San Diego and
Babies Toddlers
From Baby Bump to Toddler Time
If you’re expecting a baby or already have a little one, you’ll find a lot of helpful information in San Diego Babies and Toddlers, an annual digital publication produced by San Diego Family Magazine. You’ll find a variety of topics, from creating a birth plan and advice for new parents to important information about screen time and more. Our advertisers also offer valuable resources to support the parenting journey.
Creating a birth plan makes baby’s arrival less stressful, giving parents more control over the process. However, it’s important to remember that the birth plan is a guideline; unexpected situations may arise that will require flexibility.
We know that breastfeeding promotes healthy babies. While it’s beneficial, it’s essential to relax and find what works best for both you and your baby. If you encounter breastfeeding challenges, there are helpful suggestions available. Remember, it’s OK to seek support!
Potty training can be a stressful experience. Again, it’s important to relax and look for signs of readiness. If your toddler needs to be potty trained before starting childcare, consider finding a daycare that accommodates non-potty-trained toddlers. Read more about choosing childcare in this issue.
Babies grow quickly, so it’s fun to have a way of tracking their growth. Before you know it, the little one you’re holding will be starting school! Looking back at their milestones is a reminder of their early days.
How can you not smile and laugh when that little baby beams up at you? Love it! Relax and cherish every moment with your precious little one.
• family@SanDiegoFamily.com
SanDiegofamily.com
on the web
Get to know SanDiegoFamily.com, where you’ll discover these articles and a plethora of awesomeness for parents.
Parenting: Pregnancy
Maternal Wellness
In the third and fourth trimesters
Doulas 101
How doulas make a difference in childbirth
The Big Reveal!
19 gender reveal ideas that wow
Parenting: Baby
Understanding Postpartum Depression
What it is and what to do if you have it
Talk to Me, Baby!
How to encourage speech and language
Best Snack Ideas for Breastfeeding Moms
Healthy snacks to stay nourished between meals
What’s in a Name?
Trying to find the most popular baby names online is not as quick and easy as it sounds. After all, if you ask Nameberry, a leading authority on all things “naming a newborn,” baby name trends for 2025 fall into 10 categories such as Fast Fashion, Country Rebrand, Global Americana and Landscapes—with at least 30 top names in each one.
Gone are the days of James and Mary topping the charts. In fact, according to the Social Security Administration (SSA), Liam and Olivia have dominated the number one spots in the U.S. for four years straight. Here were the top 10 baby names of 2023* in the U.S., per the SSA:
Boy names
1. Liam 2. Noah 3. Oliver 4. James
Elijah
Mateo
Theodore
Henry 9. Lucas 10. William
Girl names
1. Olivia 2. Emma 3. Charlotte 4. Amelia 5. Sophia 6. Mia
7. Isabella 8. Ava
9. Evelyn
10. Luna
Unless parents are set on a family name, all types seem to be on the table: celebrity names, classic names, cool names, unique names—oh, and “Gen Z” names—that is, names that have a “z” in them. There are so many more. No wonder naming children is a head-spinning task! For all these lists, plus naming trends, advice and name meanings, visit www.nameberry.com.
*2024 results were not available at time of publication
Liesel Teen, BSN, RN
Advice from an expert All About Birth Plans
As a labor and delivery nurse, I’ve read a lot of different birth plans. I’ve seen how helpful they can be and witnessed how they can set women up for disappointment. One thing that’s certain, I do recommend creating a birth plan before reaching full term. Birth plans are an empowering tool that gets parents thinking about the details of birth before it happens. Just like a good childbirth class, the process helps eliminate some fear and anxiety about the unknown. Ready to dive into the ins and outs of birth plans?
What is a Birth Plan?
A birth plan is a document that lets providers and birthing teams know a mother’s preferences about labor, delivery, immediate newborn care and the postpartum hospital stay. Birth plans are a tool to communicate prior to birth so your labor and delivery team can help you have the best birth possible.
The Caveat
There is a pretty big caveat surrounding birth plans—don’t let them be the downfall of your positive experience. A birth plan should be considered birth “wishes” because it’s impossible to predict how your unique birth will progress and unfold. It’s important to keep a mindset of flexibility. Creating a rigid birth plan leads to disappointment when things don’t go as planned.
When to Make a Birth Plan?
Start thinking about a birth plan at the beginning of the third trimester, but complete it before reaching full term (ideally, between weeks 35 and 37) so there’s time to discuss details with your provider. Ask if the birth plan can be included in your hospital preregistration packet. For some hospitals, this is standard practice, but if not, many will accommodate it. Even if you provide a copy of your birth plan ahead of time, bring a printed copy in your hospital bag, just in case.
Why is a Birth Plan Important?
While a birth plan communicates preferences during labor and delivery, there are many reasons that they are important:
• Gets parents thinking about labor, birth and newborn care decisions
• Sparks dialogue and questions surrounding labor, delivery and newborn care
• Helps moms visualize the experience
• Exposes parents to possible options and outcomes
• Provides a voice in your birth experience
• Provides your partner and birth team with a tool for advocacy on your behalf
• Inspires research on interventions, options, pain relief and norms associated with labor, delivery, newborn care and hospital stay
• Creates an opportunity to learn more about your birthing place policies and standard care procedures
• Reduces anxiety about birth, creating a sense of control and confidence
• Empowers mothers to take an active role in their care
What a Birth Plan is NOT
Remember that a birth plan contains birth “wishes”—it is not a binding contract. The most important component of every birth is to keep mama and baby safe. In order for that to happen, sometimes things don’t go according to plan.
Parents can establish goals that the birth team will try to honor even when a birth outcome progresses differently than hoped. Such as, always having a partner or support person at your side, practicing skin-to-skin contact with baby immediately after birth (if medically safe) or initiating breastfeeding within 1–2 hours after birth. Many preferences like these can be achieved regardless of birth outcome.
What to Include in a Birth Plan
One of the first steps to creating a birth plan is deciding what type of birth you prefer: natural/unmedicated birth (accepted to mean birth without an epidural or C-section), birth with an epidural, planned C-section or VBAC.
Depending on what type of birth you’re hoping for, there are specific decisions to make about each one. For instance, if you’re writing a birth plan that includes an epidural, you can specify how long you imagine laboring before receiving one. For those striving for a natural birth, you’ll want to consider which pain relief strategies you’re willing to try, if needed. Consider including preferences for unplanned procedures as well. It’s better to prepare so you aren’t caught off guard.
