Boosting. Baby s Brain Tips for Nurturing a Lifelong Learner Pages 4 5. Cord Blood Banking Is It Right for You? Page 7

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1 A HEALTH education AND NEWS Resource FOR NORTH COUNTY FAMILIES Boosting Baby s Brain Tips for Nurturing a Lifelong Learner Pages 4 5 Cord Blood Banking Is It Right for You? Page 7 Happy New Year Create Kid-Friendly Resolutions Page 10 Watching Baby Grow What to Expect the First Year Page 14

2 Inside this Issue... Volume 7 Issue 1 Editor in Chief Janet Gennoe Klitzner Director of Marketing & The HealthSource janet.klitzner@pph.org Managing Editor Tami Diamond Weigold Marketing Manager tami.weigold@pph.org Content Editors Gustavo Friederichsen Chief Marketing & Communications Officer gustavo.friederichsen@pph.org Bobette D. Brown Marketing Specialist bobette.brown@pph.org Mary Coalson Health Education Specialist mary.coalson@pph.org Tammy Chung Coordinator, Marketing & The HealthSource tammy.chung@pph.org Contributors CeCe Wilkens Wilkens Communications Design/Production Chase Design info@chrischasedesign.com Trina Hinch Marketing Project Manager trina.hinch@pph.org Mark Seal Rush Press Photography Eleanor Bell Linda O Neill Special Features 4 5 Boosting Baby s Brain Your newborn arrives ready to explore, learn and make sense of the world. Learn how to provide your baby the building blocks she needs to be ready to learn. 7 Cord Blood Banking: Is It Right For You? new parents may choose to store umbilical cord blood as a type of insurance in case it is needed to help save a life. Learn more about the process so you can make the right decision for your family. 9 One Stop Shop: Breastfeeding Services The Palomar Pomerado Health Women s Health Connection Boutique and Resource Center serves as a one stop shop for breastfeeding and educational needs. 9 Women s Boutique Offers New Items check out what s new at the Palomar Pomerado Women s Health Connection Boutique and save 10 percent on your first purchase. 10 Kid-Friendly New Year s Resolutions involve your children in this annual tradition by identifying ageappropriate goals for health improvement throughout the year. 12 House Calls for Baby From vaccinations to preventing birth defects, PPH physicians answer your questions about popular pregnancy and baby-care topics. 14 Watching Baby Grow: Four Months to One Year They grow up so fast! Learn more about the developmental milestones to look for during months four through twelve. Education 6 Childbirth Preparation Classes PPH offers a wide variety of classes and services to help you and your partner prepare for pregnancy and delivery. 6 Prenatal and Postnatal Exercise Classes our prenatal and postnatal yoga classes will help you to stay in shape, feel your best and maximize your total well-being during and after pregnancy. 8 Breastfeeding Classes and Lactation Services 11 Infant- & Toddler-Care Classes Take advantage of our special presentation infant- and toddler-care classes including Baby-Care Basics, Basic Training for Dads, Bright Futures for Kids and CPR for Friends and Family. 15 Young Adult, CPR and First-Aid Classes 2

3 Numbers to Know Keep these important numbers handy for use in the event of an emergency. Emergency Crisis Hotlines 24-Hour Service Fire, Police or Emergency 911 Poison Control California Missing Children Hotline California Youth Crisis Hotline child Abuse Hotline Rape/Crisis Hotline Missing, Abused & Exploited Children National Runaway Switchboard Suicide and Crisis Counseling San Diego Police Department Class Locations * To register for a class, call The HealthSource at Finding a Physician To select a Palomar Pomerado Health physician for your pre-pregnancy and pregnancy care, or to register for a PPH childbirth class, please call The HealthSource at POWAY Pomerado Hospital Pomerado Road Poway, CA Pomerado Outpatient Pavilion Pomerado Road Poway, CA *Off-site classes are also available for groups, businesses and other organizations that would like instruction on a particular health topic. Call for more information. The HealthSource retains the right to cancel a community education class if minimum enrollment is not met. If you have a disability, please notify us 72 hours prior to the event so that we may provide reasonable accommodation. SAN MARCOS The HealthSource 125 Vallecitos de Oro, Suite A San Marcos, CA ESCONDIDO Palomar Medical Center 555 East Valley Parkway Escondido, CA The views and opinions expressed throughout this publication are provided for informational purposes only and do not necessarily reflect those of PPH. Featured articles and classes are not intended to substitute for professional medical advice, diagnosis or treatment, nor are they intended to reflect all possible opinions on a subject. We recommend that all patients seek the advice of their physician or other qualified health provider with any questions they may have regarding treatment options or a medical condition. Stork Club Tours Call for dates, times and locations. Tours of the Birth Centers at Palomar Medical Center and Pomerado Hospital are available by appointment only. If you are taking a childbirth class at the Jean McLaughlin Women s Center or Palomar Medical Center, there is no need to take this tour as well. Tours of the Birth Center at Palomar Medical Center are available in Spanish on the 2nd and last Wednesdays of each month from 7 to 8:30 p.m. FEE: Free registration required No children please. For a physician referral, or to register for a class, call The HealthSource at

