Wednesday, March 14, 2012

Car seat safety: The biggest mistakes parents make, and how to avoid them.

Not using a safety seat consistently

"We were only going to the grocery store ..." "He hates to ride in his car seat, so just this once I didn't make him ..." "She was having a meltdown, so I took her out of her seat for a minute to calm her down." Safety experts hear these words all too often from distraught parents after tragedy has struck. Remember, a one-time lapse can result in a lifetime of regret.

In any case, using a safety seat consistently and correctly is the law. All 50 states require that children up to 3 years of age (or 40 inches tall in Kentucky) ride in car seats in private vehicles, and many have laws requiring car seats or booster seats until a child is considerably older.

There's good reason for that. Every year, tens of thousands of children are injured in car crashes, and about a thousand are killed. In fact, auto accidents are by far the leading cause of death for American children.

Using an old or secondhand seat

That safety seat you scored at a garage sale for a fraction of its original price may seem like a bargain, but it could cost your child his life. The same goes for that older-model seat your sister gave you after her child outgrew it.

Not only are used seats unlikely to come with the manufacturer's instructions (vital for correct installation), but they could be missing important parts, have been involved in an accident (even unseen damage can affect the seat's functioning), fall short of current safety standards, or have been recalled due to faulty design. Moreover, plastic gets brittle as it gets older, so a seat that's too old could break in a crash.

If you must use a secondhand seat, make sure it has the original instructions (or contact the manufacturer for a replacement copy), has all its parts (check the manual), has never been involved in a serious accident, and hasn't been recalled. (Check your seat's recall status here.)

In addition, to avoid the dangers of aging plastic, SafetyBeltSafe U.S.A. recommends sticking with car seats that are ideally less than five years old and definitely less than ten years old. You can usually find an expiration date stamped somewhere on the seat. read more

Sunday, March 11, 2012

Snoring babies more likely to develop behavioral problems

Mon, Mar 5 (HealthDay News) -- Infants and toddlers who snore or have other breathing issues while sleeping are more likely to develop behavioral problems by the age of 7, new research suggests.
Those issues can include hyperactivity and inattention, emotional problems such as anxiety and depression, conduct problems such as rule-breaking and aggressiveness and problems with peer relationships, researchers said. The study is published online March 5 and in the April print issue of Pediatrics.
The researchers assessed more than 11,000 children in England, who were followed for six years, beginning when the kids were 6 months old. Parents were asked about snoring, mouth breathing and witnessed apnea -- when a child takes abnormally long pauses in breathing during sleep -- at various points throughout infancy and childhood. Taken together, those symptoms are called sleep-disordered breathing.
Parents also filled out questionnaires about their child's behavior at the ages of 4 and 7.
Those who had the worst sleep-disordered breathing were almost twice as likely to have behavioral issues at age 7 as kids whose breathing was normal. Kids were considered to have behavioral issues if their parent's ratings were in the top 10 percent, relative to kids their age, for problem behaviors.
"Parents should pay close attention to their child's sleep, and if you think something is going on you should consult a pediatrician or a sleep specialist," said study author Karen Bonuck, a professor of family and social medicine at Albert Einstein College of Medicine of Yeshiva University in New York City.
The research showed only an association between sleep-disordered breathing and behavioral problems, not causality. However, there could be several reasons for the connection, Bonuck said.
By interfering with the quality of rest, sleep-disordered breathing leaves kids overtired. That may contribute to behavioral issues, such as being easily distracted, hyperactivity and irritability.
Previous research has also suggested that sleep-disordered breathing affects brain physiology via a lack of oxygen to the brain, carbon dioxide buildup and abnormal gas exchanges, Bonuck explained. For children, that may have a long-lasting impact. "We are sleeping to restore our brains, and sleep-disordered breathing interferes with that process," Bonuck explained. "For kids, these are critical periods in brain development."
Heidi Connolly, division chief for pediatric sleep medicine at University of Rochester Medical Center in New York, said the study adds to a growing body of research showing that snoring, mouth breathing and sleep apnea in children should be taken seriously. "These findings echo many of the other studies that show having sleep apnea and symptoms of snoring are bad for neurodevelopmental outcomes in children," Connolly said.
While snoring is a symptom of sleep apnea, it can have other causes, such as nasal allergies. Other studies suggest that even snoring alone, without apnea, can cause kids to do worse developmentally, she added. read more

