Category Archives: From the Real Experts at NYU

When Fido Meets Baby: A Primer for Pet Parents Expecting a Newborn

babydog

The birth of a new baby is a joyous moment for parents, as well as a transition for the entire family, including pets. Many pet owners think of their pets as family, and are eager to ensure a safe, healthy connection with the new baby.  Expectant parents who are pet owners may have questions about circumstances that commonly arise where babies and pets coexist. Here are some things to consider and helpful tips for preparing your dog for a new baby:

• Don’t make assumptions about a dog’s breed being more or less suitable for a baby. Much of what ensures safety between dog and baby stems from learned behavior and reinforcement.
• It’s important for your dog to recognize and respect your role as family leader. Start early to instill and/or correct a leadership dynamic with your dog helps to set healthy boundaries and ensure comfort and safety for everyone.
• Prepare your dog for baby’s arrival by establishing physical boundaries in your home. For example, it is a good idea to keep your dog’s toys in a distinct location away from the baby’s toys. It may also be a good idea to train your dog to stay out of your baby’s nursery, or to set limits for access.
• Establish a “go to” place for your dog, and train him/her to follow your “go to place” command.
• Make a safe zone or space for your dog to be able to escape to if he/she needs to get away from new stresses and stimuli.
• Manage the introduction of your dog to your baby and take things slowly. It may be a good idea to walk the dog first, for example, giving the dog an opportunity to discharge energy before greeting baby.
Always supervise your dog and baby when they are together; never leave them alone.
• Remember to make time for your dog and try as much as possible to ease the dog into changes in his routine. Doing so can help to minimize the stress of change.
• As your baby grows, be sure to teach him or her good manners towards your dog (i.e. no yanking or pulling on its ears or tail). Dogs are often very patient with displays of affection, but learn to recognize early signs of stress in your dog to prevent an escalation to aggression.

The Center for Perinatal Education and Lactation at NYU Langone offers a monthly, two-hour-long information session called Dogs and Storks for expectant women and partners to help prepare the family pet for a new baby.  The session is taught by a licensed dog trainer, certified by Family Paws.

Receiving expert guidance on concerns such as those outlined above can make all family members, including our furry ones, to feel safe, happy and comfortable together.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Elizabeth Moore, BSN, RN, is the coordinator for Parent Education and Community Outreach in NYU Langone’s Parent Education Program. As a doula and childbirth educator, she has worked as a maternal-child health nurse and educator for over 20 years.

 

Does My Child Have Hearing Loss?

hearingHearing is a critical factor in speech and language development for children. In the early 2000’s a nationwide program to screen the hearing of newborns was introduced and has been wildly successful in identifying hearing loss before the age of 3 months. Despite this successful program, hearing loss can develop after birth, so it is important for parents to be aware of the signs and symptoms of hearing loss and know when to get their child to a doctor. Early intervention is the key to mitigate any long term effects of hearing loss.

If your child shows any of the following signs of hearing loss, do not delay in getting to a doctor for evaluation:
• Does not startle or awaken to loud sounds
• Does not respond to familiar voices by calming down, smiling or cooing
• Does not turn head or eyes towards sounds by the age of six months
• Does not begin to babble or say simple words, such as “mama” or “dada,” by the age of one
• Only responds to visual stimulation such as turning towards someone entering a room, but not to auditory stimulation such as someone calling the child’s name
• Responds to some sounds (ex: a door slamming), but not to others (ex: speech, noisemaking toys)
• Does not try and mimic sounds that you make
• Ear infections, tugging on ears or complaints of ear pain
• Speech delay or unclear speech
• Difficulty following directions
• Asks for repetition often (i.e. “huh?”, “what?”)
• Often increases volume of music, TV, iPad or other devices

It is important to remember that all children develop at a different rate and not all types of hearing loss are permanent. If you have any concerns, even if your child passed the newborn hearing screening, you should have your child’s hearing evaluated by a doctor immediately.

List adapted from the Centers for Disease Control and Prevention, National Birth Defects and Developmental Disabilities (https://www.cdc.gov/ncbddd/hearingloss/)

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Kit S. Frank, Au.D., is an Audiologist at NYU Langone Medical Center. She tests and treats children with hearing loss at Hassenfeld Children’s Hospital at NYU Langone.

 

Snacks to Keep Your Kids Fueled in the Summer Sun

trail-mixWith summer fast approaching and school years wrapping up, many families are gearing up for new routines and schedules. With the new season comes a variety of fresh produce and different meal and snack schedules for the kids. It can be hard to navigate food preferences for unpredictable days at the beach, away at camp, or hot summer nights at home. Here are some top snack tips to make the sunny season a little easier (and more delicious!) for everyone.

