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“Home for the Holidays” May Look A Little Different This Year

January 7, 2021 by  
Filed under Uncategorized

By Mia Armstrong 

“It’s the most wonderful time of the year…” (cue the music!).  Or is it?

For many of us, 2020 has been one of the most challenging years of our lives, and as we quickly approach the holiday season, it leaves us wondering how we can safely spend time with our families during the Covid-19 pandemic. Well, if 2020 has taught us anything, it’s showed us that we need connections with others now, MORE THAN EVER!

Courtesy of Unsplash

Gather ‘round the table

The end of the year is often filled with joy and memories as families gather together to celebrate various holidays. While this year in particular is going to look a little different, we can still make this holiday season memorable, for good reasons! For many, the holidays are filled with delicious smells and tastes as we share a family meal. While we may be tempted to feed the little ones separately from the adults, the Juvenile Products Manufacturers Association (JPMA) encourages us to make the holiday dinner an event for the whole family. Even infants can experience the sights and smells of a delicious dinner with fun dinnerware items like these from Ashima. Pull up a high chair (like this one from Nomi) to include your baby while the family enjoys the meal.

Mealtime with Baby 101

If you are given any mealtime baby items or furniture as gifts this season, please make sure to review the manufacturer’s website to ensure the item hasn’t been recalled. The manufacturer’s instructions will also provide helpful tips for disinfecting items to keep things as clean as possible. It is important to make sure any infant seats are at eye-level to ensure the baby makes good eye contact with family members. However, the high chair should be positioned at a safe distance away from the table to prevent a curious baby from accidentally touching glassware, utensils, or hot foods. Another safety precaution is making sure that the high chair restraints are secure to prevent accidental falls. By following these recommendations, and making sure your child is supervised, your family can safely enjoy mealtime.

Speaking of food… 

Now is the time many people indulge in decadent holiday favorites, both savory and sweet! Whether you plan to loosen your dietary restrictions (and your belt!) or stick with your health plan, it’s important to consider age-appropriate foods for your young child. Be sure to have foods that your baby loves, but keep a watchful eye to prevent choking hazards. Several child-safe plates and utensils are available to help your child feed themselves and partake in the holiday meal.

What about safety during the pandemic?

Unfortunately, the end of the Covid-19 pandemic is not in sight, so we must be sure to follow the recommended safety precautions during our family gatherings.  It’s important to stay up-to-date on health advisories from the Centers for Disease Control as well as your local health authorities. Try to limit the number of dinner guests as much as possible, keeping in mind that our loved ones can still call in to share the meal virtually with the rest of the family.  Also, if there will be guests from outside your immediate family circle, try to plan seating to maintain an appropriate 6-foot social distance whenever possible.  Likewise, don’t forget that masks are still recommended for all family members two years old and older.  Having an area for handwashing, or bottles of hand sanitizer nearby, will help everyone have clean hands before enjoying the delicious holiday meal.  Depending on the weather, outdoor seating during the meal will help reduce the risk of infection.  A crisp, cool day is always refreshing! And, the family will be in the perfect position to begin the traditional after-dinner football game.

The season of gratitude 

During the meal, take time to share favorite memories from past holidays, as well as focus on gratitude for the love within your family. Though your child may be too young to speak complete sentences, caregivers can still encourage young ones to give thanks by babbling or speaking their own sweet gibberish. This simple activity will encourage language development for your child. There are some great non-tech gift ideas to help engage your children while encouraging learning and language development. Though our lives have been consumed by virtual meetings and classes, holiday meals should be a time to shut down the devices. In between bites of stuffing, create new traditions and memories by teaching kids gratitude.

The New Normal

Though the holidays may look a little different this year, we must strive to maintain a sense of normalcy for the kiddos, while navigating the change of the times. For many adults, as well as children, this time of year can be emotionally challenging, and the addition of a pandemic just compounds that. It’s important to calm little ones’ fears, manage stress, and keep the peace at home. With a little planning this holiday season, families can still celebrate the many reasons we have to be grateful.









About the author: Mia Armstrong, MD is a Board-Certified Pediatrician and a fellow of the American Academy of Pediatrics. According to her mother, she dreamed of becoming a Pediatrician since the age of three years old! She accomplished her goal by receiving her Medical Degree from the Medical College of Georgia in Augusta, GA. She completed her Pediatrics training in Jackson, MS at the University of Mississippi. Dr. Armstrong loves caring for children and teaching families how to be healthy! Though she enjoys working with children of all ages, she has a special interest in teaching new parents to care for their newborns and offering breastfeeding support as a Certified Lactation Counselor. Her other medical interests include asthma education, routine well care, and immunizations. She also enjoys traveling and exploring new cuisines and adventures. Dr. Armstrong loves to talk, never meets a stranger, and is excited to share her insight with parents everywhere through her blogs!

To Trick-or-Treat or not Trick-or-Treat: That is the Question!

October 23, 2020 by  
Filed under Uncategorized

By Nina Washington, MD, MPH

Ahhh, the coronavirus pandemic. One virus single handedly changed everything about the way we live. Zoom weddings, quarantine birthday parties, and socially distanced picnics are just a few of the ways we have adapted to this new lifestyle.

Yet, time and the calendar wait for no man, woman, or mommy! Fall is now upon us, and, as the weather grows cooler, daylight hours shorten and the remaining days of 2020 become less and less, surely our next challenge in adapting to the pandemic is how we will shift our traditional fall holidays and celebrations. First up, Halloween!

To trick-or-treat or not trick-or-treat? In a pandemic? That is the question!

