Tag Archive for: Babies

CHOKING RISKS THAT MAY SURPRISE YOU

We often assume that food is the #1 choking threat when it comes to infants and yet the latest data from the Centers for Disease Control & Prevention reveals that object-related choking deaths significantly outnumber food-related deaths during the first year of life.

The study reviewed mortality data from 2018-2023, comparing food and object-related death across the lifespan. They found that “food-related choking peaked at age 1, when self-feeding becomes more common, while overall rates declined through early childhood.”

The lead author of the study, Dr. Rachel Ruiz, a pediatric gastroenterologist, looked at the analysis and it made her question her long standing assumptions about choking deaths. “As a pediatrician I was always taught that choking on food is one of the leading causes of accidental death among young children and what I found out was that’s not true.”

She acknowledged that while there has been great work done in educating families regarding food textures and portion sizes, we also need to be just as vigilant about nonfood items in the home.

Choking hazards abound when little ones begin to crawl and walk. Dr. Ruiz recommends that parents & care providers “get down on the ground and make sure you are really vigilant about vacuuming.”

This is especially true during the holidays when the risks increase. Some of the most common choking hazards include small toys (anything small enough to fit inside a toilet paper roll is a huge threat;) batteries (small lithium cell batteries, in particular;) coins, marbles, and small stones; magnets (found in magnetic toys; refrigerator magnets are also a risk;) art supplies and decorations (think beads, buttons, etc.)

Save a Little Life™ encourages parents to register with the Consumer Products Safety Commission (cpsc.gov) to receive updates on the many nonfood items that have been recalled due to choking hazards.

VACCINE CONFUSION – TO B OR NOT TO B?

In case you haven’t noticed there have been some rather ambiguous statements made by the Centers for Disease Control and Prevention recently regarding previously accepted standards for certain vaccines for infants.

The most recent of these statements and recommendations come from the CDC’s Advisory Committee on Immunization Practices. Specifically, they are referring to the hepatitis B vaccine for infants. The committee voted to make vaccine recommendations “based on the mother’s testing status.” So, if a mother tested negative for hepatitis B parents should decide, with the guidance of their doctor, whether the vaccine is appropriate for their newborn.

The Los Angeles Department of Public Health (DPH) criticized the decision and described it as “a return to selective, risk-based newborn vaccination”, which officials argued was “not based on new evidence suggesting that hepatitis B vaccine birth dose is unsafe or ineffective.” The DPH further argued that a “risk-based strategy” was shown to be inadequate more than 35 years ago, and can reintroduce preventable risks, in particular communities such as L.A. County where hepatitis B prevalence and risks are higher. Consequently, the county has decided to continue the current, science-based recommendation for hepatitis B vaccines for newborn.

To keep this in context, the new CDC recommendations are occurring while other vaccines for newborns are also being brought into question, in particular, the vaccine for measles which has also been questioned by the new CDC while there have been outbreaks in several U.S cities.

House Representative, Judy Chu, D-Pasadena, a member of the House Ways and Means Committee and Chair emerita of the Congressional Asian-Pacific American Caucus, criticized the CDC’s decision as “reckless and dangerous.” She added: “Asian Americans, Native Americans and Pacific Islander communities who make up only 7% of the U.S. population yet account for 60% of chronic hepatitis B cases. She argued that these vaccines have been life- saving protection for these communities.”

We strongly continue to suggest that all expectant and recently delivered parents speak frankly and honestly with their pediatricians regarding newborn vaccines for their newborn.

PEDIATRIC ALLERGIES – ARE ELIMINATION DIETS NECESSARY?

At a recent meeting of the American Academy of Pediatrics there was a wide-ranging discussion of popular myths about pediatric allergies. Discussions included topics such as First vs Second Generation Antihistamines, Local Organic Honey for Treatment of Allergies, How to Diagnose Cow’s Milk Allergies, Penicillin Allergies and Treatment of Hives.

Another issue, very relevant to breast feeding mothers, is whether there is a need to eliminate foods that might be passed along to infants in breast milk. The discussion was led by David Stukus, MD, a professor of clinical pediatrics in the division of Allergy and Immunology at Nationwide Children’s Hospital, Columbus, Ohio.

Stukus explained that breastfeeding mothers do not typically pass allergens to their infants in breastmilk, “so it is rare that a mother would need to eliminate anything from her diet if her baby experiences atopic dermatitis, colic, GI reflux or similar symptoms.”

