The basics of RSV

RSV is most common during October to April, which coincides with flu season. This can make it tough to tell which illness your child has, and your pediatric provider can order a nasal swab to test for both. Commonly, kids will have:

• Runny nose
• Decreased appetite
• Cough
• Wheezing
• Fever
• Fast breathing
• Tiredness or fatigue

The biggest worry with RSV is that it can make it hard for people to breathe. This video shows what to look for when it comes to RSV and breathing. Call your pediatric provider or seek emergent care if you notice any of these symptoms – even one. Babies under age one, children born prematurely, and any child with a high-risk condition are at greatest risk for complications. Older people are also at higher risk of hospitalization and complications from RSV. Encourage the grandparents and other older adults in your life to get vaccinated to protect the whole family.

What now?

If your child has been diagnosed with RSV, or it’s strongly suspected, try not to panic. Most children recover well and only need rest, hydration and maybe medication for fever. Keep a close eye out for severe symptoms and breathing difficulties, and alert your pediatric provider if your child is high-risk or having trouble eating or drinking. 

For young children and babies, it can be hard to eat and drink while sick with RSV. Signs of dehydration can be found here, but try to offer lots of fluids or water-rich foods, like fruit or popsicles, often throughout the day. Babies under age one don’t need additional water, just breastmilk and/or formula. Breastfed babies may want to breastfeed all day or find it tough to stay latched – both are common experiences. On the other end, it can be helpful to track wet diapers again in the Ovia Parenting app – even if it’s been a while! 

Because RSV spreads so easily, your child should not go back to daycare or preschool until their symptoms have resolved. Your family may also want to consider limiting contact with other high-risk family members, like grandparents.

Preventing RSV

Preventing RSV is similar to preventing other respiratory illnesses like the flu or Covid-19. Hand washing, masking and avoiding large indoor groups during RSV season can all help. Preventative treatment is approved for babies entering their first RSV season or high-risk children entering their second RSV season. 

In addition, there are currently two ways to protect your baby from the risk of getting RSV that you may want to consider. 

Nirsevimab (Beyfortus) for infants

• The RSV antibody is available for babies and some young children to protect against severe RSV.
• Recommended for infants under eight months of age born during RSV season or about to enter RSV season, especially those who are at an increased risk, such as infants:
  • Children born prematurely
  • Those with a severely compromised immune system
  • Children with cystic fibrosis
  • American Indian and Alaska Native children
• If the birthing parent gives birth 14 or more days after being vaccinated against RSV, except in rare circumstances, most infants younger than 8 months of age do not need to receive the Nirsevimab vaccine.

RSV Vaccine (Pfizer ABRYSVO) for those who are pregnant and people over 60

• An RSV maternal vaccine for the pregnant parent to pass on protection to their babies. 
• Individuals in their third trimester, from September through January, should receive the vaccine, specifically during weeks 32-36 of pregnancy. 
• Taking the vaccine will pass on valuable antibodies to your newborn baby. 
• RSV Vaccine is also approved for people over 60. If you have close family members who may live with you or care for your children, discussing vaccination may be a good idea to help protect both the baby and family members.

It’s important to explore these options with your OB provider and family to determine what’s best for your baby. It’s a big step forward in protecting those most vulnerable to severe RSV infection and hospitalization.

Reviewed by the Ovia Health Clinical Team

Sources:

• Signs & Symptoms of RSV in Babies. American Academy of Pediatrics, AAP. Oct 26, 2022 https://www.youtube.com/watch?v=_2qh31Wndls
• Signs of Dehydration in Infants & Children, HealthyChildren.org. Healthy Children. Last Updated 9/24/2019 https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/dehydration.aspx
• RSV in Infants and Young Children, CDC, Center for Disease Control, Last sourced: July 17, 2024 https://www.cdc.gov/rsv/high-risk/infants-young-children.html
• RSV Immunizations to Protect Infants. CDC, Center for Disease Control, Last Reviewed: July 17, 2024 https://www.cdc.gov/rsv/vaccines/?CDC_AAref_Val=https://www.cdc.gov/rsv/about/prevention.html

Medications and vaccines

Immediately after giving birth, routine care for newborns includes a few different treatments. It can be really helpful to know more about these recommendations ahead of time!

An antibiotic eye ointment, called erythromycin, is a clear gel that is gently squeezed into each eyelid. It looks greasy, but should not cause your baby any discomfort. It helps to protect against an eye infection called neonatal conjunctivitis that can be caused by many different bacteria present in the vagina, or rarely in amniotic fluid. Neonatal conjunctivitis can cause serious complications like blindness and requires IV antibiotics for treatment. In some states, you may not be able to sign refusal for this medication, it is mandated by law. 

Vitamin K is a small injection of — you guessed it — Vitamin K. Vitamin K is essential for forming blood clots. After infancy, our bodies develop bacteria in the gut that make Vitamin K for us. But when they’re born babies don’t have this in their bodies yet. The shot gives them protection against bleeding while they develop their own gut bacteria to take over the job of making the vitamin for them. 

Not having enough vitamin K can cause bleeding issues that range from minor — like a little extra bleeding after getting a shot — to a severe condition called Vitamin K Deficiency Bleeding, which can be fatal. Many parents are curious about using oral Vitamin K as an alternative to the shot. This is an option, but because Vitamin K in this form is processed through the digestive system (instead of going directly into the muscle and being absorbed into the bloodstream with the shot), oral doses have to be given weekly and are less effective than a one-time injection of the vitamin. Therefore, they are not typically offered or recommended. 

