Social-Emotional and Behavioral Red Flags for Toddlers and Preschoolers

It might be hard to imagine what mental health concerns may look like for your toddler or preschooler. Red FlagsHowever, it is important to realize that children experience the same emotions as adults do. They experience happiness, sadness, anger, fear, loneliness and embarrassment, however, they do not always know how to express these feelings in appropriate ways, so it’s important to look for red flags. When their feelings get too big, children do not always have the words to use to express themselves, resulting in using challenging or unsafe behaviors to express these big feelings. These behaviors make learning, play and relationships at home, and in the classroom difficult and can be very distressing and frustrating for everyone involved.

Here is a list of common red flags that can help you to determine if your child needs support:

  • Separation Anxiety:
    • Extreme distress (crying, tantruming and clinging to you) when separating from you or knowing that they will be away from you.
    • The symptoms last for several months versus several days
    • The symptoms are excessive enough that it is impacting normal activities (school, friendships, and family relationships).
    • The continuation or re-occurrence of intense anxiety upon separation after the age of 4 and through the elementary school years.
  • Social Concerns:
    • Little interest in playing with other children.
    • Poor body awareness that impacts relationships with peers
    • Failure to initiate or to participate in activities
    • Difficulty making eye contact with others
  • Behavioral Problems:
    • Defiance: Failure to follow rules or listen to directions and is often argumentative with adults.
    • Overly Aggressive Behavior:
      • Temper tantrums that last more than 5 to 10 minutes.
      • Excessive anger through threats, hitting, biting, and scratching others, pulling hair, slamming/throwing objects, damaging property, and hurting others.
  • Difficulty with Transitions:
    • Difficulty focusing and listening during transitions
    • Extremely upset when having to transition from one activity to another. Before or during each transition, your child may cry excessively or have temper tantrums that last more than 5 to 10 minutes.
  • Excessive Clinginess or Attention Seeking with Adults
    • Excessive anxiety related to being around new and/or familiar people/situations.
    • Child freezes or moves towards you by approaching you backwards, sideways or hiding behind you. Your child behaves this way in most situations and no matter how you support them, they continue to avoid interacting with others.
  • Attention concerns:
    • Difficulty completing tasks and following directives on a daily basis.
    • Easily distracted and has difficulty concentrating or focusing on activities.
  • Daily Functioning Concerns:
    • Toileting: Difficulty potty training and refuses to use the toilet.
    • Eating issues: Refusing to eat, avoids different textures, or has power struggles over food
    • Sleeping problems: Difficulty falling asleep, refuses to go to sleep, has nightmares or wakes several times a night.

Children can exhibit concerns in the above areas off and on throughout their childhood. It is when these behaviors begin to impact peer and family relationships, cause isolation, interfere with learning and cause disruptions at home and in school that it is time to reach out for support.

Who can help?

  • Licensed Clinical Social workers (LCSW),
  • Licensed Clinical Professional Counselors (LCPC),
  • Marriage and Family Therapists (MFT)
  • Psychologists

Therapists will work with your child to help them to learn how to handle their big feelings and behavioral challenges. Therapists will use a variety of modalities during sessions including play, art, calming and self-regulation strategies, behavioral therapy, parent-child therapy, and parent education and support. They can also provide parent support and coaching to assist in diminishing the challenging behaviors at home. Often these professionals will collaborate with your child’s school and can provide additional support for your child within the school setting.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Food Milestones: From Mashin’ to Munchin’

Mealtime and achieving food milestones can be a stressful time for many families, especially for those whose kids demonstrate Food Milestonesdifficulty consuming a variety of flavors and textures. Instead of stressing over consuming those calories and pumping on the weight, take time to relax and enjoy a meal. Take away the stressors from your day and use mealtimes as an opportunity to bond with your little one. There is great variety in the development of infants and toddlers due to differences in the rate of physical and mental development as well as how often these skills are promoted by caregivers. As children develop their preferences for different foods (tastes & textures), they learn to accept or reject specific foods, which is OKAY!

The old mother’s tale “you can’t get up until you finish your peas” has proven to be an ineffective way to have children smoothly go through the realm of trying different foods. Instead of “forcing” your child to eat different foods, give them options…”you can eat 5 or 6 peas…you pick!” Give great verbal praise despite how big of a gain the child has made that meal.

Please see the developmental chart below that guides you through a variety of food milestones while providing ideas on how to keep mealtime positive!

