October is Eczema Awareness Month, which feels like a good time to talk about something I see all the time in family medicine: eczema.

Atopic dermatitis—the most common form of eczema—is one of the most common skin conditions in children, affecting an estimated 20–25% of kids.

It’s also one of those conditions that sounds relatively straightforward until you actually have a child with it.

Is this eczema? Is it dry skin? Is it an allergy? Did something they ate cause it? Should we bathe them more? Less? What moisturizer should we use? Are topical steroids safe?

So, let’s start at the beginning.

First: what actually is eczema?

“Eczema” is really an umbrella term for a group of conditions that cause inflamed, itchy skin. When we’re talking about eczema in children, we’re usually talking about atopic dermatitis.

And eczema isn’t simply really dry skin.

Atopic dermatitis involves a combination of skin-barrier dysfunction, immune-system activity, genetics, the skin microbiome and environmental factors.

I like to think about the outermost layer of your skin as a brick wall.

The skin cells are the bricks. The lipids around them are part of the mortar. Together, they’re supposed to keep water in and irritants, allergens and pathogens out.

With eczema, that wall doesn’t work as well as it should.

The skin loses moisture more easily, becomes dry and is more vulnerable to irritation and inflammation. Then it gets itchy.

And that’s when we enter one of the most frustrating parts of eczema.

The itch-scratch cycle

Eczema itches.

Your child scratches.

Scratching further damages the skin barrier.

The damaged skin becomes more irritated and inflamed.

Which makes it itch even more.

So they scratch again.

You get the idea.

This itch-scratch cycle can be incredibly difficult to interrupt, particularly in babies and young children who don’t exactly respond to, “please stop scratching that.”

This is why eczema treatment isn’t only about making a rash disappear. We’re also trying to restore the skin barrier, reduce inflammation and get the itching under control.

What does eczema look like?

There’s no single eczema rash.

It can look dry, rough, scaly, red or discolored, swollen, cracked or weepy. And eczema can look different depending on a child’s age and skin tone.

Where it appears can also change as children grow.

Babies often develop eczema on areas like the face and cheeks, scalp, trunk and outer surfaces of the arms and legs. As children get older, eczema commonly appears in places like the folds of the elbows and knees.

And then there is the symptom parents sometimes underestimate:

the itching.

Itching can interfere with sleep, school and everyday life. Atopic dermatitis can have a significant effect on quality of life not only for children, but for their families.

Anyone who has spent a night trying to keep a toddler from scratching themselves knows exactly what I mean.

So what causes eczema?

There isn’t usually one culprit.

Genetics matter. Immune function matters. The skin barrier matters. Environment matters.

And then there are triggers, which aren’t necessarily the underlying cause of eczema but can make existing eczema flare.

Common triggers can include heat and sweating, cold or dry weather, fragrances, harsh skin-care products, certain detergents, irritating fabrics and stress. Different children have different triggers, and sometimes you never identify one obvious trigger at all.

This is an important distinction because parents understandably start searching for the thing that caused their child’s eczema.

Often, there isn’t one.

Is eczema caused by a food allergy?

This deserves its own section because I get this question a lot.

Food allergy and eczema can be associated, particularly in children with more severe eczema. But that doesn’t mean every child with eczema has a food allergy—or that removing foods from their diet will make the eczema disappear.

In fact, unnecessarily eliminating foods from a child’s diet can create its own problems.

If you’re concerned that a particular food is causing an immediate allergic reaction or seems consistently associated with symptoms, that’s a conversation to have with your pediatrician or allergist rather than beginning a major elimination diet on your own.

What actually helps?

This is where eczema treatment can become surprisingly unglamorous.

A huge part of it is consistent skin care.

Current pediatric guidance recommends short baths or showers with lukewarm water and a gentle cleanser, avoiding products with added fragrances, dyes or essential oils, and applying moisturizer liberally and regularly. Moisturizers help support the skin barrier and reduce water loss.

For kids with eczema, I generally think boring skincare is pretty great skincare.

You don’t need seven products.

You don’t need your baby to smell like a lavender field.

You want gentle cleansing, consistent moisturization and as few unnecessary irritants as possible.

And yes, sometimes you need medicine

This is important.

Moisturizer is an essential part of eczema care, but moisturizer alone isn’t always enough to treat an active eczema flare.

Topical corticosteroids have been a standard treatment for atopic dermatitis for decades and remain a first-line treatment for active inflammation. When appropriately selected and used under medical guidance, they are considered effective and safe.

I know the word “steroid” can make parents nervous.

But undertreating significant inflammation isn’t necessarily safer. Persistent itching and scratching can further damage the skin barrier and can make eczema much harder on a child.

Depending on the severity and age of the child, doctors now also have a growing number of non-steroid topical and systemic treatments available.

The goal isn’t to use as much medication as possible.

It’s to use the right treatment for the right child and get the inflammation under control.

When should you call your doctor?

If you’re dealing with a small patch of mildly dry skin, gentle skincare and moisturizer may be all you need.

But eczema deserves medical attention when it’s persistent, severe, disrupting your child’s sleep, not improving with appropriate skincare, or showing signs of infection.

Increasing pain, warmth, swelling, drainage, crusting, rapidly worsening redness or a fever are all reasons to contact your child’s healthcare professional.

And if you aren’t sure whether the rash you’re looking at is eczema in the first place?

Also a good reason to ask.

There are plenty of things that can look like eczema.

The bigger picture

The thing I wish more parents knew is that eczema isn’t a sign that you’re doing something wrong.

It’s a complicated condition involving the immune system and one of the body’s most important organs.

And while we can’t always prevent it, we can do a lot to manage it. Gentle skincare, consistent moisturizing, and treating inflammation when needed can make a real difference.

The goal isn’t perfect skin every day. It’s keeping your child comfortable, protecting their skin barrier, and knowing when to ask for help.

Good luck!

Dr. Max

Sources:

American Academy of Pediatrics. Atopic Dermatitis: Update on Skin-Directed Management. Pediatrics. 2025.

American Academy of Dermatology. Atopic dermatitis: Diagnosis and treatment.

American Academy of Dermatology. Eczema: Tips to help your child feel better.

Medical Disclaimer:

This article is for general educational and informational purposes only and is not a substitute for individualized medical advice, diagnosis or treatment. Always talk with your pediatrician, dermatologist or other qualified healthcare professional about questions regarding your child’s skin, eczema or treatment.

A family in my office recently had a newborn, and in the middle of our conversation they said something I hear all the time:

“I cannot wait until they’re a toddler. Things are going to be so much easier.”

I didn’t have the heart to tell them.

There is something about the newborn stage that makes you constantly look toward the next milestone. Once they sleep through the night, this will be easier. Once they can sit up, this will be easier. Once they can walk, this will be easier. Once they can talk, this will be easier.

And then suddenly you have a toddler.

I say this both as a family medicine doctor who has taken care of a lot of babies and as a dad currently living through toddlerhood:

I’m not convinced parenting gets easier. It just gets different.

The newborn stage is exhausting—but relatively simple

Newborns are incredibly demanding. They wake up throughout the night. They cry for reasons that aren’t always obvious. They need to eat constantly. They need to be changed constantly. And especially for first-time parents, every little sound, rash, spit-up, poop, and breathing pattern can feel like something you need to investigate.

But their world is also remarkably small.

Most newborns need some combination of three things: feed me, change me, hold me.

They aren’t trying to climb onto the kitchen counter. They aren’t opening cabinets. They aren’t running toward the street. They aren’t negotiating which shoes they’re willing to wear or having a meltdown because you peeled their banana when they apparently wanted to peel it themselves.

They also sleep, a lot. A newborn may sleep somewhere around 14–17 hours over the course of 24 hours, although rarely in the longer stretches that exhausted parents would prefer.

