Big Sky Pediatrics

12/07/2025

TODDLER SPEECH

A few weeks ago, I had a problem with my website. I couldn't figure out what had happened. I made some calls, but I wasn't able to explain my problem. Either it was the wrong person to talk with, or they didn't understand what I was trying to say, or I didn't know the right terms. Eventually, after quite a bit of frustration, I finally got it worked out- got a new domain, transferred the website and I was back on track.

The whole situation made me think about toddler's trying to speak. When babies start exploring making sounds, they start with cooing. Those are vowel sounds like “ooh” and “aah”. Next, they move to babbling which is a string of consonants with some vowels thrown in, such as “baba”, “gaga”, and “dada”. “Ah” sounds are still common, but they may start to use other vowels. They respond happily when their family reacts to their sounds.

Imitation is necessary for babies to move to more complex speech. They need to hear other people, not speaking “baby talk” but clear speech. They will understand what you say long before they can say it. At some point, when you say “Where is Daddy?”, they will start looking around. As they hear more speech, they move to jargoning. Jargoning is when the child uses sounds with inflections (the ups and downs) of speech. I describe it as sounding like they are talking, but in a language no one else understands! If you get the idea of what they want (in spite of it being in a different language!), say something back like “Oh, do you want your blue bunny now? Here's the blue bunny.” If that's not what they want, they will surely let you know!

Eventually, they start picking up understandable words. Usually, by 12-18 months, they will use single words, often pointing as well. They may start with only a couple of words, but they rapidly increase to 10-50 words. By 2 years old, they may start putting words together such as “More milk” or “Go bye-bye”.

During this whole process, it's critical for parents, guardians, siblings, everyone to talk to the child clearly, repeating words that the baby is trying to say. Describe what you are doing - “We are going to go pick up Daddy at work”, “We are putting on your shirt now. It's a green shirt”. Talk about anything and everything. I think my father read to me from his textbook when he was in graduate school.

Reading is fantastic for speech development (as well as social skills). Read aloud to your child every day. If they are not very interested in the story, point to pictures and name them. Describe what they are doing. Your child will gain far more vocabulary than from what you ordinarily talk about. Sing songs, especially with hand motions. When you learn something in a song, it stays with you for a long time. When I started singing to my babies, the first songs I remembered were the Sunday School songs I had learned ages ago.

Learning to speak is hard work for your child. They may get frustrated at times when you aren't understanding what they mean (like me with the website support people!). Be patient and work with them to find what they are trying to say. Listen and repeat more clearly, if you think you have an idea. It takes time.

If you have any concerns about your child's speech development, be sure to mention it to your child's provider. If there is a problem, it's always best to treat it early.

Contact Dr. Cheryl Coldwater at Big Sky Pediatrics for more information about your child's development.

Big Sky Pediatrics Dr. Cheryl Coldwater, MD A new kind of Pediatric Practice. Do you want care for your child or adolescent that works *with* you? Big Sky Pediatrics is a unique practice. I am a board-certified Pediatrician with 39 years of experience. I see patients in my office in Marble Falls by....

11/25/2025

Wishing you and your family a Happy Thanksgiving.

11/10/2025

Big Sky Pediatrics has a new website address.
It's now

Big Sky Pediatrics Dr. Cheryl Coldwater, MD A new kind of Pediatric Practice. Do you want care for your child or adolescent that works *with* you? Big Sky Pediatrics is a unique practice. I am a board-certified Pediatrician with 39 years of experience. I see patients in my office in Marble Falls by....

11/08/2025

This is helpful information. I agree with the ideas of correcting someone who is making negative comments about your child. Speaking up to them and giving a positive comment in front of your child.

Your child definitely hears you if you give positive or negative comments to someone else.


By--School Counselor Mama is in Pittsburgh, PA.

When someone makes a comment about your child that doesn’t sit right—
you don’t have to freeze or fake a laugh.
You can gently reframe it in the moment. Here’s how:
✅ Replace labels with descriptions.
Instead of “He’s shy” → “He likes to take his time before jumping in.”
✅ Shift the narrative.
Instead of “She’s bossy” → “She’s learning to be a strong leader.”
✅ Acknowledge growth.
Instead of “He’s so emotional” → “He’s working on handling big feelings.”
✅ Speak to the truth you want your child to believe.
If they hear you correct it calmly, they start to absorb that instead.
Because our kids are still becoming.
And one quick comment can stick longer than we think.
🙋🏼‍♀️ Follow for more ways to protect your child’s inner voice—without guilt.
📌 Save this for the next awkward moment you’re not sure how to respond.

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10/31/2025

Happy Halloween. Stay safe and enjoy!

10/29/2025

The Big Sky Pediatrics website is temporarily down. I'm trying to get them to get it back up. Thank you for your patience.

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09/17/2025

DENTAL HEALTH

Taking care of your child's teeth is important from the very beginning. Your teeth are important for eating, talking and smiling! The health of your mouth can also affect your general health as well.

Before their first tooth, wiping their gums with a clean, damp cloth helps prevent problems. As soon as they get their baby teeth, you can start brushing with a soft brush without fluoride toothpaste at first. The first dental appointment should be within 6 months of the first tooth or at 1 year old. This helps to find problems before they become major.

Brushing teeth is important, but it's not the only thing to keep your child's teeth healthy.