Dr. Stukus also addressed other allergy-related misconceptions including:

  • There is no need to wait a certain number of days between introducing new foods to infants. He suggested letting babies explore new foods and textures at each mealtime and to reassure families that 95% of children never develop food allergies. In reality, he said, “early and ongoing consumption of different foods has the greatest likelihood of preventing food allergies.“
  • Egg allergy is not a contradiction to the flu, measles, mumps rubella and yellow fever vaccines. Again, he is quoted…“Despite concerns about a theoretical risk that vaccines made using chick embryos could cause an allergic reaction, the evidence has shown otherwise, and allergy to a vaccine ingredient is not usually a contradiction to receiving it.”
  • When comparing first vs second generation antihistamines parents should consider not using diphenhydramine (Benadryl) in favor of newer antihistamines such as Zyrtec or Claritin as they have a quicker onset with fewer side effects. 

    It is vital that all young families speak with their own pediatricians regarding food allergies, various treatments, or any other issues that you are concerned about.

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MEASLES ARE BACK

It has been a quarter century since measles was officially eliminated in the U.S. Yet here we are in 2025 seeing a resurgence. Numerous cases have been reported in different states which are giving health experts great cause for concern.

As of mid-May 2025, there were more than 1,000 new cases of measles and three measles-related deaths in the U.S., surpassing the 285 cases reported for all of 2024, according to public health statistics.

Researchers at Stanford University just published an article in the Journal of the American Medical Association which suggests that with the current level of immunizations, measles would return to endemic status with more than 850,000 cases in 25 years.

 

WHAT ARE MEASLES AND WHY ARE THEY SO DANGEROUS?

Measles is a highly contagious airborne virus which can lead to serious complications like ear infections, pneumonia, and brain inflammation (encephalitis) which can be fatal. Children are obviously the most vulnerable but it can affect people of all ages, especially those whose immune systems are weak.

According to Jay Varma, MD, an epidemiologist and primary care physician in New York City “The healthcare delivery system is not prepared for the resurgence of measles.” Measles is twice as contagious as COVID-19 so given what occurred during the recent pandemic it is very likely that a measles epidemic would push the healthcare system beyond its capacity.

 

WHY ARE MEASLES ON THE RISE AGAIN?

There is a lot of misinformation out there about vaccines which has resulted in reduced vaccination rates in some communities. That is further compounded by recent policy changes that have taken place in Washington some of which have been spearheaded by the new director of Health and Human Resources who has openly questioned the need for various vaccines,

When it comes to your family’s health we believe it is vital that you always check with your healthcare provider for the best advice.

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INTRODUCING SOLID FOODS TO YOUR INFANT – When, What, How

When to initiate semi-solid and then solid food for your baby is one of the most commonly asked questions during our Pediatric CPR & Family Safety classes. These concerns are clearly associated with the risk of choking. We fully understand these anxieties and do our best to help families be prepared to deal with them.

Our friends at Beverly Hills Pediatrics have provided a very helpful set of guidelines to make the process easier and less stressful.

Answers to the following questions will help you get started.

WHEN CAN YOUR BABY EAT SOLID FOODS?

They are typically ready between 4 and 6 months of age. By this time, they have improved their head, tongue, and mouth coordination.

It is advisable to start with pureed foods that an infant can manage more easily. These foods should not necessarily replace breast or formula feeding but are an addition to those other valuable nutrients.

An infant is ready to begin this process when they display certain signs of readiness, in particular, the ability to sit upright with minimal or no support from a parent or care provider.

Close focus and attention to the infant is always essential for safety.

4-8 MONTHS

New research shows that introducing a wide variety of foods as early as possible is important for developing adventurous eaters and may be important in reducing the risk of food allergies.

At 6 months you can start introducing water via a “sippy cup” or straw.

Shows a baby boy in a high chair drinking from a yellow sippy cup

During infancy the only food you should avoid is honey as it is not tolerated well and could cause botulism.

WHAT ABOUT FOOD ALLERGIES? WHAT, IF ANYTHING SHOULD WE AVOID?

The introduction of more allergenic foods (peanuts, tree nuts, eggs, dairy and fish) early and frequently helps reduce rates of allergies. Our experts suggest including small amounts of these foods in your child’s diet 2-3 times per week. However, if your little one has a history of severe eczema or a family history of severe allergies please consult with your pediatrician before starting these foods.

It is advised to avoid processed foods while aiming for whole ingredients. You can start with spooning small amounts of food(s) and observe the natural process that we all possess at this young age.

Remember, babies love the taste of food just as we do so if you want to puree your entire dinner and offer it in small amounts to your baby, go for it!

