Friday, December 30, 2016

Medicine Cabinet/What to have on hand/Getting rid of expired meds

Topic of the week:

What's in your medicine chest?
How to get rid of expired medications?
(Flushing them is NOT the correct action)

If you or your child becomes ill in the middle of the night, that 3:00 am visit to the local pharmacy may furnish you with some interesting anecdotes about the odd folks lurking in the aisles, but generally it is something you want to avoid. Try to have some basic medications on hand ahead of time. A little preparation goes a long way.
Here are some suggestions of items to keep on hand.
Fever reducers/Pain relief
Acetaminophen and Ibuprofen are the most common medications used for this.
Remember that you never want to give actual aspirin to a child.
Acetaminophen/Tylenol Infant and Children's Liquid are the same concentration so they are actually interchangeable, but the infant bottle comes with a nifty little measuring system and a spill proof bottle which is safer.  For those of you with older kids, yes you are right, they used to be different products, but that changed several years ago.
Acetaminophen also comes as a suppository, which is great for a child who is vomiting or resisting medication by mouth. Keep those in the fridge. Mushy suppository??? Enough said.
Ibuprofen is also known as Advil or Motrin. This medicine also comes in a more concentrated infant form. The infant and child dose are not the same. Make sure you understand your child's proper dose. 

Benedryl and/or Zyrtec are the ones we most commonly use.
The generic name for Benedryl is Diphenhydramine HCL. There is no special liquid specifically for infants. Most of the bottles have a caution not to use for children under 4. In our office, we do use it for younger patients if indicated. I do not recommend giving it  to a young child without speaking to your health care provider.
These antihistamines would be given for general allergic reactions, itchy skin rashes or insect bites.
While Benedryl will make most kids (and adults) very sleepy, it also can cause a few patients to be jittery.
My favorite allergist, Dr. Fast counsels against giving Benadryl if you are worried about an anaphylactic reaction. The ensuing sleepiness might make it hard to figure out if it is a reaction to the medication or a further complication of the anaphylaxis.
.Zyrtec (Cetirizine) also comes in a liquid. Zyrtec typically has a more even response, with less likelihood of either sedation or the jitters. Claritin also comes as a liquid. It is fine for sneezy allergies, but perhaps not quite as effective for itchy rashes.
It is probably worth having both Benadryl and Zyrtec on hand. Dr. Hurd has a slight preference for Benedryl when treating her younger patients. There are many times when that sleepiness is a bonus.
Tummy issues
Pedialax or glycerin suppositories are worth having on hand If your child is prone to constipation. If days have gone by without a poop and diet enough hasn't helped to get things moving, these are often the next step. If  it is the wee hours of the morning and you have a miserable, grunting and straining kid, getting the poop out is a good strategy.
If your child is vomiting, you will be glad to have an oral rehydration solution in the house.  Options include:
Breast milk is also great for that, but not everyone is lucky enough to always have it on hand. Pedialyte is the one you most likely have heard of. It seems to have recently become a bit more palatable. It also comes in popsicle form, which is great for older kids. Drip Drop has been on the market for several years and tastes a bit better. Some Walgreen's carry it, but alas it is not always easy to find. This is where planning ahead will help you out. You can get it from Amazon. It comes as a powder which you mix with water.
Pediavance is newer product. It comes in a pre-dosed concentrated liquid that gets mixed with water. These would also be handy to take along on a trip. I haven’t gotten reports about the taste yet. Drip Drop and Pediavance are both great travel options.
Dr. Hurd also counsels that it is worth having a box of saltines in the pantry just in case.
If you have an infant, have some colic remedies on hand (blog post) My favorite is anything with Simethicone!

