Your Baby

New Guidelines for Newborn Genetic Screenings

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Certain medical conditions can be present at birth but not easily identifiable. Metabolic or inherited disorders can impede a child’s normal physical and or mental development in lots of different ways. Without even knowing that they are carriers, parents can pass on the genes that produce these types of disorders. That’s where genetic screening of newborns comes in. With a simple blood test doctors can tell if the newborn has a condition that may eventually cause the child problems. Some of these disorders, if treated early, can be managed.

The federal government has not set any national standards, but many states have mandatory newborn screening programs. Parents can opt out of genetic testing if they want. Parents should discuss genetic screening with their pediatrician or child’s doctor so they can weigh the pros and cons.

Many states screen for more than 30 disorders and the screenings are often covered in the delivery and hospital charges. If a parent wants expanded testing on their newborn, they may have to pay an extra cost but it may be worth it to their baby.

To help guide states and parents determine what criteria should be used for genetic screening, the American Academy of Pediatrics and the American College of Medical Genetics and Genomics just offered new guidelines.

The new guidelines say that all newborns should be tested for the genetic diseases that are included in their state's newborn screening panel, but anything beyond that is up to parents and the decision must be made in the child's best interest.

The recommendations distinguish between genetic testing for childhood onset conditions versus those for adult onset conditions.

"There is an important role for counseling before and after genetic screening," added policy author Dr. Lainie Friedman Ross, a pediatrician and ethicist at the University of Chicago. "The focus should be on education of families, counseling them and helping them make decisions that focus on the child's best interest."

Testing for disease in the presence of symptoms is another area addressed by the new recommendations. "Clearly, if a child has symptoms, we need a diagnosis to help the family make clinical decisions that are in the child's best interest. This is important even when the disease has no current therapies," Friedman Ross added.

She also said that the results should be explained to the child when they reach the appropriate age.

New technology offers direct-to-consumer genetic screening tests, but the authors caution parents about using these products because of a lack of oversight and results are open to interpretation.

Some experts agree that being forewarned is being forearmed, but are not fans of the direst-to-consumer genetic tests.

"We highly discourage these even on adults, and particularly on children, because there is nobody there to provide counseling and interpretation," says Dr. Joyce Fox, a medical genetics doctor at North Shore University Hospital in Manhasset, N.Y. “These can also be very costly, and are likely not covered by insurance." Fox says.

Parents should educate themselves about genetic screening before the baby is born.  Most babies are born healthy and glide right through the genetic screening. But there are cases when the genetic testing panel reveals serious conditions such as PKU or Sickle Cell Anemia. 

If a baby’s screening results are negative, it means the tests did not show any signs of the conditions in the screening. On the other hand, if there are any positive results, it means there are signs of one or more of the conditions included in the screening,

A positive result does not always mean that the baby has the condition. It does mean though, that further testing is needed to make a final determination.

Early treatment for some of the conditions screened for can prevent serious future complications; so don’t delay if more tests are needed.

Pediatricians and geneticists say they approve of the new guidelines. The guidelines were published online in the journal Pediatrics.

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Sources: Denise Mann, http://consumer.healthday.com/Article.asp?AID=673692

http://kidshealth.org/parent/system/medical/newborn_screening_tests.html#cat150

Your Baby

Recall: Aveeno Baby Calming Comfort Lotion

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Johnson & Johnson on Friday said it is recalling more than 2,000 tubes of its Aveeno Baby Calming Comfort Lotion after U.S. regulators identified excessive levels of bacteria in a product sample.

J&J said the product, one of many consumer brands it has recalled in the past two years due to quality-control lapses, was being voluntarily withdrawn in Kansas and eight Southern states out of "an abundance of caution" and that its potential for harm was "remote."

The company said a test by the U.S. Food and Drug Administration showed that the lot of Aveeno lotion "exceeded the specifications for common bacteria" allowed for consumer products. But J&J said extensive testing later by an independent laboratory did not show that specifications were exceeded.

Source: http://www.reuters.com/article/2012/01/27/us-jj-aveeno-idUSTRE80Q25A2012...

Your Baby

Preemies Health Problems Sometimes Inherited

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An interesting new study says that not all health problems linked to premature births may be the result of a too early delivery. Only some of the physical and mental health problems previously connected with preterm birth are actually caused by it, the study says, other health issues may simply be inherited.

