Dr. Madeleine Gagnon
Ask the Pediatrician
As a pediatrician who treats children with medically complex conditions, I’m often asked questions about genetic testing. It’s only natural for parents of younger children to want to know more about a child’s possible developmental delays, or physical or cognitive differences. And sometimes genetic testing can offer that clarity. I tell parents, however, that realistic expectations are important. And I urge them to recognize what genetic testing can do for your child and... more
Teen health concerns
I was one of thousands of pediatricians in attendance at the 2017 American Academy of Pediatrics (AAP) national conference in September. We spent our days in learning sessions, discussing research and new recommendations from the pediatric health-care organization that sets the stage for more than 66,000 pediatricians. ... more
Yet another shot!?
Q: Can we skip the HPV vaccine?A: Many parents find HPV vaccination to be a particularly challenging topic as they struggle with the idea of thier child receiving an injection related to sexual health.But the vaccine — which is given during elementary school — is recommended to prevent multiple types of cancer in adulthood for both... more
Flat feet?
Q: My son seems to have really flat feet. And he trips a lot. Would special shoes help him?A: A flat foot refers to a condition in which the arch of the foot disappears or diminishes when a person stands. Most often, the arch will reappear if the person is sitting or standing on the tiptoes. Almost all babies and young infants are... more
Fever help!
Q: I’ve heard it’s OK to give infants Advil and Tylenol at the same time when treating fever. Is this true?A: I get many questions as to how to best administer these medications in combination. The honest answer is that there is no one, single way. Both Advil (ibuprofen) and Tylenol (acetaminophen) work to reduce fever. And,... more
Help for shot phobia
Q: My young toddler is needle phobic. Help!A: Vaccines are incredibly important for all children. They prevent life-threatening or debilitating infections; decrease illness and comorbid conditions; and challenge our immune systems to weather disease exposure throughout life, regardless of where we might travel.Most... more
No sleep for a year?
Q: The AAP now says parents and infants should sleep in the same room through age 1. But I can’t sleep because I wake up with every false cry my baby makes! Can I break this rule?A: In October 2016, the American Association of Pediatrics (AAP) officially recommended that in order to lower the risk of Sudden Infant Death Syndrome (SIDS),... more
Fighting off acne!
It’s the bane of every teen’s existence: Acne! Indeed, imperfect skin is an unfortunate reality for many kids during adolescence. And it comes right about the time teens care more about their appearance than ever.While the reasons for developing acne are complex, there are ways to help prevent and treat outbreaks when they occur.... more
What kind of milk is best for our child?
Q: My husband and I have started the discussion of what type of milk our son (10 months) will drink when we switch from formula to milk. My husband is pretty set on not giving him dairy milk, but I’m not convinced soy, almond and other sources of “milk” are such a good idea. Any suggestions?A: Milk types can be divided into two... more
When will she ever really sleep?
Q: Our daughter is 6 and still isn’t sleeping through the night!  A: Sleep problems are common in kids. Such disturbances in sleep — falling asleep, staying asleep, awakening early and restless sleep — can impact the whole family, not just at night, but throughout the day. While there are many learned behavioral issues that can... more
What are pinworms?
Q: I keep hearing about pinworms: How will we know if our kid gets them?A: Many aspects of pinworms — how to find them and how they’re spread — are very unpleasant. Fortunately, pinworms usually aren’t a serious health issue. These creatures are small, thin worms that live in the intestinal tract. When an adult worm is ready to lay... more
Abuse concerns at daycare?
Q: Who should parents call if they suspect abuse at daycare?A: If you ever have any concerns that your child has been abused or neglected by a caregiver, contact your child’s doctor right away for advice on what to do next. This may involve an immediate office visit. If the issue is something that goes beyond what a doctor’s office can... more
The side effects of teething
Q: Can teething cause diarrhea or fever?  A: There are many misconceptions about symptoms associated with teething. Research has shown that low-grade fevers can be seen with teething. However, any temperature of 101 or higher very likely isn’t due to teething, but rather some sort of infection. Looser... more
What is W-sitting?
Q: Our preschooler has a really hard time sitting ‘crisscross applesauce’ during circle time. He instead sits with his legs in a W shape. Do we need to break him of this habit to protect his knees?A: As you may have already discovered, there are differing opinions on the topic of W-sitting.It can be common for younger children to prefer... more
What is PANDAS?
Q: Our daughter recently got over strep and a mom at school told us to watch out for ‘PANDAS?’ What’s she talking about?A: PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. It’s a relatively newly known syndrome, first described in the late 1990s. Revised diagnostic criteria and... more
Causes for under-eye circles
Q: What could cause dark under-eye circles in my toddler?A: The area under eyes has thin and delicate skin, which often will easily show the capillary bed, which can show up in the form of dark, under-eye circles. Among young children, the most common cause is nasal congestion. This can be caused by allergies, smoke exposure, a... more
Effective ADHD supplement?
