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Your Child

New Studies Look At Childhood Asthma

1.45 to read

2 new studies take a look at childhood asthma. One suggests that antibiotics given to babies in the first year of life may increase a child’s chances of getting asthma by age 18, while the other study cautions that childhood food allergies may be a predictor of asthma later in life.2 new studies take a look at childhood asthma. One suggests that antibiotics given to babies in the first year of life may increase a child’s chances of getting asthma by age 18, while the other study cautions that childhood food allergies may be a predictor of asthma later in life

Antibiotic Use and Childhood Asthma Pediatricians have cautioned parents about taking antibiotics, and giving their children antibiotics, without a true medical need. Now a study appearing online in the journal Pediatrics, suggests that infants who take antibiotics during the first year of life may be at a slightly increased risk of developing asthma by age 18. In a separate analysis, the children of women who took antibiotics during pregnancy were nearly 25% more likely to have asthma compared to mothers who did not take the drug. Asthma can be a life threatening condition. Nine million children under age 18 in the U.S. have asthma, according to the American Academy of Allergy, Asthma & Immunology. Here’s how the study was conducted. Researchers gathered data from 22 previous studies between 1950 and 2010. Two of the 22 studies looked at antibiotic exposure during pregnancy while 19 studies evaluated antibiotic exposure during the first year of life. One study assessed antibiotic exposure during both time periods. Other studies have shown that infants who receive antibiotics are at an increased risk for developing asthma by age 7, and the more courses of the drug given that first year, the greater the risk. This review analyzed the results of studies using over 600,000 participants. It also grouped studies according to design type to see how the results were affected. When all 20 studies were grouped together, researchers found that infants who took antibiotics during their first year of life were about 50% more likely than babies who never received the drugs to be diagnosed with asthma. Researchers also analyzed studies where children who were treated with antibiotics for respiratory infections, were removed.  The respiratory infections skewed the overall results because of the possibility that the infections themselves might be a precursor to asthma. In studies that adjusted for these respiratory infections, a child who took antibiotics was 13% more likely to be diagnosed with asthma than a child who never took the medication. The researchers say they are not suggesting that early antibiotic exposure causes childhood asthma, but that even a slight increase in risk may be a good enough reason to avoid the unnecessary use of antibiotics during pregnancy and the first year of life. Food Allergies and Childhood Asthma Infants and toddlers often have some type of food allergy, while teens and adults are more prone to dust, ragweed and mold allergies according to U.S. researchers. A preliminary release of the Quest Diagnostics Health Trends Report, Allergies Across America, is based on laboratory testing from more than 2 million U.S. patient visits. In this report the findings reveal a pattern of allergen sensitivity consistent with the "allergy march," a medical condition by which allergies to foods in early childhood heighten the risk for the development of additional and more severe allergy-related conditions - including asthma- later in life. "Allergy and asthma often go hand in hand, and the development of asthma is often linked to allergies in childhood via the allergy march," Study investigator Dr. Harvey W. Kaufman says in a statement. "Given the growing incidence of asthma in the United States, our study underscores the need for clinicians to evaluate and treat patients, particularly young children, suspected of having food allergies in order to minimize the prospect that more severe allergic conditions and asthma will develop with age." The most common foods responsible for allergic reactions are eggs, cow's milk, peanuts, soya, fish and shellfish in children and peanuts, tree nuts, shellfish and fish in adults. Substances that are used as food additives and preservatives can also affect individuals. Although a causal link has not been determined, increased awareness of the heightened risks of having both childhood asthma and allergen sensitivity plus good patient-parent education and management of both conditions, can lead to improved health and medical outcomes.

Daily Dose

Q-tip Injuries

1:30 to read

I know I am asked on a regular basis, “how do I clean my baby’s/child’s ears?  I have replied for years with something that I know I was taught many years ago, maybe even by a grandparent? “Nothing smaller than your elbow should go in your ear”. Who knows where that saying came from but it is a good visual that you should not “stick a Q-tip” or anything into the ear canal.

 

Now an article published in the journal Pediatrics sure makes that adage seem timely, as about 12,500 children younger than 18 are treated in emergency rooms annually, which translates into about 34 children per day.  The study also showed that about two out of three patients were younger than 8 years and children younger than 3 accounted for 40 percent of all injuries. 

 

Cotton swabs are really intended to clean the outer ear and should not be placed into the ear canal…even though most people put a q-tip right into the canal which may cause injury when pushed too far.  The study showed that about 30 percent of injuries caused by the cotton swabs were feeling as if there was a foreign body in the ear, while 25 percent of injuries were a perforated ear drum and 23 percent were soft tissue injuries. WOW…talk about expensive health care costs related to one little cotton tipped swab!