Researchers analyzed the medical records of 3.3 million children born in Sweden between 1973 and 2008, and confirmed the strong link between preterm birth (generally classified as before 37 weeks' gestation) and the risk of infant and young adult death, autism and attention-deficit/hyperactivity disorder (ADHD).

However, the study authors also concluded that many other problems that have been linked with preterm birth -- such as severe mental illness, learning problems, suicide and poverty -- may instead be more closely related to other factors that people share with other family members.

"The study confirms the degree to which preterm birth is a major public health concern and strongly supports the need for social services that reduce the incidence of preterm birth," study lead author Brian D'Onofrio, an associate professor in the department of psychological and brain sciences at Indiana University Bloomington, said in a university news release.

"Yet, the findings also suggest the need to extend services to all siblings in families with an offspring born preterm. In terms of policy, it means that the entire family, including all of the siblings, is at risk," he added.

Previous studies have compared preterm infants to non-related full-term infants. This study however, compared preterm infants with full-term siblings and cousins, an approach that shed new light on the issue.

"Our study is part of a growing interest in research and public health initiatives focusing on very early risk," he added. "When you look at early risk factors, they don't just predict one type of problem; they frequently predict lots of problems with long-term implications."

The study was published in the September issue of the journal JAMA Psychiatry.

 

Nearly half a million babies in the U.S. are born premature each year.

There are a number of risk factors associated with spontaneous preterm birth but more than half of preterm births happen in pregnancies where there are no identifiable risk factors. While there is no way to predict if you will have a preterm birth, there are some common risk factors that can increase the likelihood of a preterm birth. They include:

- You have had a previous preterm delivery

- You’re pregnant with twins or other multiples

- You are younger than 17 and older than 35

- You were underweight before your pregnancy and have not gained enough weight during pregnancy

- You are African American

- You’ve had vaginal bleeding in the first or second trimester. Vaginal bleeding in more than one trimester means the risk is even higher.

- You’ve had moderate to severe anemia early in your pregnancy

- You smoke, abuse alcohol or use drugs, especially cocaine, during pregnancy

- You’ve had little to no prenatal care

- You are pregnant with a single baby that is the result of fertility treatments.

Spontaneous births can also be caused by medical conditions such as infection, having a problem with the placenta, structural abnormalities of the uterus or cervix or having abdominal surgery while pregnant to name a few.

The best thing that a mother-to-be can do for herself and her unborn baby is to start prenatal care as soon as she discovers she is pregnant. There are no guarantees that you will have a full term delivery with no complications, but you can increase the odds to your favor by getting good prenatal care, sticking to a healthy diet, exercising and keeping your body free of drugs, alcohol and cigarette smoke.

Make it a point to learn about yours and your spouse’s medical family history. There may be clues that your OB/GYN should be aware of as he or she provides your prenatal care.

Sources: http://health.usnews.com/health-news/news/articles/2013/09/25/preemies-woes-sometimes-due-to-heredity-study-says

http://www.babycenter.com/0_preterm-labor-and-birth_1055.bc

 

Your Baby

New Support for Breastfeeding

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According to the “Call to Action,” breastfeeding protects babies from infections and illnesses that include diarrhea, ear infections, and pneumonia. Breastfed babies are also less likely to develop asthma, and those who are breastfed for six months are less likely to become obese.Support for mothers who breastfeed has been given a helping hand by the U.S. Surgeon General.

