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.
One of the most popular gifts at a baby shower is the baby rattle, a toy that has been used since antiquity.
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
Has your baby had their first cold yet? It is just the beginning of cold season and there are many more colds ahead during the next 5 months of upper respiratory season.
I remember as a mom/pediatrician that the first cold a baby has is the hardest. Like so many things in life, once you have some on the job training, you can look back and realize that you can manage many issues, including the common cold.
A baby with a cold looks like we all do, they have red rimmed eyes, a runny nose, a cough and they act like they don't feel well. A baby may also run a bit of a fever on the first day of a cold, so remember, fever is your friend (another post).
The best way to treat a cold is the same for baby/child/adult, you just have to treat your symptoms. Unfortunately, there is still not a cure for the common cold, and when there is one day, the cure will win the Nobel Prize in Medicine!
For an infant, one of the biggest problems is the congestion and runny nose and the fact that cannot yet blow (or even pick) their own nose. But, at the same time they are snotty and have a hard time breast feeding or taking a bottle and worst of all they don't sleep well. Us older parents were used to using the bulb syringe, but now the parents of babies are swearing by the Nosefrida.
I must admit I was totally skeptical and thought they were inserting this contraption way into their baby's nostril! We doctors used to use a Lee catheter somewhat like this in the delivery room to clear a baby's nose but this little device is placed at the edge of the nostril, rather than into the nose itself.
A small tube extends from this and the parent then uses their mouth to suck on the tube (like a straw) and the mucous is sucked into this little tube with a filter to keep the mucous from going up the tube. (no buggies in the mouth). Does that all make sense? You can use just the right am
While my middle son was home for a long weekend, the discussion about who was the most difficult baby in our family came up once again. Whew, COLIC!!! I still cringe thinking back about the first 6 months of my now 26-year-old's life.
No one really knows what causes colic and there are many different definitions of colic. The word is derived from the ancient Greek word Kolikos, which means pertaining to the intestines. (vague enough)
Colic typically begins somewhere between the 3rd and 6th week of a newborn's life. Doctors have looked up and down for medical problems with these babies and I can attest to the fact that the most frustrating (although reassuring) thing is that they are HEALTHY.
Colicky babies cry and they cry much more than the average baby. While most newborns cry somewhere around 3 -4 hours/ day, a colicky baby will cry for hours on end. While doing so they typically draw their legs up, get stiff and arch their backs and turn bright red and I remember our son even seemed to get hoarse from crying so much. Colic typically occurs throughout the day and night which is different than that evening fussy spell that most babies experience. The crying makes parents feel anxious, frustrated, exhausted, concerned and everyone just wants an ANSWER! If you can solve the mystery of colic you will win the Nobel Prize in medicine as well as the hearts of every parent.
As physicians I tell parents that colic is short lived and self-limited, but those terms are relative when you are living through what we affectionately termed, baby hell. After listening to incessant crying short lived means less than 10 minutes! Colicky babies have very intense cries, whether they are wet, startled, need to burp or are just uncomfortable. They tend to be tense andjust never seem to relax.
A colicky baby is difficult for any parent, whether you are a first time parent or seasoned. It is difficult to not blame yourself
I am often reminded of the adage, this is going to hurt me more than it hurts you before beginning infant vaccinations. I can remember my own parents saying that to me before a spanking (the preferred discipline of my childhood) and that statement never made any sense to me until I too became a parent.
As I discuss infant vaccinations with new parents, I somehow know that they are wishing they could take the needles for their own child. I really do believe that those first vaccines at 2 months of age hurt the new parent, more than the infant. It is an early parenting hurdle to get through those first immunizations and realize that your baby handled the vaccines without much ado and somehow the next set of vaccines at 4 and 6 months are a bit easier. Pain is not anything that a parent wants their child to endure, and if there is any way to mitigate the pain associated with immunizations I am all for it.
Many parents come to my office prepared with sucrose to let their baby suck on during the immunizations. I recently read an article in Pediatrics that showed the 5 S's - swaddling, side/stomach positioning, shushing, swinging and sucking on a pacifier significantly reduced the pain associated with vaccines in 2 and 4 month old infants. In fact the 5 S's worked substantially better to reduce post vaccination pain than sucrose alone.
So, if you are concerned about the pain associated with your infant's vaccines, come ready to swaddle, shush, swing and let your baby have a pacifier as well. A little tummy time after the immunizations might be good medicine too.
