San Diego
Babies and Toddlers From Baby Bump to Toddler Time
Publisher’s Letter
inside 6 Meet Our Local Mom Contributors Moms who shared their tips and experiences 8 The First 1,000 Days The importance of baby nutrition 12 Sweet Dreams
Welcome
Is it time to consider a sleep coach? 16 Super Smiles Optimizing oral health
It’s our second Annual San Diego Babies and Toddlers digital guide!
20 Tummy Trouble
Hi Moms and Dads,
Parent-recommended pediatricians and more
This year we added a list of local parent-recommended OB/ GYNs, midwives and pediatricians. Thanks to everyone who referred your favorite doctors. Check them out on page 24. All parent comments are listed at www.sandiegofamily.com/parenting/baby. If you are looking for a new doctor, these comments might help you decide.
28 Smart Start
We have articles regarding maternity leave, baby sleep habits, health and nutrition, brain games to play with baby, and a round-up of some of our favorite new products on the market. View all the services throughout the magazine— you may find just what you’re looking for. We (at San Diego Family Media) are happy to connect our readers with San Diego County advertisers. Please tell them you saw their ad in San Diego Babies and Toddlers.
36 Maternity Leave Realities
Enjoy parenthood—it’s the greatest gift on earth!
The scoop on poop and other digestive issues 24 Is There a Doctor in the House?
10 brain-building games for baby 32 Oh Baby! Some of our favorite baby and toddler products Strategies to help transition back to work
Thank you to our advertisers! 3 Fertility Specialists Medical Group 5 Floaties Swim School 7 Nature’s Whisper Family Wellness Center 10 SDSU Foundation WIC Program
sharon@sandiegofamily.com
14 Children’s Choice Pediatric Dental Care 18 The Super Dentists
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2 • SanDiegofamily.com • Baby Guide 2020
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on the web Get to know SanDiegoFamily.com, where you’ll discover a plethora of awesomeness for parents.
Parenting • Early Childhood Red Flags • How and Why to Develop Growth Mindset in Kids
Parenting: Baby • What New Moms Need to Know about Breastfeeding • Tips to Help with Postpartum Depression • Outdoor Activities in San Diego for Babies and Toddlers
4 • SanDiegofamily.com • Baby Guide 2020
Heads up, Parents!
Important Public Service Announcements
Give Your Little Ones a Healthy Start Have questions or concerns about baby’s growth and development? Don’t delay in having those questions answered! California Early Start is a federally funded program that provides free assessments to infants and toddlers and, if needed, important therapeutic services (free to eligible families) early enough to make a huge impact in a child’s development. For information about the Early Start program, call the San Diego Regional Center at 858-496-4318 or Exceptional Family Resource Center (EFRC) at 619-594-7416.
Make In-Person Appointments with Pediatrician With current health concerns, many families are opting for virtual medical appointments when offered, but it’s important to attend annual well-baby and well-child appointments in person, as many important areas of concern can be overlooked during a virtual visit. Depending on age, kids may be screened for vision, hearing and mental health, blood pressure is taken, spine development is checked and there could be other important tests and vaccinations that would not be administered in a virtual appointment. Ask your pediatric office what measures are being taken to separate sick kids from those who go for well-checks and plan to have your kids see the pediatrician in person.
Your child's health and safety is our #1 priority Masks + Temperature Checks + Social Distancing + Regular Sanitation
of Health SD Dept.
ED APPROV
Meet Our
Local Mom Contributors
We know that moms value the advice of other moms more than anything, so we are thrilled to include wisdom and expertise from a few who have walked the baby or toddler path recently (or are on it right now). Here are this year’s mom contributors. Find their tips and shared experiences throughout the publication.
Tia Hutchinson lives in Point Loma with her husband and two daughters, ages 8 and 4. She was born and raised on the tiny island of Jamaica and married her high school sweetheart (also from Jamaica). They’ve been a U.S. Navy family for 10 years and love all things outdoors and adventurous. Fun fact: You can get Tia to say yes to almost anything if coffee is involved! Follow her on IG @coffee.with.tia.
Sandra Page drove from her home on the East Coast to San Diego 10 years ago. She married her college sweetheart and they are now raising 2-yearold twin daughters in Rancho Santa Fe. Sandra loves exploring San Diego with her girls and hosting get-togethers for friends who don’t have family in town (like them). Fun fact: She used to be a gymnastics coach at the YMCA. Follow Sandra on IG @playdatesandpints.
Melissa Varela of Rancho Peñasquitos has three kids, ages 8, 4 and 2. She’s a Registered Dietitian turned skincare consultant and stayat-home mom who enjoys discovering new adventures in San Diego. Fun fact: In order to minimize arguing between kids during quarantine, her family started “leader of the day.” The leader gets to be in front when riding bikes and chooses activities for the day. Follow Melissa on IG @sandiegoadventurekids.
Victoria White of East County has three kids, ages 11, 10 and 6. You can find her chasing after God, her children and her goals, with the support of her husband. As a U.S. Marine Corps spouse who has faced many setbacks, Victoria encourages moms to remember their “why” to stay motivated. “I don’t care if you fall 50 times. Get up, adjust and stay encouraged.” Fun fact: Besides being a busy mom, she works full time and is pursuing a master’s degree. Follow Victoria on IG @TheWhitePartyofFive.
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Anne Malinoski
Improving child nutrition in
The First 1,000 Days
What mothers and babies eat and drink in the first 1,000 days (from conception to a child’s second birthday) has a profound impact on a child’s growth and development. Learn more at www.thousanddays.org.