A birth plan also includes questions about birth preferences, such as:
• Who will be in the room with you during labor?
• Who is your main support person?
• Will you have a doula?
• What are preferences regarding light, sound and music?
• Do you prefer a calm, quiet atmosphere during delivery or one that is more upbeat?
• If there are different types of labor rooms, which do you prefer? (for example, labor tubs vs. hydrotherapy showers)
• Do you have photography or video plans? (check hospital/birth center policies)
• Are candles or essential oil diffusers permitted in the labor room?
• How do you feel about hands-on labor support from a nurse or provider?
• Would you like to limit the number of hospital staff in the room if possible?
• Are you open to student nurses, midwives, or practitioners observing your labor and delivery?
There are also opportunities to state wishes about pain management, induction, fetal monitoring, pushing positions, cord and placenta preferences, newborn care procedures and more. There is a lot to learn and think through, which is why it’s important to go through the process well ahead of due date. v
Liesel Teen, BSN, RN, is a labor and delivery nurse, founder of Mommy Labor Nurse and a mother of two kids. Follow her on IG at @mommy. labornurse for education, tips and solidarity on all things pregnancy, birth and postpartum.
Free Birth Plan Templates
Detailed birth plan templates (both vaginal and C-section) were created by my team of labor and delivery nurses. Visit www.mommylabornurse.com/ how-to-make-a-birth-plan to have them sent to your email inbox.
Rebekah Diamond, MD
Fed is Best
What I learned from breastfeeding
Once upon a time, women had magical pregnancies. They danced through meadows in flowing Grecian gowns with a crown of wildflowers until their exact due date. When they went into labor, they were lifted by a flock of doves and laid onto a fresh bed of lavender. Surrounded by loved ones, they smiled through childbirth and delivered a beautiful baby who was placed on their breast, only to immediately latch and feed on ample mother’s milk. Two rainbows appeared and there were never any wars or famine again.
Oh, if it were only that simple. Between social media and my own expectations, it was hard not to think my breastfeeding experience would be this easy. What a surprise to discover that, like so many other moms, breastfeeding would be one of the more difficult and stressful parts of my postpartum journey. My baby didn’t latch, my supply was low, pumping was miserable, and I pushed through months and months of a joyless feeding plan that was rooted in an obsessive desire to maximize the amount of breast milk my daughter got.
It took far too long to let nuance, science, compassion and common sense redirect my breastfeeding path. Looking back, I wish I had given myself
permission to stop pumping earlier and focus on the parts of bonding and feeding that were going well and that I enjoyed. I didn’t know how to
balance the benefits of breastfeeding with the harm of obsessively striving to produce as many drops of breast milk as possible.
I didn’t know that it’s possible to create an individualized, dynamic feeding plan that includes working in earnest to breastfeed without needless suffering.
My Experience
Between the births of my two daughters, I spent time filling the gap with knowledge. I looked at the science, talked to experts, worked with tons of new moms, and created a new and nuanced approach. My own counseling with families transitioned from an all-or-none “breast is best” approach to open, personalized discussions that prioritize the health of each motherbaby pair. As a result, I’ve seen how it is possible to embrace an individualized, flexible approach to breastfeeding and still have it be a “success,” no matter how much breast milk your infant consumes. I’m honored to have been part of this success with mothers I’ve counseled, and fortunate to have shared my framework with readers of my first book, Parent Like a Pediatrician I was even luckier to be able to use my new model and methods when my second daughter was born. It was a completely different and healing experience that included storing colostrum when pregnant, avoiding electric pumps for the first few weeks, on-demand feeding postpartum, working hard to get baby to latch, and perhaps most importantly, a willingness to supplement with formula if needed. I breastfed exclusively for six months (until introducing solids) and have continued a mix of breastfeeding and table foods—still going strong and enjoying the experience at 9 months. While it’s been a complex, challenging journey, meeting my personal goals has been a source of bonding, healing and pride. It’s provided a sense of fulfillment I hope every mom can experience. Society has a long way to go to support breastfeeding mothers. For now, take time to prepare logistically and emotionally to have the most joyful experience possible.
It’s true that the American Academy of Pediatrics recommends exclusive breastfeeding during baby’s first six months, but don’t let this goal be a set up for perceived “failure.” Any amount of breastfeeding is great, as long as your circumstances support it—and it’s what you really want to do. When mothers start by focusing on effort (versus quantity, frequency or longevity), it makes sustainable breastfeeding more attainable.
Be Informed
“Breast is best” pressure is not the answer, but neither is depriving mothers the chance to have their own version of breastfeeding success. It is possible to support and encourage breastfeeding, highlight the potential benefits, and be honest about the science of breast milk without placing undue pressure on moms.
Well-intentioned, formulanormalizing advocates may make it seem like there is zero upside to breastfeeding, but that isn’t true. There are many health benefits for mother and baby, and breastfeeding may very well be a positive experience. While the picture-perfect breastfeeding scenario (with those doves and flowering fields I mentioned earlier) may not exist, I have spoken to countless mothers who genuinely enjoyed a year or more of breastfeeding. Every mom deserves the chance for this to be her story, or to create whatever breastfeeding narrative is best for her circumstances.
What is often overlooked (or not talked about) is whether or not health benefits of breastfeeding far outweigh the breastfeeding experience for mother and baby. That can only be determined on a case-by-case basis. The barriers to breastfeeding are real and challenging: supply issues, difficulty latching, workplaces that don’t support pumping, inadequate parental leave,
and insufficient long-term lactation support make it hard for even the most determined moms to exclusively breastfeed. If it doesn’t work out, it really will be fine. Keep in mind that there are mothers who are biologically or emotionally unable to even try. Decisions about how much effort to put in, how often to breastfeed and for how long should be yours and yours alone.
Do Your Best
There’s no magical amount of breast milk or formula that guarantees health and happiness for mother and baby. The most important thing is to make healthy, informed and appropriate feeding decisions. For most, this means embracing simple advice: Try breastfeeding as much as you can, and use as much formula as needed to keep excess stress and aggravation at bay. If baby’s belly is full and your milk supply is active, you are a successful breast-feeder. When breastfeeding is no longer possible (even with formula in the mix), stop.
