San Diego Babies and Toddlers 2024

published by

2024

San Diego

Babies and Toddlers From Baby Bump to Toddler Time

Publisher’s Letter

inside

Welcome to our Babies & Toddlers digital publication!

Congratulations on your new baby! San Diego Babies & Toddlers is for first-time, second-time and third-time parents. Babies grow up fast, but we cover toddlers also.

Look through the whole publication at your leisure, then come back to it when you need advice, helpful information and resources.

If you are working while pregnant and plan to go back to work after baby, find good suggestions of how to prepare (steps to take while still working) on page 8.

Breastfeeding has many benefits. On page 16 is a list of healthy snacks to enjoy while breastfeeding. Remember, if mama is healthy it helps baby stay healthy.

It is always a cheerful time when you can finally say, “She slept all night.” Stevie Trujillo, a local postpartum doula and sleep consultant, gives great advice to getting baby to sleep all night (page 12). Read through the suggestions to learn how to establish healthy sleep habits from the beginning.

As babies start eating solid food, they might be more interested in snacking than eating what is prepared for dinner. Get help on page 30. My advice, as a grandma, is to make healthy foods they like to snack on part of dinner.

Just remember that toddlers have attention spans of 2–3 minutes. Don’t expect them to sit at the table throughout the whole meal. And most important, don’t get uptight.

Enjoy little ones at every stage as they grow. Find a friend group to talk to, bounce ideas off of and to laugh with.

Contact the advertisers in this publication; they offer valuable services that can help or answer questions you might have.

sharon@sandiegofamily.com

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Third Trimester To-Do List

8 Before Going on Maternity Leave How and why to plan your return to work early 12 Sleep Shaping How to establish healthy sleep habits for baby 16 Snacking for Breastfeeding Moms Healthy snacks to stay nourished 20 Understanding Postpartum Depression What it is and what to do if you have it 26 Oh Baby!

Some of our favorite baby and toddler products 30 Help! My Toddler Won’t Eat Dinner How to handle toddlers who want to snack all day 32 Cheesy Cauliflower Fritters A favorite for all ages

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Building communication while letting your child's true colors shine True Colors Speech Therapy offers one-on-one, in clinic and in-home therapy tailored to meet your child’s unique speech and language development needs.

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Get to know SanDiegoFamily.com, where you’ll discover these articles and a plethora of awesomeness for parents.

Parenting: Pregnancy

Doulas 101 How doulas make a difference in childbirth

Third Trimester To-Do List If you’re in your fifth or sixth month of pregnancy (or know someone who is), the checklist below may be helpful. It’s a list of suggested classes to take, things to plan for and tasks to complete during the third trimester so parents feel more organized when baby arrives. Find the full list (and other free resources) at www.mommylabornurse.com.

Start doing kick counts

The 4-1-1 on Fitness for Moms Exercise during and after pregnancy

Take a birth class Write a birth plan Take a baby care and CPR class Take a breastfeeding class Pre-register with your hospital/birth center Choose a pediatrician Prepare for maternity leave Choose childcare for when you return to work Wash baby clothes and linens

Parenting: Baby

Stock dresser and changing stations

How to Cope with Crying Babies Tips to address persistent crying

Sanitize and clean baby gear Stock up on postpartum essentials

Talk to Me, Baby!

How to encourage speech and language

Finalize baby name Clean, declutter and organize your home Finish decorating baby’s nursery Order a breast pump Schedule newborn photos Make or purchase healthy freezer meals Pack your hospital bag Install baby’s car seat, read the manual and practice using it Make plans for childcare/pet care for when you deliver

Parenting: Toddler

Best San Diego Playgrounds for Early Walkers Smaller parks suited for little ones Tips for Potty Training Success Signs of readiness and the 3-day method

Know the signs and stages of labor (and when to call your healthcare provider) Plan a date night Rest up

Liesel Teen, BSN, RN, is a labor and delivery nurse, founder of Mommy Labor Nurse and a mother of two kids. Follow her on IG @mommy.labornurse for education, tips and solidarity on all things pregnancy, birth and postpartum.

4 • SanDiegofamily.com • Baby & Toddlers Guide 2023

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Stephanie Kramer

How to Navigate a Return to Work

Before Going on Maternity Leave “Pregnancy is work, but as you build your career while you grow your family, it is more than a milestone.

It is monumental. The intersection of work and pregnancy is significant, and its importance is something to recognize, to normalize and to celebrate.” ~ Stephanie Kramer, author of Carry Strong: An Empowered Approach to Navigating Pregnancy and Work With the right support and thoughtful planning, it can be very powerful to unburden your confidence, broaden your perspective and unlock your potential for the journey to working motherhood (and through it). I’m here to discuss the why and how of anticipating your return to work after baby while you’re still pregnant.

“Anticipate” is the key word.

Your needs and feelings will likely change when baby arrives, but understanding the possibilities and preparing now helps you see options, when needed, with clarity. This includes assessing your boundaries and current work environment, which helps downregulate the feelings of a looming return to work before going on maternity leave and focus on what you’re looking forward to with your growing family.

Beyond transitioning work responsibilities, preparing coworkers and celebrating this mega moment (take a photo at work!), there are three things to do before going on maternity leave to empower your journey of becoming a working mom.

Do a Walk Through Physically walk through your workday while pregnant, imagining yourself with baby. Start with when you wake up and contemplate each portion of your day until you’re back home (or if you work from home, when you switch off your “day job”).

Think about what you may need throughout the day (and who), but also how you may feel. Be as detailed as possible, making lists as you go. Ask questions now to relieve what’s on your mind. For example, what does your commute look like and how will that need to change? When you’re at work, is there a mother’s room available, should you be breastfeeding and need

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to pump? Is it somewhere that needs to be reserved? Where will milk be stored?

Go into detail. Are there services available if you need to travel?

Beyond logistics, what are expectations outside of work hours for how you check in (or not)—assess your own boundaries and work responsibilities. What will you need to do if they change after maternity leave?

Ask for a Review Regardless of formal review process timing, meet with your boss or manager (if you have one) with the purpose of obtaining feedback, versus only discussing off-boarding or timeline for maternity leave. Discuss your performance on day-to-day tasks, long-term plans or projects and your value as a teammate.

