Dr. Kimara Gustafson
Ask the Pediatrician
Q: My son seems to have really flat feet. And he trips a lot. Would special shoes help him?A: A flat foot refers to a condition in which the arch of the foot disappears or diminishes when a person stands. Most often, the arch will reappear if the person is sitting or standing on the tiptoes. Almost all babies and young infants are initially flat footed as the muscles and soft tissues in their feet are just developing the strength associated with standing and walking.In older children (around... more
Fever help!
Q: I’ve heard it’s OK to give infants Advil and Tylenol at the same time when treating fever. Is this true?A: I get many questions as to how to best administer these medications in combination. The honest answer is that there is no one, single way. Both Advil (ibuprofen) and Tylenol (acetaminophen) work to reduce fever. And,... more
What is W-sitting?
Q: Our preschooler has a really hard time sitting ‘crisscross applesauce’ during circle time. He instead sits with his legs in a W shape. Do we need to break him of this habit to protect his knees?A: As you may have already discovered, there are differing opinions on the topic of W-sitting.It can be common for younger children to prefer... more
What is PANDAS?
Q: Our daughter recently got over strep and a mom at school told us to watch out for ‘PANDAS?’ What’s she talking about?A: PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. It’s a relatively newly known syndrome, first described in the late 1990s. Revised diagnostic criteria and... more
Is it a cow's-milk allergy?
Q: We think our newborn could be allergic to cow’s-milk formula. What are the signs?A: Milk-protein allergy is a condition that develops in the first year of life. The most common form is an allergy specifically to the protein in cows’ milk. Symptoms — rashes, stomach upset/discomfort, vomiting and/or diarrhea — can appear within a... more
When does puberty start?
Q: At what age do girls begin puberty? We’ve heard as young as 8! A: You’re correct that girls can begin puberty as young as 8 years old. And, in fact, that’s still considered within the range of normal. Girls typically start puberty between the ages of 8 and 13.Boys start between age 9 and 14. Keep in mind... more
Vitamin D
Q: Your advice in the November issue — recommending that parents generally avoid multivitamins for their kids (mnparent.com/vita-mn) — prompted me to write. I believe the American Academy of Pediatrics supports the recommendation of a daily supplement of vitamin D. I didn’t see this mentioned in your article. Do you happen to... more
Potty training isn't working!
Q: Dear Dr. Gustafson: I am writing becausee we are really struggling with our daughter's potty training for pooping.I started to train her when she turned 2. It took her just about a week to pee in the potty. However, she's still having trouble pooping in the potty.I know it generally takes long for No. 2, but we need to get... more
Do kids need vitamin supplements?
Q: What do you recommend for vitamins for kids? Gummies? Flintstones? And at what age should we start?A: For children older than 1, in general, the American Academy of Pediatrics doesn’t recommend vitamin supplements. It’s thought that if otherwise healthy children are eating a normal, well-balanced diet, they’re receiving what they need... more
Alternative vaccination schedules
Q: We keep hearing about alternative vaccination schedules. Is there a benefit? A: I strongly encourage all patients to stick with the recommend vaccination schedule. The vaccination schedule is developed and evaluated yearly by the top infectious-disease and pediatric experts in the U.S. The recommended timing and spacing of... more
Early signs of autism
Q: How early is it possible to detect signs of autism? A: Autism Spectrum Disorder (ASD) primarily affects social and communication skills. Because of this, most children with ASD will achieve their motor-developmental milestones, such as sitting, crawling and walking at normal times.However, some signs of ASD may be... more
Lice on the loose!
Q: Lice is on the loose at school! What’s the best way to see if our kid has it?A: Anyone can get head lice. Every year, millions of school-aged children will become infected with head lice, most commonly preschool and elementary-aged children. Though it’s not a pleasant condition, it doesn’t cause any serious health... more
Temporal thermometers
Q Do temporal thermometers really work? A These thermometers use an infrared scanner to measure the temperature in the temporal artery in the forehead. This artery carries blood from the heart to the head and can give a temperature reading that’s as accurate as a rectal temperature, which is still thought to... more
Coughing won't stop!