Hepatitis B is the only vaccine recommended for newborns. It is part of a 3 dose series, which is continued at your well-baby visits. If you have tested positive for Hepatitis B during pregnancy, the routine for your baby’s care will be slightly different.

Hearing, hearts, and jaundice

Some routine testing, like a hearing screen, cardiac screening, or bilirubin scan, are brief and non-invasive. Checking your baby’s hearing, pulse oximetry, and their jaundice level are all things you can expect before going home. If there are any red flags on those tests, your pediatric provider will discuss your options and next steps (which are often just re-checking the tests at a later hour or day). 

You might wonder why it’s so important to do these tests in the first days of your baby’s life. Let’s break it down. 

Hearing test 

A hearing test is important because even a newborn baby is already learning language. If their hearing is impaired (even in just one ear) knowing and addressing it early on can make a big difference for your baby’s language development. 

Oxygen levels

A pulse oximetry test of your baby’s oxygen level in different parts of the body — usually done by putting a sticker with a red light on your baby’s hand and foot. This test can help to catch worrying heart problems that happen in about 1 in 1,000 babies and might otherwise go unnoticed. 

Jaundice screening 

Jaundice screenings, often also done with a special light placed on your baby’s skin, make sure that bilirubin levels aren’t getting too high. Sometimes instead of a skin sensor, this is checked using a blood test, collected along with the blood sample discussed below. High bilirubin levels can cause problems like lethargy, poor feeding, and in some rare extreme cases, brain damage.

Newborn screening

Newborn screening is another test that is typically done after your baby is 24 hours old. It involves a small blood sample. You might picture having your blood drawn in your arm as an adult, but this test requires a very small sample and it can be tricky to find a tiny newborn vein. So most of the time, a heelstick is used. Your baby will have their foot warmed and then a small prick is made in their heel. Some babies barely notice, others might cry. Blood is collected onto a paper form, which is sent to your state’s processing lab by the hospital. 

But why?

The biggest question is, what are they screening my baby for? And that’s a great question! The answer varies because testing is a little bit different in each state. In general, the test covers multiple conditions that a baby can be born with and are impossible to see on a physical exam. Most of these conditions have treatments that are important to start early in life, so testing is essential.

It can be helpful to check what the testing requirements and suggestions are in your area, and discuss any particular concerns you have with your pediatric provider — such as a family history of a metabolic disorder. You can look up what your state tests for here if that information isn’t provided by your hospital. If you give birth outside of a hospital, it’s recommended that you have newborn screening done between 24 and 48 hours of life. This can typically be done by your home birth or birth center provider, or at a lab. 

Reviewed by the Ovia Health Clinical Team

Read more

• Recommended immunization schedule for baby’s first year
• Baby check-ups

Infants

Certainly, we don’t have to tell you that very young babies need a lot from you — they eat often, require frequent diaper changes, and also love attention and being close to you. And they’ll certainly cry and let you know when they’re not feeling their happiest. But there’s a lot you can do to give your baby what they need, get in your daily quota of baby snuggles, and still get work done.

• Take advantage of nap time. When your little one is snoozing, thankfully, you’ll know that you can get in some uninterrupted work time. This is the time to check off those tasks that require deep focus or full attention. If you have a good sense of when your little one usually naps, you can plan ahead for these focused periods of work. 
• Keep your baby close. This might mean wearing your child in a carrier (which many babies love because they can be close to you, get in extra snuggle time, and even feel soothed by the motion of you moving around), which can give you some hands-free time to work. This might also mean working near your little one as they play on the floor near you or in a safe playpen. They’ll be happy to have you nearby, and you’ll know when they really need you. 
• Make focused time to connect. Your baby may be plenty happy just hanging out nearby, but they also really benefit from quality time when they have your full attention. So make sure to take a break here and there to fully focus on your little one. You might read them a book, play peek a boo, or cheer them on for tummy time — you’ll probably love the break from work as much as they will. 

Toddlers & preschool-aged kids

Slightly older kids need just as much from you, just in a different way. They might not technically need to eat as frequently or have diapers changed as often, but that third request for a string cheese or the potty accident you need to clean up might still make it feel like you can’t get a break from childcare long enough to get any work done. They also need just as much attention from you, and can let you know clearly how they feel about you splitting your focus. But hearing “Why do you have to work so much?” or “You never play with me!” may not be the cheerleading you need right now. Here’s what you can do to help keep them entertained, engaged, and feeling like they’re getting the attention they need from you — and so that you can feel confident finding balance. 

