Posts Tagged ‘newborn’

What is Torticollis?

Monday, January 13th, 2014

Torticollis literally means twisted neck. It is a something you have most likely had at one time or another—many of us have probably woken up with it after sleeping in an unusual position.  However it can also occur in newborns.

In newborns, it is called infant torticollis or congenital muscular torticollis and it is relatively common. Boys and girls develop it equally.  The cause is not exactly clear. It may occur if the baby’s head is in the wrong position while growing in the womb, or if the muscles or blood supply to the neck are damaged. It may also occur after a difficult birth, especially if the baby is very large or is delivered in a breech position.

In torticollis, the sternocleidomastoid muscle, the large, rope-like muscle that runs on both sides of the neck from the back of the ears to the collarbone, is stretched or pulled. If it tears, then it causes bleeding and bruising within the muscle. Scar tissue then develops and this causes the muscle to shorten and tighten, pulling the baby’s head to one side. The scar tissue forms a mass or lump that sometimes can be felt on the side of the neck.

Congenital muscular torticollis may be visible at birth or it may not become evident until several weeks later. The following are the most common symptoms:
• tilting of the baby’s head to one side
• the baby’s chin turns toward the opposite side
• a firm, small, one to two centimeter mass is present in the middle of the sternocleidomastoid muscle

Babies may experience symptoms differently. And the symptoms of torticollis may resemble other neck masses or medical problems, so it is always important to talk to your baby’s health care provider if you are concerned.
In most cases torticollis is diagnosed through a physical exam, but sometimes x-rays and ultrasound may also be utilized.  

Treating torticollis involves stretching the neck muscle. Passive stretching and positioning are used in infants and small children. The best way to treat torticollis is to encourage your baby to turn his or her head in both directions. This will help to loosen tense neck muscles and tighten the loose ones. Also it is important to remember tummy time.  Tummy time  helps to build both neck and shoulder muscles and helps your baby get ready to crawl.  Tummy time is important for all babies—not just those with torticollis.

Most babies with torticollis improve with stretching and positioning exercises.  In some cases though, surgery to correct the neck muscle may be necessary. Again, if you think your baby may have torticollis, make sure to talk to your health care provider.

Gift ideas for the new mom

Monday, December 23rd, 2013

newbornYour friend recently had a baby and, not surprisingly, is exhausted. As much as she may want to be “super mom,” especially during the holidays, no woman can be everything to everyone. So do her a huge favor and offer a gift of help.  It won’t cost a dime and could mean the world to her.
     • Help with household chores. You can do the dishes, do a load of laundry, do her grocery shopping, or simply hold the baby while your friend takes a shower.
     • Offer to babysit at different times. Instead of going out, your friend may want to stay in the comfort of her own home and take a much needed nap. She may sleep longer and deeper knowing a trusted friend is taking care of the baby.
     • Prepare a few meals. It’s hard enough to take care of feeding a baby every couple of hours, let alone feeding yourself and your partner. Connect with some mutual friends or family members and make a series of meals that can be put in the freezer. Then they can be popped into the oven or microwave whenever needed.

Caring for a new baby can be a wonderful time in a woman’s life. But when you’re feeling overwhelmed and exhausted it’s hard to remember that the newborn days won’t last all that long. Helping your friend get through the first few weeks at home will make her better able to manage her time and energy and enjoy these first precious moments in her child’s life.

Inside your baby’s diaper

Tuesday, November 19th, 2013

diapersThe following is an excerpt from Dr. Siobhan Dolan’s book, Healthy Mom, Healthy Baby.

New parents are often surprised at what they find in their baby’s diapers. A newborn’s stool looks much different than the stool of an older baby, toddler, or child. New parents may also be surprised to learn that a newborn needs a diaper change as many as eight times a day. Every time you baby eats, his brain sends a signal to his digestive system to release urine and stool. But don’t worry – feedings and diaper changes go down in number as your baby grows.

Just after birth, your baby’s stools are loose, black, and sticky. After a day or two, the stools of breastfed babies turn loose and mustard-colored, and contain what look like small seeds; formula-fed babies have soft, tan stools. After about a week your baby’s stools become slightly firmer.

Normal newborn stools can look like diarrhea, so if your baby actually has diarrhea, it can be hard to detect. A change in frequency or consistency of stools, an unusual smell, or blood in the stools can be a sign of diarrhea. If you’re not sure whether your baby’s stools are normal, call your baby’s provider.