Surgeon General Regina M. Benjamin today issued a “Call to Action to Support Breastfeeding,” outlining steps that can be taken to remove some of the obstacles faced by women who want to breastfeed their babies. “Many barriers exist for mothers who want to breastfeed,” Dr. Benjamin said. “They shouldn’t have to go it alone. Whether you’re a clinician, a family member, a friend, or an employer, you can play an important part in helping mothers who want to breastfeed.” “Of course, the decision to breastfeed is a personal one,” she added, “no mother should be made to feel guilty if she cannot or chooses not to breastfeed.” While 75 percent of U.S. babies start out breastfeeding, the Centers for Disease Control and Prevention says, only 13 percent are exclusively breastfed at the end of six months.  The rates are particularly low among African-American infants. Many mothers who attempt to breastfeed say several factors impede their efforts, such as a lack of support at home; absence of family members who have experience with breastfeeding; a lack of breastfeeding information from health care clinicians; a lack of time and privacy to breastfeed or express milk at the workplace; and an inability to connect with other breastfeeding mothers in their communities. Dr. Benjamin’s “Call to Action” identifies ways that families, communities, employers and health care professionals can improve breastfeeding rates and increase support for breastfeeding: • Communities should expand and improve programs that provide mother-to-mother support and peer counseling. • Health care systems should ensure that maternity care practices provide education and counseling on breastfeeding.  Hospitals should become more “baby-friendly,” by taking steps like those recommended by the UNICEF/WHO’s Baby-Friendly Hospital Initiative. • Clinicians should ensure that they are trained to properly care for breastfeeding mothers and babies.  They should promote breastfeeding to their pregnant patients and make sure that mothers receive the best advice on how to breastfeed. • Employers should work toward establishing paid maternity leave and high-quality lactation support programs.  Employers should expand the use of programs that allow nursing mothers to have their babies close by so they can feed them during the day.  They should also provide women with break time and private space to express breast milk. • Families should give mothers the support and encouragement they need to breastfeed. Family members can help mother’s prepare for breastfeeding and support their continued breastfeeding, including after her return to work or school. According to the “Call to Action,” breastfeeding protects babies from infections and illnesses that include diarrhea, ear infections, and pneumonia. Breastfed babies are also less likely to develop asthma, and those who are breastfed for six months are less likely to become obese.  Mothers who breastfeed have a decreased risk of breast and ovarian cancers. A study published last year in the journal Pediatrics estimated that the nation would save $13 billion per year in health care and other costs if 90 percent of U.S. babies were exclusively breastfed for six months. Dr. Benjamin added that, by providing accommodations for nursing mothers, employers can reduce their company’s health care costs and lower their absenteeism and turnover rates. “I believe that we as a nation are beginning to see a shift in how we think and talk about breastfeeding,” said Dr. Benjamin.  “With this ‘Call to Action,’ I am urging everyone to help make breastfeeding easier.”

Your Baby

Babies Shouldn’t Be Given OTC Cold Medicines

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When a baby is sick with a cold, the first reaction for many parents is to want to give their infant something to make him or her feel better. It’s a natural response; no parent likes to see their little one feeling bad. But turning to the medicine cabinet or making a trip to the pharmacy isn’t going to help your baby get better any quicker and could be dangerous says the U.S. Food and Drug Administration (FDA).

Over-the-counter (OTC) cold and cough medicine should not be given to children younger than 2 because they could cause serious and potentially deadly side effects, the agency warned.

Children often get more colds than adults, and parents might want to give them pain relievers, decongestants and other medicines, but that would be a mistake. The FDA says the best medicine is simple rest and care.

"A cold is self-limited, and patients will get better on their own in a week or two without any need for medications. For older children, some OTC medicines can help relieve the symptoms -- but won't change the natural course of the cold or make it go away faster," Dr. Amy Taylor, a medical officer in FDA's Division of Pediatric and Maternal Health, said in the news release.

A virus is what typically brings on a cold, but people often ask their physician or pediatrician (for their children) for antibiotics to treat them. Antibiotics are only useful for treating bacterial infections.

Colds are usually accompanied by coughing which can actually be useful to the body.

"Coughs help the body clear the mucus out of the airway and protect the lungs; so you don't want to suppress all coughs," Taylor said.

"Coughs help the body clear the mucus out of the airway and protect the lungs; so you don't want to suppress all coughs," she said.

Fever helps the body fight off an infection and does not always need to be treated. But if your child is uncomfortable because of fever or other symptoms of a cold, there are alternatives to cough and cold medicine to help them feel more comfortable. Taylor says they include the following actions:

·      Using a clean cool-mist vaporizer or humidifier in a small area near the child’s bed may help moisten the air and decrease the drying of the nasal passages and throat.

·      For infants with a stuffy nose, use saline or salt water drops/spray to moisten the nasal passages and loosen the mucus. Then clean the nose with a bulb syringe.

Non-drug treatments to ease coughs in children with colds include giving them plenty of fluids, especially warm drinks to soothe the throat.

While most children with colds do not need to see a doctor, Taylor said parents should call the doctor if they see any of these symptoms:

·      A fever in an infant aged 2 months or younger, or a fever of 102 Fahrenheit or higher at any age.

