Baby

Baby Original offers free advice for expecting parents and supporting family and friends. Main topical sections include pediatrician care, parenting, grandparenting, motherhood fitness and health, and social issues including pets, siblings, and schooling.

Pregnancy to Newborm

From moments of considering to have a baby to the first moments of life your little angel plays their part. Their little red face is all scrunched up, and the sounds that voice from her puckered little mouth are the most precious notes you could ever hope for. You ache any time the nurses take her for tests, and you deny offers from well meaning friends and family who offer to hold her while you get some sleep. All you want to do is be with your new baby, and you’ll forego food, water and sleep to do just that!

Parenting to Grandparenting

Parenting is often a thankless job. It is a difficult job, and a job that keeps parents up at night. From crying babies to whining toddlers, defiant teenagers to aloof young adults, parents constantly struggle to understand and positively affect the lives entrusted them. But in the end, it is a job every parent will say is the most amazing and wonderful adventure imaginable. It is the smiles, first steps, first homeruns, family trips, hugs and kisses that outshine the less appealing aspects of parenthood, and it is for these moments parents gladly lump the rest.

Day Care and Schooling

For many, it starts with the first day of kindergarten. For others, it begins a year or two earlier, with preschool. For all, it is a momentous occasion that marks the beginning of a learner’s journey that will never end. It's late summer, and it school is about to begin!

Eager little kids follow anxious parents through stores, buying back-to-school clothes, backpacks and sneakers. They get fresh haircuts, take extra bubbly baths the night before and are sent to bed extra early to ensure a good night's sleep. The next morning they're off to school. Be it kindergarten, middle school or college, the routine is mostly the same. May be by the time they’re in high school, the bubble bath is out of the question, and they can borrow the car and do their own shopping, and by college, parents can only wonder about that good night’s sleep, but these details are only minor. The first day of school is a blend of excitement, anxiety and curiosity for all students and parents as well.

Choosing the Right Dog Breed for Your Child

Filed under: Pets — Baby Original @ 3:38 am

Choosing the Right Dog Breed for Your Child One of the most important things you must consider when choosing a dog for your child is that you will probably be the one taking care of it even when your child becomes older. For that reason you want to choose a breed that will be easy to feed, groom, and walk. You also need to look to dog breeds that are good with children and not ones that are overly aggressive like a Pit Bull. Under no circumstances should any parent take a chance on a breed that has the potential to turn even on its owners. Of course, some people will tell you that even Collies or German Shepherds have that potential, but you certainly don’t read it in the newspapers.

For a small child, a small dog is your best choice. Children tend to want dogs with which they can play and that are smaller than they are. The toy and small breeds such as Chihuahuas, Yorkshire Terriers, Boston Terriers, and other similar sized breeds are perfect for children. Chihuahuas are very noisy, but they are also very gentle and lovable with their human families as are Yorkies and Boston Terriers. The small breeds are also better for your child to learn to feed and walk. It would be rather difficult for even a six year old to walk a Collie or German Shepherd no matter how gentle it might be.

Some breeds tend to be one-owner dogs, and since you will be sharing the care of the dog with your child, this is not the breed you want. If it becomes attached to you instead of your child, he or she will become very upset. Some breeds are also very picky about who feeds and bathes them, and though this may not be a problem when your child is young, it may be a potential problem as he or she grows older and wishes to take over care of their dog.

Before choosing a dog for your child, make sure the two of them are going to get along. This may require a trip to the pet store or breeder so that your child can interact with several dogs and choose the one that best suits him. A dog will attach to a person even as a puppy, so you want to choose the one that chooses your child. Never go out and just buy a puppy for your child because just like humans, they have their own personalities and may not be the right match for your child.

Even if you decide to get a dog from the animal shelter, let your child pick the one with the sad eyes looking to go home with him. Instead of saying there is a dog for every child, you must understand there is a child for every dog, and each dog will pick out the child he feels is right for him or her. Allowing it to happen naturally will assure you that dog and child are a perfect match for one another.

Labor

Filed under: Labor — Baby Original @ 10:47 am

Labor Labor varies form woman to woman; even in the same woman labor each is different. Some labors are very fast, lasting only a few hours; some are average in length [about fifteen or sixteen hours for first time mothers and seven or eight hours for women who have had babies before]; some are very long, lasting a day or two. Some start slowly and then speed up unexpectedly; others start rapidly and then slow down. The amount of pain and fatigue varies also. It is best not to have definite expectations, but to prepare yourself for the wide range of possibilities.

Many factors play a part on how long and hard; labor will be. You can influence some of these factors but not others.

Factors Influencing Labor

Factors you cannot control

  • Size and shape of your pelvis
  • Size and shape of baby’s head and shoulders
  • Baby’s station, presentation, and position*
  • The condition of your cervix when contractions begin
  • The power of your contractions
  • The amount of rest you have between contractions
  • Some aspects of your general health and your baby’s well-being

Factors you control, to some extent

  • Your emotional state and attitude toward birth [anxiety, fear, and tension versus optimism, confidence, and relaxation]
  • Presence of helpful, caring partner[s]
  • Knowledge of what to expect
  • An environment and professional staff that help you feel secure and well cared for
  • Good care of yourself [including good nourishment and health habits]

* Station refers to how low the baby is in the pelvis.

Presentation refers to which part of the baby’s body will come first [usually it is the head, but on occasion it may be the buttocks, feet, or even a shoulder]

Position refers to location-on the right or left side of the mother-and the orientation-anterior [towards the mother’s front], posterior [toward the mother’s back], or transverse [lying crosswise]-of a given part of the baby, specifically, the occiput [back of the head], brow, chin, shoulder, or sacrum [the bone at the end of the spinal column]. For example, if the baby’s position is left occipitoanterior, the back of the head is on the left , pointing toward his mother’s front.

