Vitamin D for Babies & How to Give Babies Medicine

Here is my first video blog post!  We did this video in one take, after getting everyone at home to cooperate.  Pumpkin had fun starring in his first role, and Peanut enjoyed being director.

In the video, I am giving Pumpkin vitamin D solution.  Current recommendations for vitamin D supplements are 400 IU daily for breastfed infants, starting shortly after birth, because, although breast milk has many valuable components, it is low in Vitamin D.

Formula does contain vitamin D, but unless infants drink 1000ml of formula a day, they may also need supplementation.

Vitamin D is important for skeletal health, a healthy immune system, strength and balance, and more, as we keep finding additional benefits as new studies are done.

After the first year of life, the recommended daily intake of vitamin D increases to 600 IU a day.

As always, check with your doctor before starting any medication or supplements for your child.



Things Babies Don’t Need

I went shopping with Peanut, Sweet Pea, and Pumpkin on my “day off.”  Actually, the kids are pretty good in the store.   It’s one of my “go to” methods when they’re fussy – put them in water or take them shopping.  Still, it’s a lot of work to take them, and constant supervising, constant teaching, and constant explaining why we don’t need things.

It’s no wonder you go in looking for diapers and the next thing you know you’re walking out with an overpriced baby swing, purchased with the hope of a few moments of sanity.

At any rate, today’s shopping trip made me think of all the items babies don’t need.  I decided to make a list:

Diaper wipes:  If we could minimize the use of diaper wipes, we would save a lot of baby bottoms from rashes.  Babies don’t need diaper wipes.  Just a cotton swab and water will do.  Even the “alcohol free“ or “sensitive skin” diaper wipes can be irritating to baby’s delicate skin.  Sure, they are convenient, and I use them for bigger diaper messes at home, and pack them when we’re out, but for the most part, I try to use them sparingly.

The first thing to do when baby has a diaper rash is to avoid diaper wipes. But, not to worry, save the diaper wipes for hundreds of other uses including getting toothpaste off clothes, wiping down the car, and as the ultimate entertainment for babies who like to pull them out of the package.

Juice:  Juice is not good for anyone, no matter what the label says.   The only time I suggest giving a child juice is to help with constipation.  A couple ounces of prune juice as directed by your child’s doctor can be helpful.

Bubble baths: Kids love bubbles, but bubbles shouldn’t be in the tub.  Bubble baths can lead to urethritis (inflammation of the urethra).  The urethra is the tube that carries urine from the bladder to the outside of the body.  The symptoms of urethritis are similar to a urinary tract infection.  Bubble baths can also predispose to yeast infections.

Walkers:  Baby walkers lead to many injuries, ER visits, and studies have shown they can actually delay walking for babies.  When infants use walkers, they can’t see their legs and feet moving and contacting the floor, thus, they are deprived of visual feedback important for neurodevelopment.  Here are a couple of studies showing harm of walkers:

Bumpers: Bumpers in the crib are a risk for suffocation.  Baby’s crib should have a firm mattress, tight fitted sheet and no soft bedding or bumpers.

Shoes:  Baby shoes are adorable, but until babies are walking outside of your safe home, and need their little feet protected from rough surfaces, babies don’t need shoes.  In fact, baby’s feet should be able to develop shoe free.  When learning to walk, babies should be able to feel that their bare feet are stable on the ground.  The tactile feedback is important for baby to learn balance and normal gait.

After market car seat accessories:  The only thing that should be attached to a car seat are those that came in the box with the seat.  Anything after market was not crash tested with your particular car seat and may present a hazard to the function of the seat.  Objects placed behind and around car seat straps, like fleece seat bags, fuzzy strap covers, and infant head supports can interfere with the snug strap fit.

Sippy Cups: Babies don’t need sippy cups.  I need sippy cups.  To prevent the mess, that is.  But, a sippy cup is not a necessary transition from a bottle to a regular cup.  Babies developmentally can go straight to the regular cup.  This is even encouraged by some speech specialists.

Sleep positioners:  These products are marketed for safer sleep for babies, but they have actually lead to SIDS.  Here is an article warning parents not to use sleep positioners.