This provides a checkpoint, not about your pregnancy, but to know where you stand at work before it becomes a distant priority for a little

while. This is also a great time to share your expectations of your manager or coworkers, ask any questions and set up expectations for remaining time at work prior to maternity leave. Positive, clear and collaborative communication is always essential at work, but this is a particularly important moment to practice it. Ultimately, it will help establish gravitas that lasts with your boss and your team—creating a community of support for each other in life moments that intersect with work.

Note: If you’re an entrepreneur or work in an environment without a formal review process, take a moment to check in on your goals and touch base with those around you.

Check in with Your “Board of Directors” As part of your community of support, consider creating or rethinking a personal board of directors. This is a group of your mentors and advocates who help you through important career and personal milestones and crossroads, offering wisdom and advice to guide your thinking. Sometimes they may tell you what you don’t want to hear by asking the right questions.

Being pregnant at work and subsequently becoming a working mom is a big deal. Check in with your “board” for support during the final countdown. Evaluate if you need to add (or subtract) anyone to provide perspectives you may need right now, and when you return to work with a new incredible part of you. Is there a working parent you aspire to on your board? Is there someone who has known you long before a baby was on your radar? What’s most important is that there is a genuine connection, trust and commitment with each other now and as you anticipate your great return (or not). v Stephanie Kramer is the author of Carry Strong: An Empowered Approach to Navigating Pregnancy and Work (Penguin Life, 2023), an executive, adjunct professor, and proud mother of two young sons.

Do You Work Remotely?

Tips from local moms who make it “work” Samantha Mendoza Santee Risk Manager for an engineering firm Kids ages: 7 months; 6 years Working from home is a juggling act, but being available to my boys is the best feeling since I grew up in a singlemom household where she was always working. Here is what works for me: • Clean something different each day.

Make a schedule, such as Monday: dishes, Tuesday: bathroom, etc.

• Work on difficult tasks while baby is napping.

• Inform coworkers. I’ve been on calls where my baby is breastfeeding while I’m presenting. I let my coworkers know they may hear my son occasionally.

• Be open and honest with work regarding expectations. My boss is aware that I have kids at home; if I’m unavailable, he knows I’ll call him back when I have a moment.

• Be kind to yourself about expectations.

Deanne Gustafson Oceanside Amazon Influencer, content creator, business owner Kids ages: 4 years; 5½ years I’ve worked remotely since my kids were born; first part-time, now full-time. Being a stay-at-home mom is tough; trying to do it all while working will likely leave you frustrated and your kids on screens. Here are my tips: • Work when little ones nap.

• Once your child is on the move, get childcare, whether it’s two days a week, three days or more. Consider family members, friends, daycare and preschool. Even if your paycheck barely covers the cost, you are investing in your child’s socialization and giving yourself the opportunity to do what you love.

• Get an Instacart membership. I rarely go into grocery stores anymore. Yes, it costs a little extra, but saves so much time.

• Use Target drive-up pickup.

• Hire a house cleaner if you can. You’re delegating housework so you can get more work done.

• Make time for your kids. I used to take Mondays off and called them “Mom Mondays.”

• Find mom friends to hang out with. It’s important to have a tribe!

• Take advantage of evenings. When my kids go to sleep, I work.

• Accept that you can’t do it all.

Folake Ike, LCSW, PMH-C Mission Valley Licensed Clinical Social Worker Kids ages: 3 months; 2 years It was extremely difficult in the beginning to balance work, caring for my child and looking after the household. Now that my oldest is in daycare, I’m better at prioritizing tasks. Sometimes my husband and I both work from home, which can present challenges. Here is what has worked for us: • Communicate.

• Discuss the structure of the week ahead.

• Create a shared calendar on your phones.

• Use a calendar on the fridge.

• Verbalize changes to the schedule.

• Divide and conquer. In the mornings my husband took care of some kitchen duties while I prepped dinner.

• Remind yourself that you’re working.

If you were in the office, you wouldn’t be cooking and doing laundry simultaneously.

• Take breaks. It’s OK to sit in silence and regroup instead of using breaktime to do household chores.

• Prioritize. My husband and I collaborate on what’s most important for each of us to accomplish during the day and how can we support each other in those tasks while caring for the children.

• Outsource tasks as needed.

• Recognize that it all won’t get done today and that’s OK. Manage anxiety about long to-do lists by imagining the worst-case scenario if something is taken off today’s list and added to tomorrow’s.

• Start the day doing one thing with mastery. This helps me feel accomplished at the end of the day if nothing else gets done. Sometimes I’m giving myself credit for making one heck of a bed that morning!

Baby & Toddlers Guide 2023 • SanDiegofamily.com • 9

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Babies, Toddlers and Too Much

Added Sugars

by CPMG

Nearly all toddlers and majority of babies eat too much added sugar in US. Nearly all babies and toddlers in the U.S. consume added sugars in their diet, much of which comes from foods thought to be healthy, like yogurt and even snacks marketed toward babies like puffs, applesauce, and crackers. Early added sugar intake could lead to poor nutrition and health later on in childhood and adolescence.

Consuming added sugars is a risk for infants and toddlers because it can influence their taste and future food preferences. “The consumption of added sugars among children has been associated with negative health conditions such as cavities, asthma, obesity, elevated blood pressure, and altered lipid profiles,” said lead investigator Kirsten Herrick, of the National Institutes of Health.

It’s crucial to focus on healthful nutrition in the baby and toddler years as eating patterns early in life strongly shape eating patterns as kids get older.

The 2019 study on added sugar intake for babies and toddlers ages 6-23 months found that for toddlers, most added sugars came from fruit drinks, candy, and sweet baked goods, while sugar intake for babies mostly came from yogurt, snacks marketed toward babies, and sweet bakery goods (Herik et al, 2019).

Foods high in sugar are generally not nutritionally-dense, meaning kids miss out on getting healthy, balanced meals when more calories come from sugar. When choosing snacks for babies and toddlers, it’s important to check labels on packaged foods. Even foods marketed toward babies and toddlers like applesauce, crackers, puree pouches, puffs, and yogurt melts have added sugars.

If you need assistance in helping your kids eat a balanced diet or overcome pickiness, contact the W.E.L.L. Clinic at Children’s Primary Care Medical Group.

What’s better than buying packaged snacks?

