How to toss your cookies but not your sanity.

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Let’s talk about one of our absolutely favorite things about being a parent. Something that makes childless people totally jealous, makes you cry tears of joy, inspires the angels to sing, and brings that rhetorical unicorn to continue defecating glorious sparkling rainbows all over your home.

Your child comes to you. They have that look in their eyes- the look of true love and need for you. You open your arms to accept them and “GAHHHHGKSJHDJHERUIGTGSJGJAJSHJFDH*#$^&#^$@%#@^#&@”!!!!!!!!!!!!!!”

The stomach runneth over. You look down at the coating on your shirt. The puddle collecting in your lap. The smell invading your brain.

No? Not your favorite?  Well that’s a bummer because ‘tis the season!

toystory puke

Anyway, a common misconception is that this is a “stomach flu”. Actually it’s not the flu at all. Influenza is characterized by sudden onset fever, chills and body aches, runny nose, cough, etc. Gastroenteritis is the inflammation of the stomach and intestine, causing nausea, vomiting, cramps, diarrhea, low grade fevers, aches, and general ickiness. It’s definitely no fun.

So what can you do when you or your little one is lucky enough to contract this? Honestly, the less you do, the better. The first thing people worry about it dehydration, which is a valid concern, but it really only becomes a danger when the vomiting or diarrhea becomes excessive (think more than once per hour and continuing this way for a long period of time). The stomach is purging because it is irritated, so you want to give it a rest. Resist the urge to give your child fluid after they vomit. It will continue the cycle and prolong the misery. Let them rest and once they’ve been vomit free for more than an hour or two, allow a few SIPS of water or electrolyte drink. No drinking full glasses no matter how hard they beg! Once they’ve been vomit free for longer than that, they can nibble on crackers or something bland. If they throw up again, start back at square one with nothing by mouth again. Sometimes this lasts for just the day, sometimes a few.  Avoid giving sugary drinks like Gatorade and juice since it can irritate the stomach more. You don’t need to follow the BRAT diet- typically once kids aren’t throwing up anymore they can resume normal eating patterns but do avoid fatty, fried, or spicy foods. Avoid dairy as much as possible during this time, most irritated stomachs cannot tolerate lactose.  Breastfeeding is always ok! If you are nursing, encourage them to breastfeed as much as they want. Resist the urge to give medications. Ibuprofen can irritate the stomach and any kind of anti-emetic and anti-diarrheal is preventing the purging of the virus from the system. Just let it ride- the best medicine is rest and love.

Typically a stomach virus doesn’t require a visit to the pediatrician. Viruses are not treated with antibiotics. However, if your child is showing signs of dehydration (dry skin, dark urine or not urinating, crying without tears, sunken soft spot in infants, listlessness, or high fever) then they should be seen. Rotavirus and norovirus can cause severe dehydration, so if your child shows any of these symptoms or is vomiting/having diarrhea uncontrollably then swift action is needed.  Also if you notice red blood or dark coffee ground-looking stuff in their vomit or diarrhea, get them seen right away.

Remember to wash wash wash! Hand sanitizer is not effective in killing stomach viruses. Good ol’ soap and water is your best bet. Make your child wash their hands constantly and remember to wash yours too even if you aren’t sick! Also remember that even if they stop vomiting or having diarrhea, their stools will still be contagious for several weeks, so be vigilant with those diapers and disinfecting the bathroom/house.

quarantine-sign

Even if this isn’t your magic parenting moment, you will make it through. I have faith in you. Although may I suggest investing in a good carpet/upholstery cleaner?

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Evenflo Transitions 3-in-1 Combination Seat Recall

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Evenflo Transitions - Maleah pinkA recall has been issued for the Evenflo Transitions 3-in-1 combination seat. No injuries have been reported, but Evenflo has identified a potential safety concern and voluntarily issued a recall. Some children are able to reach the harness adjuster mechanism, allowing them to loosen the harness while they’re in the seat. Evenflo has developed a remedy kit that should eliminate a child’s access and activation of the central front adjuster (CFA) mechanism.

