"Ask Me Anything" with Dr. Krupa Playforth, MD, FAAP



  • @Rtian Yes! Eczema can be a challenge, especially at this time of year. Moisturizing, as you note, is the absolute key to prevention and management. My little one actually has eczema too, and I go through the products I use on my Instagram - but I can tell you that your goal is to use something thick and goopy (an ointment) and to moisturize 2-3 times per day as needed. Use hypoallergenic products that have the National Eczema Association Seal of Acceptance. Sometimes what works well for one child isn't the right choice for another, so there may be a trial and error piece here. The key is moisturizing within 5-10 mins after a lukewarm bath.

  • @MikeThompson It sounds very much like you're at the end of your rope here! This is not a sustainable situation, and I'm so sorry you don't feel heard. Back arching can be an indication of reflux, which can also be a result of overfeeding. Without an exam and hearing a more thorough history, I cannot really provide any specific advice. But I urge you to seek out care with a provider who will hear you out and offer concrete suggestions - just because a child is gaining weight well does not mean that reflux or other issues aren't present. In the meantime, is it possible to have family or another support source help you out for a few days so you can get some rest?

  • @SarahM If a child is gagging and then vomiting during the process of trying solids, this can be part of the adjustment process. But this change sounds more sudden, which is a reason to reach out to your pediatrician. It sounds like you're trying to troubleshoot well, but I would want to make sure there isn't anything more going on - for example, an allergy or a condition called FPIES, which can present with vomiting after eating certain foods. Banana, in particular, is a known trigger for FPIES. Reach out to your doc!

  • @Jocelyn I encourage you to focus less on the "amount" of solid she is eating and more om the experience of the meal. Part of our goal as the parent is to provide the food and then honor our children's experience of eating it - even in babies. Sometimes when we become overly fixated on volume, the meal can become stressful and emotional, which interferes then with success and positive eating experiences. This is called a responsive feeding approach. I plan to post on this a lot over the coming few weeks on Instagram.

    More practically: I'd allow her to play with the food, especially if you are trying to move towards more finger foods. Have her sit with you during a meal and watch you eat (the same food, ideally) and let her get messy and play around with textures. At 10 months, the majority of her nutrition will still be coming from milk, and as long as she is gaining weight well, your goal right now is teaching positive food associations and exposing her to a variety of textures.

    In terms of bottle refusal, this is a huge topic - briefly, I would let her play around with a cup (you can put water or milk in the cup). Focus less on the goal and let her simply play without pressure.

    Finally, on the standing on her own - she sounds like she's on track developmentally. If you're concerned, as always, reach out to your pediatrician for a closer assessment!

  • @SD123 Many babies spit up, and we often gauge our level of concern on certain factors: feeding comfort, weight gain, other symptoms. Always discuss with your pediatrician as a first step. If your baby is gaining weight well, and doesn't seem uncomfortable when they spit up (even if the volume seems to be a lot), and your pediatrician isn't concerned, you probably have something we call a "happy spitter" - this is usually more of a laundry problem than a medical one. It sounds like you're doing all the right things!

  • @Rogette Ahh yes. Totally developmentally normal! At 4 months of age, baby sleep cycles transition to more adult-type sleep cycles, which includes more phases of "lighter" sleep. The 30-40min duration is probably about the duration of a full sleep cycle, and some babies wake up and cry as they transition through from one cycle to the next. As hard as it is, your goal is to try to teach them to transition with minimal assistance, which can mean using some sleep "training" techniques. The specific ones depend a lot on the baby and parent's philosophy (notice I don't say to necessarily jump to CIO!). Our 5 month old is doing the same thing, and what we're doing right now is just letting him try to work it out for about 5-7mins. Sometimes it works, sometimes it doesn't. Sometimes I go in and place a hand on his chest, or shush him (without picking him up), or just sit in the room with him, and that can be the trick to getting him to go back to sleep. A few other tips: make sure your sleep environment is ideal (dark, cool, white noise), and try to make sure your responses are as consistent as possible. There are several other tips but start here and see how it goes!

  • @Xtinelu Keep trying. Focus on variety and positive mealtime associations, and try to do a mealtime at a time when she's otherwise happy, not hungry/tired/etc. Have her sit with you at mealtimes. The change in stooling pattern is quite normal as the gut adjusts. If she is closing her mouth, she may want to try to feed herself - you could try giving her the spoon or trying some baby led feeding (once 6 months old) to see if she prefers this approach!

  • @willkeim I hear you. This whole situation has left those of us with young children (who are not yet eligible for vaccines) feeling left behind. I have posts on this, and also on how to do a risk assessment, but as you mention, with Omicron everything is still in flux. I wish there was a single "right" answer or a way to predict how things would go over time, but things are not that simple. I'd recommend leaning on reliable sources that look at evidence (I write about this regularly, but I also recommend Emily Oster) and recognizing that everything is ultimately a risk/benefit analysis. Ways to minimize risk in general include mitigation strategies (trying to make sure everyone around baby is vaccinated AND practicing common sense precautions) and focusing on the activities that mean the most to your family. We are also not really discussing how to use rapid tests in a smart way - the rapid test options are actually pretty good, especially as an indicator of being "contagious" - for important family events, it is completely reasonable to ask members to test on the day. I wish I had a better, more concrete answer for you. But know this: I see you, and hear this concern (I have a 4 year old and a 5 month old too).

  • KrupaPlayforthMD
    KrupaPlayforthMD Member, Expert
    edited December 2021

    @Vmedchill Yes! So in an otherwise healthy child with a typical diet, pediatricians don't usually recommend supplements. But for children who have underlying issues or diets that exclude entire food groups, there are some supplements we think about. I have a post on this that goes through it more thoroughly, but I'd think about Iron, B12, Vitamin D, omega 3s.

  • @JasminRose Good question! I have a post on this, but you can go either cold turkey or gradual.

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