Parent Center: Chicken Pox ( 12 to 24 mo.)

My toddler has a spotty red rash all over her chest. Could it be chicken pox?
It could be. Chicken pox, also called varicella, typically causes an itchy rash that starts out as small red bumps. These bumps quickly change into clear, fluid-filled blisters on a pink base, which eventually become dry brown crusts. New waves of blisters often spring up as the illness progresses.

The rash often appears first on the scalp, face, or trunk. It can then spread over the entire body. Children usually get between 250 and 500 blisters, although it's possible to have just a few.

Your toddler will probably be tired and slightly feverish. She may have a loss of appetite and a mild headache or abdominal pain. For a couple of days before the rash appears, she may have a cough or a runny nose. Chicken pox usually lasts five to ten days.

How did my toddler get chicken pox?
Chicken pox is caused by the varicella zoster virus, which passes from person to person with remarkable ease. If your toddler hasn't received the chicken pox vaccine or had the illness herself, she's likely to come down with it if she's exposed to an infected person.

People with chicken pox can pass the virus along by touching someone after touching the blisters or coughing or sneezing onto their hand, or by releasing it into the air whenever they sneeze, cough, or even breathe. The virus can also spread from direct contact with the fluid from the blisters before they crust over.

Once your toddler has been exposed to the virus, it usually takes 14 to 16 days for the pustules to appear, although they can show up anytime between ten and 21 days.

Is chicken pox dangerous?
For healthy children, chicken pox is usually more of a nuisance than a real threat. On rare occasions, though, even healthy children can develop serious complications from chicken pox, like a bacterial skin infection, pneumonia, or encephalitis, a swelling of the brain.

If your child has chicken pox, call the doctor if she seems sicker than expected, if she develops a fever after the first few days, if the rash spreads to her eyes, or if the skin around the pox becomes swollen, painful, or very red.

If your toddler has a weakened immune system from a chronic illness such as leukemia or from taking high-dose oral steroids (for asthma, for example), the infection can cause grave complications. Some special protective measures, such as an injection of varicella zoster immune globulin or the varicella vaccine, can only be useful shortly after exposure. If your toddler's immune system is compromised, call her doctor at the first sign of chicken pox — or even if she's only been exposed to someone who's sick.

Adults who come down with chicken pox can get very sick and are at risk for such complications as bacterial pneumonia. If you're pregnant and have never had chicken pox, read our article on chicken pox during pregnancy and ask your doctor what precautions you should take and what to do if you've been exposed.

What are shingles?
The same virus that causes chicken pox can cause a painful rash called shingles. When a child has chicken pox, the virus remains in the body and can reappear as shingles many years later. This happens to about 1 in 10 adults who had chicken pox earlier in life.

Is there any way to prevent chicken pox?
Yes. A vaccine has been available since 1995, and the American Academy of Pediatrics (AAP) recommends that children receive the shot at 12 to 15 months of age, with a second dose at 4 to 6 years.

The vaccine causes few side effects in healthy children and keeps more than 95 percent from getting a serious case of chicken pox. The shot isn't recommended if your toddler has had a severe allergic reaction to gelatin (yes, the stuff that makes Jell-O hold together), the antibiotic neomycin, or a previous dose of the vaccine.

If your toddler has cancer or any disease that affects her immune system, has recently had a blood transfusion, or is taking high doses of oral steroids, her doctor will carefully evaluate whether receiving the vaccine would be a good idea.

See our article on the chicken pox vaccine for more information on the pros and cons of the shot.

How should I treat my toddler's chicken pox?
Keep your child home from daycare until all the sores have crusted over to prevent her from spreading the disease and to give her time to recuperate. Unfortunately, children are most contagious the day or two before the rash erupts, usually before parents know their child is sick.

While your toddler's recuperating, the most comforting thing you can do is relieve the itching. Give her a cool bath every three to four hours. Sprinkle baking soda or colloidal oatmeal (made specifically for the bath) into the water for added relief. (You can also use uncooked oats. Tie them in a cheesecloth bag and toss it in the tub.) After the bath, put calamine lotion on the itchy spots.

It may seem like an impossible task, but try to keep your toddler from picking and scratching her sores, which can slow the healing process. Sores that aren't allowed to heal can leave scars or lead to skin infections such as impetigo. Keeping your child's nails short can help.

Bring down your toddler's fever with acetaminophen or ibuprofen. Never give aspirin to your child as it can trigger Reye's syndrome, a rare but potentially deadly condition.

If your toddler seems really uncomfortable, you might try giving her the proper dose of an over-the-counter children's antihistamine to help reduce the itching.

Doctors can prescribe an antiviral drug called acyclovir to treat chicken pox, but it's not generally recommended for otherwise healthy children. For children with weak immune systems, however, acyclovir can be crucial.

source from http://www.babycenter.com

Baby Center: Dry Skin (12 to 24 mo.)

What's making my toddler's skin so dry?
Children can get dry skin just like adults do. In fact, because young skin is more delicate, it's more susceptible to becoming dry.

Cold, dry outdoor air and indoor heating can rob skin of its natural moisture in the winter. And if your toddler is prone to dry skin, he'll break out in dry patches in the summer as well, because the summer sun, air conditioning, salt water, and the chlorine in pool water can all be drying.

What can I do about my child's dry skin?
Cut back on bath time
Bathing dries a child's skin because it removes the skin's natural oils along with the dirt. But as long as you take a few precautions, even daily baths shouldn't be a problem, says Seth Orlow, director of pediatric dermatology at New York University School of Medicine.

