Tuesday, March 12, 2024

hello from the rocking chair at 1:20 Am

 Hello from the rocking chair in a dark quiet room, at 1:20am.

I am holding sweet baby Coby. Trying to give Lauren a little stretch of sleep. I am channeling my mom, who did the same for me, way back when.

There is no place I would rather be.

For any of my connections on Facebook, this was the post that I wrote last week when my new grandson was just a couple of days old.

For the first several nights after the baby came home from the hospital, Adam went to sleep with 3 year old Elliot and I stayed with Lauren. This way I was able to do the burping and help the baby settle in between feeds.

Things were a blur, but at one point in the middle of the night Lauren and I were giggling and for some absurd reason we were trying to see if we remembered the words to the Brady Bunch theme song…..we did. Yes, we sang it together all the way through.

That is absolutely what I will remember, not the tiredness.

Trying to figure out the best way to offer support to new parents differs for everyone.

I realize that our family’s close relationship makes us among the lucky ones.

Sandy and I  are still down here in LA for another few days, soaking up the time with the kids before heading back up to SF. Alana also joined us for several days and when we are gone, Aunt Barbara and Uncle Richard will be down. After they leave, my sister Amy will be here for another couple of weeks. Adam also has an enormous and supportive family here in LA. It takes a village.

Because I often look for ideas of things to write about, here are some glimmers that have been flitting through my mind during the wee hours of the night when I am up with the baby.

I think it is just a fact that the first several weeks with a new baby are challenging. EVEN with help. Even with a relatively smooth postpartum recovery. Even with a relatively chill baby. Show me a parent who thinks it is easy and let’s do a science experiment on them because they are such a rarity!

What does real help actually look like?

Spoiler alert, it isn’t pointing out piles of laundry or crumbs on the floor.

Most new parents are too exhausted to be able to effectively delegate or communicate the best way for the support system to help. 

Entertaining the older child or holding the baby so that the parents can have special time with their big kids or simply get some rest is the obvious thing. 

Is there a pet? Give them extra attention as well.

Beyond that, frankly, many people don’t even know what they even need. Plus, what feels like it is the most useful one day may not be exactly what will be at the top of the list the next. And if you are like Lauren and Adam, you don’t like to ask for help, so delegating, even when it would be incredibly valuable, can feel uncomfortable.

Maybe it is just the extra set of hands putting together the bassinet

Trying hard to actively figure out what actual help looks like can be a game changer.

One of Lauren’s friends also had a baby fairly recently. When the visiting grandmother asked what she could do, the new mom told her that washing the bottles and parts would be amazing. Grandma was happy to do it, but the next day, when there were more bottles to be washed, grandma made no move to automatically take care of them and the new mom felt uncomfortable asking. I have no doubt that she would have been happy to keep being the bottle washer, but without effective communication, that didn’t happen.

Recognize that there are some tasks that are fairly constant and try to list them.

Ideally consider doing this before the baby arrives, but it is never too late.

For folks that are not breastfeeding, washing those bottles often tops the list. 

Consider this a menu of ways that people can be useful.

Present it as an option, not a demand.

Here are some things that would be enormously helpful. If there is anything on this list that you would be willing to take on while you are here, we would be so appreciative

Aside from bottles, dishes, laundry, emptying garbage and other household tasks need to be tended to routinely, not just as a one time thing.

If you have gadgets or methods that your ‘assistants’ might not be familiar with, put step by step instructions in writing. Don’t take anything for granted

Try to find your rhythm.

I have gotten into the habit of being down in the kitchen to help Elliot with his breakfast before he heads off to school.

It feels a bit like groundhog day. Now I know that he wants to cut his own cantaloupe, but it is okay if grandma pre-slices the strawberries. With any 3 year old there is a learning curve, and woe unto you if you get it wrong. Now, we have some nice little breakfast rituals going every morning.

We have also figured out that Lauren’s best shot at being able to fall back to sleep for a small stretch is in the morning as soon as EJ is out the door and the house is suddenly quiet. So that is when I try to make sure to have the baby (so delicious) while mama takes a morning nap.