4 Boosting Baby s Brain Tips for Nurturing a Lifelong Learner Your newborn arrives ready to explore, learn and make sense of the world. As the hub of developmental learning, your baby s brain is a powerhouse of brain cell connections waiting to be stimulated and engaged. By giving your baby loving attention, rich language interaction and sound nutrition, you are providing the building blocks your baby needs to develop necessary skills that are needed to be ready to learn in school and life. Newborns are amazing in their ability to acquire several developmental skills starting within the first weeks of life, says Neil Goldfinger, M.D., a board-certified pediatrician with Arch Health Partners. The brain is the control center for building and retaining language, sensory, physical and emotional abilities. Giving your baby a healthy head start on life begins long before birth and even before pregnancy, according to most experts. Nutrition is key, along with a commitment to being an engaged parent/teacher. Palomar Pomerado Health (PPH) offers a range of services including parenting education and health screenings for children designed to assess and enhance their health and well-being. Getting a Head Start Many physicians recommend starting prenatal vitamins and folic acid before becoming pregnant to help assure that your body can provide the essential nutrients from the earliest moments following conception. A healthy pregnancy includes balanced nutrition; regular exercise, weight and stress management; avoidance of cigarette smoke, drugs and alcohol; plus early and continuous prenatal care. Good nutrition for a healthy pregnancy and fetal development is based on eating a colorful variety of fresh vegetables and fruits, lean protein, and whole grains for fiber, says Halle Elbling, M.S., Registered Dietitian and Certified Diabetes Educator for PPH. In addition, drinking six to eight glasses of water daily is important, especially in the third trimester to help prevent premature labor. During pregnancy, you help boost fetal brain cell development by seeking foods that are rich in DHA Omega 3 fatty acids. These include wild salmon, halibut, tilapia and small amounts of tuna. Natural sources for folic acid include deeply colored vegetables such as spinach and carrots. If you are a vegetarian and pregnant or nursing, it is especially important to get enough protein from tofu, beans, nuts and seeds, Elbling says. It s also helpful for pregnant women to get sufficient sleep and exercise regularly. Newborn Brain Power Once your baby is born, your attention turns to taking care of his physical comfort needs feeding, diapering, sleeping, safety in addition to helping him learn about his new world and who it is that provides comfort and nurturing. Newborns typically sleep 20 to 22 hours a day, so parents should take advantage of the awake hours to engage their baby in stimulating activities, Dr. Goldfinger says. Get close to his face while talking or singing. When diapering, touch your baby s head or tummy to further stimulate sensory development. Respond promptly when your baby cries. By soothing, comforting and caring for his needs, you are developing a close, trusting bond that signals emotional security. Developmental Guidelines Each child develops at his or her own pace, so it is not helpful to compare your child to another, says Veronica Toliver, Developmental Services Specialist with PPH s Healthy Development Services. The earliest form of learning is shown when your baby imitates a sound or look. Within the first few months, your baby should be able to follow moving objects, begin to babble and grasp hand toys. Encourage this by playing peek-a-boo, singing and having meaningful conversations to stimulate language development. Within the first few months, most babies will delight their parents with a real smile, which is an exciting step and indicates healthy emotional and social development, Dr. Goldfinger says. By four months, babies are starting to roll over; however, we have noticed that many infants are taking somewhat longer to do this, Dr. Goldfinger says. The delay may be related to 4