 Q: We saw this supplement at Costco and on Amazon and we were intrigued because our 5-year-old has been presenting some ADHD-like symptoms at school. It promises to ‘support memory, concentration and focus.’ Is it worth a shot before trying prescription drugs? Reviews online seem positive.A: First it should be noted that 5-year-... more
Combating stinky toes
Q: My 3-year-old has insanely smelly feet. Help! A: Ah, one of the unforgettable aromas of childhood.Yes, kids have sweaty feet — and sweaty bodies — for a good part of the day. They’re constantly in motion, frequently breaking into sprints or suddenly wrestling with friends, often exercising on and off all day long. From... more
Find the right formula
Q: Which baby formula should we choose?A: Though the formula options available on store shelves can be dizzying — organic, iron-fortified, non-GMO, probiotic- and DHA/AHA-enhanced — the good news is, the major “brand name” formulas contain all the essential nutrients, minerals and vitamins needed for healthy infant growth and development... more
Should I separate my twins?
Q: Should twins sleep in separate bedrooms?A: Sleeping arrangements for your children is really a matter of what works best for your family. There’s no compelling need for twins to have separate bedrooms, nor do they automatically do best if they’re in the same room, especially when they’re very young. However, keep in mind that,... more
Should I worry about a bloody nose?
Q: Should I worry about the occasional bloody nose for my 4-year-old?A: Most minor spontaneous bloody noses are nothing to worry about. In Minnesota, in the winter months, dry air is one of the leading causes of these occasional, spontaneous nose bleeds.Children with nasal allergies are more likely to experience nose bleeds,... more
How to soothe dry winter skin
White snow, bright sun and dry skin — it’s wintertime in Minnesota! This time of year, typically November through March, people of all ages struggle with skin issues. And for kids, winter can be a particularly uncomfortable time of year. In fact, roughly 20 percent of babies develop dry, sensitive skin, and older kids face... more
Why isn't my kid walking?
Q: My 1-year-old isn’t walking. How can I encourage her to at least try?A: It takes incredible strength, balance, coordination and bravery to take those first steps. Babies typically start walking between age 9 months and 15 months.Babies, who learn to walk best with bare feet, often begin near-walking by “creeping” alongside furniture... more
Does my teen have noise-induced hearing loss?
Q: Our teenager listens to music with over-ear headphones and she CRANKS them so loud! What is her risk of noise-induced hearing loss?A: If you’ve ever been to a music concert and left experiencing ringing in your ears and difficulty hearing, you know firsthand that loud sounds can cause hearing damage. Most of the time,... more
Is lisping normal for toddlers?
Q: My daughter is 2 years old and has a bit of a lisp. Does she need a speech therapist?A: Articulation concerns are common among parents. Acquisition of language sounds is expected along a continuum based on age, placement of tongue, generation of sound location and coordination. There’s also quite a range of anticipated “normal” ages... more
Sports: How to stay out of the ER
Q: My daughter has started playing hockey. What do I need to know to keep her from ending up in the ER?A: In the State of Hockey, it almost seems as if some children are born with hockey sticks in their hands and skates on their feet. Fortunately, organized youth hockey programs have made safety a priority and have taken a number of... more
What is thrush?
Q: My baby boy has white patches on the insides of his cheeks. What is it?A: Generally, when parents notice white patches on the insides of their infants’ cheeks, it’s usually a condition known as thrush.Thrush is an excessive growth of a yeast (fungus) in the mouth and is very common among infants in the first few months of life. ... more
Chiropractic care recommended for infants?
Q: What do you think of chiropractic care for babies? I’ve heard it can cure colic and help with many other infant problems. A: There are a variety of opinions regarding the effectiveness of chiropractic care for infants. I believe if the purpose of the care is mainly to help with soothing, muscle relaxation and using muscle... more
Is it a cow's-milk allergy?
Q: We think our newborn could be allergic to cow’s-milk formula. What are the signs?A: Milk-protein allergy is a condition that develops in the first year of life. The most common form is an allergy specifically to the protein in cows’ milk. Symptoms — rashes, stomach upset/discomfort, vomiting and/or diarrhea — can appear within a... more
When does puberty start?
Q: At what age do girls begin puberty? We’ve heard as young as 8! A: You’re correct that girls can begin puberty as young as 8 years old. And, in fact, that’s still considered within the range of normal. Girls typically start puberty between the ages of 8 and 13.Boys start between age 9 and 14. Keep in mind... more
Why does my child prefer to play alone?
Q: My 2-year-old likes to play alone when other kids are around. Why? A: It’s normal for a 2-year-old to engage in solitary play. Solitary play is the first stage of play development.Children will explore learning and interacting with toys on their own or with caregivers, and at their own pace.They’re like little... more
Night terrors!