• Get on their level. You may not be able to do this all day, but if it’s possible for you to spend some time doing some work at your child’s level — maybe sitting on the floor with your laptop beside where they’re doing a puzzle, or alongside them at the table while they play with clay — they’ll feel happy and secure knowing that you’re so close. If you check in occasionally — to tell them how proud you are that they’re sticking with a challenging puzzle or to ask them if they’re making something new with their clay — they’ll also feel like you’re engaged in their play and they’re getting the attention they need. They may even be less likely to beg you to join them to play approximately one million times if you’re already right there.
• Help them find fun. Children at this age still don’t have the longest attention spans, and while they may, occasionally, stay really engaged in an activity that they’re excited about, it’s very common for them to want to bop from one set of toys to another. To help them embrace this curious energy, give them the freedom to choose what to explore (most little ones love choices!). This is not only exciting for them, but it also means you’re not constantly coming up with playtime activities. Try setting up little “stations” intended for different kinds of play that they can explore on their own while you work. Not that your living room suddenly needs to become a classroom, but if you think of a typical preschool space with an area for dolls, an area for art, an area for blocks, and so on, then you might get the idea. You can keep it simple by making a few different types of toys or play materials available to your little one — on a table, the floor, in small baskets, whatever is easy for you and accessible for them. Then your child can play a little with one, explore another, and, hopefully, let you get some work done. Over time, you may want to rotate out these toys on a regular basis so that your child feels like a toy is“new” even if they just haven’t played with it in a while.
• Focus on quality, not quantity. Kids at this age may be very vocal about wanting you to play with them and not work, which can be very tough to hear. Providing a little attention can help avoid “Why won’t you play with me?” questions. If possible, take a few moments throughout the day to step away from your work and really focus on engaging with them, free from other distractions. Worry less about how much time you can spend with your child and focus instead on really engaging with them when you do spend time together. Sit down where they’re playing and ask what they’re doing. Jump in and play along, but let them continue to take the lead. Find time every day to read a story together, and ask them questions about the characters, the plot, or the illustrations as you go. You could even cook a meal or take your dog for a walk together — those things you have to do anyway can be tons of fun for your child, and a special time you can both spend together consistently. 

Certainly, everyone’s job responsibilities are different, and everyone’s child has different ideas of what quality time looks like. No matter what, know that if you’re figuring out how to juggle your work and caregiving responsibilities, you’re not alone. You don’t have to aim for perfection, just whatever it takes to get through the day. You’re doing a great job.

Reviewed by the Ovia Health Care Team

Sources

• Corinn Cross. “Working and Learning from Home During the COVID-19 Outbreak.” American Academy of Pediatrics. American Academy of Pediatrics, June 16 2020. Retrieved Sept 30 2020. https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Working-and-Learning-from-Home-COVID-19.aspx.
• Damon Korb. “Age-Based Tips to Help Juggle Parenting & Working at Home During COVID-19.” American Academy of Pediatrics. American Academy of Pediatrics, June 16 2020. Retrieved Sept 30 2020. https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Tips-to-Juggle-Parenting-and-Working-at-Home-COVID-19.aspx.

Snacks should be “mini-meals” — nutritious and filling. Your little one should have either a meal or a snack every two to three hours, and not “graze” on foods throughout the day. This has the added benefit of encouraging a regular eating schedule, and helping your child identify when they’re hungry and when they’re full (so they can learn to regulate their eating).

It’s crucial for toddlers to eat a variety of nutritious foods (that don’t contain added salt or sugar) from all food groups, says the USDA, because eating patterns in the first 1,000 days shape lifelong eating habits. 

What foods should toddlers eat, according to the USDA guidelines?

• Fruits and vegetables in many colors and varieties (they should be a priority)
• Protein-rich foods like meat, fish, seafood, eggs, soy products, nut products, and seed products
• Whole grains 
• Dairy foods, like milk, yogurt and cheese

Opting for healthy homemade snacks that meet the USDA guidelines helps little ones choose and love healthy foods throughout the rest of their lives. Today, we’ll share 10 easy and healthy snacks that your little one will enjoy. 

1. Yogurt and fruit 

Ingredients

• Plain yogurt with no added sugar
• Chopped fruits such as peaches, raspberries, blueberries, strawberries kiwi, pears and mango. Be sure to bake, steam or otherwise soften harder fruits like apples 

Instructions

With fruit and plain yogurt, the possibilities are nearly endless! 

1. Keep it simple and add 1-2 fruits at a time to yogurt. 
2. Or, create a rainbow of fruits on top of baby’s yogurt with blueberries, strawberries, kiwi, and peaches (or any multicolored combination).
3. You could also place the fruit on the bottom of a container and then spoon in the yogurt for a homemade take on “fruit on the bottom” yogurt cups. 
4. Or, layer different colors of fruit and plain yogurt in a see-through cup for a colorful fruit and yogurt parfait! 
5. Try softening apples, peaches or pears in the microwave, sprinkling the fruit with cinnamon, and adding it to the yogurt.

2. Sugar-free banana, avocado, and apple muffins

Inspired by My Fussy Eater

Ingredients

• 1 cup whole wheat all-purpose flour
• 1 cup rolled oats
• 1 teaspoon baking powder
• 1/4 teaspoon baking soda
• 1 medium banana
• 1 medium avocado
• 1 cup applesauce
• 1/4 cup milk
• 1 egg

Instructions

1. Preheat the oven to 350 degrees F.
2. Combine the flour, oats, baking powder and baking soda in a large bowl.
3. Mash the banana and avocado in another bowl. Then, mix in the applesauce. Add the milk and egg, and mix well. 
4. Add the wet ingredients into the dry ingredients. Mix just enough to combine all the ingredients.  
5. Place cupcake/muffin tin liners into a muffin tin and pur the mixture into the liners.
6. Bake for 25 minutes. 
7. Let the muffins cool, remove the liners, and serve.
8. The muffins can be stored in the fridge for up to 5 days, or frozen and saved for later.

3. Butternut squash hummus with veggies 

Inspired by Yummy Toddler Food

Ingredients

• 2 cups chickpeas (or 2 cups white beans)
• 1 cup butternut squash, either pureed or roasted and cubed (or 1 cup pureed or roasted sweet potatoes)
• 3 tablespoons plain Greek yogurt with no added sugar (or 3 tablespoons tahini/sesame seed paste)
• Lemon juice from 1 lemon
• ½ – ¾ cup water

Instructions 

1. If the chickpeas are canned, drain and rinse them off to remove as much salt as you can. 
2. Combine all the ingredients together in a food processor. Add as much water as you need to make the hummus light and fluffy. 
3. Serve as a dip with cucumber slices or sticks, cooked bell pepper slices, thin raw bell pepper slices, cooked and sliced carrot sticks, chopped tomato pieces, green beans, or snap peas. 