5 putting them to sleep on their back as recommended to help prevent sudden infant death syndrome (SIDS). We theorize that the back to sleep position may delay neck and shoulder muscle development that is needed to physically roll over. Every interaction with your child is an opportunity to teach and guide. - Neil Goldfinger, M.D. Dr. Goldfinger recommends tummy time activities when your baby is awake to stimulate head and neck movement. Because many babies don t like tummy time, start with just a minute or two and increase the time each day. Make it entertaining by getting down on eye level with your baby and putting your face up close to play and talk or sing. Place a mirror in front of your baby s face and watch how he interacts with his reflection. Nutrition Fuels the Brain Breastfeeding is the best way to provide rich nutrients that help your newborn s brain develop, Dr. Goldfinger says. Additionally, breastfeeding provides many short- and long-term health benefits for both moms and babies and promotes bonding. As your infant starts on solid foods and throughout childhood continue to focus on sound nutrition that teaches portion management, limits sugar and encourages fresh fruits and vegetables. Learn more about family nutrition at Breakfast is really important because it fuels the brain and body for a start on the day s activities, Elbling says. After the first year, whole grains in toast or cereal, a little lean protein such as natural peanut butter and an egg are good choices. Eggs are rich sources of choline, a mineral shown to be essential for developing healthy neurological functions such as memory and reasoning. Zinc, found in whole grains, lean beef, lamb, poultry, pork and beans, is good for cellular metabolism. As your baby grows, choose toys that continue to develop his reasoning skills. For example, stackable blocks can teach cause and effect. By 18 months, your child should be able to understand and follow simple instructions, which is a good time to enlist his help in picking up toys. Use bath time to let your child experience different textures of slippery soap and terry towels, as well as the smells of soap and shampoo. Talk your way through these activities with your child. Talking stimulates brain connections and helps children understand the world around them. Every interaction with your child is an opportunity to teach and guide, Dr. Goldfinger says. While there is no scientific evidence that you can make your child brilliant, you can provide the centerpiece of healthy development by surrounding your child with lots of love. Resource: American Academy of Pediatrics, Healthy Children PPH s Healthy Development Services Palomar Pomerado Health s (PPH) Healthy Development Services provides free, easily accessible, comprehensive services for children and families, including: parenting education and resources; early childhood health screenings, assessments and treatment services; and referrals as needed. These services are provided by experienced, caring PPH staff at no cost to families through a grant from the First 5 Commission of San Diego County. Transportation to classes and services is also available upon request. Free services include: LEAP LEARNING EARLY, ADVENTURES IN PARENTING: Each series of five classes is dedicated to the development and growth of a particular age group - infant, toddler and preschool. Parents learn how to promote child development, build healthy relationships, enjoy an active and healthy lifestyle, and find resources in the local community. Refreshments, childcare, and ageappropriate learning gifts are provided. Developmental Services: Developmental check-ups and individual child services from experts in a variety of settings. Vision and Hearing Screenings: Vision and hearing screenings are offered starting at 18 months and continuing annually until age five. Referrals are provided to your child s doctor for additional services as needed. Parent Support: Resources, education and support are available for families with children who have special needs. Care Coordinators: Assistance for families receiving Healthy Development Services and referrals to valuable community resources. Our goal is to empower parents with the education and support they need to help their children grow healthy and strong, says Veronica Toliver, Developmental Services Specialist with PPH s Healthy Development. Speech, occupational and physical therapy are available in addition to group classes. Behavioral Services: Classes, parent coaching and individual child therapy are available. Services are also offered to your child s daycare or preschool provider if your child is experiencing challenging behavior in these facilities. For more information, to sign up for classes or to request services, please call For a physician referral, or to register for a class, call The HealthSource at

6 Childbirth Classes Preparation for Childbirth Five-Week Series 6:30 9 p.m. Choose one of the following five-week series: Tuesdays, January 11 February 8 Wednesdays, February 23 March 23 Tuesdays, April 12 May 10 Palomar Medical Center (Escondido) Birth Center Classroom, 4th Floor Choose one of the following five-week series: Wednesdays, January 12 February 9 Tuesdays, February 22 March 22 Wednesdays, April 13 May 11 Prepare for a safe and satisfying birth experience with this five-week childbirth preparation series. Small classes ensure personalized instruction focusing on the signs and stages of labor, hospital procedures, medication options and Cesarean birth. A general overview of labor-coping techniques is provided, and newborn characteristics, infant feeding and postpartum adjustments are discussed. A tour of the birth center is included. FEE: $70 / mom or couple (includes childbirth manual) Preparation for Childbirth In a Weekend 9 a.m. 3:30 p.m. (Saturdays) 10 a.m. 3:30 p.m. (Sundays) Choose one of the following weekend sessions: January 15 16; January 29 30; February March 5 6; March 26 27; April 30 May 1 Palomar Medical Center (Escondido) Birth Center Classroom, 4th Floor Choose one of the following weekend sessions: January 22 23; February March 19 20; April Our weekend class includes the same information covered in our five-week series, but takes only two days to complete. A tour of the birth center is included. Early registration is recommended. FEE: $70 / mom or couple (includes childbirth manual) Cesarean Birth Lecture Call for dates, times and locations. Expectant parents who anticipate a Cesarean birth and choose not to enroll in a childbirth class may attend a one-hour lecture about Cesarean birth that is part of our regular childbirth series. Information covered includes indications for a Cesarean birth, pre-operative procedures, medications, the birthing process, and post-operative and recovery procedures. FEE: $10 / mom or couple NEW Class Relaxation for Labor 6:30 8 p.m. Tuesday, April 5 Palomar Medical Center (Escondido) Birth Center Classroom, 4th Floor Monday, March 14 Relaxation for Labor is a continuation of the breathing and relaxation techniques that you learn in the Childbirth Preparation series. Participants will learn and master comfort techniques to relax their body during contractions. Techniques include tense/release, progressive relaxation, abdominal breathing, positional changes and supporting mom through labor. FEE: $10 / mom or couple Yoga Prenatal Yoga Six-Week Series 6 7:15 p.m. Mondays, January 17 February 21 and Mondays, March 7 April 11 A regular practice of yoga postures during pregnancy helps to strengthen the belly and back, reduce back pain, increase well-being and improve physical comfort. Prenatal yoga, taught by Certified Childbirth Educator and Yoga Instructor Liza Janda, assists in preparing for birth by working with the body and breath to help facilitate the labor process. For women in their first through third trimesters. FEE: $72 / participant for six-week series Infant Mommy & Me Yoga Six-Week Series 10:30 11:30 a.m. Mondays, January 24 February 28 and March 7 April 11 Finding time to exercise after having a baby can be a challenge. Mommy & Me Yoga is the perfect way to stay in shape and spend quality time with your child. Registered yoga instructor Erin Noland teaches Hatha yoga with babystyle centering and songs. Toys are provided please bring a blanket and yoga mat. Appropriate for new mothers with non-walking infants age four weeks to one year. FEE: $60 / mom and baby for six-week series 6

