Twitter Facebook RSS Feed Print
Daily Dose

"White Noise" and Babies

1.00 to read

I received an email from Meredith (via our iPhone app) because she had heard that “white noise” might cause a child to have speech/language delays. She used a sound machine in her children’s rooms at night, and was concerned about the possibility of “interfering with their speech”.

So, I did a little research and found an article from the journal Science in 2003.  A study from the University of CA at San Francisco (UCSF) actually looked at baby rats who listened to “white noise” for prolonged periods of time. The researchers found that the part of the auditory cortex (in rats) that is responsible for hearing, did not develop properly after listening to the “white noise”.   

Interestingly, when the “white noise” was taken away, the brain resumed normal development. Again, this study was in baby rats, and to my knowledge has not been duplicated.  But, these baby rats were exposed to hours on end of  "white noise” which may not be the same thing as sleeping with a “sound machine” at night. 

We might need to be more concerned about background “white noise”. We do know that babies learn language by listening and absorbing human speech. They need to hear their parent’s talking to them from the time they are born.  They listen to not only their parent’s speech, but also to siblings, grandparents etc. and from an early age respond to that language by making cooing sounds themselves, often imitating the sounds they have heard. They are also exposed to a great deal of “white noise” or background noise with the televisions being on, computers, telephones, vacuum cleaners, lawn mowers etc. going on all day.  The “white noise” that may be reduced by turning off televisions, videos, computers etc and replacing that background noise with human speech through reading, singing and just talking to your baby and child could only be beneficial. One might surmise that “white noise” in the form of a sound machine at night would not affect a child’s speech development, as this is not a time for language acquisition.

Having a good bedtime routine, reading to your child before bed, or singing them a lullaby will encourage language development, and the sound machine may ensure a good night’s sleep.  Just turn it off in the morning!

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

Daily Dose

Getting Your Baby to Sleep!

1:30 to read

Did you know one of the biggest Google internet searches for parents revolves around “how do I get my baby to sleep?”  I guess that any new parent in the middle of the night is online searching for “THE ANSWER”, so of course you “Google it”!

Now that we are grandparents and the baby is about 6 weeks old (although technically she is a week old, as she was 5 weeks early) my son is also looking for answers on the internet to that same to make her sleep, so I can too! He even asked me if their was “magic” to this?

If only there was an answer on Google or in any book. It just takes time and every baby is different.   I guess there are some babies that sleep through the night from the time they get home from the hospital, but I have never seen one.  I think some parents just forget that at some time or another they were up at night with a newborn.

A newborn baby does not understand circadian rhythm and they are really not “trying” to keep parents up at night.  It takes weeks for a newborn to even begin to have some “routine” to their day and I try never to use the word “schedule” when discussing a newborn.  A baby is not a robot, they do not eat every 3 hours and then sleep for 3 more before eating again. They are “little people” and their tummies sometimes need to eat in 2 hours and then later it may be 3 hours before another feeding.  Don’t you sometimes eat an early lunch one day and a later lunch the next? 

But by trying to awaken the baby throughout the day and offering a feeding every 2-3 hours you will hopefully notice after several weeks that your baby is eating more often during the day and suddenly may thrill you and sleep 4 hours at night. it just takes time....YOU cannot make it happen.  I tease new parents that awakening a newborn during the day and prayer is about all you can do....all babies do eventually sleep, but it may not be right after you get them home from the hospital...think several months (as in 2-4) and you will be happy if it happens sooner.

Lastly, with all of the tech in the room, don’t pick up your baby in the middle of the night if they are just “squirming” around. Babies are notoriously loud sleepers and if they are not crying let them be and you may be surprised that they arouse and went back to sleep. If your baby cries you absolutely go get them and console them and feed them too if it is time. An infant should not be left to cry. 

This too shall pass and sleep will come, but there will be new stages down the road that will keep parents up at night, of that you can be assured. Comes with the territory.

Daily Dose

Belly Button Care

1:15 to read

Belly buttons seem to make new parents a bit crazy.  Once the “lifeline” from mother to child is clamped in the delivery room, the umbilical cord really serves no further purpose...other than to cause a lot of anxiety and annoyance for new parents.

I get many questions concerning “how to fold the diaper” and “not rub the cord” or “what if I got a little water on the cord when I gave the baby a sponge bath?”.  I had a text today saying, “the cord is dripping a bit of blood, did we do something to it?” 

It typically takes anywhere from 5-14 days for the cord to fall off. During that time it typically just “sits” there...and dries up. Some hospitals still apply gentian violet to the umbilical cord and others now just leave it alone and let it dry.  Either way....your job is to try to ignore the cord and just let it fall off.