Breastfeeding is worth trying in earnest, and something moms should continue for as long as it works. v
Dr. Rebekah Diamond is a boardcertified pediatrician and the author of “Eat Sleep Tantrum Repeat.” Follow her on IG at @parentlikeapediatrician.
Breastfeeding Resources
To connect with a lactation consultant or find a local breastfeeding support group, ask your healthcare provider or contact these organizations.
San Diego Breastfeeding Center www.sdbfc.com
San Diego County Breastfeeding Coalition https://breastfeeding.org
Lisa Pawlak
Helpful or Harmful? What
parents need to know about screen time for babies and toddlers
The first year of parenting is often filled with difficult decisions: Bottle or breast? Cloth or disposable? Cry-it-out or comfort? Then, as little ones move beyond infancy, new challenges arise: picky eating, sleep regression, temper tantrums and many other “joys” of toddlerhood. (Rest assured that these phases are temporary!)
While there are many methods to help manage the early childhood years, there’s one approach you may want to avoid—screen time. Before handing your little one a tablet to calm down, entertain or provide a distraction while you perform other tasks, consider important pediatric guidelines, scientific research and expert advice on the topic.
Screen time may initially appear a quick and effective fix, but it can ultimately impact brain development,
make toddler behavior worse and result in long-term cognitive, socialemotional and physical health issues. That said, not all screen time is created equal—and it is, after all, the year 2024. Here’s important information parents need to know.
Screen Time Guidelines for Babies and Toddlers
Consider these guidelines from three different expert sources:
- According to the American Academy of Pediatrics (AAP), media use for children younger than 2 years old should be very limited and only when an adult is standing by to co-view, talk and teach (for example, video chatting with family along with parents). For children ages 18–24 months, choose high-quality programming and use media together with your child (avoid
solo media use). For ages 2–5 years, limit screen use to one hour a day of high-quality programming (i.e. Sesame Street, Bluey).
- Rebekah Diamond, MD, board certified pediatrician, assistant professor at Columbia University, mother of two littles, and author of Parent Like a Pediatrician, takes a slightly more liberal approach. “I focus on a realistic, adaptable ‘less is more’ approach where I encourage parents to minimize screen engagement as much as possible, but focus more on what types of screens are used and how they use them,” she says. “Sedentary, solo and especially restrained screen time for babies and toddlers is much more detrimental than interactive screen use with others. I’ll take a two-hour movie with snuggles on the couch over 20 minutes of strapped-in YouTube videos any day.”
- Divya Kakaiya, Ph.D., M.S., clinical director and founder of Healthy Within in San Diego, has been treating brain and psychological conditions since 1983. She draws a solid line when it comes to screen time usage. “Babies and toddlers are forming core sensory awareness,” she says. “They need only three-dimensional experiences for the first four years of their lives. Babies need to interact with the real world in order to create proprioception (the sense of their body [position and movement] in the world). They need tactile play for healthy brain development. My recommendation is zero screen time until they are over 24 months. Zero!”
Know the Risks
While screen time may appear to calm children down, it can ultimately lead to increased outbursts and tantrums, according to a 2024 study published in JAMA Pediatrics. The study found that early childhood tablet use may contribute to a cycle that is harmful to emotional regulation. Meaning, toddlers who spend a lot of time on tablets appear to be more prone to tantrums, which leads to a vicious cycle when parents provide screens as a means of pacification.
“This is an evolving field, with lots of new research that comes out daily,” says Dr. Diamond. “There’s a lot of nuance and it’s hard to draw straight lines between something as general as ‘screen use’ and bad outcomes, because it’s such a vague term. However, there is good evidence that excessive screen use—especially when sedentary and even more so when kids are restrained in place—is associated with issues relating to physical health (like obesity), development and behavior.”
Dr. Kakaiya lists a range of negative behaviors associated with toddler screen time. Along with poor emotional regulation, she notes reduced empathy, an inability to bond with others, severely increased distractibility, and difficulty waiting or dealing with boredom. She explains that once kids have screens, they begin to crave screens more, similar to a drug. “Brain
development is significantly delayed, resulting in impairment and slowed developmental markers,” she says.
Bottom line: Research demonstrates correlations between excessive screen time in early childhood and impaired cognitive development, language development and social-emotional development. Physical health and development may also be impacted.
How Babies Learn Best
Early childhood development experts agree that children under 2 learn best by interacting with others and exploring the physical world around them. Babies and toddlers are unable to understand how what they see on screens relates to the real world. For instance, a toddler can’t learn to stack blocks from watching it done on a screen; they need to physically interact with the blocks.
Young children require activities that stimulate the senses (i.e. touch, sight, hearing) to develop neural pathways in their brains. Reading tactile books, exploring nature and playing with sensory toys are all important for brain development. Place your child’s focus on exploration, curiosity, problem solving and creativity. To learn more about sensory play, go to www.busytoddler.com/why-is-sensoryplay-important.
If you need a few minutes to yourself (and who doesn’t?) create safe spaces where little ones can freely explore on their own. Provide sensory bins so they remain busy and engaged. Let them discover the wonders of empty cartons, bubbles and even food. For more sensory play ideas, visit www.sandiegofamily.com/parenting/ benefits-of-sensory-play.
Be Intentional, but Don’t Beat Yourself Up
“Every parenting decision is a balance of risk and benefit for your individual situation, and screens are no exception,” says Dr. Diamond. “You will consider
your unique circumstances, personal privilege, life’s realities, and what works for your family when deciding how screens are used. Each decision is also a moment in time, and there will be situations when exceeding the limits you’ve deliberately set will have more benefit than harm.”
For situations where the benefits of screen time outweigh the risks (i.e. during times of illness, air travel, etc.), you can still limit usage, choose highquality content and actively participate alongside your child. Alternatively, consider saving special non-screen toys and activities for use during challenging circumstances.
Finally, remember that your young children are watching YOU interact with your own screens. “The hardest part of screen time moderation is focusing on your own consumption,” Dr. Diamond says. “It’s also the most important. Doubling down on your own relationship with your screens— the amount of time you spend and how it’s altering your engagement with the world—will benefit your children more than anything.” v
Lisa Pawlak is an award-winning contributing writer, living in Encinitas with her family.
More Resources
Learn more about early childhood brain development:
Brain Matters Documentary (one hour)
www.youtube.com/ watch?v=Rw_aVnlp0JY and Understanding Brain Development in Babies and Toddlers
www.zerotothree.org/resource/ distillation/understanding-braindevelopment-in-babies-andtoddlers
Easy Games that Help Baby’s Brain Development www.sandiegofamily.com/ parenting/baby/baby-braingames
Pearls of Wisdom for New Parents
Being a mom is by far the greatest joy of my life, but also the most challenging.
