The Baby Manual

Dr. Carole Keim talks about the all-important subject of sleep in this episode. Sleep is a frustrating thing as a new parent which is why there is so much sleep advice and so many sleep books available. Dr. Keim will break down what sleep patterns are normal at different ages and give information on different ways to help babies (and parents, by extension) sleep well. 

All babies are different and what works for one baby’s sleep may not work for another. But there are normal sleep patterns for different ages and Dr. Keim clears up confusion around those necessary patterns. She explains why babies crave the rocking and contact of being held as opposed to being laid in a bed to sleep and offers advice on how to slowly get them accustomed to the change. From night feeding to sleep positions to not using your phone in your baby’s room to all the different alternative healing modalities that have been shown to be helpful in promoting sleep, Dr. Keim gives the key information parents need on the topic of sleep. 

In this episode:

Sleep  (00:27)

• Intro: helping babies sleep at night is one of the most difficult and frustrating things as a new parent.  All babies are different.  What’s normal at different ages: 
  • Newborns cluster feed and wake at least once every 2-3 hours 
  • For the first 2 months of life, a baby can’t sleep more than 4 hours 
  • From 2-6 months it’s ok to let them sleep longer, but most still wake 2-3x at night to feed
  • From 6-9 months, allowed to sleep as long as they want, typically wake 1-2x per night, worse when teething
  • From 9-12 months, can start offering water at night. Feeding higher fat/protein meals at dinner time can help them sleep better.
  • After 12 months, they don’t need milk at night, only water if they wake up, and reassure for night waking.  Cosleeping will make you both get worse sleep, and remember a thin blanket is ok, but no thick blankets and no pillows til age 2. Sleeping with a tight shirt can help curb breastfeeding at night.  
• Western -  graduated or progressive extinction method.  “Cry it out” is not recommended due to emotional trauma.  Melatonin is not recommended on a regular basis; can be used intermittently when traveling (jet lag) but not more than 2-3 days.  Also a consistent bedtime routine helps - run/play, brush teeth, bath, reading/singing, low lighting, avoid screens x 2h before bed.  
• TCM - pediatric acupuncture (shonishin) and Chinese herbs can both help with sleep.  Speak to a pediatric acupuncturist for specific recommendations.
• Chiro - pediatric chiropractic and craniosacral therapy can help your baby or child sleep better.  Chiropractic is built around relaxing and resetting the nervous system, so regular adjustments tend to be really helpful for sleep.  
• Nutrition/supplements - Eating a dinner high in fat and protein and low in sugar at least 2 hours before bedtime, magnesium supplements (check with a doctor for dosing), chamomile tea over age 1 or for breastfeeding moms; can give a spoonful of chamomile tea under age 1 (no honey!) 
• Homeopathy - aconitum napellus, arsenicum album, belladonna, china officinalis, chamomilla, calcarea carbonica, and pulsatilla.  Note: not supported by western science; speak to a CCH for specific recommendations.  
• Aromatherapy - Can diffuse oils or dilute in a carrier oil and rub onto baby’s back and feet.  The best oils for sleep are Roman chamomile, German chamomile, neroli, tangerine, pettigrain, and lavender.  Lavender can be stimulating in children; if this seems to be the case, try chamomile oil instead.

End of season; stay tuned for more in the future!

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, which can be ordered here. Her first book, The Baby Manual, covers year one of your baby’s life and is the subject of the first two seasons of this podcast. Follow Dr. Carole Keim on her TikTok and YouTube channels for additional tips and advice on babies and toddlers. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• There is more information like this in the Holistic Mamas Handbook.  You can order the Holistic Mamas Handbook on Amazon
• The Baby Manual is also available on Amazon
• Dr. Keim’s Supplement/vitamins link for 10% off

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Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim talks about baby’s skin today, specifically baby acne and diaper rash. She explains what causes each irritation as well as how they typically present. She then goes through Western and alternative medicines that offer relief or healing. 

Baby acne often starts in the first month or so of a baby’s life. There are several causes for baby acne and it will typically cover the face and upper chest. There are ways to soothe it or help it heal faster but, as Dr. Keim says, it’s “self-limited” and goes away on its own. Diaper rash is extremely common and there isn’t just one type that babies can get. The redness and irritation can get colonized with yeast or it may be one of two types of bacterial infections worsening the rash. Dr. Keim details what to look for with each type of diaper rash, when to contact a doctor, and all of the prevention and curative measures offered by healing modalities.

In this episode:

Baby Acne (00:45)

• Symptoms: pimples on face and upper chest. Caused by a combination of hormones, dryness, and irritation.  Hormones cause increased oil production, dryness causes sebaceous glands to produce more oil to moisturize skin, oil gets trapped in the pores and becomes acne.  Being overheated or sweaty will do the same thing.  Dirt, too much lotion, and regurgitated milk can irritate the skin and block the pores, making acne flare up more.  
• Western -  typically no treatment; keep baby clean but don’t wash too often (1-2x per week) so skin doesn’t get too dry.  Keep room temp 68-72 degrees so they don’t overheat.  No need to change diet.  Call your doctor if your baby has pimples that are larger than 2mm across, if the lesions are filled with clear fluid or yellow pus, if the pimples are in clusters, or if you aren’t sure if it’s baby acne or something else.
• Acu/traditional Chinese medicine - acupuncture doesn’t specifically treat baby acne, but can decrease overall inflammation, and someone certified in Chinese herbalism may be able to recommend topical treatments
• Chiro - n/a
• Nutrition/supplements - can put breastmilk on baby’s skin 
• Homeopathy - calendula cream topically; no oral remedies 
• Aromatherapy - Calendula oil, lavender oil, oregano oil, and tea tree oil may be mixed into a carrier oil and applied topically 

Diaper Rash (08:19)

• Symptoms: caused by moisture + friction; most babies will have one at some point. Starts with redness/irritation of skin but can get colonized / super infected with yeast or bacteria.  Candida rash (yeast) has satellite lesions.  Bacterial has boils.  Strep butt (perianal strep infection) is a bright red circle around the anus and happens in older children.  
• Western -  prevention (decreased likelihood, sometimes you can’t prevent it!) involves changing diaper as soon as it’s wet/poopy, use water wipes after each poop, apply diaper cream (zinc oxide based vs petroleum), air it out, don’t use baby powder.  If not improving within 2-3 days with these treatments, it might be colonized/infected.  Nystatin cream for candida, mupirocin for bacterial - both are used 3x per day; use regular cream in between.  Oral amoxicillin for perianal strep.  
• Acu/TCM - acupuncture doesn’t treat diaper rash; chinese herbs may be helpful, check with a pediatric acupuncturist
• Chiro - n/a
• Nutrition/supplements - acidic foods make it worse (strawberries, citrus, tomatoes).  Probiotics can help.  
• Homeopathy - calendula cream topically; borax veneta, calendula officinalis, cantharis, merc sol, nitric acid, and sulphur can be given by mouth, or dissolved in water and applied topically.  
• Aromatherapy - nothing for regular/irritant rash.  For candida, can use oregano, geranium, or tea tree in a carrier oil.  For bacterial, can use tea tree or lemongrass in an oil on the boils.  

Also in the Holistic Mamas Handbook: ringworm, cradle cap 

Refer to last week’s episode about eczema 

Next week: Sleep!

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, which can be ordered here. Her first book, The Baby Manual, covers year one of your baby’s life and is the subject of the first two seasons of this podcast. Follow Dr. Carole Keim on her TikTok and YouTube channels for additional tips and advice on babies and toddlers. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• There is more information like this in the Holistic Mamas Handbook.  You can order the Holistic Mamas Handbook on Amazon
• The Baby Manual is also available on Amazon
• Dr. Keim’s Supplement/vitamins link for 10% off

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Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim explores the topics of allergies and eczema in this episode. She defines what each disease is and what typically causes their appearance. All your questions about what symptoms to look for in your infant or child as well as how you can treat allergies and eczema when discovered will be answered by Dr. Keim.  

Allergies, eczema, and asthma are called atopic diseases and tend to run in families. So if there’s a family member that has either allergies or eczema or asthma, or multiples of these, your child is at higher risk of developing them. Dr. Keim explains the science behind the reactions and symptoms before detailing exactly what types of medicines or interventions are safe and effective. While there are many Western medicine treatments available, holistic alternatives do exist and Dr. Keim explains which are safest to pursue.

