Welcome your Royal Highness Prince (name to come) and congratulations to new parents Prince William and Duchess Kate.
A new study just published in the August online edition of Pediatrics confirms what I see in my practice.
If you look at a baby's legs it is easy to see how they were folded so that they fit inside the uterus. Those little legs don't get unfolded until after delivery.
I still get a lot of questions about starting solid foods in a baby.
I recently received a question from a Twitter follower related to cradle cap and dandruff. She wanted to know if there was a difference in the two. You know there really isn't as they are both due to seborrheic dermatitis, an inflammatory condition of the skin in which the skin overproduces skin cells and sebum (the skins natural oil). Cradle cap is the term used for the scaly dermatitis seen on the scalp in infants. It is also seen on the eyelids, eyebrows, and behind the ears. It is typically seen after about three months of age and will often resolve on its own by the time a baby is eight to 12 months old. It is usually simply a cosmetic problem for a baby as it looks like a yellowish plaque on a baby's scalp and is often not even noticed by anyone other than the parents. Unlike seborrheic dermatitis in adults, cradle cap typically doesn't itch. It is thought that cradle cap may occur in infancy due to hormonal influences from the mother that were passed across the placenta to the baby. These hormones cause the sebaceous glands to become over active. In some severe cases an infant's scalp becomes really scaly and inflamed and causes even more parental concern, as it appears that the infant is uncomfortable and may be trying to scratch their head by rubbing it on surfaces. The treatment for cradle cap is to wash the baby's scalp daily with a mild shampoo and then to use a soft comb or brush to help remove the scales once they have been loosened with washing. When washing the head make sure to get the shampoo behind the ears and in the brows (keeping the soap out of baby's eyes). This is usually sufficient treatment for most cradle cap. In situations where the greasy scales seem to be worsening it may help to put a small amount of mineral oil or olive oil on the baby's head and let it sit (I left a small amount on my children's heads overnight) and then to shampoo the following day. The oil will help the scales to loosen up and come off more easi
Many a new mother has struggled with whether to breast-feed or give her newborn formula. A recent study, published in the journal
Have you ever sucked on your baby's pacifier to clean it? Many parents have. Babies drop their binkies all the time and if you're in a hurry or just figure a little spit-cleaning won't hurt, you're more likely to stick it in your own mouth and give it a quick once over.
A new study out of Sweden says the spit-cleaning technique may actually help your infant avoid eczema and asthma.
It was surprising that the effect was so strong, says pediatric allergist Dr. Bill Hesselmar of Queen Silvia Children's Hospital in Gothenburg, Sweden, lead author of the study published Monday in the journal Pediatrics.
The study involved 136 infants who used a pacifier in their first 6 months. 65 of the infants had parents that reported sucking the pacifier to clean it. In those children, both eczema and asthma were strongly reduced when they were examined at 18 months of age. At 36 months of age, the protective effect remained for eczema but not for asthma.
Scientists didn't know why the sucking on the baby's pacifier acted as a protector or whether it was filtering out germs. The technique didn't have any impact on respiratory illness, meaning that the babies were not more likely to get a cold or the flu from their parents. Common sense would dictate that if you have a cold or the flu or any other contagious condition, then it's not a good idea to suck on your baby's binky. Otherwise, maybe it's not such a bad idea.
Why is sucking on your infant's pacifier possibly helpful in preventing asthma or eczema in your child? Scientists hypothesize that tiny organisms in the saliva of the parents may be why. Parent's saliva introduces gut micoflora that live in the digestive tract of the baby. We know that if infants have diverse microflora in the gut, then children will have less allergy and less eczema,says Hesselmar. When parents suck on the pacifier, they are transferring microflora to the child.
What are the words that a child first speaks that changes everything?
Back to more funny office stories - they really keep my job interesting and always a little bit of fun.
When your baby cries should you pick him or her up and walk or find a good rocking chair and rock back and forth? A new study from Japan says that infants respond best when mom (or any caregiver) picks them up and walks around.
Researchers said that the babies rapidly beating hearts also slowed down, proving that they felt calmer.
"Infants become calm and relaxed when they are carried by their mother said study researcher Dr. Kumi Kuroda, who investigates social behavior at the RIKEN Brain Science Institute in Saitama, Japan. Interestingly, the study also observed the same response in baby mice.
