Archive for the ‘Uncategorized’ Category

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.

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.

Join our Twitter Chat on smoking and women’s reproductive health

Monday, July 14th, 2014

chatAre you pregnant? Hoping to be pregnant? Do you smoke? Are you worried about the possible effects on your baby?

Join us on Wednesday, July 16th from 2-3pm ET, for a Twitter chat on smoking and women’s reproductive health.

We are joining the CDC, the Office of the Surgeon General and other guests to discuss the newest information on this topic. Learn how you can protect yourself and your  baby from the harmful effects of smoking. We will discuss the findings of the recent Surgeon General’s report on smoking, as well as the services and resources available in your community to help you or loved ones quit smoking.

We’d love for you to share your tips and experiences with us. Jump in the conversation at any time to ask questions or tell us your story.

Just follow #SGR50chat. We hope to see you then!

Kids in cars – preventing deaths due to heat

Friday, July 11th, 2014

sunIt takes a very short amount of time for a car to heat up to dangerous temperatures. Recently, I heard about another baby who died due to being left in a hot car. Tragically, it happens far too often.

From 1998 – 2013, 622 children have died from heatstroke (extreme overheating) in a vehicle. Nearly half of those cases were due to the parent or caregiver forgetting that their child was in the car. The other half were due to children playing in an unattended car, an adult deliberately leaving a child in a car, and other unknown reasons.

According to the AAP, “Even at relatively cool ambient temperatures, the temperature rise in vehicles is significant on clear, sunny days and puts infants at risk for hyperthermia. Vehicles heat up rapidly, with the majority of the temperature rise occurring within the first 15 to 30 minutes. Leaving the windows opened slightly does not significantly slow the heating process or decrease the maximum temperature attained.”  For example, on a day when the outside temperature is in the mid 80′s, temperatures inside a car can reach 130 – 150 degrees!  And, because a child’s body heats up more quickly than an adult’s, he is at a higher risk for heatstroke and death.

Know the facts. According to safercar.gov:

•    In 10 minutes, a car can heat up 20 degrees Fahrenheit.
•    Cracking a window does little to keep the car cool.
•    With temperatures in the 60s, your car can heat up to well above 110 degrees.
•    A child’s body temperature can rise up to five times faster than an adult’s.
•    Heatstroke can happen when the temperature is as low as 57 degrees outside!
•    A child dies when his/her temperature reaches 107.

These accidents usually happen to responsible, well-intentioned parents or caregivers. People get distracted, don’t pay attention, are overly stressed or tired and forget that their child is in the back seat. Rear facing car sears also make it impossible to see your baby, which makes it easier to forget he is there.

How to avoid this tragedy

Here are suggestions for making sure this tragedy doesn’t happen in your family:

•    When you get in the car, put your purse, briefcase, backpack or whatever you carry, in the back seat. When you open the door to take it out, you’ll take your baby with you.

•    Always lock your car. Never leave car doors unlocked or allow children to play in cars.

•    Never leave your child alone in the car – not even for a minute!

•    Keep your child’s snowsuit (or something else unusually noticeable) in his car seat when he is not in it. When your child is in the car, put the snowsuit in the front seat next to you. It will look odd and remind you that he is in the back.

•    Keep a pacifier in the car and put it over your keychain whenever you drive with your child. It will remind you when you turn off the engine to take your quiet, sleeping baby with you.

•    Just as you have learned to put on your seatbelt every time you get in the car, train yourself when you get out to walk around the car and look in the back windows, or open and shut every door of the car if your windows are tinted dark.

•    Create a checklist to give to grandparents and babysitters or anyone else who drives your child.

•    It is just as dangerous to leave a pet in a car, even with the windows cracked open.

In my home state of Connecticut, one police department made decals available to the public which read “Closed cars don’t breathe. Check your seats before you leave.” People put the decals in their car on the dashboard, on the driver’s window, on their garage door, front door of their home, and other places to remind them to check the back seat of the car before walking away. Whatever method you choose, be consistent and get in the habit of doing it every time you get in/out of your car. It could save your child’s life.

Please remember, if you see an infant or child alone in a car, call 911.

Everyday tips for dealing with sensory special kids

Wednesday, July 9th, 2014

hair washingMany kids with sensory issues struggle with typical everyday activities. Here are suggestions from parents of children with sensory difficulties to help you get through each day in a sensory friendly way.