And, most noteably, they stay where you put them.

You can put a newborn in a bassinet and reasonably expect to find them there a few minutes later. You can put them in a carrier and go for a walk. You can sit at a restaurant while they sleep beside you.

Then mobility arrives…

Toddlers are a completely different species

A toddler may sleep around 11–14 hours in a 24-hour period, including naps, which means there are suddenly a lot more waking hours to fill.

And those waking hours are active.

Toddlers wake up ready to explore the world. They open the cabinets. They empty the drawers. They climb on furniture. They put inexplicable objects in their mouths. They run away from you while laughing. You clean up one room while they destroy another.

But perhaps the biggest difference is that toddlers have opinions.

Strong ones.

A newborn doesn’t particularly care what they’re wearing. A toddler might.

A newborn drinks milk. A toddler may request strawberries, refuse the strawberries, cry because you removed the strawberries, and then become devastated when you offer the exact same strawberries again.

This isn’t bad behavior. It’s development!

Toddlers are discovering autonomy. They’re learning that they’re separate people who can make choices and influence the world around them. Their language, emotions, motor skills, curiosity, and independence are all developing at an incredible pace.

The frustrating parts of toddlerhood are often inseparable from the wonderful parts.

The baby who once stared quietly at the ceiling is now running across the room to hug you.

The newborn who communicated almost exclusively through crying can suddenly tell you what they saw, what they want, what they’re afraid of, and eventually that they love you.

It is harder in some ways and infinitely more interesting in others.

Parenting doesn’t have a finish line

I think one of the biggest traps in early parenthood is convincing ourselves that life will become easier after the next milestone.

Once we get through the four-month sleep regression.

Once they’re done teething.

Once they’re walking.

Once they’re talking.

Once they’re potty trained.

There is always another stage coming.

And each one solves problems while introducing completely new ones.

Eventually your child sleeps through the night—but now they can climb out of the crib. They learn to feed themselves—but now half of dinner ends up on the floor. They learn to walk—and suddenly you spend your entire day preventing them from accidentally injuring themselves.

That’s parenting.

The goal isn’t to reach some mythical stage where everything finally becomes easy. I’m not even sure that stage exists.

Instead, I think the trick is learning to appreciate the particular version of your child that exists right now.

Good luck! Have fun!

Medical disclaimer: This article is for general educational purposes only and is not a substitute for medical advice from your child’s healthcare provider.

Dear Parent,

First off, thank you for asking the question that so many parents are afraid to say out loud!

I can’t tell you how many times I’ve had a parent lower their voice during an appointment and whisper something like: “Can I tell you something terrible?”

Then they confess that, lately, they simply enjoy being around one child more than the other.

It is often immediately followed by guilt.

“Does that make me a bad parent?”

The answer is no.

In fact, it’s much more common than you think.

Most parents go through seasons when one child simply feels easier to parent.

Maybe one is sleeping through the night while the other is melting down before breakfast. Maybe one wants to cuddle and read books while the other seems determined to test every boundary you’ve ever set.

That doesn’t make you a bad parent.

It makes you human.

One analogy I like is fruit.

Some days I’d rather have a white peach.

Other days a yellow peach sounds better.

It’s partly about the fruit: the ripeness, the sweetness, the texture.

But it’s also about me. My own mood, my own appetite, what sounds good that day.

Children, of course, are infinitely more complex than peaches.

Children change.

You change.

Life changes.

And relationships change.

You might have a two-year-old who seems to spend every waking moment saying “no,” throwing food, and discovering new ways to climb onto dangerous furniture. Meanwhile, your six-year-old wants to help cook dinner, tells hilarious jokes, and proudly reads you a book before bed.

It’s okay if, in that season, you find yourself naturally gravitating toward the six-year-old.

A year later, everything may be different.

The toddler starts speaking in complete sentences and develops the funniest little personality you’ve ever seen. The six-year-old becomes fiercely independent and wants nothing to do with your bedtime routine.

Suddenly, the relationship shifts again.

That’s what parenting does.

The important thing is recognizing that liking is a feeling. Love is a commitment.

Feelings naturally ebb and flow.

Commitments are just that.

You don’t wake up each morning and measure how much you love each child. Love isn’t divided into percentages. It isn’t a competition, and it certainly isn’t determined by who happened to have fewer tantrums that week.

Love shows up in the thousand ordinary things you do every day:

-Packing lunches.

-Reading the same bedtime story for the seventeenth time.

-Cleaning up another spilled cup of milk.

-Sitting beside a sick child at two o’clock in the morning.

-Showing up, over and over again.

Those acts of love don’t disappear just because one child happens to be easier to enjoy this month.

If anything, the child who is hardest to like in a particular season is often the one who needs your patience the most.

So instead of feeling guilty when you notice these feelings, become curious about them.

Ask yourself:

Why does this child feel difficult right now?

Are they going through something?

Am I exhausted?

Am I expecting something from them that isn’t developmentally realistic?

Sometimes the answer has much more to do with your own stress than it does with your child.

Finally, remember this:

Children don’t need parents who enjoy every moment equally.

They need parents who show up for them consistently.

And those are two very different things.

So if you’re carrying guilt because one child feels easier to be around than another right now, you can put some of it down.

This season won’t last forever.

It never does.

Love,

Dr. Max

Medical Disclaimer: This advice is intended for educational purposes and reflects common experiences in parenting. Every family and every child is unique. If feelings of frustration, resentment, depression, or emotional disconnection become persistent or overwhelming, or if you’re concerned about your own mental health or your relationship with your child, it’s important to speak with your healthcare provider or a licensed mental health professional. Seeking support is a sign of strength, not failure.

One of the biggest misconceptions I hear from new parents is that there’s a day when a baby simply “starts eating.”

Parents often imagine introducing solids as a clear milestone: you buy the high chair, open the baby food, and suddenly your child is eating meals.

In reality, introducing solids is a gradual process, one that unfolds over months, not days. And that’s exactly how it’s supposed to be.

The early months of solid foods aren’t about replacing breast milk or formula. They’re about exploration, practice, and helping your baby’s immune system learn about the world.

Why Early Exposure Matters

Over the past decade, one of the biggest shifts in pediatrics has been our understanding of food allergies.

For years, parents were told to delay introducing foods like peanuts and eggs. We now know the opposite is generally true: introducing common allergens around the time babies are developmentally ready for solids (often around 4–6 months) can actually reduce the risk of developing food allergies later in life.

One reason is that early exposure helps educate the immune system. Rather than viewing these foods as foreign threats, the body has an opportunity to recognize them as normal, healthy parts of the diet.

This doesn’t mean every baby should be eating spoonfuls of peanut butter at four months, but it does mean that, once your pediatrician says your baby is ready for solids, introducing allergenic foods shouldn’t be unnecessarily delayed.

Nutrition Isn’t the Main Goal

One thing that surprises many parents is that babies don’t get a significant amount of their nutrition from solid foods for quite some time.

For most infants, breast milk or formula remains the primary source of nutrition throughout the first year, especially during the early months of introducing solids.

So if it feels like more food ends up on the floor than in your baby’s mouth...

That’s completely normal.

Those tiny bites are accomplishing something much bigger than calories.

Your baby is learning how to move food around their mouth, chew, coordinate swallowing, tolerate different textures, and participate in family meals.

Every messy meal is practice.

Keep It Simple

Parents often feel like they need to prepare elaborate purees or buy special baby foods.

In reality, introducing solids can be much simpler.

If you’re eating a healthy meal, there’s often something your baby can safely explore, too. A mashed piece of avocado, soft scrambled egg, flaked fish, yogurt, oatmeal, or well-cooked vegetables are all wonderful first foods. As your baby’s skills develop, they can gradually explore more textures and foods from the family table.