Time for Yourself

Filed under: Motherhood — Baby Original @ 10:39 am

Time for Yourself As you recognize your life to adjust to having a baby, do not forget your own requirement to have some time for yourself, however difficult it may be to schedule. You need private time to be a person in your own right and not only a parent, a homemaker, a spouse, and perhaps an employee. You need the time to build and maintain the self- esteem that makes you effective in all those roles and effective at being yourself. You need time to exercise, to groom yourself, to read, or to work on a hobby… or to look at sky or water and let your mind wander. Finding this time will probably never be easy for you again, but it will continue to be very important that you do find it. Always look on it not as a luxury or a reward, but as an obligation to yourself. You won’t always be able to have the hour or more that would do you the most good and be the most enjoyable, but you’ll find that even a few minutes snatched from a busy day will refresh you.

If you are a early riser, at your best in the morning, you may enjoy a few minutes of peace and privacy over a cup of coffee before the rest of the family is awake. Your baby’s daytime naps may give you some precious time. Even later, when you may not feel the need to sleep every time your baby does, nap time should be for you, not for housework. Evening is a wonderful time for a leisurely bath, even for a good read in a warm tub.

And evening is probably also the best time for a quiet hour or two for spouses. As important as it is for each to have some solitary time, it is equally necessary for a married couple to spend at least some time together alone.

Diapering and Dressing

Filed under: Diapering — Baby Original @ 10:21 am

You’ll probably feel a little awkward and clumsy the first few times you diaper and dress your baby, but with a little practice, you’ll be handling him with ease and confidence. Use a waist high table of some kind even for a tiny baby so you won’t have backaches. An old dresser with a pad on top will now, but modern changing tables have built-in safety straps to hold your baby when he is old enough to squirm and resist. If you use disposables, diapering is almost automatic: lay the baby on the diaper, fold the front half of the diaper up over the baby and fasten it with the convenient attached tapes. [Those tapes sometimes tear, instead of throwing a diaper away, mend it with masking tape.] To keep wetness from soaking into outer clothing, use disposables with elasticized legs and turn the plastic top of the diaper to the inside. A cloth diaper can be given a figure eight twist at the crotch for both double thickness and a tighter fit. Pin the back of the diaper over the front, slipping one or two fingers between the cloth and the baby’s skin to keep the pin from sticking the baby. Use a pincushion or bar of soap to hold diaper pins [do not use ordinary safety pins, and keep them out of the baby’s reach] Never hold pins in your mouth. Whichever kind of diaper you use, lay an extra one over your baby boy to avoid being squirted while you change him.

The kinds of clothing you select for your baby will reflect your own taste and inclinations. Some parents are willing to spend the extra time necessary to iron natural-fiber, woven- fabric because they like the look of a dressed up baby; others opt for simple knit clothing that needs little care. Whichever kind of clothing you prefer, look for garments that will be easy for you to put on and take off the baby-those with few, if any buttons, necklines with large enough openings to fit easily over the baby’s head, and sturdy crotch fasteners that make diaper changing easier.

Bathing Your Baby

Filed under: Bathing — Baby Original @ 10:16 am

Most babies come home from the hospital with remnants of the umbilical cord still attached to the belly button, or the umbilicus. Until this falls off give your baby only sponge baths. Clean the navel area twice a day or so with a cotton swab dipped in antiseptic. Do this gently but thoroughly, making sure to get to the base of the cord stump. Watch for yellow matter, a sort of “weeping” that may develop, and for redness. These are signs of possible infection-notify your doctor if they persist. Keeping the top edges of the baby’s diaper folded down below the navel will help to keep the area dry. When the cord falls off, usually within ten days to two weeks after the baby’s birth, it is not unusual for a few drops of blood to be left on the navel. No bandage, binding, or tape is required. If the umbilicus doesn’t dry up in a few days after the cord comes off, an umbilical granuloma may be present. This is a little nubbin of tissue in the umbilicus at the junction of the old cord and the new skin. Your doctor can remedy the situation easily at the baby’s first checkup. If there is much bleeding or a foul odor coming from the cord, consult your doctor earlier for any special instructions needed.

For a sponge bath, you will need a warm, draft free room, a basin of lukewarm water, and two big towels-one to bathe the baby on, and the other to wrap him in after the bath. If your baby cries when totally undressed, give him a bath in stages, removing only part of the clothing at one time. Many babies love the feeling of being totally naked, though and enjoy waving their arms and legs about freely. You don’t really need soap for a newborn, some parents don’t use it for several months. If you can’t bring yourself from skipping it altogether, use very little because soap will dry up your baby’s delicate skin. Ordinary scented soap may trigger an allergic reaction, and it will disguise the wonderful “baby smell” that lets everyone in the house know that an infant is present.

Infants do not need to be bathed every day. The diaper area is of course, cleaned frequently, and two or three full baths a week are sufficient.

