Popular rocking sleepers have been in the news lately for all the wrong reasons. 

Last week, Kids2 recalled all of its rocking sleeping models after reports that say five children have died in its sleeper since they were introduced in March 2012. 

Approximately 700,000 products were sold at major retailers including Walmart and Target. The brand names of the sleepers included Disey Baby, Bright Starts and Ingenuity.

Earlier in the month, Fischer-Price chose to recall its Rock ‘n Play Sleeper after 32 infant deaths associated with the product. Fisher-Price chose to recall approximately 4.7 million of the units on April 12, following a report from the U.S. Consumer Product Safety Commission (CPSC).

Less than two weeks later, two class action lawsuits have been filed against Fischer-Price and its parent company Mattel.

While there were claims that the deaths were only associated with the unsafe use of the device, the CPSC stated the deaths occurred “after the infants rolled from their back to their stomach or side while unrestrained, or under other circumstances.”

“And our concern doesn't stop with only the Rock 'n Play or the Kids2 products,” said Justin Smith, M.D., medical advisor of Digital Health at Cook Children’s. “Other sleep aid devices such as hammocks, nests and wedges also can put babies at risk for both suffocation (where a baby turns into a soft surface and rebreathes their own breath) and positional asphyxiation (where a baby's airway is squeezed off by flexion at the neck).”

“It's clear that the safest position in which a baby should sleep is on their back, on their own in a boring, flat surface.”

So what do you do with a baby that never slept well anywhere else? We talked to Dr. Smith and Diane Arnaout, M.D., a Cook Children’s Pediatrician at Forest Park to get some ideas.

Dr. Smith: First of all, we want to say that we know the idea of making this transition away from a sleep device or the idea of having another baby without one (when your first baby only slept in one) is scary and overwhelming.

We hear you.

And, believe me, if we could recommend something magical that would help your baby sleep, we would tell you all about it. No one needs to sleep more than pediatricians, especially pediatricians who are parents.

Here are some tips that might help you survive with a baby who is a poor sleeper:

Give your baby their best chance to sleep by maximizing their environment.

Dr. Arnaout: Try to mimic the womb environment. What happened in the uterus? It was a dark, warm, noisy place. A baby is looking for that same type of environment outside of the womb.

Some adjustments that you can make that might help:

• Use a sleep sack that is snug but not tight (if you choose to swaddle make sure that you are stopping after two months)

• Turn on a sound machine to provide some white noise-this mimics the sounds of the blood vessels in mom's tummy.

• Allow your baby to use a pacifier once breastfeeding is established - not only does it help with sleep, it's also protective for SIDS.

• Help your baby go down to sleep drowsy but not asleep, this will help them make those transitions at night when they enter lighter sleep stages.

• Practice, practice, practice - use your sleep routine (or at least an abbreviated version) with every sleep, this helps your baby understand when it's time to go down.

Remember the bottom line is that babies should be sleeping alone in their own crib, staring on their back, with no blankets or pillows.

Dr. Arnaout: "I know this seems out of the blue and unrelated, but - It’s really important to make sure your baby is getting "full feeds". This doesn’t mean any particular number of ounces or minutes of nursing - this just means discouraging “snacking”. I tell parents daily that babies who snack all day are gonna snack all night. Babies who are encouraged to empty both breasts, or fill up on as many ounces as possible during a bottle feed, are able to go longer between feeds and are able to fast for longer periods at night."

We know that the transition out of the Rock N Play is going to be brutal. But you were going to have to make that transition at some point, this probably just accelerated the timeline (or kept you from having to make one at all). So, expect some rough nights and do your best to prepare.

Seek help when you need it. It's more than OK. It's necessary.

Dr. Smith: It's particularly hard to shoulder this burden of poor sleep when you feel like you're on an island. And I know there are parents out there who struggle to get help. But this is a situation where a tired baby, makes for a tired parent and a tired parent doesn't have the same patience to work with a fussy baby to help them through this transition.

I know that sometimes partners need to go to work the next day and feel like they can't work on shortened sleep. But, keep in mind, that staying home and parenting after no sleep is no walk in the park either. Find creative ways to share the burden. It's amazing what one good night of sleep will do to prepare you for a few difficult nights.

If both parents are working and your baby isn't sleeping well, seek out friends or family who might be willing to take a night or even just a few hours for you. Friends and family, when you hear that mom and dad are struggling to get sleep...don't ask what you can do to help, ask what night they want you to come over.

