stroller safety

Get into Pre-Baby Shape: Stroller Safety Edition

Celebrities make getting back into pre-baby shape look so easy! I’m sure you could too with your own team of nutritionist, nannies, personal trainers, and seamlessly infinite amounts of free time. Unfortunately, this is not the way of life for most people and those new moms who are looking to get in shape must utilize their time wisely. Often times this means dual-tasking: squats during trips back and forth to the laundry room, taking the stairs 2 at a time, jogging while pushing a stroller. So if you’re thinking about getting back in shape through some stroller jogging, here a few tips to optimize your workout and prevent injury.

Make the most of your stroller-based exercise with these safety tips:exercising stroller mom

  1. Good Posture – Good posture applies to more than static positions such as sitting and standing. When walking or jogging, it is important to remember to engage your core muscles to maintain an erect posture. This provides the base for all other muscles to work most effectively. When pushing a stroller, it is important to remember that you are pushing the stroller, not using it as a device to hold you up. A good rule of thumb is if you were to fall over if you let go of the stroller, you are leaning too heavily on it.
  2. Shoulder and Elbow Alignment – Once your core base is set, the next thing to look at is the angles at which forces are being relayed up to your shoulders and elbows. Ideally, your shoulders should be between 0 and 45 degrees of flexion and at neutral rotation. To find this position start with arms at your side. Bend your elbows to make 90 degree angles and point your thumbs to the sky. You have just now put your arms in 0 degrees of shoulder flexion and neutral rotation! Depending on preference, you can now raise your arms anywhere from at your sides to just below the nipple line for most people. This is the 0 to 45 degrees of shoulder flexion range.  When looking at elbow positions, the most important thing to remember is to keep those elbows bent! Once we lock out those elbows into full extension, we dramatically increase the joint compression force dealt to the shoulders, thereby decreasing the amount of overall arm muscle activation. This elbow extended position also tends to lead to leaning on the stroller. And as we previously talked about, this inhibits our ability to maintain a good posture. Ideally you should have between 90-135 degrees of elbow flexion.
  3. Scapular Stability – If you’re finding it difficult to keep your elbows bent and off your body, even though your posture is great, you may need to look to your shoulder blades to make sure they are providing the stable base needed for arm movement. The scapulae (shoulder blades) provide the bases for muscles further down the chain to work most effectively. Muscle fatigue in shoulders or arm muscles may be attributed to poor scapular strength. By working on scapular stability strength, you may be able to decrease shoulder pain and fatigue, and get more from your work out.

  Please seek medical attention if pain persists longer than 2 weeks or inhibits daily function.

Click here to learn more about what makes exercise so good for the body!


how tp prep your child for a new sibling

How to Prep Your Child for a New Sibling

Have a little one at home and another one on the way?  You might be thinking, “No problem, I’ve done this before!” However, this time may be a little different.  Through all of your doctor’s appointments, new room preparations, and pregnancy aches, you have a child who may be feeling any number of ways as she prepares for her new baby brother or sister.  If there’s already more than one little one at home, one might expect that reactions to the third or fourth child will be the same as when your second one came.  But beware…things change. Here is how to prep your child for a new sibling.

My primary piece of advice when preparing your child for a new sibling is to follow her lead.  Some kids might have lots of questions and show great interest in talking about the new baby.  Others might act as if you never even told them the news.  Don’t worry, kids react to these changes in all different ways.  Make yourself available to your son or daughter, while never forcing the topic.

With so much going on in your life right now, it can feel overwhelming to stay on top of all of this.