·       Signs of breathing problems, including nostrils widening with each breath, wheezing, fast breathing or the ribs showing with each breath.

·      Blue lips, ear pain, not eating or drinking, signs of dehydration.

·      Excessive crankiness or sleepiness, a cough that lasts for more than three weeks, or worsening condition.

·      A persistent cough may signal a more serious condition such as bronchitis or asthma.

"You have to know your child," Taylor said. "With small infants, fever is a major concern, and you need medical advice. If you are worried about your child's symptoms, at any age, call your pediatrician for advice."

The FDA voluntarily removed cough and cold products for children under two years old from the market because of on-going safety concerns discussed in 2007.  These safety concerns revealed that there were many reports of harm, and even death, to children who used these products.  These reports of harm occurred when the child received too medication such as in cases as accidental ingestion, unintentional overdose, or after a medication dosing error.  In those reports of harm that lead to a child’s death, most of those children were under two years of age.  

Since infant formulations of cough and cold products were voluntarily removed from the market years ago, parents who currently give these products to their infants (less than 2 years of age) may be using cough and cold products designed for older children and modifying the doses, for instance by giving half the recommended amount to the infant than what is recommended for an older child.  This can be especially dangerous as dosing adjustments cannot safely be made this way and could add to the existing risk of giving these products to young children.

Colds can be tough on children and adults and this is certainly the time of year when we all are more susceptible to getting one. Fluids and plenty of rest, plus sanitizing the area around the sick person and not sharing objects like silverware and drinking cups is the best treatment for colds. And of course the most important cold remedy for baby is mommy and daddy’s love and tender touch. 

Source: Robert Preidt, http://consumer.healthday.com/respiratory-and-allergy-information-2/common-cold-news-142/steer-clear-of-cold-meds-for-babies-fda-advises-693878.html

http://www.fda.gov/Drugs/ResourcesForYou/SpecialFeatures/ucm263948.htm

Your Baby

Avoiding Tragic Hot-Car Deaths

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You can count on it. As spring turns to summer and temperatures outside start climbing, a child will die after being left in a hot car.

It happened recently in Dallas. A mother arrived at work, parked her car, grabbed her purse, locked the car and went into her workplace. She didn’t see her baby asleep in the backseat.

When officers arrived about 6 hours later, they said she seemed truly surprised when they confronted her. She asked if her husband was ok or if something had happened to her baby at daycare. She was sure she had delivered her baby to daycare that morning up until the moment she was told her baby had died in her car.

Variations of this story play out across the country every year and children die because they are either intentionally or accidently left in a hot car.

Many people are shocked when they hear or read about something like this happening especially when a parent or caregiver simply forgot the child was with them or thought they had left the child with someone else. They wonder how could that possibly happen?

While there is no excuse for negligence, experts say that parents who are otherwise loving and attentive to their kids can forget that their child is in the car when they are super-focused on getting somewhere, distracted while driving, under tremendous strain or when taking their child to daycare is not part of their daily routine.

Another factor that may contribute to a parent’s forgetfulness is rear-facing car seats. Originally intended to save lives, when the car seat is placed behind the driver’s seat a parent may miss the visual cue of a child when glancing in the rear-view mirror. Children are usually pretty noisy when they are in the car, unless they fall asleep. The silence doesn’t offer the sound cue that someone else is in the car.

Then there are the parents or caregivers who deliberately leave their child in the car when they run an errand. They often think that it’s easier and faster to leave them there, particularly if their child is asleep, get what they came for and get back to the car. They may even crack a window thinking that’s enough to keep the car from getting too hot. It’s not.

Heat coming into the car from a window is absorbed by the interior and the glass acts as an insulator. According to the National Highway Traffic Safety Administration, 'a locked car sitting in the summer sun quickly turns into an oven,' and 'temperatures can climb from 78 degrees to 100 degrees in just three minutes, to 125 degrees in 6-8 minutes.'

But it doesn’t have to be boiling outside for a car to heat up to a life threatening temperature; it just takes a few minutes longer.

While you may think you could never forget that your child is in the car it’s still an excellent idea to get in the habit of setting visual cues as well as considering some of the new technology driven gadgets that can give you that extra peace of mind.

