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Archive for Possible Problems

Introducing Egg

By Jan Murray

egg-gry

The introduction of egg has recently changed.

Babies used to be given cooked egg yolk at around 8 months and cooked egg white around 11 months. From research (references through link) it is now suggested that cooked egg be given (in small amounts) to babies before 6 months of age.

Egg is best give to babies initially in very small amounts (little fingernail size) then increase as tolerated. Eggs are potentially allergic but a reaction doesn’t necessarily mean allergy, it could mean a sensitivity or intolerance to the amount given at the time. Often there are other factors (environmental or social) that add stress to the body making food intolerance levels lower.

egg-allergy

This 6 month old baby was enjoying fruit and vegetables and lentils and had no known family history of allergy to egg. His parents ate eggs with no allergic reactions and he was breast fed.  This rash occurred within a few hours after he was given two teaspoons of scrabbled egg mid-morning. It resolved next day and didn’t worry him in any other way. He’ll have another try in a week or two in a smaller quantity.

Research has shown there is possibly a ‘window of opportunity’ between 4 – 7 months for foods to be introduced with further suggestion that withholding foods could increase allergic response.

It is recommended that babies be introduced to solid foods while they have the immune protection of breast milk.

More advice on infant feeding in ‘taste it’

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This article was brought to you by Jan Murray, Private Child Health Consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance. Jan publishes regular ezine and blog articles to provide free parenting tips, tools and resources to educate and support those caring for young babies and children.

Plagiocephalie Or Flat Head Area in a Baby

Plagiocephalie or flattened head area can develop in babies after birth. This occurs from  applying constant pressure on one part of their head.

The first 6 – 8 weeks of babies life is the most important time to avoid a flattened head area (Plagiocephalie) developing. This is because the bones in a newborn’s head are thin and flexible and the head is soft and easy to mould.

Four reasons why flat areas may occur in a baby’s head:

1. Lying in one position for long periods of time.

2. By always turning the head to the same side when lying on their back (favouring looking out a window to the light).

3. Always sitting in a propped up position. May occur in babies who suffer from reflux pain.

4. Birth trauma resulting in neck pain – leaving a baby to favour a pain free position.

Discover eight important steps to facilitate a baby developing muscle balance and therefore decreasing the risk of developing a flattened head area.

1. Alternate the head position when putting them down to sleep.

2. Alternate laying baby at different ends of the cot when putting him to bed.

3. A period of tummy time during every play time.

4. Change the position of the toys when babies are on the floor so they move their head to different angles.

5. Vary holding and carrying positions.

6. Changing the side that a baby carry sling is worn on.

7. When picking babies up, approach them from different sides of the body.

8. Visit a baby accredited chiropractor or physiotherapist to assess baby’s head alignment, especially after a long or difficult birth, forceps assisted birth or birth by caesarean section. Babies who do not feed well from a particular side, hate tummy time or suffer from considerable wind, may have an alignment issue requiring attention.

Seek professional help EARLY if you see baby’s head becoming flattened in areas or the head constantly tilts to one side or he favours facing a certain direction.

A physiotherapist may advise a cranial helmet be worn for a period of time if a baby’s head remains flat beyond five to six months.

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Jan Murray has been committed to studying and working as a Registered Nurse, Midwife and Child Health Nurse for over 25 years. Jan is a mother of 5, Child Health Consultant who co-founded and directs Settle Petal. Jan provides information and support for parents to develop their knowledge base and confidence. Receive your FREE Routine at http://myoptinpage.com/?pid=2151223 to unlock a secret to helping babies settle, sleep and grow.

Nappy Rash

napkin-thrush-s

By Jan Murray

Leaving a nappy on your baby for long periods of time is a common cause of nappy rash but not the only cause. Some babies get nappy rash no matter how well they are cared for, while others do not get nappy rash at all. Your baby may get nappy rash when he has a cold, when he is teething or when he is suffering from an illnesses or food intolerance. Signs of nappy rash include:

  • Inflamed skin: the skin around the genital area and anus looks red and moist
  • Blistering: the skin may blister and peel, leaving raw patches that can develop into ulcers
  • Spreading: the rash can spread onto the tummy and further onto the buttocks
  • Ulcers: small ulcers can sometimes form on healthy skin near the area of the rash.

A secondary bacterial or fungal infection is commonly the cause of nappy rash that spreads or fails to heal by airing, bathing and applying barrier creams or ointments. The damaged skin is often uncomfortable, itchy or sore. When your baby has nappy rash he may have unsettled sleep due to pain and irritation.

