Newborns have a sucking reflex that enables them to nurse or bottle feed. This reflex involves opening their mouths and moving their tongues in and out to “milk” the nipple. When babies start solid foods around 6 months of age, they usually push food out of their mouths because that’s what their tongues are used to doing. It takes a week or more for babies to learn how to use their tongues effectively with spoon-feeding, but they continue with the milking action when taking breast milk or formula.
Sippy cups have been around for as long as I can remember. Straw cups are relatively new on the scene. When babies drink from sippy cups, some of them continue to push out their tongues, which could lead to lisps and other speech problems later on. However, with straw cups, they are more likely to keep their tongues in their mouths, which is theoretically better for speech development.
So which type of cup is better for infants and young children? Here’s what Maia Magder, a speech pathologist at NIH, has to say about the matter: “There is no hard evidence that sippy cups cause speech delays, but it’s important to provide infants with opportunities to move their mouths in more advanced patterns to foster feeding and speech advancement.”
Regular “open” cups are the best for speech development, but babies are pretty messy, so many parents aren’t ready for this step until the toddler years. Here is Maia’s take on getting rid of spouts and straws: “Offering an open cup as early as 8 or 9 months helps with jaw stabilization, which is another important factor in speech development. As for the messiness, like other aspects of parenting, think of it as balancing the new with the old. It’s always important to read a baby’s signs and signals when using cups so that your baby doesn’t choke.”
If you spend time outdoors with children, you’ll need to keep them safe from mosquitos, biting flies and ticks. For young infants, the best approach is to protect them with clothing or nets that cover their strollers. For older children, you’ll need an insect repellent to get the job done. DEET can be used with infants as young as 2 months, but the American Academy of Pediatrics (AAP) recommends not using products with more than 30% DEET: http://www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx. Lower concentrations of DEET work well, but last for shorter periods of time. A 10% concentration lasts for about two hours. I prefer an ingredient called picaridin because it works almost as well as DEET, but feels nicer on the skin. If you want a natural product, the soy-based repellent in Bite Blocker lasts about 90 minutes.
If you use a product containing DEET or picaridin, a lotion or pump spray is safer than an aerosol. Don’t apply it to your child’s hands and be careful to avoid the eyes, nose and mouth. It’s also a good idea to wash it off when you come inside.
You should not use products containing insect repellent and sunscreen. Instead, apply the sunscreen first, wait until it’s absorbed, and then apply the insect repellent. Keep in mind that sunscreen should be used liberally and reapplied every two hours. Bug sprays are applied sparingly and many should not be reapplied. Always read the instructions that come with the product you’re using.
One of the frustrations that comes with itchy rashes is something doctors call the “itch scratch cycle.” The process goes like this: A rash itches so we scratch it. Although the scratching makes the itch go away, it can irritate the skin causing the itch to recur. This can lead to itch-scratch-itch-scratch, etc. Eventually, the skin can become so irritated that scratching the area actually hurts. The best way to deal with this is to put something cold on the itchy/painful area for 5 to 10 minutes. Of course, not getting into this bind is even better.
If your child starts to scratch a bug bite, you can use 1% hydrocortisone ointment (not cream) and a “dot” Band-Aid to stop the itch. First, put a small amount of the ointment on the bite. Second, open the Band-Aid and briefly stick it to your shirt or pants. (This takes some of the adhesive off the bandage so your child is less likely to complain when you remove it.) Third, place the Band-Aid on the bite and leave it in place for about 15 minutes. You can repeat this up to three times a day for four or five days if necessary. Facial skin is thinner than skin on the rest of the body, so don’t use Band-Aids for facial bug bites. The hydrocortisone can still help, but you shouldn’t use it for more than three days.
If the bite gets very red or develops discharge, call your doctor to make sure it hasn’t become infected.
Patients are sometimes confused when doctors differentiate the terms pain and tenderness. The reason we use these words differently is because they mean different things when it comes to making a diagnosis. If something is painful, that means it hurts. If something is tender, that means it hurts when it is touched or moved. A good example of how we use these terms relates to abdominal pain. I could have a horrible stomachache, but if it doesn’t hurt more when someone pushes on my abdomen, I am not tender. Appendicitis always causes a tender abdomen. Similarly, migraine headaches cause severe pain in addition to nausea and photophobia (it hurts to look at lights), but patients with migraine usually don’t have scalp tenderness. If someone has a bad headache associated with scalp tenderness, it’s often due to muscle tension that’s brought on by psychological or physical stress such as carrying a heavy backpack or keyboarding for long periods of time.
Although the human body isn’t perfect, there are lots of awesome ways that it functions. One of these is called the gastrocolic reflex. In this context, “gastro” refers to the stomach and “colic” refers to the colon or large intestine.
When we eat, the stomach stretches and begins digesting our meal. The stomach does this by releasing chemicals and contracting to break down the food we have eaten. At the same time, the “machinery” of the intestinal tract is turned on. The rhythmic contraction of the muscles in the stomach and intestine is called peristalsis. If a child is constipated, the onset of peristalsis within the large intestine (especially the rectum) can cause pain as the intestinal muscles contract against large or hard fecal material. If the pain was because of stool in the rectum, having a bowel movement will usually relieve the pain. If the pain was because of stool higher up in the large intestine, stooling won’t necessarily relieve the pain. Sometimes the pain is so severe that parents may worry their child has an appendicitis.
Constipation isn’t the only condition that can trigger pain after someone eats. Lactose intolerance, overeating and celiac disease can cause similar symptoms. However, 90% of the time pain after eating is due to constipation.
Many childrearing books tell you not to use soap on a baby’s face. One of the reasons for this is because soap may irritate a newborn’s sensitive facial skin. Another is that a newborn’s skin is slightly acidic, which helps prevent infection. Soap can reduce the natural acidity of a newborn’s skin.
The problem with not using soap on a baby’s face is that some of them will be more prone to newborn acne and other rashes because of dead skin, saliva and regurgitated milk that accumulates on their face. The answer to this problem is to wash the baby’s face with a ph-neutral soap substitute like Cetaphil Gentle Skin Cleanser. Using Cetaphil with a washcloth helps remove dead skin, etc. without harming the baby’s skin.
Body temperature varies throughout the day whether you’re sick or healthy. If you take your daughter’s temperature three times a day for a number of days, you will see that the highest readings come in the evening. Similarly, if she is sick, you are more likely to find high temperature at 9pm rather than 9am. This diurnal variation in body temperature causes two problems for parents. First, it’s harder to manage high fevers at night when everyone is trying to get some sleep. Second, if your feverish child wakes up cool, you may think all is well until the fever returns in the afternoon or evening. Although it’s not always clear when a child isn’t contagious, most schools have adopted a 24-hour fever free policy because they know temperatures can come back as the day progresses. That’s why you shouldn’t take your kids to school the morning after a feverish night.