For the 4 Month Old

For the 4 Month Old

FOR THE 4 MONTH OLD

You’ve made it 4 months!  You are probably super comfortable with being a Mommy or Daddy by now.  This article will be a shorter one because not too much changes at this milestone.

Your baby is feeding every 3-4 hours and breastfeeding is probably taking about 10-15 minutes each time.  Your baby is likely sleeping longer stretches overnight or even through the night and you are finally getting some real sleep.

At this stage, more tummy time is better.  They should have good control of their neck and be able to push up with their arms from their tummy laying position.  In addition, your baby should be starting to show signs of rolling over.  To help them with this, you can put your baby on their belly and put toys all around them.  Babies will typically roll from front (tummy) to back first, which is why putting them on their tummy is suggested.  Don’t expect them to roll over back to front first, because that’s harder than rolling over front to back.

Placing toys away from them at arm’s length will help them reach for things and help with fine motor skill development.  In addition, you’ll probably notice your baby will start holding toys between their hands and start putting things in their mouth.  This is the time to be careful about what you place around them and make sure nothing can pose a choking or swallowing hazard.  General rule of thumb, if an item can fit through a toilet paper tube, it is too small and poses a choking risk.

Your baby should also become more interactive at this milestone.  They should be smiling, laughing, giggling, and looking to their parents.  They should be making lots of noises with “Ooo” and “Ahh” sounds and enjoying their interaction with you.  Enjoy this time with baby now, and stay tuned for my 6 month article next week when we deal with the idea of starting solid foods!

**Disclaimer – Any information found in these blog posts is only for informational purposes and not intended to replace the diagnosis and care of a physician.  Should you have any specific concerns about your child, please consult with your family doctor or pediatrician.

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For the 2 Month Old

For the 2 Month Old

FOR THE 2 MONTH OLD

You’ve made it 2 months with your bundle of joy!  By now, you probably have a predictable schedule.  Things are seeming to get a bit easier and your baby is interacting with you a bit more, smiling and watching as you walk around the room.  At this point, you can breathe a sigh of relief.  Your baby should stay on a regular schedule of feeds every 2-4 hours throughout the day now.

Your baby is now safe to sleep longer stretches overnight, usually 4-5 hours.  But remember, they should still be sleeping in their crib without any padding, pillows or stuffed animals.  Be sure your baby is getting tummy time at least 3 times per day for 10 min each time.  This will promote neck strength and promote gross motor skills as well as help prevent flattening of the head.  Feel free to review my last two articles on Safe Sleep and Preventing a Flat Head for a quick refresher if needed.

In BC, 2 months is when baby gets their first set of vaccinations.  It is usually 3 shots in the thighs and 1 oral vaccine.  You can get these done at your local public health nurse’s station or your family doctor or pediatrician if they offer vaccines in their office.  Remember to keep track of your child’s vaccines.  It is ok to get the vaccines a week past the scheduled 2 month visit, however I would not suggest delaying the immunizations by much longer as it is easy to get behind on vaccinations, but troublesome to catch up.

Usually babies tolerate the 2 month vaccinations well.  They are often a bit fussy afterwards and may not feed as well as before and can even have a slight fever.  These symptoms usually only last 1-2 days.  You can give Tylenol prior to the vaccinations in anticipation of discomfort and fever or give it as needed based on how your baby behaves following.  Be sure to follow the Tylenol dosing on the bottle or ask your physician or pharmacist for appropriate dosing based on your baby’s weight.

**Disclaimer – Any information found in these blog posts is only for informational purposes and not intended to replace the diagnosis and care of a physician.  Should you have any specific concerns about your child, please consult with your family doctor or pediatrician.

 

 

Preventing a Flat Head

Preventing a Flat Head

PREVENTING A FLAT HEAD

Everybody wants their baby to have a beautiful round head.  A flat head is not only a problem in the future if your child decides to shave their head, but there can actually be other significant issues that may arise.  Imagine if you took a perfectly round ball of clay and drew a line down the middle separating it into two sides.  If you took a flat palm and squished down on the back of one side to mimic a flat side of the head, what happens to the front of that side?  The front naturally gets pushed forward and causes the ball of clay to become asymmetric.  Something similar can happen with the head of babies, potentially distorting the natural symmetry of the face permanently.  Here are a few tips to prevent flattening of your baby’s head in the first 4-5 months of life.

Firstly, tummy time while awake for 10 minutes three times per day.  This will promote neck strength and keep your baby off the back of their head.

Secondly, during the first 4-5 months of life, parents are recommended to have babies sleep on their backs.  Your baby will always look towards the more interesting side of the crib, usually towards the side where there’s more movement.  Always placing your baby with their head pointing in the same direction can cause regular nightly pressure on the same side of the head, leading to a flat spot.

So to help prevent this, alternate the position in which your baby’s head faces each night.  For example, place your baby with their head pointing to the left side of the crib on Monday, Wednesday, and Friday.  Then on Tuesday, Thursday, and Saturday, do the opposite and place your baby with their head pointing to the right side of the crib.  Sundays can be determined by a coin toss or a simple game of rock, paper, scissors between parents.  If you worry about forgetting which side your child was facing the night before, tape a sign to the crib with the following on it “<– M, W, F  //  T, Th, Sa –>, Sun (??)”.

Keep in mind, this prevention tip only works in the first 4-5 months.  This is because after this time, babies can start rolling over on their own and therefore will not necessarily stay in the same place you left them.

If you find your baby is always looking in one direction regardless of how they are held or placed in bed, then this is a warning sign that they may need to be seen by a health care professional for assessment of torticollis or twisted neck.

**Disclaimer – Any information found in these blog posts is only for informational purposes and not intended to replace the diagnosis and care of a physician.  Should you have any specific concerns about your child, please consult with your family doctor or pediatrician.