Dr. Arnaout: I think one of the hardest things for me to realize with my first baby was that we were gonna have good nights and bad nights, and one day…I’d sleep full nights again.

Dr. Smith: I think it’s important for parents to know that safe sleep is accessible for all babies. What doesn’t work one night may work the next, as the child grows and develops. And kids’ sleep is phasic - you’re gonna have weeks where they rock it, and nights when you’re totally questioning your life decisions.

Recognize your exhaustion as temporary! It will get better!

The more weight your baby puts on and the more self-calming mechanisms they develop as they grow will both help you climb out of the early infant months well-rested and feeling confident your child is safe while they sleep! And as always - if you need help - ask your pediatrician! We are honored to be a part of your “village” and have helped thousands of families during this trying time.

We know that this topic is one that inspires a lot of passion. No one wants to make a family feel guilty who has used the Rock n’ Play in the past or who are currently struggling with what to do. But, the reality is, that new information is almost always a good thing. And this information says that these devices are not safe. While we'd love to compromise, we can't advocate for using a device that causes infant death, especially when used as directed.

What about babies with reflux?

Dr. Arnaout: "One morning, I woke up to find that my first baby, who experienced pretty bad reflux, had barfed all over the place sometime in the night. It was everywhere - in his hair, his ears, and soaked into his sheet and sleep sack. I felt horribly guilty for not hearing it or being there to help - even though I was laying in bed right next to his bassinette. I was an exhausted mom, and looking back, I needed to forgive myself. I was worried that morning - what if he had choked? Aspirated? But then I remembered all the protective reflexes babies have to protect their lungs - namely, gagging and coughing - that gets it all out, and allows them to breathe again.

There is some thought that tucking a blanket or wedge under the mattress to elevate the baby might help, but lately, research has proven that elevation may not really help: "The supine sleep position does not increase the risk of choking and aspiration in infants, even those with gastroesophageal reflux, because infants have airway anatomy and mechanisms that protect against aspiration.”

What do you think about baby monitors?

Dr. Arnaout: I think monitors are both helpful and not helpful. The AAP says babies are most safe in the parents’ room in the first year, in their own sleep space (crib). But my kids were noisy little people - and I am a light sleeper who would jump up at every single noise. I’ve eventually used monitors with both of my kids when I moved them to their own room and depended on them to let me know when my baby wasn’t feeling well or was hungry. But I always turned the volume on low, and it only alerted me if the baby was yelling pretty loud. I did this because all babies make noises while they sleep: snort, sigh, cough. Refluxy kiddos are honky and loud sometimes when they sleep because the tummy acid juices and milk sometimes irritate the back of the nose as it goes up and down.

October is Health Literacy Awareness Month. What is health literacy?

Health literacy is being able to find, understand, and use health-related information to make good health care decisions for you and your family.

We get health information from doctors and nurses, medical websites or apps, and even conversations with family and friends.

Some of it can be written or spoken in a way that is confusing. What can you do if you don’t understand?

Take charge! And take this pledge with me:

I, Dr. Smith, pledge to help with my patients with health literacy by:

1.Listening to my family’s story fully before jumping in to ask questions or provide information.

2.Speaking in normal language, not doctor speak and taking extra time for confusing or difficult topics.

3.Researching and sharing good medical websites and apps with families.

I, (insert name here), pledge to help my doctor with health literacy by:

1.Preparing the story of my child’s illness or making sure the person who brings the child in has all the information.

2.Asking my doctor to explain words or terms that I don't understand.

3.Reading information from credible sources and bringing that information to visits for discussion.

Asthma is a big problem across the country with about 25 percent of children age 9 diagnosed. Children ages 6-9 are three times more likely to have asthma than others in the state of Texas.

Fortunately, most of those cases are mild and require only rare treatments with albuterol inhalers. However, some of those cases can be severe and can result in significant issues for families.

The social complications of asthma are costly:

1. Missed school for doctor visits, emergency room and hospital stays.
2. Missed work for families.
3. Decreased activity level resulting in other poor health outcomes.

There are times where these complications might be unavoidable. But these should be very, very rare cases.

I don’t believe that any general pediatrician should use physical activity restriction as a means to manage a child’s asthma.