Mouth sores
If you child is prone to mouth sores or irritations, I find Glyoxide very helpful and seems to help things heal up pretty quickly
Tip: With any of your medications, put a strip of masking tape on the side of the open bottle and sign and date your doses.
This will avoid the common incident of parents double dosing their babies. This also will help you keep track for yourself when you are sleep deprived. I get plenty of frantic calls from parents who have inadvertently overdosed their kids by giving the medications too often. If there is a concern your first call should be to Poison Control.
1-888-222-1222   (California)
Tip: Have a syringe or dropper on hand for much more accurate measuring.

If you child has a history of wheezing, now is the time to make sure you have asthma medications available. Please check the expiration date and see when they were opened. Many of those are light sensitive so you should always mark the package when you open them. If your child uses a nebulizer, the tubing should be replaced every 6 months.  If you or your child use an inhaler, it should be rinsed out at least once a week. If it hasn't been used for more than a week it may need to be primed. Check the directions on your specific medication. Pro Air, which is one of the more popular inhalers, needs to have 3 extra puffs to clear it if it hasn't been used in 2 weeks.
Flovent and Qvar are others that need to be primed if they haven’t been used recently.

Topical creams/ointments
  • Triple antibiotic ointment for cuts or scratches
  • Anti fungal cream for yeasty rashes or fungal infections
  • Arnica for bruises
  • hydrocortisone cream for mild itchy irritations
HC cream comes is a variety of strengths. You can get the weakest ones over the counter.
It is also worth having a basic barrier cream for diaper rash.
If you call the nurse team to ask about a rash, chances are good that we are going to play “paint by numbers” with a combo of the above ointments.
Please pay attention to this rather disgusting factoid:
It is easy for tubes of ointments to get contaminated. Think about it. If the tip comes in contact with bacteria from a finger or directly from the body...there you go. Yuck! One study that I read suggested that more than half of the tubes of creams and ointments that people have laying around are contaminated with Staph. The best way to avoid this is to make sure that you don't directly touch the tip to anything. Try to keep it sterile. Squeeze the desired amount onto a spoon and then use whatever applicator you want (clean fingers are usually fine.)

I particularly like the self adhesive gauze popular brands Coban/Co-flex. They come in lots of colors and are pretty inexpensive.
The advantage of these is that not only do they not hurt when you take them off, Your child can’t pull them off without help. Also, your little one can’t eat the band-aid..
Having a baggy with some gauze, neosporin and a roll of Coban would be a good addition to your diaper bag.
Invest in child friendly ice pack that you can keep in your freezer. There are loads of adorable ones on Amazon. Holding a soft little penguin or bunny against the booboo might elicit a bit more cooperation.
Keep a bag of Epsom salts on hand. They come in handy for all sorts of things.

Have a working thermometer that you have tested for accuracy before someone actually has a fever. As long as your baby is over 2 months, I am not one who is going to focus too much on the exact degree of the fever, but we do want to get a sense of how high it is.

Make sure that all your medications are stored in a safe, childproof location (a steamy bathroom is possibly not the best place.) Don't underestimate the ability of a climbing child who knows where the gummy vitamins or yummy medicine is stashed. Even older kids can catch you by surprise at times. This year we had a 7 year old with mystery tummy aches. He finally confessed to being in the habit of sneaking handfuls of gummy vitamins daily.

Do a routine check for expired medications. Even though I try to stay on top of this I can be occasionally stunned by the old stuff that I find lurking in the back of my own medicine cabinet (it runs in my family.)

Please don't randomly toss expired medication down the drain or flush it in the toilet. Medicine can pollute the bay and ocean, or be accidentally misused or abused. Wastewater treatment plants are not designed to remove medications or other chemicals in waste-water, so after traveling down your drain, medicine may affect our environment.
.Here in SF you can take your expired medications to:
When you visit one of the pharmacy sites, simply deposit your medicine in the green drop-box. If you visit a police station, take your medicine directly to the window.  At police stations, you may be asked for your name and address. You are free to decline to give them that information.
We are also looking into being part of a pilot project called Mail-back med project.
This project will supply us with postage paid envelopes that you can pick up from us and use to mail back acceptable expired meds.
I will update this post on the blog when that goes into effect