Q: Our daughter, 3, is waking up terrified in the middle of the night. Help! A: Night terrors are sleep disruptions that typically occur a few hours after kids fall asleep during transitions between sleep phases. This is different than nightmares, which arise during the dream stages of sleep, late into the night or in... more
How much sugar is too much?
Q: How many grams of sugar a day is OK for a kindergartener?A: Appropriate sugar intake is an important topic for kids, teens and grown-ups.Americans are, by far, some of the most obese and unhealthiest people in the world, despite our amazing health-care systems.Excessive sugar intake puts kids on a path to struggle with high... more
Can bee stings lead to future allergic reactions?
Q: Our son was stung on his finger by a bee and his whole hand became swollen. Will his next sting be worse or cause an allergic reaction?A: Local reactions to bee stings — redness, swelling, pain and itching — are very common in children.The good news is that previously stung kids aren’t likely to have worse reactions the... more
Toddler sunburn triage
Q: What's the best way to treat a toddler’s sunburn? Ouch!A: Sunburns are especially unpleasant for toddlers because they don’t understand the cause of the pain. Prevention, of course, is really the most important step to take. Sun blocks with an SPF of 30 or higher are important to use frequently, even on cloudy days if your child... more
Can tubes stop ear infections?
Q: My daughter gets so many ear infections. How do we know if she should get tubes?A: Thank you for this question! Frequent ear infections are common for many families. This is a problem that involves persistent fluid and/ or infection in what is called the middle-ear cavity — normally a very small, air-filled space behind... more
Summer rashes!
Summer in Minnesota is synonymous with frequent trips to the cabin up, vacations up North, day hikes and camping for many local families. But all that warm-weather outdoor fun can cause some major skin issues. Fortunately, most rashes, spots and bumps are easily treatable. Here are some of the most common summertime conditions... more
Dealing with sleep regression
Q: Is there such a thing as a 4-month sleep regression? Our daughter was sleeping seven hours a night and now — at 3½ months — she gets up every three hours! A: Sleep regression at four months is challenging: Parents — whose babies begin to sleep through the night — are just finally feeling like they can get uninterrupted sleep.... more
Picky eater or problem eater?
Q: We think our son is a problem eater (versus just a picky eater) because he eats only 10 foods — at age 2! What can we do to help him?A: You are not alone, despite almost all parents feeling like they are. Feeding challenges in children are common and affect approximately 20 percent of kids. The majority of this 20 percent are picky... more
What’s toe walking?
Q: Why does our 2-year-old insist on walking on his toes? A: When learning to walk, toddlers quickly discover that they have more control over their balance with their weight shifted slightly forward toward the balls of their feet. Then, when they lose their balance, they can more easily fall forward and use their arms and... more
Diaper rash creams
Q: What products do you recommend for chronic diaper rash? A: Diaper care and the prevention of rashes have become much easier in many ways as diaper technology has evolved. Improved absorbency of diapers prevents persistent wetness on the skin. Changing diapers as soon as they become wet or soiled also helps prevent rashes.... more
Zika virus
Q: I’m pregnant. What can I do to protect myself against the Zika virus?A: Zika virus disease has become an international health concern because of the multiple countries currently affected by the virus. Mexico, Central America and the northern two-thirds of South America are countries where the virus currently is causing... more
Car-seat colic
Q: Help! My baby despises her car seat and cries during every ride. A: This is a very challenging situation and a very good question. Being unhappy in a car seat can be related to a number of different causes: She may be tired and a car seat position may be one in which she can’t fall asleep. Some infants are... more
Vitamin D
Q: Your advice in the November issue — recommending that parents generally avoid multivitamins for their kids (mnparent.com/vita-mn) — prompted me to write. I believe the American Academy of Pediatrics supports the recommendation of a daily supplement of vitamin D. I didn’t see this mentioned in your article. Do you happen to... more
Tub time!
Q: How often do toddlers need baths? We don’t want our kid’s skin to dry out!A: Bathing a couple times a week may be sufficient for toddlers if they have days where they manage to stay relatively clean. But it really depends on how active toddlers are and how dirty they become each day. One factor may be if they’re... more
Toddler word count
Q: How many words should a normal 2-year-old be using?A:  2-year-old should have two to three dozen words that are generally easy to understand.  To start, it’s helpful to think about language in two parts: The first is receptive language: Does your toddler seem to understand what you’re saying? This part generally develops... more
Overfeeding your baby?