In this episode:

Allergies (01:10)

• Symptoms: allergic cascade: antigen binds to IgE (produced by B cells which are white blood cells), IgE binds to mast cells, and mast cells degranulate and release histamine and other cytokines (cellular chemicals) that cause blood vessels to dilate and leak fluid into surrounding tissue, which causes symptoms of nasal congestion, watery eyes, runny nose, and mucus in airways / cough; histamine also causes itching, rashes/hives, and spasm of airways causing wheezing. Severe allergic reactions can make the blood pressure drop dangerously low from the blood vessels dilating and can cause severe airway spasm and swelling - this is known as anaphylaxis.  Parents who have allergies/asthma/eczema (atopic diseases) are more likely to have a child with allergies, but it’s often to different things than the parents are allergic to.
• Western - avoid allergen (keep the house clean, use HEPA filters, avoid pets, wash off after being outside, avoid foods and medications you’re allergic to); we work backwards / up the allergic cascade: antihistamines, steroids, mast cell stabilizers, anti-IgE injections, allergy shots (which contain small amounts of what your child is allergic to and are gradually increased to retrain the immune system into recognizing it as ok); epinephrine for anaphylaxis to reverse the vasodilation and bronchospasm
• Acu - decreases overall inflammation, great for environmental allergies 
• Chiropractic - can help with overall wellness and inflammation, but doesn’t specifically treat allergies.  
• Nutrition/supplements -  none in the US other than avoiding foods you’re allergic to (nuts, fish, and shellfish will cross-react with others in the same group, and milk will cross-react with soy); outside the US they do sublingual immune therapy which is kind of like allergy shots but the antigen is given orally, but this has a risk for anaphylaxis. 
• Homeopathy - whatever the allergen is 
• Oils - eucalyptus/peppermint in a diffuser, lavender and tea tree topically (anti-inflammatory) 

Eczema  (23:01)

Symptoms: dry skin, rash, itching; more common on surfaces that rub (cheeks and extensor surfaces in babies, flexor surfaces in older children) 

• Western - keep skin moisturized (emollients like vaseline or aquaphor for dry skin, unscented lotion on a daily basis), avoid scented lotions/soaps/detergents, wash new clothes before wearing them, steroid cream
• Acu - decreases overall inflammation and can help 
• Chiropractic -  can help with overall wellness and inflammation, but doesn’t specifically treat eczema 
• Nutrition/supplements -  avoid allergenic foods (wheat, dairy, eggs, nuts, fish), consider hydrolyzed formula, limit sugar in older children, add more fresh fruit/veggies/fiber to decrease inflammation, vitamin C, Vitamin D.  
• Homeopathy -  calendula cream, pine tar soap, antimonium crudum, graphites, sulphur 
• Oils -  can try topical oils in a carrier - lavender, chamomile, oregano, tea tree - sometimes topical oils or the carrier oil will make eczema worse 

Also in Holistic Mamas Handbook: asthma, nosebleeds (can be related to allergies) 

Next week: baby acne and diaper rash! 

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, which can be ordered here. Her first book, The Baby Manual, covers year one of your baby’s life and is the subject of the first two seasons of this podcast. Follow Dr. Carole Keim on her TikTok and YouTube channels for additional tips and advice on babies and toddlers. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• More like this in the Holistic Mamas Handbook.  You can order the Holistic Mamas Handbook here: https://amzn.to/3rlXhb7
• The Baby Manual is available on Amazon
• Supplement/vitamins link for 10% off

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Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim talks about constipation and urinary tract infections (UTIs) in this episode. Dr. Keim details how to tell if your infant or child is truly constipated and what can be done to help alleviate the discomfort, as well as what to look for if you suspect a UTI. Her advice includes all holistic options that are applicable to alternative care.  

The rate of true constipation in infants under a year old is very rare, roughly 3% of babies. But that changes when children are older than a year. Constipation can become a lot more common as children age. Dr. Keim explains all the science, medical information, and care options for constipation and she also explains that children who are constipated are more likely to also get UTIs, which is why this episode is about both topics. UTIs tend to be more common in summer and in girls, but Dr. Keim explains that they can happen throughout the year and to boys as well. The information in this episode will ensure you are prepared to assist your child through either condition, should they arise.

In this episode:

Constipation (00:32)

• Symptoms: poorly defined; decreased number of poops with harder texture. Pellets in the diaper.  Note: discoordinate stooling happens at 4-6 weeks of age and is a normal phase they go through; your baby isn’t constipated at this age!  
• Western - in first 6 months just increase amount of feeds (don’t add water until they are eating foods) and talk to your doctor about possible food allergy/intolerance; when they start solids start offering 1oz of water for each 1oz of food; avoid milk at 1 year of age; increase water intake in children 6 months and older, prune juice as a medicine, increase fiber, P foods (pears, plums, peaches), polyethylene glycol (miralax), belly massage, tummy time, warm compresses to abdomen.  
• Acu - acupuncture and herbs can help 
• Chiro - yes 
• Nutrition/supplements - high fiber foods, fiber supplements, psyllium, dried apricots, prebiotics, probiotics 
• Homeopathy - speak with a CCH, they need to look at the constellation of symptoms 
• Aromatherapy - Ginger, fennel, peppermint, rosemary, lemon, and lavender oil may help - in a diffuser or mixed with a carrier oil and rubbed onto the abdomen.  Also any of these, or castor oil on a warm wet washcloth on the abdomen can help.  Don’t give EOs or castor oil by mouth; EOs are potentially poisonous and castor oil is very irritating to the gut and no longer recommended.
• Yoga can also help with constipation - check out videos on youtube! 

UTI  (21:00)

• Symptoms: urinary frequency, urgency, and dysuria (pain with urination), bed wetting in a potty trained child, fever in infants (warrants immediate medical intervention). There shouldn’t be blood; if there is blood in the urine that also warrants immediate medical check.  Test is urinalysis.  Constipation can lead to UTIs in children; also being in a wet diaper or swimsuit too long, tight clothing/sweating in the summer, and bubble baths.  
• Western -  antibiotics, increase fluids, phenazopyridine / pyridium / AZO in older children, plain water baths 
• Acu - acupuncture and herbs can help 
• Chiro - no 
• Nutrition/supplements - limit sugar and dairy, low acidity foods (limit citrus and tomatoes), cranberry juice or supplements, probiotics 
• Homeopathy - not recommended
• Aromatherapy - not recommended

Also in Holistic Mamas Handbook: pinworms (the most common cause of itchy butt in children!)

Next week: Allergies and eczema!

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, which can be ordered here. Her first book, The Baby Manual, covers year one of your baby’s life and is the subject of the first two seasons of this podcast. Follow Dr. Carole Keim on her TikTok and YouTube channels for additional tips and advice on babies and toddlers. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• More like this in the Holistic Mamas Handbook.  You can order the Holistic Mamas Handbook here: https://amzn.to/3rlXhb7
• The Baby Manual is available on Amazon
• Supplement/vitamins link for 10% off
• Pediatric chiropractors: icpa4kids.com
• Dr. Keim’s juiceplus+ link

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Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim discusses vomiting and diarrhea in this episode, explaining the causes and symptoms of each. Beyond Western medicine treatment, Dr. Keim dives into alternative and holistic options for the treatment of both vomiting and diarrhea in babies and toddlers.  

Vomiting and diarrhea can often appear together, caused by viral infections, but vomiting alone can be a red flag for issues beyond infection, especially in older children. Dr. Keim details what to look for if your child is vomiting and how best to treat the symptoms. While the medical community isn’t fully in agreement on how to define diarrhea, it is essentially looser and more frequent stools. Dr. Keim explains the various colors that can appear in a baby’s stool and when they should see a doctor versus when holistic options may be useful.

In this episode:

Vomiting (02:38)

• Symptoms: Forceful expulsion of stomach contents; different than spitting up. Note: if vomit is green that indicates bile and may be a sign of obstruction and warrants immediate medical attention. 
• Western -  we typically don’t treat vomiting in children as it keeps the infection in longer; focus on liquids (small sips at a time - broth, tea, watered-down juice, oral rehydration solution), popsicles, smaller light meals of bland foods 
• Acu - acupuncture and herbs can help
• Chiro - can help with overall wellness and inflammation, but doesn’t specifically treat this. 
• Nutrition/supplements - ginger, small sips of liquids, bland foods; for viral infections, supplements such as Vitamin C, Zinc, Echinacea, Vitamin D, and Elderberry can help boost the immune system and heal the body faster.  
• Homeopathy - antimonium crudum 
• Aromatherapy - ginger, peppermint, lavender, fennel seed, lemon, rose - either in a diffuser or diluted in a carrier oil and rubbed on the abdomen

Diarrhea (11:25)  

• Symptoms: poorly defined but more frequent and looser stools; poop that soaks into the diaper.  Note: normal baby poop is very loose and yellow or green but sits on top of the diaper lining.  
• Western -  typically no medications as this can make the infection worse; BRAT diet (bananas, rice, applesauce, toast), bland foods, limit juices or only give watered-down juice
• Acu - acupuncture and herbs can help
• Chiro - can help with overall wellness and inflammation, but doesn’t specifically treat this.
• Nutrition/supplements - for babies with green poop can do block feeding (twice on one breast, twice on the other) or mix pumped milk in the fridge to get more hind milk and less fore milk; older children avoid dairy and sugar, avoid fruits, give probiotics; For viral infections, supplements such as Vitamin C, Zinc, Echinacea, Vitamin D, and Elderberry can help boost the immune system and heal the body faster.  
• Homeopathy - china officianalis, arsenicum album, podophyllum peltatum 
• Aromatherapy - anise, fennel, peppermint, coriander, lemon balm, cardamom, cinnamon - either in a diffuser or diluted in a carrier oil and rubbed on the abdomen. 

Next week: constipation and UTI!

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, launching on November 15, 2023. Pre-orders are available here. Her first book, The Baby Manual, covers the year one of baby’s life and is the subject of the first two seasons of this podcast. Follow Dr. Carole Keim on her TikTok and YouTube channels for additional tips and advice on babies and toddlers. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• More like this in the Holistic Mamas Handbook. Pre-order the Holistic Mamas Handbook, launch date 11/15/23
• The Baby Manual is available on Amazon
• Supplement/vitamins link for 10% off
• Pediatric chiropractors: icpa4kids.com

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Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim talks about colic and reflux in this episode. She explains what they are and explores how different modalities can help alleviate your baby’s discomfort. There are supportive and alternative care options that Dr. Keim doesn’t often get a chance to address in the office but can present here.    

Dr. Keim defines a baby with true colic as one who cries for “three hours per day, three days per week, for three weeks”, or the rule of threes. The cause of colic is still largely unknown but common understanding links it to gas in the intestines. Dr. Keim lays out all the options for alleviating your baby’s colic distress. Reflux, or when stomach contents come up into the esophagus of young babies, is mainly treated with non-medicinal measures, a variety of which Dr. Keim explains.    

