Archive for the 'Health & Wellness' Category

Preserve that smile: Tips for finding the right dentist for your kids

child getting teeth cleaned

Tooth decay is the most common childhood disease, so finding a good dental home is paramount in achieving dental health. Much like well-visits with a pediatrician, regular dental check-ups should be a priority. And starting dental care early can help promote a positive life-long dental experience.

Getting started

Referrals are very helpful when choosing a dentist and a good place to start is by asking your pediatrician. Friends and family with kids can also be good resources. If you’re looking specifically for a pediatric dentist, the American Academy of Pediatric Dentistry has a great search feature by location.

Both family dentists and pediatric dentists can see pediatric patients. However, a pediatric dentist received two additional years of training pertaining to pediatric dental needs and psychology; he or she may be better prepared to address pediatric-specific dental issues including thumb-sucking.

It is a good idea to consider location as well, especially when your child is new to the dentist and may need to go more frequently than every six months. Once you have some recommendations, it is a good idea to visit the practice to get a feel for the atmosphere before choosing a dental home.

Office environment

While credentials may be of utmost importance to parents, a child’s first impression will be the waiting room and staff they meet upon arrival to the dental practice. An office with books for kids to look at and cheerful imagery will go a long way in reducing anxiety. Some small things like a step stool in the bathroom, no cavity clubs, positive reinforcement treats/stickers, and sunglasses to wear when under the bright lights can make kids feel welcome too.

Ask questions to find out who will be cleaning your child’s teeth; regardless of whether it is the dentist or the hygienist, make sure that person has experience with kids of all ages. Ask how he or she responds to a child who has some anxiety at the dentist and if you think your child may fit that bill, plan ahead and see if there is anything you can do to prepare your child. Determine what is included at the first visit and how frequently the dentist typically sees a child. Inquire as to what imaging studies may be routine and how often they are recommended. Finally, ask how the dentist handles after-hours emergencies.

As we observe pediatric dental care month, take the time to find a dental home and protect your child’s smile for years to come.

– Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of three young children and volunteers with the Parenting Program.

Raising healthy girls through sports

two girl soccer friends

As the mother of two daughters, a prime focus of mine is raising them to become strong, confident women. One way to encourage this is through sports.

Even for those not athletically inclined, introducing sports from a young age encourages development of physical strength and confidence, which helps create a healthy body image and increased self-esteem. Sports can be introduced in the form of individual sports or team sports.

Fostering a love for individual sports, such as running or swimming, can provide a later groundwork for future stress relief. If you and your child share that individual sport, it is a great way to bond with your child and sharing a lifelong love of a similar activity can be beneficial later in life as a constant to bond over.

Team sports can also provide a lot of benefits for girls by encouraging teamwork and facilitating positive social interactions. Sports also help to teach discipline, which can positively impact behavior at home and in school. Introducing sports from a young age can help girls to appreciate their bodies for their strengths and not just their beauty as many stereotypes focus upon.

Getting started

Introducing young girls to sports is easy even if you aren’t passionate about sports yourself. Many individual sports such as running can be practiced at home or in a nearby park. It can be fun to use a timer to track a child’s pace, help her achieve her goals, and monitor progress.

Most team sports start as young as age 3, but it isn’t necessary to wait until kids are preschool age if you’re able to join them for some parent/daughter bonding time. Once kids are about 18 months, there are many parent and child classes offered in the surrounding communities. Some common early-organized sports available to young girls are soccer, t-ball, dance, basketball and tennis. Once girls are preschool age, many of these organized sports are offered in a team setting through local YMCAs, community centers, and studios. Public schools also are a great resource as their varsity and JV teams sometimes have outreach programs offered to introduce school-age children to their corresponding sport. And, if you’re like me when introducing something new, a great place to visit is the library. After watching a few innings of a local elementary school softball game last summer, my daughter happily checked out several books on softball and baseball.

