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Your Baby

Longer Breast-Feeding Time, Less Childhood Obesity

2:00

A new study looks at the duration of breast-feeding and babies who are high risk for obesity, as they get older. Researchers found that the longer mothers breast –fed these higher risk babies, the less likely the babies were to become overweight later.

"Breast-feeding for longer durations appears to have a protective effect against the early signs of overweight and obesity," said lead researcher Stacy Carling, a doctoral candidate in nutrition at Cornell University, in Ithaca, N.Y.

Carling and her colleagues followed 595 children from birth to the age of 2. They tracked the children's weight and length over this time, and compared individual children's growth trajectories to how long the children breast-fed.

Which children are considered at high risk for extra weight gain? Researchers found that babies whose mothers were overweight or obese, mothers with lower education levels and mothers who smoked during pregnancy were more likely to have overweight children. Almost 59 percent of the children at risk for being overweight had mothers with one or more of these characteristics, compared to about 43 percent of the children not at risk for excessive weight gain.

Higher-risk babies who breast-fed for less than two months were more than twice as likely to gain extra weight than those who breast-fed for at least four months.

Although the study didn’t prove that longer breast-feeding actually reduced risk for obesity, it did provide several reasons why the link between the two may exist.

"Breast-feeding an infant may allow proper development of hunger and satiety signals, as well as help prevent some of the behaviors that lead to overweight and obesity," Carling said.

"Breast-feeding, especially on demand, versus on schedule, allows an infant to feed when he or she is hungry, thereby fostering an early development of appetite control," she said. "When a baby breast-feeds, she can control how much milk she gets and how often, naturally responding to internal signals of hunger and satiation."

The study did not include information on whether the babies were exclusively breast-fed or how often they were getting milk at the breast versus from a bottle, but the time required to reduce obesity risk was not long.

"The difference of two months of breast-feeding may be enough to reap some benefit," Carling said.

There are many reasons mothers choose to breast-feed for shorter periods, and some mothers are not able to breast-feed at all. For mothers that choose to breast-feed, Carling believes they need to be supported on many levels.

"Ultimately, increasing breast-feeding rates in the United States means increasing knowledge and support at a variety of levels from institutional to interpersonal," Carling said. "Our study recognizes the benefit of longer duration breast-feeding in a specific population and, hopefully, this and other studies will lead to more customized breast-feeding promotion in those populations at higher risk for overweight and obesity."

The findings were published in the January print issue of Pediatrics, and funded by the U.S. National Institutes of Health. The authors reported no conflicts of interest.

Source: Tara Haelle, http://consumer.healthday.com/women-s-health-information-34/breast-feeding-news-82/breast-feeding-for-longer-may-protect-infants-at-risk-for-obesity-694218.html

Your Baby

Should You Let Your Baby Cry Itself to Sleep?

1:30

As any parent of an infant will tell you- sleep is a precious thing. So, what’s the best way to get your baby to sleep through the night? There are many ways to help baby drop off to dreamland, but two of the most common had researchers wondering if there might be long-term harm resulting from these techniques.

Turns out, they was nothing to worry about.

The study tested two methods; graduated extinction and bedtime fading.

Graduated extinction is more commonly known as controlled-crying or letting baby cry his or herself to sleep while learning how to self-soothe without parental involvement

Bedtime fading is keeping baby awake longer to help them drop of more quickly.

Researchers discovered that both techniques work and neither had any long-term negative effects.

The graduated extinction approach also showed babies waking up fewer times during the night.

Parents worry about the controlled-crying method, in particular, according to study leader Michael Gradisar, a clinical psychologist at Flinders University, in Adelaide, Australia.

With that technique, parents resist the urge to immediately respond to their baby’s nighttime cries, so he or she can learn to self-soothe. Some parents worry that will damage their baby emotionally, and possibly cause "attachment" problems or other issues in the long run, Gradisar explained.