Halloween, or All Hallows’ Eve, celebrated in the United States annually on October 31st, is a favorite holiday of children and adults alike. Costumes and masks (coincidentally, not the ones we’ve now grown accustomed to wearing), haunted houses, carving Jack-o-lanterns, and oodles of candy are just a few of the many reasons this holiday is relished by many. However, that was before we were slapped in the face with the most ghoulish of ghouls – the coronavirus.

How is one to navigate this terrain? Should Halloween be cancelled? Unfortunately, there is no clear-cut answer. Every mom will have to consider the pros, cons, and level of comfort with participating in traditional Halloween activities, modifying this year’s festivities, or foregoing the celebration all together. More than anything, moms should be assured that there is no right or wrong solution. The only requirement is to be safe, be responsible, and do what is best for your family!1

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) provide specific guidelines and helpful tips to assist with this year’s celebration. According to the CDC, the first step in planning a holiday celebration is to assess the COVID-19 infection levels and risk for infection in your community.2 If either of these levels are elevated or worrisome, it is in the best interest of your family and community to postpone or cancel any in person celebrations. Alternatively, the celebration could be held among your primary family unit. In general, celebrations should aim to be small (i.e., avoid large gatherings), maintain social distancing of 6 feet, and wear masks. Events held outdoors are also preferred over those held indoors.2

If that initial assessment provides comfort in that your community has low levels of the virus, is actively practicing mask wearing, handwashing, and social distancing, then consider celebrating Halloween based on one of the following three tiers as described by the CDC.3

Low risk activities:

  • Hosting a virtual Halloween contest with family and friends.
  • Carving or decorating pumpkins with members of your household. This activity can also be done outside with friends while practicing social distancing.
  • Gather the members of your household and have a Halloween movie marathon. Make it extra exciting by dressing up as the characters from the movie! You can even invite friends to virtually share in the movie and costume experience.

Moderate risk activities:

  • One-way trick-or-treating. Place prepared goodie bags at the end of the driveway for trick-or-treaters to pick up at their leisure. Use duct tape to mark 6-foot distances so crowds do not form at your “treats table”.
  • Celebrate by visiting apple orchards or pumpkin patches where social distancing is easier to maintain. Be sure to wear your mask, wash your hands, and use hand sanitizer before and after picking apples and pumpkins.
  • Have an outdoor Halloween movie viewing party or an outdoor Halloween costume party. Members of the same household should stay together and maintain social distancing.

The CDC recommends AVOIDING these higher risk activities such as:

  • Traditional trick-or-treating that includes going from house to house and receiving candy.
  • Trunk-or-treats where multiple people gather to pass out candy from the back of their cars or trucks.
  • Attending crowded indoor Halloween costume parties or celebrations.
  • Visiting haunted houses where multiple people may all be in the same room and screaming occurs.

*Only a sampling of the activities provided from the CDC website were listed in this article. For the full list please see CDC reference below.

A special note about masks:

Those wearing costumes this Halloween should consider wearing a Halloween themed cloth mask instead of traditional Halloween masks. It is strongly recommended that children and adults NOT wear a traditional Halloween mask over a cloth mask. Wearing both masks may cause significant difficulty breathing.

Like much that has transpired since the pandemic was declared in March, Halloween gives us another opportunity to adjust and adapt. It is still very possible for mommies along with their little ghosts and goblins to have a fun and safe Halloween. Following these tips and suggestions will keep the coronavirus “monster” from spoiling your festivities.


  • https://services.aap.org/en/news-room/news-releases/health–safety-tips/american-academy-of-pediatrics-offers-tips-for-a-safe-halloween-during-pandemic/
  • Newsweek. CDC Issues COVID-19 Halloween Guide. https://www.newsweek.com/cdc-issues-covid-19-halloween-guide-if-screaming-will-occur-greater-social-distancing-advised-1536488
  • Centers for Disease Control. Coronavirus Disease (COVID-19): Holiday Celebrations.  https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays.html

Kids on The Move: How to Pick the Safest Car Seats

September 18, 2020 by  
Filed under Uncategorized

By Mia Armstrong, MD

Parents everywhere are faced with the challenge of creating healthy and safe environments to help kids reach their fullest potential.  While maintaining a child’s general health and nutrition is essential, making sure kids are safe in the car is equally important. In recognition of Child Passenger Safety Week 2020 (September 20 – 26), JPMA is answering common questions about car safety seats, including both car seats and booster seats. As the voice of the industry on quality and safety for baby and children’s products, for more than 40 years, JPMA has helped parents feel confident in choosing safe products for their children.

Photo Courtesy of Unsplash

Does my child need a car safety seat?

According to the Centers for Disease Control, motor vehicle accidents are a leading cause of death for children in the United States. Therefore, car safety seats are required in all states to provide adequate protection for young children. As children age, motor vehicle safety recommendations shift to the use of seat belts, which will be discussed later in our article.   Periodically, the car safety seat recommendations are updated to reflect current guidelines from the American Academy of Pediatrics (AAP). It is important to remain up-to-date with all AAP safety recommendations, as well as state-specific transportation laws.

In 2018, the AAP updated their guidelines and recommended that car safety seats remain rear-facing for as long as possible, which is until the child reaches the weight OR height limitations for their specific seat. This information is found on the manufacturer’s website. This change was made in order to provide optimal protection for a child’s developing spine.  In the event of an accident, the spine is better protected when the seat is facing backwards. PLEASE NOTE: the prior recommendation for switching to forward-facing seats at age two years old has been removed.

When a child has reached the upper weight or height limit for a seat that is rear facing, along with any minimum age requirements prescribed by state law or manufacturer instructions, the next step is forward-facing with harnesses. One key call-out is that all current forward-facing seats have top tethers to provide better head protection and other crash protection benefits. The car seat instructions tell you how to attach and adjust it, while the vehicle owner’s manual provides information on the correct tether anchor and routing. It is best to continue using this type of seat as long as allowed by the car seat instructions.

