Podcast

Building immunity

Building immunity at 24 weeks with Cassidy Mason | S2 Ep43

Building immunity in babies – the how, when & why is on today’s agenda as 24-week old Max is suffering from his first proper cold. Meg gives parents the information they need to know about how immunity builds in babies and why exposure to some germs is necessary. She also shares some tips about sterilizing items and how babies explore with their mouths as part of their development. The mums also chat about whether Max could be teething at the same time. Cass also shares some of her tips for helping Max sleep while his nose is blocked.

 

Building immunity with solids

Cass gives Meg an update on Max’s weight – which was a problem a few weeks ago but he now seems to be heading in the right direction. Cass also shares that while he’s been feeling poorly he hasn’t wanted to eat any solids. Meg discusses why that may be – she also explains the norm when it comes to eating and feeling unwell and she asks Cassidy about whether Max is getting enough iron in his diet & needs a supplement.

If you need some expert guidance from co-authors of Weaning Sense, Meg Faure & Clinical Paediatric Dietician, Kath Megaw, then download Parent Sense app. You don’t need a subscription to access affordable in-app purchases like the 5-week, interactive Weaning Sense online course.

 

Self soothing & changing awake times

They also talk about awake times that are changing now that Max’s is growing and staying awake for longer stretches. Meg summarizes what Cass is doing right when it comes to bedtime and giving Max a chance to learn to self soothe and put himself to sleep at night.

Join Meg and Cass for this week’s episode of Sense by Meg Faure where they chat about the highs and lows of parenting in that first year of a baby’s life.

Guests on this show

Cassidy Mason

Cassidy Mason

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Building Immunity

Intro

Welcome to Sense by Meg Faure the podcast that’s brought to you by Parent Sense, the app that takes guesswork out of parenting. If you are a new parent, then you are a good company. Your host Meg Faure is a well-known OT infant specialist and the author of eight parenting books. Each week we are going to spend time with new moms and dads just like you to chat about the week’s wins, the challenges, and the questions of the moment. Subscribe to the podcast, download the Parent Sense App and catch Meg here every week to make the most of that first year of your little one’s life. And now, meet your host.

Meg: Welcome back, mums and dads. It’s always awesome to have you join us as we journey with mums and sometimes with some experts who come and join us along the way. Sometimes we have our sessions that focus specifically on topics like sleep or sensory personalities, but most of the time I try and bring on mums who are real mums just like you, who are going through the journey of early motherhood. And the person that we have connected with most over the course of the last year is Cassidy. Cassidy was a career woman before she had Max and took a break for a little bit just before she had him. And then Max was born and he is now going to be this week, 24 weeks old. And so we’ve been following Max’s journey all the way along and following Cass’s journey too into motherhood. And each week we talk about the highs and there’s some wonderful ones like Max sat for three seconds in our last session when we were chatting last and of course now 24 weeks. I’m eager to hear whether or not he’s progressed any further than his three seconds. And then they’re also the lows. Like last time we spoke about that incredible juggle about fitting in feeds and sleeps and everything in the day. It is a juggle. And so I’m very, very delighted this week to welcome back Cassidy and Max. Hi, Cass.

Cass:  Hi. Hello.

Meg: Good to have you back. So how are things going with our big boy? Our 24-week-old, so he’s almost six months old, Cass.

Cass:  I know he is. He isn’t…Last time he’s got a cold.

Meg: Oh, okay. Is that his first kind of really…

Cass:  This is his first proper cold and it’s a streamer. Bless him.

Meg: Well get used to it. I think actually, if I’m not mistaken, two sessions ago, I’m sure I had said to you about how immunity develops, but a little reminder for everybody who maybe didn’t catch that one. So Immunity’s incredible because first of all it’s established in utero. So all the little viruses and germs and everything that you had when you were pregnant with Max were transferred to him through the umbilical cord and he gets born with certain antibodies. Then of course, step number two is magical colostrum. And this is one of the reasons why even if a mom chooses not to breastfeed, I always say you have got to give colostrum because what gets transmitted in colostrum, which is that very rich early milk only lasts for three days, but what is in there is just full of great antibodies. And then of course there’s breast milk which also has lovely antibodies.

