Infant

All Articles in the Category ‘Infant’

Zika Virus And Pregnant Moms

mosquitoIt’s January, 2016. News stories have inspired significant anxiety about Zika virus. It’s a scary topic because news about the outbreaks are just unfolding and this affects an already anxious group, PREGNANT mamas and expecting families. I want to share with you real time information and data to try to alleviate anxiety and educate the best I can. I suspect with time some of this will change. I’ve curated the most common questions and answers directly from the Centers for Disease Control (CDC) below. The most alarming information coming from these outbreaks are the effects of Zika on pregnant women and their babies. First things first, Zika virus will only affect an unborn baby who is exposed to Zika in utero if mom is infected WHILE she is pregnant. Meaning, women not pregnant who get Zika can have Zika virus, clear the virus from her bloodstream (typically about 1 week after illness resolves) and not transmit Zika to future babies. If you are pregnant, there is no question it makes sense to think carefully about travel. That babymoon just can’t be the priority if it will put you at risk. Zika is potentially dangerous to a baby during any trimester or pregnancy or at the time of delivery.

Zika virus is unusual in a couple ways: only 20% of people who get it know it — meaning most people infected won’t develop any symptoms. Secondly, we don’t have a vaccine and we don’t yet have an anti-viral to protect pregnant moms and their babies from side effects. So, unlike infections caused by influenza and polio, or rubella or mumps, we have to change our social determinants of health — basically pregnant moms have to take precautions with where they go and how they expose themselves. I’ve found this CDC Q/A extremely helpful.

What Is Zika Virus Disease?

CDC: “Zika is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week.”

Like mosquitoes all over the world, the mosquitoes that carry the virus and spread it to people breed in open ponds/pools of water. The ones that carry Zika tend to bite and infect primates and humans during the day. These little buggers can get the virus from an infected person and then bite another person and transmit it during outbreaks.

What Are The Symptoms Of Zika?

CDC: “About one in five people infected with Zika will get sick — symptoms from being ill. For people who get sick, the illness is usually mild. For this reason, many people might not realize they have been infected. The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin 2 to 7 days after being bitten by an infected mosquito.”

Remember, 80% of people who get Zika won’t have any symptoms. So heading off to a country with an outbreak and coming home feeling fine doesn’t ensure you haven’t been exposed. This is key in protecting those at risk. We can’t make a lot of assumptions of who has it and who doesn’t.

How Is Zika Transmitted?

CDC: “Zika is primarily transmitted through the bite of infected Aedes mosquitoes. Aedes mosquitoes, which spread the virus, live in every Western hemisphere country but Canada and Chile. It can also be transmitted from a pregnant mother to her baby during pregnancy or around the time of birth. We do not know how often Zika is transmitted from mother to baby during pregnancy or around the time of birth.”

Research will likely evolve through these outbreaks. What we know is that unborn babies are at most risk for serious complications. They are dependent on their moms making great decisions during pregnancy. Holy moly, it’s always a lot of pressure but this sure is another one for us to bear.

More on who is at risk, what to do if you’re planning a trip to Mexico for a babymoon, and ways to prevent getting Zika:

Read full post »

Ban Baby Crib Bumpers

bumpersI cleaned out the closet for houseguests last week and discovered an old bumper. Instead of giving it away I am literally cutting up the fabric for crafts and putting the rest in the garbage. A no-brainer savvy parenting tip: baby crib bumpers are dangerous. Don’t use them, don’t even give them to charity, don’t pass them on to friends. Let’s get them out of circulation, outsmart the marketers, protect these little babies.

Smart parents just don’t use crib bumpers. More data out this past month to prove it.

Crib bumpers are soft bedding that can pose risk of suffocation, entrapment, strangulation, or additional risks from causing a baby to be wedged into an unsafe position. It may seem like they protect babies, but there is no evidence they prevent serious injury in infants. Choosing a crib can be an exciting nesting activity, here’s tips for doing it with smarts.

Banning bumpers feels to many like an inconvenient truth. Perceived risk is low and they are so darn cute. But with all the time we spend as parents spend doing everything we can to protect our babies this is an easy opt-out. Forget spending time worrying about organic baby food and what brand of stroller of you want and just get rid of your bumper. Or better yet, don’t buy one in the first place. Let’s get them off baby registry lists, out of marketing and advertising and most importantly OUT of baby’s crib. Read full post »

What To Do If Your Child Is Drowning: Infants & Toddlers

6-1 baby in waterWarm weather is here and summer is approaching and if mother nature is kind, we’ll have plenty of sun-filled days over the next few months to spend by the pool or at the beach. Unfortunately, this is also the time of year when drownings increase. Young children are especially high-risk because of their profound curiosity around water and lack of awareness of danger.

