NEWBORNS and INFANTS
Bringing a new baby home is exciting, but can also be intimidating. Newborns have many needs and health issues that are different from older children and adults. Your baby will go through many changes during the first year of life and reach some exciting developmental milestones. It’s important to ask for help any time you need it.
SAFE SLEEP RECOMMENDATIONS
The safest place for your infant to sleep is on its back, on a firm surface such as a crib, bassinet, play pen or a separate bed from the parent. An infant’s risk of sudden infant death syndrome (SIDS) is five times higher when placed in a bed with an adult. The only thing that should be in the baby’s bed is a tight-fitting mattress with a tight-fitting sheet and the baby – nothing else. Stuffed animals, blankets, bumper pads are all unsafe for your baby’s sleeping environment.
Although it might seem strange to leave your baby alone in a stark crib, the reality is that it is the safest
environment you can create for your child. Soft bedding that parents think is safe increases the risk of accidental death from suffocation or strangulation. While infants are at heightened risk for SIDS between the ages one and four months, new evidence shows that soft bedding continues to pose hazards to babies who are 4 months and older.
The American Academy of Pediatrics recommendations for a safe sleep environment include:
- Place the baby on his or her back on a firm sleep surface such as a crib or bassinet with a tight-fitting sheet.
- Avoid use of soft bedding, including crib bumpers, blankets, pillows and soft toys. The crib should be bare.
- Share a bedroom with parents, but not the same sleeping surface, preferably until the baby turns one but at least for the first six months. Room-sharing decreases the risk of SIDS by as much as 50 percent.
- Avoid baby’s exposure to smoke, alcohol and drugs.
New guidelines released in 2016 also call for infants to share their parents’ bedroom for at least the first six months and, optimally, for the first year of life. Breastfeeding is also recommended as added protection against SIDS. After feeding, parents should move the baby to his or her separate sleeping space, preferably a crib or bassinet in the parents’ bedroom.
Other recommendations from the American Academy of Pediatrics :
- Offer a pacifier at nap time and bedtime.
- Do not use home monitors or commercial devices, including wedges or positioners, marketed to reduce the risk of SIDS.
- Infants should receive all recommended vaccinations.
- Supervised, awake tummy time is recommended daily to facilitate development.
For an open, non-judgmental conversation about your baby’s sleeping habits, please call our office at 440-653-8091.
FEVER IN BABIES UNDER TWO MONTHS OLD
A fever helps the body fight infection, making the body less hospitable to germs, and triggers immune defenses. It is also a sign that the baby’s immune system is working properly. Despite what you may have heard, fever will not injure your child’s brain.
However, babies younger than two months, with a rectal temperature of 100.4 degrees or higher, should we taken to the emergency room. Young babies do not show signs of severe infection like older babies do, and can develop a blood infection (sepsis) and not display any typical symptoms. Also, some bacterial infections can cause damage in young babies very rapidly.
It is impossible to determine if what is causing the fever is a bacterial or viral infection without blood, urine, X-ray or stool testing. (The exact tests depend on your baby’s age and symptoms).
After the baby is examined, you can help your baby feel better by keeping him or her hydrated with breast milk or formula. It may also help to give the baby a lukewarm bath, or dress your baby in light clothes and keep the environment comfortably cool. For example, if the room is warm and stuffy, use a fan to keep the air moving. You can always call our office for medical advice.
INTRODUCING SOLID FOODS
A good sign your baby is ready for solid foods is if he or she is fascinated by watching you eat, or by watching your plate. The American Academy of Pediatrics recommends starting your child on solid food between the ages of 4 and 6 months. Within this time frame, look for some of these developmental milestones:
- Can sit upright and hold up head
- Is curious about surroundings and food
- Has mastered tongue movement
- Seems hungry even after a full day of milk (eight to 10 breast feedings or 32 ounces of formula)
Start your baby of with single-grain cereal or pureed fruits or vegetables – steer clear of any solids slightly thicker than a liquid. Offer the food on a small scale at first. Choose one food to introduce at a time, and feed only that new food for a few days before introducing another new food (to be certain of allergic reactions). If you notice vomiting, rashes or diarrhea, consult our office.
If at first the baby rejects the solids, try again a few days later. If the baby is closer to six months, patiently continue to try the solids as frequently as possible. Continue to offer breast milk or formula at meal time. As your baby gets older you can gradually increase the solid food intake. Take notice if the baby turns his or her head, or spits out the food. This is a sign that they are done eating.
Until your baby is seven to 10 months old, they will drink most their calories. So, mealtime is primarily about getting them used to the act of eating, the feeling of certain textures and tastes of foods. Once your baby is excited about mealtime, start them on a routine for breakfast, lunch and dinner even if they are not hungry. It would be ideal to the have baby on a regular eating schedule by the time they turn one, this means three meals a day with two or three snacks in between (such as finger foods, crackers).
Be prepared for some challenges. It will take time for the baby to feel comfortable with the spoon. And, there will most certainly be some messes from time to time. This is not unusual. Try to keep meal time calm and avoid loud music or the television while eating.
CAR SEAT GUIDELINES
The American Academy of Pediatrics recommends that children ride in rear-facing seats at least until the age of two. Extensive research shows that placing an infant in rear facing car seat reduces the likelihood of accident related fatality by 71%.
Installing your car seat can be tricky. Read the directions that come with your car seat and follow them without alteration. Car and car seat combinations vary widely. For vehicles made after 2002, there may be a LATCH system used to secure car safety seats. LATCH stands for Lower Anchors and Tethers for Children and is an attachment system that eliminates the need to use seat belts to secure the car seat. Instead, there is an anchor in the car that allows a hook on the car seat to attach to it. Remember, for LATCH to work, both the car seat and the car must be compatible with LATCH.
Make sure the seat is attached firmly. You should not be able to move it more than an inch in any direction. Make sure the angle of the seat doesn’t allow the infant’s head to flop forward. If your seat does not adjust, you can put a rolled-up towel at the back and the bottom where the vehicle seat meet under the base of the car seat.
Read the manufacturer’s directions and specifications for weight and height requirements for your child’s car seat because not every seat is the same. In general, large infants (>20 lbs.) or infants in a bulky snow suit in the winter whose knees are encroaching on his/her face, or infants whose head is extending out past the top of the seat’s backrest (about 26 inches) should be placed in a convertible car seat.
Very small infants should have support on either side of them for additional support. The shoulder harness should come through the back of the seat at the same level as the shoulders, or lower. Harness straps should lay flat and be tight enough for no more than two fingers to fit in between the strap and collarbone. The chest buckle should be at armpit level.
If in a car accident, manufacturers recommend replacing a seat after a moderate to severe crash. It is very possible that a seat has been weakened and damaged without any visible indicators. Some insurance policies pay for a new car seat.
Resources to help:
For Recalls: 888-327-4236 or the National Highway Traffic Safety Administration (hyperlink)
For installation help: www.seatcheck.org or call 866-732-8243
National Highway Traffic Safety Administration www.nhtsa.dot.gov, 888-327-4236
Center for Injury Prevention www.cipsafe.org, 800-344-7580
U.S. Consumer Product Safety Commission, www.cpsc.govTODDLERS