- First and foremost, always put your cell phone, purse, or briefcase, and anything else you'll need that day, on the floor of the backseat. When you retrieve it at the end of the ride, you'll notice your child.

- Keep a teddy bear or other stuffed animal in the car seat when it's empty. When you put your child in the seat, move the animal to the front passenger seat, to remind you that your baby's on board.

- Put the car seat on the passenger side of the back seat.

- Ask your child's babysitter or daycare provider to always phone you promptly if your child isn't dropped off as scheduled.

- Make a habit of always opening the back door of your car after you park, to check that there's no kid back there.

- Never assume someone else, such as a spouse or an older child, has taken a young kid out of her seat. Such miscommunication has led to more than a few hot-car deaths.

- Check online about child safety gadgets that can warn parents when they’ve left a child in a car. There are even phone apps that will send you an alert.  

- Put visual cues in your office and home. There are decals you can buy (or make yourself) that remind you to check the car seat.

- Never leave your child unattended in a car. Weather isn’t the only factor when it comes to keeping your child safe from a dangerous outcome. A child left unattended in a parked car is vulnerable and easy prey for someone intent on doing harm.

If you see a child left unattended in a car- call 9-1-1. Don’t worry about offending someone or anything other than making sure that the child is rescued - whether it’s hot or not.

These types of articles and warnings go out every summer and yet children still die from being left in parked cars. More than any generation before, we are living in a multi-task, fast paced and distracting world. A lot of us are a little more forgetful than we used to be and anything you can do to slow yourself down and focus on your little one in the back seat of the car is a thing worth doing.

Source: Melissa Balmain, http://www.parenting.com/article/tragedy-in-the-backseat-hot-car-deaths

Your Baby

Fatty Acid Supplements in Baby Formula

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Studies have shown that breastfed babies score higher on mental development tests. One thought behind the higher thinking and language skills is that breast milk contains more fatty acids. So infant formulas enriched with DHA and ARA omega fatty acids from algae have found their way into the jam-packed baby formula aisle. But do these supplements actually give an infant a brainpower edge? Not according to a new study published in the journal Pediatrics.

The study says that baby formula supplemented with fatty acids doesn’t boost infants’ brainpower any more than formula without extra fatty acids. The results don't necessarily mean fatty acids in formula have no benefit. But they suggest the fats don't give children the thinking and language advantage that's been tied to breastfeeding.

Researchers explain in their study that infants raised on breast milk tend to score higher on tests of mental development than those who are fed formula.

One reason for the gap could be the higher levels of fatty acids found in breast milk, given that the fats are essential for babies' brain development.

"The differences in cognitive development between breastfed and formula-fed infants were a substantial motivating factor in adding (fatty acids) to infant formulas," according to the report.

Most baby formula is cow milk based and fortified with fatty acids and other nutrients.

Studies on the issue have had mixed results, so the researchers, led by Dr. Ahmad Qawasmi at Yale University in New Haven, Connecticut and Al-Quds University in Jerusalem, sought to get a better verdict by combining them into one analysis.

They used data from 12 trials that compared babies fed formula with fatty acid supplementation to babies fed formula without the extra fats. In total, about 1,800 infants took part in the studies, which were conducted between 1998 and 2005.

The children started drinking formula by one month of age, and around the time they turned one, they underwent exams to measure their motor skills, language abilities and mental development.

Just two of the studies included in the analysis found that babies fed supplemented formula performed better on the tests.

A third report showed a fatty acid-linked boost on some developmental measures but not others, and the remaining nine studies found no cognitive benefits in the babies getting added fatty acids.

Taken together, the studies show the extra fats provide no advantage as far as braininess goes, the researchers said. But it's still possible that adding fatty acids to formula could benefit infants in other ways, such as with a boost in eyesight or immune function, they noted.

"There also remains the possibility that (fatty acids) could impact later cognitive development or more specific aspects of cognitive development such as attention, information processing, mood, or behavior."

The American Academy of Pediatrics recommends women breastfeed exclusively for six months, followed by at least another six months of nursing while solid foods are introduced.

For various reasons not all mothers are able to breastfeed their babies, so formula is still a good option. Formulas supplemented with fatty acids may offer babies other valuable benefits.

Sources: http://news.yahoo.com/fatty-acids-formula-dont-babies-smarter-152740451....

http://bit.ly/N5q59o Pediatrics, online May 28, 2012.