Some kids find bath time and hair washing to be a stressful experience. For other children, getting dressed in the morning or eating meals can be incredibly challenging. Yet others cringe at hearing typical sounds or noises. Here is what some parents recommend:

Tips for bathing

•    Let your child get in the bath when the water temperature feels right to him. He may need to stand in it a while before sitting down, in order to adjust to the feel of the water on his skin.
•    During hair shampooing, use a little pail or plastic bucket to rinse hair instead of using the shower nozzle. Water coming from a shower nozzle can be too direct and forceful.
•    When your child is old enough, allow him to rinse his own hair. Being in control of the pail and the water on his own head is less shocking to him than when someone else pours water on his head.
•    Use a facecloth to cover his face if water on the face will cause distress. Then allow your child to wipe his own face with a damp facecloth.
•    Use distractions in the bath, such as bath foam or toys, to make bath time more appealing.
•    Let your child decide if showering is preferable to bathing (when he is old enough).

Tips for dressing

•    Remove tags from clothing before wearing.
•    Let your child decide what kinds of clothes feel good on his skin. Usually brushed flannel or soft cotton or acrylic fabrics work well, but your child will know.
•    If your child hates getting dressed in the morning (due to the sensory changes), dress your child the night before in the clothes he will wear the next day. In other words, let him wear his clean clothes to bed. He may look a tad more wrinkled in the morning, but he will get his day off in a sensory calm way.
•    When you find a pair of pants, a shirt or outfit that your child loves (i.e. it “feels right”), buy two of them. This way, one can be laundered when the other one is being worn. Or, buy them in different colors if possible. Comfort- not fashion -is key here.

Tips for eating

•    As much as possible, have healthy choices available. If you know your child loves chicken with pasta, then child using forkmake a double portion. This way you can feed it to him another night in the same week, even if the rest of the family is eating something different. This allows you to eat together as a family and yet you did not cook two meals in one evening.
•    Freeze individual portions for meals on the fly, for the babysitter to serve to him, or when the family meal is sure to be too hard for your child to swallow (literally).
•    Ask your child’s pediatrician or consult with a Registered Dietician who is familiar with sensory issues to learn other ways of getting your child to eat a healthy diet. Perhaps mixing vitamin powder into your child’s food (such as spaghetti sauce) or offering protein shakes will substitute nutrients that your child may be missing.

Tips for sound sensitivity

•    Prepare your child for events that may be uncomfortable, such as large assemblies with people clapping, musical events, a meal in a big restaurant, birthday parties, etc. Soft ear plugs are often helpful to use at these events so keep them handy. Other children prefer noise-cancelling headphones.
•    Once home, provide a quiet environment so your child’s ears can rest.

Learn more

These are just a few tips for getting through a day in a sensory successful way. See my prior posts: Sensory difficulties in children to learn more about the different kinds of sensory problems that exist, and Help for sensory issues to learn about different treatments. Ask your child’s pediatrician if a treatment such as Sensory Integration Therapy (a form of Occupational Therapy) may be helpful. You can also discuss other treatments which are available.

Feel free to share what has worked for you and your child. We’d love to hear from you!

If you have questions, or would like more information, please write to us at AskUs@marchofdimes.com.

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.

Thirdhand smoke is dangerous

Monday, July 7th, 2014

child on floorThirdhand smoke, the residue left behind in a room where someone has smoked, is harmful to your child.

You have heard how smoking can negatively affect your pregnancy by causing birth defects and nearly doubling your risk for preterm birth. You may also know about the harmful effects of secondhand smoke on your health and that of your children.

What is thirdhand smoke?

Thirdhand smoke is the residual chemicals and nicotine left on surfaces by tobacco smoke. The American Academy of Pediatrics (AAP) states that a few days or weeks after a cigarette is smoked, particles remain on all types of surfaces. Thirdhand smoke can be found anywhere – on the walls, carpets, bedding, seats of a car, your clothing, and even in your child’s skin and hair. Long after someone has stopped smoking, thirdhand smoke is present. Infants and children can inhale, ingest and touch things that result in exposure to these highly toxic particles.

Thirdhand smoke can be just as harmful as secondhand smoke and can lead to significant health risks. The AAP says that children exposed to smoke are at increased risk for multiple serious health effects including asthma, respiratory infections, decreased lung growth, and sudden infant death syndrome (SIDS).

The residue left from smoking builds up over time. Airing out rooms or opening windows will not get rid of the residue. In addition, confining smoking to only one area of the home or outside will not prevent your child from being exposed to thirdhand smoke.