Common Obstetric Procedures

Filed under: Obstetrician — Baby Original @ 9:55 am
Procedure Description Purpose[s] Indicated or Desirable if: Optional if All is Normal Not Necessary or Desirable if:
Enema in early labor* Spout attached to bag of watery solution is gently inserted into anus.
Solution empties into intestine. You hold it in, then expel it into toilet or bedpan
To empty your bowels You are constipated and it is slowing labor Yes * You have emptied your bowels early in labor. You do not mind passing some feces during late labor
Intravenous Fluids Bag containing special hangs by bed. Tube from it is inserted into vein in hand or arm To ensure that you remain hydrated without drinking fluids. To provide
a route to administer medication
Labor is very long. You have continual nausea and vomiting You were given regional anesthesia You received oxytocin to speed labor Yes* Labor is not prolonged You can drink and hold down fluids
Fetal Scalp Blood Sampling Blood sample is drawn from baby’s scalp during labor. Tested for oxygen and carbon dioxide levels and Other factors. Takes two to thirty minutes to get results. To confirm whether fetal distress observed on monitor is real To help decide if a caesarian is necessary Interpretation of monitor tracing is unclear There is strong desire to avoid caesarian section Yes Baby’s heart rate seems normal. Doctor feels there is no time to wait for results. Hospital does not have facilities to do lab work. Mother has
infection and use of procedure would increase chances of baby catching it.
Electronic Fetal Monitoring [extreme or internal]* External: Two belts around your waist. One contains ultrasound device to detect baby’s heartbeat. One contains device to detect contractions. Both
connected to machine that records baby’s heart rate and contraction strength Internal; Two devices placed into uterus via vagina. One is attached to baby’s scalp and detects pulse; the other picks up contractions. Internal method is more accurate than external.
To provide continuous recording of fetal heart tones and the contraction pattern. You received oxytocin A nurse or midwife cannot be with you continuously There are doubts about the baby’s condition *[many obstetricians feel that all laboring women should be monitored] Yes* [Highly controversial]
Artificial Rupture of Membranes [breaking the bag of waters] On vaginal exam, doctor inserts long “amnihook”and painlessly breaks bag of waters. Gush of fluid flows To speed labor To check amniotic fluid for meconium, infection or bleeding To apply electronic fetal monitor Labor is prolonged Fetal distress is suspected Internal electronic fetal monitoring is to be used Yes Labor progress is normal Fetal heart rate seems to be reassuring
Pain Medications Injections containing drugs given into skin, muscle, or intravenous tube. Also, medications can be injected into area of spine or pelvic floor to decrease pain and cause numbing. To reduce labor pain To enhance sleep or relaxation Painful procedures need to be done Labor progress is slowed by mother’s anxiety You want them Yes You do not want them You are coping well using alternatives to pain medication Labor progress is normal
Vaginal Exams Doctor or nurse washes hands, puts on sterile glove, and inserts two fingers into vagina to feel cervix and baby’s head To determine labor progress [dilation and thinning of cervix, descent of
baby]
Labor is prolonged. Decisions are about to be made on interventions and medications To some degree Vaginal examinations are necessary to determine the progress of labor.
However, an excessive number of vaginal exams during labor is undesirable
because bacteria may be introduced into the uterine cavity, which may lead
to infection
Intravenous Oxytocin Oxytocin [a hormone causing uterine contractions] is given in the same way as intravenous fluids. Amount given is precisely controlled with special infusion pump To contract the uterus to start or speed up labor To contract the uterus after the birth You are well beyond your due date Inadequate contractions have caused slowing of labor There is excessive postpartum bleeding Yes Labor is normal or extremely intense Pregnancy is not yet at term Placenta delivery is normal. Uterus is contracting well
Restriction to Bed Mother kept in bed, sometimes in only one position To lower blood pressure To provide rest To slow labor contractions Blood pressure is elevated Premature labor is threatened A particular position benefits the fetus who is thought to be in distress Yes Labor is normal Fetus is normal
Vacuum Extraction A suction device is placed on baby’s head. Doctor pulls on it during second stage contractions to assist of speed birth. To speed delivery when necessary Medications have reduced your pushing effectiveness The baby’s size or position is slowing delivery Fetal distress is suspected Not used in normal cases Baby’s decent is normal and there is no fetal distress
Use of Forceps Two steel instruments [spoon-shaped at one end, with long handles] are
placed in vagina on either side of baby’s head and locked together. Doctor
pulls during second stage contractions to assist or speed difficult birth. [Doctor’s preference usually dictates choice between forceps and vacuum extractor]
To speed delivery when necessary Medications have reduced your pushing effectiveness The baby’s size or position is slowing delivery Fetal distress is suspected Not used in normal cases Baby’s decent is normal or use of vacuum extractor is successful Baby is high in the birth canal
Episiotomy* Surgical cut between vagina and anus to, done shortly before delivery.
Done with or without anesthesia
To enlarge vaginal opening to speed delivery or take pressure off baby’s
head To try and avoid a tear in the perineal tissues.*
Fetus is in distressPerineum is rigid and unable to stretchYour doctor wants to prevent a tear Yes* Progress in delivery is good Your perineum will stretch Your fetus is doing well. You want to avoid an episiotomy
Cesarean Section Surgical incision in abdomen and uterus to remove baby. Done with patient under anesthesia. To deliver the baby without completing labor: If vaginal birth is dangerous or impossible if there are emergency problems
for mother and baby
Hemorrhage is present True fetal distress is suspected Cord prolapse is suspected. Labor has failed to progress. Position or size of baby will make delivery hazardous. Presentation is breech.This is a multiple birthYou have a certain illness that would make vaginal delivery hazardousA difficult forceps delivery is the alternativeThere is placenta previa Not used in normal cases Labor progress is normal and the fetus is not in distress Problems can be resolved with less risky procedures.
Suctioning of Newborn’s Breathing Passages Tip of rubber suction device is placed in each nostril and then in mouth to suck mucous and fluid from airway. Done as head appears or immediately
after birth. A longer tube may be inserted via nostril down into windpipe to
remove deeper secretions.
To clear the airway To remove the liquids and meconium that might impair breathing Baby passed meconium into amniotic fluid before birth Baby is not breathing well Baby cannot cough or sneeze to rid airway of secretions. Baby has excess secretions in nose and throat Yes, though most babies are suctioned with bulb Baby is breathing well There were no signs during labor that baby might develop problems
Baby Placed in Warming Unit Baby placed in special bed with heater above. Thermometer taped to
baby’s skin turns up heat if baby cools
To maintain or increase baby’s body temperature Baby’s body temperature drops Observation in nursery is deemed advisable. Baby is premature Yes Baby can be placed skin to skin with the mother and covered with hat and warm blanket Parents want time with normal baby
Eye Care With Antibiotic Ointment or Silver Nitrate Drops Medication placed in each eye of baby within the first hour of life To prevent infection and blindness due to Gonococcal and chlamydial organisms sometimes present in vagina Infection is present [State and provincial laws require it] No, all states and provinces require it
Bottle Feeding of Water, Glucose Water, or Formula A substitute for breastfeeding To “wash out” jaundice* to provide calories and liquid before milk comes in* To check baby’s ability to swallow*To feed baby if you are unwilling or unable. You do not wish to or cannot breastfeed Tour baby has phenylketonuria [an inability to tolerate the protein in breast milk] or other rare problem in digesting breast milk. Yes You wish to establish breastfeeding You wish to avoid nipple confusion between breast and bottle for your baby
Limited time with baby Baby is taken to nursery and cared for by nurses, except at certain times spent with mother To let you rest To observe a sick or premature baby Baby needs observation or special care You are unable to care for your baby Yes You wish more time to become acquainted with your baby and to become skilled in baby care and feeding
Circumcision Skin is separated from end of penis and removed with surgical knife or tied to special plastic “bell” device [foreskin will drop off in days].
Usually done without anesthesia
To remove the foreskin from a baby boy’s penis Religious or cultural beliefs require it You prefer the appearance and ease in cleaning of the circumcised penis Yes* You wish to avoid the pain and risk of the surgery You prefer the appearance of the uncircumcised penis8 Your child’s penis is abnormal in structure. The baby is ill

