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Daily Dose

Safe Sleep & Tummy Time

1.30 to read

I keep getting so many questions about “tummy time”   Ever since the American Academy of Pediatrics recommended that all infants sleep only on their backs (to reduce the chance of SIDS), parents forget or are afraid to put their baby’s on their tummies. Tummy time is important to help reduce the incidence of head flattening as well as to give your baby time to develop different muscle groups.   

Tummy time is encouraged from the first days after a baby’s birth, but so many parents ask, “just how much time?”  Tummy time does not mean “timed” in the sense that you do it for a certain amount of time or minutes a day.  Tummy time, is not rigid.....it is flexible.  Off and on throughout the day when your baby is awake, you let them experience tummy time.   

Just like so many activities with a newborn, sometimes tummy time is for only a minute or two before the baby starts to fuss or cry.  Other times an infant may enjoy their tummies for 10- 20 minutes before they are ready for a change.  

At other times you put the baby on their tummy, they settle down and then decide to fall asleep.  Keep in mind, you MUST turn them over, even if you are watching them. Remember, NO TUMMY sleeping until your child rolls over on their own. 

So, many parents come in during the first days to weeks after their baby’s birth with not only feeding charts, but “pee and poop” charts and graphs of tummy time down to the minutes.  It is really not necessary to graph the amount of tummy time your baby gets, just make sure you remember to do it.  

As your baby gets older, they typically enjoy their tummies for longer periods of time and are soon lifting their heads, supporting themselves with their shoulders and around 4 months will likely begin to roll from tummy to back. After that milestone it is not long before they start sitting alone and tummy time is old hat by then.  Your baby should also have a beautiful rounded head from getting tummy time from the start. 

Daily Dose

Moving From the Crib to a Bed!

1.30 to read

I am often asked, “when should I take my child out of their crib and put them in a bed?”  I really think that there are several reasons to transition a child from their crib to a “big boy or girl bed”.  

The first and foremost reason seems to be when your child is climbing out of their crib. I have had many a patient (and a few of my own children) who will attempt to climb out their cribs one time and then if seems as if they were frightened by the experience and that was the end of it. 

On the other hand there are some children who are adept climbers and they will routinely climb out of their cribs. In this case, due to safety concerns, I think it is necessary to put the child (typically a toddler 12 - 18 months), into their own beds. Now some of my patient’s parents have purchased a crib tent rather than even think about going to the “big bed”!  They don’t even want to discuss beds! 

I think another compelling reason to transition a child to a “big bed” is when you need the crib for the next baby. Call me frugal, but it seems crazy to purchase another crib when you really won’t need it for long. It is possible to put a 15 -18 month old to bed in their “big boy” bed and they will stay put! With that being said it is also possible that the child will decide they just want to get out of bed on their own, but this problem can occur at any age, and requires behavior modification. 

I remember putting our first born son in a twin sized bed that he helped “pick out” when he was not yet 2 as I was expecting another baby. We also let him pick out his sheets for the new bed (I think they had Big Bird on them) and he easily transitioned to the bed. But, when he turned 3 years old he decided he wanted to get out of bed and “rejoin” the parents and he was difficult to break of this habit! 

The last reason to transition to the “big bed” is when the child is either just too big for the crib (or breaks your back trying to get them in there), or when you as a parent are ready for the next step.  For most of my patients this occurs when their child is around 3 years old, and the crib goes away and the big boy/girl room starts.  

I do have patients that are over 4 years old and still in a crib, but that is the usually the exception. One cute mother comes to mind who has twin girls (her youngest). When I asked why they were still in their cribs she replied, “I just can’t find the right bedroom furniture” which made me laugh. We all have our reasons!  Those cute girls are now 6 and she finally found the “perfect” beds and they are happily tucked in each night.  

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

Daily Dose

Time Change Effect Your Kids?

1.15 to read

Did the time change and “falling back” allow you and extra hour of sleep or did your children awaken at their usual hour?  I expect that many parents were up an hour earlier than they wanted to be, the only difference being that it was light outside at 6:30 a.m.  

It is hard to explain to a toddler or pre-schooler that it is not really 7:00 a.m. any more! Their biological clocks awaken them, and they are ready for breakfast.  Children need routine bedtimes and typically awaken at around the same time everyday, at least until they are adolescents, when they want to sleep during the day and stay up half the night. 

Many children will have some difficulty adjusting to the time change and it may take several weeks to get back to a “normal” routine.  The key is to try and stay on the same schedule and let their “clocks” slowly re-adjust.  

Bedtime may be harder for a few days as well.  Since it will be getting darker earlier, some children will be worn out and cranky and it will only be 6:00 p.m.   You may need to have an earlier bath and story time for a while and put them to bed 30 minutes earlier than usual as well. 

Don’t despair, it doesn’t take that long before your child’s circadian rhythms will be on “standard time” and you won’t find yourself making pancakes an hour before you wanted to. 

For us adults, our brains have to adjust as well, we may be going to work in the morning light, but it will be really dark for the drive home.  I think bedtime may be a bit earlier for me for a week or two as well!

Your Baby

Half of U.S. Parents Using Unsafe Bedding for Infants

2:00

Parents are getting better about using loose bedding and leaving soft objects in their baby’s bed, but about half of U.S. infants are still sleeping with potentially hazardous bedding according to a new study.

Blankets, quilts and pillows can obstruct an infant’s airway and pose a suffocation risk according to the American Academy of Pediatrics (AAP).  This type of bedding is a recognized risk factor for sudden infant death syndrome (SIDS).

The researchers investigated bedding use from 1993 to 2010 from the National Infant Sleep Position study.

