What information is available online for my child’s health?

Dr. Samuel DavisWhen you search for health information online there’s a lot of information easily available, but the first results in your search are not necessarily the most accurate. One of the websites that I like for health information is healthychildren.org. It’s a great online resource by the American Academy of Pediatrics that provides trustworthy answers to the questions you have about your child. This website covers practical topics in short articles that you can read quickly. For example, in addition to medical topics it also covers subjects like bathing, skincare, and how to trim your baby’s fingernails.

Another useful website that I recommend for a lot of people is infantrisk.com, which specializes in medication safety for pregnant women and nursing moms. This is an excellent site because it has the most up-to-date research on medicine and answers to common questions.

I’ve put some more sites that have reliable information on my website childpluspediatrics.com. Of course, if you have questions about any specific source of information, please feel free to call the office. We want to make sure you are getting the most up-to-date and accurate information to keep your child healthy and safe.


Dr. Davis

How Much Screen Time Should A Child Have?

Screen time limitations for children vary by age (e.g. tablets, phones, TV, and video games.) Under the age of 18 months, screen time is not recommended at all and it should be avoided altogether. Between the ages of, 2 and 4, thirty minutes or less is recommended. Ages 4 to 5, you should limit it to an hour a day. And with older children, you could sometimes extend the time, however, you still want to put limitations on the material they’re watching and limit their screen time. I wouldn’t do more than two hours a day.

In addition to screen time limitations, children’s screen time should be assessed to see what type of media they’re watching on the screens. Is it educational or does it serve an educational purpose? Or is it just for entertainment? Are there parental controls on the material as far as, is it age-appropriate? Is there any violence in the media that they’re watching?

Under the age of 18 months, it’s crucial to limit screen time or avoid it because their brain is so rapidly growing and developing that it really can affect how they process information. If they’re used to looking at a screen and being overwhelmed with a stimulus, then that can often provoke their brain to process information that way. And that can create attention deficit issues down the road if they’re exposed to a lot of screen time early on. Another issue with excessive screen time is that we don’t know how the blue light from electronics will affect children’s eyes in the future.

The use of screens can also affect kids’ attention spans. For example, if they’re used to watching very fast-paced media on their screens, this type of stimulus can affect how their brains tend to process information. It can also affect their sleep depending on what time of day they’re watching their screens. If they’re doing those things too close to bedtime, it can drastically affect their sleep quality and how long they sleep uninterrupted. It can also change their school behavior if they’re not getting good sleep. Usually it’s recommended to stop screen time one to two hours before bed and do something like read a book and/or take some quiet time to decompress.

It definitely isn’t straightforward in this day and age with the way society revolves around social media, electronics, and screen time. And with the use of electronics in schools it can be hard to limit screen time for your child. However, even though educational screen time is a good alternative it still should be limited.

Why should parents make an annual well check a routine for each child regardless of age?

The annual well visit for a child is very important. Especially, you know, even as they get older, we may only see them once a year, but it’s still very important because we’re checking on their overall development and their growth. And there’s things that we can pick up along the way that if we’re not seeing them we may not be aware of. So whether it be issues at school or, you know, different milestones that they’re not meeting or growth delay, different issues like that, If we’re not seeing them on a regular basis, then we’re not able to pick up on those things and intervene earlier than we could.

We see kids very often, you know, from the time that they’re newborns until about the age of three. So we’re seeing them every few months up to, you know, every six months until they are three. And then after three, we see them once a year at least. But often, you know, when those immunization visits decrease and they’re not needed anymore and there’s a gap in the time that they receive immunizations, a lot of parents will think, “Well, I don’t need to take my child in.” So there may be a gap of a couple years from the time that they bring them in for well visits. But it’s really necessary and needed for us to see them on a regular basis, on a yearly basis at least, so we can, you know, potentially catch things that otherwise might be missed.

I would definitely say there’s a benefit to seeing the same provider or the same group of providers because there’s more consistency in the care. We can follow, you know, how has this child been developing and growing from the first time we saw them as a newborn? And we can see the trends there and be able to track that better and know that this is normal for this child versus it wouldn’t be normal for another child.

