Monthly Archives: November 2020

Preventing tooth decay in young children



Before you know it, your baby has teeth! But it turns out that those beautiful new teeth painstakingly working their way through your baby’s gums are already at risk of tooth decay as soon as they appear. You may hear lots of advice from other parents about using bottles and sippy cups before your child can drink from a regular cup.

Jade Elliott spoke with  Dr. Hans Reinemer, a spokesperson for the American Academy of Pediatric Dentistry and a pediatric dentist from Intermountain Primary Children’s Hospital about how bottles and cups can affect your child’s teeth.

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How Can Bottles Lead to Tooth Decay?

One of the risk factors for early childhood tooth decay (sometimes called baby bottle tooth decay or nursing decay) is frequent and prolonged exposure of a baby’s teeth to liquids, such as fruit juice, milk or formula, which all contain sugar.

Tooth decay can occur when a baby is put to bed with a bottle, or allowed at-will access to a bottle or sippy cup. Infants under one should finish their naptime or bedtime bottle before going to bed. Encourage your children to drink from a cup by their first birthday.

What About Sippy Cups?

Many training cups, also called sippy or tippy cups, are available in stores. Many are no-spill cups, which are essentially baby bottles in disguise. No-spill cups include a valve beneath the spout to stop spills. However, cups with valves do not allow your child to sip. Instead the child gets liquid by sucking on the cup, much like a baby bottle. This practice defeats the purpose of using a training cup, as it prevents the child from learning to sip.

Don’t let your child carry the training cup around. Toddlers are often unsteady on their feet. They take an unnecessary risk if they try to walk and drink at the same time. Falling while drinking from a cup has the potential to injure the mouth.

A training cup should be used temporarily. Once your child has learned how to sip, the training cup has achieved its purpose. It can and should be set aside when no longer needed.

What Kind of Training Cup or Sippy Cup is Better for Your Child’s Teeth?

For sipping success, carefully choose and use a training cup. As the first birthday approaches, encourage your child to drink from a cup. As this changeover from baby bottle to training cup takes place, be very careful.

Parents should choose

  • What kind of training cup to use
  • What goes into the cup – water is best. Children can enjoy other drinks at meal times only.
  • How frequently your child sips from it. No worries it it’s water
  • To not let their child carry the cup around

Talk to your dentist for more information. If your child has not had a dental examination, schedule a well-baby checkup for his or her teeth. The American Academy of Pediatric Dentistry says that it’s beneficial for the first dental visit to occur within six months of the appearance of the first tooth, and no later than the child’s first birthday.

What Foods Can Cause Tooth Decay in Toddlers and Young Children?

Now more than ever, kids are faced with a bewildering array of food choices, especially during the pandemic when more children are home for extended periods than ever before. This makes the pantry and refrigerator available all day, which was not possible when kids were in school. What children eat and when they eat it may affect not only their general health but also their oral health. Avoid grazing!! Sugary foods and snacks should only be available during meal times.

Americans are consuming foods and drinks high in sugar and starches more often and in larger portions than ever before. It’s clear that junk foods and sugary drinks gradually have replaced nutritious beverages and foods for many people.

What Habits Can Cause Tooth Decay in Toddlers and Young Children?

Alarmingly, a steady diet of sugary foods and drinks can ruin teeth, especially among those who snack throughout the day. Common activities may contribute to the tendency toward tooth decay. These include grazing habitually on foods with minimal nutritional value, and frequently sipping on sugary drinks. When you eat sugar, you are cavity prone for about 30 minutes, so if you eat three meals a day, you are then cavity-prone for 90 minutes each day. If you snack all day, then you are cavity prone ALL DAY!! Frequent access is the main thing to consider.

When sugar is consumed over and over again in large, often hidden amounts, the harmful effect on teeth can be dramatic. Sugar on teeth provides food for bacteria, which produce acid. The acid in turn can eat away the enamel on teeth.