And then as we go through the rest of the year, all that immunity sticks around until around about six months. And then it starts to wane. And of course he’s hitting six months and he’s showing us exactly that where they have to start to be a little bit more self-reliant and he will have a very robust immune system. And so they have to be more self-reliant and that self-reliance means that they need to have exposure to germs and ohos then their body needs to mount a response to that and they need to do it approximately 14 times before they actually start playgroup or school. And so these early little bouts of illness are actually really a good thing. So as painful as it feels, because I know trying to feed a baby with a snotty nose is awful and they wake up more often at night and, and and…But it’s actually just part of the progression of him developing his immunity, isn’t it?

Cass:  Yeah. So actually, he’s caught it off his dad. Alex came home with a cold on the weekend and sure enough so Alex had it on the weekend and then by the Thursday Max had got it, in fact it was the first day he had his first swimming…I use the term lesson loosely .

Meg: Get social, lovely.

Cass:  Whatever, and which he absolutely lovely. He woke up with this cold and I really didn’t know. I thought, oh gosh, should we take him to swimming because he’s got a bit of a cold and is that going to make it worse? But he was in really good spirits, so really happy, and actually until we got into the pool. I still didn’t even know if I was going to, but he slept on the way there and we decided it was all very warm in the pool and warm in the…So we took him and he absolutely adored it. I’ve never seen him love anything as much, but he, yeah, his cold has got progressively worse. The hardest thing about it actually is as you mentioned, the feeding because he’s obviously, when he’s drinking his milk, if his nose is blocked he can’t breathe and that’s been so… I’ve got Oliversol for babies and I’m putting that on a muslin just before his feed and sort of just hovering it near him, having him sit on my lap and we read a book or something with that nearby so it can help to clear his nose.

Meg: Good Idea.

Cass:  And then I have it just below him while he’s feeding. It’s not making…It is making a difference but he’s still having to sort of, he’s at the stage now where he’s pushing the milk and bringing it forward. So he kind of pushes the milk away, catches his breath and then goes again. So, the other thing that you mentioned about waking at night, I cannot swear enough about on the Calpol plugin. I don’t know if you’ve heard of it?

Meg: No, tell me.

Cass:  But it’s a plugin, and you put these little discs into it and it just emits this, it makes the room smell and very sort of menthol-y and it’s got Lavender and Chamomile and he has not woken extra at night at all from his cold.

Meg: So it’s a little tab that kind of fits into the wall and it emits these amazing smells. It’s very interesting. I haven’t heard of it.

Cass:  Yeah, and it clears completely. It’s like, I mean it’s a bit like an oldest plugin but it’s got Lavender and Chamomile in it as well and he just can breathe clearly at night. It helps him and it’s made such a difference because of course the other thing is the importance of sleep when they’re not very well.

Meg: I know. Yeah.

Cass:  So that if any mums has had a baby with a cold, get yourself a Calpol plugin if you can because they’ve made such a difference.

Meg: Yeah. And that’s so interesting. I mean one of the things that I think is important to note and it is so frustrating when your little one can’t breathe, you know, your default position would be, we’ll just get them a decongestant because that’s what we do for ourselves. But babies of this age actually can’t take decongestants and unless they are prescribed by a medical doctor for specific reason and even then usually they don’t prescribe them for this age. They can have a little bit of Calpol painkiller, which was what I was confusing this with. Because when you said it was a pad, I wasn’t sure or plugin, I wasn’t sure how the painkiller worked but of course it’s not, it’s just to clear the nose. So that’s excellent. But you can do a little bit of Paracetamol if he’s really feeling quite miserable and out of sorts.

Cass:  Wow. Yes, because, and I think this is quite common from what the app said, because I was reading stuff on the app. We went to the doctor because he had to have his monthly weigh in because…If people have listened to previous episodes, he’s had weight problems, so we now have to go every month to the doctor to be weighed. But he’s doing really well. He’s 8.15 kgs.  So he’s still on the 75th percentile. So he is doing really well. While we were sitting there, the doctor said he’s teething now. So we have actually been giving him some Calpol at night, but more I think for the teething because he’s just seemed a bit, I can feel the lump on his gum and he’s just been sort of a bit, I mean I can’t imagine the poor little thing. He has no idea what’s going on. He’s got this searing pain in his mouth and he can’t breathe. I mean he does not understand.