The World Health Organization
found that a child’s nutrition in the first 1,000 days of life—from conception through the second year—has a substantial impact on physical and behavioral development. According to Dr. Christina Valentine, a neonatologist focused on infant and maternal diet, parents should consider this strongly when choosing a child’s first foods. “We want kids to develop physically, but we want them to be social as well,” she says. “Brain development affects not only how you learn but how you see the world and respond to sensory inputs. We need DHA from salmon or egg. We need iron from meat. In the first 1,000 days all that development in
8 • SanDiegofamily.com • Baby Guide 2020
the brain is happening and needs some of these key foods.” According to Dr. Valentine, children in the U.S. tend to be deficient in vitamin D, DHA, potassium, fiber, vitamin E and iron. These deficiencies are not only affecting physical development in youngsters—they are hurting social and emotional development as well. To combat this trend, Dr. Valentine recommends introducing these nutrients as soon as babies are ready to add “complementary foods” to their primary nutrition source of formula or breastmilk. Parents can look for cues like finger-raking to determine when
a baby is ready to try solid foods, usually around 4-6 months of age. Once baby seems ready, think about starting with foods that have iron, such as strained meats, fruits, vegetables and eggs. Baby cereal was once recommended as a first food, but it doesn’t have as much nutrition or sensory appeal as these other options. From there, continue to add nutrient-dense, brightly colored whole foods to baby’s diet. Be sure to consult your child’s pediatrician about baby’s specific health needs. The United States Department of Agriculture (USDA) will release new dietary guidelines in January 2021. According to Dr. Valentine, we can expect to see more guidance pertaining to sugar and its role in creating nutrition gaps in young children. Researchers have found that the most predominant “vegetable” in an American toddler’s diet is french fries. About 30 percent of tots are consuming sweetened beverages like cola or sweet tea daily. As a result, many American children are malnourished, despite exceeding daily calorie needs. Their high-sugar diets leave little room for nutritious foods.
For that reason, the new USDA guidelines will be clear about avoiding sweets. Dr. Valentine recommends looking for foods with less than 6 percent added sugar. Check labels—especially on things like granola bars and breakfast bars since they often have a surprising amount of sugar. “If you can replace sweetened foods and beverages, you can get more fruits and vegetables and fiber into a child,” says Dr. Valentine. “That will not only help development, but decrease weight and risk for cardiovascular disease and diabetes. It can also improve immune health!” Mealtime should be fun and exciting for babies. Each meal together is an opportunity for baby to experience new flavors and socialize with the family. Try to enjoy eating together and don’t stress too much if you’ve made a few mistakes already. “It’s never too late,” says Dr. Valentine, adding that good nutrients benefit children no matter when they are added to their diets. v Anne Malinoski is a contributing writer. She lives in Santee with her husband and two sons.
Dr. Valentine’s Tips • Roast those veggies! Dice and roast vegetables with a little olive oil for a more appealing texture. Babies are sensory beings, and mushy foods might not be appealing. • If your baby takes formula, choose a brand developed in the U.S. Our guidelines are trustworthy and based on good science. • Make crispy salmon cakes to help children get enough DHA. Packaged salmon with tuna oil is super nutritious. “Mix it with one egg and some Italian breadcrumbs and make tiny patties,” she says. “Sauté in olive oil and let it cool.” • Eat the rainbow! Bright colors have nutrients and appeal to baby’s senses. • If you’re concerned about nutrition gaps, try making highly nutritious pancakes or muffins by adding powdered toddler formula (containing DHA and iron) to the batter.
Local Mom Tips When baby starts solids, follow the baby-led weaning approach. My friend and fellow dietitian, Katie Ferraro, has a great IG page @babyledweanteam. Melissa, Rancho Peñasquitos One of my favorite things to do is grow a vegetable garden and cook with my kids. Is it messy? Of course! But it’s so fun to see them get excited about picking vegetables and eating them in a dish they’ve learned to make. Sandra, Rancho Santa Fe Read about our local mom contributors on page 6. Baby Guide 2020 • SanDiegofamily.com •
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What is WIC?
San Diego Families Grow Healthy With WIC
WIC is California’s Sp Women, Infants, and C of nutritious foods tha and active. WIC servic
What does WIC
Individual and group n online nutrition classe Support and informati access to breastfeeding The California WIC Ca and vegetables, whole butter, soy milk, tofu, Referrals to other prog and dental care and pa
The California W The CA WIC card allows:
The family’s food bene one WIC card.
The food benefits to be in the family account. or stolen family memb benefits.
To locate the
Call us toll-f 10 • SanDiegofamily.com • Baby Guide 2020
1
pecial Supplemental Nutrition Program for Children. WIC provides benefits for a variety at support you and your family to be healthy ces are provided at no cost to you.
C provide?
nutrition sessions, with many locations offering es. ion about breastfeeding your baby, including g educators. ard to buy healthy foods- such as fresh fruits e grains, milk, eggs, bread, cereal, juice, peanut and more! grams or services, such as childcare, medical arenting classes.
You can participate in California WIC if you live in California, meet the income guidelines, and one or more of the following applies: You are pregnant You are breastfeeding a baby under age 1 You have had a baby in the last 6 months You have a child under age 5 You have experienced a pregnancy loss within the past 6 months
Income Guidelines: NUMBER OF PEOPLE IN FAMILY*
GROSS MONTHLY INCOME
2
$ 2,658
3
$ 3,349
4
$ 4,040
5
$ 4,730
6
$ 5,421
*Pregnant women count as 2 people
WIC Card is HERE!
efits to be together on
e secured electronically If card is lost, damaged bers will not lose their The California WIC App will be able to assist you with shopping for your WIC foods. Other features include: reminders about your next appointment, ability to review your existing food balance, and reminders of when your food balance is set to expire. Find the app in Google Play & the App Store!
DID YOU KNOW?
San Diego Families Grow Health With WIC
Families who meet the above requirements and receive Medi-Cal, CalWORKS (TANF), or Calfresh (Food Stamps/SNAP) may be automatically eligible for WIC. Give us a call to find out if you qualify! Foster children under the age of 5 are eligible for WIC. Military families who meet the requirements may be eligible for WIC. Basic Allowance for Housing (BAH) is not included when calculating income for military families. Families who meet the requirements may be eligible for WIC regardless of immigration status.
To locate an you, use Children under the age of 5office who arenear cared for by fathers, grandparents, or other legal guardians may be eligible for WIC. the WIC locator tool: sdwic.com
Visit us at www.sdsuwic.org or call us toll–free at 1-888-999-6897
Call us toll-free to set up appointment!
1-888-999-6897 Or visit us online
e an office near you, use e WIC locator tool:
www.sdsuwic.org
sdwic.com
free to set up appointment!
1-888-999-6897 Or visit us online
Baby Guide 2020 • SanDiegofamily.com •
This institution is an equal opportunity provider
11
Anne Malinoski
Sweet Dreams Is it Time to Consider a Sleep Coach?
