How To Keep Kids Healthy
Episode 7: How To Keep Kids Healthy with Dr. Anjuli Gans of @resilientrascals
Disclaimer: This episode is for entertainment and educational purposes only and does not constitute medical advice. Please seek immediate care from your physician if you have any concerns about your baby or child’s health.
Join Rachael and Dr. Anjuli Gans as they talk about cold and flu season with your kids and babies, partnering with your healthcare team, trusting your own parental intuition, and more! Dr. Anjuli will also answer some of the most-asked questions directly from our listeners!
In this episode we discuss:
how and why Dr. Ajuli started her Instagram page and resources for parents
forming therapeutic alliances with your care team
trends in medical advice on social media and how to know who to trust
how to manage cold and flu season with little ones
tips for hydrating your babies and kids when they’re sick
RSV season and how to protect your baby, especially with older children around
signs of respiratory distress and when to be concerned
homeopathic remedies top things to be feeding your child to keep them healthy
multivitamins and if they are necessary or not
is melatonin recommended for babies and kids?
benefits of breastfeeding past 12 months
managing congestion and silent reflux in newborns
and more!
Dr. Anjuli Gans is a pediatrician at the Children's Hospital of Philadelphia and a Clinical Assistant Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and at Georgetown University School of Medicine. She’s worked in pediatrics for over a decade -- and focuses on early childhood development and pediatric mental health and well-being. But it wasn't until she became a mom of two young children that she realized how little practical health information there was out there for parents. She remembers all of the advice she used to give, before she had kids, that now feels truthfully very unrealistic.
You can follow Dr. Gans on Instagram @resilientrascals to find simple, intentional, step-by-step health tips for parents. You can also purchase one of her in-depth guides on her website Resilient Rascals as well as find a variety of other resources and blogs. Specifically, you can find her Vitamin Guide for children from birth through three years of age here.
Rachael is a mom of 3, founder of Hey, Sleepy Baby, and the host of this podcast.
Listen to the full episode
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Rachael: Welcome to the No One Told Us podcast. Today I am so excited to talk with one of my very favorite pediatricians. I wish she was my pediatrician in real life. Dr. Anjuli Gans is a pediatrician at the Children's Hospital of Philadelphia and a clinical assistant professor of pediatrics at the Perelman School of Medicine. Am I even saying that correctly?
Dr. Anjuli Gans: Yeah, the Perelman School of Medicine.
Rachael: Okay, great. At the University of Pennsylvania and Georgetown University School of Medicine. She's also a mom of two and she started her Instagram page, Resilient Rascals, to be a bridge between parents, incredible instincts and practical medical care that you can use at home to feel confident, caring for little ones in those tough health moments. Hi, Dr. Anjuli. Thank you so much for joining us.
Dr. Anjuli Gans: Oh, hi Rachael. I'm so happy to be here chatting with you. I know we've talked a lot in different contexts, but this is really exciting to be with you on your podcast. It's exciting.
Rachael: I'm really excited to have you here and I really appreciate you doing this fresh off of your bedtime routine. You just put your little ones down. How old are they right now?
Dr. Anjuli Gans: So they're just turning four and six. So we actually used your Better Bedtimes Guide for my little. Because he was having a lot of bedtime separation anxiety, questions, and so thankfully it was a lovely process tonight.
Rachael: Oh, good. Thank you so much. I'm so glad. It could be helpful. It can be such a tricky age. I think a lot of times we get this idea that sleep just gets easier and easier and that parenting gets easier and easier and they really are just always going through a different phase. So were your kids and your journey as a parent. I mean, I guess we became moms kind of around the same time about six years ago. Was that the inspiration behind starting your page or was it more your practice? What made you want to start Resilient Rascals?
