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LIVE Q & A  with  Dr. Dina Kulik

Recorded January 7 2021

ABOUT THE AUTHOR

Dr. Dina Kulik, MD, FRCPC, PEM

Pediatrician, Emergency Doctor

Dr. Dina Kulik is a mother, pediatrician and pediatric emergency medicine physician in Toronto. She is the Founder of Kidcrew, a multidisciplinary clinic for children. She is Canada’s leading child health media expert. Her greatest joy is her family and being the mom of four active, happy boys. 

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Full Transcript

Recorded January 7 2021

Why don’t you guys introduce yourself?

I’d love to know who is here and how many kids you have, how old are your kids. And you could literally write whatever questions you have in the chat. And they’re going to answer your questions and we can, we can have a chat and see what you guys are worried about, where you’re concerned about what you have questions about.

And I will do my best to answer you. Welcome. Welcome.

Hopefully everyone’s has their quiet and your kids are in bed and all this good. Hi Hattie. Nice to see you. Yeah, so like, I’d love to know who you guys are. Hi, Joanna. And yeah. How old are your kids? How many kids you have and really like, right?

Any questions you got because we’ve got an hour and we could dig in and we can talk about whatever topics you like really. As long as I can answer, I’m happy to kind of haul three months, a little five video. And I Penelope hi guys. So exciting. Yeah. There’s a bunch of people here. We have 32 so far and quite a few more that registered so happy to help.

Hi, Carla. Eight months old. It’s such a fun age or like really starting to like move and like be real people and giggle and eat. And it’s, it’s a fun time. All right. Questions are coming. Okay. So hi Karen.

So Karen says, I just, haven’t Sorry guys. I lost the question. It’s okay.

 

My three-year-old is a much Montessori school that is going to open in-person teaching next week. We’re in New York region. Nervous sending her. What are your thoughts? Should we keep her home a few more weeks?

Oh goodness. I wish there was like a simple, easy answer for this. And it’s so personal, right? So it depends where you live. It depends on your social circumstances. It depends who’s home or not home. Are you working from home or you’re not working from home?

How can you work at home when your child is home?

It’s really complicated. There’s not really easy. Yes. You should totally send your kid or no, you should totally not send your kid. That will come down into a public health measures. Right. Things may be forcefully closed like we had in March. So we’ll see, we found out this evening that my kid’s school will be closed for two extra weeks.

So there’ll be back in person on January 25th or so if that happens, I don’t know. I mean, numbers are going up and kids are definitely getting COVID. They don’t seem to be getting very sick with COVID still, even as numbers rise, we still haven’t seen kids getting particularly sick. They’re not needing hospitalization very much homeless. No kids have died in this whole pandemic.

So it’s very reassuring. So kids seem to be pretty safe. I mean, kids get sick. No doubt. There’s definitely kids getting COVID. I’m definitely hearing from many families every day of kids that confirmed positive on testing. So it’s happening. But again, they’re not getting that sick. So the argument of keeping them home, because we’re worried that they’re going to get sick.

That’s why kids are going back because they’re not really getting sick. However, I still think it’s very, very important to maintain distance from older people. So people older than 60, so that could be parents or Lisa or aunts, uncles, grandparents, et cetera. These are people that are higher risk of getting very sick or dying from COVID. So I still think that if kids are in school and daycare,

that we should be avoiding contact with those people that are higher risk. Also recognizing that some people live with people that are higher risk. So it’s a tough one. I don’t know. Yeah. You have to make a decision for yourself, but to be honest, like what might happen between today and next week or the week after we’ve seen numbers rise.

So I think everyone has got to decide for themselves what their risk factor is and if Ms. Tolerance and there’s their situation, right. It’s, it’s very personal. All right, I’m going to scroll back up again. Hey, Laura. Vivian. Hi Janine. I’ve been lop 2.8 Penelope. I’ve never heard people say that before. It’s like, you always counted like eight months,

nine months, 12 months after 18 months before like two, two and a half, three, 2.8 is funny. Okay.

So Joanna says:

Hi, my name is Joanna. I’m a mother of a 16 month old congrats. This past year was obviously being really hard for centralizing my daughter due to the pandemic. What are your thoughts on how safe it would be to take her to places like Walmart or the grocery store?

Since she’s too young to wear a mask personally, I wouldn’t do it. I don’t see great value a 16 month old. Sure. I mean, they’ll see other people and be interested by other people, but you know, these are indoor places with a lot of other people potentially. And you don’t know who was just there on the aisle before you and who has touched what and what their hand situation was like their hand hygiene.

I personally do not recommend take your kid grocery shopping that you know, I’d rather go for a walk outdoors and have a walk by the playground or even play in the playground, distanced from other people with clean hands, then go to somewhere like Walmart or grocery store. Personally, I would avoid that. It also depends where you live and the case rate where you live.

Of course, I go, when I’m in Toronto, the numbers are definitely going up and you know, much of many major cities are that way as well. But there’s certainly areas in the world that the case rate is quite low and I’d feel much more comfortable going shopping. But if you’re in the GTA, I would avoid it. Personally.

Laura says:

Hey, Laura, being home the next few weeks, any tips on keeping kids engaged, focus, sad for missing friends?

Yeah. I mean, this is very age-specific and really specific to, I think some kids do really well on like virtual light dates or virtual chats with friends that other kids don’t at all. Like my eldest, my 10 year old has no interest whatsoever in talking to his friends virtually they’ll do it if they want to talk,

but he’s not asking for it. He’s really, you know, he doesn’t care. He doesn’t care, but he’s doing virtual school. No problem. And is happy with that. He obviously pleased with his brothers, my second kid, my eight year old wants to talk to his girlfriend every single day, twice a day. He’s asking that really drives him.

And that gives him a lot of, I guess, good feeling. He’s happy about that. And my next kid, my six year old also doesn’t really seem to care. He’ll do it if it’s friends want to talk, but he’s not asking for it. So it really depends on the kid. So virtual dates could be helpful. I think being outside as much as you can,

it can be very isolating being at home. And if they’re virtually learning and they’re in front of a screen all day, that could be really isolating even for me and you. And so being outside every day, you know, certainly not interacting necessarily next step of people, but just going for a walk or playing a game of soccer in the park, or,

you know, riding your bike, if that’s accessible to you without snow or having a snowball fate, I think getting outside every day is really, really important. And I think focusing on the silver linings to like, this is a really awesome time to share some moments with your family, share some moments with your kids. I have to say, like,

it’s been a huge eye-opener I would say, like, I was always very connected with my kids and my partner, but I’ve really gotten much more connected with them. Like every moment that I can, I have with them without a screen, without my own distractions. And I’m being much more aware and in the moment, and I think that’s been like a huge value that huge gain get a win for me personally.

So I think that’s really important, you know, kids miss their friends for sure, but they also really, really, really want time with you. So actually around that topic, I think what’s very challenging for families is oftentimes we’re working and we’re trying to do our work. And we’re also trying to watch our kids and help educate our kids and help them do okay.

You know, emotionally, academically, all the rest of it. And it’s very burdensome. It’s very, very stressful. So families often ask me like, how do I do that? How do I work full time? How do I be a full-time employee or business owner or whatnot, and a full-time mom and an educator and an entertainer and a comforter.

How do I do all of these things? And it, for me personally, I think the best way has been to, I guess, pillar things or put things into, into categories or silos. So for me personally, if I’m spending the whole day at home, if I’m trying to watch my kids being educated or educate them myself, and I’m trying to work and I’m trying to also take care of another kid, we’re so pulled apart, we’re like diluted as, as individuals.

I, I personally a much more effective and efficient if I’m like, okay, the next four hours I am working and I’m not with my children. Like that could be 7:00 PM. You know, it could be like now, right? Or it could be my partner. My husband is watching the kids for the next four hours.

He’s not doing other work. I’m going to try to do business work just with the kids. And then we’re going to swap when I’m doing that four-hour chunk of time. I’m only working. I’m not with my kids. I’m not near my kids. I’m in the other room. They know not to bug me daddy’s on. And then swapping because I find if you’re like try to do too many things at once, nothing happens.

