Back to Sleep, Tummy to Play

Source:  American Academy of Pediatrics

What Are The 2 Most Important Things To Remember About Safe Sleep Practices?

1.      Healthy babies are safest when sleeping on their backs at nighttime and during naps. Side sleeping is not as safe as back sleeping and is not advised.

2.      Tummy time is for babies who are awake and being watched. Your baby needs this to develop strong muscles.

Remember…Back to Sleep, Tummy to Play

How Much Tummy Time Should An Infant Have?

Beginning on their first day home from the hospital or in your family child care home or center, play and interact with the baby while he is awake and on the tummy 2 to 3 times each day for a short period of time (3-5 minutes), increasing the amount of time as the baby shows he enjoys the activity. A great time to do this is following a diaper change or when the baby wakes up from a nap.

Tummy time prepares babies for the time when they will be able to slide on their bellies and crawl. As babies grow older and stronger they will need more time on their tummies to build their own strength.

What If The Baby Does Not Like Being On Her Tummy?

Some babies may not like the tummy time position at first. Place yourself or a toy in reach for her to play with. Eventually your baby will enjoy tummy time and begin to enjoy play in this position.

Doesn’t Sleeping On Her Back Cause The Baby To Have A Flat Head?

Parents and caregivers often worry about the baby developing a flat spot on the back of the head because of sleeping on the back. Though it is possible for a baby to develop a flat spot on the head, it usually rounds out as they grow older and sit up. There are ways to reduce the risk of the baby developing a flat spot:

1.      Alternate which end of the crib you place the baby’s feet. This will cause her to naturally turn toward light or objects in different positions, which will lessen the pressure on one particular spot on her head.

2.      When the baby is awake, vary her position. Limit time spent in freestanding swings, bouncy chairs, and car seats. These items all put added pressure on the back of the baby’s head.

3.      Spend time holding the baby in your arms as well as watching her play on the floor, both on her tummy and on her back.

4.      A breastfed baby would normally change breasts during feeding; if the baby is bottle fed, switch the side that she feeds on during feeding.

How Can I Exercise The Baby While He Is On His Tummy?

There are lots of ways to play with the baby while he is on his tummy.

1.      Place yourself or a toy just out of the baby’s reach during playtime to get him to reach for you or the toy.

2.      Place toys in a circle around the baby. Reaching to different points in the circle will allow him to develop the appropriate muscles to roll over, scoot on his belly, and crawl.

3.      Lie on your back and place the baby on your chest. The baby will lift his head and use his arms to try to see your face.

4.      While being watched by an adult or caregiver, have a young child play with the baby while on his tummy. Young children can get down on the floor easily. They generally have energy for playing with babies, may really enjoy their role as the “big kid,” and are likely to have fun themselves.

Back To Sleep and Tummy To Play

Follow these easy steps to create a safe sleep environment in your home, family child care home, or child care center:

1.      Always place babies on their backs to sleep, even for short naps.

2.      Place babies on a firm sleep surface that meets current safety standards. For more information about crib safety standards, visit the Consumer Product Safety Commission Web site at www.cpsc.gov.

3.      Keep soft objects, loose bedding, or any objects that could increase the risk of suffocation or strangulation from the baby’s sleep area.

4.      Make sure the baby’s head and face remain uncovered during sleep.

5.      Place the baby in a smoke-free environment.

6.      Do not let babies get too hot. Keep the room where babies sleep at a comfortable temperature. In general, dress babies in no more than one extra layer than you would wear. Babies may be too hot if they are sweating or if their chests feel hot. If you are worried that babies are too cold, infant sleep clothing designed to keep babies warm without the risk of covering their heads can be used.

7.      If you are working in a family child care home or center, create a written safe sleep policy to ensure that staff and families understand and practice back to sleep and sudden infant death syndrome (SIDS) and suffocation risk reduction practices in child care. If you are a parent with a child in out-of-home child care, advocate for the creation of a safe sleep policy.

Food Allergies in Children

Source: American Academy of Pediatrics

How do I know if my child has a food allergy?

A food allergy happens when the body reacts against harmless proteins found in foods. The reaction usually happens shortly after a food is eaten. Food allergy reactions can vary from mild to severe.

Because many symptoms and illnesses could be wrongly blamed on "food allergies," it is important for parents to know the usual symptoms.

Symptoms of a food allergy

When the body's immune system overreacts to certain foods, the following symptoms may occur:

• Skin problems
  • Hives (red spots that look like mosquito bites)
  • Itchy skin rashes (eczema, also called atopic dermatitis)
  • Swelling  
•     Breathing problems
  • Sneezing
  • Wheezing
  • Throat tightness
• Stomach symptoms
  • Nausea
  • Vomiting
  • Diarrhea
• Circulation symptoms
  • Pale skin
  • Light-headedness
  • Loss of consciousness

If several areas of the body are affected, the reaction may be severe or even life-threatening. This type of allergic reaction is called anaphylaxisand requires immediate medical attention.