7 Umbilical Cord Blood Banking Is It Right For You? The umbilical cord that provides a lifeline to your unborn baby can also prove lifesaving in the future. Parents may choose to store umbilical cord blood at the time of childbirth, as a type of insurance in case it is needed to help save the life of their child or another family member. Umbilical cord blood is a rich source of genetically unique stem cells, the body s building blocks for blood, organs, tissue and the immune system. Stem cells reproduce and change into other cell types, features that make them valuable in fighting cancers and treating blood disorders, immune deficiencies and genetic diseases. Currently some 80 diseases can be treated with stem cell transplants, and new applications in regenerative medicine for the treatment of conditions such as type 1 diabetes and cerebral palsy are being researched. Umbilical cord blood can be stored at a private cord blood bank for future personal use by the immediate family or at a public bank where it will be typed and matched with individuals who need a transplant. It s not easy to make a public donation in San Diego County where there are no local cord blood banks and the San Diego Blood Bank is not currently accepting donations of this type. Less than 3 percent of hospitals nationwide provide public cord blood storage because of the costs involved. Once cord blood is donated to a public blood bank it may not be available to the family if ever needed. While it s difficult to make a public donation, it can be beneficial because it has the potential to help save lives. says David Golembeski, M.D., a board-certified neonatologist and medical director of the Rady Children s Neonatal Intensive Care Unit at Palomar Medical Center. Learn More Cord Blood Banking 6 7:30 p.m. Thursday, February 10 To bank or not to bank? Join us for an informative seminar and get the tools you need to make the right decision for you and your family. Learn more about the collection process, how cells are stored and used, and the benefits of cord blood banking. FEE: Free registration required Family Cord Blood Banking Parents who deliver at Palomar Medical Center and Pomerado Hospital can choose to have a private cord blood bank to store their infant s umbilical cord blood. It is then available in the event the child or another family member develops a lifethreatening disease. Storing umbilical cord blood provides protection for the infant and other immediate family members, says Karen Kohatsu, M.D., a board-certified obstetrician-gynecologist. It is a genetically perfect match for the infant donor and there is a 75 percent chance that it will be an acceptable match for siblings. Cord blood transplants from a family member are twice as successful as transplants using cord blood from a non-relative. This is especially important for minority ethnic groups. Because most bone marrow donors are of Caucasian descent, they have a 50 percent chance of finding a donor through the National Marrow Donor Program. However, if a match is found, it may not be a best match. For other ethnic groups, the chance of an acceptable match drops significantly, especially for persons from mixed ethnicity. To make a well-informed decision, expectant parents should discuss storing cord blood with their obstetrician during pregnancy. Check online for information about companies that are accredited by the American Association of Blood Banks. Initial fees for registration plus annual storage fees are disclosed by each company. Kits can be ordered from the company and are also available in the delivery rooms at both hospitals. At the time of delivery, the cord blood is collected from the placenta and placed into the sterile kit provided by the cord blood bank. The cord blood sample is then transported to the cord blood bank where it is processed and stored. Donating umbilical cord blood is part of the future, knowing that researchers are actively pursuing new applications for disease treatment, Dr. Kohatsu says. I encourage patients to consider this as an insurance policy not only for the baby whose cord blood was collected but also for other members of their family. For More Information ViaCord Cord Blood Banking + Research, Cord Blood Registry, StemCyte, PacifiCord, National Bone Marrow Program, For a physician referral, or to register for a class, call The HealthSource at

8 Breastfeeding Classes Successful Breastfeeding (Prenatal) 6:30 9 p.m. Choose one of the following four classes: Thursdays, January 6, February 3, March 3 or April 7 Palomar Medical Center (Escondido) Birth Center Classroom, 4th Floor Choose one of the following two classes: Mondays, January 17 or March 21 Breastfeeding is nature s way to feed a baby, but it doesn t always come naturally. Enhance your opportunity for a positive breastfeeding experience with this informative class led by a certified lactation consultant. Topics include the benefits of breastfeeding, breast anatomy and physiology, getting off to a good start, common difficulties and solutions, and returning to work. FEE: $25 / mom or couple PPH Breastfeeding Telephone Advice Warmline: Breastfeeding Support Groups, Tuesdays and Fridays 1 2:30 p.m. Meet with a certified lactation consultant and other new moms to share information and learn new ideas during these weekly group sessions. Breastfeeding support groups are not a substitute for the Successful Breastfeeding class. Call the Women s Health Connection Boutique at for more information. FEE: Free Healthy Development Services also offers Breastfeeding Support Groups at the following location: First United Methodist Church 341 South Kalmia Street Escondido, CA Thursdays 11 a.m. 12:30 p.m. FEE: Free For more information, please call Healthy Development Services at or Lactation Services Palomar Pomerado Health s certified lactation consultants provide guidance to new mothers who choose to breastfeed their babies. Breast pumps are also available for sale or rental through the PPH Women s Health Connection Boutique, along with a wide variety of breastfeeding supplies and literature. Pomerado Outpatient Pavilion Pomerado Road Poway, CA Ask about our breast pump exchange program! The Medela Freestyle hands-free, double electric pump is perfect for working moms. This advanced technology is available at the PPH Women s Health Connection Boutique. Lactation Consultations Personal outpatient lactation services provided by certified lactation consultants. Appointments Available: Tuesday Friday 10 a.m. 5 p.m. Baby Latch and Weight Check Free Lactation Consultation (30 minutes) $35 Lactation Consultation (60 minutes) $65 In-Home Lactation Consultation $125 Women s Health Connection Boutique Medela breast pumps for rental or purchase; pump kit accessories; nursing bras; breast care products and more. See story on page 9 for more information. 8