For the study, researchers monitored the responses of 12 healthy infants ages 1 month to 6 months. The scientists wanted to discover the most effective way for mothers to calm a crying baby over a 30-second period " simply holding the baby or carrying the infant while walking.
Results showed that infants carried by walking mothers were the most relaxed and soothed compared to babies whose mothers sat in a chair and held them. As a mother stood up with her cradled her baby and started to walk, scientists observed an automatic change in the baby's behavior.
These results held even after the researchers took into account other factors, such as the child's age and sex, and the mother's age and walking speed.
Kuroda said she was surprised by the strength of the calming effect. Researchers noted that the rhythm of walking might be more effective in soothing infants than any other rhythmic motion, including rocking.
Babies cry for a variety of reasons. If an infant is hungry or in pain, they'll most likely start crying again when they are laid back down. But sometimes a baby just feels a little anxious or unsure about their environment and will relax when held close and comforted. Kuroda acknowledged carrying might not completely stop the crying, but it may prevent parents from becoming frustrated by a crying infant.<
How much fun is a 4-6 month old baby? I just love this age, and if you have a baby of your own, you probably know what I mean. I call this age a chia baby! They are just perfect and low maintenance like the chia pet.
Think about it, this precious aged baby only requires watering, i.e. they just drink - no real food yet, so no meal planning or mess to clean up. They don't move , so you know where they are at all times, no looking for them under foot, or worrying if they will be home on time. They sleep for at least 6-8 hours at night (those early months were much more exhausting) and typically wake up with a smile on their face.
When you talk to this age baby they smile, babble and laugh at whatever you say. They think you are funny and clever (not always the case during their teen years), even when you might not be. A 4 month old baby packs up easily and can travel, just like moving a chia pet from one window sill to another. (wait till toddlerhood and trying to convince the same child to sit still on a plane).
I am always ready to take a 4 month old baby home with me for a few days. I tell the parents at the 4 month check up that I will gladly babysit . I just wish I could keep a 4-6 month old baby around at all times. I do believe that this stage of infancy is God's gift to parenting.
Don't worry, there are many different stages in a child's life that are also special and perfect, but this is just the first one. This stage is well worth the first months of sleep deprivation and exhaustion! If you have a younger baby, hang in there, it's getting ready to get really
Did you read the latest study from the CDC about the number of infants who are starting solid foods too soon? One of the only things that I think has stayed pretty constant since I began practicing medicine (and what I did with my own children), was waiting until they were around 6 months of age to begin solid food.
Beginning a baby on solid foods is not really momentous, in that it does not make a baby sleep through the night, it does not make them less fussy, or gain weight faster, but it certainly is a little more work. A baby really does just fine on breast milk or formula for the first 6 months of life. It is wonderful to watch a newborn grow and thrive, and it all happens with milk alone.
While many new parents are anxious to start solids, there is no rush. Actually, once you are starting baby foods you soon figure out that it is really more work, and you get to fix meals for the next 18 years! Formula or breast milk seems like a great meal when you are too tired to cook one night when they are older. Milk for dinner just doesnt work for a 10 year old.
Early introduction of solid foods may be linked to obesity, diabetes, eczema and celiac disease. While the studies on these issues continue, why risk any of these problems when your baby is doing well on breast milk or formula alone for 6 months?
When beginning solid foods your baby should be able to sit up in their high chair and open their mouths when the spoon is introduced. There is no magic as to how much a baby will even eat when you start baby foods. For some babies, eating solid foods is cosmic and they may love it and continue to eat more and more.
When should babies be introduced to solid foods? Many physician groups and the American Academy of Pediatrics (AAP) recommend waiting till your infant is at least 6 months old before solid foods are introduced into his or her diet.
But a new study from the U.S. Centers for Disease Control and Prevention (CDC), reports that 4 in 10 parents start feeding their babies solid foods before their four-month birthday.
Why should parents wait? According to the AAP, its partly because early solid foods have been linked to obesity and other chronic conditions. Public health experts also agree that a mothers breast milk or nutritionally fortified formula is best fed exclusively till the baby is about 6 months old.
"Introducing solid foods early means that the baby gets less breast milk over the course of their infancy, and that decreases the ability to get optimal benefits, like protection against infection," said Dr. Alice Kuo, from the UCLA Center for Healthier Children, Families and Communities.
Choking on solid foods is another concern experts have noted.
