Archive for the ‘Baby’ Category

Do you have your measles vaccination?

Monday, August 18th, 2014

vaccinationMeasles is a disease that is easily spread and causes rash, cough and fever. In some cases, it can lead to diarrhea, ear infection, pneumonia, brain damage or even death. Measles spreads through the air by breathing, coughing or sneezing. It is so contagious that any child who is exposed to it and is not immune will most likely get the disease. Measles can cause serious health problems in young children. It also can be especially harmful to pregnant women and can cause miscarriage or premature birth.

This year the U.S. is experiencing a record number of measles cases. The Centers for Disease Control and Prevention (CDC) states that between January 1 and August 1, 2014, there have been 593 confirmed measles cases reported. This is the highest number of cases since the U.S. declared that measles was eliminated from this country in 2000.

The majority of the people who get measles are unvaccinated. Children under 5 and adults over 20 are at higher risk for getting complications from the measles virus, including hospitalization and death.

The measles, mumps and rubella (MMR) vaccine protects against the measles disease, as well as the mumps and rubella diseases. Your baby gets the MMR vaccine in two doses: the first between 12 and 15 months, and the second between 4 and 6 years.

If you’re thinking about getting pregnant, make sure you’re protected against measles. If you need to get vaccinated, get the MMR vaccine before pregnancy. Wait at least 1 month before trying to get pregnant after getting the shot. The MMR vaccine is not recommended if you are already pregnant.

To read more about vaccines before, during and after pregnancy, click here.

If you have further questions on measles or vaccines, feel free to email us at AskUs@marchofdimes.org.

Click here to read more News Moms Need blog posts on: pregnancy, pre-pregnancy, infant and child care, help for your child with delays or disabilities, and other hot topics.

Eye care for your child

Friday, August 15th, 2014

baby-eyesTaking care of your eyes is very important at all ages. Visual information helps children develop and to process the world around them from the time they are babies. Difficulty seeing can result in problems in learning as well as relating to the outside world. Most vision problems can be treated and corrected, but it is important to identify them as early as possible.

The American Academy of Pediatrics (AAP) as well as the American Academy of Ophthalmology recommend regular vision checks:

Newborns
The first vision exam should occur before your baby even leaves the hospital nursery. Newborns should have their eyes checked for infections, structural defects, cataracts, or congenital glaucoma.

Premature infants will need a special eye exam done by a pediatric ophthalmologist. A pediatric ophthalmologist is an eye doctor trained and experienced in the care of children’s eye problems.  Preemies are at risk for a condition called retinopathy of prematurity (ROP). ROP happens when a baby’s retinas don’t fully develop in the weeks after birth. The retina is the nerve tissue that lines the back of the eye. ROP usually affects both eyes. If your baby has ROP, getting treatment right away is very important.

Six months
Pediatricians should screen infants during their well-baby check-ups to make sure they have proper eye alignment. This means that their eyes are working together. They should continue to look for signs of eye disease.

Three to four years
At this age, both the eyes and vision should be examined by your child’s health care provider for any abnormalities that may cause a problem with educational development. Concerns will result in a referral to a pediatric ophthalmologist.

Five years and older
Regular screening of visual acuity and other eye functions should be completed every year during the well-child exam. The visual acuity test is used to determine the smallest letters you can read on a standardized chart or a card held 20 feet away. There are other ways to check vision in very young children if they do not yet know their letters or numbers.

Although routine eye exams are important, as a parent you may notice signs that your child is having difficulty seeing. According to AAP, some of the signs that a child may have a vision problem include:
• sensitivity to light
• poor focusing and poor visual tracking (following an object)
• abnormal alignment or movement of the eyes (after 6 months of age)
• persistent (lasting more than 24 hours) redness, swelling, crusting, or discharge in the eyes
• excessive tearing of the eyes
• frequent squinting
• drooping of one or both eyelids
• pupils (the center circle of the eye) of unequal size
• eyes that “bounce” or “dance”
• inability to see objects unless they are held close
• a white pupil instead of black in one or both eyes
• any cloudiness in the eye

If you notice any of these symptoms, make sure you contact your child’s health care provider right away. If caught early, many eye problems can be treated and corrected.

Click here to read more News Moms Need blog posts on: pregnancy, pre-pregnancy, infant and child care, help for your child with delays or disabilities, and other hot topics.