There are also many low-cost ways to introduce your daughters to sports with minimal equipment. Many local school playgrounds are open to the public during after-school hours and in the summer. There are often basketball hoops, soccer goals and baseball diamonds available at these schools. Investing in some kid-safe equipment and joining your daughters in practicing sports can build confidence and can be a fun bonding experience. In addition, some good sidewalk chalk can go a long way in creating a baseball diamond at home, although encouraging a younger brother to run to second base may still pose a challenge!

Above all, what is most important when introducing sports to young girls is to help foster a healthy appreciation of sports. By instilling this healthy habit, girls can increase their confidence through strength and positive social interactions, which in turn can help them to become strong, confident women.

– Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of three young children and volunteers with the Parenting Program.

Hand washing: Instilling healthy habits in your children

mom teaching boy to wash hands

Hand washing is one of the most important preventative measures that everyone can take to stay healthy. Making this part of a routine from an early age can help prevent many future illnesses. While it can take only a few seconds for your little ones to accidentally infect themselves from dirty hands, the resulting illness can last days to weeks. So take the time now to prevent those lengthy illnesses as we focus on the importance of hand washing.

Teaching kids about germs

Proper hand washing can remove germs that lead to illness but the idea of germs can admittedly be a bit abstract for young children. In my family, we often look to books when embarking upon a new adventure and there are plenty of books about hand washing—including “Germs Are Not for Sharing” by Elizabeth Verdick—that are perfect for a young audience.

For older, school-age children, glitter or washable paint are cool visuals for demonstrating the spread of germs. Try this fun project to help visualize the spread of germs, although I think I might save this lesson for the summertime when it can be done outside.

When should we wash hands?

As a general guideline, hand washing should occur:

  • Before and after playing with other children
  • After playing outside
  • After touching a pet
  • After using the bathroom
  • After coughing or sneezing
  • Before and after eating

While hand sanitizer is great in some situations, it isn’t always best. Children’s hands are often visibly dirty; soap and water will remove dirt and soil unlike hand sanitizer. However, if you are on the go, hand sanitizer can be very helpful when water is not accessible.

Making it fun

Hand washing should take about 20 seconds, which is about the length of time it takes to sing “Row, Row, Row Your Boat” twice. I like to use these lyrics to make it more fun for my children:

Wash, wash, wash my hands

I can wash my hands

Washy, washy, washy, washy

Now I’ll wash some more

Wash, wash, wash my hands

I can wash my hands

Washy, washy, washy, washy

Now my hands are clean

While singing the song, the following steps should be done to ensure clean hands:

  1. Roll sleeves up
  2. Thoroughly wet hands
  3. Place a dollop of soap on hands
  4. Scrub fronts and backs of hands
  5. Rinse
  6. Thoroughly dry on a disposable towel

Other helpful tips

  • Place a step stool near the sink and put soap within arm’s reach, so hand washing is more accessible for smaller children.
  • Rewarding children with a sticker (for step stool decorating) after proper hand washing can make hand washing more fun for toddlers when they’re learning and in that “do it myself” phase.
  • Letting children pick the scent of the soap can give them something to look forward to as well.

Take the time now to instill this healthy habit into your routine and it can pay dividends in your family’s future health.

– Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of three young children and volunteers with the Parenting Program.


Is using a car seat covering safe?

woman carrying infant carrier with canopy

image credit: Amazon

As the winter months approach, children will soon be sledding down snow hills, building snowmen, and really little ones will be traveling in cold weather in their car seats. As a Certified Child Passenger Safety Technician (CPST), I can assure you that there are many steps that a parent can take to ensure their children stay warm and safe this upcoming cold season.

One recommendation is to avoid heavy, bulky coats on children harnessed in their car seats; there are many articles and infographics that discuss why this is important. However, there is a hidden danger that many parents are unaware of: using car seat covers or aftermarket canopies that cover your infant’s head for a long period of time while installed in his or her car seat.

