Paediatric Disorders

The tale of the eight limbed girl

2007-12-20T22:46:00.000-08:00

Do you have this???

2007-11-08T07:56:00.000-08:00

Q Our 3-year-old son keeps coming into our bed at night. What can we do to stop this without making a big deal of it?

Health Visitor Dawn replies: As soon as your son arrives in your bed, gently take him straight back to his room and his own bed with as little talking as possible. If he needs a cuddle, calming down or reassuring then it's important that you give him this, but wait until you are back in his room before doing so. Let him know that it's time for him to go to sleep now and that his room is a nice place to be.

Do you have this problem???

2007-11-08T07:52:00.000-08:00

My 1-year-old daughter’s favourite new word is ‘no’. Every time I offer her something—even something I’m sure she really wants—she shakes her head and responds negatively. She also refuses to hold my hand. I’m finding this quite annoying and I fear we’re going to be constantly at loggerheads.

Therapist Lesley replies: Your daughter's becoming a toddler and saying no often is actually a normal and essential part of her development-even if it doesn't make life easy for you. For the first time, she's able to test limits, exert some power and have her own opinions, which is vital in helping her become her own person. It may seem strange when she rejects treats you know she'd really love, or a helping hand from you, but to her, saying ‘yes' can feel as if she's handing her power over to you. Try to respect her resistance rather than get into battles. A bit of tact will help you steer through most tricky situations, so try giving her choices rather than yes or no options. For example, ask ‘Do you want an apple or a banana?' rather than ‘Here's a banana', or say, ‘Walk or piggy back to bed?' rather than ‘Go to bed'.

Breast Feeding

2007-11-03T13:53:00.000-07:00

Breast-feeding

Nourishing your baby can be a daunting task for the first few weeks. Here's a guide to print out and keep at hand during feedings.

How to Breast-feed Your Baby

Breast-feeding may be natural, but that doesn't mean it always comes naturally. It often takes practice, so be patient and persistent -- it's worth the effort. In the first few days, your baby may not be too hungry, but she'll become more interested as her need for nourishment increases.

If you or your baby finds nursing difficult, seek advice from your healthcare provider or a lactation consultant.

Things to Know:

Nurse your newborn as soon as possible after birth, preferably within the first hour, and every time she shows signs of hunger thereafter. Watch for increased alertness, mouthing, nuzzling against the breast, or rooting (a reflex in which your baby opens her mouth and turns her head toward something that touches her cheek).

If you follow her cues, you'll probably be breast-feeding every two to three hours around the clock for the first four to six weeks. But do allow your baby to breast-feed more frequently if she wishes.

In the early weeks, if four hours have elapsed since the last feeding, you should rouse your infant by gently moving her arms and legs. If she doesn't awaken enough to nurse after a few minutes, stop and try again in half an hour.

Getting Started:

Settle into a comfortable position: sitting up or lying down, with baby angled across your breasts or alongside you. The baby's entire body should be facing you, not just her head. Use pillows as needed to support your arms, your back, and/or the baby. (Make sure no part of the pillow might impede baby's breathing.)

Ignore distractions and concentrate on the softness of your baby's face against your breasts. If your baby doesn't immediately suckle, you can usually trigger the rooting reflex by gently stroking her cheek with your finger or your nipple.

Help your baby to latch on to your breast correctly. Her mouth should encircle the entire nipple area (called the aureole), not just the nipple itself. Some babies take a while to learn how to do this, but it's essential, because incorrect latching-on quickly leads to sore nipples. Help her by placing your nipple in the center of her mouth, with as much of the as possible aureole within her lips. Press your breast down away from her nose, if necessary, to allow her plenty of breathing space.

Adjust your position and hers as necessary while she's feeding. The more relaxed you feel, the better the feeding will go.

Allow your baby about five minutes on each breast when you first begin. Over the course of the next few days build to ten to fifteen minutes per breast. This depends on your baby's appetite -- and each baby's needs are different. Don't force the issue -- you'll know if you're baby is getting enough nourishment by your pediatrician's weigh-ins and the number of wet diapers (about 5 to 8 per day during the first few days, 6 to 8 per day thereafter).

To break suction so you can switch breasts, simply slide your finger between her mouth and the nipple.

Unless your nipples are sore, it's okay to let her enjoy slowly sucking for as long as she likes.

After she's finished with each breast, burp her by patting gently on her back as you hold her against your shoulder or in some other comfortable position (some babies prefer a sitting up position on your lap). Put baby atop a clean cloth as you do this -- occasionally milk comes up with the burp. Be aware that she won't always burp audibly, but it's important to try to help her get rid of any gas.

NURSING BASICS
BREAST MILK AND SUPPLY
BREAST FEEDING AND PAIN

Breast Feeding and Pain

2007-11-03T13:51:00.000-07:00

Pain

Check your latch. I knew I had the latch down when there was no white tip or line across the nipple and it didn't hurt after a few seconds to nurse. The initial pain went away after a few weeks.