Friday, December 23, 2016

Talking to your child about Santa

Over the years several parents have asked me to weigh in on the ‘Santa discussion’
What is the best way to keep the magic alive while not endangering the trust that is so important in any relationship?
For the general discussion, we  can lump Santa into the fine company of the Tooth Fairy and the Easter Bunny, but it is safe to say that Santa is usually the member of this trio that has the most emotional connection.
Let me preface this post by saying that I think it is essential to be honest with people in your lives. You don’t need to hit them on the head with the truth, but If they ask a question and press for an answer, please don’t lie.
In my Jewish family, the girls never gave too much thought to the man in the red hat or the giant bunny, but we did get routine visits from the tooth fairy every time the girls lost a tooth.
When I started writing this, I gave my grown girls a call to see if they remembered any feeling of betrayal when they realized that it was daddy sneaking the money under the pillow.
Lauren tried hard to remember. She vaguely recalls that she figured it out reasonably early, but played along for several years. She wanted to make sure that the gravy train didn’t dry up. Alana was too busy trying to figure out if monsters were real or not (thanks to having a big sister who haunted her nights with strange noises) to worry too much about the Tooth Fairy.
For the young kids who ask if the mythical creature is real, you might deflect the questions fairly easily without telling a falsehood if you want to extend the magic for another year.
A simple,“What do you think?” works pretty well.
Or, “It is fun to believe in magic sometimes and Santa is part of the holiday magic”
Keep in mind that once your child gets to Kindergarten believing that Santa is actually going to try to fit down your chimney, rather than the ‘spirit of the holiday magic,' your child may be set up for a shocking disappointment when they learn the truth. There are lots of kids at school eager to share the cold hard facts with your innocent child.
It is much better if this discussion comes from youbefore your kids find out a harder way. 
I spoke to several  people who recounted that they believed in Santa with all of their hearts and were completely heartbroken when they learned the truth.They felt deceived.  One person told me that finding the truth was the moment they stopped believing in all magic. How sad!
Letting them know the truth gently doesn’t have to be a negative experience.
For older kids, I love a good story. Many stories start with an element of historical truth.
“Once upon a time in a far off country there was a man named Nicholas. He loved to do good things for other people. What was special about him is that when he gave people presents or did nice things, he didn’t do it because he wanted something in return. He simply wanted to do good things. Lots of times he did it in secret and no one even knew who did something nice for them. Maybe this Nicholas was big and jolly and had a white beard.He became known as Santa Claus.Santa is a symbol of love and magic and hope and happiness. He teaches children how to believe in something that they can’t see or touch.  I am on his holiday kindness team and now you can be too. Really little children might believe that there is one Santa who manages to be everywhere at once. Big kids like you get to know the secret. Team Santa is all the big kids and grown up who want to help make other people happy. “

Perhaps take the opportunity to help your child be an active member of this awesome team; an initiation of sorts. Is there someone in your life that seems like they need a little kindness? What could you do for them. Is there a little gift that might make a difference? Plotting a secret kindness is the thing that wonderful lasting holiday memories are made of.