But more importantly, remember that by vaccinating your baby you are protecting them from disease for their entire childhood and into adolescence (when I am not sure the immunizations are any easier).
The 5 S's seem like an easy solution for parent and baby, and a lollipop or ice cream cone goes a long way for pain relief in the 4-11 year o
Lots of new babies and one frequent question that comes up early on is, how often do I need to bathe my baby?. Good question and I don't think there is a right answer.
Babies are frequently born with dry and peeling skin, especially on their hands and feet. This is one way that the doctor can tell that the baby is term. Despite being bathed or not bathed, the infant will peel and flake off this little bit of dry skin and then will be left with that beautiful baby skin all over.
Some people say not to bathe a baby everyday, but I honestly think it is totally up to the parent. I bathed all of my babies everyday, as I loved the way they smelled after a bath, and I was also convinced that a daily bath before bed would make them sleep better!! (not so sure this helped at all).
Whatever you decide to do about bathing, you want to make sure you are using a mild soap, and I like Aveeno and Cetaphil products, especially if your baby is prone to dry skin. I always started by washing the baby's face, then their body and lastly did their hair and scalp. Babies lose most of their heat through their heads, so I did this last so that I could bundle them up right after the bath.
After a bath it is a good idea to apply a moisturizer to the skin and again there are a lot of good products out there. Many of the baby products just smell good as well (what beats the smell of the pink baby lotion), but some are not as good moisturizers as others. If your baby has really dry skin and needs the hydration use one of the newer products that contain ceramides ( Aveeno, Cetaphil, Cerave). They may not smell as good, but they are hypoallergenic and are better for dry skin and babies who are prone to eczema.
Bath time is a fun time for both baby and parent! Before you know it your baby will no longer be getting baths in the infant bathtub, but they will be splashing away with toys in yo
More evidence that the flu vaccine is safe for pregnant women has been released. A new study shows that there is no link between the flu vaccine and the risk of serious birth defects. That's the number one concern that mothers-to-be have when considering getting a flu shot.
The study noted that of nearly 9,000 pregnant women who got the flu shot, about 2 percent had a baby with a major birth defect, such as a malformation in the heart or a cleft lip. That was the same as 77,000 pregnant women who did not get the shot.
Researchers also found that women who got vaccinated were less likely to suffer a stillbirth. Point 3 % did not experience a stillbirth versus point 6 % of un-vaccinated women. Their newborns also had a lower death rate: point two percent died soon after birth, compared with point four percent of babies born to unvaccinated moms.
It's not certain that the flu shot had anything to do with the lower stillbirth, but there may be a link says Dr. Jeanne S. Sheffield, the lead researcher on the work. The flu shot may have prevented a more serious case of the flu. Plus, these findings suggest that the flu shot is at least safe, and possibly has a benefit against stillbirth.
Despite recommendations to get the flu shot, most pregnant women do not. In the U.S., only between 10 percent and one-quarter of women have been vaccinated each flu season over the last couple decades, Sheffield's team notes.
Sheffield noted that "it's amazing" how many women are unaware that the flu itself is considered a risk during pregnancy.
"The flu is a problem in pregnancy," she said. "But we have a vaccine to prevent it. And it's considered safe and effective in any trimester."
A Centers for Disease Control and Prevention (CDC) study published last year found "no unusual patterns" of pregnancy complications or newborn health problems among U.S. women who received the flu shot between 1990 and 2009.
The new study was
I have many new parents who ask me about the pros/cons of circumcising their newborn sons. As of today, The American Academy of Pediatrics (AAP) has just released a new policy statement on circumcision. The last recommendations were made in 1999. The new policy statement will also be published in the September 2012 issue of the journal Pediatrics.
After a significant review of the scientific evidence, the AAP agrees that male circumcision has been shown to have health benefits that outweigh the risk of the procedure. The AAP policy statement does not recommend routine circumcision for all newborn males, but does believe that the benefits are enough to warrant access to the procedures for those families choosing it, and should be covered by insurance. This is a stronger statement regarding the medical benefits of circumcision than was made in the 1999 statement.
Circumcision has been shown to reduce the risk of sexually transmitted infections including HIV, syphilis, HPV, and genital herpes. Circumcision has been shown to reduce the risk of penile cancer as well as cervical cancer in sexual partners. Circumcision also reduces the risk of urinary tract infection in a baby's first year of life. The reason the AAP issued this new policy statement? The data shows numerous medical benefits of circumcision and the health benefits outweigh the risks.
