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Can I Spoil My Newborn?

Written By Jennifer Shaer MD, FAAP, FABM, IBCL

Parents of newborns often ask me if holding their baby too much will spoil him or her. The answer to this question is a resounding “No”.

Newborn babies are accustomed to being held 24/7. This was their existence during their entire gestation. Any amount of time that a newborn is not being held can be stressful. An infant does not need to learn and cannot learn to be independent immediately after birth. Newborns do not have the capacity to be lazy or manipulative at this stage.

The best way to comfort and care for a newborn is to imagine recreating the feeling of being in utero. If your baby falls asleep on your chest, enjoy it. Newborns regulate body temperature, heart rate and breathing best when lying chest to chest with mother or father.

Because of this, baby wearing has become popular of late and is a great way to nurture your baby hands free while taking care of yourself and even your other kids.

However, this does not mean that you need to be a slave to your baby. If you need to put your baby down and he cries, it will not harm him in the long run.

My advise is to follow your instincts. Hold your baby whenever you want to without the guilt that you are spoiling him.

Cherish this time. All too soon he will be grown up. On the other hand, do not fret if you have to or want to put him down to take care of something. Consider using a sling which will allow you to multitask.

As babies grow up, this advice changes. Older babies do benefit from learning how to self soothe. For now, enjoy those first few months. Forget the laundry, cooking, entertaining and other chores unless critically important. Spend this time bonding with your newborn and enjoy every moment while it lasts.

 

Dr. Shaer is a pediatrician and a board certified lactation consultant (IBCLC). She is director of the Breastfeeding Medicine Center of Allied Pediatrics of New York.

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Why Feeding Your Child With A Spoon Is Better For Her Development

Written by Jesse Hackell MD

messy face2

Growing up in the sixties, outer space was truly the final frontier. We greedily devoured all sorts of arcane facts about the nascent space program, from the rigors of pre-flight training to the seemingly more mundane details of how, exactly, one managed to eat and drink in the zero-gravity confines of outer space.

We knew that the astronauts drank Tang, which no self-respecting parent today would ever mistake for fresh-squeezed, locally sourced, organic and pesticide-free orange juice.

And astronaut foods were freeze-dried, and provided in pouches. When water was added to the pouches, the food was rehydrated and reconstituted, and the space explorers “ate” by sucking the resulting slurry out of the mouthpiece of the pouch.

Fast forward fifty years, and pouches aren’t just for astronauts any more. All sorts of fruits, vegetables and combinations thereof, in flavors which would certainly have thrilled early spacemen, are now seemingly the food deliver mechanism of choice for today’s on the move infants and toddlers.

No longer does feeding your baby on the go require a high chair, bib, bowl, spoon and yards of paper towels for clean-up.

Just pop off the top (don’t hand the top to the baby, although the caps are ingeniously designed to prevent choking should the little one happen to get hold of it and have it lodge in the airway), hand the pouch to your child, and–slurp–4 ounces of highest quality, organic produce goes down the hatch.

That’s progress, no? One prediction of the future made in the sixties actually coming true in the twenty-first century!

But I am not so sure that this new feeding mechanism actually represents progress for babies. They are born knowing how to suck nutrition out of a “container”–breast or bottle.

Progress in feeding, for an infant, comes not only in learning about new tastes and textures, but also in learning about new, more mature means of getting their comestibles out of the container and into their mouths.

These pouches (along with so called “sippy cups” with spouts) are really just bottles in disguise. (They are also a whole lot more expensive than either store-bought jars or homemade baby foods.) We do not generally recommend putting puréed foods in baby’s bottle, so why create a new bottle substitute?

Let me make a plea for a return to the older, admittedly messier, mealtime, with the baby sitting upright, wearing a bib, and being fed with a spoon. It will encourage the baby to learn new mouth movements and new positions for eating. And it will provide lots of opportunities for those adorable, messy face baby photographs!

Dr. Hackell is a founding member of Pomona Pediatrics PC, a division of Children’s and Women’s Physicians of Westchester. He practices in the lower Hudson River Valley just north of New York City.

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Will Having a Baby Stand Make Them Bow Legged?

Written by Kristen Stuppy MD. Dr. Stuppy is a practicing pediatrician in Kansas. She feels privileged to be able to help families keep their children healthy and she loves watching entire families grow!  Dr Stuppy is active on Facebook and puts a more personal touch to pediatric topics on her blog.

