Bath Time Tips for all ages

Bath Time Tips for all ages

I can still remember the first time we put my daughter Lauren in the big tub. My husband was in the other room tackling his first solo messy diaper. The episode was a big learning experience that got referred to as 'Poopageddon'. He had neglected to fold over the poopy diaper and Lauren managed to get her feet right in there. Poop was everywhere including the walls. “Jude? Can you come in here? I need an extra hand”. There was no way a sponge bath was going to do the trick. Fortunately her cord was off so doing a full bath was an option. If I remember correctly, at this point Sandy needed a bath as well. He got in first and I handed him the baby. Our bath routine was created. Both of my kids learned to love the bath in the security of daddy’s lap. (If you don't have two willing partners I would usually use a big sink until the babies are good at sitting.) I have patients who swear by the blooming lotus bath aid As you bathe them, I would start with the face and head.......then do the body and end with the tush (going from the cleaner areas to the dirtier areas). You can use a warm, wet cotton ball to clean the eyes. I suggest cleaning from the outside of the eyes in towards the tear duct/ nose. There is not one bath routine that works for everyone. Tub and sink sizes, babies temperament and willing partners will vary from family to family. Until the cord is off and any circumcision is healed, the babies should not be submerged in a tub. This is usually around 10 days to 2 weeks. Until you can do that first bath, you can simply do some gentle sponging off. Babies are not terribly dirty. As long as you get the face and tush you are fine. Safety review Once you are ready to submerge the baby, safety is key. NEVER LEAVE THE BABY FOR EVEN AN INSTANT Remember that babies can drown in even an inch or two of water Have all supplies at hand (towel, wash cloth, cup for rinsing) Make sure there are no electric cords or tools nearby ( like shavers or hair dryers) that can get pulled into the water Wet babies are squirmy and slippery! Wearing a terry cloth robe will help keep you dry as well as offering traction to a wet slippery baby. Have a rug on any tile surface to keep from slipping. Watch out for faucets. There are faucet covers to keep from getting bumped As a safety precaution I would have you turn down your hot water heater to 120 degrees. Many hot water heaters come from the factory set to 140 degrees. No one needs it to be quite so high. Check the water temperature in the tub to make sure it isn't too hot. Grandma did just fine by testing with her elbow, but there are all sorts of floating bath thermometers that will take the guesswork out of it. A good water temperature range would be between 36-38 Celsius or 97-100 Fahrenheit. Some infants have a little trouble regulating their body temperature so water that is either too hot or too cold can make them uncomfortable. The normal body temperature averages 37 or 98.6. Too cold is no good, but too hot is probably worse. Babies have very sensitive skin that can burn easily. While I don’t ever advocate keeping the bedroom too warm, 68-72 is fine; it is nice to have a cozy environment for drying off right after a bath. Making it a pleasant experience from start to finish will help keep bath time from being an ordeal. Many folks use a little space heater for this. Make sure any appliance is kept well away from the water. How Often? Babies don't get too dirty and usually don't need to be fully bathed more than 2-3 times a week. Faces and diaper areas should be washed at least daily. All skin-folds also need to tended to DAILY as well. Don’t skip this or you will be the one sheepishly calling me to tell me that you discovered some nasty areas on your baby. Common areas are under the arms, in the neck, thighs and groin. The area behind the ears also can get gross. You can proactively avoid this with a routine skin fold check, spread the creases, wipe with cetaphil cleanser (no water needed) and then add a layer of aquaphor or cerave ointment. If your baby loves the bath and it is part of your routine, it is perfectly fine to do one daily. Make sure you moisturize your kids after the bath. This is especially important for anyone with dry skin. Other considerations It isn’t uncommon for kids who used to like their tub time, to become “bath phobic.” One of my patients had an issue when a couple of siblings were having their routine bath time together. The younger one had a large poop in the tub. The older one freaked out. There was no fixing that. He ended up taking showers for a while. In the case of Dr Elizabeth’s son, their tub has some jets. He hit a button, It made a horrid noise and it took a month before he would get in without a struggle. One slip in the tub, or shampoo in the eyes can make kids who used to like the baths reluctant to get in. Having one parent in the tub is usually my best suggestion. To protect the eyes, using a cup to rinse the hair usually helps. A sports bottle can work well for this. There are also lots of little specialty bath items with spouts on the market. Having your child look way up for the hair rinsing can help keep the eyes