Why? Most cases of asthma can be managed by the pediatrician and involve the following treatments:

Avoid Triggers

Allergies - If the child has allergies, make sure that he or she is on adequate treatment using a step approach to include antihistamines up to nasal steroid sprays.

Viral infections -Train your children to wash their hands frequently especially during winter months. Get your child a flu shot every year.

Stop smoking - If you are smoking, you do not get to tell your child that they cannot participate in sports. It’s hard to quit smoking, but it’s harder to be a child who wants to do an activity but can’t because their parent’s smoking makes their asthma too severe.

Develop a Treatment Plan

Treatment plans for asthma are called “asthma action plans.” Children with have asthma need one.

Treatment for asthma generally starts with albuterol on an as needed basis. This might be the case in a child who has rare symptoms or who only wheezes once or twice a year when they get a bad cold.

Treatment for asthma should include some type of daily medication for control if either of the following is present:

• Symptoms more than twice a week or a limitation in activities due to asthma
• Symptoms at night more than twice a month (waking up coughing or with difficulty breathing).

Refer to a pulmonologist

If you and your general pediatrician cannot seem to get a handle on your child’s asthma, request a referral to a pulmonologist or allergist before telling your child that he or she cannot participate in physical activity.

Here are a few guidelines based on current asthma severity that might help when you are managing asthma and physical activity:

• Children with well-controlled asthma who are symptom free should not be restricted in any way. They don’t get to run less or skip out if they are feeling well.

• Children who are having mild symptoms (cough from an upper respiratory infection) may need to be modified but sometimes do not need to be completely sedentary. (They can walk around the gym if everyone else is running.)

• Children with moderate to severe symptoms should be receiving medical care by the school nurse or their pediatrician. Asthma can be serious, even deadly so don’t wait to call if you are concerned.

Children with asthma can and should participate in physical activity. I do not believe that they should be restricted based on the recommendation of a general pediatrician alone.

Everything should be done to allow them to play first: avoiding triggers, treating aggressively, even to seeing a pulmonologist.

For more information about what is being done in our area to help prevent and treat asthma, check out the report from The Center for Children’s Health’s Asthma Think Tank-Childhood Asthma: A Guide to Action.

Even highly competitive and high intensity training can be healthy, but can it become unhealthy?

One of the dangers of intense training can be a lack of food intake to keep up with the demands of the sport. Have you seen the pictures of food in front of Olympic swimmers? They often eat up to 10,000 calories per day. Yet, our young teenage athletes, in an attempt to manage their weight or achieve a particular body image sometimes cut calories to levels even below their less active peers.

This is when their health could be in danger.

Certain sports may put athletes at higher risk to engaging in unhealthy behaviors. Think about those where body image plays a large role such as dance or gymnastics. Those competing in sports that classify participants based on weight class can also be at risk. Even participants in sports that don’t fall into these categories can have pressure put on them to “lose a few pounds” in order to improve.

These problems can arise in boys and girls, but girls can have particular health consequences that need to be considered.

What is the female athlete triad?

• Energy deficiency (not eating enough food)
• Loss of periods
• Low bone mass (osteoporosis)

Energy deficiency -This can be the result of simply not consuming enough food or it can be a conscious method to decrease calorie intake for weight loss. In more severe cases it can be the results of an abnormal body image or an eating disorder.

Loss of periods -The calorie deficiency can lead to decreased production of hormones that help periods to be regular. This can lead to missed periods or for periods to stop altogether. Missed periods are often the symptom that brings attention to the overall problem. Because of this, I recommend you check in with your athletes intermittently about their periods. Despite the weird and embarrassed look on faces (it translates, “Mom, can you believe he’s asking this?”), I ask at every check-up.

Low bone mass - Decreased hormones and intake of calcium can lead to thinning of the bones. When severe, this can cause stress fractures, which are fractures that occur with very little or no trauma. In addition, girls are supposed to building up bone density in this time frame and the long term implications of not doing so could have severe consequences.

What can you do?

Pay attention to your athletes and their eating habits.

If you see any of the following, set up a visit with your pediatrician to address your concerns:

1. Weight loss or disorder eating habits.
2. Irregular periods or no periods.
3. Injuries from mild activity or that tend to linger.

Together you and your pediatrician can gather a team around your athlete to ensure their health for now and into the future.