 Q: I’m bottle-feeding our baby and I’m worried about overfeeding. Can you share your tips to avoid giving her too much?A: This is an excellent question. Infants, for the most part, take in only the calories they need to maintain their current health and provide for good growth. They rarely over-eat — or under-eat. If your... more
Kids and probiotics
Q: Do you ever recommend probiotics for children?A: Probiotics may benefit kids in a number of ways, but research still needs to be done to understand exactly how they can be most beneficial.The intestinal tract contains millions of microorganisms — primarily bacteria and fungi (yeast). These microorganisms are generally considered... more
Carseats on airplanes? Yes!
Q: Do we need a car seat for our 1-year-old on an airplane?A: Airline travel with young children is no easy task. The planning checklist often includes items needed to ensure adequate entertainment, food, diapering and clothing changes and comfort or transitional objects. But the most fundamental planning must start when... more
Potty training isn't working!
Q: Dear Dr. Gustafson: I am writing becausee we are really struggling with our daughter's potty training for pooping.I started to train her when she turned 2. It took her just about a week to pee in the potty. However, she's still having trouble pooping in the potty.I know it generally takes long for No. 2, but we need to get... more
Do kids need vitamin supplements?
Q: What do you recommend for vitamins for kids? Gummies? Flintstones? And at what age should we start?A: For children older than 1, in general, the American Academy of Pediatrics doesn’t recommend vitamin supplements. It’s thought that if otherwise healthy children are eating a normal, well-balanced diet, they’re receiving what they need... more
Say no to cold meds
Q: Our 3-year-old daughter has a terrible cold, but none of the available OTC medications are listed as safe for ages 3 and younger. Our friends give their toddlers these medications anyway. Is this safe? A: For years, there were dozens of medicines to help relieve kids’ runny noses, watery eyes and harsh coughs. Today, however... more
Goodbye, binky?
Q: What’s the best time to take away a pacifier?  A: The easiest time to get rid of a pacifier is to never start using one in the first place. I realize this isn’t a practical or popular suggestion, since the vast majority of infants probably use pacifiers to some extent. But I believe they really don’t need them. The... more
Does our son have ADHD?
Q: Our 5-year-old son’s teacher is hinting that he has ADHD because he can’t sit still in class. And yet, his grades are nearly perfect. We think he’s just being a normal kindergartener. How should we proceed?A: There’s a wide range of activity and attention levels in 5-year-old children. If your son is doing well... more
Alternative vaccination schedules
Q: We keep hearing about alternative vaccination schedules. Is there a benefit? A: I strongly encourage all patients to stick with the recommend vaccination schedule. The vaccination schedule is developed and evaluated yearly by the top infectious-disease and pediatric experts in the U.S. The recommended timing and spacing of... more
Early signs of autism
Q: How early is it possible to detect signs of autism? A: Autism Spectrum Disorder (ASD) primarily affects social and communication skills. Because of this, most children with ASD will achieve their motor-developmental milestones, such as sitting, crawling and walking at normal times.However, some signs of ASD may be... more
Lice on the loose!
Q: Lice is on the loose at school! What’s the best way to see if our kid has it?A: Anyone can get head lice. Every year, millions of school-aged children will become infected with head lice, most commonly preschool and elementary-aged children. Though it’s not a pleasant condition, it doesn’t cause any serious health... more
Sleeping 'through the night'
Q: How can we get our son, 4 months old, to sleep through the night? He’s still getting up every three hours.A: Infant sleep training has many notable gurus, Dr. Sears and Dr. Ferber, to name a few, who have devised methods to encourage sleep. The most important thing to recognize is that every baby is different and every... more
Starting solid foods
Q: When should we start our baby on solid foods? I've heard everything from a few weeks to four months!A: It’s not surprising that parents are confused about when to start solids, because clinicians are too! There’s evidence to wait until six months of age and evidence to start much earlier. Organizations, such as the... more
Twins in crib together?
Q: How long is it safe to keep infant twins in the same crib?A: Although it may seem harmless or even more natural to have twins in the same crib, this isn’t a practice endorsed by the American Academy of Pediatrics. The reason for this is the increased risk of sudden infant death syndrome (SIDS). Twins are often born... more
Backpacks: How heavy is too heavy?
Q: Our kids’ backpacks get heavier every year. How much weight can a child safely carry? A: This is an excellent question. Planning for what to put in a child’s backpack is an ideal opportunity to work with your child on effective school and homework planning. A number of health groups recommend that a child shouldn’t... more
Asthma action plan
Q: I’ve heard that kids with asthma should start their medications before school starts in anticipation of cold season. What do you advise?A: Any child with a diagnosis of asthma, especially if the child has frequent or persistent symptoms, should have an asthma action plan. Some children are especially susceptible to wheezing when... more
Pink eye diagnosis?