Offer fruit and vegetables. Introducing fruits and veggies early and offering them often can prevent picky eating (or make picky phases shorter), and improve health now and in the future. Instead of reaching for pouches and purees, offering soft, small pieces of fruit and veggies can help babies get used to the taste of fruits and vegetables without them being overpowered by fruit juices, which is common in baby food pouches.

The W.E.L.L. Clinic specializes in helping kids, teens, and families make habit changes to improve health in the following areas: nutrition, physical activity, sleep, stress management, and screen time. To make a W.E.L.L. Clinic telehealth appointment in La Costa call 760-633-3640, and for Oceanside call: 760-547-1010.

Easy fruit and veggie snacks for babies and toddlers (note: cut into small pieces for babies and young children) • Berries • Banana slices • Peaches, pears, nectarines • Apples • Applesauce (no added sugar) • Steamed cauliflower, carrots, or broccoli • Bell peppers • Cucumber • Avocado • Raisins • Sweet potato

Sources: Herrick, K.A., Fryar, C.D., Hamner, H. C., Park, S., Ogden, C.L. 2019 . Added Sugars Intake among US Infants and Toddlers. Journal of the Academy of Nutrition and Dietetics. https://doi. org/10.1016/j.jand.2019.09.007

Stevie Trujillo

Sleep Shaping How to establish healthy sleep habits for baby

Sleep shaping, sleep hygiene and sleep conditioning are terms for essentially the same thing: establishing a healthy sleep routine and environment from the start that support a good night’s rest for baby and parents. The goal with each is to create sleep associations that babies have throughout development, helping them fall asleep independently from the beginning. Your baby may want to nurse or rock to sleep, but baby will need to be weaned from those things at some point. Don’t get me wrong, rocking is a necessary and recommended way to soothe your baby, but it should be used as a tool, not a crutch. If you rely on this method every time, it’s the only way she’ll be able to fall asleep.

Habits are very easy to start, but much harder to break.

Sleep conditioning, shaping and hygiene are not to be confused with sleep training, which comes into play when healthy habits haven’t been established from the start and it’s necessary to break unhealthy habits.

Start baby (and parents) off on the right foot with the following tips. Consider the use of an overnight doula for additional support, if needed.

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Rules for Healthy Sleep Habits when Baby First Comes Home: • Allow baby to fully wake up before trying to soothe or pick her up from the crib or bassinet.

• Do not use feeding as a way to calm baby down. Feed baby if she is hungry or because it is feeding time. Overfeeding can cause baby challenges in the long run, such as digestive issues or dependency on food to calm down when stressed.

• After feeding, baby should be fully satisfied and should not need a pacifier. Very rarely do babies need a pacifier after a full feed. If baby is still rooting after a feed, it’s possible she has discomfort and needs to be burped, she is still hungry, or she is tired and is relying on suck to sleep.

If this happens, try to burp baby first, then try to offer breast or bottle again to see if she is still hungry before offering the pacifier as a last resort.

• Put baby to sleep for naps and bedtime without a pacifier. Use pacifiers as a way to soothe babies; do not make baby dependent on the pacifier to stay asleep. If baby needs a pacifier to soothe to sleep, that’s OK, but if the pacifier falls out, let it be. Don’t keep putting it back into baby’s mouth.

• Have baby sleep on a flat surface (such as their crib or bassinet) from the beginning, day and night.

• Allocate 12 hours for daytime sleep and 12 hours for nighttime sleep as soon as baby comes home from the hospital. Babies are born with an internal clock, but it’s up to parents to program it correctly. Put baby to sleep after a 7 p.m. or 8 p.m. feeding.

During the following 12 hours of “nighttime,” there is no stimulation and minimal light; only feeding, diaper changes and sleep. During the day, feel free to have lots of lights and noises on. Take baby outside at least once a day to help set the internal clock.

• Babies need a lot of sleep in the beginning. Be sure not to keep baby up all day with the idea that she will sleep better at night. Babies need sleep during the day and at night. Follow age-appropriate wake windows, which for the first 12 weeks are 30-90 minutes long (and follow baby’s cues).

Nighttime Guidelines for First Four Weeks: • Keep light as low as possible or use red or orange nightlight (which helps create melatonin in the brain).

• Keep sound machine on all night.

• Try to keep all stimulation to a minimum (low voices, calm environment).

• Un-swaddle prior to nighttime feeding for the first 2–3 weeks.

is breastfeeding, you may experience nights of cluster feedings (where she wants to eat more frequently), this is especially normal if baby is going through a growth spurt; if you are bottle feeding, follow baby’s cues.

• When you first tend to baby at night, try soothing her while she’s in the crib or bassinet until it is time to feed. Use the “ladder of support” to figure out what she needs. Start with shushing and gently patting, then try light bicycle kicks (to make sure there’s no gas); if that doesn’t work, try the pacifier. If you spend a few minutes on each and baby is not soothed, then pick her up to determine if she needs to be burped, needs a diaper change or needs to eat.

Nighttime Guidelines for Weeks 5–12: Starting with week 5, baby has usually gained enough weight that she can feed more during the day and sleep for longer stretches (and fewer wake-ups) at night.

This is a good time to start focusing more on the nighttime routine.

• Start implementing your nightly routine 6 p.m.–8 p.m., based on baby’s cues.

• After nighttime routine, lay baby in her crib awake and happy (but ready for bed).

• Keep light as low as possible or use red or orange nightlight.

• Keep sound machine on all night.

• Un-swaddle prior to feed.

• Change diaper before feeding. This allows you to put baby down after feeding without changing her again; it also helps waken baby (if she’s asleep) for a full feed. Baby may poop during the feed, so another diaper change is possible.

• Change diaper after feed (unless there is a poopy diaper beforehand that needs to be addressed). Changing baby’s diaper after the feeding will wake her if she’s fallen asleep, which helps prevent any feeding/sleep associations. v

• Do not feed before the three-hour mark at night (unless pediatrician says otherwise). Try to encourage full feeds every three hours. If baby

Stevie Trujillo is a Certified Postpartum Doula and certified sleep consultant in San Diego County. Learn more at www.stevierosedoula.com.

Common Questions What are methods to address baby’s gas?