Friday, December 16, 2016

Holiday Safety Checklist 2016

Have you thought of everything?
The lights are twinkling and the radios are playing the holiday tunes. People are putting up the holiday decorations. It is time for the holiday safety post.
For most people, holidays are a time for celebration. That means more cooking, home decorating, entertaining, and an increased risk of fire and accidents.
Call me a Debbie Downer if you must, but the mind of an advice nurse is a skewed one. For every aspect of holiday celebrations, I can tell you the story of a patient who called with a related accident. It is not my intent to scare folks with my tales. As I tell parents who attend my safety class, if you know ahead of time what accidents can happen, you have a way better chance of avoiding them.
Baking cookies is just one example. A patient's mom called to tell me that her 10 month old had sustained a burn on his hand. She was holding him in the crook of one arm as she removed the cookie sheets  from the oven. As she recounted, he turned into a cartoon character with a telescoping reach and he was able to stretch across her body and grab a hold of the piping hot tray. Simple solution: don't hold your child when you are working with hot stuff in the kitchen. Their arms are longer than you think. If even one accident has been prevented, this post was worth it.
Candles are another hazard. It was a winter evening several years ago in a cabin at Lake Tahoe. Dr Jessica and family lit some holiday candles and went to sleep. Somehow one of the candles ended up burning a hole through a plastic mat that was on the table. Luckily the smell of burning plastic woke them up before any real damage was done, but it was a frightening lesson. This was a vacation rental. In this instance there seemed to be no working smoke detector. She had no idea if and where there was a fire extinguisher. There are several obvious lessons here. Never to go to sleep leaving candles or a fireplace still burning. Get acquainted with the safety features of any place your family is staying.    
Below are some safety considerations for dealing with the holiday season ahead. Some of these may seem like common sense but there might be a few tidbits in here that you haven't thought about.
Beware of  button batteries. They are everywhere nowadays in all sorts of small electronics (and musical cards) and can be quite hazardous if swallowed. Take time in advance to do a mental inventory of items that you have around that may be powered by these. Put a piece of duct tape over the battery compartments to make sure they can't fall out.
Certain holiday plants like poinsettias can be mildly toxic (especially to someone with a latex allergy). You may not have them in your own house, but if you are visiting a friend or even a supermarket make sure little hands don't grab the pretty red leaves and put them in their mouths.
Be very careful transporting hot food to a holiday potluck. I have patients who have been burned from hot food spilling on them in a car.

We had a tragedy this year. An eight year old healthy dog got into a wrapped package that was filled with chocolate. The amount ingested proved to be too toxic for this little dog to handle and they didn't make it. Please don't let this happen to you. Make sure that any mystery packages are no where near where a pet can get to them. 

Christmas tree checklist:
  • When purchasing a live tree, check for freshness. A fresh tree is less of a fire hazard
  • Cut 1-2 inches from the base of the trunk immediately before placing the tree in the stand and filling with water to ensure absorption
  • check the water level daily to avoid the tree drying out
  • When purchasing an artificial tree, look for the label "Fire Resistant"
  • Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights and a person touching a branch could be electrocuted
  • Place your tree at least 3 feet away from all heat sources, including fireplaces, radiators and space heaters
  • Make sure the tree is steady enough that it can't be pulled over by a toddler
  • Trim your tree with non-combustible or flame resistant materials
  • Before using lights outdoors, check labels to make sure they have been certified for outdoor use
  • Make sure all bulbs work and that there are no frayed wires, broken sockets or loose connections
  • Plug all outdoor electric decorations into circuits with ground-fault circuit interrupters to avoid potential shocks.
  • Strings of lights and garlands are a staple of holiday decorating, but they can also pose a strangulation hazard.
  • Avoid trimming the tree with things that look like candy which may pose a temptation to the kids.
  • Keep sharp, glass or breakable ornaments out of reach of small children
  • Holly berries and other small decorations can be choking hazards
  • Don't overload extension cords; make sure that your extension cords are high quality
  • If you are going to use your fireplace, make sure that you have the chimney checked and cleaned if it has been awhile since you built your last fire.

This is not a safety issue, but it is worth mentioning:
Is your child exhibiting any new allergy symptoms? Take a minute to consider whether or not they started during the holiday season. Trees, scented candles and other seasonal extras can trigger some allergies.
Hanukkah doesn’t fall on the same date every year since it is based on a lunar calendar. Many folks laughingly refer to it as coming either “early or late” This season it is on the late side and the first candle will be lit on Christmas eve.
  •  Make sure that all candles are safely out of harms way
  •  the menorah should be on a glass tray or aluminum foil
  •  Make sure candles are not close to wrapping paper
  •  Don't go to sleep with candles still burning
  •  Don't leave the matches or lighters hanging around
  •  If you are frying latkes (fried potato pancakes that are a holiday tradition, yum) make sure that no one gets spattered by oil
  • Never leave the hot oil unattended
  • Remember that  adding water to a grease fire will make it worse! Baking soda is okay, but a fire extinguisher is best. Make sure you know how to use it.
Kwanzaa may be the safest of the holidays, (no hot oil or stressing the electrical outlets) but there are still candles involved, so make sure they are placed in a safe place and toddlers don't have access.

