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Daily Dose

Study: Treatment for Colic

A new study looks a treatment for your baby's colic. Having had a baby who suffered with colic, I am always interested in reading any new studies that are related to new findings on treating colic.

Colic, which affects up to 25% of all infants, results in frequent and inconsolable crying throughout the day, and seems to have no "known" etiology. Parent's are at their wits end and are ready to do anything to help console their baby (yet alone get some rest themselves). I am convinced as both a parent and a doctor that the person or persons that discover the cure for colic will not only win the Nobel Prize, but will also win the hearts of every parent who has ever suffered "with" their colicky baby! A study in the March, 2011 issue of Pediatrics from researchers at the Peninsula Medical School in the UK, looked at 15 different studies of over 940 babies and different treatments for colic.  These studies included complimentary and alternative medicines that have been used including supplements, herbs, sugar water, probiotics, massage and reflexology. The review basically showed that none of the "treatments" were found to work consistently and the study design was even often flawed.  There were some "encouraging results" for fennel extract mixed herbal teas and sugar water, but all of these needed further study. So, once again it comes back to the basic tenet for treating colic, "Tincture of Time" and "TLC". I'll keep reading and for those of you looking for a "fix", I assure you I have felt your pain, and the only thing I can add is "this too shall pass".  None of these medicines is easy to swallow! Do you have a favorite treatment for colic? Let me know and we’ll share it.

Daily Dose

Starting Baby on Solid Food

1.30 to read

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 doesn’t 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.  

For others, the spoon and baby food just doesn’t hold the same excitement, and they push the spoon out of their mouth and are less than thrilled.  Experiment with pureed foods for your 6 month old, but don’t be worried if it takes some time...let your baby “lead this dance.” 

I typically have parents puree as many different foods as they can, and introduce a different one every 2 to 3 days.  The more different foods the better.  At this age your baby will like all sorts of things that might surprise you.....broccoli, asparagus, black eyed peas,kale, beets.  Same thing for fruits...try kiwi, melon, avocado, papaya, grapefruit and mango.   

Even as your child is beginning “solid” food they are still getting the majority of their calories from breast milk or formula.  It will be several months before they are eating enough solid food to change their milk intake. 

No rush....solid foods have nothing to do with sleeping through the night either. That too comes with time.

Daily Dose

Umbilical Cord Hernia

1:15 to read

It is not uncommon for me to see a newborn baby in the first few weeks of life with an umbilical hernia.  Once the umbilical cord detaches and is healed, some babies have an “outy” belly button.  While this causes a bit of parental concern, the bulge is typically due to the fact that the abdominal muscles around the belly button have not fully closed.  

In some cases the hernia may be tiny and barely noticeable, but in other cases the “bulge” may be as big as a quarter or half dollar.  The bulge is often bluish in color and “squishy” as the hernia allows a small bit of the intestine to push through he defect.

While the hernia is disconcerting for parents...who often wonder if their baby’s belly button will always be an “outy” or if they will need most cases the muscles usually come together and the hernia will close on its own over months...sometimes several years.

When I was first in practice it was not uncommon for me to see a baby come in who had their tummy “bound” with an Ace bandage and maybe a quarter or half dollar “pushing” the belly button back in. But over the years I guess the word is out that this really does not help and like many things in parenting if you just leave it will get better.

Lastly, you may notice that the hernia gets bigger when your baby cries or pushes to poop. Don’t worry that is totally is just the increased pressure on their abs...and when the baby relaxes the hernia is not as apparent and should easily be pushed back into the tiny defect.  

If you have any concerns make sure to talk to your doctor.

Daily Dose

Colic & Your Baby

1.30 to read

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 for your babies crying and the fantasy of that “perfect baby” is shattered. These babies are not “like babies on TV”. A colicky baby provokes exhaustion and can lead to things like breast feeding failures, marital discord, post partum depression and even child abuse.

 So what do you do and what are the current theories?  More to come….

Your Baby

Special Baby Formulas Don’t Prevent Asthma, Allergies


Parents that have a baby at risk or allergies, asthma or type-1 Diabetes sometimes turn to hydrolyzed milk formulas in hopes of lowering their infant’s risk of developing these problems.