• Bicycle kicks • Tummy rubs • More tummy time during the day • Probiotics (if approved by your pediatrician) • Visit to a specialized chiropractor My baby makes so much noise at night. Is she OK? Babies make a lot of noise at night, which is completely normal.

If baby is grunting, moaning, wiggling or just mildly fussing, it doesn’t mean baby needs to be soothed. If baby cries for a moment, she could still be asleep.

It’s best to wait until baby is at a full cry before responding.

Responding too soon could actually wake your sleeping baby.

How do I know if my baby is going through a growth spurt?

Growth spurts are common in the first month, during which times babies will cluster feed (eat more frequently) to help Mom produce more milk. If you’re not sure if baby is going through a growth spurt, the Wonder Weeks app provides helpful growth spurt information based on baby’s age and due date.

I’m overwhelmed. Who can help me?

Consider hiring an overnight postpartum doula who will take care of baby’s needs while supporting Mom’s recovery and the parents’ need for sleep.

Postpartum doulas provide support to the entire family with evidencebased information, resources and emotional support to parents, as well as help with light chores such as baby’s laundry, washing bottles and meal prep.

Baby & Toddlers Guide 2023 • SanDiegofamily.com • 13

All Colors Photography MH

All Colors Photography

San Diego, CA www.AllColorsPhotographyBlog.com @ChrisDowdAllColorsPhotography

All Colors Photography MH

Snacking for Breastfeeding Moms Easy, healthy snack ideas to stay nourished between meals

Liesel Teen, BSN, RN

If you’re a nursing mama, then you

know breastfeeding hunger can seem intense. So, how do lactating moms stay nourished and fueled between meals while staying healthy? Here you’ll find easy, healthy snack ideas and answers to common questions about breastfeeding nutrition.

10 Easy, Healthy Snacks for Breastfeeding Mamas Two quick tips to keep in mind when hunger strikes between meals: 1. Think of snacks as “mini meals” and try to include 2–3 food groups, and 2. When in doubt, pair a carb with a protein for a solid energy boost and more staying power. Here are easy snacks to have on hand.

1

Apples and peanut butter.

Apples are a great source of vitamins and fiber. Peanut butter is a good source of protein and healthy fat.

Customize this snack by substituting almond butter or another nut butter.

2

Chicken salad with nuts and grapes. Diced chicken mixed with nuts, grapes and a bit of mayo is delicious and nutritious. When you have chicken for dinner, use the leftovers to make this snack.

3

Cheese and crackers. Cheese is a good source of protein and fat while whole-grain crackers provide much-needed fiber. Customize with your favorite types of cheese.

4

Greek yogurt with fruit. Greek yogurt is a great source of protein (plain Greek yogurt avoids added sugar). Combine with berries and honey to sweeten. For crunch, calories and variety, consider adding granola or nuts.

5

Cottage cheese and fruit.

Cottage cheese is a great low-calorie, high-protein snack. Add fresh fruit for a delicious option. You could also use cottage cheese as a dip for graham crackers or topping for rice cakes.

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6

Hummus and veggies. Hummus is a good source of protein and healthy fats. Pair it with fresh veggies for a ton of nutrients in every bite. There are many delicious hummus varieties, which keeps this snack interesting.

7

Rice cakes with peanut butter and banana. Again, you’re getting a protein and fat boost from the peanut butter, fiber from the rice cakes (brown rice cakes are even better), and natural sweetness from banana. Customize with different nut butters and a variety of fresh fruits. Rice cake + SunButter + blueberries is one of my favorite versions of this snack.

8

Energy balls. Make energy balls with oats, nuts, nut butter and dried fruit for a quick snack of protein and fiber. The oats (and other ingredients) may even help boost milk supply. Like so many things on this list, energy balls can be customized to your liking.

Questions regarding Breastfeeding Nutrition Does breastfeeding really make me hungry?

Your body works hard to produce milk for baby, which uses a lot of energy. Breast milk is packed with vitamins, fat, protein, carbohydrates, immune boosters, enzymes and more.

Making that kind of superfood requires your body to draw its nutrients and fat from calories you consume. That’s why lactating moms can feel so hungry.

It’s important to know that milk production might not be the only thing causing you to feel hungry. It could also be sleep deprivation, diet, hormone imbalance or postpartum stress. Talk to your doctor about ways to address these potential factors.

How many calories do I need while breastfeeding?

9

Avocado toast. Avocado toast is a great source of healthy fat. Top it with sliced hardboiled eggs, scrambled eggs or smoked salmon for an added protein boost.

10

Smoothies. A smoothie is a convenient and delicious way to pack a lot of nutrients into a single drink for home or on the go. Customize with fresh fruit, frozen fruit, leafy greens, nut butter, yogurt, kefir, cow’s milk, milk alternatives, chia seeds, oats, protein powder – the list goes on.

According to the American College of Obstetricians and Gynecologists, women require an additional 450–500 daily calories to make breast milk, but that doesn’t necessarily mean every nursing mom needs to consume more calories.

For many, continuing to eat a variety of healthy foods from all food groups (fruits, vegetables, grains, dairy and lean proteins) will meet your body’s caloric needs to breastfeed.

Talk to your healthcare provider about your weight, regular diet and activity level to determine if extra calories are needed to keep you and baby healthy.

Are there foods that boost milk production?

There are many foods that boost milk production, but when it comes to snacking, here are good ones to keep in mind: Avocados are a good source of B vitamins, vitamin K, folate, potassium, vitamin C and vitamin E. Avocados are nearly 80 percent heart-healthy fats and help maintain a feeling of fullness.

Nuts are high in essential minerals such as iron, calcium and zinc, as well as vitamins K and B. They are also a healthy source of essential fatty acids and protein.

Healthy snacking between meals is a great way to remain satiated throughout the day, stabilize blood sugar, and ensure you’re getting a sufficient number of calories. Be mindful about snacking to feel fuller longer and to avoid impulsive snacks with empty calories. v

Hummus/chickpeas are a good source of protein, vitamins, minerals and phytoestrogens.

Liesel Teen, BSN, RN, is a labor and delivery nurse, founder of Mommy Labor Nurse and a mother of two kids. Follow her on IG @mommy.labornurse for education, tips and solidarity on all things pregnancy, birth and postpartum.

Learn more about breastfeeding and breast milk production at www.nichd.nih.gov/health/ topics/breastfeeding.

