Infant Soy Formula: A Review of Recommendations from the American Academy of Pediatrics

Parents often ask me about giving their infant a soy formula when their infant shows signs of difficulty tolerating breast soy formulamilk or cow’s milk based formulas. Soy seems to be a common go-to alternative; however, there are actually only a few scenarios where soy formula is recommended. The American Academy of Pediatrics published a journal article that reviewed the use of soy based infant formulas in 2008. Here is a summary of the main points.

A Review of Infant Soy Formula:

  • Soy formula is not indicated as an alternative for breast milk or for cow’s milk based formulas except in the case of Galactosemia and hereditary lactase deficiency (both are rare diagnoses). Soy formula may also be an option for parents who desire a vegetarian diet for their infant, if breastfeeding is not possible.
  • Soy formula is not indicated for children diagnosed with cow’s milk protein allergy. Instead, an extensively hydrolyzed formula should be considered, because 10-14% of these infants will also be allergic to soy protein. Read more

Speech and Language for the Adopted Child

The number of foreign adoptions in the US continues to grow every year. Children who are adopted may be at greater risk for speech and/or language difficulties. Occasionally, this is secondary to a congenital disorder and, at times, the difficulties are secondary to the abrupt change in the child’s primary language. It is important to be aware and know what to expect with an adopted child.  

When Should An Adopted Child Start Speaking? adoption and speech

Speech/language should be closely monitored for the first 12 months. This is approximately enough time for a child to “catch-up” with their native speaking peers if adopted before age 2-2 ½. Adopted children that are older than 2 ½ will often catch up quickly as well; however, it may take a longer period of time to acquire the language.

How “Age” At Adoption Makes An Impact On Speech:

The orphanage conditions have an impact on the exposure and quality of language and interaction that your child received during these very important years, therefore, the longer the child was exposed, the longer amount of time the child may require to readjust. Unfortunately, some research by Gunnar & Quevedo (2007 ) indicates that prolonged exposure in these orphanages may have permanent effects on stress that can impact the memory storage and retrieval areas of the brain associated with language. The younger the child is when adopted, the better outcomes predicted.

Children adopted during the preschool years have minds that are uniquely prepared  to absorb language, regardless of their birth language. In other Read more

8 Tips to help your Child Accept being a Big Brother or Sister

With a new baby on the way, there is a lot of excitement, joy, and preparation involved. In addition to all of these emotions and tasks sibling with new babyto complete, parents also need to keep in mind of the feelings of their older child. For an older child, the thoughts of Mommy and Daddy having another baby could be mixed. There is the thrill of being a big brother/sister, but there are also concerns that the attention will no longer be on him/her as well as the uncertainty of what exactly a new baby entails. The older child might start to feel left out or the need to take on more responsibilities.

If you want to help your child accept being a big brother/sister, try the below strategies:

  1. Prepare your older child. Talk about the baby and what will be happening before, during and after the new baby comes with your oldest child. Read books to your child about new babies as well as about becoming a big brother/sister. In addition, get a baby doll for your child to start playing/interacting with. With a baby doll, you can help teach your child how to appropriately care and play with their new brother/sister.
  2. Keep the routine the same. When possible, keep your child’s routine the same throughout pregnancy as well as after the baby is born. Let your child stay in his/her different activities and allow him/her to continue doing the activities that he/she enjoys.
  3. Arrange for positive interactions. Your child can help with choosing items for the baby, such as for the baby’s room and the new baby’s clothes. Your oldest child and you can create a welcome card as well as get a special welcome gift that your child picks out himself/herself. Once the baby is born, your child can read books, sing songs and hold the new baby with supervision.
  4. Provide praise. When your older child is appropriately interacting with or helping out with the new baby, be sure to provide very specific praise for these situations. For example, “You are playing so nicely with your little brother/sister!” or “Thank you for bringing us a clean diaper!”.
  5. Brag about the older child. When the older child is around, talk to the baby about the great things he or she does. For example, “Look at how far Richie threw the ball! When you get older, he can teach you to throw far!” or “Your big sister, Sarah, is so helpful! She cleaned up all of the toys!”
  6. One-on-one time for each child. If you and the new baby are participating in “Mommy and Me” classes or “Daddy and Me” classes, make sure to also find a class or activity that you and the older child can go to together. Spending time together can be as simple as taking the older sibling with you on an errand while the baby stays at home with the other parent.
  7. Family time. Make sure to make time for family time and family outings. Include everyone in different activities that are be fun for both the older child as well as the new baby.
  8. Make the baby wait. In many cases, the older child will have to wait while you care for the baby. Every now and then, if possible, make the baby wait and finish helping out your older child. You do not always have to stop what you are doing as soon as the baby cries (as long as immediate attention is not necessary).