Some causes of nappy rash include:

  • Chemicals in urine become ammonia and burn the skin when in direct contact for too long
  • Thrush (Candida) – grows in a warm, moist environment. This type of nappy rash spreads in red patches and does not go away with barrier creams
  • Chemicals in nappy soaking solutions, laundry detergents, fabric softeners, cleansing wipes, scented soaps and lotions and certain brands of disposable nappies can irritate baby’s skin
  • Anti-fungal medicated creams applied too thick can burn
  • Plastic pants keep your baby’s clothes clean and dry, but most prevent airflow. Clothes do not get wet and your baby is often left in a wet or dirty nappy for long periods. The skin remains wet and urine changes into ammonia that burns. The area becomes warm leaving it susceptible to thrush
  • Rough nappies, sand or dirt can rub and chafe baby’s sensitive skin
  • Bowel movements are more acidic when your baby is teething – burning delicate skin
  • Certain foods eaten or ingested through breast milk can burn such as hot curry
  • When your baby has frequent diarrhoea
  • If your baby has little nappy-free time and lots of soiled nappies
  • If your baby has started solids and is not tolerating certain foods – commonly dairy or wheat.

For more information Mum, Baby & Toddler – together we learn

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This article was brought to you by Jan Murray, Private Child Health Consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance. Jan publishes regular ezine and blog articles to provide free parenting tips, tools and resources to educate and support those caring for young babies and children.

Is it Really Teething?

By Jan Murray

By the time your baby turns two years old she’ll have a mouthful of beautiful pearly white teeth. For some infants these eruptions arrive with considerable discomfort while for others they appear without any give-away signs or symptoms at all. There is no way of telling who will suffer specific symptoms and who won’t. However, there seems to be a genetic link of ear infections with teething, largely due to the shape and slope of the Eustachian tube.

Most baby teeth break through at around 6 to 10months of age. However, it is not unusual to see first teeth appear as early as 4months of age. Very occasionally, babies are born with a tooth but these are generally loosely embedded and need removing.

While it is obvious that teeth appear at different ages, there is inconsistency between health professionals as to what signs and symptoms are directly associated with teething and what comforting remedies are safe and useful to use. Over the years of working with many babies and first-hand experience of raising five of my own children, I have definitely seen teething related signs and symptoms but whether these have been due to other causes has not always been clear.

For this reason, each episode of suspected teething symptoms should be given individual attention with the diagnoses of ‘teething’ as only one of many possibilities.

tooth

It is very common to hear parents use excessive gnawing and drooling as a sign that their baby is teething. However, this increased drooling and oral exploration naturally occurs as part of infant development around 4months of age and lasts until about 9 to 10months of age; the period in which teeth tend to erupt.

Increased saliva (drool) is produced to aid digestion but babies’ mechanical process of swallowing is not sufficiently developed resulting in the overflow of excess drool. Babies’ increased oral motor ability improves by 9months and drooling is consequently reduced. But whether drool is part of teething or not, saliva does have properties that cool and lubricate the gums bringing comfort for many babies who are teething. Moisturising the face with suitable non-fragrant creams can prevent cheek, chin and neck rashes developing from exposure to excess saliva. Gnawing and biting down on anything gives counter-pressure and pain relief to erupting teeth so make sure you provide cold washers and hard toys to bite on.

Large amounts of saliva contain increased amounts of enzymes necessary for digestion, which may upset your baby’s digestive system. This can cause her bowel actions to be loose and offensive, and she’ll often refuse to eat. Her poo can be quite acidic making her bottom sore and red, which can turn fungal if not given regular nappy free time and her skin not protected with a natural barrier cream.

With a disrupted digestive system, ear aches and painful gums just before teeth erupt, your baby can feel miserable, irritable, and insecure making her clingy. Giving her extra cuddles during this time can go a long way in providing the comfort and reassurance she needs. Cuddle comforts should come before using any of the increasing varieties of natural and pharmaceutical remedies on the market for teething relief. However, if you do choose to use teething remedies, use only with professional instruction and avoid using any on a long term basis.

Your baby’s unsettled days often lead to unsettled nights but rarely is teething the cause of poor sleep if your baby is happy and content during the day. Teething pain is generally not causing night waking but it can prevent him from going back to sleep after waking for other reasons. Hunger or the reliance on props such as dummies, feeding, and rocking to settle to sleep are common reasons for night waking from 6months.

A clear nasal discharge is another common symptom often associated with cutting teeth. Nevertheless, it is also important to consider other possible childhood illnesses because from 6months of age the maternal antibodies provided from birth have reduced in your baby’s system, lowering her immune levels, leaving her more susceptible to illness in general.

