By Joanna Winograd and Lauren Lappen; Co-Founders of Wee Sleep Solutions

If you’re having a hard time figuring out the optimal times that your baby should be going down for sleep you are not alone!  As pediatric sleep specialists, we often see parents struggling to find their baby’s natural sleep window.  
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Place your baby down to sleep when they are tired, but not yet overtired, a.k.a. the magic sleep window.   It should be simple, right?  We know it’s not always as easy as it sounds!  Below are some helpful hints at making this task easier!  

We recommend using wakeful periods based on your baby’s age as a guide for determining when your little one needs sleep.  Wakeful periods refer to the average amount of time your child can stay awake before becoming overtired.  Knowing those average times will make your lives much easier! A baby whose awake time is limited to an age appropriate length will be able to settle and drift off to sleep more easily, and will stay asleep longer, than a baby who has been awake and stimulated for too long a time.  

Typically, a newborn can only comfortably stay awake for 45 minutes to 1 hour before needing her next nap.  As a baby gets older that wakeful period will slowly stretch and by 4 months most children will be able to happily keep their eyes open for up to 1.5-2 hours.  By 6 months, usually 2-2.5 hours can be comfortably tolerated, and a slightly older baby may be able to stay awake and happy for up to 3-4 hours.
   
It is equally important to learn your little ones’ tired cues, which can include yawning, looking less alert, pulling his ears and rubbing his eyes. Watch your baby carefully and if you notice any tired cues (even prior to the end of their optimal wake window), begin a brief soothing routine and place him down for sleep.  The opposite is also true.  If the optimal awake time has passed, but you haven’t yet noticed any tired signs, you should still begin your soothing routine and place your baby down for sleep.  Some little ones are very good at hiding tired signals so be mindful of your baby’s wake time and put him down even if he seems ready to party!

Why is it so important to identify this magic window of time?  If your baby has been awake for too long he will become overtired, which means his brain has signaled for the release of cortisol, a.k.a the wakeful hormone.  An overtired baby will either be fussy and irritable, or will appear wide-awake and wired.  Either way, placing your baby down for sleep once they have already reached an overtired state will result in difficulty falling asleep and staying asleep.  If you are able to identify your baby’s correct sleep window (by using the clock and sleepy cues as a guide) he will settle more easily and sleep more soundly.  The result: a happier, well-rested baby and family.

Lauren Lappen is a Certified Sleep Consultant and co-founder of Wee Sleep Solutions.  As a mom of daughter Ellie and twins Rebecca and Kira, Lauren recognized the importance of self-care and sought to instill healthy sleep habits in her children so that she could ensure her own rest and be at her best as a parent, wife and friend.   
 
Lauren studied under Deborah Pedrick, a pioneer in the field and founder of the Family Sleep Institute (FSI) and International Association of Child Sleep Consultants. She is thrilled to be able to educate families on the importance of sleep and to empower parents with the knowledge and ability to teach their kids to love sleep as much as her girls do!

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​Almost everyone has a family member, friend, or coworker whose allergies have kicked in. Some say they never had allergies before or can‘t recall the last time it affected them. Nowadays, it seems rather common than previous years, which has everyone asking “why allergies are on the rise?”
 
The symptoms aren’t simple sneezes and runny noses anymore. Today’s allergies come with rashes, hives, cramps, diarrhea, vomiting, swollen tongue and throat, tight chest, and passing out. If today’s allergy sufferers don’t have an EpiPen or can’t call an ambulance, serious complications could result.
 
Science and the medical industry are finding new reasons every day why allergies are rising. The fact is that allergies have become more common since the mid-20th century. Preservatives, pre-packaged foods, climate changes, massive storms, and just about everything synthetic have combined to change the atmosphere in which we live.
 
Changing Lifestyles
Before city and suburban living became the norm, people lived on farms and in the country. From childhood, they breathed nature in all her facets. The immune system recognized potential allergens and would defend against them. Playing outside in early childhood refined the immune system.
 
With the increase in technology, people turned in their relationship with the outside for what one would a homebody lifestyle. They sat in front of TVs, played video games, texted, and talked on Skype. Central air conditioners replaced fresh air, and well water morphed into city water. Though these are changes that were imminent, they affect all of us.
 
