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KidBitz with Dr. Randy

Dr. Randal FEdoruk

I am a pediatric occupational therapist.  I have worked with children in various settings for over twenty years.  I am a professor and I teach pediatrics and mentor Doctoral students completing research with a pediatric focus.  

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Child Development
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Crawling Matters

1/28/2024

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While both scooting and crawling are ways for babies to explore their environment and develop mobility, there are certain advantages to promoting crawling over scooting. Crawling is considered a crucial developmental milestone that offers a range of physical, cognitive, and sensory benefits. Here are some reasons why encouraging crawling is often preferred:
1. Physical Development:
  • Muscle Strength: Crawling engages a variety of muscle groups, including the core, arms, and legs. This helps in building strength, coordination, and motor skills.
  • Balance and Coordination: Crawling involves coordinating movements on both sides of the body, promoting better balance and coordination.
2. Cognitive Development:
  • Spatial Awareness: Crawling allows babies to explore their surroundings in a three-dimensional way, enhancing spatial awareness and perception.
  • Problem-Solving Skills: Crawling involves navigating around obstacles, encouraging problem-solving skills as babies learn to maneuver through their environment.
3. Sensory Development:
  • Tactile Exploration: Crawling encourages tactile exploration as babies use their hands and fingers to touch different surfaces.
  • Visual Stimulation: Crawling provides opportunities for visual exploration as babies move through various spaces, promoting visual tracking and depth perception.
4. Independence and Confidence:
  • Independence: Crawling is a more independent form of movement that allows babies to explore freely without relying on being carried or scooting.
  • Confidence Building: Successfully crawling and exploring the environment contributes to a baby's sense of confidence and autonomy.
5. Speech and Language Development:
  • Integration with Speech: The cross-lateral movements involved in crawling are linked to the development of language skills. Crawling helps integrate both hemispheres of the brain, potentially supporting later speech and language development.
6. Social Interaction:
  • Interacting with Peers: Crawling facilitates interaction with peers during playdates and baby groups, fostering social skills and the ability to engage with others.
7. Preventing Developmental Delays:
  • Motor Skill Milestone: Crawling is considered a motor skill milestone, and it may be a concern if a baby consistently avoids crawling or other developmental stages.
8. Preventing Asymmetrical Movement Patterns:
  • Encouraging Symmetry: Crawling encourages a symmetrical movement pattern, helping prevent the development of asymmetries or favoring one side of the body.
While scooting is a natural and sometimes preferred method of movement for certain babies, especially those who find it more efficient, it's beneficial to provide opportunities for crawling to ensure a well-rounded and comprehensive development. If you have concerns about your baby's motor development, it's always advisable to consult with your pediatrician or a pediatric developmental specialist for personalized guidance.
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When to introduce solid foods

1/21/2024

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Introducing solid foods to a baby is an exciting and important milestone in their development. The American Academy of Pediatrics (AAP) recommends introducing solid foods around 6 months of age, as this is when most babies are developmentally ready. However, every baby is unique, and it's crucial to watch for signs of readiness before starting solids. Here's a step-by-step guide on how and when to introduce solid foods to your baby:
Signs of Readiness:
  1. Head Control:
    • Your baby should be able to hold their head steady and sit upright with support.
  2. Loss of Tongue Thrust Reflex:
    • Babies typically have a natural reflex that pushes food out of their mouths with their tongues. When this reflex diminishes, it's a sign that they may be ready for solids.
  3. Interest in Food:
    • If your baby shows interest in what you're eating, reaches for food, or opens their mouth when you offer a spoon, they may be ready for solids.
  4. Ability to Chew:
    • Your baby should have the ability to move food to the back of their mouth and swallow.
Step-by-Step Guide:
  1. Start with Single-Ingredient Purees:
    • Begin with single-ingredient, iron-rich purees such as rice cereal, oatmeal, or pureed fruits and vegetables. Start with a small amount (a teaspoon or so) and gradually increase.
  2. Introduce New Foods One at a Time:
    • Wait a few days before introducing a new food. This helps you identify any potential allergies or sensitivities.
  3. Gradual Texture Progression:
    • Progress from smooth purees to mashed, lumpy textures as your baby becomes more accustomed to eating. This helps develop their chewing and swallowing skills.
  4. Offer Iron-Rich Foods:
    • Iron is essential for a baby's development. Introduce iron-rich foods such as pureed meats, poultry, and iron-fortified cereals.
  5. Include a Variety of Foods:
    • Introduce a variety of fruits, vegetables, grains, and proteins to provide a well-rounded diet and expose your baby to different flavors and textures.
  6. Responsive Feeding:
    • Pay attention to your baby's hunger and fullness cues. Let them guide how much they eat during each feeding.
  7. Use a Soft Spoon:
    • Choose a soft, rubber-tipped spoon for feeding to protect your baby's gums and emerging teeth.
  8. Gradual Transition to Finger Foods:
    • As your baby becomes more adept at eating, introduce soft finger foods such as small pieces of ripe fruits, cooked vegetables, and soft cheeses.
  9. Avoid Certain Foods:
    • Avoid introducing honey before the age of one due to the risk of botulism. Also, avoid foods that are choking hazards, such as whole grapes, nuts, and hard candies.
  10. Stay Patient and Responsive:
    • It may take time for your baby to adjust to eating solid foods. Be patient and responsive to their cues, and make mealtimes a positive and enjoyable experience.
  11. Continue Breastfeeding or Formula Feeding:
    • Solid foods are complementary to breast milk or formula until at least the age of 1. Continue breastfeeding or formula feeding alongside the introduction of solids.
Always consult with your pediatrician before introducing solid foods to ensure that your baby is developmentally ready and to address any specific concerns or recommendations based on your baby's health and individual needs.
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How to help your baby sit without support