Can we feel so frustrated and we just don’t wanna accomplish anything. And our kids don’t get a good part of us and our work doesn’t get a good part of us and all of this, just a total mess. So I try to really, if you can do that, you’ll be more efficient. Anyway, there’s no point in working for eight hours when you’re really working for like three hours and it’s tidbits and it’s just garbage work.

I think you’ll be much more efficient if you do four hours and four hours or something. And again, that means you have to have another person that’s helping care for your kids. And I recognize that’s not accessible to everybody, but that’s sort of how I kind of fragment things. All right. Hopefully that helped Laura. Let me know. If not guys, I.

Joyce asked, Hi Joy:

What’s the best approach to wean an 11-month-old who was exclusively breastfeeding. She doesn’t like bottles. Should I lean to a strike upper to a cup or strike? Let me choose formula, go straight to cosmic.

So great question. So after nine months of age, kids don’t need a formula anymore. And of course you could breastfeed as long as you’re interested in doing so, but if you’re wanting to ween, you can certainly lean right to homo milk. So kids need a high fat source of milk.

So homo milk or the like till at least two years of age, after 12 months, I’m looking for 16 ounces of milk or less. I don’t want them having too much milk because that’s just one source of nutrients. Like it’s calcium and vitamin D and fat, but it doesn’t have a lot of iron and it doesn’t have the variety of vitamins and minerals that we want.

So by a year of age, my goal is no more than 16 ounces of milk a day. Again, homo milk. And after nine months, most kids can take a sippy cup or a straw or an open cup. Some kids are not great at it at first, but you just keep practicing and just keep trying it. Sometimes when kids are not really good at the straw, yet I get ones that have like, if you squeeze them, the milk will come up the straw.

So it’s sometimes easier for them to take that way. A sippy cup or a struck up or open cup is totally fine, no more than 16 ounces a day.

And I don’t personally feel like you have to wean off in any kind of strategic way or, you know, give a bit of breast milk mixed with formula or mixed with homo milk. I don’t think kids care so much about that. I don’t find a lot of kids rejected. It doesn’t really matter to me how you went off in terms of breastfeeding.

What I typically suggest is starting with the last feed of the day that you would otherwise breastfeed because most moms have their peak milk supply, first thing in the morning. And then it goes down throughout the day. So in terms of getting a Gorge and uncomfortable and where they filled up with milk, if you start and you drop the first feed of the day and you didn’t hand express or pump or something, you might feel uncomfortable.

So I would start with the latest feed of the day and then work your way forward, dropping feed by feed. And that could be entirely dropping a feed at a time, or let’s say breastfeed instead of 10 minutes, it’s now seven minutes, five minutes, et cetera. Some women have lots of milk and they get quite uncomfortable when they drop a feed at this age.

And some women really don’t that don’t have that much more milk anymore because babies are taking much more food, which is what we want anyway. So it really depends on the woman and her body, but basically starting with the end feed, working way forward, dropping them or shortening the duration. And you can absolutely switch to homo milk by any means whether it’s a bottle or a sippy cup or struck up.

Let me know if that, if that clarifies, if that’s helpful.

All right, Vivian says:

I want to ask about a skin condition for my five-month-old. She’s pretty bad. Excema since three months we started on 0.5 Piper. I assume percent hydrocortisone, and we’ve gone to destined. I that’s just a stronger, more potent steroid. We said twice a day for two weeks and started scaling back. But now we’ve noticed the red patches are coming back. Should I continue with a cream or just do something else?

So obviously I’m not seeing you in person. I can’t provide direct medical advice to you, but in general, what I like for exam, and this is really the time of year for this, right? So it’s way more dry. It’s way more cold.

Many of us are heating our houses, of course, depending on where you live. And so this is really the peak time for examine. I don’t know how much you guys can see, but I’ve examined my neck. I never used to. It’s very strange. I’m not sure why this year I have, but I usually start with things that are lubricating.

That would be things like Vaseline or coconut oil or petroleum-free jelly. Many times, if that’s not quite enough, we will use something like hydrocortisone. Hydrocortisone comes in two main strengths 0.5%, which is basically nothing. And it’s not very useful. And I don’t personally ever prescribe it. And the next step would be 1% hydrocortisone. I personally like lubricated versions in other words, appointment much more than cream.

So my first step, if I’m going to give something, that’s not just over the counter, like Vaseline would be 1% hydrocortisone and, and you can get that over the counter actually. Or your doctor can give you a perspective and that you can use one, two or even three times per day, and it can go anywhere it go on the face, like on the cheeks and go on the scalp, it can go anywhere on the body.

And I would still also do lubrication like Vaseline or coconut oil. And I always recommend humidity. But the same reason I was saying before it’s dryer, it’s called the reading or houses. So I like humidity. So I have a humidifier in my bedroom. You can crank the humidifier on your furnace.

If you have one that can be really, really helpful. But yeah, lubrication, hydrocortisone 1% ointment would be my go-to and humidity. And you, in terms of like what to use next, that’s something that you should really discuss with your own healthcare provider. But I wouldn’t even bother with 0.5% hydrocortisone. This is not something that I really ever recommend.

Cause it’s not really much better all than cream, like normal cream, like Vaseline or, or moisturizer. Perfect.

All right. Onto the next Sandra. Hello. Nice to see you. Okay. So Sandra is two questions:

 

One her eight year old seems to be having a hard time falling asleep. I try to have him in a half and be as physical as possible. Perfect like exercises. Great. I even have him meditate prior. Amazing. Also. So meditation or mindfulness or those kinds of practices where we’re kind of chilling out can be really helpful for sleep for adults as well. Is there, is there a vitamin like melatonin that I can give him that is obviously safe?

So this is also I think, a conversation to have with your healthcare provider as well.

Cause there’s many reasons why kids can’t fall asleep, but mindfulness is great. Certainly, I would recommend no screen time within two hours of bedtime. And this is true for adults too. Hello. Last many of us are on our phones or computers before bed, but we know that when we watch screens, any screen, computer, iPad phone, any of these things that it decreases your own, brain’s chemical called melatonin, which is like the sleepy hormone is the hormone that our brains make to create and make us sleepy. When we watch a screen, your brain is stimulated and it doesn’t make melatonin.

In fact, it decreases melatonin production. So the very best way to cause sleep issues for yourself and your kids is watching screens before bed.

So first rule, no screens in the bedroom period, how don’t shouldn’t either. I don’t have a screen in my bedroom. Well, I lie on my phone in my bedroom, but I try not to use it before bed, but I definitely don’t have a TV.

It’s a very good way to have sleep issues. And if you don’t have sleep issues cool. But if you are struggling with, you know, having difficulty falling asleep or rousing frequently or having trouble settling, first thing to go is screens within two hours of bedtime getting at least one hour of heart racing activity every day, which is, sounds like you’re doing Sandra, which is lovely.

And, and then mindfulness practice meditation. These kinds of things like you, something like yoga before bed or reading something calming before bed, not something that’s going to kind of rile you or them up.

That’s really helpful. Melatonin can be taken exotic to see like a pill or a liquid or gummy form.

Many people use it. I use it if I’ve done an overnight shift and I come home at like 7:00 AM and I need to sleep. My brain is like, no, you’re not meant to sleep right now.

So sometimes I’ll take melatonin. It is a kickstart. Sometimes we definitely don’t want to use it every day. So I’ll use it if I’ve done an overnight shift, but I don’t do it every single day. So it could be something to give for children again, as a kickstart to get them back on the right track and feeling confident and less stressed about sleeping because some kids and adults get in their head.

Like I can’t fall asleep, I can’t fall asleep. I’m never going to fall asleep, et cetera. So it could be a way to kind of calm them and take the edge off, but you never want to do it every single day. And, and I would touch base with your own healthcare provider before giving up, but it is an option, but it’s really kind of the lower down on my list in terms of what I would suggest.