Age Strategies and foods that should be introduced Tips and Tricks
Birth-2 months
  • Nipple feeding by breast or bottle
  • Semi-reclined position during feeding

Foods:

  • Breast milk or formula (approx. 18-28 ounces)
  • Sing songs or tell stories while you feed your infant, build a rapport
2-3 months
  • Start forming a consistent schedule

Foods:

  • Breast milk or formula (approx. 25-32 ounces)
  • Make silly faces with your infant, make meal time a reciprocal relationship
3-4 months
  • Infant starts to put hands on bottle during feedings

Foods:

  • Breast milk or formula (approx. 28-39 ounces)
  • ˷4 mo, rice cereal trials
  • Always avoid television or electronics during meal time, practice songs or rhymes
  • Have your infant sitting at the table during adult meal times

 

5-6 months
  • Start to introduce pureed spoon feeds
  • Tongue will continue to “mash” the food to consume

Foods:

  • Breast milk or formula (approx. 27-45 ounces)
  • Overly ripe fruits/vegetables
  • Oatmeal
  • Rice or wheat cereal
  • Puree a food that you are having for dinner to make it easier with food preparation

 

6-9 months
  • Moves to a more upright position during feeds
  • Helps caregiver with moving spoon to mouth

Foods:

  • Breast milk or formula (approx. 24-32 ounces)
  • Sweet potato mash
  • Cottage cheeses
  • Puff cereal bites
  • Encourage infant to hold bottle independently
  • Think of a variety of different flavors to introduce, even mix flavors based off babies preference
  • Take small trials of foods from your plate to give baby to try
9-12 months
  • Progresses from pureed to more textured food
  • Increases finger feeding
  • Introduction of straw based cup or open cup
  • Moves to a more “munching” formation with jaw and tongue

Foods:

  • Breast milk or formula (approx. 24 ounces)
  • Egg-free noodles
  • Variety of fruit/vegetables
  • Mild cheese slices
  • Offer new foods without the expectation of eating the food (he/she can poke, smell, lick, etc)
  • Always offer small portions on a child sized bowl or plate (don’t overwhelm)

 

12-18 months
  • Grasps utensils and self-feeds
  • Complete transfer from bottle to straw based cup or open cup

Foods:

  • White potato mash
  • Chicken
  • Beef
  • Beets
  • Offer foods of different textures: pudding, soup, crackers, mashed sweet potatoes, etc
  • Have child come with you to the store to pick out their “special cup” to encourage discontinued use of nipple based bottle
18-24 months
  • Primarily self-feeding
  • Able to chew different textures and flavors

Foods:

  • Eggs
  • Lentils
  • Beans
  • Cantaloupe
  • Never ask a child “Do you want ____” because you will have to respect if they say “no”
24-36 months
  • Holds open cup independently
  • Eats a wide variety of solid foods

Foods:

  • Cleared to try any food
  • Have your toddler “get messy” with their food, spread the different textures on their hands, face, or even nose
Continuum into childhood
  • Continue to use choices to give your child the “control” during mealtimes
  • Have your child participate in mealtime prep as much as possible

 

Remember, mealtime goals shouldn’t be about consumption, but about a positive experience for the child. Always consult your pediatrician about diet concerns or questions.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

References:

Developmental Stages in infant and Toddler Feeding., Infant & Toddler Forum., 2014.

McCarthy, Jessica., Feeding Infants & Toddlers: Strategies for Safe, Stress-Free Mealtimes. Mosaic Childhood Project, Inc., 2006.

1998, The American Dietetic Association. “Pediatric Manual of Clinical Dietetics”. 1998.

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Encouraging Muscle Development in the Infant Stage

Importance of Tummy Time for Muscle Development

Tummy time is a great way for infants to strengthen their muscles and develop age appropriate motor Muscle Developmentskills. When a baby is born they are in a position referred to as physiological flexion which simply means they are in a “curled up” position. All their back muscles are stretched and their core muscles are tight. By incorporating as much tummy time as possible, babies are allowed to strengthen their back by extending and stretch their tummy and core muscles at the same time. Encouraging floor time is key to developing motor skills such as rolling, sitting, crawling, and eventually walking.