Instead of a 30-minute bath, cut bath time down to about ten minutes. Use warm water — not hot — and soap up sparingly. In fact, Orlow suggests using a fragrance-free, soap-free cleanser, which is much less harsh than regular soap.

Let your toddler have his playtime in the tub before you wash him, so he won't be sitting in soapy water. And don't leave the cleansing bar floating in the tub. You'll probably want to cut bubble baths out of your child's routine — or at least limit them to special occasions.

While bath oils may seem like a good idea, they can make the tub dangerously slippery, and most of the oil slides down the drain anyway. Applying an emollient after bathing is a better route.

Slather on the moisturizer
Once you take your toddler out of the bath, quickly and lightly dry him with a towel, then apply moisturizer immediately. Applying the moisturizer within minutes of getting your toddler out of the tub will seal in the water that's still in his skin from the bath.

As far as moisturizers go, the general rule is the thicker the better. If your toddler's skin is still dry even with daily moisturizing, try switching from a lotion to a thicker cream or ointment.

You might also want to consider moisturizing twice a day — once after bathing and once during the day. If your toddler doesn't have the patience for a midday slather, you might let him listen to a favorite song or watch a video while you apply the moisturizer.

Don't let salt or chlorine dry on his skin
Chlorine and salt water can both be very drying. After a swim in the pool or ocean, rinse off your toddler with tap water, and then apply moisturizer while his skin's still damp.

Keep your child well hydrated
Dry skin lacks water. Offer your toddler plenty to drink year-round to replace the moisture that's evaporating from his skin.

Keep in mind that drinking a lot won't do anything if you don't moisturize as well. It's like pouring water into a bucket with a hole, says Orlow. Without moisturizer to hold in the water, your child's skin won't properly hydrate.

Run a humidifier
If the air in your home is dry, use a cool mist humidifier in your child's room.

Protect your child from the elements
Make sure your toddler wears mittens in cold weather to keep his hands from becoming dry and chapped from the cold and the wind. In summer, take steps to protect him from sunburn.

Could dry skin be a sign of some other kind of condition?
If your toddler has itchy red patches on his skin, it's possible he has eczema, also known as atopic dermatitis. Sometimes even eczema will clear up with regular moisturizing, though, so you needn't rush to the doctor unless the patches don't get better or your child is itchy or uncomfortable.

In rare cases, dry skin can indicate a genetic condition called ichthyosis. Ichthyosis shows up as dry skin with scaling and, occasionally, redness. It's also generally accompanied by a thickening of the palms of the hands and the soles of the feet. If your doctor suspects that your child has ichthyosis, she'll probably refer you to a dermatologist for treatment.

Should I talk with the doctor about my toddler's dry skin?
At your child's next doctor's visit, ask for recommendations for battling dry skin. Schedule a visit if you think your toddler has signs of eczema or ichthyosis (above). Also call for an appointment if your child's skin doesn't improve with home treatments or you see any signs of an infection, like a yellow discharge or swelling around a crack in his skin.

source from http://www.babycenter.com

Weaning (12 to 24 mo.)

What does it mean to have weaned a child?
When your child stops nursing and gets all his nutrition from sources other than the breast, he's considered weaned. Although children are also weaned from the bottle, the term most often refers to when a child stops breastfeeding.

Weaning, when it's the mother's idea, usually requires a lot of patience and can take time, depending on your child's age and how well and how quickly he adjusts. The experience is different for everyone.

Weaning is a long goodbye — emotional, sometimes painful, and freeing at the same time. But weaning needn't signal an end to the intimacy you and your child have established through breastfeeding. It just means you have to replace breastfeeding with other nourishment and nurturing activities. If you've often nursed your child for comfort, find other ways to make him feel better. Read a book or sing a song together, or play outside instead.

How do I wean?
Proceed slowly, regardless of the age of your child. Experts advise that you not abruptly withhold your breast, which can be traumatic. A weekend away from your toddler with your partner, for example, is not a good way to end the breastfeeding relationship. Try these methods instead:

Skip a feeding. Skip a feeding and see what happens. Offer a cup or bottle of milk instead. As a substitute you can use your own pumped milk, formula, or cow's milk. If you reduce feedings one at a time over a period of weeks your child will have time to adjust to the changes. Your milk supply will also diminish, without leaving your breasts engorged or giving you mastitis, a breast infection.

Shorten nursing time. Start by cutting the length of time your child is actually on the breast. If he usually nurses for five minutes, try three. Follow the feeding with a healthy snack like unsweetened applesauce or a cup of milk or formula. Bedtime feedings may be harder to curb — they're usually the last to go.

Postpone and distract. Try postponing feedings if you're only nursing a couple of times a day. This method works well if you have an older child you can reason with. If your child asks for the breast, say you'll feed him later and distract him. Instead of nursing in the early evening, you could tell him to wait until bedtime.

What to do when weaning becomes a struggle
If you've tried everything to wean your child and nothing is working, maybe the time isn't right. Have you recently gone back to work? Your child may still be adjusting to this new development. Has your child been sick? Often children who aren't feeling well will want to nurse more often — in fact, breastfeeding may be in a sick child's best interest.

Has your household gone through a major life change, such as a move or a divorce? Events such as these will also make weaning more difficult. Even going through a new developmental stage can make it hard to wean. Try again in another month. Sooner or later, it'll happen.

source from http://www.babycenter.com

The Lowdown On Children's Vitamins (12 to 24 mo.)