Dr. Anjuli Gans: It was, so I think it was for me, I had been a pediatrician for a long time before I had kids, relatively long time I guess, and I had always practiced and learned everything and had wonderful mentors along the way. So I feel like I knew the health things really well and could communicate those with parents. But once I became a mom, I realized how much of it is the care part of healthcare. How do you actually get your baby to take medicine if they refuse to take medicine or all of the things that surround breastfeeding or sleep or nutrition in those first couple years when you're in it as a parent, it's so different. I mean, you have expertise in an area and when you're going through it, you're like, oh my gosh, there's so much more dimension to it. And so I started this page because I felt like I saw a lot of health professionals online talking about big topics and being, talking heads in the media, interested in different things. But what I really cared about was the care part of the healthcare and making sure that parents had a quick place that they could go if their baby has a cough in the middle of the night and just walk them through it simply with intention step-by-step. And it's been incredible, the growth, the community I have, these parents are so wonderful, so warm, so positive, so life giving. So it's been a wonderful journey. It's taken on a lot of different dimensions since then.
Rachael: It's such a fabulous resource. I have used it so many times, kind of like you said in the middle of the night when one of my kids has had something going on with them and I'm like, oh, shoot, I don't remember what to do, or I don't remember the signs or symptoms that I should be looking for. I think this is what's going on. And instead of Googling, we all know that Google is not a good idea when you're thinking about symptoms with your kid. So instead of Google, I go to your page and it's so just warm and I don't know, you just have this way of being so reassuring and giving parents the information that they need to know without being scary. But also what I find and what I have found in the work that I do on Hey Sleepy Baby, is that a lot of times there's this kind of divide between pediatrician and parent because pediatricians are, you have such a huge job and a huge responsibility. And so I think sometimes the advice that might be given is that standard by the book, evidence-based advice or recommendation. And then that doesn't always translate to real life and real parenting with little humans that are all so different and have different needs. And I do hear a lot from parents who are so discouraged by conversations that they've had with their pediatrician about things like sleep or breastfeeding. So I am just so glad that you are out there to kind of be this voice of reason in that space and to just meet parents with such compassion. I think it's just so important.
Dr. Anjuli Gans: That’s very kind of you, Rachael. It's a very sweet thing to say and it means a lot because I agree with you. I think in this space it's a) just very challenging to have any kind of nuanced dialogue. And so you are right, people start to retreat into corners. And for many pediatricians, they're very overworked. There is not enough time to talk about all the things that we would love to talk about. I wish I had hours with every patient, because I would be able to talk about everything and answer every question and make sure that we were all comfortable leaving. So I do understand that it's a challenge for a lot of health professionals to be in a system that is really challenging at times. And at the same time, there I think there are a lot of health professionals in this space who maybe don't practice anymore. And this is their domain. And I think that sometimes for a variety of reasons, you can kind of forget that there's evidence and that that's really the foundation of how you give recommendations. But there's also clinical context and that's so important, right? And that's where you see a lot of the guidelines starting, even though it's very slow, but starting to shift with the breastfeeding medicine, for example, recommendations for a lot of subgroups within the AAP to marry the evidence with that clinical context. And then lastly, I think we, in my practice at my hospital, it's one of the best children's hospitals in the whole world. It's an amazing place to work. And we still do regular conferences and regular meetings to talk about personal bias, professional experiences that create bias in the way that we approach our practice. And that's everyone, right? We all bring some sort of background or some experience or some bias to the practice that we give, especially when it relates to other families and parenting. And so I think that it's important to recognize that for anyone working with families in any capacity, and it's okay, we all recognize that we have that, whether it's personal, whether it's parenting, whether it's race, whether it's socioeconomic experience. It's okay to say that we all come to things with a little bit of bias and to recognize it and to know why we have it, and then to adjust accordingly. And I think it's really kind of a shame when you see these things on social media where people feel so defensive about what other people say, that they kind of feel like they have to say, I'm a pediatrician and I read and I do continuing education. We all do that. We all get it. Everyone's in it. But that doesn't mean that you can't grow in your profession. And I think that clinical practice in general does really help you to do that. Not that everyone isn't practicing, but I think that it forces you because it's an evolving field and you have to really be a part of it. And I think a lot of the sad stories that you talk about just, they break my heart. I'm sure nobody goes into this practice thinking, gosh, I really hope I can just make people feel uncomfortable and then walk away. I'm sure nobody's becoming a pediatrician to get rich. Nobody's becoming a pediatrician to do anything but to serve families and kids. And it's sad. It's a rupture in a relationship that should be positive and comforting and warm.