Your Baby

Sunscreen Safety Tips

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Most children get 50% to 80% of their lifetime sun exposure before the age of 18, so it’s important that parents and caregivers teach them how to use sunscreen safely. With the right precautions, you can help reduce your child’s chance of developing skin cancer later in life. Most parents and caregivers understand the importance of applying sunscreen to their children to protect them against sunburn. However, a couple of questions may still linger such as, what is a safe age for a child to start using sunscreen, and what ingredients should I look for?

Most children get 50% to 80% of their lifetime sun exposure before the age of 18, so it’s important that parents and caregivers teach them how to use sunscreen safely. With the right precautions, you can help reduce your child’s chance of developing skin cancer later in life. The sun produces 3 types of ultraviolet rays. When these rays reach the skin, they cause tanning, burning, and other skin, and eye damage. The three types of ultraviolet rays are: UVA, UVB, UVC. - UVA rays cause skin aging and wrinkling and contribute to skin cancer, such as melanoma. Because UVA rays pass effortlessly through the ozone layer (the protective layer of atmosphere, or shield, surrounding the earth), they make up the majority of our sun exposure. Beware of tanning beds because they use UVA rays as well as UVB rays. A UVA tan does not help protect the skin from further sun damage; it merely produces color and a false sense of protection from the sun. - UVB rays are also dangerous, causing sunburns, cataracts (clouding of the eye lens), and effects on the immune system. They also contribute to skin cancer. Melanoma, the most dangerous form of skin cancer, is thought to be associated with severe UVB sunburns that occur before the age of 20. Most UVB rays are absorbed by the ozone layer, but enough of these rays pass through to cause serious damage. - UVC rays are the most dangerous, but fortunately, these rays are blocked by the ozone layer and don't reach the earth. When Can I Start Applying Sunscreen To My Child? For Babies younger than 6 months: Use sunscreen on small areas of the body, such as the face and the backs of the hands, if protective clothing and shade are not available. Because infants have thinner skin and underdeveloped melanin, their skin burns more easily than that of older kids. But sunscreen should not be applied to babies under 6 months of age, so they absolutely must be kept out of the sun whenever possible. If your infant must be in the sun, dress him or her in clothing that covers the body, including hats with wide brims to shadow the face. Use an umbrella to create shade. For babies older than 6 months: Apply to all areas of the body, but be careful around the eyes. If your baby rubs sunscreen into her eyes, wipe the eyes and hands clean with a damp cloth. If the sunscreen irritates her skin, try a different brand or try a sunscreen stick or sunscreen or sun-block with titanium dioxide or zinc oxide. If a rash develops, talk with your child’s doctor. To avoid possible skin allergy, don't use sunscreens with PABA. For kids age 6 months and older, select an SPF of 30 or higher to prevent both sunburn and tanning. Choose a sunscreen that states on the label that it protects against both UVA and UVB rays (referred to as "broad-spectrum" sunscreen.) If your child has sensitive skin, look for a product with the active ingredient titanium dioxide (a chemical-free block). For sunscreen to be affective it must be applied correctly and you must use a high enough SPF to do block the rays for a longer periods of time. 1. Apply sunscreen about 15 to 30 minutes before kids go outside so that a good layer of protection can form. Don't forget about lips, hands, ears, feet, shoulders, and behind the neck. Lift up bathing suit straps and apply sunscreen underneath them (in case the straps shift as a child moves). 2. Don't try to stretch out a bottle of sunscreen; apply it generously. 3. Reapply sunscreen often, approximately every 2 hours, as recommended by the American Academy of Dermatology. Reapply after a child has been sweating or swimming. 4. Apply a waterproof sunscreen if kids will be around water or swimming. Water reflects and intensifies the sun's rays, so kids need protection that lasts. Waterproof sunscreens may last up to 80 minutes in the water, and some are also sweat- and rub-proof. But regardless of the waterproof label, be sure to reapply sunscreen when kids come out of the water. 