Once a child outgrows the weight or height limits for the forward-facing car seat, it is safe to shift to using a booster seat. A booster seat is a supportive chair that lifts the child into the correct position to wear a seat belt. Boosters should be used until a child reaches a height of 4 feet 9 inches tall AND is between eight and twelve years old.

Should you purchase a used safety seat?

Raising kids can be EXPENSIVE, but investing in safety products to protect their lives is PRICELESS! While repurposing childhood items is helpful to limit expenses and reduce waste in our society, careful attention must be paid to reusing baby gear, including car safety seats. Check the manufacturer’s instructions or website for recommendations on how long to use a particular seat. Make sure that your chosen safety seat is without cracks and includes all parts/buckles. Also, confirm that the safety seat comes with the original label including the date of manufacture and model number. This information is necessary to research if the seat has been recalled. You can search the National Highway Traffic Safety Administration (NHTSA) website for all car safety seat recall data. Lastly, never use a safety seat that has been in a moderate or severe traffic accident, as its ability for protection decreases upon impact. The NHTSA website can offer more specific guidelines on pre-used safety seats and manufacturer instructions should always be followed.

IMPORTANT NOTE: If you have questions about your specific car safety seat, contact the manufacturer directly.

So many choices! How do I choose the correct car safety seat for my child? 

Thankfully, the American Academy of Pediatrics (AAP) provides helpful tips for choosing a car safety seat. Your child’s Pediatrician or Family Physician is also a valuable resource. In addition, you can ask trusted family members, friends, or coworkers for their recommendations. Another good suggestion is checking manufacturer reviews. Choosing the best possible car safety seat depends on your child’s size/weight, your family’s personal needs, and your vehicle type. It is best to ensure your child’s car safety seat follows these recommendations as listed on the AAP website:

​​Types of Car Seats at a Glance​ 


​Type of Seat

​General Guidelines​ 

Infants and toddlers

​• Rear-facing-only

• Rear-facing-convertible

All infants and toddlers should ride in a rear-facing seat until they reach the highest weight or height allowed by their car safety seat manufacturer. Most convertible seats have limits that will allow children to ride rear facing for 2 years or more. ​

​Toddlers and preschoolers

​• Forward-facing convertible

• Forward-facing with harness

​Children who have outgrown the rear-facing weight or height limit for their convertible seat should use a forward-facing seat with a harness for as long as possible, up to the highest weight or height allowed by their car safety seat manufacturer. Many seats can accommodate children up to 65 pounds or more.

School-aged children

​• Booster

All children whose weight or height exceeds the forward-facing limit for their car safety seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are 8 to 12 years of age. All children younger than 13 years should ride in the back seat.

​Older children

​• Seat belts

When children are old enough and large enough for the vehicle seat belt to fit them correctly, they should always use lap and shoulder seat belts for the best protection. All children younger than 13 years should ride in the back seat.

Image Credit: The American Academy of Pediatrics https://www.healthychildren.org/


When does my child no longer need a car safety seat?

Once the adult seat belt fits correctly, which is around the time a child reaches a height of 4 feet 9 inches and is between eight to twelve years old, they can safely transition to the vehicle’s regular seat, but should remain in the backseat until at least the age of thirteen years old.  Also note, the lap and shoulder seat belts should be fitted properly for the child’s best protection. This includes specifically crossing the child’s chest (not the neck) and his or her hips/thighs (not the stomach).

Where can I find additional help?

As with any aspect of childhood wellness, it is important to consult your Pediatrician or Family Physician first. They are most familiar with your family’s history, as well as your child’s overall health and medical needs. However, it is reassuring that more support is available to help navigate this critical issue. The individual manufacturer websites, the National Highway Traffic Safety Administration, and Safe Kids are all great resources to provide additional information. Likewise, JPMA is an excellent resource that lists specific product information.

As children grow and develop, their car safety needs change and it is necessary to remain aware of current recommendations. Also, please remember that children should never be left unattended in vehicles.  They are our most prized possessions and deserve safe journeys as they move throughout life.

Photo Courtesy of Unsplash

About the author: Mia Armstrong, MD is a Board-Certified Pediatrician and a fellow of the American Academy of Pediatrics.  According to her mother, she dreamed of becoming a Pediatrician since the age of three years old!  She accomplished her goal by receiving her Medical Degree from the Medical College of Georgia in Augusta, GA.  She completed her Pediatrics training in Jackson, MS at the University of Mississippi. Dr. Armstrong loves caring for children and teaching families how to be healthy! Though she enjoys working with children of all ages, she has a special interest in teaching new parents to care for their newborns and offering breastfeeding support as a Certified Lactation Counselor. Her other medical interests include asthma education, routine well care, and immunizations. She also enjoys traveling and exploring new cuisines and adventures. Dr. Armstrong loves to talk, never meets a stranger, and is excited to share her insight with parents everywhere through her blogs!


  • https://www.cdc.gov/motorvehiclesafety/child_passenger_safety/cps-factsheet.html#:~:text=Motor%20vehicle%20injuries%20are%20a,116%2C000%20were%20injured%20in%202017.
  • https://www.safekids.org/state-law-tracker
  • https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/How-long-should-my-child-ride-rear-facing.aspx
  • https://www.nhtsa.gov/equipment/car-seats-and-booster-seats#inspection-inspection
  • https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx
  • https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Seat-Belts-for-Older-Children-Adults.aspx

What to Tell Your Child When Their Superhero Dies

September 18, 2020 by  
Filed under Uncategorized

By Nina Washington, MD, MPH

On August 29, 2020, the world stood in shock upon learning of the death of celebrated and talented actor, Chadwick Boseman. Boseman, only 43 at the time of his death, succumbed after a 4-year battle with colon cancer – a battle he quietly fought while portraying iconic and historic figures on film. There is no doubt that his most iconic figure was The Black Panther, Marvel Comic Book’s only black superhero.