Some potential members of the team could include a:

1. Pediatrician
2. Dietician
3. Counselor
4. Coach or trainer

A recent study done in the adult oncology world and published in JAMA, found that doctors had a perception that patients were demanding extra treatment and testing. Review of the patient encounters showed that doctors perceived demands that did not actually occur. Many of the requests that did occur were medically appropriate.

In pediatrics, the most common issue where this comes to a head is the desire to give children antibiotics. It can also play out in other areas as well. Another common one that comes to mind is request for further testing for diagnosis.

Fortunately, in my experience, parents are becoming more informed about what situations require antibiotics and which illnesses will pass with a little time and TLC.

The problem is that many doctors have gotten into the unfortunate habit of wanting to provide what the parents are requesting without actually asking the parent what they expect. Doctors may perceive that parents want antibiotics or further testing when, in fact, they simply want reassurance that waiting is OK. This becomes a particular problem in urgent care or retail clinics where patient satisfaction plays a bigger role in getting patients to come back and see you.

So, how can you prevent this from happening to you?

Here are five casual statements that you might use the next time you visit the doctor to help them understand your expectations:

1. I’m pretty sure I’m just over concerned. I just wanted you to check things out so I can be sure.

2. I don’t really like to give my kids medicine but I wanted your opinion about what we should do next.

3. I’m totally OK with waiting, if that’s what you think is best.

4. What would you do if it were your child?

5. Are there other things we can try first or other options?

Your doctor should not feel threatened by these statements. If antibiotics are the only right choice, they should be able to explain the reasons why that is.

Flu Myth #1

The flu shot can give you the flu.

Nope. Not true.

http://www.usatoday.com/story/news/health/2013/01/14/can-flu-vaccine-cause-the-flu/1833793/

Flu Myth #2

The only time I got the flu was the year I got the flu shot.

This may be true, but it’s completely coincidental. There’s no mechanism where the shot would make you more susceptible to getting the flu.

Flu Myth #3

The flu is annoying, but harmless.

This is true for many children, but we should watch for dehydration and difficulty breathing. Kids with asthma and other chronic medical conditions should be monitored closely.

Flu Myth #4

I had the “stomach flu.”

If you had vomiting and diarrhea only, you probably had another virus. Flu symptoms are fever, cough, congestion and body aches but rarely stomach problems.

Flu Myth #5

Because the flu shot is only covering 2 strains, you should skip it.

Getting coverage for 2 strains is better than 0.

http://www.checkupnewsroom.com/does-my-child-still-need-a-flu-shot/

Flu Myth #6

Over the counter cough and cold medicines help kids with the flu.

Cough and cold medicines do not work very well for anyone and can be harmful in kids. Just skip them. Run a humidifier and if over one year, give them some honey at bedtime.

Flu Myth #7

If you suspect your child has the flu, they need to see the doctor right away.

If they are drinking OK and staying hydrated, home care can be appropriate. Certainly call your doctor before going to the emergency room unless they have symptoms other than fever, cough and congestion.

http://www.checkupnewsroom.com/more-flu-longer-waits-in-the-ed/

Flu Myth #8

Every child who has the flu needs Tamiflu.

If your child is healthy (no asthma), the benefits of Tamiflu are minimal if anything, it is expensive and there are possible side effects. Consider these factors when and have a conversation with your doctor.

About the author

 is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.

“Mrs. Jones wants to talk with you about something before you go in the room with Jimmy, want me to grab her?”

I overhear this conversation regularly between parents and nurses in my offices. Usually it leads to a long discussion between the parent and me. We discuss the pros and cons of a drug test, including the implications of a positive or negative test. It’s a conversation I would like to have with you who are reading this today.

Here are some signs that your teenager might be using drugs from the article Early Detection of Illicit Drug Use in Teenagers from the Innovations in Neuroscience:

• Change in behavior or mannerisms
• Change of friends/social circle
• Prefer to be alone
• Skip family time-daily family dinner or bigger events
• Impaired sense of judgment
• Sudden, unexplained drop in grades

On May 26, 2014, the American Academy of Pediatrics (AAP) released a statement against the involuntary drug testing of adolescents. I’m not sure how the rest of my fellow conservative Texas pediatricians will feel about this statement (they don’t always agree with the AAP on certain things), but I have to admit that I applaud this statement.  It's how I've addressed this issue since I started practicing and here's why.