In this episode:

Colic (00:52)

• Symptoms: Rule of 3s: 3 hours per day, 3 days per week, for 3 weeks. Peaks at 4-6 weeks of age.
• Western -  Nonmedical: burp baby every 5 minutes if breastfeeding or after each 1oz if bottle feeding, tummy time, bicycle legs / up and downs, belly massage (clockwise) or back massage (counterclockwise). Medicines: probiotics, simethicone (OTC).
• Acu - both acupuncture and chinese herbs can help with colic; check with a pediatric acupuncturist
• Chiro - helps with colic
• Nutrition/supplements - probiotics, prebiotics (increase fruit/veggies if breastfeeding; formula and breastmilk have prebiotics in them), gripe water (not FDA regulated), chamomile/licorice/ginger/mint tea (mom can consume if breastfeeding; can make it 1/2 to 1/4 strength and give a spoonful 1-2x per day to baby).
• Homeopathy - chamomilla vulgaris, colocynthis, and lycopodium clavatum
• Aromatherapy - can use fennel, star anise, marjoram, ginger, roman chamomile, rosemary, and/or bergamot topically - mix the essential oil with a carrier oil and massage in a clockwise direction on the abdomen. Breastfeeding moms can consume 2-5 drops of peppermint, ginger, or chamomile oil in water and drink it; don’t give oral essential oils to babies

Reflux (09:19)

• Symptoms: spitting up (sometimes through the nose too), arching the back.  GERD is when the reflux is so bad that it causes other problems like severe pain, inability to gain weight / weight loss, or aspiration (choking).  All babies have reflux for 6-12 mos as the lower esophageal sphincter (LES) matures.
• Western -  Nonmedical approaches: burp often, keep upright for 20-30 mins after feeds, avoid swinging/rocking/laying baby flat/belly massage for those 20-30 mins.  Can consider thickening feeds; check with your doctor first.  Medicine: ranitidine will decrease the acidity of stomach contents but doesn’t stop the reflux from happening, so still use supportive measures.
• Acu - both acupuncture and Chinese herbs can help
• Chiro - can help with reflux and spit ups
• Nutrition/supplements - thickened feeds, breastfeeding moms can decrease acidity by eating less acidic foods and avoiding chocolate, caffeine, alcohol, spicy foods; ginger tea, chamomile tea, (only a spoonful of dilute tea for babies less than 1 year, or mom can drink the tea if she’s breastfeeding and it will get into breastmilk; can allow children over 1 year with reflux to drink ginger or chamomile tea, can use honey or sugar to sweeten it over 1 year of age)
• Homeopathy - antimonium crudium, chelidonium majus, nux vomica
• Aromatherapy - ginger, chamomile - mix in carrier oil, apply topically for babies under 1 year, can give a few drops of diluted oil orally for children over 1 year

Next week: vomiting/diarrhea!

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, launching on November 15, 2023. Pre-orders are available here. Her first book, The Baby Manual, covers the year one of baby’s life and is the subject of the first two seasons of this podcast. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• More like this in the Holistic Mamas Handbook. Pre-order the Holistic Mamas Handbook, launch date 11/15/23
• The Baby Manual is available on Amazon
• Supplement/vitamins link for 10% off
• Pediatric chiropractors: icpa4kids.com

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Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim talks about teething, a subject that comes up a lot and that parents have many questions about. She explains all about what to expect in terms of your baby’s teething discomfort and what modalities can help alleviate some of the pain.    

Teething happens to babies and then again to older children and is uncomfortable both times, though the experiences are slightly different. Dr. Keim discusses how teething can take place at varied intervals for each child, what sort of symptoms might show up in babies and younger children, and how Western medicine treats teething pain. She also explores what acupuncture, chiropractic treatment, and nutrition and supplements have to offer your baby.  

In this episode:

Teething  (00:34)

• Symptoms: pain/fussiness/clinging/crying, drooling, diarrhea, low-grade fever, tooth buds (eruption cysts)
• Western - tylenol, ibuprofen (over 6 mos), orajel, frozen washcloths, frozen fruit in mesh teethers, teething toys (list in email series!) 
• Acu - acupuncture / acupressure points on hands and feet, herbs for teething
• Chiro - adjustments can help - upper neck (very gently with pinkies only) and/or skull bones (craniosacral therapy).  Soft tissue techniques - move swelling out of the jaw /neck 
• Nutrition/supplements - soft cold foods (yogurt, applesauce, jello, mashed fruit, pureed baby food), teething foods (teething crackers), calcium (dairy, soy, dark green veggies), vitamin D (sunlight, supplements), magnesium (green veggies, nuts, legumes), phosphorus (meat), Vit A (eggs, dairy, yellow/orange veggies), Vit C (citrus fruits, strawberries), fiber (fruit, veg) 
• Homeopathy - Hylands tablets - cautious
• Aromatherapy - lavender and chamomile oil on jawline (under 6 mos), 6-24 mos can use ginger oil on gums and marjoram on jawline, over 24 mos can use clove bud oil on gums 

Next week: colic/reflux!

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, launching on November 15, 2023. Pre-orders are available here. Her book, The Baby Manual, covers the first year of baby life and is the subject of the first two seasons of this podcast. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• Season 2 Episode 10: Supportive Care for Colds
• Pre-order the Holistic Mamas Handbook, launch date 11/15/23
• The Baby Manual is available on Amazon
• Supplement/vitamins link for 10% off

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Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim discusses ears and two main issues that your baby can experience. Ear infections, also called otitis media, and ear wax. Dr. Keim explains the many symptoms of an ear infection, what causes them, and explores the holistic options for treating the pain and infection. She also talks about how best to clear ear wax from a baby’s ears.   

While Dr. Keim doesn’t talk about swimmer’s ear in this episode, she covers it in the Holistic Mamas Handbook for those who want that info. But for ear infections and wax, you’re going to learn a lot in this episode. What do you look for in terms of ear infection symptoms in an infant? What modalities offer the most help? What supplements can be given to babies? Are Q-Tips really as bad as people say? Carole answers all these questions related and more.

In this episode:

Otitis media (ear infection)  01:09

• Symptoms: ear pain, sometimes also fever.  Pain is worse with pressure on canal and tragus, and a little worse with pulling on pinna.  Typically occurs along with (or just after) congestion/URI symptoms/allergies - anything that causes swelling in the nasopharynx.  More common in babies who lie down with a bottle and those who are formula fed.  If untreated, can cause ruptured eardrum, mastoiditis, and rarely meningitis.  Recurrent AOM can cause scarring of the eardrum, and persistent fluid can cause verbal delays.  
• Western - ibuprofen x 48h.  Antibiotics for bacterial AOM - high dose.  Ear tubes for recurrent AOM.  Decongestants for symptoms (ginger, steam, nasal saline, spicy foods), fluids, rest.  
• Chiro - neck adjustments and craniosacral therapy help fluid to drain; can treat the active infection and/or prevent future infections.  Definitely recommended for children at risk of needing ear tubes.
• Acu - acupuncture and/or herbs can help 
• Nutrition/supplements -  avoid sugar and dairy as these feed bacterial infection.  Can use immune boosting vitamins like vit C, vit D, zinc, echinacea, elderberry for viral infections.  Most AOM is viral.   
• Naturopathy - onion earmuffs / garlic oil, NAC or mucinex to thin secretions, eustachian tube massage / fascial manipulation, wet socks 
• Homeopathy - allium cepa, pulsatilla, belladona, calcarea carbonica
• Oils - 
  • Pain mix: 1/2 oz vegetable oil, 10 drops lavender, 5 drops german chamomile, 6 drops palmarosa, 3 drops cardamom; mix and put 1-2 drops into ear for pain. 
  • Infection mix 1: 1/2 oz vegetable oil, 3 drops thyme, 3 drops lavender, 10 drops roman chamomile, 3 drops palmarosa; mix and put 1-2 drops into affected ear.  
  • If the ear is very painful, you can wet a washcloth with warm water, put 1/2 teaspoon on the washcloth, and use as a warm compress outside the ear.  

Earwax  19:30

Symptoms: often asymptomatic, sometimes hearing loss / verbal delay, wax leaking from ears, sometimes discomfort.

• Western - q-tips / cotton swabs daily or for yellow wax (medical community is split on this, some recommend doing nothing); for brown wax use debrox, hydrogen peroxide, ear wash (irrigation) with warm water and dish soap, curette removal, baby oil, colace drops.  
• Chiro - n/a
• Acu - no acupuncture but chinese herbal drops, ear candling 
• Nutrition/supplements -  garlic mullein oil or olive oil drops in the ears can help break up wax and make it flush out more easily 
• Naturopathy - fish oil (po) (mom can take if breastfeeding), food intolerances if chronic, ear lavage with hydrogen peroxide (syringe with dull needle)
• Homeopathy - not really, would need to be as part of a constellation of symptoms 
• Oils - no EOs, can use olive oil or garlic mullein 

Check out Holistic Mamas Handbook for swimmer’s ear!  

Next week: teething!

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, launching on November 15, 2023. Pre-orders are available here. Her book, The Baby Manual, covers the first year of baby life and is the subject of the first two seasons of this podcast. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• Pre-order the Holistic Mamas Handbook, launch date 11/15/23
• The Baby Manual is available on Amazon
• Supplement/vitamins link for 10% off

--

Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim talks about two conditions that can affect your baby’s eyes. The first is lacrimal duct stenosis and the second is pinkeye. She explains what causes each condition, how they typically present in your child, and ways each modality of medicine can help with treatment. All this information will also be found in her new book, Holistic Mama’s Handbook.   

Lacrimal duct stenosis is often called a blocked tear duct but it’s not the tear duct that is blocked, it’s the lacrimal duct located in the corner of the eye on the bottom eyelid. Dr. Keim details what it looks like and how long it might last. Pinkeye can be caused by viruses or by bacteria. Viral infections are more common than bacterial ones. Dr. Keim outlines the differences in each, what symptoms to watch for, and how western and alternative medicines can help. 