When teething, gums can be inflamed and swollen or bluish from an underlying haematoma. Hence, a low grade fever is not uncommon with teething as fever is the body’s reaction to all inflammation. Fever lasts about 24 hours and occurs just as teeth push through the gum. A higher fever (above 40°C) or a lower fever lasting for longer than three days requires further professional assessment. Suspected teething or not, always be alert to any deterioration in behaviour, low urine output and lethargy, and seek medical assistance immediately.

Teething often gets the blame for disruptive behaviours but don’t use teething as an excuse and forget to consider other causes for night waking, fever, digestive issues, biting, and irritable behaviour. Seek advice from your child health professional if any ‘teething symptoms’ persist for weeks with no teeth to show for the abnormal symptoms and irritable behaviour.

References:

http://pediatrics.aappublications.org/content/128/3/471.full.pdf+html

http://pediatrics.aappublications.org/content/105/4/747

http://smartpediatricadvice.com/teething

http://www.moderndentistrymedia.com/sept_oct2010/tsang.pdf

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This article was brought to you by Jan Murray, Private Child Health Consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance. Jan publishes regular ezine and blog articles to provide free parenting tips, tools and resources to educate and support those caring for young babies and children.

Infant Misshapen Head

By Jan Murray

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No doubt you have noticed uneven head shapes on babies. But while their head shape is largely genetic, how you position your baby when she is sleeping, resting or laying around during the early weeks and months can have an effect. This is because infant heads have several bones with pliable connections that expand as the brain grows. Couple this mouldable softness with the fact that she spends a lot of time laying on her back and it leaves her at risk of developing plagiocephalie.

Flat spots can occur in various parts of the head depending on the area baby tends to favour, which is why you may hear it called ‘positional’ plagiocephalie. A flat head shape will not interfere with brain growth but if severe enough and left untreated it may result in uneven skull growth and other associated problems such as orthodontic and visual issues later in life.

To reduce long term effects of misshapen heads it is a good idea to have your baby checked regularly by a child health professional, particularly during the first three months when heads are easily flattened from external pressure but are also easily managed back into the correct shape. Early corrective and preventative measures are best, as between 6 and 12 months of age treatment is much more difficult and after 12 months the opportunity for correction is minimal.

Your little one can sometimes find moving their head into certain positions difficult. This may be due to pain or discomfort as a result of a forceps assisted birth or from torticollis—a congenital shortening and tightening of muscles on one side of the neck. Both these conditions will improve with time but during the healing process bub risks a flat area developing on the head. In either of these conditions your baby may also be unsettled with neck pain when she stretches out her neck during tummy time or when she positions herself to feed from a particular breast.

Occasionally, an asymmetrical head shape is caused by the early closure of cranial sutures, the area that allows the skull to expand. This is an uncommon condition known as craniosynostosis, which requires corrective surgery and is picked up at regular child health checks.

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Being aware of how flat areas form is important for knowing how to prevent or correct a flat head. For example, your baby may adopt the same position every time she is put down because her eyes are drawn to a stream of light coming through a crack in the door or through the curtains. She will also stretch her head in the direction where she can see you, the television or other siblings playing. If your baby is always placed in the same side of a side-by-side stroller or fed from the same side when feeding from a bottle this may also lead to the formation of a flattened area. Even constantly having her propped up in a rocker or bouncer in an attempt to alleviate uncomfortable symptoms of gastro-oesophageal reflux can result in the skull becoming flattened at the back.

Once an area on the head begins to flatten it becomes a comfortable spot to naturally rest her head but there are some things that you can do to help prevent this happening.

positionalplagio

Start soon after birth by placing your baby at alternative ends of the cot or bassinette to sleep, while still placing her feet close to the end. Make supervised tummy time a regular part of each wake period during the day. Increase the length of time on her tummy as she and gets older and gains neck strength. Side lying is also good while bub is awake and being watched. Don’t always cradle her the same way. Instead, while safe in your arms, let her see the world from different angles (using a sling can be helpful here too). Be conscious of her feeding positions. If you are feeding from only one breast, a mix of under-arm feeds (also known as football hold) and across-your-lap feeds is a good idea. If you are bottle feeding change the arm you feed from each feed.