Before and after a new baby is introduced into the home, keep these tips in mind to help your older child accept and love being a big brother or sister. A new baby is an exciting and life-changing event for everyone in the household. At times, it’s easy to overlook the concerns of someone who might not be able to express themselves completely about the new addition to the family.

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5 Roles to Assign a Sibling When There is a New Baby

It’s Friday night and you are at the dinner table with your 3 week old baby boy and 5 year old daughter. After taking a sip of water, your daughter looks at you and says, “Mommy, I need a diaper.” Because your daughter has been potty trained for 2 years now, these are words that you never thought you would hear again from her. Before you scream, take a deep breath and RELAX. She is simply adjusting to the new little one – this is normal. Since the new baby is taking up a lot of your time, your 5 year-old is going to act out (or act younger) to get your attention, especially if you are feeding or spending time with the new baby. The best thing to do is give your 5 year-old special “big sister” or “big brother” roles. The following are five roles you can assign to a sibling when you have a new baby:

5 Roles To Assign a Sibling When There is a New Baby:

  1. Baby Watch – Put your older child on “baby watch”. sister and new babyWhile you are still in the room, ask him or her to make observations about what the baby is doing and let you know. Ask your older child what he/she and the baby have that is the same and what is different.
  2. Night time reader– Let your older child tell the baby a story. Engage him/her in making a picture book with you that includes all the fun things that you have done together, so the new baby can learn about activities you do in your family. After you have finished creating this book, tell your older child that he/she is on “night time reader” duty. Explain the importance of reading this story to the baby and how important it is that the baby gets to learn who everyone is. Stress how great he/she is with learning who everyone is and how you want him/her to teach the baby… BECAUSE HE/SHE IS THE BEST TEACHER!!!
  3. Special jobs helper– When you are giving your baby a bath, ask your older child to help. He/she can get the soap and help wash the baby’s legs. If your baby needs a new diaper, you can ask your older child to go get it. You can ask him/her to help rub your baby’s back to calm her down when she is crying. Remember to praise your older child when he/she is able to soothe the baby!
  4. Advice helper– When you are dressing the baby, ask your older child what he/she thinks the baby wants to wear. If the baby is crying, ask your older child if he/she thinks the baby is tired, hungry, etc. You may already know the answer to this question; however, asking your older child for his/her advice makes him/her feel very important.
  5. Creative helper– Ask your older child to think of a creative nickname for the baby to help establish a special bond between them. Helping create that bond and relationship is one of the toughest tasks. Creating a close bond at an early stage will ensure that the bond will last a lifetime.

10 Do’s and Don’ts for Talking about Adoption

“Where do babies come from?” This question can feel overwhelming for any parent to tackle, but when adoption is a part of your child’s story, this question can become more complicated. Understanding adoption as a part of one’s identity is a life-long process. As your child’s understanding of family, relationships, and society develops, so will her ideas about her own adoption. Talking to your child about her adoption requires empathy, validation, openness, and courage. Here are some tips you can use along the way.