Climatic Changes
Whether you call it a hole in the ozone, global warming, or other climatic word or phrase, the air surrounding us has changed and not for the better. In the last 10 to 15 years, the instances of asthma, allergies, and other lung conditions have skyrocketed.
 
The major climatic change that causes the trouble is massive storms. Storms are all about changes in temperature. These are triggers for air pollution, pollen, mold spores, and poison ivy.
 
Massive storms pass, leaving behind bacteria, viruses, mold, and other contaminants that set off asthma and allergy attacks. These are the basis of other illnesses, but asthma and allergy sufferers get hit the worst.
 
Stress
To understand how stress triggers allergic reactions, it would be a good idea to understand how the immune system works. First, pollen or other foreign particulate enters the body. The immune system thinks it’s an intruder because it came from outside. The immune system produces histamine, a substance forcing the body to expel the particulate through runny nose mucus, runny eye water, sneezes, and coughs. Now the immune system knows what the particulate is, how to expel it, and prepares for the next intrusion.
 
Stress is a little different. The particulates are there, but the stress hormones increase the allergic reaction. The “fight or flight” hormones kick in, which makes allergic symptoms worse. This might be why so many allergy medications, both chemical and natural, make you drowsy. If you’re sleepy, then stress hasn‘t taken a huge toll on you… yet.
 
Synthetics
If you take a can of something out of a six-pack ring, eat from a plastic or foam plate or cup, feed the baby from a bottle, carry home plastic grocery bags, or buy takeout in some kind of container, then you are using synthetics. If you wear it, chances are good the fabric is synthetic. Most fabrics made are from petroleum products. When they touch the skin, contact dermatitis is the result. When consumed from products made from petroleum products such as food containers, then allergies result. The only difference is one allergic reaction is inside, and one is outside. Asthma, allergic reactions and other lung conditions result from inhaling such synthetics for a long period.
 
Food Additives
Your red Jello, Vitamin D-fortified cereal and milk, and your vanilla flavored Coke are all about food additives. According to the FDA, additives can be natural or synthetic, and they classify both the natural and synthetic as “Generally Recognized As Safe”, or GRAS.
 
However, some additives cause allergic reactions. Some are preservatives that keep the product fresh or prolong shelf life. Others enhance colors, flavors, or fight botulism.
 
Common additives include Monosodium glutamate or MSG, sulfites which prevent foods from turning colors upon contact with air, sugar substitutes like aspartame, nitrates, and paraben among others.
 
While allergic reactions to food additives typically last only one day, allergic reactions are rare. This being the case, no recorded symptoms exist, so doctors treat the symptoms instead of the cause.
 
Prepackaged Foods
Today’s manufacturers produce varied foods for different brands. You could get a package of pre-made mashed potatoes you can just heat in a microwave. However, its preparation is a mystery to you. The manufacturers could have made the product in the same machine that a peanut product found itself an hour before, all unbeknownst to the consumer. Those allergic to nuts would get sick.
 
While there are sanitary procedures to which every food producer must adhere by law, trace amounts of allergens still get into prepackaged foods. By law, producers must label their prepackaged foods with a list of allergens it contains.
 
Precautionary allergen labeling or PAL has become prevalent worldwide. In fact, the National Institutes of Health tells of an American study in which contamination was worse in labels stating “prepared in shared facilities” to those stating “may contain.”
 
Add to this the fact that the law doesn’t require food manufacturers to list trace amounts of an ingredient. Those trace amounts could be allergens to someone sensitive to the ingredient.
 
Stay Informed With a Specialist
Dr. Kathryn Edwards is an allergist in Princeton and Robbinsville, NJ at the offices of the plastic surgeon Daniel G. Becker. Dr. Edwards’ star has blazed from her undergraduate time at the University of Delaware to the Uniformed Services University of the Health Sciences to a pediatric residency at Walter Reed Army Medical Center. Dr. Edwards also trained at the prestigious National Institutes of Health.
 
Dr. Edwards’ 16 years in the Army involved treating her patients in Iraq as an allergist and immunologist. She treated seasonal and environmental allergies, asthma, food allergies, and skin conditions.
 