Rachael: I agree. I know, and I still remember my pediatrician. I think I went to him until I was like 22 or 23. I just never wanted to leave.
Dr. Anjuli Gans: You relate with them.
Rachael: It was just such a great relationship that my whole family had with him. And we love our pediatrician that we have now, and it can be such a special relationship. And my mom still talks about him and how she used to go to him for advice and ask him his opinion on pretty much everything and call him all the time. And it is sad that people don't always have that relationship. And there also comes a time where we do need to also listen to our intuition and know that you don't necessarily have to get, I think a lot of people feel like they have to get their pediatrician's stamp of approval for absolutely every choice that they make. And I think what you seem to do is put the empowerment back in the parents' hands and let them know that, no, you fought this your baby, and you know what you're doing. I'm here to support you and to help, but you don't need my permission to do anything.
Dr. Anjuli Gans: Yeah, absolutely. And I think that's so important because I feel like when you're a new parent, I mean, it's so wonderful because it's such an empowering thing, but also there's so much to think about, so much to worry about that I always tell parents in the office, outside the office, you do know your baby best, you know your baby 24 hours a day, the ins and outs. So even if you don't believe that you know them best or you think that I have to give you a stamp of approval for something, that's not the way it should be, right? We're partners, the relationship of a parent and their care provider, whoever that is, should be one of partnership, not of deference necessarily. And I think you're right. I feel like it's really important to give parents the tools they need so that they feel good walking into a visit. And so they feel comfortable saying, I don't really want to talk about that. I've got it under control, or I'm good. Don't even worry about that. And I feel the same way. I'm a doctor, but when I go in to see doctors, I had this back thing happen with this injury, it was horrible. And I went to the emergency room, which I haven't been sick in 15 years, I think.
Rachael: Oh my gosh. You must have an immune system of steel from working.
Dr. Anjuli Gans: Yeah. Yeah. Thank God. I mean, it's a blessing, but just from years of experience, I haven't had a cold or a fever, nothing. And so I had an injury and I had to go to be the patient. And I understand that instinct. You're kind of like, okay, well, I don't want to disrupt too much and I don't want to upset anyone.
Rachael: Don’t they say that doctors are the worst patients.
Dr. Anjuli Gans: Yeah. I mean, I'm definitely, my husband will attest that we're not great. We think we know everything, but also we sort of don't want to. It's just a lot. I don't know. So I understand the instinct, it's what I need to say, but I do think that it's important to feel empowered and in this day and age when these relationships can be different than they were 20 years ago, it's important to make sure you feel comfortable standing up for yourself. I'm standing up for your child and advocating for them in any capacity. And it's hard to do, and we're all so polite and we want to be nice, but also it's okay to say, I'm going to set a boundary around this, and that's where I am at the end of the day. It's your family.
Rachael: It's so true. And you were talking before about how you know your baby best and you see them 24/7, and nobody could possibly know them better than you as the parent. So that kind of brings me to what I want to talk to you about with our health segment here is what are some things that you would look for getting into cold and flu and cough season and everything? What would be some things that you would look for? So maybe a parent is noticing some different behaviors or some new symptoms crop up. What are some things that you would say like, oh, that is definitely something that you want to get checked out. That's kind of a red flag. If you start to see these changes in your child, this is something that you definitely want to be watchful for.
Dr. Anjuli Gans: So I think for specifically cough and cold season, so whatever the virus is that your babies are dealing with or bacteria for cough and cold at any age, the big things you want to look for overnight or if you're kind of away or anything are respiratory distress. And I have a reel that I have pinned on my Instagram page that will walk you through exactly how to do that and how to assess a baby the way I would if I were in the office looking at your baby. So it's counting their breathing rate. It's looking to see if they're working hard to breathe. So if they're using accessory muscles like in their rib cage, if their nostrils are glaring, if they're making any extra sounds that you haven't seen before or heard before, those are immediate things to seek care for. And that doesn't mean you have to race to the emergency room, but if you have a care provider, you want to call them. And it can really help if you write the things down that you see in terms of your baby's breathing. Because a lot of times I think when you're in it, you're tired, it's overwhelming. You can just be like, something's not right. But the more data you have, the better. So if you can count how fast they're breathing every minute, if you look for those things that I mentioned that can really be helpful.