Frozen peas aren't just food. A bag of frozen peas [is] awesome as a cold compress for engorgement.

Cabbage combats soreness. Use cabbage leaves for soreness -- they are cooling and feel great! Just place individual cabbage leaves inside your bra (break them apart, wash, separate with paper towels, place in a big plastic bag, and keep them cold in the fridge.)

No biting allowed. The advice I got was to watch while the baby is latched on. If you watch, you can see when the latch is dropped and a bite is coming, so you can pull out before it happens. If you do get bitten, I've been saying "No bite!" and then not letting him back on for a minute so he associates that with not nursing.

Breast Milk and Supply

2007-11-03T13:47:00.000-07:00

Breast Milk and Supply

Breast Milk

Give it a swirl. Milk that has been stored in the refrigerator tends to separate and that is normal. So before you give it to your baby, give it a swirl. You'll see that it will come back together.

Don't worry about the consistency. If your milk is watery, you're extracting the foremilk. If it is thicker and whiter, it is the hind milk. You may also find that after your baby drinks your breast milk, the bottle has a residue. Don't worry -- it's the fat of the hind milk left in there.

Milk Supply

Moist heat encourages let down. I was stressed and worried I wouldn't let down. The worst thing for me was hearing everyone tell me to just relax. What helped was moist heat. I put a wet towel in the microwave for a short time. A shower worked as well.

Reading may help you relax. I found that reading or doing a crossword puzzle while pumping would really help. I guess it took my mind off getting enough milk, or pumping for a certain time. It sort of distracted me. Find something you like to do and if possible do it while pumping.
Pump while you nurse to boost output. One way to quickly pump is to pump the boob baby's not nursing on while she nurses on the other. That way, your let-down happens faster. I always had trouble alone, but got a great stash by nursing and pumping together.

Nursing Basics

2007-11-02T12:42:00.000-07:00

Nursing Basics

Got breastfeeding issues? Get advice from the experts -- moms who got it right. Paid pros, like lactation consultants, are great, but sometimes mom-to-mom tips ("this worked for me") are the ones that really click.

Avoid comparisons. I think the biggest mistake nursing mamas make (I did this too) is compare themselves to what other nursing mamas are doing. Each nursing relationship is unique. I expected my nursing experience to be like my sister's and we are worlds apart: she had too much milk, I had too little.

Trust yourself. Before you quit, give yourself time (6 to 8 weeks) to adjust to breastfeeding.

Keep well hydrated. Get a water bottle with a straw (my hospital gave me one), and keep it filled to the brim. You never know when you'll get thirsty, and it might not be a convenient time [like while you're nursing] to get more water.

Get a Boppy. I love my Boppy. I still use it for my 9-month-old. To me, it just makes it easier to have one hand free while you nurse.

Your pump can help with problems. If you have inverted nipples, I found that pumping a few minutes to draw them out helped.

Keep at it even if you have a cold. Your breast milk will [help] keep your child from catching your cold. I learned this from my midwife and after trying it during the winter months when I got sick. And even when my baby did get a cold, I found it was very short lasting.

If you need to, supplement. You can do both -- breast feed and formula feed. It doesn't have to be only breast milk, but every drop your child gets is beneficial.

Don't worry if your baby looks tiny. My doctor told me babies don't start looking chubby until they're into their 8th pound. It took us 6 weeks to get there.

Practice nursing in public. I feel uncomfortable about nursing in public, so my plan is to buy a nursing camisole to cover my tummy and practice in front of a mirror so that I know what people can and can't see. As for other people giving me unpleasant looks, I don't plan on looking up! I will just look lovingly at my daughter.

Diaper Check

The scoop on poop. My pediatrician said after one month, breastfed babies may go up to 10 days without a poop and that is normal. However, in the first month you should see dirty diapers more often. Obviously, they don't magically hit one month and start going longer stretches, but those are the general guidelines. My daughter is 3 months old and usually goes every day, but occasionally goes 36 hours and then has a massive blowout!

Seedy is good. If her poopy diaper [looks like it has] seeds in it, that's leftover hind milk that her body doesn't need. Be happy. Your baby is well fed.

Don't worry if the poop comes in different colors. When I called the pediatrician about my son's stool having different colors, I was told that anything in the yellow, brown, or green hues is not a problem.

How wet is wet? To tell if my daughter's diaper was wet enough, I used to pour 4 tablespoons of water into a clean diaper. That's how I was told I could tell what a wet diaper felt like.

Baby Bottle Toxic or Not?