DOs and DON’Ts for talking to young children about adoption

  1. DO begin talking about adoption with your child at an early age.  Talking about adoption with your child early on can set the tone that adoption is a comfortable and safe topic to discuss, which canadoption family encourage children to ask questions and develop their adoption stories as they get older. See below for a list of activities you can do with your children when talking about adoption.
  2. DON’T use adoption as a descriptor for your child.  Using terms, such as “our adopted child” can make children feel inferior to children who are raised by their birthparents. Instead, use adoption positive language, such as, “We are so happy we adopted you and that you are our son!”
  3. DO start at the beginning.  When first telling young children about their adoption, start at the beginning of the story with their birthmother and birthfather. For toddlers, use simple explanations about why the birthparents made their decision (ex. “They loved their baby but couldn’t take care of her and wanted to find a mommy and daddy who could love and care for her”) and why adoptive parents wanted to adopt (ex. “We really wanted a baby girl to love and be a part of our family. We were so excited to meet you and are so happy you are our daughter!”) Be sure to emphasize that there was nothing “wrong” with your child, but rather that her birthparents could not raise a baby. Also, emphasize that adoption is permanent, as children may fear that they could be placed for adoption again. Note: Families have varying circumstances and reasons for adoption, and parents can include these unique details into the adoption story as they see fit (ex. Domestic adoption, international adoption, transracial adoption, foster parenting, adopting relatives, adopting infants/children/teenagers).
  4. DON’T minimize loss and grief.  An adoption story begins with a loss for children-loss of the birthparents. As children reach preschool age, they may start to question why their birthparents made the decision to place them for adoption. They may have questions about their birthparents and feel sad when they do not have answers. They may also feel out of place among their peers when they realize that most of them live with their birthparents. Also, with comments, such as “You are such a lucky girl to have been adopted,” a child may think that she should feel grateful and not sad. As parents, normalizing your child’s feelings of loss and grief is vital. Children need a place where they can feel safe discussing these difficult feelings.
  5. DO pay attention to your own feelings.  When your child makes statements, such as “You are not my real parent” or “I wish I could meet my birthparents,” you may understandably feel sad and confused. Having a space to discuss your own feelings as an adoptive parent is important. Children in general, both adopted and non-adopted, make comments, such as “I hate you” or “I wish you weren’t my parent,” but these statements may feel more loaded when they are made by a child you adopted. Attending to your own feelings can ensure that when your child makes these statements, instead of taking these comments personally, you can provide validation and empathy for your child’s feelings of loss, confusion, grief, and anger.
  6. DON’T lie to your child.  While there are some parts of the story that children may not be ready to understand, you can add these details to the story as children get older.
  7. DO add more to the story as children become older.  As children get older, they may have more questions and thoughts about their adoption. Adding more developmentally appropriate details to the story is important, so that children can process more information when able. Also, adding to the story can encourage children to continue to ask questions as they have them. Adoption experts suggest that children should know all of the history and facts about their adoption by their teenage years.
  8. DO initiate conversations.  Initiating conversations about adoption is a great way to provide an open, safe space for children to talk about their adoption. Some children may not ask questions or talk about adoption on their own, but this does not necessarily mean they are not thinking about adoption. Opening the conversation as parents models to children that adoption is a comfortable, appropriate topic to discuss and can allow children to initiate conversations in the future.
  9. DO encourage questions.  Children may need prompts from their parents to ask questions. They may think that it will hurt their parents’ feelings if they ask questions about their birthparents. When able, use concrete, simple language to answer questions. If children ask questions you do not know the answer to (ex. “Do you think my birthmother is looking for me?”), be honest and empathize with and validate your child’s question (ex. “I can understand why you want to know that, but I don’t know either. It must be hard to not know. Would you like to talk about it?”).
  10. DO reach out and educate yourself.  Adoption is a life-long process, and more questions and issues may arise as children get older. Learning about potential conversations to expect as children get older, as well as strategies to provide validation and empathy for your child, can help with this process. One way to reach out and educate yourself is to join support groups. There are parent-child support groups, as well as separate groups for parents and children. These groups can provide a safe, understanding environment, as well as promote community and belonging. Here is a website that can help you search for support groups based on state, county, and family type (any, U.S., international, foster): http://www.adoptivefamilies.com/support_group.php

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“Can you check under my bed for monsters?”: DOs and DON’Ts to Help Children Who are Afraid of the Dark

Teeth brushed? Check. Pajamas on? Check. Story read? Check. Tucked in? Check. Search the closets for monsters? Should you or shouldn’t you? Manychild scared in bed children are afraid of the dark, and these fears becomes especially present during bedtime, when they are alone with their thoughts of monsters, ghosts, or other scary creatures that lurk in the dark. Children may also have difficulties differentiating between fantasy and reality, especially if they hear scary stories at school or see monsters on television. Implementing a consistent bedtime routine takes time and energy, and when children are afraid of the dark, this routine can become stressful for everyone involved. As parents, listening to your children’s fears and empathizing with them, creating appropriate accommodations, and empowering your children are ways to help them with their fears.