Her educational accomplishments include acceptance into the competitive fellowship program in Allergy and Immunology at Walter Reed Army Medical Center, training at and being assistant chief at the National Institutes of Health, and being chief of allergy/immunology her last three years in the Army. Learn more about Dr. Edwards at the Becker ENT site.

By Lauren Lappen, Certified Infant and Child Sleep Consultant at Wee Sleep Solutions
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The dreaded daylight savings is upon us! We "spring forward" this Sunday, March 10th at 2:00 am. It often feels like we just recovered from one time change, and another is approaching.  So what can we do to help our kids adjust to this change (and keep our sanity!)?

In an ideal world, we could to begin to shift our children’s schedules a week ahead of time. Every few days we’d move their sleep and mealtimes by 15 minutes, so by the time daylight savings hits, they’ve already adjusted. Despite this being the “official recommendation” for a smooth daylight savings transition, I’ve yet to meet one person to actually do it (myself included with my own kids!).  The world outside our homes doesn’t accommodate such a gentle shift; school starts when school starts and you need to get to work on time, not 15-45 minutes late. 

Never fear! Here are some tips to help your children adjust to the new time.

Expose your children to lots of sunlight during the day.  Our circadian rhythms align with the sun, so exposure to natural light helps our bodies adjust to the appropriate time.

Now that it’s lighter later, children often protest going to bed when the sun is up.  About 30 minutes prior to bedtime, dim the lights to help the body transition to nighttime.  Room darkening shades can really help with this, too.  Keep the environment calm, and quiet before bed to get children relaxed and ready to sleep. 

​Stick with your bedtime routine.  If you don’t have a bedtime routine already, now is a great time to start. Children thrive on routines, so having one can be incredibly helpful to give structure to the time before bed.  A quiet routine is calming to them and helps them relax and ease into bedtime. It can be as simple as pajamas on, brush teeth, read a book/sing a song, lights out.  Don’t make it overly complex. You want this to be replicable daily, and easily done by a babysitter in your absence.  

Minimize exposure to electronics at least an hour prior to bedtime. This is true all year round, but especially now when we’re trying to help kids adjust to daylight savings time. Electronic screens emit a blue light that mimics a bright, sunny sky and tricks the body into thinking it is daytime. The result of this is that melatonin, the hormone that helps induce sleep, is suppressed, making it more challenging to fall asleep.

If all else fails, find a big mug and fill it with coffee. I’m sure you’ll be in good company!

Lauren Lappen is a Certified Sleep Consultant and co-founder of Wee Sleep Solutions.  As a mom of daughter Ellie and twins Rebecca and Kira, Lauren recognized the importance of self-care and sought to instill healthy sleep habits in her children so that she could ensure her own rest and be at her best as a parent, wife and friend.   
 
Lauren studied under Deborah Pedrick, a pioneer in the field and founder of the Family Sleep Institute (FSI) and International Association of Child Sleep Consultants. She is thrilled to be able to educate families on the importance of sleep and to empower parents with the knowledge and ability to teach their kids to love sleep as much as her girls do!

By Nidhi Sharma, PT, DPT, OCS
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The time after delivery is known as the postpartum period and this is one of the most important phases in a woman’s life. As the body tries to return to pre-pregnancy state, the physical influences at this time can affect the long-term health of the mother. 

After undergoing radical changes for much of 9 months and an exhausting delivery process, moms are often overwhelmed by the responsibilities of childcare. Their body, specifically the pelvis never gets a chance to heal and recover. 
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Here are the 4 most common physical complaints of post-partum period. 

1. Urinary Incontinence: The “leaky” bladder is not just a problem during pregnancy, it persists in over 80% of women after giving birth! Often, the leaking happens with coughing, sneezing, running, etc. but can happen with almost any activity of daily life. The research shows that leaking does not go away by itself and should be addressed soon after delivery. 
2. Diastasis Recti: In simple terms, it is separation of the superficial layer of abdominal muscles due to excessive intra-abdominal pressure. Women usually notice a protruding belly or a “pouch/bulge” which is most evidentright after childbirth. Sometimes, the mothers notice that they still look “pregnant” after having the baby. The usual exercises for abdominals like crunches and planks can often hurt rather than help the problem. 
3. Pelvic Organ Prolapse: Sometimes due to weakness of muscles and ligaments, the organs like bladder, uterus and bowel can droop down outside the vaginal opening. Again, pelvic floor muscles can be strengthened to help support these organs back into their place. 

