Expert Q&A with Holly M. Milligan

Q: A friend’s toddler recently had a severe case of RSV with wheezing and difficulty breathing. Naturally, I’m concerned about my own children. Do you have any strategies for prevention?

A: Yes, there are great ways to protect your family during respiratory syncytial virus season from October to March. RSV can simply present a nasty cold, but for infants and toddlers, the symptoms can be very serious and life-threatening.

Everyday Prevention:

Wash hands with soap and water for at least 20 seconds (or use sanitizer).
Clean toys, doorknobs, phones and surfaces daily.
Teach kids to cough/sneeze into their elbow.
Keep breast feeding your baby, if possible.

Reducing Exposure:

Keep babies away from anyone with a cold, cough or fever.
Avoid crowded indoor spaces during RSV season.

Medical Protection:

RSVpreF (Abrysvo): Given to pregnant people at 32-36 weeks to protect their newborn. In most cases, infants born in RSV season won’t need the shots listed below.
Nirsevimab (Beyfortus) & clesrovimab (Enflonsia): A shot for babies that lasts at least five months.

Q: This is a somewhat difficult subject for me, but I think my middle schooler may be approaching obesity. He has always been a big kid, but lately, his appetite and weight have increased. Should I be concerned?

A: The simple answer is “no.” Many parents notice weight changes in their middle schoolers. This is a time of rapid growth, changing metabolism and increased independence around food choices. This is normal, expected and OK!

My general rule of thumb is to avoid initiating conversations about a child’s weight. If they initiate the conversation, it is essential to foster a safe environment by coming from a place of love, curiosity and support. This is a crucial and impressionable time in their development, so how we talk about our own bodies and weight can directly impact how they view themselves now and into adulthood.

Avoid singling out your child. We all have room for improvement, so if you are concerned about your child’s weight, make family lifestyle changes and consider discussing these topics with your child’s pediatric provider: puberty, growth patterns over their lifetime, family history, mood, etc.

Q: I’ve been having a really difficult time with my newborn. She cries constantly in the evenings and has a hard time settling. I’ve tried many ways to soothe her, but there seems to be a “witching hour” where she is inconsolable. What is causing this and how can I help her?

A What Could Be Happening:

Normal newborn behavior: Many babies have a fussy period in the late afternoon/evening, around 6pm to midnight—it can last for up to three hours.
Immature nervous system: Babies can be overstimulated by the end of the day—by light, sound, touch and new experiences; their immature brains have a hard time shutting down.
Gas or digestion: Some babies swallow air while feeding or may have sensitive tummies.
Colic: About 20% of infants experience inconsolable crying and gas. It can be a sign that the infant is sensitive to the foods the breastfeeding parent is eating. Thankfully, colic typically stops around three to four months.

Strategies that May Help:

Soothing environment: Dim the lights, reduce household noise and add white noise to create a calm routine at the same time each evening.
Swaddle & sway: Gentle rocking, swaddling or holding skin-to-skin can provide comfort.
Motion: A stroller walk, babywearing or a ride in the car may calm the infant—see what works.
Burping & tummy comfort: Make sure she’s well burped after feeds; try tummy massage or bicycle legs if gas is the culprit.
Parent breaks: If your baby is safe in their crib, it’s okay to step away for a few minutes to regroup. Remember, caring for yourself first helps you care for them!

When in doubt, reach out to your child’s provider for any concerns, such as an out-of-the-ordinary sounding cry, poor weight gain or difficulty feeding. Remember, your gut knows best!

This article appears in BendNest Winter 2025.