I am surprised how often I am asked if having a baby “stand” on a parent’s lap will make them bow legged or otherwise hurt them.

Old Wives Tales are ingrained in our societies and because they are shared by people we trust, they are often never questioned.

Allowing babies to stand causing problems is one of those tales. If an adult holds a baby under the arms and supports the trunk to allow the baby to bear weight on his legs it will not harm the baby.

Many babies love this position and will bounce on your leg. It allows them to be upright and see the room around them. Supported standing can help build strong trunk muscles.

Other fun activities that build strong muscles in infants:

Tummy time: Place baby on his tummy on a flat surface that is not too soft. Never leave baby here alone, but use this as a play time. Move brightly colored or noisy objects in front of baby’s head to encourage baby to look up at it. Older siblings love to lay on the floor and play with baby this way!

Lifting gently: When baby is able to grasp your fingers with both hands from a laying position, gently lift baby’s head and back off the surface. Baby will get stronger neck muscles by lifting his head. Be careful to not make sudden jerks and to not allow baby to fall back too fast.

Kicking: Place baby on his back with things to kick near his feet. Things that make a noise or light up when kicked make kicking fun! You can also give gentle resistance to baby’s kicks with your hand to build leg muscles.

Sitting: Allow baby to sit on your lap or the floor with less and less support from you. An easy safe position is with the parent on the floor with legs in a “V” and baby at the bottom of the “V”. When fairly stable you can put pillows behind baby and supervise independent sitting.

Chest to chest: From day one babies held upright against a parent’s chest will start to lift their heads briefly. The more this is done, the stronger the neck muscles get. This is a great cuddle activity too!

What were your favorite activities to help baby grow and develop strong muscles?

Such a simple, kind way to illustrate why we take the time to buckle-up

Post originally appeared on seattlemamadoc.com Written by Dr. Wendy Sue Swanson MD

When I first watched this video, the computer volume was off (I didn’t know it) and I thought this was a silent video. I loved the stillness of the quiet mixed with the emotion of the ad.

I cried (yes, I’m the kind of person who always does) one of those quiet cries, the kind where you’d never know I was crying unless you were looking straight into my eyes. Tears just dripped silently.

Instead of being impregnated with fear, this public service announcement is loaded with hope.

Isn’t it amazing how much people love you?

Dr. Swanson practicing pediatrician and the mother of two young boys.  She sees patients at The Everett Clinic in Mill Creek, Washington. She is also  on the medical staff at Seattle Children’s and am a Clinical Instructor in the Department of Pediatrics at the University of Washington. Dr. Swanson is passionate about improving the way media discusses pediatric health news and influences parents’ decisions when caring for their children.

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Child Proofing Your Home: 21 Tips

By Jennifer Gruen, MD

By the age of six months you need to think very seriously about protecting your children from the world around them, before they become mobile explorers.

The best approach to childproofing is to think in terms of multiple barriers.

The first barrier between a child and any danger is generally you, always watching out of the corner of your eye. But that doesn’t always work- particularly with the distractions of ordinary life such as phones, computers, and other children.

Unfortunately, we cannot avoid such distractions, but we can create additional barriers. For example, a second barrier is to keep the door to a dangerous room closed at all times, and maybe locked.

But sometimes that might be left open. So, a third barrier is to keep the dangerous stuff high in a cabinet. But sometimes an older child will be visiting and might climb up there and offer that forbidden substance to your child. So, a fourth barrier is to keep it locked.

Most protective measures you will be able to figure out for yourselves with a trip to the childproofing section of ToysRUs, Target, or children’s store. Here are a few tips to get you thinking:

1. Get down on your hands and knees and crawl thru your home- you will get a child’s eye view of what is easy to access.

2. Use the “toilet paper roll rule”- if it fits thru the tube, it can be choked on.

3. Put all dangerous items (medicines, cleaning agents, knives, small choking hazards) up high- and preferably in a locked cabinet (remember your child will one day climb!)

4. Beware of where you put what you are drinking. Coffee cups belong far out of reach of toddlers. Pots on the stove should have their handles turned inward. If you have a party, don’t leave your drinks around afterwards .

5. DO NOT USE WALKERS-they allow children to access dangerous areas such as stairs.

6. Sharp objects, especially little ones such as toothpicks, are dangerous. Keep them well hidden, preferably locked and at a height.

7. Electrical outlet covers are essential- I prefer the kind that require you to insert a plug in partway, then turn to access the holes of the outlet. Plastic plug-in protectors are often easily removed by an adept toddler.