Should I give my toddler a vitamin supplement?
Experts disagree on whether a daily multivitamin/mineral is a good idea for all children. The American Academy of Pediatrics (AAP), for example, advises giving your child a supplement only if your pediatrician recommends one. Because so many common foods are fortified, most children don't need supplements, the AAP argues. On the other hand, the AAP acknowledges that a multivitamin/mineral supplement won't hurt as long as it doesn't exceed the recommended daily allowance (RDA) for any vitamin or mineral. Other experts say that a daily supplement is a good way to fill in any gaps in your child's nutrition.

Most experts do agree that:

• As long as you don't overdose your child on supplements (exceed the RDA for any one vitamin or mineral), a daily multivitamin won't hurt.

• Some children — like vegetarians, or those with sensitivities to certain foods, for example — might need a daily multivitamin/mineral supplement to meet their RDAs.

• Supplements are not a substitute for good food, and they should never be used to justify a poor diet. If your child isn't eating well, give him a supplement, but also take steps to improve his eating habits.

Should I give my toddler a multivitamin if he's a picky eater?
If you're concerned that your toddler's lacking in any area — because he won't put anything green in his mouth or because he goes on food jags when he seems to eat nothing but cheese and crackers for days — then you might want to give him a supplement for your peace of mind. It provides a little extra insurance that he's getting what he needs, says Debby Demory-Luce, a registered dietitian with the U.S. Department of Agriculture's Agricultural Research Service, a nutrition arm of the agency, and an instructor of pediatrics at Baylor College of Medicine. As long as you give your toddler just one daily multi, he won't "overdose" on a particular vitamin, even if he's already getting more than he needs of that vitamin from his food.

Should I give my toddler a vitamin supplement?
Experts disagree on whether a daily multivitamin/mineral is a good idea for all children. The American Academy of Pediatrics (AAP), for example, advises giving your child a supplement only if your pediatrician recommends one. Because so many common foods are fortified, most children don't need supplements, the AAP argues. On the other hand, the AAP acknowledges that a multivitamin/mineral supplement won't hurt as long as it doesn't exceed the recommended daily allowance (RDA) for any vitamin or mineral. Other experts say that a daily supplement is a good way to fill in any gaps in your child's nutrition.

Most experts do agree that:

• As long as you don't overdose your child on supplements (exceed the RDA for any one vitamin or mineral), a daily multivitamin won't hurt.

• Some children — like vegetarians, or those with sensitivities to certain foods, for example — might need a daily multivitamin/mineral supplement to meet their RDAs.

• Supplements are not a substitute for good food, and they should never be used to justify a poor diet. If your child isn't eating well, give him a supplement, but also take steps to improve his eating habits.

Should I give my toddler a multivitamin if he's a picky eater?
If you're concerned that your toddler's lacking in any area — because he won't put anything green in his mouth or because he goes on food jags when he seems to eat nothing but cheese and crackers for days — then you might want to give him a supplement for your peace of mind. It provides a little extra insurance that he's getting what he needs, says Debby Demory-Luce, a registered dietitian with the U.S. Department of Agriculture's Agricultural Research Service, a nutrition arm of the agency, and an instructor of pediatrics at Baylor College of Medicine. As long as you give your toddler just one daily multi, he won't "overdose" on a particular vitamin, even if he's already getting more than he needs of that vitamin from his food.

What kind of vitamin should I give my toddler?
Any generic type of children's multivitamin will do, unless your toddler has special needs. (Choose liquid forms only, as chewables can post a choking hazard for this age group.) For example, if your child is a vegetarian, you'll want to make sure that the supplement contains adequate vitamin B12, which will be lacking in his diet. And if your doctor has decided that your child is anemic, she may recommend a supplement with a particular amount of iron.

Note that supplements often don't contain 100 percent of every vitamin and mineral, so you'll still want to make sure your child gets the needed nutrient from other sources. If your toddler doesn't drink milk or eat enough dairy, for example, and gets about 15 to 20 percent of the RDA for calcium from his supplement, then you'll need to find other, food-based sources, such as calcium-fortified orange juice.

An important caution: Children often view vitamins as candy (they're shaped, colored, and flavored to be appealing to kids, after all) and may eat several at a time if given the opportunity. But an overdose of iron, in particular, could be fatal. So treat vitamins as medicines. Make sure the caps are childproof, but don't depend on them — always keep vitamin bottles well out of the reach of your child.

Dietitian Demory-Luce, a mother of two, learned this the hard way: "My youngster got his hands on a bottle of vitamins, opened the safety top, and ate ten vitamins before I got to him," she says. "Luckily, the vitamins didn't have iron in them." Now she keeps vitamins locked away in a cabinet. (To be on the safe side, call poison control if you suspect that your child has taken vitamins on his own, even if they don't contain iron.)

Should I give my toddler more than one vitamin a day if his diet is especially bad one week?
No. There's never any reason to give your child more than the recommended daily dose (usually one pill per day). "Some people think that a little is good but more is better," says Demory-Luce. This is a dangerous way to approach vitamins. Not only could it hurt your child, as with too much iron, but an overdose of certain vitamins could also prevent the absorption of others, creating a nutritional imbalance.

source from http://www.babycenter.com

How To Teach Your 2-year-old To Share

What to expect at this age

"Mine!" your 2-year-old shouts, grabbing a doll from her playmate. No sooner have you smoothed out that squabble than another erupts. "No!" your child yells as her visitor picks up her favorite ball and rolls it across the floor. As far as you're concerned, your kid is acting selfish and bossy, and if she keeps it up she's likely to wind up friendless.

