Dr Rungsima Pediatrician

This is their shot! Children 12-15 years old are now eligible for the covid vaccine from Pfizer. Please check with your local vaccine sites for appointment.

Election Day is approaching. Being a good role model is an important part of parenting. Here’s some tips about how to talk to your child about voting. We can start as early as toddler years.

https://www.ahaparenting.com/blog/how-to-talk-with-your-child-about-voting

My baby has bowlegs, should I massage it out?!!! My toddler has knock-knees, should he/she see the specialist?

Understanding Bowlegs and Knock-Knees

A common concern for parents, bowlegs and knock-knees are primarily due to the child’s normal growth and development. However, only a very small number of children need treatment. Physiologic bowlegs and knock-knees will not affect a child’s ability to crawl, walk, run or play. Some children may walk with their toes pointed in, trip more or appear clumsier than other children their age, and, children at the extremes of the normal growth curve may have bowlegs or knock-knees that often look severe. However, these are symptoms of bowlegs and knock-knees seen in most children, which the child will typically outgrow.

The following is the normal growth and development for children, from infancy to the age of 10:
* From infancy to 18 months, a child’s legs are initially bowlegged (varus), causing toddlers to often walk with their feet wide apart.
* When the child is between 1-1/2 and 2-1/2 years, the legs have usually straightened.
* By 3 to 4 years, the child’s legs typically grow into a knock-knee (valgus) position.
* Finally, by age 8 to 10 years, the child’s legs have settled in to what will likely be their adult alignment.

For the vast majority of children, treatment only involves observation (allowing growth and time to correct the legs) and parental reassurance. Physical therapy, chiropractic, special shoes, vitamins, and bracing have no effect on the normal development of normal legs.
If the pediatrician does have concerns about the severity of either condition, a referral to a pediatric orthopaedic surgeon for evaluation is often recommended.

One of the most common questions that come up during 1 yr visit is milk and milk alternatives. Also what to do if their children refuse to drink milk. Around 1 yr babies can start being introduced to milk. WHO recommends breastfeeding for at least the first 2 years old life, but continuing breastfeeding might not be possible in some families.

Here are common questions…

❓Why do toddlers need milk?
👉Toddlers don’t NEED milk; however, they do need key nutrients that milk contains. While milk is not the only source of these nutrients that kids can eat, toddlers tend to get those easiest from milk.

❓Allergy to dairy, lactose intolerance, or prefer plant-based milk, what is good alternative milk?
👉To answer this question, it’s better to ask what is the key nutrients toddlers need?
🥛Calcium: see reference for daily requirement
🥛Vitamin D : Toddlers & young children need 600 IU/day
🥛Vitamin B12 : found in animal products so vegan children are at the highest risk for vitamin B 12 deficiency; therefore, supplementation is recommended.
🥛Protein : important for toddlers and young kids for growth and development
🥛Fat : Toddlers & young kids need fat intake for brain development and to help absorb fat-soluble vitamins (A, D, E, and K). Toddlerhood is not the time to reduce fat and calories.

2 cups of cow’s milk provide just the right amount of these nutrition toddlers need. However, in case of allergy, intolerance, or family preference, choosing the right alternative is important to provide the right amount of nutrition to your child. Soy and pea milk are the ones that have comparable amounts of protein, calcium, and vitamin D but less fat, which can be supplemented by other healthy fat.

❓How much milk should a toddler be drinking?
👉It is important to limit your toddler's milk intake to no more than 24 oz per day. Ideally, 12-16 oz/day max.

If they are consistently drinking 24+ oz of milk, they are likely not eating enough of other foods needed for growth and development. There is also a higher risk of anemia that comes with drinking too much milk and not enough iron-rich foods.