Rachael: Or even take a video, would it be a good idea to take a video?
Dr. Anjuli Gans: That’s a great idea. Yeah, that's a great idea. Videos are incredibly helpful, especially with sounds. That's a really good idea. So I think in terms of cough and cold season, it's really, really important to know what respiratory distress looks like. So that's one thing. The other thing is dehydration and making sure you know how to look at, not just how to hydrate your kids, how to keep them hydrated, but also how to know they really haven't, for toddlers, let's say they haven't really peed two to three times in the last day, or for a baby younger than one, if you notice that they've had less than five or six wet diapers that day. Dehydration is one of the main reasons that babies with respiratory illnesses are hospitalized in the winter.
Rachael: Oh really?
Dr. Anjuli Gans: Yeah. So it's not always just the breathing. It's often times they're breathing so fast, they're really uncomfortable that they can't take enough fluids in to support that extra metabolic need. So those are the two biggest things that every parent should know in my opinion, is how to assess hydration and dehydration and then how to look at respiratory status.
Rachael: Okay, that's so good to know. I didn't know that about the dehydration, but I know that under six months you're not really supposed to give water. So how do you make sure that your baby is getting enough fluid?
Dr. Anjuli Gans: So there are two big ways that you can do it. So under six months, you're right. You always want to do it in conjunction with your care team just because it's such a vulnerable time. So if you have any extra breast milk or formula, whatever you're using to feed your baby, you can give it to them in a syringe. If they're not feeding at their normal rates, you can help to supplement them in those ways. You can talk with your pediatrician or with your care team about an oral rehydration solution after three months old, something like a Pedialyte or some similar version of that. Those are safe ways to rehydrate babies at those young ages. But you're right, your options are a little bit less common, a little more limited, I should say, at those ages. So do in conjunction with your care team. We do things like that all the time.
Rachael: And then for older babies who are started on solids, toddlers, young kids, you can get a little more creative and a little more fun with broths and popsicles and stuff like that. And then, I mean, I know that you talk a lot about more natural or homeopathic remedies too, which I absolutely love that you kind of marry that with western medicine. So what are the top things to be feeding your older baby or your child if they're struggling with a cold or a cough or something like that?
Dr. Anjuli Gans: That's wonderful. Yeah, so I'm Indian. I grew up with a lot of Ayurveda in my house, and my mom and I still are very much like, we use medicine when we absolutely have to, but truthfully, it's very rare in our families to use things unless we really have to. So it's good to have as a tool, you always want to use it if you need it, but if you can do it in other ways, it's wonderful. So in terms of foods that kind of help support immunity during cough and cold season, zinc is a big one. So a lot of foods, different foods have zinc in them. You can just look and check and see common things that your baby's probably already eating, have that in them. Vitamin C probably won't help to prevent a cold, but there is a lot of data that it can help to reduce symptoms and shortened duration of illnesses. So everything that has Vitamin C in it, fruits, cuties, orange juice, things like that really can help. Vitamin A is another one that can help. And all of these, it's really ideal if you can get them through diet. I know it's not always easy. I know babies and toddlers can, they never want to do what you want them to do in the moment of, oh, they need this. But those are three kind of things that can help. And then if they're already sick with coughs and colds, a big thing that helps is an amino acid called cysteine, which is basically a protein that you find in chicken broth. So chicken soup really does help. We all grew up thinking about that and hearing about it. It actually really does. It's kind of neat. So the cysteine in it helps to break down mucus and congestion, and so as much broth as you can do, it's not just hydrating, it's got great electrolytes in it, but also the deep part of it will really help with healing. So whether that's bone broth or chicken broth or you can make lentils, they have a lot of it in them. There's lots of ways to do it.