Q: How can we tell if our 1-year-old daughter has pink eye?A: This is a common and challenging situation for parents of toddlers and preschoolers. Typically anytime a child has a redder than normal eye — or if there’s any drainage from the eye — he or she is thought to have a contagious form of pink eye (conjunctivitis). ... more
Temporal thermometers
Q Do temporal thermometers really work? A These thermometers use an infrared scanner to measure the temperature in the temporal artery in the forehead. This artery carries blood from the heart to the head and can give a temperature reading that’s as accurate as a rectal temperature, which is still thought to... more
Coughing won't stop!
Q Our daughter’s been coughing every night for a week. Would running a humidifier help? A Coughing in young children can be especially difficult to deal with! Often the cough can linger for longer periods than typical for older children or adults.This is partly because a younger child may not be able to generate... more
New rules for peanut butter
Q When can we give our baby peanut butter? A This is a great question. If you had asked this question a few months ago, it would have resulted in a different answer. In 2000, the American Academy of Pediatrics recommended that the introduction of peanut butter, or other allergenic foods, should be delayed until a child is at... more
Infants and allergies
Q: Can infants suffer from seasonal allergies?A: Allergies often are inherited, so observing for symptoms is important. When the immune system repeatedly is presented with a substance (allergen), the body can erroneously begin to recognize it as foreign and set off a cascade of cell activities similar to those triggered by an... more
Tips for trimming toenails
Q: How important is it to trim our son’s toenails? He’s too ticklish and/or fussy to let us near his feet.A: This is a perfect example of “choose your battles.” Toes are wiggly and feet are ticklish. Cooperation in this situation can be negligible, but distraction is an excellent strategy. Try doing the task while... more
Dealing with tantrums
Q: Our 3-year-old is having tantrums that last more than 30 minutes. What is going on?A: Imagine being too small to see what you’re looking for, dependent on others to offer you something to eat or drink and too uncoordinated to perform the skills you think you’re capable of. You have no choice in your wardrobe, daily... more
18-month-old not talking?
Q: Our son is 21 months old and not talking beyond the word “Mama.” Should we be concerned? His older sister was talking in sentences much earlier.A: This is a great question and important issue to address with your pediatric clinician sooner rather than later. Optimal speech and language development in toddlers depend on a lot... more
Teen acne: Help!
Q: Help! Our teenage son has terrible acne. Over-the-counter products are just not working. Is this a hormone issue? Would prescription medications fix it?A: Yes, it’s a hormone issue. And, yes, there are many prescription options that can work if the over-the-counter products aren’t helping.Acne results from increased sebum (oily... more
Spicy foods for toddlers
Q: Our 2-year old loves spicy food (really spicy!). Is there any harm in him eating these foods?A: Spicy food isn’t a problem for children. Usually the problem is getting them to try spicier than normal foods. There are only a few rare foods that can actually cause a chemical burn to the skin and mucous membranes, and most families... more
Stubborn loose tooth!
Q: My 7-year-old’s loose tooth won’t fall out. Is it safe to do the string-to-door technique?A: No, I wouldn’t recommend the string-to-door technique to remove a stubborn baby tooth. If your child wants to try to remove a tooth on her own, she could try that. For this method, it is recommended to firmly grasp the loose tooth... more
Is it eczema?
Q: Our 1-year-old has red patches of skin on his cheeks. It is eczema?A:  Eczema is a chronic skin condition. Since it’s chronic, the symptoms can fluctuate in severity. At times the skin can look completely normal. When it’s exacerbated or triggered, it can appear quite dry, red or irritated and can be quite itchy or painful.... more
Flying with baby
Q: At what age is it safe to take our baby on an airplane?A: The best thing you can do is discuss this with your baby’s doctor. In general, healthy newborns may be able to handle airplane travel without any issues. However, there are certain health conditions or other factors you may want to consider. These might include if your baby was... more
Safely swaddling
Q: How long is it safe to swaddle our baby? She’s now 3 months old and starting to break out, even as we swaddle her tighter, sometimes double-wrapping her.A: Swaddling infants to help them sleep has been around for a very long time. It’s a classic way of helping comfort young infants and it allows them to sleep for longer stretches... more
Recurring stomach aches
Q: Nearly every morning lately our 4-year-old has a bad tummy ache (cramping pain), followed by painful diarrhea (usually after eating milk and cereal for breakfast). Then he’s fine for the rest of the day. Could he be lactose intolerant?A: As strange as this may sound, some of this may just be a normal pattern for your child.... more
Talking about sex
Q: When should we start talking to our daughter about sex?A: The short answer to this question is as soon as she starts asking questions. Discussions should be at an age-appropriate level. These questions often start with questions like, “Where do babies come from?” Questions about an obviously pregnant woman are likely to come up, too.... more
Birthmarks
Q: My son (age 7) has a dark birthmark on his back that I think he’s had all his life. His doctors have looked at it in the past and all have said it appears to be normal, but it keeps getting larger as his body grows bigger.  A: Birthmarks come in a variety of colors, shapes, locations and can change over time. There... more
Climbing out of the crib
Q: My toddler (20 months) is starting to climb out of her crib. Do we need a toddler bed already? A:  Yes. For your daughter’s safety, transitioning to a toddler bed is recommended. The act of climbing out of the crib is dangerous. It could result in a limb fracture from an arm or a leg trapped in between the crib slats,... more
Melatonin to help with sleep?
