BABYWEARERS OF BOZEMAN
by Laurie Rugemer

The second Wednesday of each month, new parents and parents-to-be gather downtown to discuss and learn about the benefits and nuances of wearing their babies. This practice, the art of using a carrier or sling to hold your baby, is gaining momentum in many communities, thanks in part to the work of advocates like those found in the Babywearers of Bozeman group. Cindy Maxwell, the group’s founder, is an outgoing, kindhearted mother of three. As a strong supporter of babywearing, Cindy started the Babywearers of Bozeman in 2008 to provide a resource for parents interested in learning more about this valuable practice.

There are many benefits to wearing your baby. Many of us are familiar with the concept of the fourth trimester from The Happiest Baby on the Block, by Harvey Karp. Carrying your baby close to you can help their transition into the world by simulating the womb environment where the heartbeat, breath, and movement of the mother are a part of baby’s normal existence. Aside from this, constant contact enhances the bond between parent and child, as well as calms the baby so that he/she cries less and can spend more time in the quiet, alert state that is important for development. Stimulation is automatic, as your baby sees what you see and can more easily take in everything in the environment.

These are benefits for your baby, but wearing your baby also allows parents to do more while keeping baby close. Cleaning the house, doing dishes or laundry is much easier with your baby secured to your body, and a more content baby makes for less stressed parents. Above all else, babywearing acknowledges that your newborn needs you, and babywearing makes it easy to embrace the attention you give to your baby.
Given these benefits, it is no wonder that more and more parents are becoming babywearers. But with so many different types of carriers available for parents, it can be hard to wade through the information out there and choose a carrier that works best for each individual. This is where the Babywearers of Bozeman group provides assistance.

Not only do parents receive guidance as to the types of baby carriers and slings available, but they are also encouraged to bring in their own and get help using it properly. With five different styles of carriers on the market, the group has at least ten of each and makes them available for parents to try at the meeting or take home for a test-run.

A typical meeting might include a mother learning to nurse easily in a sling, a new parent chatting about the benefits of babywearing, or a father learning to carry his newborn in a pouch. Individual concerns are attended to, and the meetings provide a social opportunity for new parents. Pregnant moms, Expectant fathers, Parents of newborns and toddlers alike – everyone interested in babywearing is welcome!

For $15 a year and $5 per carrier, the group also provides a lending library of over 75 carriers and slings that parents can borrow in order to see what type works best for them and their baby. Parents are encouraged to become comfortable with a style and brand before making a purchase, and the resources and knowledge are provided to do so. All of the money made from the lending library goes back into the group for the purchase of new carriers.

Twenty or more parents may visit a typical meeting. For more personalized attention, Cindy provides private consultations at client homes for $20/hour which is highly recommended for parents with a newborn.

Bozeman Babywearing Group Meetings:
2nd Wednesday of the month
The Birth Place at 820 N. Wallace
10AM-1PM (come and go as you please)

Also visit the BWB blog: bwbozeman.com
Or email Cindy at info@bwbozeman.com

It's every parent's dilemma: whether or not the benefits of vaccination outweigh the risks for their child. On the one hand, research seems to show that vaccines are safe; on the other, anecdotal reports of vaccine adverse effects, from fever-induced seizures to developmental delay and even autism, abound.

What’s a parent to do?
Perhaps it depends on the child, the family situation, and the communities in which the child may be exposed to vaccine-preventable illnesses. In the current environment, it is a parent’s responsibility to participate in the decision, and give what’s known as informed consent to vaccinate their child. Informed consent implies that one has all the information necessary to make a choice.

Legally, a physician or other health provider counseling on vaccination must present both pros and cons of giving any type of vaccine. In many clinics, unfortunately, this responsibility is glossed over when time is short. Parents must advocate for themselves and their children by becoming familiar with childhood illnesses, vaccine types and the risks associated with each vaccine. Also, each family member’s individual risk of contracting a communicable illness versus having a negative reaction from vaccination must also be taken into consideration. The need for booster vaccinations may or may not be necessary, depending on a child’s existing immune status. A simple blood test to measure antibody titers to a particular vaccine can be performed to help in the decision making process.

Vaccines may decrease the risk of contracting a potentially serious illness, or shorten the duration of an illness. Childhood illnesses also may increase missed days of school for the child and days of work for the parent. These are also important considerations.

But not all children or their family situations are the same. Consideration of the individuality of your child and their vaccine needs are also important, and may include these questions:

• Does your child have allergies (or a family history of allergies) to egg or other vaccine ingredients that may make him or her more vulnerable to a severe allergic reaction to a vaccine?