As the cord dries up and it detaches it may bleed a bit...remember the umbilical stump is like a scab.  It is not uncommon to see if few drops of blood or dried blood on the edge of the diaper.  As the cord detaches even more there may be a part that oozes a bit as well....but don’t be concerned, just like a skinned knee your child will have one day...the scab will heal with a bit of time and TLC.

Once the cord falls off you can now give your baby a more sponge bathing. And don’t worry if the belly button is a bit of an “outy, as it will often change over time unless there is an umbilical hernia...which is yet another discussion.

Your Baby

Weight Gain During Pregnancy

2.00 to read

Every pregnant woman wonders how much weight she could gain during pregnancy. For some women, being pregnant is an open invitation to eat whatever and whenever they like, while other woman worry what the weight gain will do to their figure. There is no absolute law about weight gain during pregnancy, but there are set of guidelines that can help you.

Weight gain should be based on your pre-pregnancy body mass index (BMI.) Your health and your baby’s health also play a role in how much weight you should gain.

Here’s a list of suggested pregnancy weigh gain related to a healthy woman’s BMI.

  • Underweight (BMI less than 18.5) – 28 to 40 pounds
  • Normal weight (BMI 18.5 to 24.9) – 25 to 35 pounds
  • Overweight (BMI 25 to 29.9) – 15 to 25 pounds
  • Obese (BMI 30 or more) – 11 to 20 pounds

Multiples are a different story. If you are carrying twins or other multiples you’re likely going to need to gain more than average weight. Your health care provider can help you determine what is right for you. Here are the recommended weight gain options.

  • Normal weight (BMI 18.5 to 24.9) – 37 to 54 pounds
  • Overweight (BMI 25 to 29.9) – 31 to 50 pounds
  • Obese (BMI 30 or more) – 25 to 42 pounds

If you are overweight when you become pregnant, pregnancy increases the risk of various complications including diabetes and high blood pressure. Of course, a certain amount of weight gain is normal, but too much adds to the possibility of dangerous health risks for the woman and the child.

Remember that if you gain more than the recommended amount during pregnancy and you don't lose the weight after the baby is born, the excess pounds increase your lifelong health risks. Gaining too much weight during pregnancy can also increase your baby's risk of health problems at birth and childhood obesity.

If you're underweight, it's essential to gain a reasonable amount of weight while you're pregnant. Without the extra weight, your baby might be born earlier or smaller than expected.

Calculating your BMI is not difficult; you just need to know your height and weight. There are several online BMI calculators that will do the math for you. Your healthcare provider should also have a BMI chart that can show you your BMI.

So, how is the extra weight used by your body when your pregnant? Here’s a simple list to help you follow a normal weight gain.

  • Baby: 7 to 8 pounds
  • Larger breasts: 2 pounds
  • Larger uterus: 2 pounds
  • Placenta: 1 1/2 pounds
  • Amniotic fluid: 2 pounds
  • Increased blood volume: 3 to 4 pounds
  • Increased fluid volume: 3 to 4 pounds
  •  Fat stores: 6 to 8 pounds

During your first trimester, you probably won’t gain much weight. Steady weight gain is more important in the second and third trimesters, especially if you begin at a normal weight or are underweight.

Exercise is also important during pregnancy. Even a moderate amount of exercise will help keep your body strong as the extra pressure builds while you are carrying.

As your pregnancy develops, more than likely you’re appetite will increase. That’s not a bad thing. Just fill those hunger pains with healthy food choices!




Daily Dose

Reflective Gear for Baby

1.15 to read

I was driving home from work the other night…it was a beautiful spring evening.  The sun had already set and it was already dark. I was in my neighborhood, which I must say is not well lit, but it is a neighborhood   Our neighborhood does not have sidewalks, so people (who are out for an evening walk) usually do so in the street.  We’re all familiar with each other, so most of us are good about slowing down and watching out for pedestrians. 

So, I came upon a young couple strolling with their baby in a stroller. They were all dressed in black, and the stroller was black as well. I suddenly realized that they were right in front of me on the side of the road. I could not see them at all until I was right on top of them!! Scary. 

This made me think about taking a walk with a baby in a stroller. Or actually, strolling at dusk or night at all. All of the strollers that I typically see in my office are dark in color. I wonder if they have any reflective stripes or coverings on them at all? Certainly, the one I saw the other night did not have any markings that reflected as my headlights scanned the road. 

On top of that, both parents were dressed in dark sweat clothes, and they to did not have on any reflective “gear” at all either. They were a family of three, 2 walking, one in a stroller and they appeared as a dark blur. 

I guess the point of this is that your child’s stroller should have reflective tape or something (I see a great marketing idea here) on it. If you (mom or dad) go out for a night time stroll, don’t wear dark colors and wear reflective gear. The more markings the better!  Safety is paramount and being seen is the most important part of being a pedestrian. 