Liesel Teen, BSN, RN
Going into parenthood, I completely underestimated how hard the beautiful journey would be, which is why I’m offering advice for new parents—things I wish I’d known sooner. I only have seven years of parenting experience, but am learning every day. Here are pearls of wisdom to help new parents thrive on this wild ride.
Ask for (and Accept) Help
I really struggled with this when I became a mom. It felt unnatural to ask for or accept help. But if I could do it over again, I would accept all the support offered!
Your circle of people wants to help, so don’t be afraid to ask. Whether it’s providing a meal, folding clothes, taking older siblings out of the house, holding baby so you can shower, nap or eat, people feel good taking something off your plate. A win-win if you ask me.
Trust Your Instincts
When something doesn’t feel right, speak up. If the answer isn’t satisfactory, be persistent and ask more questions. Some mamas feel intimidated to advocate for themselves or a loved one—this is especially true if it requires questioning a medical professional or an “expert” in a particular field. You are your little one’s advocate, and he is counting on you. Don’t let someone’s title, degree, expertise or perceived knowledge squash your mama instincts. If you don’t feel heard or supported, seek another opinion. Your instincts exist for a reason—tune in, listen and trust them.
Practice Patience
And no, I don’t just mean with your baby. Practice patience with yourself and your partner as well. You are new at this, your partner is new at this, your baby is new at this—you are all learning together. Give yourself grace and time to figure out your new role as a mama and new roles as parents.
Remember, it’s a
Phase
When my boys were babies, I begged for time to speed up when they were sick
or in a particularly trying phase. It seems like difficult moments will never end. Here’s a reminder that eventually baby will sleep through the night, that illness will pass, that the tooth will pop through, and that there will come a day you don’t feel so tired.
On the flipside, “babies don’t keep.” I despised when people said this to me, especially when I had a tough day or week. But it’s true—time is a thief and babies grow fast, so enjoy the present as much as possible.
Stay Flexible
This is one of my biggest pieces of advice for labor and birth (flip to my birth plan article on page 8 for details), but flexibility is fitting (and advised) for parenthood in general. There will be unexpected changes and disruptions in plans: sickness strikes, naps end early and schedules get derailed, but life goes on. It took me a while to come to terms with this as a new mom. Once I accepted that some things are out of my control, life got easier.
Make Time for Yourself
Finding time for yourself is one of the hardest things to do as new parents. Those first few months feel like “feed, change, soothe, repeat.” It’s near impossible to find time for anyone else, including yourself.
Take note: Prioritizing self-care is not selfish; it makes a huge impact on mental health. A healthier, happier mama typically leads to a happier baby, so think of it as an investment for the whole family. Self-care may be grabbing a cup of coffee with a friend, taking a warm bath, going for a walk or listening to a podcast. Find your “me” thing and carve out time to make it happen.
Prep for Postpartum
I was so focused on labor and birth during both of my pregnancies that I completely neglected postpartum. Truth be told, my lack of preparation negatively impacted my experiences.
Even though many of my postpartum struggles involved breastfeeding (something else I was unprepared for),
there were steps I could have taken during pregnancy to be more prepared. Set yourself up for success. Read some of my tips at www.mommylabornurse.com/ preparing-for-postpartum.
Ask Questions
This goes along with “trust your instincts” mentioned previously. If this is your first baby, everything is new. If it’s not your first, each baby experience is different and unique. Ask your questions loud and proud.
Don’t Compare Yourself to Other Moms
This one is hard! There’s a natural instinct to compare ourselves to others, which unfortunately, starts at a young age. Fast forward to parenthood and there is perceived pressure regarding every parenting decision at every baby stage. We put enough pressure on ourselves as new parents; we don’t need added pressure from society, peers, family, etc. It can be really difficult, but try not to compare yourself to others. Guard yourself from what is posted on social media. You never know what’s really going on with people or how different their reality may be.
Adjust Expectations
Parenting is unlike any other life journey. You can read all the books, listen to all the podcasts, and take all the advice, but nothing fully prepares someone for the realities of being a mother. It’s better to set the bar low, take things in stride and be pleasantly surprised than the other way around.
Parenthood can be messy, exhausting and challenging, but it is beautiful. There is nothing else that compares to looking into the eyes of your new baby for the first time! v
Liesel Teen, BSN, RN, is a labor and delivery nurse, founder of Mommy Labor Nurse and a mother of two kids. Follow her on IG at @mommy. labornurse for education, tips and solidarity on all things pregnancy, birth and postpartum.
Coast Pediatrics
All locations now accepting new patients!
Welcome to personalized pediatric care in a modern and comfortable environment. Our practice style allows us to remain small so that we can form long-term relationships with families and really get to know each child. We offer convenient access, continuity with your doctor, and same day appointments. Join us as we elevate pediatric care in San Diego!
4S i new patients
model th
Shakha Gillin, MD • Robert Warner, MD • Lori Taylor, MD Founders, Coast Pediatrics
Kara Hutton, MD has been practicing pediatrics over 15 years. Kara enjoys developing close relationships with her patients and believes family-centered care is key. She loves newborns and their first time parents and has special interests in child development, nutrition and adolescent medicine. She was recognized as a “Top Doctor” by her peers in 2023 and 2024.
Mona Bagrodia, MD has recently relocated to San Diego after practicing out of state for 12 years. Her interests include newborn and childhood wellness and mental health. Known for her warm demeanor and unwavering dedication, Mona ensures that every child under her care receives personalized attention and the highest standard of medical treatment. She was recognized as a “Top Doctor” by her peers in 2023 and 2024.
Raha Shaw, MD
Raha has practiced pediatrics in San Diego since 2007. Though she has worked in the Emergency Room at Rady Children’s Hospital and the newborn nursery at Scripps Memorial Hospital Encinitas, her heart is in primary care where she cares for children and adolescents of all ages. She practiced in a general pediatrics clinic in Carmel Valley for nearly 15 years, and is very excited to join the fabulous team at Coast Pediatrics. Raha loves watching children grow and seeing families evolve over time. She enjoys taking time with her patients to develop relationships based on trust and open communication.
