Countdown to a Healthy Lifestyle

Many of you may be familiar with some of the slogans that are being developed to try and help all of us lead healthier lifestyles. One of these is “5-2-1-0.” It means: 5 helpings of fruits and vegetables, no more than 2 hours of screen time, at least 1 hour of activity, and 0 added sugars each and every day! “Fruits and vegetables” means FRESH fruits and vegetables that are cooked in a healthy manner and not slathered with butter and sugar. “Screen time” means all kinds of screens including TV, computers, DVDs, and phones. “Activity” means hard activity…a sport that makes you sweat, breathe hard, and your heart go pitter patter! “Zero sugar” means zero added sugar…no sodas, no juices, pop tarts… you name it. Drink lots of water and avoid the ever-present high fructose corn syrup as if your life depended on it….because it does.  
We would add one more number to the slogan and make it “9-5-2-1-0.” The nine would be for 9 hours of sleep. Sleep, especially for kids, is perhaps as important as activity. A lot of children don’t get enough and it can lead to over-eating and depression. Enforce an earlier bedtime at your house as another component of healthy living.

With the school year just beginning, it’s a great time to get your routines down now, and start living 9-5-2-1-0.

If any of you reading these articles have other great ideas to help us live healthier lives, please let us know.  We’re always looking for ways to help all our patients.    


Remember when you were a child and went on a trip? Some of us are old enough to remember everyone jumping into the back of a station wagon and taking off. Many of us – especially in Virginia – have a story about all the kids piling into the back of a pickup truck.

Things are different now. There are more roads, they’re bigger, the vehicles are faster, and there’s a whole lot more of them. Child safety and car seats are now very important. In fact, on July 1 st, Virginia passed a new law that mandates that all children under 2 be placed in a backward-facing car seat.

It’s important to remember that not all car seats are the same.

The very first car seats were like baby jumpers. They hung over the backs of the front seats, with little holes for your baby’s legs, and were pretty much designed so that parents didn’t have to hold their children while they drove.

It wasn’t long before more people had cars, and the family vacation became a real thing. It became time for a new, and better car seat. This one, however, was primarily a booster seat so that your little one could enjoy the scenery while you motored down the road.

Perhaps this is what gave birth to the “Red Car” game.

It wasn’t until 1962 that someone designed a car seat that was really about safety. That year, Leonard Rivkin designed a car seat that actually made use of the seat belt.

Let’s say you’re in the market for a car seat. What should you look for?

Your first step is to do some due diligence. You’ve found a seat you like, but has the company ever had a major recall? Have you seen any ratings or safety tests on it?

Also, make certain that you’re looking at the right seat. A car seat is not something a child will “grow into.” Certain seats are designed for newborns and infants, and as baby grows, their needs in a car seat will change.

Your brother’s friend’s sister has a seat she’s no longer using. Can you take it?

Answer all of the questions you would ask when buying a new seat first. If you’re moving forward, think of it like buying a car. Do you have all of the necessary paperwork? Are all of the tags still on it? Has it ever been recalled? Has it expired…

Yes. Car seats can expire. Plastics get brittle. Fabrics begin to fray. Metals start to fatigue. Most safety products on the market – from football helmets to shin guards – have a shelf life.

And lastly with the car analogy: Is this the car seat your brother’s friend’s sister was using when she totaled the family van? You likely wouldn’t trust a used car that had been in a wreck. There’s no reason to trust a car seat that lived through one.

Your final step is to get your new seat into your car. Once you’ve done all of this homework, it will defeat the purpose of the seat to just wing it when it comes to installation. The Virginia Department of Health sponsors regular Certified Safety Seat events. These are often held at your local sheriffs or police department. Many times, your local fire department can help you with a proper car seat installation. Visiting the Department of Health website or a quick phone call will set you up with a trained professional.

Once you’ve had your seat installed, you’re ready to travel the world.


Perhaps you have a sick child. Maybe you need a physical to start playing soccer. It may have been a while since you’ve seen us.

Whatever the reason, you’re planning on a visit.

We strive to make the experience as pleasant and painless as possible, but not that many folks actually enjoy going to the doctor’s office. There are, however, some things to
plan on that can help make your visit that much easier.


This is going to be your most time-consuming visit. Once you’re done, each following visit will be much smoother, but since we don’t know you yet, there are some things we
would like to learn.

Your first step is to go through our Patient Forms. This contains some forms explaining our compliance with patient confidentiality rules, what your rights are, and almost all
of our patient and billing policies. It also houses some checklists, and is where you can give us information about your child. We’ll learn about past pediatricians, what medical files are available to us, some history about your family, allergies, and the like.

Some of these you can submit online, and any of them can be brought into our practices. But we’ll need all of this before we start our visit. It’s easiest to get them out of the way before you come.


The first thing you do upon arrival is let us know that you’re here. Unlike many pediatricians, we schedule pretty generously. We like to spend quality time with our families. This, however, doesn’t mean we don’t stay busy. As flu bugs go around, sports seasons start, and the cycles of the school year go by, we have our ebbs and flows, but being just a few minutes early assures that you get all of the time with us that you deserve.

Make certain that we know WHY we’re seeing you today! You’ve hopefully told us when you made your appointment. “Chloe seems to have a sore throat.” But it’s good to
have that reminder.

If you were a First Timer, there may be some I’s to dot and T’s to cross in your paperwork, but hopefully you’re ready to see your pediatrician. If you’re a returning patient, unless something has changed since your last visit (change in insurance, newly diagnosed allergy, etc.) we may not need anything else.


You’ve had your visit with our pediatrician, and everything went great! So, you’re ready to go home…

Not so fast!

