Babies

TOP FIVE MEDICAL MISTAKES NEW PARENTS MAKE

No. 5: Confusing Vomit and Spit Up
Spit-ups can come without warning and are generally a wet burp that may happen when the baby is just “bouncing around and having fun,” pediatrician Dr. Jim Sears explains. Often the baby will just spit up whatever it had been eating.

“My general rule of thumb,” Dr. Sears says, “is if it doesn’t bother the baby, it doesn’t bother me.”

If there is projectile vomit or if the baby is fussy while spitting up, however, it should be looked at more seriously. Also, if the baby spits up blood or bile -- which can be yellow or green -- call your doctor.

No. 4: Overfeeding

Dr. Sears says a normal serving for a baby is about the size of its fist. Once you feel your baby has had enough to eat – a serving or so – turn the baby’s attention to something other than the food. Putting water in the bottle and giving it to the baby is also a good tool, because the baby is still consuming something, but not taking in the calories.

Signs that your baby is overeating include vomiting after eating and stomach pains, which the baby may show by drawing his legs up or having a tense stomach.

No. 3: Delaying Oral Care

“What we’re trying to do now,” Dr. Sears says, “is create healthy habits. We want [the baby] to think brushing his teeth is fun.”

To make it an enjoyable experience for the baby, put non-fluoride toothpaste on gauze-wrapped fingertip and gently brush inside the baby’s mouth. Also, make brushing teeth a family event so the baby will mimic the behavior.

No. 2: Nail Clipping

To prevent accidentally injuring your baby's fingers, there are clippers designed specifically for babies that have magnifying glasses, lights at the end and even safety guards to prevent the clippers from going too far. If the baby becomes fussy about the idea of clipping its nails, try a distraction method while you finish.



No. 1: Managing Crying

When to hold your baby and when to let your baby "cry it out"?

“One thing I want you to remember,” Dr. Sears says, "Is trust your instincts. They’re usually right. If he’s fussy and your instincts are telling you to pick him up, then pick him up. If your instincts are saying ‘You know, he doesn’t seem that upset, maybe he’ll settle down after a minute or two, then let him try.”

Most 4-month-old children will not sleep through the night, Dr. Sears says. They will probably need to feed a few times and then be helped back to sleep. But over time, babies will start sleeping longer and longer and will get into a good sleeping routine, such as a bath, a massage and some snuggling.

Dr. Sears warns that if a baby cries vigorously by itself for longer than 10 minutes, blood flow to the brain can be decreased. Interestingly, “If you’re with the baby and he’s crying, that whole blood flow thing doesn’t change,” Dr. Sears says. “If the baby is laying in his crib and you’re in there, maybe with your hand on his back trying to settle him down, but you’re not actually picking him up, that’s one way of communicating to the baby ‘Hey, it’s time to sleep and we’re not going to play.’”

Whether you are with the baby or not, if it has been crying for more than 10 minutes, “they’re so worked up, you’re going to have to shift gears a little bit and try something else,” Dr. Sears says.

The Best Way to Handle Crying Babies

Parenting TipsPediatrician Dr. Jim Sears offers essential tips to new parents. Learn how to keep your newborn safe!

 Circumcision

In the U.S., 60 percent of males are circumcised at a young age. Dr. Jim Sears and Dr. Drew Ordon demonstrate how circumcision is performed and note that the procedure is slightly more complicated for adult males.

Benefits of Circumcision:
• Decreases chance of catching and spreading sexually transmitted diseases
• Decreases chance of penile cancer
• Increases quality of hygiene

Risks of Adult Circumcision:
• Chance of infection
• Chance of scarring
• Chance of erectile dysfunction

Comprehensive Screenings Explained
Doctors perform a heel-stick test by pricking a newborn's foot to draw blood, which is then tested for a bevy of metabolic disorders.

"The reason we do it is because all these disorders are pretty much impossible to diagnose until the symptoms are too severe to really do something about them, until it's too late, essentially," pediatrician Dr. Jim Sears explains.

Comprehensive newborn screening programs recommend that babies be tested for 54 disorders, but the amount of tests offered varies from state to state. Talk to your doctor about which tests are available in your area. 

"The good thing about these kinds of disorders is that if you diagnose them early, the treatment is often very easy -- simply just diet changes," Dr. Sears says.