Alicia Christiansen, MD Alicia completed medical school in Chicago at Northwestern University Feinberg School of Medicine where she fell in love with pediatrics. She has worked in hospital-based pediatrics where she took part in pediatric resident education, hospital-based newborn care, and primary care pediatrics in a variety of settings. She holds herself to the standard of “what type of care would I want for my own children” as a guide to care for her patients. Alicia is very excited to be part of the amazing team at Coast Pediatrics and is committed to provide excellent care to Coast Pediatrics families.
Del Mar office
Carmel Valley office
Potty Training 101
Rebekah Diamond, MD
Safe, stress-free and scientific tips from a pediatrician
“I can’t wait to potty train my toddler,” said no one ever. As parents face various challenges while preparing toddlers to become functioning little humans, helping them pee and poop on the toilet can truly be a pain in the butt. While there are almost always stressors associated with the process, the angst is unnecessary. The biggest challenges around toilet training are often the product of a society that makes the basics of parenting overcomplicated. Here’s how to approach potty training with confidence and minimal worry.
1. Formal toilet training is optional.
This might be hard to believe, but there is no evidence to support the need for an official method or schedule to help children learn how to use the toilet. I was surprised to discover this through my personal journey. Initially eager to potty train my eldest daughter, instead I had little motivation. It was a perfect storm of circumstance, personality and privilege. I had no daycare deadlines, could afford diapers and was dealing with a happy, growing toddler who started to explore using the toilet on her own.
In my situation, the effort of formal training was more headache than it was worth. I followed my daughter’s lead, encouraging her interest to sit on the toilet, and creating awareness when she started (or finished) urination and bowel movements. I used potty training strategies, including verbal praise, matter-of-fact bodily discussions, timed “toilet sits” and even some rewards.
The best training method is the one that’s right for your family.
2. Consider your child’s readiness milestones.
There are a host of interconnected factors that determine when to start the toilet-teaching adventure. While it can be a complicated decision, start with your child’s readiness. To gauge readiness, consider these physical and cognitive milestones that will make potty training easier for children.
Physical milestones:
• Awareness of the urge to void
• Ability to hold in urine (and usually later, stool)
• Relaxation of appropriate muscle groups when on the toilet
• Awareness of when bowel and bladder are empty
• Ability to take pants off and on
• Ability to perform developmentally appropriate hygiene
Cognitive milestones:
• Ability to communicate that they have to go potty or need help
• Goal-oriented motivation or behavior
• Memory and attention (helps keep them on track)
• Social and emotional development
From ages 1–3 years, there’s a huge shift in psychology. Toddlers seek increasing autonomy, take pride in “mastery” of skills and enjoy social praise. It’s the scientific reason that, even without formal training, most kids could (and want to) learn to use the bathroom on their own timeline and in their own way.
3. Get a bigger picture of “readiness.”
In general, most typical children achieve readiness milestones between 2–3 years. This is when childcare centers either start potty training (or observe children eagerly dive in as they witness already trained peers), or require that kids are potty trained before enrolling. Sometimes deadlines are too early, defying statistical physiologic norms.
Some parents may need to choose a childcare option that requires potty training before their child is ready. That’s our society and it’s nothing to feel guilty about. Even the most realistic age-based expectations will be too soon for some kids’ physical readiness, and too soon for many kids’ emotional development.
On the flip side, you may, like me, find yourself ditching formal training even if your child is technically fully “ready.” That’s because your readiness matters too! You may need to wait until a calmer time in your life, even if your child seems eager to learn. Your strategy has the best chance of working when you feel empowered and have the bandwidth.
4. Red flags to avoid.
There are countless potty training methods to choose from. If you take the formal route, keep the following important caveats in mind when deciding which ones to try.
• Training techniques that ignore readiness. Training before you’ve seen all signs of readiness is an understandable choice, as long
as it’s deliberate. Training guides should always acknowledge how readiness plays into the equation, including emotional readiness. Anything that’s black-and-white ignores a child’s individuality. A method that boasts toilet training in a certain number of days will either fail some children by definition, or push some families to the brink with extremism in order to achieve results.
• Punishment. Discipline is never advised during potty training. Reinforcements such as praise, sticker charts—even tablet use— are a much better idea, and won’t take away from all the gentle, mindful parenting you do daily. I’m not a fan of food reinforcement. It’s hard enough to teach good eating habits and model a healthy relationship with food as it is. I’ll take an iPad reward over an M&M’S reward any day.
• Techniques that interfere with bodily functions. Messing with a child’s physiology is much worse than ignoring it. Some guides suggest it’s a good idea to overhydrate your child, increasing urination frequency and speeding up the training process. In the best-case scenario, this is just mean—overfilling a child’s
bladder when learning how to control it and causing discomfort. More importantly, there could be very serious health implications. Water toxicity is a rare but life-threatening complication of overhydration. In addition, repeated bladder overdistension can lead to long-term incontinence.
5. Remain flexible. Accidents such as soiled pants, wet floors and car seats (and beyond) happen. As do unexpected hiccups and learning opportunities on your potty training journey. The approach you thought would work best for your family might turn out to be an absolute disaster. Maybe you encounter behavioral, medical or developmental challenges that make strict toilet training impossible, or cause a delay. Or perhaps the heavens will smile down upon you and your child will ditch diapers before the glitter glue dries on your sticker chart. Whatever the case, remain flexible. You can stop, modify and restart your approach as much as needed. v
Dr. Rebekah Diamond is a boardcertified pediatrician and the author of “Parent Like a Pediatrician” and “Eat Sleep Tantrum Repeat.” Follow her on IG at @parentlikeapediatrician.
Amanda Cavallari
Keepsakes and Milestones
Thoughtful ways to commemorate baby’s special moments
The first few years of a child’s life are filled with special moments and milestones. These transitions— from a newborn’s first smile to a toddler’s first words—mark significant changes in development. It’s natural to want to commemorate them with a celebration or keepsake memory. Here are ideas to celebrate milestones and create meaningful keepsakes that will be cherished for years to come.
Emily Marbach of La Mesa keeps a growth chart on the wall as a visual record and reminder of her son’s growth. “We received [a growth chart] as a gift on Christmas when our son was 2,” she says. Marbach carries on a longstanding family tradition started by her great-grandparents. “They started marking heights on the garage door when my grandparents were kids and [have done so] for every child in the family,” she says. “I hope to continue the tradition in our home and have it last as long as my great-grandparents’ has.”