Image by Mohamed Hassan from Pixabay

Image by Mohamed Hassan from Pixabay

The news of Chadwick Boseman’s passing meant the King would now be laid to rest.

A few days after Boseman passed, a medical school friend of mine confided that she had not told her son of Boseman’s death. She also feared her son would learn of the Black Panther’s death from a friend or classmate. Without missing a beat, I responded, “That’s why YOU should tell him.”  In that moment, I realized Chadwick Boseman’s death may be many children’s first encounter with mortality.

So how do you tell your child their superhero died?

Be Honest

Children are so much smarter and resilient than what we give them credit for. They are skilled in picking up on context clues and body language. They are also great at eavesdropping and hear a lot of the “adult” conversations taking place around them. For these reasons, it is likely your child already has an inkling that something sad and tragic has occurred. This is your opportunity to tell them the truth. This is your opportunity to begin a discussion it takes many of us a lifetime to become comfortable with having. Talk about the beginning of life – that moment when we are born from the womb. Then gently, yet honestly, inform them that just as being born is natural, dying (or no longer living) is just as natural. This means that even though King T’Challa and the Black Panther’s body and mind are no longer with us, his movies, his spirit, and his memories always will be.

Don’t Refer to Death as Sleep

Many children know that sleep is followed by an awakening. They wake from sleep every morning. They wake from their afternoon nap. To refer to death as sleep implies that their superhero, their loved one, their friend, will soon awaken. Sadly, this is not the case and may lead to more confusion regarding death. Carefully inform your child that death is a permanent event. Depending on your family’s beliefs, this may also be a good time to begin the discussion of how death is understood and perceived by your faith or personal philosophy.

Answer Their Questions

If this is your child’s first experience with death, be prepared for a myriad of questions. Why did this happen? Will I die? Can I still watch *insert superhero’s* movies? Did he do something bad to cause him to die? These questions are reasonable and to be expected. Be honest with your child and answer each of their questions. Set aside a time when you are not rushed and there are no pressing or urgent tasks that require your attention. Be sure to consider your child’s age, maturity level, and temperament when answering their questions While the goal is to always be honest, the conversation should be tailored to their individual characteristics. This may necessitate multiple conversations. Using the Black Panther (i.e., Chadwick Boseman) as an example, this would be a wonderful opportunity to talk about illness – specifically, cancer.

Allow Them to Grieve

Children, like adults, will grieve differently. For some children grieving is wearing their superhero costume all day for the next week. For other children, grieving is watching the superhero’s movies on repeat. Grieving may also manifest as increased clinginess to parental units or family members. Even still, there may be bouts of crying, outbursts, or defiant behavior. Help your child process what they are feeling. Ask how they feel regarding the death of their superhero or loved one. What would make them feel better? Can any of their emotions be redirected? While grief is to be expected after death, there should be an understanding that healing must also occur. Help your child to grieve a little less with each passing day.


Conversations about death are never easy. However, we owe it to our children to have these difficult discussions. When doing so, being honest, answering questions, and allowing your child time to grieve will hopefully make this painful experience less so for you and your family.

Relax? In a Pandemic? What’s a Mom to Do?

August 29, 2020 by  
Filed under Uncategorized

By Nina Washington, MD, MPH 

As much as we all would like it to go away, it seems the Coronavirus pandemic, at least for the foreseeable future, is here to stay. When the pandemic was declared by the World Health Organization in March 2020 and the world subsequently came to a screeching halt, it was hard to imagine that 5 months later, we’d still be living a life of social distancing, face-mask wearing and incessant hand washing and sanitizing.  Yet, here we are.

Now, with schools re-opening in some states and charged discussions over home schooling versus virtual programming versus returning to brick and mortar buildings in others, it’s very likely that moms across the country are more stressed and overwhelmed than ever.

With so many decisions to make and the health of her children and household on the line, how is a mom to relax in perhaps the greatest pandemic in history?

I’m glad you asked. Here are 3 not so obvious activities that are sure to give you a moment of respite and reprieve in a time where everything seems to be turned upside down. 

Fend for Yourself Night! 

“I LOVE being asked ‘What’s for dinner?’“ said no mom anywhere on earth! In fact, this was the question my own mother most loathed! For any adult, deciding what’s for dinner can often be a self-ruminating, mind numbing task. Now imagine being asked that question every night! It’s enough to make any mother a little overwhelmed; and let’s be honest, slightly annoyed.

Enter, “Fend for Yourself Night”! A night where children “fend” for themselves when it comes to the age-old question of “What’s for dinner?” Now of course this doesn’t mean caution is thrown to the wind and children are left “begging for their supper.” Instead, age-appropriate children begin the valuable life skill of learning their way around the kitchen. Grade school children? Easy! PBJ’s, fruit, and air-popped popcorn! Teenagers? Even better! Breakfast for dinner! Scramble an egg, make toast in the toaster, and turkey bacon on the side! Toddlers? Sorry, mom they’re not capable of fending yet! 

Podcast, podcast! Take me away!