Sharing parts of your meal also exposes children to a much wider variety of flavors than they might experience from packaged baby foods alone.

Repetition Is More Important Than Quantity

One of the most important things I tell families is this:

Don’t worry about how much your baby eats.

Instead, focus on how often they’re exposed.

Babies frequently need to see, touch, smell, and taste a food many times before they become comfortable with it. That’s completely normal. A rejected food today may become a favorite a few weeks later.

The goal isn’t to get them to finish a serving.

The goal is to make mealtime a positive, low-pressure experience.

My Advice to Parents

When your baby is developmentally ready for solids—typically around 4 to 6 months—start small.

Offer tastes rather than meals.

Introduce a wide variety of foods, including common allergens when appropriate.

Let your baby get messy.

Eat together whenever you can.

Most importantly, remember that these early months are less about nutrition and more about learning.

You’re helping your child build lifelong eating skills, develop a healthy relationship with food, and teach their immune system about the incredible variety of foods they’ll enjoy for years to come.

Medical Disclaimer: This article is intended for educational purposes only and should not replace personalized medical advice. Every infant develops at their own pace, and readiness for solid foods can vary. Talk with your child’s healthcare provider before introducing solids, particularly if your baby was born prematurely or has a history that may increase their risk of food allergies.

If you’ve opened your phone recently, you’ve probably seen headlines about Cyclospora, a parasite linked to recent foodborne illness outbreaks associated with fresh produce.

Whenever food recalls make the news, I hear the same concern from families:

“Should we stop buying fresh fruits and vegetables?”

The short answer is no.

In fact, one of my biggest concerns after outbreaks like this is that fear leads people to avoid some of the healthiest foods we have. The nutritional benefits of fruits and vegetables far outweigh the risk posed by this relatively uncommon infection.

The goal isn’t to stop eating produce.

It’s to understand what’s happening and know when to seek care.

What is Cyclospora?

Cyclospora is a microscopic parasite that causes an intestinal infection called cyclosporaiasis. People become infected after consuming food or water contaminated with the parasite.

Unlike many viruses that cause “24-hour stomach bugs,” Cyclospora tends to linger.

Symptoms typically begin about one week after exposure and may include:

• Persistent watery diarrhea

• Abdominal cramping

• Bloating and excess gas

• Nausea

• Fatigue

• Loss of appetite

Without treatment, symptoms can continue for several weeks.

Why This Outbreak Looks Different

The current outbreak has largely been linked to produce from large commercial agricultural supply chains. These systems move enormous quantities of food across the country, which unfortunately means that when contamination occurs, many people can become sick before investigators identify the source.

That doesn’t mean all produce is unsafe.

And it certainly doesn’t mean you should stop supporting your local farmers.

While no food source is completely risk-free, local and regional farms often have shorter supply chains, making products easier to trace if problems arise.

The Good News: It’s Treatable

One reassuring aspect of Cyclospora is that it is very treatable.

If you’ve had diarrhea that continues for several days and it isn’t improving, your healthcare provider can order specialized stool testing to look for the parasite. Because Cyclospora isn’t detected on routine stool cultures, specific testing is often required.

Once diagnosed, treatment is typically straightforward with an antibiotic called trimethoprim-sulfamethoxazole (TMP-SMX), and most patients begin feeling better quickly.

So What Should You Do?

Fortunately, there isn’t much that needs to change about your daily routine.

Continue eating a diet rich in fruits and vegetables. Wash fresh produce thoroughly before eating or preparing it. Practice good hand hygiene while cooking.

And if you develop persistent diarrhea, especially if it lasts more than a few days or follows eating fresh produce, reach out to your healthcare provider rather than trying to simply “wait it out.”

A Reminder About Why Public Health Matters

One thing these outbreaks remind us is that food safety doesn’t happen by accident.

When patients across different states begin developing similar symptoms, it takes an enormous amount of behind-the-scenes work to recognize the pattern. Physicians, clinical laboratories, epidemiologists, local health departments, state agencies, the CDC, and the FDA all work together to identify outbreaks, trace contaminated foods through complex supply chains, and remove products from the market before more people become ill.

Most of us never see that work happening.

But it’s one of the reasons food in the United States remains remarkably safe despite an incredibly complex agricultural system.

The Bottom Line

Headlines are designed to grab your attention and cause panic.

The vast majority of fresh produce is safe, nutritious, and worth keeping on your family’s table. Stay informed, wash your produce, and don’t let a rare outbreak discourage the healthy habits that benefit your family every day.

And if you’ve been dealing with persistent diarrhea that just won’t go away, don’t ignore it. Cyclospora is uncommon, but it’s something we can test for, diagnose, and treat.

Good Luck!

-Dr. Max

Medical Disclaimer: This article is intended for educational purposes only and should not replace medical advice from your healthcare provider. If you or your child are experiencing severe dehydration, bloody diarrhea, high fever, persistent vomiting, or symptoms lasting more than several days, seek medical evaluation promptly.

In the Thick of It

As many of you know, my daughter Esther is now over a year old, and thankfully, we’re in a much different place with sleep than we were when I first wrote this.

I originally wrote this during the height of her 4 to 5 month sleep regression, when every night felt unpredictable and every morning began with the question, “How did we all end up so tired?”

Like many parents, I searched for answers. I revisited the research, reread the literature, and leaned on years of caring for families in my practice. What I found was reassuring: this is one of the most common developmental phases of infancy. It feels incredibly isolating when you’re living through it, but parents all over the world experience the same stretch of sleepless nights.

If you’re in the middle of it now, I hope this helps explain what’s happening—and reminds you that it does get better.

Understanding the 4-Month Sleep Regression

I often refer to this less as a regression and more as a progression.

For many families, this stage can feel like you’ve suddenly gone backward. Your baby may have started sleeping longer stretches—or even through the night—and then, seemingly overnight, everything changes.

Somewhere between 4 and 6 months, babies often begin waking more frequently. They may be fussier than usual, harder to settle, and unable to stay asleep for more than a few hours at a time.

You find yourself asking the same questions over and over:

Are they hungry? Is this teething? Is something wrong?

Sometimes they want to eat. Sometimes they don’t. Sometimes there isn’t a clear explanation at all.

The only thing that feels certain is that everyone is exhausted, and for many families, this happens just as parental leave is ending and someone needs to wake up for work.

What’s Happening?

This stage reflects a major milestone in brain development.

Newborns sleep in two basic stages: deep sleep and active (REM-like) sleep. Around 4 months, the brain reorganizes into a more mature sleep pattern, much more like our own. Sleep now includes lighter sleep, deeper sleep, and REM sleep, with cycles lasting about 45 to 60 minutes.

Just like adults, babies briefly wake between sleep cycles. The difference is that they’re still learning how to regulate and fall back asleep on their own.

At the same time, almost everything else is changing too.

By 4 to 5 months, babies become much more aware of the world around them. They’re recognizing familiar faces, tracking movement, rolling, beginning to explore their environment, and becoming increasingly social. It’s an exciting period of development, but all of that stimulation can make settling to sleep much more difficult.

Providing Predictability

When so much is changing internally, consistency becomes incredibly helpful.

Simple routines can provide the predictability babies need to regulate themselves.

Some examples include:

• A consistent bedtime with the same calming routine each night, such as dim lights, a book, a song, or cuddles.

• Daily activities that happen around the same time, like a stroller walk, outdoor time, or music.

• Age-appropriate naps. Most babies around this age transition to three naps rather than four, although every child develops at their own pace.

Responding to Night Wakings

Many babies continue to need one or more overnight feeds at this age, and that’s completely normal.