Most people also don’t have a Papa like Sandy who has been on auto-pilot, cleaning the HEPA filters, doing laundry, running errands, and even oiling the squeaky doors of the new house with WD40. He also has taken part in some nightshifts with me and it was his idea to have baby Coby sleep with us a few nights, with me delivering Coby to Lauren for feeding and then bringing him back to our room to sleep. Nights involve lots of singing oldies. It is never too early to get introduced to the Beatles although we found that the length of Bob Dylan songs is most conducive for Coby to fall asleep!

Even if you aren’t up for a full night, remember that even a two hour stretch of being off duty can feel like gold to new parents. Have them conk out at 8pm and you can hold the baby while you watch some mindless tv for several hours until it is time for the next feeding.

Grandparents, savor this time! Especially if you don’t live close by.

New parents, talk about what might be the most helpful for you and if you are lucky enough to have help, share your list. Don’t expect people to be mind readers.

Just in case these aren’t on your radar

Products that Lauren has found helpful:

  • Large water bottle for the nursing mom (or water bottles stationed around the house)

  • MYLICON ( I should buy stock in the company)

  • Alcohol free hand sanitizers all over the place to make it easy for the toddler to ensure that everyone who touches the baby cleans their hands first

  • Baby wrap of your choice, but wearing them can be a game changer. Adam likes the nesting days wrap for dads. That is his ‘go-to’ gift for new daddies.

Instagram accounts that she likes

  • Milestones.and.motherhood (pediatric PT)

  • Karrie_locher (RN, BSN CLC)

  • Resilient Rascals (Pediatrician) 

Friday, March 1, 2024

Introducing a new sibling/One plus One may no longer feel like it equals two

 The timing of this post is no coincidence. I am delighted to share that Elliot became a big brother on February 25th……..

You will no doubt be seeing Coby as my newest model for my blog posts.

The first baby….there is nothing quite like it. That little person enters your world and things are never going to be the same.

General handling

With the first one, they seem so fragile and small. Parents learn how to handle them, oh so carefully, making sure to support the head. Allowing a young child to hold them? No way.

With second babies, you might a bit nervous as the oldest clamors  to handle their new family member, but if you are lucky you have someone gentle like Elliot

Third kid? They get scooped up without so much thought.  You get more and more relaxed with each child.

Mama Tamar adds:

As they grow, the distance they travel when they are playfully thrown up in the air is double what it was for their older sibling at that age, as is the breadth they're given at the playground. They climb blissfully on the play structure and are encouraged to jump off things.

Therapist Brittany adds, 

First time parents might explicitly  request no touching/holding of the baby. Second-time parents usually reverse that by explicitly asking someone to help with the toddler or secretly wish someone would ask to hold the baby so they could spend time with their first born. 

Parents with three or more kids are grateful for any help holding the baby or entertaining the older kids. Having any time off is often a rare gift.

Cleanliness

First baby? The world is kept as sterile as possible. Everyone who handles the infant is asked to wash hands thoroughly with warm soap and water.

If a pacifier falls, it needs to be boiled before getting put back in the mouth.

Anyone with any type of congestion is asked to steer clear. 

Second kid? If you are in a hurry, quick pump and swish your hands with some hand sanitizer. The dropped pacifier? That gets wiped on your sleeve (with third baby, perhaps the dog gets to lick it).

Keeping them away from colds and coughs? Good luck with that. If there is a big sibling in daycare or preschool, you have come to the conclusion that the runny nose is a constant. You also realize that there is no way to stop the older brothers and sisters from planting wet kisses all over the baby.

Sleep and schedule

First baby? Schedules are established. Life revolved around nap times.

Second baby?  Naptime? Yeah, right….

Hopefully they can snooze in the car seat or the stroller. There are school drop offs and pickups that you need to deal with. There are playdates, activities and places to go.

Nutrition

With first kids it can be a bit nerve wracking to start solids. Some parents have charts and flowsheets. One food is carefully initiated at a time to make sure there are no allergies and reactions.