Being an early morning walker myself, often before dawn, I am now the proud owner of a reflective vest and arms bands for my early morning walks. Lesson learned for me as well. 

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

Daily Dose

SIDS Risks

1.30 to read

Sudden Infant Death Syndrome (SIDS) is every parent’s worst nightmare. From the time a family has their new baby until that child is 1 year of age, SIDS is of a concern. 

Most new parents in 2012 know about the Back to Sleep campaign (BTS), which was recommended by the AAP in 1994. After  the recommendation for newborn’s sleep position was changed from prone (tummy) to supine (back) the incidence of SIDS in the U.S. showed a sharp decline (more than 50%) over the first 10 year period. Unfortunately, the overall SIDS rate has plateaued since that time, and SIDS is still the leading cause of infant mortality in the U.S. 

A study in the April 2012 issue of the journal Pediatrics looked at risk factors for SIDS. Parents need to know that greatest risk for SIDS is during the first 12 months of life (the so named “Critical” development period). There are also both intrinsic and extrinsic risk factors for SIDS as well. All of these factors contribute to the vulnerability for SIDS. 

The peak incidence for SIDS is still between 2-4 months of a baby’s life. (postnatal age). The intrinsic risk factors for SIDS include, male gender, prematurity, genetic differences (now being found called polymorphisms) and a child’s prenatal exposure to cigarettes and/or alcohol. Extrinsic risk factors include tummy or side sleep position, bed sharing, over bundling, soft bedding and a child’s face being covered.  In this study 99% of SIDS infants had at least 1 risk factor, and 57% had at least 2 extrinsic and 1 intrinsic risk factors. Only 5% of the SIDS victims studied had no extrinsic risk. I think this is important for all parents to know! 

So what can parent’s do to lower the risk of SIDS for their baby?  Well, while you cannot change the peak incidence of SIDS between 2-4 months of a baby’s life there is a lot you can do! 

Looking at intrinsic factors:  gender is a 50-50 deal and seeing that I have 3 sons, I don’t know a lot about gender selection, so will not even touch that topic. But, you can prevent prenatal cigarette and alcohol exposure, and every pregnant mother (and father due to second had smoke issues) should eliminate smoking. That sounds easy enough. 

Prematurity may be lessened when a mother is healthy prior to her pregnancy and continues to do as much as possible during her pregnancy to ensure a full term birth. Basically maintaining a healthy diet, getting good prenatal care and listening to your doctor will help to prevent many pre-term births. 

Extrinsic factors are the easiest to change. While prone sleep positioning is a large risk factor for SIDS, there is now evidence that some other risks may appear in conjunction with sleep position.  Putting a baby on their side where they may roll to their tummies may be one issue.  Leaving soft objects or blanket in the crib may be another. Bed sharing is also not advised. 

So, the so-called “triple risk factors” for SIDS may be important information in providing risk reduction strategies for parents and caregivers. Any change that may lessen the risk of SIDS is meaningful and beneficial and will help new parents sleep a bit better as well!  I also did not see any mention of video cameras in the room as a reduction in risk, just saying..... 

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

Daily Dose

Big Breasts in a Newborn?

Why do some newborn babies have large breasts? Should parents worry?I recently saw a new baby for their 2 week old check up.  During this visit there are many questions about what is “normal” and what is “abnormal”, as new parents are just finding out the nuances of their baby.

While all babies are different, there are many similarities among a newborn. One of the most commonly asked questions is “why does my baby look like they have breasts?”  This is even a more common question when the infant is a baby boy. Many parent’s will notice that their baby seems to have swelling under their nipples, sometimes it is both nipples at other times it may be asymmetrical.  There should not be any redness and the area should not be tender.  If you are feeling the area you may note a small moveable mass beneath the nipple.  All of this is very normal and the benign breast enlargement is due to maternal hormones that influences the baby’s breast tissue. At times parents may even report that they have noticed a milky substance coming from the baby’s nipple.  This is called galactorrhea, and the neonatal milk is also known as witch’s milk.  Galactorrhea is seen in about 5% of newborns and occurs in both sexes. The term “witch’s milk” is derived from ancient folklore where the milk was thought to be nourishment for witches spirits.  (I guess we’ve come a long way in our medical knowledge). Infant’s who seem to have galactorrhea seem to have more breast enlargement, and is also seen more often in babies who are breastfed. In most cases the breast enlargement resolves spontaneously within several months.  No treatment is necessary and I tell parents not to press on the baby’s breast tissue.  If you manipulate the breast tissue it may actually force bacteria into the milk glands. If the breast tissue gets infected an infant may develop mastitis, just like a nursing mother.  I actually saw a baby earlier this year who had developed a breast infection that actually had to be drained and required IV antibiotics and a short hospitalization. I am happy to say that baby is perfectly well, the breast enlargement has resolved and he will never know that he had “baby boobs” in the first month of his life!!!  Some things are better kept as secrets. That’s your daily dose for today. We’ll chat again tomorrow. Send your comment or question to Dr. Sue!