from getting shampoo in them. If you can, perhaps stick a little sticker or decal on the ceiling of the tub for them to look at. Some kids feel empowered if they are holding a dry washcloth that they can hold over their eyes for the rinsing. Find a nice gentle baby soap. There are a lot of good brands. Watch for any rashes or irritation when trying anything new. It is worth being a careful label reader. There can be ingredients lurking in some products that you want to avoid. Parabens and phthalates can be hidden under the ingredient ”fragrance;” these can potentially disrupt the hormone system. If you are local, you are safe getting any product from Natural Resources on Valencia. They don’t let any product in the door unless they have carefully vetted all of the active and inactive ingredients. The lines that they like to carry are Earth Mama and Think Baby. EWG is another source to checking on product safety   Bubble baths can cause urinary discomfort in some sensitive little girls, so I I avoid them except for very special occasions. Some kids can get irritations from simply sitting in the soapy water so if you have an older baby who enjoys the bath, let them play in the clear water and then do the soaping and rinsing right before they get out. Things you can add to the bath Adding a splash of apple cider vinegar to the tub seems to be useful at preventing some rashes. It is hard to give an exact amount since the tub volumes vary so much, but I usually suggest between ½ to 1 cup. Baking soda is also a popular thing to add. For babies use about 2 tablespoons; for older kids you can add up to a cup. This is a good one for an itchy rash like poison oak. Believe it or not, it can also help with constipation. Do NOT mix the vinegar and the baking soda unless you are doing a science experiment and want to create a volcano. Bleach baths are good for eczema or any potentially bacterial rash. If properly diluted and used as directed, a bleach bath is safe for children and adults and believe it or not, this is a standard recommendation from many dermatologists. The directions are to add ¼ - ½ cup of bleach to a standard tub that is filled. Don’t do this more than 3 times a week, and only soak from the neck down. Oatmeal - Aveeno makes a nice product that is good for dry itchy skin. Bath toys are fun, but can get gross! Make sure you clean them regularly. The get quite moldy and slimy There is nothing quite like the scent of a clean, sweet smelling baby. Enjoy the moment!

Nurse Judy the Mom

How many of us feel inadequate when we look at other parents who appear to be super mom or super dad. These magical beings seem to manage to handle whatever life throws at them with ease? They never ever make a mistake or lose their temper. Their children think they are perfect. Um, not likely. What you may see on the outside is not always accurate. As a Mother’s Day gift to you and I going to share an inside look at Nurse Judy the mom, including the story of one of my more epic 'mommy fails'. For the most part, I am blessed and my kids have made it easy for me to look pretty good. The truth is though, that we all have our moments. If you ask my daughters for the lamest mommy stories, I certainly have my fair share of times that I did something that they didn’t appreciate or a time I embarrassed them. Lauren recalls an incident at a zoo night when she was around five that still makes her grimace. That evening there were costumed characters roaming around the zoo dressed as animals. Some had instruments. “Mommy, I dare you to ask that Lion to sing 'The Lion sleeps tonight'” Dare me? Silly girl. The Lion’s response was, “Only if you sing with me” Much to Lauren’s chagrin, the guitar toting Lion and I created a lovely duet of Weem-a-Wopping ‘In the Jungle’ as we wandered all through the zoo. I think the only time I actually embarrassed Alana was the first time I discovered Lemon Drop Martini's at a friends Bat Mitzvah Party and danced the night away with a large group of tipsy moms. Those things are dangerous! There was also the time that Lauren and I were practicing our karate moves. She practiced some punches on me and then it was my turn. She had a pillow up to her belly for protection but wasn’t standing properly, I did my move and she went flying across the living room. I was horrified. She was furious. Moral of the story, check your stance. But the hands down winner is the time I drugged Lauren and then put her on a horse. We were doing a family vacation up at the Russian River and scheduled a horse back riding session at beautiful Armstrong Redwood state park. My girls and I could count the number of times that we had been up on a horse. Sandy, the New York City boy, was actually an experienced rider. Lauren had a mild cold and her allergies were bugging her, so I gave her a little something to help dry her up and we were off on our adventure. We were in a guided group along some pretty steep trails. Lauren’s horse had a mind of his own and didn’t want to stay with the others. To compound things, Lauren was feeling really quite out of it and was having a hard time staying awake. Sandy held back on his own horse to make sure she didn’t get left behind. She managed to