A new review of the data on hydrolyzed formulas finds that there is no evidence that they actually protect children from these types of autoimmune disorders.

"We found no consistent evidence to support a protective role for partially or extensively hydrolyzed formula," concluded a team led by Robert Boyle of Imperial College London in England.

"Our findings conflict with current international guidelines, in which hydrolyzed formula is widely recommended for young formula-fed infants with a family history of allergic disease," the study authors added.

In the study, Boyle's team looked at data from 37 studies that together included more than 19,000 participants and were conducted between 1946 and 2015.

The investigators found that infants who received hydrolyzed cow's milk formula did not have a lower risk of asthma, allergies (such as eczema, hay fever, food allergies) or type 1 diabetes compared to those who received human breast milk or a standard cow's milk formula.

The researchers also found no evidence to support an FDA-approved claim that a partially hydrolyzed formula could reduce the risk of the skin disorder eczema, or another conclusion that hydrolyzed formula could prevent an allergy to cow's milk.

Other experts in the United States said that the finding casts doubt on the usefulness of these kinds of specialized products.

"Allergies and autoimmune diseases [such as asthma, and type 1 diabetes] are on the rise and it would be nice if we did have a clear route to preventing them," said Dr. Ron Marino, associate chair of pediatrics at Winthrop-University Hospital in Mineola, N.Y.

"Unfortunately, despite U.S. Food and Drug Administration support [for hydrolyzed formula], the data are not compelling," he said.

Dr. Punita Ponda is assistant chief of allergy and immunology at Northwell Health in Great Neck, N.Y. She stressed that when it comes to infant feeding, breast milk is by far the healthiest option.

However, "current mainstream guidelines for infant formula do recommend that parents consider using hypoallergenic formula if a close family member -- like an older brother or sister -- has a food allergy," she said. That was based on prior studies supporting some kind of protective effect, Ponda said.

Protein hydrolysate formulas were first introduced in the 1940s for babies who could not tolerate the milk protein in cow’s milk.

Protein hydrolyzed formulas are formulas composed of proteins that are partially broken down or “hydrolyzed.” They are also called hydrolysates.

There are two broad categories of protein hydrolysates:

•       Partially hydrolyzed formulas (pHF)

•       Extensively hydrolyzed formulas (eHF)

Both partially and extensively hydrolyzed protein formulas are based on casein or whey, which are proteins found in milk.  

Hydrolyzed formulas have had the protein chains broken down into shorter and more easy-to -digest chains. The more extensively hydrolyzed the formula, the fewer potentially allergenic compounds remain.

Hydrolyzed formulas are also more expensive than regular cow’s milk formulas and often harder to find.

The researchers review was published March 08, 2016 in the BMJ.

Story sources: Robert Preidt,

Victoria Groce,


Daily Dose

Babies & Bow-Legs

1.15 to read

Fact or fiction: if a young baby puts any weight on their legs they'll become bow legged? Dr. Sue weighs in.I’m sure you have noticed, babies like to stand up! With that being said, I still hear parents coming into my office who say, “I am scared to let my baby stand up as my mother (grandmother, father, uncle) tells me that letting a baby put weight on their legs will cause bow-legs!  How is it possible that this myth is still being passed on to the next generation?

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. A newborn baby’s legs continue to stay bent for awhile and you can easily “re-fold” those legs to see how your baby was positioned in utero. Almost like doing origami. So, how do those little bent legs get straight?  From bearing weight. If you hold a 3-5 month old baby upright they will instinctively put their feet down and bear weight.  A 4 month old likes nothing more than to jump up and down while being held. They will play the “jumping game” until you become exhausted. That little exercise is the beginning of remolding the bones of the leg, while straightening the bones. If you look at most toddlers many do appear bow-legged as the bones have not had long enough to straighten. Over the next several years you will notice that most children no longer appear bow legged. For most children the bow legs have resolved by the age of 5 years. I child’s final gait and shape of their legs is really determined by about the age of 7 years. Next time you hear the adage about bow legs, you can politely correct the myth. Standing up is going to make that baby have straight legs! That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

How to Treat a Colicky Baby

1.30 to read

We talked a little about colic earlier this week, so now it’s time to talk about some of the theories about what causes colic and some of the different approaches to treating it.