As exasperating as these episodes can be, try to be philosophical about them. Your child is acting in perfect keeping with a 2-year-old's view of the world, in which her own things (or anything that strikes her fancy, for that matter) are an extension of herself. "Two-year-olds are beginning to understand possession, and they are developing a strong sense of self, which make mine and no two of their favorite words," says Roni Leiderman, associate dean of the Family Center at Nova Southeastern University in Ft. Lauderdale, Fla.

Of course, some 2-year-olds are happy by nature to give a pal one of their cookies, but most are more possessive. In fact, many 2-year-olds aren't developmentally ready to share. Sure, they can play side by side with other kids if you keep a close eye on them, but expect some inconsistencies with give-and-take. Sharing is a learned activity, and mastering it takes some time. Nonetheless, you can introduce your child now to the merits of sharing, then build on the groundwork you're laying as she gets older.

What to do
Practice taking turns. You flip one page of your child's bedtime book, and she flips the next. Or you stack a block on top of hers, then she stacks another on top of yours. You could also take turns putting puzzle pieces together or pushing a toy car down a ramp. Try give-and-take games, too: You hug her teddy, then give it to her to hug and return to you. You kiss her teddy, then give it to her to kiss, and so on. She'll begin to learn that taking turns and sharing can be fun and that giving up her things doesn't mean she'll never get them back.

Don't punish stinginess. If you tell your 2-year-old that she's selfish, discipline her when she doesn't share, or force her to hand over a prized possession, you'll encourage resentment, not generosity. "Never punish a child, especially a 2-year-old, for not sharing," says Susanne Denham, Ph.D., developmental psychology professor at George Mason University in Fairfax, Va. "It is, after all, a very personal decision."

Talk it up. Help your child explore the emotions that relate to sharing. If a friend is holding something back, explain to your child how her buddy might be feeling. For instance: "Josie loves her teddy, and she really wants to hug him right now." Help her put her own feelings into words too: "I know you want your doll," or "You're sad because Sofia took your car." Give your child plenty of praise when she does loosen her grip on something. At snack time, for instance, remark on how nicely she and her playmate are divvying up the cookies and point out how much fun it is to share a treat with a friend.

Cheer little steps toward sharing. Two-year-olds sometimes show their possessions — and even let others touch them — without actually letting go of them. "Encourage this 'proto-sharing' by telling your child how nice it is that she's showing her toy," says Denham. Eventually, bolstered by your praise, she'll feel secure enough to loosen her grip.

Set the stage. If you're expecting pint-size company, have your child put her "special" toys away before her friend arrives. In their place, provide playthings that are easy to enjoy in tandem — blocks, tea sets, crayons and coloring books, dress-up clothes, and modeling clay, for instance. Tell your 2-year-old and her visitor that they can share these things, and compliment them when they do. If one of the children is heading for a toy her friend has a death grip on, distract her with a question, a snack, or another toy.

Respect your child's things. If your 2-year-old feels that her clothes, books, and toys are being manhandled, it's unlikely she'll give them up even for a moment. So ask permission before you borrow her crayon, and give her the option of saying no. Make sure that siblings, playmates, and babysitters respect her things too, by asking to use them and by taking good care of them when they do.

Lead by example. The best way for your child to learn generosity is to witness it. So share your ice cream with her. Offer her your scarf to wear, and ask if you can try on her barrette. Use the word share to describe what you're doing, and don't forget to teach her that intangibles (like feelings, ideas, and stories) can be shared too. Most important, let her see you give and take, compromise, and share with others.

source from http://parentcenter.babycenter.com

Choosing Formula: A Primer

I'm bottle-feeding my baby. Which formula is best?

It's easy to feel overwhelmed in the formula aisle. Choosing the best nourishment for your baby is a pretty weighty decision, and there are lots of choices. When choosing a formula, you'll want to consider the form it comes in (ready-made, concentrate, or powdered), the type of protein it uses (cow's-milk-based formula is the most popular, but there are other options), and what other ingredients are included (such as DHA and iron). Here's what you need to know:

Forms of formula
Formulas come in three basic forms: ready-made, concentrate, and powdered.

Ready-to-use formula is undoubtedly the most convenient — no mixing or measuring required, just open and serve. It's hygienic and especially helpful in circumstances where you might not have access to safe water. It's also a good choice if your baby was born with a very low birth weight or is otherwise immuno-compromised, because it's sterile. But for everyday use, the convenience of ready-to-use formula comes at a price — ready-to-use formula costs about 25 percent more per ounce than powdered formula. The containers also take up more storage space in your cupboard and more space in the landfill, unless you can recycle all of the cans or bottles. Once opened, ready-to-use formula has a short lifespan — it must be used within 48 hours. Also, because it often has a darker color than powdered formula, many moms complain that it's more likely to stain clothes.

Liquid concentrate formula requires you to mix equal parts of water and formula, so read the instructions on the container carefully. Compared to ready-to-use formula, concentrate is less expensive and takes up less storage space. Compared to powdered formula, it's a little easier to prepare but more expensive.