You can learn more about Dr. Dolan’s book, watch a video, read excerpts, and even order a copy through this link.

Flu can be serious for kids with special needs

Wednesday, October 23rd, 2013

flu-shots-signIt is very important that children with special needs get a flu shot. They are especially at risk for serious complications that can be life threatening, if they get the flu. 

Which children are most at risk?

Children younger than 5 years of age and children of any age with a long-term health condition are at high risk of complications from flu. High risk conditions include:

     • Developmental disabilities (including a moderate to severe developmental delay)
     • Neurological and neurodevelopmental conditions, such as disorders of the brain and spinal cord, cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), muscular dystrophy, or spinal cord injury.
     • Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
     • Asthma
     • Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
     • Blood disorders (such as sickle cell disease)
     • Endocrine disorders (such as diabetes mellitus)
     • Kidney disorders
     • Liver disorders
     • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
     • Weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids)
     • Children who are receiving long-term aspirin therapy.

Children in the high risk group are more likely to stay sick longer and have a more severe case of the flu, than children who are not in the high risk group. In fact, of all children who died from complications from the flu in 2009, nearly two thirds had a neurologic disorder.

A recent study  shows that many children with neurological disabilities did not receive a flu shot during the 2011-2012 flu season. The Administration on Intellectual and Developmental Disabilities (AIDD), the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) urge health care providers and parents to vaccinate children against the flu, especially if they are in the high risk group.

Flu shot or nasal spray?

The CDC recommends that everyone 6 months of age and older get a flu vaccine. But, children with neurologic conditions and kids under the age of 2 should ONLY get the flu shot and NOT the nasal spray vaccine.  

There are special vaccination instructions for children ages 6 months through 8 years. Ask your child’s health care provider or see the CDC’s recommendations.

What about babies under 6 months?

If your baby is under 6 months of age, he is too young to receive the flu vaccine. So, be sure that everyone in your household and those who come in contact with your baby is vaccinated against the flu to help keep your baby healthy.  Check out our website to learn ways to protect your infant.

Get yourself vaccinated – for your child’s sake

If your child has a chronic condition, it is even more important that you and all of your child’s caregivers receive the flu vaccine. You need to be at your best to be able to care for your child. If you are pregnant, it is also very important and recommended that you get a flu vaccine.

What if your child still gets the flu?

If your child gets the flu, be sure that he sees his health care provider as soon as he becomes ill. Treatment with antiviral drugs within 48 hours is recommended, to reduce the chance of becoming seriously ill.  Know the symptoms of flu:  fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue, and sometimes vomiting and diarrhea.

Bottom line

Each year an average of 20,000 children under the age of 5 are hospitalized because of flu complications. No one likes getting the flu.  But, it is vitally important that children with special needs get the flu shot. For them, getting the flu can be especially severe. So, talk to your child’s health care provider about getting your child immunized now.     

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the menu on the right side to view all of the blog posts to date. As always, we welcome your comments and input.

Have questions? Send them to AskUs@marchofdimes.com.

Newborn screening and the March of Dimes

Tuesday, October 15th, 2013

newborn-screening-picture1This year, the March of Dimes and other health organizations are commemorating the 50th anniversary of newborn screening. In 1959, the March of Dimes began to explore newborn screening (NBS) as a means to detect and prevent the catastrophic consequences of metabolic conditions such as PKU (phenylketonuria) on a large scale. Subsequently, we funded research into several genetic and metabolic diseases that can be tested at birth, expanding the concept of newborn screening as an essential component of maternal/child health care delivery. We have worked tirelessly to promote expanded newborn screening programs in every state and to obtain federal guidelines for newborn screening, which has improved and saved the lives of countless thousands of affected children.

Linus Pauling (1901-1994), winner of the Nobel Prize in Chemistry in 1954, received one of the earliest basic research grants awarded by the March of Dimes. Dr. Pauling proposed the concept of molecular disease, using sickle cell anemia as a model. His finding that sickle hemoglobin differs in a measurable way from normal hemoglobin introduced the idea that heritable changes in the structure of a molecule could lead to improper function and result in disease. Dr. Pauling’s work laid the groundwork for the techniques used in newborn screening and diagnosis of sickle cell anemia.

