Author Archives: Vrinda Kumar, M.D.

AAP New Safe Sleep Recommendations

Vrinda Kumar, M.D.

Vrinda Kumar, M.D.

Approximately 3,500 infants die each year in the United States from sleep-related infant deaths, including SIDS, deaths without a certain cause, and accidental choking/strangulation.

Just last week, the American Academy of Pediatrics (AAP) released new “safe sleep” recommendations to protect against SIDS (sudden infant death syndrome). These are the first updates to the recommendations since 2011. SIDS is an otherwise unexplained death of a child. The risk and incidence of SIDS is highest at 6 months of age and under, but can be seen in older infants and young toddlers as well.  Even though many SIDS deaths are often unexplainable and have no obvious cause, we do know that unsafe sleeping habits can contribute to SIDS.

The new recommendation still includes some of the older recommendations, including “back to sleep” (putting children to sleep on their backs), no co-sleeping, no soft bedding/bumpers/blankets/or other items in the bed. Babies should sleep on a firm mattress made for infants/toddlers.)
Sleeping baby

However, the recent recommendations to decrease the risk of SIDS in children also include:

  • Share a bedroom with parents, but not the same sleeping surface, preferably until the child turns 1, but at least for the first 6 months. Room sharing decreased the risk of SIDS by as much as 50 percent.
  • Fully vaccinate child according to CDC guidelines.

The older recommendations have not changed and still apply:

  • Avoid baby’s exposure to smoke, alcohol, and illicit drugs
  • Back to sleep
  • Use a firm sleep surface
  • Breastfeeding is recommended
  • Keep soft bedding and loose bedding away from sleep area
  • Consider offering a pacifier at nap time and bedtime
  • Avoid head covering and overheating
  • Avoid positioners and wedges (and choking hazards like teething necklaces!)
  • Do not use home cardio respiratory monitoring devices as a strategy to prevent SIDS. They have not been shown to decrease risk of SIDS.
  • There is no evidence that swaddling decreased risk of SIDS.

It is important to understand that some deaths are not preventable, even if all the above guidelines are followed. However, following these decreases the chances of a SIDS death and should be followed, despite media and commercial advertisements which may potentially promote other environments which are not consistent with AAP recommendations.

Learn more about safe sleep at


Flaming Hot No-No’s!

Crunchy junk foods have always been tempting “treats” among young and old alike, and let’s be honest…we all indulge every now and then even though we know that these processed, fried, crunchy snacks are terrible for us. Over the past few years, however, there has been an evolution of this genre of foods that now […]

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Eczema 101: Do You Have the Itch?

Eczema is a general term used to describe an inflammation of the skin with can cause itching, oozing, weeping, crusting or scaling. Even though there are several different kinds of eczema, in a pediatrician’s office, you will often hear the terms “eczema” and “atopic dermatitis” used interchangeably. The symptoms of eczema are caused by a […]

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Tis the Season for Flu

It’s flu season!  That means runny noses, body aches, fevers/chills, cough for seven to 10 days…ick!  Lucky for you, influenza shots are now available so you can be armed and ready for the next few months.  A lot of people wonder whether or not they should get the flu shot.  Well, let me share some statistics with […]

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Vrinda Kumar, M.D.

Vrinda Kumar, M.D.

Teething: Can you handle the tooth?

The teething process generally begins between four to eight months of age.  Some babies will start earlier, and some babies won’t get their first tooth until after a year old. Usually (but not always), the two bottom middle teeth come first, then the two upper middle teeth, then the teeth to the side of those, and then finally the teeth in the back. By the age of two, most kids will have all 20 of their baby teeth!

It is normal for the teeth to not come in straight, and it is normal for those first few teeth to have wide gaps in between them.  Don’t worry!  They usually straighten themselves out as the other teeth start coming in.

Symptoms of teething:

  • drooling
  • gum swelling/redness
  • fussiness
  • difficulty sleeping
  • solid food aversion
  • biting and chewing everything in sight!

Some babies may also have:

  • low grade fevers (<101 degrees F)
  • loose stools (they can be green and slimy from all that extra drool making its way through the gut)
  • diaper rash (from all those loose stools)
  • ear pain (it is normal for teething babies to pull on their ears because in babies, tooth pain is felt in the ears)

If your child has high fevers >101 F, signs of dehydration (not a lot of wet diapers, not a lot of drooling, no tears when crying), or other symptoms that are persistent, you should call your doctor.

Things you can try to help your teething baby deal with the pain:

  • give your child something clean and safe to chew on (firm teething toys or a cold clean washcloth, for example)
  • try giving your baby cold foods if he/she is eating solidsteething
  • Orajel naturals (The active ingredient Benzocaine in regular Orajel has some rare but serious side effects: the benzocaine, if swallowed, can numb a child’s airway cause them to potentially choke on their saliva, and it can also affect the hemoglobin in your child’s red blood cells, a condition called methemoglobinemia)
  • teething tablets and teething gels are available, and are generally safe if used as directed
  • for those nights where nothing else seems to help, an occasional dose of Tylenol

Teething necklaces with amber beads are available as alternative to medication. Even though some parents say they work, it makes me very nervous to have a choking hazard hanging around a child’s neck, and I do not generally recommend it.

I hope this helps. And remember your child won’t teethe forever, so hang in there!