This recall includes model numbers 34411686, 34411695, and 34411029, all manufactured prior to January 29, 2016. Owners should be contacted by mail if they registered their seats, or consumers can submit a form to Evenflo or call them at 1-800-233-5921.

Owners of the recalled seats will receive a kit that includes a replacement seat cushion, a new harness adjuster assembly, and instructions. You can view a video of how to replace the adjuster here. The video is very helpful because it is a detailed process and you want to make sure you’ve done it correctly.

Evenflo transitions - recall CFA

If you own a Transitions and are using it in harnessed mode, you have a couple options while you wait for your fix kit to arrive:

If your child has not shown an interest in loosening it, or cannot reach the central front adjuster (CFA) with the harness straps tightened properly, you can monitor the situation while continuing to use the seat.

Evenflo Transitions - 4 yo 2If your child is loosening the harness, the first thing you should do is the Pinch Test to double check that the harness straps are tight enough. It’s a lot easier to reach the CFA if the harness isn’t properly snug. A snug harness has no visible slack and you cannot pinch any webbing in the straps above the chest clip near the collar bone. In our experience, most younger kids can’t manipulate the CFA if the harness is appropriately snug because their arms just aren’t long enough. Older kids with longer arms are more likely to be able to reach the CFA and unlock it. If the harness is snug but the child can still reach the CFA and the behavior persists, Evenflo suggests using the seat in booster mode (if the child is at least 40 pounds and 43.3 inches tall) until the remedy kit arrives. If the child is under that height/weight and playing with the adjuster, Evenflo recommends discontinuing use of the seat until the remedy kit is applied.

Note: This recall is for the Evenflo Transitions, not to be confused with the Graco Tranzitions which is a completely different carseat.

Preview: 2017 Chrysler Pacifica- Kids, Carseats & Safety

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Pacifica stockWhen CarseatBlog visited the Chicago Auto Show, we wanted to be sure to get a look at the all-new Chrysler Pacifica minivan.

The Pacifica isn’t an update of the existing Town & Country, and it’s not a revamp of the crossover Pacifica SUV/Wagon that was discontinued more than 10 years ago—it’s a completely new vehicle with a brand new look.  If you read about our little mishap, you might have the wrong impression that we were not excited by this new minivan.  To be fair, we saw a prototype at a media event and we are actually very encouraged that this should be a big improvement in terms of safety and carseat installation.

The Pacifica will be available in 7- and 8-passenger models. In both models, there are full sets of LATCH in both second-row captains chairs, and also two full sets of LATCH in the third row (more on that in a minute).  In the 8-passenger model (below, left), the center seat in the second row also has a top tether anchor.  The 7-passenger model can be configured with an aisle in the center of the 2nd row (below, right).  Sliding doors with wide openings are a given.

Pacifica 2nd center seatbelt Pacifica 2nd Tilt

Now, let’s talk about those two sets of LATCH in the third row. That sounds great, but it comes with a couple caveats. One set of LATCH is on the passenger outboard side, and appears to be pretty standard. That’s a nice improvement, too, over the Town & Country.

Pacifica 3rdThe other set of LATCH is offset between the center and driver’s outboard sides, meaning that if you installed a seat with LATCH there, you’d be using up two seating positions. (This is similar to the existing Town & Country setup.) On the plus side, that gives you plenty of room to put two seats back there. On the downside, you can only put two seats back there if you use that offset LATCH position. (You could use all three seatbelt positions, though, or install with LATCH on the passenger side and use the two seatbelts in the center and on the other side.)

The two tether anchors in the third row are designed for use with the seating positions that also have lower anchors, so there’s one for the outboard passenger side, and one that’s centered to align with that offset position. This means that particular tether anchor doesn’t align with the center or driver’s outboard seats when using a seatbelt. We don’t know whether Chrysler will allow the anchor to be used for those positions.

