A lot of parents are asking me about this year’s flu vaccine. It is the topic of the moment! So here is the quick and dirty regarding this year’s flu season.

The flu season can start as early as October, tends to peak around December to February, and can last until May.

In Canada, there are two forms of the quadrivalent flu vaccine available and recommended for children. It is recommended that ALL children >6 months of age should receive the flu vaccine. The first available vaccine is the inactivated influenza vaccine (IIV) that is an intramuscular injection, and the second is the live attenuated influenza vaccine (LAIV) that is administered intranasally (nose spray). They have both been proven to be equally effective at protecting against this year’s influenza virus. The intramuscular IIV can be given to any child > 6 months of age, but the intranasal LAIV cannot be given until a child is >2 years old.

Another common question connected to the flu shot is the fear of an allergic reaction due to an egg allergy. The only contraindication to the flu shot is a previous anaphylactic reaction to the flu shot or a component of the flu shot EXCEPT egg, or the development of Guillain-Barre syndrome. So let me repeat, egg is not a contraindication for either the IIV or the LAIV flu vaccine, and this comes from the National Advisory Committee on Immunizations.

Another thing to keep in mind that any child <9 years of age receiving their first ever flu vaccine will require 2 doses 4 weeks apart. So don’t forget to make your second appointment before you leave!

Please speak to your healthcare provider about which form of this season’s flu vaccine is best for your little one as there are additional contraindications for the LAIV form. And don’t forget that you as a caregiver should also visit your healthcare provider or local pharmacy to receive your flu vaccine.

Wash you hands, get your vaccine, and be a flu fighter this year!

Hey all! I am super excited to attend this years Halloween edition of #MomsTO lunch at La Carnita on October 26th! I will be the events medical professional there to answer questions and concerns from the everyday modern and cool mom! MomsTO is a great initiative that was started to reinvent maternity leave. It is a way for moms and their babes to get together, chat, eat, and drink in a safe and non-judgemental space. If you are interested in partaking in one of their upcoming events, check out their website or Facebook page!

Website: http://www.momsto.com
Facebook: MomsTO – Mommies that Like to Wine: Mommy Events & Meet Ups

I am excited to meet all the moms and babes and help them navigate their healthcare queries! And don’t forget your costume!!

See you there!

A lot of parents ask me about the timing of breast or bottle-feeding and how they are told to feed every 3 hours. The confusion for most parents lies in whether that is 3 hours from the start of the feed or 3 hours from the end of the feed, cause gosh some of those feeds can last for what feels like forever! So, let’s clear the air! You are supposed to feed an infant every 3 hours counting from the START of one feed to the START of the next (ie. you feed at 9am, 12pm, 3pm etc), no matter how long the feed lasts. I know at the start your babe may feed upwards of an hour, but as time goes by and both you and your baby gain experience, the timing will start to decrease. Soon your feeding session will last 20-30 minutes (maybe longer if you allow your baby to pacify on you after a feed. You can unlatch you baby at this point and give a pacifier if you need a break!). This timing is for both daytime and nighttime feeding. Rest assured, before you know it, your little one will be 4 months old and should be able to sleep through the night without a feed. If an infant wants to feed during the night after this time, this is more of a trained behaviour rather than a physiological need. Feeding is a schedule like anything else and you will get the hang of it! Remember, this is also a time for bonding between a parent and child no matter what your feeding choice is, so indulge and take advantage of this special time!

Parents ask me all the time about what exciting things they can look forward to now that they have their baby home! I am going to review just a few of the amazing skills you will see your baby learn in the first 6 months of their life.

6 weeks:

This is when your baby will start you show you his or her social smile! This time it won’t be because of gas! Your baby will also be able to watch and follow objects that are moving in front of them.

2 months:

All that tummy time practice will pay off because by 2 months your baby should be able to lift their head full yon their own when on their tummy! Also, your baby should start to “coo” and be able to look toward a sound! The best milestone parents love at this age is your babies ability to recognize your face!

4 months:

This is a big age for milestones, but also for increased supervision and safety. Your baby will begin to roll from their tummy to their back by 4 months, grasp objects and pick them up, and brings objects to their mouth. Your baby also learns how to respond to affection, is able to babble more, laugh, and squeal! Another amazing skill your baby learns at this age is the ability to self-sooth, as well as starting to sleep through the night! Woohoo!