Whether for entertainment, self-help, pop culture round ups, or (sigh) more news, there is a podcast to suit your fancy! Ranging from 25 – 60 minutes, a podcast is a great way to escape from a world where so much is transpiring. Many podcasts have seasons and accompanying episodes which will allow you to regularly treat yourself to an escape. There’s no greater feeling of listening to and completing a podcast while you’ve washed the dishes, folded a basket of laundry, or heck, simply sat on your couch or in your favorite chair absorbing every single minute. Podcasts are equally indulgent because they are often listened to with headphones. Since no one else knows what you’re listening to, there are no spoilers from those who’ve already listened, no questions from those who haven’t listened to the previous episodes or can’t keep up with the current one, and no groans when you decide to rewind and listen to that juicy tidbit one more time. The podcast is your secret entertainment and your 30 to 60-minute opportunity to unwind.


Nope. That’s not a typo. Every now and then the best way to relax is to do absolutely NOTHING! Leave the clothes in the basket, the floors can be mopped later in the week (or better yet, have someone else mop them), and life won’t end if the bed goes unmade.

With work weeks blending into weekends, kitchens becoming home offices, and everyday tasks like going to the grocery store resembling preparing for battle, doing nothing is a great way to reset. Take a day to play in the back yard, have a movie marathon with homemade popcorn, eat cold pizza for breakfast and (remember “fend for yourself” night?) breakfast for dinner.

The world will not end. The weight from your shoulders will be lifted and you’ll be prepared to start all over again tomorrow.

Let’s face it. Moms are the superheroes of the home – especially during this difficult time. Relax. Take a load off. You need it and you’ll be better for it.

About the Author

Nina T Washington, MD, MPH is a double board-certified pediatrician and pediatric rheumatologist. In June 2019, after practicing in her home state of Mississippi for 6 years, she decided to take a sabbatical and travel the world. She’s traveled to over 11 countries and currently resides in Split, Croatia.

Disinfection Practices to Protect Our Children

August 27, 2020 by  
Filed under Uncategorized

With the rise of the Coronavirus pandemic (Covid-19), handwashing and wearing masks are on the forefront of everyone’s mind. We are all paying more attention to cleaning our homes and may have experienced the frustration of searching various stores for that elusive Lysol container. Now, more than ever, parents around the world are ramping up cleaning practices to ensure their homes are as healthy and safe as possible.  As parents, we know that young children are inquisitive and learn by touch, using their little hands to explore everything within reach.  Unfortunately, a child’s innocent touch may be exposing them to more than just new textures; they are in contact with harmful germs found on the object’s surface.  The National Institutes of Health published a research study citing that Coronavirus particles lived on plastic and stainless-steel surfaces for two to three days.1 Therefore, routine disinfection of household items and surfaces is necessary to prevent the spread of infection.

What is the difference between cleaning, sanitizing, and disinfecting?

Cleaning surfaces simply means physically removing visible dirt and debris, often with the use of regular soap and water.  While routine cleaning is recommended for many household surfaces, certain surfaces require a more thorough cleaning process that involves disinfection.  While sanitation decreases the number of germs on surfaces, true disinfection is the best method to prevent spreading harmful germs by physical contact. The process of disinfection is what truly kills viruses and bacteria on surfaces.  The United States Environmental Protection Agency (EPA) defines both sanitizers and disinfectants as antimicrobial pesticides.2 However, surface disinfectant products undergo more rigorous testing by the EPA, so they are the most effective products to use for deep cleaning.  According to the EPA website, there are no “sanitizer-only” products with approved antivirus claims. Therefore, sanitizers are not included in the EPA’s recommended list of disinfectants helpful for fighting against the Coronavirus.  This list that details the ingredients found in common disinfectants, such as: hydrogen peroxide, ethyl alcohol, isopropanol, and sodium hypochlorite (an ingredient found in Clorox).  In general, soap and water are good for cleaning hands, but stronger disinfectants are useful for surfaces.

What products are the safest and most effective to disinfect surfaces?

As the EPA reported, disinfectants are proven to be effective in killing harmful bacteria and viruses.  But, are these chemicals harmful for children?  There is quite a dilemma about what products are safest to use in the presence of children.  It is worth the reminder that all cleaning products, whichever you choose, should be stored out of reach of children, and adequate supervision while using these products is necessary.  Disinfectants can be harmful, even deadly, and caution must be used at all times. The American Academy of Pediatrics offers useful parenting advice regarding household cleaners on their website: HealthyChildren.org.3

For accidental ingestions or eye/skin exposure, contact Poison Control immediately: 1-800-222-1222.

For those concerned about the toxic effects of disinfectants, rinsing the cleaned items with plain water should help relieve these concerns. For the purposes of this article, natural disinfectants will not be discussed, and parents are encouraged to adequately research the effectiveness of whichever options they choose.  To assist in making this decision, please consult with your child’s Pediatrician or Family Physician.

What surfaces require disinfection?

  • Changing tables, Potty chairs, Diaper pails
  • Plastic toys in contact with the mouth, including pacifiers
  • Machine-washable toys
  • Cribs, cots, mats
  • Play-activity centers
  • Strollers
  • Car seats

What is the most effective process for disinfecting surfaces?

  • Read the manufacturer’s instructions for all products to see if specific disinfecting recommendations are mentioned. If not, contact customer service for the product. Manufacturer warranties may be impacted by certain cleaning methods or care processes.
  • Set a routine for disinfecting commonly used items at regular intervals.  A deep, thorough cleaning should be planned at least once weekly, and more frequently if your items have been exposed to an infected person or someone outside your home.  On other days, a quick swipe with a disinfecting wipe is helpful. The National Association for the Education of Young Children provides detailed guidelines regarding the frequency of cleaning, based on product type.
  • When cleaning for the first time, do a “patch test”, especially on cloth surfaces, to make sure the integrity of the fabric or material will not be affected by the product. During this test, a small amount of product is applied in a hidden area to see how the surface responds.
  • Rinse or wipe surfaces thoroughly using a clean cloth and plain water after cleaning to remove chemical residue.