Pacifica offset latchThere’s one other potential downside to that offset LATCH position. Because it overlaps two regular seats, there’s a seatbelt buckle (for the driver’s side passenger) and a mini-connector (for the center seatbelt position) sitting smack-dab in the middle of the LATCH anchors. That means that a car seat would have to sit on top of the buckles. I thought for sure there would be a way to tuck them out of the way, but there wasn’t. I could kind of shove them in, but that actually created a bigger lump closer to the seat bight (photo right, tan).  Chrylser has since informed us that the display Pacifica was an older prototype third row seat configuration.  We have a photo of what will apparently be the improved final design for the third row belt layout with the buckles tucked away for LATCH installation of a carseat (below, light grey):

Pacifica New 3rd Row Bench

Photo courtesy of Chrysler

FullSizeRenderOne major complaint about the Town & Country is that the third row seatbelts often don’t fit well on kids in booster seats and kids big enough to be out of boosters. The belt might not make contact with their shoulders or torsos, which is a problem. We wanted to see if the Pacifica addressed that issue.

Mythbusters: Your pediatrician is a car seat expert

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Our Mythbusters series is back, please welcome CarseatBlog’s newest writer, Katie.

It’s been a while since any myths have been busted around here and I think that it’s about time we get back to setting the records straight. This is one that is of particular interest to me because I have a stake in both sides of the issue.

Myth: Your Pediatrician has been educated in child passenger safety and is the best source of information on when to turn your child forward facing or stop using a booster.

In the years I’ve been a car seat enthusiast, one of the most common reasons I’ve heard for turning children to forward face too soon or to switch them out of a car seat altogether is “my pediatrician said it was fine.” So I thought maybe it would be good to look at whether a pediatrician is a good source of car seat information. Now, let’s be clear, I love pediatricians. I married a pediatrician, I don’t want, for even an instant, to imply that I think physicians are anything other than extraordinary human beings. I just want to delve into whether our pediatricians are good sources of information on car seat safety.

doctor

First, let’s look at medical school education. The first 2 years of medical school are the spent in classrooms listening to lectures, memorizing information and taking absurdly difficult tests. The second 2 years are where med students do rotations in clinics and hospitals and look really scared a lot (I kid, I kid).

The curriculum in the first two years includes: gross anatomy, developmental anatomy, radiographic anatomy, histology, biochemistry, genetics, neuroanatomy, neurophysiology, immunology, pharmacology, ethics, nutrition and often an elective or two. Looking closely at that list, while they are learning about a lot of the principles that our car seat knowledge and decisions are based upon, there’s not any actual education on car seats in medical school.

So maybe residency then?

A general pediatrics residency lasts 3 years and includes insanely long hours and a lot of very hard work. These 3 years are divided into hospital and clinic-based work where most learning is done through hands on experience and then hours of journal and text reviewing at home. During a pediatrics residency, the resident will spend weeks/months in most major specialties including (but not limited to) pediatric neurology, immunology, pulmonology, cardiology, intensive care, gastroenterology, etc.

The American Board of Pediatrics of does provide a single line about car seats in the learning specifications for pediatric residents. It states that they should be able to “recommend appropriate car restraint systems, including car seats, based on age and weight of the child, including those appropriate for premature infants.” It should be noted that this is a single line in an 80 page document of learning objectives, so while it’s there, it’s not a significant portion of the education of a resident.

I think it’s also important to note that outside of CPST training, there really isn’t a class that residents can take to learn about this. There typically aren’t talks about it at conferences or other frequent opportunities to be educated about it, so many times these physicians are looking at the exact same sources that parents are. I know that my husband never received any training in car seats in his residency and that my research on car seats was essentially the first he had ever heard about rear facing beyond infancy. While child passenger safety is undeniably important for pediatricians and their patients, it is not medicine and it’s understandably not their area of focus.

Notably, the AAP does have a statement on car seat usage, which is pretty much what your pediatrician should be telling you about car seats, if anything. The most recent revision, from 2011, states that

“The AAP advises parents to keep their toddlers in rear-facing car seats until age 2 or until they reach the maximum height and weight for their seat. It also advises that most children will need to ride in a belt positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.”

CONFIRMED, PLAUSIBLE OR BUSTED? With the exception of a few wonderful CPST pediatrician hybrids, this myth is BUSTED.

Pediatricians are hardworking, intelligent people and outstanding sources of information on myriad topics related to your child(ren), but when you need specific safest practice information on car seats, NHTSA, Safe Kids, this very website or a local CPST are usually much better options.