Common Obstetric Procedures

* Hospitals and doctors vary on this. For some it is optional; others believe every woman and baby should have it. You will need to investigate the policies in your area.

Day Care

Filed under: Day Care — Baby Original @ 9:41 am

It’s almost certain that every parent trying to find a good day care situation has thought of the sexual abuse that has been reported in the media. How do you know that you are leaving your child in a safe place and what are the different options?

Breastfeeding can be a problem of convenience, though for some working women who are adaptable and willing to experiment, it is possible to have the best of both worlds-working and nursing. Your success will depend on your working conditions, your day care arrangements, your milk supply, and other factors. The tiniest of babies can be incredibly flexible, and you may be able to nurse the baby in the evenings and on the weekends when you are at home and have your caregiver feed the baby bottles of formula or your expressed breast milk. Your breast milk can be safely stored by refrigerating it for up to twenty-four hours or freezing it for two weeks. An occasional woman is lucky enough to find as a caregiver a nursing mother who will feed her infant charge as well as her own baby.

First, consider your child’s needs. Some centers may expect your child to play quietly all day, others may provide a pre-school atmosphere with structured activities. Consider how many children will be there during the day, large groups may not work well for a shy, easily “lost” child. The point here is that the “ideal” daycare situation will be different for each child. One one-year old may be ready for a structured pre-school type day care center, while another may be much happier staying with a neighbor.

Consider your needs. What hours will you need care, and what location will be the most convenient? And don’t forget to consider how much you can afford.

The most difficult problem is leaving a baby only a few weeks old is that of finding adequate care for him of her while you are gone. Most new mothers who return to work leave their babies with trusted and competent relatives. If you do not have family members who can provide this care, you my have trouble finding a sitter or day care center that will accept responsibility for such a young baby, and charges will probably be higher than they would for an older baby.

As Twins Grow

Filed under: Twins — Baby Original @ 9:23 am

As Twins Grow Learn to save your strength as you care for your twins [or any baby] by lifting them as seldom as possible, and when you do lift them, by using the muscles in your legs instead of those in your back. When they can crawl or walk, save steps by letting them come to you for playing and loving as you sit on the floor. Childproof your home very carefully, two inquisitive little people will find more than twice as many things to get into as one.

It’s wise to prepare yourself for strong jealousy of your twins among other children, both older and younger. Twins receive a great deal of admiration and attention from outsiders, they take more of their parent’s time, and they are so often so devoted to each other that they shun other children. On the other hand, many twins wish they were singletons. They tire of always having to contend with a sibling of the same age who receives the s me treatment.

That is one reason you will continue to treat your twins as individuals. Provide two birthday cakes. Don’t always dress them alike. Encourage them to have different interests. Don’t use nicknames that marks them as twins [”Pete and Repeat” for example] and try to discourage others from doing so.

Make a point of not worrying about your twins’ development in comparison with other children their age. If they were born prematurely, think of them in terms of their gestational age-their expected birth date-rather than their chronological age. They may be so content with each other’s company that they aren’t in a hurry to move from one stage to another. Twins often develop their own special language, which only they can speak and understand; discourage this by speaking to one twin at a time and waiting for him or her to answer.

Signs and Symptoms

Filed under: Pediatrician — Baby Original @ 3:53 am

Signs and Symptoms Whenever your child is ill, your observations of what’s going on are very important. When you are assessing your child’s illness, you’re really looking at two different things-signs and symptoms. These terms have specific meanings to your doctor.

A symptom is something a patient complains about. A sign is something the doctor [or you] can see, measure, hear, taste or smell. So, if your child complains of her ear hurting, that’s a symptom; if she’s pulling on her ear, that’s a sign.

Signs and symptoms are indications of illness, but they are not illnesses themselves. When your doctor treats your child, he or she may treat the signs and symptoms of the illness, the illness itself, or both. For example, aspirin or acetaminophen is frequently given to a child with a fever, either may reduce the fever, but neither affects the underlying illness causing the fever. However, an antibiotic given to your child when he has an ear infection, actually helps the body to fight off the infection and, so, is treating the illness. The earache [a symptom] and the fever [a sign] will go away because the infection [the illness] is being treated.

Most of the medicines you can buy in the drugstore without a prescription treat symptoms but doesn’t treat the illness itself. So the “cold” medicine you may buy for your child doesn’t make the cold go away any more quickly, but they may make your child feel a little better.

There’s an ongoing debate about treating signs and symptoms of common illnesses. Some doctors believe that unless the signs and symptoms are severe, you’re better off not treating them. Some of the symptoms of an illness may actually be beneficial and speed recovery. Every medicine has side effects, and sometimes these can be worse than the illness itself.

Well-Baby Examination

Filed under: Examinations — Baby Original @ 3:51 am

Well-Baby Examination Your doctor’s well-baby examination consists of many different parts, each designed to help her find certain information. You may have to watch closely to see her do each part of the exam because she probably has developed her own tricks and techniques. Some doctors like to have the baby on the examination table; others prefer that the parents hold the baby. Sometimes the doctor will be talking to you while examining your baby.