Rachael: Okay. Amazing. So you mentioned that it's really best for our little ones to get these important vitamins and nutrients through food, but I know that a lot of parents wonder about vitamins and if their babies should be taking supplements or vitamins. What are your thoughts on that?
Dr. Anjuli Gans: So I think this is such a good question. It's the most common question I get asked.
Rachael: Oh really?
Dr. Anjuli Gans: Outside of the office. So it's a great, great question. Really, if you have an otherwise healthy baby, healthy child, they don't need extra vitamins. They will get enough, even if they're a selective eater, they will get enough through their diet to support general growth. Now, the kids who there is some benefit to a vitamin or a supplement are kids who maybe are profoundly selective. So a lot of kids who it's not just a week of really refusing to eat, it goes beyond that. Or there are kids who maybe have sensory sensitivities or textural sensitivities, neurodivergent kids, children who have chronic medical conditions, so celiac disease, other medical conditions or kids who are taking other medications that might interfere with vitamin absorption. There's very specific groups in that. Now I say that, and I know that I had toddlers until very recently, and I know they can be incredibly selective. So you can always choose vitamins during those times to help support their general wellbeing. But the truth is that most healthy kids really don't need them. And I know that goes against the grain of what everyone is out there selling, talking about promoting. There are things that will help your kids if they get sick. There is very little that will help to prevent them from getting sick if there's general exposure or just really in day-to-day life. So I always like to kind of emphasize that because I think there's a lot out there. I'm a parent on social media and I see people lining up their things of supplements and probiotics and all that stuff, and it's totally fine. If you want to do that, that's fine. Do I think that'll make the difference between you having a completely sick free kid for yours versus not? Probably not. But again, in those specific situations, or if you feel like it's really helping your family, that's fine.
Rachael: And if you were going to do them, you'd want to make sure that you're just getting something that's high quality. And I know there's also just so much that's unregulated, and especially like you said on social media with people hawking all kinds of things all the time.
Dr. Anjuli Gans: And it's hard. I know people feel very strongly and they love the brands they love, and that's great. If it works for you again, it's totally fine. But yeah, I would look for brands that are, I don't know that they're necessarily higher quality, but that maybe are a little bit longer established that have been out there for 10 or 15 years. I have a vitamin guide if people want it just to take a look. It's on my website and it's just, I poured through all of the brands that I see people talking about out there, and then the ones that I would recommend, and it kind of talks you through when your kids are healthy, when they're sick, if they’re dairy free, if they have food allergies. It just gives you a couple options if that's helpful.
Rachael: Oh my gosh, that is so helpful. I didn't know you had that. That's amazing. Okay, great. I'll make sure that we put that in the show notes for people to find it easily too. And then people always ask me, and I'm like, ask your doctor about melatonin. So the same type of question here. It's like, do you need to give your toddler melatonin? Really? I am always on the side of no, but again, I'm not a doctor, so I would love to hear what you think about melatonin. I know there's been a huge uptick in its use for kids since COVID.
Dr. Anjuli Gans: Yeah, and I understand the instinct because for so many kids falling asleep can be so challenging. So I'm sure that's what you see when you're talking with clients. They're like, oh, it'll just help them fall asleep and then we can get over that hump. The things I'll say about melatonin in general are that there is a very specific place for its use, and there is some data that supports its use mostly in the setting of kids with some sort of neurodivergence who maybe do really have difficulty regulating, especially when it comes to sleep. That said, it's a hormone. It's not something that's just kind of in the water. It's a hormone. And so as a hormone, there are lots of things that it can affect in your body. The second thing is it helps you fall asleep, but it won't help you stay asleep. So if you have a baby or a toddler who's waking up multiple times a night, it's probably not going to help that. There's probably a root cause that you need to look at beyond that, whether it's routine or behavior or other things or organic pathologies. And then the other thing I'll say about melatonin, that you're right, there's been a huge uptick in people using it. And I get it, life is very challenging in this day and age, the way we're expected to raise our kids. But there's also been a huge uptick in overdoses of melatonin, kids visiting the ER for that. So I think it's specifically one of those things that is very much unregulated. You can find it dosed in incredibly different ways, and there's no clear sense of where you start dosing an infant or toddler. So I think there are specific uses for it. And like you say, I think you have the right instinct with it, which is just to say that there's a very specific need for it. And if you meet that need and work with your care team on it, I think it can have a purpose. But in general, I think it's pretty overused. Yeah.