8-12 MONTHS

At this age you should feel safe offering them finger foods. At this point, please make sure that the size of the food is small enough so pieces can dissolve more easily. Start with pea-sized bites and advance slowly. Some larger foods that might seem too big such as bananas or whole cooked carrots and sweet potatoes are good, healthy examples.

Shows a baby girl eating a piece of apple while sittiing on a counter wearing chef whites with a pink scarf and a pink skirt.

Encourage them to try a variety of mild spices and flavors yet try to avoid over salting their foods as excess sodium isn’t good for any of us.

By this time many clinicians suggest decreasing breast feeding to 3-5 times per day and formula intake from 29-32 oz. per day to 16-24 oz. per day.

FOODS TO AVOID

Some foods are just too risky and can increase the risk of choking. These include popcorn, whole nuts, whole grapes or any hard foods until at least the age of three.

Beyond this age parents and care providers need to continue to observe them while eating in case of an unexpected choking event.

BE PREPARED, JUST IN CASE!

Parents, family members, and care providers need to be prepared in case of a true choking event. All adults who care for little ones must take a CPR course to learn how to resolve this emergency. Remember, paramedics will never be there in time to assist in a severe choking episode.

CHOKING PROTOCOLS – Are Anti-Choking Devices the Best Option?

Choking is a very real threat and scary issue when it comes to infants, toddlers, and small children so it’s a rare occurrence if I don’t get questions in a CPR class regarding the use and benefits of anti-choking devices.

In a previous article, De-Choking Devices – Friend or Foe? we looked at some of the possible dangers and misinformation surrounding these devices. However, if you believe the promotions for the so-called Doctor Endorsed “Dechoker” or “LifeVac” anti-choking devices, you’re still likely to feel compelled to run out and get one immediately.

A closer look at the research and official recommendations for a choking baby or child, however, might have you come away with a different opinion.

First of all, it’s worth noting that the FDA’s recommendations do not include any of the above-mentioned devices. That holds true for the American Heart Association and the American Red Cross. Instead, they recommend that the first line of defense be the skills learned in an infant or child pediatric CPR class.

Why?

Responding to an actual complete airway obstruction requires quick action by a family member or trained care provider/nanny. Anyone responsible for the care of your baby or child must be prepared to act immediately and be well-versed in how to do so. Even a paramedic response may not be of any help because time is of the essence.

So, why not rely on an anti-choking device? They look simple enough to use.

In this video, the first in an excellent 4-part series, Dr. Darria Long Gillespie, an ER doctor and mom talks about the issues:

If you are a previous client of Save a Little Life™ you have learned the necessary skills in class. A reminder, the standard protocol is either back blows and chest pushes for an infant or a measured Heimlich Maneuver for toddlers or older children. If you were to discuss this with your pediatrician, she/he would tell you that those skills are the most important responses for complete obstruction.

If those methods do not work, then as a last resort you might consider the use of an anti-choking product.

In every class we preach the following prevention methods which should be part of your daily choking prevention routine, including:

  • Do not leave the self-feeder alone during mealtimes
  • Once able to crawl or walk do not give them any food or snacks and only do so when in a proper highchair
  • Do not provide food or snacks in the car until they are much older
  • Try to avoid overreacting to gagging episode(s) but if you feel the need to go into a small mouth, always go in along the cheek line and then sweep across. This will avoid an accidental episode of pushing food into their airway

Again, anyone with care responsibilities for a baby or child must know the proper skills…without exception.

For an in-depth comparison and investigation of the most popular anti-choking devices be sure to view the Dr. Darria’s complete series on this topic: Part 1 | Part 2 | Part 3 | Part 4

 

If you’re interested in refreshing your CPR skills or are a first-time parent wanting to learn, please contact us for more information

VISIT OUR CALENDAR FOR UPCOMING CLASSES

PEDIATRIC INTENSIVE CARE UNITS–WHAT YOU NEED TO KNOW

Most expectant and recently delivered parents are familiar with the term Neonatal Intensive Care Unit or NICU (“nick-u”) which might be necessary in the case of a newborn that arrives sick or premature. For that reason, all hospitals who deliver babies are required to have access to a NICU, just in case.

But what happens when an older infant or child requires intensive care? Are they also cared for by the NICU unit?

The answer is no. NICU patients are typically newborns, although some NICUs care for babies up to two months old. Beyond that, a Pediatric Intensive Care Unit or PICU is required for all children, generally up to the age of 18.

What’s important to know is that PICUs are specialized units that don’t exist in all hospitals. Therefore, it is important that parents find out where the nearest PICU is located so their little ones can receive the best care if and when they are seriously or critically ill or injured.