What to Know Before: Breastfeeding

Jesse Zilberstein, lactation educator from The Pump Station in Los Angeles, California, conducts lactation classes for moms-to-be. She demonstrates the best ways to get a newborn to latch onto the nipple and how to tell if your baby is getting enough milk.
 

Breastfeeding Techniques
Many women experience difficulty when learning to breastfeed. Sore nipples and improper latching are just a few of the problems. New mom Jenna says breastfeeding her son was painful and frustrating, so she started using nipple shields, which helped, but now she can't wean her son off of them.

Breast specialist Dr. Kristi Funk took Jenna to The Pump Station and Nurtury, a new mother's breastfeeding resource center, to learn the Dos and Don'ts of breastfeeding.

Pediatrician Dr. Jim Sears says there are many benefits of breast milk: It improves IQ, boosts the immune system and even promotes healthy teeth. It lowers the risk of diabetes, obesity, heart disease, asthma, allergies, pneumonia, respiratory infections and ear infections. The benefits to mom are increased bonding with the child and burning up to 500 calories a day.

Dr. Lisa clarifies that breastfeeding doesn't cause breasts to sag; pregnancy does.

Dr. Funk gives you more breastfeeding tips, and learn more about the differing opinions on breastfeeding in public .

How Long is too Long to Breastfeed?

Lactation consultant Leigh Anne says that breastfeeding for an extended period of time -- anywhere up to 7 years of age -- can be beneficial for a child. However she also notes that decision should be left up to the mother. While the notion of nursing a toddler or a preschooler shocks most of the audience, pediatrician Dr. Jim Sears says that worldwide, the average age for children to be weaned is close to 4 years old.

Leigh Anne adds, “Nobody should answer the question of how long you should breastfeed. That’s up to a mother and her child.” 

Benefits of Breastfeeding in Children

Increases intelligence

Decreases risks of:

  • Obesity
  • Heart disease
  • Diabetes
  • Multiple sclerosis
  • Allergies
  • Asthma
  • Digestive illnesses

Pediatrician Dr. Jim Sears notes that the American Academy of Pediatrics recommends breastfeeding for at least a year and after that, he says it’s up to the parents. He adds that breastfeeding can be soothing to mothers as well, because the act of nursing releases hormones that help moms relax.

The lactation support group The Pump Station offers more information on breastfeeding and extended breastfeeding.

Smoking and Breastfeeding
A mother who smokes can cause serious harm to her unborn fetus, but what about a mother who smokes while breastfeeding? “Moms have to be very careful about what they put in their bodies when breastfeeding,” Dr. Lisa cautions. “The nicotine from cigarettes we know is absolutely bad for you, it’s bad for baby, it can cause respiratory problems, and it has been linked with sudden infant death syndrome.” See what happens when you smoke while breastfeeding.

Sore Nipples
Doctors recommend breastfeeding for at least a year, but many women wind up with sore nipples within months.

“Breastfeeding, when it’s your first baby, can be so, so painful,” Dr. Lisa says.

If your nipples are red or hot, call your doctor.Nipple shields can help, but only use them after you’ve consulted a lactation specialist.

Common Cause of Sore Nipples
Cause Remedies
Baby improperly latches onto nipple or baby has trouble suckling properly  In both cases, working with a lactation specialist to learn breastfeeding and positioning techniques will help alleviate the problem.
Raw, irritated skin Lanolin cream can soothe affected areas.
Candida, or yeast infection of the nipple Antifungal cream prescribed by your doctor.

Breastfeeding and the Flu“If a mother that’s breastfeeding develops the flu, regular flu or swine flu, it’s actually very rare to pass the virus through the breast milk,” pediatrician Dr. Jim Sears says. “What you will pass through is antibodies, which will actually help the baby. If a mom gets sick, it’s actually good to keep breastfeeding.”

“You can sometimes pass viruses,” Dr. Lisa says. “We worry about this more with HIV. We don’t know how much with this virus. A lot of doctors will suggest that you not do the first morning feeding, and pump because there will be more of a load in there. If you’re sick, consult your doctor.

Breastfeeding is beneficial for babies; it can help protect against a number of infections, and it may also protect a baby against the H1N1 virus.