2007-10-20T10:09:00.000-07:00

Your baby's bottles may not be as safe as they seem. According to a new report from the National Institute of Environmental Health Sciences, certain types of plastic bottles contain a potentially dangerous chemical called bisphenol A (BPA), which has been linked to a number of health conditions in animals, including early onset of puberty, increased diabetes risk, hyperactivity, and certain cancers. Freaked out a little? So were we. Because it can be downright scary and confusing to digest these health risks (especially amid conflicting statements from the plastics industry), we tapped expert researchers to understand the real deal. Here, answers to your major concerns:

Q. Why the sudden bad rap for bottles?

A. Here's what we know for sure: BPA is a hormone-disrupting chemical found in hard, clear plastic baby bottles; over time, it can seep into the containers and into your baby's milk. Here's what we don't know: "We haven't yet found definitive long-term health consequences in people," says Rebecca Roberts, PhD, an associate professor of biology at Ursinus College in Collegeville, Pennsylvania, who studies BPA. Yet there are enough tangible risks -- especially for young babies and children, because they're still developing -- to be concerned. "I'm a mom too, and I believe it's important to balance your lifestyle with what the science says," Roberts says. "I can't say that my kid lives a completely BPA-free life, but I can minimize her contact."

Q. How can I tell if the bottles we use contain BPA?

A. Flip them over, says Roberts. Often, polycarbonate plastics -- the ones that contain BPA -- are marked by the recycling symbols #7 or PC. But the absence of these marks is not a guarantee of safety -- if the bottle is hard and clear, check with the manufacturer to be sure.

Q. What can I do to reduce my baby's exposure?

A. Consider BPA-free alternatives, like glass or softer, cloudy-looking plastic bottles (check out our finds below). "And if you are using bottles made with BPA, try not to microwave them or put them in the dishwasher," says Roberts, since heat can break down the plastic and trigger the chemicals to leach more readily. Also, toss bottles when they start to look scratched -- another sign of plastic degrading. According to one recent report, BPA may leach after as few as 50 to100 washings.

Q. Are there any other sources of BPA that could affect my baby?

A. There is some evidence that BPA is found in the lining of metal cans, including ready-to-feed formula. "To lessen the risk, it's best to opt for powdered formula, which is usually not sold in metal cans," says Sonya Lunder, MPH, an analyst at the Environmental Working Group. In a paper separate from the NIEHS study, the Washington, D.C.-based nonprofit found detected some BPA in liquid formula packaged in steel cans from companies including Enfamil and Similac. (Even though powdered formula containers may look like they're metal, most are actually made from a very stiff paperboard material). But if you're not sure whether your container is safe, then hold a magnet up to it, says Lunder. "If it sticks, then the can is metal and you should try to avoid it."

Q. I'm pregnant. Should I be worried?

A. BPA isn't just a baby bottles issue, says Phillip Landrigan, MD, a Parents advisory board member and a professor of pediatrics and community and preventive medicine at Mount Sinai School of Medicine in New York. "The chemical can cross the placenta, so if you're exposed during pregnancy, there's a chance it can impact your developing fetus." The best ways to protect your health while you're expecting: Avoid heating and dishwashing food containers made from polycarbonate (flip the storage container and look for the recycling symbols #1, #2, or #5 instead -- all safer forms of plastic) and Nalgene water bottles. "Luckily, BPA is not everywhere," says Roberts. "And there are plastic alternatives that are totally fine for moms and babies to use."

Help for making sure baby gets better.

2007-10-19T00:16:00.000-07:00

Help for making sure baby gets better.

When you're giving medication to your baby, make sure to follow all of your doctor's directions as well as these additional safety tips:

Take the whole course of an antibiotic as prescribed, even if your child seems cured after a few days.
Don't reuse a prescription left over from a previous illness, even if you suspect it's another bout of the same sickness.
Measure medicine carefully -- even the difference of a mere milliliter can overdose a baby -- and use an appropriate dosing device rather than a kitchen spoon.
Don't call medicine "candy."
Don't forcibly squirt medicine down the back of your child's throat. A portion can get into the lungs, causing her to gag.
Call your doctor if the medicine doesn't seem to be working, your child's condition worsens, or you notice unexpected side effects.

Understanding Birth Defects

2007-10-06T16:16:00.000-07:00

Understanding Birth Defects

The vast majority of babies born in this country are healthy. But if your child is one of the 3 in 100 infants born with a congenital (acquired after conception) or hereditary birth defect, how can you ensure her long-term health?

While some defects are treatable with drugs or surgery, it's usually your family's efforts to create a positive environment for your child that help minimize the disability.

First Steps

The first thing you should do if your child is diagnosed with a birth defect is get a second (or more) opinion. Start with your pediatrician or obstetrician, who can refer you to appropriate specialists. In addition to appointments with specialists, you should also keep up with regularly scheduled well-baby visits, because many birth defect complications can be treated through early detection and intervention.
Here are some of the most common birth defects in the U.S. and the impact they may have on your baby and you.