While contact with germs is unavoidable, the health and safety of our children is most important.  Appropriately cleaning and caring for household items helps to maintain their quality and usefulness for years to come.  Most importantly, disinfecting the surfaces in contact with the littlest members of our families, ensures a bright and healthy future for them as well.


  • https://www.nih.gov/news-events/nih-research-matters/study-suggests-new-coronavirus-may-remain-surfaces-days#:~:text=It%20remained%20infectious%20for%20up,amount%20of%20virus%20deposited.
  • https://www.epa.gov/coronavirus/whats-difference-between-products-disinfect-sanitize-and-clean-surfaces
  • https://www.healthychildren.org/English/health-issues/conditions/prevention/Pages/Cleaners-Sanitizers-Disinfectants.aspx

Written By:

Mia Armstrong, MD

About the author: Mia Armstrong, MD is a Board-Certified Pediatrician and a fellow of the American Academy of Pediatrics.  According to her mother, she dreamed of becoming a Pediatrician since the age of three years old!  She accomplished her goal by receiving her Medical Degree from the Medical College of Georgia in Augusta, GA.  She completed her Pediatrics training in Jackson, MS at the University of Mississippi. Dr. Armstrong loves caring for children and teaching families how to be healthy! Though she enjoys working with children of all ages, she has a special interest in teaching new parents to care for their newborns and offering breastfeeding support as a Certified Lactation Counselor. Her other medical interests include asthma education, routine well care, and immunizations. She also enjoys traveling and exploring new cuisines and adventures. Dr. Armstrong loves to talk, never meets a stranger, and is excited to share her insight with parents everywhere through her blogs!

4 Tips to Help You Navigate the Challenges of Raising a Child with Complex Needs

July 21, 2020 by  
Filed under Uncategorized

According to the National Survey of Children With Special Health Care Needs, 12.8 percent of children have special needs in the USA. For the parents faced with raising a child with special needs, life and parenthood can look vastly different to that of their peers. The journey from learning your child has been diagnosed with a lifelong condition that may result in physical, emotional or learning difficulties is often filled with both highs and lows, and follows a path forged by love and determination. From medical appointments to educational choices and planning for your family’s financial future, parenting a child with complex needs can be a rollercoaster. However, by being better prepared, you can navigate the journey successfully and help your child thrive.

Educate Yourself On Your Child’s Condition – The Good, Bad And What’s To Come

If there is one thing that weighs heavily on the minds of parents of children with complex needs, it is the uncertainty. Educating yourself on your child’s conditions, treatments and help that is available does more than help you feel more in control; it gives you hope. For the financial aspects, resources like the Special Needs Planning Guide, along with the government’s benefits website, can provide useful information on grants, aid and financial assistance available. 

For medical treatment and information on the condition, head to individual organization websites, or speak to your child’s doctor. Both of them can easily provide information on available treatments, the future, and everything attached to it, including emerging medical treatments, educational options, and a special needs life planning checklist for families, including additional steps for certain medical conditions. For instance, a child with cerebral palsy will probably need assistance throughout their life, and a cerebral palsy life care plan will ensure that they are supported even after childhood.

Find Your Support Network – At Home And Beyond It

Having a support network is vital for a parent of a child with complex needs. It provides emotional support for both parent and child, and in some cases can be a useful route to discovering helpful resources. Along with a strong network of family and friends, look into emotional support groups for your child and their careers in the local community. If your child attends school, a local school or district group can help them find commonalities with children in similar circumstances. Finally, consider reaching out to larger non-profit disability support organizations like Reaching for the Stars, March of Dimes, and The Arc. These organizations and many more are great for relieving stress, expressing difficulties, and offering hope for families dealing with special needs.

Take Steps To Get Your Finances In Order

Over 54 million Americans face the rising costs of living with special needs, according to the National Organization of Disability. While the average cost of raising a child is pegged at just above $240,000, that cost rises substantially when you are the parent to a child with complex needs. One example: Autism Speaks estimates that the cost of raising a child with autism or intellectual disability to be between $1.4-$2.4 million. 

Find out what benefits and aid you are entitled to. Federally, programs like Social Security Disability Income and tax breaks can provide much needed financial relief on household expenditure and medical bills. To access information on the resources applicable to you and your child, the Benefits Finder questionnaire can provide quick and clear information on the aid available for parents of children with special needs. The financial planning does not stop there either. Make it a priority to implement a regular household budget along with automated savings dedicated to upcoming medical bills and educational costs. Finally, consider securing medical, income, and life insurance for yourself, your spouse and your child where applicable. 

Leave Time For Yourself

While it may seem like the majority of your time is spent caring for and helping your child to grow, it is also important that parents leave time for self-care. This can be incorporated into simple daily habits, as well – for instance, by waking up before your child to practice mindfulness or meditation for 20 minutes a day. Alternatively, you can rely on family for babysitting for a few hours and pursue a hobby of yours. It can even be as small as adopting healthier eating habits to support your physical and mental health. After all, you cannot pour from an empty cup.

Raising a child with complex needs can be challenging and filled with unplanned surprises. However, by thinking ahead and making use of the resources around you, it can be a much easier and smoother journey – one that is rewarding and filled with love.

Handwashing: Our Greatest Weapon against Covid-19

July 2, 2020 by  
Filed under Uncategorized

by Mia Armstrong, MD

WASH YOUR HANDS!!!”—the battle cry of parents everywhere!  Since the Coronavirus pandemic (COVID-19) was declared at the end of 2019, people around the globe have devoted more attention to handwashing.  While handwashing in and of itself is a simple act, it is important to know the key steps to EFFECTIVE handwashing.1 Successful handwashing skills diminish the risk of spreading germs to surfaces and other people.