But, he said, his team found no evidence that was the case.

For the study, the researchers randomly assigned parents of 43 babies to one of three groups: one that started practicing controlled crying; one that took up bedtime fading; and a third, "control" group that was just given information on healthy sleep.

The babies ranged in age from 6 months to 16 months. All had a "sleep problem," according to their parents.

Parents in the controlled-crying group were given a basic plan: When their baby woke up crying during the night, they had to wait a couple of minutes before responding. They could then go comfort, but not pick up, the baby.

Over time, parents gradually let their baby cry for longer periods before responding.

Bedtime fading is a "gentler" approach, according to Gradisar: The aim is to help babies fall asleep more quickly by putting them down later.

Parents in that study group were told to delay their baby's bedtime for a few nights -- to 7:15 p.m. instead of 7 p.m., for instance. If the baby was still having trouble falling asleep, bedtime could be pushed back another 15 minutes.

After three months, the researchers found, babies in both sleep-training groups were falling asleep faster when their parents put them down -- between 10 and 13 minutes faster, on average. On the other hand, there was little change in the control group.

A year after the study's start, children in the three groups had similar rates of behavioral and emotional issues. They were also similar in their "attachment" to their parents -- which was gauged during standard tests at the research center.

Experts say that infants are usually able to sleep longer through the night, as they get a little older. By the age of 6 months, 80 percent of infants sleep all night. By 9 months, about 90 percent do.

If your baby doesn’t seem to be able to sleep through the night by those ages, contact your pediatrician to see if your little one may have a problem that needs checking out.

Story source: Amy Norton, http://www.webmd.com/parenting/baby/news/20160524/what-really-works-to-help-baby-sleep

 

Daily Dose

Why Newborns Should Sleep on Their Backs

I received another e-mail today from a listener who was worried about her newborn’s sleep position and she also enclosed photos.I received another e-mail via our free iPhone App from a listener who was worried about her newborn’s sleep position and she also enclosed photos. (Just like I said last week, what did we all do as parents before we could send emails and attached pictures to ensure an accurate description!?).

She was concerned because her infant son, who is now about four-months-old, is “scooching” around in his bed and likes to get up against his bumpers. She has always put the baby down on his back, as recommended, and he has been comfortable in that position. She also has a ceiling fan in the room, as there was an article last year that showed that there were fewer SIDS (sudden infant death syndrome) deaths among children who had a ceiling fan in their room. Lastly, he uses a pacifier as this was also found to be protective against SIDS in yet another study. In other words, she is doing all of the correct things to try and prevent SIDS. The current recommendations by the American Academy of Pediatrics (AAP) state that an infant should be placed in the supine position on a firm mattress without soft bedding materials being placed in the crib. The baby should also not be overheated, so again blankets are not routinely recommended, but rather a sleep sack. Placing bumper pads in a crib for a newborn in the first several weeks of age is typically not problematic. The problem with bumper pads is that as an infant starts moving around the bed their heads may become lodged up against the bumper, as her son is doing, or their little head may even become entrapped under the bumper pad. Both of these in theory could obstruct an infant’s airway. So in the case of her child, I would recommend removing the bumper pads until he is older to eliminate even one variable in the SIDS puzzle. Despite the fact that the baby may prefer snuggling up to bumpers and pillows, the risk of SIDS is greatest in the first six months of an infant’s life. I know it is hard to be a sleep deprived parent, but the risks are just far too great to let your baby sleep on their tummies or with their heads buried in their bumpers or on a favorite large stuffed animal etc. This was a good question by an astute parent. Since the AAP recommended back sleeping in 1992, about 80% of children are now sleeping on their backs and the SIDS rate has dropped by over 40%. The only issue with back sleeping has been some head flattening that can be mitigated by having a baby get frequent “tummy time” off and on throughout the day (and those nights too when infants are still not sleeping). Many babies like their tummies when they are fussy, but once calmed and ready for sleep need to be turned over and put to sleep on their backs. Getting your baby into good sleep habits is important, but their sleep position is key! That’s your daily dose, we’ll chat again tomorrow. Send your question or comment to Dr. Sue now!