For a Day at the Beach or Pool
Packing up a cooler for a long day out can be tough. Alongside the sandwiches throw in some mozzarella sticks or Babybel cheese circles for a quick snack between sand castle building and swimming. Peanut butter sandwiches (or sunflower seed butter for kids with allergies) cut into quarters can also make an easy on-the-go treat for fuel. Keep fruit such as cut apples or grapes and veggies, such as baby carrots, celery, and bell peppers handy for kids to munch on throughout the day.

Packing Up for Camp
If your kids are headed to day camp, be sure to keep them fueled with extra snacks. Have your kids help build their own daily trail mix, choosing from a variety of nuts (such as cashews, peanuts, and almonds) and dried fruit (raisins, dried cranberries, dried cherries, dried strawberries, dried bananas, and/or coconut flakes). They can also add a little cinnamon or cocoa powder to dust on extra flavor.

Frozen Summer Treats
There’s nothing like ice cream and popsicles in the middle of a sweltering day. If you want to steer your kids away from a sugar overload (and subsequent crash!) try mixing up yogurt pops or smoothies instead. For the yogurt pops, blend Greek yogurt with berries or other favorite fruits. Pour into popsicle molds and freeze (at least two hours). If you’re craving something chocolate-y, blend cocoa powder, peanut butter, and a frozen banana with milk for a twist on the traditional milkshake. You can even add extra ice to make it closer to a soft-serve ice cream consistency.

Overall, remember to embrace the summer season choosing a variety of fruits and vegetables to ensure you’re eating all the vitamins and minerals throughout the day. Enjoy the summer and all the treats that come with it!

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Bridget Murphy, MS, RDN, CDE, CDN is a registered dietitian and clinical nutritionist at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone.

 

Summer Sun Safety for Kids

Sun protectionWith summer rapidly approaching, everyone is thinking about fun under the sun. Whether it’s a trip to the beach, getting ready for camp, or simply playing in the backyard or park, everyone needs to know how to protect their family from the sun. The simplest solution—staying inside—has obvious drawbacks, but you should do all you can to limit exposure to harmful sunlight. Here are some helpful tips for safe summer fun:

Try to be indoors or in shaded areas between 10am-4pm, when the sun’s UV rays are strongest.

Use sunscreen. Remember, you can get sunburn even on cloudy days. Use enough to cover all exposed areas, especially the face, nose, ears, feet, hands, and even backs of the knees—and rub it in well. Apply sunscreen 15-30 minutes before going outdoors.  This allows it time to absorb into the top layers of the skin. Sunscreen should be reapplied every 2 hours, as well as after swimming, sweating, or drying off with a towel. Also, while we are focused on the summer, be aware that one can get sunburn even in winter.

What is SPF? A sunscreen’s efficacy is measured by its sun protection factor, or SPF. SPF is not an amount of protection, but instead indicates how long it will take for UVB rays to redden skin when using a sunscreen, compared to how long skin would take to redden without any protection. For example, if it takes 10 minutes for skin to redden on its own, it will take 15x longer with a sunscreen of SPF 15 applied.  An SPF 15 sunscreen screens 93 percent of the sun’s UVB rays; SPF 30 protects against 97 percent; and SPF 50, 98 percent. But regardless of an SPF number, sunscreen needs to be reapplied often.

How to choose? The AAP (American Academy of Pediatrics) and AAD (American Academy of Dermatology) recommend that all sunscreen you use should provide broad-spectrum (UVA and UVB) protection, have an SPF of 30 or higher, and be water resistant.

Keep babies younger than 6 months out of direct sunlight and under shade. If an infant is out in the sun and protective clothing and shade are not available, use sunscreen on small areas of the body, such as the face.  For babies older than 6 months, apply sunscreen to all areas of the body, but be careful around the eyes.

When possible, dress yourself and your children in cool, dark colored, and loose clothing that covers as much of the body as possible.  Good examples include lightweight cotton pants, long-sleeved shirts, and broad brimmed hats. Select clothes made with a tight weave; they protect better than clothes with a looser weave. If you’re not sure how tight a fabric’s weave is, hold it up to see how much light shines through. The less light, the better. Or you can look for protective clothing labeled with an Ultraviolet Protection Factor (UPF). The higher the UPF number the better. For a good comparison, a white cotton t-shirt has a UPF rating of 6.

Look for child-sized sunglasses with at least 99% UV protection.