Baby Videos:  The AAP policy is no TV for kids under age 2.  Babies don’t need videos to become little geniuses.  Babies learn much more from play and from social interactions than from television programs.  Here is a previous blog post where I wrote about our experience with Dora.

Well, I came up with ten, but feel free to add the items you didn’t need for baby. I hope this helps par down your shopping trip!

Chalk this up for things babies don’t need. Here is Peanut’s first ride in a cart. Notice the extra blanket cushion along with the cart cover. We’ve relaxed a little since then.

A Story about Motherhood and Going Back to Work

I’ve been a little busy over the past month.  Turns out, having three kids ages three and under doesn’t leave a lot of writing time.  The experience I have had over my maternity leave has been beautiful and fulfilling, yet downright exhausting at times. There were times when I felt like I may be approaching my wit’s end… Like this one…

I’m sitting on the couch trying to breastfeed Pumpkin.  He’s not sure if he wants to eat, but he is sure that he wants to cry.

Sweet Pea is alternating between crying for me to lift her up and crawling through the maze of pots and pans filled with water (and who knows what else) from our leaking ceiling.  She only puts her hand in the pots a couple of times, each of which times I nearly faint of germophobia.

Peanut is throwing her stack of ABC cards around the room, dispersing them nicely in corners, crevices, and spatially oriented over the floor.  She found a spool of yarn (which is odd because I don’t sew, craft, or even own any of those devices to use with yarn).  She is running throughout the house with this mystery yarn, essentially creating a large booby trap.

There is no dinner in the oven, because it is broken.  Meh, who am I kidding? I can’t manage much more than a fixing a turkey sandwich anyway.


This is our living room. Yep, we’ve all been there…

I’m tired.  I’m sooo tired.  A newborn, a one year old with four separate ear infections , a three year old with a case of  “I think I’ll wake up in the middle of the night because, hey, everyone else is doing it,”  and hospital call for Daddy MD meant a near zombie-like state for me for a couple of months.

But, just when motherhood gives you more than you think you can possibly handle, those little stinkers know how to make you happier than you ever thought you could be.

The witching hour(s) from 4pm til whenever Daddy gets home eventually end.  He takes the girls and I get a moment with Pumpkin.

Pumpkin smiles for the first time.  I’m elated, and I forget I haven’t slept more than two hours at a time in 5 weeks.

Later, I’m rocking Sweet Pea.  She doesn’t want to go to bed – shocker, I know.  But, instead of squirming her way out of the rocking chair and pointing to the door, she drags her little finger to my eyes, nose, and mouth giggling as she names each one.  I giggle too, and hold my baby, who is becoming a toddler too quickly.

Then, Peanut’s special time.  We’ve collected enough of another deck of cards from around the room to play “Old Maid,” (the Peanut version where I have to hold the Old Maid at all times).  Peanut says to me, “I love these days.”  I do too, Peanut, more than you will ever know.

I’m holding onto these sweet moments as my maternity leave ends.  It’s my third time “back to work,” and it never gets any easier.  Here are a few things that have lessened the stress:

Getting organized: things as simple as hanging work clothes in the bathroom, finding your car keys, and packing a lunch the night before can save rushing around in the morning.

A transition period with caregivers before the first day back to work.  A few shorter times with your child and new caregiver can help ease your mind that the kids are comfortable while you are at work.

For breastfeeding moms, practicing pumping for a couple weeks before will increase your confidence, as well as build up a supply so that you won’t worry about having enough milk that first week back.

Baby Brother Arrives! Embracing the Newborn Period

Our sweet baby boy was welcomed with lots of love this past month.  Peanut has nicknamed him, “Pumpkin,” a name she came up with all on her own.  The name does seem appropriate, considering all the pumpkin pie I ate during pregnancy.  And, “Pumpkin” fits with our nicknames for the girls, so we’ll go with it for the blog too.

Peanut and Sweet Pea are adjusting well.  Peanut has taken on her little mommy role, and Sweet Pea points to Pumpkin and says, “tada,” which we think is her name for baby.  Sweet Pea has a new found interest in her baby dolls, especially putting them to “night night” in her play crib.