Q: Our 3-year-old son is having sleep troubles. Our friends are recommending melatonin supplements (gummies). Are they safe? A: Sleep problems in a 3-year-old are common and normal. Children at this age want to know their parents are available to them at any time, day or night. They want to delay sleep as long as... more
Ibuprofen for fevers
Q: How many nights in a row is it OK to give a 2-year-old ibuprofen for a 100- to 101-degree fever?A: I know having a sick 2-year-old in the middle of the night is never fun. The first thing you want to do is help him feel better. What I’d recommend is this: While you’re giving that first dose of ibuprofen to help with the... more
Warts, ewww!
Q:  My son, age 4, has multiple warts on his feet! What’s causing this and what do we need to do? A: Warts are caused by a virus (human papillomavirus). They can occur on any part of the skin on the body, but are most commonly seen on the hands, feet, knees and elbows. They’re very common in children. They can be... more
Diagnosing ear infections
Q: We’re mystified by ear infections: When we take our 2-year-old to multiple doctors, the diagnoses aren’t consistent. One will say she has no ear infection at all. Another will say she has a severe ear infection!A: To better understand variation on diagnoses of ear infections, we may need to take a step back and more clearly define... more
Winter weather risks
Q: Can you please explain the risks associated with frigid weather so we can get our teenager to dress sensibly this winter?A: Winter weather presents two big risks for anyone, regardless of age: Frostbite and hypothermia. Frostbite is a condition in which skin tissue will get cold enough to freeze. It’s most commonly seen when... more
Protecting kids against enteroviruses
Q: I’ve been hearing a lot about enterovirus D68 (as well as Ebola). What can I do to protect my kids?A: Enterovirus D68, which first hit the news in late summer, causes primarily respiratory symptoms. Even though the enterovirus family of viruses is very large, this particular strain is uncommon and hasn’t been around much,... more
What counts as screen time?
Q: My 5-year-old watches a lot of TV, but he’s also playing at the same time with LEGOs. Does this count as screen time?A: Yes, it counts. Reducing screen time to no more than two hours per day is a good approach with all children, regardless of what else they may be doing at the same time. Multitasking with LEGOs is... more
Pillows for baby?
Q: At what age is it safe to let a child sleep with a pillow?A: It’s recommended to not use pillows for children younger than 2 years old. Young children can easily suffocate with large pillows, fluffy comforter blankets, large stuffed animals and other accessories. A safe crib has a firm mattress without extra padding,... more
Potential downsides to hand sanitizers
Q: My son hates washing his hands, so we’ve resorted to using hand sanitizer almost exclusively, which he seems to do well with, even on his own. Is there a downside to this method?A: There are two potential downsides. First is that, though hand sanitizer is useful when there’s no sink/water and soap available, it’s not as effective... more
Helping your teething child
Q: What can I do to help my child get through teething?A: Teething usually first occurs starting at about 4 to 7 months old. Usually the front top or bottom two teeth emerge first. (If your infant is older than 7 months and still doesn’t have any teeth showing, don’t worry. Teething times can vary dramatically.)Teething can cause mild... more
Ice for a toddler's injury
Q: Do toddlers respond to ice treatment after an injury the same way adults do? It’s nearly impossible to apply ice to a bump on a 2-year-old child, but is it worth trying?A: Ice can be very helpful in treating a variety of toddler injuries, but its use may require some creativity on your part. Wrapping an ice bag or pack in a wash cloth... more
The importance of well-baby visits
Q: I’m wondering about the value of the many well-baby visits required for my 6-month-old. She seems very healthy. Why do they need to see her so often?A: Children should have routine well-child visits quite frequently, especially during the first two years. Though it can feel taxing, this schedule of visits was developed by... more
Helping your children embrace their school sleep schedule
Q: How can I get my kids to better embrace their fall sleep schedules? A: Sleep issues are common for infants, children and teenagers. It’s rare for families not to have to deal with this issue after summer breaks, especially. The best advice is patience and age-appropriate expectations. One of the biggest obstacles to a... more
Limiting infant spit-up
Q: My infant son constantly spits up after feeding, to the point where he seems to spit up almost his entire bottle. He still has full diapers, so we feel he’s getting enough food, but should we try to limit the amount given? He screams when we stop feeding him midway through a bottle. Are there any tips to limit spit-up?A: Part of the... more
Overeating in toddlers
Q: I feel like my toddler’s overeating. And she constantly asks for food (not just sweets, either). Should I limit her food intake? A: Toddler energy requirements — despite their impressive energy expenditures — aren’t abnormally large. In fact, children age 1 to 3 years old need about 40 calories for each inch of... more
Storing expressed breast milk
Q: I’m nursing my newborn and want to give her expressed breast milk when I eventually go back to work. What’s the best way to store breast milk, and how long can it be at room temperature before I have to throw it out?A: Clinicians at the Mayo Clinic in Rochester (mayoclinic.org) recommend the following for the handling and storage of... more
Pacifiers, nipple confusion and nursing
Q: What’s the story on pacifiers, nipple confusion and nursing? What about thumb sucking? I’m expecting next month and would like some information.A: Infants find sucking to be very soothing. They also like to exercise their facial structures and this probably helps enhance speech and language skills. It’s an important developmental task... more