9 BIRTH DEFECTS AND TREATMENTS

FRAGILE X SYNDROME
SPINA BIFIDA
DOWN SYNDROME
BABY CLEFT LIP
PKUPHENYLKETONURIA
CLUBFOOT
SICKLE CELL DISEASE
INFANT CONGENITAL HEART DEFECTS
UNDEVELOPED LIMBS

Fragile X Syndrome

2007-10-06T16:10:00.000-07:00

A Chromosomal Birth Defect

Prevalence:

Fragile X syndrome primarily affects males (1 in 1,500). Although 1 in 1,000 females is a carrier, only one in three shows outward signs of having the defect, including intellectual impairment. The range of retardation varies from mild to severe.

Symptoms:

The physical characteristics of Fragile X syndrome may include large ears, an elongated face, poor muscle tone, flat feet, large testicles, overcrowded teeth, cleft palate, heart problems, and autistic-like tendencies. Affected children may also suffer seizures.
However, many children with Fragile X syndrome appear to be physically normal at birth, so a diagnosis may not be made until the ages of 18 months and 2 years. At that time, a lack of language development coupled with other developmental delays usually prompts testing.

Treatment:

As with Down syndrome, children with Fragile X syndrome can be expected to do most things that any young child can do, although they also generally learn these things later than unaffected children. And, as with most of these birth defects, early-intervention programs begun in infancy can help maximize the child's development.

Down Syndrome

2007-10-06T16:06:00.000-07:00

Chromosomal Birth Defects

Two of the most common abnormalities, Down syndrome and Fragile X syndrome, are also frequent causes of mental retardation. Both can be diagnosed before birth. While neither defect is curable, early intervention allows a child to develop to his full potential.

Down Syndrome

Prevalence:

Though Down syndrome occurs in 1 in 800 births overall, the incidence is much higher in older mothers.

Symptoms:

A child with Down syndrome generally has characteristic physical features, including slanted eyes; small ears that fold over at the top; a small mouth, which makes the tongue appear larger; a small nose with a flattened nasal bridge; a short neck; and small hands with short fingers.
More than 50 percent of children with this defect have visual or hearing impairments. Ear infections, heart defects, and intestinal malformations are also common among children with this defect.

Though children with Down syndrome have some degree of mental retardation, most can be expected to do many of the same things that any young child can do -- including walking, talking, and being toilet trained -- although generally they learn how to do so later than unaffected children.

PKU(phenylketonuria)

2007-10-06T15:48:00.000-07:00

A Biochemical Birth Defect

Prevalence:

PKU (phenylketonuria) is an inherited metabolic disorder that occurs in 1 in 15,000 births (less commonly among African-Americans and people of Jewish descent).

Detection:

All babies in the U.S. are tested for the disease soon after birth.

Symptoms:

A child with PKU is missing a crucial enzyme that breaks down a protein called phenylalanine that is found in many goods. If PKU is left untreated, this protein can rise to high concentrations in the body and cause mental retardation.

Treatment:

Children born with PKU can live a normal life if put on a strict diet. Usually started before the fourth week of life, this diet is low in foods that contain phenylalanine, including breast milk and cow's milk. Instead, an affected child must be fed a special formula.
As the baby gets older, however, she can eat certain vegetables, fruits, and grain products but usually must avoid cheese, meat, fish, and eggs. Regular blood tests of phenylalanine levels can help determine what an affected child can and can't eat.

Sickle-Cell Disease

2007-10-05T17:55:00.000-07:00

Biochemical Birth Defects

Sometimes certain substances essential to a baby's proper body functioning are either abnormal or completely absent. Without intervention, deficiencies like the following can be devastating (and often even fatal) because they affect many bodily systems.
Sickle-Cell Disease

Prevalence:

Sickle-cell disease occurs in around 1 in 625 births, mostly affecting African-Americans and Hispanics of Caribbean ancestry.
Detection: Because of its prevalence, 30 states require that newborns be given the blood test that detects the disorder.

Symptoms:

The disease can cause debilitating bouts of pain and damage to vital organs and can sometimes be fatal. Sickle-cell disease affects the hemoglobin (a protein inside the red blood cells) in such a way that the cells become distorted: Instead of their normal, round shape, they look like bananas or sickles (hence the name).

These misformed cells then become trapped in and destroyed by the liver and spleen, resulting in anemia. In severe cases, an affected child may be pale, have shortness of breath, and tire easily. The episodes of pain, called crises, happen when the cells become stuck, blocking tiny blood vessels and cutting off the oxygen supply to various parts of the child's body.

Another complication of sickle-cell disease, noticeable mostly in infants and young children, is vulnerability to severe bacterial infections. Two weapons against this risk are immunization (the usual vaccines, as well as pneumonia and flu shots) and daily preventative penicillin treatments.

Treatment:

Although the disease can't be cured, a number of new therapies that reduce the severity and frequency of crises are being studied. Acupressure is very effective

baby Missing or Undeveloped Limbs

2007-10-05T17:51:00.000-07:00

An Anatomical Abnormality

Causes:

Unfortunately, the cause of this birth defect is largely unknown. Some experts believe that maternal exposure during pregnancy to a chemical or virus that only mildly affects the mother might be possible causes.