Tamar knows folks who fed their kids the first taste of peanut butter while sitting in the parking lot of a hospital just to be on the safe side,

This is more common than you might think but usually it is the first child.

My friend Dee-Dee says her first child didn’t get a grain of sugar during his first year. By the time she had her third, she was buying one pound bags of M&Ms in the supermarket just to keep them quiet.

Attention

The first child knows what it feels like to get undivided attention. 

There is usually a tough transition as they learn to deal with the new reality when they are no longer the only child. 

Ultimately they realize that no one makes the baby smile and laugh quite like they can.

The second (third, fourth,…etc) don’t know enough to miss what they never had. Instead they have the magic of an older sibling.

Tamar says:

My partner’s  mom was so busy as a single parent of two (in the age before cell phone cameras) that there is zero video footage of him as a child.

My mom carefully constructed a book of baby photos for her oldest, but by the time I came around there wasn't time. I made my own baby book. You can imagine the third and fourth - happy memories will just have to suffice. "It was all a blur," she says anytime I ask her anything about my childhood or how she raised us. "A happy blur."

Easing the transition

Some big brothers and sisters are actually eagerly expecting the baby's arrival. Others are too young to really understand what is going on. Regardless, there is a big adjustment to be made. Many parents report that the older siblings are quite sweet to the baby, but act out horribly to the parents. Once in a while, but less often they will also act out towards the baby. One of the nurses who used to work with me remembers the time that her oldest daughter dropped a medicine ball on her new sister. Others have no malice but don't have a sense of how to be gentle.

For some kids, a little ‘big brother or sister gift’ from the baby is often very much appreciated.

Baby Coby got Elliot a little stuffed Minnie Mouse that he had been wanting.

Elliot did ask

How did he manage to get this?”

but didn’t spend too much time wondering about it, and thanked his brother.

Lauren’s friend Arielle took it a step further. She got the idea from her friend Adia.

Makai became a party planner and planned an entire welcome home/zero birthday party for his sister Lila.

He baked a cake, decorated a sign and had a balloon and a special stuffed animal  waiting for her.

Validate that all emotions are valid. There are just some responses that are more appropriate than others

Here is my Blog post about managing emotions

Name some of the issues:

It is hard and loud when the baby cries

It doesn’t feel good to have to wait for something while I am tending to the baby

It doesn’t seem fair that the baby gets to sleep in mommy's room.

If you can manage, make sure the big sib gets one on one time with each parent. If the baby is in the room, some kids will think that it doesn’t count.

Be creative. Maybe when you are in the kitchen making a meal only the big one can join you in there to be your sous chef. Or if time and space is really at a premium, invite them into the bathroom with you as if it is a privilege.

Let them be helpers. Find some tasks that they can assist with. This can mean getting out the diaper and wipes for a change, or entertaining the baby.

“Look how the baby lets me change him when you are keeping him interested, without your help I would probably get poop everywhere!”

I like to make the big siblings the deputies of the Hand Washing Patrol. Have hand sanitizer such as Purell around. 

Call it magic soap. Tell your ‘deputy’ that they are in charge of making sure that anyone who is going to touch the baby cleans their hands first. This may help make sure that they don't feel like they are constantly being nagged at.

Note about hand sanitizers..If your toddler is prone to putting things in their mouth, you can also get the hand sanitizer that is alcohol free just to be on the safe side.

Be aware that regression behavior is pretty common. 

Suddenly the older kid is interested in drinking from a bottle, talking in baby talk or asking for a pull up

Author Julie King, suggests that you allow your older one to ‘play baby’

Here let’s pretend for a little while. Let me swaddle you, here is a pretend bottle. Now let’s snuggle.

After a bit, they are likely to be done with that game. At that point you can point out that big kids like them are so lucky that they know how to walk, eat real food and use their words. 

Therapist Brittany Williams adds that allowing the older sibling to care for their own stuffed animal/baby doll can help redirect their focus. Rather than feel as if they are missing out, they feel like they have something to tend to, just like their favorite adults. 