8. Keep electrical appliances such as blow dryers and toasters unplugged when not in use.

9. Never leave a child unattended in a bath, even for a minute.

10. All children should learn to swim by the age of five to seven; we also have brochures for a terrific water safety program for children as young as infants in the office. The more barriers between a pool and your child the better- think safety covers, pool alarms, and multiple fences at least 5 feet high.

11.Turn down your water heater, if you can, to a maximum temperature of 120 to 130 degrees. At these temperatures accidental water burns will be much less severe.

12.All stairs need two sets of gates- at the top and bottom. Gates at the top of stairs must be bolted to the wall, and have vertical slats so that a child cannot easily climb them.

13. Cut window-blind cords, or use safety tassels and inner cord stops so children can’t get entangled.

14. Lock stove knobs- keep kids from igniting stove burners by using protective appliance knob covers.

15. Hide all cords (electrical, computer, phone.)

16. Don’t use bumpers in the crib, nor have blankets or toys in there. Once a child can sit up, lower the mattress down to the lowest level. Once a child can climb out of the crib, take the side off to create a toddler bed, or put a mattress on the floor. Put a gate in the doorway to prevent wandering toddlers at night.

17. Secure furniture (bookcases, chest of drawers) that can topple to the wall.

18.Avoid choking foods for infants and toddlers, and never let your child wander while eating. Worst offenders: hot dogs, whole grapes, popcorn, dried fruits such as raisins, small candies.

19. Help older children store small items and toys in labeled bins that are put out of reach of toddler siblings- if they have their own room, allow them to gate it off from their younger sibs.

20.Put stickers with the poison control # on all phones: 1-800-532-2222. If you fear your child has ingested a poison, or taken too much of a medication, call poison control rather than the pediatrician- PC is much better equipped to calculate whether there is a need to seek medical help. Never give a child ipecac or any other liquid after an ingestion without calling poison control first. If your child appears to be in distress (difficulty breathing, choking, trouble swallowing, drooling) FIRST CALL 911, then poison control.

21. LEARN CPR. We can arrange for individual classes with our certified CPR instructor, or help you find a class.

With all these necessary precautions, we still have to strike a balance and leave our children room to wander. One of the best places to do this is in a controlled area- try to make one central room a safe place to explore, and a location where you can safely deposit your child should you need to run to the bathroom, or answer a call.

Fill your bottom kitchen cabinets with pots, pans, Tupperware and other items that your child can discover and play with. Let your child have adequate floortime to explore in a safe environment (walkers and exer-saucers actually delay a child’s walking !)

Dr. Gruen opened her practice, Village Pediatrics, in 2009, but prefers spending time creating fantastic kids birthday parties.

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Top Ten Newborn Questions, and Answers

Written by Jenn Gruen MD

1. Does my baby have a cold?

Many, if not most, newborns have a congested nose and frequent sneezing for the first month or so. Unless you see mucus coming from the nose, it’s usually not a cold. Unless your baby has difficulty with feeding due to nasal congestion, you do not have to use the nasal bulb syringe. In fact, if you use it frequently, you may irritate the nose linings and make the congestion last longer.

2. What about my newborn’s peeling skin?

It looks so dry—should I use lotion? This is normal – most newborns “peel like a snake” and this requires no treatment. If there is some cracking or excessive irritation around the ankles or wrists, you can lubricate with a little Vaseline or diaper ointment.

3. Should I worry if my baby is breathing funny?

Well, yes and no. Normal newborn breathing can seem strange. Sometimes they will stop breathing for a second or two and then breathe very quickly for several seconds. Sometimes they sound funny because they snort due to a congested nose (see #1).

Sometimes they make a high-pitched whistle when they breathe in due to a flexible windpipe (tracheomalacia). However, if you see very fast breathing (more than 70 times a minute) that persists, or if the baby has to work very hard to breathe, or you have worries about his or her breathing, don’t hesitate to contact us.

4. What if there is oozing or blood when the cord falls off?

A bit of yellowish wet gunk at the site of the cord that dries over a few days is normal, as long as the skin around the base of the cord remains normal color (if it becomes increasingly red, call us immediately).

You do not need to use alcohol. A few drops of blood on the diaper as the cord is falling off is also normal. If it bleeds a whole lot (which almost never happens), apply pressure to stop the bleeding and call us.