Here are 4 steps that will ensure effective handwashing:

  1. First, thoroughly wet both hands. Surprisingly, this is the step that is most often omitted!
  2. Using soap, lather and then rub hands together for at least twenty (20) seconds. A fun and easy way to approximate 20 seconds is to sing the “Happy Birthday Song” or the “Alphabet Song” at a moderate speed.
  3. While washing, pay special attention to the backs of your hands, underneath your nails, around jewelry, and between the fingers.
  4. Finally, rinse hands and dry well with a clean towel.

But what about hand sanitizer?!? 

While effective in a pinch when soap and water are not available, several studies have proven that hand sanitizer is not as effective at eliminating germs; good old soap and water are the most effective.2 When hand sanitizer is the best option available, the Centers for Disease Control (CDC) recommend formulations with at least 60% ethanol or 70% isopropanol.3 In the presence of children, however, hand sanitizers pose a hazardous risk! If they are ingested, there is potential for physical harm. Ethanol and isopropanol are both alcohols, and the ingestion of large amounts of alcohol can affect the central nervous system (brain, spinal cord, and nerves). It can cause low blood sugar, loss of consciousness, and even death! While a taste or small amount of hand sanitizer may not be lethal,4 as people are buying larger amounts of hand sanitizer during the COVID-19 era, it may pose more of a risk to the children in your home.  The best way to limit this risk is to store containers of hand sanitizer out of reach and supervise well when children are around it and using it.  Hand sanitizer should be handled with care in much the same way as any other chemical or medication in your home.  It should be stored in a high location, out of reach from the littlest hands.  In the home, purses or diaper bags containing hand sanitizer should be placed in a secure location. When riding in a car, these bags should be closed and in the supervisor’s eyesight at all times.

In the event of an accidental (or intentional) ingestion, call POISON CONTROL immediately: 1-800-222-1222.5

In addition to the potential risk of hand sanitizer ingestion and poisoning, there have also been concerns of containers of hand sanitizer exploding when left in hot cars — a likely phenomenon that may occur more frequently as summer progresses and we experience higher temperatures.  Several pictures of car interiors with burn damage have gone viral (pun intended!) on social media.  While this occurrence has not been substantiated, there is significant evidence that hand sanitizer is combustible when ignited by an open flame.6 Therefore, hand sanitizer is not a completely benign substance.  Yet, we cannot ignore the benefits of its use in a situation when soap and water are not available.  So, with knowledge and extreme caution, this necessary evil can still be used for good…not only fighting off Coronavirus, but other “bad guy” germs that may cause illness and destruction!  So, a parent’s life would not be complete without imploring their children to “wash your hands!”  Ideally, handwashing would be with soap and water using the steps detailed above.  When that is not the case and hand sanitizer is the next best option, it is my hope that your hand sanitizer will both be used and stored safely.  Happy handwashing!


  1. https://kidshealth.org/en/parents/hand-washing.html
  2. https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html
  3. https://www.cdc.gov/coronavirus/2019-ncov/hcp/hand-hygiene.html
  4. https://www.poison.org/articles/2007-jun/hand-sanitizer-whats-the-real-story
  5. https://www.poison.org/
  6. https://www.cdc.gov/handhygiene/firesafety/index.html


About the Author

Mia Armstrong, MD is a Board-Certified Pediatrician and a fellow of the American Academy of Pediatrics.  According to her mother, she dreamed of becoming a Pediatrician since the age of three years old!  She accomplished her goal by receiving her Medical Degree from the Medical College of Georgia in Augusta, GA.  She completed her Pediatrics training in Jackson, MS at the University of Mississippi. Dr. Armstrong loves caring for children and teaching families how to be healthy! Though she enjoys working with children of all ages, she has a special interest in teaching new parents to care for their newborns and offering breastfeeding support as a Certified Lactation Counselor. Her other medical interests include asthma education, routine well care, and immunizations. She also enjoys traveling and exploring new cuisines and adventures. Dr. Armstrong loves to talk, never meets a stranger, and is excited to share her insight with parents everywhere through her blogs!


Be a Hero Too

June 5, 2020 by  
Filed under Uncategorized

By Samantha Rohe, MD

I was initially inspired to write a children’s book about Covid-19 by my son Henry. He is 3.5 years old and at the start of the pandemic he was constantly asking me questions. “Mommy why can’t I see the virus? Why can’t we go see Grandpa and Grandma? Is the zoo stillllll closed due to the germs?” In addition, I was stressed about all the changes myself and I could tell that he was sensing some of my anxiety. As a pediatrician, I talk to kids about all kinds of issues. However, addressing questions about a pandemic was new. If I was struggling to explain these concepts to my son, then many parents of my patients were likely going through the same thing. I decided to write a children’s book to help.

Writing my first draft didn’t take long. My children really love flowy lyrics, which is why I chose the rhyming style. I wanted it to be simple for them to understand, but yet have a positive message about how they play a part and can make a difference. Once I had a draft, my husband and I would read it out loud to one another and to our children. This helped me make any edits for words that resonated with our children better or to make a stanza flow better.

The biggest challenge I had was to find an illustrator. I asked a few friends that I knew did graphics work, but most of them could not commit to the short turnaround time we needed as they were still working full time. A friend from residency suggested reaching out to medical students as many of them wanted to provide services to patients during the pandemic, but were being sidelined due to trying to conserve PPE. Through a similar acquaintance at UNMC, I was introduced to Sophie Cemaj, a 2nd year medical student with a talent for what she calls doodling. She jumped on the project right away and started working on illustrations.