9 One Stop Shop Promotes Breastfeeding Success As a Medela Certified Nursing Center, the Palomar Pomerado Health (PPH) Women s Health Connection Boutique and Resource Center serves as a one stop shop for breastfeeding and educational needs. Personal lactation consultation, breastfeeding support groups and a full line of Medela breast pumps, nursing bras, breast care products, breastfeeding supplies and information are available. The Boutique offers comprehensive services and products designed to help all nursing moms be successful, says Annamarie Martinez, R.N., director of Maternal-Infant Services and Early Childhood Programs. Although breastfeeding is nature s way of feeding a baby, it does not always come naturally for all babies or moms. Our comprehensive lactation services offer strong, personalized support for all breastfeeding moms. Comprehensive services help women prepare for breastfeeding before childbirth and continue to provide expert advice and support throughout breastfeeding. Prenatal breastfeeding classes are available throughout the year. Individual lactation consultations offered at the Women s Health Connection Boutique and at home provide an opportunity for one-on-one advice designed to improve the breastfeeding experience for mother and child. Free breastfeeding support groups with certified lactation consultants meet throughout North County. The Women s Health Connection Boutique offers free baby latch and infant weight checks to assess if the baby is feeding well. Lactation consultants also provide a quick and easy evaluation of the caloric and fat content of breast milk. We highly recommend all breastfeeding moms schedule a lactation home visit within the first week after leaving the hospital, especially for first-time moms, Martinez says. This one-on-one support in the comfort of your home helps to answer questions and address individualized needs. Our caring, knowledgeable and experienced lactation consultants provide a clinical assessment of moms and babies, and help enhance education received prenatally, after delivery, and in breastfeeding support groups. All services are offered in English and Spanish. To learn more, or to schedule an appointment, please call the Women s Health Connection Boutique at Women s Boutique Offers New Clothing, Spa Items Check out what s new at the Women s Health Connection Boutique and Resource Center and mention this story to save 10 percent on your first purchase. The newly expanded retail options feature a range of quality products for expectant and nursing moms, newborns and infants in addition to wellness and relaxation products from the Chopra Center. New items include attractive maternity loungewear, clothing for nursing moms, stylish baby clothes, early learning games for infants, infant care items and Medela breastfeeding products. The Chopra Center items include bath and body products, massage oils, relaxation tapes and aromatherapy supplies. Located in the Pomerado Outpatient Pavilion behind Pomerado Hospital, the Boutique is also a learning center, where women can attend health information classes and support groups, borrow information from the library, learn about resources and receive expert assistance from certified lactation consultants and health educators. In addition to shopping at the Boutique or gift shops at Palomar Medical Center and Pomerado Hospital, products can be purchased by phone. Online purchasing is expected to be available later this year. Gift purchases can be delivered to patients in the hospital or at home, if they have been recently discharged. P: F: E: kimberly.paden@pph.org W: Pomerado Outpatient Pavilion Pomerado Road Poway, CA Kimberly Paden, IBCLC Women's Health Coordinator Orange: pantone 144 c Pomerado Outpatient Pavilion Jean McLaughlin Women's Center Pomerado Road, Suite 100 Poway, CA For a physician referral, or to register for a class, call The HealthSource at