Robert Guthrie, MD (1916-1995) was a March of Dimes grantee who developed a simple blood test to detect PKU, a cause of brain damage and intellectual disability. Dr. Guthrie refined an earlier PKU test, making it possible to analyze a dried spot of blood on filter paper instead of a liquid blood sample, an easier and inexpensive method that could be used on a mass scale. His breakthrough ushered in an era of state-mandated newborn screening programs. In 1963, Massachusetts became the first state to pass a law making the Guthrie PKU test mandatory, and New York followed soon after. The year 1963 marks the birth of state-mandated newborn screening, whose 50th anniversary we recognize this year.

The March of Dimes went on to award grants to develop inexpensive screening tests for congenital hypothyroidism, congenital adrenal hyperplasia, and biotinidase deficiency. In 1992, we called for every state to establish built-in safeguards for their newborn screening programs so that babies born with potentially catastrophic but treatable metabolic disorders would get help in a timely fashion. In 2000, we proposed a national standard for NBS and applauded an American Academy of Pediatrics review for improvements to the nation’s newborn screening programs, insisting that the primary consideration should be the health of the infant.

In 2008, Congress passed the Newborn Screening Saves Lives Act which established national guidelines on what conditions should be tested in newborn screening programs. The March of Dimes actively advocated in favor of its passage. At present, we promote 31 core conditions for newborn screening based on the U.S. Department of Health and Human Services Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children.

Rooming in with your newborn

Monday, July 1st, 2013

mom-and-newbornMany hospitals offer the option of keeping your newborn in the baby nursery while you’re in the hospital or letting your little one room in with you. Rooming in is becoming more popular these days. As always, there are pros and cons for each.

Rooming in allows you to have closer contact with your baby, respond to her needs quickly, breastfeed more often which can increase your milk supply faster. In many hospitals, family-centered care applies, which means that the same nurses are caring for both mom and baby, which can improve communication on health questions and foster better breastfeeding techniques and success. This can help mom feel more prepared when she leaves to go home. While this helps some women relax, other moms report that, with everyone coming in to check on her and the baby, they feel like they’re never able to rest with the baby there 24/7.

Traditional hospital nurseries offer centralized care under a nurse’s watchful eye. Tests, a bath, comforting of crying babies are performed in the nursery. Babies are brought to mom at feeding time. The best benefit touted of this model is allowing mom to get more rest… but the fact of the matter is that between phone calls, visitors, mom’s medical checks and tests, most new mothers are not really getting significant recuperative sleep.

Is there a best of both worlds? Some hospitals offer, or moms ask for, rooming in during the day and then having baby sleep in the nursery for several hours during the night. This would work for a nice nap time, too. Whether you choose this option or any other, the trick to rebuilding your strength and bonding with your baby is to sleep when your newborn sleeps. Exhaustion doesn’t help anyone.

What did you do with your newborn? Would you do the same thing with your next baby? What tips do you have for moms who are about to deliver?

Newborn jaundice

Friday, June 7th, 2013

infantJaundice is a yellow coloring of the skin and the whites of the eyes. It is caused by a build-up in the blood of a substance called bilirubin. Jaundice occurs in about 60 percent of all newborns.

A baby’s skin usually starts to turn yellow a few days after birth. In most cases, jaundice is mild and does not harm the baby. Mild jaundice goes away without treatment. However, babies with severe jaundice can have high bilirubin levels, which can pose a risk of brain damage.

The American Academy of Pediatrics (AAP) recommends that all babies be checked for jaundice with a physical exam, skin test or blood test before they leave the hospital. Babies should be examined again by a doctor or nurse at 3 to 5 days of age because this is the time when bilirubin levels are highest. When necessary, a baby can be treated to prevent bilirubin levels from getting too high.

Jaundice occurs when bilirubin builds up in the blood. Each day some red blood cells in everyone’s body are recycled. Bilirubin forms as these cells break down in the recycling process. Normally, the liver removes bilirubin from the blood. The liver of a newborn may be too immature to keep up with bilirubin removal, causing bilirubin to build up in the blood. This build-up turns the skin and, sometimes, the white part of eyes yellow. Premature babies have especially immature livers, making jaundice more likely.

Breastfed babies are more likely than formula-fed infants to develop jaundice. However, jaundice occurs mainly in babies who are not nursing well. These babies may not get enough calories and may become dehydrated, both of which may contribute to jaundice. This should not be a reason to avoid breastfeeding, however, as breast milk is the ideal food for babies and provides many health benefits, including reducing the risk of infections. Breastfeeding mothers should nurse their babies at least 8 to 12 times a day for the first several days of life to help keep their baby’s bilirubin level down.