Time is flying by already, and my thoughts are clouded by sleep deprivation, as can be expected with a newborn.  I recall Sweet Pea’s pediatrician telling me at her well newborn check, “You’ll eventually block much of this first month from your memory.  We know that happens, otherwise, no one would ever do this again, because it’s so hard.”

It is hard, this first month of caring for baby on little sleep, especially with two other young children.  The advice, “sleep when your baby sleeps,” is a funny little joke when you also have a Peanut and a Sweet Pea.

I was so tired this week, that when I heard Pumpkin rustling in his bassinet and then fall back to sleep, I dreamt, “oh, he must have gotten up and fed himself.”

But, despite the craziness of sleep deprivation, I really don’t want to lose any of these moments from my memory.

I want to remember how wide his eyes get just before he latches on to eat. I want to remember how when he’s full, he lifts his chin, lips pursed, raises his eyebrows to wrinkle his forehead with his eyes closed, and turns his head side to side, as if to say, “yes, that’s all, I’m finished.”  I want to remember just how soft the soles of his feet feel.  I want to remember those big stretches with arms just long enough to reach the top of his head.  I want to remember those sweet baby sleeping noises, “hmmm, hmmm, hmmm.” I want to remember the times when I pick up my restless baby, and he immediately lays his head on my chest to sleep.  I want to remember watching the rise of fall of his back as he sleeps soundly on my chest, and the feeling that the two of us are right where we are supposed to be.


Here are a few key things to know when bringing home a new baby:


  • Babies need a safe sleeping place on a firm mattress with a tight fitted sheet only.  No bumpers, blankets, or anything soft in the crib.  Babies should be put to sleep on their backs.
  •  If baby has a fever in the first two months of life, seek medical care right away.  A fever is a temperature of 100 degrees F or greater, checked rectally.
  • Babies cry.  Crying is communicating.  Try to calm yourself first, and listen to your baby.  It will take awhile to learn, but babies really do have different types of cries for different needs.  (I’m much better at deciphering these with the third baby than with the first!)  Crying slowly increases over the first month and usually peaks between 6-8 weeks old.
  • The first several weeks with a newborn will be some of the most special, yet most challenging times of your life.  Don’t be afraid to ask for help.  Asking for help when you need it is part of being a responsible and caring parent.


Here is a link with list of resources for new parents in Grand Rapids.

Sweet Pea is 1! An Ode to One-Year Olds


This post is for our Sweet Pea as she turns one year old.

You are one today.  Everything you do is so precious and cute – from the way you tilt your head way back and scrunch your face to drink your sippy cup, to the way you reach out for us and open and close your little hands when you want to be picked up.

Your nickname, Sweet Pea is so fitting.  You are such a snuggly baby.  You love being carried and held; so much so that you won’t put your feet down when we try to help you support your weight with your legs.  You’ll lift your legs straight out in a plank to avoid touching the ground.

You love your big sister.  No one can make you laugh quite like Peanut.  I love that big belly laugh she gets you to do.  She’ll run in circles and you’ll crawl around to chase her, squealing with delight when she meets you around the other side.

You have a few words.  Peanut’s name was your first, then “dada,” and “nigh, nigh” (for night, night).  This week you crawled to me and rested your head on my arm and said, “na, na.”  I’m pretty sure you meant “mama” because my heart melted when you said it.

We’re so proud of how your caring personality is developing.  You give your stuffed animals hugs by holding them up to your cheeks.  Sometimes, you pat my back when I carry you around the house.  You look with concern at Peanut if she cries.

You love music and bounce your head with big smiles at anything with rhythm.

You’re really becoming interested in toys and anything with a door.  We bought you a little play door for your birthday and you’ve been crawling in and out with smiles and giggles for three days straight.  You were so excited to play at your birthday party you wouldn’t take a break for a diaper change.  You shook your head no, and pointed back to your toys.

You have such a cute sense of humor. You imitate our silly sounds, and make your own.   Daddy and I love your square-jawed gummy smile and the way you breathe through the corners of your mouth in a little baby chuckle.  You know that makes us smile every time.