When I was pregnant with my first
son, I read at least 10 books about birth. Sure, I knew the birthing process would last a mere one to two days and I’d chosen a trusted provider to guide me through that singular event. But I really wanted to understand every detail in order to soothe my own anxiety, so I over-prepared. Had I known that baby sleep would be my biggest stressor for the next one to two years, I’d have studied circadian rhythms instead! My son was four months old when I started to feel that everything had gone wrong with his sleep. I was so tired that daily activities were overwhelming. What my sleep coach helped me understand is that I’d never established healthy habits surrounding sleep, and that both my baby and I would need to adjust to some changes. Like many nursing moms, I loved that our evening feed helped my son fall asleep for the night. It was impossibly sweet to watch him doze off in my arms. If he woke on our way to the crib, I’d just feed him a little more until he was happily snoozing again. But as he got older, I needed to feed him multiple times and for longer periods. Soon the bedtime nursing session was taking an hour or more. When he woke at night, he expected the same lengthy routine
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to get back to sleep. I was exhausted! My husband couldn’t put our baby to bed, and neither could I without the enormous crutch I’d created. We had a serious problem. According to Certified Sleep Consultant and San Diego mom Jessica Cheeley, many parents seek coaching for some version of the same problem. “It’s the baby’s inability to fall asleep on their own,” she says. “They rely on something to get them to sleep or put them back to sleep.” For some families, this might be a baby who needs to be rocked to sleep or who screams when put down for a nap. It could be the infant who wants to sleep on dad’s chest or who only naps for 30 minutes at a time. All these stories began the same way. At some point, we taught our infants (and ourselves) that they can’t get to sleep or stay asleep without our help. “We don’t typically look at falling asleep as a skill, but it’s an essential skill we have to learn,” says Cheeley. “If you set the right habits early, they learn to fall asleep by themselves without needing to be fed or rocked to sleep.” Once parents identify the habit that needs breaking, it helps to make a plan. What’s the new, healthy bedtime routine? What will you do when baby
resists it? Make sure everyone in the household knows the plan and is prepared to remain consistent. Expect this change to be hard at first. The good news is that babies can learn positive sleep habits quickly. “If it’s a mild to moderate sleep issue and if all the baby’s needs are met (he is fed, not in pain and his diaper is dry), you will typically see progress in three to five days if you are rock solid consistent,” says Cheeley. So how do you know if you need a sleep coach? It might be time to call a consultant if sleep issues seem severe, or if you’ve tried implementing healthy sleep habits but are struggling to stay consistent. One thing I noticed
during my firstborn’s sleep struggle is that exhaustion made it hard to remain confident in my plan. My sleep coach was mostly a cheerleader who gave me the support I needed to follow through. She also helped me regroup and switch gears when our first approach wasn’t working for our family. My baby’s sleep issues were complex and unique, just like him. Cheeley says, “The most rewarding thing I hear from my clients is, ‘You gave me the confidence I needed to do this.’ Because sleep training at its core is setting a foundation of healthy sleep habits, every single family can benefit from understanding what that looks like and how to actually implement it into their family unit.” v Anne Malinoski is a contributing writer. She lives in Santee with her husband and two sons. Follow Jessica and her team on Instagram @sleepshopconsulting where the consultants post tips and tricks for healthy sleep habits. Learn more at www.sleepshopoc.com.
Expert Tips for Establishing Healthy Sleep Habits •
Put baby in the crib while he’s drowsy, but still awake.
•
Make sure baby’s daily calorie needs are met. Hungry babies will wake often.
•
Establish the ideal sleep environment. The room should be 68–72 degrees and darkened with blackout shades. Use a sound machine that stays on all night.
•
Use a swaddle (especially in the early weeks) to help baby adjust to life outside the womb. Cheeley says babies who fight the swaddle are often the ones who need it the most. So, keep trying! Her favorite is the Ollie Swaddle. Baby Guide 2020 • SanDiegofamily.com •
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Super Smiles
Malia Jacobson
Optimizing oral health Every time you test the temperature of your baby’s bottle with your mouth or share food, a straw, or a utensil with your toddler, you’re also sharing bacteria that cause tooth decay. That’s right, cavity-causing dental decay is an infectious, transmissible disease that parents can unknowingly pass to their children, per the National Institutes of Health (NIH). After decades of decline, the rates of cavities in children under 5 are on the rise; experts blame a diet higher in sugary foods and drinks. The National Institute of Dental and Craniofacial Research (part of the NIH) reports that one-third to one-half of children under age 5 develop cavities in baby teeth. But like many infectious diseases, dental decay is preventable. Here’s how to protect your child’s oral health, even if pearly whites are still months away.
When to Visit a Dentist In the National Poll on Children’s Health (Mott Poll), researchers found that most parents weren’t sure when their child should first visit the dentist. Out of this majority, over 16 percent believed kids didn’t need to visit a dentist until after age 4, reflecting a common misbelief that cleaning baby teeth isn’t all that important—they’ll just fall out anyway, right? Wrong. Decay in baby teeth harms oral health both now and for years to come. The bacteria that cause tooth decay in baby teeth can break down enamel of permanent teeth as they begin to come in, making these teeth more vulnerable to cavities. And because baby teeth serve as placeholders that guide permanent teeth into position, losing baby teeth too early as a result of tooth decay can create a crooked, crowded smile later on. Scheduling a dental visit by age 1, or six months after the first tooth
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pops up, helps safeguard oral health in a few important ways, per experts at C.S. Mott Children’s Hospital. First, establishing a relationship with a dentist early on helps pave the way for less stressful visits in the future, when your child begins “real” dental cleanings or needs a filling. Visiting the dentist by 12 months of age also helps the dentist spot any early signs of trouble and provide advice on the best way to care for your child’s teeth.
Little Cavities, Big Deal What’s the dentist looking for at these early visits? Before tooth decay causes a cavity, it may cause white spots on tooth enamel, which signal that the enamel is breaking down. From there, a cavity may look like a small, light-brown spot on a child’s tooth. If the cavity isn’t treated, the spot becomes larger and may turn darker brown or black. More advanced tooth decay may cause a toothache, sensitivity to hot or cold, bad breath and swelling. Per the American Dental Association, tooth decay in baby teeth can affect a child’s overall general health as well.