You’ll need to see the receptionist on your way out. You may have a co-pay obligation, or we may have a question about your coverage. Let’s sew those up before you leave.

Your pediatrician may also want a follow-up visit. Sometimes this is as simple as a phone call. “Chloe’s fine. Thank you!” We may want to have another look into those little
ears to make certain things are progressing as quickly as we like.

Even if there’s no immediate follow-up requested, it’s a good idea to go ahead and think about your next checkup. For grownups, you can sometimes put them off for a little
while. Things move a bit quicker in a smaller and growing body, so we like to see our little patients a bit more often.

NOW you’re ready to leave…

Not so fast!

Did the pediatrician offer medication or a prescription for Chloe’s throat? Did they refer you to a specialist? Did they suggest a diet change?

You’re going to want to follow the doctor’s orders, and do it in a timely fashion.

We would love for all of our visits to be Well Visits and not sore throats. It would be great if each visit were planned well in advance. Things do sometimes pop up, and we
expect that. But doing a few of these small things can help to make your visit a quality time visit with your pediatrician, and not an administrative chore.


It’s getting close to Summer. That means your little ones will be free from school, the sun will be shining, temperatures warmer, and thoughts will turn to your favorite
theme park. What could be more fun? Some exciting rides, some friendly characters and mascots, and snacks galore…

But just as traveling with an infant is an adventure in preventative packing – taking children to a theme park requires some strategic planning.

Having a good day in a theme park starts before you leave the house. In a perfect world, your day is going to be sunny. You’re going to need sunscreen. And you’ll need more after spending some time in the park. You’ll also need walking shoes, and if you don’t relish the idea of carrying a sweaty toddler, that means for everyone. But emergencies happen.

Don’t get us wrong – your chance of becoming sick or injured in a theme park is slim. But it does happen (like the woman struck with an errant cell phone while enjoying King’s Dominion). To minimize that risk, follow the rules. This means the rules you’ve set for being in a public place (stay together, walk – don’t run, and don’t eat that unless you know where it came from), and the rules established by the park. If it says “You Must Be THIS Tall” to ride that ride, make certain your rider IS THAT Tall. If a sign says to stay behind a certain line, stay behind the line. If something does happen, most every theme park has two areas you should identify on arrival: A First Aid Station and a station to meet the missing member of your party. If someone from Disney sees your toddler wandering alone along Main Street, USA, they’re trained to take them somewhere special. Your kids should also know what to do should they become lost. A great first step is to find someone in a uniform.

What if your child has different needs?

Theme parks used to be off-limits for those with mobility or emotional needs. Times have changed, and most parks have wonderful plans in place to make your day enjoyable for everyone. Kings Dominion, for example, has tools for those with hearing impairment, special access and services for those in wheelchairs, and programs for visitors with service animals. Walt Disney World has a host of services catering to those with emotional needs. If your child can’t stand to wait in a line, they offer advanced tickets, Rider Switch (one person waits while the other waits with the visitor not riding – then they switch), and “break areas” for folks who may become overwhelmed. Rest assured; planning your day at the park isn’t as worrisome as planning your first ascent of Mt. Everest. It should be a day of enjoyment, laughter, and happy memories. At the end of the day, you’ll hopefully have a wonderfully tired child, free from scrapes and sunburns.

The little steps will make that a certainty.


I bet you can’t think of anything more smile-making than a baby smile.  It makes you smile; it warms your heart; it makes you forget about worries and strife.   As a pediatrician I get to see baby smiles every day. I’m spoiled and sometimes forget how life affirming it is, but then I see those beautiful ear to ear grins and it always makes me smile both outside and in.

How do baby smiles start?  Babies don’t smile right away but I always tell my new parents at their baby’s two month visit that things are going to get a lot more fun from now on.  Let’s face it, the first two months are pretty tough: sleepless nights, constant feeding, completely mysterious crying. I sometimes refer to it as the “crying, sleeping, pooping, growing phase.”  Sometimes you get a random smile, sometimes they focus on you, but then some distant neuron doesn’t fire quite right and they’re looking off at some random spot on the wall. Don’t be fooled. You may not see it, but millions of neurons are connecting, talking to each other, taking control.  

It’s mind boggling how complicated it all is.  Neurons have to make the right connections to other neurons; different neurons have to connect to muscles; electrical discharges change calcium concentrations in muscle fibers, and so on and so on.  Then those muscles have to be coordinated in order for anything to actually move. The whole process is something you learn in medical school and makes you start believing in a higher power. How could all this work?  There are so many things that need to happen or could go wrong and yet, it almost always happens perfectly.

At first, your baby knows how to cry (no kidding !), swallow, breath, etc, but when born, it can’t yet truly smile.  Yes, sometimes they smile when they’re sleeping, or farting, or who knows what, but true social smiling takes some time.  It’s a natural process, but you are very important to this working out right. Your holding them, your talking to them, your touch, your feel….all of this is important (and they can’t get this from an iPhone….just sayin’!).  You can’t spoil them at this age, but if you don’t talk to, hold, rock, and yes, smile at your child it’s going to slow this wonderous process.

It’s a social thing.  It’s what makes us human.  There’s now evidence that smiling is not uniquely human, but so what.  It’s so important to us as a species that it happens very quickly. It’s definitely a survival technique for babies because it helps mom and dad bond so that they want to take care of them.  But it is so much more than that as we all know. And after those first two or three months of talking and cooing and smiling with no real response, all of a sudden they break into an ear to ear smile and your heart just melts.  There is no way you can resist that.

Yes, babies are unknowingly looking out for themselves, but when you see that glorious baby smile you know they’re looking after you too.