Maintaining  as much of your firstborns daily & weekly routine before baby will help them traverse the change with more emotional margin.  

Regardless of how much prep you have done, at some point the majority of new big siblings are likely to suggest that it is time for that baby to be put back in mom’s tummy. This does not mean that you have failed either one of your children. 

 Other considerations

Every kid is different and it takes some longer than others to get used to this new world.

It is also an adjustment for parents! You have been used to having a big, sturdy kid who can tell you what they need. It is suddenly shocking to revert to having a baby who feels so small and can’t really communicate. And that poop!? Is it normal for it to be so squirty? We forget!

One more important thing to keep in mind is that all of your kids will reach their milestones on their own timeline. It doesn't pay to compare them to each other or to the other kids in the play group.

The list of very valid reasons that many families stop at one child is a long one. There are millions of folks who are only children who never missed having a sibling. 

But for those of you who are going through the joys and the challenges of expanding you families, here are some final thoughts…. 

Siblings can be a blessing

My mom was an only child. I can remember her telling me that she never missed having siblings until she was an adult.

In most situations, even if it feels like there is a rough patch at the beginning, remind yourself that giving your kids a sibling is a gift.

Thanks so much to Tamar for introducing me to the following poem. The author is unknown.

Loving Two

As I walk along holding your 2-year-old hand, basking in the glow of our magical relationship. Suddenly I feel a kick from within, as if to remind me that our time alone is limited. And I wonder: How could I ever love another child as I love you?

Then she is born, and I watch you. I watch the pain you feel at having to share me as you've never shared me before. I hear you telling me in your own way, "Please love only me" And I hear myself telling you in mine,"I can't," knowing, in fact, that I never can again.

You cry. I cry with you. I almost see our new baby as an intruder on the precious relationship we once shared. A relationship we can never quite have again.

But then, barely noticing, I find myself attached to that new being, and feeling almost guilty. I'm afraid to let you see me enjoying her -- as though I am betraying you.

But then I notice your resentment change, first to curiosity, then to protectiveness, finally to genuine affection.

More days pass, and we are settling into a new routine. The memory of days with just the two of us is fading fast. But something else is replacing those wonderful times we shared, just we two.

There are new times -- only now, we are three. I watch the love between you grow, the way you look at each other, touch each other. I watch how she adores you -- as I have for so long. I see how excited you are by each of her new accomplishments.

And I begin to realize that I haven't taken something from you, I've given something to you. I notice that I am no longer afraid to share my love openly with both of you. I find that my love for each of you is as different as you are, but equally strong

And my question is finally answered, to my amazement. Yes, I can love another child as much as I love you -- only differently.

And although I realize that you may have to share my time, I now know you'll never share my love. There's enough of that for both of you -- you each have your own supply.

I love you -- both. And I thank you both for blessing my life.

Thanks to the valuable contributors to this post. It takes a village

Tamar S is an educator and mother of 2. She was one of the inspirations for this post when she sent me a photo of her second child being held by his feet, upside down.

Julie King is the co-author of two best-selling books: How To Talk So LITTLE Kids Will Listen and How To Talk When Kids Won't Listen, and the app HOW TO TALK: Parenting Tips in Your Pocket. Julie leads online, interactive workshops based on her books, as well as workshops about how to handle the fighting and arguing, and help kids get along. She also consults privately online with parents of kids from tots to teens, and speaks publicly to parent groups and school and business communities. To learn more, visit her website, julieking.org.

Brittany Williams is a wonderful therapist who I was lucky enough to work with during my time at the Oathcare start-up

Dee-Dee S, Tamar’s mom as well as one of my best friends whose wisdom as a mother and grandmother is a gift

Last and certainly not least

My daughter Lauren: She is an extraordinary mommy. She has done it all right so far. Watching EJ welcome home his new brother has been nothing short of amazing

Do you have ideas to share that haven’t been mentioned? I would love to hear about them in the comments

Friday, February 23, 2024

Election 2024/Get your kids involved and make sure to vote!

 VOTE!!

This post is geared for families with kids who are no longer infants.