For example, let’s say a 3-year-old child has fallen from a height that caused a brain injury and they are showing signs of a severe concussion or worse. That child would require hospitalization in a PICU for intensive monitoring and treatment by specialized physicians and nurses until they were stable and continuing to improve.

PICUs are most often located in medical centers that are teaching hospitals. A teaching hospital trains physicians in all areas of medicine, from pediatrics to neurology to orthopedics and so on. They have 24/7/365 capacity to provide rapid care to babies, children and adolescent patients.

What you need to bear in mind is that these represent only a small percentage of the hospitals in the greater Los Angeles area.

So what happens if the paramedics arrive and determine that your baby or child requires hospitalization?

Paramedics are extensively trained to evaluate and treat infants and children both in your home and en route to the hospital. Please follow their instructions and lead as they are making decisions based on sound clinical judgement.

If they determine that your little one will likely need intensive care, they will not take them to a hospital that cannot care for them, however, it is also possible that they will go to a medical center where your pediatrician does not have admitting privileges.

It goes without saying that ideally, you would want your child to go to a medical center where your pediatrician admits and practices.

So, an important question to ask and one that all parents should know the answer to is where does your pediatrician admit the most serious patients? 

It’s helpful to know that pediatricians have admitting privileges at one or more of these medical centers – in fact, many have done their resident training at these centers – but don’t take anything for granted. If you don’t already know, please ask your pediatrician where she or he admits little ones.

In Los Angeles, the following medical centers have a PICU:

  • UCLA Medical Center (Westwood)
  • Cedars-Sinai Medical Center
  • Children’s Hospital of L A.
  • County USC Medical Center
  • most Kaiser Permanente hospitals
  • The recently enlarged Providence/Cedars Tarzana hospital also has a critical care unit for pediatrics
  • In outlying areas, Loma Linda Medical Center and Harbor UCLA Medical Center should be included in the list

Save a Little Life™ is dedicated to educating parents, family members, and care providers to respond to most pediatric health emergencies, if needed. Never underestimate the importance of that knowledge. Keeping CPR and airway emergency skills current can make the biggest difference in critical health events.

 

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BEE PREPARED

Most of us will likely be stung by a bee or yellow Jacket at some point in our lives. What should you expect if this happens to your little one?

As you might expect, there will be some pain or discomfort at the site and it is usually accompanied by local swelling, a feeling of heat and itching around the location. On occasion, the swelling might move from one hand to the forearm. This is not that uncommon. Itching may continue for several days and can be alleviated by a cool compress to the area.

How do I remove the stinger?

The stinger itself is a hollow tube through which venom enters the body. The preferred method for removal is to use something firm like a credit card to sweep the stinger off from the side. Grabbing the stinger with tweezers or your fingernail will likely eject additional venom into the person.

What does a severe reaction look like?

The following reaction(s) to a bee sting that require immediate attention include:

  • Hives, in parts or larger sections of the body
  • Nausea/vomiting
  • Stomach cramps
  • Any swelling of the body not associated with the site…particularly in the neck, face, tongue that might affect breathing

Some reactions are not specific to the site itself. If there is some swelling elsewhere, consider using an anti-histamine such as Benadryl. The liquid version enters the body more quickly, plus many young ones cannot swallow a pill.

Continue to observe the person closely and if needed, go to a local emergency department.

What to do when the bite victim has a known, severe allergic history to bee stings

If the bite victim has a known, severe allergic history to bee stings you should expect severe symptoms within minutes. If an EpiPen is available, use it as directed, then call 9-1-1. Driving to a hospital under these circumstances has risks, including traffic accidents.

What is an EpiPen?

EpiPen is a commonly known brand name of an auto-injectable device that delivers the drug epinephrine, a life-saving medication used when someone is experiencing a severe allergic reaction, known as anaphylaxis.

Do I need an EpiPen at home, even if no one in the household has a known allergy?

Most pediatricians will not prescribe one unless there is a confirmed history of a severe reaction to any substance that could cause a life-threatening event.

SIDS–WHY SAFE SLEEP PRACTICES MATTER

Nowadays, most first time parents are well-informed about the current guidelines regarding SIDS, but are they practicing them?

Dr. Rachel Moon, MD, FAAP is a widely-renowned pediatrician and the chair of the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome (SIDS). In her most recent study (The Tension Between AAP Safe Guidelines and Infant Sleep, Pediatrics, March 2024) we learned that most people know the ABCs of safe sleep but are not practicing them.