Below are some tips that parents have found helpful when preparing their child for a new sibling:

  1. Discuss changes that will occur when the newborn arrives, and start early! A newborn will bring how tp prep your child for a new siblingmany changes to the entire family, such as different responsibilities for all members of the household.  If your child will have to make significant changes such as moving his/her bedroom, try to make this change long before the newborn arrives.  This will help your little one not feel like they are being displaced by their new brother or sister.  While sharing is expected among siblings, let your son/daughter know about things that will remain theirs and stay constant.
  1. Read books about welcoming new brothers and sisters. Your local librarian is a great resource for age-appropriate books about the arrival of a newborn and books are a great way to learn about life transitions. While reading a book on the topic may spark rich discussion, it also may not.  Don’t be discouraged though; give your child time to let the changes sink in.
  1. Allow your son or daughter to be part of the planning and preparation for the newborn. Whether it’s setting up the baby’s room, looking at ultrasound pictures, or purchasing items for the nursery, having your son or daughter participate in the preparations, may help ease some of their anxiety.
  1. Expect some mixed feelings. Children’s emotions often seem all over the place. One minute they may be talking excitedly about their role as a big brother/sister and the next minute showing zero interest or even stating that they do not want to be an older sibling.  People’s emotions are often mixed about life transitions/changes, so remember to let your child know that it’s normal to have some mixed feelings about the new addition to the family.
  1. Lastly, be prepared to provide some extra support to your son or daughter, possibly more so than he or she typically requires. Of course this depends on each parents individual schedule and what time/life permits. However, spending lots of family time together and focusing on this special time you have together before the new addition arrives is important. If your child seems anxious about the arrival of the new sibling, reassuring him or her of their relationship with you will be helpful.  Maybe show them pictures from when they were a baby, so they see what it was like. While there may be lots of time and attention given to the newborn, let them know you’ll still be sure to make time for them.

Click here for 5 Roles to Assign a Sibling of a New Baby!

If you have concerns about how your child is adjusting to a new baby in the family, click here to meet with a social worker.


the anatomy of a good baby carrier

The Anatomy of a Great Baby Carrier




One question I get from my clients or friends who are having babies for the first time is this: what do physical therapists think about baby carriers such as the BabyBjorn, slings, or wraps? They also wonder if baby carriers really lead to hip problems.

There are now more carrier choices than ever before, which makes the decision of which carrier to choose that much harder.

Here are the things physical therapists look out for when it comes to choosing baby carriers:

1)    Baby Position – Does the carrier let your baby keep her joints in a natural position? For example, young babies have a naturally flexed position, meaning their back is round, their hips and knees bent, and their heads need to be supported. When she is a little older and can hold her head up on her own, she can face outward and interact with the world a little more. A carrier that lets her do that is optimal. Just like with any other baby equipment (crib, boppy, car seat, bouncer, etc), pay close attention to any asymmetries when your baby is in any sort of carrier. Babies aren’t meant to be in the same position for a long period of time. If the carrier only allows them to face to the right or left, then be sure to switch them in and out of that position frequently.

2)    Parent Posture – The same thought of proper positioning goes for parents as well. The point of baby carriers is to make life easier for you, not create unnecessary back strain, shoulder soreness, or neck cramps. Carriers with asymmetrical, off to the side, designs should be used with care, and the sides should be alternated frequently. Carriers that do not offer enough adult back support to accommodate for growing babies will do more harm than good in the long run.

3)    Carrier Material – Along the same lines, baby carriers should focus on one thing: comfort, for parent and baby. Soft padding is essential to protect the parent’s shoulders and back. Ultra-soft material should be in contact with baby’s skin. Avoid hard fabrics, buckles, or insertions that place pressure on your trunk or rubs on the baby’s limbs.

For everything else, it really is based on your needs and what you want to get out of your baby carrier; whether it’s for hiking outdoors or just getting things done around the house. While there is no medical research indicating one type of carrier contributing to hip dysplasia in babies more than others, certain positions are better for hip alignment.

See below for some helpful websites to discover the perfect baby carrier for you and your baby:

Infant Soy Formula: A Review of Recommendations from the American Academy of Pediatrics

Parents often ask me about giving their infant a soy formula when their infant shows signs of difficulty tolerating breast soy formulamilk or cow’s milk based formulas. Soy seems to be a common go-to alternative; however, there are actually only a few scenarios where soy formula is recommended. The American Academy of Pediatrics published a journal article that reviewed the use of soy based infant formulas in 2008. Here is a summary of the main points.