*This hummus can be stored in the fridge for up to 5 days.

4. Roasted carrot “fries”

Inspired by Yummy Toddler Food

Ingredients

• 6-8 sliced medium carrots 
• Olive oil (approx. 1 tablespoon)

Instructions

1. Preheat the oven to 375 degrees F.
2. Cut the ends off the carrots, peel them, and slice them into matchstick” shapes (about the width of a pencil)
3. Place the sliced carrots onto a large rimmed baking sheet. Toss the carrots in the olive oil. 
4. Spread out the carrots evenly on the baking sheet.
5. Bake for 20-24 minutes or until they’re soft and just starting to brown. 

*You can store the carrot fries in the fridge for 3-5 days, in an airtight container.

These carrot fries are great on their own, paired with the hummus above for dipping, or paired with sliced fruit. You can also serve them as a side dish during a meal.

5. Peach and zucchini smoothie bowl

Inspired by The Lean Green Bean

Ingredients

• 1 ½ cup frozen chopped zucchini
• 1 ½ cup sliced peaches (fresh or frozen)
• 1 cup plain yogurt with no sugar added
• 1/4 – 3/4 cup water 
• Sliced fruit for a topping (you could try strawberries, raspberries, blueberries, or mango)

Instructions

1. Combine all the ingredients except the topping fruit in a blender. Blend until smooth. (Add the water as needed, but keep a relatively thick texture.)
2. Pour into a small bowl. 
3. Top with the sliced fruit and serve right away. 

This recipe makes enough smoothie for you and your toddler to enjoy together. You can also freeze the leftover smoothie in popsicle molds for later. 

6. Cheesy spinach egg rolls

Inspired by Parents Magazine

Ingredients

• 3 eggs
• 2 tablespoons shredded baby spinach
• 4 teaspoons shredded cheddar
• 2 teaspoons butter

Instructions

1. Whisk together 3 eggs in a bowl.
2. Add in the spinach and cheese, and whisk together.
3. Melt the butter in a 12-inch nonstick skillet, over medium-high heat.
4. Add the egg mix into the skillet and swirl to cover the bottom of the skillet. 
5. Cook until the egg is set (about 2-3 minutes). Occasionally shake the pan to prevent burning.
6. Cover a cutting board with parchment. Slide the egg onto the cutting board with a spatula, and roll it up in the parchment.
7. Let the rolled up egg “log” cool for 5 minutes (seam side down). Then slice it into round rolled-up pieces and serve.

7. Veggie, egg, and cheese mini muffins

Inspired by Yummy Toddler Food

Ingredients

• 1 cup veggies (either shredded zucchini squeezed to dry, shredded yellow squash squeezed to dry, grated carrots, grated sweet potato or finely chopped broccoli)
• ½ cup shredded mozzarella 
• 1 tablespoon grated Parmesan
• ¼ cup whole wheat flour
• 2 lightly beaten eggs

Instructions

1. Preheat the oven to 375 degrees F.
2. Grease a mini muffin tin with nonstick spray. 
3. Pour all the ingredients in a bowl and mix well until fully combined. 
4. Fill 12 cups of the mini muffin tin right to the brim.
5. Bake for 14-16 minutes or until the tops feel firm and the edges are just starting to brown.
6. Let cool, then serve.
7. Store in the fridge in an airtight container for up to 5 days, or freeze in a freezer bag (with as much air removed as possible) for up to 3 months.

8. Cucumber chicken salad bites

Ingredients

• 1 cup roasted shredded chicken
• ¾ cup plain yogurt with no sugar added
• A drop or two of lemon juice
• Finely chopped cucumber (approx. ¼ cup)
• Whole-wheat bread

Instructions

1. Combine the chicken and yogurt together to make chicken salad. Add a few drops of lemon juice.
2. Chop the cucumber into small pieces and combine with the chicken salad.
3. Spoon the cucumber chicken salad onto small rectangles of whole wheat bread and serve.

9. Berry smoothie bowl

Inspired by Yummy Toddler Food

Ingredients

• 1 cup cow’s milk or almond milk
• 1 cup frozen blueberries or mixed berries
• 1 sliced banana 
• ½ cup plain yogurt with no sugar added
• 1 tablespoon pre-soaked chia seeds
• Sliced banana for a topping 

Instructions

1. Blend half of the sliced banana, all the frozen berries, the milk, the yogurt, and the chia seeds together until very smooth.
2. Pour into bowls and top with the rest of the sliced banana. 

This recipe makes enough smoothie for you to enjoy with your little one. Freeze any leftovers in popsicle molds. 

10. Yummy fruit and veggie salsa

Inspired by Yummy Toddler Food

Ingredients 

• 1/2 medium mango 
• 1/2 small kiwi
• 2-3 medium strawberries 
• ½ of a small cucumber 
• 2-3 diced yellow tomatoes
• 1 1/2 teaspoon fresh lime juice

Instructions

1. Cut the fruits and vegetables into small pieces: Peel and dice the mango and kiwi, and dice the strawberries, cucumber, and tomatoes.
2. Combine all the fruits and veggies together in a bowl, then add the lime juice. 
3. Let the salsa sit for 5 minutes. 
4. Baby can eat the salsa with a spoon or with small slices of whole-wheat pitas/tortillas. (Make sure the pitas/tortillas don’t contain added sugar, and don’t contain too much added salt). 