If Baby Has a Cavity After a dental exam, the dentist may suggest X-rays to help diagnose tooth decay. In many cases, small cavities can be filled in a single visit; the dentist removes decayed enamel and uses tooth-colored material to fill the hole. The process may not be fun, but kids shouldn’t experience pain and can usually eat or drink soon afterward.
Caring for Gums and Baby Teeth Before baby’s teeth appear, use a (clean) soft cloth or small piece of gauze to gently wipe the gums after feedings. This helps prevent sugary milk or food residue from remaining on baby’s gums, providing an environment where the bacteria that cause tooth decay can grow.
Parents should start brushing baby’s teeth as soon as the first one appears, advises Stanford Children’s Health. Young toddlers need just a dab of toothpaste (the size of a grain of rice), while preschoolers can use a pea-size amount. After age 2, add flossing to your child’s routine. Does your toddler need an electric toothbrush? Most dentists say no—a child-sized, extra-soft toothbrush will work—allow kids to choose the toothbrush (or at least the color) themselves. Consider The Super Toothbrush from The Super Dentists (for kids ages 3 to 7), which features AR technology and a song to let kids know how long to brush. v Malia Jacobson is a health and family journalist.
Local Mom Tips
Fun Apps that Help Tots Brush •
Brush Up: Toothbrush Trainer
•
Toothsavers Brushing Game
•
Disney Magic Timer
•
Brush DJ
•
Chomper Chums
Make toothbrushing as fun as possible! My 2-year-old can’t stand having his teeth brushed, but when we turn on Blippi Toothbrushing Song (YouTube), he’s all smiles. Melissa, Rancho Peñasquitos Oral health starts early! Make sure to wipe baby’s gums after a bottle (even before teeth) and take little ones with you to the dentist so they start to see it and are not afraid. Sandra, Rancho Santa Fe Read about our local mom contributors on page 6.
Baby Guide 2020 • SanDiegofamily.com •
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Malia Jacobson
Tummy Trouble
The scoop on poop and other first-year digestion issues Babies, especially newborns, spend most of their waking hours feeding and pooping, so it’s understandable that digestive issues are a top concern for new parents, says Uma K. Pisharody, MD, a specialist in pediatric gastroenterology. “New babies mostly eat, poop and sleep, so anything that makes them fussier than normal often leads to an assumption that there’s a problem with the baby’s digestion.” Most babies have healthy, functional digestive systems—even those who experience an occasional bout with gas, diarrhea or tummy pain. But because common digestive issues like spitting up, reflux, diarrhea, gas, constipation and changes in bowel movements top the list of new parent concerns, they’re worth addressing. From the first poop to the first birthday, Dr. Pisharody answers questions about first-year digestion issues. What are the top digestive issues you see in babies? Most babies who come to see me are brought in for fussiness or excessive crying. The vast majority of the time, the baby is otherwise fine. The top issues I see and treat in babies are feeding problems, difficulty gaining weight, vomiting, changes in bowel movements like diarrhea or constipation, and reflux. Conditions like digestive tract birth defects or bowel obstructions are much less common.
What’s the first step you take when a new patient comes in? I ask the parent or caregiver a lot of questions about feeding: What’s going on in the home during feeds, when do
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feeds occur, and how do feeds relate to fussiness or other symptoms. I then look for red flags that tell us there could be a digestive problem. Those red flags could be forceful vomiting (noticeably more forceful than normal spit up), particularly vomit that has a fluorescent yellow/green color or blood, any blood in the poop, or problems with the baby’s growth.
When it comes to spitting up, what’s normal? How much is too much? There is actually no “normal” or “abnormal” amount of baby spit up, as each and every baby is different and it’s best not to compare babies to each other. What I look for first and foremost is whether or not there is any forceful
Red Flags that Need Medical Attention Contact your baby’s pediatrician if any of these symptoms are present. • Feeding aversion—an infant who seems disinterested or is opposed to feeding. • Baby is not gaining weight or growing. • Prolonged jaundice—lasting longer than two weeks. • Stools that lose the normal brown or yellowish color and become white or creamy could signal a problem with baby’s liver and bile ducts. • Belly distension, extreme or sudden fussiness, forceful and/ or bilious or bloody vomiting or bloody stools. When in doubt, contact your provider with questions about your baby’s digestion. If you search for answers online, Pisharody recommends visiting www.gikids.org. vomiting; second, does the spit up contain bile or blood; and third, is the baby gaining weight? If a baby spits up dozens of times [without the above issues] and is happy and growing well, I don’t consider that a problem. On the other hand, a baby could spit up just a few times each day, but if those issues are present, there could be something going on.
Does a breastfeeding mom’s diet create gassiness in her baby? Byproducts of foods that cause a mother to have gas can also occasionally cause gassiness in her infant, but this type of gas typically shouldn’t cause severe pain. The gas produced within a mother’s own digestive tract after she eats certain foods doesn’t get passed through breastmilk. I tell mothers that it’s wise not to eat too much of any one food, but to eat a varied and healthful
diet while breastfeeding. Broccoli, beans, and yes, even chocolate are often OK in moderate portions.
Newborn poop is already so watery—how can parents tell if their baby has diarrhea? When I examine diarrhea in newborns, I am looking for a significant change in frequency of bowel movements more than a change in consistency. If a baby who was having six watery bowel movements each day suddenly begins having 10 to 15, that’s probably diarrhea and worth a call to your pediatrician. With constipation we look for changes not only in frequency, but also in consistency. A baby should pass the first black, sticky stool, called meconium, within 24 hours of birth. From there, a baby’s bowel movements will vary in frequency from many per day (for example, after each feeding) to as long as one every two weeks for breastfed infants; the latter is not typical, but can be normal. We look for changes in each individual baby’s routine: If a baby is having 3 to 4 stools each day and then starts going a few days between stools, or if the stools suddenly become firm, that’s something to bring to your healthcare provider’s attention. Until solids are introduced to a baby’s diet, we want bowel movements to be fairly runny.
What is colic and how common is it? Colic is inconsolable crying that starts around 1 to 4 weeks of age. Around 1 in 4 babies have it. It’s thought to result from immaturity of the nervous system, rather that digestive problems or gas as many parents assume.
What are signs that a baby is experiencing gas and how can caregivers help? One way to tell that your baby’s discomfort is from gas is that the pain seems to be relieved by burping or passing gas. I haven’t found over-thecounter gas drops to be particularly helpful, but I don’t have a problem with them, if parents want to use them or find them helpful.