"A lot of people think, 'Oh, what if the mom gets sick, she should probably stay away from the baby, right?'" Dr. Sears says. "That makes sense, but actually it's the opposite. If mom is either vaccinated against H1N1 [virus] or has the H1N1 [flu], she's actually going to be making antibodies. The [antibodies transfer from] the breast milk into the baby. The baby might be too young for the vaccine, so the baby gets protected that way."

Antibodies in breast milk can help reduce the baby's chances of coming down with the H1N1 flu, but it does not mean the baby is immune to the disease.

The H1N1 vaccine is not recommended for children under 6 months of age, but if a mother breastfeeds while she is infected with the H1N1 virus, she can help protect her unvaccinated baby. "Exclusive breastfeeding for [babies up to] 6 months [of age] will give optimal protection," Dr. Lisa says. "But if you do mixed, like if you do pumping and formula, you still get some protection [for the baby]."

Read more information from the Centers for Disease Control and Prevention about breastfeeding while sick with H1N1 virus.

Can eating peanut butter while breastfeeding give your baby a peanut allergy?
During pregnancy, eating peanut products does not affect the fetus because the allergens and antibodies don’t cross the placenta. While breastfeeding, however, peanut allergens can appear in the breast milk and can affect the baby.

Breastfeeding CookiesBreastfeeding has numerous benefits for babies and mothers, but oftentimes, new moms have difficulty keeping up their milk supply. Eating Milkmakers Cookies may be a solution. The cookies contain healthy ingredients such as brewer's yeast, flaxseed and oats, and are rich in omega-3s, which helps increase milk production. They may even help new moms shed their baby weight faster!

"It's important for Mom to get the omega-3s, because she's giving it to her baby in the breast milk, so she needs to replenish her supply," pediatrician Dr. Jim Sears explains.

Jocelyn, 31, has been eating a Milkmakers Cookie every day since her 6-month-old daughter was born. "Incorporating Milkmakers Cookies into my diet has allowed me to keep up with my baby's milk demands," she says. "I haven't had to supplement with any formula. She's solely breastfed. They work fabulously for me."

Weaning Babies from Breast MilkTo Wean Your Baby from Breast Milk:
• Breastfeed at least until your child’s first birthday
• Start by dropping a feeding every five to seven days
• Stop your least favorite feeding time first
• Wait a few days until your supply decreases and then drop another feeding
• Avoid nipple stimulation

OB/GYN Dr. Lisa Masterson demonstrates how nipple stimulation causes the hormone prolactin to produce breast milk.


Baby Bottles

Milk or formula in a baby bottle should be served at room or body temperature, Dr. Sears advises. “Never use the microwave!” the pediatrician cautions. “It can create super-hot spots within the milk or formula, basically frying the milk, and it can actually burn the baby’s mouth.” The heating process can also leach dangerous chemicals from the bottle and deposit them into the milk. Try using a thermometer that sticks to the side of the bottle and indicates whether the liquid is too hot, too cold, or just right.

Dr. Sears also suggestsrunning warm tap water over the bottle or submerging the bottle in a pot of warm water to heat the contents to body temperature. To test the heat, spritz a bit of milk on the inside of your wrist.

Weaning Kids from the Bottle and Pacifier

Brooke Burke and pediatrician Dr. Jim Sears offer advice on when and how to wean your child off the bottle and pacifier.

Bisphenol A (BPA) Dangers

• Industrial chemical used primarily in the production of polycarbonate plastics and epoxy resins.
• High levels of BPA may lead to hormone problems, obesity, diabetes, heart disease and liver toxicity.
• A Johns Hopkins University Study found elevated levels of BPA in pregnant women lead to babies with smaller head circumference and lower birth weights.
• BPA is banned in the European Union.
• In the US, effort has been made to eliminate BPA from baby bottles and water bottles, but it is still found in the linings of food cans and containers.

Silent Threat: SIDS

Sudden infant death syndrome, or SIDS, is the unexplained sudden death of a child under 1. SIDS is the leading cause of death in infants between 1 month and 1 year of age, with about 3,000 babies dying from SIDS each year in the United States. “SIDS these days is decreasing,” Dr. Sears says. “But more and more kids are dying from asphyxiation, strangulation, things like that, so we need to do something about the crib environment.”