There are ways you can limit or prevent thirdhand smoke. AAP recommends:

• Hire only non-smoking babysitters and caregivers.

• If smokers visit your home, store their belongings out of your child’s reach.

• Never smoke in your child’s presence or in areas where they spend time, including your home and car.

• If you smoke, try to quit. Speak with your child’s pediatrician or your own health care provider to learn about resources and support.

The only way to fully protect against thirdhand smoke is to create a smoke-free environment. For more information on how to quit smoking, visit http://smokefree.gov/.

 

Fireworks are not fun for kids with sensitive hearing

Wednesday, July 2nd, 2014

fireworks displayFor kids with sensitive hearing, fireworks can be frightful instead of fabulous. Here are some tips to get your child to still enjoy this colorful display without suffering pain.

July 4th…the very date evokes images of summer: flags waving, backyard barbeques, ice cream, home town parades and amazing fireworks displays celebrating our nation’s independence. It should be a fun, patriotic display of colors and designs in the night sky, but for kids whose hearing is extra sensitive to sound, it ends up being a torturous event. The loud popping of the firework explosions at unexpected moments creates anxiety and panic. Add to that the additional noisemakers on July 4th such as firecrackers, and this day of celebration for most people becomes a painful day for a child with sensitivities (and a challenging day for his family).

What can you do?

Aside from avoiding firework displays altogether, here are some ways to enjoy them:

•    First, see if you can watch a fireworks display on TV or DVD before going to a live display. Letting your child understand what a fireworks display is all about will help decrease anxiety. Sometimes towns offer fireworks displays on the weekend after the 4th so you can view a TV display beforehand.

•    Park a distance away from the crowds and firework display, and stay in your car. The noise may be muffled enough to allow your child to enjoy the visual display without being close to the noise. Your child will also feel more protected.

•    Have your child use ear plugs or noise cancelling headphones. With the ear plugs, he can still hear some noises and conversations, but the offensive sounds will be significantly decreased.

•    Alternatively, have your child listen to his favorite music (either with ear buds or on the car radio) as the fireworks are going on. It will help camouflage the offending sounds.

Remember, your child cannot help being hyper-sensitive to sound. It is not something he can control. It is painful and upsetting for him to be around sounds that hurt his ears. So, learning how to enjoy events on his terms is key to being able to attend or participate.

For a longer term solution, speak with your child’s pediatrician about possible treatments. Also, email AskUs@marchofdimes.com and request additional resources. We can refer you to a list of books written for children (to help them understand why they feel sensitive) as well as books written for adults (to help you understand your child’s sensory issues). We’re happy to help you!

We hope everyone has a safe and happy 4th of July holiday!

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.

Keeping your child healthy and safe in a pool

Monday, June 30th, 2014

child in kiddie poolSmall inflatable or plastic kiddie pools are great fun for small children in the summertime. But, these pools can also make your child sick. The dirty pool water may cause recreational water illnesses (RWIs). RWIs are caused by water that is contaminated by feces or urine. RWIs can be spread by swallowing or having contact with contaminated water.  As the number of children using a pool increases, the more the risk for illness increases.

The CDC offers tips on how to keep your child healthy and safe when using a small inflatable or plastic pool:

• Before your child or any of his friends use the pool, give him a soap bath. Do not allow a child who is ill with diarrhea or vomiting to use the pool.

• During swim time, remind children to avoid getting pool water in their mouths. Take your little one on a bathroom break every hour or check his diaper every 30-60 minutes to help keep germs out of the water. If you see feces in the pool or a child has a dirty diaper while in the pool, clear the pool of children right away. Then, drain the water, clean it, and leave the pool in the sun for at least four hours to kill germs.

• Swim diapers and pants can delay diarrhea-causing germs from leaking into the water, but swim diapers do not keep germs from contaminating the water. If your child wears a swim diaper, remember to continue to take him for frequent diaper changes or bathroom breaks.

• Empty the pool water daily, unless you have a filter system.

• Always watch children carefully. Even small pools with shallow water pose a drowning hazard to children.

• Learn CPR (cardio-pulmonary recessitation). It is a great skill to know in the event a child is drowning. The American Red Cross is one organization that offers widely recognized CPR programs. You can usually find programs in your community.

Learn more about ways to keep your child safe in the water this summer. With a little caution and a few rules, your child can stay cool in a pool.