Although the AAP does not routinely recommend circumcision, they do believe that the final decision remains with parents, which is the same language used in the 1999 policy statement. The policy statement states parents are entitled to factually correct and non-biased information about circumcision and must be allowed to weight the health benefits and risks in light of their own cultural, religious and personal preferences.
So, if you are having a new baby boy, discuss the AAP policy as it relates to circu
They fly, crawl and can ruin a perfect summer day. Bugs are creeping everywhere this time of year and there is only one way to keep them at bay...insect repellent.
Whether it's vacation, shopping, hanging out at the pool or lake or simply in the backyard lots of families will be spending time outdoors. Because their skin is thinner and they lack the ability to sweat, experts want parents and guardians to know that babies need extra protection from the sun.
You might think that sunscreen is the solution - and many parents trying to do the right thing, do cover their little ones in it - but the U.S. Food and Drug Administration and the American Academy of Pediatrics, does NOT recommend sunscreen for infants under 6 months old.
Dr. Hari Cheryl Sachs, a pediatrician with the FDA, said parents should avoid putting sunscreen on their infants. Sachs explained that young babies' skin is much thinner than that of adults and can absorb the active, chemical ingredients found in sunscreens more easily. She noted that because they have a relatively high surface-area to body-weight ratio, they are at greater risk for allergic reactions or inflammation from exposure to sunscreen.
"The best approach is to keep infants under 6 months out of the sun, and to avoid exposure to the sun in the hours between 10 a.m. and 2 p.m., when ultraviolet (UV) rays are most intense," Sachs said in an FDA news release.
Stroller canopies or an umbrella can offer shade if you have your infant outside. If there are no other options available, a small amount of sunscreen with a sun-protection factor of at least 15 can be applied to small areas of exposed skin, such as the cheeks and back of the hands. Applying a small amount of sunscreen to the baby's inner wrist first to test for sensitivity is a good idea, Sachs noted.
Sachs and the American Academy of Pediatrics (AAP) offered additional tips to ensure infants are protected from sun exposure, including:
I continue to see a lot of new babies (so fun) and there seem to be a lot of questions and concerns around when to start feeding a baby solids and how to actually do it as well.
The consensus about beginning solid foods has really not changed in the last 30 years. Infants do not need to begin solid foods until somewhere around 6 months of age, give or take a few weeks.
It has also long been recommended to start feeding a baby rice cereal as their first solid food. Again, there is no real data on this and the AAP is at work on new feeding guidelines as I write this. We may be changing things around and starting protein before cereal?
Never the less, I typically recommend starting a baby with some type of cereal as it is easy to make and easy to wipe up if your baby does not like it!! One of the biggest things about beginning foods is it can tend to be messy, and this is an important part of a baby's feeding experience as well.
I start feeding a baby cereal from the spoon, typically as a breakfast meal, after the baby has had their morning breast or bottle feeding. I pick the mornings as most babies are happy in the morning, so you can pick the best time to feed your own baby. You don't want to start a new project with a fussy baby.
Put your baby in the Bumbo chair or high chair, so they are sitting up, and mix up the cereal (with either breast milk or formula) to the consistency that you can spoon feed it. Not so thick your child gags and not so thin it runs off the spoon. Then you just do the airplane to the mouth game (somehow I always find myself also saying yum, yum and see how your baby feels about eating cereal. Some babies love it and others will seal those lips and scream. There is no magic about beginning solid foods and don't try to make your baby open their mouth, it is practice practice.
After several days to weeks you will see that your b
The U.S. Consumer Product Safety Commission and Health Canada, in cooperation with Kolcraft Enterprises Inc., announced a voluntary recall of the following consumer product. Consumers should stop using recalled products immediately unless otherwise instructed. It is illegal to resell or attempt to resell a recalled consumer product.
Name of Product: Contours Options three- and four-wheeled strollers
Units: About 36,000 in the United States and 270 in Canada
Manufacturer: Kolcraft Enterprises Inc., of Chicago Ill.
Hazard: A child or consumer's finger can become caught in the opening formed when locking and unlocking the hinge mechanism which is used to adjust the handlebars on the strollers. This presents an amputation and laceration hazard to children and the adults handling the stroller.