Getting your child ready for kindergarten
Q:  What can I do to help my child get ready for kindergarten?A: Transitioning to school can be a big deal for many 5-year-olds — most of the time in a very positive way. Reinforcing the notion of this being such a “big boy” thing to do — and how great it is that he’ll be starting kindergarten this fall — will ease... more
Sunscreen and skin sensitivity
Q: My daughter seems to react strongly when sunscreen is applied near her eyes, nose and mouth, and now she refuses to let us put it on. What can we do?A: In many ways, sunscreen lotions have great success preventing sunburns — and also reducing long-term cancer risks. And, in recent years sunscreen lotions have been made... more
Life vests: Not optional
Q: My son refuses to wear a life vest each time we go out on a boat. What can I do?A: Life vests, especially for younger children and toddlers, are an essential safety need, so this really can’t be optional. If you meet significant resistance, here are some things you can try:• If possible, have... more
Twins and triplets sharing a classroom
Q: Our 4-year-old triplet girls are starting preschool. Should they be in separate classrooms?A: In working with families that have twins or triplets, one of the biggest challenges is for the children to develop their own, separate identities over time. Having them all in the same classroom, unless there isn’t another option, tends... more
Food allergies and picnics
Q: My 3-year-old son was recently diagnosed with severe food allergies. We frequently enjoy picnics during the summer with our friends and family. What can we do to prevent exposure to foods that will cause reactions?A: Be very aware of all the foods available at the picnic. Since you know what foods your child is sensitive to, this will... more
Lyme disease
Q: How can I protect my kids from ticks and Lyme disease this summer?A: Think small. The kind of tick bites you should be most concerned about come from deer ticks, which are smaller than the larger and more common wood ticks, also known as dog ticks.Many parents mistakenly think wood ticks can transmit Lyme disease. They can’t. (Be... more
Bee stings and Epi-Pens
Q: My 10-year-old daughter is highly allergic to bee stings and has been prescribed an Epi-Pen to use if she ever gets stung. How can I help her overcome her fear of having to use this shot?A: Practice, practice, practice. If it’s been a while since you received this prescription for your child, you may want to check with the office that... more
Water safety
Q: We’re past the stage of baby-and-me swimming classes. When is a good time to enroll my twin sons in swimming lessons?A: Helping children be safe and comfortable in and near the water can start at a very young age, as you’ve already learned. Once a child is about 3 years old, families can usually find places in their community... more
Sports overload
Q: My kids love sports, but I’m concerned with overloading their schedules. How much is too much? A: Participation in sports can be very good for children and teens. It can promote positive socialization and help them develop skills for working through disputes and disagreements. It also helps them stay busy in positive... more
Talking to your kids about cancer
A: Cancer is an extremely challenging topic. And children have a limited ability to understand concepts like this. To help them understand, you will have to say repeated, short messages in very concrete and specific ways. It is important to tell them the truth. This can be very difficult for you personally because of the likely... more
Tips for a young left-handed child
A: The good news is that gone are the days when children were basically forced to do everything right handed — even if they preferred their left hand. Your daughter will likely learn a variety of techniques to help her adjust to many right-handed activities. If you know someone who is left-handed — like your husband — they will be... more
Supplies for warm weather vacation
Q: We are soon going on a family vacation to a very warm climate. What items will we need — beside our swimsuits, that is!A: Family vacations can be a great experience. A warm weather vacation after a very cold Minnesota winter will be welcome by your kids as much as you. Much of what you need to know and bring would also apply to a... more
Preparing children for a new baby sibling
Q: We are expecting a new baby in three months. How do we get our toddler ready for the arrival of her baby brother or sister?A: In spite of the great joy that it brings to parents and grandparents, the birth of a new brother or sister can be very disruptive to the future older sibling, especially if the older sibling is a first born.... more
Selecting a new pediatrician
Q: We are new in town. How do we pick a new pediatrician for our three kids?A: Many parents are often faced with choosing a new pediatrician for their children, whether moving to a new area or changing clinics with new insurance coverage. Depending on your personal preference, wants, comfort level and style, you are highly likely to... more
Lice: What to do
I am terrified of my child catching lice and there is an outbreak at her school. What can I do to prevent her from catching this?Lice continue to be a very commonly shared infestation by kids in preschool and elementary school settings. And, unfortunately, a number of misconceptions about families whose children get lice remain. Families... more
Diaper Rash Solutions
How can I cure diaper rash?The good news here is that most diaper rashes are skin irritations instead of actual infections or more serious skin disorders. The best approach will depend a little on what kind of diapers you use, but a few general rules will help reduce irritation. Frequent diaper changes and keeping the diaper area dry are... more
Wheezing: Asthma or just a cold?