And I would focus on other things first. All right.

And then the second question is:

 

I work in childcare and I’m freaked out about going back to work. I’m in full PPE and I shower immediately when I get home, do I need to be concerned?

I don’t know. I mean, I’m working, you know, we got to work. I don’t know. I’m seeing patients every day.

I’m only seeing healthy patients or patients that I think are healthy. I recognize there’s probably a lot more asymptomatic COVID patients out there and I’m searching, I’m getting exposed.

I’m also wearing PPE and I’m being mindful. You know, as I mentioned at the outset, you know, kids don’t seem to be getting very sick at all or dying from COVID, which is amazing and lovely and very reassuring. No one wants to have been COVID home to their families.

And we certainly don’t wanna get sick ourselves, but it’s, you know, it’s a risk being around other people is a risk.

I don’t know. I am taking that risk every day too. So it’s a challenge, you know, as an oppose rise, if they continue to rise, maybe we’ll all be home for a bit, but I hope not. All right, we’re going to read down the list. Hello, everybody, more people have joined us. Hopefully, you guys are well.

And basically, just throw your question up here and we’ll get to as many as we can. And if we don’t get to all of them, then I’ll be back in another day. All right.

So my hall says:

 

My three month old has a mouth diaper rash between the cheeks for six weeks. It looks more and more red, but isn’t really spreading and he doesn’t seem upset. We’ve done a lot of airtime use lots of ZinCo facts, which is a zinc based diaper cream. That typically is 40% zinc, which is great. We change it within five minutes of his poops, giving them time to wrap up at this point. Should we ask the pediatrician we are new at this?

Yeah. I mean, it’s one of those things that,

you know, rashes are a thing that, you know, we just see visually, if I saw a picture of a rash, don’t post a picture of a rash, but if I saw a picture of a rash in clinic at work, virtually, I could tell you right away, is this an infection? Is this yeast? Is this bacteria, or is this just irritation from pee and poo?

Which most of the time it is, but I can give you kind of a generic summary, which is if the area where pee and poo has been is causing redness to the skin. And it’s just kind of localized in that area and it’s not incredibly tender and there’s no POS coming out and there’s not little red dots. It’s usually just contact dermatitis, meaning contact with the acidity of the pee and the poo coming in contact with that very sensitive skin causing irritation.

And for that, we typically use highs and oxide based creams like Cinco fat or Dessa tin or Isles paste. Those are other options. The big trick though, is you want to layer it like icing on a cake, right? So what happens is if you put the cream on the bum and then you put the diaper on diapers are really absorbent. And so sometimes you’ll then take the diaper off and the cream has gone.

Ideally it’s more like layered and thick. And then when there’s a pier, Ripu, you want to very gently wipe the poo off of the white cream, but not scrub all the white off. You basically want to avoid seeing red on that skin for a few days. So you just like slot more white on like very gently wipe the poop off. You don’t have to go crazy on it.

You don’t play bathe or take all the cream off and then, you know, layer more cream on top to avoid seeing the red, the more there’s a barrier there, more of the pee and the poo will not come in contact with the skin and the faster it can heal. I mentioned a little red dots, a classic yeast infection or thrush infection,

which is incredibly common and pretty much every baby gets it. At some point looks like redness on that area. And then discreet little red bumps around those areas. We call those lesions. So it’s like, you know, red and dots around. And that usually requires a prescription. Something like co-trimoxazole, again, this is a question to bring up with your doc and show a photo or,

or see your doc in person, if they’re doing that. And that requires just a very simple prescription. So those are the kind of two main rash types. You can get any bacterial diaper infection that looks very angry, very beef. You read expanding over time. Sometimes discharge, sometimes fever. It’s very uncommon. I haven’t seen a strap diaper rash in a year.

Maybe, maybe two it’s very uncommon, but contact dermatitis is the most common by far. So stick zinc, oxide, diaper cream like icing on a cake. Don’t rub it all off. Get the poop off, gently, put more a diaper cream and obviously touch base with your doctor, but to persistent. Two-person all right. How does that, what would you suggest for a girl almost four years old who doesn’t show much interest in using a pencil for alphabet tracing,

coloring and drawing? They were home or daycare. Would it be okay to force her as she’ll be going to JK for September? The difference between January and September for four-year-old is ginormous. We’re talking about, you know, a seventh or eighth of this child’s life, not being interested in writing your name or drawing at four. I’m not typically worried about it.

You know, as long as your pediatrician or family doctor is not worried about, you know, development overall writing your name is a milestone we’re looking for at the end of S K middle of SK. I don’t need kids to be writing letters or tracing it for in fact, pretty intense for most kids that are four. I don’t even expect them to really recognize all the letters necessarily early on to this year,

especially before JK, but they might be interested in drawing, but drawing it for is like a circle scribbling, a very rudimentary box, but that’s what I’m expecting. Not to letters. I get a, B, C, not at all. And I find a lot of parents, especially now when we’re home with them or like focus on learning and focus on academics,

I’m going to get them ahead. And a lot of that I think is nonsense. Like my kid’s three and a half, my youngest, I have a ton of letters. He recognizes letters, but that’s because he’s interested, he’s throwing these in writing them. And he didn’t really want to, he drew me a picture on the weekend. He took a picture of a pop patrol coloring book.

And he like, went like this. He was like, mommy, it’s beautiful. I was like, this is kind of embarrassing. Like, I can’t even show this to anyone. It was like, nothing. You did nothing. You just like scribbled, but that’s what they do. Like, that’s what they do at three. So yeah, I would focus less on academics.

There’s also no evidence at all that pushing kids to do academic type work, like learning letters or writing letters, et cetera at this age puts them ahead at all. I mean, they might learn it. They might be able to do it, but does that change their IQ? Does that put them ahead of their peers in life? It doesn’t a lot of these things kind of equalize themselves out.

So I would focus less on the academics, I guess is what I mean, read a lot. Single moms play together, do Lego or played over kinds of things, but you definitely don’t need to. And I wouldn’t even want you to, but they focus on academics or learning per se. A couple days ago, I saw a family of the kid is three and mom is showing her cue cards all the time,

you know, with like cat and bat and you know, the, those animals and figures on the back. And she’s trying to like get her to learn the words. Like what’s the benefit of that. Even if she learned all of those words, we think that’s going to set her apart from her peers or put her farther ahead than our peers. So evidence for that at all,

it just kind of stressful. The kid was stressed by it. She was like not into it at all. So kids would really learn much more like sponges at this age. And truly, you know, when your kid first speaks, as long as it’s in the normal range, when they first read their first word, as long as it’s in the normal range,

when they first walk or crawl or stand on their own or feed themselves, as long as it’s in that normal range, there’s no evidence to suggest that if you’re earlier in that range, that the outcome is any defense. Okay. All right. I don’t know guys. There’s no way I’m gonna answer all of them, but I will try my best.

Okay. So grace says, my name is grace. My daughter’s blood test showed a low iron. How often should it prior to be tested iron in your blood? Your blood cells turn over every three months. So if we test for iron and a child is found to be iron deficient and started on iron in the diet, or by supplement, we test three months later because it takes three months for your blood cells to turn over.

So there’s no value in testing before the three month Mark judge, question one, two, she refuses any iron supplements based on the taste of their iron supplements for almost four year old. That tastes good. Not really. I wish there was. I’m not really aware of any. Sometimes I have compounding pharmacists, make them for me. So I’ll take elemental iron and mix it into like a gummy or a compounded liquid solution.

