Can I Spoil My Newborn?

Written By Jennifer Shaer MD, FAAP, FABM, IBCL

Photo Courtesy – http://blog.kidsfunplaza.com/

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.

Quick Tips To Avoid Health Issues Associated With Winter

Written by Richard Lander, MD

Winter is here and as the song says, “baby it’s cold outside”. Here are a few quick tips to avoid some health issues commonly associated with winter.

First of all, make sure your children are dressed appropriately for the cold weather. That doesn’t just mean a warm coat or layering of clothes.

Since heat is lost from the top of our heads, have your child put on a hat on their head. Also, put a scarf or face mask and be sure to protect hands and fingers from getting wet and/or cold.

Gloves help protect the skin on  hands which tends to get dry.

When skin becomes too dry, your child’s hands may become cracked making the skin more susceptible to infection.

Be aware of frostbite. This is caused when the skin has become so cold that the circulation to the fingers is compromised.

The skin becomes pale or grayish in color and may blister. Next your child may lose feeling in her fingers. If your are worried that this has happened, place your child’s hands in warm water, about 104 degrees, which is average bath water.

Then carefully pat them dry and place them on dry warm cloths. If this happens to their nose, use warm, wet compresses initially,  but be careful not to rub and then use warm dry compresses.

Often playing outside in the cold weather leaves your child’s clothes wet. Take off the wet clothes as soon as they return inside, put on warm, dry clothes and drink warm liquids, such as soup, hot chocolate.

If you and your children are spending extended periods of time outside, remember to keep yourself hydrated; drink lots of fluids.

There are many outdoor activities to enjoy during the winter months, such as skiing, ice skating and sledding.

Make sure your equipment (skis, snowboards, blades on the ice skates or the runner of the sled) are in good condition and that your children have not outgrown them.

If they are taller this year you might need longer ski poles. Perhaps their feet have grown since last year and their ski boots or ice skates are too small.

Does their helmet still fit properly?

If the children are going to use a sled, make sure the the steering works and tell them to go down feet first, not head first.

Parents, when sending your children to the bus stop remember that it is dark and cold outside. Remind your children to stay on the sidewalk and look both ways before crossing the street.

A brightly colored scarf, hat or gloves is a great way to ensure that they are visible in the dark.

Winter is a fun time of the year. Be safe and be smart.

Dr. Lander has been practicing pediatrics for 32 years in New Jersey and is the immediate past chairman of the American Academy of Pediatrics Section on Administration and Practice Management.  He says if he had to do it all over again he wouldn’t hesitate to be a pediatrician

Top Ten Newborn Questions, and Answers

Written by Jenn Gruen MD

Photo Credit: http://www.newbornbloodspots.org

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.

You Think You Know A Lot, Then You Have Kids

I’ve seen this post in and around the Interwebs before. As far as I can tell, this was originally posted by an anonymous Mother in Austin, Texas. She describes the 26 things her children have taught her. Every time I read it, I giggle. Not only is it funny, I think it is brilliant. Only a parent can truly appreciate it.

Enjoy!

1. A king-sized waterbed holds enough water to fill a 2000 sq. ft. house 4 inches deep.
2. If you spray hair spray on dust bunnies and run over them with roller blades, they can ignite.
3. A 3-year old’s voice is louder than 200 adults in a crowded restaurant.
4. If you hook a dog leash over a ceiling fan, the motor is not strong enough to rotate a 42 pound boy wearing Batman underwear and a Superman cape. It is strong enough, however, if tied to a paint can, to spread paint on all four walls of a 20 x 20 ft. room.
5. You should not throw baseballs up when the ceiling fan is on.
6. When using a ceiling fan as a bat, you have to throw the ball up a few times before you get a hit.
7. A ceiling fan can hit a baseball a long way. (a wiffle ball still does enough damage)
8. The glass in windows (even double-pane) doesn’t stop a baseball hit by a ceiling fan.
9. When you hear the toilet flush and the words “uh oh,” it’s already too late.
10. Brake fluid mixed with Clorox makes smoke, and lots of it.
11. A six-year old can start a fire with a flint rock even though 36-year-old man says they can only do it in the movies.
12. Certain Lego’s will pass through the digestive tract of a 4-year old.
13. Play Dough and microwave should not be used in the same sentence.
14. Super glue is forever.
15. No matter how much Jell-O you put in a swimming pool you still can’t walk on water.
16. Pool filters do not like Jell-O.
17. VCR’s do not eject PB&J sandwiches even though TV commercials show they do.
18. Garbage bags do not make good parachutes.
19. Marbles in gas tanks make lots of noise when driving.
20. You probably do not want to know what that odor is.
21. Always look in the oven before you turn it on. Plastic toys and ovens are a bad combination.
22. The fire department has a 5-minute response time.
23. The spin cycle on the washing machine does not make earthworms dizzy.
24. It will, however, make cats dizzy.
25. Cats throw up twice their body weight when dizzy. (Very True)
26. The mind of a 6-year old is wonderful. First grade…true story.