Well, the social aspect of a child’s development is very important, just as important as their physical development, and so that’s something else that we’ll be looking at each time that we see the child for their well visit. We’ll be checking to see, how do they interact socially at home, with friends, at school, with their teachers? And so, it’s nice to be able to be proactive and identify maybe some issues early on and get them the intervention that they need rather than waiting till there’s a problem at school and parents are getting calls or phone calls or meetings with the teacher because there’s real issues at school. If we can be more proactive in that, that would be best.

What is the difference between a regular physical and a sports physical for children?

The difference between regular physical and a sports physical is the comprehensive part of the exam. A regular physical would involve a head-to-toe exam of the child, looking at their growth on the growth chart, their weight and height and comparing their BMI weight to height ratio, talking about developmental milestones and where we are as far as meeting those milestones, their performance or their behavior at school and at home, talking about kind of the whole big picture of what’s going on with your child at that age.

A sports physical is gonna be very concentrated and focused on their performance in a sport and are they physically able and healthy enough to participate in that sport. So, we’re doing a fairly quick head-to-toe checkup just to make sure that we’re healthy enough to participate in that sport.

A concussion is basically a symptom or a group of symptoms that occurs when a child hit their head. It can be from a fall or hitting an object with their head. But when they are hit in the head and then they exhibit certain symptoms such as vomiting, lethargy, confusion, any loss of consciousness when they exhibit those symptoms after a head injury, that would be considered a concussion. There are some of those symptoms that can linger sometimes for up to a few weeks. So that’s something that we want to monitor over that time and limit their stimulus during that time and their activities that would put them at a higher risk for another head injury potential.

Why are childhood immunizations important and which vaccines are needed for school?

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Why are childhood vaccines important and which vaccines are needed for school? Childhood vaccines are important to protect your child against contagious, infectious diseases that at different times in our history have taken the lives of many, many children. The vaccines prevent the transmission of these infections and their widespread presence in the community. They’re not only protecting your child, they protect other people around your child who may not yet have been immunized such as young infants or whose immune systems may not function as well such as the elderly or people getting certain types of medical treatment.

So vaccines are not only preventing your child from getting sick, they also protect other loved ones in your family and people in your community. The vaccines that are necessary for school will vary depending on the child’s age. So definitely if you have concerns or you think your child might be behind on their vaccines, talk to your pediatrician and show them, bring in your shot record and let them know what your child has had and they can help you get caught up if there’s anything missing.

Is there one meal that is more important than another when it comes to a child doing well at school?

So, I would say the most important meal of the day for your child would be breakfast and they usually go, you know, the longest span of time between the time that they get to school and lunch. They’re doing a lot of learning in that time frame. They usually put the harder subjects in the beginning part of the day. And so they need a good balance of protein and carbohydrates for their breakfast, so that it holds them over keeps their blood sugar stable, and they’re not having kind of a crash and burn effect as far as their energy level and ability to pay attention in class.

Lunch is important as well, but I would say breakfast is probably even more important than lunch. Your healthier carbohydrates would be your whole grains, whole wheat breads, things of that nature combined with a protein is best. And again your processed carbohydrates like cereals, pancakes, waffles, things like muffins. Things like that are going to be higher in sugar and your body’s going to process that much quicker and it’s not going to keep your blood sugar as stable. I mean, I would say you could do like a whole wheat toast, but combine it with, you know, a breakfast sausage, or eggs. or a protein source combined with that whole wheat bread is best. So that you’re always pairing a good protein with the carbohydrate.

What are some summer tips for children and how can summer’s extreme heat affect children?

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What are some summer tips for children and how can summer’s extreme heat affect my children? Summer tips for activities, get out and be active. Swimming is great. You know, swimming is one of the best summertime activities. You really have to be cautious though because every year in North Texas, there’s a lot of unintentional drownings. And so children of all ages require constant supervision in the water. If you have a pool in your backyard, the safest way to do that is to have it completely enclosed by a fence that locks and to have the backdoor locked. You want at least two locked gated doors between the house and the pool. Most unintentional drownings occur in pools that are not enclosed in that manner. And that’s the safest way we know to prevent small children from getting into the water unobserved. Other great summer activities, obviously bike riding is a lot of fun. It’s a great thing you can do together as a family. Wearing a helmet is definitely recommended for maximum safety to protect developing brains.