Treatment:

When a child is born with a limb anomaly, the doctor refers the parents to an orthopedic specialist and a physical therapist. The child is then fitted with a prosthesis (artificial body part) as soon as possible so that he becomes comfortable with it early on.
He will also undergo intensive physical therapy so that he learns to use the prosthesis much as other children learn to control their body parts.

Spina Bifida

2007-10-05T17:48:00.000-07:00

An Anatomical Abnormality

Prevalence:

Spina bifida occurs in about 1 in 2,000 births, most frequently among Caucasians of European extraction.

Causes:

It's caused by a malformation of a neural tube (the embryonic structure that develops into the brain and spine) that prevents the backbone from closing completely during fetal development. Some cases of neural-tube defects can be detected through tests given to the mother during pregnancy. When one is suspected, the baby usually is delivered by cesarean section so specialists can be on hand during and after the birth.

Symptoms:

Spina bifida ranges in severity from practically harmless to causing leg paralysis and bladder- and bowel-control problems.

Treatment:

In the most severe cases, the baby is operated on within 48 hours of birth (or in-utero through a new technique that is not yet widely available). Parents then learn how to exercise the baby's legs and feet to prepare her for walking with leg braces and crutches. Some children will eventually need to use a wheelchair. The child will also work with specialists in orthopedics and urology.

Baby Cleft Lip or Palate

2007-10-05T17:44:00.000-07:00

An Anatomical Abnormality

Prevalence:

Cleft lip or palate appears in about 1 in 700 Caucasian babies, more often among Asians and certain groups of Native Americans, and less frequently among African-Americans.
Causes: The exact cause is hard to determine, but it's likely that genetic and environmental factors interact to prevent either the hard palate (the roof of the mouth), the soft palate (the tissue at the back of the mouth), or the upper lip, all of which normally are split early in fetal development, from closing.

Symptoms:

The cleft can be mild (a notch on the upper lip) or severe (involving the lip, the floor of the nostril, and the dental arch). A child with a cleft palate usually needs a speech pathologist. Language development can be affected not only by the structure of the lip and palate but also by the side effects of middle-ear infections, which are common in babies and toddlers with this defect (probably because their ears don't drain properly).

Babies with a cleft palate may also need help with feeding. (Those with a cleft lip generally don't have problems in this area.) Because they have trouble sucking, they must be fed in a sitting position with a special bottle. Depending on the severity of the condition, mothers who breastfeed may have to express milk and bottlefeed baby until the cleft is repaired.

Treatment:

Surgical repair for a cleft lip should be done by about 3 months of age. Surgery to repair a cleft palate, which restores the partition between the nose and the mouth, is usually done later -- between 6 and 12 months of age -- to allow for some normal growth of the child's face.
Though follow-up treatment is sometimes necessary, repair of a cleft lip or palate almost always leaves the child with only minimal scarring and a face that looks like that of most other children.

Clubfoot

2007-10-05T17:41:00.000-07:00

An Anatomical Abnormality

Prevalence: Clubfoot occurs in approximately 1 in 400 newborns -- affecting boys about twice as often as girls -- and includes several kinds of ankle and foot deformities. The exact cause of clubfoot isn't clear, but it's probably a combination of heredity and environmental factors that affect fetal growth.

Symptoms:

Clubfoot can be mild or severe and can affect one or both feet. Mild clubfoot is not painful and won't bother the baby until he begins to stand or talk.

Treatment:

For a mild case, treatment starts immediately after diagnosis and involves gently forcing the foot into the correct position and helping the child do special exercises.

Often, however, the baby needs more drastic treatment, such as plaster casts, bandaging with splints followed by time in special shoes, or surgery followed by exercises. The process may take three to six months, which checkups for several years after.

Infant Congenital Heart Defects

2007-10-05T17:39:00.000-07:00

An Anatomical Abnormality

Prevalence: Congenital heart defects occur in about 1 in 110 births and have a variety of causes, including genetic abnormalities or a mistake during fetal development. Some may be so mild that they have no visible symptoms.

Detection: In such cases the doctor usually discovers the problem when she detects an abnormal heart sound -- called a murmur -- during a routine examination. Some murmurs are meaningless; further tests are usually required to determine whether your baby's is due to a heart defect.

Serious heart defects are outwardly detectable and, if left untreated, can cause congestive heart failure, in which the heart becomes incapable of pumping enough blood to the lungs or other parts of the body.

Symptoms:

Rapid heartbeat
Breathing difficulties
Feeding problems (which result in inadequate weight gain)
Swelling in the legs, abdomen, or about the eyes
Pale grey or bluish skin

Treatment: Most heart defects can be corrected or at least improved through surgery, drugs, or a mechanical aid like a pacemaker.