Some additional devices or a rolled cloth can be helpful in some situations to restrict her head turning to the flat spot. In severe cases of flat head syndrome in an older baby (usually 5 – 8 months old), a customised corrective helmet may be required. This is a decision made by your child health professional. But rest assured, even if a helmet is necessary it is only temporary. Your baby may not like it at first but as a teenager with a beautiful head shape and no orthodontic issues—she will thank you.

plagiohelmet

References:

Deformational_Plagiocephaly.pdf

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This article was brought to you by Jan Murray, Private Child Health Consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance. Jan publishes regular ezine and blog articles to provide free parenting tips, tools and resources to educate and support those caring for young babies and children.

Teething

By Jan Murray

Teething gets the blame for many things but is it really justified? Here are a few things to think about when it comes to teething.

When babies feed well, sleep well and happily play without any problems during the day, teething is unlikely to be the cause for a disturbed night sleep.

If babies or toddlers are in a habit of waking at night, teething discomfort can make it harder for them to settle back to sleep but is generally not the cause of the waking.

Babies go through a developmental change around three to four months old. They begin to drool, put their fingers in their mouth or even try to shove their whole fist in. While drooling moistens the mouth ready for teething it is not necessarily a sign that teeth are imminent. Babies that dribble copious amounts of saliva often cut teeth with ease and with less associated pain.

When to expect teeth

It is not uncommon for baby teeth to start showing at four months old but more often they poke through around seven to nine months old. Occasionally teeth don’t appear until after twelve months old and although rare, some bubs are born with a tooth.

In some babies, the first sign of a tooth is when they bite down on a finger when playing or a nipple while feeding. Other babies suffer ear infections and are miserable for a few days before a tooth erupts.

Baby teeth usually erupt in pairs – one appearing a few days after the other.

teeth-chart

This chart shows a sequence that baby teeth are expected to appear, but it is not uncommon for teeth to show up in a different order. The first teeth predicted to appear are the two lower central incisors (cutting teeth) followed by the two upper central incisors. Next are the four incisors either side. If bub has followed this sequence they will be proudly showing off eight pearly white pegs by twelve months old. The four back molars (chewing teeth) are next to appear and may cause a little more pain and discomfort coming through than earlier teeth. The four canines (pointy teeth) are next, followed by the other four back molars, often referred to as two year old molars. That makes a mouthful of twenty teeth by the time they are around two years old.

Baby teeth are eventually pushed out by adult teeth growing up. It’s possible for second teeth to come through decayed if baby teeth are not looked after.

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Picture from www.healthtap.com

Signs and symptoms

The following signs and symptoms suggest that teeth are on the way. Babies are a little more grizzly and clingy and may have a clear nasal discharge and dark pink puffy gums. Some babies experience ear infections while others have a slight fever just as teeth erupt. Drooling, as mentioned earlier, is associated with a developmental phase that is happening while bub is teething. Dry red cheeks may be present but not necessarily a symptom of teething.  Smelly, poo and an angry red nappy rash may be present. Babies and toddlers may be off solid food but there is no need to worry as the enjoyment of eating will return. Babies and toddlers may experience all, some or none of these signs and symptoms of teething.

Give comfort

When babies are teething you can help them feel more comfortable by giving them cold drinks and foods – use a feeding net if they are too young to handle solid food. Reduce the risk of biting you and their play mates by giving them something to chomp on like a large cold chicken bone, lamb bone, a cold solid teething ring, wooden toy or a slightly dampened washer that has been cooled in the freezer. There are natural remedies such as amber necklaces, topical gels, oils, powders and mixtures that work systemically to reduce fever, pain and induce calm. Make sure you get professional instruction for how and where to use these products. If your littlie is having a particularly bad day and won’t be comforted by these suggested measures, administer an anti- inflammatory or analgesic medication recommended by your local pharmacist.

Provide babies and toddlers with a healthy diet and a balanced and settled day. This will help reduce the poor behaviour that teething often gets the blame for.

All children are different when it comes to what helps when teething so keep positive while you try to find a remedy that works best for your child.

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This article was brought to you by Jan Murray, Private Child Health Consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance. 

Baby’s Ear Ache

by Jan

Earaches are painful and distressing.

When and where ear pain occurs

Ear pain can occur when your baby is teething, flying in a plane, swimming, or after an illness. Pain can come from the outer or middle ear.

Structure of the ear supports infection

Babies are at risk of ear infection because the Eustachian tube, which connects the middle ear to the back of the throat and nose, is short and straight. This shape makes it easier for bacteria from infections in the nose and throat to travel up into the middle ear.

Fluid becomes trapped in the middle ear creating a wet, dark, warm environment, perfect for growing bacteria and viruses. Trapped thick fluid builds up in the middle ear causing the eardrum to bulge. This condition called Acute Otitis Media. If your child’s immune system is strong, inflammation and infection will clear and pressure will be relieved before the eardrum perforates.