10 Make 2011 the Year for Kid-Friendly New Year s Resolutions Before finishing your New Year s resolutions, think about involving your kids in this annual tradition of self-improvement. While we all know it s not easy to fulfill resolutions for losing weight, exercising regularly and eating more fresh fruits and vegetables, your chances for success are improved if you make this a family affair. It can be just as hard for kids to keep resolutions, so help them identify age-appropriate goals for health improvement throughout the year. Making resolutions for the whole family helps children to learn healthy choices that will serve them well throughout life, says Nancy Roy, Community Outreach Liaison for Palomar Pomerado Health (PPH). Participating in community resources is a great way to start. For example, our Project21SD program fights childhood obesity with activities for children and families. Jump-start your planning with these suggestions: Lose Weight: This tops most resolution lists. The not-so-secret secret for success is to increase physical activity while decreasing caloric intake. How to succeed: Aim for one hour of exercise several times a week. Plan family walks or bike rides. Play tag with your toddler and shoot hoops with your teen. Learn a new sport, such as soccer, basketball or swimming. Pick an activity you like so you will stick with it over time, says Carol LeBeau, PPH s Health Champion. Learn portion size. Choose grilled, baked or broiled instead of fried. Plan well-balanced meals and eat an extra serving of fruits or vegetables instead of more potatoes or bread. Improve Family Time, Communication: Limit television and computer time. Try to have family meals regularly when you can talk about everyone s day. Parents: talk less, listen more and take advantage of small moments to interact with your children. Personal Hygiene, Safety: Even preschoolers can pledge to brush teeth twice daily and wash hands frequently. Discuss and update family emergency plans for wildfire and earthquake evacuation. Also: Apply sunscreen 30 minutes before heading outside. Always buckle up, use car seats and never text or talk on the phone while driving. Choose resolutions that matter most to your family, set goals and don t forget to pick a fun, healthy reward to recognize your group success. Project21SD Gets Kids Moving Since 2007, Palomar Pomerado Health s (PPH) Project21SD has focused on educating children, parents and educators about the risks of childhood obesity, diabetes and cardiovascular disease. Ongoing activities include: Running Clubs The Project21SD Running Clubs have proven popular with students throughout Inland North County. Each year, more than 7,000 students walk, jog or run throughout the week for health and fun. Qualcomm and Verizon have teamed up with Project21SD to offer Smart Phones that record each student s distance and calories burned while tracking their continued progress through the year, says Nancy Roy, PPH Community Outreach Liaison. Project TODAY The Transforming Obesity and Diabetes Awareness in Youth project screens fifth graders for diabetes and obesity. Parents of atrisk children are contacted and informed about these health issues. They also receive assistance in finding a physician or obtaining health insurance. The Backyard Produce Project This project collects surplus fruits and vegetables from Poway, Rancho Bernardo and Rancho Peñasquitos home gardens and donates the fresh produce to a local charity for distribution to families in need. In a typical month, 250 local families share this bounty. Community partners include the PPH Community Action Council of Poway/Rancho Bernardo/Peñasquitos, Sunshine Care, Shea Realty, and many other local businesses, organizations and volunteers in addition to the individual homeowners who generously donate their produce. 10

11 Baby-Care Basics 10 a.m. 12:30 p.m. Saturdays, February 12 or April 9 Since babies don t come with instructions, this class will provide you with the guidance needed to experience a more confident beginning. Topics include basic physical care skills, growth and development, normal daily activities/habits, safe-proofing your home, nutritional needs and management of illnesses. FEE: $30 / mom or couple Bright Futures for Kids Five-Week Series 6 8 p.m. Palomar Medical Center Café Conference Room (2nd floor) Thursdays January 20 February 17 Pomerado Hospital Café Conference Room (3rd floor) Thursdays March 3 31 Managing behavior issues in young children can be a difficult task for parents. Explore therapeutic interventions for behavioral concerns in children ages 0 5 with a trained parent educator. This five-week series of classes in provided by Jewish Family Services of San Diego, in partnership with Palomar Pomerado Health, and is funded by First 5 Commission of San Diego County. No childcare is provided. Space is limited. FEE: Free registration required Basic Training for Dads 9:30 a.m. Noon Saturday, February 26 Are you a first-time dad-to-be in need of some basic training? Learn what to expect during the last trimester of pregnancy, birth and the first few weeks at home. Plus, discover practical tips on diapering, feeding and soothing the newborn. This class is intended for expectant fathers in the second or third trimester of their baby s pregnancy. It is a fathers only class featuring special guests Veteran Dads (BT graduates) and their newborn babies. Leave the class with a boost of confidence to be the best dad you can be! FEE: $40 / dad CPR for Family and Friends 9:30 a.m. 12:30 p.m. Fridays, February 25 or April 29 The HealthSource, San Marcos 6 9 p.m. Friday, January 28 This course teaches basic life saving techniques including how to relieve an obstructed airway. It is suggested for the lay rescuer such as new parents, grandparents, babysitters, caregivers or anyone who is preparing to help others in distress but does not need certification. FEE: $25 / participant Physician Referral For a physician referral, or to register for a class, call The HealthSource at ClassesInfant and Toddler Mothers of Twins & Triplets Have you been blessed with multiple bundles of joy? The Mothers of Twins and Triplets Club meets monthly and provides a forum for friendship and support for families, or expecting families, with twins or triplets. Speakers and special programs help parents deal with the pressure of raising multiple-birth children. For more information, call For a physician referral, or to register for a class, call The HealthSource at