Powdered formula is the most economical choice and the most environmentally friendly. It takes up the least amount of space in transport, in your pantry, and in your trash can. Powdered formula takes more time to prepare than other types of formula, and you must follow the directions exactly, but it has a one-month shelf life after the container has been opened. Besides, you can mix up just the right amount whenever you need it — as much or as little as you want — which is especially helpful if you're a breastfeeding mom who may only need an occasional supplemental bottle for your baby.

Types of formula
There's a formula to suit every baby's needs.

Cow's-milk-based formula: Most formula available today has cow's milk as its main ingredient. The protein in the milk is significantly altered to make it easier to digest, because your baby won't be ready to digest regular cow's milk until after his first birthday.

Soy-based formula: If you're avegan, or if your baby has trouble digesting cow's milk protein, the doctor may suggest a soy-based formula. These are made with a plant protein that, like the protein in cow's milk, is modified for easy digestion by babies. You may also want to talk with your baby's doctor about giving soy-based formula a try if your baby has colic. The evidence isn't conclusive, but some research suggests it's worth a try.

Lactose-free formula: If your baby is lactose-intolerant, or unable to digest lactose, which is the sugar naturally found in milk, his doctor will recommend a lactose-free formula in which the lactose is replaced with a different sugar, such as corn syrup.

Extensively hydrolyzed formula: In these formulas, the protein is broken down into smaller parts that are easier for your baby to digest than larger protein molecules. Your baby may need a hydrolyzed formula if he has allergies or trouble absorbing nutrients. The doctor may also suggest trying a hydrolyzed formula if your baby has colic.

Formulas for premature and low-birth-weight babies: These formulas often contain more calories and protein, as well as a more easily absorbed type of fat called medium-chain triglycerides.

Human milk fortifier: This product is used to enrich the nutrition of breastfed babies who have special needs. Some are designed to be mixed with breast milk, and some can also be fed alternately with breast milk.

Metabolic formulas: If your baby has a disease that requires very specialized nutrition, he may need one of these specially developed formulas.

What's in formula? How do formulas differ?
There are six main ingredients in formula: carbohydrate, fat, protein, vitamins, minerals, and other nutrients. What makes one brand of formula different from the next is the specific carbohydrate or protein it uses, as well as any additional ingredients it includes. For example, casein and whey are two kinds of cow's milk proteins that are found in various proportions among different brands of cow's-milk-based formula.

It's very easy to get confused by all of the items listed on the ingredient label. Below, we guide you through the maze of ingredients, and compare them to those found in breast milk.

Carbohydrate: Lactose is the main carbohydrate source in breast milk, and it is also the primary carbohydrate source in cow's-milk-based formulas. Corn maltodextrin is sometimes used as a secondary source of carbohydrate. Lactose-free, soy, and special formulas contain one or more of the following carbohydrates: sucrose, corn maltodextrin, modified cornstarch, or corn syrup solids.

Protein: Breast milk contains about 60 percent whey and 40 percent casein. Most formulas have similar protein content. Others contain 100 percent whey. Some studies indicate that whey protein is digested faster than casein, which could be beneficial for babies with gastroesophageal reflux disease (GERD).

Soy formulas contain soy protein isolate. Some brands use partially hydrolyzed soy protein to encourage easier digestion.

Sometimes the protein in formula is partially hydrolyzed, or broken down. Partially hydrolyzed formulas are not hypoallergenic — don't use one if your baby has a protein allergy, or even if you suspect he may have one. However, partially hydrolyzed whey formulas have been shown in one study to reduce atopic dermatitis, compared to standard cow's-milk formula.

Extensively hydrolyzed formulas contain extensively broken-down casein with additional amino acids, which are the building blocks of protein. These formulas are considered hypoallergenic and are used for babies who have a protein allergy.

Fat: Breast milk contains a blend of monounsaturated, polyunsaturated, and saturated fat. Formulas use a variety of oils to match the fat makeup of breast milk. They include soy oil, coconut oil, corn oil, palm or palm olein oil, and high oleic sunflower oil. Although palm and palm-olein oil are widely used, research has shown that these fats can reduce absorption of fat and calcium from formula. In other words, your baby may not absorb as much fat and calcium as he would from a formula that doesn't contain these oils.

Medium-chain triglycerides require less effort to digest and are more easily absorbed. They're used in special formulas for premature infants and for infants who have trouble digesting or absorbing nutrients.

The FDA has approved the addition of two long-chain fatty acids to formula: DHA (docosahexaenoic acid) and ARA (arachidonic acid). Both of these substances are found in breast milk when the mother's diet is adequate, and both are important for brain and vision development. Babies get DHA and ARA from their mother during the third trimester, but the transfer is cut short when a baby is born prematurely. All babies need a continuing supply of both substances throughout their first year.

Two studies published in April 2005 support the supplementation of formula with DHA and ARA. One, a report published in the American Journal of Clinical Nutrition, showed that full-term infants fed DHA- and ARA-supplemented formula had significantly better visual acuity than infants who did not receive the supplements. And a study published in The Journal of Pediatrics states that DHA and ARA enhance both cognitive and physical growth in preterm infants.

There aren't any long-term studies confirming the safety of these substances, although there's no evidence suggesting that these additives are harmful to babies, either. Formulas that include DHA and ARA are priced about 15 percent higher than standard formula. The American Academy of Pediatrics (AAP) has not taken a position on whether these fatty acids should be added to formula.