Infant Anemia

2007-10-05T17:28:00.000-07:00

The most common cause of anemia in babies is iron deficiency. This usually can be corrected pretty easily with supplemental iron. Supplements are quite safe at that age, at the appropriate dose, which is about 3mg of iron per kg of body weight. The iron drops are usually given for about a month and then the blood test is repeated.

If the anemia isn't much better, it's time to consider reasons other than iron deficiency for his anemia. He may just have a normal hgb at that level, for instance, and not need any treatment at all.
If the anemia has improved, kids usually stay on the iron for another two months or so. He should also have a careful physical, if he did not have one recently, to be certain that his development is proceeding on course.

Iron in the diet is great, but forcing kids to eat, pushing them, or even coaxing them with fun airplane noises usually does not improve eating. Offer foods, but if he is happy, growing well, and making plenty of wet diapers, it's okay not to take much in the way of solids. Kids get most of their nutrition at that age from what they drink, not what they eat. The solids are mostly for the experience.

Baby Sleep Problems and Solutions 1

2007-10-04T14:27:00.000-07:00

The Rocker

Sleep Scenario #1

My baby is 5 months old. I've always rocked her to sleep, but I'd like to be able to lay her down and have her fall asleep on her own. How can I make this happen without a lot of trauma and tears for either of us?

In order for a baby to transition from falling asleep while rocking in your arms to falling asleep on her own, she has to master two smaller skills -- the ability to fall asleep someplace other than in your arms, and the ability to fall asleep without being rocked, explains Ann Douglas, author of Sleep Solutions for Your Baby, Toddler, and Preschooler (Wiley).

If you aren't comfortable with making your baby learn to put herself to sleep "cold turkey," you can try substituting what Harvey Karp, MD, author of The Happiest Baby on the Block (Bantam) and an American Baby advisor, calls a new sleep association. From being inside your body, babies are born accustomed to drifting off to sleep amid noise, tactile stimulation, and rocking. Gradually replace rocking with white noise (you can play a CD), Dr. Karp recommends. If you play the sounds while you're rocking the baby to sleep for four or five consecutive nights, she will begin to create a new association with sleep, and her transition from falling asleep in your arms to falling asleep in the crib will be easier, Dr. Karp says. "The idea is to create other sleep associations that don't require your presence to help the baby fall asleep," he adds.

Be prepared for your baby to put up a big fuss the first few times you lay her down awake. Some sleep-training techniques instruct parents not to pick up a crying baby but to come into the room at set intervals (every five minutes, for example) and talk to her in a reassuring voice.

But that approach doesn't work for all babies or parents. Christine George, of Lansing, Michigan, tried that method with her 6-month-old, Kayleigh, but the crying didn't stop, even after 10 or 15 minutes. Instead, Kayleigh became more and more upset until she was screaming, red faced, and gagging. "After two nights of becoming almost as upset as my baby was," George says, "I decided that technique just wasn't going to work for me."

What did work? "We'd walk around the room with her for a few minutes until she was drowsy, and when we laid her in the crib, we'd gently bounce the mattress with one hand while pressing her belly with the other hand and saying 'Shhhh' for a minute or two until she fell asleep," George says. "After a while, we were able to do it without the hand on the belly, and then without the bounce, and finally we were able to lay her down awake and she'd fall asleep." The process took two weeks.

Remember that there's no one-size-fits-all approach, advises Claire Lerner, LCSW, an American Baby advisor and the director of parenting resources at Zero to Three, the National Center for Infants, Toddlers, and Families. "With some babies, you can pat them or just sit there so they can see you, but for a lot of babies that's just confusing," she says. But even if you choose to walk away from her bed, the crying isn't likely to last more than a few nights. "The more consistent you are, the quicker she'll learn," Lerner says.

Chickenpox for Baby

2007-09-26T13:54:00.000-07:00

What Is Chickenpox?

Chickenpox is one of the most common childhood illnesses. Before the vaccine was approved in March, 1995, there were 4 million cases of it appearing in the United States every year. In fact, 95 percent of adults in America today had chickenpox before the age of 18. It occurs most often in the late winter/early spring and in children between the ages of 6 and 10.

Chickenpox is caused by Varicella zoster virus and is highly contagious. About 90 percent of people who never had chickenpox (or the vaccine) will catch it if a family member has it. A person with chickenpox is contagious from one to two days before the rash starts until about five days after the rash appears. It can be spread by direct contact (through lesions or sores) or through the air. Children with chickenpox have to stay home from childcare or school until they are no longer contagious.

A child who catches chickenpox may not show symptoms for 10 to 21 days after being exposed to the virus. At that point, the characteristic symptom usually appears -- an itchy rash, which usually develops first on a child's scalp and body, and then spreads to his face, arms, and legs over the next three to four days. In total, a child with chickenpox will have 250 to 500 itchy blisters that dry up into scabs two to four days later.