There are a couple of instances where getting a drug test (even if it is not consented to) are critical:

1. A teenager who is not acting normal or having other symptoms that could be related to drug intoxication (seizures, abnormal heart rhythms). In these situations knowing what the adolescent has taken is critical in choosing the correct treatment plan.
2. A teenager has shown a change in behavior over time that could be consistent with drug use. This should only be done after careful conversation with and without the parents to see if the patient will admit to using in those contexts.

Some other situations where drug screens are commonly requested, but caution should be used:

1. Juvenile delinquency - We want to know if our adolescents are doing drugs but I'm not a prosecutor and it's not my job to report them should I get a positive screen. Thus, I need to have clear documentation of who is requesting the drug test and why before I'll do a drug test that I'm not requesting because of a clinical need.
2. Foster care - Again, I'm not in the prosecution business so if CPS wants a drug test because there were drugs in the house where a child lived, etc., I like to see who is requesting the test and why.
3. School requests or general screening - If there has been a history of drug use and the school is requiring for re-entry, I understand. Of course, if your child is balking at random drug screening, then there's probably a conversation that needs to happen anyway.
4. Just because - I actually get this request from parents more often than you'd think. This is the primary reason I thought commenting on this AAP statement was important.

4 Reasons Why "Random" Drug Testing for Your Teenager Could be a Bad Idea

Again, this is not to say that you should fight the school district if they are requesting for athletic participation or for other reasons. I am talking about going into your doctor’s office and requesting a drug test.

1. Trust - A request for a drug test commonly comes in the form of a little note handed to my staff or a hallway conversation outside of the context of the visit. In those cases, it seems that the parent is requesting that I check the urine for drugs without the child knowing. This sets up a scenario where we have violated the trust of your teenager on multiple fronts. What if the test is positive? How do you handle that information? "Son, remember that urine sample that you gave at the doctor’s office, that wasn't actually for a kidney test and, by the way, why are you smoking dope?"
2. False positives - This is rare, but can happen and imagine the headaches that it causes. Families end up chasing an unnecessary rabbit trail of therapies and other interventions because a test is imperfect.
3. False negatives - Even if a child shows all the above symptoms of drug use and everyone is sure they are using, sometimes the tests come back negative. Now the adolescent has a free pass (at least for a while) because they can refer back to their negative test for months when you are "bugging" them about their behavior.
4. Cheating the test - If a child is resourceful enough to get drugs and hide their use from you, they can probably find a way to cheat a drug test. This again provides a false sense of security to the parent and a free pass for the teenager for a while.

This video about the #WorldsToughestJob went viral last week.  If you haven't watched it yet, please do, it is worth your time.

In thinking about this video, I thought of #AnotherToughJob that I thought I would write a job description for:

• Able to deal with people when they are at the end of their stress level, operating on very little sleep and have been waiting to see you or talk with you for hours.
• Able to deal with a boss who has a strong personality and convince them to complete tasks (i.e. filling out forms) when they would rather be doing something else (i.e. playing golf).
• Able to let said boss take all the credit when something goes right but force you to be the bad guy day after day.
• Able to deal with very messy situations - no exemption from poop, pee or puke exposure.
• Able to skip lunch or go without a potty break for hours should "special circumstances" arise (like most days).
• Able to deal with very sad situations and be a person of support even when you feel very sad yourself.

It's not all bad though...

Perks include:

• Dealing with the coolest people in the world-our patients and their parents.
• Watching a child grow to be a young adult (and eventually a parent themselves).
• Watching children who are sick return to health.
• Working with other great people who love children as much as you do.

So, say a special "Thank You" to all of our amazing nurses at Cook Children's.  

From our primary care offices to inpatient to specialty to home health, we have some of the best nurses in the country!

Leave comments for your favorite nurses and we'll pass the message along!

When deciding about starting a medication as a breastfeeding mother, here are some questions that need to be considered:

1. Has the medication been studied in humans or other mammals?

2. How important is the medication to the mother?  For example, what would happen if the mother did not take the medicine?

Clearly if something is well studied, safe and very important for mom, go for it. If something has been shown to be unsafe and not important, then skip it. In my mind, everything I see is a gray area. If you are not impressed with the helpfulness of this “brilliant” analysis, here are some resources you can use:

1. Your pediatrician or obstetrician. I don’t memorize all the possible drugs, but I do know where to look them up.
2. Infant Risk -Dr. Hale from Texas Tech is one of the national leaders in medication use during pregnancy and while breastfeeding.
3. LactMed –The National Library of Medicine’s Drug and Lactation Database

A Special Consideration: Anti-Depressant and Anti-Anxiety Medications

Because of the relatively small number of breastfeeding mothers on anti-depressants, they are still mostly unstudied. Many have been found to enter the bloodstream at less than 2 percent of the dose (adjusted for the babies weight), but some do reach higher levels (near 10 percent).