Friday, March 9, 2012

Buckle up your kids or go to jail

Cape motorists could face jail if they don’t buckle up their children while on the road.
The province and the City of Cape Town want to criminally charge and prosecute motorists, including parents, caught with children not wearing seatbelts. In cases of car crashes where there are severe injuries or death, the charges could include jail time. The Western Cape transport department said the case of Jacob Humphreys, who was jailed for 20 years after 10 children died in his minibus taxi, paved the way for prosecutors to get tough on errant motorists. Humphreys jumped a queue at a level crossing, colliding with an oncoming train.
The plan has received support from several quarters. Arrive Alive spokesman Ashref Ismail said: “Seatbelts are absolutely vital. It goes without saying that we would support every possible legal means to clamp down on this.” Ismail said research showed that in countries where motorists complied with seatbelt laws there was a substantial drop in fatalities. In 80 percent of car crash cases treated at the Red Cross Children’s Hospital, the children were not wearing seatbelts.

Transport MEC Robin Carlisle wants prosecutors to crack down on parents and other drivers who “fail to protect children” by buckling them up as the law requires. Following taxi driver Jacob Humphreys's conviction and sentence of 30 years for murder - after 10 schoolchildren were killed in his taxi when it was hit by a train at the Buttskop level crossing in Blackheath in 2010 - Carlisle has asked his legal team to investigate the precedent in relation to the widespread failure to strap in children. Carlisle said: “We have been emboldened by the Humphreys verdict, and believe extremely strongly that the legal concept of 'criminal negligence' should be considered by prosecutors in every possible relevant case, when bringing drivers to book.
“Drivers - and this includes parents - who are criminally negligent with regard to their children must understand that they could the full force of criminal law,” Carlisle said. “More children are dying prematurely in car accidents than from any other cause.”
“Do parents leave their sanity behind when they climb into a car with their kids?”
“Between 200 and 300 children are treated each year at the Red Cross Children's Hospital for serious injuries sustained in crashes - and over 80 percent were not restrained in any way. It shows how absolutely clueless SA drivers are.“If they had any idea of what happens in an accident - about the horror that goes on inside and eventually outside their cars - they would never do that.” Legal sources canvassed by the Cape Argus, including within the National Prosecuting Authority (NPA), confirmed that Carlisle's plan was possible within current legislation.
Carlisle is now planning to request that the NPA takes several hard measures.
First, parents caught endangering their children typically face fines only. But Carlisle will now request the NPA to ask its prosecutors at courts around the province to no longer offer admission of guilt fines only. Instead, prosecutors are to demand that parents and other drivers appear in court.
In cases where the state could prove severe negligence - like allowing a child to stand on a front seat on a highway, for example - the parent or driver could still only receive a fine, but could then carry a criminal record thereafter. Second, in cases in which children who were not strapped in are killed or seriously injured, the actual traffic violation of not buckling a child in would become incidental. Instead, a parent or driver could be charged with one of several criminal charges: “Reckless or Negligent Driving”, “Culpable Homicide” or even - in particularly egregious cases - “Murder”. read more

Wednesday, March 7, 2012

When should I introduce solid food to my baby?

You can introduce solids any time between 4 and 6 months if your baby is ready. Until then, breast milk or formula provides all the calories and nourishment your baby needs and can handle. His digestive system simply isn't ready for solids until he nears his half-birthday.

The American Academy of Pediatrics recommends that babies be breastfed exclusively for at least six months – though parents will attest that some babies are eager and ready to eat solids earlier.