Drownings are preventable deaths but even the thought of them spooks most of us. Often, a drowning event looks, sounds, and appears unlike we’d expect. I’ve written before about the silent danger of drowning, but rather than reiterate the warnings of how to prevent drowning, this year I wanted to find out what you should do if you realize your child is actually drowning. Put a couple thoughts and tools in your hands to know WHAT to do if faced with an emergency.

I tapped Dr. Linda Quan, an emergency attending physician and drowning expert at Seattle Children’s for information on what to do if you come upon a infant/toddler, school-age child or teenager is drowning. Preparing for this can help boost awareness and response if ever you support or discover an infant or young toddler in need for rescue. Read full post »

Peanuts During Infancy To Prevent Food Allergy

Photo from Edwart Visser Flickr Creative CommonsThere’s new data out to support stronger recommendations for introducing peanuts during infancy. Like hemlines, it may seem like this data keeps changing. As time, the science and our understanding of risk unfolds we’ve seen shifts in advice about starting solids that have left many parents wondering what really is best when starting foods and wanting to decrease risk for food allergy.

Briefly, and in general, it’s best to start a variety of foods for your child during infancy, starting around 4 to 6 months of age. In fact its now believed that it may be protective to introduce things like wheat, egg, soy, fish, and peanuts even before a child takes their first step around a year of age. The 2013 recommendations (that exclude information about peanuts) are explained in this post, “When Should I start Baby Food?”

The recommendation to share diverse foods during infancy that includes fish and eggs may feel new to you. For example, when my babies were born (mid-2000’s) advice and consensus suggested that avoidance of peanuts until after a year of age was best — the thought that avoidance of peanut during critical development may be protective against severe allergy development. Now, concomitant with a doubling in food allergies, we face an utter and potentially embarrassing reality — perhaps medical advice and our work to improve allergy risk by restricting foods in  infancy did just the opposite. Perhaps avoidance was exactly the wrong thing to do. Maybe we’ve engineered part of the problem.

This kind of advice can feel intense when raising children. “Do this, don’t do that, do this now, don’t do this now!” Doing the right thing is what we all want but doing right can remain elusive, especially when recommendations shift. I remember a fellow pediatrician questioning my eating a peanut butter sandwich while I was pregnant with my second son. She couldn’t believe I’d made that choice. At the time I remember not only feeling judged but a little terrified too. Perhaps I’d not take the data seriously enough? Oh goodness, I thought, as I diligently didn’t introduce “high allergy” foods until toddlerhood for my boys. Today I realize that wasn’t all that right either. It can feel like another hemline change for sure and yikes these sure are shorter skirts!

Fast forward 7 years to 2015. A New England Journal of Medicine study out this past month systematically evaluated risk for development of peanut allergy in children who were at higher risk for developing the allergy in the first place. And they started with infancy and introduced peanuts early in some of the babies. Researchers found if infants were introduced to peanuts early in life (between 4 and 11 months of age) their risk of peanut allergy at age 5 years significantly decreased.

The early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among children at high risk for this allergy.  ~ New England Journal Of Medicine

Read full post »

The Inconvenience Of Prepackaged Baby Food

dv2159103Feeding a toddler is hard work because of all sorts of normal shifts that happen after the first birthday. But new data out this past month (see below) reminds us how pre-packaged baby food isn’t the best food source, despite package claims. Whole food, the food your family eats, and the fresh stuff is the way to go.

Infant hunger matches their rapid growth; we’re used to our babies ravenous and near consistent basis from day one yet as infancy progresses feedings space out and form meals. By a year of age most children go 4 hours or more between eating. Toddlerhood is a completely different story; growth slows after a year of age and toddlers start to test limits in profound ways. Food is no exception. It can be tempting to reach for whatever’s convenient that you know your kid will eat (fish crackers, anyone?) but in the long run making good nutritional choices for whole food regularly will exceed the nutritional detriments of pre-packaged “toddler” food.  In fact, a new policy statement released by the AAP this month is urging parents (and schools, daycares etc.) to take a “whole diet” approach to kids’ nutrition, namely focusing on a mix of foods from the five food groups and avoiding highly processed foods. Read more about the policy here from my friend Dr Claire McCarthy. These “fresh is best” ideas aren’t new to you I suspect but the data about food being marketed to us (and our children) is: Read full post »

What To Know About Baby Teeth

Image courtesy: American Dental Association

Image courtesy: American Dental Association

Things have changed over the past couple of years regarding how to care for baby teeth. Official recommendations for fluoridated toothpaste begin with the very first sighting of the very first tooth. This is news to many.