For babies, gas in the digestive tract is usually caused by swallowed air. Along with regular burping after feeds, I recommend working with a lactation consultant to improve a baby’s latch during breastfeeding to reduce air swallowed during feeding. Gentle abdominal massage can help a baby who is experiencing gas pains. For a new baby, you can place the baby tummy-down on your lap, knees tucked in towards the chest, and gently massage the abdomen with your hands. This has the added benefit of lifting the baby’s bottom up, so gas rises upward and can more easily pass. For older babies, laying them on their backs and gently bicycling the legs can help. v Malia Jacobson is a health and family journalist.
Local Mom Tips Our toddler had a lot of issues with constipation. Her doctor prescribed medication to soften her stool, but we didn’t want to rely on that. We made changes to her diet to include more fruit, fiber-rich foods, increased fluids, and dried prunes (we told her they were candy!). Victoria, East County My youngest (now 4) had a bad milk protein allergy when she was a baby that resulted in frequent spit-ups and other issues. Since she was breastfed, I switched to a complete dairy-free diet from months 2 to 6. It was rough, but worth it. Tia, Point Loma I took my infant twin girls to a chiropractor to help with a variety of issues, but I saw an immediate improvement in their digestion! As they’ve grown into toddlers, I now ask how they feel after eating different things. It helps me (and them) understand what makes them feel good, and what their bodies aren’t loving. Sandra, Rancho Santa Fe Read about our local mom contributors on page 6. Baby Guide 2020 • SanDiegofamily.com •
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Eating less SUGAR & the best healthy sources by Cassandra Padgett, MS
Nearly all toddlers and majority of babies eat too much added sugar in US. Nearly all babies and toddlers in the U.S. consume added sugars in their diet, much of which comes from foods thought to be healthy, like yogurt and even snacks marketed toward babies like puffs, applesauce, and crackers. Early added sugar intake could lead to poor nutrition and health later on in childhood and adolescence. Consuming added sugars is a risk for infants and toddlers because it can influence their taste and future food preferences. “The consumption of added sugars among children has been associated with negative health conditions such as cavities, asthma, obesity, elevated blood pressure, and altered lipid profiles,” said lead investigator Kirsten Herrick, of the National Institutes of Health. It’s crucial to focus on healthful nutrition in the baby and toddler years as eating patterns early in life strongly shape eating patterns as kids get older. The 2019 study on added sugar intake for babies and toddlers ages 6-23 months found that for toddlers, most added sugars came from fruit drinks, candy, and sweet baked goods, while sugar intake for babies mostly came from yogurt, snacks marketed toward babies, and sweet bakery goods (Herik et al, 2019).
Foods high in sugar are generally not nutritionally-dense, meaning kids miss out on getting healthy, balanced meals when more calories come from sugar. When choosing snacks for babies and toddlers, it’s important to check labels on packaged foods. Even foods marketed toward babies and toddlers like applesauce, crackers, puree pouches, puffs, and yogurt melts have added sugars. What’s better than buying packaged snacks? Offer fruit and vegetables. Introducing fruits and veggies early and offering them often can prevent picky eating (or make picky phases shorter), and improve health now and in the future. Instead of reaching for pouches and purees, offering soft, small pieces of fruit and veggies can help babies get used to the taste of fruits and vegetables without them being overpowered by fruit juices, which is common in baby food pouches.
Easy fruit and veggie snacks for babies and toddlers
(note: cut into small pieces for babies and young children) • Berries • Banana slices • Peaches, pears, nectarines • Apples • Applesauce (no added sugar) • Steamed cauliflower, carrots, or broccoli • Bell peppers • Cucumber • Avocado • Raisins • Sweet potato
Cassandra Padgett is a mom to a 3 year-old girl (and one on the way!). She’s a Senior Health Educator and ACE certified health coach for the W.E.L.L. Clinic at Children’s Primary Care Medical Group- La Costa. The W.E.L.L. Clinic helps kids and families optimize health by making habit changes in nutrition, physical activity, sleep, stress management, and screen time. Cassandra also helps run the Carlsbad chapter of Walk with a Doc, and is passionate about helping kids and families improve health, one small change at a time.
If you need assistance in helping your kids eat a balanced diet or overcome pickiness, contact the W.E.L.L. Clinic at Children’s Primary Care Medical Group. The W.E.L.L. Clinic specializes in helping kids, teens, and families make habit changes to improve health in the following areas: nutrition, physical activity, sleep, stress management, and screen time. To make a W.E.L.L. Clinic appointment in La Costa call 760-633-3640, and for Oceanside call: 760-547-1010. As a free, added service for the community, Children’s Primary Care Medical Group is now offering Walk with a Doc, a weekly walk for families, at two convenient locations in North County. Walk with a Doc is offered in Vista on Thursdays at 4:15 and La Costa on Tuesdays at 4:00pm. A healthy snack is always provided.
Check out walkwithadoc.org/carlsbad for more information. Sources: Herrick, K.A., Fryar, C.D., Hamner, H. C., Park, S., Ogden, C.L. 2019 . Added Sugars Intake among US Infants and Toddlers. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j. jand.2019.09.007
Cassandra Padgett, MS
Health Educator and mom
Is There a Doctor in the House?
Parent-recommended pediatricians, OB/GYNs and midwives Thank you to all the local parents who responded to our request for favorite pediatricians, OB/GYNs and midwives in San Diego County. Doctors and providers are listed alphabetically by organization, some of which also fall under the umbrella of Rady Children’s Hospital. Find a full list of comments and quotes from local parents in “ParentRecommended Doctors” at www.sandiegofamily.com/parenting/baby.
