by Herschel Lessin MD
My first appointment of the day is a visit I enjoy immensely: the first well baby visit for a new mother and her newborn infant. At this visit, new mothers and very often new fathers, will have their first interaction with the Pediatrician. They usually come loaded with questions. After all, babies don’t come with an instruction manual. Despite the many books on the market that try to serve as one, there is nothing like a dose of reality to make the entire process seem nothing short of overwhelming.
EVERYONE IS AN EXPERT
If you’ve ever been pregnant or had children, you’ve undoubtedly noticed an odd phenomenon. People who normally wouldn’t even consider giving unsolicited advice about your personal life seem suddenly unable to suppress their desire to tell you all the secrets of delivering and raising a healthy and happy child.
Most of the advice is very good and will work very, very well. A lot of it, however, falls into the category of “Old Wives’ Tales”.
TO WHOM DO YOU TURN?
One does not have to be an old wife to pass along an old wives’ tale. In fact, a lot of what people call “common sense” is not really very sensible. As a parent, you must make decisions that affect your children’s lives, and yours as well. It is one of your many jobs as a parent to filter through the enormous amount of well meaning advice you receive and decide which of it is useful and effective.
Your Pediatrician ought to be of some help here. A large part of pediatric practice is the giving of advice that helps parents cope with the thousands of small day to day challenges that this new young person in their lives will bring. Your doctor should be ready, willing and able not only to dispense such advice, but to comment on advice given by others and found in the media (including the Internet). My job as the Pediatrician is to give you a convincing reason why my advice might be better than your mother’s.
OLD WIVES TALES ABOUT FOOD
The care and feeding of children is a fertile area for unsolicited advice. Feeding a child has an emotional impact that is often way out of proportion to the problems involved. This is easily understood, since if we can’t even feed our children, what kind of parents are we? The wonderful truth is that our kids seem to survive and thrive no matter how we try to feed them. Now I am not talking about families in which poverty prevents children from getting enough to eat. I am talking about middle class families where this is not an issue. Here are a few pieces of advice you ought to ignore:
If you don’t force a child to eat, he’ll starve. NOT TRUE.
Young children generally eat when they are hungry, rarely overeat, and refuse food only when it they honestly don’t want it, or if it upsets their parents enough to be fun. Never fight with a child over food. You will lose.
Early introduction of solids will make a young infant sleep through the night. NOT TRUE
Infants generally do not want or need solids prior to around 4 months of age. They will sleep through the night when they are good and ready. Giving them a few spoons of cereal at bedtime which contains perhaps 20 calories will not put them out for the night.
You shouldn’t give a child with a cold, milk because it causes phlegm.
Unless your child is one of the few that are actually allergic to milk, there is no truth to this one. If your child with a cold wants milk, give it to him. No harm done.
OLD WIVES TALES ABOUT FEVER
Fever and illness is another fertile area for bad advice.
“Feed a cold, starve a fever…” or is it “Starve a cold and feed a fever?” It really doesn’t matter, since both are wrong. Good nutrition is important to all children, especially sick ones. One should maintain the best nutrition possible, regardless of colds or fever. If a child has a stomach bug, some degree of dietary restriction is often suggested, but a quick return to good nutrition is always the goal.
A high fever is dangerous.
While the disease that causes the fever may indeed be dangerous, the fever itself is not. A fever in a child that is acting well is rarely a cause for alarm. The only exception to this is in the case of heat stroke, where the body’s sweating mechanism is not working. Then body temperature can rise to 107 or higher which is a danger all by itself. In the absence of heat stroke, the temperature will not rise more than 106, which while very scary, will not, in itself cause harm. A high fever can be an indication of a serious underlying illness, so high fevers should always be discussed with your Pediatrician.
Parents are constantly asking me if it is OK to give their feverish child a bath. It is OK. A lukewarm bath may help lower the temperature and may make the child look and feel better. So bathe away — it’s not a problem. Just don’t let the child get so cold as to shiver. That will raise his internal temperature and make him feel worse.
You must keep a head injured child awake. Not Always
If your child has a head injury that is severe enough to cause loss of consciousness, it is severe enough to seek immediate medical attention. If your child has a minor head injury, it is often normal to be sleepy, but not unconscious. Trying to keep such a sleepy child awake will only make him feel worse. One should check such a child frequently to make sure he is arousable, and always call your doctor for further instructions after any significant head injury.
OLD WIVES TALES THAN CAN CAUSE HARM
While most old wives tales cause only anxiety, a few can cause harm. The most common one is the advice to put something greasy like butter on a burn. This is dangerous. Grease will hold the heat inside the skin, deepening the burn and making it more severe. If your child is burned, the first thing to do is to get something cool, but not freezing, on it. This will reduce the heat and minimize the damage.
Poison ivy is dangerous if it involves the eyes.
Old wives’ tales also wrongly tell us that some very mild things are dangerous. Poison ivy on the face may cause swelling of the eyelids, but while this is very uncomfortable, it will cause no lasting harm. Oh, and by the way, poison ivy is caused by oil found on the plant. Once it is washed off, you cannot spread poison ivy by touching the affected areas.
Another worry is that one should not let a child cry because that will cause him harm or he’ll choke. This is not true. The only one harmed by prolonged crying is the parent listening to it.
There are few things in life as miserable to live through as the first 3 months of life with an infant who has colic. The old wives will tell you that there is something that you are doing to cause the colic or that there is a real medical problem. Once a good physical examination has ruled out organic illness, you should realize that not only is it NOT your fault, no one has any idea what causes colic. It is extremely common, and that there is very little anyone can do to make it better. It will, however, magically go away after the baby is 3 months old, if you live that long.
A FEW MORE PIECES OF QUESTIONABLE ADVICE
Over the years, I have heard of more complaints and illnesses attributed to teething than almost any other cause. Some facts about teething. First of all, it rarely is severe enough to wake a child up at night out of a sound sleep. If your child is up at night and has a cold, think ear infection, not teeth. Teething does NOT cause fever. It does not cause congestion or mucus and it does not cause diarrhea. It can make an awake child irritable and is best dealt with by either occasional use of rub on anesthetics or by giving a dose of acetaminophen by mouth.
Another thing new parents are often told is: “Don’t pick the baby up all the time, you’ll spoil him!” This is absolutely wrong. Young infants need to be picked up a lot in order to have normal psychological development. As they get older, they can be spoiled, but rarely by paying attention to their legitimate needs.
I am also amazed at how important it is for people to have their children be “regular.” Perhaps it’s the influence of all those laxative commercials. Being regular is of no importance to young children. Most children will find their own pattern and timing of bowel movements, from once a day to once a week for some infants. Going once a day is not special.
I’ll finish up with feet. I’ve never understood why so many grandparents feel that if you let a young infant stand up, he’ll get bow legs. He won’t. And believe it or not, buying an infant an expensive pair of shoes will not prevent flat feet. Aside from the fact that all infants have flat feet, this is rarely, if ever, a problem at any age as long as the foot is flexible. In any case, shoes make absolutely no difference.
Bringing a new baby into your lives is an exhilarating and exhausting experience. It can provoke a great deal of anxiety. I encourage new parents to seek out advice from any source of support that you can find. Just be sure that the advice is good advice, so you don’t fall victim to old wives’ tales.
Dr. Lessin has been practicing Pediatrician in the Hudson Valley since 1982. He is a founding partner and serves as both Medical Director and Director of Clinical Research at the Children’s Medical Group