If all your protection efforts fail and your child gets sunburn: most sunburns are mild, but ALL are real burns, if only superficial. Cool compresses, pain relief medication, rehydration (with water or 100% fruit juice), and staying out of the sun are usually all that is needed for care of 1st degree burns. Severe sunburns are classified as 2nd degree, and can be accompanied by severe blistering and pain. Any child who develops fever and severe blistering or cracking of the skin should call their pediatrician and/or seek immediate medical attention.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

David Shipman, MD, is a pediatrician and clinical assistant professor in the Department of Pediatrics at the Hassenfeld Children’s Hospital at NYU Langone Medical Center. He sees patients at NYU Langone at Trinity.

 

Helping Children with Autism Build Skills as They Grow Up

autismAt its core, autism spectrum disorder (ASD, or autism) is a social disability that is present across one’s lifespan. Areas of difficulty and goals for treatment evolve as the child with ASD grows older and social interactions become more complex.

Social skills are highly nuanced and difficult to measure, but one thing is clear; early diagnosis and treatment help. With an infant or toddler, red flags for ASD can include failure to make eye contact, point to or express interest in objects, engage in social games like peekaboo, or use simple language to request, comment, and make social initiations. Although developmental delays are not always symptoms of ASD, concerned parents should seek guidance from their pediatrician. Treatment for young children typically involves using rewards to motivate and reinforce specific skills and behaviors, such as pointing, vocalizing, or making eye contact.

Building skills as symptoms change
As children grow up, the social demands of the world change and become more complex—we expect different skills from a 12-year old than a three-year old! Verbal skills become increasingly important; the give-and-take of conversation with friends that most of us take for granted is tough for them to master on their own.

Children with ASD may be able to hold a long conversation about a topic that interests them, while friendly chatting and two-way conversations on subjects they find less interesting could be a challenge. Progress can be complicated further by difficulty picking up on more subtle, nonverbal cues, such as recognizing when a friend is bored or annoyed by reading his facial expressions and body language.

The importance of teamwork between children, parents, and clinicians
This is where parents and clinicians can help. As children with ASD grow up and face escalating social demands, they benefit greatly from working with a clinician who can measure progress, assess areas for further development, and establish and adjust individualized, incremental, and achievable goals. Parents are a critical component of progress and can be great social coaches for their children.

The Child Study Center
The Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone, offers a number of evidence-based programs that help children with ASD improve their social skills at each stage of development. All of these programs include an equally important parent group.  We know that parents are by far the most important supporters and coaches for their kids, which is why the parental component is the highlight of our group programs. While the children learn skills through lessons, in-class practice, and homework assignments, the concurrent parent programs show parents how they can reinforce their child’s social development at home.

Children learn social skills at different rates, but as with any skill, the more practice, the better and faster the progress. We encourage parents to make sure that their child has an abundance of opportunities to practice and develop these skills in their day-to-day lives.

For more information on the Child Study Center’s social learning programs, email us at csc.sociallearning@nyumc.org or call 646.754.5284.

April is National Autism Awareness Month. Learn more online at the Autism Society.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Rebecca Doggett, Ph.D. is a clinical assistant professor of Child and Adolescent Psychiatry at the Child Study Center at Hassenfeld Children’s Hospital at NYU Langone.

 

Effective Parenting: Finding Balance Between Structure and Flexibility

parenting

 

What’s the most effective parenting style—being firm or flexible? Effective parenting actually involves both. Research has shown that a firm yet flexible parenting style has positive outcomes for both parents and children. Too much or too little of either can have unintended consequences.

Structure v. Flexibility
Providing structure can be beneficial.  Predictability provides children with comfort. However, being too rigid and adhering to structure at all costs can result in increased conflict and stress for both parents and children.

Flexibility also has benefits. For example, flexible parenting builds strong parent-child relationships and increases children’s self-esteem and self-regulation skills. However, too much flexibility (e.g. having too few behavioral expectations for your child) can lead to children feeling overwhelmed, insecure and lacking self-discipline.

Tools for Parents
Deciding when to be firm and when to be flexible is difficult. Here are some tools and guidelines to help you strike an appropriate balance:

You can avoid being too rigid—and seeming that way to your children—by involving them in decisions. Where possible, try to trust your child to do things for him/herself, even if the outcome isn’t what you desired (e.g. trusting your child to get to school on time).

• Be mindful of being insistent on “must-do’s”. Instead, reevaluate whether a set approach is working for you and your child and be open to change.

• Set reasonable demands for your child (e.g. curfews, expectations for school). Be consistent and follow through with consequences. However, when your child falls short of expectations or if there are extenuating circumstances (e.g. your child broke curfew after being at a concert that went late), allow your child to explain what happened and adjust your response accordingly.