Low-fat dairy. Whether you prefer yogurt, milk or cheese, low-fat dairy products are an important part of healthy breastfeeding, as they deliver a boost of bone-strengthening vitamin D and calcium for baby and you.

Baby & Toddlers Guide 2023 • SanDiegofamily.com • 17

Liesel Teen, BSN, RN

Understanding Postpartum Depression What it is and what to do if you have PPD

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If you don’t know if you’re experiencing postpartum depression, consider taking the online screening test at www.postpartumhealthalliance.org/screening-test and sharing the results with your healthcare provider.

Researching “postpartum depression” is probably the last thing you expected to have to do. Dealing with physical postpartum recovery is challenging enough, combine that with sleepless nights, exhausting feedings and overwhelming feelings—it doesn’t feel fair, and no partner truly understands.

So, how do you determine whether what you’re experiencing is normal “growing pains” that come with new motherhood or something deeper and more destructive? Here Mommy Labor Nurse, Liesel Teen, differentiates between baby blues and postpartum depression, shares common symptoms and provides helpful tips. You will get through this.

What is Postpartum Depression?

Postpartum depression (also called PPD) is a severe form of depression that starts following the birth of a baby.

While postpartum depression may start anytime within the first year of baby’s life, most women are affected within the first few months. According to the National Institutes of Health, PPD

preoccupations you cared about

occurs in 6.5–20 percent of women. The percentage is likely higher since many women never seek help or know they’re suffering from PPD.

• Feeling irritated or angry often

Signs of Postpartum Depression

• Suicidal thoughts

There is a myriad of ways PPD presents in new moms, which can make it difficult to identify—there is no cutand-dry diagnosis. Below are common symptoms, but it’s not necessary to experience all the signs to be struggling with PPD. It looks different for everyone, but PPD symptoms typically show for at least two weeks.

• Feeling sad, numb or hopeless • Inability to focus or concentrate • Crying often, sometimes without knowing why • Fatigue and difficulty sleeping and/or eating • Feeling guilty, overwhelmed or worthless • Feeling disconnected and/or withdrawing from your support system • Losing interest in hobbies or

• A perceived lack of bonding with baby • Thoughts of hurting baby

What to Do if You Have PPD 1. Seek help. Seeing a therapist can significantly improve your mental and emotional state. Having an unbiased third party who will listen, empathize and guide is so valuable. Your experience is unique to you, so individualized care is probably the fastest route to recovery.

If you aren’t sure where to start, talk to your doctor, contact WellMamas Family Counseling at www. wellmamascounseling.com, or call one of these numbers: Postpartum Health Alliance: 619-2540023 San Diego Access and Crisis Line: 1-888-724-7240 Both are available 24 hours/day, 7 days/ week in English and Spanish. They

Baby & Toddlers Guide 2023 • SanDiegofamily.com • 21

can listen, offer support and help find mental health resources.

2. Self-care. You can’t take care of anyone else if you aren’t taking care of yourself. Self-care is one of the most difficult—and one of the most important—parts of postpartum. It can be as simple as taking a bath or meeting with a friend. Ask a family member to sit with baby a couple times a week to give you some peace and quiet.

3. Exercise. Not only is postpartum exercise one of the best ways to get your body back in shape, it also supports mental health. Put baby in the stroller and go for a walk—every day, if possible. When exposed to sunlight, serotonin levels increase while melatonin levels decrease. That means there’s a scientific reason for getting fresh air. If that’s not enough, exercise has been proven to decrease stress, so it’s a win-win.

4. Eat well. Nutrition plays a significant role in brain function.

After childbirth (and especially when breastfeeding), bodies need more nutrients to heal, so give your body what it needs. Eating healthy snacks and meals will help provide stamina to get through each day.

5. Seek familial support. Being vulnerable and asking for help is especially difficult for people who view it as some kind of failure or weakness.

Everyone needs support at times. Do yourself, your baby and your loved ones a favor by continuing to engage with them.

Vent to someone who will demonstrate unconditional love and validate what you’re going through. Avoid people who are judgmental, critical or who think depression is a choice.

6. Hire a doula. Not only do postpartum doulas assist with newborn care, but they also take care of babies so new moms can sleep, take a shower, etc. Having someone to validate worries and fears, help around the house (without judgment), and ease mothers into their new role is priceless.

Local mom Stevie Trujillo is a certified

postpartum doula who provides information on her website: www.stevierosedoula.com.

7. Find a “village.” Look for an inperson group to join that has moms with babies around the same age. It can be incredibly rewarding to do life with people who’re going through the same phases. Such groups can provide support, validation and shared experiences. Local groups include San Diego New Moms Network, Fit4Mom, MOPS, San Diego County Breastfeeding Coalition and others.

8. Practice bonding with baby.

Bonding with baby can be especially challenging for women suffering from postpartum depression. Don’t feel guilty if it’s a struggle—it may just come a little slower for you. Bonding is incredibly important because it’s when babies learn to form healthy attachments that impact their entire life, but it’s OK to take it slow. Practice low-key activities such as rocking, singing, skin-to-skin contact or cuddling. Do what you can and know that you’ll get there.

9. Write down feelings. Writing (or journaling) is a great way to release feelings you don’t want to share with someone, and it can be incredibly cathartic. When you’re done writing, consider ripping up paper containing negative or overwhelming feelings to symbolize them leaving your body.

Regardless of how you do it, do not keep negative feelings inside or only to yourself.

10. Join a moms Facebook group.

Facebook groups come in handy if you can’t bring yourself to join a physical group. While these groups can be helpful, be cautious as you don’t want to join a group that does more harm than good. Find a community where helpful opinions and ideals are shared and respected.

11. Get some sleep. Crazy talk, I know. I realize it’s already a priority, but it can’t be emphasized enough that getting sufficient sleep will help

22 • SanDiegofamily.com • Baby & Toddlers Guide 2023

How does PPD differ from baby blues?

Postpartum blues (aka baby blues) is a minor form of postpartum depression. A whopping 80 percent of new mothers experience baby blues.

Baby blues symptoms: • Feeling sad, moody or irritable • Having trouble eating and sleeping • Indecision • Feeling like an inadequate mother

What causes baby blues?

The extreme changes to your hormones and new lifestyle are often contributors to baby blues.

