Category: Infant Care
For generations, a host of symptoms and behaviors have been attributed to infant teething. It is not unusual for parents to wonder if crankiness, diarrhea, drooling, diaper rashes and trouble sleeping are related to teething, illness or a normal phase of development.
A recent analysis of the medical literature related to teething found that teething causes babies to rub their gums, be a little crankier and drool more. This conclusion was the result of of a meta-analysis, published in March 2016 in the journal, Pediatrics, where over one thousand citations from researchers around the world regarding teething were studied. The researches then narrowed down the citations to 22 studies from eight different countries to concentrate on. The children in the studies ranged from birth to age 3 years. The authors, led by Carla Massignan, DDS, concluded gum irritation, irritability and drooling were the main manifestations of infant teething. A key finding is that while some infants have a slight rise in their temperature, it was not up to 100.4 degrees F, the standard cut off for a fever. Based on their meta-analysis, the authors concluded teething does not cause a full-fledged fever or any other sign of actual illness. Now, based on the research, lets look at some of the myths and facts surrounding teething:
“Many parents who come to me share the fact that, well before they end up in my office, they have read a pile of sleep advice books without getting results,” says a local sleep consultant in Westport, CT. “As a result, they often worry there is no real solution for the problems they face with their child’s sleep.”
However, the specialist adds, “The good news is, with the several hundred families I’ve worked with, this has never been the case. The problem isn’t with their child – it’s with the source they’re using for help with getting a child to sleep.” Read More
A baby’s first tooth is something that most parents will always remember! From the way it changes that cute smile to the teething issues it causes, the eruption of a tooth is a pretty big deal. Yet, with all of the other things parents and caregivers must do to care for a baby or toddler, those tiny teeth are often neglected … sometimes with painful results. Today Willows Pediatrics wants to remind you to brush your child’s teeth.
Believe it or not, dentists across the nation report that they are seeing more preschoolers at all income levels with 6 to 10 cavities or more! And recently the Centers for Disease Control found that the number of preschoolers requiring extensive dental work has increased for the first time in forty years. Several factors may be at work here.
The first is too much snacking and the over-consumption of sugary snacks and drinks such as juices or sodas. Parents shouldn’t allow their child to snack or graze constantly. In addition, they should avoid gummy or sticky snacks—even fruit snacks—that can get lodged in the teeth and should be careful when giving their babies and toddlers juice – even watered down juice – in a bottle or a sippy cup, particularly as a means to help the child fall asleep. Dr. Stanley Alexander, chair of pediatric dentistry at Tufts University School of Dental Medicine in Boston noted that bedtime drinks are “especially problematic since children’s enamel is thin to begin with, and the mouth’s natural cleaning processes are less active when people sleep.” The same problem occurs when a child falls asleep while breastfeeding. Breast milk contains natural sugars that can erode teeth.
The second factor is a lack of daily dental care. Parents just simply aren’t brushing their children’s teeth twice a day. According to the American Academy of Pediatrics, it’s never too early to start brushing your baby’s teeth:
Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a slight “smear” of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a “pea-size” amount of toothpaste and perform or assist your child’s tooth brushing. Remember that young children do not have the ability to brush their teeth effectively.
Moreover, by the time your child is one year old, he or she should have taken a trip to the dentist. Dr. Jennifer Epstein of Kids First Pediatric Dentistry & Orthodontics in Fairfield says that the American Academy of Pediatric Dentistry recommends that children establish a “dental home” no later than 12 months of age. The purpose of this is to create an ongoing relationship between the dentist and the patient that is inclusive of all aspects of oral health care in a family-centered way.
According to Dr. Epstein, “The 1 year old visit is an opportunity for new parents to familiarize themselves and their child with a dental office.” She notes that topics typically addressed at the first visit include tooth brushing technique and use of toothpaste (fluoride free), eruption of primary or “baby” teeth, and habits such as thumb sucking and pacifiers. Moreover, the dental hygienist and pediatric dentist also like to use this first visit to discuss a healthy diet. “Infant and child tooth decay is still a prevalent problem in our society,” she says, “so the earlier the discussion about good food choices and limited juice consumption begins, the better the chance children will have of avoiding cavities.”
We hope that all of our patients will take this advice and remember to care for those little pearly whites! Of course, if you have any questions about your child’s oral health, we are more than happy to answer them. We want all of our patients at Willows Pediatrics to have a lifetime of smiles!
Image by MomPOM/Jenn via Flickr.com
Willows Pediatrics offers non-invasive computerized vision testing for children starting between six and nine months of age and up to the age of four. The test, Enfant Computerized Vision Testing, can diagnose eye and vision problems in pre-verbal children and allows for early treatment of issues ranging from “lazy eye” (amblyopia) to more serious eye diseases.
Recently, Dr. Jeffrey Owens performed the test on a six-month baby girl. The results indicated a possible problem, so she was referred to a specialist and eventually to an ophthalmic oncologist at Yale University. She was diagnosed bilateral retinoblastoma, a rare and serious form of cancer. The good news is that the disease has a high survival rate if treated early.
A video about this case is available for you to view at this link: http://youtu.be/Rx-n2CkGo1g. We hope you will take a few moments to watch it. As you can see, the patient, her parents and all the physicians at Willows Pediatrics are thrilled with the outcome.
All of the doctors here at Willows are parents, and we’ve all experienced the jitters and uncertainty that can be part of becoming a parent for the first time. Taking care of newborns can be nerve-racking for sure. But with a little information and good parenting practices, we can help you ensure that your little one will be healthy and happy!
That said, one of new parents’ biggest fears is often sudden infant death syndrome (SIDS). That term is applied to infant deaths that cannot be explained. Another term, sudden unexpected infant death (SUID) is used to describe any unexpected death from SIDS or causes such as suffocation, entrapment, arrhythmia and trauma. Today we want to address SIDS and the subset of SUIDs that occur during sleep.