A Review of Infant Soy Formula:

  • Soy formula is not indicated as an alternative for breast milk or for cow’s milk based formulas except in the case of Galactosemia and hereditary lactase deficiency (both are rare diagnoses). Soy formula may also be an option for parents who desire a vegetarian diet for their infant, if breastfeeding is not possible.
  • Soy formula is not indicated for children diagnosed with cow’s milk protein allergy. Instead, an extensively hydrolyzed formula should be considered, because 10-14% of these infants will also be allergic to soy protein. Read more

How to Set Boundaries for Your Baby Without Saying “No”

Parents often ask when they should start teaching babies the word “no.”  In answering this question, it is important tobaby proofing consider things from the baby’s point of view.  Babies from 6 months to 2 years like to chew on things, bang things, take things apart, touch things, and put things in their mouths.  Babies and toddlers use these methods to learn about their world.  While it is tempting to use the word “no” to discipline your baby, there are more effective ways to keep him, and your home, safe.

Tips for Keeping Your Baby Safe Without Using the Word “No”:

  • Baby-proof your home so that your child can be free to touch, crawl or walk around without getting into trouble.
  • Use safety gates.
  • Keep medicines, cleaning supplies, and other dangerous items out of reach of your child or stored in locked cupboards. Read more

Racial Differences in the Diagnosis of ADHD

A recent study published in the June issue of the Journal of Neurosurgery: Pediatrics indicated that Caucasian children are more likely to receive a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD)ADHD in comparison to minority children.  This study followed more than 17,000 children across the nation from kindergarten through eighth grade and asked their parents whether not their children were ever diagnosed with ADHD.

Findings-Racial Differences in the Diagnosis of ADHD:

The researchers found that Hispanic and Asian children were about half as likely to receive a diagnosis of ADHD as Caucasian children.  African American children were about two thirds less likely to be diagnosed with the condition.

Implications of this Study:

It is important to realize that the study cannot indicate whether or not ADHD is over diagnosed in Caucasian children or under diagnosed in minority children.  However, the numbers are pretty glaring and most definitely indicate a discrepancy in not only diagnosing the condition, but also in the interventions received. Read more

Family History and Kids with Special Needs

If you have a brother, nephew, uncle or some other member in your family with certain special needs, you will want to be cautious and family tree mindful that many neurodevelopmental conditions have a high genetic component. Recent studies have indicated that genetics account for 70 to 80 percent of the risk of having Attention Deficit Hyperactivity Disorder. A 2004 study indicated that there is considerable evidence that demonstrates that genetics play a major role in the risk of having an anxiety disorder. It is important to realize that the risk factors are high; however, they are not necessarily 100%.  This simply means that just because a parent or relative has a neurodevelopmental disorder, it does not mean that the child will exhibit the condition. What it does indicate is that the child is at a higher risk for the condition.

As a parent, it is important to realize that your child may be at risk for a condition if a relative has that same condition. Do not be alarmed; instead, be aware. Always pay attention to any concerns, seek out advice from your pediatrician, psychologist and/or developmental therapist.

There are numerous possible warning signs for the purpose of this blog;  however, below is what to be on the lookout for:


• Does the child shy away from peers?
• Does the child have sleep onset  issues?
• Does the child engage in behaviors such as picking, biting nails, pacing, etc.?
• Are there fixed routines that the child engages in?

Click here for more on anxiety


• Does the child have difficulty focusing on work?
• Does the child require a lot of redirection and repetition of information?
• Does the child make careless errors with work?
• Does the child always seem to be on-the-go?

Click here for more on ADHD

Autism Spectrum:

• Does the child struggle with initiating and sustaining appropriate eye contact?
• Are there language delays?
• Does the child avoid seeking out others for interaction?
• Does the child avoid engaging in nonverbal behaviors such as gesturing?

The information above should not be considered to be a diagnostic check sheet, but rather possible concerns that might require further assessment. Parents, if you know that there is a family history of a neurodevelopmental condition and you see any of the above signs or symptoms expressed in your child, it is then time to seek further guidance.