• Does your child use medications (like steroid inhalers for asthma) that may prevent a good immune response from a vaccine?

• What are the most common vaccine preventable diseases in your community? A simple call to the local county or state health department will reveal any current or recent outbreaks in your area. When planning travel, this resource is also helpful.

• Does your child attend daycare?

• Is there a parent or caregiver who is able to stay at home and care for a sick child if he or she contracts an infectious disease?

• Are their other adults, children, or infants in the household who need to be protected from particular illnesses?

• Has your child had a previous adverse reaction from a vaccine?

Luckily, vaccination is not an all-or-none decision. Your child may be more likely to tolerate certain vaccines over others, and your family needs may dictate choosing some vaccines but not others.

There are also ways to reduce the risk of vaccine reactions if you choose to vaccinate. For example, many parents are concerned about the number of vaccines given at one time at a typical clinic visit: six or nine vaccines given in two injections is common. Giving one or two vaccines at a time (“monovalent” or “bivalent”) is an alternative available for some vaccines (as a specialty order by a clinic or doctor’s office) that may provide a superior immune response as well as a reduction in potential adverse effects. Also, giving one shot at a time and spacing additional shots days, weeks or months apart. Boosting your child’s immunity with vitamins and other natural medicines before and after a vaccine has been shown to reduce risk of vaccine reactions. Requesting and using thimerasol-free vaccines, if available, is another way of reducing potential risk.

To make the best decisions possible about vaccines, parents need to learn about each preventable illness, each individual vaccine type, and their particular child’s needs and vulnerabilities. Although it may seem like a daunting process, there are many books, on-line resources, and physicians willing to take the time to counsel parents on an individual basis these days in order to make the process easier. This way parents can be sure that they’re gathering all the information they need in order to make a decision about vaccination for their children.

Dr. Breana McElgunn and Dr. Robin Thomson are both naturopathic physicians (N.D.) practicing at Gallatin Valley Natural Medicine in Bozeman, Montana.

WHY ALL THE WELL CHILD EXAMS?
by Marie Mitchell, PNP, FNP

“Are you kidding me, another clinic appointment for the baby?” Stacey scurried around the house filling the diaper bag and trying to get the baby and her three year old into the car in time for their 2 p.m. appointment.
Life was already hectic caring for a new baby and Hailey, just six months old, had already been seen four times for “well baby exams.”

Today she was to have a six month well baby exam and Hunter, her three year old, was also to have a well child exam. What is more, Hailey and Hunter were well. Couldn’t Hailey just get her six month vaccinations and dodge the well baby visit? This was getting to be ridiculous—and Stacey planned to talk to the nurse at the clinic about it, if she ever managed to get there on time!

Why So Many Visits?
Sound familiar? In the first two years of life, most babies are recommended to be seen for a “well baby exam” about ten times after birth: three to five days later, at one month of age, and then on a schedule at two months, four months, six months, nine months, twelve months, fifteen months, eighteen months and twenty four months of age. If there are concerns, additional visits might also be added. As a result of all these visits, you might feel like you are renting a room at your health care provider’s office! You may be wondering, like Stacey, why your baby needs to be seen so often—especially when she is not sick. (For the American Academy of Pediatrics’ recommended well baby and well child schedule, see www.aap.org)

Most babies grow and develop faster in the first two years than at any other time in life and deviations from what is expected for age are sometimes subtle. Through wellness exams, growth, vision, hearing, and developmental issues can be identified and addressed before they are apparent to the average person. If you are a new parent, you may feel a whole lot better getting your baby checked frequently and knowing that you are doing all you should be doing. Some experienced parents also feel this way, but sometimes the numbers of visits—especially when everything is all right—seems to be a bit much. And when there are other children in the home to attend to, well sometimes these moms and dads feel that the visits are not worthwhile—especially being experienced parents have already “been there, done that.”

But health isn’t just about not being sick, which is why well baby and well child exams are recommended. These exams focus on preventing illness, promoting healthy behaviors, monitoring areas such as growth and development, and identifying conditions, syndromes, and behaviors that may not be readily apparent in one visit or which may have previously been attributed to illness. Trying to discuss things like toilet training when your baby is screaming with an ear infection isn’t the ideal time to carry on these conversations!