Vitamins and minerals: The majority of words on the ingredient label describe vitamins and minerals. These words can be hard to figure out — ferrous sulfate is iron, for example, sodium ascorbate is vitamin C, and calcium pantothenate is a B vitamin.

The AAP recommends that all healthy babies who aren't breastfed exclusively be given iron-fortified formula until they reach their first birthday. It's important that babies receive the minimum recommended amount of iron (4 mg of iron per liter) to prevent iron-deficiency anemia.

Anemia inhibits the blood's ability to circulate oxygen, which all of the body's cells need to function properly. Studies have shown that getting enough iron in the first year of life is important for success in school later on. A baby's iron stores are established in the last trimester, so it's especially important for premature babies to get plenty of iron.

Most formulas contain at least 4 mg of iron per liter, although "low-iron" formulas are still on the shelves. These were developed years ago in response to the misconception that iron causes constipation. The AAP would like these low-iron formulas to be discontinued or labeled as nutritionally inadequate.

Other ingredients Here's where the different brands tweak their formulas to make them stand apart from one another.

Nucleotides: These are the building blocks of DNA and RNA, naturally present in breast milk. They have several functions and may aid in immune system development. Different brands of formula have different amounts of nucleotides added.

Rice starch: Rice starch is added to "anti-regurgitation" formula. Some research shows the pre-thickened formula does result in less spitting up and choking. However, other research indicates there may be the same amount of acid reflux regardless. Ask your baby's doctor before using an "AR" formula to help with your baby's spitting up.

Dietary fiber: Soy fiber is added to soy formula for the temporary treatment of diarrhea. The only formula containing fiber is Isomil DF, which is clinically shown to reduce the duration of diarrhea.

Amino acids: Amino acids such as taurine, methionine, and carnitine are added to soy formulas, and sometimes to cow's-milk formulas, to match the amount of amino acids in breast milk.

"Designer" formula: This formula is unique in that it has a protein ratio similar to breast milk, but the proteins are partially broken down to aid digestion. It also has 25 percent less lactose than regular formula.

Are generic brands nutritionally adequate?
Generic brands of formula must meet requirements from the federal Food and Drug Administration (FDA) for nutrients in formula, so in many instances, the only difference between generic and brand name is the price. Whether you're buying generic or name brand, though, take a minute to look at the label before you purchase the formula. Specific ingredients do vary from brand to brand, and this can make a difference to your baby.

Can I make my own formula?
No. It would be impossible to include all of the ingredients in the right amounts for your baby. Homemade formula could lead to failure to gain weight, malnourishment, or even death.

What about adding cereal or milk to my baby's formula?
Never add vitamins, cereal, fatty acids, olive oil, regular cow's milk, or any other ingredients to your baby's formula unless your doctor recommends it. Formula is a carefully developed substance with precise amounts of dozens of nutrients. Adding anything to formula could jeopardize your baby's health.

Olive oil, for example, can lead to permanent lung damage and even death, because of the danger of inhaling the oil into the lungs when spitting up. Because cow's milk is so hard for babies to digest, never mix cow's milk with formula or give it to your baby straight until he's at least 1 year old. And adding breast milk to formula is a waste of breast milk if your baby doesn't drink the entire bottle.

What if I'm still not sure?
If you've decided to feed your baby formula and you're still baffled by the many options available, or you're considering switching formulas, talk with your baby's doctor. She'll consider your baby's health, age, and nutritional needs and make an appropriate recommendation. She can also monitor your baby's reactions and investigate any symptoms. Don't try to diagnose an allergy or sensitivity on your own. You could miss a serious underlying condition or prevent your baby from getting adequate nutrition.

source from http://www.babycenter.com

Toys for 18-to 24 -month -olds

Your toddler is becoming more excited about independence but is constantly being reminded of her own limits. So while she insists on doing something "Myself!" one moment, the next might find her turning to you for help.

The way she learns what she can do is by getting her hands into everything. She fiddles with knobs, opens and shuts doors, flips light switches on and off — it's enough to drive any parent nuts. Toys with interlocking parts — pop-up toys, nesting toys, sorting toys, trucks with doors that open and shut, play kitchens with knobs and doors — can create endless opportunities for your child to explore, and push, her limits while keeping her away from the light switch.

At this age, children learn best from unstructured play, so just make the toys available and off she'll go.

Plastic tea set or playhouse: Your child will get a kick out of play eating and drinking. And in general, scaled-down toys, from rakes, push brooms, and shopping carts to miniature kitchens, give her a chance to do one of the things she loves best — mimic what she sees the adults around her do and organize her world to her own satisfaction.

Large and small blocks: Working with blocks lets your toddler build her handling skills by grabbing, stacking, and sorting. Large cardboard bricks easily add up to toddler-size forts and hiding spaces. Small wooden ones can be sorted and organized into any number of original designs.

Toy instruments: Children generally love music and the chance to create their own sound, no matter how cacophonous. Give her a toy guitar to strum or a keyboard to bang on and she'll treat you to many original compositions. Make sure whatever instrument you find has a volume dial you can turn down so that you — and your neighbors — can tolerate those early tunes.

Puzzles: Puzzles are a good way to give your young child little victories — the simple satisfaction of putting something exactly in place is a marvelous thing. Choose puzzles that have very few pieces and are made of thick, easy-to-manipulate blocks of wood.

Illustrated books and cassette tapes: While recorded stories are no substitute for reading to your child, many toddlers do enjoy the novelty of hearing a voice come out of a machine and can appreciate that the voice is new and different. The regular patter of nursery rhymes is particularly pleasing to a toddler's ear. For more ideas, see our recommended books and music for this age.