Sophie’s inspiration for the illustrations came from various friends, family, and favorite places. The cover and super hero of our book is inspired by her niece. The heroes on page 7 were inspired by her dad (a physician at UNMC), a good friend who is a nurse, and a friend who is a scientist. As we are both from Omaha, this gave her inspiration for the skyline and “Henry’s” (also my son’s name!)  Zoo on page 9. Throughout the book you can see Sophie’s fun personality come out through numerous hidden Easter eggs. Make sure to pay attention to the virus on page 1, the order of people on this page, and then how the virus gets transmitted throughout the book. Try to find the Nebraska inspired coffee mug, Napoleon virus, King Kong virus and various plays on some favorite childhood movies (Honey I Shrunk the kids, Lady and the Tramp, and Home Alone).

Once complete, we started sharing with family and friends. Our overall goal was to provide a resource for children and their families to open up the conversation about the coronavirus pandemic. We want our book to be a free resource for patients and families who otherwise might not be able to afford a book for their children. Most of all I want to emphasize to parents that there have been a lot of changes for families given the pandemic. Every child handles it differently. Some may brush it off and hardly notice, but many are much more observant and pick up on a lot more than you realize. They may have some fears and worries about our current world. The best way to know what these anxieties are is to talk with them. This book will help do just this. It helps start the conversation about what is going on.

Download and read the books here:

Be a Hero Too    Seě un Heěroe tuě Tambieěn

About Samantha Rohe, MD: I was born and raised in Newcastle, Nebraska and was always drawn to medicine. I attended Creighton University in Omaha, NE and while there it didn’t take long to know that being a Pediatrician was for me! I loved the resilience of kids, the ability to be silly while working, the constant changes day to day, and being able to work with the entire family. I attended residency at Saint Louis University/Cardinal Glennon Children’s Hospital in Saint Louis, Mo. It was here that I met one of my mentors, Aline Tanios, who is one of the Mommy MD Guides. She was a great mentor for me when trying to figure out being a working mom! After residency, I worked in Saint Louis until my husband finished medical school. During our time in Saint Louis we were blessed with 2 beautiful children, Henry age 3.5 years and Lilly age 1.5 years. When my husband graduated, we headed back to our home state for his residency, where I currently work as a general pediatrician for Children’s Physicians/UNMC.

How Can Moms Take Care of Themselves at This Time?

May 6, 2020 by  
Filed under Uncategorized

By Elizabeth Berger, MD

What I would like to highlight is the idea that the way the question is posed is itself a window into the problem women face. The problem is that all of us—men and women—accept without examination the idea that a woman’s fundamental function on earth is to take care of others. Anything a women does to “take care of herself” is an added extra—permitted, in small doses, but only to the degree that the job of taking care of others has already been fulfilled. We all accept this as part of reality, rather than a choice that society has made—a choice that an individual woman can go along with—either with joy, with ambivalence, with resignation, with panic, or on occasion perhaps with refusal. No one would pose the question, “How can Dads take care of themselves at this time?” That question is absurd! No one perceives Dad as torn between taking care of others and taking care of himself. This does not mean that Dads aren’t hardworking and self-sacrificing and often heroic. But it does suggest that Dads are seen as coherent human beings with a natural right to find a balance between work and play, between service to others and simple personal enjoyment. But Moms are always in conflict with themselves. They are “naturally” torn between taking care of others and finding an opportunity to take care of themselves. It is assumed that Dad already knows how to take care of himself and that Mom takes pretty good care of him too. That’s her job! But apparently no Mom knows how to take care of herself. She needs an expert to tell her and, importantly, to give her permission. She needs bullet points and advice that emphasize how Moms won’t be able to take care of others properly unless they somehow find a way to take care of themselves. For Moms to take care of themselves, it has to be twisted around so that taking care of yourself is actually an aspect of taking care of others!

Moms don’t “take care of themselves” because this is not how society works.

Moms can take care of themselves by becoming aware of why this is an issue, recognizing that “taking care of themselves” is defined as something that is OK for Mom to do once everyone else has been taken care of. It is defined as something to do with those left-over moments around the margins. It is defined in terms of the entitlement of all those who are not Mom to have Mom take care of them first—before she takes a long hot bath reading her favorite book with a pretty scented candle burning away the hours.

The problem is that a woman’s fundamental function as caretaker is built into society at every level and it is built into the brains of every man, woman, and child who lives in this society. It is not the fault of individual Dads who don’t feel obligated to wash and put away the laundry and the dirty dishes before they are entitled to collapse in front of the TV. No man thinks that way, of course—although every woman thinks this way.  It is not the fault of teenagers who count on Mom to keep it all running smoothly. It is not the fault of Moms who feel obligated to take care of the family’s needs before taking care of themselves. It is everyone’s fault because we all accept this system as if it were actually built into reality rather than a social problem.

The best thing that Mom can do, then, is to recognize that the tension between taking care of others and taking care of herself is not a problem caused by her personal neurotic martyrdom or her husband’s personal laziness or her children’s personal self-centeredness. The entire world participates in this tension. We are all in this jam. This is a social problem. Recognizing that this is a social problem means that fixing it is going to take resources that no individual Mom can summon.

Recognizing that we are all in this jam helps Moms take care of themselves. It explains why it is so hard to tear oneself away from taking care of everyone else and take care of yourself. It makes sense of the guilt over the clean laundry in the dryer and the resentment of Dads who are sitting there watching TV. That already feels better, right there.

About the author: Elizabeth Berger MD is a child psychiatrist, author of Raising Kids with Character  (http://elizabethbergermd.com/), mother of two, and grandmother of four.


The information on MommyMDGuides.com is not intended to replace the diagnosis, treatment, and services of a physician. Always consult your physician or child care expert if you have any questions concerning your family's health. For severe or life-threatening conditions, seek immediate medical attention.