Meg: What’s going on? Yeah, so actually couple of things there. So I mean he does have a cold because you’ve talked about how that kind of preceded the teething, but teething can actually also sometimes be confused with illness as well. And the reason for that, and moms will often say to me, my little one’s teething is really under the weather. But actually what happens is that when little ones are teething, they do produce a lot of liquid and moisture and it can be a really snotty, runny clear snot nose. It can be a huge amount of mucus coming around their mouths. And then that often is associated with them knowing on their hands. And that then in turn spreads the mucus around the mouth and so you get the, this little kind of rash coming up around the mouth as well.

And so that quite typically are all things that you do see with teething. And then with teething you get these incredibly stinky poos. I always say that they’re like almost acidic smelling, slightly sickly sweet smell in the poos and that’s because all of that moisture and mucus that’s moved through and in his case it’s double whammy because he is got it coming through from his nose as well, moves through the elementary canal and it actually creates this horrible kind of stinky poo and we call them teething poos and they’re often a little bit more slimy, slightly different consistency and they often do cause nappy rash as well. So I don’t know if you’ve seen any of the other sides of teething as well.

Cass:  Yeah, he does have some mild nappy rash. There’s no rash around his mouth. And there have been a couple of occasions where I found myself saying, Ooh that’s a stinker, Max when changing is nappy, so that does make sense. But he also, I feel isn’t as happy about solids.

Meg: Mm-Hmm, Definitely

Cass:  He doesn’t seem to be interested in eating.

Interlude
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Meg: Yeah, so I mean Max is, we’ve discussed it before, he’s a settle baby stroke social butterfly. So his sensory profile is that he’s got a slightly higher threshold for sensory information. So he’s probably not as perturbed by what’s going on in his mouth as another baby would be. But our sensitive babies and our slow to warm up babies typically go off food altogether for about three days around teething. They just won’t tolerated because having that spoon go into their mouth; mouths is sore, their gums are sore, they’re irritable around their mouth, they’re just not going to eat. I don’t know if you’ve ever had like an outbreak of  kind of gum boils or mouth ulcers and like you just don’t want to eat because every time you eat, sore so, and that’s kind of what they’re experiencing. So he hasn’t gone off food completely, but you can get the little ones who do, so yes the fact that he’s gone off a bit makes sense.

Cass:  Interestingly, he has not gone off his milk at all though. Is that normal?

Meg: Yeah, that’s normal because milk is much less, it’s more neutral, not as acidic. So it’s not going to…If there’s a little kind of hole, or where the tooth comes through, it’s not raw, firstly. And secondly it’s the sucking the companies that rather than a hard spoon. So yeah, it’s very typical at this age that they do go through a little bit of a hiccup if they do teeth. And by the way, for other mums who are listening, Max is almost six months old as we know. And that’s when little ones start to teeth; over 80% of babies will teeth their first tooth between six months and a year, so it’s highly unusual to teeth before six months. I think he’s about two weeks off six months, so he’s there. But what’s interesting is that often when they start to gnaw on their hands at four months old, because they do find their hands then, parents think, oh they must be teething. But actually they’re not. You do need to wait around until they’re about six months old. So Max is doing a textbook style.

Cass:  Yes, but I have to say so, if she listens to this I apologize to you because I know she’ll know who she’s, but my great friend, she’s been on the podcast before, the mother of my goddaughter. Mel said to me her baby was about for four months. Yeah. And said, yeah she started teething and in my head I thought, Meg’s said this, she’s not teething and she has two teeth now.

Meg: Oh, no worries. Ok, there you go. So it does happen and that we’ve often spoken around the podcast as well that there is no perfect textbook. So she’s in that 20%, in fact less than 20% of teeth early because remember there’s also a percentage that for their first tooth later than a year. So I had a cousin whose little one only teeth his first tooth at 18 months. And I can remember her doing a wild email to me saying, “Look, I haven’t tapped you for any information that, is it possible that my child is never going to get teeth So, I said, “No promise he will get teeth. He’s just taking his time.”