Jumpers, Swings, and Exersaucers

Devices that aid in childcare can be lifesavers, such as when you are taking a shower or cooking, however, they should never replace the benefit that a child receives from floor time. When a baby plays on the floor they are using their entire body to explore their space. On the contrary, when they are in a swing or jumper, something is not being utilized. Excessive use of swings can result in flattening of the skull or a preference to tilt their head to one direction which can then lead to muscle shortening that requires intervention. Jumpers, exersaucers, and bumbo seats can also result in muscle disuse since the hips are frequently placed in unnatural positions and the core is not allowed to rotate as much as when a child is working to navigate the floor. When using devices such as the ones mentioned above, be mindful to limit their use in order to maximize muscle development.

Developmental Red Flags to Be Aware of

Sometimes babies will discover a pattern that is different than what we typically expect. Below are some movement patterns to be aware of and mention to your pediatrician should you notice them.

  • Scooting on their bottom to get around rather than crawling. This does not allow for the proper leg strengthening and cross lateral movement that crawling incorporates.
  • Pulling up to stable surfaces using only hands and not adjusting legs in order to push themselves up.
  • Stiffness in the legs or trunk that is constant and impacting movement; may first become evident with a lack of voluntary rolling.
  • Head position that is not in line with the body or a preference to only look in one direction, roll in one direction, or reach with only one hand.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood,Glenview, Lake BluffDes Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Fine Motor Skills: Is Your Child Lagging Behind?

Fine motor coordination is the capacity of the small muscles of the upper body to allow Blog-fine-motor-skills-Main-Portraitfor controlled movements of the fingers and hands. They include the ability to hold a writing utensil, eat with a fork, open containers, and fasten clothing. These small movements correspond with larger muscles such as the shoulder girdle, back, and core to provide stability for gross motor functioning and with the eyes for hand-eye coordination. Weaknesses in fine motor skills are often the result of poor hand strength and poor motor coordination.

Red Flags for School-Aged Children

As a former Kindergarten teacher, at the start of each school year, I received a group of children with an assortment of fine motor skill-sets. Because children have such different preschool experiences, their skills will vary based on the activities to which they have been exposed. If a child has had the opportunity to practice cutting with scissors, for example, he or she will likely be able to accomplish snipping a piece of paper by 2.5 years old. Fine motor development occurs at an irregular pace, but follows a step-by-step progression and builds onto previously acquired skills.

By the approximate ages listed below, your child should be able to demonstrate these fine motor skills:

2 to 2.5 Years

  • Puts on and takes off socks and shoes
  • Can use a spoon by himself, keeping it upright
  • Draws a vertical line when given a visual example or after an adult demonstrates
  • Holds crayon with fingers, not fist

2.5 to 3 Years

  • Builds a tower of blocks
  • Draws horizontal & vertical lines when given a visual example or after an adult demonstrates
  • Unscrews a lid from a jar
  • Snips paper with scissors
  • Able to string large beads
  • Drinks from an open cup with two hands, may spill occasionally

3 to 3.5 Years

  • Can get himself dressed & undressed independently, still needs help with buttons, may confuse front/back of clothes and right/left shoe
  • Draws a circle when given a visual example or after an adult demonstrates
  • Can feed himself solid foods with little to no spilling, using a spoon or fork
  • Drinks from an open cup with one hand
  • Cuts 8×11” paper in half with scissors

3.5 to 4 Years

  • Can pour water from a half-filled pitcher
  • Able to string small beads
  • Uses a “tripod” grasp (thumb and tips of first two fingers) to draw, but moves forearm and wrist as a unit
  • Uses fork or spoon to scoop food away from self and maneuver to mouth without using other hand to help food onto fork/spoon

4 to 4.5 Years

  • Maneuvers scissors to cut both straight and curved lines
  • Manages zippers and snaps independently, buttons and unbuttons with minimal assistance
  • Draws and copies a square and a cross
  • Uses a “tripod” grasp (thumb and tips of first two fingers) to draw, but begins to move hand independently from forearm
  • Writes first name with or without visual example

4.5 to 5 Years

  • Can feed himself soup with little to no spilling
  • Folds paper in half with edges meeting
  • Puts key in a lock and opens it

5 to 6 Years

  • Can get dressed completely independently, including buttons and snaps, able to tie shoelaces
  • Cuts square, triangle, circle, and simple pictures with scissors
  • Draws and copies a diagonal line and a triangle
  • Uses a knife to spread food items
  • Consistently uses “tripod” grasp to write, draw, and hold feeding utensils while moving hand independently from forearm
  • Colors inside the lines
  • Writes first name without a visual example, last name may be written with visual
  • Handedness well established

