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Daily Dose

Why Is Your Baby Not Sleeping?

1.15 to read

I recently received an email from a mother who was beginning to have new sleep problems with her 6 month old. Whenever I get questions about a 6-9 month old and new sleep issues, most parents relate the problem to either teething and or not getting enough cereal/solids before bed time. 

In fact, new sleep issues often arise around this age as your baby is beginning to think and use those frontal lobes. Many babies had been sleeping for 6-10 hours a night by now and then suddenly begin to awake and they are crying.  This must be pain from teething, right?  So in response to that, many parents start giving their baby a pain reliever, such as acetaminophen nightly, but the sleep problems do not go away and still no teeth! 

At the same time, most babies are eating solid foods beginning around 6 months, and parents were convinced that starting solids would also cure the sleeping issues.  The baby is eating cereal and  waking up in the middle of the night. What gives? 

I think the most important milestone for this age baby to ensure good sleep:  the baby must put themselves to sleep. Many of the babies who are having awakenings are being rocked to sleep, or having the pacifier put back in their mouth all night long.  They are routinely rocked every night and then put down, so when they have arousals (as we all do all night long) they want to be rocked back to sleep, they are smart now and know what they want!   Similar to wanting a back rub every time you wake up, sounds good right? 

While all of this is going on in your baby’s mind your parent mind is telling you it has to be teething pain or lack of food or something worse, and not just a new phase of baby sleep!  Suddenly habits are started, the baby is getting fed in the middle of the night again, or you are giving acetaminophen every night, and typically the arousals continue.  

Sleep is precious for both baby and parent and a baby between 6-8 months of age should be able to not only put themselves to sleep at bedtime, but self console to go back to sleep in the middle of the night. Makes sense but takes a bit of work. This usually requires letting your baby cry for awhile. I am not a propionate of letting an infant cry it out or (CIO as this cute mom emailed), but I do see the need in this age baby. They have to learn to self-console and it is easier to break a bad habit sooner than later. Some babies have more stamina too, so each baby is going to be different in how long they can CIO. 

Practice putting the baby down awake and going back into the room to let them know you are present but not active in getting them to sleep.  Lengthen the time between each visit to their room. Repetition and consistency are the key.  It takes a while but most babies will then get back into even better and longer sleep at night, and you can stop all of that acetaminophen. They get teeth forever (well, at least for 12 years) and that is usually not the reason for waking up. Ask them when they are 5 and getting molars and sleeping well! 

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 raw....it 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. 

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Daily Dose

Colic & Your Baby

1.15 to read

I had a chance to visit with my middle son (he lives out of town) and the discussion about who was the most “difficult” baby in our family came up once again. I still cringe thinking back about the first 6 months of my now 25 year olds life. He struggled with COLIC!

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 a physician, 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 and just 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….

Daily Dose

Your Baby's Toenails

1:15 to read

I have noticed over the years, that babies are born with the weirdest toenails.  I get a lot of phone calls, pictures and questions during those first few visits about these little toenails.  Just like everything else, they are just “immature” and often are totally flimsy or at times appear to be “ingrown” as they grow and push a bit of skin away.

In most cases I tell patients to just leave them alone, even is they are a bit irritated and red on the edge. That is unless the toe is warm to the touch, or tender or has an obvious infection with drainage. Typically when you push on the toe the even though it may appear a bit irritated and bothersome to you, it should not bother your child or seem to cause them pain.  They should NEVER have a fever due to the toenail issue and if your infant has a temperature above 100.4 you do need to call your doctor.

While a baby’s fingernails seem to grow overnight (and are really sharp), newborns toenails grow at a snails pace. It sometimes seems babies don’t really even have all of their toenails until they are over 1 year and in most cases by then you have stopped paying attention as your child is walking, falling and has a lot of bumps and bruises so the toenails are no longer an issue.

If your baby’s toenails look irritated, clean them with a little soap and warm water and leave them alone!

 

Daily Dose

Baby Nursery or High-Tech Hideaway?

1.30 to read

My goodness, there really is a baby boom this summer! I have been seeing so many new babies and I am suddenly realizing that a new baby’s home nursery is “fancier” than an intensive care unit!  I can hardly keep up with all of the technology that new parents are talking about. They are asking me questions about setting up heart rate monitors, pulse oximeters and respiratory rate monitors - all for their precious new babies, none of whom have any underlying problems. These are just new parents with a lot of technology at their disposal.  

What did a parent do before all of this “uber” technology?  Ask your own parents- they just listened for the baby to cry. Incredible, huh?  No monitor or video monitor, just a crib in the nursery (which was typically close the parents room) and when the baby cried you went to check on them.  The market for newborn monitoring has gone through the roof and I am sure there is more to come. Of course every parent wants the very best for their baby, but is all of this really necessary?  Are you being overprotective?

In my opinion having the nursery as wired as an ICU is really causing parents even more anxiety as they are constantly looking to see what their baby is doing. They are technology addicts and cannot stop themselves.  Check the oxygen monitor, look at the video monitor, listen for breathing?   A newborn must feel some “invasion of privacy” as their every breath, movement and squeak is monitored,  I only wish some parents with misbehaving teens were this connected.

Every new parent is fearful of SIDS, that has been true for many years, and will always be a concern for parents.  Unfortunately, studies have shown that the best protection against SIDS is not a video monitor or a pad under your newborn to detect respiratory rate, if it was wouldn’t doctors be recommending this?  We would all be selling you a monitor. The best protection is simply back sleeping on a flat surface without blankets, pillows or toys in the crib.  

SIDS is typically a silent event and can occur even when the baby is in the room with you, or has a video monitor on them.  Being an anxious parent does not cause or prevent SIDS.  But, being able to enjoy your newborn is important. Not being able to leave the nursery to go to the kitchen, or even to leave the house without a video monitor streaming pictures of your baby just doesn’t seem healthy.  

So, I would save the money on the ICU nursery.  Buy a simple monitor so that you can hear your baby cry if you are in another area of the house, or in the yard with your other children, and put the money saved in the college fund!

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 surgery...in 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 alone...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 normal...it 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.

Your Baby

Fisher-Price Recalls Infant Cradle Swings

1:30

Fisher-Price is recalling three models of their cradle swings: CHM84 Soothing Savanna Cradle 'n Swing, CMR40 Sweet Surroundings Cradle 'n Swing, and CMR43 Sweet Surroundings Butterfly Friends Cradle 'n Swing.

The swings have two different swinging motions - rocking side-to-side, or swinging head-to-toe, and six different swing speeds from low to high. The product number is located on the seat under the pad. 

When the seat peg is not fully engaged the seat can fall unexpectedly, posing a risk of injury to the child.

Fisher-Price has received two reports of a seat peg coming out from the seat, causing the seat to fall. No injuries have been reported.

Consumers should immediately stop using the recalled cradle swing and contact Fisher-Price for revised assembly instructions.

The infant cradle swings were sold at buybuyBaby, Target and other stores nationwide and online at Amazon.com and other websites from November 2015 through March 2016 for about $170.

Consumers can contact Fisher-Price at 800-432-5437 from 9 a.m. to 6 p.m. ET Monday through Friday, or online at www.service.mattel.com and click on Recalls & Safety Alerts for more information. 

Source: http://www.cpsc.gov/en/Recalls/2016/Fisher-Price-Recalls-Infant-Cradle-Swings/#remedy

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 raw....it 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

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….

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