Here are some of the major areas your doctor will consider and what she looks for in each category:

  • General Appearance: cleanliness, nutrition, alertness
  • Skin: color, rashes. Bruises, swelling, condition of hair and nails
  • Head: Shape, softness of the anterior fontanel [soft spot]
  • Eyes: redness, good movement, light reflexes [checked with an instrument called an ophthalmoscope, looking for problems with the retina]
  • Ears: irritation or infection of the ear canals or ear drums
  • Nose: congestion, discharge
  • Mouth: gums, tongue, throat, tonsils
  • Neck: swelling of the thyroid or lymph nodes, mobility
  • Heart: rate and rhythm, murmurs
  • Lungs: breathing rate, abnormal noises, air exchange
  • Abdomen: bowel sounds [normal stomach gurglings], enlarged organs or tenderness
  • Genitals: In girls-normal appearance of external genitals, redness. In boys-penis [if circumcised, check that it has healed well; if not, check that foreskin is normal], both testicles are in scrotum
  • Arms and Legs: normal movement and color, absence of swelling and discoloration
  • Pulses: equal femoral pulse [same on both sides]
  • Neurologic: tone, muscle movement and coordination, strength

The Next Two Years

Filed under: Developmental — Baby Original @ 3:50 am

The Next Two Years As your baby grows, he will not need to be seen routinely as often as when he was an infant. Instead of every three months, most doctors see children once every six months. These visits are for the same reasons as the earlier ones-to make sure your child is growing and developing as he should and to provide you with an opportunity to ask questions. New topics will become important, although many of the old ones such as behavior and eating may need to be discussed again.

Your child’s doctor will continue to examine your child completely at each visit. These exams may become more difficult as your baby begins to resist, not wanting a stranger to touch him. This reaction is normal as your baby grows and matures. Doctors expect to see this resistance and actually become a little concerned if it isn’t present.

You may wonder how doctors can examine a screaming child and get useful information. Surprisingly, the doctor can usually find out most of what she needs to know. Some decide not to force the issue if the child is getting extremely upset, but a fair amount can be learned from a screaming baby.

As your child grows, more emphasis is put on his behavioral growth and development. Developmental milestones are still very important. Walking, talking, toilet training, and setting limits are some of the topics you should discuss with your doctor. Safety continues to be a concern because accidents are the number one killer of young children.

Before You Call the Doctor

Filed under: Examinations — Baby Original @ 3:50 am

Before You Call the Doctor From your discussions with your doctor, you will know how she wants to deal with emergencies and after hour’s calls. Keep her guidelines in mind when you think about calling her. However, if you are very concerned about your child, then call. Most childhood illnesses can be handled over the phone, and the child won’t have to be seen by the doctor until morning.

Before you call your doctor, you need to gather some information and think about what information you want to get from the call. For example, if you feel your child is going to need some medicine, don’t wait to call until all the local drugstores are closed. In some communities, it’s next to impossible to get any medicines after the pharmacies are closed. It’s better to call your doctor earlier instead of later. Also, almost all illnesses seem to get worse as the night progresses, so if your child isn’t well at seven o’clock, there’s little chance that he’ll be a lot better by ten o’clock. If you are concerned, call at seven o’clock instead of ten o’clock. If you really want your child to be seen, tell the doctor right from the beginning. It’s helpful for her to know that. She will realize that all the reassurances she can give you over the phone won’t help if you really want to have your child examined. However, if you just want some advice over the phone, let her know that also. It will make her job easier.

Be sure your after hours call is really necessary. Think about what you would do if you didn’t have that information until morning. Would that delay change things? Remember that doctors have families and things they like to do besides practice medicine. Out of consideration for them and their families, all non-emergency calls should wait until office hours.

Once you have decided to make the call to your doctor, there’s some important information you should have on hand. By preparing for the call, it will be easier for you to let your doctor know exactly what’s going on. Here are some questions you should be ready to answer when you call:

What are the basic data on your child? Start with your child’s name, when he was last seen by a doctor, and who that was. This will help your doctor place your child. Tell her his age and weight, what medicines he’s taking, and what illnesses he’s had.

What’s wrong with your child? This may sound like a silly question to prepare for, but all too often a parent can’t answer it concisely. Think about your child’s problem and be prepared to describe exactly what’s going on. Things to think about include the following: What is your child eating [solids, liquids, nothing]? Is he urinating a normal amount? Is he having diarrhea? Is he acting normal? If not, what’s abnormal about his actions? Is he running a fever? If so. How high his temperature is and what method did you use to take it?

What’s happened or changed to make you decide to call the doctor now? This is an important question for you to think about. For example, your child’s temperature may have gone up a lot, or he may have suddenly begun to cry and pull at his ear, or he may just begin to vomit violently. Or perhaps you are just concerned and want some advice. If your questions can wait, your call can probably wait until morning.

What do you think is ailing your child? Often, parents know what’s wrong with their child. This is particularly true if their child has had many episodes of the same illness. For example, many parents know when their child is coming down with another ear infection. Or, if other members of the family have had a similar illness, there’s a good chance your child is getting the same thing. Let the doctor know what you think is going on.

Where do you want a prescription filled? You should decide which drugstore you want to use and make sure it’s opened and has a pharmacist on duty before you call. Have the phone number ready to give your doctor.

Doctors who take care of children expect interruptions and emergencies-they go with the age group. Most have no problems with appropriate phone calls at any hour. What irritate even the most caring physician are inappropriate calls and patients who abuse their services.

Immunization Schedule

Filed under: Immunization — Baby Original @ 3:49 am

Immunization Schedule Over the years, a commonly accepted immunization schedule has evolved. Most doctors follow it, although there are some acceptable variations. The schedule is designed to give your child the maximum protection available as soon as possible. The reason some shots are not given earlier is that the child’s own defense system hasn’t matured enough to develop immunity. For example, a number of years ago, the measles, mumps, and rubella vaccine were given to infants at twelve months. It was discovered that many of these infants didn’t develop protection against these illnesses because their own defense systems weren’t able to react to the vaccine correctly. The date was changed, and now the vaccine is much more effective.