Incidents/Injuries: Kolcraft and CPSC have received five reports of injuries involving the hinge mechanism, including reports of three children whose fingertips were amputated and two adults whose fingers were either smashed or lacerated.
Description: This recall involves Kolcraft Contours Options three- and four-wheeled strollers. Strollers included in the recall have model numbers starting with ZL002, ZL005, ZL008, ZL015 and ZL018. On the ZL002 model, the model number and date of manufacture is printed on a sticker above the left wheel. On the ZL005, ZL008, ZL015 and ZL018 models, the model number and date of manufacture is printed on a label sewn into the edge of back of the stroller seat pad. The strollers were manufactured from January 2006 through November 2009 and sold in various color schemes.
Lazy days by the pool are a warm weather ritual for many families. But, if your child is spending a lot of time outdoors, you need to make sure they are protected from the sun.
Millions of families across the United States will hit the road this Memorial Day weekend...with a majority of them driving. I want to make sure you arrive safely so it's important for everyone to buckle up and restrained properly.
Allergy season is literally in full bloom with flowers, trees and grasses all contributing to the sneezing, itchy eyes, runny noses and coughs which are seen in allergic children. If your child continues to suffer from allergies despite medical therapy with daily antihistamines and nasal steroids, your pediatrician may recommend a visit to a pediatric allergist.
It's winter and that means cold dry air, heat on in the house and dry and chapped skin as a consequence.
During a recent office visit, I saw a 4 year old child who is not one of my routine patients. He had a fever and runny nose. His mother was giving me the childs medical history during the time I was beginning to examine the little boy. I had my back slightly turned from her.
The mother was explained to me that her son had had a fever the previous evening and said, I gave him some ASPIRIN before putting him to bed. I immediately turned around and with a stunned voice said, you mean you gave him Tylenol or Motrin or Advil, right? She really looked at me like I was crazy or that I had not been listening to her and she said, No I said baby aspirin. He likes the chewable ones.
I was shocked, as I had not heard of anyone giving aspirin to their children for a fever in over 20 years!! This very nice, young, concerned mother could not figure out why I was so worried about the aspirin. I then had to explain to her about the risk of Reyes Syndrome. She had never heard of Reyes Syndrome and said that her mother had kept baby aspirin in the house for her, so that is what she bought to use for her own child.
I know that they sell enteric coated baby aspirin for adults to take to help prevent a stroke. I guess I didnt even realize that regular old baby aspirin was even around. There was so much publicity in the 1980s about the link between aspirin or any salicylate containing medication and the development of Reyes Syndrome, as well as warning labels about not giving aspirin to children that had a fever or chicken pox that I had not heard of anyone using aspirin for years!
I explained to her that Reyes syndrome affects the brain and liver and is a very serious disease, which may lead to death. It occurs in children between the ages of 4-18 and causes recurrent vomiting, lethargy and coma and was often seen
A parent emailed me via our iPhone App and asked if her childs constipation, which started as he was transitioning from formula to whole milk, could be a sign of lactose intolerance. She is concerned because her son is now having very hard stools.
Actually, lactose intolerance does not typically cause constipation, but conversely causes abdominal pain and often loose stools or diarrhea. In the case of this 1 year old child who suddenly is having hard stools, it may seem to be caused by the switch from formula to whole milk, but is probably coincidental.
It is routinely recommended that parents stop giving a child a bottle and formula at 1 year, which often results in a toddler drinking less milk (recommended amount is about 16 ounces /day) and therefore they are getting less fluid which may result in harder stools. This is also the age that childrens diets are changing as they are self feeding and often eat a lot of carbohydrates (breads, noodles, rice etc) and fewer fruits and vegetables, even when offered as they become pickier eaters.
