Dr. Amy E. Armada

02/16/2023

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"I can see you do your potty dance, go sit on the potty."

"NOOO NO POTTY!!!"

*8 brutal minutes of negotiation*

“Okay FINE! Do what you want."

*Toddler p*es their pants.* 🆒🆒🆒

It's FRUSTRATING, right!? We can't even really identify WHY, but it pushes our parental buttons to the extreme, especially if we JUST told them to sit on the potty + they refused.

BUT (this is crucial): ✨The more you push, the more they resist.✨

Toddlers LOVE to be in control. The "NO!'s" and "I DO IT!" AND? In ALL my years working with kids + being a Mom, here is the big truth bomb: You can't force someone to do basic bodily functions like p*eing or eating. You can pick that kid up when it's time to leave the park, you can close the iPad when it's time to be done with screentime. But you just.can't.make.a.kid.p*e.on.the.potty.

So, when you see your kid doing the p*e dance, we want you to channel your inner IDGAF, I'm seriously sooo chill right now vibes and: PLAY IT COOL😎 The more you back off + lower that pressure, the higher success rate you'll see with this whole potty thing.

Here's how you prompt them, as soon as you see that p*e dance:
✨EMPOWER THEM✨
”Ok, listen to your body.”
Because, THIS is the true way they'll learn to potty train. The ultimate goal is to teach them to LISTEN to THEIR body, not by YOU dictating when they go.
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✨REMIND THEM✨
”When you feel the p*e coming, the potty is right over there.”
Make sure you ALWAYS show them exactly where the potty is.
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✨PUMP THEM UP✨
”I know you can do it!”
When your kid feels confident, they're more likely to make it to the potty.

And? When your kid DOES have an accident (and they WILL, it's part of the learning process!), SAY THIS:
"You p*ed your pants. That feels yucky, huh? It’s ok to feel sad about p*eing your pants. Next time, when you feel it down there, run to the potty. I know you can do it!"

01/07/2023

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Both ibuprofen and acetaminophen are still is shorter than normal supply. In my area I’ve been seeing it creeping back on the shelves (more so ibuprofen). With choices limited it seems a good time to revisit the questions: which med should I choose? ⁣
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*Some information is specific to the U.S.*⁣⁣
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Always ask your child’s own provider before starting a new medication. While acetaminophen & ibuprofen are safe when given in the appropriate dose for most children, some kids have additional considerations (other meds they are on, medical conditions, ect.). ⁣⁣
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This is a summary of key differences between the two commonly available.⁣⁣
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Personally, after my children reached 6 months I kept ibuprofen on hand instead of acetaminophen. It lasts longer and has anti-inflammatory properties that are beneficial in certain situations. Both options work well and have few side effects when used appropriately!

01/07/2023

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Too much milk —> iron-deficient anemia —> short term issues with energy + long term issues with cognition, development.

You do not need to push for a certain number of ounces of cow’s milk each day.

What I tell parents & what we do at our hose—> offer milk (cow’s, almond, oat, etc.) at mealtime…one sippy cup full is plenty.

Rest of day, have water available for thirst.

12/21/2022

“JUST TAKE ONE BITE!”
“See how YUMMY THIS IS?!?! OOOOH YUMMY! YOU'RE MISSING OUT. TRY IT! TRY IT!”

Real talk? We get it!! As parents, we are so desperate for our kids to eat, to be healthy and also to avoid that hangry meltdown if they DON'T eat.🌪️ That's why we're praising + celebrating the bite of broccoli, that's why we're TRYING to shift them away from sugar + why we're basically ESPN sportscasters of our kid's mealtime, giving a play by play of every ever loving thing going in their mouths.🏁

BUT Research shows that high parental involvement during mealtime actually leads to MORE picky eating. Yep, all of those desperate tactics you're using? Well, they're ACTUALLY what is causing the picky eating to begin with. We're ditching the old school ideas about eating +rolling with the new science, baby!👩🏻‍🔬👩🏼‍🔬

✨Say goodbye to:
👎 Praising vegetables + new foods ➡️ makes your kid think oohhh I DEFINITELY don't want these
👎 Talking negatively about sweets or junk food ➡️ You just made ‘em sound like something they NEEED to have
👎 Watching them eat + commenting on eating ➡️ So.Much.Pressure. For all things eating, remember this: The more you push, the more they resist. Even if you think you're not pushing, if you're commenting at all on their food intake, they feel it as pushing.

So, instead, you're gonna PLAY IT COOL😎
👍 Once you put that plate down, release + let go! ➡️ Less pressure feels safer for exploration
👍Talk about the day, tell jokes ➡️ Keep that atmosphere loving + light, and the focus OFF what they are (or aren't) putting in their mouths
👍 Allow her/him to eat as much/little as desired ➡️ They’re the keeper of their own body! Toddlers go through INSANE phases. Eating literally air for 3 days, then eating like a football player for 3 days. THIS IS OK.