How Are Wellness Exams Different?
As the name implies, well baby and well child exams are specifically designed to assess a baby or child who is not ill. Wellness exams, as planned visits, are scheduled ahead of time and most offices allot more time for them than for ill visits, in order to allow time to provide a checkup for your baby or child, answer questions, and discuss concerns you may have. Topics usually include growth, development, diet, safety, recent medical
advances and new information, including health teaching (for example, how to take a temperature) and what kinds of things you can expect at the next stage of your child’s age and development. Experienced parents who already know this information may only need a brief update or review. However, with each child added to a family there are individual differences and challenges in raising that child, and even experienced parents may find that the new child, increased family size and changes in family dynamics present new and different challenges. The well child visit provides an opportunity to explore and discuss these issues.

Updates: New Information and Immunizations
Advances in medicine are occurring all the time, so advice you were given for your three year old may be different for your new baby. For example, once an association was made between aspirin use and Reye’s Syndrome, a condition in which there is brain swelling, often leading to death, babies (and children under 12) were recommended not to be given aspirin for viral illnesses, a recommendation that continues today. Prior to that time, aspirin was commonly given to babies and children for viral illnesses like colds and chickenpox.

New practices sometimes have unexpected results. Beginning in 1994 (and continuing today) parents were advised to change the position in which they put their babies to bed (on their backs instead of their tummy) in what is now known as the “back to sleep” practice. This recommendation came as a result of a study that showed an increase in the risk of SIDS (sudden infant death) for babies who were put to bed on their tummies rather than their backs. As a result of the new sleeping position, some babies’ heads get flattened at the back, something that didn’t use to be an issue when they slept on their tummies. This is a topic that is frequently addressed at well baby visits—both from a preventive stance as well as “after the fact.”

At well baby and well child visits you might learn about new or updated recommendations. For example, cold medications for young children are no longer recommended. Finally, well baby and well child visits are times to have vaccinations updated and to get information about vaccinations that might be needed in upcoming visits.
For Stacey, the well child visits proved to be worthwhile after all. It was reassuring to know that both Hailey and Hunter were growing and developing normally. In addition, Hailey received her six month vaccinations and Hunter was recommended to receive a pneumonia booster with the new pneumonia shot that recently became available. (see “PCV 13 and PCV 7 updated” at www.cdc.gov/vaccines/pubs/vis). Stacey had also forgotten that there were some questions she had been meaning to ask the nurse practitioner and was glad there was time to do so at this visit. She also had to admit that there was an advantage to having time to talk with the practitioner when she wasn’t trying to console a sick child. Even more important, Stacey felt that the practitioner “knew” her children, having seen them when they were both ill and well.

Marie Mitchell is board certified and licensed as both a Pediatric Nurse Practitioner (PNP) and Family Nurse Practitioner (FNP), providing general health care for individuals and families. She is the owner of Four Corners Health Care, which is accepting new patients.

529 PLANS
Saving for College is Simpler Than You Think

by Kathy Sena

It seems like not that long ago that my main concerns for my son were potty training and preschool. Suddenly, he’s in middle school, and time is marching forward faster than I can say “SATs, anyone?”

College costs are marching along, too — upward. And parents need to be prepared, says Ron Goldner, a fee-based financial planner with Wealth Strategies Group, Inc. in Memphis, Tennessee. A 529 plan can help, he says. And while these are tough financial times, even a $25- or $50-per-month contribution can add up to a nice college nest egg over the years, thanks to compounding of interest.

WHAT ARE 529 PLANS?
These plans offer tax-deferred savings for future college costs. They’re sponsored by states or educational institutions and are authorized by the Internal Revenue Service. Utah, Nebraska, Massachusetts, Virginia and New York are known for having particularly good plans, according to Russell Wild, a fee-only financial advisor (meaning that he advises clients but sells no investment products himself) in Allentown, Pennsylvania
(www.globalportfolios.net).

“Parents can save up to around $300,000 in a 529 plan, depending on each state’s plan,” says Goldner. Each plan has a cap. You are not required to invest in the plan from your state, he adds. Not all 50 states sponsor plans. Goldner notes that, while the best time to start such a plan is when your child is born, it’s never too late to start, even if your child is already in college.
A 529-plan account can’t be owned by both parents jointly, Goldner notes. It must be listed under just one owner. But you can always buy more than one account per child.

THERE ARE TWO TYPES OF 529 PLANS:

Pre-paid Tuition Plans
These plans allow parents to purchase credits at participating colleges and universities for future tuition and, in some cases, room and board. Most are sponsored by state governments and have residency requirements. Many states guarantee investments in their pre-paid tuition plans, according to the U.S. Securities and Exchange Commission (SEC).