Cass:  Yeah, I mean it’s exciting and he is coping, you know, it goes back to his sensory personality. He is coping amazingly with it because you know, yes the cold is one thing and the Calpol plugin is helping him at night, but he’s still not waking up any more in the night than he was. We’re giving him Calpol before he goes to bed after bath. He’s having a dose of Calpol if he’s been a bit niggly. The other night we didn’t give him and at about 11 he kind of woke up and we ended up giving him Calpol. But most of the time if we give him Calpol at his bath, he goes through till sort of 1:00, or 2:00 and then he’s doing his feeding 1:00 or 2:00, and then he’s then he’s going through till the morning. So that’s excellent. So it doesn’t seem to be affecting him too much.

Meg: Yeah. Excellent, sure, sure, little one. And immunity, just on that; I know we spoke about sterilizing a few weeks ago and if anybody didn’t hear the sterilizing session, do go back and listen to that because we talked about when’s is right time to stop sterilizing. But when it comes to immunity, and I’ve already said, as I said today, it starts in pregnancy and goes through to six months. But from six months some babies then are recommended a supplement in order to help them with their immunity. And just a couple of principles there; the first one is that we always try and get everything that we need in our diet nutritionally from food, that’s our first port of call.

However, some little ones won’t always get everything they need from food, either because they’re very fussy or because they had a trickier start in life or they were born prematurely. And those babies do need some nutritional supplementation. So for instance, a prem baby will almost always be on an iron supplement and many pediatricians will actually put little ones onto a supplement at around about this age because immunity is starting to be tested. And in particular one of the supplements that little ones are often put on particularly breastfed babies is iron. Not all babies have to go on iron if they’ve got a really robust diet of dark green veggies and meat red meats, they don’t need to have iron. But many babies do actually need iron at a roundabout this age as well. So it’s just something to look out for, and probably something to ask your Ped if he hasn’t already mentioned those.

Cass:  Yeah, he hasn’t mentioned anything yet, but at the moment, I mean we have been introducing some dark green veggies in there. He’s actually going to be having, I think beef is on the list for next week. So, but no, we’ll keep an eye. He seems to be the cold’s definitely improving, which is good. He seems to have taken a very natural course where he got the cold and he’s been streaming but it’s not any worse and he now seems to be on the mend.

Meg: You can now tick that virus off the lists because he’s got immunity for that. Well, that’s good.

Cass:   Exactly that particular unique strain of cold.

Meg: That probably won’t happen again next year, but anyway this year. But it just also tests the immunity. It gets their immunity to know what to do. Like, okay. So I’ve a germ, I’ve responded to it and now I’ve got the antibodies. So it really is good for them.

Cass:  I’m glad you know, it sounds strange to say, I’m glad my son has a cold, but you know, as you said, he needs to start getting things. Before the cold came about, because otherwise I would’ve attributed it probably to that is, one thing we’ve noticed is he used to be such a dream, particularly in his cot in the day to put down for day sleeps. He started being harder to put down, just more fussy. I could put him down and I would leave the room and that was it. I could then go off and do my chores or whatever, but now I’m having to go up a few times and sometimes he can be crying.

Meg: And is that for all of his sleeps of the day or specific ones?

Cass:  I mean all of them. He’s more fussy, but some of them…I mean, the other day he took two hours nearly to try and get down steep and that he ended up, you know, in my arms with me rocking. We did one the other day, my husband and I went for a walk in the pram and he just stared us through whole hour. We tried putting the hood down, we tried lifting the hood up. We had the dummy, we didn’t have the dummy, we tried everything and he’s just was…Not moaning, just staring at us, just awake, and then we got home. But it had been so long that I ended up again rocking him and he was in my arms. I’ve played with awake windows I tried to do slightly longer and that got, he started going down really quickly for a day and then the next day

Meg: So, what are you currently doing for his awake windows?

Cass:  An hour and a half for the first one in the morning and then two hours after that.

Meg: Yeah. So next week he’s going to be on two hours to two and a quarter and I would recommend that now you move him up to two for all of them. And turn a quarter for the last one of the day. So, you’ll stretch it out a little bit. So go two hours from wake up to the first sleep. How long are his sleeps at the moment? Are they 45 minutes or are he linking?

Cass:  So they are 45, as always with babies, that is not a simple question. They’re 45 minutes in the cot, most of the time in the pram he can do over two hours. Sometimes we have to wake him for a feed at the lunchtime pram, but only if he’s in the pram. A car seat is also 45 minutes, unless we’re still moving.

Meg: Driving.