This recipe makes enough salsa for you and your toddler to enjoy together. The original recipe is halved because this snack is best served fresh!

Reviewed by the Ovia Health Clinical Team

Content provided by Ready, Set, Food!. Ready, Set, Food! is a complete guided system that gently introduces your baby to the top 9 most common childhood food allergens, including peanut, egg, and milk. 

Does your newborn want to feed several times close together, often during the evening? Do they crash after this timeframe and often have the longest sleep of their day? This may be frustrating, but it’s completely normal — it’s a feeding pattern known as cluster feeding. Here’s what you need to know, including tips for this often-tiring pattern. 

What is cluster feeding?

Cluster feeding is when your baby wants to feed several times during a shorter period. A cluster feed usually lasts for a few hours at a time, and looks differently from baby’s typical feeding habits. Baby might alternate between eating, crying and possibly resting several times in a 2-3 hour period. They might want to feed as often as every 20-30 minutes within this timeframe. 

Cluster feeding is perfectly normal, so don’t be alarmed at the changes in your baby’s feeding routine. If however, your baby seems to cluster feed around the clock, this may be something else, and it’s a good idea to get some support for feeding.

Why do babies cluster feed?

Cluster feeding is a way for newborn babies to make sure they get enough breastmilk (or formula). Often people notice it when they’re going through a growth spurt, increasing milk intake to satisfy their increased developmental needs. 

During this growth spurt, Baby instinctively knows that feeding in clusters is the best way to encourage their mother to produce more breastmilk. Breastmilk production is all about “supply and demand” — the more baby drinks, the greater supply their mother will have to meet their needs. 

If you’re breastfeeding, this doesn’t mean that you weren’t producing enough milk before, baby’s just entering a time where they need more milk.

While cluster feeding is most common in breastfed babies, don’t be surprised if your bottle-fed baby starts cluster feeding.

Cluster feeding can also happen when a baby is tired or sick and needs shorter, more frequent feeds. When babies get overwhelmed or tired at the end of the day – you often see some cluster feeding as they soothe their needs in the best way they know how. 

How to know if Baby is cluster feeding ?

Generally, your 0-3 month old baby will feed 8-12 times every 24 hours. If they’re looking for more than this, they’re likely cluster feeding. Here are some other signs:

• Baby wants to feed repeatedly and constantly 
• Even if they’ve already been fed, baby doesn’t seem satisfied with the feeding (especially in the evenings or later afternoons)
• Baby eats more frequently, in shorter sessions than normal
• Your baby won’t stop crying until they’re fed- other soothing methods don’t help
• Besides the urges to feed frequently and the added fussiness when hungry, nothing seems “wrong” with baby
• Baby is content during feedings
• Baby still has the same amount of wet and dirty diapers

When they’re in the cluster feeding phase, your baby will usually exhibit signs of hunger frequently during the evenings, even after they’ve already been fed. These may include:

• Rooting (searching for the breast or bottle, or turning their head towards whatever touches their cheek)
• Nuzzling against the breast
• Opening the mouth wide 
• Mouthing
• Moving the fists to the mouth
• Lip-smacking
• Fussiness 
• Becoming more alert

How long does cluster feeding last? 

Cluster feeding can be a normal part of a baby’s daily pattern or it can be brief, lasting for a few days at a time. Babies usually “grow out of” cluster feeding around 3 or 4 months of age (of course, every baby is different.) 

Again, if your baby’s “cluster feeding” goes around the clock, it’s a good idea to check their weight and get feeding support, as this might be a sign that your baby isn’t efficiently getting enough milk.

How to deal with cluster feeding?

While it can be exhausting, try to lean into this pattern and feed Baby as often as they need and want to. This time will pass.

Here are some tips

• Don’t be afraid to ask for assistance when you need it.
• If you’re breastfeeding and you’ve pumped breastmilk, or if you’re bottle-feeding, you could have another family member offer a bottle (or bottles). Use that time for self-care (such as a walk, a shower, or a few uninterrupted minutes to yourself), 
• Keep water and nutritious snacks by your feeding area to stay nourished. 
• Try to nap just prior to when you expect the cluster feed.
• Plan ahead in other ways if you can. Use the bathroom, and try to get comfortable in your feeding area, right before you think Baby will want to cluster feed.
• Plan to cluster feed in front of the TV so you can watch a movie or show that you enjoy. 
• Or, plan to listen to an audiobook, podcast, or music during a feed. 
• Practice feeding Baby in a sling or carrier. That way, you’ll be able to walk around hands-free
• Call a friend or family member during feedings
• Lie down to feed Baby, so that you can rest your body as much as possible.
• If you have older children, designate special toys (or shows) for them that they can only take out during baby’s feeding times.
• Ask your partner (or friends/relatives) for help with cooking and housework during baby’s cluster feeding periods.

A lactation consultant can be extremely helpful as you navigate breastfeeding, cluster feeding, and caring for your mental health. 

How to soothe Baby during cluster feeding times?

Cluster feeding usually coincides with baby’s fussiest times. They may cry a lot in between feedings, even though they’ll be satisfied during the feedings themselves. 

Try these tips

• Move Baby around while feeding (walk while using a sling or carrier, or gently rock Baby). 
• Try skin to skin snuggles
• Sing or talk to Baby with a gentle voice. 
• Play soothing sounds (white noise or calming music). Turning on a fan may also create white noise.
• Hold Baby close to help them feel secure. Lightly swaddling them may help as well.
• Feed Baby in a quiet, dark room to remove unsettling stimuli.
• Try holding Baby in different positions.