"Infants should be able to sit up (and) take food off the spoon," said the CDC's Kelley Scanlon, who worked on the research." Sometimes if they're not ready, if they get presented with the food, they might not open their mouth or they might spit it back up."
The teams research included 1,334 new moms who filled out questionnaires each month about what their baby had eaten in the past week. The surveys were conducted between 2005 and 2007, when AAP recommendations called for starting solid foods no earlier than four months of age. Just over 40 percent of parents reported their babies were eating solids, such as cereals and purees, before that point.
Why were the mothers feeding solid foods so early? They gave several answers. They thought their baby was old enough, their infant seemed hungry " even after being breastfed or given a bottle, and surprisingly many re
I keep getting so many questions about tummy time Ever since the American Academy of Pediatrics recommended that all infants sleep only on their backs (to reduce the chance of SIDS), parents forget or are afraid to put their baby's on their tummies. Tummy time is important to help reduce the incidence of head flattening as well as to give your baby time to develop different muscle groups.
Tummy time is encouraged from the first days after a baby's birth, but so many parents ask, just how much time? Tummy time does not mean timed in the sense that you do it for a certain amount of time or minutes a day. Tummy time, is not rigid.....it is flexible. Off and on throughout the day when your baby is awake, you let them experience tummy time.
Just like so many activities with a newborn, sometimes tummy time is for only a minute or two before the baby starts to fuss or cry. Other times an infant may enjoy their tummies for 10- 20 minutes before they are ready for a change.
At other times you put the baby on their tummy, they settle down and then decide to fall asleep. Keep in mind, you MUST turn them over, even if you are watching them. Remember, NO TUMMY sleeping until your child rolls over on their own.
So, many parents come in during the first days to weeks after their baby's birth with not only feeding charts, but pee and poop charts and graphs of tummy time down to the minutes. It is really not necessary to graph the amount of tummy time your baby gets, just make sure you remember to do it.
As your baby gets older, they typically enjoy their tummies for longer periods of time and ar
I have had several clever little patients lately who are enjoying driving their parents crazy by taking off their diapers and then doing all sorts of things with pee-pee and even poop around the house! A pregnant mother with a 2 1/2 year old walked in to my office just this week, without an appointment, but with lots of tears. She told the receptionist she just had to see me and when asked if it was an emergency she answered truthfully, it was an emergency to her.
Seems as if her toddler had taken off his diaper during a nap, and painted the walls with poop! That is enough to bring anyone to tears, yet alone a tired, stressed, hormonal pregnant woman.
So, we worked her into my schedule which means I was behind, seeing patients but sometimes that just happens. At any rate, after a few more tears and tissues, I told her I might not have all of the answers for her defiant toddler, but I thought I could help with this issue. Just put that diaper on backwards! It usually is enough of a deterrent to most children who are unable to reach around and unfasten the diaper. We used duct tape to keep that diaper on, but this is an easier solution and works about 95% of the time. One mother told me you are a genius, wish it was so.
Many other toddler issues to drive a parent crazy, but this issue was resolved. Now we have to talk about potty training him, but that seems a few more months down the road.
If you are a new parent or even if you have older children, you can probably remember your baby's first smile, almost vividly I bet!!
When a parent first brings their new baby home from the hospital it is such a time of great joy, but parents quickly learn how demanding a newborn baby really is. The first 6-8 weeks of a baby's life is all about eating, peeing, pooping and maybe a little sleep, although not on any sleep schedule an adult can remember. The little sleep a parent and the newborn gets comes in 2-3 hour increments and after about 6 weeks of sleep deprivation a new parent can understand why sleep deprivation is used on POWs. It sometimes does feel like torture.
But just when you think you can't take it ANYMORE, and wonder why you thought you wanted a baby, (and you are actually telling your baby this), you suddenly realize that your baby is making eye contact and REALLY SMILING! It is such a wonderful and amazing moment! One little smile can erase weeks of no sleep and pure exhaustion. At that moment you begin to understand why you wanted to be a parent, and the pure joy a small smile can bring.
Parenting, like so many things in life, is about give and take. With a newborn it is all take, take, take, and then suddenly that tiny little baby learns to smile and they are giving!! The smiles, which are soon followed by sweet coos and goos, become ever more frequent, and the give and take becomes a bit more equal.