Rachael: Yeah. I appreciate you saying that. I know it's kind of an unpopular opinion.
Dr. Anjuli Gans: I know people will be like, oh, we're going on a flight and we have to use something. And I'm always the waa, waa person in the office always like, oh gosh…
Rachael: I know. That's usually what people will ask me about in that scenario too with travel. And I get it. It's hard, but like you said, maybe it'll help them fall asleep, but it does not help them sleep better overnight. So what's the point? Alright, well thank you for answering that one. Just back to coughs and colds really quick before we get into some of our listener questions. I know something that is on a lot of people's minds right now is also RSV. We're kind of getting into that season. RSV can be really serious and really scary. I remember it was almost exactly a year ago now because I was very pregnant. My middle daughter had RSV when I gave birth to my baby. So we were bringing this baby home to an RSV infected house, and it was super, super scary. We just kind of did our best with hand washing and cleaning and making sure she didn't stuff her face in the baby's mouth or anything. But it's hard when you have toddlers who don't really understand. And what would be your top advice for parents who have more than one child or they have a new baby that's coming and they are trying to keep this baby healthy from RSV, what would be the top things that you would tell them?
Dr. Anjuli Gans: Yeah, it's such a good question. This is one of those areas where I see just a lot of advice that I always think is so impractical. They're like, oh, we'll just isolate and you and the baby go to one place. I mean, I don't know about other people's toddlers, but my toddler when I brought home our baby would not have had that.
Rachael: Absolutely not. That was her baby.
Dr. Anjuli Gans: And it would've been distressing for him to just suddenly have us not around. So there's a lot to think about. So I think the big thing I would say is, just like you said, you do your best in a family. So the best thing you can do, as you mentioned it, is really just kind of working with your older siblings on how to change their contact points with the newborn or with the baby. So maybe they're not stuffing their face into the baby's mouth. Maybe they get a special place on the baby they can touch and maybe that's like their feet and that's their special place and nobody else can touch it, touch the baby there and that's theirs. Or maybe you say you do try to keep your distance as much as you can. That's one thing. But when you're a family in a home, it's tough.
Rachael: It's hard.
Dr. Anjuli Gans: It's hard. And I think hand washing will do incredible amounts. Air purifiers can sort of help to reduce the respiratory droplet components. So RSV travels or bronchiolitis can travel through the air. It's a respiratory disease, it travels through touch, so direct touch and then just kind of high contact surfaces as well. So doing your best with hand washing, doing your best with changing the ways that your toddler and baby interact. And then for you, if you get kissed and dust with the toddler, just make sure that you wash your face off and hand wash as much as you're able before switching to kids, if you're able to do that. And then the last thing I would say, is that I know this is really scary. It's so scary to have a newborn who's sick, especially in the winter, but it happens, and if it happens, it's nothing you did that's a failure. It's just real life. And so we do our best and sometimes our newborns get sick and it's scary and it's horrible to go through, but it happens and it's nothing to do with anything you did that was within your control.
Rachael: Yeah. That's so important to let parents know that I know that there's so much anxiety about tiny, tiny babies getting sick and like you said, we can do our very best and we can know the signs to look out for, like you mentioned earlier, and that's sometimes the best we can do. Alright, I would love to get into some listener questions right now. This is going to be a breastfeeding question. Hold on.
Listener 1: Does breastfeeding actually help with all of these illnesses, particularly after one, because we always hear the benefits almost stop at six months or a year.