5. How many bowel movements are normal?

Breastfed newborns generally have 3 or more bowel movements per 24 hours by day 3 or 4. Formula fed infants generally have at least 1 bowel movement per 24 hours. But some infants can have up to 20 per day and still be normal! And normal breastfed newborn stool is extremely loose.

In an adult, this would be called diarrhea, but it is normal for a newborn. Formula fed stool tends to be more pasty. Any color from bright yellow to green to brown is normal. By age 3 to 6 weeks, the frequency of stool decreases (even once a week for a breastfed infant at this age can be normal as long as it is soft and passes easily).

6. Is the discharge from my baby girl’s vagina normal?

Yes, it may be clear, white or bloody, and it is from withdrawal from the mother’s hormones. You don’t have to wipe it away, but you can if you want to (top to bottom).

7. Is it normal for my nipples to hurt (for breastfeeding mothers)?

It is normal in the first week to have pain for the first 1-2 seconds of latch on, but if you have pain in the nipples beyond the first second or two, ask us about it.

8. Can my baby see me?

Baby’s sharpest vision is the distance from the breast to the face. Babies recognize their mother’s faces within a short time after birth. They can identify their mother’s breastmilk smell immediately, and will recognize the voices (and soon the faces) of close family that they heard talking while in the womb, like fathers or siblings.

9. Is it normal that my baby lost weight after birth?

Yes, most babies lose weight after birth and this is normal. We will tell you if we are concerned that the weight loss is too much.

10. When should my next appointment be?

Usually 1-2 days after you leave the hospital, we would like to see you back in the office to check your baby’s weight, color, and heart.

If your baby has a fever more than 100.4 rectally (only take temperature if baby seems warmer than usual), is irritable, lethargic or not feeding well, call right away. If your baby seems yellow other than the eyes/gums/face (i.e. chest/abdomen/legs), call us during office hours. Also call during the day if your infant is not having normal stool (see #5).

Have your baby sleep on the back or side. Make sure that your car seat is correctly installed and used, call 1-866-SEATCHECK or go to seatcheck.org for a free car seat checkpoint near you.

CONGRATULATIONS! ENJOY YOUR BABY

Dr. Gruen opened her practice, Village Pediatrics, in 2009, but prefers spending time creating fantastic kids birthday parties.

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Why would a six-month old infant still need to be fed every four hours through the middle of the night?

Written by Jesse Hackell MD

Ah, yes, one of the most vexing new-parent questions, brought on by, yes, six months of interrupted sleep, daytime drowsiness and increasing irritability.

Why, indeed?

The answer is that it is usually a habit engendered in the infant, learned by the repeated feedings that he or she has received at all hours of the night. But how, and when, can this habit be broken?

Remember, first, that no one—not the parent, not the doctor not the grandmother—can determine when and how much a baby needs to eat.

Only the baby knows that for sure, based on the body’s need for growth and maintenance. And worst of all, those needs are not the same every day—a baby’s growth is not the same from day to day, nor is his energy expenditure.

But nature built in a wonderful system for appetite control—if given access to food throughout the day, an infant will eat what he needs, and then stop. Healthy babies do not starve themselves; neither do they overeat, unless they have been taught to do so by repeatedly being fed when they are not asking to be.

Think of a baby’s nutrition needs—for protein and calories, mainly– in terms of a 24 hour day.

Based on internal signals, the baby will require a certain amount of nutrients during each 24 hour period. If you feed the baby every four hours by the clock, the baby will essentially divide these needs into six portions, and eat one portion at each feeding time—which might well lead to one or more middle-of-the-night feedings.

But if the baby gets larger feedings during the daylight hours, her needs will have been met by bedtime, and there will not be the same signals prompting eating during the wee hours.

This will not occur instantly, however. In order to prompt the baby to eat more during the day, he needs to be hungrier than usual for those daytime feedings. So the first step should be to begin skipping the early morning feeding, and allowing the child to cry himself back to sleep. Then when he wakes a few hours later, he will be ravenous, and eat more than usual—which in turn will lead to a longer break before the next feed, a hungrier baby again, and greater intake through the day.

Then on the following night, secure in the knowledge that your child has taken more food than usual that day, the tired and sleep-deprived parent can be comfortable forgoing the nighttime feeding yet again. And with a small amount of manipulation, voila—your baby has given up the middle-of-the-night chowdowns.

Dr. Hackell is a founding member of Pomona Pediatrics PC, a division of Children’s and Women’s Physicians of Westchester. He practices in the lower Hudson River Valley just north of New York City.