Almost all foods have some type of sugar that cannot and should not be eliminated from our diets. Many of these foods contain important nutrients and add enjoyment to eating. But there is a risk for tooth decay from a diet high in sugars and starches. Starches can be found in everything from bread to pretzels to salad dressing, so read labels and plan carefully for a balanced, nutritious diet for you and your kids.

How to Reduce Your Child’s Risk of Tooth Decay

  • Sugary foods and drinks should be consumed with meals. Saliva production increases during meals and helps neutralize acid production and rinse food particles from the mouth.
  • Limit between-meal snacks. If kids crave a snack, offer them nutritious foods.
  • If your kids chew gum, make it sugarless – Chewing sugarless gum after eating can increase saliva flow and help wash out food and decay-producing acid.
  • Monitor beverage consumption – Instead of soft drinks all day, children should also choose water and low-fat milk.
  •  Help your children develop good brushing and flossing habits.
  • Schedule regular dental visits

For more information about pediatric dentistry visit:

https://intermountainhealthcare.org/

https://mouthmonsters.mychildrensteeth.org/ 

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Brushing your child’s teeth



It’s exciting when your baby gets a first tooth! But it’s a long and somewhat painful process before your baby has enough teeth to start really chewing food. But with that discomfort in your baby’s gums, you may wonder when it’s time to start brushing those new teeth.

Jade Elliott spoke with Dr. Hans Reinemer, a pediatric dentist with Intermountain Primary Children’s Hospital and spokesperson for the American Academy of Pediatric Dentistry to help answer all things about your baby’s teeth and their care.

When should you start brushing your child’s teeth?

Begin cleaning or brushing an infant’s teeth as soon as the teeth begin to erupt. Use an infant brush or moistened clean soft gauze to brush or wipe the teeth after feedings. One parent can hold the baby in a comfortable position, while the other parent brushes the child’s teeth.

For toddlers, let them chew on a brush during bath time. Keep your eye on your child at all times in the bathtub. This is safer than letting them walk around with a toothbrush. This gets them used to the look and feel of a brush and the chewing motion can massage the gums and erupting teeth. Parents should follow up and brush their child’s teeth to make sure every area is clean.

Tell, Show and Then Do

As children get older and understand basic instruction, use “Tell-Show-Do” when guiding the behavior of children. Pediatric dentists use this in the dental office. Parents can use the same techniques at home when it comes to teaching children to brush. Tell small children what you are going to do, show them how to do it on a stuffed animal or doll, then perform on the child.

Talk to your child about their teeth and why they need to brush them to prevent cavities and tooth decay. For older children, explain how you need to brush away the bacteria, because the bacteria produces acid. The acid in turn can eat away the enamel on teeth. For younger children, a parent can explain that there are tiny “bugs” on the teeth that make them dirty.

Take Turns

Encourage the child to try brushing first, then the parent should always get a turn. Parents should look for areas the child may be missing and help at as needed.

Give Your Child a Choice

Let your child pick out their own age appropriate toothbrush. If they like it, they will use it more. Some toothbrushes make noise, light up, play music or come in fun styles like superheroes or princesses.

Ideas to Make Brushing Fun

1. Play a game. Find ways to make it fun and reward the small child with surprises for a good efforts and consistency.

2. Put on some tunes. Teach them to brush for the length of one song.

How Long to Brush

For a toddler, the length of the ABC song may be good.

As children get older, monitor the time. Splashing a little water on the teeth for five seconds is not enough! Don’t be afraid to send them back to the sink for the appropriate length of time – two minutes.

The bottom line is, never assume any child of any age is going to do a thorough job at brushing teeth. Teach, observe, time and follow up twice daily.

How Much Toothpaste to Use?

A schmear (grain of rice) of fluoridated toothpaste is appropriate until the child can predictably rinse and spit, then progress to a pea-sized amount.

When Can Children Brush Their Teeth on Their Own?

Children may have the manual dexterity to brush on their own when they can tie their own shoes. The child may not need help anymore, but watch to monitor thoroughness.