Ear infections are not directly contagious but can follow viral or bacterial illness. Regular hand washing is the best defence against the spread of germs. Fever is nature’s way of fighting bacteria so don’t be too quick to give medications to reduce fever; let fever do its work first. Giving fluids, rest, cuddles, and pain relief may be all your baby needs to recover. Even when the drum perforates, fluid drains and it heals quickly on its own.

Glue ear and grommets

If thick fluid doesn’t drain and is constantly in the middle ear it is referred to as Glue ear, a condition, which stops the ear functioning as it should[i] and results in hearing loss and subsequent behaviour and language problems.[ii] To avoid this happening, some babies will be prescribed a course of antibiotics to help clear the infection. Your GP may suggest seeing an Ear, Nose and Throat specialist who may recommend an operation to insert an artificial tube (Grommet) through the eardrum. This tiny tube allows air and fluid to flow freely through the ear. Grommets usually remain in place for about six to 12-months if they don’t fall out earlier.

Hearing loss

If your baby has more than three or four ear infections a year, a hearing test (by an audiologist) will rule out any hearing loss that can hinder language development.

In-flight sucking

In-flight earaches occur during take-off and landing due to changes in air pressure within the middle ear. Try reducing your baby’s ear pain by getting her to suck on a dummy, breast or bottle when taking-off and landing.

Learn how to clean ears: Caring for newborn sensitive bits

References:

[i] http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=303&id=1855#2

[ii] http://www.babycenter.com/0_ear-infections-in-babies_83.bc#articlesection1

[iv] http://raisingchildren.net.au/articles/ear_infections.html/context/645

[v] http://healthychild.org/five-natural-remedies-for-ear-infections/

[vi]http://www.rch.org.au/kidsinfo/fact_sheets/Ear_infections_and_Otitis_media/

 

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This article was brought to you by Jan Murray, Private Child Health Consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance. Jan publishes regular ezine and blog articles to provide free parenting tips, tools and resources to educate and support those caring for young babies and children.

Gagging is not Choking

by Jan Murray

It is important for parents to understand the difference between when a baby gags on food and chokes on food… gagging is normal infant development whereas choking can be harmful.

Learning in the mouth

During the first year of life babies learn through senses in the mouth. Different textures, temperatures and tastes stimulate learning and the development of neural pathways in the brain. Until four to six months of age babies only swallow liquid. Swallowing is different when food is involved. There are different tastes, textures and temperatures to explore and become familiar with. Some babies are sensitive to these changes while others are not.

Swallowing

Soft, pureed or chewed food pass over the tongue touching the gag reflex at the back of the throat on the way to the stomach. Suitably prepared food, softened and mushed (mechanically or in the mouth) slides down the oesophagus into the stomach and intestines for further digestion.

This process of swallowing often involves gagging when the food is new. Choking occurs when food items are too hard or large. Gagging is not the same as choking.

Choking

Choking occurs when a substance gets lodged in the small oesophageal tube and pushes into into the trachea (airway) lying alongside it.

Food matter can partially obstruct the trachea or completely obstruct the tube. This depends on the size and firmness of the lodged substance. Sitting upright helps food matter slide down.

Never offer babies food that could get lodged in this tube such as peanuts, raw carrot, apple, and hard biscuits that don’t soften with saliva.

Gagging

Gagging is when babies are getting use to different textures. When food travels down the oesophagus babies may regurgitate it up from the back of their throat but often swallow it again. It is important for babies to be in an upright position to aid this process. Gagging is necessary for babies to understand how to chew and swallow different textures. Giving babies soft foods that are age appropriate will usually not cause choking but often causes gagging during the chewing and swallowing process.

Always sit with babies when offering them solid food. Avoid showing panic reactions in front of them if they do gag. Instead, smile and be encouraging, knowing that they are capable of regurgitating and re-swallowing. If you panic babies may inhale the food they have in their mouth.

Enjoy the experience of eating 

Help babies enjoy the experience of eating in a non-rushed, non-distracted atmosphere. Sit in front of them face-to-face with an encouraging smile and keep a ‘sippy cup’ of water handy.

Staying on mush

Many parents hold off moving their infants onto textured food. This can lead to fussy eating and slowed speech development. Parents may fear choking or only use processed foods from jars, squeeze packets and tins, which are kept soft for legal reasons.

This article was brought to you by Jan Murray, private child health consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance. Jan publishes regular ezine and blog articles to provide free parenting tips, tools and resources to educate and support those caring for young babies and children.