keep it together for the several hours, but just barely. She could barely keep her eyes open. I was concerned that she was really coming down with something worse than a cold. When we got back to our cabin, I figured out what the problem was. I had not taken the time to read the box and had grabbed and given her the nighttime cold/ cough medicine instead of the daytime one. The poor girl was sedated! Since fortunately she didn't fall off the horse, we can laugh about it now. I promise that I never did anything so careless moving forward. Trust me. Most parents have done some dumb stuff, the photos on Instagram are usually just showing the better moments. If you are human, take it easy on yourself as long as you gather wisdom and learn lessons. We all have fairly different parenting styles. Alana (who I never punched across the room) generously offered to let me share a glimpse of mine. Because I actually kept (and still keep) a journalof milestones, I recently reread the letter that I had written to her as she left for college. She was the baby moving out. This was a big milestone for me as well. I did need to make some mild edits and I have some explanations at the bottom for some of the more cryptic references. Warning This letter is not rated G. Oh Goodness….Dear little Pooh of mine, How is it possible that it is time for the ….letter. Just a blink ago you were my sleeping, spitty, very large baby. First of all, you know (but I will tell you anyway) how very proud I am of you. I must have done something very wonderful and you are my reward. There is no one quite like you. You are a magical person. You never lose a friend, you just keep collecting them. You are fun to be with. You are kind. You are smart. You are wise beyond your years. Of course, no doubt, that is partly due to me (mommy takes a bow.) We will now review the mommy theories of life. The PIE theory You know the pie theory very well. So we will simply discuss its relevance now. Your pie is changing more drastically than it ever has before. You have pieces shrinking and other pieces dramatically growing. Brush off that student piece please…it has been fallow. Create a brand new…”let's do some laundry piece” Just be aware that huge pie shifts are exhausting…if life seems overwhelming for a bit it is perfectly natural as the pieces settle into place and you achieve a new balance. (My pieces will be shifting as well, but my mommy piece is always available to be a large as you need it to be) The Stress Point theory Everything in life causes some amount of stress. Obviously some things have way more stress points than others. Sometimes, though even the littlest thing can tip the scale and move you from mild stress to moderate stress or to completely stressed out (otherwise known as the straw that broke the camel's back.) Starting anything new is worthy of plenty of stress points. Make sure you get enough sleep, especially at first!! Sex, Drugs, Rock and Roll Sex Make good choices…I do not expect you to remain a virgin until you are 30. That would actually be most unfortunate, Just make sure that anything you do is something you will feel good about. You are worth a lot. Condoms are an unfortunate fact of life until you are in a committed relationship. Frankly I would insist that an experienced partner be tested before I did anything   *(remember the lollipop story) okay fine…let's quickly move on... Parting words, remember that you can always talk to me about anything and Lauren, I am sure is another fine resource if you want to bounce something off of someone other than your mom (even though she is remarkably cool.)   Drugs easy….just say no, Actually just be smart and safe. Alcohol is a drug, and lemon drops taste good…be careful. If you do drink a bit too much, the body can get dehydrated as well as hypoglycemic. Orange juice and graham crackers are good things to eat/drink. Remember: Vomiting all night… Not fun! Know your limit Rock and Roll That’s fine, just don’t start liking country or rap Relationships Remember that relationships are learning stations. You will learn what it feels like to dump someone, you will possibly learn what it feels like to be dumped (or at the very least lied to.) You will learn what characteristics you like in a partner and what things you don’t want to put up with. Never regret anything. Cherish the good memories learn from the bad ones and move on. And the very new theory…men are like shoes Some you try on (have them tested first…just kidding; second thought not kidding…do it.) Some you buy Some are comfy, Some just look good, Some will give you blisters if you wear them too long, Some get tight but can be stretched out and worn in (This works doesn’t it!!!) Happy shopping QUICK LIST French onion soup on a first date is probably not a good idea if you want to impress Check your blind spot Floss Use sunscreen Take viactiv Don’t get a job where you need to wear a stupid hat No reality shows (sorry I know this is a tough one) Optical illusions When you get in a disagreement with someone, remember that life is often like an optical illusion, People see what they see, and know what they know. There are indeed white arrows there, but they can’t see the black arrows