Train sets: Your toddler can use her new dexterity to link the cars and run the whole train around the house. She'll love seeing how it can take corners, and the difference between running it over a carpet and across a bare floor.

Washable crayons and paper: Your child is becoming more interested in making her own mark — on floors, walls, furniture. Clear a space for her to work, give her a big sheet of paper (tape it to the table) and a couple of crayons (you don't want to overwhelm her), and she'll get the idea that art has its place. Hang up whatever she makes for you. (See our article on writing and your toddler.)

source from http://www.babycenter.com

Toys for 12-to 18 -month -olds

Your toddler is really taking off these days — and as you chase her little body down the street, you may miss the days before she learned to use her legs so well. "Active" is an apt way to describe her now, and she likes any toy or game that allows her to throw her whole self into it — balls, swings, and tiny climbing sets, to name a few.

Her hands are becoming more coordinated, too, and she can now use toy sorters more efficiently, build even greater block towers, and scribble a drawing. Her play involves lots of experimentation, like "What happens if I drop this ball?" or "What happens if pull this lever?" She's very interested in the consequences of her actions, and because her memory isn't well developed she won't tire of repetition. Toddlers also like to try out what they see adults doing, so look for toys that imitate daily life.

Large building bricks: These light cardboard bricks are big enough to stack up into a fort or wall, or any other way your toddler wants. But the most satisfying part of the process continues to be the finale — when the walls come tumbling down.

Push and pull toys: Heavily weighted push toys can give your beginner something to lean into as she motors around your home. Wagons can be ideal. Pull toys are for slightly advanced walkers who can look behind them as they move forward. Give them something to look at: Pull toys that flap, bobble, squeak, or in any other way make a scene are favorites. To find out more about walking and your toddler,

Sorting and nesting toys: Toddlers love to sort, stack, unsort, unstack, and basically reorganize their lives. Sorting and nesting toys are great fun for those who are trying out their early problem-solving skills.

Climbing gym: A tiny gym can give your toddler a safe place to climb, hide, slide, and practice all her emerging motor skills — over and over again. But these sets can also be pricey and are quickly outgrown.

Balls: Any ball that's easy to grasp will be a hit with this group — underinflated beach balls, vinyl balls, cloth balls. Stay away from foam balls that could end up as a mouthful. This is the age at which you can introduce your child to "catch." Start slowly — she'll begin to get the back-and-forth rhythm with some practice.

Washable crayons and paper: Let the scribbling begin! Hand your toddler no more than a couple of crayons at a time — you don't want to overwhelm her — and tape the paper to the floor so she can make her mark without dragging the paper along with her.

Ride-on vehicles: This mode of self-locomotion may be even more popular than walking. Many small ride-on toys have models with handles for an adult to push when the child gets tired. Avoid the electronic versions — they're expensive and take away from the fun of getting around under your own power.

Tool bench or toy kitchen: Junior fix-it kids or aspiring chefs will get hours of play out of plastic or wooden models scaled to their size. Sets like these give a child a chance to emulate the things he sees adults doing, and they'll continue to hold his interest for several months as his play gets more sophisticated.

Picture books: Your toddler will enjoy more advanced picture books showing familiar objects and activities. She may also start to take pride in her own library and the chance to pick out a favorite for you to read. For more ideas, see our recommended books for toddlers.

source from http://www.babycenter.com

How To Avoid Power-Struggles With Your Kids

Inevitably, sometime within your parenting career, you will face a power-struggle with your child. If you don’t, you may be too intimidating, your child may be rather compliant, or you have mastered the art of managing conflict. Power-struggles occur due to a variety of factors, but invariably make a parent feel fatigued, frustrated, and helpless.

Power-struggles emerge as a conflict over demands, wants and needs. Parents will attempt to get their child to manifest certain desired behaviors while the child may choose to react to the request in a negative manner. Children demonstrate various techniques for “testing” their parent’s patience. They may cry, have temper tantrums, manipulate, avoid contact, become aggressive, and refuse to comply with expectations. Parents may employ various methods in trying to hold their children accountable regarding their requests. They use control, lecturing, pressure, guilt, bribery, sulking, or aggressive behavior as strategies to get what they want from their children. None of these methods generally work very effectively.

Parents who seek counseling will indicate that they have tried everything in their arsenal in an attempt to get appropriate behavior displayed by their children. Power-struggles may occur over issues such as schooling, household chores, and a child’s desire for more freedom, or a child merely wanting his own way. Power-struggles can be minimized if parents will change their tactics with their children. This process can be accomplished if a parent is open to new ways of managing problems:

• Parenting is not about doing things the “right or wrong” way. If what you are doing isn’t working, shift gears and move in another direction.

• Most power-struggles can be avoided by establishing meaningful, consistent, logical consequences. Children should be informed regarding the nature of positive and negative consequences. Fight the urge to engage and merely lay out the consequences for appropriate or inappropriate behavior.

• Major in the majors. Don’t “lock horns” over issues of little consequence. If you do, the little issues will become major storms.

• Involvement, teaching, role-modeling and coaching work better than power as a means of managing your children.

• Never acknowledge or entertain temper tantrums. Distance yourself and isolate your child (time-out) until she is ready to respond rationally.

• Don’t get “hooked” by your child’s behavior. Step back, take a deep breath, disengage, and set logical consequences appropriate to the offense.