If your baby wakes, take a brief pause before responding. Sometimes babies fuss or stir between sleep cycles and settle back to sleep independently. If the crying escalates or your baby seems hungry or distressed, respond as you normally would.

When your baby does need help settling, start with the least stimulating intervention first. Gentle shushing, placing a reassuring hand on their belly, offering a pacifier if they use one, or simply giving them a moment to reorganize may be enough. If they continue to struggle, rocking or holding them may be appropriate.

The goal isn’t to avoid comforting your baby. It’s to gradually help them develop the ability to connect one sleep cycle to the next while still responding to their needs.

The Takeaway

The 4-month sleep regression is really a sign that your baby’s brain is growing exactly as it should.

Their sleep cycles are maturing. Their circadian rhythm is developing. Their motor skills, social awareness, and curiosity about the world are all accelerating at once.

It’s exhausting, but it’s also temporary.

If possible, this is one of the periods when extra support from a partner, family member, or parental leave can make an enormous difference. A little help during these weeks can go a long way.

And if you’re reading this at 3 a.m. while wondering if your baby will ever sleep again, know that you’re not alone. Almost every family feels this way for a little while.

This phase passes.

Medical Disclaimer: This article is intended for educational purposes only and should not replace medical advice from your pediatrician or healthcare provider. Every child develops differently. If your baby has persistent feeding difficulties, poor weight gain, breathing concerns, fever, excessive lethargy, or you’re worried something more serious may be going on, seek medical care promptly.

Father’s Day has always felt magical to me.

Part of that is where it falls on the calendar. Every year it arrives around the summer solstice, the longest day of the year in the Northern Hemisphere. There is something fitting about that. The holiday seems to arrive wrapped in sunlight, with long evenings and the feeling that there is somehow more time than usual.

But Father’s Day carries a different kind of meaning for me too.

Growing up, I never saw a family with two dads.

My mother was a preschool teacher, and I spent much of high school babysitting. I loved children and always imagined that one day I would become a parent. The desire to be a dad was never something I questioned. But what I questioned was whether it was possible.

For much of my life, I held two truths that didn’t seem to fit together. I knew I was gay, and I knew I wanted to be a father. Yet I couldn’t picture how those things coexisted. I didn’t have examples around me. I didn’t see families that looked like the one I would eventually build. Somewhere along the way, I began to believe that becoming a father might require becoming someone other than myself.

It wasn’t until my late twenties that something shifted.

As I learned more about surrogacy, adoption, and fostering, I began to realize there were many paths to parenthood. More importantly, I began to understand that I didn’t have to choose between authenticity and fatherhood. I could be both. I could build a family while remaining fully myself.

That realization changed my life.

Today, Father’s Day is not simply a celebration of me being a dad. It is also a celebration of my husband as a father. It is also a celebration of the longest days of the year with the most sunlight. It is also a celebration of being my authentic self. A celebration of PRIDE!

Father’s day has now become the best day of the year.

I often think about the younger version of myself who always wanted to be a father but wasn’t sure how. Who felt lost and confused. And while there were so many growing pains along the way, I am so grateful to have arrived at this point in my life, celebrating so much on this very special day.

Love,

Dr. Max

I get a lot of questions from my husband about our daughter, but one of the most common responses that comes out of my mouth these days is, “I don’t know.”

I say it all the time.

Why is she crying?

I don’t know.

Is she hungry?

I don’t know.

Why did she wake up at five in the morning?

I don’t know.

Is she teething?

Maybe. I don’t know.

This surprises both of us because, on paper, I should probably know this. My professional life revolves around caring for newborns and helping parents navigate the uncertainties of early childhood. If there were anyone who should have all of these answers, it would probably be me.

And yet, almost daily, when my husband asks me a question about our daughter, I find myself responding with those same three words. “I don’t know”

Because the truth is that becoming a parent has taught me just how much of childhood exists beyond explanation.

Medicine has trained me to search for patterns. Families come to me because they are looking for reassurance, guidance, and answers. My job often involves helping parents distinguish between what is normal and what is concerning, between what requires intervention and what simply requires patience. There is tremendous value in that work, and I love doing it.

But raising my own child has reminded me that children are not clinical problems to be solved. They are people becoming themselves, and the experience of watching that happen from the inside is entirely different from observing it professionally.

When I see children in my practice, I might see them every few weeks or every few months. The changes are obvious. They’ve gained weight, learned a new skill, become more verbal, more coordinated, more independent. But those changes happen in snapshots.

At home, I see these changes happening in real time. Even overnight! Every morning I wake up and it feels as though something about my daughter has shifted. A new expression. A new interest. A different way of interacting with the world. A new sense of humor. A new frustration. A new curiosity.

It’s as if she wakes up each day slightly more herself than she was the day before. What I thought parenthood would require was knowledge. What it has actually required is openness.

As parents, we spend so much time worrying about whether we’re doing enough. Are they sleeping enough? Eating enough? Are they hungry? Are they learning enough? Developing appropriately? We become consumed by measurements, schedules, milestones and ANSWERS!

And yet when I think about the moments that have mattered most to me as a father, they are moments of wonder. Moments of questioning. Moments when I am reminded that childhood is not something to be managed or answered. Moments when I DON’T KNOW.

My daughter has brought more uncertainty into my life than I expected. But what surprises me most is that I no longer find those words uncomfortable. Instead, they have become one of the greatest gifts of parenthood. Because on the other side of “I don’t know” is curiosity, expansion and the discovery of who my daughter is, and who I am becoming as a father.

This Father’s Day, that’s what I find myself most grateful for.

Love,

Dr. Max

News of the recent NARA formula recall may be bringing up a lot of anxiety for families.

For some parents, it may feel familiar.

Last fall, many families experienced similar fears during the ByHeart formula recall, and we spent a great deal of time discussing infant botulism, risk, and what parents should actually watch for.

Since we’ve welcomed many new subscribers since then, I wanted to revisit some of that guidance and offer reassurance during what can be a scary and uncertain time.

Before we dive in, the most important thing to know is this:

The overwhelming majority of babies potentially exposed to a recalled formula will never become ill.

That doesn’t mean recalls should be ignored. They should absolutely be taken seriously. But it does mean that a recall is not the same thing as an emergency.

One of the hardest parts of parenting is learning how to hold two truths at the same time:

A recall deserves your attention.

Your child is still overwhelmingly likely to be okay.

What a “Recall” Actually Means

When parents see the word “recall,” it’s natural for their minds to jump immediately to the worst-case scenario.

But recalls are often initiated because of a potential risk, not because harm has already occurred.

In many cases, manufacturers identify a concern through routine testing, supplier audits, or quality control processes and voluntarily pull products from the market before any illnesses have been reported.

This is exactly how the safety system is supposed to work.

It’s important to understand the distinction between several very different concepts:

A potential contamination is not the same as an exposure.

An exposure is not the same as an infection.

An infection is not the same as serious illness.

These differences matter because headlines often compress all of those possibilities into a single frightening story.

Why This Recall Has People Talking About Botulism

The concern surrounding this recall involves the potential presence of Clostridium botulinum spores.

Parents often hear the word “botulism” and understandably become alarmed. The reality is a bit more nuanced.

When most people think of botulism, they think of food poisoning caused by consuming botulinum toxin. That is not what we’re discussing here.

In infant botulism, babies are exposed to spores, not toxin.

In rare circumstances, those spores can settle in an infant’s intestines, grow, and begin producing toxin within the gastrointestinal tract. This is why infant botulism occurs almost exclusively in children under one year of age, whose intestinal microbiomes are still developing.

Even when spores are present, illness remains extremely uncommon.

Exposure does not automatically lead to disease.