For more information about pediatric dentistry visit:

https://intermountainhealthcare.org/

https://mouthmonsters.mychildrensteeth.org/ (The parent resource of the American Academy of Pediatric Dentistry)

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Mom shaming: Why it hurts more than it helps



By nature, motherhood is an emotional journey filled with daily choices about how to raise your kids and how you are as a mother to your children. Because we love our children, we have strong emotions about these decisions, and because these decisions have an impact on our lives and the lives of our children, we wonder if we’re doing the right thing for our child and our family. Because of this, sometimes we look at other families who are making choices that are different from our own and question if we, or they, are making the right choice, and unfortunately, that can lead to shaming other moms or being shamed by other moms.

Jade Elliott spoke with Laura Cipro, a psychiatric mental health nurse practitioner with Intermountain Healthcare who treats children and adults for both emotional needs, to talk with us about mom shaming — what it is, and how to manage it if you experience it, and how to avoid doing it yourself.

What is shame?

Shame (verb) – the act of making or causing someone to feel guilt, humiliation, or distress.

Shame (noun) – as defined famously by Brene Brown (researcher at the University of Houston, author, and podcast host) as “an intensely painful feeling or experience of believing that we are flawed and something we’ve done or failed to do makes us unworthy.”

It’s important to understand that shame is different from guilt, which is an awareness of hurt or harm caused to others). Shame is not a productive feeling and breeds insecurity and anxiety, whereas guilt can motivate change.

“Mom shaming” is criticizing a mother for her parenting choices because they differ from the choices the person shaming would make or has made.

Why is mom-shaming especially damaging?

1. It’s unfair

It doesn’t take into account that as mothers we are often not the sole caregivers for our children. Mom shaming doesn’t consider the role of fathers, other caregivers (grandparents, daycare providers, nannies, babysitters, etc). Fathers especially, don’t receive the same level of scrutiny for parenting choices that mothers face, and that is certainly a double standard.

Mom shaming also doesn’t take into account other factors such as financial constraints and how this affects parenting choices. It doesn’t take into account that single moms carry heavier parenting burdens than those who have a partner. It also doesn’t take into account that all children are different, and one parenting style or approach will not meet the needs of or be effective for all kids.

2. It leads to unreasonably high expectations of mothers

It reinforces antiquated ideas and narratives that mothers have to be perfect and that we are defined by how we raise our children, rather than the idea that raising our children is just one part of who we are. Women are not only mothers, but employees, coworkers, friends, daughters, sisters, partners, athletes, leaders, etc. We can’t operate in all of these roles at 100 percent all the time. Social media can contribute to unrealistic expectations, when people are posting all their ideal moments, but not the true reality moments.

When mothers can’t meet these unrealistic expectations, they are set up to be disappointed, feel like failures, or become insecure about their parenting abilities. Data shows this can lead to an increase in rates of anxiety and depression in mothers.

3. Mom shaming also affects children

Mom shaming can cause the shamed mother to be insecure or anxious about their parenting abilities and choices and compensate by “over-parenting.” Over-parenting can undermine children’s confidence, independence and subsequently their ability to cope with life’s challenges. When children make their own mistakes, it’s an opportunity for them to learn from those mistakes and grow and develop their character.

Why is it unhelpful to criticize the decisions other parents make during the pandemic, when they’re faced with difficult choices about school, work and childcare?

First, I think it’s especially hard during a pandemic not to be invested in other parents’ decision making, because their choices just might directly affect you and your child’s health. However, it’s also especially not helpful during a pandemic to criticize or shame others. There are so many factors. Every family situation is multi-factorial. The pandemic adds more factors. We can’t possibly know all of the factors other parents face, so we shouldn’t judge.

We only see the tip of the iceberg of family life

I like to think of the photo of the iceberg floating in the ocean. The top 10 percent of the iceberg is visible above the water to the naked eye, but underneath the water lies the remaining 90 percent of the iceberg. This is how we should be thinking about other families. Outsiders looking in, see or know 10 percent (or less) of what is going on in that mother’s life that contributes to the choices her family makes during this pandemic. We don’t know the other 90 percent.