Pro Tip: Always serve a “safe food” with every meal.

✨If you're struggling with picky eating, our course, Winning the Toddler Stage, is here to help. Our eating module was co-written by a registered dietician who specializes in toddler picky eating. Mealtimes don't have to be a battle. Let’s get you back to enjoying mealtime - you deserve it! For people with kids ages 1-6. Link in bio!✨

12/13/2022

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✨ Do your kids believe in Santa or the Tooth Fairy?

Have you ever worried about how — or whether — to burst their bubble?

😅 Most childhood development experts agree that parents don’t need to feel guilty about “lying” — since the topic at hand is a fun, magical legend that kids *want* to believe in. When they’re little, you’re simply engaging in their world of make-believe, which is actually a really developmentally appropriate way to bond with your kids.

🤔 BUT if your kiddo is starting to have doubts or outgrow the magic, there is a point where you need to be totally honest. Here’s how to approach it.

⚠️ Whether your kids believe or not, avoid using Santa (or elves, etc.) as a behavioral manipulation strategy for kids (i.e. threatening them with no presents). Santa should be kind and fun, not someone who makes kids feel worse about their behavior.

🔗 If you’d like more tips—including the Qs you should ask yourself if you’re still deciding whether to make Santa part of your fun holiday traditions—check out our link in bio.

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12/12/2022

Repost from @ themonkeymashup
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Our children are so precious, we need to let them know just how important they are to us every day!

There's a lot of important things that you should say to your children.

Here are 5 of them we should say to our children.

✅I’m proud of you
✅It’s OK to cry
✅I’m listening to you
✅It’s OK to be scared
✅You did a good job

📌Source: https://www.care.com/c/10-things-you-should-say-to-your-children/

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Visit our website www.themonkeymashup.com to connect with parenting experts!
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11/18/2022

We're often asked it’s normal to keep coughing for weeks. Short answer: It can be.

Long answer:
Most viral upper respiratory infections start with one or more of the following symptoms: runny nose, sore throat, cough, fatigue and fever.

These symptoms are most prominent over the first 3-5 days, then start to resolve.

Fever should go away after the first 4-5 days. Fever generally is worst at night and can improve during the day. If you give acetaminophen or ibuprofen, it can lower the temperature, but the goal is not to make the fever go away completely. The goal is comfort. If a fever lasts more than 5 days, your child should be checked out to look for treatable reasons. Unless they are struggling to breathe or dehydrated, this can be done during regular office hours. Our local pediatric urgent cares and ERs are full - avoid using them if not a true urgent or emergent need.

Runny nose and congestion usually start improving by 10 days but the cough can linger for 2-3 weeks typically. If one has a history of asthma or wheezing, be sure to follow your Asthma Action Plan. If you don't have one, schedule a visit with your usual doctor to make one. As long as there's no difficulty breathing, shortness or breath, or limit to activity, the 3 week course of cough is not a concern. Some infections (notably COVID) tend to cause many months worth of cough and sometimes one infection is layered upon another, making the cough seem prolonged. Usually no specific treatment is needed, but if a cough lasts more than 3 weeks, have it checked by your regular doctor.

If kids are active and playful and seem to have their normal energy level, this is reassuring and they're on their way to recovery. 
The cough is annoying but it’s not dangerous if they're otherwise well!

Honey, saline and suction (or blowing if a child can blow their nose), and lots of water (to drink, and added to the air) are the standard treatments for upper respiratory infections.

Learn more about symptom management: https://pediatricpartnerskc.com/Resources/Is-Your-Child-Sick

11/14/2022

Kelly Fradin MD

11/12/2022

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9 year olds

In honor of my son’s upcoming birthday, I put this together. We rarely talk about the ages after 5… and it’s because there is a wide range of normal and less precision in when kids do what. But in general this is what we see most commonly.

Milestones:
📚begin reading to learn vs learning to read
🪥fine motor skills to brush teeth
🌎growing awareness of broader world
🦷halfway through losing baby teeth
📏grow about 2.5 inches and 7 lbs over a year *highly variable*. .

Parenting challenges
👿early signs of puberty - mood swings
😴still need a lot of sleep around 10 hours
😘💋romantic curiosity begins
🫂often new strategies are needed to connect
😬more anxiety or body image concerns emerge

Highlights:
❤️show more empathy and social awareness
❤️able to enrich friendships and enjoy sports
❤️become more organized and independent
❤️more sophisticated conversations
sense of humor

Do you have a 9 year old? What do you see unique to this age?

11/10/2022

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Do you use the anatomically correct words for body parts in your house?

🗣️ Using the correct terms and talking openly about body safety and consent can help your child stay safe and set healthy boundaries!

(Via )

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11/10/2022

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Step 1 of skin care routine. Find a hydrating, gentle cleanser. These are some of my favorite drug store brands.