What we do early in our child’s life can have lasting consequences. Some quick reminders for new parents, grandparents and anyone out there lucky enough to be hanging out with an infant. Keep their mouth delicious!

5 Things Every Parent Needs To Know About Baby Teeth

  1. Use fluoridated toothpaste at tooth eruption. The minute those baby teeth come in consider it the start of the lifelong brushing habit for your baby. Brushing and rinsing the teeth after breastfeeding or formula, solid meals or snacks will always be recommended.  In minimum, build brushing into everyday, ideally morning and night, with a tiny amount of fluoridated child toothpaste (see image above). This may be most important after the last evening feeding.
  2. Tap water! Brush with tap water twice a day and provide tap water for your infants and children when serving water. After you brush teeth DON’T RINSE with water. Let the tiny amount of fluoride from the brushing sit on the teeth as long as possible to prevent decay.
  3. Use the right amount of toothpaste (image above). This provides protection from bacteria and acid but also avoids concern for too much toothpaste.
    1. < 3 years of age – rice sized smear of toothpaste on the brush.
    2. > 3 years (including adults) pea sized amount of toothpaste is all you need on your brush once you know how to spit.
    3. Don’t rinse after brushing.
  4. Timing: Most infants and toddlers, preschoolers and young children can brush their teeth and tongue in about 1 minute — goal really is to brush at the gumline on all sides of each tooth, paying special attention to back teeth, molars, and lower teeth where bacteria love to reside. For older children, teens and adults the rule of thumb is typically 2 minutes of brush time to brush teeth, tongue and rid mouth of dragon breath!
  5. Bacteria: Baby teeth enamel is thinner than adult (secondary) teeth so the mix of sugar and bacteria in the mouth must be deterred. We unfortunately transfer oral bacteria to babies when we share utensils, kiss them, clean their pacifiers with our mouths (don’t do it!), and drink from shared cups. If you have a history of lots of cavities the American Academy of Pediatrics’ new policy says, “Parents/caregivers, especially those with significant history of dental decay, should be cautioned to avoid sharing with their child items that have been in their own mouths.” I’m all for smooching babies so I say this: get to the dentist yourself to make sure your mouth is in tip-top shape to avoid some bad transfers…

Read full post »

Power Of A Kiss And Family Oral Health

Image courtesy: American Dental Association

Image courtesy: American Dental Association

Oral health doesn’t start and end with the dentist. Times are changing as the Washington Dental Service Foundation has trained 1,600 pediatricians and family physicians throughout the state on the importance of oral hygiene in young children. Pediatricians are now applying fluoride during well-child check-ups and counseling families more comprehensively on how to prevent dental decay while also referring to dentists for prevention and acute dental problems. Just last month I attended the 1-1/2 hour oral health training with a pediatric dentist. That learning coupled with a new policy statement from The American Academy of Pediatrics highlighting the importance of oral health inspired me to get the word out. I suspect we can all do a bit better protecting our children’s mouths. Recommendations for fluoridated toothpaste have recently changed (use it with the very first baby tooth!) as has knowledge and reminders about how we share our bacteria with our children. What we do for our mouth may have direct effects on our children’s.

The Most Common Chronic Childhood Disease

  • The facts about oral health in children are a little surprising. By their first birthday 8% of toddlers have cavities in their mouth and the Pediatrics policy detailed 24% 2-4 year-olds, 53% 6-8 year-olds and 56% 15 year-olds also have dental disease. Since oral health (even in babies and toddlers) is an integral part of overall health of children this is problematic. Dental disease has strong links between diabetes, respiratory infections and heart disease. The numbers for children with dental disease are high (!!) which makes dental disease the most common infection of childhood.
  • Good news is much of this disease can be prevented (or corrected) and because infants and young children see the pediatrician more frequently than the dentist, it’s becoming clear that pediatricians need to hone skills on oral health, the disease process, prevention and dentist interventions when necessary.

4 Things I Learned About Oral Health

Read full post »

Boring, Bare, Basic: Keep The Crib Safe

bare, boring,  basicWe’ve known for several years that a crowded bed and a decorated crib (pillows, quilts, stuffed animals, bumpers) can put babies at risk for sudden infant death syndrome (SIDS) and unintentional sleep-related suffocation. Boring, bare and basic beds are still best for babies. Tell every mother, father and grandparent to an infant you know. A Pediatrics study out today shows hazardous, soft bedding is still being used by as many as 50% of US parents despite years of public health messages urging the opposite. I see where these numbers come from– we parents love to dote on our babies. We instinctively provide warmth and coziness to our babies all day so images of abundant bedding at nighttime can look divine. Further, our families (mothers or mothers-in-law!), coworkers and neighbors may encourage soft bedding because of old habits; many feel warmer bedding is better. However when it comes to the crib, our instincts may deter us from providing the safest sleep. As friends, parents, relatives and co-workers we have to support new parents in creating a basic, boring, and bare crib. Our responsibility extends from our own home to the workplace and to our neighborhood — what we buy and hand-down for that baby showers matters! The study out today reminds us we have lots of work to do, especially as data finds some groups of parents may be at more risk for using the soft stuff…