All told this often leads to bouts of constipation that can be managed with the addition of more fluids as well as clever ideas such as apple prune juice, bite sized prunes (often can be sold as raisins to a young child) and even with milk of magnesia if necessary. (see older posts on constipation)
Lactose intolerance is defined as the inability to digest lactose which is a sugar found in milk and milk products. It is due to a deficiency in the enzyme lactase, which is produced by cells lining the small intestine. Lactose intolerance is uncommon in young children and is typically not seen before the age of 2 -3 years. It is more common in older children and teens who may complain of abdominal pain,
One of the best parts of my practice is continuing to see newborns and young families. The one thing that never changes are some of the questions that parents have, because most babies have similar behaviors in the early days. One of the common questions is about "spitting up" or the newer name of GERD (gastroesophageal reflux). It is funny when I talk to a family about their baby's spit up and then get a follow up phone call saying "I really think that they have reflux not spit up" so I can tell that I need to change my jargon. Whatever you want to call it, many babies spit up, and the main thing to watch for is that a your-baby is gaining weight. It is difficult to believe that your your-baby can really gain weight when they seem to "spew" breast milk or formula all over you with each feeding. So I have parents bring the baby in so that I may examine them, check their weight out, and maybe even watch them eat while they are in the office. That way I too get some reflux experience on me! Most babies reflux can be managed with tincture of time and reassurance, but some newborns may require a little intervention. A "happy spitter" will thrive and outgrow the reflux despite always leaving their parents covered with milk. If your baby is fussy and irritable due to reflux it may be time to add medication to see if it will help the pain associated with reflux (heartburn) but it will not correct the spit up problem as that requires time for the muscle between the tummy and esophagus to tighten as the baby grows. If your baby is formula fed it may help to thicken the feedings. There are many different ways to manage reflux, but the problem is usually self limited and most infants have out grown this problem by five to six months of age. Keep those cute burp pads handy! That's your daily dose, we'll chat again tomorrow. Send your question to Dr. Sue!
I can't believe that I am writing another post on RSV! After another long day in the office with tons of wheezing and coughing, I decided to take a look at the national RSV statistics. Guess what, most of the country is still in the throes of RSV season (Florida is lucky as their rates are on the decline). So I know that everyone is still dealing with RSV (respiratory synctial virus) and we may still be several more weeks away from declining viral rates and the end of the RSV season.
I am still seeing many parents who are fearful of RSV, as their day care or schools have sent home notices that there are cases of RSV. I am still confused by the need to send out notices which may only scare parents, as at this time of year, RSV is virtually everywhere.
RSV is a virus that occurs every fall, winter and often into early spring. It causes cold symptoms for most of us, and most of the population (both child and adult) can never name the virus that caused their terrible runny nose and cough. By the time a child is 2 years old the majority of them (upwards of 90%) have had at least one RSV infection. Again, most parents never need to know the name of the virus that is causing their child to have that terrible cough and runny nose. It is just another bad cold!
But, with that being said there are children, especially those under the age of 2 who will have more problems with RSV. In some cases, especially young infants, the virus will cause not only a runny nose, congestion and coughing, but wheezing as well, and in a few, respiratory distress. It is in those cases that we name that tune and test to confirm that the baby has RSV.
Our office does not routinely test every child with a cough, runny nose or even all of the kids that are wheezing to see if they have RSV. (If we did we would be testing almost every child!) We only do the tests on the sickest children that end up
Placing a baby "back to sleep" became a routine recommendation beginning in 1994 after evidence showed that babies who slept on their backs had a much lower risk for sudden infant death syndrome.
No one knows for sure why babies get colic. Colicky babies cry non-stop and don't respond to being comforted.
Premature infants have a fight on their hands from the moment they are born. Part of the battle includes painful medical procedures that are needed to help a preemie survive.
A new study suggests that something as common as a few drops of sugar-water along with comforting and reassuring holding can ease their pain.
I am often asked, "when should I take my child out of their crib and put them in a bed?" I really think that there are several reasons to transition a child from their crib to a "big boy or girl bed".
Do you ever wonder how a baby learns to talk? A new study suggests that a baby learns how to form words by reading lips.
Parents who have a hard time getting their babies and toddlers to sleep at night may also often have trouble at mealtime, new study findings suggest.
The cold and flu season is in full swing and while over the counter (OTC) medications are a great relief for some folks, mothers-to-be and breastfeeding moms might want to reconsider using them.
Experts estimate that 1 percent of the population of children in the U.S. ages 3-17 have an autism spectrum disorder. Autism occurs in all racial, ethnic, and socioeconomic groups, and is more likely to occur in boys. It is the fastest growing developmental disability in children and there is great concern that a new definition of autism may have a huge impact on the care and treatment of people who have the disorder.
A new study looks at a baby's reaction to his or her mother's voice and the tone that is used verses the words that are said. Researchers showed that babies reacted in the same way to mom's voice regardless of what she is saying or what language she uses.
To date, it has been an unbelievably quiet flu season throughout the country. But with that being said there is still some flu and there could be more to come, this is typically the time of year that flu begins to peak.