Daddy and I are so lucky to have you and Peanut as our daughters and we want to remember these days vividly and always.

Turning one is a milestone in so many ways, but I’ll stick to a couple topics for tips for parents of one year olds here:


Most one year olds will be on table food; 3 meals and a couple of healthy snacks a day, averaging to eating about every 3 hours.  Serve milk with meals and water in between.  Growth slows down in the second year, so trust your toddler’s appetite.

Please don’t give your kids juice.  There is no nutritional value, even if it says 100% juice.  Juice has a lot of empty calories and sugar, and leads to childhood obesity and dental caries.  It’s much better to get vitamin C from a piece of fruit.  Though, a few ounces of prune juice here and there is fine to help with constipation.


Even if you were looking forward to flipping that carseat around, please keep your one-year old rear facing.  New recommendations from the American Academy of Pediatrics (AAP) advise that children be rear-facing at least until age 2, and as long as your child is within the weight limit of the rear-facing carseat.  Here is a link with more information and a video.  We want children to be rear-facing to better support the head, neck, and spine.

Now, on with the adventures of toddlerhood!

The Sibling Bond


Peanut and Sweet Pea really love each other.  I don’t think there is anything that could warm my heart more than watching the two of them play together.  Still, I wonder, do siblings ever need a break from each other?  Do they ever feel like they are competing for mommy and daddy’s attention?  Do they grow tired of consistently wanting the toy that the other one has? After all, they do spend a lot of time together, every day.

Peanut has done well assuming her role as the big sister, and truly enjoys making Sweet Pea laugh.  But, the whole idea of another baby seems to overwhelm her.  We’ve had our share of Peanut acting out lately, which I’m attributing to the growing size of my belly and closeness to delivery.  I’ll tell you the baby powder disaster story later.

We decided to sign Peanut up for Spectrum Health’s new sibling class – a 2 hour session with fellow 3-5 year olds.  We attended class this week.

It was adorable.

I honestly have never seen Peanut listen so intently.  She sat amongst her peers (an added benefit of the class is the peer support) and looked wide-eyed as the teacher described that baby was in a skin sack in mom’s belly, so that when mom eats, food doesn’t get all over the baby.  Ohhh… now that made sense.

Sometimes, when we’re nervous, we really just need more information.  It must be so abstract to a three year old to think about how baby grows and comes out of mom’s belly.

So, I appreciated how honest and simple the teacher explained how baby grows, and how someone special would be staying with Peanut while Mommy and Daddy went in to the hospital.  She told Peanut how happy Mommy and Daddy would be when Peanut comes to see us in the hospital.

The kids answered questions about babies.  Most knew that babies couldn’t talk, and so they will cry when they need something.  They learned to only hold a baby while sitting with Mommy and Daddy’s help and got to practice with baby dolls.  Lastly, we took a tour over to the hospital to see the post-partum floor, a hospital room where Mommy and Daddy would be staying, and a real newborn in the nursery.

After the class, we took Peanut into the cafeteria and let her use the frozen yogurt machine – an old favorite of ours during our residency days.  We let Peanut know that when she comes back to the hospital to meet baby brother, Daddy will let her make frozen yogurt again.  Talk about a perk of being a big sister!

We all enjoyed the entire evening, and Daddy MD and I loved the special time with our big girl.  We’ve tried to give Peanut lots of individual attention to reassure her she’ll always have Mommy and Daddy time.

I had also arranged for a special Mommy and Peanut day– her first trip to a ballet.  As I was loading her into her car seat to head to the performance, Peanut said, “I wish Sweet Pea was coming.”

Here I was trying to give Peanut her own day and she immediately thought of her sister.  In that moment I was so impressed with the bond between siblings, and the tolerance they must have with one another.  I am optimistic about giving Peanut and Sweet Pea another sibling to love.

In Peanut’s take home packet from her sibling class, there was a great list of tips for new siblings.  Here are a few I really liked:

Before birth: Prepare your child for your hospital stay.  Present the separation from you as something special, “Grandma is coming to our house and she will bake cookies or take you to the park.”