#1 Minor GI problems:  gas, cramps and tummy issues. But if that is the case why does colic start at 2 -3 weeks of age as babies have gas beginning at birth and they will pass gas well after they are 3 months old. I do hear parents complain that gas gets worse at about 4 weeks of age?  Babies also swallow a lot of air when they are crying and parents often try OTC simethicone drops, although typically with little help. There may be some placebo effect?

Some parents feel as if they get some relief by changing formula and at times an elemental formula such as Nutramigen nor Alimentum seems to help. For a breast fed baby many recommend eliminating many different foods from a mother’s diet. I too tried eliminating almost everything and would try to only have chicken, rice and bland foods. In my case (not statistically significant) my colicky baby remained colicky and I was miserable giving up so many foods.

I decided to eat what I wanted as it did not seem to make a difference and I was less stressed and also felt better eating again. Baby was still fussy.

#2 Major GI problems:  Gastrointestinal reflux is the buzz word these days. The diagnosis has increased at least 20 fold.  It is estimated that only 2 – 4% of colic is really related to reflux .  Reflux actually peaks at a later age, around 4 months, and resolves around 8 months, long after symptoms of colic have resolved. Regardless, many parents want a trial of anti-reflux medication but the latest studies show that PPI’s (proton pump inhibitors) rarely help the symptoms of reflux and are not routinely recommended.  

#3 Maternal Anxieties: this is counter intuitive as it seems that a colicky baby typically causes the anxiety and not vice a versa.  Colicky babies are not necessarily first born children either and most mothers would admit that they were more anxious with their first child (who might have been a placid baby).  I just don’t see the correlation. It does become a vicious cycle though as everyone ends up stressed, tired and anxious.

#4 Infants have immature neurological systems:  Babies are not yet “hard wired” when they are first born. They have all sorts of immature reflexes including a moro reflex, irregular breathing patterns (called periodic breathing of the newborn), quivers etc. During the first 3 months a baby’s entire neurological system slowly matures and an infant begins to have purposeful movements, starts to smile and just seems to get easier. Some call this period of time the 4th trimester. This makes a lot of sense to me, as colic seems to gradually improve, with TIME.

What is there to do to soothe a colicky baby:  DO WHATEVER HELPS (within reason), I can remember taking advice from total strangers and I was a pediatrician!! Some seemed absurd but I can tell you I bought all sorts of gizmos to see if anything would soothe my unhappy baby.

Babies who are colicky usually like the following:

Swaddling – Whoever invented the “miracle blanket” really was a genius!! It makes swaddling so easy. There are numerous methods to swaddling but with practice it is easy. 

Swaying – whenever you have a baby you learn to “rock” while you are holding them. After about a week of parenting, it almost seems like instinct. Once you have been a parent, any time someone hands you a baby you automatically begin to SWAY. Swings work well too

Shshshing……..  Quietly whispering this sound to a baby seems to be calming as well.  Babies also like to hear soft music or soft lullabies with the same sounds repetitively.  Remember, “Hush Little Baby”, always a good one. When your voice wears out try the hairdryer or vacuum cleaner in the background. Some parents swear by a white noise machine.

Sucking - As I have said many times, I am a huge believer in a pacifier. Infants need to suck to calm themselves. They need to suck to eat but there is also a need for non- nutritive sucking.  The biggest problem is that baby’s have a tongue thrust and often spit out the pacifier just as you get them calmed, but even having to put it back in is often worth it!

Stomach – fussy baby’s often calm when they are on their tummies. But, with that being said NEVER let your baby sleep on their tummy. It is hard to turn that quieted baby over once asleep but you MUST, even if you are watching them!

I wish I knew the reasons for colic or the miracle to end the long days and nights. I do know that the majority of these irritable colicky babies suddenly blossom into happy, joyful 4 month old infants.

Lastly, any help is welcome when you have a newborn, especially a fussy one. Accept offers of help and take a break and get out of the house for an hour to take a walk or grocery shop in solitude. All parents need breaks!

That’s your daily dose for today.  We’ll chat again tomorrow. 

Daily Dose

Diaper Dermatitis

1:30 to read

Newborn babies have the softest little bottoms and they also have a lot of poop! The combination often leads to a raw red bottom and a diaper rash. A newborn often poops every time they eat and sometimes in between....and you don’t even realize they have pooped again.