Not a food allergy

Food can cause many illnesses that are sometimes confused with food allergies. The following are not food allergies:

• Food poisoning—Can cause diarrhea or vomiting, but is usually caused by bacteria in spoiled food or undercooked food.
   
• Drug effects—Certain ingredients, such as caffeine in soda or candy, can make your child shaky or restless.
   
• Skin irritation—Can often be caused by acids found in such foods as orange juice or tomato products.
   
• Diarrhea—Can occur in small children from too much sugar, such as from fruit juices.

Some food-related illnesses are called intolerance, or a food sensitivity, rather than an allergy because the immune system is not causing the problem. Lactose intolerance is an example of a food intolerance that is often confused with a food allergy. Lactose intolerance is when a person has trouble digesting milk sugar, called lactose, leading to stomachaches, bloating, and loose stools.

Sometimes reactions to the chemicals added to foods, such as dyes or preservatives, are mistaken for a food allergy. However, while some people may be sensitive to certain food additives, it is rare to be allergic to them.

Foods that can cause food allergies

Any food could cause a food allergy, but most food allergies are caused by the following:

•    Cow milk
   
•    Eggs
   
•    Peanuts
   
•    Soy
   
•    Wheat
   
•    Nuts from trees (such as walnuts, pistachios, pecans, cashews)
   
•    Fish (such as tuna, salmon, cod)
   
•    Shellfish (such as shrimp, lobster)

Peanuts, nuts, and seafood are the most common causes of severe reactions. Allergies also occur to other foods such as meats, fruits, vegetables, grains, and seeds such as sesame.

The good news is that food allergies are often outgrown during early childhood. It is estimated that 80% to 90% of egg, milk, wheat, and soy allergies go away by age 5 years. Some allergies are more persistent. For example, 1 in 5 young children will outgrow a peanut allergy and fewer will outgrow allergies to nuts or seafood. Your pediatrician or allergist can perform tests to track your child's food allergies and watch to see if they are going away.

Full vaccine schedule safe for kids, no link to autism

Source:  USA Today

A new study is the latest research failing to find a connection between autism and vaccines.

At least 10% of parents of young children skip or delay routine vaccinations, often out of concern that kids are getting "too many shots, too soon."  A new study finds that children who receive the full schedule of vaccinations have no increased risk of autism.

"This is a very important and reassuring study," says Geraldine Dawson, chief science officer at Autism Speaks, who wasn't involved in the new paper. "This study shows definitively that there is no connection between the number of vaccines that children receive in childhood, or the number of vaccines that children receive in one day, and autism."

The study, published today in the Journal of Pediatrics, is the latest of more than 20 studies showing no connection between autism and vaccines, given either individually or as part of the standard schedule. The paper is the first to consider not just the number of vaccines, but a child's total exposure to the substances inside vaccines that trigger an immune response.  Study authors say they sought to address the fear that multiple vaccines are "overwhelming" children's immune system, possibly contributing to long-term problems. Twenty years ago, children were vaccinated against nine diseases. Today, they're vaccinated against 14, according to the Centers for Disease Control and Prevention, which funded the study.

Though kids get more needle sticks, the next-generation vaccines they receive are easier on the immune system than those used two decades ago, says Frank DeStefano, lead author of the new paper and director of the Immunization Safety Office at the Centers for Disease Control and Prevention.  That's because modern vaccines are more sophisticated, using just a few critical particles — called antigens — to stimulate the immune system, DeStefano says. These antigens, found on the surfaces of bacteria and viruses, spur the body to make antibodies, which block future infections.

For example, an older version of the pertussis (whooping cough) vaccine, used until the late 1990s, was made using an entire, killed bacteria. That vaccine, called DTP, exposed the body to more than 3,000 antigens.  A newer, streamlined version, called DtaP, uses only the four to six antigens critical to producing immunity, DeStefano says. 

Because of these sorts of improvements, fully vaccinated 2-year-olds are exposed to a total of 315 antigens, the study says.  That's a drop in the bucket compared with the billions of microbes — from bacteria to yeast — that babies encounter in their first hours of life.

The new research confirms the findings of a 2010 study in Pediatrics, which compared babies who received all vaccines on time in the first year of life with those who skipped or delayed their shot. That research found no neuropsychological differences, such as stuttering, facial tics or lower scores on IQ tests.

"A lot of parents are concerned about the number of 'owies' that children get," says Michael Smith, an author of the 2010 study and pediatric infectious disease specialist at the University of Louisville School of Medicine.  "But there's no benefit to delaying vaccines," says Smith, who wasn't involved in the new study. "When you delay your child's vaccines, you put them at risk."