PEDIATRICIANS Arch Health Medical Group Dr. Stuart Graham Poway
Kaiser Permanente Dr. Patricia Cantrell Grantville
Sharp Rees-Stealy Dr. Michael Antos Otay Ranch
Bailony Pediatrics Dr. Ahmad Bailony National City
Dr. Stephanie Washburn La Mesa
Dr. Jennifer Barkley Carmel Valley
Dr. Joanne Wong Grantville
Dr. Cherie Chu La Mesa
Scripps Coastal Medical Center Dr. Dania Lindenberg Hillcrest
Dr. Lizzie Giangreco Rancho Bernardo
Childrens Physicians Medical Group Dr. Gina Rosenfeld San Marcos Children’s Primary Care Medical Group Dr. Jessica Coullahan Escondido
Scripps Clinic Dr. Erin O’Leary Santee
Dr. Jershonda Hartsfield Otay Ranch Dr. Peggy Manuel Kearny Mesa
+Dr. John Hansen Kearny Mesa
Dr. Matilda Remba Mission Valley
+Dr. Trevor Henderson College Area
Dr. Albert Martinez Scripps Ranch
Dr. Lynne Scannell Santee
Dr. Theresa O’Dea Scripps Ranch
Dr. Regina Mangine Santee
Dr. Jenny Ou Rancho Bernardo
Dr. Randall Metsch Encinitas
+Dr. Eric Reed La Mesa
Dr. Ursula Pertl Oceanside
Dr. David Reynaldo Del Mar
Dr. Anita Pinto El Cajon Dr. Nancy Shiau College Area Dr. Kamei Tolba Encinitas Coast Pediatrics Dr. Jamie Lien Carmel Valley Dr. Rob Warner Del Mar
Dr. Eric Reed [Sharp Rees-Stealy, La Mesa] has been the only pediatrician who truly cared and listened when we knew our son was on the Autism Spectrum. He always listens to our concerns, never pushes medications, and always gives us printed information on things we can do and learn to help our son. Our children love visiting Dr. Reed—he makes every visit fun. – LiLiAnn, Santee
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Both Dr Jessica Coullahan and Nurse Practitioner Adrianna Haas [CPCMG Escondido] respond right away if I have medical concerns about my children. Dr. Coullahan even sent a message via “my chart” to ask how my kids were doing! They are both working moms, so it’s nice to have doctors who actually know what you are going through. – Elizabeth, San Marcos
+ Received more than one parent recommendation.
OB/GYNs Cap Women’s Health +Dr. Nikolas Capetanakis Encinitas Ho Vu Women’s Healthcare Dr. Lac Vu College Area (East)
Dr. Cap [Capetanakis] is calm, encouraging, realistic and highly skilled. He has an amazing way of helping you have the birth you envision. I recommend him 110 percent! – Deeanne, Oceanside
Dr. Blair Henderson Otay Ranch Dr. Christopher Lafferty La Mesa Dr. Andrea Seid Santee Dr. Maia Uli Rancho Bernardo
Kaiser Permanente Dr. Patricia Ann Brown Grantville
Dr. Anupam Garg Hillcrest
Dr. Kelly Cork San Marcos
Dr. Renee Nelson La Jolla
Dr. Tina Ziainia Scripps Ranch
Dr. Amber Knight El Cajon
Dr. Ronald Salzetti Rancho Bernardo
Dr. Nah Yong Moon San Marcos
Dr. Elizabeth Silverman La Jolla
South Bay OBGYN Dr. Juan Rivera Chula Vista
North County Women’s Specialists Dr. Victoria Young Escondido
Dr. Lily Tsai Encinitas
Palomar Health Dr. Gregory Langford Escondido Scripps Clinic Dr. Stephen DiMarzo La Jolla
MIDWIVES Best Start Birth Center Shari Stone-Ulrich Point Loma Birth Local Midwifery Kayti Buehler Kensington Birth Roots Women’s Health and Maternity Center Donna McBride Hooyen Chula Vista Kaiser Permanente Marianne Richard Grantville UC San Diego Health Christine Cortes La Jolla Erica Vu Hill La Jolla
Sharp Rees-Stealy +Dr. Robert Barmeyer Kearny Mesa Dr. Dana Chortkoff Del Mar Dr. Philip Diamond Otay Ranch
Dr. Jenny Vesona Scripps Ranch
Dr. Juan Rivera [South Bay OBGYN] ensures his patients receive the best care, annual exams and prenatal visits. He has been my provider through three pregnancies and one miscarriage, and was there for me every step of the way. I trust him with my health and the health of my babies. – Elyse, Chula Vista
Donna [McBride Hooyen] has nine kids of her own (six born at home) and several grandchildren. She was also a Le Leche League leader for 20 years, so she has a lot of life experience. Birth Roots has a sliding fee scale based on income, making it possible for almost anyone to have a midwife-assisted birth if they want it. – April, Downtown San Diego
Read “Parent-Recommended Doctors” at www.sandiegofamily.com/parenting/ baby to see all the comments local parents made about their favorite pediatricians, OB/GYNs and midwives. Baby Guide 2020 • SanDiegofamily.com •
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WE ARE FAMILY
MORE SMILES. MORE HUGS. MORE LOVE. Adding to your growing family means more of life’s most precious moments. And at the Palomar Medical Center Poway Birth Center, take comfort in knowing our highly trained labor & delivery team can provide the personalized birthing experience you’ve planned for. We’ll be there to make every moment special and safe. Because when you’re here, we are family.
We Provide the Birth Experience You’ve Planned. • Same physician from prenatal appointments to baby’s delivery
• Doula friendly
• Natural and holistic birth options and tools
• Compassionate Lactation Consultants with the highest breastfeeding rates
• Large private rooms with laboring tubs for your entire stay
• Spinning babies educated nurses
• VBAC supportive physicians
• Mobility during labor
• Lower than average C-section rates
• Low patient to nurse ratio
• 98% Patient Satisfaction
Learn attending a childbirth class or scheduling a tour at To learnmore more,byvisit PalomarHealth.org/PowayBirthCenter or call 442.272.0076. Receive a free gift for attending a tour!
Malia Jacobson
Smart Start: 10 brain-building games to play with baby Playing with your baby yields more than adorable smiles, squeals and coos. According to researchers and child development experts, simple everyday games boost baby’s brain development, fostering growth in language, science, math and organizational skills (called executive functions), along with social and emotional learning. Babies at play learn about themselves and their world, says Sarah R. Lytle, Ph.D. “Babies are natural scientists. They’re always playing games that are actually experiments. Every time a baby drops a spoon off their high chair, they’re figuring out their world and how it works.” Here’s how to encourage your little scientist with games that benefit cognitive development from birth through age one.