Risk of OCD after Childbirth

A recent article found in the Journal of Reproductive Health (March/April 2013) that was published by researchers at Northwestern pregnancyUniversity has indicated that new mothers are four-times more likely to present obsessive compulsive disorder symptoms than that of the general population.

Obsessive Compulsive Disorder (OCD) is a condition in which the individual engages in several repetitive or ritualistic behaviors in order to help deal with intrusive, anxiety-provoking thoughts. Having a newborn is a time of increased stress and anxiety. The entire family’s daily life and expectations change. It would be abnormal for a new parent to not exhibit any anxiety or stress during this time.

If family members or friends begin to notice a new mother engaging in excessive ritualistic behaviors that change daily activities, it may be time to seek help.

Symptoms to look out for:

  • Repetitive behaviors.
  • Checking things.
  • Washing hands, putting on hand sanitizer at an excessive degree.

Do not be afraid to approach a new mother about possible concerns and to suggest possible help and intervention if need be.

Infant Reflexes: What They Are and When They Are Normal

There are a number of reflexes that your infant will exhibit. Some children develop reflexes during gestation and they go away shortly baby foot reflexafter birth. Other children may not develop until later in their life and the reflexes may remain forever. Reflexes that do not develop on time or reflexes that do not integrate (go away) at the appropriate age may impact your child’s development. In addition, it can also be a sign of neurological problems, therefore, it is a good idea to know what they are and when they are considered normal. Below is a list of important early infant reflexes and the time-frame in which you can expect to see them.

Early Reflexes:

  • Sucking-swallowing reflex: When a finger is placed in the child’s mouth, the infant will reflexively begin to suck in a rhythmical pattern:
    • Starts: 28 weeks gestation
    • Integrates: 3 months Read more

3 Reasons Your Child Needs A Meal Schedule

Today, there is the great debate among parents to whether or not put their kids on a schedule. Should I give my child a daily routine or Family eatinggo with the flow of what they want, when they want it? In terms of feeding, schedules are very important for kids that are over 6-12 months old. Prior to 6 months old, feeding really should not be done on a schedule, but rather on demand. Breast or bottle feeding on demand helps infants learn to respond to hunger and satiety cues. In addition, it allows them to eat what they need to grow to their potential. At this age, eating is very instinctual and babies know best how much to eat and when to eat, with the exception of some cases of medical or developmental issues.

During the transition to solids, between 6-12 months of age, I advise parents to introduce a routine of “meals” from the beginning. Feed the infant at the same time as the rest of the family’s mealtime(s) every day. Then, as the child gets older, continue sticking to regularly scheduled family mealtimes and snacks that occur around the same time each day.

Below are three reasons why a meal schedule is crucial for children:

  1. Teaches good mealtime habits. Ask any parent and they will say that they have experienced mealtime struggles at some
    point. One way to eliminate mealtime struggles is to have set expectations from the beginning of introducing solids. Teach your young child that when it’s time to eat, we come to the table, sit in a high chair or booster seat and have a variety of healthy foods to eat. It makes the connection for them from the very beginning that sitting at the table means that it is time to eat.
  2. Prevents “grazing”. Grazing happens when we eat randomly all throughout the day. This can lead to over-eating unhealthy foods for older kids and it may actually lead to under-eating for younger kids. When children eat little amounts here and there, they fill up just enough to decrease their appetite for well-rounded meals.
  3. Promotes healthy digestion. Eating on a schedule means that we are filling up the gut at meals and then giving it time to empty before filling up again. The rhythmic filling and emptying of the gastrointestinal tract is the ideal pattern to stimulate regular bowel movements. Furthermore, a regular pattern of meals helps keep blood sugar balanced throughout the entire day, which helps to improve energy, concentration and moods.

If your family struggles with implementing mealtime schedules or routines, contact one of our registered dietitians to schedule an appointment. A registered dietitian can help you implement ways in which you can get your family back on track and address any nutrition concerns.