Breastfeeding a baby with a cleft lip/palate

Monday, August 11th, 2014

mom loving babyA cleft lip is a birth defect in which a baby’s upper lip doesn’t form completely and has an opening. A cleft palate is a similar birth defect in a baby’s palate (roof of the mouth). A baby can be born with one or both of these defects. If your baby has a cleft lip, a cleft palate, or both, he may have trouble breastfeeding. It is normal for babies with a cleft lip to need some extra time to get started with breastfeeding. If your baby has a cleft palate, he most likely cannot feed from the breast. This is because your baby has more trouble sucking and swallowing. You can, however, still feed your baby pumped breast milk from a bottle.

Your baby’s provider can help you start good breastfeeding habits right after your baby is born. The provider may recommend:

• special nipples and bottles that can make feeding breast milk from a bottle easier.

• an obturator. This is a small plastic plate that fits into the roof of your baby’s mouth and covers the cleft opening during feeding.

Here are some helpful breastfeeding tips:

• If your baby chokes or leaks milk from his nose, the football hold position may help your baby take milk more easily. Tuck your baby under your arm, on the same side you are nursing from, like a football. He should face you, with his nose level with your nipple. Rest your arm on a pillow and support the baby’s shoulders, neck and head with your hand.

• If your baby prefers only one breast, try sliding him over to the other breast without turning him or moving him too much. If you need, use pillows for support.

• Feed your baby in a calm or darkened room. Calm surroundings can help him have fewer distractions.

• Your baby may take longer to finish feeding and may need to be burped more often (2-3 times during a feed).

• It may help to keep your baby as upright as possible during his feeding. This position will allow the milk to flow into his stomach easier, which will help prevent choking.

How breastfeeding can help your baby:

• His mouth and tongue coordination will improve, which can help his speech skills.

• His face and mouth muscles will strengthen, leading to more normal facial formation.

• If your baby chokes or leaks milk from his nose, breast milk is less irritating to the mucous membranes than formula.

• Babies with a cleft tend to have more ear infections; breast milk helps protect against these infections.

If your baby is unable to breastfeed: 

• Feed your baby with bottles and nipples specifically designed for babies with clefts. Ask your baby’s health care provider for recommendations.

If you are concerned if your baby is getting enough to eat, or if he is having trouble feeding, speak with a lactation counselor, your baby’s provider or a nurse if you are still in the hospital.

If you have any questions about feeding your child with a cleft lip or palate, email us at AskUs@marchofdimes.org.

 

Breastfeeding your baby in the NICU can be challenging

Monday, August 4th, 2014

feeding in the NICUMost babies, even those born very premature can learn to breastfeed. Breast milk provides many health benefits for all newborns, but especially for premature or sick babies in the NICU. Feeding a preemie may be much different than what you had planned. If you must pump, you may feel disappointed that you are not able to feed your warm baby on your breast. But, providing breast milk for your preemie is something special and beneficial that you can give him.

Here are tips to help you breastfeed your preemie while in the NICU.

If your baby is unable to feed or latch:

• Start pumping as soon as you can to establish your milk supply. Ask a nurse for a pump and assistance.

• If your preemie is tube feeding, your baby’s nurse can show you how to give your baby his feedings.

• Pump frequently, every 2 to 2-1/2 hours around the clock for a couple of days and nights (or 8 to 12 times during the day, so you can catch some sleep at night).

• Practice skin to skin or kangaroo care if your nurse says it is ok. Both are beneficial, even if your baby is connected to machines and tubes.

If your baby is able to suckle:

• Ask to feed him in a quiet, darkened room, away from the beeping machines and bright lights.

• Many mothers find the cross cradle position very helpful for feedings. Start with kangaroo care. Then position the baby across your lap, turned in towards you, chest to chest. Use a pillow to bring him to the level of your breast if you need to.

• Preemies need many opportunities at the breast to develop feeding skills regardless of gestational age. This requires practice and patience.

• You may need increased support to breastfeed your preemie. Look for support from your nurses, the hospital’s lactation consultant, friends or family.

Not every tip will work for every mom. Try to find the feeding methods and solutions that work best for you and your preemie. More information on how to feed your baby in the NICU can be found here.

If you have questions about how to feed your baby, email us at AskUs@marchofdimes.org.

Preemies and hearing loss

Wednesday, July 30th, 2014

baby's earNearly 3 in 1,000 babies (about 12,000) are born with some kind of hearing loss in the United States each year. Most babies get their hearing checked as part of newborn screening before they leave the hospital. Newborn screening checks for serious but rare conditions at birth.

If your baby doesn’t pass his newborn hearing screening, it doesn’t always mean he has hearing loss. He may just need to be screened again. If your baby doesn’t pass a second time, it’s very important that he gets a full hearing test as soon as possible and before he’s 3 months old.

