Happy Birthday! Let’em Eat Cake!

After completing my pediatric training, I worked for a couple of years in a large pediatric office before I had any children of my own. I was always struck by the Life Event of a child’s first birthday. This milestone carries so much meaning and emotion for families. My patients’ parents described huge birthday parties with characters such as Elmo walking around or Moon Bounces, large catered affairs with numerous friends and family members and entire neighborhoods.

Often I would see a child sick in my office a few days before such an event with parents who were panicked that their child might be sick on his Big Day, or I would see a child for his one year well check and hear many details about the enormous party. Of course I also saw plenty of children a few days after their first birthday party who became ill, most likely, from a well-intentioned friend or relative who was already sick and passed the illness on to the birthday child at the party. I heard about the kids who clapped for the Happy Birthday song and kids who cried and one who vomited from excitement… all over the birthday cake. Many of my patients had their first full blown temper tantrum during their own over-stimulating first birthday party.

I remember not quite understanding why parents go through such effort and expense to throw a party that their child will never remember at a developmental stage where 99 percent of children are having stranger anxiety and separation anxiety, often forgoing daily routine to skip naps, eat at erratic times, and then expect their birthday child to perform in front of a large crowd singing loudly at them. “My husband and I will do it differently,” I would tell myself.

Now, three of my own children later, I must apologize for not quite understanding about that first birthday. I remember waking up on the day my oldest turned one year. My pediatrician brain first exclaimed “Hurray! No more SIDS risk!” Then my mommy brain took over, “Ohmygosh, I survived the first year of parenthood!” This day is about Celebration of the Parent. I finally understood completely why my patients’ parents needed all the hoopla.

Because I am actually a little uncomfortable in large crowds, my son’s first birthday party included all close relatives who lived nearby, people he was well familiarized with. Some pediatric tips I had picked up which I will pass on:

1)      Sing the Happy Birthday song, complete with clapping at the finale, for about one month straight leading up to the birthday. Children love music and hearing a very familiar song sung by a large group is not as overwhelming as hearing an unfamiliar song.

2)      Plan mealtime around your child, not the guests. If you are inviting people close to your heart, they will accommodate. Dinner can be at 5:00pm if that’s when your child usually eats, or have a lunch party that starts midmorning and then end the party in time to allow your child to have his regularly scheduled afternoon nap. Most one-year-olds are usually at their best in the morning anyway.

3)      If your child becomes sick, cancel the party. Your child will not be disappointed because he won’t understand what he is missing. You as parent would have a lousy time anyway because all of your attention will be on your ill child and you will be anxious. Your guests who are parents will appreciate your refraining from making them and their own children sick.

Recently while performing a one-year-old well child check I asked about my patient’s birthday party and her parent told me “Oh, we didn’t have a party. It was like any other day, although we did give her a cupcake for dessert.”

Now THIS is a pragmatic approach to parenting  because, again, no child will ever have memories of her own first birthday. However, I hope the parents did take time, at least with each other, to congratulate themselves and to feel really good about making it to that huge milestone in their parenting career. I hope they savored their accomplishment as much as their child savored the cupcake.

Julie Kardos, MD and Naline Lai, MD

©2009 Two Peds in a Pod®

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Save Money: How to Penny Pinch Without Hurting Your Children

When it comes to our children, we want the best that money can buy. However, in these difficult economic times, I want to offer some suggestions from the medical perspective that can save you money without compromising your child’s health or safety.


Don’t buy “Sippy cups.” Just teach your child to drink out of regular open cups. Sippy cups are for parents who don’t like mess-they are not a required developmental stage.  They are actually bad for teeth when they contain juice or milk and they do not aid in child development.


 


Buy generic acetaminophen (brand name = Tylenol), ibuprofen (brand name = Motrin, Advil), diphenhydramine (brand name = Benadryl), allergy medication (brand names Claritin, Zyrtec). If your child’s health care provider prescribes antibiotic such as amoxicillin (for ear infection, Strep throat, sinusitis), ask the pharmacist how much it costs because usually the cost of paying for this commonly prescribed antibiotic out-of-pocket is less than your insurance copay.


 


Accept hand-me-down clothes, shoes, etc. The purpose of shoes is to protect feet. Contrary to what the shoe sales-people tell you, cheap shoes or already-worn shoes will protect feet just as well as expensive, new ones. Just make sure they fit correctly.


 


Don’t buy “sleep positioners” for the crib. Place your newborn to sleep on his back and he will not/cannot roll over. If you need to elevate your baby’s upper body to prevent spit up or to provide comfort from gas, don’t buy a “wedge” but instead put a book under each of the 2 crib legs so the entire crib is elevated. Wedges and positioners are NOT shown to prevent SIDS (Sudden Infant Death Syndrome) and are NOT endorsed by the American Academy of Pediatrics.


 


Make your own baby food and do NOT buy “baby junk food” such as “Puffs” for finger food practice. Instead buy “toasted oats” (brand name = Cheerios) which are low in sugar, contain iron, and are much less expensive. “Stage 3” foods in jars are finger foods so just give your kids what you are serving the rest of the family cut into small bite-sized pieces instead of buying the expensive jars. One exception: do buy the baby cereals (rice, oatmeal, or barley) because they contain more iron than regular oatmeal and babies need the extra iron for their growth.


 


The best toys are ones that can be reconfigured and used again and again. Legos, blocks, crayons/markers/chalk, small cars, dolls, balls come to mind. Avoid one-time only assembly type items, breakables, etc. Have a “toy recycle” party or a pre-Halloween costume recycle party: everyone brings an old costume/toy they would like to trade and everyone leaves with a “new” item (kids don’t care if things are brand new or not, only if you teach them to care will they care). Along these same lines, inexpensive paint can turn a pink “girl’s bike” into her younger brother’s blue “boy bike.”


 


Borrow books from libraries instead of buying them in stores or look for previously owned ones at yard sales, thrift shops, etc.


 


Do not buy endless videos for your child. First of all, despite claims made on the packages, NO video has been shown to advance baby/toddler/child intelligence. In fact, almost all studies show that the more screen time a child logs in, the worse they fare in their language and intellectual development. Also there is some evidence that TV/video viewing in babies can be detrimental to their brain development. Now, as a pediatrician mom, I am not saying that I never sat down and watched Sesame Street with my children (I am a product of the “Sesame Street Generation,” after all). I’m just saying that I recommend using moderation and taking advantage of free offerings on public television instead of spending money on videos. Many libraries also offer free lending of videos if you and your child want occasional “down time” in front of the screen.

Julie Kardos, MD

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