Before diving into the research and reasons why this is potentially dangerous, let’s rewind for a minute. The practical reason for a covering children is to protect them from wind, rain and snow while you transport them in and out of the vehicle. As the parent of a winter-born baby, I can tell you that I covered my child with a blanket in his infant carrier many times after strapping him in the car during our Michigan winters. My job as a CPST is to provide you with information so you can make an educated decision about keeping your child safe.

There is an increasing amount of research that discusses how car seat canopies and other coverings are potentially dangerous. A specific concern is the risk of CO2 rebreathing. During the breathing process, your body inhales oxygen and exhales carbon dioxide (CO2), maintaining a balance between these two gases. However, rebreathing CO2 can have harmful effects on the body. When an infant has soft, fluffy or loose fabric around his face, the carbon dioxide can build up around the baby’s head. Rather than breathing fresh oxygen, the baby is rebreathing the expelled CO2 (Blair, Mitchell, Heckstall-Smith and Fleming, 2008). Many babies may cry, turn their head or attempt to get out of this unsafe situation, however infants who are at-risk (i.e., preterm, respiratory concerns) may have extra difficulty notifying a caregiver they are struggling (First Candle – Rebreathing Carbon Dioxide and Suffocation as they related to SIDS, 2009).

In April 2014, Baby Carrier Industry Alliance (BCIA) issued an executive statement regarding infant carrying that is applicable to car seat safety and any situation to where a child’s face might become covered and breathing could be compromised. It stated, “[C]overing a baby’s face makes it impossible to monitor a child’s breathing, in addition to putting the baby at risk for suffocation, or CO2 rebreathing.”

This does not mean that you have to expose your infant to cold weather and crippling winds when taking baby to the car in the winter. The key is to protect your child with a temporary cover. Use a receiving blanket to protect your child from the elements, but be sure to remove it once baby is secured in the vehicle. The American Academy of Pediatrics (2016) recommends against over-bundling and covering the face and head.

My recommendations

  • Avoid car seat canopies that strap onto the infant carrier’s handle. Parents often pull back the cover and leave the strap for convenience, but this poses a suffocation risk if the fabric accidentally falls down over the infant’s face.
  • Avoid car seat covers that zip close to a child’s face.
  • Always be aware of your infant’s airways and the car seat environment. We recommend using the “visible and kissable” phrase, which means keep your baby’s face uncovered and able to receive kisses at any given moment. This ensures that you can easily see and assess your child’s breathing while in the car seat.

Together we can ensure all babies stay warm and safe while traveling to and from the vehicle. As we know all too well, the sledding and snowman season will be here before we know it.

– Stephanie Babcock, CPST, is an IFS coordinator with the Parenting Program. She’s also the proud mommy of two boys.

Nutritional considerations for children with Crohn’s disease

child holding bowl of berries

For children with Crohn’s disease, good nutrition is important to allow them to grow and develop at a healthy rate. What your child eats or is able to eat can depend greatly on whether their Crohn’s is in remission (not active) and experiencing few symptoms or if it is active and causing increased inflammation of the digestive tract.

When your child’s disease is in remission, the goal is to maintain a well-balanced diet featuring a wide variety of nutrient-dense foods. These foods include: protein (meats, fish, poultry, dairy products, beans and legumes), carbohydrates (whole grain cereals and breads, vegetables, fruit), and fats (monounsaturated and polyunsaturated oils, avocado, nut spreads). A well-balanced diet can help make sure that your child gets enough calories, protein and vitamins/minerals.

When the disease is active and your child is experiencing more symptoms, the goal is to make sure your child is consuming sufficient calories and nutrients. Your child’s health care provider may suggest a modified diet that may be helpful during this time such as a low fiber/low residue diet or a lactose-free diet. Changes to your child’s diet are recommended mainly to help with any discomfort or unpleasant symptoms your child may be having.

Low fiber/low residue diet

Fiber is the part of food that cannot be digested; it is also known as bulk and roughage. Fiber helps the body move food through the digestive tract. Eating foods high in fiber — such as fresh vegetables and fruit, whole grains, nuts and popcorn — when your child’s disease is active may increase diarrhea, increase pain and discomfort with bowel movements, and increase bleeding. A low-fiber diet can help to “rest” the intestines.