Safe Sleep

Safe Sleep

SAFE SLEEP

Sudden infant death syndrome (SIDS), can be described as every parent’s worst fear.  It is the sudden and unexplained death of a child under 1 year of age in their sleep.  In this post you will learn some useful tips to help you reduce the risk of SIDS in babies.

It is found that babies who sleep in the following conditions are LESS likely to die from SIDS.

Babies should sleep in a crib with a firm mattress and not on a couch or recliner.  The mattress should be covered with a tight sheet and there should be NO bumpers, pillows, blankets, stuffed animals or anything soft inside the crib.

Babies should be put to sleep on their backs.  They should be wearing a sleeper or a onesie and not be over bundled.  Babies that are overly dressed or overly warmed are shown to have a higher risk of SIDS.  They should not be swaddled in a blanket to sleep.

Don’t be afraid to let your child use a pacifier when they fall asleep.  In fact, there is a growing body of evidence to support pacifier use to reduce the risk of SIDS in babies.  Once they fall asleep, the pacifier will usually drop out of their mouths and can be safely scooped away.

In addition, some of the things parents can do as well is to ensure there are no smokers in the house and to refrain from allowing your baby to co-sleep with any adult (specifically an overtired or intoxicated individual).

Taking all these steps will help you keep your baby healthy, happy, and sleeping safely!

**Disclaimer – Any information found in these blog posts is only for informational purposes and not intended to replace the diagnosis and care of a physician.  Should you have any specific concerns about your child, please consult with your family doctor or pediatrician.

 

For The Newborn (Part 2)

For The Newborn (Part 2)

FOR THE NEWBORN (Part 2)

All babies should lose weight within the first few days of life.  This is NORMAL.  They can lose up to 10% of their birthweight.  They should however, starting gaining weight by day 4 or 5 such that they regain weight back to their original birthweight by the time they are 10 days old.

Your baby will often get their first bath in the hospital.  We try to have this done by about 24 hours of age, but if your baby is having difficulties staying warm, then this is often delayed until they can keep their temperature within normal range.

Other things to know:

If your baby is larger than the average, smaller than the average, born earlier than 37 weeks or you had diabetes in your pregnancy then the nurses will check your baby’s blood sugar with a heel poke a few times after birth.  There is a chance baby can have a low blood sugar in these cases and require extra feeds or IV sugar treatment.

If there was concern regarding fever or infection during your labor, your baby will be monitored more closely to ensure they don’t develop an infection.  This usually means checking their breathing, heart rate and temperature every four hours as opposed to every 6 or 12 hours.  If there is greater concern of serious infection during your labour, then your baby might get bloodwork within the first few hours of life as well.

All babies get a heel poke at or after the 24hour mark for routine screening bloodwork.  In BC, this is called a newborn screen.  The lab will come and poke baby’s heel for some blood and fill in three dots on a piece of paper.  This test screens for 23 rare but treatable diseases that can occur in infants.  If you do not want this done for your child, then a waiver must be signed indicating that you declined this test.  I highly recommend you do this test as this testing has caught and saved many babies from developing life-threatening or life-altering consequences which would occur if the diseases were not found early.

Nearly all babies also get their bilirubin tested with the newborn screen.  This test is looking for jaundice.  Nearly all babies have a risk factor for jaundice and so most hospitals will test all newborns for this.  Clinically speaking, jaundice is the yellow colouration of the skin and eyes which occurs from accumulation of bilirubin.  Bilirubin is a byproduct of the blood in your body.  Healthy adults can get rid of this easily, but infants have immature livers and kidneys which makes it slower for them to get rid of the bilirubin.  There are also other risk factors such as incompatibility with Mom’s blood, infection etc which can contribute to jaundice.  Very high bilirubin can cause kernicterus which is deposition of bilirubin in the brain.  This can lead to deafness, seizures, abnormal movements, and developmental delay.

**Disclaimer – Any information found in these blog posts is only for informational purposes and not intended to replace the diagnosis and care of a physician.  Should you have any specific concerns about your child, please consult with your family doctor or pediatrician.

For The Newborn (Part 1)

For The Newborn (Part 1)

FOR THE NEWBORN (Part 1)

Congratulations on your new baby!  It is a new and exciting time in life, but also very scary and tiring.  For the first few days of your baby’s life, have very few expectations.  They should learn to eat, sleep, poo and pee, and that is about it.  Babies should poo and pee at least once within the first 24 hours of life.

Breastfeeding is not an automatic skill that babies are born with, and Moms should not expect a natural instinct as to the techniques necessary to breastfeed.  It is a difficult process.  Breastmilk takes 3-5 days to start coming in and this is NORMAL.  Babies are made to only need a little bit of colostrum (precursor to breastmilk) in the first few days.  This does not mean your baby will not feel hunger however.  Generally, for the first 24 hours of life, babies sleep like angels and cry very little because they are resting from the birthing process.  The following 24 hours are when baby starts to feel hunger and most Moms only have a little bit of colostrum to give them at this time.  This is ok.  Your baby will not starve or dehydrate.  Just keep breastfeeding, this will make your milk come in faster and help your baby learn to feed.

Do not expect to have a regular feeding schedule until about 5 days of life.  Babies will feed erratically in the first 5 days of life.  For example, they may feed for 5 minutes, stop for 10 minutes, then want another feed, then stop and not want a feed for 2 hours, etc.  It will be unpredictable.  Following that time, most babies will breastfeed for about 30 minutes every 2-3 hours.

To Be Continued… Stay Tuned!

**Disclaimer – Any information found in these blog posts is only for informational purposes and not intended to replace the diagnosis and care of a physician.  Should you have any specific concerns about your child, please consult with your family doctor or pediatrician.