When it comes to providing the appropriate amount of flexibility and structure, you should plan ahead to avoid conflict.  It’s easy to fall back on routine in stressful situations. However, by anticipating obstacles, you can give yourself the opportunity to avoid stress and the rigidity that may accompany it.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Amy DiBernardo, LMSW, JD, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone Medical Center’s Child Study Center.

 

Talking to Your Child’s Peers and Classmates about Celiac Disease

gluten-free

 

Having celiac disease can often cause children to feel self-conscious or embarrassed. As children grow and their social skills develop, they may become more aware and concerned about the opinions of their peers.

1. Empower your child with knowledge. Help her to gain the best possible understanding of celiac by presenting infor­mation in an age-appropriate way, providing opportunities for her to ask questions, and encouraging an open dialogue.
2. Support healthy self-esteem. Your child may not be able to eat all of the same foods as his peers, but celiac disease does not make him any less capable and does not need to get in the way of a normal, healthy, happy childhood.
3. Meet other kids and families with celiac disease. Make new friends and share tips and ideas.
4. Talk to teachers, coaches, parents of your child’s friends, and other trusted adults. It can be very useful to have a well-informed authority figure to support your child when you can’t be there. Plus, they can help to ensure that activities they facilitate are inclusive for all children participating.
5. Help your child to educate others in a fun way. Have a party and teach your child’s friends how to make some favorite gluten-free treats. Encourage your child to use opportunities like “show and tell” to teach classmates (and teachers!) about celiac.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Janis Atty Meadow, MA, CCLS, ATR-BC, LCAT is a child life specialist and creative arts therapist at NYU Langone’s Fink Children’s Ambulatory Care Center, and is part of the Pediatric Celiac Disease and Gluten Related Disorders Program. She helps pediatric patients and their families understand and cope with medical illnesses and experiences. By providing education, preparation, emotional support, and guidance, she promotes positive development and well-being in patients facing a wide range of challenging life events.

 

The Truth About Baby-Friendly Hospitals

baby

 

The Baby-Friendly Hospital Initiative was launched by the World Health Organization and UNICEF in 1991 to encourage and recognize hospitals and birthing centers that offer high-quality, evidence-based care for infant feeding and bonding between mother and baby.  Some of the parents we see at NYU Langone Medical Center have misunderstandings about what being “baby friendly” really means for moms and babies. Let’s look at some of these misconceptions and get to the truth about Baby-Friendly practices:

1. “Baby-Friendly hospitals force moms to breastfeed.” Not at all! The aim of the Baby-Friendly Initiative is to provide women with the best information that they need to make their own choices about how to feed their babies. In fact, Baby-Friendly designated hospitals have committed to providing better information about formula feeding and safe formula preparation to women who choose to formula feed.

2. “Baby-Friendly hospitals have no nursery.” While Baby-Friendly hospitals encourage babies sleeping in the same room with mom, most do provide an area for babies who temporarily require observation. NYU Langone provides a newborn observation area for this purpose. Rooming in is encouraged because research shows that mothers sleep better when their babies are rooming in with them. Rooming in has the added benefit of helping new moms learn their babies feeding cues, while the babies are comforted by being close to their mothers—they cry less and are easier to calm.

3. “Baby-Friendly hospitals don’t have formula.” They do! The difference is that, in Baby-Friendly hospitals, care is taken to provide formula only to those babies whose mothers have chosen to formula feed, and to those for whom it is deemed medically necessary by the baby’s provider. This strategy helps to stop the “casual” use of formula, which may undermine breast feeding for nursing babies.

4. “Baby-Friendly hospitals don’t give babies pacifiers.” This is mostly true, since the American Academy of Pediatrics discourages pacifier use in breastfeeding babies until at least 4 weeks of age.

Breastfeeding and bottle-feeding moms both benefit from choosing a Baby-Friendly hospital, where each can be sure that that her plan for optimal feeding and bonding is fully supported.  In an environment where staff receives consistent training in the best practices, all moms can be empowered.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Elizabeth Moore, BSN, RN, is the coordinator for Parent Education and Community Outreach in NYU Langone’s Parent Education Program. As a doula and childbirth educator, she has worked as a maternal-child health nurse and educator for over 20 years.

 

Tips for a Healthy Diet for Kids with Type 1 Diabetes

diabetes2

 

Parents and children alike worry that with a diagnosis of type 1 diabetes their diet will forever change. In reality, kids can continue to eat a regular diet with an emphasis on healthy food choices and variety. Along with these healthy choices, a regular diet can also include desserts and other treats in moderation. The only foods that we ask kids with diabetes to avoid are liquid carbohydrates, such as fruit juice and regular soda.