It is that time of year. Our mailboxes are filled with flyers telling us to vote yes on this and no on that. The phone is ringing and if it isn't the IRS, it is possibly the recorded voice of a celebrity telling you why to support a specific candidate. Television and radio spots are election related. Many give a collective sigh of relief when election day comes and goes. 

And this is just the primaries. I don’t foresee a real break until after the November elections. Sigh.

But take a moment and remember what it’s all about.

I just voted this week. I usually like to go to the polls but I will be away on the actual election day, so this time I used an absentee ballot.

It was drilled into me at an early age that voting matters. I have early memories of going with my parents to their polling place. Knowing something about the issues and people running for office is our responsibility as much as it is a privilege. Of course growing up in Pennsylvania was quite a bit different than the robust California ballots that we are faced with here. Having to figure out how to vote on all of the propositions can be overwhelming.

Over the years I have voted on some strange ones; this is San Francisco after all. I used to bring our fat voting pamphlets home to my mom just for her entertainment.

A few of the odder ballot measures from the past that come to mind were:

Could a SF police officer use his ventriloquist puppet dummy while he was on the job?

Should the waste treatment center be renamed after George W Bush?

There have been years when there are more than 30 proposals to dig through.

Let your kids see the process. Invite friends over to talk about the issues. It is a great way for them to see that many of the ballot measures are multifaceted and often not black or white. How do you weigh all of the arguments? How do you sift through all of the information to find the points that sway you the most? Ask your kids how would they vote if they were eligible? Why? There are so many talking points and lessons to be learned.

This included perhaps one of the most tricky issues:

How do you deal with friends and family who have different opinions? 

If you vote by absentee ballot, have your kids help you fill them in and put them in the mail. If you go to the polls, take your kids with you. And wear your "I Voted" sticker proudly.

The photo of Sandy, Alana and me rocking our stickers is from a past election.

Friday, February 16, 2024

Introducing allergens to your child/ for some it should be done earlier than you might think

 Starting solids can feel overwhelming. 

When you sort through all the overwhelming amount of information out there, there really aren’t a lot of hard and fast rules, but here are a couple.

1. Babies younger than one year should never have any raw honey

2. Have some common sense choking precautions. This means: no whole nuts, round hard things, etc

Really that’s it, so relax!

But is anything really that simple? 

There are actually a few considerations.

Some kids are eagerly watching every bite you take. They are willing you to share whatever you are munching on.

Others aren’t at all interested. They are not impressed by your acting skills as you make loud YUM noises over a spoonful of mushy peas.

Some families have lots of free time, love to cook  and want to make their own food, others are perfectly content to open some jars.

Some kids have lots of poop issues that start after the solids begin.

Some have a history of family allergies or severe eczema and understandably want to proceed carefully around allergens.

As you can see, no situation is exactly the same.

Some parents create lists, charts and flowsheets (you know who you are). This is especially common with first kids. Most of the time as siblings come along, the second (and subsequent)  babies simply get fed whatever else the family is eating, without paying too much attention.  Assuming that allergies aren’t a significant issue, those kids turn out just fine.

But there is a lot of buzz about introducing allergens that is worth paying attention to.

Peanuts are the food that are often the most associated with severe allergic reactions. Because of this, folks were quite cautious and often kept kids away from their first exposure until they were at least two or three-years-old.

It turns out that this caution was possibly exacerbating the problem. As more and more kids were identified as being allergic, in the mid 2000s, some scientists noted that kids in Israel were not following the same trajectory. What was fascinating was that these same kids were genetically very similar to Jewish populations scattered throughout the world. So why did kids in Israel have much lower rates of peanut allergies than their Western counterparts?

It is as simple as Bamba. It turns out that young kids in Israel were routinely exposed to a popular peanut based puff. This routine and early exposure seems to prevent many of the kids from ultimately becoming reactive to the nuts.

After examining this trend, new guidelines were established. Now, as opposed to delaying that initial introduction, it is suggested that the ideal age to introduce some of these tricky foods is between 4-6 months.