Daily Dose

Teething and Fevers

1:15 to read

Does teething cause a fever?  Ask many parents and they will say yes… but a recent study in the journal Pediatrics says no.  Researchers looked at signs and symptoms associated with primary tooth eruption in 3500 healthy children ages 35 months and under.  For most children the first tooth appears around 6 months, but don’t be overly concerned if your child does not cut their first tooth until later, there is still a lot of variability.

In this study 71% of children had some signs or symptoms related to teething including gum irritation, drooling and irritability.   Although about 25% of those studied reported “fever”, the rise in temperature was actually less than the level of 100.4 degrees, which is the definition of fever. About 20% of those studied also reported diarrhea.

The study also showed that the peak of signs and symptoms during teething were reported when the incisors (front teeth) erupted and that symptoms seemed to decrease with age. ( interesting as well, as I wonder if parents were just less focused on teething as their child gets older?).

While many parents will bring their child in to my office complaining that they are teething and have a temperature of 102 degrees, the two issues are not related. I had always been taught that teething does not cause a fever…so this study only serves as further confirmation.  Babies and toddlers are getting many viral infections during the same time that they are “teething” and their illness is the reason for the fever. This means that a child with a fever over 100.4 cannot go to daycare or school, despite the fact that parents want to send them with a note stating, “they are just teething”. 

I continue to tell many parents that their “irritable” toddler is probably just in a bad mood and “being a toddler” rather than attributing their temperament to cutting a tooth.  Once your child is older you begin to realize that teeth come ( and go) and many times you don’t even know it until your child drops to the floor throwing a tantrum and you see those molars have broken through the gums.  The same about sleep issues, as your child will cut teeth when they are 5, 7, 10 years of age and don’t complain that they can’t sleep or have hourly sleep awakenings.  A toddler that has sleep awakenings is more likely to be dreaming than teething, and is not “in pain”.

So when your child wakes up with a fever, don’t be attributing the fever to teething - something else is going on and that is usually yet another viral illness. 

Daily Dose

All About Naps

1.00 to read

Just how many naps should your baby be taking and how long? When you are an adult, there is nothing better than taking a nap. Shouldn’t it be the same for children?  I get lots of questions from parents who ask when their children should take naps; how many times a day they should be napping and when do children stop napping?

Many new parents expect their newborn infants to take regular naps throughout the day (and then to sleep all night) even when they are only 4-10 weeks old. Unfortunately, a newborn’s sleep cycle is not ready for 2 hour naps in both the morning and afternoon followed by a 10 -12 hour extended sleep at night. But, by the time your child is 6-9 months of age (and sooner for some great sleepers); they should be on a good schedule with a morning and afternoon nap.  Naps are usually anywhere from 45 min – 2.5 hours.  I think naps serve a dual purpose, as they provide rest and rejuvenation for both child and parent. Nap time, just like bedtime should be scheduled, typically mid morning and mid afternoon and a child should be able to put themselves to sleep after a book or a story. Naptime routines can be bit shorter than the bedtime routine. You will be able to tell when your child is ready for a nap as they may rub their eyes, or get fussy, or some may just lay their heads down or point to bed as they know they are tired. By the time a toddler is somewhere between 12months – 2 years of age they will usually drop a morning nap and continue to have their midafternoon nap. This is usually right after lunch. Transitioning from 2 naps to 1 nap a day is a little “dicey” at first, as your child may get quite cranky in the morning as you drop that nap, while at the same time their afternoon nap may become longer. This adjustment period usually only lasts several days to a week and then you will find that they are back on a good nap/nighttime schedule. I get asked about stopping a child’s nap. I think naps are important (and as we adults know a privilege) for children until they are in elementary school. Most kindergartens continue to have “rest” time after lunch and many children will fall asleep for 20-30 min while the teacher reads them a book or music is played and the children lay on their mats. Even if your 4 – 5 year old child doesn’t “want” to nap in the afternoon, they need to have quiet time.  This may be for an hour or so in the afternoon, and is time for them to lay in their bed and read, color, play with dolls etc.  I do not think is the time for video games, or computer time etc. Many a child will fall asleep once they are in bed reading and will continue to take a good nap, they just didn’t know that they needed it! Moms, Dads, babysitters etc all need this quiet time too, to get much needed work done around the house, or dinner started etc. It was just a rule at our house that naps didn’t stop until you were in “big boy” school.  A quiet house for an hour each afternoon seemed to make the rest of the day and evening a happier time for everyone! That’s your daily dose for today. We’ll chat again tomorrow.


Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.



Just how much sleep does your child need?

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.


Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.