By age 7, children are usually adept at most fine motor skills, but refinement continues into late childhood. If you notice your young child demonstrating difficulties in the above “red flag” areas, it may be time to consult with an occupational therapist. For at-home ideas to improve hand strength and fine motor abilities, read my other blog, Fine Motor Skills: Ideas for At-Home Improvement.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Resources:

Beery, K.E., & Beery, N.A. (2006). The Beery-Buktenica Developmental Test of Visual Motor Integration. Minneapolis: NSC Pearson

Folio, M.R., & Fewell, R.R. (2000). Peabody Developmental Motor Scales, 2nd Ed. Austin: Pro-Ed.

Retherford, K.S. (1996). Normal Development: A Database of Communication and Related Behaviors. Greenville, SC: Super Duper Publications

Get Your Baby to Start Cruising

Cruising is an important gross motor milestone that occurs when a baby steps sideways Blog-Baby-Cruising-Main-Landscapewhile holding on to a safe and stable piece of furniture. Cruising facilitates core, hip and leg muscle development, standing balance, and is a crucial stepping stone (no pun intended!) to independent standing and walking.

This is a milestone that is typically reached around 10 months of age. Before your baby can cruise, he or she needs to be able to stand, accepting weight evenly through both legs, with 1 or 2 hands supported at a safe and stable piece of furniture, such as a couch or ottoman. Many babies are excited once they can start standing on their own at a piece of large furniture, although they often do not know how to move around.

Here are a few useful tips to help your baby learn how to cruise:

  1. Place toys a few steps away in either direction. If your child has the toy she is interested in playing with right in front of her while she is standing at the couch, there will be little motivation to move. However, if you place the toy just a few steps away, your baby will be highly motivated to try and get to the toy. Make sure you don’t place the toy too far away though, as that might encourage your child to crawl to the toy instead, or your child may lose motivation due to feeling that the toy is completely out of reach.
  1. Show your baby how to cruise. Since the cruising motion is most likely different from any other movements your child has performed, he may not know that he can step sideways or how to activate the muscles required to do so. When your baby has both hands supported on the stable piece of furniture, slowly and gently elevate the lead leg off the ground, move it a small distance to the side, and then bring the other leg to meet it.
  1. Practice! Learning new gross motor skills takes lots and lots of practice. Babies learn through trial and error, so the more that they work on a new skill the better at it they will become. Give your child frequent, supervised opportunities to practice cruising.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Should I Be Concerned With My Child’s Speech?

As a parent, everyone wants the best for their child. They want their child to grow and Blog-Speech-Concerns-Main-Landscapedevelop appropriately, and flourish socially and academically. One component to success is your child’s ability to effectively communicate their wants, needs, and ideas. Which begs the question, when should you be concerned with your child’s speech and language development? In a world where no child is the same, one thing is for certain: early intervention is better than late intervention, and late intervention is better than no intervention at all. Look for these red flags early in development.

  • Difficulty following directions
  • Difficulty answering questions
  • Difficulty understanding gestures and nonverbal cues
  • Difficulty engaging in conversation
  • Difficulty identifying age-appropriate vocabulary and concepts
  • Frustration when communicating

Expressive Language

More specifically, children should be babbling between 6 and 8 months, with their first words produced around the age of 12 months. By 18 months, your child should possess an expressive vocabulary (spoken words) of approximately 50 words. Two-word combinations are expected around 24 months, with an expressive vocabulary growing to about 300 words. By the time your child is 36 months old, expect 3-5 word combinations (or more!), with most adult language structures mastered around 60 months (5 years).

Receptive Language

Children should follow basic commands around 12 months (“Come here”), and use gestures to communicate along with a few real words. They should be demonstrating comprehension of common objects and animals, by following commands involving those items or identifying them in books (puppy, cup, shoes, etc.) around 18 months of age. Look for your child to answer questions, ask questions, and talk about their day around the age of 3 years.

