Are you having a brutal winter where you live?  We sure are here in Philadelphia.  Even as a native Canadian, I have to say that this is the roughest winter I can remember in a long time!  With this cold weather, day in and day out, comes the challenge of caring for the delicate skin of the little ones in our house.  So, I turned to Dr. Kara Shah for some advice that I could use and share with you, my fellow Calm Moms!

Dr. Shah is an Assistant Professor of Pediatrics and Dermatology at the University of Pennsylvania School of Medicine and Attending Physician, Pediatric Dermatology, Children’s Hospital of Philadelphia.  Here are her responses to the questions I sent her.

1.How often should kids bathe during the winter?

KS: Most infants in general, regardless of the season, only need a full bath 1-3 times per week; on other days, parents can target washing to areas such as the face, hands, and diaper area. Toddlers and older children also usually do just fine bathing 2-3 times per week. In any season, but particularly in the winter when the air is cold and dry, attention should be paid to limit the time in the bath or shower (ideally 5-10 minutes or less), to use a gentle non-soap cleanser (examples include Dove Sensitive skin, and Cetaphil), and to moisturize after every bath or shower and ideally 1-2 times per day, more if the skin is particualrly dry. Frequent use of emollients helps to counteract the drying and irritating effects of cold, dry air.

2. Should parents be using lotion on their kids? If so, what should parents look for in a lotion?

KS: I think every child should have an emollient applied at least once daily, including after bathing. Children with eczema or sensitive skin benefit from more frequent applications of an emollient. I generally avoid lotions (generally come in a pump bottle) as these usually have alcohols in them, which can be drying and irritating. I prefer cream-based emollients (examples include Cerave, Cetaphil, Eucerin and Aveeno). Some children with very dry skin or eczema may be better with an ointment such as Aquaphor or Vaseline petrolatum ointment. I avoid products that have fragrance or lots of botanical derivatives added (these can be irritating to sensitive skin and can even cause skin allergies) and those products with a long list of ingredients (less is more !)

3. How about lip balm?

KS: Lip balm in great for cold weather or for kids who lick there lips a lot. Plain old Vaseline/petrolatum works just as well, though ! The one benefit that some lip balms do have is sunscreen, which is important to use during the summer.

4. A lot of kids can’t or won’t keep gloves in during the winter. How should parents handle that? Is it dangerous for kids to be outside in these cold temperatures without mittens or gloves?

KS: When the temperature is below freezing, in particular if there is a significant windchill effect, mittens or gloves should be considered mandatory . Frostbite or frostnip (milder cold-induced skin damage that causes only temporary effects) can and do occur in children, who may not recognize the early signs such as itching and numbness. Parents should start placing mittens on their children’s hands when they are infants to get them accustomed to wearing them. No mittens, no playing in the snow!

5. Should parents be worried at all about the harmful effects of the sun during the winter months? Personally, I wear a light moisturizer all year round, every day, with SPF but it never dawns on me to put sunscreen on the kids when it is 10 degrees outside. Should we be doing so? Or, is the exposure to sunlight good for them (Vitamin D etc.)

KS: Even during the winter, children can develop a sunburn if outside on a sunny day for an extended period of time; the sun is reflected off of the snow and ice. The American Academy of Pediatrics recommends that children wear sunscreen on exposed skin when outside during the winter for extended periods of time. My kids aren’t snow birds and are rarely outside for more than 15-20 minutes; therefore I don’t use a lot of sunscreen during the winter! If you take a snow and ski vacation with your children, however, and they are outside a lot, sunscreen is recommended. Both the American Academy of Dermatology and the American Academy of Pediatrics recommends that children receive the recommended daily intake of vitamin D through diet and supplementation as opposed to sun exposure.

Yesterday, I shared with you a chart showing how much sleep your little ones SHOULD be getting.  Are yours getting enough?

Often, behavior problems can be attributed to too little sleep.  Here are some tips on getting your little ones some good, long zzzzz’s:

-Dial it back slowly: If your kids currently go to bed at 10, don’t lose hope….you can re-train their brains to go to bed at 8.  Just do it slowly.  Dial back bedtime by 15 minutes each night. 

-Have a solid bedtime routine: Read about sleep routines for babies (also here) and kids on The Calm Mom.com.   Set a simple routine, and stick to it religiously, EVERY NIGHT. 

-Allow each family member to have their own place to sleep, all night: We all have our own views on sleep and I am crystal clear on mine.  I believe that each family member deserves to have their own place to sleep, all night long.  When babies and kids sleep with their parents, they are denied the opportunity to learn to fall asleep on their own — a skill we all need every night for the rest of our lives.  I often work with kids who are 10 or 11 or 12 and still sleep with parents (and by that age, no one is happy about it).  Trust me, it is way easier to teach a child to sleep independently at 6 months old than at 12 years old!  Furthermore, when kids come into parents’ rooms during the night, parents are denied the opportunity to get a good night sleep which they need to be calm during the day and do well at their jobs.  It can take some work to get kids to sleep independently, but it is worth it in terms of sleep quality for every member of the family. 

