age. 
  2. Look for signs that your baby is ready for solid foods. These  include  good head and neck control, sitting up with support, opening his/her mouth for a spoon and having interest in the foods you are eating.
  3. Start with one new food at a time. After a few days if the new food well tolerated, you can introduce another new food. It does not matter which order you introduce new foods, for example vegetables first versus fruit first. Your baby will develop preferences over time regardless of the order the foods are introduced. 
  4. Keep in mind it may take 10-15 times of offering a new food before you baby may like it.
  5. Let your baby tell you when he/she has had enough. Signs that your baby is full include turning away or leaning back. The amount of pureed food your baby takes will not be the same each feeding. Offer solid foods 2-3 times a day. Formula and breast milk intake may decrease once you start solid foods. This is ok and we will monitor your baby’s growth at each well visit.
  6. Do not give raw honey or any large chunks of food that can be a choking hazard. 
  7. It is OK to give foods with eggs and peanut butter. Research now shows that introducing these foods at an earlier age may actually prevent food allergies. Talk to your pediatrician first if you have any questions.

Dr. Joanne Wagner, MD

Joanne Wagner, MD was raised in Raleigh and attended North Carolina State University. She went on to East Carolina University School of Medicine and then the University of Virginia where she did her pediatric residency and met her husband, Scott, who is a family medicine physician.

Shortly after the births of her twin daughters, Joanne returned to family and friends in Raleigh to join Growing Child Pediatrics. She enjoys spending time with her family, swimming, boating, and just about any water activity. Doctor Joanne looks forward to forming lasting relationships with her patients and their families.

This is the last in a series of blogs on the current situation with COVID-19 and your children from the interview with Dr. Robin Gurwitch, Ph.D, a psychologist and professor at Duke University Medical Center and Yahoo News.

  • Maintain routine as much as possible: This means bedtimes, mealtimes and behavior rules. Getting good rest and eating healthy is important for overall health.
  • Consider implementing designated family time for a family activity as part of your routine. Give each family member a turn to choose this activity.
  • Take a break: It is important to take a break from COVID-19 coverage and discussions. Do this by doing activities you usually do when you are stressed or anxious. Activities like meditating, watching a movie, reading a book, working on puzzles, art, journaling, gardening or listening to music are all great ways to take a break from the news.
  • Be a role model: Children look to you to determine how they should be coping. Being a good role model can reduce children’s worries. Be sure you have adults to talk to about your concerns (out of earshot of your child). If you need professional support for your distress, there are hotlines that are available 24/7.
  • When in doubt, approach things with a little extra patience, attention and love: These will go a long way to reduce your child’s distress. We can all benefit from these three qualities.
  • Something humorous by Jimmy Fallon on handwashing to watch

Fifth in our blog series deals with talking with your teen during this difficult time. Taken from an interview done by Yahoo News with  Dr. Robin Gurwitch, Ph.D  a psychologist and professor at Duke University Medical Center.

If only we had a magic formula of how to speak with teens so they would always listen,” Gurwitch jokes.

Teens are very, very different from younger children in that they have access to information through their friends and social media, but similar in that you can approach them by asking what they already know and meeting them on their level. Additionally, Gurwitch says that “teens are developing a greater sense of independence; therefore, we need to respect that they have their own ideas and opinions.”

This does not mean that we should be letting teenagers engage in unhealthy behaviors, but it does mean having an open and honest conversation about how COVID-19 is affecting all of us. Explain to your teen that teenagers are low-risk for contracting the virus or may not show symptoms, but if they are out and about, the risk of returning home and passing this to loved ones who may not be as fortunate is greater than if they are responsible and follow recommended guidelines.

With a lot of teenagers facing sporting events, school musicals or plays, proms and more being canceled, there is bound to be a lot of disappointment and frustration. Some are facing very real disappointment that they haven’t had to work through before. Being unable to see their friends or go out to socialize is just the icing on top of the cake. Be honest with your teen about why they cannot go out and why it’s important not just for them, but for others, to stay home to stop the spread of the virus.