Soft Bedding Increases Risk

Several studies around the world dating back to the 1990’s have found SIDS risk increases with soft, loose bedding. This includes blankets, pillows, stuffed animals, quilts and similar materials either covering/on top of or underneath the infant. Read more about risk modes for SIDS, and why I hate sleep positioners. What we know: data in the early 1990’s was so compelling that in 1996 the AAP began recommending that infants sleep in firm, stark bedding environments on their back. The great news is that parents took notice of the “back to sleep” campaign and there was a sharp decline in the use of bedding in the 1990’s. Between 200-2010 the progress slowed. More from the study about moms and babies at risk: Read full post »

Baby Talk: How Moms And Dads May Differ

baby talk photo edited

There may be a stereotype that women talk more than men; the language environment in which we’re raised, starting at day one, may have influence on this. Whether or not women are chattier than men is due largely in part to the context of the conversation. But a new study published in Pediatrics shows when it comes to parents talking to their babies, the term “Chatty Cathy” probably rings truer than “Chatty Carl.” And this has the potential to change the game with your child as they age. It’s well founded that the number of words your baby/child hears in the first few years of life has dramatic impact on their vocabulary, school success and education for a lifetime. Parent-talk has more impact on a child’s IQ and vocabulary than their education or socioeconomic status. Who we are as talkers really changes our babies’ lives.

Gender Differences In “Baby-Talk” And “Parent-Talk”

The Pediatrics study out this week evaluated the intersection of both baby-talk (comparing preterm and term baby boys and girls vocalizations for 16 hours at a time) and parent-talk (comparing Moms’ to Dads’ vocalizations to their infants) at birth, at about a month of age (based on original due date), and at 7 months of age. More than 1500 hours of recordings (derived from little devices worn on babies’ vests) were analyzed to compare family language interactions. Babies in families with a Mom and Dad at home were included (no same-sex couples). About ½ of the babies were late preemies (note: 1/4 of all the babies studied had a stay in the NICU) and 1/3 of families were raising children in a bilingual home. I found three key takeaways: Read full post »

Perhaps Not Intuitive? Car Seat Use From Day One

car seatNew data presented at the recent American Academy of Pediatrics meeting found 93% of parents to newborns incorrectly positioned and buckled their infants into their car seat on their first trip home. A little more proof that perfectly buckling a car seat isn’t an innate early-parenting skill! Even Prince George’s royal family didn’t get it right. I’m certain I didn’t do this perfectly either on our maiden voyage home (I remember using a zip-in blanket in the seat) nearly 8 years ago. As The Car Seat Lady reminds, “products that have a layer that goes under the baby’s body can make the baby unsafe. This is true even if the product is designed with slots for the harness straps to fit through.” Most of us clearly mess this up and although the first trip is just one trip, it may be emblematic of our everyday use.

Car seats and booster seats are important for child safety; our habits for their use begin the moment we leave the hospital or birthing center. Although those “bucket” infant car seats are safest (we’d all be safer in the car facing the rear, and in a bucket) we move away from them when our infants are around 9-12 months of age. But do remember, with every graduation to a new seat, you decrease protection. For example, when you move from a a rear-facing infant seat —> rear-facing carseat—>forward-facing carseat—>booster seat—>seat belt—>front seat at age 13,  each time you advance the child safety seat, you’re decreasing protection you provide. Don’t rush the transition! Keep your child rear-facing until at least age 2 years and in a booster until they are at least 4 foot 9 inches (57 inches) tall.

The No-Duh Importance Of Car Seats

  • Car crashes are the leading cause of death for children in the US. Creating safe habits from day one matters…don’t blow off importance of car seat safety as helicopter parenting. Using the child car seat well every time is an easy way to layer protection and channel your bursting baby love.
  • Infant car seats, rear-facing seats and boosters all hold equal import. Only two states require car or booster seats until age 8 (WA is not one of them) even though children should be in booster seats until they are both 4 foot 9 inches and between age 8 and 12 years.
  •  Car seats reduce risk of death by 71% for infants and 54% for toddlers if used properly: “Results of several studies have indicated that misused child safety seats may increase a child’s risk of serious injury in a crash.” (Page 9)

Read full post »