 

Ear nose and throat doctors (otolaryngologists) will tell you that the ear canals are usually self cleaning and using a cotton tipped swab to clean the ear only pushes the wax further down the canal and closer to the ear drum. If in fact the wax becomes impacted by using a q-tip, it is even harder to get the wax out. There are over the counter drops that you can instill in the ear canal to help soften wax and then use a wash cloth to clean the outer ear.

 

So..resist the urge to put a Q-tip into your ear canal and simply use them to take off makeup, paint small places or any of the millions of other uses…just NOT in the ear!

 

 

 

 

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Daily Dose

Baby Bling Can Be Dangerous!

1:15 to read

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 can re-wrap for re-gifting and re-wearing at a later date. Safety before bling! 

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Daily Dose

Foods You Can Eat When Breast Feeding

1.30

Should breast feeding moms avoid certain foods?I was making hospital rounds today and talking to all of the new moms (and dads) about their newborns.  I love talking to new parents about the importance of having healthy meals to support breast feeding! I even had a young dad asking “what foods should I avoid cooking for my wife while breast feeding?”  How cute is that! Can we clone him?!

After breast feeding my 3 children, I have decided that you can really eat whatever you want!  I know some people swear that certain foods you eat will cause a breast fed baby to have gas. But think about it, bottle fed babies and breast fed infants all have GAS!  None of the formulas contain broccoli, or cauliflower or beans or tomatoes and bottle fed babies have gas too. It is just a fact, newborn babies are gassy for the first several months as their digestive tracts mature. And yes, it is stinky too! So… I told this dad, “good for you for cooking for your wife.  Make her healthy, well balanced meals and throw in a few of her favorite foods.”  I would not change anything unless you can definitely correlate that a food ALWAYS makes your baby more uncomfortable (and that is so hard to keep track of). Eat what you want (in moderation) to be healthy and happy.  I have no data but feel certain that happier mothers must in some way have an effect on a  baby, so at least enjoy mealtime. When I had a colicky baby (previous post), I tried eating only broth and bland foods, and with me equally miserable and starving…this stressful situation only got worse. Final words, if I was going to try eliminating anything from my diet while breastfeeding to try and help “relieve “a gassy baby, it would be excessive dairy, as there has been some data on this. Remember, everything in moderation. I’m willing to bet that by the time your baby is 4 months old (the magic age) you are not even worried about what you are eating, as you are having too much fun laughing with your baby! What foods (if any) bothered your baby while breast feeding? I would love your comments.  Leave them below. That’s your daily dose for today. We’ll chat again tomorrow.

Daily Dose

How to Treat a Baby With Thrush

I have received some recent e-mails and now an office visit regarding the possibility of a baby having thrush. Thrush is a yeast (fungal) infection that involves the mouth, and is most typically seen in infants.I have received an email via our iPhone App and now an office visit regarding the possibility of a baby having thrush. Thrush is a yeast (fungal) infection that involves the mouth, and is most typically seen in infants.

The yeast infection usually involves the inside of a baby’s cheeks and lips and occasionally the tongue. It appears as white, almost cottage cheese like patches, and is often visible when a baby is yawning or crying. A baby who only has a white tongue typically does not have thrush, but just a milk coated tongue (see if you can wipe some of the milk off of the tongue, as yeast is usually more adherent). Thrush is fairly common as we all have yeast in our digestive tracts, and babies are often colonized with yeast as they travel through the birth canal. For unknown reasons, in some infants there is an overgrowth of yeast and thrush may develop. Many mothers feel guilty that they “gave their baby” a yeast infection. They worry that thrush has something to do with cleanliness (NOT) and somehow that maternal guiles thing is already beginning. (Dads have already cut to the chase and say, how do you treat it?!) Thrush can happen to any infant. In a breast feeding baby it may also cause a mother to have inflamed and tender nipples, and the baby and mother actually pass the yeast back and forth during feeding (no guilt, as breastfeeding is good!) In most babies thrush does not cause a lot of problems and may go away by itself. But if the infection becomes extensive it may become painful and cause an infant to be uncomfortable when nursing or taking a bottle. If you notice that your baby has white plaques in their mouth or under their lips it may be worth a phone call to your pediatrician. (This is not an emergency and can wait till office hours.) There are several prescription preparations that may be used to treat thrush. The most common being Nystatin, which is a liquid medication that is given to the baby after they have been fed, and is squirted into the mouth on the inside of the cheeks, to treat the yeast infection.  It is also beneficial to treat a nursing mother’s nipples with an anti-fungal agent. I usually tell patients to use the medications for at least seven days or until the white patches have been gone for several days before stopping treatment. It is not uncommon to get thrush again, so don’t fret if your baby develops another infection, at least you know what it is and how to treat it. A yeast infection in the mouth may often lead to a yeast infection in the diaper area (candidal diaper dermatitis), because as you know what goes in the mouth comes out in the poop. But that rash is for another day…. That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue!