Why Babies Under One Year Are Different

One of the reasons pediatricians advise against giving honey to infants under twelve months is because honey can occasionally contain Clostridium botulinum spores.

For older children and adults, these spores pass harmlessly through the digestive tract.

Young infants are different.

Their gut bacteria are still developing, which means they have fewer natural defenses against organisms that older children easily handle.

This vulnerability is what makes infant botulism possible—but it is also why the condition is largely limited to infancy.

As babies grow and their microbiome matures, the risk drops dramatically.

What Symptoms Should Parents Watch For?

Unlike food poisoning, symptoms of infant botulism do not occur immediately after exposure.

If illness develops, symptoms often appear gradually over the course of days and may not begin until one to six weeks after exposure.

Parents should seek medical attention immediately if they notice:

• Unusual sleepiness or lethargy

• Poor feeding

• Weak suck or milk leaking from the mouth

• Weak or unusually quiet cry

• Constipation accompanied by weakness

• Reduced muscle tone or a “floppy” appearance

• Difficulty breathing

Fortunately, infant botulism is a condition pediatricians know how to recognize and treat.

When identified early, outcomes are generally very good.

What Should Families Do Right Now?

If you have been using a formula included in a recall:

1. Stop using the product immediately.

2. Photograph the lot number, expiration date, and packaging before disposal.

3. Follow the manufacturer’s instructions regarding refunds or replacement products.

4. Contact your pediatrician if you need guidance on alternative formulas.

5. Monitor your child for symptoms, but remember that illness remains unlikely.

Importantly, healthy babies do not need preventive testing.

Testing is only recommended if symptoms develop.

The Bigger Picture

One of the challenges of modern parenting is that we are constantly exposed to information.

Within minutes of a recall announcement, parents can read news stories, social media posts, online forums, and alarming headlines from around the world.

While access to information is valuable, it can sometimes make risk feel much larger than it actually is.

As pediatricians, our job is not to tell parents to ignore recalls.

Our job is to help families understand risk accurately.

The goal is not panic.

The goal is informed action.

Take the appropriate steps. Stay informed. Watch your child. Reach out to your pediatrician if you have concerns.

But don’t let a frightening headline convince you that catastrophe is around the corner.

A Final Word

If you’ve been following along for a while, some of this information may sound familiar from our discussion during the ByHeart recall last year.

Unfortunately, situations like these arise from time to time, which is exactly why understanding how to respond calmly and appropriately is so important.

Remember:

A recall should be taken seriously.

And your child is still overwhelmingly likely to be okay.

Both things can be true.

Love,

Dr. Max

Medical Disclaimer: This article is intended for educational purposes only and should not be considered medical advice. It does not replace evaluation, diagnosis, or treatment by your physician or healthcare provider. If your child is experiencing symptoms such as poor feeding, unusual sleepiness, weakness, or difficulty breathing, seek immediate medical attention. Always consult your pediatrician regarding concerns about your child’s health or nutrition.

The Shape of Loss

When I lost my mother in 2019, I was 34 years old.

Not too young, but not old enough for my mother to see my life fully unfold. She never got to meet my husband, see me become a father, or watch me build a career as a physician.

When you lose somebody you love, grief arrives in waves. And if it isn’t fully processed, those waves can harden into something darker. I’ve seen this time and time again with patients in my medical practice: they lose somebody they love, and suddenly their entire life becomes shaped by that tragedy.

We even have a medical diagnosis for this called “prolonged grief disorder,” characterized by a persistent, intense yearning for a deceased loved one that lasts longer than “culturally expected” and significantly interferes with daily life. In the United States, that “longer than expected” is generally considered to be around six months.

What “Interference” Really Means

What I often see as “interferes with daily life” is a partial blindness, or a myopic view, where everything is seen and defined by the death of their loved one. Activities that would normally bring joy are avoided because they trigger the painful yearning and longing. The psychology becomes: “Why do something beautiful if it’s only going to remind me of what I’ve lost?”

This is something all of us experience in some form after loss, myself included. While I personally haven’t experienced the profound catatonia I’ve seen in some patients, since my mother’s passing I’ve often found that longing for her darkened what could have been brighter, more joyous experiences.

And while I try not to diagnose myself, I undoubtedly do so all the time. Yes, by definition, I probably have experienced “an intense yearning for a deceased loved one that lasts longer than culturally expected and significantly interferes with daily life.”

But “interference in daily life” is another vague definition in the ICD criteria for prolonged grief disorder.

Since my mother’s passing, I’ve gotten married, had a child, bought two homes, started two businesses, and swum 22 miles from Capri to Naples. From the outside, life has continued fully. But beautiful experiences have often felt dimmed by the thought: “I wish she were here.”

And I think many people who have lost somebody know exactly what that feels like.

A Morning in Greece

But something shifted last summer that changed the way I think about grief, loss, and what it means to move forward after losing somebody you love.

I was having breakfast at a small taverna on an island in Greece. Earlier that morning I had gone for a mile swim in crystal green water, fed my four-month-old daughter a bottle by the shore, played with her at the water’s edge, and put her down for a morning nap. Then I walked across the sand to the taverna and sat beside an older woman in her seventies smoking a cigarette.

As I drank an espresso, I felt a sudden wave of grief for my mother. The cigarette smoke, the deeply lined skin, the warmth of the morning — all of it reminded me of her. And suddenly, the joy of the morning dissolved into longing.

Why wasn’t she here? Why couldn’t she see this?

As I sat with that radical shift, another thought emerged: what if this feeling wasn’t loss, but abundance? What if my mother’s passing allowed me to feel more joy because it reminded me of all that is precious in life, and all that connected me to her, her happiness, but also to my own? What if grief itself was evidence of how deeply joy once existed?

“They’re Always With You”

One of the most common things people say after somebody dies is, “They’re always with you.” And while that may be true, being “always with you” can sometimes feel like carrying a constant weight sadness and loss.

But I also think death can deepen joy. A life ends, but joy and spirit do not. Those things are intangible, but they continue moving through people, through memories, through generations.

Humanity is beautifully exponential in that way. Joy creates more joy. Spirit creates more spirit. It grows in every generation.

So I took a deep breath of cigarette-tainted air at this beautiful taverna on the sand in Greece and invited my mother’s joy into the moment with me. And suddenly I didn’t feel loss. I actually felt fuller.

I realized what I was missing in that moment wasn’t actually my mother herself, but my ability to carry her joy into my own experiences. And once I allowed myself to do that, I felt relief — as if I had finally moved forward from her death six years earlier.

Another Espresso

The day my perspective shifted was the day my mother’s joy came back to life. It no longer felt like a heavy longing tied to death, but instead became a way to feel more light, more gratitude, and more happiness whenever I thought of her.

And with that, I ordered another espresso.

Love,

Dr. Max

Medical Disclaimer:

This article is intended for informational and reflective purposes only and should not be considered medical or mental health advice. Experiences with grief and loss are deeply personal and vary widely from person to person. If you are struggling with persistent grief, depression, anxiety, or thoughts of self-harm, please seek support from a qualified healthcare professional or mental health provider.

What Is Pink Eye?

“Pink eye” is a diagnosis that often worries parents and frequently prompts daycare directors to send a child home. But not all pink eye is the same.

The medical term is conjunctivitis, which simply means inflammation of the thin lining covering the white part of the eye. Causes include viruses, bacteria, allergies, or irritants like dust or chlorine.

Viral Pink Eye

Most cases in children are viral, often caused by adenovirus, the same virus responsible for many colds.

Symptoms typically start in one eye and can spread to the other. Eyes appear red and watery, sometimes with clear or slightly sticky discharge. Children may also have other cold symptoms like a runny nose or cough.

While it can look alarming, viral pink eye is not dangerous and usually resolves within about a week. Antibiotics do not help.