When your teen is helping out around the house, playing games with the family and using social media to stay in contact with their friends, be sure to let them know how much you appreciate their actions. Perhaps even reward them somehow!

 Let us help at Growing Child Pediatrics if you are having any problems with your child.

Continuing our blog series on the current situation with coronavirus (COVID-19) and your children, Dr. Robin Gurwitch, Ph.D., a psychologist and professor at Duke University Medical Center discusses how best to approach this topic.

Gurwitch suggests being honest and telling your toddler that, because we need to make sure that we are healthy, we have to do some things that are not as much fun, like staying away from our friends. Instead you can:

  • FaceTime/Skype/WhatsApp family and friends for “playdates”
  • Give them the alternative of having plenty of fun with the family! Ask them what games they would like to play, what activities they find the most fun, and find some fun projects to do together.

Let us help at Growing Child Pediatrics if you are having any problems with your child.

Third in our Blog series on the current situation with coronavirus (COVID-19) and your children with Dr. Robin Gurwitch, Ph.D., a psychologist and professor at Duke University Medical Center.

“Discussing death with children is often frightening for adults as we may struggle with what to say,” Gurwitch acknowledges. But that does not mean that these conversations are not important. In fact, it is incredibly important that we do not shy away from these conversations.

Here’s an example of language you can use while talking to your child: “Even though doctors and nurses and everyone are working to keep us well, sometimes, sadly, it is not possible and people die. Together, we are doing all we can to keep ourselves well.”

Gurwitch stresses that you should “never promise children/teens that you or they will not get sick.”

“We cannot guarantee that we can keep this promise,” she explains. Adding, “When we make any promise that is broken, our children’s sense of trust in us is compromised, they are less likely to bring us concerns in the future and they are less likely to trust our responses.”

Let us help at Growing Child Pediatrics if you are having any problems with your child.

Second in our Blog series on the current situation with coronavirus (COVID-19) and your children with Dr. Robin Gurwitch, Ph.D., a psychologist and professor at Duke University Medical Center.

First of all, it’s important to validate your child’s feelings. Gurwitch says to ask yourself: “Has it ever worked for you when someone says, ‘Don’t feel that way?’ ”

“When a child/teen shares their feelings or thoughts, reflect their statements back to them,” Gurwitch advises. “This lets them know they are heard and assures that you understood them.” For example, if your child tells you that they are scared, you can say something like, “I know it is a little scary. Sometimes I get a little worried too, but here is how we are going to keep ourselves as healthy as we can so that we can be okay.”

When you do this, be sure that you are staying calm and providing a sense of ability to cope with the current situation. Providing your child with a sense of security, optimism and confidence will help your child feel the same.

Next, talk to your child about actions that are being done in your community, state and country. Make sure that you are keeping this language age-appropriate.

For young children, Gurwitch advises saying something along the lines of: “Everybody in (city, state) is working very hard to be sure we are as healthy as we can be. That is why we are staying home. When we stay home, it gives everybody a chance to be sure our schools/childcare settings can be cleaned. It also gives us time to be sure we are doing everything in our family to stay healthy.”

Then, tell your child what your family is going to do to stay healthy.

Tell your child that you are going to be washing your hands with soap and water (and maybe even singing while you do it), showing them how you will sanitize surfaces and keep the house clean to keep the family as healthy as possible. Here’s some language Dr. Gurwitch suggests:

“We can do lots of things to keep our family as healthy/well as possible. We need to wash our hands with soap and water to be sure we wash any germs away. When we wash our hands, we can sing ‘Happy Birthday’ two times. That will get rid of any germs. I will be sure to wipe things that can have germs, so we can be even more healthy. When we sneeze or cough, we cover our noses and mouth. We can also sneeze into our elbows.”

Make sure that you are encouraging your child as they use good hygiene and demonstrating these behaviors for your child.

Finally, encourage your child to ask questions.

Letting your child know that your initial conversation is not the last time you will be talking about COVID-19 and opening the floor to conversation down the line is essential as children try to wrap their head around the situation. Gurwitch suggests ending the conversation by saying, “If you have any questions about this virus or what we are doing, I am here to talk to you anytime you need me.”