Q Our daughter’s been coughing every night for a week. Would running a humidifier help? A Coughing in young children can be especially difficult to deal with! Often the cough can linger for longer periods than typical for older children or adults.This is partly because a younger child may not be able to generate... more
New rules for peanut butter
Q When can we give our baby peanut butter? A This is a great question. If you had asked this question a few months ago, it would have resulted in a different answer. In 2000, the American Academy of Pediatrics recommended that the introduction of peanut butter, or other allergenic foods, should be delayed until a child is at... more
Stubborn loose tooth!
Q: My 7-year-old’s loose tooth won’t fall out. Is it safe to do the string-to-door technique?A: No, I wouldn’t recommend the string-to-door technique to remove a stubborn baby tooth. If your child wants to try to remove a tooth on her own, she could try that. For this method, it is recommended to firmly grasp the loose tooth... more
Is it eczema?
Q: Our 1-year-old has red patches of skin on his cheeks. It is eczema?A:  Eczema is a chronic skin condition. Since it’s chronic, the symptoms can fluctuate in severity. At times the skin can look completely normal. When it’s exacerbated or triggered, it can appear quite dry, red or irritated and can be quite itchy or painful.... more
Flying with baby
Q: At what age is it safe to take our baby on an airplane?A: The best thing you can do is discuss this with your baby’s doctor. In general, healthy newborns may be able to handle airplane travel without any issues. However, there are certain health conditions or other factors you may want to consider. These might include if your baby was... more
Ibuprofen for fevers
Q: How many nights in a row is it OK to give a 2-year-old ibuprofen for a 100- to 101-degree fever?A: I know having a sick 2-year-old in the middle of the night is never fun. The first thing you want to do is help him feel better. What I’d recommend is this: While you’re giving that first dose of ibuprofen to help with the... more
Warts, ewww!
Q:  My son, age 4, has multiple warts on his feet! What’s causing this and what do we need to do? A: Warts are caused by a virus (human papillomavirus). They can occur on any part of the skin on the body, but are most commonly seen on the hands, feet, knees and elbows. They’re very common in children. They can be... more
Diagnosing ear infections
Q: We’re mystified by ear infections: When we take our 2-year-old to multiple doctors, the diagnoses aren’t consistent. One will say she has no ear infection at all. Another will say she has a severe ear infection!A: To better understand variation on diagnoses of ear infections, we may need to take a step back and more clearly define... more
Pillows for baby?
Q: At what age is it safe to let a child sleep with a pillow?A: It’s recommended to not use pillows for children younger than 2 years old. Young children can easily suffocate with large pillows, fluffy comforter blankets, large stuffed animals and other accessories. A safe crib has a firm mattress without extra padding,... more
Potential downsides to hand sanitizers
Q: My son hates washing his hands, so we’ve resorted to using hand sanitizer almost exclusively, which he seems to do well with, even on his own. Is there a downside to this method?A: There are two potential downsides. First is that, though hand sanitizer is useful when there’s no sink/water and soap available, it’s not as effective... more
Helping your teething child
Q: What can I do to help my child get through teething?A: Teething usually first occurs starting at about 4 to 7 months old. Usually the front top or bottom two teeth emerge first. (If your infant is older than 7 months and still doesn’t have any teeth showing, don’t worry. Teething times can vary dramatically.)Teething can cause mild... more
Limiting infant spit-up
Q: My infant son constantly spits up after feeding, to the point where he seems to spit up almost his entire bottle. He still has full diapers, so we feel he’s getting enough food, but should we try to limit the amount given? He screams when we stop feeding him midway through a bottle. Are there any tips to limit spit-up?A: Part of the... more
Overeating in toddlers
Q: I feel like my toddler’s overeating. And she constantly asks for food (not just sweets, either). Should I limit her food intake? A: Toddler energy requirements — despite their impressive energy expenditures — aren’t abnormally large. In fact, children age 1 to 3 years old need about 40 calories for each inch of... more