In this episode:

Lacrimal duct stenosis  00:33

• Symptoms: watery discharge, light crusting on lashes, buildup of what can look like pus in the eyes but is just skin cells, whites of eyes stay white.  No long term effects, goes away typically before 1 year of age.  
• Western - massage the duct during diaper changes, wipe with clean washcloth, wait until 1st birthday, can consider surgical dilation. If eyes get infected, can add antibacterial eyedrops. 
• Acu - point near the lacrimal duct can be used and has shown great results in studies 
• Chiro - craniosacral / skull bones 
• Nutrition/supplements - none specifically.  
• Naturopathy - fascial manipulation, Can put breastmilk in eyes.
• homeopathy - Pulsatilla, Merc Sol, Apis Mellifica, or Stannum Met may be tried.
• Aromatherapy - none 

Pinkeye  06:27

• Symptoms: watery/purulent discharge, crusting, redness of the whites of the eyes. Viral bilateral, bacterial usually unilateral.  Viral is self-limited with the illness, can last 1-2 weeks, and can sometimes get a bacterial superinfection if kids rub eyes.  
• Western - Viral: supportive care, cool compresses to eyes, avoid rubbing/touching.  Bacterial: antibiotic eye drops 
• Acu - viral: treat underlying cause/imbalance.  Bacterial: n/a.
• Chiro - nonspecific but can help with overall wellness 
• Nutrition/supplements - viral: Vitamin C, Vit D, zinc, echinacea, elderberry.  None for bacterial.
• Naturopathy - breastmilk, topical eyedrops (western), some can make herbal tincture eyedrops (need to be sure it’s very sterile), wet socks 
• Homeopathy - There are homeopathic eye drops to help with symptoms of pinkeye.  Euphrasia can be used orally for viral conjunctivitis. Oral Pulsatilla and Calcarea Sulph may be tried for bacterial conjunctivitis, but you should see a doctor for antibiotic eyedrops if it’s not helping within a day.
• Aromatherapy - not recommended topically, but can use decongestant oils such as eucalyptus or peppermint in a diffuser 

More like this in the Holistic Mamas Handbook. Next week: ears!

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, launching on November 15, 2023. Pre-orders are available here. Her book, The Baby Manual, covers the first year of baby life and is the subject of the first two seasons of this podcast. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• Pre-order the Holistic Mamas Handbook, launch date 11/15/23
• The Baby Manual is available on Amazon
• Supplement/vitamins link for 10% off

--

Dr. Carole Keim MD: linktree | tiktok | instagram

Welcome to Season 3 of The Baby Manual podcast with Dr. Carole Keim - pediatrician, mom, author of The Baby Manual and the upcoming Holistic Mamas Handbook. In this new season Dr. Keim will take parents through things like teething, colic, constipation, and allergies. This first episode explores what types of modalities are available, from Western medicine to acupuncture to naturopathy and more.   

In visiting alternative practitioners, interviewing them, and going through the research, Dr. Keim has learned how many things are available to parents to help children feel better when they’re ill. Western medicine, our traditional medical system in the US, has great advantages but is not always the best at improving quality of life. So Carole explains the options for a multifaceted approach, what to look for, and how each can help children thrive. 

In this episode:

Why CAM? 00:26

• Many modalities of healthcare 
• Western medicine does a lot of things well, but nobody does everything the best
• Kids under age 3 can’t take most OTC medications, but still suffer from many ailments
• A multifaceted approach is often the best one
• Treat symptoms and underlying disease at the same time
• Important to know which ones might interfere with others, and what’s safe for babies
• Writing HMH to help parents through this time; let you know what’s safe, what will actually help 
• Stay tuned because this season we will cover teething, colic, constipation, allergies, and more

Practitioners

• Western
• Chiropractic 
• Acupuncture
• Nutrition
• Massage
• Homeopathy
• Aromatherapy
• Naturopathy 
  • These are in the Holistic Mamas Handbook
  • The most common ones used in the US are chiropractic, acupuncture, homeopathy, and naturopathy

Western med  02:03

• Philosophy: Body = collection of independent systems.  Treat the underlying cause when possible.  Prolong life.  
• Tools: Physical examination, lab testing, imaging, medications whose direct action is well understood 
• Training: 4 years of college, 4 years of medical school, 3-5 years of residency, additional years of fellowship to subspecialize
• How to spot a good one: MD or DO, open minded, offers more than one solution, works with you on the treatment plan 

Acupuncture  04:19

• Philosophy: stimulating points along specific channels can affect nerves and muscles, releases chemicals into the bloodstream, and triggers the body’s natural healing mechanisms to bring about homeostasis.  Shonishin dates back to the late 1600s 
• Tools: shonishin is the technique used for children - observe the child, ask questions, feel pulses, and treat.  Blunt tools are used to stroke, tap, and press on the points.  Should be painless and not scary.  Sometimes also use cupping and/or indirect moxibustion.  Moxa is made from mugwort. 
• Training: 4 years of college, plus 3 years of acupuncture school for LAc, 4 years for DACM.  
• How to spot a good one: certified in shonishin, has pediatric experience, DACM vs LAc.

Chiropractic  07:21

• Philosophy: body has an innate ability to heal itself.  Nerves control everything, and pressure on those nerves from bones being out of alignment causes dysfunction.  
• Tools: adjustments - manual, clicker, drop table vs flat
• Training: 3-4 years undergrad, 3-4 years of chiropractic school, earn DC 
• How to spot a good one: Webster certified, icpa4kids.com, gentle, listens to the child

Naturopathy  09:40

• Philosophy: the body has the inherent nature to heal itself, the whole person is treated (mental, emotional, genetic, environmental, and social components), first do no harm, identify and treat the cause (not just the symptoms), prevention is the best cure, and the ND is a teacher whose main role is to educate, empower, and motivate patients to take responsibility of their own health
• Tools: nutrition, homeopathy, herbal remedies, hydrotherapy, massage, fascial manipulation, acupuncture, fasting, breathing.  Since naturopathy is so broad, few studies have been done on it as a discipline, but there are many studies about the specific techniques used.  
• Training: 4 years of undergrad, 4 years of ND school.  Curriculum includes many of the same classes as western medical doctors, but less pharmacology and more training on herbal and alternative remedies and modalities.
• How to spot a good one: certified by AANMC, knows when to refer to western medicine for pharmacologic interventions 

Homeopathy  12:54

• Philosophy: like cures like, and the more dilute a preparation is, the stronger it is.  
• Tools: observation of a person’s constitution, remedies that are made from an herb or pathogen and are diluted until no longer detectable and made into pellets with sugar 
• Training: 2-4 years undergrad, 3-4 years homeopathic school 
• How to spot a good one: CCH = certified classical homeopath 

Essential oils / Aromatherapy  15:05

• Philosophy: strengthen the self-healing process by stimulating the immune system.  Inhaled scent molecules travel along the olfactory nerves to the amygdala (emotional center of the brain)
• Tools: essential oils are extracted by steam distillation or cold pressing.  Oils are either inhaled, ingested, or applied topically.  Children should not ingest essential oils because they’re not regulated and very concentrated.  If you’re using them on your child’s skin, always use a carrier oil to dilute them so they don’t get irritation or a chemical burn.  
• Training: none required
• How to spot a good one: someone with a range of experience who isn’t tied to one brand in particular.  Good oils will come in dark glass bottles, will list the plant name in latin, and won’t have other chemicals added.  

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments come together in her new book, Holistic Mamas Handbook, launching on November 15, 2023. Pre-orders are available here. Her book, The Baby Manual, covers the first year of baby life and is the subject of the first two seasons of this podcast. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. And remember, it’s always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• Pre-order the Holistic Mamas Handbook, launch date 11/15/23
• The Baby Manual is available on Amazon
• Supplement/vitamins link for 10% off

--

Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim discusses all the supportive care options available for your child’s cold, beyond the over-the-counter medications. She details alternative medicines and things you can do to alleviate your child’s cold symptoms.

Most viruses don’t have specific treatments in Western medicine. We have COVID and flu vaccines, but beyond that, there isn’t much medically to be done for a cold. Dr. Keim not only explains what alternative options are available, she breaks down exactly what each virus does and what symptoms manifest in your child. This is a truly valuable resource episode.

In this episode:

• Overview of colds 
• Fever  
• Congestion and ear pain 
• Runny nose
• Cough 
• Immune boosters 
• Sample regimens 

Overview 00:51

• Viral infections - no specific treatment for most 
• Many types and subtypes of viruses
• Typical course: illness lasts 7-10 days, peak on day 4, cough can linger for up to 2 weeks after
• Red flags: respiratory distress, dehydration (dry lips/tongue, decreased urine output, lethargy), fever for 5 or more days in a row, fever that goes away for more than 24 hours and then comes back (can indicate a secondary infection such as UTI/AOM/pneumonia)

Fever 04:40

• Acetaminophen / paracetamol 
• Ibuprofen
• These will also help with systemic symptoms - pain, body aches, lack of energy, lack of appetite, trouble sleeping.
• These do NOT treat cough, congestion, or runny nose 
• Magic socks - wet cotton socks, cover with wool socks before bed 
• I don’t recommend potatoes, garlic, or onions on feet - I’ve seen some burns 

Congestion and ear pain 09:01 

• Eustachian tubes drain at the back of the nasopharynx, so congestion leads to fluid buildup in ears, so decongestants treat both
• Medications for adults and children over age 6: pseudoephedrine by mouth, oxymetazoline nose spray
• Children under age 6: nothing for congestion; ibuprofen for ear pain (x48h before abx)
• Saline nose spray or sinus wash - hypertonic saline
• Ginger, spicy foods, steam, vick’s 
• Oils -  eucalyptus, peppermint, menthol, breathe blend 
• Sinus drain/massage - OMT or chiropractic - tapping on sinuses and pressing along lymphatic channels
• Acupuncture 
• Onion earmuffs for ear pain 

Runny nose 18:43

• Antihistamines DO NOT work.  
• Use saline spray to keep the mucus cleared out.  Can use bulb sucker if boogers are stuck.
• Wash your hands every time you wipe their nose 
• Color of mucus has to do with the amount of inflammation and not necessarily whether it’s a bacterial or viral infection 
• If mucus is very thick and seems to be stuck, can use guaifenesin (Mucinex) to help them clear it out.  Kids almost never need this and it works by causing them to cough, so many parents avoid it because it makes their child seem worse.

