‘infants’

All Articles tagged ‘infants’

Why Broad Spectrum Sunscreen?

I’ve written about sunscreen before (Protecting Children From The Sun, 10 Tips on Tanning, & the video on Protecting Infants included below). More important and than any granular, scientific detail about a sunscreen ingredient, UVA/UVB radiation, or it’s vehicle– a spray or a lotion or an ointment–is how you use it. The best sunscreen is the one that is used early and often on children. No sunscreen is waterproof and no sunscreen is play proof. For infants and toddlers, I’ve found the best trick for easy application is to put it on while they are strapped into the car seat on your way to the beach! There’s no controversy that it’s best to apply sunscreen 20 minutes before sun exposure and repeat the application head to toe every 1-2 hours during active play/swim.

Don’t be fooled– sunscreens marketed for children may not provide any increased safety or protection. You’ll see and hear conflicting reports on ingredient safety, particularly as differing groups discuss concerns about chemical ingredients versus physical/mineral ingredients. Trouble is, groups now warn about the physical/mineral ingredients (previously felt to be the safest) due to their particle size. And although the FDA warns against using spray sunscreen with children (concerns about inhalation of the fumes) most families love the convenience. Here’s a comprehensive, current review on ingredients & safety.

Good thing is, most everyone agrees that the ingredients in sunscreen are less risky than any significant sun exposure or burn in childhood.

The video above explains the need for broad spectrum protection. You’ll need to look for a sunscreen that has 2 or 3 ingredients to cover all the range of UVA and UVB rays that damage our skin. Here’s the American Academy of Dermatology’s tips.

A Little Science About UVA/UVB Light & Sunscreen:

  • UVA radiation causes Aging and deeper skin damage. To protect against the entire spectrum of UVA rays, you’ll likely need two ingredients in the sunscreen–most commonly you will see oxybenzone or avobenzone coupled with another (zinc oxide, titanium dioxide, for example) to cover the entire UVA spectrum of light. Although some people report concerns about oxybenzone’s irritation to sensitive skin, recent research finds when it’s only at typical 1-6% concentrations, skin reactions are unlikely. If using a sunscreen for the first time, apply a small patch of sunscreen to your child’s leg as a test before using it elsewhere. UVA radiation is constant throughout the year, regardless of season or heat index. Read full post »

5 Ways To Avoid Cavities And Still Feel Like A Celebrity

Dental caries (cavities) are preventable for most children. To keep those pearly whites pearly it takes being thoughtful about eating habits, brushing habits, drinking habits, and being knowledgeable about your child’s water supply. Although physicians are making robots to perform surgery and putting tiny cameras in our bodies to explore the inside, we may sometimes lose sight of easy, affordable ways to improve the lives of millions. Maybe we simply retreat from those prevention efforts…or maybe it’s something else.

The CDC reported this spring that for the first time in 40 years, preschoolers have more cavities than they did 5 years ago. And many children have so many cavities that they show up at the dentist with double-digit numbers requiring general anesthesia for repair. In one month alone, I’ve done a number of pre-op visits for dental anesthesia for patients in my clinic.

Many national headlines have covered this data over the last few months. And I would suggest there is one thing to stress here. Part of this increase in cavities may be a cultural issue, a parent-culture issue. That is, many parents may not be brushing their children’s teeth because of push-back from their children and a goal to maintain harmony at home. And many parents believe bottled water is safer than that from the tap. When it comes to teeth, that isn’t the case.

Sometimes we really have to act like adults and do the flossing.

I think this bump in cavity numbers is a parenting issue more than anything else. Read full post »

How Do Doctors Screen For Autism?

Pediatricians, nurse practioners, and family doctors start screening your baby or toddler for signs of developmental or communication challenges like autism from the very first visit. As a pediatrician, how your baby responds to you (and to me) during the various visits during infancy and toddlerhood guide me in their screening. In the office I get to observe how a baby giggles, how they look to their parents for reassurance, how they try to regain their mom’s attention during our conversation, how they point or wave, how they respond to their name, and even how and why they cry when I’m around. Those observations in combination with family history, health exams, and parental perspectives remain extremely valuable for me in helping identify children at risk for autism.

However, more formalized screening is recommended at both the 18 month and 24 month well child check. In most offices, clinicians use the M-CHAT, a 23-point questionare parents fill out. Often, I have to help parents answer one question in particular, (“Does your child make unusual finger movements by their face”) but other than that, most families find it easy to fill out. Using this standardized screening, pediatricians can pick up children at risk for autism and will be prompted to start conversations about language delay, concerns about behavior, or possible next steps for a toddler at risk with additional genetic, neurologic, or developmental testing.

It’s important to note that screening isn’t diagnosing. If your child has a positive screen for autism, it doesn’t mean they will be diagnosed on the spectrum. And further, if your child screens normally but you continue to worry about autism, don’t be shy. Read full post »

Baby’s First Shots: Swaddling And Shushing

The 2 month-old check up may be harder for parents than it is for babies. Getting the first set of shots is anxiety provoking for we moms and dads; no question that it’s unsettling to allow a medical provider to cause our beautiful, new, healthy baby pain. Research has found that the pain and discomfort associated with shots is one of the primary reasons parents “elect not to perform timely vaccination.”