So if you have access to a compounding pharmacy, they might be able to do that for you. But it also depends on a lot of things. How low was the iron? Was it not that low such that dietary changes could increase that level? There’s a lot of pieces to this, but, but I would touch base with a compounding pharmacist if you have access to one,

because that could be a really good solution. Hello, My son was born in April. Congratulations. And we’ve basically been isolating at home ever since he’s not exposed to many people. Is there a concern that he won’t be introduced to common germs? He’s never even had a stuffy nose that lead to issues when he’s older, we don’t really know to be,

to be honest, I don’t think that he’s not being exposed to any germs, right? I mean, there’s things in your home and hopefully you’re not like sterilizing everything always. I would, you know, you know, after he was born in April, he’s already eating foods. And so foods have bacteria in them as normal food to do so I wouldn’t be crazy,

but sterility in your home. Of course, if you’re leaving the home, wash your hands, keep your distance, all the things. But we don’t live in bubbles. We don’t live in sterile environment. So I’m not really worried about that. To be honest, you know, like daycare is very much like a westernized thing. There’s many, many committees in the world,

probably the vast majority of the world doesn’t do daycare. You know, kids often stayed home with parents or grandparents until school starts and their immune systems are no weaker than kids that go to daycare. So no, by and large, I’m not really worried about the germ situation, as long as you’re not sterilizing your universe inside the home. Carla though, it’s Carly says,

since I’ve started solids and transferred to formula or eight month old at six months, she’s constipated, I watched one of your reels, which was a great of a constipation. It looks like, how can I help her? So I’m assuming the reel you’re talking about is where I take a diaper of a baby headshot actually. And I turn it upside down.

What I would say is if, if a baby’s in a diaper or child’s in a diaper and they poop, you want the poop to be mushy like peanut butter. So if you’re in a diaper and you’re pooping, if you take the diaper and you turn it upside down, you do not want the poop to fall out. Do you want it to be stuck to the diaper should be peanut butter,

like mushy, like peanut butter, obviously older kids. You’re not going to have a feel of the texture, but it shouldn’t be hard to push out. And you want, the idea would be if you were to touch it, which I’m not encouraging, but the idea would be if you were to touch it to people, she squishable as if you were in a diaper,

it would be squished. So it’s not usually a formula issue per se. It’s often a fiber issue. So I’ve got a huge fan of baby cereals because they can be very constipating, I’m much more fan of real food. So, you know, by eight months, six months, et cetera, kids should be eating. Ideally what parents are eating with the caveat that they’re not drinking milk milk,

not until nine months. And they’re not having honey until a year, but otherwise you do want to try new foods every few days. And by eight months, for sure, I want kids eating what parents are eating, including the grains and the veg and the proteins, et cetera. No, honey, no drinkable milk at that time. But you basically want to think about the fiber and also water.

So a lot of parents are hesitant to give their kids water. Kids could absolutely drink water after they start solid food. Solids are not sterile and water doesn’t need to be sterile, right? So the kid is eating. I don’t know, you know, applesauce at four months, that applesauce is in sterile. So there’s no reason in my mind that they can’t have water as well,

help push all the fiber through. Do you want to think about lots of water? You want to think about minimizing things that are constipating like baby cereals or rice or wheat or other things like that. And upping fiber. My favorite sources of fiber come in fruit and veg form berries are excellent. Mangoes are awesome. Peas like goons, like lentils and beans and Apple and pear with the peel or the skin.

A lot of parents will appeal like, you know, fruits and veg that don’t need to be peeled. So like an Apple or a pear, you would, I would eat with the peel on we’d wash it while, and we eat the peel. The peel is a lot of the fiber. When people peel those things off, they are actually removing a lot of the fiber.

So what I say to families is if you would peel it for yourself, for example, a banana, I’m not gonna eat a banana peel or a mango peel. Then I would peel it for my kid, but I eat grapes with and apples and pears and peaches with peel. So I would eat those or I feel close to my kids as well,

just as meeting them as well. So keep the peel when you can obviously wash them. Well, and those foods that I mentioned are great and water as well. And obviously again, as always talk to the doctor, if any concerns, but babies and adults should be pooing at least once a day, easy to push out and where she liked Jacqueline.

Hello. So Jacqueline says she has a 15 month old son aside from knowing a couple of basic science. He doesn’t say anything other than mama. Why do I started worrying about delayed speech? How do I get intervention? So the intervention piece, I would say discuss with your healthcare provider because every province, every state, every country has different kind of rules and opportunities in Ontario.

There’s the public system and the private system, the public system is called early abilities. Again, this is just Ontario and that is accessible by your like going online and actually registering yourself. You don’t need a referral for early abilities in Ontario, that’s parents accessed, but the wait time could be long, which is challenging for some, the private system would be any private speech therapist that you’d have to pay out of pocket or through health insurance.

If you have that, that’s again, a system on a system in Ontario and every place is different, asked a few months, but I’m looking for, I said a minimum of five words or expressions. And for me personally, I count signs in that. I’m just looking for kids to go to express themselves in some way. So if they’re signing five or 10 signs,

or they’re saying a few words, or they’re making animal sounds or like room or a Wolf moon, you know, those kinds of things. If they have five to 10 expressions or things that I understand, and you understand, I’m happy with that, they should also be able to follow some simple commands, like where’s your nose or get your shoes or things like that.

They should be starting to point. They should be interested in other people. So social reciprocity, they should be kind of like Feldman conversation, looking back and forth between the people they should have. What’s called the shared attention. So pointing something out to you, that’s interesting to them or bringing a toy to you that they’re excited about. If they’re reading all those things,

I’m relatively reassured that development is okay. And what I’m looking for by 18 months is at least 15 to 20 words. And there should be more words at this point. So less, I mean, they can have more expressions of course as well, but I want those, you know, like if they’re doing more than, I want them to start saying more while they’re also doing the sign as well.

So that’s what I’m looking for by 18 months and as always talk to your doctor, but if they have some signs and a word or two, and they have those other social signs of, of normalcy and they are following commands, then that’s reassuring. Sometimes we were, but hearing if kids have delayed language and that’s again, something to talk about with your doctor kidney.

Hello. So curious about correlation of H of COVID and RH negative. Is that true? Is it a factor? My kids, I didn’t really know early on, there was some talk about if you were Oh, negative or actually, I don’t know about the RH piece, but if you were, Oh, you were less at risk. And if you were a,

in terms of blood type or something to that effect, and there was some study that came out of China very early on, like April or may or something. I don’t know that it’s been replicated. And I don’t know of any truth to that. And I’m not sure anything, but our reach to be honest. And in terms of kids, like,

you know, as I mentioned earlier, kids don’t really get sick with COVID. So there’s not really anything that really increases the risk to COVID infection for kids even being immunosuppressed, even being very young or older, or have some kind of underlying chronic health concern. It does theoretically increase your risk, but it hasn’t really proven to do so in, in young people.

So in general, my worried about COVID for kids in as much as their own illness, certainly though they could pass it to other people that could get very sick with COVID and, and look, I mean, if you have enough people that get COVID in a population have, let’s say 1% of people, they get really sick with COVID our children, as an example.

I mean, depending where you live, the stats are going to be different. If you have a thousand people that get COVID, 1% will be a kid that’s one person, right? Or, sorry, they’ll be 10, that’s it? Okay. A hundred. Let’s say you have a hundred people that get COVID the people that get really sick with COVID as a hundred people.

One of those people will be a kit. Okay. If it’s 1%, I think if you have a million people that get really sick with COVID and 1% of those people are children, then again, you have a much higher number, right? So if we see numbers go up and up and up, we are going to see more kids that get go.

We’re going to see more kids that get sick with COVID. And we are going to see more kids that died with COVID, but on a population basis, there’s obviously being many, many millions of people that got COVID and sadly many, many deaths, very few of those people are children. All right. I can say hello. And then we think,

how did a fellow parents that’s so nice. So we have an empty seven month old due to the pandemic, like many other babies. He hasn’t had the chance to interact with other babies his age, or even meet new people. I know social anxiety tends to peak around eight months. It doesn’t all come back to that and a slightly better in kids who tend to meet other people as well.