They found that from 1993 to 2010, bedding use declined, but remained a common practice. The rate of bedding use averaged nearly 86 percent in 1993-1995, and declined to 55 percent in 2008-2010. Prevalence was highest for infants of teen mothers (83.5 percent) and lowest for infants born at term (55.6 percent). Researchers also found that bedding use was highest among infants who were sleeping in adult beds, placed to sleep on their sides, or shared a sleep surface.

AAP recommends that the best place for a baby to sleep is in the same room as his or her parents and always in a crib, not in the same bed. The crib should be free from toys, soft bedding, blankets, and pillows.

Other safe sleep practices are:

•       Place your baby on a firm mattress, covered by a fitted sheet that meets current safety standards. For more about crib safety standards, visit the Consumer Product Safety Commission’s Web site at http://www.cpsc.gov.

•       Place the crib in an area that is always smoke-free.

•       Don’t place babies to sleep on adult beds, chairs, sofas, waterbeds, pillows, or cushions.

•       Toys and other soft bedding, including fluffy blankets, comforters, pillows, stuffed animals, bumper pads, and wedges should not be placed in the crib with the baby. Loose bedding, such as sheets and blankets, should not be used as these items can impair the infant’s ability to breathe if they are close to his face. Sleep clothing, such as sleepers, sleep sacks, and wearable blankets are better alternatives to blankets.

•       Place babies to sleep on their backs to reduce the risk of SIDS. Side sleeping is not as safe as back sleeping and is not advised. Babies sleep comfortably on their backs, and no special equipment or extra money is needed.

•       “Tummy time” is playtime when infants are awake and placed on their tummies while someone is watching them. Have tummy time to allow babies to develop normally.

•       Remove mobiles when your baby is able to sit up.

Study authors conclude that while the numbers have improved significantly, infants are still being put to bed in an unsafe sleeping environment; about half still sleep with blankets, quilts, pillows, and other hazardous items.

It’s not unusual that many parents may not be aware of the dangers of blankets, pillows and quilts in a baby’s bed. Lots of people were raised with all these items in the bed, but that was also before scientists began to understand SIDS better and the possible causes. True, many babies did fine before these alerts and safety suggestions became more popular but a lot of children also died – we just didn’t know why.  Parents today are able to access better infant safety information than their own parents.

The study, “Trends in Infant Bedding Use: National Infant Sleep Position Study 1993-2010” was published in the January issue of the journal Pediatrics.

Source: http://www.healthychildren.org/English/News/Pages/Study-Shows-One-Half-of-US-Infants-Sleep-in-Potentially-Hazardous-Bedding.aspx

Your Baby

Is Your Baby Safer Sleeping in a Box?

2:00

Is your baby safer sleeping in a box instead of a crib? Some parents think so and are ditching the traditional infant crib for a specially made cardboard box.

The Baby Box Co., is a Los-Angeles based business that is partnering with hospitals across the U.S. to give away free “baby boxes” to new parents.

The parents also receive a 15- minute educational video about safe sleeping habits for infants. Also included in the box are infant clothing, a mattress, a fitted sheet plus $150 worth of baby necessities.

While relatively novel in the U.S., the baby-box isn’t a new idea.  It’s modeled after a program in Finland that began more than 70 years ago. Baby boxes are aimed at curbing infant mortality rates by promoting safe sleeping practices for newborns.

New Jersey adopted the first statewide baby box program; distributing a total of 105,000 boxes. And now, Ohio has joined up, along with hospitals in Philadelphia and San Antonio, Texas.

Proponents of baby boxes say the combination of educational tools and free resources will bring America's infant mortality rate closer to those found in wealthy Nordic countries.

The goal of the Baby Box program is to bring the rate of children dying from Sudden Infant Death syndrome (SIDS) down. SIDS is usually attributed to sleep-related accidents such as strangulation, suffocation or entrapment. In 2015, the Center for Disease Control (CDC) reported about 3,700 infants died from SIDS.

The U.S. saw a drastic decline in its infant mortality rate since 1994, when the CDC launched its "Back to Sleep" campaign urging parents to have their infants sleep on their backs rather than stomachs, but disadvantaged groups still tend to be affected by SIDS more than others.

In Finland, Baby Boxes have had a dramatic impact on infant mortality since the program was launched in 1949. In the 1930s, the country's infant mortality rate was 65 deaths per 1,000 infants. Beginning in 1949, that number has shrunk to 3.5 deaths per 1,000 births— a decrease that's credited in part to baby boxes. Comparatively, the United States had an infant mortality rate of about 5.8 deaths per 1,000 births in 2016.

One University of Chicago study found that primarily lower socioeconomic groups drive the higher infant mortality rate in the U.S. after the mother and child leave the hospital. Contributing factors may include health coverage insurance and the mother’s amount of education.

What else can be done to curb infant mortality rates?

Some experts argue that policies geared toward enhanced post neonatal care for mothers of low socioeconomic status would be most effective in combating the U.S. infant mortality rate.

Universal home nurse visits, available in a number of European countries such as Finland and Austria, are one option. A provision of the Affordable Care Act offers money for a number of similar programs, such as the Nurse Family Partnership founded in 1977 in New York.

The program, which sought to rein in infant deaths in the U.S., provides low-income, first-time mothers with registered nurses who visit their homes to provide assistance and child health education for mothers.

According to the Baby Box Co. website, Baby Boxes are not only available through some hospitals, but also direct to consumer.

Story source: Avalon Zoppo, http://www.nbcnews.com/news/us-news/hospitals-u-s-give-away-free-baby-boxes-curb-infant-n732421

http://www.babyboxco.com

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DR SUE'S DAILY DOSE

Baby bling is cute, BUT....

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