The risk of hearing loss is significantly higher in babies born with a very low birth weight (less than 1500 grams). However, hearing loss can be caused by other factors, such as genetics, family history, infections during pregnancy, infections in your baby after birth, injuries, medications or being around loud sounds. See our article  to learn more about the different causes of hearing loss.

Possible treatments

Different treatments are available depending on your child’s level of hearing loss, his health, and the cause of the hearing loss. They include medication, surgery, ear tubes, hearing aids, cochlear implants, learning American Sign Language and receiving speech therapy.  The article on our website discusses each of these types of treatments.

If a child needs speech therapy, it can usually be provided through the early intervention program for babies and toddlers. Read this post to understand how to access services. The sooner your child gets help, the sooner language skills will emerge and improve.

If you need more detailed information, check out these sites:

Early Hearing Detection and Intervention (EHDI) Program

Individuals with Disabilities Education Improvement Act 2004 (IDEA 2004)  

Hearing loss treatment and intervention services

Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. While on News Moms Need and click on “Help for your child” in the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). We welcome your comments and input.

 

The do’s and don’ts of bottle-feeding

Monday, July 28th, 2014

bottle-feeding babyWe all know breastfeeding is best for your baby, but if your baby is taking formula from a bottle, it is important to make sure each feeding is safe and clean.

Powdered infant formula is not sterile. It could contain bacteria that can cause serious illness to your baby. By preparing and storing formula properly and sterilizing bottles, you can reduce the risk of infection.

Here are some tips for keeping bottle-feeding safe for your baby:

• Boil bottles and nipples for 5 minutes before you use them for the first time. After the first use, wash them for 1 minute in hot, soapy water and rinse after each use. This removes harmful bacteria that can grow and make your baby sick.

• To be sure your baby’s formula is sterile, feed her prepared liquid formula, especially when she is a newborn.

• Wash your hands before preparing each bottle.

• When you first open your formula container, make sure it is sealed properly. If it is not sealed, return it to the store.

• Check the “Use By” date on the formula package. Do not use it if it has expired.

 If you are using powdered formula:

• The safest way to prepare formula is to boil the water before use. Allow the water to cool down before mixing with formula. If you do not boil the water, prepare the formula with sterilized bottled water.

• Avoid mixing up large amounts of formula at one time.

• Be sure to use the right amount of water to mix with your baby’s formula. Read the directions on the packaging label. Too much water may keep your baby from getting the right amount of nutrients she needs to grow. Too little water may cause diarrhea or dehydration.

For all bottles:

• Don’t heat formula in the microwave. Some parts can heat up more than others and burn your baby. You can warm or cool the bottle by holding it under running water. Make sure the running water is below the lid of the bottle. Then, shake the bottle to mix the formula to avoid hot spots.

• To keep bacteria from growing, don’t leave formula out of the refrigerator for more than 2 hours. If you do not plan to feed your baby right away, refrigerate the bottle until the feeding.

• If you plan to make a bottle of formula in advance to use later, prepare the feedings separately and put them in the refrigerator until they are needed. Throw away unused formula that has been in the fridge for more than 24 hours.

• If your baby does not finish the entire bottle of formula, discard the remaining formula.

•  If you are traveling, keep the prepared formula cold by placing the bottle in a lunch bag with ice packs.

For more information on how to prepare bottles safety, visit the World Health Organization’s guidelines for cleaning, sterilizing & storing. For information about formulas and what to ask your baby’s doctor, visit our website.

For information on safe handling and storage of breast milk, visit our blog.

If you have questions about bottle-feeding safety or other pregnancy and newborn health questions, email us at AskUs@marchofdimes.org

Phenylketonuria (PKU)

Friday, July 25th, 2014

newborn-screening-picture1Phenylketonuria (also called PKU) is a condition in which your body can’t break down an amino acid called phenylalanine. All babies born in the United States are tested for PKU through the newborn screening program in their state.

What is phenylalanine? 

Phenylalanine is an essential amino acid. Amino acids are building blocks for proteins. Our bodies need amino acids for proper growth and development but we cannot make them on our own. We need to get them from food sources. Phenylalanine is found in most foods that contain protein. This includes beef, poultry, fish, soy products, eggs, cheese, etc.

Once phenylalanine is in the body, it is converted into tyrosine, another amino acid. Tyrosine is then used by the body in a variety of ways, including the formation of chemicals that are necessary for your brain to function properly.

Why is phenylalanine harmful for people with PKU?