If your child’s doctor recommends a low-fiber low/residue diet, this article might be a useful reference for appropriate foods on a low-residue diet. In addition, a multivitamin or vitamin supplements may be recommended in order to add nutrients normally found in fruits and vegetables.

Remember to always check with your child’s health care provider before beginning a new diet.

Lactose-free diet

Lactose is the carbohydrate portion of milk. Children may experience lactose intolerance, especially with the disease in the small intestine. Symptoms include nausea, bloating, increased burping, increased gas, stomach pain and diarrhea. These symptoms can decrease or go away completely when milk and other dairy products, such as cheese, ice cream and yogurt, are removed from the diet.

Because milk and dairy products are very important sources of calcium and vitamin D for a growing child, your health care provider may suggest switching to lactose-free milk or fortified soy milk/almond milk/rice milk, or recommend your child take a lactase supplement when eating milk products.

Consult your health care provider before taking dairy products out of your child’s diet. A dietitian can also make suggestions that will help to lessen symptoms and keep up the amount of calcium and vitamin D in your child’s diet.


Children with Crohn’s disease may benefit from vitamin and mineral supplementation of calcium, iron, B12, magnesium and/or phosphorus due to a variety of reasons including location of disease within the GI tract, poor absorption, surgical resections or poor food intake due to decreased appetite. Do not start supplementation without consulting your child’s medical health provider.

There is not one set diet that is applicable to every child with Crohn’s disease. Keeping a daily food journal can help identify foods that may trigger symptoms and avoiding these foods, especially when your child’s disease is active, may help lessen symptoms. It can be helpful to consult with a dietitian who can help develop a specific dietary plan for your child. A dietitian can also review your food journal to see if there are any patterns in your child’s diet in relation to his/her symptoms.

Mary Ligotti-Hitch, R.D., is a registered dietitian with the Beaumont Health Center’s Weight Control Center.


Dysphoric Milk Ejection Reflex

mom breastfeeding baby

Cropped image. Cheryl, Flickr. CC license.

What is Dysphoric Milk Ejection Reflex (D-MER)?

D-MER is a condition affecting lactating women that is just recently been recognized. It is characterized by abrupt dysphoria, or negative emotions, that occur just before milk release. This reaction to letdown may occur when pumping, breastfeeding or when experiencing spontaneous letdown (i.e., milk releasing when not breastfeeding/pumping).

Moms have used many different words to explain the feelings that take place with D-MER. Some of the most frequent descriptions are anxiety, sadness, dread, nervousness, emotional upset, irritability and hopelessness.

D-MER presents itself with slight variations depending on the mother experiencing it, but it has one common characteristic: a wave of negative emotion just prior to letdown. This emotional response is the consistent key component in D-MER. The breastfeeding mother experiences a surge of negative emotions 30 to 90 seconds prior to her milk release when breastfeeding, pumping, or with spontaneous letdown.  It can last for a few seconds at the beginning of a feeding or it can happen repeatedly with multiple letdowns in the same feeding.

For some mothers D-MER is gone by the time the baby is 3 months old, but for other moms it lasts until weaning.

What is the cause of D-MER?

Before discussing what it is, it is important to discuss what it is not.

  • It is not a psychological response to breastfeeding.
  • It is not postpartum depression or postpartum mood disorder.
  • It is not general dislike of breastfeeding.
  • It is not breastfeeding “aversion”.
  • It is not due to a history of depression, a history of physical/sexual abuse.
  • It is not related to the mother’s birthing experience.
  • It is not because she doesn’t love her baby enough or because she’s a bad mother.

Other important things to note:

  • Mothers themselves cannot cause D-MER. It is a hormonal problem.
  • The feelings a mom experiences with D-MER are not real. They are her hormones are fooling her and even though it feels like it’s in her head, it’s not.
  • Mom did nothing to cause it, and she cannot make herself snap out of it

Research tells us that D-MER is physiological not psychological. This means that hormones in the mom’s body, not past experiences or repressed memories, that are causing the condition.