How can I tell if my child is wheezing from a cold or if they have asthma?Winter months can be a tough time for infants and young children who can develop wheezing as part of an upper respiratory infection. Most of the time this wheezing, which is also known as bronchospasm, is relatively mild and self-limited. For a small percentage of... more
Keeping a sick child home from school
How long should I keep my child home from school when he or she is sick?In many ways, taking a common sense approach will be very helpful in making this decision. Also, many schools and daycare facilities will have specific guidelines to help you decide when returning is a good idea.In general, your child should be fever free for at... more
When to see the doctor
Q1: When do I need to make sure my preschool/school-aged child is seen by a doctor if they are sick with a sore throat, cough, fever, aches, or other symptoms?First of all, it is important to say if your child looks ill or distressed, please act on those concerns right away. Many clinics will have a nurse advice or triage line that... more
Ask the Pediatrician
Q1: We’re first time parents. What sorts of things should we look for in a daycare provider?The biggest question to consider as you are choosing a setting is whether it will be a smaller home-based daycare or a larger center. It’s also a good idea to ask to talk with one or two of the current parents at a facility you are interested in,... more
Ask the Pediatrician
Q1: My child is extremely afraid of the dark and cannot go to sleep unless a light or music is on. What can I do to help him overcome this fear?Being afraid of the dark is a very common fear for children. Even older teens can retain a fear of the dark for a number of reasons. For children, the “dark” also represents all those things that... more
Ask the Pediatrician
Q1: My four-year-old is stuttering a lot, and I am worried that he will have problems a year from now when he starts kindergarten. What can I do? Stuttering is a very common in preschoolers and is seen in many three- to five-year-olds. Speech and language development is rapidly progressing at this time. The child’s ability to... more
Ask the pediatrician
Q1: My kids all have pretty bad allergies beginning in late summer. What can I do to minimize their symptoms of sneezing, runny noses, and itching eyes?Seasonal allergies are very common in children and teens. They can range from a mild inconvenience to a major disruption in day-to-day life. The symptoms described above are the most... more
Ask the Pediatrician
Q1: My 16 year old is really struggling with acne. Is there anything that can be done to help treat this condition? Acne is, of course, a very common skin condition, affecting roughly 80 to 85 percent of teenagers.It is caused by a combination of four processes that affect skin pores causing “pimples,” which are basically an infection in... more
Ask the Pediatrician
Q1: Should I apply SPF lotion to my baby and if so, what number should I apply?Protecting all children and teens from excessive sun exposure and the damaging effects of ultraviolet light is an important effort to make as a parent. Starting early in life and continuing throughout childhood and adolescent years will go a long way to help... more
Ask the Pediatrician
Q1: I have not vaccinated my son. He's now two and she's been just fine. If all of the other children have been vaccinated, why should I concern myself about vaccinating mine?Unfortunately, there is a lot of misinformation about vaccinations that parents can easily find. There is also an excessive fear by some parents that vaccines will... more
Ask the Pediatrician
Q1: Tell me more about the importance of “family meal time.”Having family meals regularly can have many positive effects that extend far beyond the nutritional advantages. Being able to connect together on a daily basis to hear all about the events of your child’s day—both the good and challenging portions—is essential for emotional... more
Ask the Pediatrician
Q1: I have heard a lot about concussions lately. I want my child to participate in sports but now I am very concerned about permanent brain injury. What do I really need to know about concussions?The term “concussion” can be very concerning for parents, but thankfully very few of them lead to any longer-term problems. On the other... more
I am about to return to work and ...
Q1: I am about to return to work and my three-month old infant is not yet sleeping through the night. What can I do? Having an infant sleep through the night is a combination of two factors: your baby’s internal “clock” or sleep-wake cycle and a learned pattern of falling asleep. The first factor you do not have much control over,... more
What can you tell me about croup?
Q1: My two-year-old has a very harsh cough. What can you tell me about croup?Croup is a very common infection in young children under four. It generally refers to a harsh, barky, high-pitched cough that some parents describe as a “seal bark.” It is usually caused by a viral infection that produces some swelling and infl ammation of the... more