12 House Calls For Baby The Question about Vaccines George Delgado, M.D. Board-Certified Family Physician Escondido QMy friend isn t vaccinating her toddler and is encouraging me to do the same. What advice do you have for new parents Aabout this issue? Whether to vaccinate or not is an issue that all new parents must decide because they are best equipped to determine what is best for their infants and family. Therefore, my role is to advise parents by answering their questions and providing information that will help them reach an informed decision. The incidence of serious and life-threatening childhood diseases has all but disappeared from our public health consciousness, thanks to the widespread use of vaccines designed to prevent those diseases. To some degree, the effectiveness of these vaccines in greatly diminishing the incidence of infectious diseases has now caused some parents to question their value. Some parents are concerned about risks and side effects of vaccines and have heard that autism may be related to certain vaccines. After carefully reviewing available medical research on this topic, I do not believe there is any credible scientific evidence linking autism to childhood vaccines. Parents who choose not to vaccinate their children should let their friends and family know of their decision since unvaccinated children can spread vaccine-preventable illnesses. They should also stay informed of public health news related to contagious diseases and decide if they need to vaccinate their child if an outbreak occurs. The recent resurgence of whooping cough, a highly contagious disease, is one example where some of my patients have reconsidered their previous decision and brought their children in for the pertussis (whooping cough) vaccine. Like everything in life, there are small risks associated with vaccines. For example, a child may develop a fever or feel uncomfortable for a short time after vaccinations. However, I am relatively certain that the benefits of childhood vaccines outweigh the small risks. Q Preventing Birth Defects Josue Leon, M.D. Board-Certified Obstetrician-Gynecologist North County Women s Specialists Escondido I am 38 and planning to become pregnant. Knowing there are increased pregnancy risks at my age, including birth defects, Awhat can I do to have a healthy baby? Having a child after age 35 tends to increase the risk of certain chromosomal abnormalities, including Down syndrome. But age alone is not the cause of certain birth defects. Genetics and your health status are also important factors that determine the health of every newborn. Although your age cannot be changed, you can take steps to help assure a healthy pregnancy by talking to your physician about your plans and your current health. This is especially important if you are overweight or obese, or if you have high blood pressure, diabetes or other chronic medical conditions. This is a good time to determine if you have diabetes or pre-diabetes, which can impact your health and that of your fetus during pregnancy. If you are taking any prescribed medications, ask your physician if they may pose a risk during pregnancy. For example, beta-blockers, which treat a variety of cardiac diseases, may lead to a smaller or growth-restricted infant. If you don t exercise regularly, start a physical activity you can stick with over time to help maintain a healthy weight and manage blood pressure and cholesterol. Exercise also helps prepare your body for the physical stress of pregnancy and childbirth. In addition, regular exercise and a healthy diet provides essential nourishment for your body before and during pregnancy. (Please see related article, Boosting Baby s Brain, on page 4 for more nutritional information.) Start taking prenatal vitamins, which include iron and folic acid, at least one year before becoming pregnant. Once you become pregnant, be sure to have regular prenatal care and follow all advice your doctor offers. Do you have a question for House Calls? Visit to submit your inquiry. Selected questions will be answered by Palomar Pomerado Health physicians in future issues of The BabySource magazine. Past questions and answers have been archived online for review. What s on your mind? 12

13 San Diego s finest pediatric care just got closer to home. Rady Children s Hospital-San Diego is pleased to announce that our nationally recognized* pediatric and neonatal intensive care services are now available at Palomar Medical Center** (PMC) in Escondido. Through a collaborative agreement, the pediatric and neonatal beds at PMC are fully operated under the Rady Children s license. Parents can remain confident that their high-risk newborn or sick child will continue to receive the highest quality, expert inpatient care provided by Rady Children s physicians in our new convenient North County location. Rady Children s mission is to restore, sustain and enhance the health and developmental potential of children through excellence in care, education, research and advocacy. Our physicians, nurses and staff are proud to bring this mission a little closer to home for the families of Inland North County and to be a part of Palomar Medical Center. For more information about Rady Children s at Palomar Medical Center, or to learn more about pediatric healthcare services in your neighborhood, please call our Customer Service and Referral Center at *U.S. News & World Report recently ranked Rady Children s Hospital Neonatology, Orthopedics, Urology, Pulmonology/Respiratory Medicine and Endocrinology/Diabetes services among the best in the nation. **Palomar Medical Center is a Magnet -recognized hospital, signifying nursing s highest honor for excellence in patient care. Rady Children s at Palomar Medical Center, 555 East Valley Parkway, Escondido, CA rchsd.org/pmc For a physician referral, or to register for a class, call The HealthSource at

14 Watching Baby Grow 4 Months to 1 Year From 8 to twelve months of age, your baby will become increasingly mobile, a development that will thrill and challenge both of you. Being able to move from place to place will give your child a delicious sense of power and control her first real taste of physical independence. Here are some milestones to look for at twelve months: Movement Milestones Gets to sitting position without assistance crawls forward on belly by pulling with arms and pushing with legs Assumes hands-and-knees position creeps on hands and knees supporting trunk on hands and knees Gets from sitting to crawling or prone (lying on stomach) position Pulls self up to stand Walks holding on to furniture Stands momentarily without support May walk two or three steps without support From age four to seven months, the most important changes take place within your child. This is the period when he ll learn to coordinate his emerging perceptive abilities (the use of senses like vision, touch and hearing) and his increasing motor abilities to develop skills like grasping, rolling over, sitting up and possibly even crawling. Here are some milestones to look for at the end of the fourth month: Movement Milestones Rolls both ways (front to back, back to front) Sits with, and then without, support of her hands Supports her whole weight on her legs Reaches with one hand Transfers object from hand to hand Uses raking grasp (not pincer) Language Milestones Responds to own name Begins to respond to no Distinguishes emotions by tone of voice Responds to sound by making sounds Uses voice to express joy and displeasure Babbles chains of consonants Cognitive Milestones Finds partially hidden object Explores with hands and mouth Struggles to get objects that are out of reach Social and Emotional Milestones Enjoys social play Interested in mirror images Responds to other people s expressions of emotion and appears joyful often Milestones In Hand and Finger Skills Uses pincer grasp Bangs two cubes together Puts objects into container Takes objects out of container Lets objects go voluntarily Pokes with index finger Tries to imitate scribbling Language Milestones Pays increasing attention to speech Responds to simple verbal requests Responds to no Uses simple gestures, such as shaking head for no Babbles with inflection Says dada and mama Uses exclamations, such as oh-oh! Tries to imitate words Cognitive Milestones Explores objects in many different ways (shaking, banging, throwing, dropping) Finds hidden objects easily Looks at correct picture when the image is named Imitates gestures Begins to use objects correctly (drinking from cup, brushing hair, dialing phone, listening to receiver) Social and Emotional Milestones Shy or anxious with strangers Cries when mother or father leaves Enjoys imitating people in play Shows specific preferences for certain people and toys Tests parental responses to his actions during feedings (What do you do when he refuses a food?) Tests parental responses to his behavior (What do you do if he cries after you leave the room?) May be fearful in some situations Prefers mother and/or regular caregiver over all others Repeats sounds or gestures for attention Finger-feeds himself Extends arm or leg to help when being dressed. Source:

15 CPR & First-Aid Classes American Heart Association Basic/Advanced Life Support and HeartSaver First-Aid Courses Courses are offered through the Palomar Pomerado Health/ American Heart Association (AHA) Training Center. Onsite group training is available with a minimum of six participants. The AHA strongly promotes knowledge and proficiency in BLS, ACLS and PALS and has developed instructional materials for this purpose. Use of these materials in an educational course does not represent course sponsorship by the AHA, and any fees charged for such a course do not represent income to the AHA. Basic Life Support Courses Call for dates, times, locations and registration information on the following classes. CPR for Family and Friends (Non-Certified) This course teaches basic life saving techniques including how to relieve an obstructed airway. It is suggested for the lay rescuer such as new parents, grandparents, babysitters, caregivers or anyone who is preparing to help others in distress but does not need certification. FEE: $25 / participant HeartSaver CPR (Certified) This class provides CPR certification and is designed for the layperson who may serve as a rescuer in the workplace. FEE: $40 / participant BLS for the Health-Care Provider This class provides CPR certification for the health-care professional, paramedic, lifeguard or nursing student. FEE: $50 / participant HeartSaver First-Aid This four-hour class includes instruction on the general principles of first aid, as well as medical, injury and environmental emergencies. FEE: $45 / participant HeartSaver AED This class provides certification in Adult CPR and the use of an AED (Automated External Defibrillator). Classes are offered to groups who either have or would like to purchase an AED. FEE: $50 / participant HeartSaver Pediatric First-Aid The HeartSaver Pediatric First-Aid program will contain information on how to manage illness, injuries, blood-borne pathogens, infection control and asthma related emergencies. This course meets the CA requirements for First Aid, Infant/Child CPR and the use of the ARD and BBP for daycare facilities. This eight-hour class in designed for daycare providers, teachers, new parents and babysitters. FEE: $70 / participant Young Adult Classes Babysitting Basics* 2 5 p.m. Saturday, February 12 The HealthSource, San Marcos 6 9 p.m. Friday, March 18 This three-hour babysitting course is designed for boys and girls ages 10 to 14. Topics covered include babysitter responsibilities, caring for children, overview of first-aid, safety and accident prevention, handling emergencies, playing with children, behavior management, and tips for a professional babysitter. Those completing the course receive a certificate of completion to present to prospective employers. FEE: $20 / boy or girl (includes course materials) Becoming a Young Woman* 10 11:30 a.m. Saturday, March 19 The HealthSource, San Marcos 7 8:30 p.m. Friday, March 11 This informative class helps young women 10 to 12 years old explore the emotional and physical changes of puberty. Emphasis is placed on how each girl experiences changes in her own special way. Additional topics include challenges with competition and development, communicating with parents, menstruation, purchasing personal female items, cramps and other common menstrual discomforts, and emotional changes and hormones. Mothers are encouraged to attend and share this unique time with their daughters. Please note there is no discussion on sex. FEE: $15 / daughter and mother *The Babysitting Basics and Becoming A Young Woman classes are available for off-site instruction upon request. Please call for more information. Advanced Life Support Courses Palomar Pomerado Health also offers Advanced Life Support Courses for health-care professionals including Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Neonatal Resuscitation (NRP) and Pediatric Education for Prehospital Professionals (PEPP). Call for more information. For a physician referral, or to register for a class, call The HealthSource at

16 The HealthSource Innovation Drive San Diego, CA Palomar Medical Center 555 East Valley Parkway Escondido, CA Pomerado Hospital Pomerado Road Poway, CA Pomerado Outpatient Pavilion (POP) Pomerado Road Poway, CA The HealthSource San Marcos 125 Vallecitos de Oro, Suite A San Marcos, CA For a physician referral, or to register for a class, call The HealthSource at If you would like to be removed from our mailing list, please contact The HealthSource at PRST STD U.S. POSTAGE PAID SAN DIEGO, CA PERMIT NO. 2838