Your Baby

Why Do Babies Eyes Change Color?

1:30

Close to the top of questions many parent’s have about their newborn is what color will my baby’s eyes be?

It’ll take a while before you actually know your baby’s true eye color. That’s because eye color is a genetic trait that depends on several factors. While your baby may have gray or blue eyes at birth, his or her eyes may eventually be brown, blue, green, hazel, gray, violet or even a combination of colors. 

Parents' genes can mix and match in many different ways. The influences from each parent aren't known until after the baby is born. Eye color traits also include grandparents. A brown-eyed mother and father can have a child with blue eyes if there are blue eyes in his or her genetic history.

The colored part of the eye is called the iris, which has pigmentation that determines our eye color.

Human eye color originates with three genes, two of which are well understood. These genes account for the most common colors — green, brown, and blue.

Most babies are born with blue or gray eyes that can darken in their first three years.

Iris color, just like hair and skin color, depends on a protein called melanin. We have specialized cells in our bodies called melanocytes whose job it is to go around secreting melanin where it’s needed, including in the iris. When your baby is born his eyes will be gray or blue since melanocytes respond to light and he has spent his whole life in the dark.

Over time, if melanocytes only secrete a little melanin, your baby will have blue eyes. If they secrete a bit more, his eyes will look green or hazel. When melanocytes get really busy, eyes look brown (the most common eye color), and in some cases they may appear very dark indeed. Because it takes about a year for melanocytes to finish their work it can be a dicey business calling eye color before the baby’s first birthday. The color change does slow down some after the first 6 months of life, but there can be plenty of change left at that point.

We used to think of brown being "dominant" and blue being "recessive." But modern science has shown that eye color is not at all that simple.

Children can have completely different eye colors than either of their parents. But if both parents have brown eyes, it's most likely that their children also will have brown eyes.

The darker colors tend to dominate, so brown typically wins out over green, and green tends to win out over blue.

Eye color is one of those interesting things that pique our curiosity, but no matter what color your baby’s eyes end up being; they’ll be beautiful because they belong to your special little one!

Story sources: David L Hill MD,FAAP,  https://www.healthychildren.org/English/ages-stages/baby/Pages/Newborn-Eye-Color.aspx

Burt Dubow, OD, http://www.allaboutvision.com/conditions/eye-color.htm

Daily Dose

Babies and Infectious Diseases: A Hug Away

Dr. Sue discusses the dangers of babies and herpes.I had a really unusual case last week.  It is interesting now because all is well, but during this baby’s evaluation there was much concern on everyone’s part.

