It’s found in every steady hand And every brave pursuit.It’s the light that guides the way, A heart so bright and true.

The magic here at Cook Children’s Starts with mothers like you.

From all of us at Cook Children’s, #HappyMothersDay weekend! 

According to the study published this month in the journal Pediatrics, just half of mothers surveyed said they always put their babies to sleep on their backs.

The findings are alarming for physicians who say back-sleeping is a key way to reduce the risk of sudden infant death syndrome (SIDS).

“We see it all the time, and it is tragic,” said Corwin Warmink, M.D., medical director of the Emergency Department at Cook Children’s Medical Center. “SIDS is responsible for more infant deaths in the United States than anything else during the first year of life.”

While experts don’t know exactly why back-sleeping is best for preventing SIDS, it is believed that babies who sleep on their stomach get less oxygen and retain more carbon dioxide because they are “rebreathing” air. It is also possible that tummy-sleeping can lead to upper airway obstruction and choking.

“Infants should always sleep on their backs in a crib with a firm surface and a tight fitting sheet. No bumpers, pillows or soft bedding should be used,” mentioned Dr. Warmink.

Another big reason infants arrive in Cook Children’s Emergency Department is co-sleeping. While many parents find comfort in sharing a room with their baby, bed-sharing is never recommended.

“New parents are understandably exhausted, but even a quick nap with a newborn can turn deadly,” said Dr. Warmink. “It’s horrible to see a parent lose a child because they were accidently smothered in their sleep. Sharing a bedroom with an infant makes sense, but never on the same sleep surface.”

Dr. Warmink also insists infants should never sleep on a couch, sofa or cushioned chair, even when alone, and especially not with another person.

About Safe Sleep

Tarrant County has one of the highest infant mortality rates among Texas counties–exceeding the national average. The Center for Prevention of Child Maltreatment is guiding a safe infant sleep awareness campaign in collaboration with Baylor All Saints, JPS and Texas Health Harris Methodist. Learn more here.

I have moms in my office tell me all kinds of variations of the "I'm a bad mom statement" and it is always for minor things - still using a pacifier, let them have too much candy or still lay with them to help them sleep. I know a lot of this is looking for reassurance but I also think we do this to ward off mom-shaming. If I say it first then you can't shame me about it.

We live in a world where many small joys and achievements are shared online, but also in which we can see and judge each other's actions easily. This causes some of us to doubt our own ability and choices as mothers.

Maybe this doubt causes some of us to make other moms feel bad about choices that were not the same as ours. Maybe we want to shout loudly about the one thing we feel we are doing right and push away all the things we are doing wrong.

In either case shaming a mother is really a selfish act of making one person feel better at the expense of another - even when it is coated in words like "I'm just trying to help."

Moms often come to the end of a well child checkup and have one or two questions they feel they must ask to make someone else happy. Things like - "I'm not really worried, but my mom thinks hitting is not normal at this age" or "my friend says my child is not getting enough milk but I think it's OK, what do you think?"

One of things I love most about being a pediatrician is supporting parents to be the best parents they can be and affirming their skills and abilities.

Parents are showered with choices on how to feed, discipline and teach their children, and it feels like the "rules" or advice is always shifting. Thankfully for many things, there is no single perfect way to raise your child and anyone that tells you there is, is not thinking broadly enough.

Part of our job as pediatricians is to help you raise a healthy child. We will advise you on safety, health and what we have seen work, but we must also take into account different family styles that impact choices around feeding and sleep.

The "I breast fed for a year," "my 2 year old loves broccoli" and “my child slept through the night at 6 weeks of age" are all statements that are wonderful accomplishments of child rearing. But they can be also be used to shame other moms to feel bad about their own parenting.

I want to remind new moms, especially by the time your child is 10 no one will care about how you did any of these things. Your child will be wonderful because YOU are his or her parents.

And if you care enough to read this and ask your pediatrician questions then you are doing a great job already.

Unfortunately, stories of mothers harming their children have become far too prevalent in recent years. But there are often times hints a mom may abuse her child.