5. Remember that you can get sunburn even on cloudy days. Also, UV rays can bounce back from water, sand, snow, and concrete so make sure you’re protected. Keep in mind that every child needs extra sun protection. The American Academy of Dermatology recommends that all kids — regardless of their skin tone — wear sunscreen with an SPF of 30 or higher. Although dark skin has more protective melanin and tans more easily than it burns, remember that tanning is also a sign of sun damage. Dark-skinned kids also can develop painful sunburns. The skin is not the only part of the body that is affected by too much sun exposure. The sun can also damage the eyes. Even 1 day in the sun can result in a burned cornea (the outermost, clear membrane layer of the eye). Cumulative exposure can lead to cataracts (clouding of the eye lens, which leads to blurred vision) later in life. The best way to protect eyes is to wear sunglasses. Not all sunglasses provide the same level of ultraviolet protection; darkened plastic or glass lenses without special UV filters just trick the eyes into a false sense of safety. Purchase sunglasses with labels ensuring that they provide 100% UV protection. But not all kids enjoy wearing sunglasses, especially the first few times. To encourage them to wear them, let kids select a style they like — many manufacturers make fun, multicolored frames or ones embossed with cartoon characters. And don't forget that kids want to be like grown-ups. If you wear sunglasses regularly, your kids may be willing to follow your example. Providing sunglasses early in childhood will encourage the habit of wearing them in the future. Some Medications May Increase Sun Sensitivity Some medications increase the skin's sensitivity to UV rays. As a result, even kids with skin that tends not to burn easily can develop a severe sunburn in just minutes when taking certain medications. Fair-skinned kids, of course, are even more vulnerable. Ask your pediatrician or pharmacist if any prescription (especially antibiotics and acne medications) and over-the-counter medications your child is taking can increase sun sensitivity. If so, always take extra sun precautions. The best protection is simply covering up or staying indoors; even sunscreen can't always protect skin from sun sensitivity caused by medications. Choosing a Sunscreen Use a sunscreen that says “broad-spectrum” on the label - that means it will screen out both UVB and UVA rays. Use a sunscreen with an SPF (sun protection factor) of at least 15. The higher the SPF, the more UVB protection the sunscreen has. Look for the new UVA “star” rating system on the label. One star is low UVA protection. Two stars is medium protection. Three stars is high protection. Four stars is the highest UVA protection available in an over-the-counter sunscreen product. For sensitive areas of the body, such as the nose, cheeks, tops of the ears, and the shoulders, choose a sunscreen or sun-block with zinc oxide or titanium dioxide. While these products usually stay visible on the skin even after you rub them in, some now come in fun colors that kids enjoy. Treating Sunburn The Skin Cancer Foundation recommends these tips for treating children with sunburns. Your baby's skin: soft, sweet-smelling, vulnerable.  You notice that when you're diapering:  irritation develops easily; a soothing cream clears it up like magic. Young skin heals faster than older skin, but it is also less able to protect itself from injury, including injury from the sun. Babies under six months of age should never be exposed to the sun.  Babies older than six months should be protected from the sun, and wear UV-blocking sunglasses to protect their eyes.  However, if your child is sunburned: 1.     For a baby under one year old, sunburn should be treated as an emergency.  Call your doctor immediately. 2.     For a child one year or older, call your doctor if there is severe pain, blistering, lethargy, or fever over 101 F (38.3 C). 3.     Sunburn can cause dehydration.  Give your child water or juice to replace body fluids, especially if your child is not urinating regularly. 4.     Give Acetominophen if your child's temperature is above 101 F. 5.     Baths in clear, tepid water may cool the skin. 6.     Light moisturizing lotion may sooth the skin, but do not rub it in.  If touching the skin is painful, don't use lotion. 7.     Dabbing on plain calamine lotion may help, but don't use one with an added antihistamine. 8.     Do not apply alcohol, which can overcool the skin. 9.     Do not use any medicated cream — hydrocortisone, benzocaine — unless your baby's doctor tells you to. 10.   Keep your child out of the sun entirely until the sunburn heals. Familiarize yourself with the rules of sun protection, and make sure that no matter where you child goes — daycare, play dates, nursery school, your child is protected from sunburn.

Your Baby

Preparing for a New Sibling

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Bringing a new baby home is one of the most exciting times for parents and grandparents.  9 months of planning and anticipation finally pays off when the new addition arrives safe and sound.  However, there may be one person who isn’t quite sure what all the fuss is about and what having a new child in the family is going to mean for them. The sibling.