Do’s and Don’ts to Help Children Who Are Scared of the Dark:

Listen, normalize, and empathize 

DO: Listen to your children’s concerns with an open, warm, nonjudgmental stance. They will be more likely to share their fears with you if they feel supported. Express curiosity about your children’s fears to gain an understanding of where their fears may have come from. This can help you reassure your children. For example, if they saw a show on television that had scary monsters, you can explain that television is pretend and different from real life.

DO: Help your children feel accepted by explaining that everyone has fears, even adults! Reassure your children by explaining that even though people feel afraid sometimes, they can overcome their fears. Children may feel embarrassed or hopeless about their fears; knowing that everyone has fears and that there are steps they can take to overcome them can help children feel reassured and hopeful.

DO: Empathize with your children’s concerns even if their fears are irrational. Let your children know that it is okay to feel scared.

DON’T: Minimize your children’s fears. Saying “You have nothing to be afraid of” or “That is silly! There are no such things as monsters!” can make your children feel embarrassed. Minimizing your children’s fears can also stop them from opening up to you in the future.

DON’T: Reinforce your children’s fears. Checking for ghosts or monsters, for example, shows children that you think they exist too, which can exacerbate their concerns. Instead, check for items that do exist. For example, open a closet and say, “Look! There are clothes and shoes in here, just like in the day” rather than “There are no monsters!”

Create appropriate accommodations

DO: Help your children feel safe at night. Problem solve with them to see what they think will help them feel safe. This process can also help them feel in control and brave. Asking, “What do you think you can do to feel safe at night?” is a great place to start. Appropriate accommodations include listening to a favorite bedtime story, sleeping with a special blanket or stuffed animal, and using a nightlight.

DO: Add these accommodations to your children’s bedtime routines in a consistent way. If children know they can expect a goodnight kiss, a special stuffed animal, and a nightlight every night, they can feel safe and comfortable.

DON’T: Allow your children to sleep in your bed. As tempting as this may be and as much as your children may want to sleep in your bed, showing your children that they can feel safe and sleep in their own beds is very important. Letting your children sleep in your bed can send the message that their fears are legitimate and can, in turn, reinforce and maintain their fears.

Expose and Empower

DON’T: Pressure your children into exposure they are not ready for. Facing their fears without a plan or comfort can make children feel even more afraid.

DO: Help your children overcome their fears by gently exposing them to the dark in a fun way. For example, you can play games in the dark, such as flashlight tag, so your children can associate the dark with an enjoyable game.

DO: Give praise when your children are able to sleep in the dark through the night. In the morning, you can say, “I’m so proud of you! Even though you were scared, you slept by yourself in the dark all night! I know you can do it again tonight.” You can also offer praise at night, by saying, “I like how you are trying to be brave and sleep in your bed. I know you can do it!”

What have you tried to help your children who are afraid of the dark? What has worked? What has not worked? Please share with us!

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Choosing the Right Toys to Promote Your Child’s Language Development: Part 2

With the holiday’s approaching, you may be looking for gift ideas for your little ones, or it may just be time to revamp the toy shelves.  Parents often askwhich toys will help their child’s speech and language skills develop.  Flash cards?… Baby Einstein?…Wi?

boy playing on pretend phone

In Part 1 of this blog, we talked about principles to consider when choosing the right toys for your child.  In Part 2, I’m excited to share 5 favorite “go-to” toys to encourage speech and language skills in toddlers.  Keep in mind that every child is unique, including their developmental level and personal interests. And no matter which toy you choose, the most important contributor to promoting your child’s speech and language, is one-on-one time with caregivers and loved ones!

5 Great Picks To Promote Speech in Children

1. Fisher-Price Little People Animal Sounds Farm This activity encourages “make-believe” play as children bring each animal to life.  Imitating animal sounds (e.g. moo-moo, neigh-neigh) is a great way to develop speech sounds while having fun.  This activity also lends itself to following directions, playing with others, and learning about location concepts (e.g. in, on, under).
2. Barn Yard Bingo Barn Yard Bingo is an excellent way to encourage turn-taking skills.  This activity also promotes labeling animals and colors, matching, and speech sound development.  You can facilitate and encourage turn-taking (e.g. “It’s your turn!… my turn!”) while naming animals or imitating animal sounds (e.g. “cow says moo!”).
3. Basic Vocabulary Picture Books, such as Baby Einstein’s “First Words”  Books are a great way to build your child’s vocabulary and develop early literacy skills.  For infants and toddlers, choose books with large and simple pictures, and avoid books that are too visually distracting.  Practice identifying and labeling pictures (e.g. “Where’s ball?… there it is!”), and answering questions about each picture.
4. Melissa & Doug Pretend Food  Pretend picnic foods are a great way to encourage pretend-play and social interactions.  Your child can build vocabulary and learn basic categories while they plan a picnic with family members or friends.
5. Play-Doh Play-doh (or any molding clay) is an excellent activity to foster creativity and ideation.  There are many ways to enjoy play-doh, whether it’s making different shapes, or creating a pretend-picnic.   This activity encourages interactions with others, cooperation, pretend play, and vocabulary building.  **Children should be carefully monitored while playing with play-doh, as many children enjoy mouthing/swallowing it.