1/14/2024

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Promoting independent sitting in babies is an exciting developmental milestone that typically occurs around 6 to 8 months of age. It's important to note that each baby develops at their own pace, so patience and support are key. Here are some tips to encourage and support your baby as they develop the strength and balance needed for independent sitting:
1. Tummy Time:
  • Start Early: Begin tummy time as early as possible. This helps strengthen your baby's neck, back, and core muscles, which are essential for sitting.
  • Gradual Increase: Gradually increase the duration of tummy time sessions. Initially, start with a few minutes and gradually extend as your baby becomes more comfortable.
2. Use Supportive Seating:
  • Boppy Pillow or Nursing Pillow: Place a Boppy pillow or a nursing pillow around your baby to provide support during playtime. This gives them a sense of security and helps them practice the sitting position.
3. Surrounded by Toys:
  • Encourage Reach and Grasp: Place toys slightly out of reach to encourage your baby to reach and grasp. This helps build arm and upper body strength, promoting the development of sitting skills.
4. Sit Them Up:
  • Assisted Sitting: Support your baby in a sitting position using your hands or by placing cushions around them. This provides them with a sense of balance and helps them get used to the seated position.
5. Cushion Support:
  • Surround with Cushions: Place soft cushions or pillows around your baby while they are sitting to provide a supportive and safe environment. This helps prevent them from toppling over and builds confidence.
6. Mirror Play:
  • Use a Mirror: Place a baby-safe mirror in front of your baby during sitting practice. Babies are often intrigued by their own reflection, and this can encourage them to maintain the sitting position while engaging with the mirror.
7. Interactive Play:
  • Engaging Toys: Use toys that capture your baby's interest and encourage them to maintain a sitting position while playing. Interactive toys that make sounds or have colorful features can be especially engaging.
8. Encourage Crawling:
  • Crawling Practice: Encourage your baby to practice crawling. Crawling helps strengthen the muscles necessary for sitting independently and promotes overall mobility.
9. Supervised Playtime:
  • Supervise Carefully: Always supervise your baby during sitting practice to ensure their safety. Be ready to provide support if they start to tip over.
10. Use a High Chair:
  • High Chair Sitting: Use a high chair during mealtime or playtime. The supportive structure of a high chair helps your baby practice sitting with less risk of falling.
11. Offer Positive Reinforcement:
  • Celebrate Achievements: When your baby manages to sit independently, celebrate the milestone with positive reinforcement. Encouraging words, clapping, and smiling create a positive association with the achievement.
12. Avoid Forcing:
  • Let it Happen Naturally: Avoid forcing your baby into a sitting position. Allow them to develop the necessary strength and balance naturally through play and exploration.
Remember that each baby progresses at their own pace, so it's essential to be patient and supportive. If you have concerns about your baby's development or if they are not reaching developmental milestones within the expected timeframe, consult with your pediatrician for guidance.
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Visual Development in Babies

1/7/2024

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Visual development in infants is a dynamic and intricate process that involves the maturation of the eyes, the development of visual pathways in the brain, and the refinement of various visual skills. Understanding the stages of visual development in infants is crucial for caregivers and parents to provide an environment that supports healthy vision. Here's an overview of the key aspects of visual development in infants:
1. Newborn Vision:
  • Limited Visual Acuity: Newborns have limited visual acuity and can see best at a distance of 8 to 12 inches, which is approximately the distance between their face and a caregiver's face during feeding.
  • Preference for High Contrast: Infants are attracted to high-contrast patterns and bold, black-and-white images.
2. Tracking and Following Objects:
  • Tracking Movements: Around 2 to 3 months, infants begin to develop the ability to track moving objects with their eyes.
  • Smooth Pursuit: Smooth pursuit movements, where the eyes smoothly follow a moving object, start to emerge during this stage.
3. Depth Perception:
  • Binocular Vision: By 4 to 5 months, infants typically develop binocular vision, enabling them to use both eyes together to perceive depth and three-dimensional space.
4. Hand-Eye Coordination:
  • Reaching and Grasping: Infants start reaching for objects and developing hand-eye coordination around 3 to 4 months, refining these skills as they grow.
5. Color Vision:
  • Color Discrimination: Color vision continues to develop during the first few months, with infants becoming more adept at distinguishing colors.
6. Object Recognition:
  • Recognition of Faces: Infants are drawn to faces and can recognize familiar faces, especially those of their primary caregivers, from a young age.
7. Visual Exploration:
  • Visual Exploration of Surroundings: As infants become more mobile, they engage in visual exploration of their surroundings. This exploration is essential for cognitive development.
8. Refinement of Visual Skills:
  • Fine-Tuning Visual Skills: Throughout the first year of life, visual skills such as visual tracking, focusing, and depth perception continue to refine as the neural connections in the brain mature.
9. Screen Time Considerations:
  • Limiting Screen Time: Excessive screen time, especially in the early years, may have potential implications for visual development. The American Academy of Pediatrics recommends limited or no screen time for children under 18 months.
10. Regular Eye Exams:
  • Monitoring Eye Health: Regular eye check-ups are crucial to monitor eye health, detect any potential issues early on, and ensure that visual development is progressing as expected.
11. Responsive Caregiving:
  • Responsive Interaction: Providing responsive caregiving, such as making eye contact, talking to the baby, and using visually stimulating toys, supports healthy visual development.
In conclusion, visual development in infants is a multifaceted process that involves the integration of various visual skills over the first year of life. Caregivers play a vital role in supporting this development by creating visually rich environments, engaging in interactive play, and ensuring regular eye check-ups to address any potential concerns promptly. Understanding the milestones and stages of visual development empowers parents to foster healthy vision in their infants.
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