A new brother or sister may be thrilling to most of the family members, but a new baby who is getting all the attention can seem overwhelming to the first child, especially for very young siblings. Their very sense of security can feel threatened, leaving them feeling angry and acting out. So, before the little bundle of joy arrives, it’s a good idea to prepare the older child for big changes ahead.

You can do that as early as when mom starts showing. Introduce the idea that mommy is pregnant. Being pregnant means that mom & dad are going to have another child, and that means a little brother or sister is going to be part of the family.

One good tip is to have a calendar on hand and circle the date when the baby is due. Have the older child start marking the days as they go by.

If you have a very young child you can say “ the baby will arrive in the summer, when the weather gets hot.” Or “in the fall, when all the leaves start to fall.” Give them something they can identify with if they are too young to understand dates.

Once that’s established, ask them if they have any questions about having a little brother or sister. Children may be so surprised that they don’t have anything to ask right away. But as time goes on, they will have plenty of questions. Give answers that are age appropriate in a language that is easy to understand. Keep your answers simple but inclusive of how a new baby may affect their life. An example might be “the baby will cry and may wake you up at night for a while. That’s normal behavior for a new baby. We’ll all be tired for a little while, but it will get better. ” 

You can also bring out pictures or videos of when they were babies. Children love to hear stories about when they were little. Explain how much you loved them then and now. This little exercise in closeness can also help them understand the importance of babies and what a baby can bring to the family.

As the due date gets closer, try and keep everything as routine as possible. Avoid big transitions such as potty training, changing to a big girl or boy bed, getting rid of the pacifier or binky or anything that may separate the older sibling from the family. If the sibling must undergo some of these changes, start as early as possible so that they don’t make a negative association between these changes and the baby.

One unavoidable change that might occur is that mom will be away for a few days when the baby is born. Prepare your child for your absence during the birth of the new baby (how long you will be gone, where your child will stay). If your child is going to stay with someone else for a few days, do a couple of practice stay-overs so they will see that you will come back and bring them home.

For toddlers, you might also consider role-playing with dolls. Let them use the doll to ask questions or talk about their fears or excitement about the baby.

Once the baby is born allow the sibling to come to the hospital and see the baby and that mom is ok. A cute tip is to have a gift from the new baby for the sibling.

Once baby is home, suppress any negative comparisons such as “ you cried a lot more’, or ‘he or she is a lot calmer than you were.”

Other things to keep in mind are:

- Don’t be alarmed if siblings don’t express an interest in the new baby. Sibling relationships have a lifetime to develop.

- Accept that some regression may occur; this is normal. Baby your big-boy/girl for a while, if that’s what he/she seems to need.

- Remind visitors to pay attention to your older kids and monitor gift-giving. It can be upsetting for sibling to see all of the presents that the newborn receives, especially when people don’t bring something for them.

- Try not to blame the baby for your new limitations (“Mommy can’t play with you now because I have to feed the baby,” or “Mommy needs to change the baby, so you need to read to yourself.”). Blaming new babies for decreased time spent with you can breed sibling resentment. Instead, involve siblings in child-care as helpers.

- Create opportunities for older siblings to be participants and not competitors (e.g., getting a diaper ready, reading the baby a story, pushing the carriage).

- Remind siblings of the things they can do because they are older (e.g., eating food, playing with toys, going to the playground).

- Remember to give siblings private time with you and reinforce the idea that many of the things they are able to help out with (e.g., errand running, meal preparation, etc.), are because of their advanced abilities.

While you are busy with a new baby, developmental changes are still going on with your older child. Kids that are two or under may have difficulty with a new addition because they still have strong needs as well. Stress in the family can make the sibling’s adjustment more difficult. So remember to stay calm when you’re with the children.

One more thing to be aware of is how rough a sibling may be with a new baby. They really don’t understand how delicate the baby is and have to learn what kind of playing or interaction is too rough. They may also hug a little to hard. You’ll have to guide them in the correct gentle behaviors. Focus on your older child’s positive behaviors towards the new baby such as “ I like how you gently kiss your little brother or sister.”

Having a new baby in the family is difficult, but don’t despair. The first few months will be an adjustment for everyone. But before you know it, the new baby will feel like he or she has always been a part of the family.

Source: Bronwyn Charlton, PhD, http://www.everydayhealth.com/kids-health/prepping-your-child-for-a-new-sibling.aspx

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