After birth: A small photograph of the older sibling may be taped to the newborn’s crib at the hospital.  Your child will enjoy seeing it there when he or she comes to visit the new baby.

Regression and Dependence: Your older child may become more clingy, whiny, or demanding.  He or she may develop new behaviors you haven’t seen in awhile – interrupted sleep, thumb-sucking, bed-wetting.  The behaviors will fade when he or she understands that his or her place in the family is secure.

3 Kids, 3 and Under

I’m really starting to look pregnant, pregnant enough for people to ask, “How far along?” And then, “Is this your first baby?”

When I tell them this is baby number three, and that we also have a three year old and an 11 month old, they give me an almost universal reaction: “You are going to be busy!”

I’m lucky to have lots of patients who have had multiple young kids – they offer up tips and tell me I can do this.  I really appreciate the blatantly honest advice, too, as one patient told me completely straight-faced, “Oh, you’re in trouble.”

Yes, the impending chaos in the Armstrong household is now quickly approaching.

Although I’m not sure if any parents can ever be truly prepared for a new baby, we’re doing our best to be ready.

We did a lot of “preparing for baby” with Peanut before Sweet Pea was born and overall, I think she handled the adjustment well.

This time seems a little different.  Being so close in time to when Sweet Pea was born, I feel like Peanut is a little extra nervous, because she knows what is about to happen.

I haven’t had time to forget how rough that first 1-2 months was with a newborn and a toddler.  I have vivid memories of attempting to latch and breastfeed a hungry baby, while entertaining a meltdown (over an immediate need for crackers) from a toddler, who was stomping in a milk puddle in her rain boots.


Minnie had a rough day. Sometimes you just have to laugh and take a picture of Minnie face down in milk.

I’m sure Peanut remembers that she had to sacrifice some of mom’s attention when Sweet Pea arrived.  We talk a lot as a family.  We remind Peanut what a good big sister she is to Sweet Pea and how we are so happy about how she cares for her little sister.  We ask her what she thinks about having a baby brother.

Peanut and I were having a heart-to-heart about refraining from jumping and climbing all over mommy while baby brother is in my tummy and she said, “Ok, I’ll wait until after baby brother comes out.  But then, no more babies in your tummy.”

Sounds like a plan.

We really are overjoyed for the upcoming arrival of baby brother.  We’re mostly concerned about how the girls will react to the change.  Here are a few things I’ve read and tried to prepare siblings for a new baby:

Show your child he/she is special and important: We went through Peanut’s baby book with her, talking about all the pictures and things we did for her when she was a baby.  Involve your child in the naming process for the new baby, ask for suggestions, and ask him/her which names she likes.  Peanut wanted to name Sweet Pea, “little tiny baby” and she has been calling baby brother “pumpkin strawberry.”  Take your child along with you to OB appointments to help listen to the baby.  Its’ lots of work for me to take the girls along, but Peanut loves being included in my OB visits.

Once baby arrives, be sure to include one-on-one time for each child everyday.  I know it’s hard to have the energy to keep up with a toddler after being up all night with a newborn.  But, kids crave and need this individual attention from mom or dad, so try to let your child lead you in an activity each day.  It could be as simple as cuddling up to a few books.

Routines.  Children are comforted by consistency.  Try to keep the day’s schedule as close to before baby as possible.  Rules are still rules, and don’t feel guilty enforcing them.  Children actually will feel better if the rules stay the same; it’s reassuring that their world is not completely changing.

Here are a couple things every parent should do before baby:

Make sure the car seat is properly installed.  Research shows that 70-80% of car seats are incorrectly installed.  Here’s a link to have your car seat checked.

In Grand Rapids, we are fortunate to have the Safe Kids program at Helen Devos Children’s Hospital.  They offer car seat safety checks among lots of resources.

Cocoon your newborn.  Make sure all visitors for baby’s first few months are immunized against pertussis and the flu, with a Tdap, and an influenza vaccine.  New recommendations this year from the ACIP advise all pregnant women to have a Tdap during pregnancy, preferably during the last trimester, when antibodies start to transfer to baby.