It’s really important to drink a lot. Outdoor activities in the Texas heat, drink, drink, drink. Take frequent water breaks. If you’ve been sweating vigorously outdoors for over an hour, a sports drink is not a bad idea, but certainly not necessary for shorter activities, you know, 20-30 minutes duration. Also in the Texas sun, you know, protecting kids from sun exposure is important. Getting a sunscreen, we would recommend at least SPF 24, and reapply regularly for sweating or water activities. Wearing a hat to protect the face, sunglasses for the eyes, all are good ideas even for younger infants. For infants, we would recommend not using a sunscreen till about six months old. Keep them in the shade. Their skin is far more sensitive and I wouldn’t even risk having them out in the sun. After six months, you can apply small amounts of sunscreen. You really want to again rely primarily on shading for some protection though. A floppy hat’s a great idea. When you use sunscreen on younger infants, often try applying some in a small area first to make sure that there might not be a reaction. Many children do have reactions to sunscreens. It may not be the active ingredient of the sunscreen, it may just be another chemical in the sunscreen, but it’s important to test first, especially for kids with sensitive skin.

How can I help my child have a better experience with vaccinations?

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How can I help my child have a better experience with vaccination? Many kids have anxiety about getting shots. There is a lot of things that parents can do and there are things that we can do to make that a better experience. The things that we wanna do are to minimize pain with vaccine in the office. Here are some ways we can do that.

For young infants, one of the most effective things you can do is to nurse your infant while they’re getting their shots. This may sound strange but if you are comfortable with it my staff is well trained and equipped to do it at the same time. Many small infants won’t even cry at all if they get their vaccines while they’re nursing. So that’d be my first recommendation. The second thing I would recommend would be to use proper holding technique. In the past, you know, we’ve sometimes really stressed holding kids down tightly. That’s actually been shown to increase anxiety over time. So now we’re trying to use different holding techniques whenever possible that will allow the child to feel less constrained. Another thing we’re looking to do is implementing more distracters. You know, many people bring their own to the office as far as a phone or tablet to show a favorite video or a song while the child gets vaccines. that can often distract them from the process. Other things that can work are sometimes bubbles or other things to look at while they’re getting their vaccines. Another option is numbing medicine. The application of a lidocaine-containing cream for at least an hour before getting vaccines can provide some local relief at the area of the shot and make it less painful. You can buy this over the counter and apply it yourself or we also have some available in the office as well.

That’s the stuff we can do in the office to help with your shots. The things that parents can do are also important. One is to prepare your child. I don’t recommend keeping shots a secret. If you know there’s gonna be vaccines talk about it ahead of time. Don’t spring a surprise on your child. I don’t think that’s something any kid wants to hear at the last minute. And don’t use shots as a threat. Sometimes I hear parents say, I think they’re joking, but they say things like, “If you’re not good I’m gonna tell the doctor to give you shots.” Again that sends the wrong message. The shots are…they’re there to help the child, they’re there to prevent illness. When used even jokingly as a threat it does increase anxiety, increase the child’s perception of the vaccination as a truly negative experience. Another thing that parents can do to help with their child is to portray a positive attitude themselves. Children definitely look to their parents for their emotional cues as to how they should feel in a certain situation. So certainly even, you know, if we have anxiety about these, setting a positive message, being calm around your child even if you don’t feel so calm on the inside can often go a long ways to making your child more confident with the experience.

If I drink a glass of wine, do I have to pump and dump?

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If I drink a glass of wine or some alcohol, do I need to pump and dump? That’s a question about nursing. A lot of moms are rightly concerned about the effect that alcohol may have on their developing infant’s brain. Certainly, while a mom is pregnant, there’s no known safe level of alcohol that can be consumed. So the safest and most appropriate recommendation is to abstain from alcohol. There’s been studies over the years that have suggested that there may be some wiggle room on that, but the exact levels have not been determined. And we know that alcohol, when consumed, can have serious and lifelong effects on the infant’s brain. So again, the safest amount to drink in is none. After the infant is born I would generally recommend abstaining for the first at least three to four months of life.