For example, I might not know that one of her children has an underlying health conditions, I might not know she is caring for an elderly relative, I might not know she is an essential worker, I definitely don’t know her financial situation, etc). We are all weighing the risks for our specific situations.

Don’t judge

No one should judge others for the decision they make during this pandemic in regard to childcare, education, attending public events, etc. because the factors leading to the decisions to home school, attend in-person school, get a nanny, go to daycare, skip the neighborhood birthday celebration or whatever are undoubtedly different than the factors that myself, or you, or the mother down the street evaluated in order to determine what she felt was best for her family.

We all have anxieties and the COVID-19 pandemic has added some

Also, from a mental health perspective, no one feels 100 percent confident about the decisions they’ve made. We can’t, because there’s still so much unknown about this virus. There’s still risk that we are all accepting for whatever choice our family makes, and a certain level of anxiety and fear about that risk and that decision.

In addition to all of our baseline anxieties, we now add the fear of living in a pandemic, facing rising unemployment, adjusting to a new normal for family life, work, school, etc. In my practice I see many children with online learning challenges, and motivational challenges due to the pandemic.

Studies find worsening mental health for parents and children since the pandemic

According to an American Academy of Pediatrics study about the effects of the pandemic on mental health, more than one in four parents reported worsening mental health, and one in seven reported worsening behavioral health for their children since coronavirus began to spread in March. About 10 percent reported that both parent and child were affected. Mental health decline was reported most by females and unmarried parents. Families with younger children had highest rates of declining mental and behavioral health.

A recent CDC study found that almost 41 percent of adult respondents are struggling with mental health issues stemming from the pandemic – both related to the coronavirus pandemic itself and the measures put in place to contain it, including physical distancing and stay-at-home orders.

Support other parents even when their decisions differ greatly from our own

People right now don’t need the added shame and anxiety from others criticizing and critiquing the choices we’ve made. We need to be supporting others and helping them through these difficult times.

Respect the choices they’ve made for their family and the boundaries they’ve set during the pandemic. Don’t pressure or push others outside of their comfort zone.

Communicate support for the choices other moms make

Focus on the positive and offer non-judgmental support.

Re-frame your thinking to be supportive of other moms

I think there can be a tendency to interpret differences in choices as a dig about the choice that you’ve made. Re-framing can be especially important here. Rather than seeing differences as a challenge to your choice or critique of your choice, try to see the underlying struggle that might have led this mother to her choice. For example: A mother’s decision to send her kids back to school might reflect her insecurity about her own ability to be an effective teacher. I think it’s easier to have compassion when we look at the issue this way. Also, remember that all mothers want the best for their kids and we all have this in common.

Tools moms can use if they experience mom-shaming

Use disarming statements. This is a tool I teach children to cope with bullies, and I think it applies, since people who mom shame are engaging in a type of bullying. Disarming statements are neutral responses that aim to shut down a conversation, help a person stand up for themselves, and not engage in bullying back. For example: “Thanks for sharing your opinion.” “Hmmm I’ll have to think about that.” Or “I don’t appreciate when my choices are questioned.” “I try not to comment on others’ parenting styles.”

For more information

Intermountain Healthcare has a free emotional health relief hotline available. The phone number is 833-442-2211. It’s available 7 days a week from 10 a.m. to 10 p.m. Interpretation services are available.

To find out more about Intermountain’s behavioral health resources, visit: https://intermountainhealthcare.org/services/behavioral-health/

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Virtual support group teaches moms self-care and stress management tools



Being pregnant for the first time or being a first-time mom means a woman will be making a lot of changes. You now have another person’s needs to care for and think about, besides managing your own personal needs.

It’s a big adjustment that can be even harder with the added stresses of a global pandemic.