**Start introducing a cup around 6 months. If your baby is breast or bottle fed, you can offer water in the cup to get them used to it. **When you start putting formula, breast milk, or whole milk (after 12 months old) in the cup, start putting water only in the bottle so your baby will prefer the cup.
**Avoid juices and sugar-sweetened drinks (soda, sports drinks, etc) since they have a lot of sugar. If you give juices after a year old, limit it to 6 ounces per day and always use a cup not a bottle.
**Don't give your child a bottle or cup in bed.
**Wean your child from the pacifier. If you “disappear” it when they are 4-6 months, it is much easier. If not, you can start limiting where they get it (like only at bedtime), and when it I gets lost, don't replace it.
**Never put your baby's pacifier in your own mouth and then give it to the baby. Adults have different bacteria in the mouth and early exposure may increase the risk of cavities in your child.
**Start a routine of tooth brushing early- every morning and every evening. If your child is resistant, let them play with a separate toothbrush while you clean their teeth, so it's a bit of a game.
**As your child gets older, let them take more responsibility for brushing regularly.
**Help your child learn about healthy food and drink choices. Lead by example by eating healthy foods yourself. Keep sweets and junk foods for a special occasion.

Help your child to have strong, healthy teeth right from the beginning. If you have any concerns, talk with your dentist.

09/03/2025

You are not alone.
It's ok not to be ok.
You matter.

September is .
If you or someone you know is struggling, please reach out for help.

Lend an ear, reach out a hand, support each other.

🌎 www.988lifeline.org
☎️1-800-273-TALK or 988
📲Text "talk" to 741-741

08/26/2025

EYES

Many of us are pretty good about getting check ups for our children and taking them for vaccines. We, as adults, may be less conscientious about taking ourselves for check ups or getting recommended vaccines. But, even worse, most of us do not get regular eye exams!!

We need our eyes! They are such an important part of our body and it's possible for our vision to change without us noticing the problem until it is severe. Some degree of vision loss is very common, especially as we get older. But vision can be affected by so many things- trauma to the eyes, sun damage, diabetes, genetic disorders, high blood pressure, smoking, etc.

A couple of years ago, I went to the eye doctor for a routine check up. Surprisingly, I found that I was almost blind in my left eye! I had a retinal tear, which if it had not been treated, would have definitely progressed to blindness. My other eye was still healthy, so it had compensated and made the vision loss less noticeable. I was able to get the retinal repair and get most of my vision back, but there would be an increased risk of cataracts.

That time has come and I will be having cataract surgery next month. It is one of the most common eye surgeries in the country and is very safe and effective. My husband has already had his done, so I know the procedure.

Children can't always tell us when they can't see well. Getting a good vision exam yearly is important. But, that definitely doesn't mean that parents should neglect their own vision check ups. Get an appointment with an eye doctor to keep up with your visual health!

08/20/2025

Big Sky Pediatrics will be closed 08/21-26. I may be reachable by text or email, but may not be able to respond immediately. If you have an emergency, please go to urgent care or the ER.

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08/03/2025

Exciting news!

There is exciting news in my family. My husband, Martin Noel has received his full license as a Marriage and Family Therapist in the State of Texas. This is the culmination of years of hard work in the process of attaining his Master's degree, completing a Practicum, and completing over 3000 hours of client care.

He will be working on getting credentialled to accept various types of insurance, and will also accept cash pay clients as he has been doing. Hopefully, this will allow him to be more accessible to people who want Marriage and Family Therapy.

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07/20/2025

DIVORCE

When two people get married, they are rarely thinking about getting divorced. They don't really know how their relationship will end up. Even when things go well, there can be minor arguments and miscommunications. And sometimes, there are much deeper incompatibilities that can't be resolved. They may go to therapy, they may try to adapt to each other's needs, but they can still end up with a broken relationship. It is a sad situation, but both parties are adults and they can move on with their lives separately.

Unfortunately, their children may have a much more difficult time. It may seem that their whole world has been destroyed. They don't know what to do and they may feel that it's never going to be okay again. They may express anger and other strong emotions. Some children may shut down and hide their feelings. If their parents are fighting or speaking badly about each other, it is extremely traumatic for the children.

Young children may have more temper tantrums or crying. They may show more fearfulness. Older children may alternate between being mad at one parent or the other, blaming them for the disruption of the family. They may avoid both parents for a while.

Parental divorce can also cause children to have school problems, trouble focusing in class, and not getting their work done. This is a major trauma in their lives, and studying math or history may not seem important at all.

When children experience the trauma of parental divorce, they may easily become distrustful. They may not believe that people will be truthful with them. They may not know who they can count on. They may feel abandoned. Even when you remind them that you love them and the divorce doesn't change that, they may not believe it all the time.

These feelings may lead to an overall distrust of other people and isolation which can affect their relationships even as adults. The process of overcoming these attachment issues can take a long time, even with good psychotherapy and support.

The emotional toll on children of divorce is terribly difficult. A good therapist, particularly one with experience with family issues and childhood trauma, is recommended, if at all possible. Having a way to deal with the big emotions they are feeling is extremely important to their mental health.

If you and your partner are divorcing, make a special effort to work with your children and help find a good therapist. Martin Noel, LMFT – Associate is a Marriage and Family Therapist who can work with your family during this difficult time. Dr. Cheryl Coldwater is a Pediatrician with a specialty in Pediatric Mental Health who may be able to help as well. Call us for more information.

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