4 or 6 months? A note on the age for starting solids:

Understandably, there are a lot of opinions about the age for starting solids. Solid Starts, the very popular baby-led-weaning app, doesn’t recommend starting any true solids until 6 months. If you think about what makes sense evolutionarily, there’s probably some gray here. Cave people didn’t track their infants’ exact age, they just saw that they were watching the food they brought to their mouths attentively and reaching for it. It’s likely that at that point, they were given a bone to chew on or some other foods. When your child is sitting supported in your lap, watching you eat, and reaching for the food you bring to your mouth, as long as they are at least four months old, Dr. Ted and I think that they’re effectively ready to play with solids. ‘Play’ is the operative word here. This is about exploring. It is not about meeting their nutritional needs. Breastmilk and/or formula are all they need until 6 months.

Not everyone needs to pay such careful attention to the introduction of allergens.

Kids who have lovely buttery soft skin are unlikely to have any issues with foods.

But if your little one is one of the many who have dry patchy skin, any signs of asthma or family history of food allergies, it is really important to introduce things early in the effort to avoid allergies later.

Any time you are exposing your baby to ANY new food, I strongly suggest that you do it in the morning when you are in the position to keep a close eye on them for the next hour or so. Have them dressed in clothes that are easy to lift us so you can see if there are any rashes developing.

Recognizing Allergic Symptoms

What are allergic symptoms that are cause for alarm and need immediate attention?

These symptoms may begin within minutes to an hour after ingesting the food.

  • Hives (these are not little red dots, but typically full body welts and large areas of red raised skin that will often have a white center and tend to move around the body)

  • Breathing difficulties like excessive coughing or wheezing

  • Vomiting

  • Swelling of the lips or face

  • Sudden fussiness

  • Sudden dramatic sleepiness

What are symptoms that are NOT cause for alarm?

These are common reactions and the ones we get asked about the most. They are more often benign food sensitivities. 

  • Rashy red cheeks that show up after eating and linger (they might show up quickly, but can last for hours and even days).

  • Diaper rashes that are either red dots or large red rings.

  • Mild changes in poop consistency or color in kids that are otherwise happy.

There are a million opinions about what to do with these benign reactions to food. Dr. Ted usually says to just power through, unless the face is so rashy that it’s breaking skin, then consider using a bunch of Vaseline. Nurse Judy will advise people to cut back a little on the extra berries that are so often the culprit. 

For the First Introduction of Peanuts

Before you start: if you have a known severe (anaphylactic) reaction to peanuts in the family, do not try peanuts on your own at home. Ask your pediatrician for testing first, or a referral to an allergist.

It is important to know that before having a food allergy reaction, a sensitive child must have been exposed to the food at least once before, or could also be sensitized through breast milk. It is the second time your child eats the food that the allergic symptoms happen.

  • Prepare some peanut butter by thinning it out: You can mix it  with a few drops of warm water or breast milk. Make sure it’s natural, free of honey, and with no extra salt or sugar. There is also peanut powder as an option (more on this below).

  • Rub a small amount of the thinned peanut butter on the inside of the infant's lip (not on their skin), or dip your finger and let them suck it off. 

  • I used to recommend touching peanuts to skin, because indeed allergic babies would react. This seemed less scary at the time. It turns out that skin exposure to allergens might be part of what causes allergies. As such, if you have a rashy child, you should apply some Vaseline or other skin barrier around the mouth before feeding allergens. It seems weird (and tedious), but this simple fix may decrease the likelihood that allergies will develop.

  •  If there is no reaction after a few minutes, feed the baby  ¼ teaspoon of the thinned peanut butter and observe for 30 minutes.

  • If there is still no allergic reaction, give ½ teaspoon of smooth peanut butter/paste and observe for a further 30 minutes.

  • If it is well tolerated, parents should continue to include peanut butter in their infant’s diet in gradually increasing amounts at least once or twice weekly, as it is important to continue to feed peanut to the infant as a part of a varied diet.  As a bonus, peanuts are a nice source of protein!

