Category Archives: Parenting tips


If there were no automobiles, children would never die from car accidents. Right.

But we need cars. They take us to cool and important places, like your Pediatrician’s office, or work, respectively. Therefore, we accept the risk of putting our children into cars, and do our best to make them as safe as possible. Carseats, anti-lock brakes, air bags, speed limits, rules of the road, etc.

If there were no crib bumpers, infants would never die from crib bumpers. Also right.

However, we don’t need crib bumpers. At all. Ever. They are seriously pointless, and worse, they can be deadly.

An article published by the Journal of Pediatrics this past year found that 23 infants were killed by crib bumpers from 2006-2012. Notice I didn’t say “only” 23 infants. These deaths are entirely preventable, making one such death needless and tragic.

So why are they still found in cribs?

Well, Pottery Barn Kids makes us think we need them; why else would they display them in their stores?



Pintrest makes us think we need them; how else can that barren crib look cute and cuddly?



I’ll grant even common sense might make us think we need them, to prevent limb entrapment, or banging a vulnerable head against a hard rail.

Ultimately, all of these considerations are misleading.

Proposed benefits of crib bumpers include preventing entrapment of head, neck, or limbs between the crib rails, or preventing head trauma. Fortunately, the width of the rails, or ‘slats’ are regulated to be less than the width of a soda can. Limb entrapment does occur, but is not prevented entirely by crib bumpers. More importantly, limb entrapment is not a serious or deadly injury. There was one case of an infant hitting his head on a crib rail, causing a bruise. We (and your infant) can live with that.

We (and your infant) can also live with a plain, boring, nothing-but-baby, crib.

Pediatricians have advocated strongly against their use, and all soft bedding, as part of a comprehensive safe sleep policy statement issued in 2008, and reiterated in 2011. I personally don’t let a family leave my newborn nursery without explaining the safest possible sleep environment, ie, the lowest risk of sudden unexpected infant death. I tell parents to remember your ABC’s of safe sleep: Place infants Alone, on the Backs, and in their own crib. No bumpers. No stuffed animals. Make pinterest scoff in pity and disapproval. Your baby is sleeping safe tonight!

But it’s not enough, clearly. In this recent article published last month in Pediatrics, investigators got sneaky and filmed parents and their infant’s sleep environment. I’m not kidding. 91% had the stuff I just talked about in their sleep environments (bedding, bumper pads, pillows etc).


If only we treated crib bumpers like we do other things that are completely unnecessary and dangerous. Like, nuclear waste. You can’t buy that stuff because its dangerous, and unless powering your 1985 DeLorean for time-travel purposes, is completely unnecessary to possess. It’s probably illegal. Wait. Yes! That’s it! What if a crib bumper, which is clearly a hazardous, unnecessary material, were illegal to sell? Impossible? Wrong.

Maryland’s state department of health did just that, and in two short years from conception to action, passed a regulation banning the sale of baby bumper pads. You can read more here.

The INAAP Perinatal and Infant Mortality Committee believes Indiana should follow suit. On Monday, October 17th we will be advocating  “Ban the Bumper” day. On this day we invite everyone to share our messages through your Twitter and Facebook social media accounts, using #BanTheBumper.

Messages to share (cut and paste away!) include:

  • Crib bumper deaths are needless, tragic, and 100% preventable! #BanTheBumper #LaborOfLove16
  • 23 infants died because of crib bumpers from 2006-2012. We can put an end to this! #BanTheBumper #LaborOfLove16
  • Indiana ranks 45/50 in perinatal mortality. Let’s do everything possible to save these lives! #BanTheBumper #LaborOfLove16
  • A baby should be the only cute object in a crib #BanTheBumper #LaborOfLove16
  • Boring crib = safe sleep #BoringIsBest #BanTheBumper #LaborOfLove16
  • Your baby can live with a boring crib without crib bumpers! #BanTheBumper #BoringIsBest #LaborOfLove16

This date coincides with the Indiana department of health sponsored infant mortality summit, “Labor of Love,” where I will be presenting the dangers of crib bumpers, and advocating their removal from infant stores. And by all means, if you are driving by an infant supply store, or perusing Pinterest, and see these deadly, unnecessary objects in cribs, let them know they are endorsing a real threat to infant safety.

I hope you will join with INAAP as we encourage everyone to #BanTheBumper.

Tony GiaQuinta, MD FAAP


Zika, Chikungunya, and Aedes Mosquitos. Oh My!

Until our honorable elected officials stop their political posturing and decide Zika is real bad and needs real attention, here are some tips to protect yourself and your kids from mosquitoes.

There are three basic strategies:

  1. Whenever outside, constantly scan your arms, legs, and all other exposed skin areas waiting for a mosquito to land. Quickly smack that son-of-a-gun into a unrecognizable insect paste. Make sure someone is constantly scanning your neck and other hard to reach areas, also ready to deliver a nice whack.
  2.  Never ever ever go outside this summer. There are plenty of great HBO series to get caught up on anyways.
  3.  Use a safe, effective insect repellent.

This doc wants you to go with #3.

#1 sounds exhausting and might start a fight. #2 would worsen our obesity epidemic, and kids aren’t mature enough for the suggestive adult content of some HBO series (I’m looking at you, Game of Thrones). No, kids really do need to spend time outside this summer, and you do, too.  Here’s how to do so safely.


Honestly, just remember to use a repellent with DEET in it. Or N,N-diethyl-meta-toluamide as I like to call it. Yeah, I know it’s a chemical made up of big chemically words, and I have no idea if it is gluten free or not. But it is the most widely used ingredient and has the most data on safety and efficacy.