Your Baby

Mom and Baby Benefit by Skin-to-Skin Contact Right After Birth

1:30

Over the years, modern birth methods have changed how newborns and mothers interact with each other. Typically, the baby is cleaned up and wrapped in a blanket then given to the mother to hold. A new scientific review suggests that skin-to-skin contact is better for the mother and gives her infant a better start in life.

The review noted that women who had skin-to-skin contact with their naked babies soon after delivery were more likely to breastfeed longer and be breastfeeding months later than women who didn't have their babies placed on their skin right away.

"The more you can do to place the mother and baby together and disturb them as little possible during that first hour, the better off they’ll be," said lead author Elizabeth Moore, of the School of Nursing at Vanderbilt University in Nashville, Tennessee.

Researchers looked through medical literature and found 46 randomized controlled trials to include in their review. The trials included 3,850 women and their newborns from 21 countries. All babies were healthy and most were born at term.

"We compared those trials to usual care, and usual care was very different depending on the trial," said Moore. Trials from the 1970s may have separated mothers from their babies for hours. In more modern trials, babies might be swaddled in a blanket before being handed to the mother.

Moore and her team found evidence that babies who had received skin-to-skin contact were more likely to breastfeed successfully during their very first breastfeeding session, and they also tended to have higher blood glucose levels and stronger heart and lung function.

 “It’s just something that if at all possible should happen," Moore told Reuters Health.

Skin-to-skin contact should begin as soon as possible and last for at least 60 minutes, she said. The hour will give babies time to recover from the birthing experience, find the mother's nipple and latch on.

"It’s not something you can do in just 15 minutes," Moore said.

Not all physicians and hospitals are on board when it comes to immediate skin-to-skin contact after birth.

“I would recommend that a woman make sure she adds skin-to-skin to her birth plan," Moore said. "I think it’s a really good thing for a woman to put together a birth plan before she heads to the hospital and show it to her physicians or midwife."

What if your baby is premature or is delivered by cesarean? The researchers didn't find any benefits to initiating skin-to-skin contact immediately after birth versus after the baby had been examined and washed. They also failed to find any clear benefits to skin-to-skin contact that lasted longer than an hour.

"The evidence supports that early [skin-to-skin contact] should be normal practice for healthy newborns," the researchers wrote, "including those born by cesarean and babies born early at 35 weeks or more."

The review was published in the Cochrane Library in November. 

Story sources: Andrew M. Seaman, http://www.reuters.com/article/us-health-birth-skin-idUSKBN13V2UZ

Kenza Moller, https://www.romper.com/p/why-skin-to-skin-contact-after-birth-could-be-beneficial-for-mothers-babies-alike-24423

 

Daily Dose

Prevent SIDS

1:15 to read

A new study on swaddling and sudden infant death (SIDS) was just published this week in the journal Pediatrics. Not surprisingly, it found that infants who were swaddled and placed on their sides or stomach had a higher incidence of SIDS. It has been routinely recommended for more than 15 years that all babies sleep on their backs and since that time the incidence of SIDS has been dramatically reduced.  Unfortunately not everyone follows the AAP recommendation. 

While it has been known that tummy sleeping has been associated with SIDS this meta analysis looked at data which was gathered over two decades and from 3 different global sites. The review found that infants who were swaddled and placed on their sides were almost twice as likely to experience SIDS and the risk of SIDS did double in those babies who were swaddled and placed on their stomachs.  

I discuss swaddling with all of my patients as there are so many different swaddle blankets available.  Actually, one of the first things a newborn nurse seems to teach a new parent is how to swaddle their baby.  While swaddling has been promoted to aid in calming a newborn as well as to help their sleep, the recommendation that the baby be placed on their back in their crib continues..  Many a baby looks like a little burrito…rolled up in the swaddle and then being placed on their back in the crib.