Dr. Anjuli Gan: No, the benefits continue. The benefits continue. Your antibodies pass through breast milk, however you choose to breastfeed your baby or give them breast milk, those antibodies continue. All of the amazing things about how you feed your baby are just really neat over time. So your breast milk adapts over time. So beyond six months beyond a year, the components of it, like the fats and the carbohydrates and the protein adjust to meet your baby's needs, it's really incredibly dynamic. So you're right that you really only hear about it from six months to a year, but the guidelines and the recommendations on it have changed and have extended to support moms. They're not perfect. They don't take into account a lot of the challenges moms face, but in theory they want to support you till beyond that six months or a year. So yeah, it definitely can help.
Rachael: Okay, great.
Listener 2: Hi yes, my 2.5 month old girl, we’ve been dealing with a lot of nasal congestion, constantly several times a day clearing boogers out of her nose, doing saline drops, the nose sucker, the booger picker, we have a humidifier in her bedroom. I am just wondering if that's normal because it's been going on for several weeks. We went to a doctor and they said that it was normal, but I am having some strange is mama instincts about it. So any suggestions there?
Dr. Anjuli Gans: So I wouldn't say that it's necessarily normal to have congestion that persists in the newborn into that timeframe. You can certainly have congestion in a two month old that can come from just having boogers in a small nose, like babies have small nasal passages. It can sometimes be hard to clear. So doing all the right things is really great because it kind of helps you to eliminate those things as causes. The other thing that I always want parents to think about is we think about the lungs and the nose, like the respiratory thing. So humidifiers, saline, suction, those things are all great. Around this age, reflux can also start to really crop up. So it's really, really common for babies around six weeks old to eight weeks old, especially because of the way their gut is changing and the development that it's seeing, to have increased reflux symptoms. So a lot more gas, a lot more spitting up, a lot more fussiness. And sometimes reflux can look like spitting up a ton of milk, but sometimes it can look like a thing called silent reflux, which is where the milk might come back up into the back of the throat or the back of the nose, but not come all the way out. And the way that you would notice that is congestion and chronic congestion. So it might not be that they're actively spitting up, but it might be that they're a little bit uncomfortable after feeds or they're fussy or when you've lay them down, they start to seem uncomfortable. And also it sounds just like nasal congestion, because it is milk that is sitting in the back of the nose and the throat, and it's just the same exact sound. So I would definitely think about that. Very rarely you can have other causes that are more anatomical causes for congestion that kind of continues in the newborn period. So one nostril is not as open as the other or other things are happening. But those are the big things I would sort of think about. I think your instinct is always good, so I would trust.
Rachael: What about allergies? Would that be something that would show up this young if they had an animal in the house or dust or could a newborn have congestion from stuff like that?
Dr. Anjuli Gans: Yeah, it's great, oh, actually that's a very good point. So babies can get, we call seasonal allergies, allergic rhinitis. So from all this stuff we get with just seasonal allergies, babies tend to get, if they get allergies to environmental things, we call it non-allergic rhinitis, which means that dust might trigger their nose to have the symptoms. So maybe they sneeze a little bit more or they have more congestion, but it's not the whole body allergic response that it is in older kids. That's a very good point. One of the most common reasons for congestion in newborns is actually not just dust, but candles or essential oils like the scents that come from those. So it's something we usually try to avoid or recommend avoiding for parents of newborns, but that's a very good point.
Rachael: Okay, great. I think that's super helpful and that'll give Candace a lot to think about. Okay, thank you. Let's do one more.
Listener 3: Hi, my question is more directed towards toddlers and older kids. You know we always say don’t kiss the baby, especially when it's RSV and flu season, and I’m just kind of wondering if that still holds true when they're closer to three and even older. Not that I want a bunch of family members kissing him, but, you know, as far as parents, do we still need to be conscious of that? Or is it not quite as serious once their older?
Dr. Anjuli Gans: Yeah, it's a good question. Probably yes. In terms of how respiratory viruses tend to spread, it's through your nose and your mouth, so it's sneezing, it's coughing, it's kissing. And again, all of that in context of what's feasible in your family, what makes sense, but in general, especially if those older kids are in a childcare setting or in school, just making sure that you're kind of limiting how they interact with a young baby. Things that can also help as kids get older and maybe are exposed to more in the world are just making sure that they change clothes when they get home at the end of the day, or that they wash their hands as soon as they get home, or even if you do bath time every day to just change bath time. So it's kind of as soon as they get home. So you're reducing the germ burden as soon as they get home from the outside day can help too.