This baby was about 2 and a half weeks old and he had been a perfectly healthy newborn, and I had actually seen him several times due to some slow weight gain and jaundice. All of that resolved and he was fine, when a day later he developed a rash on the upper part of his chest and beneath his armpit.  The mother had never seen the few “spots” before, (seemed that they had popped up overnight), and 2-3 were already scabbed over. The baby was feeding fine, had not had a fever but she decided to bring him in. He was seen and we all agreed that he looked well, but sent him to see the pediatric dermatologist to see what she thought.  The few scabbed lesions looked like impetigo, but there was one that was vesicular and there was concern that it had remote chance of being herpetic (there was NO history of herpes in the mother etc.)  Again, this precious baby was oblivious. He was happy to breast feed and snuggle with an almost “what’s the fuss about?” attitude. So….cultures were taken, he was started on some antibiotics for a suspected impetigo skin infection and was  sent home. He was doing well when.  7 days later his culture report turns up positive for herpes!!!  Again, this baby appears perfectly fine, and by now the lesions in question are all gone. I have to call the parents with the news and I also had to consult my infectious disease buddies as to what to do. After many doctors weighed in on the subject of neonatal herpes, which can be quite serious in the immediate newborn period, a decision was made to admit the baby for further workup. Now, if you read even more about neonatal herpes, it can cause serious problems and including brain injury and death if a baby contracts herpes from the mother during delivery etc. But, the biggest issue for this very sweet family is that they thought their baby was just fine, and now a week later I am calling them to tell them we have to put their “seemingly” healthy newborn in the hospital for a spinal tap, blood work, MRI of the brain and more!!!  To watch their perfectly blissful, new parent faces dissolve into tears is just incredibly difficult. Trying to reassure anxious parents is a job that pediatricians have to do, but sometimes it is harder than others. Now, (long story short) after an anxious 36 hours all of the baby’s tests came back negative.  The more I looked at this baby the more I believed that he contracted a herpetic skin rash from someone who had picked him up (as it was in the perfect distribution of a hand beneath the armpit) who probably unknowingly had herpes on their hand. I will never be sure, but this taught me another lesson.  I am continuing to learn from my patients and their families and in this case, I learned all sorts of new things about viruses, probably more than I will ever need to know (as I must have consulted 10 other doctors). I also learned, washing hands is still the most important thing we can keep doing! That’s your daily dose.  We’ll chat again tomorrow.

Daily Dose

Why Videos Don't Educate Infants

Did you see the recent news regarding The Baby Einstein video series? It seems that there was a lawsuit regarding advertising surrounding Baby Einstein, and claims that “the videos can educate infants”.Did you see the recent news regarding The Baby Einstein video series? It seems that there was a lawsuit regarding advertising surrounding Baby Einstein, and claims that “the videos can educate infants”.

Now I must admit that I have only seen the Baby Einstein series while I am at the office and parents bring in their portable DVD players and are showing the videos to their children while they wait. The children are typically between the ages of about nine months to three years. Children do seem to be mesmerized by the videos, but I must say, they didn’t appear to be especially educational, just lots of repetition and colors. But what do I know; I always teased the parent’s that I was probably just envious that I didn’t make the videos. But I do believe that Disney has done the right thing by admitting that you can’t educate infants through a video, and are now going to refund the price of the DVD. They certainly may be entertaining, but as far as making an infant and child smarter, there is certainly no evidence to substantiate that. Parents are the key to educating their children and not TV or videos. How do you educate an infant and young child? It is once again back to the basics. The most important activity you can do with an infant and child is to talk to them. Babies love to hear their parent’s voices. Parents ask me what they should talk about; an infant doesn’t care. Babies just need to hear voices talking to them about anything:  sports, news, what the dog is doing, the weather, you name it, they love to hear language. Babies also need interactive play, with simple toys like rattles, blocks, and books. It doesn’t have to be fancy or have batteries to be worthwhile for your child. Think about simple games like “peek a boo” and “how big is the baby.” What about singing songs and laughing with your baby, it doesn’t get better than that! There are more games to play with your child such as “where are your eyes?” and “where’s Mommy’s nose? “ and “pat a cake”. All of these help a baby reach their developmental milestones. The time spent interacting with your baby is far more valuable than any time they may spend in front of a video player. Baby Einstein may be entertainment, but parents are the real teachers, and Disney seems to agree. That’s your daily dose, we’ll chat again tomorrow.

Your Baby

Does Your Unborn Baby Hear You?

2.00 to read

More than twenty years ago I remember reading that fetuses can learn to recognize their mothers and father’s voices and then respond to those voices as newborns. I thought… well maybe… but it seemed to me that voices from outside of the womb would sound muffled from inside. Of course, I don’t remember my in utero experience so I don’t really know how words sound.

Over the years though, scientists have continued to examine how and what babies learn before they are born.

A recent study by researchers at the University of Helsinki in Finland have determined that fetuses not only hear and recognize voices but they can become familiar with different words and different pitches used when saying those words.