I don’t think that’s true. Do you feel the pandemic would have any impact on when or how he developed social anxiety or how babies born in the pandemic would interact with the general with other people? So we’ve been in this for about a year and I would tell you, I could tell you from my own personal experience and professional experience, I have seen absolutely nothing different in kids,

like at all, in terms of babies and social anxiety or separation anxiety, or fear of me in the office, like zero, not at all. Separation anxiety tends to peak around 15 to 18 months for babies. So we often see kids at like walk into the office and you could see immediately, they’re scared. They’re looking around, they’re unsure. They might remember vaccines from the previous visit at 12 months.

There’s very much a fear factor that 15 month, 18 month Mark eight month sometimes have separation anxiety, but much, much less than they then toddlers do. And I would have thought that because these kids have less exposure to other people and I’m wearing a mask and you know, they’re just have less exposure that they’d be more fearful. And I found that not to be the case at all at all at all.

I find no difference at all. At the same number of kids are scared of me. The same number of kids are smiling at me. What I find really interesting is I’m wearing a mask and usually wearing my glasses. You don’t want to see much of my face. If I walk into a room and there’s a toddler there, I could say nothing.

Most toddlers and children will smile at me. And I don’t see anything except for my eyes kind of, but I’m wearing my glasses. I find that really fascinating. So there is something about kids and babies. They tend to be very social, even if they don’t have that same social cue that you would have with a smile. And, and yeah,

I don’t really find kids to be any worse off babies. I should say, developmentally or socially, et cetera. If your child and your baby has a person that loves them and it communicates with them and plays with them and reads and sings and does all these things with them, they’re going to be fine. Even if they don’t have a whole bunch of kids playing around them.

You know, I spoke about this earlier. Many kids around the world grew up with just the parents at home or just grandparents at home. You know, this daycare paradigm is not universal. And kids around the world don’t have different developmental capacity because they went to daycare or didn’t, or went to playgroups or didn’t, that’s very much a westernized world kind of construct and kids around the world to do fine,

you know, regardless of daycare or no daycare. So I don’t think most of us need to be worried about socializing our kids in that regard. And you can still socialize your kid without them playing with other kids. Right. I spoke before about going for a walk, you know, taking them outside. They can see other people and smile at other people and wave at other people,

but we’re coming and touching them. Right. We can be social. I’m being social with you guys right now. I’m socially office without the parents, we can be social and still keep our distance. Perfect. And elevate, sorry. There are two years apart. Exactly. Didn’t know how to say it. You’re right. No one says it that way.

Right? I think you’re commenting on the 2.5, 2.8 years of age. So that’s fine. Hi, Leah, Leah. I have three and a half year old. Who’s getting totally trained right now. This is the third try. And she got pee in the toilet, but seems to be afraid of a bowel movement, super common. We are trying different things with daycare.

I’m wondering if you have any suggestions of how to help her. Absolutely. Yeah. So this is a really, really common question that people have for me. Babies kids tend to be very scared of pooing. I don’t know why it is. It’s a really, really common thing. It’s been a master, but very, very frequently for me. If kids are 12 to train for PS,

if they’re not having accidents for poos, I will go without the diaper. Go though the pull-up. And if they pu at night, if they pu at nap time with a pull-up or a diaper on, that’s fine with me, like I’m really not bothered by that at three, but I would offer it. I would, you know, encourage it.

But without being scary about it, a lot of kids this age, you have three, four, or even two year olds will have a favorite place to pu. So a lot of these kids will go into the corner of a room and they’re like fever place and they’ll put on the pull-up or diaper, or they’re already wearing it. And they, and they have their bowel movement.

A lot of kids like to stand to have their bowel movement. So then when we say, okay, you’re going to sit in this room and you have to push it out. I don’t really know why, but it could be very, very scary thing. So if you have the kind of kid that likes to go into the corner of the room and pull and poos,

standing into the pull-up or diaper, what I do is I gradually moved them towards the normalcy of coming in the potty with a toilet. So I say, okay, here’s your flopper diaper, go in the corner, do your thing. Cool. Next step is here’s your pullover diaper go in the washroom anywhere you wanted to wash her. Okay. It could be the corner.

It could be the tub. It doesn’t matter who anywhere you want. You can do your standing thing. That’s cool. Okay. When they’re comfy with that, and you’re gonna say, here’s your pull up or diaper? You can poo sitting on the potty or the toilet. You can wear the pull-up or diaper though. Then when you feel comfortable with that,

that’s when you’re gonna get rid of the pull-up or diaper. So for them, it’s a control thing. They want control. They want to feel like they are able to do what they want when they want to, but you’re going to move towards the normalcy of who we get to the toilet or the potty, but they’re going to be less stressed about it because they have control over it.

And at the end of the day, they decide to have some success and feel like it isn’t as scary as they think it’s going to be. And I mentioned earlier, a lot of kids like to stand to Pooh. It’s totally foreign to us, but many, many toddlers like the standard poo. So you could certainly also try target practice if you will,

where kids can stand over the potty and try to get in the body. It was gross maybe, but it might give them some confidence or you could try the same thing, send over the potty or the toilet with the diaper on. And then when they feel comfortable with that, then you can encourage them to sit down. But it’s all about being calm and patient about it.

I never force it because forcefulness is very scary for kids and I can make them much more fearful. And then if they’re scared, they often hold it. When you hold your poo, it gets more dry and more hard because water gives more and more absorbed as the stool sits in the rectum. So you’d never want to force it. And you want them to go every single day and make it soft,

like peanut butter, like we talked about before. All right, Vincent. So my daughter is 2.9 years old. Is there a mild sedative? And then it stopped. Let’s see, let’s see. We come back to that. Okay. Heather says my 13 month old they’ll drink water from a three 60 competent sippy cup, but she averages six ounces of water a day.

I know the recommendation is eight ounces for one-year-old, but I don’t want to force it on her. She drinks plenty of she eats plenty of fruit applesauce, yogurt interrupt between her 53 to 50 months of milk milk for damage to me and Ms. Mills. So 350 mils of milk is fine. I’m totally cool with that. As we spoke about less than 16 ounces,

which is 16, sorry, 600 mils. I’m not bothered by six ounces versus eight ounces of water. I don’t know where that recommendation comes from. I don’t measure it for children. I let them drink as much as they’re interested in drinking and you know, children, like we have lots of food in our diets that have water in them, whether it’s fruit or veggie or Apple sauce over it,

et cetera, I’m not stressed by this number. I would let them drink as much as they want. And I agree don’t force it. That’s not gonna make anything any better for Hannah. Nice to see you. So my daughter is nine months old and has acid reflux since birth. She vomits every day. My pediatrician says it will fade away as time goes by,

but she didn’t recommend any medication or therapy. But as a mother, I can’t see my daughter vomits like a tin of milk coming up from her milk each day. Can you please suggest about this? So reflux. Okay. So there’s gastroesophageal reflux that and it’s GERD G E R. What that means is that milk or food goes into the entity, a soft milk mouth esophagus stomach,

and it comes back up, okay. That is totally normal in 99.9% of cases up until even a year, sometimes even longer. Oh, my kids spit up like crazy. All my kids. I would like hang out with them, burp them, feed them, whatever. And then when I went to work, I would change my sweater and my shirt before I left.

Cause I always had puke on them. Like as we’re all huge spitters and that’s gastroesophageal reflux, I mean, mail comes up. It isn’t dangerous. It is definitely an annoyance and a laundry problem. People say facetiously, but it doesn’t, it’s not a problem. And medicine doesn’t prevent milk from coming up at all. There’s no medicine. That’s gonna that.

If a kid takes it’ll prevent the milk from coming up. That’s not how it goes. GERD, gastroesophageal reflux disease is the same pathology kids drink or eat, goes to the stomach. It comes back up, but it hurts a lot. It burns, they argue back, they cry. They might refuse the bottle or a solid food or the breasts.

And they get really upset by it. This is when it’s really acidic and it’s burning them. So there’s a very big discrepancy there. If your child is just, you know, spitting up and or otherwise gaining weight well feeding, well happy developing. Well, all these things. There’s nothing to do. You keep them elevated, right? As much as you can,

the more they’re upright, the better. And it does get better over time because the stomach muscles get stronger and tighter. The sphincter, the muscle that goes between the esophagus and the stomach that sphincter will get tighter and stronger, therefore preventing milk and food from coming upwards. And when they’re more upright, gravity is going to keep the milk in the food in the stomach more.