What is the difference between cluster feeding and colic?

When your baby is cluster feeding, they may cry a lot, especially during the evenings, but they’ll be satisfied during feeding. However, if Baby keeps crying for several hours per day, for no reason you can find, and feeding and other efforts don’t soothe them, they may have colic.

Colic crying can sound like screaming, while cluster feed crying will sound like Baby’s normal “hungry” cry. Also, colic crying tends to peak at six weeks, continue without a break, and stop around three months of age.

You’ve got this

Even though it may be frustrating, cluster feeding is a normal feeding pattern. Lean into ways to cope. You’ve got this!

Reviewed by the Ovia Health Clinical Team

Allergic reaction vs. eczema flare-up

• Eczema may flare up when your child’s skin is exposed to any number of triggers, including food.
• Food allergic reactions should be reliable and reproducible. If your child is allergic to a food, they’ll reliably develop an allergic reaction shortly after eating that food, every time they eat it.
• The red itchy rash associated with eczema is different from the hives that food allergies can cause
• Food allergic reactions should only appear when your child is exposed to an allergenic food. Eczema is most often chronic or lifelong, with symptoms persisting regardless of your child’s exposure to allergenic foods
• Eczema and food allergies belong to the atopic march. In other words, eczema is a precursor to food allergies, and eczema symptoms usually appear before food allergies. 

Food allergies and eczema are closely related. Both conditions involve the immune system. Babies with eczema are at the greatest risk of developing food allergies. And foods can cause both allergic reactions and eczema flare-ups.

But how can you tell the difference between an allergic reaction such as hives and an eczema flare-up, so you can get the right care for your child? We break down what parents need to know.

Food allergic reactions: What triggers them?

Our immune systems protect our bodies from foreign invaders, like viruses and bacteria. But when someone eats a food they are allergic to, their immune system mistakes the proteins of that food for a foreign invader. The immune system signals their body to over-defend itself against those food proteins, and this triggers an allergic reaction. 

Food allergic reactions: What do they usually look like?

In babies and young children, the most common signs of an allergic reaction are hives and vomiting.

Hives caused by a food allergic reaction

Mild or moderate allergic reactions can also cause swelling of the face, lips, and eyes. Usually, these symptoms appear within seconds or minutes and they’ll almost always occur within 2 hours of eating the food. 

People with food allergies don’t always develop the same symptoms every time they have an allergic reaction. So, you can’t predict what an allergic reaction will look like in your child. 

Most importantly, remember that a mild to moderate reaction can sometimes quickly turn severe. This is true even if your child never had an allergic reaction before. 

Severe food allergic reactions: What do they look like?

Symptoms of a severe food allergic reaction can include:

• Swelling of the tongue
• Swelling or tightness of the throat 
• Struggling to swallow
• Struggling to breathe
• Noisy breathing
• Persistent coughing
• Wheezing
• Struggling to vocalize
• Change in voice or cry
• Diarrhea 
• Dizziness 
• Collapsing or fainting 
• Pale appearance 
• Feeling floppy (only in infants and young children)

When a food allergic reaction causes severe symptoms in more than one organ system, it is classified as anaphylaxis. Anaphylaxis can be life-threatening.

Eczema flare-ups: What triggers them?

Your child’s eczema may flare up when their skin is exposed to any number of triggers. If your child has food or environmental allergies, their allergens could trigger a flare-up. In addition to allergens, dry skin, dry air, heat, existing skin infections, and irritants may also trigger eczema flare-ups. Some irritants that may trigger flare-ups include fabrics (like polyester, nylon, or wool), fragrances (found in soaps, laundry detergents, lotions, and shampoo), chemicals, and metals.

Eczema Flare-Ups: What do they look like?

Eczema makes the skin dry, red, and itchy. It can cause patches of red or dry skin, rough and itchy skin, or crusty scales and bumps that may leak fluid. These flare-ups often appear on the forehead, cheeks, scalp, knees, elbows, arm joints or leg joints. 

Eczema flare-ups v. Allergic reactions

Foods can trigger both eczema flare-ups and allergic reactions. So, how can you tell the difference? If your child has food allergies and eczema, a food allergic reaction may make their eczema worse.

But, the red itchy rash associated with eczema is different from the hives that food allergies can cause. And there are many other symptoms of an allergic reaction that aren’t associated with eczema (like swelling and vomiting). A good rule of thumb is the National Eczema Association’s explanation that food allergic reactions are “reliable, reproducible, consistent and timely.”

If your child is allergic to a food, they’ll reliably develop an allergic reaction shortly after eating that food, every time they eat it. Once you remove the food(s) they are allergic to from their diet, they will no longer show symptoms of a reaction. 

Whenever your child appears to have a flare-up, keep track of all their surroundings, including what they ate within the past 2 hours. What fabric is their clothing made of? Did you use soap, lotion or shampoo with a fragrance? It can be difficult, but finding and removing other consistent eczema triggers can help you figure out whether food is an eczema trigger — or an allergen. 

If you’re having trouble pinpointing the issue, allergy testing is the most reliable way to determine whether your child has a food food or other allergy. 

The atopic march and chronic eczema

The atopic march describes how children with one allergic condition are at increased risk for others, and how allergic conditions tend to appear in a certain order (one usually “marches” after the other).

Eczema and food allergies are both considered allergic conditions, and both are part of the atopic march. Babies usually develop eczema before food allergies, and infants with eczema are at increased risk for developing a food allergy. 