The American Academy of Pediatrics recently revised and updated its recommendations to reduce the risk of SIDS and sleep-related suffocation, asphyxia and entrapment in infants. Some, like getting regular prenatal care and voiding smoke, alcohol and drugs during pregnancy, are applicable before the baby is born. The remaining recommendations apply to infants up to one year of age and should be used consistently until your child turns one.
Back in 2008, the Food and Drug Administration (FDA) recommended that over-the-counter (OTC) cough and coldmedication should not be used in infants and children under the age of two, and Willows Pediatrics agrees. The FDA found that these products could cause serious and potentially life-threatening side effects in young children including convulsions, rapid heart rates, decreased levels of consciousness and death. This recommendation led to a voluntary recall of these types of products marketed to children under two. Read More
Willows Talks About The Family Bed & Co-Sleeping
Many families spend their days together. Others stay together at night too! The “family bed,” or co-sleeping is a common practice in many societies, and there are advocates for it here in the U.S. too. However, there are child safety concerns related to having adults and children share a bed. So, is it an acceptable practice?
A recent blog posted on CT Now (and written by former local mom Sarah Cody), asked the same question. She’d heard about the possible benefits of co-sleeping—better nursing and enhanced emotional security—but worried about the dangers to newborns and infants, including injury and suffocation.
She turned to Willows Pediatric Group physician Dr. Jeff Owens for his take on the issue. Dr. Owens rightly pointed out that ‘”The American Academy of Pediatrics still doesn’t recommend it.” He also noted that the dangers stem from two major concerns: soft bedding and impaired judgment. A baby should never sleep on a futon, couch or waterbed, and a parent should not drink, smoke or use drugs with the infant nearby. Moreover, twenty-four hour bonding can challenge a couple’s need for a healthy physical relationship and leave a mother drained and exhausted.
However, Dr. Owens did allow for some wiggle room. “If it’s a stark, firm [bed] and the baby is on his back, the baby is probably safe.” Dr. Owens believes we should also respect different cultures, some of which believe “the family bed” is the answer to peaceful nights and strong attachments.
In other words, “do what works for your family as long as it’s a safe situation.”
Recently Time magazine featured a brief article about early detection of autism. The column correctly noted that because autism’s behavioral symptoms don’t become obvious until about age 3, pediatricians have been challenged to find ways to pick up indicators of the condition at an earlier age.
“But,” as the article stated, “researchers say it may be possible to detect subtle warnings of the developmental disorder as early as 12 months—and all it takes is a simple 24-item questionnaire that parents can complete in the pediatrician’s waiting room.”
Good news for patients at Willows Pediatric Group: we routinely offer the M-CHAT, a screening test like the one referred to above, to children at their 15-month checkup. M-CHAT, which stands for Modified Checklist for Autism in Toddlers, is widely recognized and recommended by the American Academy of Pediatrics. The M-CHAT does not provide a diagnosis, but it can indicate if a child is at risk and should receive further evaluation.
In terms of insurance coverage, we submit this service to your insurance company, but as is with all services provided in this office, we do not know or guarantee that your insurance company will pay for the service. At Willows we strive to provide the best care to your child without regard to reimbursement. If you have any questions about reimbursement please feel free to call us and we will help to guide you through the insurance maze.
At Willows, we are always available to discuss your child’s health and any behavioral issues that may be of concern. Child development is an integral part of child health and we are here to answer any questions you have about your child’s speech and language or social skills. If you have any questions about M-CHAT or other child development issues, please don’t hesitate to contact us!
Last fall, we blogged about the importance of correctly using car seats and booster seats to keep babies and older children safe while driving. Just a few weeks ago, however, the AAP released new recommendations relating to car safety, and we wanted to share them with you.
The AAP issued two important revised recommendations:
(1) Parents are now advised to keep toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat.
(2) The AAP now recommends that children ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.
More detailed information on these guidelines can be found at the AAP’s website.
According to the CDC, in 2008, an average of 4 children ages 14 or younger were killed in motor vehicle crashes every day, and many more were injured. Willows Pediatrics is here to answer questions about car seats or child safety in general. In addition, most of our local communities offer car seat check services.
We hope you will take these new recommendations into consideration when putting your children in the car. Use your best judgment and try to adhere to the weight/height guidelines, even if the age guidelines might not be appropriate for your child. For example, as Dr. Czuzcka notes, “The new 4’9” advice to stay in the back booster seat would mean that my wife’s grandmother would be a in a booster seat until she died in her 80s!” In other words, while these are important safety recommendations, each child is unique and there are times when exceptions may be made. (Feel free to ask us about your own child and your specific concerns at your next appointment.)
Thanks for checking in today … and, please, drive safely!
In November 2010, the AAP issued new age-based recommendations for iron intake in infants and toddlers. Because iron deficiency can have irreversible long-term effects on children’s cognitive and behavioral development, the AAP Committee on Nutrition stated that, “It is critical to children’s health that we improve their iron intake status starting in infancy.”
Babies born healthy at full term are born with sufficient iron stores for the first 4 months of life. Therefore, full-term babies do not need iron supplements prior to four months of age. However, if the infant is breast-fed, the AAP now recommends a 1-mg/kg daily dose of oral iron starting at four months, and continuing until an infant begins eating solid iron-rich foods – typically around six months of age. (Formula-fed infants will receive sufficient iron in their formula and do not need a supplement between four and six months of age.)
There is one caveat: Preterm infants do require iron during the first four months. If they are bottle-fed, the iron-fortified formula will provide the proper amount for these infants. However, according to the AAP, preterm infants who are breast-fed should take a 2-mg/kg daily dose of iron starting at one month of age.