4. Lower Back Pain: Lower back pain is extremely common in new mothers and often multifactorial. All of the conditions explained above can compromise core stability and contribute to lower back pain. In addition to that, demands of childcare like frequent lifting, carrying, and breastfeeding, etc.can put repetitive stress on joints in the spine and pelvis.

What can you do? 
Postpartum Rehabilitation focuses on the health of new mothers by customizing the program to the unique physiological changes of pregnancy and demands of childcare. The program focuses on improving posture and alignment, strengthening trunk and pelvic floor muscles, and training in proper breastfeeding/childcare positions. It is important to know that all of the above conditions are closely related to each other and should be addressed as a unit. Often the lower back pain is caused by underlying pelvic floor weakness and won’t improve until incontinence is addressed. A good program looks at abdominal, lower back, and pelvic floor muscles individually as well as a coordinated system. 
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If you are pregnant or recently had a baby, give your body some much-needed TLC. See a Women’s Health Physical Therapist at Func Physio Physical Therapy and get back to things you love. Sooner the better!

Func Physio Physical Therapy
111 Brooke Street, 3rdFloor 
Scarsdale , NY 
Contact : 347 497 0500
www.funcphysio.com

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Turmeric is a ginger-colored spice that’s been a part of Middle Eastern and East Asian cooking for centuries. The warm and flavorful bitter taste is frequently used in curry dishes. Turmeric however is also widely known for its health benefits and has garnered the attention of nutritionists and physicians worldwide. Curcumin, turmeric’s most active and healing compound, is a powerful antioxidant and anti-inflammatory which has contributing factors in combating osteoarthritis, heart disease and digestive issues. 
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Turmeric is proven to treat arthritis as it helps reduce joint inflammation according to a recent study. A study by the Nirmala Medical Center provided evidence that curcumin is as effective as anti-inflammatory drugs at reducing swelling and tenderness of joints in patients with rheumatoid arthritis. 
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Another amazing fact about Turmeric is that it can be used to treat wounds, cuts and rashes. Life Sciences concluded that topical application of curcumin has a great therapeutic effect on skin wounds and also concluded that it accelerates wound healing. Add to this its heart health benefits and improved digestion and you can be on your way to better health with just a spoonful of turmeric a day.
 
What is the best way to incorporate this super spice into your diet? Simply sprinkle it on your favorite foods along with a little black pepper to aid with absorption. You can reap these health benefits with a teaspoon of turmeric on salads, soups, and dressings. You can even rub it on your favorite steak before grilling! 
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Turmeric owns the reputation of a powerful anti-inflammatory that can reduce arterial plaque buildup, accelerate wound healing and relieve joint pain. That’s a good reason to spice things up a little when cooking at home! As always, check with your St. John’s Riverside physician before making any changes to your diet and health plan!

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If the answer is yes, you are not alone. The reported cases of sleep deprivation or insomnia are growing to epic proportions nationwide. More than 60 million Americans suffer from poor sleep quality, and more than 40 million meet the diagnostic criteria for sleep disorders. Americans are sleeping less and consequently are putting their health at risk. 

Patients who toss and turn all night will initially complain of lack of energy, irritability, and loss of appetite. Left untreated, inadequate sleep carries with it both short- and long-term consequences including obesity, diabetes, anxiety, stroke or cardiac arrest. 

Why are we losing so much sleep? Insomnia could be caused by a medical problem, a side-effect of medicine, psychiatric illness, or lifestyle. Everything from what we eat what we drink, how often we are on “screen time” to our hectic work schedules can contribute to how well or how poorly we sleep. 

If you believe you are suffering from a sleep disorder, insomnia, sleep apnea, or restless leg syndrome, there are things you can do about it. 

“We now have comprehensive Sleep Centers in both Andrus and Dobbs Ferry” says Rajendra Rampersaud, MD, Pulmonologist.

To meet the growing incidence of sleep apnea and other sleep disorders, St. John’s Riverside Hospital now has Sleep Diagnostic Centers available at both Dobbs Ferry and Andrus Pavilions. Both locations offer a convenient, quiet setting that was created to help restore the connection between a well-rested body and a healthy body. 