Rachael: Okay. That's a really good idea. Thank you. And I know that you have, I mean you your amazing Instagram page, but you also have some other incredible resources for parents who are looking for more about how to keep healthy, especially during cough and cold season. I know you have your health handbook. Can you tell us a little bit about what's inside that?
Dr. Anjuli Gans: Sure. I love the Health Handbook. It's been something that parents have just said has been really helpful to them, which makes me feel so warm inside and warms my heart. So basically it will take you through the 35, I think, most common illnesses that kids have in their first three years of life. So whether that's reflux or eczema or bronchiolitis or croup or GI bugs, it takes you through them as though I'm right there with you. So it basically will give you a little background on what it is, but then it will take you through step-by-step what to do, what things to have at home. And then for me, the most valuable part of it is when to call your pediatrician. And it's not the general stuff you see. Like you said out there on the internet, it's very specific triage based information. So it's exactly what I would say if I was on call and a parent called me and they were like, when do I come in? When do I go to the emergency room? And it walks you through exactly when to seek further help. So hopefully it's helpful for people, especially as we get into the sicker season this year.
Rachael: I love that. I think just having a handbook is just so genius because like I said, I use your page all the time as a resource, but just to have something like a hard copy of something that I can just reference all the time is such a genius idea. I'm so glad that you did that. And then you also, you're getting ready to launch some products, is that right?
Dr. Anjuli Gans: Yes, I am. I'm really excited about it. It's sort of an extension of the Health Handbook, which is basically, as you and I were talking about earlier, I feel like we really need to blend the health with the actual care. So what things you actually need at home. So I'm really excited. It's going to be a couple of basic care packages. So if you have a newborn at home, if you have a baby with eczema, here are some things that are all bundled up together that are high quality recommended based on the latest pediatric guidelines and things that I've tried with my own kids or just personally have tried to make sure that you have just anything you could possibly need at home ready to go. So you're not frantically racing out to the pharmacy, you're ordering stuff online in the middle of the night or trying a million different things. It's kind of just exactly what you need. It goes through the handbook, does just how to use them, what to do.
Rachael: I love that. That's such a good idea.
Dr. Anjuli Gans: Yeah. Hopefully that'll be helpful to people.
Rachael: Oh, for sure. I mean, I love your recommendations just for that. I mean, I love stuff. Obviously that is tried and true by a mom, but the fact that you're a pediatrician makes it even better. I just always know that I can trust when you're recommending something, and I know you're not just trying to sell whatever you really believe in what you're sharing.
Dr. Anjuli Gans: I mean, I don't do any sort of paid ads mostly just because I want everyone that is with me and that meets me to know that everything I do is just, it's created by me, and it's because I've tried it and used it, and I know you do the same. It's wonderful that the products that someone believes in.
Rachael: For sure, for sure. Well, thank you so much. I feel like we need to do a part two because we didn't even scratch the surface of all of the things I wanted to ask you about. Maybe we could talk about potty learning next time. I know that's another thing that tons of people had questions about.
Dr. Anjuli Gans: Yeah, I love that. Maybe in spring, earlier in the time, that would be a good time. It's always a good time to start thinking about it.
Rachael: Yes, that's so true. Okay, well, let's do that. Thank you so much, Dr. Anjuli. Where can people find you and find all of your amazing resources?
Dr. Anjuli Gans: You’re so sweet, Rachael. This has been so fun and everyone's questions were so great. Thank you. So you can find me on Instagram at Resilient Rascals, or my website is resilientrascals.com. It's really easy. It's got all of those resources that we mentioned, as well as a searchable blog. If you just don't want to be on Instagram in the middle of the night, you can just look up things that way too about all of the same information. So hopefully that's helpful to families.
Rachael: Perfect. Thank you so much for joining us. I'll talk to you soon.
Dr. Anjuli Gans: Talk to you soon, Rachael. Thanks for having me.