A parent has unconditional love for their child, and that never changes. But to have your child reciprocate that love, with just a first smile, is a moment that will always be remembered. That smile will get a parent th
If you're the parent of a 5-10 month old baby, have you noticed that your baby is coughing, but they don't seem to be sick? Does the cough clear your child's congestion or their throat which is what pediatricians like to call an effective cough? I bet you want to know why your baby only coughs when you're around. I have always said parenting starts at a very young age and this is one of the first signs that your child is learning to manipulate you a bit: truth!
This back and forth with you and our baby is called an attention cough and occurs when your baby realizes that when they cough you turn your head to look at them. Now, you are probably only turning your head to make sure they are ok, but your baby just sees your face turn to them and that you make good eye contact which is reward enough for a cough! Very clever!
An attention cough is one of the earliest ways that your baby gains your attention. Later on it may be high-pitched squeals, followed by them throwing a toy your way. All of these are just a means of early nonverbal attention seeking behavior. Just wait, I promise it will continue and it may not always be quite so cute (think teenage years).
So, if your child gets a little cough, it doesn't seem like they are sick and you find yourself turning your head, the diagnosis may be attentional cough. Save yourself a trip to the doctor and a co-pay as well. The best thing to do is just smile.
Have you ever heard of vesico-ureteral reflux (VUR)? This is a problem that I have be seeing lately which occurs in the urinary tract.
In the normal scenario urine is produced in the kidneys and then travels through the ureters (which are like a straw) from the kidneys to the bladder. The urine is supposed to only proceed in one direction, and only down and into the bladder and then out the urethra when you urinate. But in some children, the kidneys are fine and doing their work of making urine but the ureters (the straws) allow the urine to go in a retrograde fashion (both up and down, or back and forth or whatever terminology you want) from bladder to kidney, ;and this is termed vesico ureteral reflux (not to be confused with gastro-esophageal reflux). Vesico-ureteral reflux is often diagnosed in infants and young children who present with prolonged fever which may be an indicator of a urinary tract infection. When a child under the age of 2 has persistent fever (usually over 72 hours), without any other focus of infection, a urinalysis and culture is often performed to rule out a urinary tract infection. It is also more prevalent to see this occur in little girls rather than in boys. If a urinary tract infection is confirmed it was previously the standard of care to perform a VCUG (voiding cystourethrogram) which is a radiographic study where dye is injected via a catheter into the bladder to look for retrograde flow of urine (the back and forth, up and down) to rule out VUR. In the past several months there have been changes in the management of VUR especially as it relates to first urinary tract infections.
The new recommendations state that, children of any age, regardless of gender, with a first febrile UTI should undergo a renal/bladder ultrasound, rather than a VCUG. In other words, no more radiation and dye (not to mention the associated trauma) that went along with the voiding study. Years ago a VCUG was performed without any sedation, b
After breast feeding my 3 children, I have decided that you can really eat whatever you want!
I recently saw a TV segment on blinging your baby and toddler. It seems that the latest craze is decking out not only little girls, but also little boys. Being the mother of three sons I can understand wanting to dress up boys as well (little boy clothes can be a bit boring) but a few of the models on TV were wearing necklaces.
Now, a boy wearing a necklace doesn't bother me at all, but a baby or toddler with a necklace worries me! This isn't about gender, rather about safety.
A necklace is a real choking and strangling danger for babies and young children. I know that many parents receive necklaces for their babies on the occasion of a baptism and in some cultures an infant is given a necklace made of string or beads to wear soon after birth.
But, whenever a baby comes into my office with a necklace on I discuss the possibility, even if remote, of the child suffocating if the necklace gets caught or twisted around the child's neck. There is no reason to even risk it!
Baby bling is great if you want to put your child in cute shirts, hats, or even trendy jeans. Go for it! But I would never put a necklace on a child. It is akin to the adage about peanuts...when should a child be allowed to eat peanuts? When they can spell the word!
We pediatricians are no longer worried about peanut allergies in the young child, it is the choking hazard that is the real concern. It's the same for a necklace. Let your child wear it when they can spell the word, or put it on when your 3 year old plays dress up, but take it off once finished. There is no need to ever have a young child sleep in anything like a necklace, or anything that has a cord until they are much older.
Children ages 4 and under, and especially those under the age of 1 year, are at the greatest risk for airway obstruction and suffocation. So, put the necklace back in the jewelry box for awhile. You ca