6 months:

By this age, your baby should be showing off how they can roll in both directions, well they can control their head and how they can sit with support or in a tripod position. They also show you how they can grab so hard and pull your hair and how they can transfer an object from one hand to the other. In terms of speech and language, your baby can now make more sounds when spoken to, can imitate sounds, and is able to respond to their name! Your baby should also now be able to hold their own bottle and feed themselves with finger foods.

It is important to remember that every baby is different and some babies will achieve these milestones slightly earlier or later than others. Your doctor or NP is there to answer any questions you may have as your baby develops.

 

Many parents often ask why, when it comes to giving vitamin D because “doesn’t my child get that from the sun?”. That is correct! Vitamin D is a fat-soluble vitamin that is not very common in most foods and is naturally obtained from sun exposure. However, in Canada, most of us are vitamin D deficient, especially during the winter months, which is why vitamin D supplementation is so important, especially for exclusively breastfed infants (Infants who are formula fed receive their vitamin D in the formula, therefore supplementation is not required).

The daily requirement for vitamin D for an infant is 400IU, according to Health Canada. Breast milk provides about 10IU of vitamin D in the winter and about 20IU in the summer. Vitamin D is important for calcium absorption, for adequate bone growth, for cell growth and immunity, and cell metabolism.

Administration is easy! You can purchase vitamin D drops at your local pharmacy. Most companies require just one drop a day! I always tell parents to get into a routine and give it at the same time every day so they don’t forget. It is simple…just simply place a drop of the Vitamin D either onto the breast or nipple of a bottle before a feed. 

It is important to talk to you doctor or NP about adjusting the dose as you infant grows to ensure your child is always getting enough.

Toilet training is a major undertaking when you have a toddler on your hands. The first thing to know and remember is that there is no set age for when a child is ready to be trained or a deadline by which a child should be trained. Most children are not ready for this feat until they are 18-24months old, with girls being developmentally ready 2-2.5 months before boys. It is important to begin preparing your child from an early age by making them familiar with the bathroom and the function of a toilet and the routine of washing ones hands after using a bathroom. Parents should also make a child familiar with how the body works in relation to toileting and the sensations they may feel and what that may mean. Bowel training is often achieved before bladder training because it is a more regular function. There are 3 major things too look for in order to assess toilet training readiness:

• Physical readiness
  • by 22-30 months most toddlers are voluntarily able to control their anal and urethral sphincters
  • Able to wake up dry from a nap and/or remain dry for 2 or more hours
  • Ability to sit, walk and remove clothing independently
• Mental readiness
  • Ability to identify the feelings and sensation of having to use the toilet and the communication skills required to inform a parent of such feelings and urges
  • Ability to copy behaviors and listen to instructions
• Psychological readiness
  • Ability to remain seated on a toilet for 5-8 minutes (do not leave child on a toilet for more than 8 minutes and remain with child the entire time)
  • Curiosity about parent or older siblings ability to use a toilet
  • Desire to be changed when diaper is soiled

When you see the readiness signs in your child, it is time to start training! Remember to practice with positive reinforcement and provide your child with praise for good behavior and successful use of the toilet. Dressing your child in clothing that they can easily remove, or using “pull-up” diapers will help with the training process. It is also important to frequently remind your child about going to washroom as children can easily get distracted by play. Regression is common when it comes to toilet training so do no view it as a failure rather a minor setback that will require a little extra encouragement to overcome! Be patient as this process can take time. Good luck!

I was flower shopping in Toronto and was walking around the store and noticed, tucked nicely away around side of the flower shop, was a little linen pop-up shop. The soft pinks, bright blues, and lavender colours immediately drew, me but gosh there is so much more!! Auggie was started by two Torontonian sisters and their products are sold in Canada and the United States. I must say their products are fabulous and fancy! They make full linen sets and amazing quilts for your baby’s crib, your toddlers “big kid” bed, even twin and queen sized beds, pajamas and more! This company makes it easy to put together the perfect bed for your precious little one! I am just obsessed! Take a look at the Felix Collection, Pretty with Pink Collection, and the Rabbit Patch Collection at http://www.littleauggie.com. Shop online or find a realtor near you! Enjoy!