Immunization and Testing Schedule
  • 2 months — DIP and TOPV
  • 4 months — DIP and TOPV
  • 6 months — DIP
  • 9-12 months — TB test
  • At least 15 months — MMR
  • 18 months — DIP and TOPV
  • 2 years — HiB and TB test
  • 4-6 years — DIP and TOPV
  • DIP [diphtheria-tetanus-pertussis vaccine]: This immunization is given as a shot, usually in the thigh. Many children have no reaction to it. Some have swelling and redness at the injection site, as well as some fussiness.

    TOPV [trivalent oral polio vaccine, also called the Sabin vaccine]: Your child is given a small amount of liquid to swallow. Side effects from this vaccine are very rare.

    MMR [measles, mumps, and rubella vaccine]: This vaccine is given as a shot. Your child needs only one shot to have lifelong protection from all three viruses.

    TB Test [tuberculosis test]: Some doctors feel that routine tuberculosis testing is necessary and do it on all children. Other doctors feel that this testing is not needed and do it only when they believe the child is at risk of exposure to this disease.

    HiB [hemophilus influenza type B vaccine]: This relatively new vaccine protects children against developing several types of infections including one type of meningitis [infection of the coverings of the brain and spinal cord]. This meningitis is more common in children two to six years old who are exposed to a number of other children, such as in day care centers, or who stay with babysitters who care for four or more children. Although this type of meningitis isn’t common, if your two to six year old child is in day care or with a babysitter, you should discuss the HiB vaccine with your doctor.

    Boosters: After your child has his childhood shots, he’s all set unless he is going to be traveling in certain foreign countries or until he turns twelve. The tetanus shot provides protection for five to ten years.

    Smallpox: The immunization used to be routine, but it has been discontinued because the risk from the vaccine itself is greater than the risk of getting smallpox. This disease has almost been wiped out worldwide.

    Taking a Temperature

    Filed under: Pediatrician — Baby Original @ 3:48 am

    Taking a Temperature It’s often helpful to know your child’s temperature. It is sometimes an indicator of the seriousness if the illness, although this isn’t always true. A normal oral temperature is 98.6 degrees Fahrenheit. A rectal temperature is one degree higher; an axillary [armpit] is one degree lower. “Normal” means average-some people run a slightly higher or lower temperature, and that is “normal” for them. Temperature varies throughout the day; a person’s temperature is usually a little higher in the afternoon and evening.

    The most accurate way to take the temperature of a young child is rectally. Any thermometer will do, although one designed for rectal use is shaped a little differently so it will go in more easily. If your child can’t keep a thermometer under her tongue and can’t keep her mouth closed for three minutes, it’s more accurate to use a rectal thermometer.

    When you are taking your child’s temperature with a rectal thermometer, it’s easiest if you lay your child on her stomach. Shake down the thermometer to 96 degrees or lower and lubricate it with some petroleum jelly. After separating her buttocks with the thumb and first finger of one hand, gently insert the thermometer to a depth of about one inch. Then pinch closed her buttocks. Hold the thermometer in place for three minutes to be sure you get an accurate reading.

    Taking the oral temperature of a young child may be difficult. After shaking down the thermometer, put it under her tongue. She should close her mouth around the thermometer and keep her mouth shut for three minutes. Be sure she hasn’t drunk anything cold within fifteen to thirty minutes before you take her temperature [if she has, the reading will be artificially low].

    Axillary temperatures are not very accurate. The same applies to the strips that are held against a child’s forehead.

    The new electronic thermometers are accurate and much easier to use than the older, glass ones. They are quicker and easier to read, and they signal you when they have reached their final reading.

    Sick-Baby Care

    Filed under: Examinations — Baby Original @ 3:47 am

    Sick-Baby Care There’s nothing scarier for a new parent than a sick baby. Your infant is fussy, not eating well, and has a fever. Should you take her to the hospital? Should you call your doctor? Or are you overreacting? As a well-informed parent, you want to know what you should do-when to be concerned and when not to worry. You want to know when to call the doctor and what to tell him. That’s what this section is all about.

    What You Need to Know

    All parents need to learn to tell when their child is sick, when to seek professional help, what to do in emergencies, and how to give medicines. Once you know these facts, you will be able to make the best decisions
    One of the best ways to deal with illness is to be prepared. This includes knowing about common childhood illnesses and emergency measures, as well as having and knowing how to give the appropriate medicines. There are some general steps you should take to prepare yourself for illness or accident:

    • Know the telephone numbers of your doctor, the hospital you use, the local poison control center, the fire department, and the ambulance service. These numbers should be posted near the telephone. Make sure your babysitters know where these numbers are located.
    • Ask your doctor what he wants you to have on hand for emergencies and treatment of common ailments. Many doctors recommend that you have syrup of ipecac and activated charcoal on hand for poisonings. Some want their patients to keep certain common medicines on hand for late night illnesses.
    • Discuss with your doctor what you should do in case of an emergency. If your child eats a bottle of pills or drinks a poison, should you call your doctor, the local emergency room, the poison control center? [Most doctors recommend you call the poison center, first.] If your child is injured, should you call your doctor first, or take your child to the emergency room? Asking these questions before an accident occurs will make things easier for both of you.
    • Read about childhood illnesses and accidents. Books will help you be prepared for the inevitable illnesses and injuries that befall all children.
    • Take a first aid course and learn CPR [cardiopulmonary resuscitation] and the Heimlich maneuver [for choking]. Be sure the instruction pertains to both children and adults [many courses only deal with adults]. Taking a class on these topics is much better than just reading about them. In the classes you have the opportunity to practice these skills on specially constructed models that are very life-like.
    • Most important, in an emergency, DON’T PANIC! Your calmness is essential if you’re going to react properly to the situation and get your child the appropriate care.