Most food allergic reactions like hives should go away within a few days or weeks, and by avoiding the allergenic or “problem” food, should go away altogether. On the other hand, eczema can often be a chronic condition and usually starts in infancy. Chronic eczema is the most common type of eczema and can be lifelong. 

Introducing Allergens

The USDA Dietary Guidelines state: “if an infant has severe eczema, egg allergy, or both (conditions that increase the risk of peanut allergy), age-appropriate, peanut-containing foods should be introduced into the diet as early as age 4 to 6 months.”

Feeding your baby these foods consistently, starting between 4-11 months of age, is especially important for babies with eczema, because of their increased food allergy risk. 

Reviewed by the Ovia Health Clinical Team

Content provided by Ready, Set, Food!. Ready, Set, Food! is a complete guided system that gently introduces your baby to the top 9 most common childhood food allergens, including peanut, egg, and milk. 

Starting solids is an exciting milestone for you and your baby. They’re about to embark on discovering new tastes and textures. But how do you know when your baby is ready to start solids?

Although many babies are ready around 6 months of age, every baby is different. Not all babies are ready for solids at a certain age or weight. Instead, pay attention to your little one’s developmental signs to clue you in that they may be ready for solids.

Here are the top six telltale signs that your baby is ready to explore solid foods.

1. Baby can sit upright without your help.

This means that if you place Baby on the floor in a seated position, they can stay upright (with decent posture) for at least 10-15 seconds, ideally longer. This trunk and head strength is crucial for learning to eat solids safely. Imagine trying to eat while wiggling and wobbling everywhere. And if your head slumps forward, it’s tough to chew and swallow safely. For success and safety – this is #1.

2. Baby can grasp objects.

Whether they’re grasping a rattle, reaching for your glasses, or even grabbing your spoon, when baby’s able to grasp objects, that’s a sign that they’re developmentally ready for solids. They don’t need to have a certain type of grasp (like the pincer grasp) mastered. All that matters is that they’re using some type of grasp.

3. Baby opens their mouth wide.

We’ve mentioned grasping, but how about bringing that object to their own mouth? If Baby is lifting a toy, spoon or other object to their mouth, that’s a really helpful skill as they learn to feed themselves.

4. Baby has the needed hand-eye-mouth coordination. 

This involves several of the signs we’ve already listed above. Baby needs the coordination and skills to look at the food, grab the food or a spoon, pick up the food or spoon, open their mouth, place the food inside, clamp down on the food, and swallow. 

This is especially important if you want to start baby-led weaning, where Baby feeds themself.

5. Baby’s tongue reflex has changed.

Babies are born with a “tongue-thrusting” reflex that helps them push food out of their mouth. But once babies are ready for solids, they outgrow this “tongue-thrusting” reflex. At that point, instead of pushing food out of their mouth, their tongue learns to move food to the back of their mouth, and they are able to swallow. This coordination takes time, which is why the first month of solids often involves lots of trying and not a lot of eating.

6. Baby is interested in your family’s food.

Is your baby eyeing you closely as you munch on your dinner? Are they intently looking at solid foods? Then, they’re probably eager to try solid foods of their own. The same goes if they reach for and try to grasp at the food you’re holding — or try to swipe your fork or spoon. They might also imitate the chewing motions or lip-smacking that they see you make at the table. Keep in mind that this sign alone is not enough to start solids. Some babies may take an interest in your food from very early on, and some foods are not safe or appropriate to share!

When starting solid foods, you can typically use the family meal once a day. Breastmilk and/or formula is still Baby’s primary source of nutrition during the first year. Serving allergens early and often once you start solids may have a protective effect against later food allergies. If your baby or family has a history of food allergies, then talk to your pediatric provider about what steps to take.

Reviewed by the Ovia Health Clinical Team

These recent guidelines offer recommendations that include 0 to 2 year olds for the first time ever, including a key recommendation that parents should “introduce infants to allergenic foods.” Let’s break down these important new food allergy guidelines.

USDA guidelines on early introduction: 5 key takeaways for parents

1. Introduce Infants to Potentially Allergenic Foods

The new Dietary Guidelines recommend that parents introduce infants to allergenic foods like peanuts, egg, cow milk products, tree nuts, wheat, crustacean shellfish, fish, and soy. They note that, for example, introducing peanuts “reduces the risk that an infant will develop a food allergy to peanuts.” Parents should introduce these allergenic foods in baby’s first year of life along with other complementary foods.

2. There is no evidence that suggests parents should delay peanut introduction

It is important to introduce these foods early, in your baby’s first year of life.

3. Parents should introduce peanut-containing foods at 4-6 months for high risk infants

Babies at high risk for food allergies are those with severe eczema and/or egg allergy. For these babies, introducing peanuts at 4-6 months can “reduce the risk of developing peanut allergy.” Parents should consult with their healthcare provider before introducing peanuts to determine the safest way to introduce them.

4. Nuts and chunks of peanut butter can pose a choking risk

Parents should find appropriate forms of allergenic foods to introduce to their baby as nuts and peanut butter can be a choking hazard. Learn more about how to safely introduce peanuts from the NIAID Guidelines here.

5. Diversify your baby’s meals after six months

In addition to allergenic foods, it is strongly recommended to introduce a variety of foods across all food groups to help with your baby’s growth and development.

Reviewed by the Ovia Health Clinical Team

Content provided by Ready, Set, Food!. Ready, Set, Food! is a complete guided system that gently introduces your baby to the top 9 most common childhood food allergens, including peanut, egg, and milk. 