Let us help at Growing Child Pediatrics if you are having any problems with your child.

David A. Katz, DO FAAP IFMCP

This is the first in a series of Blogs on the current situation with coronavirus (COVID-19) and your children. They were from an interview done by Yahoo News with Dr. Robin Gurwitch, Ph.D., a psychologist and professor at Duke University Medical Center.

“Many parents/caregivers are worried that talking to young children will lead to increased worries and anxieties,” Dr. Gurwitch explains. “The opposite is actually the case — bringing difficult topics into the conversation can actually help to quiet these worries.”

You’ll want to approach conversations with your kiddos in a way that is developmentally appropriate for them; that way you’re not overwhelming them with information that they can’t quite understand.

Start by asking them what they know about coronavirus, and then meet them where they are with facts and compassion. Remember, you set the tone when it comes to your kids: They’re going to mirror the way that you act, so try to keep calm and not panic.

Gurwitch offers up these conversation starters:

  • There has been a lot of talk about coronavirus. Tell me what you know about it, OR, Tell me what you’ve heard about it.
  • Tell me what your friends are saying about coronavirus.

This gives you a chance to listen to what your child knows and correct any misconceptions and misinformation.

Some websites are providing comics that can help your children better understand what COVID-19 is and how we can reduce our chances of getting ill or spreading the virus with hand-washing and social distancing. This one from NPR is great for older kids, while this one from Little Puddings is great for younger children.

Let us help at Growing Child Pediatrics if you are having any problems with your child.

David A. Katz, DO FAAP IFMCP

The common cold is all too common, and parents here at Growing Child Pediatrics often want to know how to best help their children get well. Even if you’re not currently fighting colds at your house, here are five things you should know before your children get their next cold.

1) There really is no cure yet

We have identified the viruses associated with the common cold, but we still do not have a way to cure it. This does mean that, to some extent, you will have to endure a cold until the end. Furthermore, colds are also still very common.

2) Modern allergy medications do not help with cold symptoms as well as some older medications

When a cold sets in and a child starts sniffling or coughing, the instinct for many parents is to give their children an allergy medication like Allegra, Zyrtec or Claritin. The thought is that these medications will help dry up their child and help them make it through the day. Unfortunately, however, these newer medications have not proven as effective as some older medications at minimizing cold symptoms. In the past, we would give children medicines like Dimetapp, Triaminic, or Benadryl, and those actually did more to help children’s symptoms, but would they make children drowsy. When everything is taken into consideration, the non-drowsy medicines are probably the best daytime options.

3) Some of your grandmother’s remedies actually work

If your child has a cough, take the advice your grandmother gave you. Drink lots of fluids. Stay hydrated. Drink something with lemon, honey, or some tea if you need help soothing the cough and relieving some of your child’s cold symptoms. When your child has a cold with no cure, anything to help minimize the suffering is a good idea.

4) Homemade chicken soup helps boost immune systems

If you thought that chicken soup was comforting when you were growing up, you were on to something. In very controlled studies, researchers have found that homemade chicken soup with extra garlic and onion is actually an effective immune system booster. Please note, however, that this is the case for homemade chicken soup. Not every can of chicken soup you purchase at the store will necessarily have the same immune system boosts for the common cold because the ingredients can vary significantly. If you have the time, go ahead and make your soup fresh.

5) Many doctors recommend stopping dairy

Dairy can produce and thicken mucus, and many doctors recommend that children hold off on dairy for at least a day when they have a cold. If you are trying to help your child dry up, dairy can be a hindrance. Note that milk is an especially important dairy item to stop for a short time.

While no one can avoid the common cold entirely, we hope that these five facts will help prepare your family to get well quickly next time someone comes home from school with a cough.

What do you do if you have allergies in raleigh-

Allergy season can be difficult on families. In our last post, we wrote about some of the lesser-known keys for families to keep in mind in allergy season. Today, we want to give you three steps to effectively treating your child’s allergies.

First, you can give an antihistamine as a step.