Photo courtesy of Emily Marbach
Preserve Memories
Handprint and footprint art. Create a beautiful timeline of your child’s life by capturing tiny handprints and footprints at different ages.
Tip: Use nontoxic, water-based paint, washable ink pads or inkless ink pads and press baby’s hands and feet onto a canvas or piece of paper. Alternatively, make hand or foot impressions using air-dry clay or salt dough and turn them into ornaments.
Photo time capsule. Make a digital or physical photo album that captures each stage of your little one’s life over time.
Tip: Take monthly or seasonal photos; be sure to include events like the first birthday or first day of preschool.
Video diary. Record important milestones like baby’s first words, first steps and first birthday and compile them into a video each year.
Tip: Conduct birthday interviews with loved ones and record short videos asking your child questions like what they want to be for Halloween or when they grow up. As they grow, compile them into a fun video montage.
Art gallery. As your toddler starts to create drawings or paintings, frame artwork to create a personal gallery at home.
Tip: Once the artwork starts to pile up, scan or photograph it for a digital archive or turn it into a printed photo book.
Memory box. Store keepsakes such as a hospital ID bracelet from birth, first locks of hair, baby’s first pair of shoes or favorite baby toy.
Tip: Use a wooden box that will last over time (consider decorating it yourself and labeling the inside with dates or notes).
Memory quilt. A quilt made from baby clothes is a creative way to preserve sentimental items from your baby’s earliest years.
“My favorite baby keepsake of my kids is a 3D casting of their hands when they were 6–8 months old. In order to pull it off, I had a mom helper and the babies were well fed and asleep! My ‘kids’ are now ages 25, 22 and 22 (twins). Casting kits are available at craft stores and online.” ~Alyssa Navapanich, Rancho Peñasquitos
Tip: Pick out your favorite baby clothes, bibs and blankets to incorporate into the quilt. Find a local maker or company to send the items to and have them make it for you.
Send emails. Create a passwordprotected email address for your child and send emails to be read in the future.
Tip: Throughout the year, send pictures of your child playing with friends, trips to amusement parks or recordings of them dancing or talking with you.
Write a letter. Writing a letter to be opened in the future is a heartfelt way to express your emotions during your child’s various developmental stages.
Tip: Alternatively, use a journal to record significant milestones.
Growth chart. Growth charts are a timeless way to capture your child’s physical development as they grow taller.
Tip: Use a wooden growth chart that can be moved if you ever decide to paint the walls or move to another house.
Celebrate Milestones
Here are creative ideas for celebrating a child’s transitions from baby to toddlerhood.
Moving from a crib to a big kid bed. Let your child pick out new sheets or pajamas for their new bed. Be sure to
include something familiar as well, like a favorite blanket or stuffed animal.
Switching from bottle to cup. Encourage positive associations by saving favorite drinks for when little ones use a cup. Think smoothies and juice or add ice or a straw to make it a fun experience.
Potty training. Print out a chart and tape it to the bathroom wall so little ones can add stickers when they use the potty successfully. Let your child choose special big kid underwear to use once potty training is complete. Going to school or daycare. Give littles something to look forward to by letting them help pack their lunch or snack. Or, promise a special afterschool activity like a trip to the park or their favorite dinner.
Saying goodbye to a pacifier. Have you heard of the binky fairy? Have your child leave their pacifier under their pillow at bedtime in exchange for a surprise left by the binky fairy. The promise of a gift may help them forget about their pacifier at bedtime.
Celebrating successful transitions helps boost confidence and encourages children to feel proud of their accomplishments and newfound independence. Whether through meaningful keepsakes or celebrations, honoring each milestone preserves special moments that come and go so quickly as baby grows. v
Amanda Cavallari is a lifestyle writer residing in San Diego.
Whatever the reason or the season, we are dedicated to the overall health of your child, every step of the way.
With locations throughout San Diego County and Southern Riverside, it’s easy to find just the right pediatrician for your child. From routine vaccines, well-check visits and everything in between, we are dedicated to providing expert care for newborn babies to collegebound teens. In partnership with Rady Children’s Health Network, our commitment will always be to help you raise healthy, happy kids.
SLEEP SMARTS
Essential Advice for Parents on Children’s ZZZ’s
by Gina Rosenfeld, MD
Regardless of the reason for your visit, pediatricians frequently find a way to ask about and discuss the importance of sleep. Sleep is an important topic to discuss as it plays a key role in physical and mental function at every age.
How you feel, act, react, learn, and work in part depends on what happens when you sleep.
How you feel while awake depends partly on what happens while you sleep. During sleep, your body supports healthy brain function and maintains physical health. Sleep is not just a restful state for children and teens but a critical support system for growth and development. Inadequate sleep over time can elevate the risk for chronic health problems and impact cognitive abilities, learning, and social interactions. Understanding how sleep affects the body is important for parents to ensure the well-being of their children and teens.
Sleep is vital for children as their bodies and minds develop; it affects every aspect of health. Unlike our body’s quiet physical state, the brain is quite active during sleep, carrying out many vital functions.
So, how much sleep is enough, what are the effects of poor sleep, and what habits are essential to good sleep?
The American Academy of Sleep Medicine offers recommendations for children’s total daily sleep needs by age group. Their recommendations serve as a general target, but it’s important to remember that a healthy
amount of sleep will vary among babies and kids based on various factors, including their temperament and developmental differences.
• Infants aged 4 to 11 months should get between 12 and 16 hours of sleep daily. While some infants may begin sleeping through the night at around 5 or 6 months old, they still obtain a significant portion of their overall sleep from daytime naps. Babies spend more than half of their time sleeping because this is a period of substantial growth.
• Toddlers should get between 11 and 14 hours of total sleep every day. Their napping decreases and frequently accounts for 1 to 2 hours of daily sleep. Preschool-aged children, 3 to 5 years old, should get 10 to 13 hours of sleep daily. Naps may get shorter or even stop on a regular basis.
• School-age children, 6 to 12 years old, should get between 9 and 12 total hours of sleep daily. Insufficient or poor-quality sleep can lead to challenging behaviors, reduced learning and memory retention, and a tendency toward poor eating and growth in young children.
• Adolescents should get between 8 and 10 hours of sleep per night; unfortunately, many do not. Adolescents are often sleep-deprived due to biological changes in their brains, which affect when they feel sleepy. Even if they need more sleep, their brains are not ready for bed early. Research consistently shows that students who get more sleep have fewer motor vehicle accidents, better grades, and improved mental health.