If your baby is born with PKU, she cannot break down phenylalanine. Phenylalanine then builds up in the blood and interferes with normal brain development. Without treatment, babies born with PKU begin to have signs of the condition at about 6 months of age. These include:

  • Jerky movements in arms and legs
  • Seizures
  • Skin rashes
  • Small head size
  • Developmental delays and behavioral problems

What causes PKU?

PKU is inherited. This means it’s passed from parent to child through genes. A gene is a part of your body’s cells that stores instructions for the way your body grows and works. Genes come in pairs—you get one of each pair from each parent. Sometimes a change in a gene can cause it to not work correctly. This change is known as a mutation.

Your baby has to inherit a mutation for PKU from both parents to have PKU. If she inherits the mutation from just one parent, your baby is called a PKU carrier. A PKU carrier has one copy of the mutation but doesn’t have PKU.

How is PKU treated?

If your baby is diagnosed with PKU, then she will need to be on a special diet that significantly reduces the amount of phenylalanine she consumes. Ideally the diet would begin in the first few days of life. Babies who have PKU may never show symptoms if they are transitioned to a low-phenylalanine diet soon after birth.

If your baby is diagnosed with PKU, she will need to maintain a low-phenylalanine diet for life. If she were to stop controlling her dietary intake of phenylalanine, changes in the brain would occur, even well into adulthood. Women who have PKU and wish to become pregnant need to be on a very well controlled diet in order to protect their baby during pregnancy.

If you have any questions about this topic or other pregnancy and newborn health issues, please email the Pregnancy and Newborn Health Education Center at askus@marchofdimes.org.

Cleft and craniofacial awareness and prevention month

Monday, July 21st, 2014

July is cleft and craniofacial awareness and prevention month. Craniofacial abnormalities are  defects of the head (cranio) and face (facial) that are present when a baby is born. Cleft lip and/or cleft palate are a couple of the most common abnormalities.

Craniofacial abnormalities can range from mild to severe. These defects can present a variety of problems including eating and speech difficulties, ear infections and misaligned teeth, physical learning, developmental, or social challenges, or a mix of these issues. However, there are steps you can take to help prevent cleft and craniofacial defects before your baby is born.

What increases the risk of having a baby with craniofacial abnormalities?

We’re not sure what causes these defects. Some possible causes are:

• Changes in your baby’s genes. Genes are part of your baby’s cells that store instructions for the way the body grows and works. They provide the basic plan for how your baby develops. Genes are passed from parents to children.

• Diabetes. Women who have diabetes before they get pregnant have a higher risk of having a baby with a cleft or craniofacial birth defect.

• Maternal thyroid disease. Women who have maternal thyroid disease or are treated for the disease while they are pregnant have been shown to have a higher risk of having a baby with an abnormality.

• Not getting enough folic acid before pregnancy. Folic acid is a vitamin that can help protect your baby from birth defects of the brain and spine called neural tube defects. It also may reduce the risk of oral clefts by about 25 percent.

• Taking certain medicines, like anti-seizure medicine, during pregnancy.

• Smoking during pregnancy.

• Drinking alcohol during pregnancy.

• Having certain infections during pregnancy.

How can you prevent cleft and craniofacial defects?

There are steps you can take to decrease the chance of having a baby with cleft and craniofacial defects.

• Before pregnancy, get a preconception checkup. This is a medical checkup to help make sure you are healthy before you get pregnant.

• Take a multivitamin that contains folic acid. Take one with 400 micrograms of folic acid before pregnancy, but increase to one with 600 micrograms of folic acid during pregnancy. Your provider may want you to take more – be sure to discuss this with him.

• Talk to your provider to make sure any medicine you take is safe during pregnancy. Your provider may want to switch you to a different medicine that is safer during pregnancy.

• Don’t smoke.

• Don’t drink alcohol.

• Get early and regular prenatal care.

If you have any question about cleft or craniofacial defects, causes or prevention, read more here or email us at Askus@marchofdimes.com.

Group B strep infection

Friday, July 18th, 2014

Between 35-37 weeks of your pregnancy your prenatal care provider will test you for Group B strep. Group B streptococcus (also called Group B strep or GBS) is a common type of bacteria that can cause infection.

Many people carry Group B strep—in fact about 25% of pregnant women are carriers.  GBS bacteria naturally live in the intestines and the urinary and genital tracts. It is not known how GBS is transmitted in adults but you can’t get it from food, water, or things you touch. An adult can’t catch it from another person or from having sex, either.  Most people do not even know they are carriers since adults usually show no signs or symptoms related to GBS.