It usually happens soon after birth, but only lasts a week or so. Once your hormones level out, baby blues will typically improve.

in many ways, including improve mood. You’ve heard it before, but take naps and sleep when baby sleeps.

Don’t spend that time catching up on household chores, running errands or making phone calls. Give yourself permission to let those things go for a while. If the house gets out of control, call for backup and be OK with giving others a chance to help.

12. Remember, it’s a phase.

Postpartum depression is awful, but it does not define you. It’s not who you are; it’s a phase you are experiencing.

Life is hard right now, and it’s difficult to imagine it getting better, but it will.

Take it one day at a time, and hang in there. I’m cheering for you every step of the way. v Liesel Teen, BSN, RN, is a labor and delivery nurse, founder of Mommy Labor Nurse and a mother of two kids. Follow her on IG @mommy.labornurse for education, tips and solidarity on all things pregnancy, birth and postpartum.

Well-Mamas Counseling MH

Welcome to Great Smiles Pediatric & Orthodontics The doctors at Great Smiles Pediatric Dentistry & Orthodontics are prominent experts in their field. They not only deliver exceptional results, but ensure their skill sets evolve with technology. Additionally, they are invested in understanding the latest discoveries within the field. Great Smiles doctors have over 75 years of combined experience providing exceptional dental care to families. Our board certified doctors provide compassionate care to each and every Great Smiles patient and give them the confidence to show off their healthy smiles.

More than just experienced specialists in their respective fields, Great Smiles doctors are former servicemen, dedicated philanthropists, servant leaders, engaged community members, Ivy League scholars, professors, volunteers and loving family members. Our doctors are leaders who contribute to the overall wellbeing of the community in any way possible.

To conveniently serve patients from Carmel Valley to Oceanside, Rancho Santa Fe to Cardiff, Del Mar to Carlsbad and all the communities in between, each Great Smiles Pediatric Dentistry & Orthodontics location is situated off of a main thoroughfare close to schools and near major retail centers, making it easy to fit appointments into your busy life. Whether a checkup to make sure your child’s teeth are healthy and clean or a routine visit for your braces, we are happy to accommodate patients with our flexible scheduling and accessible locations. Contact us to schedule an appointment today.

SOLANA BEACH: (858) 755-4223 CARLSBAD: (760) 944-5115

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GIVE YOUR LITTLE ONE THE START OF A HEALTHY SMILE! A healthy smile for your child is so important and it starts from the moment they are born! There is so much to learn as a new parent, and often times oral health is something that can be pushed aside until it may be too late! See the tips below to start your child’s oral health off right from the start!

10 Tips for Children under 12 months • Start at birth with infant oral hygiene! It sounds silly, but by starting an infant oral hygiene regimen at birth, then when that first tooth erupts, a healthy habit is already established with your infant and they are desensitized to the stimulation of toothbrushing. Start by wiping their gums with a washcloth at bath time or using a rubber “banana” toothbrush.

• Your oral health matters to your infant! That is right, if you currently have cavities or gum disease, it increases the chance that those harmful bacteria will colonize more of your infant’s mouth than the less harmful oral bacteria. We share oral bacteria when we share food and even give kisses.

• The first baby tooth (usually the two lower incisors) erupt around 6 months of age.

• There is a wide range on the tooth eruption schedule, so if your infant is about to turn 12 months of age and they still have no teeth or few teeth, it is ok! The sequence of the tooth eruption schedule is more important than the timing.

• Establish a healthy, low sugar diet early on. From birth to six months of age, breastmilk, formula and water are all that your little one needs. When it is time to introduce solid foods, vegetables and fresh fruits are best.

Avocados and berries are great starts. It is not recommended to introduce juice, sugar sweetened milks, or other sugar sweetened beverages until 3 years of age. Remember, proteins, vegetables, fruits, unprocessed grains are the best things to feed your growing child.

• The first dental visit should be with a board certified pediatric dentist (like us, at Great Smiles Pediatric Dentistry and Orthodontics) by age 1 or 6 months after the first tooth erupts. Just like you establish care with a pediatrician right away, establishing a dental home for your infant will aid in providing oral hygiene instruction, making sure the teeth, gums and jaw are healthy and growing properly. A dental home is an ongoing relationship between a pediatric dentist, like us, and a patient family and includes all aspects of oral health care delivered in an easily accessible and family-centered way. www.greatsmiles.org • Toddlers are learning to walk and so accidents happen that sometimes involve the teeth, so having a pediatric dentist established early will help in the case of an emergency.

• Dental caries (cavities) in children is more common than asthma and childhood obesity! In fact, about 50% of children in the U.S. are affected by tooth decay by the time they enter school leading to over 34 million school hours lost each year due to dental problems.

• Gum disease can also affect children and that bacteria from gum disease can migrate to the brain, causing inflammation and making learning and focusing more difficult.

• Even though they are called baby teeth, the 20 baby teeth will be in your child’s mouth for quite a while. The first baby tooth falls out around age 6. The last baby teeth (those molars that come in around 2-3 years of age) will not fall out until age 12. So, besides providing a cute smile, helping with speech, they keep the jaw healthy and maintain space for the adult teeth to grow in.

OH,BABY!

A round-up of some of our favorite baby and toddler products.

Find more at www.sandiegofamily.com/parenting/baby/baby-product-review and www.sandiegofamily.com/parenting/toddler/toddler-product-review.

The On the Go Organizer $45; Colugo.com This handy organizer, featuring two cup holders and three zippered pockets, attaches to stroller handlebar and converts into a fanny pack or crossbody bag. Choose from 11 colors/patterns.

BabyLit Alphabet Series by Greg Paprocki $9.99–$12.99; Gibbs-Smith.com BabyLit alphabet board books, illustrated by artist Greg Paprocki, are a must-have! Colorful, retro illustrations keep babies engaged while toddlers become familiar with words relevant to the book topic. For instance, in the book U is for Universe, “E” is for eclipse; and in the book O is for Ocean, “N” is for narwhal.

PureBaby Penguin Ear Thermometer $39.99 PureEnrichment.com InstaRead technology ensures fast, accurate readings in one second, while the cute design helps put children at ease. Features convenient memory settings and a universal ear tip for all ages.

Easily clean between uses before replacing cap.