Articulation

It is typical for a young child (1-2 years) to have some sound errors in their speech. However, by the age of 3, a child’s speech should be at least 75% intelligible to an unfamiliar listener, and more intelligible to familiar listeners. By age 3, a child should have the following sounds mastered: /b, d, h, m, n, p, f, g, k, t, w/. All speech sounds should be mastered by age 8.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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My Child Vomits When I Encourage New Foods

If this describes your child, then it’s important to contact your pediatricianBlogNewFoods-Main-Landscape to rule out any food allergies, swallowing dysfunction, or other medical conditions, as these can lead to gagging or vomiting and need to be addressed. If you know that your child is not experiencing any of these challenges, then it’s likely your child struggles with oral hypersensitivity affecting his ability to tolerate different textures and temperatures of foods. Oral sensory aversion can negatively impact a child’s diet. There are many signs of oral hypersensitivity, but one sign that is concerning for many parents is vomiting or gagging with new foods. This often occurs when a child’s sensory system is overloaded, and as a result, his body perceives the new food as noxious.

When your child is a problem feeder due to hypersensitivity, mealtime often causes stress and discomfort for both the parent and child.

Here are 5 tips to reduce stress and help your problem feeder to conquer sensory aversion with new foods.

  1. Set aside a specific time each day to work on introducing new foods.

Mealtime is stressful as it is, adding new foods in the mix when you have a problem feeder on your hands can not only escalate your frustration, but can overwhelm your child’s sensory system. Setting aside a separate time to work on feeding with your child will help to reduce the demand, establish a calm and safe environment, and provide the structure of a daily routine that will help support your child in being successful.

  1. Warm-up, provide regulating oral and tactile input prior to beginning.

Your child’s sensory system needs to be in an optimal state of functioning for him to be able to accept novel foods. Providing regulating input prior to beginning feeding time can help to reduce sensitivity and also warm his system up to prepare him. Some regulating oral activities include blowing through a straw or biting on a washcloth. Consider tactile activities as well, such as finger painting, playing with dry rice or beans, or playing with putty or clay.

  1. Set the stage—Reduce additional sensory stimuli to avoid over-stimulation.

Prepare your child’s environment in order to support his success. This includes turning off the television and the tablet and reducing other visual and auditory distractions. Introducing new foods provides a lot of sensory input. By reducing additional stimuli in the room, a parent can prevent over-stimulation and help a child to more successfully interact with the foods presented.

  1. It’s ok to play with your food!

When working with a problem feeder with oral hypersensitivity, it’s very important to allow a child to feel safe playing with his food. This means that he will need to learn to interact with new foods, whether this includes eating the food or not. Start slow, with tolerating the food on the plate, working up to touching the food, and eventually bringing the food to his mouth. Children often require several exposures to a new food before they will feel comfortable trying it.

  1. Praise and encouragement for all improvements, no matter how small.

Remember that the new food that is causing your child discomfort or distress is noxious to his sensory system. Trying and interacting with new foods is hard work, and any progress made deserves praise. Remain positive and provide positive reinforcement for each new interaction your child has with a food.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Zika Guidelines | What You Need To Know During The Outbreak

This Guest Blog Post was written by Dr. Kudus Akinde, MD FAAP of Glencoe Pediatrics.

Today, the World Health Organization (WHO) declared a public health emergency (AAP News). There is strong suspicion that recent clusters of fetal microcephaly are occurring in babies of infected mothers in areas where Zika virus transmission appears to be common. The CDC & the AAP have become involved in issuing recommendations to health care providers and to the general public in the matter.

Zika is a mosquito-borne flavivirus with RNA as its genetic material. It is transmitted by Aedes aegypti mosquitos. An estimated 80% of all people infected have no symptoms according to the CDC’s Morbidity and Mortality Weekly Report (MMWR) from Jan 22, 2016. The report goes on to explain that symptoms are usually mild with usually a few days of fever, rash, joint aching and pink eyes without mucus or pus buildup. No antiviral medicines exist to treat Zika virus. Treatment is supportive (acetaminophen, rest, oral fluids); avoid aspirin or ibuprofen in pregnant women.

So what’s the big deal about the Zika Virus? Infections happen all over the world. Right?

Well, it turns out that there are areas in the Caribbean, North and South America where children are being born with microcephaly (heads. therefore brains, that are abnormally small for their gestational age) or intracranial calcifications. This is a problem because these findings can be associated with a whole host of neurologic and developmental delays that can be lifelong in duration.