“If I had to follow the safe sleep back is best and nothing in the crib and no contact sleeping, I don’t think that she would get much sleep, nor would I, so I don’t feel too confident in that.” – mom from Dr. Moon’s Study

And what about the other people involved in the care of your baby – Grandparents, family members, babysitters, nannies? Even if you share what you know, cultural and generational differences can sometimes cause people to question and maybe even ignore the information.

The first step towards safety is understanding why Safe Sleep practices are important. There are many resources available to help answer that question and below you’ll find videos, links, and downloads that can help.

For example, did you know…

The risk of sleep-related infant death is up to 67 times higher when infants sleep with someone on a couch, soft armchair or cushion?

Watch Charlie’s Story to find out more…

And did you know that the risk of SIDS is lower for children who breastfeed? If you’re a new parent or planning on having more children, we suggest you read our previous post Breastfeeding May Reduce the Risk of SIDS.

MUST-HAVE RESOURCES

for English and Spanish speakers (hispanohablantes)

DOWNLOADS | DESCARGAS

We highly recommend that all parents and caregivers read the article:

How To Keep Your Sleeping Baby Safe by Dr. Rachel Moon, MD, FAAP which offers excellent advice and numerous resources and practical suggestions on how to reduce the risk of SIDS.

To download a copy of the article, click here.

Recomendamos encarecidamente que todos los padres y cuidadores lean el artículo:

Cómo mantener seguro a su bebé por Dr. Rachel Moon, MD, FAAP que ofrece excelentes consejos y numerosos recursos y sugerencias prácticas sobre cómo reducier el riesgo de SMSL.

Para descargar una copia del artículo, haga clic aquí.

The NIH (National Institute of Health) has many resources available on the topic of SIDS, including videos and brochures for grandparents and other caregivers such as this video:

Video para abuelos y personas que cuidan un bebé 

Safe Infant Sleep for Grandparents and Other Trusted Caregivers

For the English version of this video click here

ADDITIONAL DOWNLOADS | DESCARGAS ADICIÓNALES

 

Safe Sleep For Your Baby (NIH)

Safe Sleep for Your Grandbaby (NIH)

Sueño Seguro Para Su Bebé (NIH)

Sueño Seguro Para Su Nieto (NIH)

 

 

 

 

 

 

 

 

 

For more in-depth info, please visit:

NIH (National Institute of Health) 

Healthy Children.org

 

 

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CANDY OR CANNABIS?

California authorities recently seized 2.2 million illicit cannabis packages designed to look like popular food snacks and candy. The sting operation focused on 11 storefronts in the city’s Toy District where businesses were making and selling packaging used to deceive customers.

According to the L.A. Times, “The packages seized in the sweep were empty, but designed to mimic popular food and candy, including Sweet Tarts sour gummies and Twinkies adorned with rainbow sprinkles, which officials said could make them attractive to children. Such packages would not be permitted in the legal marijuana market.”

Under state law, cannabis goods must be labeled to ensure that consumers know what they are buying and to prevent products from being misused. Sellers are required to have packaging that is child-resistant, resealable and opaque if it’s an edible product. Vetted products feature a marijuana leaf symbol and an exclamation mark inside a triangle.

Unfortunately, the illegal weed market is aware of this, so some are now illegally creating packaging with a forged seal to sell their black market products.

Each of the seized packages was labeled with a forged California marijuana seal, giving would-be purchasers the false impression that the products inside had been vetted by the state. 

Obviously, this poses a danger to consumers.

Governor Newsom responded stating “We will not tolerate criminal activity that undermines the legal market, especially when it puts children at risk.”

Department of Cannabis Control Director Nicole Elliot added that such counterfeit packaging can potentially pose danger to consumers, “especially when it is ripping-off well-known brands that are attractive to children.”

Why is cannabis such a risk to children?

Children react very differently to cannabis than adults. Their reaction is extremely variable with symptoms varying from none at all to a coma. In a previous post we took a look at this issue and why it has become such a concern.  You can find that article Cannabis Poisoning In Children Is On The Rise here.

In our Pediatric CPR & Family Safety Class we always discuss potential risks to little ones who might accidentally consume any substance that might harm them. Our emphasis is on the 4 specific groups of potential toxins including drugs (of all kinds), plants, flowers and common chemicals used around the home for cleaning.

We strongly recommend the following guidelines:

• Keep all medications well hidden and out of sight of toddlers and children
• Be aware that little ones are always observing adults and might think that what they consume is OK for them
• Know the toxicity of common (indoor plants) as well as those in your garden
• All chemicals used for cleaning, disinfecting, or insecticides must be kept well out of reach and in cabinets that have good quality locks

If you believe that there has been an ingestion of any substance by your little one, please call California Poison Control immediately @ 1-800-222-1222.