Healthy habits are essential to good sleep. Practicing good habits all year round, even during summer and vacation, is important. Consistency is key!
Remember, as with everything in parenting, you are your children’s biggest role model. Set an example and make sleep a priority for yourself.
• Show your children it’s part of a healthy lifestyle — like eating right and exercising regularly.
• Plenty of daily exercise and fresh air is key to being tired in the evening.
• Keep your kids on a routine; the same waking, meal, nap, and play times will help with a smooth bedtime.
• Start them early with a bedtime routine, such as bath, brush, book, and bed. Ensure your routine can work even when away from home.
• Keep the bedroom dim and cool before bedtime.
• Avoid filling the bed with toys.
• Keep TVs, computers, laptops, tablets, and phones out of your child’s bedroom, especially at night.
• Turn off all screens at least 60 minutes before bedtime.
Remember, by nurturing healthy sleep habits today, you’re not just ensuring a well-rested child, but laying the foundation for a lifetime of thriving health and happiness.
Happy Sleeping!
Gina Rosenfeld, MD Pediatrician and mom
Dr. Rosenfeld is a pediatrician practicing in San Marcos, and is the mother of two boys.
A Guide to Finding Childcare Where and How to Start
Finding reliable, high-quality childcare is a top priority for many families, but the process can feel overwhelming. Whether you’re looking for daycare, a nanny or an occasional babysitter, options vary depending on your specific needs. Here’s a guide to get the search started and help make the best decision for your family.
STEP 1) Determine childcare needs.
Before beginning the search, it’s important to assess your family’s specific childcare needs. Consider the following factors:
Schedule. Do you need full-time care, part-time care or occasional help?
Location. Do you prefer care that’s in your home, close to home or near a workplace?
Budget. What is your budget for childcare?
Child’s needs. Does your child have any special requirements or developmental needs?
Once you have a clear understanding of requirements, narrow down the best childcare options.
STEP 2) Decide what type of childcare you want.
There are several types to choose from, each with their own advantages and considerations.
Daycare centers
Daycare centers offer structured, group-based care and have trained staff, age-appropriate learning activities and set schedules.
Things to consider: Daycare centers are usually licensed or regulated by a larger organization, which may provide parents with peace of mind. They may offer early childhood education programs, a structured learning environment or regimented schedule. In a group setting, there is less individualized attention.
In-home daycare
In-home providers care for children in their own homes. These caregivers often create an intimate, home-like setting.
Things to consider: In-home daycare may provide a more relaxed, playbased environment that provides an opportunity for socialization. They may or may not be licensed. There may be limited flexibility with sick days or needed schedule changes. Depending on caregiver-tochild ratio, this option may provide more individualized attention than a daycare center.
Ana Rivera, an in-home daycare provider in Mira Mesa likes to communicate with parents frequently. “[I] often text parents throughout the day with pictures so they are aware of what we are doing,” she says. “I always tell [parents] what we are working on and encourage them to ask their child questions [about] what we learned [each day].”
Amanda Cavallari
Nannies or babysitters
Unless you’re part of a nanny share with another family, nannies and babysitters provide one-on-one care in your home, either full-time, part-time or on an as-needed basis.
Things to consider: Children receive personalized attention in the comfort of your home. One-on-one care is more expensive than group care. Finding a trustworthy individual takes extra time and effort.
Family members or friends
Some families rely on relatives or close friends to help with childcare, either on a part-time or full-time basis.
Things to consider: There is often a deep level of trust and familiarity, and this option may be the most affordable. Often friends and family members are not licensed childcare providers. Blurring the lines between family obligations and professional care can sometimes lead to tension.
STEP 3) Find childcare.
Once you’ve decided on the type of care you prefer, it’s time to start the search. Here are some effective ways to find reliable childcare.
Online childcare directories
There are many online platforms designed to connect families with vetted childcare providers. Some offer searches by location, type of care and budget. Popular childcare platforms include:
Busy Bees Babysitting: Schedule experienced, vetted, caring babysitters with an easy-to-use app. www.busybeesbabysitting.com
TOOTRiS: High quality childcare on demand with affordable, vetted providers. www.tootris.com
UrbanSitter: Helps families find sitters recommended by friends or local groups. www.urbansitter.com
State and local childcare referral agencies
YMCA Childcare Resource Service is
a state-funded program that provides free assistance to families searching for childcare in San Diego County. It offers referrals to local childcare programs and can help families apply for childcare subsidies. They maintain a list of licensed childcare providers and help match families with caregivers based on specific needs.
“Families receive resources on what to look for when choosing childcare, including questions to ask, information on the different types of care available, how to review a licensed program’s licensing history and more,” says Laurie Han, associate executive director of YMCA Childcare Resource Service. Resources and referral services are free to all families regardless of income.
For childcare referrals through this program, call 1-800-481-2151 or search online at www.ymcasd.org/childcare.
Word of mouth recommendations
A great way to find childcare is asking friends, family members or colleagues for recommendations. Facebook groups or local parenting forums on social media can also be a valuable resource. Many parents share experiences with local childcare providers and offer suggestions that may help point you toward caregivers who have already been vetted.
STEP 4) Ask questions.
Once you’ve identified potential childcare providers, the next step is to vet them. Here are some key questions to ask and things to look for during interviews or visits:
Experience and qualifications: What are the caregiver’s qualifications and experience? Is the program licensed? Is the caregiver certified in first aid and CPR? Is the caregiver certified to meet your child’s special needs (if any)?
Childcare environment: Is the environment clean, safe and wellmaintained (and how often is that monitored)? Are the toys and materials age-appropriate? What are the health and safety protocols?
Caregiver philosophy: What is their approach to education, daily schedule, discipline and communication with parents? Are they willing to accommodate specific needs such as dietary restrictions and nap schedules? Do they potty train, if needed?
References and background checks: Can the caregiver provide references from other families? If so, be sure to call them. Is the caregiver willing to undergo a background check?
Cost: Is the cost different for fulltime versus part-time care? Do they offer discounts for siblings or multiple children? Do they accept government subsidies, vouchers or other financial assistance programs?