The study involved 33 moms-to-be, and examined their babies after birth. While pregnant, 17 mothers listened at a loud volume to a CD with (2), four-minute sequences of the made-up words “tatata” or “tatota.” The words were said with several different pitches. The moms-to-be listened to the recordings beginning at 29 weeks of pregnancy -about 7 months along- until birth. They heard them around 50 to 71 times.

Following birth, researchers tested the babies for normal hearing and then performed an electroencephalograph (EEG) brain scan to see if the newborns would respond to the made-up words and different pitches. And sure enough, the brain scans showed increased activity from the babies who had been listening to the CD in utero when the words were played to them after birth. Not only did they respond to the words, but also seemed to recognize the different pitches used when they heard them.  

The babies born to the mothers who had not listened to the CDs while pregnant showed little reaction to the words or pitches.

 “We have known that fetuses can learn certain sounds from their environment during pregnancy,” Eino Partanen, a doctoral student and lead author on the paper, said via email.

“We can now very easily assess the effects of fetal learning on a very detailed level—like in our study, [we] look at the learning effects to very small changes in the middle of a word.”

Some experts believe the finding shows that not only can a third-trimester fetus hear and recognize voices; he or she can also detect subtle changes and process complex information.

“Interestingly, this prenatal exposure also helped the newborns to detect changes which they were not exposed to: the infants who have received additional prenatal stimulation could also detect loudness changes in pseudo words but the unexposed infants could not,” Partanen says.

“However, both groups did have responses to vowel changes (which are very common in Finnish, and which newborns have been many time previously been shown to be capable of).”

You may be wondering why is it even important that scientists know if fetuses can recognize voices or words.  Partanen says because sounds heard in utero may shape the developing human brain in ways that affect speech and language development after birth.

“The better we know how the fetus’ brain works, the more we’ll know about early development of language,” Partanen says. “If we know better how language develops very early, we may one day be able to develop very early interventions [for babies with abnormal development].” 

An abstract for the Finnish study is published on the Proceedings of the National Academy of Sciences website.

Does talking and singing to your baby before it’s born actually stimulate his or her brain activity and increase language learning? Some experts say definitely yes, others say it has no impact. But really, most moms and dads enjoy baby bump bonding whether it’s productive or not. And who knows, maybe your pre-born hears you loud and clear. 

Source: Meghan Holohan, http://www.nbcnews.com/health/unborn-babies-are-hearing-you-loud-clear-8C11005474

Parenting

Why Do U.S. Birth Rates Continue to Drop?

2:00

An interesting look at the U.S. birth rate was released by the Centers for Disease Control and Prevention (CDC) last week. In a nut shell, the U.S. birth rate remains at an all-time low, women are waiting longer to have children, teenagers having kids is at a historic low, C-sections are on the decline as well as preterm births, fewer unmarried women are having babies but the birth rate for twins is up by 2 percent.

Let’s look at the breakdown on these noteworthy findings.

While the U.S. birth rate remained at an all-time low in 2013, some experts expect that trend to change as the economy improves.

"By 2016 and 2017, I think we'll start seeing a real comeback," said Dr. Aaron Caughey, chair of obstetrics and gynecology for Oregon Health & Science University in Portland. "While the economy is doing better, you're still going to see a lag effect of about a year, and 2014 is the first year our economy really started to feel like it's getting back to normal."

More than 3.9 millions babies were born in 2013 and while that sounds like a lot, it’s down a little less than 1 percent from the year before.

Along with fewer births, there’s also been a decline in the general fertility rate - by about 1 percent- for women ages 15 to 44, reaching another record all-time low.

Women are waiting longer to start a family. Some experts believe that the economy may be having an impact on that statistic as well. The average age of first motherhood rose to 26 from 25.8 in 2013. Not a huge increase, but an indicator that younger women have a lot going on in their lives and want to wait a little longer before having their first child.