Cough 21:45

• Mucinex causes more cough
• Dextromethorphan, codeine, and similar anti-cough agents work by decreasing respiratory drive and can cause children under age 6 to stop breathing 
• Antihistamines only work if it’s allergies, not for infections
• The only thing that has been shown to be both safe and effective in Western medicine trials is honey (and only for children older than 1 year because of the risk of botulism!) 
• Teach children to cough in their elbow 

Immune boosters 23:45

• Vitamin D - 400 units
• Vitamin C - 1000mg for adults; 100mg per 10 lbs 
• Zinc - 30-60mg for adults
• Echinacea - after exposure or at the onset of symptoms 
• Elderberry - syrup or gummies 
• Garlic
• Lemon juice 
• Fruits and veggies - 10 servings per day, or supplement 
• The vitamins and supplements my family takes is in my link tree 

Sample regimens 29:10

• RSV and/or common cold 29:13
  • Tylenol/ibuprofen, saline nose spray/drops before eating and sleeping, can bulb suck after each time (or not), bring them into the bathroom when you shower so they can breathe the steam, put vicks or essential oils on yourself or the shower floor before getting in, use a nighttime humidifier if you live in a dry climate, give vitamin C and D, zinc, echinacea, elderberry, consider chiropractic and acupuncture 
  • Keep baby hydrated - it’s fine if they don’t eat anything at all for days, but they need to be drinking water and have at least a little sugar and salt each day.  If they have breastmilk or formula that is plenty, they don’t need food on top of that.  It’s VERY hard to eat with RSV because of the congestion.
  • If breastfeeding, take immune boosters and keep breastfeeding as much as possible.  If you’re sick, wear a mask so you don’t cough or sneeze onto your baby.  
  • Do NOT allow children with “just a little runny  nose” around your baby - RSV causes very mild symptoms in children and adults, but can cause about 1% of babies to end up hospitalized 
  • Do NOT share bulb suckers or pacifiers between children
• COVID 34:51
  • As for RSV; there might be specific treatment in the future but right now only for adults.  
  • Adults in the household should be vaccinated 
• Flu 35:27
  • Acetaminophen/ibuprofen for fever and body aches, can also help with sleep and appetite
  • Saline drops/spray for congestion, honey for cough (over 1 year), ginger for congestion and to settle the stomach
  • For vomiting and diarrhea, keep them hydrated with small sips of water, watered-down juice (50% water or more), oral rehydration solution, popsicles, jello, or commercial drinks like pedialyte/gatorade.  If they are unable to keep down fluids you need to bring them to the ER.  
  • Tamiflu is sometimes helpful and sometimes causes GI upset.  It’s approved for ages 6mos and up.  
  • Adults and children over 6 months of age can be vaccinated 

Holistic Mama’s Handbook 39:43

• I am in the midst of writing HMH
• Collaborating with pediatric acupuncturists, chiropractors, dietitians, naturopaths, etc
• For parents of young children 
• Release date Fall 2023 

Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments will come together in her new book, “The Holistic Mama’s Handbook”, due out Fall of 2023. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. And remember, it is always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• The Baby Manual - Available on Amazon
• Subscribe to this podcast 
• DrKeim LinkTree - for vitamins and supplement link

--

Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim gives parents information on daycare and preschool - from the different types of preschools available to how they operate - so you can find the best fit for your child, but also for you in terms of community. 

There is a lot to consider when choosing a preschool: in the United States there are three main types of preschools and they would each suit specific child needs or parent desires differently. Dr. Keim breaks down what to expect and what to look for in preschools. She also explains the frequency of illnesses that children are more likely to get in school, how they circulate, and how you can avoid germs at home.

In this episode:

• Daycare 
• Montessori
• Waldorf
• Reggio Emilia 
• Considerations
• Illnesses at school
• Avoiding germs at school

Daycare 00:33

• Wide range, often regulated by health and safety organizations 
• Sometimes mixed ages, sometimes separate ages
• Ratio of children to teachers can vary 
• Setting can vary - can be in a classroom, in home, at a public building, etc.

Montessori 01:34

• Layout: furniture is child sized, wooden shelves along the walls, low educational pictures/diagrams, shelf layout increases in difficulty as you move left to right and top to bottom (children are meant to move through them sequentially)
• Atmosphere: Children move around freely, do what they want when they want, adults are there to give presentations or to intervene only when needed, children of various ages help each other
• Teachers: certified in Montessori, observe
• Children: free thinkers, helpers/cooperative, self-sufficient, creative 

Waldorf 03:48

• Layout: natural, decorated with things from nature, plain wooden toys (encourage creative play), few distractions
• Atmosphere: simplicity, goodness, beauty, wonder; free play, nature exploration, projects / handcrafts, classroom functions like a home. Reading/writing/math introduced later than in public school
• Teachers: accredited, masters degree or certificate, stay with the children their whole time at the school, i.e. K-5 or K-8
• Children: creative entrepreneurs, problem solvers, self-directed learners, imaginative thinking 

Reggio Emilia 06:59

• Layout: child-based, colorful, activity/theme stations, children’s artwork on the walls
• Atmosphere: play-based learning, teachers play with the children, learning by theme, some structured activities, plenty of play time and child-directed time
• Teachers: certified in early childhood education 
• Children: learn to follow their passion, creative thinkers, well-rounded children, problem solvers 

Things to consider 09:33

• Hours
• Cost
• Location
• Ratio of children to teachers 
• Teaching style 
• Community 
• Tour the school to get a feel for it 

Illness at school 11:14

• Average 4-6 illnesses per year for the first 2-3 years (sick enough to come to the doctor), plus some milder ones 
• Tend to cluster in winter months
• Can spread between family members

Avoiding germs at home 12:31

• There’s a chapter in my book, The Baby Manual
• Wash hands as soon as you get home
• Use separate hand towels
• Keep toothbrushes apart (not in a cup with other people’s)
• Sleep in a different bed than the sick person 
• Don’t share utensils or food, blow on children’s food if you’re sick, or touch their food to your lips to see if it’s hot 
• If anyone is sick, they should not come within 6 feet (and ideally in the same room) as anyone at high risk, such as babies under a year, people with medical conditions, etc.

Dr. Keim’s information here is designed to help you make daycare and preschool choices for your children a bit easier. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. Remember, it is always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• The Baby Manual - Available on Amazon
• Subscribe to this podcast 
• DrKeim LinkTree - for vitamins and supplement link

--

Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim explains all the toddler behavior you can expect at different ages between ages one and three. She goes through all main behavior and ability changes and gets to the heart of why toddlers are acting in the way they are. 

The more understanding you have of why children are behaving in a certain way, the easier it is to see things from their point of view. Dr. Keim offers tips and tricks for navigating the word no, the repeated question why, three year old defiance, and other notable toddler behaviors. It will be difficult, they tend to push all your buttons while learning boundaries, but Dr. Keim will make you feel more confident in your navigation. 

In this episode:

• 1-1.5 yo
• 1.5-2 yo
• 2 yo
• 3 yo
• Resources

1-1.5 yo  00:37

• Starting to be able to do things for themselves
• Just starting to walk/talk, can feed themselves
• Don’t have a lot of opinions/preferences yet 
• Stranger anxiety - most will stay within sight of a parent
• Fairly easy behavior
• Parents: this is an ideal time to take a parenting class together

1.5-2yo  07:03

• Can walk, use some words, pick things up off the floor / get things for themselves 
• Separation anxiety, strong attachment to parent - explores with a parent nearby
• Mimicking
• Want to try things for themselves, show off 
• Trying out their independence 
• Learn how to use the word “no”
• Advocate for themselves
• Most wants are actually needs
• Start having some opinions and preferences but can’t express them yet 
• Offer 2 suitable choices 
• Empathy

2yo  13:21

• Run / run away 
• Say no
• Like attention (any kind) - spend 10 mins/day in child-led play 
• Struggle with transitions, have no sense of time 
• Can understand sequence a little bit - when/then statements 
• Want to experience things for themselves - natural consequences 
• Empathy, choices still 

3yo  18:30

• Drama - know about emotion, how to tell stories, have very active imaginations, are egocentric 
• Start expressing a wide range of emotions 
• Understand that their actions impact others but don’t understand empathy/theory of mind yet 
• Ask “why?” repeatedly - attempt to connect 
• Test boundaries to see where they are
• Test consequences to look for cause-and-effect 
• See how much they can get away with (testing that you still love them)
• As above (when/then statements, natural consequences, empathy, choices) plus modeling how to handle anger/frustration, anger wheel of choice, logical consequences

This guide is all about toddlers and why they behave in the way they do. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. Remember it is always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• The Baby Manual - Available on Amazon
• Subscribe to this podcast 
• Your Parenting Mojo podcast by Jen Lumenlan 
• healthychildren.org
• Love and Logic
• Bringing Baby Home
• Anger Wheel of Choice

--

Dr. Carole Keim MD: linktree | tiktok | instagram

Dr. Carole Keim talks all about picky eaters in this episode. Is it normal when your toddler reaches a point of only eating five beige foods? Yes. Dr. Keim covers this and everything to do with development, child nutrition, tempting picky eaters, and when to see a doctor about food concerns.