Even with the constant diaper changing (would you have believed you would use 8-12 diapers a day) it is very common for that newborn to develop their first diaper rash.  Not only will the skin be red and may even sometimes be so chapped that it may bleed a bit.  This diaper rash is causes a lot of parental concern and will often result in the new parent’s first of many calls to their pediatrician.

A new baby is supposed to poop a lot, so you can’t change that fact,  but you can try all sorts of things to protect that precious bottom and treat the diaper rash.  After using a diaper wipe ( non perfumed, hypo-allergenic) I sometimes bring out the blow dryer and turn it to cool and dry the baby’s bottom a bit. Then I apply a mixture of a zinc based diaper cream (examples:  Desitin, Dr. Smith’s, Triple Paste cream), which I mix in the palm of my hand with a tiny bit of liquid over the counter antacid.  (I don’t measure it:  just a lot of diaper cream and small amount of antacid so it won’t be runny).  I put a really heavy layer of this on the baby’s bottom.

If after several days rash is still not improving it may have become secondarily infected with yeast so I add a yeast cream (Lotrimin AF, Triple Paste AF) to the concoction. If it has yeast this should do the trick to treat all of the problems.

I will also sometimes alternate using Aquaphor on the bottom with the above diaper cream concoction.  It will take some time for it to totally go away but you are trying to get a barrier between the poop and the skin on the baby’s bottom. She keep something on there after each diaper change.

After a few weeks of constant pooping the number of stools do slow down and bit and that will help heal that new baby’s bottom as well. 

Daily Dose

Are Parents Too Connected?

1.30 to read

Has your spouse, babysitter or other child care provider ever called you to come home “because the baby is crying”?  It seems that technology, which is readily at our finger tips 24/7, has created yet another dilemma - what to do if a baby is crying? 

Pre-cell phone days, there really was not much to do if you the parent left home and your baby/child started crying.  Outside of calling the restaurant, store, movie theater (directly), and asking them to page a parent, most of us just muddled through a crying child.  I also think that in most cases, said child eventually stopped crying (unless there was an obvious reason that could be “fixed”) and by the time you the parent returned home, all was typically well.  

But now, with a cell phone in every hand, it only takes one call to summon the parent of a crying child.  I think this is a good news/bad news dilemma.  The good news is: parents may feel more comfortable leaving their child with a babysitter, knowing that they may be reached in the event of an emergency.  The bad news is:  is a baby or child who is only crying, typically an emergency?  Depends on your definition. 

The reason I bring this up is that I often hear young parents, and especially mothers, tell me that during the first several months of their infant’s life, they cannot leave the house for more than minutes, before being called home....because the baby is crying.  Some of these mothers are really “stressed out and exhausted” and need a bit of a get-away to “re-boot”. I am not talking about a trip to the day spa. I am simply talking about an hour or 2 to go to the store or meet a friend for lunch or just sit alone in the park and read a book.  Just a bit of quiet after being home with a baby day in and day out for the first 4 weeks of their newborn’s life.  If you have been there you understand. 

But, now that they have a cell phone, there is CONSTANT communication.  The minute the baby cries, the cell phone rings....”the baby is CRYING, come home.”  My husband would tell you that his best parenting started the first time I left him alone with our first son and I actually went away for the weekend.  (I believe the baby was 6 or 7 weeks old and off I went breast pump in hand to a reunion.)  No cell phones then, and guess what, he did a great job!!!!  He told me how after the first 24 hours he figured out that he really didn’t have to have the baby in the bathroom with him in order to take a shower. He later told me that the first shower he took, not only was our son in the room in his “bouncy” chair, but he left the shower door open as the door got steamy and he couldn’t see the baby!! How cute is that. 

Technology, as wonderful as it is, may also enable us to “cop out” when things get a bit difficult.  That goes for parenting as well. 

Turnoff your phone off sometime and let the “other parent” or babysitter handle it for awhile. Being disconnected is NOT always a bad thing!


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Struggling with feeding your kids healthy (er) meals. Rule of thumb: don't stress over it!


Struggling with feeding your kids healthy (er) meals. Rule of thumb: don't stress over it!

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