While the rash is the most well-known symptom of chickenpox, it's not the only one. Here are some other symptoms that often accompany chickenpox:

A mild fever for one or two days before the rash appears

General malaise
Coughing
Fussiness
Lack of appetite

Once someone has had chickenpox, the virus stays in her body permanently. This is usually a form of immunity -- she will probably never suffer from chickenpox again. But in about 10 to 20 percent of the population, the virus will reappear later in life (usually over the age of 50) and cause shingles. Shingles typically causes numbness and itching or severe pain in various areas of the skin. Within three to four days, clusters of blister-like sores develop and last for two to three weeks.

Hearing Loss Babies

2007-09-24T15:11:00.000-07:00

Hearing loss is surprisingly common in babies -- but a shocking number of children aren't diagnosed or treated until much too late.

The Most Common Birth Defect

Beth Trama, of Smithtown, New York, was watching her son, Luca, sleep peacefully in the hospital nursery, when the newborn next to him let out a loud, high-pitched scream. Luca didn't wake up. Trama couldn't believe that the noise didn't startle him, but she assumed he'd just gotten used to being with all those crying babies -- until he failed his hearing screening the next day.

You're probably surprised to find out that hearing loss is the most common birth defect. Every day, about 33 babies are born in the U.S. with a hearing impairment. But the news hasn't gotten through to parents -- in fact, only 1 percent of new and expectant moms ranked hearing loss as their top concern about their child's health, according to a survey by the Alexander Graham Bell Association for the Deaf and Hard of Hearing, in Washington, D.C.

A Recessive Gene

Many parents figure their baby isn't at risk if they don't have a history of deafness in their family. However, about 90 percent of deaf children are born to hearing parents. Deafness can be caused by a dominant gene -- meaning one or both parents are deaf -- or by a recessive gene, so a child can inherit the trait even if no family members are hearing-impaired. That's what happened to Luca. After his diagnosis, doctors discovered that both of his parents had a recessive gene for a genetic disorder that damages the hair cells in the inner ear so they can't carry sound to the auditory nerve. As a result, Luca is severely deaf in both ears.
Hearing loss can also be caused by many nonhereditary factors, including infections, prematurity, severe jaundice, or a lack of oxygen during delivery, says Ellen M. Friedman, MD, chief of pediatric otolaryngology at Texas Children's Hospital, in Houston. Unfortunately, most of these causes aren't preventable.

2007-09-21T20:39:00.000-07:00

PAEDIATRIC DISORDERS

Children are the gift of god to parents. They need care, affection and sympathy. It is the duty of parents to take care of every problem of their child. When the children are diseased, it is a difficult situation for the parents. The paediatric branch of medical science deals in child health. Though the diseases are the same, the treatment, management and dosage differ. There are several diseases which occur in childhood only. So we go to paediatricians for the treatment of our children because up to the age of twelve, it is the paediatrician who looks after the ailments of our child. Hence the little of this site Paediatric Disorders.

This site will give you all the information about the paediatric disorders which makes the parents suffer, and good remedies for treating those paediatric disorders.children are the gift of god and its our obligation to protect them from the paediatric disorders.

PERMATURITY

BABY MASSAGE

BABY BATHING

BABY CRY AND SLEEP

BABY GROWTH

BABY DIET

INFANT HEIGHT

BABY WEIGHT

INFANT DENTAL DEVELOPMENT

INFANT DENTAL COMPLICATIONS

INFANT WEEPING

INFANT NASAL BLOCKAGE

PREVENTION OF ACCIDENTS AND FIRST AID

SIDS Q&A

2007-09-20T20:38:00.000-07:00

SIDS Q&A

The memory of losing her infant son, Colton, is still unbearable to Kristen Marr nearly seven years later. "He was 2 months old and in perfect health when I put him down on his back for a nap," she recalls. But when she tiptoed into the nursery of her home in Crofton, Maryland, to check on him, Colton had stopped breathing. Marr dialed 911 and tried to perform CPR on her infant. But it was too late. Doctors later concluded that Colton was a victim of sudden infant death syndrome (SIDS). While its incidence has dropped by half since the launch of the Back to Sleep campaign in 1994, SIDS is still linked to about 2,500 baby deaths every year. And even taking the right precautions (as Marr did) doesn't guarantee that your child will be protected. But here's some reassuring news: Recent research is revealing more ways than ever to reduce your child's risk. Are you doing everything you can to fend off SIDS? Here are answers to your top questions.

Q: What causes infants to stop breathing while they sleep?

A: Experts believe SIDS victims have an immature arousal center in the brain. Put simply, they can't wake themselves up when they're having trouble breathing. Infants who sleep on their stomach are particularly vulnerable to SIDS. One theory is that this position increases the likelihood that they will re-inhale oxygen-depleted air. "The peak danger is between 2 and 4 months," says Marian Willinger, Ph.D., special assistant for SIDS at the National Institute of Child Health and Human Development, in Bethesda, Maryland. However, you should continue to safeguard your child until he turns 1.

