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Parent's guide to newborn testing, screening, and prevention measures

When picturing the first days of an infant’s life, what we look forward to the most is love. We express our love in so many ways: skin-to-skin, breastfeeding, swaddling and snuggling. 
 
Love also means keeping them safe. 
 
Advances in maternal-infant health are one of the greatest success stories of the 20th century, with a drop in the death rate of 99%. But some of those dangers only stay in the past through constant vigilance. Behind every screening test and preventive measure is a careful, research-driven rationale. Here are seven newborn tests, screenings, and prevention measures you should know about:
 
Vitamin K injection 
Vitamin K is vital for blood to clot properly. Newborns cannot make Vitamin K and it is poorly transferred in breast milk. Without this injection, babies are at risk for spontaneous bleeding from the umbilical cord, mucus membranes, even in the brain. Giving Vitamin K has greatly reduced this "hemorrhagic disease of the newborn," but rates are increasing as more parents refuse it. Oral Vitamin K has not been shown to prevent this potentially devastating disease. 
 
Hepatitis B vaccine
This is an anti-cancer vaccine. Before this vaccine existed, approximately 10,000 kids under age 10 contracted hepatitis B each year. Most had no known exposure to it. Kids are more likely than adults to get very sick and to have complications. Vaccination at birth has greatly reduced rates of pediatric liver cancer due to hepatitis B. 
 
Antibiotic eye ointment
This prevents bacterial eye infections. Some of these infections are associated with sexually transmitted bacteria, but not all of them are. Negative testing or a monogamous relationship does not ...

Jaundice in newborn babies

As a new parent, you’re understandably eager and excited to leave the hospital and settle into your new routine with your baby. Sometimes, that routine is delayed due to the baby’s blood test confirming hyperbilirubinemia, also known as jaundice.

Jaundice in newborns is caused by an excess of red blood cells. Jaundice is seen as a yellow color to the skin, appearing first at the head (skin and sclera – or “whites of the eyes”) then progressing to the feet. As it decreases, it lessens in reverse. Before birth, the placenta removes bilirubin from the baby’s system; after birth, the baby’s liver takes over. In breast-fed babies, an imbalance between mother’s milk supply and baby’s feeding can lead to a higher-than-expected bili level. In addition to ensuring the baby is feeding well and having enough wet/stool diapers, phototherapy or “bili lights” may be needed. Bili lights help speed up the process by breaking down the bilirubin in the skin.

For phototherapy, your baby will be ...

Infants with Milk Allergy

A 4 week-old infant and his mother came to my office last week.  The mother had started seeing small flecks of blood and stringy mucous in the infant’s diapers a week prior.  The baby was fine in every other way, breast feeding normally, and looked quite healthy when I examined him.

I diagnosed the infant as having cow’s milk protein-induced proctocolitis, the term referring to allergic inflammation of the lower gastrointestinal tract from exposure to cow’s milk. 

This is a diagnosis I make often. Here's what you should know about infants with milk allergies:

  1. It’s more common than you think. 2-3% of infants in the U.S. are allergic to cow’s milk protein. It is even more common in infants with eczema or who have parents or siblings with allergies.
  2. It’s seen in breast fed babies.  Over 50% of infants with this condition are breast milk-fed infants.  But remember, the babies are allergic to the dairy in their moms’ diets, not to their mothers’ breast milk per se!
  3. Switching to soy or goat’s milk doesn’t work.  Over two-thirds of infants with cow’s milk protein allergy “cross-react” to soy protein (which means that they may not be truly allergic to soy protein, but their immune systems are just too “immature” to know the difference between the two).  Similarly, if a mother switches from drinking cow’s milk to goat’s milk, it won’t help, because the source is still a “different species”; the infant’s immune system will still respond to the “foreign” protein.
  4. Treatment takes time. The inflammation resolves when all traces of cow’s milk (and soy), are  removed from the infant’s diet.  In the case of formula-fed infants, we switch to special hypoallergenic formulas.  Typically after a successful switch, the bleeding stops within a week.  However, with breast fed infants, the improvement can be a little slower.  Since it can take up to 2 weeks for the dairy in a mother’s diet to circulate into her breast milk, the full effects may not been seen for up to a couple weeks.
  5. Allergy testing is not recommended.  The type of allergy that ...