Baby Gym
Back and Forth
Bust a Move
Quality interactions with loving caregivers are vital to cognitive development in general—things like responding to babies’ coos and cries, gazing into their eyes and making silly faces. “In a high-quality interaction, you want to see a true back-and-forth exchange between a parent and a baby. When the baby babbles, the parent responds like they’re having a conversation,” says Lytle.
Exposing babies to music introduces the concept of rhythm, which benefits mathematical skills, says Lytle. Encourage this learning with mini dance sessions as early as the newborn stage (holding your baby, of course). Spend 5–10 minutes bouncing and swaying to the beat of songs you know and love.
Where’s the Cup? By four to seven months old, babies begin developing object permanence, or the knowledge that something still exists even when it’s not visible. Simple games like moving a cup just out of sight and asking “Where’s the cup?” help your baby toward this memory milestone.
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No, there’s no need to take your baby to spin class. But physical activity— tummy time, crawling, scooting, walking practice or parent-child swim— can boost brain growth. Canadian researchers found that physical activity benefits cognitive development, especially executive functions and language skills, in children from birth through age 5.
Why, Thank You! When baby hands you a toy and looks at you expectantly, she is initiating a game that develops social and emotional intelligence, says Lytle. Play along by responding with delight (“Thank you so much!”), waiting a beat, then handing the toy back. Keep the back-and-forth going for as long as your baby stays interested.
Rhyme Time Read books filled with rhyming words, like The Cat in the Hat, to help babies develop phonological awareness, an important component of language and literacy, says Lytle. “Books work well for this because as parents we don’t normally speak in rhymes. And we tend to get into verbal ruts and use the same words over and over again. Books expose babies to words and rhymes you might not normally use.”
As baby develops and gets older, be sure to check out our latest recommendations for baby and toddler toys at www.sandiegofamily.com/ for-the-kids/kid-tested-toyproduct-review/toys.
Face It Just hours after birth, babies show a preference for gazing at faces, which boosts visual development and cognitive growth. Stanford researchers found that by four months old, a baby’s facial recognition skills rival those of adults. A simple game like placing your face 10–12 inches from baby’s face, then switching with another person (or even a stuffed animal) and waiting for a response can help babies hone this important skill.
Skill-Building That shape sorter you may have received at your baby shower is great for developing spatial awareness and mathematical ability, says Lytle. Once babies get a bit older, building blocks can help continue that development. “With blocks, babies are testing their environment and really getting into some complex concepts related to math, such as volume, distance and how structures work,” she says.
Baby Comedian “Parents sometimes think that in order to build language skills they need to ‘fill their baby’s bucket’ with a lot of words,” says Lytle. “But the back-and-forth interaction is what really benefits cognitive growth.” Try responding to your baby’s early coos and first words with a hearty laugh, a squeal or a surprised face. The sillier the better, since babies are often delighted by these responses and more interested in keeping the interaction going.
I Get It Playing together provides opportunities to boost social and emotional skills by helping babies understand and process emotions, says Lytle. “When your child becomes frustrated, talking about the emotions they’re feeling is important. When parents say ‘I understand why that made you upset,’ they’re scaffolding [or supporting] important social and emotional concepts.” Focused, attentive interactions with loving caregivers are the best brain-builders, says Lytle. When caregivers play with babies, they can make the experience even more beneficial by focusing on their baby—putting down the phone and tuning out distractions. “To create a high-quality interaction, it’s important to be fully present and really focus your attention on your child.” v Malia Jacobson is a health and family journalist. Baby Guide 2020 • SanDiegofamily.com •
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Is Your Baby Meeting Important Milestones?
If you have concerns about your child’s development, don’t wait! Have your questions answered today!
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Early Intervention Services are Available California Early Start is a federally funded program that provides free assessments to infants and toddlers and, if needed, important therapeutic services (free to eligible families) early enough to make a huge impact in a child’s development. Services provided include early intervention instruction; physical, occupational, and speech therapy; medical diagnosis/evaluation. It’s easy to begin the process! Call the San Diego Regional Center at 858-496-4318 or the Exceptional Family Resource Center (EFRC) at 619-594-7416. Se habla español. A representative from the organization will ask a few questions about your child. You will receive a follow up call to schedule the developmental evaluation for eligibility. Once your referral is complete, you will be contacted by a Service Coordinator who will explain the Early Start Program. Learn more about the San Diego Regional Center Early Start Program at www.sdrc.org.
858-496-4318 • www.sdrc.org
Baby Guide 2020 • SanDiegofamily.com •
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W I N ! N ! WI WIN!
San Diego Family is committed to providing you award winning, accurate, insightful, compelling articles and resources for Moms in San Diego. We’re celebrating Mom Life by giving away awesome Mommy Prize Packs!
Enter for a chance to win one of the following prizes:
Th e Pre go Pack Includes a Little Folks stroller, a Chicco bassinet, a Ciao Baby chair, a Boppy newborn baby carrier, swaddle sleeves, a Smart Pump, Convertible Car seat, and more
Time for Toddle r Pack Includes a Chicco bassinet, a Boppy newborn baby carrier, a Ciao Baby chair, swaddle sleeves, an Infantino convertible high chair, a travel baby paddling pool, and more
E n t e r t o W I N Aw e so m e P r i z e s! Contest ends at noon on Oct. 25, 2021. Join our parenting community on Facebook and Instagram @sandiegofamilymagazine
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OH,BABY! A round-up of some of our favorite baby and toddler products, reviewed by local families. Close to You 3-in-1 Bedside Bassinet $299.99; ChiccoUSA.com Fabulous bassinet! Adjustable height, swivel wheels, mesh sides, quilted mattress and more. “There are many awesome features,” says mom Britany, “including two we didn’t think we’d use: soft music that entertains baby long enough to give me ‘mommy moments’ and vibration that calms helps her down.”
Africa Stacker $19.95; LeToyVan.us Little ones discover the concept of balance with this charming set of wooden stacking animals. Includes a giraffe, lion, elephant, zebra, monkey, rhino, cheetah, crocodile and parrot in a fabric bag, making them easy to transport to Mimi’s house.
Dailies Bodysuits $18-$21; TheOllieWorld.com Already well known for cozy swaddles, Ollie World presents the most comfortable bodysuits ever. Exceptionally soft, moisture-wicking fabric helps regulate baby’s temperature and reduce rashes and irritations. Available in traditional or wrap style, and three colors; sky, lavender and stone.