An April 2020 study in the Journal of American Medical Association done during the COVID-19 pandemic, reports 37 percent of pregnant women reported clinically relevant symptoms of depression and 57 percent of pregnant women reported anxiety. Pre-pandemic percentages found between 10 to 25 percent of pregnant women experience anxiety or depression symptoms.

Many women find support through connecting with other moms or joining a support group. But doing that in person during the pandemic is challenging.

Jade Elliott spoke with Clare Valles, a nurse with Intermountain Healthcare who teaches a virtual Mom and Baby Group Course and support group that helps both moms to be and new moms learn tools to manage the stress that being a new parent brings, and also take time for themselves.

Who can benefit from this virtual class?

First-time moms, moms who are new to the community or who are far away from their families or network of friends will especially benefit from this class. It’s a great way to meet moms from all different backgrounds.

We’ve seen a rise nationally in postpartum depression. A better term is peripartum mood disorders, because moms can experience this not just after childbirth but during pregnancy and symptoms can manifest not only as depression, but also as anxiety.

The virtual class is taught by trained nurses and based on a national curriculum

I’ve been a nurse in labor and delivery, a clinic setting and homecare and public health for more than 20 years. The teachers are trained nurses.

Intermountain became aware of this curriculum that was developed at Northwestern University that’s evidence-based and has been proven to help improve behavioral health outcomes for new moms and their babies.

What are the benefits of doing the course virtually?

A lot of moms are working, so we’re able to tailor the class to meet during the lunch hour or in the evening. With the course being virtual, moms save time by not having to travel to the class.

And they can tune in from anywhere. During the pandemic, especially, moms need to take a break from their responsibilities and connect with other new moms who can offer support.

What does the class focus on?

  • Self-care
  • Stress management
  • Mother-baby bonding
  • Developing positive social connections

We teach moms to take care of themselves and not feel guilty to take time away from their baby if they have a trusted adult who can watch the baby. We teach them how to include Dad. We teach them to prioritize self-care. Some mom feels they have to do all the childcare and all the housework and then they go back to work and still try to do it all and that is hard.

The course teaches these skills

1. How to understand your mood and how feelings can spiral up or down

2. How to stop unhealthy thinking and turn it into healthy thinking. Look at each day and rate it. Recall positive experiences to help re-frame things.

3. How to look at your support system and manage it.

4. How to recognize that people can be supportive, not supportive or even toxic.

5. How to be empowered to set boundaries with people who are not supportive.

6. How to share examples of how you’ve met challenges and the steps you’re taking to manage them and learn what you could do better.

Participants learn to pay attention to thoughts, feelings and behaviors

The class uses cognitive behavioral therapy which is based on the relationships between a person’s thoughts, feelings and behaviors. For example, if your mood was a six on a 10-point scale. What made it that way?

Do things to help your mood spiral up. Even simple pleasant activities like taking a shower or a walk or listening to music can help.

The importance of mother-baby bonding

The class focuses on attachment theory and the importance of mother and baby bonding.

We teach parents that they are their child’s first teacher and to comfort their baby face to face, and play with their baby. It builds self-esteem in your child. Good parenting takes time. It’s easier to ignore a fussy baby or hand them your phone to keep them occupied. But that is not what they need from you.

How a group dynamic offers support

By attending the class, many women realize they’re not the only one feeling isolated or having a hard time. Seeing people’s faces and hearing others talk. And seeing other role models can help. People emerge as different people after the class. Different people resonate to different things taught in the class. We also can refer women to other community resources if needed.

How to sign up for the virtual interactive class

You can sign up online for the Intermountain Mom & Baby Group Course. It’s a six-week class and it’s available to moms ages 18 and up in the Intermountain service area. The cost is $15. Scholarships are available. Class size is kept small to encourage connections.

How to register for online childbirth education classes

Intermountain Healthcare also has a go at your own pace, online prenatal class through YoMingo, that includes four different modules on postpartum emotions, baby blues, warning signs and a resources module that lists mental health resources in Utah.

To register, go to https://intermountainhealthcare.org/ and click on the classes and events tab and search for birth classes.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.