Cass:  Yeah. But the cot, with his cold, he’s actually done the other day he did his morning sleep and his lunchtime sleep were an hour and 20 minutes in the cot.

Meg: That’s great. That’s great. Yeah. So it’s quite typical until six months for the little ones to do 45 minutes in the cot for all sleeps. And of course the reason he’s sleeping better when he is in the car seat or in the pram is because he’s in a flex position and that curled up position just helps him to sleep better. It’s one of the things that if our babies were still sleeping on their tummies, he would be doing long stretches. But this thing of sleeping flat on their backs just does mean that they don’t quite sleep as deeply. And so they do wake up after 45 minutes and we can usually get it right that they can link those sleep cycles by about six months. And it usually is dependent on the fact that they have a big meal just before that midday sleep.

And in fact, I also love to do a little top-up bottle after that. So you kind of do a little, almost like a cluster feed at around midday to help them to sleep a little bit longer. But then regardless of how long their sleeps are, whether they’re doing the 45 minutes or whether they’re doing the two hours, you need to watch those awake-times for two hours. And then the only ones that then change is that if he’s going down and what time does he go down in the evening for bed?

Cass:  He goes up at about quarter past 6:00 for his bath and he’s down by quarter to seven because we’re having to do a quick sleep at kind of quarter to five at the moment because he’s waking up and it’s too long.

Meg: That’s perfect. So quarter to 7:00. So then what I would do is I would do quarter to 5:00, he has a sleep but he must be awake by 5:00. So it’s a cat nap. We really, and they can be grumpy after those ones and it doesn’t last forever. You’re just in that stage where he actually can’t make it through without that one and then make sure you’ve got two hours to two hours 15 before bedtime of awake and then he should settle okay. But yeah, it is…

Cass:  He’s fine going down at night still, that’s not changed. Oh good. You know, as I say that we can still, we put him down, and that’s it. Although interestingly, he has decided of his own accord he was having his, I think we mentioned a few weeks ago actually, he was having a feed before a small feed before or half a feed really before bath and then the other half of the feed after bath, then we started putting, because he was struggling a bit with his sleep at night, so he put the full feed before bath. So we were giving him a small feed just because he was used to that before bed. Of his own accord now he is refusing that feed.  After bath before bed, he’s just decided he does not want that. So now we’ve dropped that and we just read him a story and put him down. But that…

Meg: So does he have the milk before bath or before bed?

Cass:  Before bath he has his final feed and then he just said, no, I’m not having…

Meg: Doesn’t want anymore. So that’s perfect. I mean and that is actually, I mean if you look at the app, that’s pretty much what happens around about this age. We stopped splitting them milk feed for the evening. So you could experiment with it being just before bedtime. But I think the fact that it works for you just before bath time is perfect, doesn’t it?

Cass:  Yeah, he seems fine with it and as I say, we read him a story, put him down and he’ll do a full tour of his cot rolling around .

Meg: That’s brilliant.

Cass:  He will come right up to one end and then go right up to the other end and roll all over the place taking his comforter with him all the way and then just fall asleep when his ready.

Interlude
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Meg: So Cass, I’m fascinated about, because I can tell you right now that they’re going to be moms going, “What are you talking about?” Like there is no ways my baby would do that and then fall asleep. So I want to know a couple of things. How do you know he’s doing that? Do you stand in the room or are you watching him on the monitor?

Cass:  On the monitor, yeah.

Meg: Okay. So for other moms, that’s the reason that Cass, actually in many respects has such a good sleep self-settler is that she’s walked out the room and you know, I guess I think that that’s such an important principle that if you stand…If you were one of those moms and there are hundreds who are listening to this and I can tell you that I have done it, you probably have done it occasionally in your journey. If you’re a mom who stands over the cot and watches, well imagine what Max would be doing. He’d look up at you and go, “Okay, so you’re still here. Do you want a job? I can give you a job; sooth me to sleep or rock me to sleep.” And so, it’s actually a very important principle to walk out the room and you can watch from outside. And it is fascinating the way the babies will do something like that, that kind of roll around the cot or hum to themselves or other babies actually rock their heads side to side and other babies do this thing of just like hitting their legs down against the mattress. So you kind of hear it. And all of those are actually self-settling techniques and if left alone little ones who are allowed to will actually fall asleep on their own. So that’s quite an incredible thing that he’s doing, especially at this age.