But is seems from this study that some babies were being swaddled and then placed on their side to sleep. Unfortunately, even a newborn may squirm enough that they then move from their side into the prone position.  Older infants who are swaddled may actually roll from their back to their tummies, even while swaddled. While the association between swaddling and SIDS remains unclear, I think this is a good reason to start getting a baby out of a swaddle once they are rolling. So around the 3 month mark I start having parents loosen the swaddle and try to just lay the baby on their back without being swaddled.

Let me re-iterate, this article does not confirm an association between swaddling and SIDS.  I do think it is a good reminder for putting a baby, “back to sleep” and once they are rolling “ditching” the swaddle seems to make even more sense. Once less thing to worry about, right?

 

Daily Dose

New Baby Advice for the Royals!

1.30 to read

Welcome your Royal Highness Prince (name to come) and congratulations to new parents Prince William and Duchess Kate.  I imagine (like all new parents) you are over the moon in love with your new baby boy!

There really is no way to account for that instant unconditional love that a parent feels for their child.  It truly happens the minute your newborn baby takes their first breath....God opens a parent’s heart and fills it with love!

The first few days after the baby’s birth are adrenalin filled and most of the time is spent just holding and gazing in awe at your new baby.  At the same time, the reality of having a newborn has not yet really settled in.  The days spent in the hospital go by quickly and then suddenly you, (new parents), are “discharged to home” with a few instructions and “good wishes” for your new life together.

Even in a palace (and with plenty of help I assume) the reality of parenthood begins to hit with the knowledge that this baby requires attention 24/7, and many times that means sleepless nights.  For some reason a newborn does not “understand” circadian rhythm, at least for several months, and those night time feedings lead to tired parents.   Even with nurses and nannies, a mother is breast feeding mom needs to get up every 2-4 hours to feed her precious bundle.  

Remember as a new parent you need to sleep when the baby sleeps! This means you may need a nap from 2-4 in the afternoon as that darling baby may be up from 2-4 in the middle of the night, which means you are too! All new parents feel exhausted at times; it is all part of parenting.

Newborns are also quite unpredictable and even though you may have changed, fed and burped your baby, you should know that they sometimes cry and it is hard to figure out what to do next. 

I believe in picking up your newborn baby if they are crying, as sometimes they just need to be held and cuddled (even if they keep on crying).  You can’t spoil an infant. Try swaddling and swaying with the baby as you make a “shushing” sound.  

I also recommend using a pacifier (dummy in England) because a new baby may need some non-nutritive sucking which is yet another means of self calming.

Make sure your baby sleeps on their back (lowers the risk of SIDS) but tummy time is important as well so that their heads don’t get flat. 

If your baby ever falls asleep during tummy time they must be turned over to sleep on their back - even if you are standing there watching them. NO TUMMY SLEEPING!

The first 6-8 weeks are the hardest and it is really just about “survival”. Sleep when you can, make sure you are eating (especially for breast feeding moms) and know that all new parents feel overwhelmed at first.  You really don’t need to worry about “messing up” and in about 8 weeks that precious new baby will give you a beautiful smile, and that makes those memories of long sleepless nights (and some days) fade away fairly quickly.  

Congratulations and good luck!

Daily Dose

A New Baby

1.15 to read

I must say...being able to have texts and emails from my patients does make it easier to communicate. A quick question or a picture of a cut on the knee can quickly be sent over a handy phone, and I can often reassure a parent that a visit may not be necessary.   

At the same time, messages from my patients make me feel more connected to them and their family. This was the case the other day when I was out of town and missed the birth of one of my newest patients. The good news? The tech savvy, mother kept me in the loop throughout her delivery! 

This mom was having her 4th baby, and 1st girl after 3 boys. (hmmm....wonder if I should have had that 4th baby after all - a bit late to ponder that question?) 

She sent me a quick text that she had gone into labor, but it was 3 weeks early. I had hoped to be at the hospital for her delivery as it is still fun for me to be in the delivery room. There really is nothing better than observing a delivery, as you are always a reminded of the miracle of birth. 

So....out of town, missing the birth..but, she sent me a picture of her in labor, followed by quick text telling me it was almost time and then......a picture of a precious, healthy baby girl, all 7’ 2” of a new life! This picture is of the new proud dad (I think she’s already got him wrapped around her finger).  It was almost like I was there...while still enjoying a few days at the beach.   

So, one of the best parts of my job is being a part of a family and watching that family grow.  Doesn’t get better than that. 

Congratulations to sweet baby girl Roberts. You are perfect!

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