This is a great time to test your smoke alarms!!!
Stay safe and have a wonderful holiday season.

Thursday, December 8, 2016

When is your child contagious? 2016

Please see the updated post February 2018
Some of my most common questions revolve around when kids are contagious and at what point are they ready to go back to nanny-share, day care or school.
The answer is almost never clear cut. In a black and white world, this is my 50 shades of gray.  In order to logically best make these decisions there are many issues that we need to consider.
Of course we want to be a responsible parents and not expose others to our sick child. We also want to protect our own recovering child from going back into the 'germ pool' too quickly. If they are just getting over something, their immune system may a bit diminished and they are vulnerable to coming down with something new.

For older kids,sometimes they have an important test that they are reluctant to miss. Some are reluctant to miss school. (others not so much.....)
Another consideration is that some parents have an easy time taking time off and others simply can't afford to. It is naive to think that these aren't real factors.

What makes it all so tricky  is that most viral syndromes can be spread a day or two before the kids show clear signs that they are ill. Many kids may be a little fussier than usual. Perhaps they don't eat quite as much. Most savvy parents know enough to be suspicious when their 5 year old who fights naps with a vengeance announces that they are going up to have a daytime snooze. Your antenna might be up that something is brewing, but are those reasons to miss work and keep your child at home??? Of course not!

The fact is, if you child comes home from school in the afternoon and is sick that evening, most likely everyone they were with earlier that day has already been exposed and I am going to take that into consideration when we try to come up with the most sensible plan on when they can return.
It is nearly impossible to isolate siblings. Of course be scrupulous with your hand washing, avoid sharing utensils and sloppy wet kisses, but it is likely that they will catch each others cooties. Breast feeding moms, sorry to say that by the time you realize you are ill, it is too late to prevent an exposure. Hopefully the magic of breast milk will protect your baby, but it is rare that we would suggest that you avoid nursing. Most of the time we will recommend that you keep on with the feedings. (Make sure that you are getting plenty of fluid. If you are given medication, check with your nurse or doctor’s office to see if it is compatible with breastfeeding.)

If you are in a small share care situation, it is essential to have a talk with the nanny and the other families involved to make sure you are all on the same page.
I would suggest that you agree that the kids will have  a "sibling" relationship. This simply means that you all accept that the kids are most likely going to get each others mild illnesses.

As far as common colds go, the average child under 2 years of age has EIGHT colds a year. Frankly, if you plan on keeping your child at home until your little toddler is free from a runny nose, you will be waiting a very long time before you leave the house.
Remember that some clear runny noses are not contagious. Teething as well as some allergies can be the cause. (There is debate about whether or not teething is associated with congestion. Nurse Judy votes yes.)

While I would strive to keep my youngest and most vulnerable patients free from viral syndromes and colds as long as possible, exposure to these common viruses is in fact developing the immune system. At some point they are going to have to deal with the myriad of  illnesses that make the rounds. Think of it as a rite of passage. It is actually better to get some of the childhood illnesses out of the way. Unfortunate adults that lack immunity and catch these illnesses are pretty miserable.

Typically if I have a child with a fever over 101, a  new case of diarrhea, or a brand new cold that has them spewing green mucous it is worth keeping them home for at least a day or so to see what  is coming next. 

If your child has an infection that is being treated with antibiotics, we generally consider them no longer contagious after they have been on the medication for at least 24 hours.