College Savings Plans
These plans allow parents to establish an account to save for their child’s eligible college expenses at any college or university. Parents can choose among several investment options, which include stock mutual funds, bond mutual funds and money-market funds. While the plans are state-sponsored, parents don’t have to sign up for the plan in their state.

Goldner notes that parents can set up age-related 529 plans that become more conservative as the child gets closer to college age. “The portfolio would be aggressive (with a higher percentage in stocks) from birth to around age 8, moderate from age 9 to around age 15 and conservative (with a higher percentage in bonds and cash) from age 16 on,” he explains.

COVERDELL EDUCATION SAVINGS ACCOUNTS
These are a bit different from 529 plans. Coverdell ESAs may be appropriate for families that wish to save for elementary- and secondary-school expenses in addition to college, says Goldner. Even if you buy a 529 plan, you can still contribute to a Coverdell account, notes Savingforcollege.com (www.savingforcollege.com), a website that offers independent information about saving for and paying for college. Check out their terrific college-costs calculators and 529-comparison charts.)

WHY ARE 529 PLANS SO IMPORTANT?
There are several advantages to these plans, our experts say:

° Everyone is eligible. Generally, there are no income limitations or age restrictions.

° Parents get tax breaks. Contributions aren’t deductible on your federal tax return, but your investment grows tax-free, provided that the distributions are used to pay for your child’s college costs. Also, most states allow deductions on your state taxes when you sign up for your own state’s 529 plan, says Wild.

° The parent controls the purse strings. Your child has no rights to the funds. You decide when withdrawals are taken and for what purpose. Most plans even allow parents to reclaim the funds for themselves any time they desire, no questions asked. (However, the earnings portion of the “non-qualified” withdrawal will be subject to income tax and an additional 10-percent penalty tax).

° It’s an easy, hands-off way to sock away college dollars. According to Savingforcollege.com, once you decide which 529 plan to use, you complete an enrollment form and make your contribution (or sign up for automatic deposits). Your investment is managed either by the state treasurer’s office or by an outside investment company hired as the program manager. You may change your savings option annually (program permitting) or you may move your account to a different state’s program every year.

PENALTIES, FEES AND RESTRICTIONS
“Costs matter greatly,” says Wild. You can save a lot of money over the long haul by carefully choosing your plan. Prepaid tuition plans typically charge enrollment and administrative fees. Broker-sold plans will include commissions. And college-savings plans may charge enrollment fees, annual maintenance fees and asset-management fees. Make sure you thoroughly understand the plan you’ve chosen before signing up. Savingforcollege.com has information on the fees associated with various plans.

WHAT IF YOU’VE WAITED TO GET STARTED?
What if you’ve been saving for college with mutual funds or a savings account — but you never got around to starting that 529 plan? Should you sell those mutual funds (and pay capital-gains taxes — ugh) to kick start your 529 plan with a chunk of money? “Yes,” says Wild. “Take the hit,” he advises, noting that “you’ll have to take it when you withdraw the (regular mutual fund) money for college, anyway.”

The age of your child when you buy a 529 plan also will have some bearing on the type of plan you buy, of course. If your child is within five years of heading off to the dorm, you’ll probably want to choose a plan that offers that state tax deduction (assuming there’s a plan available in your state), as that will mean more to your bottom line than will the long-term performance of the plan, Wild says. But if your child is more than five years away from starting college, you’ll probably care less about the tax deduction and more about the long-term costs and performance of a particular plan.

JUST DO IT
If you’ve been putting off buying a 529 plan because the whole thing seems overwhelming, it’s time to put those fears aside. “It’s really simple,” says Wild. “Choosing one is not that difficult with the help of websites like Savingforcollege.com. Buying a 529 plan isn’t rocket science,” he adds. “In fact, it’s not even paper-airplane science.”

Keep this list of questions handy when choosing a 529 plan:

• Is the plan available directly from the state or the plan’s sponsor?

• What type of college expenses are covered?

• What types of investment options are offered?

• Does the plan offer special benefits for state residents?

• If my state’s plan charges higher fees than another state’s plan, do the tax advantages or other benefits offered by my state outweigh the benefit of investing in another state’s less-expensive plan?

• What limitations apply to the plan? When can I change investment options, switch beneficiaries or transfer ownership to another account holder?

• What fees are charged? Are there withdrawal restrictions?

Kathy Sena is a freelance writer who frequently covers parenting issues. Her son starts high school next year. Yikes. Visit her blog at www.parenttalktoday.com.