So kids do a grow a G E R GERD disease. When they’re really arching uncomfortable crying sleep, don’t want to feed et cetera. That’s another issue. And then sometimes doctors will give medicines that make it less acidic. So like a proton pump inhibitor as an example. But that again, prevents it from hurting or burning. It doesn’t prevent it from coming up.

So definitely conversation with your doctor. It sounds like your pediatrician is reassured and it’s just waiting it out. That’s fine. But, but yes, can duo grow it. So as long as they’re gaining weight, developing, well, all the things, it’s just a waiting game. Okay. Vincent’s back. Is there a mild one that can give Tim to sleep faster?

Worms and kids? How do I treat it? Okay. So I think you said your child is almost three. Is there a Mount sedative? So we talked a little bit about melatonin and we also spoke about minimizing screen time and getting lots of activity. There’s no other medicine that I command and I don’t even recommend you give melatonin unless you speak to your physician and worms.

And if you’re referring to pinworms, pinworms are little worms that are very, very common in kids and adults. Actually, they cause itch in the rectum. They look like little larva, rarely do families or doctors see them actually because they live in the rectum and they come out at night. And so they cause a lot of itching, discomfort at bedtime or overnight.

And then they go back in. So I have seen firms in my career, but it’s not very common. And a lot of parents will tell me their kids are itchy, going crazy at night, but they don’t see anything. And so if you are worried, your child has pinworms. You need to see your healthcare provider because there’s a testing kit that we use that has like a sticky paddle.

And you touch the rectum at nighttime. When the worms, when the eggs will be coming out and we send it to the lab and we see under a microscope, if there’s worms there and yes, there’s medicine to give, but you need a diagnosis first. Okay. I’m going to skip a bit because I don’t want to just two questions. Are they getting,

I feel bad. I’m only at eight Oh eight of questioning and I’m mindful that we don’t have too much more time, but clearly I need to come back again to do this again. Let’s see. So grace is back. She says, how long should I give whole milk and switch at 2%, I used to say for sure, two years of age to switch to 2% or 1%,

et cetera. There’s good evidence though. Actually Canadian evidence that shows that you can switch later from homo milk. It doesn’t really matter to me at that point. As long as child children are gaining weight, well, not excessively, like they’re not too heavy for their height and they’re eating a variety of foods. So that part is up to you. But again,

it should definitely not be more than 16 ounces a day, a two-year-old should drink a four. How much should it milk should a two-year-old and a four-year-old drink. You want your child, at least having 12 ounces of milk a day or a calcium kind of alternative or something with calcium three servings a day. So some kids don’t like a lot of milk.

My kids do not like milk. They never really have. After they stopped breastfeeding, they didn’t really have interest in milk. So they have yogurt, they have cheese, they broccoli. I had chia and flax to their oatmeal. They have a variety of things that have calcium in them, but they drink very little milk. So it’s not really about how much they should have as long as they’re having several,

you know, a few servings of calcium containing foods per day. But again, the max would be in 16 ounces for me. And what vitamins to give two, two and a four-year-old vitamin D that’s basically it. If kids are eating a variety of things, I don’t recommend supplementing with a multivitamin. Most of these are marketing to be honest, most of all,

vitamins, we pee or poo out and we don’t absorb them because we don’t need more vitamin C in our diet. If we have a well, very diet, right? We don’t need extra calcium in our diet. If we have a well varied diet. So again, discuss with your clinician. If you find that your child is very, very limited or potentially deficient in something that’s a conversation to have,

but I do definitely recommend that kids get a source of vitamin D every day. If your child is drinking milk every day, most milk. If they drink 12 ounces a day has enough vitamin D added into it. But you do want to make sure if you look at the cartoon, but that is true for that particular product. Otherwise you want to give them up to 600 IU per day for kids more than a year and 400 IUs per day.

If kids are less than a year, that’s how much vitamin D. Perfect. So maybe another question about the diaper cream, how long should it be using the cream, even putting those creams on, you mentioned for two months, as long as you need, right? As long as if you’re having very frequent poos and you keep getting rashes, you keep using the cream.

There’s no harm in continuing to use It. Oh, I think, Sorry. That was the diaper cream that was eczema. As long as you need it. Same, same answer. Really. So as long as there’s ongoing, XMR dry skin, we want to keep using the treatment for it. So when we treat it, so this is actually a common question.

People think of the use, the hydrocortisone, or they use whatever prescriptions that are prescribed. The exam is going to go away, but it is not a cure. These medicines are band-aids. They settle the inflammation, they call me inflammation, but they do not cure the Exuma. That’s going to happen. That process, that inflammation is going to happen.

As long as it wants to, you know, babies have very sensitive skin, again, in the dry weather, the cold weather we’re heating our houses. I do predict that exam is going to be around the next three or four months and sometimes year round. But over time kids, their skin gets less sensitive, less likely to be inflamed. And it improves over time,

typically for children. So most kids are not, you know, older kids using hydrocortisone every day and they see a very significant, very severe excema. Most kids need it less and less over time, but it is not a cure. It’s not going to change what happens tomorrow. It’s just going to comment for today. Yeah. Do Cheryl ask any tips for transferring napping baby to care for BestNet if they fall asleep on you while breastfeeding form a thought,

I feel like this is such a good question to ask, like, Hey, Hara, she’s good doing one. I don’t remember a couple of days from now or next week or so another one of these Q and A’s, she’s another one of our experts within the parent playbook. So Rosalie is an amazing sleep consultant and has significant expertise in this. I would suggest asking her if you can,

just because she’s the expert, to be honest, there’s a lot to this, but at four months, like the short story is I want them to learn how to self-soothe and she would agree with this as well. So I don’t at this point, encourage you to feed whether it’s breastfeeding or bottle and transferring to the sleeping baby. Because most babies of this age,

they are much more aware of the world and they will wake up the way you fall asleep. After four months of age is how you want to wake up. Okay? So if you are breastfeeding or bottle feeding to sleep and you put a baby down and they wake up and the breast or bottle is not there, they’re like, I don’t know what to do with myself.

I need to wake up the way I fell asleep. So after four months of age, I would encourage you to start thinking about teaching independence independently, fostering independence leap, so that your baby learns how to sleep independently without needing to be transferred from an asleep state. So, yeah, so hopefully you can join with, with mostly Hara. And obviously this is a question that we get asked a lot.

McKayla asks, have you come on to ask, have you ever seen a talk, sing and toddlers? I don’t know what that means. My son will be two next month. And the past two months, he started twitching when falling asleep, but also waking up all night around one or 2:00 AM. And what Twitch after waking up, we continue on or off before hours and we’ll go back to sleep.

He’s happy developing. Well, he’s a very poor eater I’ve ever seen this in generally in toddlers, I would recommend strongly that you take a video at a fit if you can, and show your healthcare provider, because it could be something significant. It could be absolutely nothing but twitching for a few hours is unusual. And I would bring that up to your doctor,

especially if these very poor eater, you know, it could be something that blood work would be warranted to make sure there’s no deficiencies, but if you can catch it on video, that would be awesome for your healthcare provider. Can you talk with the vaccine? Rebecca asks, I’m assuming you mean the COVID vaccine, you know, the long and the short of it is the COVID vaccine has not been tested in children,

period. It hasn’t. And so we don’t know if it works. We don’t know the right dose to give. We don’t know if it causes side effects. We don’t know anything about the COVID vaccine kids. Cause it hasn’t been tested yet. There are some stages phase trials where the vaccine, the different versions, obviously there’s a few versions of the COVID vaccine are being tested in.