Bacterial conjunctivitis is also usually given the all clear after 24 hours of eye drops (of course you need to finish the course.) 

Hand Foot Mouth issues come up a lot. I respect that schools want to keep this yucky virus from getting spread around. Patients can shed that virus in their stool for several weeks. I would suspect that there is a reasonable chance that the infected kids likely got it from school in the first place and/or were contagious before they were identified and segregated.Since I don’t think schools are able to genuinely keep them out until they are completely clear, I suggest common sense guidelines. If they have a fever keep them home. If they are fussy and miserable, they will be much happier home with mom or dad. If they seem to be feeling okay and are fever free, for the above reasons, I don’t think it is reasonable to exclude them from daycare/school until all the blisters are gone. Kids are going to get this.

If you are questioning whether or not to go on an upcoming play date, explain your situation to the other parents. They may be perfectly fine hanging out with you and your snotty nosed child, or perhaps they have an important event or vacation coming up and want to be more cautious. Let them decide. Full disclosure ahead of time is the best practice.

There is never any complete assurance that can be given that your little one is "not contagious".
Use your best common sense. When in doubt avoid contact with anyone who is vulnerable. This would include newborns, or someone with a compromised immune system.

Nurse Kenlee tells parents that she wishes there were a magic light that signaled the "all clear." Alas, there isn't.

Friday, December 2, 2016

Essential equipment 2016

"stuff" that may make parents life easier
How old are my kids? They are so old that they slept on their tummies in cushy little cribs surrounded by tons of stuffed animals. They survived their early years without owning a cell phone or ipad.
The  baby swing that we owned was wound up with a crank. If you are a grandparent reading this, you are nodding as you remember the model that I am talking about. The babies loved it and would be lulled into a contented relaxed state for several minutes of clickety click, clickety clack. Then alas it would wind down and need to be cranked up again. This was a noisy process that more likely than not would wake the sleeping baby who had just nodded off.
Parents of young children have a much wider variety of “parenting hacks” to choose from. There are plenty of new things constantly coming onto the market that parents will refer to as “game changers”. These are the item that really make things feel more manageable. The following products are not personal endorsements; I am simply sharing wisdom from others that may be useful to my patients and readers.

Having a safe place where where your baby can comfortably hang out is essential.
Having them on a comfy 45 degree angle is a bonus.

Dr Anne likes the Boppy newborn lounger

Some of Dr Hurd’s favorites are
the Mamarooand the Snuggabunny

Diane, a mom of twins passed along a tip. “When I started asking other twin parents which products I should buy two of, at least 5 people told me I should get two fisher price rock and plays (with auto rock). They were all correct. The rock and plays are amazing. When my girls are a little bit congested (which has happened a lot in the first 6 weeks of life), the incline helps them sleep better. And on those challenging nights where they are both fussy, I can put them each in a rocker and turn them on and they can rock gently for hours. Make sure to buy the one with the auto rock option, because the regular one you have to rock manually”

If you don’t mind a manual version, You can rock this Fisher Price rocker with your foot (never run out of batteries.) One of the nice things about this is that it is reasonably priced and can transition to be used as your kids grow.
For kids over 4 months, my husband Sandy says I can’t leave the doorway jumpers off the list. Our daughter Lauren absolutely loved hers and would bounce and twirl in that thing in rhythm to music.These of course only work if you have sturdy door jambs. With any carrier or swing, use your common sense and don’t keep the babies in there for ridiculous stretches of time.

Please never leave kids unattended.
Just this week I had a call involving a baby not fully strapped into a little bouncer who managed to flop himself forward and bonk his head (he’s fine.)
Don’t put carriers up on a high surface. Trust me, they manage to fall. You don’t want to be the person calling me about that. This is more dangerous if there is a toddler or large dog that can 'help' the baby get knocked over.

Wherever they are hanging out, Dr Anne also suggests checking out the
Summer Infant Snuzzler Infant Support for Car Seats and Strollers- this is terrific for small newborns or babies having a having a hard time transitioning to bassinet in first month.