Dr. Keim also addresses why the old food pyramid is out of date and explains the actual nutrients your child needs and which foods they appear in. She shares why eating an actual apple is healthier than processed apple sauce, why processed foods aren’t good for kids, and how to keep kids interested in trying new things. Toddler palates and pickiness are de-mystified in this episode. 

In this episode:

• Normal development
• Macronutrients
• Micronutrients
• Food pyramid
• Green/yellow/red light foods
• Talking with children about nutrition 
• Tips for new foods 
• When to see the doctor 

Normal development 00:25

• 0-6 mos: only eat one thing 
• 6-12 mos: they only eat what you give them, simple palate (1-3 ingredients, no spices)
• 12-24 mos: tend to be great eaters and willing to try most things 
• Around age 2-3 they go through a phase of eating 5 foods
• Eating pattern: eat one meal, pick at one meal, skip one meal
• Most outgrow this within a year

Macronutrients 03:03

• Carbohydrates
• Protein / complete proteins (9 essential AAs)
• Fat

Micronutrients 07:12

• vitamins A, B, C, D, E, K
• Iron and other minerals
• Omegas 
• Probiotics and prebiotics 
• Fruits and veggies 

Food pyramid 11:20

• outdated; developed in 1992 
• became my plate in 2011 
• 2020 guidelines focus on limiting processed foods, increasing nutrient-dense foods, and limiting added sugar to <10% of daily calories, Saturated fat to <10%, sodium to less than 2.3g, and alcohol to 2/day for men and 1/day for women

Green/yellow/red light foods 13:55

• another way to think about it; easy for kids to understand
• Still puts food into the “good vs. bad” spectrum 

Talking about nutrition with young children 16:49

• Focus on benefits - fiber, vitamins, nutrients, keeps you full, fuels your body, helps you grow strong, etc.
• Talk about flavors and textures - fresh fruit and veggies often crunch
• Eat the rainbow; color = vitamins/nutrients
• Put all food on the plate at the same time (including treats)
• Don’t use dessert as a reward, or other 
• Avoid the “clean plate club” - puts a lot of stress on children.  Can let children serve themselves or tell you how much they want.  

Tips for trying new foods 21:03 

• Eat together as a family
• You provide the food, they decide whether to eat it
• No pressure to taste new foods
• Keep offering 
• Offer a variety
• Make it look fun / fun utensils
• Let kids help with shopping and meal planning
• Let kids help prep food
• Once your child likes a new food, offer similar foods
• Pair new foods with preferred foods
• Use “we” statements 

When to see the doctor 24:55

• Poor weight gain or weight loss 
• Lack of variety longer than 1 year 
• Avoidance of certain textures
• Gagging or vomiting after eating
• Stomachaches associated with food 
• Chronic abnormal poops 

This guide will help you navigate nutrition for your toddler, letting you know what’s normal pickiness and when to worry. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. Remember it is always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• The Baby Manual - Available on Amazon

--

Dr. Carole Keim MD: linktree | tiktok | instagram

In Episode 6 of Season 2, Dr. Carole Keim walks us through what to expect from three year olds. This can be a difficult age because children experience a lot of emotional growth and often become oppositional. Dr. Keim offers guidance on what to expect and how to handle it.

Three year olds have a lot of big feelings and drama, they often ask “why” a lot, they do the opposite of what is asked to test boundaries. They are trying to see exactly where the boundaries lie and that they’ll still be loved if they push limits. They have more refined motor skills, are more independent, and their speech has become more coherent. Dr. Keim advises on everything from behavior to nutrition and how best to handle certain patience-testing behaviors.

In this episode:

• Social development
• Motor skills
• Behavior
• Parenting
• Nutrition
• Potty training
• Safety
• 3 year checkup

Social development 02:04

• Imaginative play, often elaborate
• Can put on a shirt, coat, or jacket by themselves
• Plays with others and can share 
• Able to follow a multi-step command (when they want to!)
• 3-word sentences 
• Speech 75% intelligible to strangers
  • When they speak, repeat back with correct grammar and pronunciation
• Tells you a story from a book or TV; make up great stories 
• Can compare things with words like bigger/smaller 
• Understands simple prepositions like on/under
• Asks “why” repeatedly 
• Many children start preschool around age 2-3
  • Types of preschools - Montessori, Waldorf, Reggio Emilia
  • Preschool vs daycare 

Motor skills 05:51

• Eats independently
• Typically potty trained for urine - can enter bathroom and pee by themselves 
• Pedal a tricycle
• Climb on and off chairs, couches
• Jump forward
• Draw a circle
• Draws a person as a face with arms or legs 
• Can cut with scissors

Behavior 08:31

• Test boundaries
• Lots of defiance
• Praise/notice good behavior 
• Offer two reasonable choices as often as possible 
• Teach them what is ok to do when they are angry 

Parenting 12:17

• Maintain routines and limits - meals, bedtime
• Encourage fantasy play 
• Play games that require taking turns 
• Teach your child about empathy (but don’t expect them to fully grasp it yet)
• Rhyme together
• Let your child pretend to read books to you 
• Limit TV to 1 hour of high quality programming that you watch together
• Avoid TV during meal times and in bedrooms
• Be aware of your own screen use around child

Nutrition 16:51

• Pattern: eat 1 meal, skip 1 meal, pick at 1 meal
• Often picky at this age; try to offer a variety and avoid falling into the trap of beige foods and sweets.  Have healthy snacks ready to go for them - cut up fruit/veggies, healthy dips like hummus / soy sauce
• Water is the best thing they can drink and can/should be the only thing they drink; limit milk to 24oz per day and juice to 4oz per day 

Potty training 17:42

• Daytime dryness comes 6-12 mos before nighttime
• Encourage frequent sitting to avoid constipation; can become a vicious cycle when they have a painful BM
• Dress them in clothing that is easy for them to remove 

Safety 18:35

• Car seat - can be forward facing
• Use helmet for anything with wheels
• Remove firearms from home
• Supervise around dogs, cars and start teaching them about safety 
• Touch supervision near water - pools, toilet, bathtubs 
• Move furniture away from windows
• Use door locks and window locks 

3-year checkup 20:22

• No vaccines other than flu/covid until age 4
• Ok to allow child to answer questions, but expect that they will give wrong answers 
• They typically feel comfortable during the physical exam; time to start talking about safety around adults / private parts  
• Ask your doctor if you have any specific questions about preschool, behavior, tantrums, nutrition, vitamins, potty training, constipation, and sleep routines 
• Regular dental visits 1-2x per year 

This guide aims to help you with your “threenager”, guiding you through the three years old development stages. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. Remember it is always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• The Baby Manual - Available on Amazon

--

Dr. Carole Keim MD: linktree | tiktok | instagram

In this episode, Dr. Carole Keim talks about what to expect from your two and a half year old. Your child is getting older, is super cute, and is now talking more, so Dr. Keim explains everything from motor skills to nutrition, and offers some parenting advice.

A child at two and a half will have enough language to communicate basics with you but their lack of full verbal skills can frustrate them and cause acting out. Their motor skills are more developed, they can run pretty well and wash and dry their hands. But they still don’t have proper awareness of dangers like cars, dogs, and especially water. Dr. Keim walks through all the ways in which two and a half year olds are advancing and all the things they need help with and that you may need patience for. It can be a tricky age but you’ve got this.

In this episode:

• Social development
• Motor skills
• Behavior
• Parenting
• Nutrition
• Potty training
• Safety
• 2.5 year checkup

Social Development 00:30

• Starting imaginary play
• Says “look at me!” to parents
• Starting to play with others 
• Phrases of 2-3 words
• Speech 50% intelligible to strangers
  • When they speak, repeat back with correct grammar and pronunciation
  • They can use pronouns correctly
• Many children start preschool around age 2-3
  • Types of preschools - Montessori, Waldorf, Reggio Emilia
  • Preschool vs daycare 
  • Expect them to play with other children but not be able to share or take turns yet
  • They may start to follow older children around and copycat them 

Motor Skills 03:02

• Stabs food with a fork 
• Walks up stairs alternating feet
• Runs well without falling
• Washes and dries hands
• Catch a beach ball 

Behavior 04:13

• Start testing boundaries and setting their own
• Praise/notice good behavior 
• Offer two reasonable choices as often as possible 

Parenting 05:55

• Maintain routines - meals, bedtime
• Have fun outings together - museums, zoos, library 
• Make time for learning through reading, talking, singing, exploring together
• Limit TV to 1 hour of high quality programming that you watch together
• Avoid TV during meal times and in bedrooms
• Be aware of your own screen use around child

Nutrition 08:09

• Pattern: eat 1 meal, skip 1 meal, pick at 1 meal
• Might graze throughout the day
• May start to get picky at this age; try to offer a variety and avoid falling into the trap of beige foods and sweets 

Potty Training 09:25

• plan for frequent potty breaks (up to 10x per day), relax during potty time by reading or singing to them 
• Teach them to wash hands with soap and dry with towel 
• Dress them in clothing that is easy for them to remove 
• For independence, must be able to remove/replace clothing, get on/off toilet

Safety 10:28

• Car seat - can be forward facing
• Use helmet for anything with wheels
• Remove firearms from home
• Supervise around dogs, cars
• Touch supervision near water - pools, toilet, bathtubs 

2.5 Year Checkup 12:43

• No vaccines other than flu/covid until age 4
• Ok to allow child to answer questions, but be ready to jump in if they feel nervous or give wrong answers (which they often do at this age)
• They typically feel comfortable during the physical exam 
• Ask your doctor if you have any specific questions about preschool, behavior, tantrums, nutrition, vitamins, potty training, constipation, and sleep routines 
• Regular dental visits 1-2x per year 

This guide should ideally help you enjoy time with your two and a half year old. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. Remember it is always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• The Baby Manual - Available on Amazon

--

Dr. Carole Keim MD: linktree | tiktok | instagram

In this episode of Season Two, Dr. Carole Keim discusses two year olds. Dr. Keim explains exactly what developmental and behavioral milestones to expect, offers potty training and safety advice, and touches on preschool and checkups for your two year old.