For steps to prevent SIDS, check out Dr. Sears' blog!

More on crib safety.

Diaper Duty
Did you know you can tell a lot about your baby’s health from the color of his or her urine? Pediatrician Dr. Jim Sears gives new parents a lesson in diaper diligence 101.

What Your Infant's Urine May Indicate
Color Why? Call the Doctor?
Clear/yellow-tinged
normal no
Orange/brick dust residue:
The brick color comes from urate crystals
This is common in the first four days after birth and can be expected to clear up quickly. If it the condition persists, call your doctor.
Blue
a rare, genetic metabolic disorder
yes
Pink/blood-tinged
could indicate a urinary tract infection, or something more serious, depending on what other symptoms are present
yes, immediately


Diaper Dandies
Imagine if your child could read before his or her first birthday. Most children learn to read by age 6 or 7, but Dr. Robert Titzer’s “Your Baby Can Read!” program claims to teach children by the time they are 9 months old. Dr. Titzer began using the program with his 17-year-old daughter, Aleka, when she was just 3 months old, and says she is now as avid and advanced a reader as anyone he knows.

The interactive program uses a combination of books, flash cards and DVDs, which display the word followed by a picture relating to it. The practice also encourages the parent and child to perform physical activities related to the word, such as clapping when the word “clap” appears.

“All babies can learn the written form of language, just like all babies can learn the spoken form,” Dr. Titzer says.

“We have some children who are just starting the program, where they’ve only memorized the words, the shape of the word. But over time, the baby figures out that the ‘B’ makes the ‘bah’ sound, just like they figure out all the patterns of the spoken language by listening to the language. If you allow them to memorize enough words, then the babies figure out that the ‘ap’ makes the ‘ap’ sound, so they’ll read ‘clap,’ ‘tap,’ ‘nap,’ and then they can start to read new words they’ve never seen before.

“The earlier the child is taught to read,” Dr. Titzer continues, “not only the better the child reads -- even if you control for IQ and socioeconomic status -- but also the earlier the child is taught to read, the more likely the child will enjoy reading.”

Diaper Rash
Dr. Freishtat says that the key to diaper rash is figuring out what’s causing it. Many things can cause diaper rash, but most diaper rashes have three common causes. 

Common Causes of Diaper Rash:

1. Contact or irritant dermatitis.
Caused by something touching the baby’s skin that irritates it, such as urine, stool, or the diaper itself.

2. Candida, or yeast.
Yeast loves dark, moist places; a diaper being no exception. Diaper rash caused by yeast needs to be treated with antifungal cream that can be prescribed by your pediatrician.

3. Bacteria on skin, such as staph or strep.

If your child’s rash is getting progressively redder and not improving, or in fact, getting worse, talk to your doctor right away so you can treat it appropriately.


Diaper Rash Prevention Tip
Rubbing a layer of Vaseline, or petroleum jelly, on the skin of baby’s diaper area can create a protective barrier between the skin and the diaper, which will help prevent diaper rash. If redness starts to develop on the skin, rubbing zinc oxide ointment on the affected area can help heal the irritation

The Mommy Docs
If you are a mom or expecting to be one soon, this show is devoted entirely to you! Pediatrician Dr. Jamie Freishtat and allergist and immunologist Dr. Rachel Schrieber, a.k.a. The Mommy Docs, lend a hand to The Doctors to answer all of your motherhood questions!


Poop Wheel
The Mommy Docs say that the most common question they get from other moms is about the poop they see in their baby's diaper.

“It’s one of those things that you don’t really talk about until you have kids,” Dr. Schrieber says, grinning.

The color, consistency and frequency of bowel movements are an excellent way to assess your baby’s health. The color of poop varies depending on how quickly it travels through the gastrointestinal tract. To help mothers everywhere readily diagnose their baby’s health, the Mommy Docs created the Poop Wheel. The Mommy Docs are quick to point out that "the frequency and consistency of the poop, and the overall state of the baby also need to be assessed. Always contact your physician right away with any concerns." 

Diagnosing Poop
Color Possible Indications   Should You Worry?
Yellow/ mustard- seedy Baby is eating breast milk No
Green Usually normal No
Brown Usually normal No
Red, dark or black Blood in stool Yes