Supportive care is usually enough:

• Gently wiping away discharge with a wet washcloth

• Cool compresses for comfort

• Good hand hygiene to reduce spread

Bacterial Pink Eye

Bacterial conjunctivitis is much less common.

It tends to produce thicker yellow or green discharge that may stick the eyelids together after sleep. Antibiotic drops can help, but many mild cases still resolve without medication.

Allergic Pink Eye

Allergies can also cause red, itchy, watery eyes, often affecting both eyes at the same time and usually linked to seasonal or environmental triggers like pollen or pets.

Do You Need Antibiotics?

Not usually.

Because most cases are viral, antibiotics will not make pink eye clear faster. Yet children are often prescribed drops “just in case,” partly because daycare or school policies require antibiotics before returning, even when they are not medically necessary.

Daycare and School Rules

Many schools and daycares require children with pink eye to start antibiotics before returning, regardless of the cause. These policies are often based on outdated guidelines rather than current medical evidence.

The American Academy of Pediatrics states that children with conjunctivitis generally do not need to be excluded unless they also have a fever or are too uncomfortable to participate.

When to See a Doctor

Seek medical care if your child has:

• Severe eye pain

• Vision changes

• Swelling around the eye

• Thickening or worsening discharge

• Symptoms that rapidly worsen

• Pink eye during the first month of life

What I Tell My Patients

Pink eye is most often viral and usually clears without antibiotics.

Supportive care, including gentle cleaning, cool compresses, and good hand hygiene, is all that is needed in most cases. Focus on comfort, monitor symptoms, and seek care if discharge worsens, vision is affected, or your child seems very unwell.

Parents should not feel pressured to start antibiotics simply to meet daycare or school policies when symptoms are mild and consistent with a viral infection.

Medical Disclaimer

This article is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If your child has worsening symptoms, significant pain, vision changes, swelling around the eye, or if you are concerned about their condition, seek evaluation from a qualified healthcare professional.

Did you know that cocaine has a distinct taste?

I didn’t.

I had assumed it was just a substance that affected the brain and body, not something you could recognize on your tongue.

I learned otherwise during a late night in the emergency room.

She arrived around 3am, covered in blood.

The patient had already tried everything people are taught to do at home: pressure, ice, more pressure. Nothing worked.

By the time she got to us, it looked like a trauma case. I was surprised she hadn’t come in by ambulance.

Instead, she was sitting upright in a hallway bed, completely unfazed, chatting with anyone who walked by.

The patient was a 74-year-old with a severe nosebleed. She had a presence. She was warm, loud, charismatic, and entirely unbothered by the situation. She waved me over and asked if we could “do something about this quickly” because she wanted to go home and watch TV.

Nosebleeds, or epistaxis, are something we see constantly in medicine.

Most fall into one of two categories: anterior and posterior.

The vast majority are anterior, meaning they come from small, fragile blood vessels along the nasal septum. These vessels can bleed easily from dry air, allergies, minor trauma, or over time, chronic irritation.

Sometimes that irritation comes from habits earlier in life. Cocaine use, even years prior, can leave the nasal septum thin, fragile, and prone to recurrent bleeding.

We started with the basics.

We packed her nose with gauze and waited. Thirty minutes passed. She talked to nurses, other patients, and anyone within earshot. At one point, she invited a stranger to sit down and tell her what was wrong with them. Everything was going well.

But when the packing came out, the bleeding continued.

We decided on chemical cautery using silver nitrate in attempt to seal the small vessels. That didn’t work. Then electrocautery, which helped slightly, but not enough.

She was still bleeding.

That is when another physician suggested we try liquid cocaine.

I paused.

This sounded like advice from an old textbook, not something I could order in a modern hospital.

Liquid cocaine does two things very well:

1. It numbs the area.

2. It causes intense vasoconstriction—meaning it shrinks blood vessels.

Due to this, it is still used in certain settings (particularly in ENT and emergency care) and can help stop persisstant bleeding.

I couldn’t just order it through the system. It was so tightly controlled that I had to go down to the hospital pharmacy myself to retrieve it. The vial couldn’t pass through anyone else’s hands.

So I went to the basement pharmacy, picked up a small glass vial, and carried it back upstairs.

The treatment that finally worked.

With guidance from a colleague, we applied a small amount to a cotton swab and gently touched it to the bleeding areas along her nasal septum.

Almost immediately, she sat upright.

She grabbed my arm and said, loudly and confidently:

“That’s cocaine.”

For a moment, the entire emergency room seemed to pause.

Monitors continued to beep, people kept moving—but heads turned. Even patients who could barely lift themselves shifted to look in her direction.

“That’s cocaine,” she repeated, delighted.

And then, finally, the bleeding stopped.

There was something surreal about the entire encounter.

A treatment rooted in 19th-century medicine, used in a modern emergency room, and recognized instantly by a 74-year-old woman with a lifetime of experiences I could only begin to imagine.

Moments like that remind me how much of medicine exists at the intersection of science and humanity. We rely on physiology, pharmacology, and evidence—but every patient brings their own history, their own knowledge, and sometimes, their own unexpected expertise.

I went into that shift thinking I understood nosebleeds.

I left reminded that even in medicine, there is always more to learn—and sometimes it’s at 3 a.m., from patients with knowledge you didn’t anticipate.

Medical Disclaimer

This article is for educational purposes only and is not a substitute for professional medical advice. If you experience persistent or severe nosebleeds, seek evaluation from a qualified healthcare professional.

Yes, I brought a medicine kit with a laundry list of things (actually, my travel medicine kit is detailed in another substack post).

Yes, we brought a huge suitcase.

Yes, I wore a mask on the plane.

But this post actually isn’t about any of those things. It’s about the much bigger feeling that comes with traveling with your infant for the first time.

The mix of excitement, anxiety, over-preparation, and eventual realization that babies, somehow, are a lot more adaptable than we give them credit for.

Traveling With an Infant Is Both Easier and Harder Than You Think

On one hand, traveling with an infant is easy. They don’t walk, run or need to move around that much, really. If you’re breastfeeding then you don’t really have to pack any snacks- it’s all ready to go. Most importantly, you don’t have to purchase them a ticket!

On the other hand, it can feel precarious to disrupt routines. Maybe you’ve just figured out nights and a time zone change feels harrowing. Babies can seem so delicate—maybe you’re worried about them getting their first cold, or if they can barely hold up their own head, how can you travel across a country or an ocean?

I’ve got a few pieces of advice for those of you want to venture out (and no pressure on those who don’t).

Babies Exist Everywhere

Remember babies are born and live all over the world! Having a newborn or an infant isn’t a uniquely American thing. You aren’t bringing a zebra to Alaska and need to pack everything so that it can stay alive. You will find everything you need, pretty much anywhere you go.

—Side note—

I wrote this last summer from a small island off of Greece, where we had to buy new baby bottles because my husband was insistent on only packing glass bottles. And convinced that if we brought four, there was simply no way we could break all of them...

Well, we were down to one bottle.

Which suddenly made the possibility of breaking the last remaining bottle feel very stressful.

But at the local (chaotic) grocery store — somewhere between the graters, blenders, and plastic pitchers — I found baby bottles, formula, baby wipes, pacifiers, and even a tiny infant bathtub, which we also bought.

Honestly, it ended up being a great cultural experience and a good reminder that babies exist everywhere, and most places are more prepared for them than we may think.

Pack for Comfort, Not Perfection

Don’t worry too much about packing everything. Focus on packing what will make your infant feel the most comfortable in a new environment.

While infants cannot easily communicate, they are cognizant human beings who can recognize their environment. Sometimes when it changes, they can get thrown off. This is why it can be hard to put down your infant at a friend’s house, yet they fall asleep easily in their crib, for example.