Since the outbreak is currently ongoing, it is difficult to make associations and good reliable information about infection during pregnancy is unavailable. As a matter of fact, pregnant women aren’t known to be more susceptible to infection with Zika virus than anybody else. It seems to infect people of all ages across the board. However, it can infect pregnant women in any trimester and if they are infected, the virus can be transmitted to the developing fetus in any trimester as well.

How To Prevent The Zika Virus?

All pregnant women should be screened for travel. If they haven’t traveled, they should strongly consider postponing travel to all endemic areas. If they do travel, they should practice strict mosquito avoidance. This includes:

  • Long-sleeved shirts and pants are preferred to the shorter varieties
  • EPA-approved insect repellants
  • Permethrin-infused clothing and other equipment
  • Using screens and air conditioning as much as possible

Pregnant women who have travelled to areas of ongoing Zika, dengue and chukungunya (similar flaviviruses with similar symptoms and also transmitted by Aedes mosquitos) infection should be tested according to CDC guidelines if they have symptoms consistent with Zika (fever, rash, pink eyes within 2 weeks of travel OR fetal microcephaly or intracranial calcifications after travel). Women wtihout symptoms and with normal fetal ultrasounds do not need to be tested according to current recommendations. If lab testing confirms Zika by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR), then prenatal ultrasounds to diagnose and monitor problems are recommended as well as Meternal-Fetal Medicine (MFM) specialist (high-risk obstetrics) or an Infectious Diseases specialist with expertise in the care of pregnant women. An antibody test also exists but the decision for which test to order should be made with/by the treating provider.

What Testing Can Be Done For The Zika Virus?

RT-PCR can be done on amniotic fluid but there are limitations to the testing. Amniocentesis carries higher risk of complications early in pregnancy (at 14 weeks or less) so it should be done at a minimum 15 weeks gestation. For babies born with evidence of Zika, testing should be done on available tissues (umbilical cord and placenta). In cases of fetal loss, RT-PCR should be done on fetal tissues as well (cord and placenta). There are no commercial tests available for Zika virus infection. The CDC and state public health agencies are the ones who can help with testing. ​

A Summary of the Zika Virus:

  • Zika virus infection is suspected of an association with clusters of fetal microcephaly and intracranial calcifications in many countries in North and South America as well as the Caribbean Islands.
  • Most infected people don’t even know they’re infected (up to 80%).​​
  • Pregnant women are being cautioned not to travel to areas Zika virus transmission. Pregnant women should be asked about travel at their pre-natal visits. If they have traveled and felt no symptoms of illness, they do not need testing.
  • Testing should be done for Zika virus (also dengue and chukungunya) on symptomatic pregnant women who have travelled to endemic areas.
  • ​​If testing is positive for Zika, serial ultrasounds and very specialized care with MFM or Infectious Diseases specialist with focus on pregnancy should be obtained.
  • If a baby is born with evidence of Zika virus infection, testing of the umbilical cord and placenta by RT-PCR should be done.
  • ​​If fetal loss occurs in a symptomatic mother with known travel to an endemic area, RT-PCR should be done.

*Special thanks to the CDC, WHO, and AAP for their leadership in this emerging matter.

 


Dr. AkindeDr ​Kudus Akinde, MD FAAP is the practicing physician at Glencoe Pediatrics in beautiful Glencoe, IL. Glencoe Pediatrics provides services including: sick or urgent visits, minor scrapes & bumps, annual check-ups, school physicals, camp physicals, sports physicals, pre-surgical physicals and more.  Dr. Akinde graduated from University of Illinois with a Bachelor of Science Degree in 1995. He attended the University of Illinois College of Medicine and obtained his MD in 2002. He completed his Pediatrics Residency at Rush University Medical Center in 2005.  He has practiced in various locales from small to large communities, urban, suburban and rural (including Rockford, Belvidere, Evergreen Park, Oak Lawn, Highland Park & Chicago, IL).  He has never met a kid he does not like.  His interests include newborn care, immunizations, nutrition, gastroenterology and adolescent issues.  He loves to spend time with his children when he is not at work.  He enjoys web browsing, bike riding, football, basketball, music and traveling among other things.

Feeding Development: The First Year

Feeding your baby the first year is a big task. Below is a guide to what your baby can eat during this important first year.

*Please note, this is just a guide. Consult your physician for specific feeding instructions for your baby.