I think it’s 12 to 16 year olds right now, but it has not been as far as I know, tested in young people. So I don’t know anything about it. I don’t know if it’s safe. I don’t know if it’s effective. I don’t know what it does. Or if there’s any side effects, so more to come, you know,

we don’t, we can’t give a vaccine to people that we don’t know if it is safe and if it works. So I will continue to update you guys as much as we, as we know. And you know, if any of you guys don’t follow me on Instagram, I do, you know, regular, mostly daily updates on what’s coming up in the news COVID and otherwise.

And so I will continue to keep people updated about the vaccine as it rolls out as it’s studied. But I have nothing more to tell you, unfortunately, Rebecca, alright, Sarah, Sarah, I’m sorry if I’m not pronouncing your name properly, but he or she says hi, my son has infrequent stools once, once every six or seven days, but he’s drinking well happy.

And as six to eight diapers, he also strains frequently for gas. Like he’s passing the stool. So we spoke a little bit about constipation earlier. If you didn’t hear that part, you can, I will be sending this out afterwards to watch it back. But essentially kids and adults should poo at least once a day. This should be different. By the way,

I don’t know how old your child is, but in the first few months before kids are having solid food stooling once every week, even two weeks is normal, especially in breastfed babies. So if this is a baby, we’re talking about it’s normal, not to poo every day or even not to poo even once a week until they start solids. Once kids are on solid,

we want them putting at least once a day, mushy, easy to push out peanut butter, like any diaper. And if your child isn’t doing that, we have some suggestions I spoke about earlier about water and fiber. And of course your doctor, if you have All right, NSSR, we’re having issues with hearing you. Hmm. I’m not sure I haven’t seen any of the messages about that,

but hopefully you guys can hear me. Grace asks is the safety given almost four-year-old deodorant. If so, what kind of brands? So some kids just get more stinky than others, right? I mean your armpit or you’re growing like they’re wet areas and there’s friction and moisture. And some kids can get a bit more stinky. Of course, if you’re concerned about puberty,

that’s a totally different story. And you should discuss that with your clinician. But I certainly wouldn’t be giving deodorant per se, to a four year old. And if your child is having that much older at that age, it’s worth discussing with your doctor. But if your child is older, let’s say nine, 10, something like that. Pre-puberty but starting to get a bit more funky.

I really like what we call crystal salt. Deodorants. They’re basically like rock salt and it’s literally a stick of salt and you wet them and you, you put them in the armpit and what it does is it, it dries it out. And when it’s more dry, bacteria is less likely to grow. And that can be really helpful in preventing coder.

But it for it’s me to discuss with your doctor, for sure, because that’s pretty young. Thomas Says, hi, Thomas, are there any plans? Kids would get the vaccines or we talked about this. What? Restrictions? Eight Jack. No idea. I dunno. We’ll see it hasn’t been tested. So I don’t know. Okay. So Marina asks hi Marina that her eight month old started solids with three weeks ago.

And by the way, did not poop for nine days. Okay. I think we talked about this. I mean, you can, you can listen back. Obviously I’m reading questions now from age 24 and his son was nine. So I hope we got to this, but you mentioned he’s having prunes and apricots peas. Those are all great banana. The trick with banana,

he hasn’t been in is very Brown. It’s going to be helpful for constipation and it’s more soluble fiber. If it’s very yellow or green, it’s going to be not helpful potentially constipating so the more you can get to a Brown phase will be helpful for constipation and again, water, et cetera. We spoke About. Okay, My boss answer maybe five more questions.

We’ll do that. Oh, Janine. Thank you. Gina says Dr. Jay, thank you so much for doing this today. You’re very quiet. It’s very much appreciated. Thank you, Jenny. And I appreciate that. Yeah. Hi says I’m not sure if the question’s already been discussed kids now on online school. How do we evaluate the screen?

Time is over five hours per day. Any solutions? So awesome question. This is a hard one. So I, if you guys know me, I’m very much a minimalist with screen time for my children. I think screen time can be very detrimental. There’s lots of, lots of studies of screen. Time’s not ideal, but alas, my kids are in virtual learning.

So you know what I’m trying to do with my kids it’s to mindful that they shouldn’t necessarily be on the screen the whole time. So if they get something to work on, I encourage them to close the screen and I’m all about the paperwork if we can. So I’m encouraged to think like I’m, and it’s not great for the environment, but we’re printing things and I’ve gotten them.

I purchased a lot of workbooks and things like that, because I think that writing is very valuable. It’s helpful for your eyes. It gets you off of the screen. So as much as we can, they’re doing a paper kind of work and not doing as much screen time. And we do basically no other screen time outside of virtual learning. So my kids have historically always gotten one movie a week before,

then watch one movie together. They have to agree on what the movie is. If you should like a Disney movie, for example, my three-year-old has no interest, which I love. And my other kids watch a movie a week. So it’s like basically 90 minutes a week. And that’s what they got like the whole week before. COVID my ten-year-old included.

And now they get a few hours a day because my ten-year-old is 10 and he’s getting a lot of screen time. So I’m mindful not to have extra screen time. They otherwise were. They aren’t gonna be spending a time on the screen. And basically for every hour that they’re watching screens, I want them to be active for an hour. And I know there’s limitations to that.

Right. But basically once they’re done school, my kids all have quiet time. I’m a big fan of quiet time. If you know my style. And then they have dinner at five, five 30, and then we run, but they just like run for the next two hours and they run for an hour at lunchtime and they’re just really moving their body.

So I dunno, it’s the confines of virtual learning. It sucks. I’m not a big fan of it, but it is what it is. And we’re rolling with the punches, but I minimize it otherwise. So if your child’s getting like four hours of screen for learning, and then also getting two hours of like social screen time, like they’re watching their favorite shows,

like that’s a lot. And so I would minimize that for sure. Nikki ask what’s the most appropriate way to clean fruits and vegetables? I don’t know. I mean, early on, you can see that I showed a video on YouTube about how to clean fruits and veggies and how to wipe down groceries and stuff. I shared that on YouTube, you can take a look.

I still do that. Quite honestly, we still watch our fruits and edge. We rinse them well and they soak in water as well. We still mostly buy fruits and veggies that we can kind of wash the outside packaging. So we, we don’t buy beans or mushrooms, for example, that are kind of free. And the bins we used to,

we don’t anymore. I buy beans that are in packages and it’s again, a huge amount of waste. And I hate what it’s doing to the environment, but I feel more comfortable with that. Less people have touched it, et cetera, less risk of contamination. And then I wipe the, I put it in the fridge and we usually eat it,

you know, two or three days later, if we can, we’re doing a lot of fruits and vets that we peel, you know, less things that we can’t peel, which is a change from before. Like I’m more inclined to buy an orange now than an Apple, for example, because I can wash the orange peel and appeal it and feel more comfortable that it hasn’t been contaminated,

but there really isn’t evidence that I’m aware of that COVID is really spread on food. It just in my head that just like, I don’t want to shake someone’s hand. I don’t want to touch something or eat something that someone else has touched. Like I know that the people in the grocery store that are shopping in the grocery store are touching things. I just know that because that’s human nature.

So that gives me like an internal factor, but we don’t really know if it’s even necessary, but we do wipe down things like, you know, cartons of milk and we wiped down bags of things. We just do. I don’t know if it’s necessary, but it makes me feel better. So I do it. All right. Let’s do two more questions.

And then we’ll wrap this up. I know you guys have so many questions. I’m sorry for that. Oh, actually says I’m negative. I tested positive for COVID. Oh, so by the way, actually the thing about blood typing isn’t that people that are Oh, or a get, or don’t get COVID more, I think the study was around severity of COVID that people that were a versus,

Oh, we’re more likely to be very sick or get more significant COVID or have die from COVID. I think that’s where the study showed. But again, I don’t think it’s really been repeated. So absolutely people with O a B a B can get COVID no doubt. There’s nothing protective about that. But I think the, again, one study showed that people with a can get more sick with COVID than,

Oh, so I mean, there’s tons and tons of questions, you know, just to mention, this is sort of what we do in the parent playbook, our membership, which is you can ask any questions and we answer those questions and there’s obviously tons of content from our experts on one of 12 experts within the group. But I’m so glad you guys brought your questions here today.

