What's your philosophy on sleep training? At what age do you start that conversation?
I have recent personal experience on this topic and I quickly realized that every baby is different. That being said, if sleep training is something that feels right for your family, then I am all about it and believe that it works incredibly. It can be hard, but maternal mental health is key in being a good and present mother; often, good sleep leads to a happier mama. I believe getting on a basic schedule from the beginning helps the sleep training experience run smoother. Babies can technically be sleep trained at around four months of age, but again, every family’s situation is different.
What's your overall philosophy on infant feeding? As a pediatrician, what kind of support can you offer families as they learn what works best for them and their baby?
Fed is best. In the early days, weight gain is one of the most important things in ensuring that your baby is healthy. Although breastfeeding has incredible benefits, a healthy baby is a fed baby.
That being said, I fully support breastfeeding and will do everything in my power to support that journey if that is what you wish to do. In concierge medicine, we can truly utilize our time together to do more frequent weight checks, as needed, to ensure your baby is getting what they need. I also have resources in the Miami community with incredible lactation consultants that I can vouch for myself.
What's your view on breastfeeding "goals" or timelines?
The AAP recommends exclusive breastfeeding for the first six months and continuing to breastfeed with solids until the baby is two years old. I believe these are great goals, but they’re not always attainable. I will work individually with your family to create appropriate and healthy goals. Combo feeding provides excellent benefits to the baby and is often a more achievable goal.
How do you approach introducing solids—do you have a preferred method or timeline?
I typically prefer starting solids closer to six months of age, especially for breastfed babies, but it completely depends on a child’s readiness based on their development. I always say there is no perfect way to start solids—the only thing we must do is start allergens early and often.
Starting solids can be fun, but it can also be very stressful. I look forward to working with parents to try and make the process slightly less stressful and a little more fun.
What's your approach to potty training?
Like many things, our outlook on potty training as pediatricians has evolved over the years. In recent years, we are tending to potty train later, which leads to easier and quicker training. I think it is good to watch for readiness cues and not force it, and also use positive reinforcement to encourage success.
What behavioral concerns in toddlers do you take seriously vs. tell parents are a phase?
Before being concerned about a particular behavior, it is good to evaluate what may be contributing to it. Children thrive on a good routine and need good sleep. We also know that increased screen time can increase irritability in children. It is a good idea to evaluate the big picture prior to getting concerned about a behavior.
That being said, toddlers can have big emotions with poor regulation, so oftentimes these behaviors are normal, but it is still very important to take each concern seriously.
How do you approach early signs of autism or sensory processing differences? What does your screening process look like?
Typically we start screening for autism around 18 months of age, but sometimes signs start showing even before that. Early diagnosis is so important because we know that early intervention leads to much better outcomes. Although a diagnosis of developmental delay or autism can seem scary, therapy is never going to harm the patient and can only contribute positively to their development.
What should a parent do if they just think "something is off with my baby" but can't quite articulate what?
Parents spend the most time with their baby. As pediatricians, we just get a small glimpse into a baby’s day or life. The beauty of concierge pediatrics is we can really sit and spend time with a family to try and identify exactly what a parent is concerned about. Parents should never be afraid to talk to their pediatrician; they know their baby best and are most likely correct if they have a hunch that something is off.