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11/10/2022

Repost from Sandy Plains Pediatrics]
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As always we are working hard to see all of our patients, but want to provide quality care, so please be patient Repost from Sandy Plains Pediatrics]
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As always we are working hard to see all of our patients, but want to provide quality care, so please be patient

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11/10/2022

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I’ve been asked many times about whether it’s normal for a kid to keep coughing weeks after catching a viral URI. Some of them started with the trifecta of runny nose, sore throat, and cough, maybe even with 2-3 days of fever at the start but now, weeks later, the cough continues to linger.
The first question I always ask is if the child has a history of asthma since those children may need different treatment for a persistent cough.
But if your kid isn’t a wheezer, the next step is to double check that other symptoms have improved (namely the fever should be gone after the first 4-5 days and even the congestion should be improving after 10 days). And finally, I ask if they are active and playful and seem to have their normal energy level. If they have no asthma, the other symptoms are improving or resolved, and the kid is active and playful, then it is much more likely a prolonged post-viral cough which can last 3-4 weeks in some kids!
I reassure families that while the cough is annoying, in these situations, it’s not dangerous!
Honey and lots of fluids (andtyring to blow any lingering snot out of that nose to minimize drainage triggering the cough) is my plan of attack for the cough that they can’t kick.
If your child is having any trouble breathing, chest pain, wheezing, or fevers return with worsening cough, then please bring them in for an exam so someone can listen to those lungs!

Hay AD, Wilson A, Fahey T, Peters TJ. The duration of acute cough in pre-school children presenting to primary care: a prospective cohort study. Fam Pract. 2003 Dec;20(6):696-705. doi: 10.1093/fampra/cmg613. PMID: 14701895.
https://pubmed.ncbi.nlm.nih.gov/14701895/

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11/09/2022

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Unless you're staying home and not watching any news, you know that there are a lot of sick kids (and their families) these days. There are many viruses circulating at the same time and kids seem more sick this year than many. It is NOT because they masked. Most of these kids (whether they know it or not) have had COVID, and we know COVID inhibits the immune system, leaving it weak to fight off new infections.

Most of the illnesses we are seeing are viral, which means home care includes keeping kids hydrated, making sure they are comfortable with a pain reliever (based on age and weight), and watching their work of breathing carefully.

Kids should be seen if
* they are breathing too fast consistently or are struggling to breathe. If your child has medicine at home to open airways (ie albuterol) use it per their Action Plan. (If you don't have an Action Plan but your child wheezes - schedule a visit to develop one.)
* they look dehydrated (no tears, dry tongue, fewer than 3-4 wet diapers/urination per day).
* they are uncomfortable and unable to sleep or drink, even after a pain reliever (acetaminophen or ibuprofen).

You can use our symptom checker to find more information about symptoms and treatments and our medication dosing page to find the right dose of medicine for your little one. Dr. Stuppy's blog also has several posts about symptom management. See our Instagram Posts link in our bio's LinkTree for all the links.

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11/03/2022

Repost from .amnahusain
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I’ve partnered with to share essential health products I ALWAYS keep stocked in my house as a pediatrician mom, including the BinaxNOW at-home COVID tests.

If you remember my newborn first-aid kit, this is similar, but with more items added because toddlers and school-aged children are constantly coming home with scrapes, germs and more!

A few other items I love and add to our "medicine cabinet" when traveling are a good emollient and of course, sunscreen.

What do you always keep your medicine cabinet stocked with?

*FDA Emergency Use Authorization. The BinaxNOW COVID-19 Antigen Self Test should be performed twice over 3 days, at least 24 hours (and no more than 48 hours) apart.
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11/02/2022

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Measuring how much your newborn baby is getting can be difficult as it's nearly impossible to measure your milk supply. ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
➡️ If you baby is gaining weight, latching well, having wet/dirty nappies and is content and hopefully sleeping well after a feed then its likely your baby is getting enough milk.⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
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However if you are like me, I never knew if my boys were getting enough. 🤷‍♀️ ⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
I battled for weeks and weeks with miserable babies before I resorted to formula and it was the best decision I made for me and my boys. They were finally full and happy! 😁⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
Here are some signs your baby may not be getting enough:⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
➡️ Your baby maybe sleepy or lethargic during awake time as Babies who aren’t getting enough milk will have low energy and may cry more often.⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
➡️ Takes too little or too much time feeding on the breast. A baby who is not feeding well may fall asleep whilst feeding or may take longer than 30-40 minutes to feed.⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
➡️ Latching is painful or you can hear slurping. A poor latch can prevent bub from getting enough milk.⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
➡️ Isn’t gaining weight or weight gain is slower than expected. ⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
➡️ Your baby is not pooing often enough⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
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At the end of the day, trust your gut and do what feels best for you & your baby. 🥰⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
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10/30/2022

https://youtu.be/6jCi-8kgq1Q
EARWAX. Drew Horning

Everything you need, or want, to know about ear wax!