Preliminary studies found that D-MER is the result of the drop in dopamine levels at letdown. This drop must occur to allow the prolactin (milk-making hormone) level to increase. This happens to all mothers, but in women with D-MER, the dopamine level drops too far or too fast in the central nervous system. This results in a wave of negative emotions.

What treatment is available?

For mothers with mild to moderate D-MER, education may be the best treatment. Many women find their symptoms are more easily managed once they are aware it is a medical problem and not an emotional one. Tracking symptoms in a log and learning what makes them better or worse is helpful for many moms.

Mothers with more severe D-MER are encouraged to visit their health care provider. Together, they can determine the best way to treat this condition effectively. So far, it has been proven that medications that increase dopamine levels in a mother can treat D-MER effectively. The best way to receive the proper treatment is to let your doctor know exactly what is happening when you experience these feelings.


D-MER is not a new condition, but until recently, little was known about it. Many mothers were embarrassed to talk about this; they thought they were the only ones struggling with the feelings they had during letdown. If they did speak of it, many times a mother’s feelings were dismissed. We are just discovering how widespread this is. As more people continue to speak up about this condition and awareness increases, progress will continue to be made in the education, support and treatment of D-MER.

– Pat Ashley, RN, IBCLC, Beaumont Hospital, Grosse Pointe

Summer salads to bring to your next BBQ

chopped vegetable confetti salad

image credit: fooddonelight

With summer right around the corner, what better way to celebrate than with some fresh vegetables? As one of the dietetic interns at Beaumont, I wanted to share two of my favorite salad recipes with you. I love to eat salad, especially in the summer time and with so many delicious vegetables to choose from, I like making a different salad every day and trying new recipes. There are so many temptations in summer from graduation parties, holidays, and birthday parties, but bringing a salad to one of your social events will keep you full, on track, and it’s sure to be a hit at the festivity.

Chopped Vegetable Confetti Salad (pictured above)


  • 4 cups cauliflower, roughly chopped
  • 4 cups broccoli, roughly chopped
  • 2 cups carrot, roughly chopped
  • 2 cups celery, roughly chopped
  • 1 red pepper, roughly chopped
  • 1 cup onion, roughly chopped
  • 2 cloves garlic, minced
  • ½ cup fat-free Italian dressing
  • Fresh ground black pepper to taste
  • *Note: To save time buy your vegetables pre-cut at your local grocery store


  1. Place cauliflower into a food processor and pulse until cauliflower is very finely diced. Pour into a large bowl.
  2. Repeat with broccoli and remaining vegetables, one at a time.
  3. Add the minced garlic to other vegetables.
  4. Pour dressing over vegetables and toss well and season with pepper.
  5. Refrigerate for an hour and serve. (Counts as low starch vegetables.)


10 servings

Recipe adapted from

Creamy Tomato and Cucumber Salad


creamy cucumber and tomato salad

image credit: Natasha’s Kitchen

  • 3 medium tomatoes
  • 2 medium cucumbers
  • ½ medium onion
  • 1 large garlic clove
  • 3 tablespoons fat-free mayo
  • 2 tablespoons fat-free sour cream or plain Greek yogurt
  • ⅛ teaspoon pepper
  • Salt to taste


  1. Cut tomatoes into 1-inch pieces.
  2. Cut cucumbers in half and slice, then thinly slice the onion.
  3. Combine all the prepared vegetables in a medium bowl.
  4. In a small bowl, combine mayo, sour cream or plain Greek yogurt, garlic, and pepper. Mix well.  Mix the dressing into the vegetables.
  5. Add salt to taste just before serving. (Counts as low starch vegetables.)


6 servings

Recipe adapted from

– Chelsea Bono is dietetic intern going through the Beaumont Dietetic Internship program.


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