Les Enfants Bamboo Products Prices vary; LesEnfants.se Bamboo blankets and nursing scarves are a favorite with moms.

Breathable, muslin blankets are smooth on baby’s skin while keeping them cozy and comfortable.

Trendy bamboo nursing scarves offer lightweight coverage while complementing outfits. Plus Collection includes blankets, squares, a nursing scarf and a food-grade silicone pacifier clip.

Dino Safari Round Cotton Playmat $34.95; Mylittlezone.com Babies enjoy playtime on this soft, high-quality cotton (excluding filler) playmat designed for baby’s delicate skin.

Polyester filling ensures baby is ultra-comfortable.

Beyond Junior Y High Chair $225; Abiie.com The high-quality, safety-certified beechwood chair that grows with your child! Easily transforms from highchair to dining chair in a matter of seconds.

Favorite features include an adjustable dual-restraint system, a dishwasher-safe tray cover, and a water-resistant seat cushion for fast, easy cleanup.

Advanced Double Electric Breast Pump $159.99; Evenflofeeding.com Quiet, easy-to-clean pump provides flexibility to pump almost anywhere. Maximize milk output with speed and suction controls that mimic baby’s nursing pattern.

more on p. 28

26 • SanDiegofamily.com • Baby & Toddlers Guide 2023

Miffy & Friends in Van Gogh Inspired Outfits $39 each; JustDutch.us Iconic Dutch characters Miffy, Melanie and Boris wear handmade outfits inspired by Vincent Van Gogh’s famous Irises painting.

ILI Wearable Teether Stacks $42; ILIKids.com Stylish bracelets for mom that double as teethers for baby. Made of pure, food-grade silicone and are dishwasher safe. Stacks are available in five trendy color combinations (four bracelets in each set).

3-in-1 Learning Booster Seat and Step Stool $99.99; LittlePartners.com This modern and sturdy wooden booster/step stool features two adjustable heights, seat pad, removable 3-point safety harness and non-slip silicone mat.

Supports ages 10 mos.–5 yrs. up to 50 lbs. Several color choices.

Sit, Spin & Stand Entertainer 360 Seat & Activity Table $105.99; Infantino.com Little ones can spin 360 degrees while exploring interactive toys, light-up buttons and sounds. Three height settings for growing babies.

When babies outgrow the sit-and-spin features, the unit transforms into a stand-and-play activity table with legs that fold down for easy storage or travel.

Affirmation & Shapes Sensory Panel Book $5.88; KidsforCulture.com Colorful patterns, shapes, a mirror and crinkle pages provide visual and sound stimulation for babies. Kids for Culture also offers Positive Pals Blanket Dolls.

28 • SanDiegofamily.com • Baby & Toddlers Guide 2023

Tranquil Turtle $54.99; Cloudb.com Little ones love bedtime buddy, Tranquil Turtle! As a night light, turtle’s shell projects soft ocean waves onto the wall or ceiling. Listen to waves, tranquil music (with waves) or choose no sound. Light and volume are adjustable.

Turns off automatically after 23 mins to support consistent bedtime routine.

Digital Bottle Warmer & Sterilizer $59.99; ChiccoUSA.com Quickly, easily and effectively warm breast milk, formula or baby food.

It works for a variety of materials including glass, plastic and silicone and has multiple heating options.

FunBelieveable MH

Sally Kuzemchak

Help! My Toddler Won’t Eat Dinner (but wants a snack) There’s a lot to love about toddlers: snuggles, endearing moments, chubby cheeks, adorable sayings and hilariously mispronounced words. But toddlers also bring a unique set of challenges “to the table” and mealtimes are no exception. One of the most common: Often toddlers have no interest in dinner, but are more than willing to eat snacks.

Here’s what to say and do in the moment and how to survive this season of life.

Why Toddlers Refuse Dinner Dinnertime seems to be what parents struggle with most when it comes to feeding toddlers. There are legitimate reasons dinner is rarely a toddler’s time to shine: • They’re tired. Days are long for toddlers, particularly if they no longer nap.

• They’ve kept it together all day, especially if they attend preschool or daycare. Toddlers are ready to let it all hang out in the place (and with the people) they feel safest around.

• They’ve snacked too much (or too close to dinner), so they’re not hungry.

• They’ve had too much milk, water or juice. Filling up on liquids leaves little room for food.

• They’re unsure. Dinner often has unfamiliar foods, casseroles with things mixed together and unfamiliar veggies.

30 • SanDiegofamily.com • Baby & Toddlers Guide 2023

Why Toddlers Prefer Snacking Snacks are fun! They’re uncomplicated, easy-to-eat, often familiar foods. Snacks often include items like yogurt, fruit, crackers, cheese sticks, maybe even sweets like graham crackers or minicookies. They already know they like these things, there are no risks involved and they can eat them on the go. What’s not to love?

What to Do (in the Moment and Tomorrow) When your toddler refuses dinner, but insists on crackers, there are steps you can take in the moment and things you can implement tomorrow.

In the moment Stay calm. Toddlers know how to push buttons, and saying “no” is an easy way to do that. As hard as it is, stay neutral.

A few helpful phrases: • “You don’t have to eat it.” If your toddler is used to drama when she says “no” at the table, she may be surprised by your new, cool-as-a-cucumber reaction.

This powerful phrase instantly defuses tension.

• “There’s XYZ on the table if you want.” Make sure there’s always something on the table your child likes—a side dish like veggies or rice, or meal component like plain tortillas or fruit. If she refuses dinner, point out the item on the table in a matter-of-fact, zero-pressure way.

• “Looks like you’re not hungry right now; that’s OK.” If your child refuses to eat, say this calmly and let her be excused from the table (or ask that she stay for a few more minutes with the family).

Wrap up their dinner. We started doing this when my younger son went on a dinner strike as a toddler. We saved his (untouched) dinner plate and offered it to him later when he asked for a snack. At first, our son didn’t want his leftover dinner (he was holding out for something better). But soon enough, he was scarfing down his spaghetti or soup, just an hour or so after the rest of the family.

Important note: A saved plate is not a punishment. It’s just a way to offer dinner when they’re hungry.