How to give safe gifts to children during the holidays

As the holidays approach, parents often wonder what toys are safe for their little ones.  When making your list and checking it twice, here are some tips to ensure that toys are appropriate for the age and developmental stage of your giftees.

For younger children/infants:

  • Make sure all parts are larger than the child’s mouth.  Most children age 3 and under consistently put toys in their mouth, and some older children do as well.  A small-parts tester, or “no-choke tube” is about the size of a small child’s airway and can be purchased to test parts if you are unsure.  If a part or toy fits inside the tube, it’s too small to be safe.
  • When buying stuffed toys, look for embroidered or secured parts rather than pieces (such as eyes or noses) that could be removed and swallowed.  Remove all loose strings and ribbons.  Avoid animals with stuffing made of small pellets or material that could cause choking. Be aware that stuffed toys given away at carnivals, fairs, or in vending machines are not required to meet safety standards, so be especially careful with these!
  • When buying hanging toys for cribs, ensure that the child cannot grab any portion, and that strings or wires are short.  These types of toys should be removed when the infant can push up onto his or her hands and knees.
  • Keep plush toys and loose, soft bedding out of the cribs of infants and young children as these can cause suffocation.

For all children:

  • Look for labeling on the package that indicates what ages the toy is appropriate for.  Remember that this doesn’t have to do with how smart your child is, it is based on physical and developmental skills for his or her age group and should be followed.
  • Ensure that batteries are  ....

Infant and Child Development is not about ‘stuff’

When we are bombarded by information and products, how are we as new parents supposed to decipher what is in the best interest of our child when it comes to their development? 

Parents can quickly become bombarded with information about everything they need to do to optimize the first months of their child’s very impressionable life. A new, overwhelmed, sleep deprived parent can find everything from music for math skills, swaddling positioners for longer sleep, bottles for better speech development, and even multiple equipment options to speed up a child’s progression for walking.  Today there are so many items available for purchase that if a person wanted to, they could  go through an entire day never having to hold, cuddle, snuggle, whisper, sing, gaze, laugh, or touch their baby…..and that is exactly the point.  When it comes right down to it, the best things that we can provide for our babies development has nothing to do with the “stuff”!

Here’s what advertisements for most baby products don’t tell you:

4th Annual Holidays at the Hospital at Swedish

We hope you can join us for a winter wonderland celebration for Swedish Pediatric patients, families, & friends!

This is a free, fun, and festive holiday celebration for the community that will feature:

  • Carolers
  • Photos with Santa
  • Teddy Bear Clinic
  • Cookie decorating
  • Holiday activities and crafts tables
  • Plus, we’ll have a super special guest from the Seattle Sounders, Roger Levesque!

We’ll also be collecting toys for children up to age 18 as well as donations for art supplies and games. Donated items will be given to children at the hospital receiving care and treatment.

Where:
Swedish First Hill
1101 Madison, Medical Tower Lobby
Seattle, WA 98122
**Free parking is available on the street or in the Marion and Minor parking garage

When:
 

More tips for feeding picky eaters

In my last post, I shared a few tips about what to expect and how to help encourage your child to eat more. Here are some more tips to help your child eat more variety of foods, including more vegetables:

How can I get my child to eat more variety?

  • Offer a "nibble tray". At snack time, fill a muffin tin or ice cube tray with bite-sized portions of colorful, nutritious foods. Try cooked macaroni, cheese cubes, kidney beans, grape halves, broccoli florets, ready-to- eat cereal, and canned pineapple tidbits.
  • Let children cook. Your child is more likely to eat what he has helped to make.
  • Children can help wash vegetables, tear up lettuce, scrub potatoes, or stir batter.
  • Be playful. Call these finger foods playful names that a two-year-old can appreciate, such as: apple moons (thinly sliced), avocado boats (a quarter of an avocado), banana wheels, broccoli trees (steamed broccoli florets), carrot swords (cooked and thinly sliced), cheese building blocks, egg canoes (hard- boiled egg wedges), little O's (o-shaped cereal). "Olive or raspberry fingers" are much more appealing to be nibbled off their fingertips.
  • Serve new foods over and over again. A food not eaten at first may ...
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