-Watch caffeine intake: In little kids?  YES!  Some small kids drink soda, iced tea, hot chocolate and even sips of parents’ coffee drinks.  All of these affect sleep and should be avoided. 

Do you have a sleep challenge you would like me to address?  Leave your comments here!

Our family just returned from our first trip to Disney World.  As I had expected, it was magical.  The look on the kids’ faces when they met their favorite characters was priceless.  They loved the rides, the Castle, the Mickey shaped waffles for breakfast, the list could go on and on.

There was one problem with the trip, however — sleep deprivation!  On our first night, we stayed up really late.  First there was dinner with the Princesses, then a Christmas parade, and then their first ever fireworks.  Our kids who usually go to bed at 7:30 hit the hay after 10:00.  And, they never really recovered for the rest of the trip.  I have written before about failure of the frontal lobe – the problem on this trip was that it set in at about 10 AM each day instead of 6 PM.  For our 5-year old, this meant behavior approximating “Grumpy” from Snow White and the Seven Dwarves.  Our 3-year old was as clumsy as “Goofy.”  They were quite a sight!

This experience inspired me to post about sleep this week.  Today, I want to share a chart from my friend Jodi Mindell’s book, “Sleeping Through the Night” (see my Favorite Things  page for details).  Here, by age, is how much sleep little ones need each night:

2 months to 12 months – 14 to 15 hours

12 months to 3 years – 12 to 14 hours

3 years to 6 years – 11 to 13 hours

Are your kids getting enough? 

Tune in tomorrow for tips on how to make sure your little ones get enough sleep…including how to balance vacation fun with sleep needs!

Fellow Calm Moms, you might have noticed the following pattern in your own home…

….A few weeks of blissful calm.  Your babies and/or children are behaving well!  Everything seems easy.  They are eating well, waking up in good moods, going to bed with ease.  They do as you ask, make you laugh and smile, and generally make you think, “I am the perfect mom.”

….And then, it all goes to pot.  For some mysterious reason, your little ones fall from the peak of the mountain to the trough of the valley.  They fall apart at the littlest upset.  Daily routines turn into struggles.  Bedtime is endless.  Behavior is barbaric.  And moms start to have the inevitable thought: “I am a terrible mom.  What am I doing wrong?”

Rest assured, this is all totally normal.  Child development is a process of equilibruim and dis-equilibrium.  Babies and children regularly go through phases where they seem to totally fall apart and, here’s the good news, come out of it a while later with a burst of maturity.

At TheCalmMom.com, we teach simple strategies to help moms deal with struggles like these.  Let’s consider two strategies here:

First, Be a Calm Thinker.  When you catch yourself saying, “I am the worst mom.  What the heck am I doing wrong?” try to re-frame those negative negative thoughts.  Consider this –

“This is all normal.  It is going to be hard for a few weeks, and then we’ll have a period of calm again.”

Also, resist the urge to puzzle out WHY the bad behavior is happening.  At times, the reason is obvious (e.g., maybe one parent has been working or out of town a lot or maybe the child has been going to bed too late) and can be resolved with simple behavioral changes.  But, so often, trying to figure it out is well, kind of a waste of mental energy.  Kids grow and change all the time and it is okay to accept that an inevitable part of growth and change is periods of not-so-good behavior. 

Second, Be your own behavior therapist.  Think about ways you can change things around for you and for your children to make everything go more smoothly.  During these troughs, it is probably NOT the time to change routine.  My sense is that babies and children go through these times when something is changing in their lives (a birthday, a transition to a new classroom, learning to walk or talk, etc.).  So, leave everything pretty much the same in your day-to day-routine.  But, consider these tips:

-Give the child who is having a difficulties some extra one-on-one time.  When one of our kids is behaving badly, our inclination is to RUN the other way!  Resist the urge.  Give your child at least ten minutes of child-directed play, with one parent who is dedicating all of their attention to the child (turn off that Blackberry or iPhone folks!).  For babies, it might mean an extra cuddle or story or a longer bathtime.  For toddlers and preschoolers, it might mean a fun game, a special art project, or an outing.  The important thing is that the child decides what the activity is and that the parent is completely attentive during that stretch of time.  Often, this little behavioral change can result in greatly improved behavior.

-Let the little things go: At times like these, it can seem like every move your child makes is naughty.  You can spend your whole day correcting them.  Put picture it from their point of view.  They already feel like they are falling apart (in a two, three, or four year old way!).  And then, on top of that, they are being told that everything they are doing is wrong.  SO, moms, leave it alone.  Don’t scream over spilled milk, or criticize a kooky looking outfit, or get cross if they fail to wash their hands after they pee.  Try to save any negative feedback for something really important, like feeding dog food to their new baby sibling. 

-Give yourself a break: It can be very taxing to be with a challenging child day in and day out.  A miserable mom can cause anxiety to a child, which can result in even more bad behavior.  So, recognize your own need for a time out.  Arrange a night out with girlfrinds, set up a date night with your husband, or just go for a long walk on the weekend by yourself.  After a little time away, you will feel calmer.  And remember, a calmer mom raises calmer kids!

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