Word on the street is there is no evidence that concentrations above 50% increase efficacy, so you can stick your nose up at that marketing ploy. My academy (The American Academy of Pediatrics) recommends using products containing up to 30% DEET for children.

Couple of considerations:

  1. Don’t use on babies less than 2 months old, use mosquito netting instead.
  2. Don’t use repellents under clothes
  3. Don’t use products that use both sunscreen and repellent, because sunscreen needs to be applied more frequently.

Pregnant? You’re good. They’ve studied DEET during 2nd/3rd trimesters of pregnancy, and didn’t see any adverse effects to the fetus.

Other options include:

  1. IR3535 – concentrations between 7.5%-20% are safe and effective.
  2. Picaridin – odorless, doesn’t damage clothing, no reports of toxicity. Use up to 10%
  3. Essential oils – Safe to use, doesn’t work as well. Zika!
  4. Citronella – Works well, doesn’t last as long

More info here!

That should do it. Enjoy being outdoors this summer! If you have time, contact your honorable congressman or congresswomen and let them your future children shouldn’t be a political pawn vs Zika. Here is the letter my academy wrote, for example.

– IndyPedsDoc


An email from our lactation consultant (a must read for breastfeeding parents)

Dear Sarah and Dr. G,

I am confident with some time both of you will work into breastfeeding success. Don’t give up and Be patient, both of you are learning and he needs some time to forget about his early days in the hospital (the separation from you both, constant NICU stimulation, tests, and bottle feedings).  He needs time to be at home, bonding with you both.  In this (stay at home), quiet,, no testing, atmosphere he will begin to relax and fit into that wonderful baby routine of eat,sleep, poop, pee and best of all being loved and touched gently.   Scheduling is ok right now keeping your breast happy with milk release by pumping or nursing, and making sure Henry  is fed by the 3rd hour.    Remember to time the next feeding from the moment his tummy is full.   It takes about 10 min after a feeding, and gentle burp for babies to slip into that deep sleep so they can be  placed in a crib without waking up.  That’s your goal.  Happy breasts, happy baby, happy Mommy, happy daddy.

> Try natural methods to increase your milk supply.   Diet, fluid intake, eat two servings of oatmeal a day, Pumping on a comfortably high setting with the larger flange 27mm.  Your breasts need a good 2 1/2 hour break between feedings or pumping sessions to replenish milk volumes.

>  Rest:   This is so important to your whole well being.  You can rest with baby skin to skin between feedings, as long as you do not drift into sleep.
Pump before feeding; Give the milk and baby to Daddy for food and bonding,  while you take your meds and go to bed for a good 3 hours.

>  Breastfeeding:  Choose your times to attempt a feeding at the breast, or when doing skin to skin bonding, his little brief latch on moments are good practice   sessions.  Let him explore your breasts and nipples and learn.
If pumping before a feeding: do this 20 min prior to even waking Henry ..  Pump both or one to collect 15 -20 mm per breast.   Wake Henry
Burp him, change his diaper, and bring him to your breast.  Cuddle and bond first, watch for his rooting, and see if he will latch to your bare Wet nipple.  If he
refuses, or fusses,  give him the fresh milk you just pumped,  once he takes that milk.  Then bring him back to your nipple, hopefully to continue his feeding.
You may use the shield as directed.  Apply wet, massage the breast, bringing a puddle of milk into the shield, so he gets instant reward when he sucks.
Massage your breasts as you pump and as you nurse Henry.  This keeps milk moving toward your nipple, for removal.

>  Use the tips provided in the engorgement phase management hand out.  Switch it up to make it work for you.

>  Clean pump parts, bottles, nipples, paci, shield, with hot soapy water, hot rinse and paper towel dry.  Dish washers can harbor bacteria.

Sarah,  Now that you are home with Henry,  Keep visitors to a minimum, stay in your PJ’s, Do a lot of skin to skin bonding with Henry,  Dr. G- this means you too. curl up next to Sarah and Henry in bed for some important gentle bonding time.  When it is time for sleep, Henry goes to his crib.    Both of you Sleep when baby sleeps.  Maternal Fatigue can disrupt milk production, and prompt frustration (tears).  Sarah, You have everything you need to feed your baby.  Working into nursing at the breast needs patients, practice, and confidence.   All of which you have.  You can do it.  You’re both such loving parents.  Keep me posted.  I will check with you tomorrow.

Our lactation consultant and Henry:

Carla and Henry

The Cold Never Bothered Me Anyway

I read somewhere last week that you can get frostbite in as little as 10 minutes with a wind-chill of -60F.

By the way, that’s 10 minutes, not 10 seconds. Yeah, it was cold last week (cold enough to do this awesome trick), but I don’t think we got anywhere near -60F. christmas-story-5

So when dropping off my two-year old at daycare, it’s with curiosity, and a bit of judgment, that I see kids piling out of cars looking like Randy from A Christmas Story.

Are they worried about frostbite in those 10 seconds from the car to the door? Is it a fear that the cold causes the ‘cold?’ Is it plain old southern frigophobia?

Judge me all you want, but when my 2 year-old and I race across the parking lot, he may or may not have his coat on.

He definitely doesn’t have it on in the car.

You see, I feel very good about my son surviving the 10 seconds of cold from the parking lot to the door. I don’t feel very good about him surviving a car accident with his winter coat on in the car. Simple as that.

Here is a great video illustrating why. If you want to bundle your kids up like Randy outside of the car, be my guest, but I’ll tell you, my two-year-old and I have raced inside by then. Sure, expect a few mean looks from folks at the entrance of the supermarket etc. Just do as Taylor Swift does and shake it off. You’re being a good parent. More resources here.

Dr. Tony GiaQuinta, MD