International Adoption and Speech-Language Development

According to the U.S. Department of State, approximately 11,059 children were adopted internationally in 2010.  Over 88% of these children were likely raised in an orphanage prior to their adoption (Johnson & Dole, 1999).  Research has well-documented that children raised in orphanage care are at a Baby Reaching Out Handhigh risk for language and developmental delays (Johnson, 2000).  For expecting parents, this may sound overwhelming and even intimidating.  However, research also says that adoption can often counteract the effects of orphanage care.  Understanding what the research says can be a liberating guide for parents as they support their child through the adoption process.  Knowing what to expect can reduce anxiety and empower parents to plan and prepare with confidence.

What Language Skills Can Adopting Parents Expect?

  • Children who have spent time in orphanage care often show delayed language skills.  It’s important to know that delays are not just in the new language, but in their birth language as well.  These children may vocalize or babble less frequently, have limited vocabulary and use of phrases or sentences, show difficulty understanding spoken language, and have poor speech clarity.
  • Most children raised in orphanage care have strong non-verbal social interaction skills.  This includes skills such as making eye-contact, using facial expressions, smiling at others, showing toys to adults, pointed to or reaching for desired toys, and pushing items away that they don’t want.
  • In most cases, language delays are a direct result of limited one-on-one interactions with adults while in orphanage care.  As children learn to speak, their sounds and words are reinforced by caregivers who model, respond and encourage language.  Without this individualized care, children’s communicative attempts become stalled.  Even in caring and well-equipped environments, less available adults per child will likely result in language delays.
  • It’s important to keep in mind that there are always exceptions.  While most language delays are a result of limited interaction with caregivers, some children might have underlying developmental disorders that are not a result of a orphanage care.  It’s important to seek guidance from a licensed speech-language pathologist to determine if your child needs intervention.
  • After adoption, children will likely loose their birth language quickly (unless their adoptive parents speak their native language).  The child’s birth language is likely to be lost before their new language is fully acquired.  During this period of time when language is temporarily arrested, a child might feel more frustrated when they can’t communicate effectively.
  • After adoption, children will quickly begin to acquire their new language.  In fact, research suggests that children adopted under the age of 2, often develop language skills that are within normal limits one year after adoption (Glennen, 2007).  Skills will continue to progress after the first year, although, the majority of language acquisition occurs during the initial year following adoption.

How Can Parents Help Their Child Develop Language Skills?

One of the most effective ways to counteract the effects of orphanage care is adoption.  Parents and caregivers play a critical role in helping their child develop communication skills.  Create a language-rich environment for your child, and enjoy one-on-one time together.  Here are specific ways to promote speech and language development in your toddler:

  • Play with your child!  Come down to their level, and sit face-to-face while you play.  Model, encourage and reinforce their communication while you play.
  • Encourage your child to imitate your actions, gestures and sounds. Make animal sounds or environmental noises (e.g. beep beep, moo moo, etc) or sing songs with gestures (e.g. Itsy Bitsy Spider, Wheels on the Bus, etc).
  • Label various objects and actions. Describe objects or actions in the environment, or read picture books while pointing to different pictures.
  • Narrate what is happening in the environment.  Use simple language to describe what you see or what people are doing (e.g. Bear is sleeping! Mommy is jumping!).
  • Play turn-taking games, such as passing a ball a ball back and forth or sharing a toy.
  • Reinforce your child’s communicative attempts by responding to and repeating what they say.

For more tips to encourage language development in toddlers, visit the blog “Encouraging Your Infant to Communicate“.