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Dr. Hillary is a pediatric nurse practitioner with a doctoral degree in health promotion and risk reduction. She knows that when it comes to family, everyone has questions that can't wait for the next available doctor's appointment. She also knows that some questions are too personal to ask a doctor face-to-face. For these reasons, Dr. Hillary is here for you.

Here are a few of Dr. Hillary's recent questions and answers!

NEW!
Q: When should I take my baby for her first dental exam?

A: The American Academy of Pediatric Dentistry recommends your baby has her first dental exam by 1 year of age.

The U.S. Centers for Disease Control and Prevention report that dental decay is one of the most common chronic infectious diseases among U.S. children. Research indicates that 17% of children 2-4 years of age have tooth decay. In addition, by 8 years of age, about 52%, and by age 17 years, 78% of children experience tooth decay.

Since an ounce of prevention can make a difference, start to brush your child’s teeth as soon as they erupt. Use soft baby toothbrush and baby toothpaste without fluoride. Your child may start to use toothpaste with fluoride when she learns to spit it out reliably. Should she swallow fluoride-containing toothpaste, she would end up with permanent white spots on her teeth.

Q: Do bed bugs spread disease?

A: Bed bugs do not spread disease. However, their bites cause uncomfortable itching.

Q: Is it safe to fly during my 24th and 26th weeks of pregnancy?

A: A healthy pregnancy should not be a contraindication to flying during the 24-26th week of pregnancy. Many obstetricians consider it safe even until 35 weeks. However, consult your doctor for recommendations for you, as everyone's situation is different.

Q: What do you think about walkers? I don't know if I should put my 6 month old baby in a walker yet. She is not sitting yet and a lot of people say I should put her in a walker because it will strengthen her back and get her to walk quicker.

A: The American Academy of Pediatrics does not recommend walkers for infants of any age, as they increase your child's risk for injuries. To help to strengthen your child's muscles, give her supervised belly time every day. Before your child is ready to learn to walk, she needs to master sitting, rolling over, crawling, and pulling herself up to stand. At six months of age, an infant should be able to have a good neck control, be able to sit well with support, roll over, and bear weight on her legs. If your baby did not reach developmental milestones expected to be reached by 6 months of age, please talk to your child's health care provider asap.

Please read my articles on developmental milestones of infants:
Birth to 6 months
6-12 months

Q: At what age should I introduce juices to my daughter? She is 4 months old now.

A: Juice can be introduced to infants at 6 months of age. But remember that even 100% juice is high in sugar, thus resulting in empty calories. Therefore, offer your infant just 2-3 ounces of juice a day and dilute it with equal parts water. Using juice to flavor drinking water will help your child maintain a healthy weight and prevent cavities.

Q: My 3YO never goes to bed without a fight. We do the same routine with her day in and day out. She gets three books, then a back rub, then it is lights out. As soon as we leave the room, she thinks of something she needs. Then if we offer it to her, she will not take it. When we go to leave, she starts screaming for it again. I have tried just leaving the room, but she will scream for hours. And I mean hours! I have tried offering her what she asked for again, but the whole cycle starts all over. We have tried setting a timer, and if she is good she will get a surprise. That worked for a little bit, then she quit doing even that. We have tried staying in her room until she falls asleep, but that can take up to 3 hours. We have tried letting her cry it out but the result is a 3 to 4 hour cry. We don't know what else to do. I think she is a very manipulative little girl, and if she doesn't get what she wants, she freaks out until she gets it. She has temper tantrums on a daily basis, which can last up to an hour. We try sticking to one thing, but she will cry and scream and do whatever she can until we give in. We quit giving in now for the last 2 months but nothing has changed.

A: Your daughter's severe temper tantrums and inability to fall asleep should be evaluated by a neurologist, as they may indicate an underlying health condition. Schedule an appointment with your child's health care provider ASAP.

Q: My son has never been a good sleeper. He has terrible sleep patterns and won't go to bed at night. He starts to wind up after dinner and it is like a circus until he finally drops at midnight. I have tried everything to get him to calm down at night. He gets restless sleep and use to have night terrors for two years. Now he talks a lot in his sleep and shouts out things. I have a hard time waking him up in the morning. Any suggestions to help would be greatly appreciated. Thank you.

A: Many parents whose children experience sleep problems report behavioral problems as well. Any tired child will act up and be cranky. First, do not allow your child to watch television 2-3 hours before bedtime. Many children have wild imaginations and relive what they see on TV in their dreams. Second, does your son snore or choke on food? If yes, your health care provider can order a neck X-ray to evaluate your son’s tonsils and adenoids. If both or either are enlarged, they block the airway and cause restless sleeping patterns. Third, have you ever heard your child stop breathing in the middle of the night or do you have a family history of sleep apnea? If yes, talk to your child’s health care provider. A sleep study will rule it in or out. In summary, you should schedule a visit with your son’s health care provider for a through evaluation as soon as possible.

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