as hard as they look. (Or they can only see the young lady and can’t see the old crone) Always try to see both images and feel sorry for those obstinate folks that simply can’t Honesty People lie all the time. They think it makes life easier. Lies are heavy to carry around and they often get complicated. It is wonderfully freeing to just tell the truth. It might be difficult for someone to hear, but oh well, they just have to deal. Don’t lie Psychic stuff Know the difference between the good spirits (which hover around you), the confused spirits (that you tend to encounter) and really icky things (that hopefully you never need to deal with.) Call upon those good ones to just weave the golden web around you whenever you feel the need. You are fairly powerful, keep learning to control it. Encounters with the strange and wonderful (real people…not ghosts) You don’t have a prayer actually. You attract the odd, the strange and yes the wonderful…Both your grandmothers and your mom have passed that lovely gene directly down to you. May you always have fun, and great stories, but be wise and know that it is better to be safe than to have a good scary adventure story to tell. Great saying Love many Trust Few Always paddle your own canoe Easy Mitzvah Call or email your Grandparents. Bambi If the deer discover the magic of Alana (hey all other animals do) don’t feed them, and learn to check your body head to toe for deer ticks. They are tiny and black and look like raised freckles, you can check your scalp by just running your hands through your hair and feeling, you would feel a raised bump (..I bet lots of moms send their kids with letters, perhaps mine is the only one with tick advice?) Have a blast Carpe diem! Seize the day! You are about to start a great adventure. Enjoy every moment! Stop and look at the sunsets! Never ignore a “good sky”. Savor the gorgeous place you are in, Oceans, Redwoods, Deer, Brunch….How lucky are you?!?! I love and adore you. Mommy ************************************************************************************ Here are some further explanations to help make sense of things Lollipop story There was a story on the news about a teacher who ultimately was fired for an unorthodox approach to teaching about safe sex. He had started the class licking and sucking on a lollipop. After a few moments of this he told the class he was going to pass it around and have everyone in the class take a few licks and keep passing it around. The students all made expressions of disbelief and disgust. He went on to point out the obvious parallels of unprotected sex. I was happy to share this with my teenage daughters. Psychic stuff I come from a family where it is hard to to find rational explanations for the oddities and coincidences that abound. Whatever it is, Alana has it in spades, Lauren has managed to avoid it so far. Mitzvah A mitzvah is a good deed and I did my share of nagging to make sure my kids made a point of reaching out to their grandparents. I am proud to say that they were pretty good about it, and probably didn’t need quite the amount of nudging that I did. Bambi/ Deer Alana was at UC Santa Cruz, the day we dropped her off, there was a deer standing in front of her dorm as if he was waiting to welcome her. She is an animal magnet; my warning not to pet the deer was necessary. Ten years after this letter, Alana has still never lost a friend and continues to collect them.

My Mother in-law/The amazing Nanya

My mother in law/the amazing Nanya

May 4th would be my mother in law's 92nd birthday. In honor of that, and with Mother’s Day right around the corner, I decided to take a break from topics like yucky viral syndromes or tick bites, and share some more personal stories about my children’s paternal grandmother. In Law. Just the word might make some people shudder and prefer reading about insects. It can make others feel warm and fuzzy. Regardless of who you get dealt in the in-law department, you have choices as to what type of relationship you establish with your partners parents. Some relationships are more challenging than others. Others are easy from the start. My married daughter Lauren couldn’t be luckier with hers. Even if you are not close at first, bringing a baby into the equation is often an opportunity to deepen the relationship in a meaningful way. Some folks have turbulent relationships with their own parents, so making the assumption that it is only an in-law that presents challenges is flawed. Take a breath and if it is all possible hit the reset button. Having a child in the mix changes everything. Before the kids came along, my dealings with Sandy’s mom were clearly going to be a bit interesting to say the least. When I met her for the first time, I was only 17 and I was outmatched from the start. Elaine was the proverbial Jewish mother who was pretty certain that both of her children were perfect. Sandy was her only son. Being the woman worthy of him was something I was clearly going to have to work towards. One of the first battles of the ‘girlfriend versus the mother’ came when Sandy had to have his wisdom teeth out and asked me to come to NY to be with him. Elaine had already made vats of soup, and had purchased