GBS, however, can be passed to your newborn during labor and delivery and it can make your baby very sick. Babies with a GBS infection may have one or more of these illnesses:

• Meningitis, an infection of the fluid and lining around the brain

• Pneumonia, a lung infection

• Sepsis, a blood infection

According to the CDC, in the US, group B strep is the leading cause of meningitis and sepsis in a newborn’s first week of life.

There are two kinds of GBS infections:

1. Early-onset GBS: Signs like fever, trouble breathing and drowsiness start during the first 7 days of life, usually on the first day. Early-onset GBS can cause pneumonia, sepsis or meningitis. About half of all GBS infections in newborns are early-onset.

2. Late-onset GBS: Signs like coughing or congestion, trouble eating, fever, drowsiness or seizures usually start when your baby is between 7 days and 3 months old. Late-onset GBS can cause sepsis or meningitis.

The good news is that early-onset GBS infection in newborns can be prevented by a simple test. During your third trimester, your provider will take a swab of the vagina and rectum. Results are available in a day or so. This test will need to be done in each pregnancy.

If you do have GBS, then your provider will give you an antibiotic through an IV (medicine given through a tube directly into your bloodstream) during labor and delivery. Usually this is penicillin (if you are allergic to penicillin, there are other options available). Any pregnant woman who had a baby with group B strep disease in the past, or who has had a bladder (urinary tract) infection during this pregnancy caused by group B strep should also receive antibiotics during labor.

Unfortunately late-onset GBS cannot be prevented with IV antibiotics. Late-onset GBS may be due to the mother passing the bacteria to her newborn, but it may also come from another source, which is often unknown.

Treatment for babies infected with either early-onset GBS or late-onset GBS is antibiotics through an IV.

Currently researchers are testing vaccines that will help to prevent GBS infections in both mothers and their babies.

If you have any questions about this topic or other pregnancy and newborn health issues, please email the Pregnancy and Newborn Health Education Center at askus@marchofdimes.org.

Medication dosing mistakes are common

Wednesday, July 16th, 2014

medicine syringe for kidsWhether you have a child with special needs or not, chances are you have given him medication at some point. A recent study published in Pediatrics revealed that many parents made mistakes when giving their child medication. “Medication errors were common: 39.4% of parents made an error in measurement of the intended dose, 41.1% made an error in the prescribed dose. Furthermore, 16.7% used a nonstandard instrument.”

The study compared parents who used milliliter-only cups or syringes with parents who used teaspoon or tablespoons to describe how they measured their child’s medicine. The researchers found that parents who described measuring the medication in teaspoons or tablespoons were twice as likely to make a mistake in giving the correct dose.

In addition, many parents did not understand the correct amount of medicine to give their child and mixed up the measuring terms. According to the American Academy of Pediatrics (AAP), “Parent mix up of terms like milliliter, teaspoon and tablespoon contribute to more than 10,000 poison center calls each year.”

Why does this happen?

One reason is because all spoons are not created equal. Dosing mistakes happen because people confuse teaspoons with tablespoons. Did you know that one tablespoon equals three teaspoons?!

Another reason is that people use everyday kitchen spoons instead of medication measuring spoons which are specifically designed to give an accurate dose. Again, the differences in the spoons can produce very different amounts of medicine given to your child.

What can you do?

• When measuring meds, use the oral syringe, dropper, or cup that comes with the medication. Do not use one medicine’s cup for another medicine. Measure carefully and exactly.

• Do not use kitchen teaspoons or tablespoons because there is a wide variety of kitchen spoons which can hold vastly different amounts of liquid.

• If you are giving a non-prescription medication (such as Tylenol or any over-the-counter medicine), be sure to give the dose that is based on your child’s weight, not his age. If in doubt, ask a doctor, nurse, physician assistant or pharmacist.

• Keep a log. Use your smartphone or a notebook to record the medication, date, time and amount that you gave your child. It is very easy to forget when you gave your child a medication, especially if you are giving more than one medication at different times during the day. Parental fatigue, multitasking and stress can also cause you to forget.  In addition, a medication “log” is very important if more than one person is giving medicine to your child.

• If in doubt, ask your child’s health care provider or your pharmacist. It could save your child’s life.

Learn more

• Check out the AAP’s video guide on how to measure meds and read about useful medication tips here.

The study’s authors suggest that children’s liquid medications only be prescribed in milliliters to help eliminate dosing mistakes or confusion. The AAP and CDC support this change. What do you think?

Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. While on News Moms Need and click on “Help for your child” in the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). We welcome your comments and input.