A healthy diet includes:

Vegetables. Encourage your kid to eat vegetables with every meal. They also make for great snacks. Try to eat as many colors from the rainbow as you can. Always have a variety and different colors to make sure your child is getting a mix of nutrients. You can never eat too many vegetables—except potatoes and french fries, which count as a starch.

Fruits. Keep a variety of fruits in your home. Fruits are a delicious and nutritious snack option. Like vegetables, kids should eat fruits of all colors. Choose whole fruits and avoid juice unless your child has a low blood sugar.

Healthy proteins. Pick lean proteins such as poultry, fish and eggs. Encourage your kids to increase their intake of plant-based proteins – beans, nuts, seeds and tofu. Avoid processed meats like sandwich meats, hot dogs, and bacon, and try to limit intake of red meat to only a couple of times per month.

Whole grains. Try to pick whole grains more often than refined grains like white bread and rice. Some great whole grain options include quinoa, farro, buckwheat, whole grain bread, brown rice and chickpea pasta.

Healthy oils. Healthy fats are an important part of a well-rounded diet. Use plant-based oils such as olive oil, avocado oil and sunflower oil when cooking and for salad dressings.

Water. Water is the best way to stay hydrated. Get your children in the habit of drinking water early in life. Kids should drink water with every meal and snack.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Vanessa Wissing, RD, CDE, is a registered dietitian and certified diabetes educator at the Robert I. Grossman, MD, and Elisabeth J. Cohen, MD, Pediatric Diabetes Center at Hassenfeld Children’s Hospital of New York at NYU Langone. She provides education and guidance to help children and their families better manage diabetes and overall health. 

A New Approach to Tackling Your Kid’s Disorganization

disorg

It’s halfway into the school year, and for many parents of chronically disorganized kids, it’s a time of mounting frustration. Your child may have started the year strong, with a brand new planner and a great system of color-coded folders, only to slowly fall back into a pattern of missed assignments, coats left in lockers, and last-minute scrambles on long-term assignments. He may have even gotten back on the wagon a few times, clearing out his bag, and starting with a fresh system, only to stumble again. And when mid-year report cards come home with grades that show a lot less than you know your child to be capable of, things can start to feel hopeless. There is hope, though—oftentimes, it just requires a shift in how we look at organizational skills problems. Below are five tips to help you do just that.

1. Resist the blame game. Oftentimes kids who are disorganized are labeled as lazy or lacking in work ethic. But research at NYU Langone over the past decade tells us that organizational skills deficits are real deficits, in the same vein as a math or reading disorder. And just like with a math or reading disorder, kids with organizational deficits need extra support. Framing the problem as a character flaw is demotivating. Instead, frame it as a challenge you and your child can overcome together.

2. Take it one step at a time. Getting organized requires a lot of sub-skills—writing down assignments, keeping paper organized, managing homework time, and planning for long-term assignments, to name a few. Asking your child to make changes in all of these areas at once is setting her up for failure. Make a list of all the specific skills your child needs to work on. Choose one skill to start with (such as filling out her planner every day), and don’t move on to the next skill until she has it mastered.

3. Step it down. For kids who struggle with organizational skills, the best organizational tools are usually the ones that involve the least number of steps to use. If filing a paper means punching that paper with a three-hole punch, pulling out a binder, opening the rings, putting the paper in, and closing the rings, that paper isn’t as likely to get filed. A better solution might be an accordion file, which allows your child to just drop the paper right in. Work with your child to find organizational systems that use the least number of steps possible.

4. Make long-term rewards short-term rewards. Many kids who struggle with organization have a learning style that favors short-terms rewards (like getting out of class quickly) over long-term rewards (like knowing all the details of your assignment, so you get a good grade at the end of the semester). You can boost organization by providing short-term rewards for use of organizational skills. Give your child a small daily prize for things like coming home with all his books, having his planner filled out completely, and having all papers filed correctly.

5. Know when to ask for help. If your child has persistent organizational problems and your efforts to help her have failed, it may be time to consider a psychological evaluation. Several psychological issues, including ADHD, can lead to problems with organization. The good news is there are empirically validated treatments to help. At the NYU Langone Child Study Center, we offer Organizational Skills Training, a program developed and researched by our doctors, at our Manhattan, Westchester, New Jersey, and Long Island locations.

Most importantly, don’t lose hope! Just because it is more difficult for some kids to develop organizational skills, doesn’t mean that they can’t do it. Providing some extra support and maintaining a can-do attitude goes a long way towards setting your child on the path to organizational success.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Jennifer L. Rosenblatt, PhD, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at the Child Study Center at NYU Langone Medical Center, and sees patients through the Child Study Center’s home- and school-based service in Westchester County, New York.