Unless your child has an underlying chronic condition such as asthma that might make the flu rougher for her, I don't think the vaccine is worthwhile. First, if the vaccine isn't formulated for the particular flu strain that appears in any given year, it's likely to be ineffective. It's also a pain in the butt, since it has to be given every year by injection. While this is my personal opinion, the American Academy of Pediatrics recommends that all babies between 6 and 23 months get a flu shot annually.
When it Starts
Between 4 and 6 months of age, teeth begin pushing through sensitive gum tissue. As a result, your baby will likely drool more and want to chew on anything near his mouth. The first tooth, often a front bottom one, typically erupts at about 7 months, though getting a first tooth as late as 15 months is still normal, says Bill Stratbucker, M.D., a pediatrician at Helen DeVos Children's Hospital in Grand Rapids, Mich., and an assistant professor of pediatrics at Michigan State University. A full set of 20 baby teeth is generally in by 2 1/2 years.
Yes, it's bigger than average, and no, you don't need to worry about it. A very large fontanel, or "soft spot," can be a sign of extraordinarily rare diseases and syndromes like dwarfism or hydrocephalus, but believe me, your doctor would know if either of these conditions was present.
The key to hydration at any age is to keep the quantities of liquid very small. Don't allow your child to take sips (or gulps) of water or an electrolyte drink; rather, give only a teaspoon every five to 10 minutes or so. When he is able to hold this much down, increase his intake to 2 teaspoons. Yes, he will be thirsty and unhappy, but if you allow him to take sips, he'll get tablespoons of fluid and throw up again.
"Two in a family" visits that include a toddler typically don't work as well as individual appointments. But if you can't do it any other way, make the experience smoother for all involved by following these tips:
Dress to undress No putting your baby in bodysuits that have to be snapped and unsnapped; dress her in a shirt that pulls over her head easily. Avoid leggings or tights for your older daughter; put her in underwear she's proud of (if she's out of diapers) so she'll be happier to get undressed.
The American Academy of Pediatrics and virtually all other experts advise against introducing solids before 6 months of age, so I'd wait awhile before giving him any more. (Babies are not meant to digest solids at 4 months, as you have observed.) When you do offer solids again, start with small amounts of fruits and vegetables, such as applesauce, pureed carrots, smashed pears or sweet potatoes; try them for a few weeks or more before offering oatmeal or cereal grains.
The most prevalent childhood disease is dental caries (aka cavities), but thankfully, cavities are largely preventable--as long as you start caring for your baby's teeth as soon as they sprout, usually at 6 to 9 months. "It only takes a couple of months for cavities to form," warns Joel Berg, D.D.S., M.S., a professor of pediatric dentistry at the University of Washington School of Dentistry in Seattle. Here's how to avoid early-childhood tooth decay.
In more than 100 years of observing women having children, physicians and medical researchers have noted that the natural timing between pregnancies for healthy women who are breastfeeding and not using birth control tends to be between 18 and 24 months. What's more, a 2006 study published in the Journal of the American Medical Association concluded that spacing pregnancies less than 18 months or more than 59 months apart appears to be associated with a greater risk of problems such as preterm birth and low birth weight.
I recommend a very gentle approach. Start by nursing your son for a shorter time in his own room and soothing him to sleep by patting and rubbing him through the bars of the crib. Do this for a few nights; for another few evenings, soothe him to sleep with no nursing. Finally, spend several nights talking to him until he falls asleep, with no rubbing or patting. I don't pretend this is a "no-cry" solution, but your baby's distress will be mitigated by your or your husband's presence. For more information, visit drjaygordon.com/development/ap/sleep.asp.
I think you need to speak up. It sounds like this child may be exhibiting signs of autism, and if he is, early intervention can be very beneficial. When you approach the parents, be honest but sensitive. Tell them you've cared for many children and have noticed that their son is speaking later and playing a little differently than most. If they ask what you suspect, simply say your experience shows that all kids with "differences" can benefit from a good evaluation.
Most experts recommend caffeine in moderation--that is, one to two cups of coffee daily--while breastfeeding. Since the servings you're having are not the "grande" size, you and your baby should be just fine. (This is one aspect of breastfeeding where cup size does matter!)