This age is often called “the terrible twos” largely because children have learned the word ‘no’ and have started advocating for themselves. They’re exploring their environments with increased motor skills and speech but not as many words as they’d like to express things. They’re also exploring boundaries. Dr. Keim explains how to navigate their frustrations and tantrums from a place of understanding where they’re at.

In this episode….

• Social development
• Motor skills
• Behavior
• Potty training
• Safety
• Preschool
• 2 year checkup

Social 00:33

• Parallel play 
• 50+ words
• Combines 2 words
• Follows 2-step command
• Speech 50% intelligible to strangers
• Names at least 5 body parts
• Likes familiarity - might want the same book every night
• Many children start preschool around age 2-3
  • Types of preschools - Montessori, Waldorf, Reggio Emilia 
  • Preschool vs daycare 

Motor 05:31

• Scoop with a spoon
• Kick a ball
• Hop with 2 feet
• Runs well
• Climb a ladder at a playground
• Removes clothing - esp socks
• stacks objects
• turns pages in book
• draw a line

Behavior 06:31

• exploring boundaries 
• Starting to advocate for themselves
• Praise/notice good behavior 
• Help them express joy, anger, sadness, frustration
• You’ll start to notice their personality around people/situations
• Encourage free play up to 1 hour per day
• Make time for learning through reading, talking, singing, exploring together
• Limit TV to 1 hour of high quality programming that you watch together
• Avoid TV during meal times and in bedrooms
• Be aware of your own screen use around child

Potty training 09:19

• plan for frequent potty breaks (up to 10x per day)
• Teach them to wash hands
• For independence, must be able to remove/replace clothing, get on/off toilet

Safety 11:12

• Car seat - can change to forward facing
• Use helmet for anything with wheels
• Remove firearms from home

Preschool 12:45

• Can help with social interactions, sharing

2-year checkup 13:13

• No vaccines other than flu/covid until age 4
• Ok to allow child to answer questions, but be ready to jump in if they feel nervous or give wrong answers (which they often do at this age)
• They typically feel comfortable during the physical exam 
• Ask your doctor if you have any specific questions about behavior, tantrums, nutrition, vitamins, potty training, constipation, and sleep routines 

Hopefully this helps you enjoy time with your two year old with less worry. For additional tips and advice on babies and toddlers, follow Dr. Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. Remember it is always okay to call your doctor or emergency services if you have concerns about your baby’s health.   

Resources discussed in this episode:

• The Baby Manual - Available on Amazon

--

Dr. Carole Keim MD: linktree | tiktok | instagram

In this episode, Dr. Carole Keim talks all about potty training. While potty training usually involves toddlers - the common age is between two and four years - it can be started as early as infanthood with what’s called elimination communication. Dr. Keim walks parents through all the major questions and issues about potty training. 

Dr. Keim first explains how to identify when your toddler is ready to start training. She then talks about how to potty train and explains various methods of working with a reluctant toddler or what she calls “secret poopers”. In addition she addresses various things that could go wrong, such as constipation or diarrhea, and how to take care of your toddler if one of these issues should arise. Dr. Keim imparts sound and thorough advice to prepare parents for the journey of getting toddlers to use the toilet.

In this episode….

• Elimination communication
• Signs your toddler is ready
• Secret poopers 
• Resistant children
• Constipation
• Diarrhea
• UTIs

Elimination communication 00:42

• Can start at any age
• Pre-verbal children
• You indicate when it’s time to potty and make noises while holding them over a potty, adult toilet, or sink
• Times to take them : after they eat, when they wake up

Toddler potty training 01:45

• Dry for 2+ hours at a time
• They indicate when they’ve gone or you can tell when they’re going
• Start anticipating these times (after meals, upon waking) and/or use a schedule
• Sit them on the potty / toilet seat with adapter 
• They don’t have to be fully independent with moving/removing clothing, pulling up pants, getting on and off the toilet, and washing hands.  Use scaffolding.
• It can take a while for them to get the hang of it
• Don’t punish them for accidents
• Don’t use treats unless you need to 
• Daniel Tiger episode 

Children who don’t mind sitting in a dirty diaper 04:51

• aka “secret poopers” 
• Can try the “oh crap” book
• Allow them to run around without diaper or pants on, especially outside
• Try nature pees/poops
• Can try the potty training in a weekend method
• Have a potty in each room so it’s easy

Children who fight using the potty 05:56

• Try nature pees/poops
• Have a potty in each room to get them used to it
• Let them sit on the potty fully clothed and play while siting there
• Have fun potty time - read a special book together, play with a toy on the potty
• If using potty treats: sticker charts are often too delayed of a reward except in children 4 and up.  I suggest a treat for trying, and a treat if anything comes out.  Food treats tend to motivate children more but are also associated with more performance anxiety.  
• It is ok to praise attempts to use the potty and success in using it, but excessive praise can also cause performance anxiety
• Becoming angry at child for refusing to use the potty can backfire on parents, as this is one of the only things a child can control

Constipation 09:17

• Decrease in frequency or size of bowel movements, harder stools, pain with stooling
• Can be acute or chronic
• How chronic constipation happens
• Avoiding it: choose high fiber and low processed foods - fresh fruit and veggies for more than 50% of each meal / 10 fistfuls per day.  Avoid dairy products.  Make sure child is drinking 1/2oz per pound of weight in water each day (so a 25 lb child should drink at least 12.5oz of water).  Try to establish positive associations with sitting on the toilet.
• Treating it when it’s acute: can try prune juice as a laxative, a glycerin suppository if stool is very hard, or an enema for a one-time cleanout.
• Chronic constipation: first disimpaction - enema of hypertonic saline or a suppository x1, followed by a stimulant laxative x 2-3 days, and a stool softener for several weeks.  At the same time, increase fiber and water, decrease processed foods, and eliminate dairy.  Encourage frequent and prolonged sitting on the toilet.
• How stimulant laxatives work and why they are addictive and shouldn’t be used more than a few days
• How miralax and psyllium work as stool softeners and why they can be used long term

Diarrhea 16:32

• Teething - symptoms, why it happens
• Viral - tend to have no or low-grade fever, no blood, can be foul smelling and green 
• Bacteria - can have fever, can have blood, can have it for over a week, can be profuse or just a few times per day.  Requires test to determine type of bacteria to guide treatment; sometimes antibiotics help, sometimes they make it worse.
• After antibiotics
• From juice
• From food
• When to be concerned
• Treatment - more water, BRAT diet x 1 day, bland foods, avoid dairy, probiotics, avoid dehydration 
• Why we can’t use diarrhea medicines in children
• Avoiding spread to family members
• Rotavirus vaccine

UTIs 19:48

• Symptoms: pain with urination, urinary frequency, urgency, accidents in a potty trained child, sometimes bad smell of urine. Fever is a late sign.
• Caused by constipation, staying in wet clothing/swimsuit too long, poor hygiene (not bathing enough, staying in dirty diaper too long), tight clothing/sweat, bubble baths 
• Treatment: antibiotics.  
• Prevention in those who get more than 1 UTI: increase water intake, more frequent voiding, avoid risk factors, decrease sugar intake.  Also they should get an ultrasound of the kidneys to determine risk for pyelo.

These are the major things to do with potty training. For additional tips and advice on babies and toddlers, follow Dr. Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. Remember it is always okay to call your doctor or emergency services if you have concerns about your baby’s health.   

Resources discussed in this episode:

• The Baby Manual - Available on Amazon
• Daniel Tiger’s Stop & Go Potty

--

Dr. Carole Keim MD: linktree | tiktok | instagram

In this second episode of Season 2, Dr. Carole Keim discusses what to expect at the 18 month stage. Your baby is a toddler now, and showing ever more personality, and Dr. Keim has advice on everything from tantrums to sleep.

Dr. Keim addresses what social and motor development looks like at this age. Your baby will want to play with you and they understand a lot more language than their few words would have you believe. She talks about the “terrible twos” and shares ways to avoid tantrums. She addresses sleep and what bed your baby should sleep in at 18 months. How should teeth brushing go? How do you navigate potty training? What are major safety concerns to address? Dr. Keim has insight on all these questions and more in this episode.

In this episode….