Q: Who's most at risk?

A: Three out of five SIDS victims are boys. African-American and Native American infants are two to three times more prone to the syndrome. Other groups at increased risk include preemies, low-birthweight babies, and infants who are exposed to cigarette smoke.

Q: Is putting my baby down on her back really that important?

A: It's vital. Back-sleeping increases a baby's access to fresh air and makes her less likely to get overheated (another factor linked to SIDS). But not all new mothers are getting the message: Eighteen percent of Parents readers say they usually put their infants to sleep on their stomach, and another 13 percent do so some of the time. "Some exhausted new parents may do it out of desperation, because infants tend to sleep better and more deeply on their stomach," says Parents advisor Jodi Mindell, Ph.D., author of Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night's Sleep. "But having your baby sleep on her tummy is a no-no."

Q: I put my child to sleep on his back at night, but can I let this rule slide for a short nap?

A: It's not worth the risk. Babies who normally sleep on their back are 18 times more likely to die of SIDS when placed down on their tummy for a snooze. "Infants seem to have difficulty adjusting to the change," says Rachel Moon, M.D., a SIDS researcher at the Children's National Medical Center, in Washington, D.C.

Q: Is side-sleeping safe?

A: No. Studies show that putting a baby down on her side rather than on her back doubles the SIDS risk. "It's easier for an infant to roll onto her tummy from her side than from her back," says John Kattwinkel, M.D., chair of the American Academy of Pediatrics (AAP) Task Force on SIDS. "And she may not yet have the skills to roll back in the other direction."

Q: My baby has a flat spot on his head from sleeping on his back. Will it go away?

A: That depends. Flattened-head syndrome, or positional plagiocephaly, occurs when the back of an infant's pliable skull is reshaped from constantly lying in the same position. By some estimates, the incidence has jumped sixfold during the past decade. Yet back-sleeping isn't entirely to blame. "This condition is preventable," says John Persing, M.D., a craniofacial specialist at Yale-New Haven Hospital, in Connecticut. "Most babies with this problem spend way too much time on their back when they're awake." To correct (or prevent) a flat spot, give your baby several supervised "tummy time" sessions every day. You can also position your baby's head when you put him down to sleep -- one night to the left, the next night to the right -- to help balance the shape of his head. And don't let your child spend too much time in car seats, bouncy seats, or infant swings. If the flattening doesn't show significant improvement by the time he's 6 months old, consult a pediatric craniofacial specialist.

Q: I'm worried about my baby getting cold. Is it safe to cover her with a blanket?

A: Wait until her first birthday. Blankets, pillows, comforters, and stuffed toys can hinder your child's breathing; even soft or improperly fitting mattresses can be dangerous. If you're worried that your little one may get chilly, swaddle her in a receiving blanket or use a sleep sack. According to a Belgian study, swaddling helps fussy infants sleep better on their back and may protect them from SIDS by causing them to startle more easily. But make sure you don't overheat your baby. "A nursery that's too warm substantially increases an infant's SIDS risk," says Warren Guntheroth, M.D., professor of pediatrics at the University of Washington, in Seattle. Set the thermostat at 68 degrees, don't put the crib near a radiator, and dress your child in light layers that you can remove easily if she gets hot.

Q: Is it dangerous to give my baby a pacifier?

A: Not at all. Binkies actually reduce the risk of SIDS, possibly by preventing babies from falling into an extremely deep sleep. The AAP now recommends that you consider giving your child a pacifier at night and for naps during his first year. Note: If you're breastfeeding, don't introduce a Binky until your infant is 1 month old and nursing well.

Q: My baby has started to flip onto her stomach during the night. How can I stop this?

A: You can't -- but don't worry. "Once a baby can roll over by herself, her brain is mature enough to alert her to breathing dangers," says Dr. Moon. "And by the time she's 6 months old, her improved motor skills will help her to rescue herself, so the SIDS risk is greatly reduced."

Q: My baby sleeps better in my bed. What's the big danger of co sleeping?

A: Actually, there are lots of them. Your infant could be suffocated by a pillow or a loose blanket. His air supply may be cut off if you or your spouse inadvertently rolls over onto him. And he could be strangled if his head gets trapped between the headboard and mattress.
Despite numerous studies that confirm the heightened SIDS risk caused by co sleeping, many moms continue to do it. According to a parents.com poll, 52 percent of readers do it all or some of the time, citing the added convenience for nighttime feedings and the security of having their infants next to them.

If you decide to co sleep, don't put your baby right in the bed. Instead, get a co sleeping crib that clamps onto the frame of your bed. Or you might simply try moving your baby's crib into your room. Several studies show this sleeping arrangement reduces the SIDS risk (presumably because you're more likely to hear your baby if he's in distress).