Feeding Guide-The First Year:

At 0-6 months, your baby can eat the following foods:

  • Breast/Bottle (0-13 months)
  • Thin Baby Food Cereal (5 months)
  • When first trying baby food your child may spit the food out… THIS IS OK. Children must learn how to safely get food out before learning to eat.
  • Eating comes FIRST, then comes manners. Exploring and getting messy with food is part of the process of learning to eat.
  • Thin Baby Food Puree/Stage 1 Baby Food (6 months)

Read our infant feeding series: Starting Solids.

At 7-9 months, your baby can eat the following foods:

  • Thicker Baby Food Cereals AND Thicker Baby Food Smooth Purees/Stage 2 Baby Food (7 months)Feeding Development: The First Year
  • Soft Mashable Table Foods AND Table Food Smooth Purees (8 months)
  • Hard Munchables (8 months)
  • These are hard textured foods for exploring only- NOT CONSUMPTION.
    • Examples: carrot stick, lollipop, hard dried fruit sticks, celery sticks, bell pepper strips,
  • Once a child can move her tongue around the munchable, she can transition to textured table food.
  • Some children will stick objects in their mouths and will not need hard munchables.
  • Hard munchables will help your child practice moving hard solid foods in her mouth, learn awareness of the mouth and become more familiar and comfortable with teeth brushing.
  • If children do not put things in their mouth, it can delay teeth eruption.
  • Meltable Hard Solids (9 months)
  • Melts in the mouth with saliva only (without pressure applied).
    • Examples: Gerber puffs, biter biscuits, graham crackers.
  • DO NOT USE CHEERIOS- Cheerios will shatter in a child’s mouth instead of melting.

Read our infant feeding series: How to Transition Your Child From Purees to More Textured Foods.

At 10-12 months, your baby can eat the following foods:

  • Soft Cubes (10 months)
  • Soft exterior but maintains its shape, needs tongue/munching pressure to break it apart.
    • Examples: Bananas, avocado, Gerber toddler cubes,
  • Soft Mechanical- single texture (11 months)
  • Soft exterior but maintains its shape, needs munching/grinding pressure to break it apart.
  • These foods will help your child learn how to chew food by using a circular chewing pattern.
  • Children need to be able to move food from their tongue to their back teeth to chew textured food.
    • Examples: soft lunch meats, pasta, cooked eggs
  • Soft Mechanical –Mixed (cube + puree) (12 months)
  • More than one of the above textures
    • Examples: macaroni and cheese, fish sticks, French fries, spaghetti, chicken nuggets
  • Your baby cannot eat a mixed textured food unless she can chew each texture individually.
  • Hard Mechanicals
  • Harder textured exterior food that needs grinding/rotary chew (circular chewing pattern) to break apart. These foods tend to shatter in the mouth.
  • Examples: cheerios, saltines, fritos, steak, fruit leathers

Read our infant feeding series: When Your Baby is Turing One Year Old.

Tips to Remember!

  • Eating is the most difficult sensory task that children do!
  • It’s hard to be neat when you are learning to eat.

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NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

reading to infants

The Importance of Reading To Infants

It is widely acknowledged that reading to preschool and school-aged kids is beneficial to their language development. However, is reading to infants just as important? The answer is yes! Reading to infants is important to their language and speech development. Not only does reading out loud to your infant benefit her brain development, but it also helps her learn vocabulary and the sounds of a language.

While you read to your infant, she will be taking in the sounds of her native language. Books with
reading-baby
rhyming words or repetitive phrases provide the most effective stimuli for infants to begin to parse out and recognize sounds in the language. As infants are read books, it also provides a perfect opportunity for them to learn vocabulary. As they hear the word “dog” and see a picture of a dog, they will begin to connect the picture and the word together. The more exposure infants have to books and pictures, the faster they will acquire vocabulary and make those connections. Brown Bear, Brown Bear, What Do You See? by Bill Martin Jr. is a perfect book to read to infants as it includes repetitive phrases, bright colors and basic vocabulary.

Books for infants should also have certain physical characteristics. Books should be manipulative for the infant. Sturdy, cardboard books are great for babies to grab, turn and flip through. Bright colors and big pictures will also help the infant focus on the book and grab his or her attention. Reading with slow, exaggerated speech will also help infants easily parse the auditory stimuli, as well as keep infants entertained.

Other must-have books for reading to your infants include Goodnight Moon, The Hungry Caterpillar, 100 First Words and Baby Touch and Feel board books.

Click here for more on how to use books to encourage speech and language development in babies.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!