    Immunizations

    Filed under: Immunization — Baby Original @ 3:47 am

    Immunizations An important part of most baby visits is immunizations. They are designed to lessen the chance that your baby comes down with certain diseases. There was a time, not too long ago that many babies died of infections. Now we can prevent many of these killers with immunizations. It’s rare to see a child with polio, diphtheria, pertussis [whooping cough] these days, although there’s been more whooping cough recently since fewer parents are protecting their children. The number of people, both children and adults, who get rubella [German measles], has declined drastically since immunization became common.

    If immunizations are so beneficial, why has there been such an outcry against them recently, particularly the one against pertussis? There has been much publicity about some of the adverse side-effects of this vaccine. These side effects may be very serious. They include severe neurological damage and mental retardation.

    There are two important perspectives from which to consider the risks of immunizations: the risks of having the vaccine and the risks of not having the vaccine. From the first perspective we consider the risk/benefit ratio-that is, the relationship between the risk of a possible negative outcome and the benefit of the favorable outcome. For example, if one of every 100,000 children given a certain immunization died or suffered a serious side-effect, that is certainly one child too many. However, if we consider that 99,999 of the 100,000 children did not die but instead developed immunity to a deadly disease, the relative risk foe any individual child is very small indeed.

    From the second perspective, we consider the risk of no treatment-that is, we ask if the risk of getting the vaccine is greater than the risk of getting the disease. For example, if one of every 100,000 children who get the vaccine suffers a serious side-effect, it might seem like an unnecessary risk to take. However, if one hundred of every 100,000 children who did not get the vaccine suffered permanent damage or even die because of the disease, then clearly the risk of no treatment is one hundred times greater than the risk of treatment.

    The figures used are merely used for purpose of illustration, but the principles involved are important considerations when you are deciding whether to have your baby immunized against diseases. The benefits to be reaped from immunization are great, but there is always some degree of risk. Researchers are at work at further reducing the risks involved with some vaccines. Ask your physician her opinion of currently available vaccines.

    Fever

    Filed under: Pediatrician — Baby Original @ 3:46 am

    Fever Fever in a child strikes fear in the hearts of many parents. They wonder if their child will have a seizure and develop epilepsy, or if the temperature will go high enough to “cook” their child’s brain and cause permanent damage. You may be concerned about the proper way to treat your child’s fever and when you should call your doctor. Fever is perhaps the most misunderstood sign in all of medicine. It’s the body’s normal response to infection.

    Everyone has an “internal thermostat’ that controls his body temperature. When an infection is present certain chemicals are released in the body that “reset” the thermostat to a higher setting. This helps to explain the chills your child may experience when his temperature is going up. He feels cold because his body wants to be a higher temperature. Once the fever breaks, he feels hot because his body wants to be at a lower temperature. The breaking of the fever means that his internal thermostat has been turned down to normal.

    Understanding how a fever occurs helps you treat the chills and sweats that often accompany an illness. When your child has the chills, it’s best to add some blankets until he feels comfortable. Similarly, when he begins to sweat and feels warm, you should take off clothes or blankets. Bundling him up when he feels warm is defeating what the body is trying to do.

    Regular Office Visits

    Filed under: Pediatrician — Baby Original @ 8:35 pm

    Regular Office Visits Doctors like to see infants at regular intervals to monitor their growth, development, and health. These visits are important because if any health problem is developing, it’s best to find it early and treat it appropriately. Although your doctor may have a slightly different schedule of visits, most infants are seen when they are two, four, six, nine, twelve, fifteen, eighteen, twenty-four, thirty, and thirty-six months old.

    At each visit, your doctor will examine your undressed baby completely. He will ask you questions about your baby’s behavior and development. He’ll be looking for certain developmental milestones-things babies are usually doing at certain ages. These milestones are only guidelines, but if a baby consistently fails to meet them by certain ages, further investigation needs to be done.

    Well-Baby Care

    Filed under: Pediatrician — Baby Original @ 8:30 pm

    Well-Baby Care During your baby’s first three years of life, she will see the doctor a number of times. These visits are important to make sure she is growing and developing appropriately. Your doctor will ask you a number of questions to see how things are going, and he will examine your baby, checking for normal growth and looking for problems. Routine and regular checkups are particularly important for you r baby during her first three years of life. Problems at this age, if not treated early, may have serious implications for her later in life.

    The first time your baby’s doctor sees her will be within twenty-four hours after her birth. The doctor will do a complete examination of the baby and will want to talk to you about your pregnancy, labor and delivery. If you smoked, took any drugs, [prescribed or “recreational”], or drank much alcohol, you need to tell this to the doctor. These factors may affect your baby’s health or growth. The doctor will examine your baby daily while she’s in the hospital and also talk to you. These visits to you are important. Not only will you find out how your baby is doing, but you will have an opportunity to ask questions. Prepare for these visits; write down your questions ahead of time. Your doctor will give you advice on taking care of your new baby, such as feeding instructions and safety ideas.
    One of the most important office visits is the first one. Most doctors like to see the baby when she is two to three weeks old. During her first month, the baby will change a lot. You will have many questions and concerns about your new baby, and this visit gives you the opportunity to ask them.

    The doctor’s staff will probably ask you some questions before you see the doctor. How is the baby feeding? Is she sleeping well? Are there any problems with her bowels? Are there any skin problems? These are just a few of the questions you may be asked. They will also measure the baby’s weight, head circumference, [the distance around her head], and body length. These measurements are important for monitoring your baby’s growth. Each will be plotted on a growth chart. These charts are the best way to determine if your baby is growing well.

    When you see the doctor, he will go over all this information and ask more questions if needed. Next comes the examination of your baby. Your baby should be completely undressed for this examination. The doctor will begin the examination at the top of her head and go to the tips of the toes, examining everything in between.

    After examining your baby, he’ll tell you his findings and if there are any problems. Rarely are there any surprises found at this visit, although occasionally a congenital abnormality [a birth defect] is found that was not apparent when the baby was in the hospital. At this age, no immunizations are given.