A study published this week affirms two truths. First, structured soothing may be a great tool for families to control crying after discomfort from shots. A group of pediatricians in Virginia used Dr Harvey Karp’s Happiest Baby on the Block 5S’s technique (shushing, swaddling, side positioning, sucking, and swinging/swaying) as an intervention for crying after the 2 and 4 month shots. The technique has been advertised to parents as a way to soothe and comfort fussy and colicky babies in the first few months of life. The researchers found that compared to a control group with no intervention and  a group of babies that received a sugary solution for comfort prior to the shots, the 5S technique helped soothe crying and pain more rapidly. Most babies that were swaddled, shushed, swung, and offered a pacifier for sucking stopped crying within only 45 seconds. Second, the great reality is that most babies stop crying within 1 to 2 minutes of getting injections anyway. The study confirmed that, too! In my experience, only rarely does a baby leave clinic still crying. Some of our anxiety about the discomfort as parents can be relieved–we really need to get the word out this is a short process. It’s rare for a baby to cry for even 3 to 4 minutes after their injections. Read full post »

Cocoon A Newborn, Only An Email Away

This week, Washington State declared that whooping cough (pertussis) has reached epidemic levels. Since the beginning of the year, we’ve had more than 600 documented cases in the state, a dramatic increase since last year. The increase puts our new babies at risk.

In clinic I’ve been urging new parents to cocoon their babies. That is, provide a family of protection by having every single child & adult immunized against whooping cough, influenza, and other vaccine preventable illnesses. By surrounding a baby with only immunized people, you cocoon them against serious infections.

Whooping cough is a highly infectious respiratory illness spread by sneezing and coughing that can be deadly to young infants. Getting a Tdap shot is the best way to avoid getting whooping cough. Amidst an epidemic, we worry most about newborns because they are most vulnerable to complications and lack vaccine-protection. If every child and adult that surrounds a newborn gets a Tdap shot, the likelihood of the baby getting whooping cough approaches zero.

Most newborns get whooping cough from their family or adults around them. That’s where an email comes to play.

You’re going to have to be fairly Mama-Papa-Bear about this. You’ll have to show some strength to create a very safe home, even when it feels somewhat over-the-top. As I said to a number of families in clinic today, “It only seems entirely over-the-top-nuts until we lose another newborn to pertussis.” Being smart now will save lives.

Make a new rule: no visits with a newborn until all visitors have had the Tdap shot. Even Grandparents.

Write an email to family and friends to explain.

A sample email for you to use/copy/share –written today by a friend of mine–mother to that darling baby girl born last week: Read full post »

Reading A Growth Chart: Mama Doc 101

Parents, pediatricians, and nurses have been using growth charts since the late 1970’s to track growth in their infants and children. The charts were revised back in the year 2000 as the data for the first charts (from a small study in Ohio) that didn’t accurately reflect the cultural and ethnic diversity of our communities.

The hallmark of a well child check is the review of a child’s growth. Growth can be a reflection of a child’s overall health, nutrition, and/or tolerance of possible underlying medical conditions. So understanding what your doctor or nurse practitioner says about your child’s growth should be a priority.

Watch the video to learn more about interpreting growth charts.

If your doc doesn’t have a computer in the room, ask to see the chart (on paper) or on a computer in their office. It will not only inform you, I suspect it will delight you to see what your child has done since the last time they have been seen.

The human body really is a fine-tuned machine and growth is simply astounding if you really stop to think of it.

If you have a challenge understanding how your child is growing or how the growth chart is presented, demand clarification. It’s okay if you don’t understand the presentation of facts on these grids; have confidence to speak up and ask for the doctor or nurse practitioner to explain it.

Revisions to the growth charts in 2000

Understanding growth charts

Pacifiers: A Love Affair Worth Having?

Pacifiers, a love affair worth having? It’s up to you, of course. Pacifiers are hotly debated among some parents, some pediatricians, some lactation consultants, and some dentists. I say some, as I believe not all clinicians have strong impressions/judgments. That’s because pacifiers don’t cause excessive harm. Yet most parents agree on one thing: they all have an opinion about what to do with one. Some hate them, others adore them. Just like babies. Silicon pacifiers can be all the rage, or none of it…

At our house, we had a love affair with a pacifier. Twice. Without even trying. And it all happened by accident.

Although the American Academy of Pediatrics and National Institute of Child Health and Human Development recommend using a pacifier at night to decrease the risk of SIDS, if your infant doesn’t like one, you certainly DON’T need to force it upon your content baby. Don’t over-think or over-value the pacifier, either.

With F (our first born), I waited, held off, and withheld the pacifier hoping to improve my changes of successful breastfeeding. We had a few sleepless weeks (with the fussing and crying normal for a newborn) until a couple weeks of age when we realize it really was the “plug” he was looking for. F’s crankiness improved, and we had another tool to help support him when holding, rocking, feeding, changing diapers, or swaddling didn’t soothe him entirely. The pacifier was just something he loved.

