A lot has changed since grandparents raised their own little ones. A local pediatrician explains seven new rules every grandparent should know.
Published: February 28, 2018
Tell me if this ever happens to you: You’re trying to engage your grandchild in conversation — How are you? How’s school? Is that a real tattoo? — but you can’t make eye contact because that precious face is glued to the laptop monitor or cell phone screen.
When that happens, and it happens a lot, it’s hard not to think about how much things have changed since today’s grandparents raised their own kids. And that goes for babies and toddlers, too.
The changing rules on raising the young ones may not be as hard to keep up with as, say, new apps for your cell phone, but they do continue to evolve at a rate that can even catch parents off-guard from the birth of one child to the next. So imagine how they can confuse grandparents, who may be set in their ways yet are more and more called on to babysit or, in many families, help with rearing their grandchildren.
Even if the call to duty is only temporary — for example, giving an exhausted new mom an extended break to catch up on her sleep — it’s important that grandparents are familiar with not only the parents’ ideas about safety
but also the recommendations of pediatric experts.
To help set the record straight, we consulted one — Dr. Tamika Maxwell, the lead physician in Pediatric Associates’ Lauderdale Lakes office. She examines seven old and new ideas about caring for children — and why the rules have changed.
1. Sleeping and Solids
OLD RULE: If you want babies to sleep longer and not feed so frequently, you can add some rice cereal or oatmeal to their milk during bottle feeds. It may help fill them up and also help calm their fussiness.
NEW RULE: The American Academy of Pediatrics recommends not adding foods other than breastmilk or formula to the diet until babies are at least 4 to 6 months old.
Introducing solids before 4 months is associated with increased weight gain and obesity, both in infancy and early childhood. When solids are introduced, a variety of flavors and textures is recommended. Children also generally need to be exposed to foods multiple times before they accept them. So, start a particular food for three to four days in a row before trying something different.
OLD RULE: Binkies interfere with breastfeeding.
NEW RULE: Put babies to sleep with a pacifier, even if they’re being nursed exclusively.
There are not sufficient studies showing pacifiers cause interference with breastfeeding. If a baby wants to suck beyond what nursing or bottle-feeding provides, a pacifier will satisfy that need. Plus, the routine sucking action of a pacifier while sleeping also appears to protect against Sudden Infant Death Syndrome. The use of pacifiers is supported up to 1 year. In an exclusively breastfed baby, the AAP recommends waiting to introduce the pacifier until after breastfeeding is established, usually by 4 weeks and before the peak age for SIDS. A pacifier should not be used to replace or delay meals, nor coated with sweeteners — and to prevent strangulation, it should never be tied to the crib or the child.
3. Safe Sleep
OLD RULE: It’s OK to put babies to sleep on their side.
NEW RULE: Healthy babies should always be put to sleep on their back.
Peaking at 2 to 3 months and occurring until 1 year, SIDS still remains the leading cause of death for infants outside the newborn period. Original AAP recommendations in 1992 discouraged tummy positioning during sleep and encouraged back or side positioning, which cut SIDS cases in half. In 2000, AAP emphasized back-only positioning after research showed that further decreased SIDS incidence. The golden rules for safe sleep: Place babies on their backs on a firm mattress in their own crib or bassinet, co-rooming — but not co-sleeping — with their caregivers in a moderate to cool temperature environment.
OLD RULE: Crib bumpers keep babies from banging their head.
NEW RULE: Keep all soft bedding, including bumpers, out of the crib.
Many studies show that bumpers and fashionable bedding pose a suffocation risk. It’s also recommended that infants sleep on a flat, firm mattress with only a fitted sheet. No pillows, stuffed toys or blankets other than one used to swaddle the infant should be in the crib.
OLD RULE: Don’t give allergenic foods like peanuts until the child is 3.
NEW RULE: Give small amounts of peanut butter to babies in their first year.
Studies have shown that the rate of food allergies in children has risen significantly since the onset of delaying food introduction. In countries where a variety of foods, including peanut products, are introduced as early as 6 months, there are fewer children with food allergies. U.S. pediatricians now recommend introducing a mixture of foods, including peanuts, to infants early on, because it’s not only safe to give a spoonful or two of peanut products but it also decreases the risk of allergy by 80 percent. Never give a baby whole peanuts until after age 5 as it poses a choking hazard.
OLD RULE: Use fluoride-free baby toothpaste until age 2.
NEW RULE: Use fluoride toothpaste as soon as baby gets a tooth.
The old rule was driven by concerns that children would swallow unsafe amounts of fluoride. Tooth decay is the most common chronic disease in U.S. children and has become more common over the past 10 years. A 2014 AAP report stated that fluoride is effective for cavity prevention in children and the recommendation changed, but fluoride is still to be used sparingly. A smear of toothpaste the size of a grain of rice should be used up to age 3. After that it can be increased to pea-sized. Over-the-counter fluoride rinse is not recommended for children younger than 6.
7. Car Seats
OLD RULE: Babies should sit in a rear-facing car seat until their first birthday.
NEW RULE: Keep a baby facing backwards until at least 2 — or until exceeding the seat’s height or weight limit.
A rear-facing car seat helps to properly support the head, neck and spine of infants and toddlers in a crash by distributing the force of the collision over the entire body. The rule of turning the seat at 20 pounds and 1 year of age is not the best option and should only be considered a minimum standard.