Rubix Reversible Handle Stroller $119.99; DeltaChildren.com Reversible handle flips without disturbing little ones, so they can face forward or the person pushing. Additional features include oversized canopy, large storage basket and removable tray.
NutriBullet Baby Bullet Blender $59.99; NutriBullet.com Puree and store fresh, healthy baby food in minutes in a “just for kids” set that provides all the tools needed to make nutritious food from scratch. Includes resealable lids, storage cups, freezer tray and more.
ComfyChic Baby Carrier $75; Boppy.com This stylish and comfortable carrier is designed for babies 8–35 lbs. with features such as vegan-leather trim, adjustable underarm straps, adjustable seat width and breathable, mesh panels.
Blooming Baby Bath Lotus $39.99; BloomingBath.com Why bathe baby in a plastic tub when she can sit in a cuddly plush flower? “We absolutely love the bath lotus,” says mom Britany. “It’s so cushy and comfortable, and there’s no fear of baby hitting her head on the faucet. Plus, it’s machine washable.” Baby Guide 2020 • SanDiegofamily.com •
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Christa Melnyk Hines
Maternity Leave Realities Strategies to help transition back to work
Just as new moms are getting into the rhythm of new
parenthood, reality hits for those who work away from home. It’s time to plan for a return to the office. Here are strategies to help manage the transition with confidence.
Coordinate your return. Schedule calls with the human resources department and your supervisor at least two
weeks before maternity leave ends to confirm the return-towork date and get questions answered in a timely manner. “They’re looking at it from two different perspectives,” says Cheryl Wright, president of Darda Human Resources Advisors. “HR is looking at leave compliance policies, but there’s also the aspect of transitioning back into the work team—your supervisor or manager can help with that.”
Advice from Local Moms When you return to work, rest assured that no one else is “raising your child.” You are a good mom. Dropping off baby for the first time is hard. If you are a nursing mom, leave your baby with something that smells like you. It’s easier to feed when babies have something that reminds them of the comforts of mom. Victoria, East County
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The biggest thing to remember is that all the guilt you feel is selfinflicted. I wish someone had told me that my baby won’t hate me, or that my friends and family don’t think I’m horrible for leaving my young baby. Just breathe and know that you’re doing a great job! Tia, Point Loma Read about our local mom contributors on page 6.
Wright suggests asking HR questions such as: • Have there been any changes to work policies and procedures? • Are personnel working from home and/or alternating days in the office (due to COVID-19)? • What are company policies for nursing mothers? Is taking time to pump a paid or unpaid break? • Is there a lactation room? If so, how do I access it? For moms seeking more schedule flexibility upon return, Wright suggests opening the dialogue with HR (or the supervisor) sooner rather than later. “That allows the company time to figure out how to accommodate the request,” she says. Also check in with one or two work colleagues. Find out what has changed in your absence to avoid surprises or a sense of disconnect from the team. Consider asking questions like: • How has the team changed? Any new hires? Promotions? • What projects are the team focused on? What projects have been completed? Confirm and visit daycare. Even if you toured daycare prior to baby’s birth, schedule another visit a week or two before heading back to work.
Know Your Rights Family & Medical Leave Act (FMLA) U.S. Department of Labor: www.DOL.gov Paid Family Leave (PFL) Employment Development Department (EDD): www.EDD.ca.gov Breastfeeding in the workplace California Department of Public Health: www.cdph.ca.gov/breastfeeding
Ask questions like: • What do I need to bring? • Would it be helpful if I wrote out my baby’s schedule? • How do you put the babies down for naps? A second visit closer to the time of going back to work was helpful to Kailee Noland, a pediatric physical therapist and mom of two. “It gave me a little bit of time and space to order things or run to the store,” she says. “We needed extra pacifiers for daycare and different kinds of bottle labels— things like that.” If your baby has special needs, go over specifics with your daycare provider in advance too. Prep baby for bottle-feeding. If you’re breastfeeding, introduce baby to a bottle at about four weeks of age, if you haven’t already. Noland recommends starting weekly (or more often) to ensure baby can take a bottle at daycare when the time comes. Consult your pediatrician with questions or concerns. Do a dry run. Visit your workplace a week or two before the first day. The short visit helped Noland ease back in, visit with coworkers, get her desk arranged, figure out where she was going to store the breast pump and milk, and to mentally prepare. “You can plan as much as possible, but you don’t really know logistically what some of those things will look like until they’re here,” Noland says. “It gave me that first opportunity to really feel the magnitude and weight of being away from my babies.” You may also discover new traffic patterns and logistical snafus you hadn’t thought of when getting to daycare and work on time. Ease back in. If you can, gradually ease yourself and your baby into the new routine. “I came back in the middle of the week and for the first week, I only worked half days,” says Alex Villalobos-
McAnderson, a mindful leadership coach and mom of two boys. “This really helped with the hormones and getting comfortable with going back.” Schedule appointments. As much as possible, get well-baby checkups and other personal appointments plugged into your calendar before returning to work to avoid the stress of squeezing them into your schedule later. Pumping at work. Planned pumping breaks can help train your body when to release milk, Noland says. Plan a mid-morning, lunchtime and mid-afternoon pump and maintain consistency in your schedule as much as possible during those first few weeks back. Noland also recommends moms store extra pump parts in their desks. “Inevitably you’re going to walk out the door one day and totally forget [the equipment]. It’s great to have one on reserve for days like that,” Noland says. “Usually insurance will cover the cost of those.” Villalobos-McAnderson says she pumped and stashed a surplus of milk in the freezer before heading back to work. “So, if I missed a pumping session, I didn’t stress about it.” Know it may not be easy. Even moms who love their careers may still experience emotional bumps along the way while adjusting to time away from baby. “I was surprised that with both my babies, I longed to be home with them,” says Noland, “especially in those early months when they were so small. It’s really hard to turn them over to someone else’s care. No daycare provider is ever going to be Mama, but usually people don’t get into childcare if they don’t love children. Know that they’re going to try to meet all of your needs. So, just honor whatever feelings you’re feeling and know they may last or may be transient.” v Christa Melnyk Hines is a nationally published freelance writer. She lives with her husband and two sons. Baby Guide 2020 • SanDiegofamily.com •
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Baby Guide 2020 • SanDiegofamily.com •
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