  • If there is any mild or moderate allergic reaction (mentioned above) at any step, stop feeding peanuts to the infant and seek medical advice. I would work closely with your pediatrician or allergist  to make a plan moving forward.

Don’t hesitate to give a dose of cetirizine (Zyrtec) at the first sign of any symptoms. Benadryl is not quite as good in these situations because it can cause sleepiness which can potentially be harder to assess, and only lasts 4-6 hours, while cetirizine lasts 24 hours. 

Of course, If there is any difficulty breathing, call 911. Be assured that actual anaphylactic reactions in kids under a year are quite rare. 

Dr. Ted’s Tidbits:

The thought of giving your child anaphylactic shock is terrifying. A lot of parents will subsequently delay allergen introduction due to this fear. I’d encourage you not to wait, and here’s why. In order to have anaphylactic shock, the body releases a large amount of histamine in multiple organs. You can tell if your baby has a propensity to release large amounts of histamine: these kids almost always have very significant eczema. Their skin is like a big flag announcing, “hey, I’m allergic!” They also might have very reactive airways and are oftentimes wheezing. If your child has, as Nurse Judy says, buttery smooth skin, they’re highly unlikely to have anaphylaxis out of nowhere, and no, you don’t need to own an epi pen “just in case.”

Introducing Other Allergenic Foods

The most common food culprits are nuts, fish/shellfish, milk, eggs, wheat, and soy.

If you are nursing and eat some of the things on the list, it is possible that your baby will show some signs of fussiness and intolerance, but not always.

As noted above, there is a big difference between life-threatening allergies and the run-of-the-mill nuisance variety.

Milk allergies usually show up as blood in the poop. Dietary changes are needed in the first year, but this is not generally dangerous and virtually all babies grow out of it.

Think about how many of your adult friends have to carry an epi pen for milk, egg, or wheat allergies. Probably not many. If you’re trying to get the most bang for your buck with early allergen introduction, focus on nuts and shellfish. 

FPIES (food protein-induced enterocolitis syndrome)

This condition is VERY rare but worth knowing about.

Unlike most food allergies, symptoms of FPIES do not begin immediately after eating. Instead, it can take hours before severe symptoms begin.

Typical symptoms of FPIES include severe vomiting, diarrhea and dehydration two hours after eating. These symptoms can lead to other complications, including changes in blood pressure (although it’s rare you’re checking this at home) and body temperature, lethargy, and poor weight gain.The most common FPIES food triggers are cow’s milk, soy, rice and oats, but any food can cause FPIES symptoms. 

FPIES is commonly misdiagnosed as a severe stomach bug because the symptoms are so similar. 

However, most tummy bugs only last for a couple of days. When symptoms are lingering is when most doctors start looking more closely for possible causes. It is generally only after repeated ingestion of the trigger food — followed by severe symptoms hours later — that indicate FPIES may be the cause.

Treatment is generally avoiding the trigger foods. Fortunately most kids outgrow this by the time they are 3.

What about these new food allergen kits?

There are a lot of new products that aim to make allergen introduction easier, and more scientific, for parents. They are small and typically flavorless powders that are essentially freeze-dried proteins from typical allergenic foods. They make it easier to introduce allergens without needing to figure out the “how” (“how will I feed a small infant a shrimp cocktail?”). You can sprinkle the powder into breast milk or add it to any other food your baby already tolerates. They are proven and effective, but not all allergists think they’re worth the price (as of this writing). If you aren’t intimidated by figuring out how to feed the real deal, you can save your money and get the same results.

In Conclusion

Breathe. This all can feel very scary. There’s something very sinister about the idea of allergic reactions…this concept that the body can just flip a switch and attack itself, seemingly without warning. Luckily this is extraordinarily rare in infants. Using the latest data and studies on allergen introduction, you can hopefully avoid serious allergies later in life and train the body to accept everything in the diet. And for the majority of you without risk factors (no eczema, no asthma, no food allergies in parents), you should relax and feed your kid. You don’t need to focus on introducing allergens to young infants.

And before you know it they are driving!

Thanks to my models EJ and Sawyer