    Physician Extenders

    Filed under: Pediatrician — Baby Original @ 8:20 pm

    Physician Extenders Two relatively new health care practitioners are seeing more and more children. These are nurse practitioners and physician’s assistants-often collectively referred to as physician extenders. Nurse practitioners are registered nurses who take one or two tears of further training in physical examination, diagnosis, and prescribing medicines. Many work with physicians, although a number of them practice by themselves. Physician’s assistants graduate from a two year program in which they learn the same things as the nurse practitioner.

    Many physicians employ a physician extender who sees patients in the office. Frequently, they see children for routine health care. They can spend more time talking with you, answering your questions, and teaching you what you need to know. Most often the charge is the same whether you see the physician extender or the doctor.

    Questions to Ask Your Pediatrician

    Filed under: Pediatrician — Baby Original @ 8:17 pm

    Questions to Ask Your Pediatrician When you go for the “get acquainted visit” before your baby is born, you should bring with you a list of questions. The doctor’s answers to your questions are important and you should make notes. Follow up on any answers you don’t understand. Be aware of the doctor’s style and how he answers the questions.

    Here is a list of some questions you should ask:

    • What hospitals do you use/ you may want to be sure the doctor uses the hospital you prefer. Does he have a preference for a hospital far from your home? If so, find out why. Perhaps that hospital offers special services or has a different approach to taking care of children.
    • What hours is your office open? With medicine becoming more competitive, doctors are doing more to attract and keep patients. This includes offering evening and Saturday office hours. If a doctor’s office hours are inconvenient for your family, you may want to find another doctor.
    • What services do you provide in your office? Many doctors’ now provide a number of services in their offices to make things easier for you. For example, they may perform many laboratory tests there, or take blood samples that need to be sent out to a laboratory for special tests. Many doctors perform hearing and vision tests in their offices. The more done in the office, the fewer places you may have to take your child.
    • What should I do if my child is sick at night or on the weekend and I can’t reach you? Most doctors arrange to have other physicians “cover” for them [take care of their patients] when they are not working or out of town. Be sure the doctor has such a system. Find out who the covering doctors are because you may have to deal with them. Be wary of a doctor who tells you to take your sick child to the emergency room when he’s not around.
    • How do I fit in to the care of my child? Some doctors want parents to active participants in the medical care of their children. Other doctors want to be completely in charge and make all the decisions without input from parents. You need to know the doctor’s feelings in this area. If they conflict with yours, the doctor probably isn’t right for you.
    • How do you feel about patient education? In this day of increasing medical awareness by parents, most doctors encourage parental education. However, there are still some doctors who buck this trend, believing that a little learning is a dangerous thing.
    • What are your feelings on “routine” medical care? There is a controversy about some aspects of pediatric care [for example, routine immunizations and circumcisions]. Is this doctor dogmatic in his approach? Is his way the only right way? If you have strong feelings about your child’s care, such an approach may lead to conflict.
    • What are your fees? This used to be a difficult question, one that both parents and doctors avoided, but this is changing. There are large differences in what doctors’ charge for the same services. Get a price list for the routine things like well-baby examinations.
    • What type of training did you receive? Any doctor should be willing to tell you about his training-medical school, residency, and any special training. Don’t be impressed by a wall full of fancy diplomas. In and of themselves, they may not mean much. Almost every medical organization sends out diplomas, and many don’t signify much except the doctor paid his dues. The competence of the physician isn’t measured by the number of diplomas and certificates he has. It is, however, a good idea to ask him if he is board certified-that is, if he has demonstrated by completion of certain requirements and passage of an examination competency in his specialty.

    After you have made your visits, talk to some of your friends. Find out whom they use and why. Ask them the questions you asked the doctor [especially about service and availability], and see if you get the same answers.

    When you have all this information, you will be in a position to make an educated decision. Once you decide, let the doctor know. Find out if there’s any information her office needs to know about you. If your children have records with another doctor, arrange for them to be sent.

    After all this work, there’s still a chance you’ll decide, after a few visits, that your new doctor isn’t what you expected. You should discus this with her. Try to explain why you aren’t satisfied. Maybe there’s a misunderstanding that’s easy to correct. Your doctor’s reaction to what you say is important. If she gets mad or rude, you should look for another doctor. Don’t feel obligated to stick with her if you don’t agree with her on some important matter, like her approach, treatment, or fees.

    When you change doctors, you should get your child’s old medical records. This is easy to do. Just send a note to his former doctor asking that his records be sent to the new doctor. Physicians will do this as a service to all patients. Most states require doctors to do this. The law says the contents of the records belong to the patient even though the actual records belong to the physician. When you send your request, be sure to sign it. Without a signature, the records cannot be sent.

    Pediatrician versus Family Practitioner

    Filed under: Pediatrician — Baby Original @ 8:16 pm

    Pediatrician versus Family Practitioner There are two different specialists that take of babies-family practitioners and pediatricians. Both have completed a residency [extra training after graduating from medical school]. A family practitioner’s training covers all areas of medicine including adult medicine, pediatrics, obstetrics, and surgery. A pediatrician’s residency is focused primarily on pediatrics. He has spent more time dealing with ill children and children with special problems. A family practitioner will take care of your entire family-from the very young to the very old. Most family practitioners encourage this. They find it easier to treat an individual if they know the whole family. Family practitioners frequently are better able to deal with emotional or family problems that affect everyone in the household… A pediatrician takes care of children exclusively. Usually they stop seeing a child when he is in his mid teens.

    Both kinds of specialists can take care of normal children equally well, however, if your child ha special problems, a pediatrician may be better.

    Choosing a Baby Doctor

    Filed under: Pediatrician — Baby Original @ 8:15 pm

    Choosing a Baby Doctor One of the most important decisions you’ll make about your baby’s health is selecting his doctor. Finding the right doctor isn’t easy. There are many questions that must be asked and answered before you make the selection. It’s important to find a doctor you feel comfortable with-someone whom you can talk to and who’ll answer your questions to your satisfaction. The doctor’s style must be right for you!

    You should meet with several doctors befor