• Consequences for children should primarily be positive providing a preventative means of avoiding the potential for power-struggles. Unreasonable consequences imparted to a child while a parent is angry will serve to reinforce the power-struggle.

• By all means, avoid power-struggles over schooling. Power-struggles over a child’s education are number one on the list. Rather than pontificate with children about grades, capabilities, and school failure, ask them to explore and make value judgments about their performance. On occasion, monitor their performance, but fight the urge to continuously confront them about their failures. Set positive consequences to encourage completed work. Emphasize the quality of their work (process) rather than grades (outcome). Utilize outside resources, if necessary, such as tutors, parent advocates, and counseling services rather than confronting educational issues yourself. Maintain a sense of involvement with your child that is not conditional upon school success. Ironically, it may break the power-struggle and generally lead a child to change his perspective about schooling.

• Remember, you are the adult. Kids will always try to test the limits.

• Make sure that your logical consequences that are based on negative behavior are reasonable.

Consequences are designed to be used until improved behavior is observable.

• Always explore problems rather than confront them aggressively. Have your children make value judgments about their behavior rather than you making judgments on their behalf.

Avoiding power-struggles involves setting appropriate limits for your children, being consistent in enforcing them, and being reasonable with the management of consequences. Remember, positive consequences are much more effective in leading to improved behavior and help eradicate power-struggles. Children will respect you more if you are significantly involved in a positive manner in your child’s life and choose to role-model the behaviors that you desire your children to emulate.

source from http://www.baby-health.net

Water Safety--(12-24mon.baby)

What are the hazards for our child of being around water?

Water is hazardous for young children. In fact, as much fun as water can be, it's dangerous no matter where you find it — in a bucket, bowl, toilet, tub, sink, puddle, pool, or elsewhere. Parents can avoid tragedy by taking this adage to heart: A young child can drown in less than an inch of water.

The best way to protect your toddler from accidental drowning is to remove even the smallest source of water from her play area, and if water is present, to not take your eyes off her for a minute. If you're at a pool or beach, it's fine to let her splash and play to her heart's content — as long as you're right there with her and watching her every move.

What about water safety in the bathtub?
There are several things to remember when bathing your child, but the most important is to never leave her unattended in a bathtub, even for a minute. If you need to leave the bathroom for any reason, wrap your child in a towel and take her with you.

• Cover the tub surface with a rubber suction mat to prevent slipping and only fill the tub with 3 to 4 inches of warm water.

• Don't allow your child to drink the bath water or submerge her eyes and head. The soap and shampoo can irritate her intestinal tract and her eyes.

• Keep the toilet lid and bathroom door closed when not in use, or get a lid lock for the toilet.

How can I keep my toddler safe at a pool, lake, or beach?
Here are a few key safety tips:

• Pool drains were named one of the top five hidden home hazards by the U.S. Consumer Product Safety Commission (CPSC) in 2007. The suction from a pool drain can be strong enough to hold even an adult underwater, pulling on the hair or on the body and forming a seal. Missing covers often cause the problem.

• Check the water to make sure it's warm enough — preferably between 84 and 87 degrees.

• Make sure you've taken a child CPR course.

• Stick to pools that are properly chlorinated and natural bodies of water that are unpolluted and safe for wading.

• If you have a plastic wading pool, drain it and store it in an upright position (so it won't collect rainwater) after each use. If you have a permanent pool, make sure it's enclosed with a fence that's at least 4 feet high, and lock the gate leading to the pool after each use. After swimming, remove any toys from the water and deck so your child doesn't go after them.

• If possible, pick a pool, lake, or beach equipped with rescue equipment and staffed with a lifeguard. Make sure to have a cell phone on hand in case of emergency.

When can my child start taking swimming lessons?
There are many swim and water safety classes for young children offered nationwide, but that doesn't mean it's a good idea to enroll your child in one yet. According to the American Academy of Pediatrics, swim classes for children shouldn't be started until age 3 because swim classes seem to make both children and their parents overconfident. That doesn't mean you and your toddler can't enjoy the water, it's just a bit early to enroll her in lessons.

As soon as you start bringing your child into the water, begin conveying simple water safety rules such as: Don't go near water without an adult, always swim with a buddy, don't run on the pool deck or boat dock, and jump in feet first. Even children who aren't yet talking understand a great deal. One day your child will surprise you by repeating an oft-heard safety phrase, and by the time she's old enough to take lessons, she'll be familiar with the basics of water safety.

What should I do if my child slips under the surface in a tub, pool, or other body of water?
If she slips under water for a moment during bath time or while playing in the pool, it's likely she'll come up coughing and sputtering. If she's been under water for longer, you'll need to move calmly and quickly. Follow these steps:

• Lift your child out of the water.

• Carry her with her head lower than her chest.

• Remove any wet clothing and wrap her in a dry, warm towel or blanket.

• Call 911 or your local rescue squad or bring your child to the nearest emergency room immediately. (Even if she appears fully recovered, she may have inhaled water, which could cause lung damage.)

• If she's unconscious, see whether she's breathing and whether she has a pulse. If she's not breathing, open her airway and begin mouth-to-mouth and nose resuscitation. If she has no pulse or breathing, begin child CPR.

Although chances are you'll never need to do CPR on your child, it's wise to learn the method, just in case. For more information, see our illustrated guide to first aid for choking and CPR.

source from http://www.babycenter.com/