• Social development and language
• Motor development
• Behavior
• Digital media
• Sleep
• Nutrition
• Teeth
• Elimination
• Safety
• Skin care, bathing, sun protection
• 18mo Checkup

Social development: 00:40

• Engaging with others for play
• Help with dressing and undressing
• Points at pictures in books
• Shows things to parents by pointing or bringing objects
• Looks at parent if something new happens
• Can scoop with spoon
• Starts using words to ask for help
• Can identify 2 body parts
• Can name 5 objects 
• Stranger anxiety starts getting better, but separation anxiety starts getting worse
• Follow simple instructions and love to help out
• Parents: encourage use of language by naming what you see, talk and sing to child, use words to describe feelings and emotions

Motor development: 04:30

• Can run, kick a ball
• Walks up stairs by doing step-together and while holding a hand
• Can sit in a small chair
• Walks around with toys
• Scribble
• Throw a ball 

Behavior: 06:10

• Terrible two’s start now - they know how to use “no”
• Offer 2 suitable choices as often as possible throughout the day.  Let them choose how things get done.
• They have a hard time expressing preferences; pretty good with needs 
• Modify their environment to avoid conflict; plan ahead for new and difficult situations
• Hitting and biting are attempts to communicate - teach them how to communicate effectively 
• Anticipate anxiety/clinging in new situations
• Spend at least 10-15 minutes in child-led play
• Prepare child for new sibling by reading books, getting them a doll

Digital media: 14:14

• Promote reading, physical activity, and play with non-electronic toys
• Make time for play every day
• No screens for at least 2 hours before bedtime; instead plan on tech-free play, bath, reading
• Use methods other than screens to calm them down: distraction, removing trigger, going outside, addressing needs like hunger/sleep
• If you do use digital media, choose high quality programs/apps and use them together: PBS kids, Daniel Tiger
• Limit viewing to less than 1 hour per day
• Be mindful of your own screen use; make a plan for family media use
• Avoid having TV on in the background, especially during meals 

Sleep: 17:55

• 10-14h at night, 0-1 nap per day.  
• In crib in their own room; consider moving to toddler bed when it’s ok for them to get out of bed (walking independently, able to safely get to your room and wake you up)
• Night waking is normal; reassure briefly, offer stuffed animal or blanket so they can self-console
• Lifehack while potty training: layer sheets and chucks 
• Blankets ok; no pillows til age 2
• No food or drinks in bed
• No electronic devices in the bedroom (TV, tablet)

Nutrition: 20:57

• 3 meals and 2-3 snacks per day at the same time as the family
• Offer a variety of foods and textures 
• Encourage self feeding and use of utensils 
• Use a cup for water; offer water with all meals and snacks
• Should be eating greens daily; ok to have meat; supplement with iron if not eating greens daily or red meat 3x per week
• You determine when child eats and what is offered, but allow child to decide how much to eat (many toddlers graze).  They are typically not picky and want to try new foods at this age.
• Less than 24oz of milk per day, less than 4oz juice (ideally NO juice)

Teeth: 25:10

• Brush teeth BID with small smear of fluoride toothpaste
• They should see a dentist 1-2x per year

Elimination: 26:09

• Typical age to start potty training - start noticing them hiding to poop or anticipate when they will go, they know and tell you when they’ve peed/pooped, they can pull pants up/down
• Typically voiding at least 6x per day, stooling 1-2x per day
• If baby is constipated: first increase water intake, increase fiber (fruit and veggies), then consider prune juice or pear juice 2oz 1-2x per day.  If not enough, talk to your doctor about miralax.
• Can start potty training by putting toddler on potty after eating and upon waking
• If toddler is resistant to potty training, can start with sitting while clothed and entertain them with a book or toy, then sitting with pants and diaper off
• Read books about using the potty
• Can keep the potty in your bathroom and try going at the same time - they love to mimic adults at this age
• Start boys sitting on the toilet; they can stand later.  Standing too early can lead to constipation.  
• Potty signal: songs

Safety: 33:13

• Childproof the house - outlet covers, stairway gates, barriers around space heaters, cleaning products locked away, electrical cords out of reach, gates around pools, small and sharp objects out of reach
• Don’t take medicines in front of children - they will learn that you’re supposed to open those bottles and put things in your mouth out of them
• Set water temp to 120’F 
• Avoid secondhand smoke
• Rear facing car seat until age 2, make sure everyone in the car is using a seat belt
• Don’t leave heavy objects or hot liquids on tablecloths or coffee table 
• Save poison control number in your phone 
• Remove guns from the home or keep them locked and unloaded in a safe
• Make a fire escape plan with the family, check smoke detectors often 

Skin care: 37:38

• Bathe as often as they get dirty (daily)
• Can use lotion; many have started outgrowing eczema by now
• Use sunblock if spending more than 30 mins outside, apply 30 mins before you go outside, and use SPF 30 or higher.  Also use a hat, sun protection clothing (long sleeve swim shirts)
• Insect repellant that is safe for babies 

18mo Checkup: 39:05

• Expect them to be clingy and sad if you leave them on the table
• Full head-to-toe exam
• Routine vaccines at this visit; should be all caught up now until age 4!
• Next checkups at age 2, 2.5, and 3 years

Resources discussed in this episode:

• The Baby Manual - Available on Amazon

--

Dr. Carole Keim MD: linktree | tiktok | instagram

Welcome to Season 2 of The Baby Manual with Dr. Carole Keim MD. This first episode of Season 2 is all about your baby at 15 months of age. From parenting to nutrition to skin care, Dr. Keim covers all the major developments of the 15 month age group. 

Dr. Keim discusses the developmental progress of your baby at 15 months and notes that they understand the word no, they have preferences, and they also feel upset if those preferences aren’t met. They quite like to help and mimic your actions. She addresses what children should eat and drink and how toddlers like trying things at this age, and explores how often to brush their teeth, when to see a dentist, making your home safe for their exploration, and what to expect at the 15 month check up. A lot of information is here to help you feel confident in navigating everything from tantrums to health. 

In this episode….

• Parents
• Development
• Behavior
• Sleep
• Nutrition
• Teeth
• Elimination
• Skin care
• Safety
• 15mo checkup

Parents: 00:31

• Engage with child often by speaking with them, tell them the names of objects
• Support toddler’s need for safety and reassurance
• Boundaries are reassuring to them
• Baby should be able to separate or move away from parent for moments, but will check back to look at them
• Look for parent-toddler play groups - Parallel play 
• Use consistent positive discipline (notice/comment on good behavior, avoid using the word “no” and instead tell them what they CAN do, use distraction, be a role model) 
• Give your child regular down time during the day; might still be napping  

Development: 05:14

• Stranger anxiety comes back
• Might have a preferred parent
• Points out objects and brings objects to show parents 
• Hands parents a book or toy to play with
• Follows simple directions (put this away / hand me a toy) 
• Imitate parent behavior (talking on the phone, taking pictures, feeding dolls, etc)
• Look around when asked questions like “where is your ball?”
• Stoop and recover
• Crawl up stairs
• Start to run
• Vocabulary starts to explode; should know at least 3 words and jabber with inflection  
• Scribble with a crayon or marker (and not just eat it)
• Feed themselves well with hands, drink from a cup without spilling

Behavior: 08:28

• Terrible two’s start now - they learn how to use “no”
• Offer 2 suitable choices as often as possible throughout the day.  Let them choose how things get done.
• They have a hard time expressing preferences; pretty good with needs 
• Modify their environment to avoid conflict 
• Hitting and biting are attempts to communicate - teach them how to communicate effectively 

Sleep: 10:41

• 10-14h at night, 0-1 nap per day.  
• Bedtime routine established: brush teeth together, quiet time, reading, singing
• In crib in their own room; consider moving to toddler bed when it’s ok for them to get out of bed (walking independently, able to safely get to your room and wake you up)
• Night waking is normal; reassure briefly, offer stuffed animal or blanket so they can self-console
• Lifehack while potty training: layer sheets and chucks 
• Blankets ok; no pillows til age 2
• No food or drinks in bed
• No electronic devices in the bedroom (TV, tablet)

Nutrition: 13:25

• 3 meals and 2-3 snacks per day at the same time as the family
• Offer a variety of foods and textures 
• Encourage self feeding
• Use a cup for water; offer water with all meals and snacks
• Should be eating greens daily; ok to have meat; supplement with iron if not eating greens daily or red meat 3x per week
• You determine when child eats and what is offered, but allow child to decide how much to eat (many toddlers graze).  They are typically not picky and want to try new foods at this age.

Teeth: 16:48

• Brush teeth BID with small smear of fluoride toothpaste; if there is no fluoride in water source can use a grain-of-rice sized amount of fluoride toothpaste 
• They should see a dentist 1-2x per year

Elimination: 17:31

• Typically voiding at least 6x per day, stooling 1-2x per day
• If baby is constipated: first increase water intake, increase fiber (fruit and veggies), then consider prune juice or pear juice 2oz 1-2x per day.  If not enough, talk to your doctor about miralax.
• Can start potty training by putting toddler on potty after eating and upon waking
• If toddler is resistant to potty training, can start with sitting while clothed and entertain them with a book or toy, then sitting with pants and diaper off
• Can keep the potty in your bathroom and try going at the same time - they love to mimic adults at this age

Skin care: 20:09

• Bathe as often as they get dirty (daily)
• Can use lotion 
• Use sunblock if spending more than 30 mins outside 
• Insect repellant that is safe for babies (citronella based is best)

Safety: 20:52

• Childproof the house - outlet covers, stairway gates, barriers around space heaters, cleaning products locked away, electrical cords out of reach, gates around pools 
• Don’t take medicines in front of children - they will learn that you’re supposed to open those bottles and put things in your mouth out of them
• Keep baby in arms or a high chair in the kitchen, keep the bathroom door shut and bring them in with you; never allow baby to be alone in those rooms
• Set water temp to 120’F 
• Avoid secondhand smoke
• Rear facing car seat until age 2
• Don’t leave heavy objects or hot liquids on tablecloths or coffee table 
• Save poison control number in your phone 
• Remove guns from the home or keep them locked and unloaded in a safe
• Make a fire escape plan with the family, check smoke detectors often 

15mo Checkup: 24:32

• Typically able to sit alone on the table; stay within arms reach so they don’t fall off
• Full head-to-toe exam
• Routine vaccines at this visit and the next one
• Next checkup at 18 mos 
• Reminder that after 1 year of age should have their first eye exam at ophthalmologist

All of the information in this episode is also in The Baby Manual book, which is available for purchase. Remember it is always okay to call your doctor or emergency services if you have concerns about your baby’s health.  

Resources discussed in this episode:

• The Baby Manual - Available on Amazon

--

Dr. Carole Keim MD: linktree | tiktok | instagram