After that, as the baby starts to feed, perhaps less often, you can drink with some sensible guidelines. First off, you really want to drink in moderation. At this point, I would say that means, you know, maybe one drink a day. It’s certainly not recommending, you know, drinking excessively by any means. And that’s because it takes time for the alcohol to be metabolized by the mom’s body and then leave her system. So most experts recommend not nursing for at least two hours after having a drink, a standard sized drink. If you do have concerns that there may still be alcohol present in your breast milk, there are certainly test strips available that you can use to test breast milk to be sure, or you can just wait. If you really wanted to be cautious, you could pump and then dump that breast milk and feed stored milk from before or formula to compensate for that feeding.

My child doesn’t exactly sleep like a baby. He’s constantly flailing his arms. Is something wrong?

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How can I help my baby sleep better? Infants have developmental stages that they go through as their sleep progresses. When they’re first born, they seem to sleep constantly and that’s really normal. During the first few weeks, they’ll spend most of their time asleep. As they get older, as they close in on, you know, one to two months old, they’ll start to develop night and day preferences just like we do, where they’ll be sleeping more at night and wake more in the day. But, you might not see that until about two months old and that’s okay. Your baby will get there. You’ll just have to be patient with them. Keep the daytime bright and active, keep the night quiet and dark and they’ll usually get the message on their own.

As they get older, it’s important to help them learn to self-soothe to fall asleep. This is usually best started between four and six months old. And the reason is that as the baby’s brain develops, they start to develop what’s called object permanence, and this is when the baby can start to remember that something that they don’t see is still there. And when that something they don’t see, his mom or dad, and they know you’re there, they haven’t yet learned how to fall asleep on there on, they’re gonna ask you to come in the room or ask them…ask you to hold them or feed them so they fall asleep every time. And so, the best time to start helping them learn to fall asleep on their own is before that gets really good, because that baby’s gonna get smarter everyday. So, you gotta start a little bit early so they learn good habits before they start to develop that object permanence and separation concerns. So, usually between four and six months old is a good time for that. You can start that by continuing your same nighttime routine as far as, you know, bath or feeding, holding, rocking. The key is that you wanna lie your baby down in their crib shortly before they fall asleep, when they’re still sleepy but not totally asleep. Then you can pat them, or touch them, talk to them and gradually redraw that over time as they learn to soothe themselves.

A lot of people ask, “What’s a four month sleep regression? You know, I hear about that when my baby just stops wanting to sleep.” A lot of times it’s not the sleep that’s worse, it’s the baby is getting smarter. Their senses are better, their vision is nearly normal at that point, and they’ve developed strong bonds with their parents, they want them around. And so, you know, that’s really the cue that it’s really time to start that sleep. You know, help them to learn to fall asleep and self-soothe at that point. And that’s again, usually between four to six months old. After six months old, most babies can sleep through the night without having to wake up to feed. Nutritionally they don’t need to do it. Some nursing babies will still want a feed or two at night because that seems to pass through them a little faster than the formula does. And that’s okay, but primarily working on that first falling asleep at night and usually the rest will take care of itself over time. Most babies are still taking several naps, at least two a day at that point as well. As long as the infant naps seem restful and soothing, they may range from an hour or two, and that’s fine. Typically, most children at that age are still getting, you know, 12 to 14 hours of sleep in a 24 hour period, and that’s kind of your goal. How that breaks down and splits up can be a little flexible.

Does an unbalanced diet affect learning and what is a healthy weight for my child

An unbalanced diet for your child can definitely affect their learning process at school. If they’re taking in, especially with breakfast, if they’re taking in a lot of carbohydrates or sugary foods in the morning like a sugary cereal or mostly carbohydrates, then it’s going to drastically affect their attention span and their ability to learn throughout the day. They’ll be hungry sooner than they normally would because they’re not getting good protein to hold them over until the next meal at lunchtime. So they’ll tend to be distracted and not be able to focus as much at school. Some children will also have hyperactivity with increased intake of sugars and carbohydrates, so limiting those before school and during school at lunch is best so that they can focus and be well-behaved and mannered in class.

A healthy weight for your child depends on their height and their age. So we have growth charts that we compare and we plot their weight and their length on those growth charts. It compares them to their peers and gives you a percentage of where they are for their weight and their height. And then the most important factor of that is to compare their weight to their height ratio to see is their weight a healthy weight compared to their height. So are we proportionate with our weight? And so there are several factors there, but it depends on how tall they are as to how much they should weigh.