"You had people right out of college having a much harder time getting a first job, and so you're going to see a lot more delay among those people with their first child," Caughey said.

Birth rates for women in their 20s declined to record lows in 2013, but rose for women in their 30s and late 40s. The rate for women in their early 40s was unchanged.

"If you look at the birth rates across age, for women in their 20s, the decline over these births may not be births forgone so much as births delayed," said report co-author Brady Hamilton, a statistician/demographer with the U.S. National Center for Health Statistics.

Teens seem to be getting the message that having a child is something they need to think long and hard about. The good news is that the teenage birth rate is at an all-time low. Rates fell for teens in nearly all-ethnic groups by about 10 percent from 2012.

"It is just an absolutely remarkable trend," Hamilton said. "We are reaching record lows, and it's really quite amazing."

What is causing the sharp decline is still up for debate, but Hamilton believes that newer policies and programs may be educating teens better about the dangers to their health and life goals if they become pregnant at too young an age. More access to birth control may also be having an impact.

The jump in twin birth rates by 2 percent is an area for concern for many experts in the health field. 

"Twins have worse outcomes, and we really hope over the next few years we'll be able to see a reduction in that rate," Caughey said. "We really want to encourage people to be more engaged when they are considering fertility treatments, to reduce the risk of any multiple births,"

Twins births may be on the way up, but the triplet and multiple birth rate dropped another 4 percent in 2013.

The CDC’s report also noted these other changes:

•       Preterm birth rate (before 37 weeks) declined in 2013 to 11.39 percent, continuing a steady decrease since 2006. Caughey chalked this up to a drop in late-preterm deliveries.

•       Cesarean delivery rate, which had been stable at 32.8 percent for 2010 through 2012, declined to 32.7 percent of all U.S. births in 2013. "The C-section rate has leveled off at a rate that's too high," Caughey said. "We feel there's a real need for the C-section rate to decline even more."

•       Birth rate for unmarried women fell for the fifth consecutive year, to 44.3 per 1,000 unmarried women ages 15 to 44 in 2013. The rate was 1 percent lower in 2013 than the year before.

Whether it’s the economy, college debt, better education for teens or lower fertility rates, the U.S. birth rate is going down.  If the economy continues to improve over the next couple of years, it’ll be interesting to see if this baby decline changes to a baby boom.

Source: Dennis Thompson, http://www.webmd.com/parenting/news/20150115/us-birth-rate-continues-decline-cdc-reports

Your Baby

Spit-Cleaning Your Infant’s Binky

1.45 to read

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.”

Many pediatricians and family doctors are concerned that children are being “excessively cleaned” into illness. With anti-bacterial soaps and swipes being used on everything, and kids not allowed to get dirty, their immune system isn’t getting the workout it needs to help fight off common illnesses. The bacterial microorganisms provided in the parent’s saliva might help stimulate the baby’s immune system.

“The most exciting result was the eczema,” says Christine Johnson, chair of the public health department at Detroit’s Henry Ford Hospital. “I’m a bit more skeptical about the asthma findings because asthma is hard to measure before a child is five or six years old.”

Hesselmar also urges moms to lick the baby’s pacifier if their child was delivered by C-section. Vaginal delivered babies receive quite a bit of microbes during delivery. C-section babies can be more prone to allergies. “If they are using a pacifier and those parents think it’s OK to suck on the pacifier, then yes, I would recommend it,” Hesselmar says.

Some parents may find the idea of picking up a pacifier that’s fallen on the floor and putting it in their mouth kind of disgusting. That’s fine, there’s no need to worry about it. If the idea doesn’t bother you, all the better says Hesselmar, “I haven’t heard of anyone getting ill from it,” he says. “There isn’t much bacteria on the floor.”

Source: Barbara Mantel, http://www.today.com/moms/why-it-may-be-ok-spit-clean-your-babys-binkie-6C9773378

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