Having sleep centers in both our pavilions is another way we strive to help patients in their hometowns. St. John’s Riverside Hospital is helping people sleep better and feel better, one wink at a time. For more information or to schedule a consultation with a sleep physician call (914) 964-4337.

​To schedule a sleep study at the Sleep Diagnostic Center call (914) 559-1010.

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As a pioneer in single incision hernia surgeries and co-founder of the only Minimally Invasive Center in Westchester, Dr. Har Chi Lau has performed more minimally invasive hernias than any other surgeon in Westchester County. We are proud that he practices at St. John’s Riverside Hospital. Dr. Har Chi Lau opened the first Hernia Center in Westchester just over two years ago now and people have come as far as California to be treated there. 
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A Board-Certified Surgeon with expertise in Minimally Invasive (MI) surgery, Dr. Lau also instructs laparoscopic surgery methods to other doctors and frequently presents on the subject nationwide. In addition, he has impressed and won the trust of a tough crowd of his colleagues who personally request Dr. Lau for their surgeries. With over 4500 surgeries already performed, it’s apparent that Dr. Lau is the first choice for patients and doctors alike. 

“Dr. Lau and his team were my first choice for my hernia operation. These guys have the expertise as well as the communication skills and personality that assured me I would be back to my old self again. They were right and I was surprised at how quickly I was able to get back to work.” - Tony Maddalo, MD Orthopedic Sports Physician for the New York Rangers.

Recent developments have changed the playing field when it comes to medical procedures, and St. John’s Riverside Hospital’s Hernia Center is on the frontline with the latest technology including the da Vinci robot and expertise to offer a new quality-of-life to all patients. Minimally Invasive surgery is how we are keeping the Westchester Community Strong. If you think you or someone you know has a hernia, call (914) 464-4DOC.
 
“It’s a very patient-centered method to performing surgery, with proven benefits and far less complications.” - MI surgeon, Har Chi Lau, MD

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Bariatric surgery enables overweight and obese people the chance to achieve significant and long term weight loss. By reducing the stomach’s storage capacity, which limits food intake, you feel full much sooner. The result is long-term weight loss that can lead to a happier and healthier you.
 
There are many benefits to Bariatric surgery, some of the most notable include:
 
Joint Pain Relief
Excessive weight puts a lot of stress on your joints and causes damage over time which leads to pain. Significant weight loss could elevate pain, allow people to stop using pain medications and become more mobile.
 
Blood Pressure
Reduced weight can improve your risk of heart disease and stroke. Blood pressure and cholesterol levels are usually reduced after weight loss helping patients return to better overall health.
 
Depression
People with excess weight may find it difficult to participate in certain activities. Losing excess weight leads to increased activity and helps improve a person’s emotional health as well.
 
“Bariatric surgery gives patients the best chance at maintaining their weight loss over time, and that plays a significant role in a patients overall health.” - Jonathan Arad, MD, Bariatric Surgeon.
 
Improved sleep, better outcomes from Type 2 diabetes and reduce risk of many other medical conditions are all additional benefits of bariatric surgery. If you are looking to losing weight and reduce or reverse the health risks associated with excessive weight or obesity, bariatric surgery may be right for you. 
 
For more information click here: http://www.riversidehealth.org/SpecialtyServices/BariatricSurgery.aspx
or call 914.964.4DOC to make an appointment.

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“Back in the day,” a mother-to-be in labor was brought into a sterile hospital room alone with her doctor and nurses. Today, the birth of a child is an event that relies on the support of the entire family and the surrounding community.

Going from a bleak hospital room to a more family-oriented birthing room required redirection and a new way of offering comfort to new families. St. John’s Five Star Maternity Unit's recently renovated maternity rooms are comfortable, state of the art private luxury suites complete with private baths, many with views of the majestic Hudson River, flat-screen televisions, plenty of seating for family members and of course, a bassinet equipped with all the essentials for your newborn to remain with you during your stay.