With O (our second), I didn’t get the choice. While in the NICU, the nurses used the pacifier to “quiet” him down. I asked that they didn’t, but when I returned to feed him, there it was again, in his mouth. And he was in love. So we continued to use it and I didn’t take it from him. As I’ve written before, I loved to see him enjoy and indulge with that pacifier. I mean, he really craved and adored the time he got with it (mostly during sleep or in the car). Weaning him from it was harder on me, it turns out. And I faltered a couple of weeks after the wean during a moment of weakness…

We used pacifiers in our homes until both the boys were just under 2 years of age. And like I said, it really was a love a affair.

The reason is simple, babies soothe by sucking and pacifiers are a perfect tool. My advice on pacifiers: follow your instincts. You’ll be able to find studies both that support use and studies that dissuade use to back up either decision. So don’t over-think this. And stop beating yourself up for using one if you are…

Mama Doc’s Cliff Notes On Pacifiers:

  1. These are things you already know: Wash the pacifier regularly (dishwasher safe are easiest) in warm soapy water, get rid of old pacifiers that show cracking or damage, and use a one-piece silicone design if possible. Don’t dip the pacifier in anything (ie sugar water, honey, etc) ever. And never tie the pacifier around your baby/toddler’s neck.
  2. As your child grows, the pacifier should, too. Don’t let toddlers have infant sized pacifiers due to choking risk. Smaller pacifiers may rest more on their front teeth as well and cause more malocclusion or “bucking” of teeth. Get the correct size pacifier if your older toddler or preschooler still uses one.
  3. When your child approaches 6 months of age, consider weaning. If neither of you are interested in breaking up with pacifier, try again at 2 years of age. By 3 years, get it out of the house or the love affair will cause a most terrible break-up.

Additional Safety Tips on Using Pacifiers:

Mayo Clinic’s Do’s & Don’ts on Pacifiers

Review article about dental problems caused by pacifiers after age 3.

Satisfying your baby’s needs: Pacifiers

What Does TV Do To My Kid’s Brain?

If you want to understand more about the effects of television on the brain, you need to watch this TEDx talk by Dr Dimitri Christakis…the science around television and its effect on children and concentration astound me. Not because any of it is counter-intuitive, but because television is as powerful as it is. Television is a [large] part of most children’s lives here in the US and this presentation of fact and observations may change what you do at home. Although it seems like there is no controversy here, last week I stumbled upon one mom proclaiming the benefits for TV at bedtime from infancy up.

We gotta get the word out.

A few take-aways on media and early learning:

  • Early experiences condition the mind. Connections between brain cells change based on experiences our children have while their brain triples in size between birth and age 3.
  • Initiation of television viewing is now (on average) 4 months of age.
  • Prolonged exposure to rapid image changes (like on a TV show designed for an infant) during critical periods of brain development may precondition the mind to expect high levels of stimulation. This may then make the pace of real life less able to sustain our children’s attention. The more hours a child views rapid-fire television, the more likely they will have attention challenges later in life.
  • Cognitive stimulation (reading books or going to a museum) reduces the likelihood for attention challenges later in life.
  • What content your child watches on TV matters: the more frenetic or violent the TV show, the more likely your child will have attention challenges later in life. Television shows that move at a typical pace may be far better for our children.
  • New studies (using mice) may demonstrate that learning suffers with excess TV viewing.
  • We need more real time play for children. (Get out the blocks or get outside!)

I’d suggest the 15 minutes or so it takes to view this video might profoundly change your thinking about TV. Direct from the mouth of a father, pediatrician, and researcher, Dr. Dimitri Christakis explains how the brain develops, what television may do, and theorizes why ample time in front of the TV as an infant and/or toddler may reorganize how a children thinks and solves problems. More than anything, watching this made me want to reverse time and go back to do even more for my little boys and their developing brains. If only the daily museum trip was plausible…

Enjoy, leave any comments or questions, and I’ll wrangle up Dr. Christakis for specific answers, as needed.

What Is A Foreskin? Mama Doc 101

Caring for your son’s foreskin is pretty much a hands-off job. But knowing what is normal and how your son’s foreskin develops and changes over time is essential for every parent to a boy with an uncircumcised penis.

In the beginning, during infancy, your son’s uncircumcised penis needs no special care. The foreskin is a piece of skin overlying the outside of your son’s penis. You never need to pull the foreskin back or detach it in any way. You clean it just like any other skin surface on his body.

Over the first 5 + years of your son’s life, the foreskin will gradually “retract” or pull away from the head of his penis. This happens without intervention as the connective tissue bonding the foreskin to the head of his penis dissolves on its own. As this happens, you can teach your son to wash the end of his penis with soap and water and rinse it well. Some boys will be able to fully retract or pull back their foreskin by the time they start Kindergarten while others may not fully retract it until puberty. Both are okay. Read full post »

How Much Salt Is Okay? Seattle Mama Doc 101


I’m a salt-fiend. I really really love it. I’d choose a pickle over a piece of cake any day. Problem is, I’m realizing my palate for the salt lick out ba