Choosing childcare is a big decision. It’s important to trust your instincts and take time to evaluate each option. In the end, with a thoughtful approach and careful research, you can find childcare that offers both peace of mind and a positive environment for your child’s growth and development. v
Amanda Cavallari is a lifestyle writer residing in San Diego
More Resources
Interested in reviewing the licensing history of a childcare program? Check out the statewide transparency website at www.ccld.dss.ca.gov/ carefacilitysearch.
Need help covering the costs of childcare? California’s Thriving Families Program helps low-income families pay for childcare up to 12 years old. Find more information at www.cappaonline.com.
Looking for more assistance finding childcare? Download the YMCA’s Choosing Child Care booklet at https://pub.marq.com/crschoosingchild carebooklet/#KTb08p_2JLc1.
Your Child’s future begins Today
5 TIPS TO PREPARE YOUR CHILD FOR A SUCCESSFUL FUTURE
The first five years of your child’s life are crucial. In these first few years, children develop 90% of their brain. It is critical to talk, read and sing to your baby every day. What we do as parents from the moment a child is born can make a lasting impression. It’s these first experiences and interactions with loving adults that fuel their growth and development.
Here are 5 easy tips that you can do every day to prepare your child for a bright future:
Talking is a brain-building activity. Every time you talk with your baby and have a high-quality interaction, new connections are made in the baby’s brain.
TALK READ
It’s never too early to begin reading to your child. While babies may play with the pages of the book and toddlers may want to read the same book every day, the activity of reading with them encourages a love of books.
3. SING
The act of rhyming, singing and talking, starting at birth, profoundly influences literacy and language development, which are the foundations for all other learning. Use known nursery rhymes or make-up songs with silly meanings to help build up memory and stimulate motor skills. Warning—singing may turn
into dance parties! such as cooing, pointing or clapping.
MAKE FUNNY FACES
Have conversations by narrating the actions you take throughout the day and use a variety of facial expressions. Also, respond verbally to gestures or noises
PLAY GAMES
Another fun way to help a toddler connect names and objects with gestures is through games. Playing “Simon Says” is a good example. You can say things such as “Simon says touch your nose,” or “Simon says turn off the light.”
These are everyday actions you can take today to ensure your child is ready for kindergarten by age five—the first step toward lifelong success.
First 5 San Diego promotes the health and well-being of young children during their most critical years of development, from the prenatal stage through five years of age. Our goal is to help ensure that every child in San Diego County enters school ready to succeed.
Must-Haves for Mamas
A round-up of some of our favorite baby and toddler products. Find more at www.sandiegofamily.com/parenting/baby/baby-product-review and www.sandiegofamily.com/parenting/toddler/toddler-product-review.
Hape Owl Bed Oscar Playmat
$39.99; 0+ Target.com
Babies love the adorable hanging accessories that come with this soft and cozy playmat. The arch folds and secures with Velcro for on-the-go convenience.
BabyBuddha 2.0
Breast Pump
$199.99; BabyBuddhaProducts.com
This hands-free, rechargeable pump is quiet, portable and easy to use. Its gentle suction mimics a baby nursing, promoting letdown and increasing milk supply for comfortable and efficient pumping. Versatile settings support individual needs at different stages.
Everyday Diaper
Backpack 2.0
$195; MeetHuhu.com
Parents love the easyto-clean fabric, durability and functionality of this everyday backpack. Features include magnetic buckle (for one-handed access), 10 storage pockets, padded laptop pocket, ergonomic back panel, key clip, two packing pouches and a changing pad. Also available in black.
KeaBabies Gear
Prices vary KeaBabies.com
If you haven’t discovered KeaBabies yet, it’s time! Owned by a certified pediatric sleep consultant and professional babywearing educator, their sustainable products are high quality and responsibly made. Discover must-have gear such as muslin burp cloths, wrap carriers, compact diaper changing pads, soft bamboo nursing pads and organic cotton bandana bibs.
Hape Grip-n-Stack Silicone & Wood Blocks
$19.99; 6–24 mos. Target.com
What’s better than a baby’s first wooden block set? A wooden block set that has soft, silicone edges that are safe for baby’s mouth and can be removed for washing! Brightly colored letters and numbers add an educational element to playtime as little ones practice fine motor skills and handeye coordination.
KeaBabies Sleep Products
Prices vary KeaBabies.com
Discover comfy, temperatureregulated swaddle wraps (with “smart design”) and stylish fitted crib sheets made of breathable, organic cotton. KeaBabies also offers an ergonomic pillow designed just for toddlers.
Board Books
The importance of reading to babies cannot be overstated, and now is the perfect time to start a book collection! Hush, Little Dozer by Rebecca Colby (illustrated by Katya Longhi) is a perfect read-aloud story for bedtime. My Little Wimmelbooks like At the Airport or A Day at the Zoo by Max Walther provide seek-and-find entertainment for ages 2–5 and inspire kids to tell their own stories.
My 1st Tumbler
$8.99; Infantino.com
The adorable 9-oz tumbler made of lightweight, premium silicone and designed with little ones in mind. Features include a leak-resistant straw with a smart valve that prevents spills, even when tumbler is turned upside down. Top-rack dishwasher safe. Seven colors to choose from.
Pop-Up Ball Pit
$24.99; 9+ mos. Infantino.com
This cheerful fun zone for little explorers encourages motor skills development in a playful setting. Measuring 35” in diameter, the ball pit folds and unfolds in seconds, making it perfect for indoor playtime, outdoor adventures and on-thego fun. Includes 50 colorful balls and storage bag.
Cuddle Baby Hooded Towel
$21.96; Newborn–6 yrs. KeaBabies.com
You’ll love these soft, luxurious and lightweight bamboo viscose towels, which are gentle and soothing for sensitive and delicate baby’s skin. Generously sized at 35” square, the towels are absorbent and quick drying. Several cute animal hoods to choose from.
What’s Inside? Soft Feely Box
$49.99; 6 mos.–4 yrs. LakeshoreLearning.com
Little ones love this colorful, soft box, filled with 10 sensory items that engage curiosity through touch. How fun to reach in and discover things like a butterfly with crinkly wings, a corduroy lion, a squeaky frog and more! Box is machine washable.
Tiny Traveler Classic Wireless Monitor
$239.99; MyTinyTraveler.com
This wireless camera monitoring system is perfect for travel and home use. The device can be removed from the car quickly and efficiently when visiting loved ones or vacationing. Compact HD camera has 8-hour battery life.
Photo by Zena Holloway