Here are some of the ones that enter at higher levels:

• Buproprion
• Fluoxetine
• Lithium
• Venlafaxine
• Diazepam
• Citalopram
• Lamotrigine

Even though we know this, we still don’t know the effects of the medication on the baby is in many ways. The AAP statement highlights the fact that these medications tend to have a build up over time. It is important to note also that baby’s kidneys and liver function (the primary way the we get rid of medications) are not fully mature. Because of this, I evaluate each mother/baby combination by these 3 criteria:

• Benefits of breastfeeding
• Risk of the medication
• Risks of mom’s depression on the child

In summary, I believe we should use caution with all medications with breastfeeding mothers.  If you are breastfeeding, please consult with your pediatrician or obstetrician prior to taking any medication.

Just in time, a new study released online in Pediatrics (the journal of the AAP) describes the risk of depression in fathers of young children (0-5). They started following males in adolescence and followed them for 23 years using a depression scale to document their level of depression.

The scales asked some fairly pointed questions regarding depression. Here are some examples:

• Were you were bothered by things that do not usually bother you?
• Did you feel depressed?
• Did you feel you were too tired to do things?
• Did you not enjoy life?
• Did you feel that people disliked you?

I found the results very interesting:

During the first 5 years of their child’s lives, fathers showed a 68 percent increase in depressive symptoms.

Does this surprise you or not?

While the study did not specifically describe the rate of depression in the immediate period after the baby was born, I would suspect that many of these depressive symptoms began to emerge during that time.  I have done this new parenting thing a few times (3 times in 5 years).  Having a new baby in the house is incredibly exciting and brings so much unspeakable joy. However, that joy comes with many changes.

I never felt that my symptoms rose to the level of depression but there were, at times, feelings of sadness and loss. Let’s walk through some of the reasons and some potential solutions.
 

Loss of routine
I am a man of routine and consistency.I like waking up, having a cup of coffee, reading and getting ready to go to work. Staying home with my wife for a week after our babies were born was very important to me but I did start to miss my routine.

Try to keep some semblance of your normal routine if possible. Remember that your sleep at night will likely be broken up (I was always the water boy for my breastfeeding wife and the post-feed burper and rocker) so you might want to get to bed earlier than normal so you can keep your morning routine in some form or fashion.

Loss of autonomy
When you got married you might have realized that your decisions were no longer just about yourself anymore. For me, having a baby is that feeling, on steroids. You suddenly feel guilty for wanting to do anything for yourself anymore as if in some way you will miss something or will be needed and not be there.

It sounds like a line from a self-help book, but remember that in order to be a good provider, you have to take care of yourself to some degree first. Find some time to do something by and for yourself at least every few days. For you, that might look like going for a run or going to read a book at Starbucks. But, whatever it is, take a little time for yourself.

Loss of intimacy
Yes, I do mean in the physical way (those OBs and their rules - seriously follow those rules). But, it’s much more than that. All of the sudden, you realize that those deep conversations you had with your wife (that you might not have thought were important) are less frequent. You are both tired and have a singular focus that tends to dominate your conversations (When was the last feed? Did I start on the left or right side last time? Is this yellow, runny stool normal?)

Try to find the time and energy to start one deep conversation per day. One great conversation starter in this time period can be: “How are you doing with all of this?” Don’t settle for, “Fine.” Ask deeper questions. Then, after you’ve taken the time to hear mom out, you’ll probably get a chance to share some things yourself. You’ll be glad you did.

The overlying concern for these feelings is that you might begin to feel guilty about having them. You know in your brain that this time is supposed to be one of the happiest times of your life. This tension is common and normal. It might be helpful to seek out other fathers whose advice you feel you can trust to talk through it. They may have more specific advice that will work better for you. The important thing is to resist the urge to tough it out and do it on your own.

Ultimately, you may feel that you are passing over from feeling a little down to actually feeling depressed.  If you have concerns about this, it’s best to seek out professional help from your doctor or a counselor.