St. John’s Riverside Hospital prides itself on an exceptional team who are an integral part of the birthing experience and quickly become “like family” to delivering patients and their children. An award-winning team of caring physicians, nurses and support staff offer gynecological care through every stage of a woman’s delivery. This includes private tours before the birth of your child, as well as visits with lactation consultants who consult with you during your stay. There’s always someone to talk to and always help from a nurturing team when needed, especially for first-time parents.
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St. John’s Riverside’s Maternity Unit provides medical care every bit worthy of their Five Star Award. They ensure that a child’s transition into this world and their patient’s transition into parenthood is the best that it can be. They provide that sense of community and support that is so dire to young parents.  They are Community Strong.

Learn more at St. John's Riverside Hospital's website.

As the new year approaches and we start to think about resolutions, getting in shape may be on your list. As a mom it can be difficult to find time to workout with kids in tow. Fortunately many gyms in Westchester offer childcare, ranging from babysitting to school break camps as well as swim lessons and birthday parties for kids.

Club Fit- Briarcliff, Jefferson Valley
A Nursery for children ages 3 months to 4 years old that has lots of space for toddlers to explore; there is a safe space for infants, a quiet space for all nursery kids for story time or playing with quiet toys, an outdoor playground, and a fun large interactive space that has games that keep toddlers moving. The Energy Center is for kids ages 5 years to 12 years. This space includes a gymnasium with kid-size basketball nets for supervised games and free play, bounce houses and tumbling mats plus space for the electronic movement games they love like wii and xbox. Lots of kids spend time in the Energy Center after school along with other club activities such as tennis lessons and swim team.  In the summer months and during the school year, kids have access to activities including group sports, swimming, tennis, and arts and crafts. Swim lessons are also available for all ages.

Equinox- Armonk, Greenwich CT, Mamaroneck, Scarsdale
Leave the little ones with us while you’re working up a sweat at the Kids Club. With tumbling, art, obstacle courses, and plenty of inspired programming, it’s a pint-sized haven of well-being.

Fenom Fitness- Harrison
​Fenom is a family sports & fitness facility that has childcare as well as a broad range of programs for children. The Venom Kids Club provides childcare needs while you workout.  Kids aged 6-months to 6 years old will be kept busy with games, toys, and arts & crafts. They also offer parties and teen nights.

Kinetic Sports Club- Pelham
A five star fitness facility and recreation center with 50,000 square feet of premium luxury fitness space for the entire family. Featuring fitness equipment, water park, Youth Sports Classes, Birthday Parties, Kids Camps, spinning studios, Yoga and Group Exercise, and so much more. The Kinetic Kids Club offers childcare while you workout.

LA Fitness- Port Chester, Yonkers
Childcare while you workout solo or participate in a class.

Lifetime Fitness- Harrison (coming to Chappaqua summer 2018!)
This is more than your drop and workout kind of place. Features spaces created just for kids. Infant areas keep the littlest members separate from energetic toddlers and grade-schoolers. Dedicated studios provide room for yoga, art, dance and more. Kids Academy: a babysitter, coach and teacher in one, offering lessons in music, sports, yoga and crafts. Swim lessons for babies through age 12, plus stroke clinics and competitive swim team. Camps: Kids express creativity, pursue interests, learn new skills and just be a kid at summer camps and school break activities. Or throw a kids birthday party for your special little one that’s packed with activity.

​New York Sports Club- Croton-on-Hudson, Dobbs Ferry, Greenwich CT, Hartsdale, Hawthorne, Larchmont, Mamaroneck, New Rochelle, Scarsdale, White Plains
This is your basic kids playroom with toys and babysitting so you can focus on you.  From after school programs to summer camps, the kids programs offer endless educational and recreational fun. Discover our diverse array of activities, offerings vary by location. They throw action-packed birthday party celebrations where kids have a blast and parents don’t sweat it. Swimming is also available at some clubs.

Premiere Athletic Club- Montrose
​Premier Athletic Club in Montrose is a place your entire family will enjoy – even your little ones! They offer onsite childcare to members, providing  little ones with supervision and entertainment while you work out.  Ages 3 months through 10 years are welcome to play. In addition, kids between the ages of 5 – 10 years can come have a blast every weekend in the Kid Zone. Plus age-appropriate sports like basketball, soccer, kickball — all supervised by the fitness center staff. And don’t forget the bounce castle every Saturday and Sunday! They also offer parties and classes for kids.