Joy Crabtree, Psy.D, a licensed psychologist for the Urgent Care and Pediatric Specialties Clinic in Southlake, said there are sometimes warning signs that a mom’s mental health is unstable or depression may be a concern including increased irritability, loss of patience, quick mood changes, excessive energy or extreme fatigue, and a sense of feeling hopeless or overwhelmed.

More serious warning signs, possibly of psychosis, include trouble distinguishing what is and isn’t real, a sense of extreme suspicion or paranoia, and even hearing voices or seeing things other people don’t see.

At times when psychosis or even an extreme depression is present, a woman can have irrational ideas about her baby — such as that the baby is possessed or that she has to hurt herself or her child. This condition can be extremely serious and disabling, and new mothers who are experiencing these symptoms need medical attention right away.

Women who have other psychiatric illnesses, such as bipolar disorder, major depression or schizoaffective disorder, may be at greater risk of developing postpartum mood symptoms. Any significant changes in behavior or bizarre beliefs require immediate medical attention and, often, a brief hospitalization. If you or someone you know is experiencing symptoms, don’t delay getting medical attention.

“The person who is in the midst of some type of mental health issue likely doesn’t know what is or isn’t reasonable,” Crabtree said. “Family members, friends, teachers, or other professionals in contact with parents need to step in if they feel a person needs help. A child should not be left alone with a parent in crisis. The care of the child then depends on other adults.”

According to the study, approximately 15 percent of 2-year-olds consume as much as 4 ounces of coffee daily. It’s a practice, health experts say, that comes with a dangerous dose of health risks.

The study followed 315 pairs of mothers and infants who were participating in an analysis of weight change during a child’s first week and its impact on body mass index at age 2. While examining diets, researchers found that 48 of the participating mothers were feeding their 2-year-olds coffee as part of their daily fluid intake.

Infants and toddlers of Hispanic mothers were more likely to drink coffee than those of non-Hispanic mothers, according to the study, but researchers did not examine further to determine why. Female infants were also found to be more likely to drink coffee than male infants.

Cultural practice may be one of the reasons some children drink coffee at younger ages, according to the study. In some countries, including Cambodia, Australia, and Ethiopia, children under 5 are given coffee.

“I think too much caffeine in childhood is a bad thing and worse in the case of a younger child,” said Joel Steelman, M.D., endocrinologist at Cook Children’s. “Coffee consumption by younger children is a big deal. I wouldn’t recommend parents start this practice. There are much healthier options. Caffeine could interfere with sleep – naps and bedtime. Overconsumption of caffeinated drinks could lead to symptoms of dizziness, headaches, mood changes and seizures.”

The U.S. Federal Drug Administration (FDA) has not provided guidelines on coffee consumption for children, but previous studies suggest there are potential negative health impacts, including Type 2 diabetes, depression, obesity and sleep disturbances. The American Academy of Pediatrics (AAP) recommends against the inclusion of caffeine in a growing child's diet.

Deborah Schutte, M.D., cardiologist and medical director of Cardiology at Cook Children’s, said her chief concern regarding toddler coffee consumption is the cardiovascular effect, particularly increased heart rate and high blood pressure.

“It boggles my mind why any parent would give a toddler caffeine. Toddlers are wired enough, why would anyone want to add to that?” Schutte asked. “My concern with caffeine and toddlers is more about tachycardia and arrhythmias. Caffeine can cause the heart to pump at an unnatural pace, resulting in palpitations.”

Schutte also points out that giving toddlers coffee could lead to dehydration, particularly since caffeine is a diuretic.

A 2013 study found that 2-year-olds who drank coffee or tea between meals or before bedtime were three times more likely to be obese in kindergarten.

“Just because there are no guidelines, doesn’t make it OK,” Schutte added. “What people don’t consider is that there is caffeine in drinks and food that we don’t always realize, such as chocolate and coffee- flavored ice cream, so caffeine levels can sneak up on you.”

According to the FDA, the average American adult consumes approximately 300 mg of caffeine each day - the equivalent to between two and four cups of coffee.

Canadian guidelines recommend no more than 45 mg of caffeine for children ages 4-6. This is equivalent to one 16 ounce can of soda.

If parents are already giving their toddler coffee, it’s possible to wean their child off the caffeinated beverage, Steelman said. He recommends parents talk to their pediatrician about a weaning off caffeine schedule.