P.S. 25.6% of the men who read this will try mixing the Clorox and brake fluid

Is Finding a Pediatrician Like Buying a New Car?

Written By Nelson Branco M.D., FAAP

Several weeks ago, a posting on The Huffington Post by Meredith Lopez titled “An Open Letter to Pediatricians” generated lots of commentary and discussion among pediatricians.  Ms. Lopez described her experiences with her son’s (former) pediatrician, who was apparently not available to answer her phone calls in the middle of the night or on a holiday, and was unable to diagnose and cure her son’s diaper rash despite several visits. When I read Ms. Lopez’s blog post, I see a relationship between a mother and pediatrician that just isn’t working because they aren’t communicating.As a practicing pediatrician, I know that not every visit leads to a definitive diagnosis and cure.  I also know that being available, professional, knowledgeable and compassionate are just as important as how quickly I can come to the correct diagnosis and recommended treatments. Communication is at the heart of all that we do in medicine.  If you can’t listen effectively and let the patient or parent know that they have been listened to, you have not really taken care of them.

I’ve practiced in cities, suburbs and rural areas.  Many times, patients, family and friends ask “Should I go into the city for this?”  For me, that city has been Boston, Providence, Albuquerque, Denver, San Francisco and Phoenix.   Which city doesn’t matter – what drives them is the desire to get their care from “the best” for whatever problem they are having.  My answer to them is always the same – the best doctor for your problem is the one you can communicate with, the one who is available to answer your questions and the one who makes you feel like they can take care of you and your problem.  Sometimes that person is right here in your own backyard, and sometimes that person is at the biggest hospital in the biggest city with the biggest reputation.  But you should do your homework to find out who that is, and part of that homework is calling your pediatrician.

Part of my job is to direct my patients to the right specialist.  In the days when HMO insurances were more popular, primary care doctors were the so-called ‘gatekeepers,’ and many patients felt that their doctor was trying to deny them access to specialists.  Now, with PPO and EPO insurance plans being the norm, primary care doctors are not necessarily involved in their patients decision to visit a specialist.  That isn’t good medicine or good care for your child.  My job as your primary care physician is to take care of all your problems – including getting help from a specialist when we need it.  I need to know where you are going for your care so that I can get information from the specialist, help you understand it and integrate it with any other issues or conditions you might have.  It’s also my responsibility to lead you in the right direction, and send you to the specialist who will help you get to the bottom of the problem.  Often, that means referring you to the person that fits your needs and personality; I know you and usually I know the specialists.  I may not be a professional matchmaker, but I usually have a good idea who you’ll work well with.

The other advantage to local care when it is appropriate is that it can be much easier to get.  All physicians know that a medication prescribed twice a day will be taken much more consistently than a medication prescribed three or four times a day.  So it is with visits, tests and follow up visits that you can do close to home.   What about when those specialists aren’t available close to home?  Or if there is only one choice for a particular specialty?  That’s the time when it’s most important to have me working alongside the specialist.  When there is only one Child Neurologist, they will be busy and won’t be able to see you frequently.  Then it becomes my job to communicate with them about questions, concerns or issues that may come up.

The bottom line is that it is important to pick the right pediatrician for you and your child.  Their personality, communication style, office setup and availability are all important.  Ask your friends, your family and co-workers.  Check the practice website, call the office and see if they are set up to do a prenatal or ‘meet and greet’ visit and meet with the doctor if you can.  Most pediatricians are kind, caring and dedicated – you’ll find the right one for you, if you look.

Dr. Branco is a practicing pediatrician in the San Francisco Bay Area and is very active with the local chapter of the AAP.