So, think about things that will make your infant feel at home, and bring them. Perhaps, a blanket, a doc-a-tot, a mobile, or a book that you read every night. In general, infants love familiar things, so start thinking about familiar objects (hopefully, ones that are easily transportable).

Flexibility Matters More Than Schedules

Flexibility while traveling with an infant is so important.

It’s OK to get thrown off routines. I think it’s actually good for your infant to learn how to cope and adapt to a changing environment.

Sometimes as parents we put a lot of pressure on ourselves to make everything perfectly optimized for our babies, but travel can be a good reminder that they are often more flexible and resilient than we think.

Your infant may take longer naps, go to bed later than usual, or eat a little more or less. They will be fine. And in many ways, it can be a healthy exercise for families — learning to respond to your baby’s cues in real time instead of feeling tied to a perfectly structured schedule.

Choose Places That Welcome Babies

Now where do you want to go?

If traveling internationally, I’d recommend a quick google search to see if that country is “baby friendly.”

Greece definitely is. We had grandmas literally lining up outside of our door to look at our baby. Waitresses at the local restaurants would routinely hold our daughter while we finished our meal. And we didn’t get ANY side-eyes when she cried/shrieked in public (which she did).

The Carry-On Rule

One practical point worth noting: make sure your carry-on has everything you would need for 2-3 days. Just in case your luggage is lost…

This usually means diapers, formula, your medications, clothing for you and your baby. Ideally, all of this you can purchase wherever you land, but it’s better if you don’t have to during the first few hours/days of your trip. So make a list of what you need on the day to day, and make sure you have enough of it for those first couple of days.

One Last Thing:

As summer approaches and families start thinking about vacations, weddings, long weekends, and visits to see family, I hope this encourages some of you to bring your babies along for the adventure.

Your baby will not remember the flight delays or the disrupted nap schedule, but they will grow within the warmth, movement, sounds, faces, and experiences of being with you in the world.

My final recommendation is to travel with plastic bottles.

The glass ones will break.

Good luck!

-Dr. Max

Medical Disclaimer: This article is for informational and entertainment purposes only and is not a substitute for individualized medical advice. Always consult your healthcare provider regarding travel with your infant, especially for newborns or children with medical conditions. If your child develops concerning symptoms, seek care from a qualified medical professional.

On a Sunny Sunday…

On April 26th, friends of Dr. Max and Molly Baz gathered in Santa Monica, CA. Guests mingled over snacks and backyard bliss, while the sounds of babies and toddlers filled the space alongside parents eager to ask questions and learn from the two hosts.

Together, through ticket sales and donations, we raised over $10,000 in support of Lucha / Poder Popular.

Some questions were submitted anonymously ahead of time, via sign-ups and DMs, while others were asked on the spot. The conversation unfolded over a 40-minute Q&A.

Below is a full, unfiltered look at what was shared.

Postpartum & Work

Q:
How to get through a rough postpartum when your job is demanding and not super supportive but you need the money and benefits as a parent?

Molly:
I think that this is a challenging one. I’m someone who works a lot. I think that carving out time for myself was really important and leaning on people around me to enable me to do that, such as my husband but also just other people in my community.

So I think it’s a matter of giving your all to whatever is right in front of you and then carving out time for yourself, whether it be like a 30 minute or one hour, whatever you can get, and not feeling bad about asking for what you need.

I think that it’s really hard for a partner to really know what the postpartum experience is like. And so the more that you can just voice what you need and share in that experience, the better that they can support you.

Don’t ever feel alone and ask for help wherever you can.

Dr. Max:
Yeah, and to that I’d just add that this question comes up a lot in my practice about how to navigate returning to work when you’re a parent and feeling like you’re doing something negligent because you have to return to work and you may need to leave your child with another type of caregiver.

And I really truly believe that infants and children have evolved in communities throughout time. And it’s really a modern day idea of a nuclear family… that if you can’t do it all on your own, all of a sudden you’re not doing it well.

And I don’t think that’s true. I think you have to rely on a community to help raise your child… and it’s not like you’re doing anything negligent because you can’t take care of a kid 24/7.

Fevers

Q:
Fevers stress me out every time. How do I know when it’s fine versus when it’s actually a problem?

Molly:
My answer is text Dr. Max…

I feel like as I went through my texts there was like four or five different ones… like “101, should I be concerned?” “102, are we worried?”

And Dr. Max would always just be like no, as long as the signs that your baby is presenting are like they’re alert and they’re not lethargic and they’re still eating.

So I’ve now learned not to rush to the emergency room and to look at other signs other than just the fever.

Dr. Max:
Yeah, that’s it. It’s always look at your kid, not the number.

One, you need an accurate temperature… everybody is doing these forehead thermometers, which aren’t super accurate, so unfortunately you just need to do a rectal temperature.

Molly: you can use lube—

Dr. Max: And then number two, it’s more about how your kid looks/seems.

You can have a kid that has an ear infection and is super sick with a fever, whereas you could have a kid that has roseola and a fever and they’re kind of doing okay.

So it’s not necessarily the number… it’s more about how your kid is behaving with the fever.

Boogers / Congestion

Q:
Any tips for boogers?

Dr. Max:
I can’t even recommend this to patients… but what has worked best for me is you just put your mouth over your kid’s nose and you suck.

I’m really sorry—

But let me tell you… the nose Frida is not that much better…

Molly:
A little nasal saline spray to loosen things up and then suction a little bit.

You need to get that stuff out one way or another.

Holding Babies

Q:
If you carry your baby too much, will they become dependent and manipulate you?

Molly:
That question suggests that you have one shot and if you do it wrong your baby is going to manipulate you forever…

I believe that they are living, growing, evolving… you can always undo bad habits and create new ones.

Dr. Max:
That’s a clear example of taking parenting styles to the extreme.

There is no right way to raise your child. What works for you and your family is going to be different.

So when you hear this parenting advice… it’s like “if you do this then this will happen”… none of that’s true.

What’s true is what works for you and your family at that moment in time.

Awkward Moment

Q:
What is one of the most uncomfortable moments as a parent?

Molly:
My son started getting boners when I would change him and I was deeply concerned that I was arousing him in some way…

I never really asked Dr. Max… I just got freaked out.

Dr. Max:
That’s totally normal.

It’s like when they pee, they’ll get a little bit of blood flow to the penis… it’s just a reflex.

It’s not anything related to sexual arousal by any means.

Molly:
Okay, phew!

Eye & Hair Color

Q:
When will we know our baby’s eye color and hair color?

Molly looking at her child:
I would like to know definitively!

Dr. Max:
Eye color… three months you’ll see a trend, and six months you’ll usually know.

Hair color usually will change drastically… they’re usually born with lighter hair and then it will get darker… around four years.

Daycare Guilt

Q:
Is it bad that daycare drop-off is sometimes the best part of my day?

Molly:
Love the honesty.

Dr. Max:
I really do believe that children have been raised in community for most of human existence.

When our nanny shows up on Monday morning I’m like, “oh great!”—but it’s not that I don’t want to see my child.

Also, I think sometimes your child gets bored with you… and that’s okay!

I don’t think you should feel guilty at all about needing time apart. It’s so normal.

Breastfeeding vs Formula

Q:
When can I switch to formula?

Molly:
I put a lot of pressure on myself… I was on flights pumping… storing milk everywhere…

It was too much.

Once I started using formula, I felt like I was able to go back to work and actually give my all to both parts of my life.

I will start formula sooner next time.

Dr. Max:
It’s funny. There are cultural swings… like “formula is best,” then “breastfeeding is best.”

It’s not an all or nothing thing.