Cass:  Yeah, no he chats away for the full tour. And actually we decided next week we’re going to have to lower the cot because he is lifting his legs and then sometimes putting them on the side of the cot.

Meg: There you go.

Cass:  Sometimes falling asleep like that with his legs up and his comforter completely over his face. The first time he likes to put the comforter, Kimber, we call the comforter Kimber, over his face and his legs sometimes will be over the side or he’ll roll onto his side kind of in that fetal position. So it’s interesting what you were saying earlier about that position, but yeah, he, in fact, Alex said to me he thinks he’s going to try experimenting, putting him in the cot facing the other way to see if it’s just that he feels he wants to face this way or if he’s just got to do a full tour before he can go to sleep.

Meg: So he ends up facing the opposite direction to the direction you put him in?

Cass:  Sometimes. So the other night we put him in and then the next thing we sort of turn the monitor on, he was right up at the top end of the cot by the camera, then we kind of sat down to have our meal. Something looked at the monitor a little bit later and he was right down the other end squashed up against the bottom of the cot. Other times he’ll just do a 180 and then fall asleep. So, it varies.

Meg: Yeah, no, look, it’s incredible that he’s doing that now and you know, I mean I know many months ago when we were talking about self-soothing, because we’ve had many discussions and if anybody’s interested in how cast did it, we have had lots and lots of conversations over the months of actually how to establish good sleep habits and how to let little ones self soothe and there was no cry out with Max ever. You know, we did it really gently and incrementally and Cass credit to you for the way that you’ve managed that. But one of the things that I said to you right back then is that there’s been research that has been done and it was done by Anders that showed the little ones who get this right between a five months old and seven months old, which is exactly where he is, are typically good sleepers. I mean it really but does bode well that doesn’t mean he is not going to have an unsettled patch because he certainly will. And sometimes it happens when they’re teething and sometimes it happens when they’re ill. And sometimes it just happens with separation anxiety, which is a new phase that’ll come between seven and nine months. But you can always go back to this because you and Max actually know that this is the baseline parameters.

So it’s really, you know, well done to you and Max. It doesn’t happen without hard work, and I think that’s often what parents don’t realize is that it’s not…And people will say, “Gosh you’re so lucky.” Well maybe a little bit of luck in his sensory personality, but there’s a lot of hard work that goes to get him here.

Cass:  Yeah. There were nights where, I mean there have been nights even in the middle of the night where I’ve sort of just laid there with the timer on watching because he’s been fussing and I’ve really wanted to go into him. And Alex, you know, I’ve even had tears in my eyes because I’ve been like, I just want to go to him. And Alex was like, “That’s fine, you’re okay. You’re doing a really good job.” But you know before…

Meg: But he wasn’t distressed, he was just moaning and fussing.

Cass:  Yeah. And I mean he was sort of, there were periods where he might cry but he wasn’t first all. I’d already been in difference once and I’d checked, everything was fine. So yeah, I can hear the difference but this is the interesting thing is that he’s fine at night, it’s just these day sleeps he…So I’ll definitely try that awake window going down because he was going down kind of 10 minutes before the two hours in preparation for the two hours. So I’ll try and put him down kind of two hours, or two hours five minutes.

Meg: Yeah, that’s perfect. And it’ll shift again in the next couple of weeks. And then your next big cusp edge happens at nine months. So, I’ll help you navigate, get through that one, that’s a really big cusp edge where we drop from three sleeps to two sleeps. But they do go through patches and this one right now is the one where he could have been having, if he was having 45 minute sleeps for all of the sleeps, he could be having as many as three plus a cat nap and that just can’t quite fit in. And so this is the age where they go from four sleeps down to three sleeps, and they just battle to navigate it because the daylight hours.

Cass:  Yeah

Meg: So, Cass, it’s so interesting. Thank you so much for sharing again this week, and I really do look forward to chatting to you next week and where we catch up a little bit further. So yeah, thank you very much.

Cass:  Absolutely. Thanks so much, Meg.

Meg: Pleasure Cass. Thanks, cheers.

Outro
Thanks to everyone who joined us. We will see you the same time next week. Until then, download Parent Sense App, and take the guesswork out of parenting.

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