Another important part of this visit is Baby’s shots – depending on what vaccines they has gotten already, there’s a good chance that this is going to be a busy visit in terms of vaccinations. Depending on your child’s vaccination schedule, they might be ready for any combination of Hepatitis A, Hepatitis B, DTaP, Varicella (chicken pox), and MMR.

Baby may not be too chatty at the doctor’s office, but outside of their appointment, they is hard at work learning a whole new language – their very first!

Children Baby’s age don’t just have to learn vocabulary words, but they also have to figure out the context for what those words mean. Baby hears you say “cat” and they may connect that with Mister Whiskers, but it may take a while for them to figure out that the word “cat” is attached to every one of those pointy-eared, four-legged meow-ers. On the other hand, they might not know that not all of their four-legged friends are cats, so don’t be alarmed if a dog or two gets called a cat, too, for a little while.

Researchers believe that the way that toddlers learn language means that they generally start by figuring out larger groups, and then narrowing down to specifics. It’s for this reason, and not because Baby thinks people are interchangable, that every woman they meets might be “mama” for a little while. A lot of learning language for toddlers comes down to categorizing the world as they learn about it, which is why toddlers can be such big sticklers for rules, once they learn them.

Milestones

• Helps you put on their clothes: Unless you have one of those toddlers who thinks they’s allergic to clothes, this might be right around the time they starts to help you get them dressed, mostly by holding out their arms, legs, and feet for you.
• Hugs you: The more you hug, kiss, and snuggle Baby the better they knows that that’s how you show affection, and they is reaching the age where they might be ready to start showing affection to you right back!

Sources

• T. Berry Brazelton, M.D., Touchpoints: Birth to Three, 2nd Edition, Joshua D. Sparrow, M.D., De Capo Press. 2006. Print.

We meditated with Faith Hunter, learned about the importance of sleep with Angela Holliday-Bell, and participated in a healing, positive affirmation exercise with Leasa Wright. 

Here are the most important moments from the event, hosted by Denise Albert, in case you weren’t able to attend.

A short, guided meditation session with Faith Hunter

Breath work gives us the ability to center ourselves. Faith led us in a breathing exercise that you can do at home; here’s how:

• Take your right hand, close your index and middle finger towards your palm
• Take your right thumb and use it to close your right nostril 
• Breath in through your left nostril
• Close off your left nostril with your ring finder 
• Release your right nostril 
• Exhale through your right nostril
• Inhale through your right nostril
• Close it off
• Exhale through your left nostril
• Inhale through your left nostril
• Repeat

Stress management & self-care with Dinah Eke, Amanda McKay, and Brooke Davis 

Dinah, Amanda, and Brooke discussed the importance of taking small moments in the middle of the day to be mindful. Check in with yourself: How are you feeling? Are you drinking enough water? Are you getting a little movement? Are you getting outside? Take a little time for yourself.

When it comes to practical ways to destress, there are two options: address the stress head-on or escape it through distraction.

Dinah offered some advice about the way list-making helps her de-stress. Just writing down the thoughts that are leading to stress when the kids are asleep can make it feel more manageable. And when you just need to escape the stress, Amanda recommends distracting yourself away by getting outside, listening to a podcast, or just laying down for a moment. 

When the mom guilt creeps up on you, remember: you are doing a fantastic job. It’s OK to take time for yourself, to feel overwhelmed by your kids, to have hard days. Give yourself permission to feel whatever you’re feeling. These feelings don’t make you less of a parent or less of a caregiver. 

And remember, it’s OK to bring other people into the conversation. Ask for help from family and friends. Ask for flexibility from your manager.

Self-care tips from Amanda McKay, Self-Care Coach for Moms

• Schedule it
• Ask for help
• Remember you need and deserve a break
• It’s ok to set boundaries and say no 

Wellness check with Elaine Bishop

Signs that you are experiencing an amount of stress that could be damaging to your mental health:

• Overwhelming feelings of sadness 
• Difficulty enjoying things you used to enjoy
• Relationship changes: Are you having more trouble reading other people’s social signals? Are you declining social invitations more than usual?
• Appetite changes: Are you experiencing significant increased or decreased appetite?
• Substance use: Are you turning to drink more often than before? Are you developing feelings of dependence?
• Thoughts of harming yourself 

If you are feeling any of these feelings, know that there is help. Try contacting the National Alliance on Mental Illness either by phone at: 1800-950-6264 or by email at: info@nami.org.

Tips from physician and sleep specialist, Dr. Holliday-Bell

Many parents find quality sleep to be a bit evasive, but the first step to getting better sleep is prioritizing better sleep. Dr. Holliday-Bell outlined a few specific tips:

• Decide on a bedtime and wake time
• Stick to a consistent schedule (weekends count too!)
• Create a relaxing, 30-60 min bedtime routine
• Keep your bedroom dark, quiet, and cool
• Master a relaxation technique (like deep breathing)

Breath work and affirmation practice with Leasa Wright 

We closed out Stressless Fest with a series of affirmations from Leasa Wright. To practice this at home, close your eyes and think of a happy memory or a happy place. Then repeat out loud to yourself:

• I live in my truth
• I boldly and freely express myself
• I follow my dreams
• I welcome goodness; I welcome love 

This may feel uncomfortable at first, but after a few rounds of these affirmations, the Stressless Fest attendees felt calmer, lighter, and more confident. We hope you will too! 

Sponsored by Airwick, Enfamil, and Beyond Yoga