So what should new parents look for? Yellow coloring usually first appears on the face and in the whites of the eyes. You often can tell if your baby has jaundice by looking at your baby under natural daylight or in a room that has fluorescent lights. If you think there is a yellowish color, you should contact your baby’s health care provider.

Most babies with jaundice do not need treatment, but some do and it’s important to have the health care provider make that decision. Providers sometimes suggest steps you can take at home to help clear up mild jaundice. They may recommend increasing the number of feedings to encourage more bowel movements, which helps eliminate bilirubin.

If your baby has more severe jaundice, however, your provider may recommend treatment. Phototherapy is a treatment you may have seen in the hospital.  The baby, wearing only a small diaper, is placed under special white or blue lights called bili-lights. He wears shields to protect the eyes. The lights help change bilirubin into a form that can be eliminated easily in urine. In more serious cases, a blood transfusion may be necessary.

For additional information about newborn jaundice contact the American Academy of Pediatrics (AAP) or the Centers for Disease Control and Prevention.

Helping your baby sleep

Monday, June 3rd, 2013

New moms and dads can find it hard to get used to a baby’s sleeping habits. And baby can find it difficult to get into a routine. In this video, Dr. Siobhan Dolan visits a new mom to give her tips on how to put her newborn to sleep and how much sleep to expect he will need. See if it helps you.

The many benefits of kangaroo care

Tuesday, April 23rd, 2013

kangaroo-care-dadIf your baby is in the NICU, kangaroo care can seem like a life saver. Kangaroo care is a way to hold your baby so that there is as much skin contact between you and your baby as possible. It has wonderful benefits for both you and your baby.

For kangaroo care, your baby is placed upright on your bare chest.
• Ask the nurse for a warm blanket to cover you and your baby.
• Strong smells like perfume or cigarette smoke on you or your clothing can bother your baby, so be sure to wash before holding.
• Hold your baby for at least an hour in this position. Be sure to go to the bathroom and put your phone away before getting comfortable. Your baby needs your full attention.

Gentle, still touch is very important, especially for the most sick and fragile of babies. It might make you feel good to stroke your baby, but it doesn’t feel good to your baby in the NICU. Stroking can make a baby feel uneasy or uncomfortable. Touching without moving your hands is best.

Kangaroo care is good for your baby because it can:
• Keep your baby warm
• Stabilize your baby’s heart rate
• Help your baby gain weight
• Comfort your baby

It’s good for Mom and Dad too because:
• It can help you bond with your baby.
• It can stimulate a mother’s ability to make breast milk.
• It can reduce your stress and lift your spirits.
• It may help you become more confident parents.

Kangaroo care is safe and beneficial, even if your baby is connected to machines. Whatever your situation, kangaroo care is a precious way to be close to your baby. You will cherish this time. You can learn more about kangaroo care by looking at our Power Point presentation at this link.

The March of Dimes gratefully acknowledges Philips’ support of our NICU Family Support® and Close to MeSM programs

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How do I know if my baby is constipated?

Tuesday, March 5th, 2013

Your baby’s bowel moments depend on her age and eating habits. Every baby is different. Some babies have a bowel movement right after each feeding. Others have it only once a day.

In the first week of life, newborns should produce some stool at least once a day. If your baby is not, let her health care provider know. You want to be sure all systems are functioning normally. After a week or two her system will shift into a pattern that works well for her. It is not uncommon for a breastfed baby (3 to 6 weeks of age) to pass stools every few days or only once a week. Formula fed babies, however, should pass stools at least once a day.

If your baby is having irregular bowel movements but her stools are soft (no firmer than peanut butter), this isn’t a sign of constipation. But if your baby’s stools are firm, she seems fussy or cries when having a bowel movement, she might be constipated. At any age, if the stools are large, hard and dry and hurt to pass, or if you see blood on or in the stool, talk to your baby’s health care provider. He may recommend giving her small amounts of water or prune juice.

In toddlers and older children, aside from increasing the amount of water they drink, you may need to add more high-fiber foods to their diet – foods like apricots, prunes, plums, peas, beans, broccoli and whole-grain cereals and breads. Back off foods that can tend to bind you up like bananas, white rice and plain white bread.