If you are carrying your baby around with you check out the Nesting Days carrier. These are invented by  San Francisco’s postpartum doula Julie Arvan

Once the babies are over 4 months old, Noe Valley Pediatrics' Lily loved her infantino flip advanced convertible baby carrier

For the Crib:
Dr Hurd suggests that all of her patients get invest in a simple crib wedge.

One of our patients Amy (mama of twins) told me about wonder bumpers

These are one of those “why didn’t I think of that” products

Amy also recommends Dr Brown's mixing pitcher

This is especially helpful for a family with twins who are mixing larger quantities of formula at a time

Many parents and Dr Anne all really like the Merlin Sleepsuit to help with the transition out of the swaddle around 3 months

Elizabeth adds:One of my new favorite baby shower gifts is the Love the Dream Swaddle:

Random Tips:
When asked for his favorite item, Dr. Schwanke put Sophie the Giraffe on the list.

This is a classic favorite of his that has been much loved by generations of  patients.

My niece Lena says that the swaddle blankets with velcro were really useful. These give the option of snugging the arms tight while leaving the feet free to be strapped into a bouncer.

My lovely patients Rita and Ricardo spend a recent date night trying to brainstorm for me. They reminisced and thought about the most essential baby equipment (especially the first time around). Here's their list:

For the tall parents out there -- the Uppa Baby stroller line is great.They  have the Uppa Baby Vista and the Uppa Baby G-Lite strollers and both are great for Riccardo (who is 6'8').

The book "Baby Bargains" - - was a great resource to help them find general baby equipment (strollers, car seats, cribs, etc).  It's not just about bargains - it's about quality, and they test and know about all the latest products.

The Frenchie Mother towell - is a towel that velcros around mom or dad's neck and makes it easier for you to take the baby out of the bathtub (and keep you dry at the same time.)  So simple but such a good invention!

Mama Regan let me know about the Oogie bear, little scoop for removing little boogies

My super adorable neighbor and patient Sean loved his Zo li sippy cup. His mom Sara says she tried a bunch before they found this winner and that it helped them transition away from the bottle.

I couldn’t do a post like this without checking in with Jennifer of Hint Mama.
She send along the following tips

1.) Glow-in-the-dark pacifiers:

2.) Sleep sacks with loveys attached

3.) These lunch boxes:

Clive’s mom Kylie says favorite toy as infant and now great distracter in car seat is baby Einstein take along tunes.

(Bells and whistles are fine and entertaining. But there is nothing as great as a cabinet full of food storage containers and lids!)

Beyond equipment, there are now all sorts of apps
Robert, the new daddy of baby Noah says that they find the baby tracker app  really useful

Parenthoods is another great resource. It is available on i phones, but the general website is available to anyone

If your favorite life changer is missing from the list, let me know. All of my posts end up as resources on my blog. I will be happy to keep this one updated.

Thanks to Pediatric Dentist David Rothman for chiming in with a bit of wisdom. His says that his kids favorite was the different colored stacking blocks that kept them happily playing for hours.
Thanks to Nurse Lainey for telling me about the DockaTot

This product has been getting some rave reviews for helping out with the all important sleep issues. 

Thanks to Tiila for sharing about the sleeper hero
After she told me about it, I have passed this tip along and many parents have called it a difference maker

Ash sent me info about a brand new product that I had never heard of:

Recently I took your common illnesses class and have been reading your awesome blog I'm wondering what you think of this UV light cleaning device called Phonesoap (to clean cell phones and other small objects). My mom got me one last year and I'm just now starting to use it and looking at the product info online...
The Discovery Channel video is particularly convincing to me...

I checked out the website and it looks intriguing. I don't advocate trying to live in a germ free world, but I imagine that most of us have disgustingly dirty cell phones that would benefit from a good cleaning.

This post lives forever on my blog. If you have some magic tips to share, let me know and I will update the post.