And you know, certainly, I mean, the membership’s close. It’s not even open right now, but if you’re interested to learn more about it, you can go to a website and take a peek, get as close as you can join now, but this is kind of what we do. And I’m very happy that you guys have brought your questions that we’re able to,

to help you along with that. And I think if you saw the initial email or you guys heard because you saw my Instagram, et cetera, I think there was like another 10 of these free webinars and Q and A’s in the next month or so. So all sorts of people talking from mostly the sleep expert to a physiotherapist, to a dietician, to people,

helping with behavior and other emotional concerns. So all these things, like if you have other questions, I’m sure some of these fall in those realms, you can certainly head to those free webinars, Q and A’s as well, and, and ask your questions there as well. But I’ll try to do this every few weeks or so. Cause I know that there’s just so much challenge and stress and anxiety now with the pandemic and hallways.

And I know a lot of people don’t have access to their clinicians right now. So I’m happy to help if that’s helped you guys. And by the way, even if you’re not a kid croup patient, if you live in Ontario, you can access our virtually as well. So you can have to upside upside too and check that out. But you know,

if you live in Ontario and your child is zero to 18 years and you don’t have access to your pediatrician or family doctor at the moment, or you have a question after hour, things like that, our pediatricians are doing virtual for anybody. It doesn’t have to be a kid crew patient. So I know, I know a lot of times we have questions and we feel,

we can’t see our doctor. We don’t want to bug her a doctor. Like that’s what we’re here. We’re there for you. So if you, if you need that, we are here for you. Okay. I’m going to ask you to answer two more questions and totally random. It’s going to randomly flip do Oh, thank you for this. Thank you,

Thomas. Thank you. He said hi, Dr. Kulak. Hi buddy. How you doing to, to do so, Pamela, that’s our 10 month old baby. We’ve had to resort to phone FaceTime since our family’s abroad. And I’ve been at this that is as bad for a son. So interestingly, the Canadian pediatric society and the American Academy of pediatrics,

their guidelines take out restrictions for screen time for young people, for virtual communication, with loved ones, et cetera. So it is okay for your young people to have access to, you know, FaceTime or zoom or whatnot, to chat with family. I wouldn’t be doing hours a day and a 10 months. They don’t really do anything, but absolutely it’s totally okay if your family abroad or even your family down the street that you may not see because of COVID to interact with your child and for your child to interact with them on some,

you know, virtual platform. I just wouldn’t do it for long. I would do like 10 minutes at a time and then turn it away. And if they become really obsessed with it and they were like, really you’re pulling out your phone all the time, which toddlers can do, then it would be minimizing that, but it is okay. It’s safe.

It’s fine. For brief periods of time. Heidi says, thank you so much for your time. The best pediatrician, goodnight. Oh, thank you. That’s really sweet of you. I appreciate that. And Joanna says the same old parent playbook is great. Thank you, Joanna. Grace’s thank you again. Thank you guys. Very, very much.

Okay. So Laura said I got skipped twice. I’m skipping. I’m just random. And looking by the way, there’s been like more than a hundred messages in an hour. So I’m sorry if I didn’t, I’ve been avoiding anyone just so you guys know there’s just so many questions. I can’t get to all of them. Okay. So Laura I’ll do and I’ll do one more after.

So Laura says hi, Dr. Gina. I’m a mom of a 12 week old baby girl. Congrats was a vinegar smelling poops for the last few days. She only puts up every other day and seems to crunch a lot with that. A passing gas I’ve been eating anything out of the ordinary, which I’ve been reading might be the cause. Food sensitivity.

Not really. I don’t really buy that. I don’t drink cow’s milk. And I’m a vegetarian, should I be concerned about these already fighting? She S she has no symptoms. There’s this like myth that baby poops don’t smell, especially if they are breastfed babies that breastfed baby poops should smell sweet or smell like nothing. Like this is nonsense. Baby poop,

smells, and a breastfed baby poop. Very commonly smells like vinegar or smells like sulfur. So again, if your baby’s doing well, your doctor’s happy. Baby’s growing well, developing while, et cetera. It doesn’t matter to me to all look at food smells like, and I don’t expect it to smell good. That’s not, that’s not something that I need or expect I’m I’m totally okay.

If it smells like vinegar, as long as your child’s otherwise doing okay, I’m gonna says, henna says, I think you only read part of my comment, but my question was to reduce the obsession with chocolate and treats in our house. This artist, you have any big question for one of the behavioral people like Holly is going to be doing one,

and Alexandra’s going to be doing one. If you go back to the list of behavioral stuff for me, I don’t like to say to families, they should not give treats or, you know, sugary foods or these kinds of foods. I’m all about moderation personally. But if you’re talking about like obsession, the kids are obsessed with it. That’s when I would like curb it like completely.

And I would add it back in and like kind of an age appropriate time-sensitive way. You know, if kids are refusing to eat meals, cause they only want to have treats or snacks or, or these kinds of foods, then I would like, no, go. Right? So in my family, what we do is we have a meal and then my kids have a fruit of their choice.

And then B have some kind of snack or treat or whatnot. They might have a cookie, they might have a granola bar, or they might have whatever, you know, whatever it is of the moment. It might be whatever rice pudding doesn’t matter when it happens away. A piece of Halloween candy that we still have from Halloween that we didn’t even go out to.

So my, my family, they could pick a fruit and it doesn’t matter to me what fruit, as long as it is a fruit after the meal, after the well, and then they can get a treat. So that’s how it goes in our family. If my kids are begging and begging and begging for treats personally, I pulled back from treats because I don’t want them to be obsessed,

but I also don’t want to limit it so much that they become obsessed with that. Right. So I don’t want to be so restrictive that they become like so focused on that. So it’s a bit of a balance that I think it’s a longer conversation than we can do at the moment. I really do think that Holly or Alexandra would be awesome for this upcoming Q and A’s as well.

Cause this is really like a big piece of their bread and butter, I guess, pun intended. But in general, you don’t want to make obsession from be so restricted, but if they needed crave at one and going crazy about it, I would pull back on it because that makes me nervous. And that’s sort of how I would do a screen time to like kids that are begging and begging and having temper tantrums for screen time.

Like for me, I’m backing off of screen time. We’re going to earn that back with positive behavior. So if kids get to run crazy for treats, I would back off and I would earn it back for positive, healthy eating behavior. So it doesn’t become this huge focus in our lives. And that’ll be true of adults too, really, right?

Like if we spent all day every day thinking about, you know, delicious, you know, food, if that’s nutritious food, amazing. If it’s really, you know, food that we shouldn’t be eating all day every day, that’s pathologic in some ways, right? So you want to be mindful of that for sure. Ashley says, and you miss,

you’re doing this in your welcome pack as much McKayla Pamela to thank you by so, so much. I feel badly. There’s so many questions left, but like it’s, it’s, it’s just it’s time. You know, some of you guys have already taken off where you’re probably going to hang out and do your thing or put your kids to bed or whatnot.

But thank you very much for joining me. I am so happy to help and I’m happy to answer questions in a upcoming Q and a again, there’s a few Q and A’s coming up. I will try to commit to doing this every three to four weeks, if I can manage with my own schedule, because I know a lot of you guys are stressed and having difficulty accessing your doctors again,

I’m offering, you know, kick crew virtual. Do you guys, if you live in Ontario and you don’t have access to your doctor, you can call, you can talk to me or one of my other pediatricians, there’s lots of us around. And if you want to learn more about the parent playbook, it’s a membership site. Again, it’s not open at the moment,

but we, you can get on our wait list and we can send you updates. But when we open again and for this month, you’ve access to our experts in their Q and A’s bring your questions. You know, we’re happy to answer any when they topic. And I will check you guys out again. And any questions, concerns, let me know.

And I’ll see you guys soon. Have an awesome night, have an awesome week. Be well, stay healthy. Bye everyone.