The truth is 75% of families will choose to combo feed by six months.

So if using formula is making you feel isolated… it’s really not the case. Most families are doing that.

Short answer: whenever is best for you and your family.

Picky Eating

Q:
We have a 15-month-old and now she’s not eating her vegetables. We just don’t want her to be a “quesadilla baby.” What do we do?

Molly:
I have a couple of answers. Sometimes it’s a textural thing, so it’s not necessarily the flavor but the texture of a vegetable—however you’re cooking it—that they just don’t want. So changing the texture sometimes can help.

Like making a pasta bolognese and throwing vegetables in there.

It’s also 15 months—they’re really pushing boundaries and wanting control.

The open-ended question I see a lot is “what do you want to eat?”—and that’s too overwhelming. They understand more than they can say, so that question is just too infinite.

Two choices is better—“do you want broccoli or carrots?”

And if the answer is neither, I feel like the human need to eat will eventually set in.

A lot of times I feel like my son just wants bread because he’s not even that hungry—he’s bored.

If they don’t eat for a meal, I’m not afraid of that. I’m like, okay, you’ll eat at the next one when you’re hungry.

Dr. Max:
Yeah, and I agree with that entirely.

The biggest misconception is that kids are machines and need to eat three meals a day with snacks in between.

We don’t do that always as adults. Sometimes I skip meals because I’m not hungry or I’m busy, and your kid may do the same.

They may not have a meal because they’re not hungry—and that’s okay.

Closing

Thank you to all who attended and donated. Every dollar raised went directly to Lucha/Poder Popular, helping sustain their food pantry and community center while supporting mothers and families as they navigate the complex legal challenges faced by immigrant farmworkers. We are so grateful and proud to be a part of this community.

With thanks,

Dr. Max

Medical Disclaimer
This article reflects a live Q&A conversation and is intended for informational purposes only. It is not a substitute for individualized medical advice, diagnosis, or treatment. Always consult your healthcare provider with questions about your child’s health.

One of the most common concerns I hear from new parents is simple:

“Am I feeding my baby enough?” Or, “Am I feeding them too much?”

With so much conflicting advice circulating, it’s easy to feel like there is an exact “right” number your baby should hit. But in reality, infant feeding is more flexible than most people think.

Babies are not machines. They do not eat the same amount every single day. Intake varies, and babies are often very good at regulating their own needs.

In clinical practice, we rarely rely on exact ounces alone to determine whether a baby is feeding well. Instead, we look at a few key indicators that tell us far more.

Read more

There are few things more frightening than watching your child hit their head. Unsurprisingly, head bangs and injuries are one of the most common reasons parents end up in the emergency room with their kids.

The reassuring truth is: most pediatric head injuries are benign and just a part of watching your child navigate the world around them.

Children are top-heavy, impulsive, and fearless. They fall constantly. Their skulls are softer than adults’, but they are also surprisingly resilient. The brain is cushioned by cerebrospinal fluid, which helps absorb many everyday jolts and tumbles.

The challenge for parents is not whether falls happen. They will. The question is how to know when a head bang is serious.

Read more

Parents often reach for water wipes because they feel simple, clean, and safe.

The messaging is reassuring, mostly water, minimal ingredients, gentle for sensitive skin. And to be fair, they’re excellent for cleaning up big messes!

But there’s one issue I see come up repeatedly in clinic.

Because they’re so saturated, water wipes can sometimes leave excess moisture on the skin. And that lingering moisture can contribute to diaper rash.

The problem isn’t the ingredients, it’s the environment.

How Diaper Rash Actually Happens

Diaper rash, or diaper dermatitis, is primarily a moisture problem.

A baby’s skin under the diaper is exposed to urine, stool, friction, and warmth. When that skin remains wet for too long, the outer protective barrier begins to break down.

Once the barrier is compromised, irritation follows. If moisture persists, yeast can grow. At that point, what started as mild redness can quickly escalate into a painful rash.

The most common drivers of diaper rash are:

• Prolonged exposure to moisture

• Friction from the diaper rubbing on damp skin

• Irritants from stool or residual cleansers

• Yeast overgrowth in warm, moist folds

Even the cleanest, most gentle wipes can leave excess moisture behind. When that dampness lingers, especially in the folds around the thighs and genitals and it creates an ideal environment for irritation and yeast to grow.

Gentle ingredients help, but keeping the skin dry matters just as much.

The Moisture Trap

Many parents wipe thoroughly and immediately fasten a clean diaper over still-damp skin. In doing so, they seal moisture directly against one of the most delicate areas of the body.

Under a diaper, moisture has nowhere to evaporate. The combination of warmth, occlusion, and friction weakens the skin barrier quickly.

In some babies, especially those with sensitive skin, eczema tendencies, or frequent stools, that is enough to trigger dermatitis.

What I Tell My Patients

If you are using water wipes, take an extra few seconds to let the skin dry completely before putting on a new diaper. You can gently pat the area dry with a clean cloth or air exposure, even briefly, makes a difference.

When the skin is intact and healthy, maintenance matters. A simple barrier layer helps protect against ongoing moisture exposure.

For daily delicate skin maintenance, I often recommend a clean, occlusive balm that supports the skin barrier without unnecessary additives.

Dr. Max’s Baby Balm was originally formulated for exactly this purpose. It provides a protective layer that helps maintain healthy skin, especially in babies prone to irritation.

If a true diaper rash flare develops, particularly with redness, rawness, or signs of yeast involvement, a thicker barrier is usually necessary to support healing. At night, when diapers stay on longer and moisture exposure increases, a more robust protective layer can make a meaningful difference in comfort and sleep. Dr. Max’s Diaper Ointment is designed to create that stronger moisture barrier while remaining gentle on sensitive skin.

The goal is simple: protect the skin, minimize moisture, and prevent breakdown before it starts.

Bottom Line

Water wipes are not the enemy, moisture is.

Clean the skin thoroughly, but don’t seal in dampness.

Dryness under the diaper isn’t about over-drying the skin or using harsh products. It’s about giving delicate infant skin the chance to stay balanced and protected.

When that protective barrier stays intact, irritation is far less likely to develop. And when babies are comfortable, they sleep better too!

Medical Disclaimer
The information provided here is intended for general educational purposes and does not constitute medical advice. It does not replace evaluation, diagnosis, or treatment by a licensed healthcare professional. Always consult your child’s healthcare provider regarding specific symptoms or medical decisions.

What brought her into the clinic was worsening headaches and blood in her urine. She told me she had lived with these symptoms for years, but recently they had intensified. We ordered a CT scan.

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Let’s Start with What’s Normal

Let’s talk about baby spit up.

For many families, spit up is simply a part of infancy. It means a lot of extra laundry, damp burp

cloths, and a faint smell of milk that never quite leaves your shoulder.

On occasions, what looks like ordinary spit-up is something more. The difference between physiologic reflux and gastroesophageal reflux disease, or GERD, is not about volume. It is about comfort, growth, and patterns over time.

Almost all babies spit-up. Most do not have GERD.

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Dear Dr. Max,

I’m 65, my wife is severely ill with Alzheimer’s and I am her caretaker. She doesn’t even recognize who I am, and I think I’m gay. What should I do?

Dear gay at 65,

I can only imagine what you are feeling right now, but I think I can help you find a way to get through this. First off, you are not alone in this circumstance. I’ve had multiple patients come out as gay in their later years after the passing of their spouse. It’s complicated, because in losing your loved one, you are, in a way, set free. But I also want to recognize the complexity of your situation. Your wife is still alive, albeit lost from her previous self. Taking care of a spouse with Alzheimer’s who doesn’t recognize you is truly one of the most difficult types of caregiving. Adding your newfound gay self to the mix is even more difficult.

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