Offer a boring bedtime snack. If the leftover dinner is refused, here’s a strategy I got from Dina Rose, author of It’s Not About the Broccoli. She advocates for having a boring but nutritious backup food that your child likes, but doesn’t love. Rose’s suggestions: cottage cheese, a glass of milk, plain yogurt (not flavored), beans or tofu.

Starting tomorrow Put a cushion between snack time and dinnertime. As a dietitian, I think snacks can add a lot of value to a child’s (or grown-up’s) day. But it’s easy for snacking to get out of hand with toddlers, who love to nibble on the go. Snacks too close to mealtime can sabotage dinner, so try to avoid snacks in the hour before meals.

Establish a rough snack schedule. Try mid-morning and mid-afternoon.

Asking your toddler to wait may be tricky at first if she’s used to snacking whenever she wants, but sticking to dependable meal and snack times reassures kids that there are lots of chances to eat.

Consider eating dinner earlier. If your toddler’s hunger doesn’t sync up with your family’s regular dinnertime, consider eating earlier or serving your child a portion of the meal (such as the

veggies) while you finish preparing it.

Remember, this is a season of life that will pass. You won’t always be cooking dinner at 4pm.

Center snacks around “meal foods.”

Snack has come to mean packaged, processed foods like pretzels, gummy fruit snacks and granola bars.

Those things are perfectly fine to have sometimes, but kids shouldn’t think “treat” when they think “snack.”

Most of their snacks should be built around the kinds of foods you serve at mealtime. I call those meal foods— fruits, vegetables, whole grains, meats, beans, nuts, and dairy (or non-dairy) foods and drinks. This practice helps toddlers eat foods filled with nutrients they need for growth (iron, zinc, calcium, etc.).

Some meal food snacks include hard-boiled egg and crackers, half a sandwich, hummus with cucumbers or pita or a small bowl of dinner leftovers.

What NOT to Do Don’t get angry. Prioritizing a pleasant (ish) dinner table is most important.

As much as possible, avoid negative emotions at the table.

Don’t insist they eat. Forcing a child to eat can disrupt a child’s internal ability to regulate hunger and fullness.

It may also cause children to dig in their heels even more. In one research study, preschoolers ate more and made fewer negative comments about food when they weren’t pressured to eat, compared to kids who were pressured.

Don’t punish kids for not eating. Eating (or not eating) should never be connected with punishment. Kids shouldn’t feel “bad” or “good” because of what they ate (or didn’t eat). Don’t withhold favorite toys or privileges because they didn’t eat dinner. v Sally Kuzemchak is a registered dietitian, nutrition writer, mom and book author. Follow her at www.RealMomNutrition.com.

Trouble-Shooting Guide to Mealtimes My toddler won’t sit at the table.

Sitting still at the table can feel boring to a busy toddler. So, adjust expectations (no long, leisurely meals); start with 5–10 minutes.

Remind them frequently that sitting at the table is what your family does at mealtime. Also be sure their seat is comfortable and appropriate. Would your child benefit from a booster or foot support?

My toddler wants to eat the same thing every day.

“Food jags” (when kids eat the same foods meal after meal) are very common at this age, but it’s important for children to eat a variety of foods. Remind your child that you eat different foods on different days and you’ll have her favorite again soon.

My toddler won’t eat foods she used to love.

This is an especially frustrating part of picky eating: refusing foods previously eaten. Toddlers have independent streaks and enjoy the power of saying no. Keep calm and stay the course. Continue to offer the foods with this reassurance, “You don’t have to eat it.”

My toddler is throwing food.

Babies throw food to explore and figure out cause and effect, but toddlers often do it to get attention. Be clear and calm. Say, “We don’t throw food,” and remove the food he’s thrown (instead of putting it back on the plate or tray and creating a game). If he continues, say, “Looks like you’re done eating,” and remove him from the chair. Next time, put smaller amounts of food on the plate. Feel free to offer more if he finishes that portion.

Baby & Toddlers Guide 2023 • SanDiegofamily.com • 31

Cheesy

Cauliflower

Fritters Cheesy Cauliflower Fritters are a fan favorite among little eaters. Recipe creator and mom of two, Andrea Bemis, has made them dozens of times to share with friends and family.

“Everyone raves about them, no matter their age,” she says. Consider serving them with Date-Sweetened Ketchup or Greek Yogurt Ranch from Andrea’s newest cookbook, Let Them Eat Dirt.

Yield: 12 small fritters • 3 cups finely chopped cauliflower (from about 1 small head) • 3⁄4 cup mozzarella cheese (if serving to a baby over 1, you can use a stronger tasting cheese like sharp Cheddar) • 1⁄2 cup sprouted chickpea flour* • 1 large egg, whisked • 3 green onions, finely chopped (white and pale green parts) • 2 cloves garlic, minced • Pinch of crushed red pepper flakes (optional) • 1⁄2 tsp. unrefined salt (optional if serving to a baby under 1) • Ghee, duck fat, tallow or coconut oil for frying

Add the cooking fat to a large cast-iron skillet over medium-high heat. Use a 1⁄4-cup measuring cup to scoop out small portions of the batter (don’t fill measuring cup all the way; these are a bit fragile, so smaller patties are easier to work with) and place the mixture into the hot skillet. Lightly press the batter down and fry each fritter for about 3 minutes per side or until lightly browned and crisp. A metal spatula works best for flipping.

Remove from the pan and place on a

Bring a large pot of water to a boil and add the chopped cauliflower. Simmer for about 5 minutes. Drain and let the cauliflower sit until it is cool enough to handle.

To a large bowl, add the chopped cauliflower, along with cheese, flour, egg, green onions, garlic, pepper flakes (if using) and salt (if using).

Mash the mixture with a wooden spoon or fork.

32 • SanDiegofamily.com • Baby & Toddlers Guide 2023

paper towel–lined plate to drain excess cooking fat.

To serve, place a whole fritter on the high chair tray or slice into thin strips.

Store in an airtight glass container in the fridge for up to 3 days. Leftovers can be enjoyed cold or reheated at 300 degrees for 10–12 minutes. *Note: Grains can be tricky to digest for young babies. It’s important to purchase sprouted grains or to soak grains overnight before cooking them.

Recipe provided by Andrea Bemis, creator of the farm-to-table food blog Dishing Up the Dirt and author of three cookbooks, including “Let Them Eat Dirt: Homemade Baby Food to Nourish Your Family.”

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