Like many other new parents, you are wondering if your baby is gaining weight, and if their weight gain is normal for their age. After birth, babies lose about 5-10% of their birth weight in the first 48 hours. This extra weight they were carrying is usually extra fluid and stool. By day 10-14 they should return back to their birth weight. Following this time, each baby gains, on average, 15-30 grams per day until they reach 3 months of age. In order to achieve this weight gain babies rely on feeding breastmilk or formula (Refer to my previous post on when to start feeding your baby solid food). You will see most of this growth in their length as they grow 1 inch per month for the first 6 moths, followed by half and inch a month from 6 months to 1 year. You can determine if your baby is getting enough fluid if they are having approximately 6-8 wet diapers in 24 hours.

Talk to your doctor or Nurse Practitioner (NP) if you are concerned about your baby’s weight gain. They will usually closely monitor the weight of your newborn for the first month, so do not be surprised if you are visiting your doctor or NP every 3-7 days for the first month.

Being a new or veteran mom, it is important to learn and understand your baby. Your baby is wise and can communicate their needs with you. Responding early to your baby’s feeding cues is the best way to meet the needs of your baby. Babies are recommended to eat an average of 6-18 feeds every 24 hours (I know that is a large range but each baby is so unique it is difficult to put an exact amount on the number of feeds). Babies display cues when they are hungry and it is best to respond promptly in order to prevent your baby from becoming distressed. Once a baby is distressed due to hunger it becomes more difficult to feed.

There are 3 stages of feeding cues and it is important to learn to recognize them.

1) Early Feeding Cues

• Squirming or stirring, movement seen in arms and legs
• Rooting
  • Reflex innate in newborns whereby they open their mouths and turn their heads in search of a nipple or suck on their fingers or hands to display they are hungry
• Bringing fingers in mouth
• Baby demeanor is still calm
• ***THIS is the best time to breastfeed your baby

2)  Mid-Feeding Cues

• Becoming fussy
• Squeaking
• Restless
• Beginning to intermittently cry

2) Late Feeding Cues

• Crying
• Screaming
• Redness seen in skin
• Difficult to sooth

It is best to recognize the early feeding cues and begin to breastfeed your baby as it can become increasingly more difficult to calm and feed an agitated baby. Hope these simple tips help you and your baby successfully and happily breastfeed!

Breast pumping is a great way to feed your baby breast milk at any time (by anyone!) and maintain your milk supply. There are many pumps out there on the market varying by style- single or double breast, single breast, electric, battery, or manually operated, and of course by price.

Electric pumps are easy to use and the fastest way to pump your breasts. Most electric pumps also provide two pumps, enabling mom to pump both breasts concurrently which is a HUGE time saver! Also, pumping both breasts at the same time increase prolactin levels (the hormone involved in milk production) allowing you to pump more milk in a shorter period of time. These pumps are your best bet if you will be pumping often and want to save time. These can be bought in stores and in hospitals. Hospital grade pumps (which also come portable) will be on the pricier side, but will eventually be worth the investment. Electric pumps are the most effective and time saving method to pump.

Battery operated pumps are also very effective however, are less powerful than the electric pumps. To make up for the decrease in power is the price (except for constant battery changes). the portability and the fact that it is a hands free system is extremely convenient, making them a popular choice among mothers.

Manual pumps are a great option if you don’t mind operating them by hand. Manual pumps are also easier on your wallet. The length of time is takes to pump will be longer, and you can only pump one breast at a time however, they will stimulate milk let down and be as effective as electric and battery operated pumps.

If you choose to pump do so as often as your baby would feed- every 2-3 hours therefore pumping at least 8 times a day. Pumping time will vary depending on your pump, if you are pumping 1 or 2 breasts, and the volumes that you are pumping, so be prepared to pump between 10 and 40 minutes. Storage of breast milk is also important to note. Milk should be stored in specialized storage containers and can remain in the fridge for 48 hours, in a freezer for 3 months, and in a deep freezer for 6-12 months (Use your milk in the order you pumped it because the components change as your baby gets older- so a date on each bottle is important!). When thawing or warming milk do NOT put the milk in the microwave as it warms the milk unevenly potentially burning your baby, and it also changes the components of the milk. Alternatively, thaw milk by defrosting it in its bottle submerged by warm water until ideal temperate is reached. Remember, once you thaw milk, it has to be used 24 hours and it CANNOT be re-frozen.

So do a little research into the different types of pumps and choose one that fits your lifestyle and budget! And remember, hand expressing is always an option to express ones milk- it is easy and free!