Myths about autism and vaccines have persisted, in spite of the scientific evidence, partly because researchers don't really know what causes autism, Dawson says. "Until we conduct the research to answer the questions about autism's causes and risk factors, parents will continue to have questions," she says.  Research increasingly suggests that many of the underlying changes that cause autism take place before birth, and even before conception. Although parents often notice symptoms of autism only after a child is 12 to 18 months old, research by Dawson and others picked up subtle changes — in eye gaze or even brain patterns — as early as 6 months.

Doubts about vaccines have led to low vaccination rates in some communities, which have fueled flare-ups of once-forgotten diseases such as whooping cough, measles and mumps, Smith says. "If someone gets on a plane from Europe or India where there is measles, then we have measles again," Smith says.

The CDC reported Thursday that the USA had three cases last year of congenital rubella syndrome, an often fatal condition that afflicts the newborns of mothers who contract rubella, or German measles, while pregnant. Affected babies often suffer from a number of painful and life-threatening problems, such as heart defects, deafness, cataracts and mental retardation. Vaccination has eliminated person-to-person spread of rubella in the Western Hemisphere. All three of the mothers last year were from Africa, where rubella still circulates. One of the babies died.

Though some parents may never believe vaccines are safe, the new study will probably reassure many others, says Karen Ernst of Voices for Vaccines, a group of parents and other vaccine advocates.  "Those who truly benefit from this article are the children of future parents," Ernst says. "These future parents will have more confidence in vaccinating their children on time. It is the job of parent-advocates like our members to speak up and make sure news about articles like this gets out."

Antibiotics less likely to be prescribed for kids' ear aches

Source:  CNN Health

Guidelines for diagnosing and treating ear infections are changing and the result may mean fewer prescriptions for antibiotics.  The American Academy of Pediatrics (AAP) recently released the new guidelines for diagnosing and managing acute otitis media (AOM), the most common form of ear infections.

Going forward, pediatricians should only diagnose acute ear infections if the child's eardrum is moderately to severely bulging or if there is discharge leaking from the ear, according to the recommendations. They may diagnose a middle ear infection if the child's ear drum is mildly bulging and there is recent onset of pain or intense redness.  Doctors should only prescribe antibiotics in children 6 months and older if there are severe signs or symptoms, which the academy defines as a temperature of 102.2 degrees or higher, or severe pain or if young children between 6 and 23 months have ear infections in both ears.

"Studies have shown that bulging (of the eardrum) is the best criteria for diagnosing an ear infection." says Dr. Allan Lieberthal, lead author of the guidelines and clinical professor of pediatrics at the Keck School of Medicine at the University of Southern California.  If a toddler or baby (older than 6 months) has an ear infection in only one ear, then antibiotics should be an option as well as simply watching the child to see if things clear up on their own. If observation is chosen and the child not better within 72 hours, then it's time to consider antibiotics again, experts say.

The key message is that parents should not be expecting antibiotics each time, Lieberthal says.

Observation has been proven to be very effective and has been recommended since the last time the AAP updated its guidelines back in 2004, says Lieberthal. But the previous guidelines recommended prescribing antibiotics under a definition of "uncertain diagnosis." That, says Lieberthal, no longer exists. The new guidelines very specifically lay out when and when not to diagnose and prescribe antibiotics for ear infections.  The guidelines are for uncomplicated acute otitis media in children aged 6 months to 12 years who are otherwise healthy and do not have recurrent ear infections.

AOM is a common condition where the middle ear is inflamed. Recurrence is defined by three separate infections in six months, or four in 12 months, with at least one of those infections occurring in the past six months. 

"If a parent would not take their child to the doctor for a common cold, the parent does not need to take the child to the doctor worrying about an ear infection, except in those two instances (high fever and severe pain)," says Lieberthal. But, he notes, "even a child with that high a fever and severe pain may not have an ear infection."  That's because ear pain is common in young children and may be caused by teething, a cold, a sore throat, jaw problems, or an ear infection, says Dr. Rich Rosenfeld, co-author of the guidelines and professor and chairman of otolaryngology at SUNY Downstate in New York. “You can't tell which one it is without seeing your doctor, but since most of these go away on their own, it isn't always necessary."

Rosenfeld tells parents it's time to take their child to the doctor if any of the following are present: "severe ear pain, persistent ear pain that lasts more than two days, temperature more than 102.2 degrees or new onset of drainage (pus or blood) from the ear canal."

The goal here is to only use antibiotics when absolutely necessary and when it will actually help.

"There is also tremendous overuse of antibiotics," says Lieberthal. "Antibiotics can cause side effects to the child such as diarrhea (and) resistant bacteria; it also hurts the community because there are more bacteria that have become resistant to antibiotics.”  Antibiotics treat bacterial infections; they don't reduce pain. Over-the-counter pain medication can be helpful for that.

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