Potty Training

What’s going on with COVID19?

I know it’s hard to figure out what the right thing is to do when considering the soon-to-be school year, especially considering days in a row of triple-digit COVID infection numbers. It’s scary.I wanted to review the most recent data for you to stay up to date with what this so-far unpredictable virus has been doing. Thankfully, most recent data still reflect trends from my last email on this topic:

• Kids 12yo and younger don’t transmit this virus well. We think it’s because kids have less of the specific receptors in their respiratory tract that COVID19 uses to enter cells of the body.
• Kids up to age 18yo have a much lower viral load compared with adults, probably also because of less receptors, which might explain why they’re less contagious and don’t get as sick. Pediatric transmission is still RARE. It can’t be ZERO, of course, but very uncommon.
• I know we don’t like to think about this stuff, but to put it in perspective: children are 10x more likely to die from influenza (please get your flu shots this season, available in September!!) and are more likely to be struck by lightning than to die from COVID19 infection.
• Reopening elementary schools in European countries didn’t lead to an increase in cases.
• Zero out of >40,000 kids of front-line workers in NYC (age 14 and under) contracted COVID in YMCA programs during the height of the pandemic.
• Precautions that might help: smaller cohorts, outdoor learning if possible, masked adults, temperature checks, and handwashing
• Any recent outbreaks in schools or daycares that you’ve read about in the news was likely caused by an adult.
• We would be better off focusing on adult behavior (masking and social distancing) to decrease spread, but other mitigating measures that schools are taking to keep kids safe can certainly help.

Here is the link again to the CDC decision-making tool for parents regarding sending kids back to school.

Even though kids have very low infection and transmission rates, there are some things I do as a healthcare worker when I come home that others might consider doing after being out all day at school or work. This includes:

• Leaving my work shoes outside, not bringing them into the house
• Disinfecting my phone and keys (I have a UV sanitizer, but a good alcohol wipe down should suffice)
• Getting my dirty clothes out of the house and making a B-line for the shower (some doctors actually leave their clothes outside in the garage for washing separately and sprint to the shower in their skivvies)
• Even after I feel like I got all the dirtiness of my day out in the world off me, I’m constantly washing my hands

Now you don’t have to do any of these things, especially if they sound extreme, and there’s actually no hard evidence yet that these are effective methods of preventing you from bringing viruses home, BUT it makes sense that it might. Certainly, if you feel inclined and it gives you peace of mind, there’s no harm practicing some of these habits during this wild time. Here is a link to a KHON piece featuring my friend and colleague, Dr. Mih, talking about some of these measures as they relate to kids and school.

What we’re doing to keep you safe in our office

In our new office, your health and safety are our #1 priority. Here are some policies we already have in place to keep you and your family safe.

• Minimal to no wait time with efficient scheduling and patient workflow
• Separate sick and well visit times to eliminate exposure
• Appropriate PPE (personal protective equipment) worn by staff at all times
• Disinfecting and cleaning schedule after all patient contact, especially high-touch areas
• Monitoring of doctors and staff for symptoms or exposures
• Pre-visit health assessment and temperature check for all who enter
• Requiring masks for all family members 2yrs and older
• Minimizing time in the office through telehealth visits and previsit questionnaires so we can have efficient, targeted, maximized in-person encounters

We are constantly thinking of ways to keep you and your family safe!! If you have ideas, and suggestions, please reply to this email!

Potty Training Tips

Having a kid was exciting for me for lots of reasons, but a big one is that I FINALLY got to test out all my theories and advice I’ve been giving to parents for years!! Not that Wren is my little experiment, but, boy, is it fun (and humbling) to learn when I was way off base and when I hit the nail on the head. Potty training is our most recent adventure!

We’ve had lots of messes to clean up, and just when I think we’re good, we have some setbacks, but for the most part, she’s getting it. Her preschool didn’t require her to be potty trained, so we went into it without pressure. Here are some tips that helped us if you’re considering potty training your toddler soon.

Getting ready

• Starting at 18mo, you can introduce the right words. We use shishi, doodoo, potty, and toilet. You can mention it all the time, when you change her diaper, when you see the dogs making shishi or doodoo, and even when you go. Surround her with the language.
• Be observant and look for telltale signs that she’s going potty. You know that face.
• Buy a potty chair and start having her play with it and sit on it. Make it fun, not intimidating.
• Explain that shishi and doodoo go in the potty, you can even dump from the diaper into her potty so she can see and understand.
• Read potty training books together, watch videos (Elmo!) and buy special underwear and treat wearing it as a privilege saved for boys and girls that go potty
• Be a role model and let her be curious by watching you go. You’ll get used to having a tag-along.

When to start?

Kids are usually ready:

• When they can tell you they have to go
• When they know what a potty is for
• When they like to sit on the potty
• When they can respond to verbal instructions

This can be anywhere from 21mo to 36mo of age

Getting started

• When you start, go to the potty often and make it part of the normal routine
• Introduce the idea of sitting on the potty without a diaper or pull up. She can sit while you’re on your potty or she can just hang out and read a book
• It’s best to stay in diapers until she remains dry for about 2 weeks
• For boys, if you’re training him to shishi sitting down, you should have his male role models shishi sitting down as well, so it’s not confusing
• When you switch to training pants, expect accidents. Don’t get mad. Explain that shishi or doodoo goes in the potty and have her help you clean up.
• Remember LOADS of praise and positivity!
• Set your expectations: most potty training takes a few months. Nighttime dryness can take a few years.

There are many other strategies for potty training, such as the 3-day method and elimination communication, so if you have any specific questions about your desired method, don’t hesitate to shoot us an email and we can discuss!