a new blender to make soft foods. “I am his mother and I will take care of him.” I did a wise, quick retreat; Mom was going to win this round. After several years when it became apparent that this relationship wasn’t going away, we got to be more and more comfortable with each other, but it wasn’t until I had my first child (and the first grandchild for my in-laws) that our relationship became set. We united in the mutual love of the kids and ultimately had a close, enduring loving relationship until the end of her life in 2012. She was another mom to me, but without the same baggage that she had with her biological children. Elaine may have had some challenging traits as a mother, but as a grandmother she was superb. She threw herself into the role with every ounce of her being. As soon as I became pregnant, Elaine started to mull over what she wanted to be called as a new grandparent. She didn’t want to be called something as common as grandma; even the mention of Bubby horrified her. She decided she would be Nanny. Lauren had other ideas and called her Nanya. It stuck and was perfect. Nanya she was. Nanya belonged to Lauren. These two were soul mates, if you believe in that kind of thing. (Spoiler alert, I do.) When baby sister Alana came along, Lauren had to learn how to share. The first time Elaine held Alana, Lauren took one look and said, “Nanya, you need to put that baby down. Give her to someone else.” Although Sandy’s parents had moved from NY to south Florida, they made a point of staying connected with visits to San Francisco every several months. It wasn’t always easy to have relatives come often and stay for several weeks, but having the open door policy is a choice I will never regret. My own mom instilled that value in me. When I was growing up, our vacations were based on grandparent visits rather than trips to more exotic locations. If you are fortunate enough to have grandparents in the mix, make the effort to help foster the relationship that they have with your children. There are so many people out there who would give anything to have their parents alive to share the joy of watching the grandchildren grow up. Don’t waste this. (apologies to any of my readers for whom this might be a trigger.) There was never a grandparent day at school that Elaine missed. She had a way about her and attracted all of the kids to her orbit. Everyone knew Lauren and Alana’s grandma. Nanya was a brilliant and fiercely independent woman. When she was in town, she took the car keys, figured out the car seats and took the kids to movies, parks and museums. It was always an adventure. One story that is hard to forget is the time she spent several minutes playing catch with a gorilla at the zoo, until someone pointed out that she didn’t want to be handling the substance that the gorilla was tossing to her! She gave money to people on the streets. She was quite clear that she didn’t care what folks did with cash. It was her choice to give. It was theirs what they ended up doing with it. One of the lessons that Lauren cherished the most from her grandmother was that it is okay to crave and insist on some alone time. Lauren also inherited the travel bug. Elaine loved to visit far off countries, often by herself. She would pick a place and spend a couple of years researching and planning what she would see. She loved art and would have a list of museum exhibits to visit. She would also learn some important phrases in the new language. When we were clearing through her apartment after she died, We found a list of some quick translations in Turkish from a trip to Istanbul: Where is the bathroom How much does this cost This is my hotel Chocolate ice cream (Lauren used this phrase personally on her own trip to Istanbul!) I admire her priorities!

She never took photos. She said that’s what postcards are for. She wanted to see things from her eyes and not behind the lens of a camera. In 2014, Lauren packed up her sturdy backpack which she still has, and is called “ chocolate Ice cream”, and went to spend a year teaching English in Israel. She took advantage of being in that part of the world to take short trips during her breaks. The first trip she rather randomly planned was to Budapest and Prague. When we told Uncle Bert, Elaine’s brother, that Lauren was going to those two cities, he paused for a moment and told us that those two places were the next ones on Elaine’s bucket list. We had no idea. She had started doing her research but age got in the way and she wasn’t able to go. We got the chills. Maybe not so random after all. One of the last but important lessons she left us with was that everyone grieves differently. There is no such thing as a correct way to deal with loss. Elaine had a framed poem that she treasured: I’m not Here Don’t stand by my grave and weep For I’m not there, I do not sleep I am a thousand winds that blow I am the diamonds glint on snow I am the sunlight on ripened grain I am the gentle autumn rain When you awaken in morning’s hush I am the swift uplifting rush Of quiet birds in circle flight I am the soft stars that shine at night Do not stand at my grave and cry I am not there, I did not die Indeed, her lessons and her love live on.