This can be an appropriate first step for someone who thinks they are having trouble with allergies. You can buy an effective antihistamine over the counter at your local pharmacy, and this could potentially help with many of your child’s symptoms.

However, do keep in mind that allergens can cause a reaction that produces more than 30 chemicals (more about allergies at our previous post), and histamine is just one of those chemicals. This means that an antihistamine can only help with some of your child’s allergies, and it is not necessarily a cure-all.

Second, if your child’s allergies are persisting, go see your pediatrician.

We cannot help you overcome your allergies without knowing what the allergies are. Some indoor environmental allergies can be removed lowering the reaction to outdoor allergens. That’s why Growing Child Pediatrics uses an appropriately sensitive allergy test. Allergy tests have advanced over the years, and the ones we use help us get a good understanding of what allergic reactions your child is having. After that, we can help develop a treatment plan.

Additionally, your healthcare provider will be able to explore whether there is anything other than allergies affecting them. It is possible that what we think are allergies are actually another issue.

Third, take and keep notes about your allergic reactions.

How do your child’s allergies compare to last year? Did they flare up at the same time? How were they feeling? Most of these questions are hard to remember after 12 months of life. That’s why we recommend writing down how their allergies affect them in the moment.

You can simply write these down on a notepad if you’d like, but we would recommend a digital note-taking application. Evernote™, for example, is a free option that allows you to easily make notes from any device. If you find yourself wondering in a year how their allergies were in the past, you can easily search through your digital notebooks to find what you wrote about their allergies. This will be helpful both for you and for the team at Growing Child Pediatrics.

Perhaps today you need to schedule an appointment with your Growing Child Pediatrics location. We hope to see you soon!

Allergies in Raleigh Durham

Each spring we at Growing Child Pediatrics get questions about allergies. This makes complete sense. After all, many children wrestle with allergies, but most of us have never studied the inner workings of allergic reactions. Try understanding these four keys about allergies to learn how to better serve your child this spring.

The Raleigh-Durham Triangle really is one of the worst regions of the entire country for allergies.

While the yellow clouds of pollen that bombard our region every spring may have given this away, we really are in a bad location for allergies.  There are a number of reasons for this, but the main point is that allergies may be impacting your family.

Your body produces more than 30 chemicals in response to allergens.

When different people come in contact with different allergens (mold, pet dander, dust mites, etc.), their bodies can produce more than 30 different chemicals. These chemicals each have different effects on people.

For example, most people know that if you have allergies, an antihistamine can help resolve some of your symptoms. This is because histamine is one of these more than 30 chemicals your body may produce. If you have a runny nose (which histamine can cause), and you take an antihistamine, you may find that your symptoms decrease significantly. The histamine in your system is being addressed by the medication. However, if you are experiencing congestion (which histamine does not cause), taking an antihistamine may not address all of your symptoms. You may need to look at other options with your pediatrician for treating your allergies at that point.

Indoor and Outdoor allergies are both seasonal.

Many patients don’t know this, but both indoors and outdoor allergens have seasons. During the spring you have probably guessed that many outdoor allergens are in season. Yet some allergens, like dust mites, are actually in season during the winter months. We close up the house and turn on the heat, and that means that dust mites can flare up.

Current allergy tests are more appropriately sensitive than some older allergy tests.

The modern blood tests that Growing Child Pediatrics uses in their various locations are fantastic. New technology developments in recent years mean that we now are able to test for allergies in a way that gives great results. Consider the following example:.

If you were to come in to get an allergy to grass tested in past years, your test would have likely tested for 4-6 kinds of grass.  However, the tests were so specific that only if you were allergic to that strain of grass would the test be positive. If you were allergic to a ‘cousin’ kind of grass it would be negative. But the current test that Growing Child Pediatrics uses would show allergy to some of the similar grasses that would have tested negative in the past. Here, less specific is better so that we can better serve your allergy needs.

So, how do we address your child’s allergies?

Next week, we’ll help you think through a good action plan for making progress in treating your family’s allergies. Until then, feel free to comment below: what other allergy questions do you have?