How will I know when my baby's ready?

Your baby will give you clear signs when he's ready to move beyond liquid-only nourishment. Cues to look for include:
  • Head control. Your baby needs to be able to keep his head in a steady, upright position.
  • Losing the "extrusion reflex." To keep solid food in his mouth and then swallow it, your baby needs to stop using his tongue to push food out of his mouth.
  • Sitting well when supported. Even if he's not quite ready for a highchair, your baby needs to be able to sit upright to swallow well.
  • Chewing motions. Your baby's mouth and tongue develop in sync with his digestive system. To start solids, he should be able to move food to the back of his mouth and swallow. As he learns to swallow efficiently, you may notice less drooling – though if your baby's teething, you might still see a lot of drool.
  • Significant weight gain. Most babies are ready to eat solids when they've doubled their birth weight  and are at least 4 months old.
  • Growing appetite. He seems hungry – even with eight to ten feedings of breast milk or formula a day.
  • Curiosity about what you're eating. Your baby may begin eyeing your bowl of rice or reaching for a forkful of fettuccine as it travels from your plate to your mouth.

How should I introduce solid food?

For most infants, you can start with any pureed solid food. While it's traditional to start your baby on solids with a single-grain cereal, there's no medical evidence to show that introducing solid foods in a particular order will benefit your baby. Good foods to start with include pureed sweet potatoes, squash, applesauce, bananas, peaches, and pears.

First, nurse or bottle-feed your baby. Then give him one or two teaspoons of pureed solid food. If you decide to start with cereal, mix it with enough formula or breast milk to make a semi-liquid. Use a soft-tipped plastic spoon when you feed your baby, to avoid injuring his gums. Start with just a small amount of food on the tip of the spoon.

If your baby doesn't seem very interested in eating off the spoon, let him smell and taste the food or wait until he warms up to the idea of eating something solid. Don't add cereal to your baby's bottle or he may not make the connection that food is to be eaten sitting up and from a spoon.

Begin with a once-a-day feeding, whenever it's convenient for you and your baby, but not at a time when your baby seems tired or cranky. Your baby may not eat much in the beginning, but give him time to get used to the experience. Some babies need practice keeping food in their mouths and swallowing.

Once he gets used to his new diet, he'll be ready for a few tablespoons of food a day. If he's eating cereal, gradually thicken the consistency by adding less liquid. As the amount your baby eats increases, add another feeding.

How will I know when my baby's full?

Your baby's appetite will vary from one feeding to the next, so a strict accounting of the amount he's eaten isn't a reliable way to tell when he's had enough. If your baby leans back in his chair, turns his head away from food, starts playing with the spoon, or refuses to open up for the next bite, he has probably had enough. (Sometimes a baby will keep his mouth closed because he hasn't yet finished with the first mouthful, so be sure to give him time to swallow.)

Do I still need to give my baby breast milk or formula?

Yes, your baby will need breast milk or formula until he's a year old. Both provide important vitamins, iron, and protein in an easy-to-digest form. Solid food can't replace all the nutrients that breast milk or formula provides during that first year. See how much breast milk or formula babies need after starting solids.

read more

Tuesday, March 6, 2012

Seven keys to creating a successful baby sleep, feeding, and play schedule

Getting into a regular schedule for sleep, feeding, and activities can make life easier for you and your baby. But how to start? Below, find seven great guidelines for establishing a routine that works.

Get your baby used to a bedtime routine early on

Once you have a consistent bedtime worked out, a daytime routine will fall into place, says Tanya Remer Altmann, a pediatrician and editor-in-chief of The Wonder Years: Helping Your Baby and Young Child Successfully Negotiate the Major Developmental Milestones.

And the easiest way to establish a regular bedtime is to start a bedtime routine that you and your baby can depend on night after night.

"The bedtime routine is the most important thing to consider when establishing a schedule," says Altmann. "You can't force it in the first few months, but you can start practicing at around 2 months."

Altmann says to keep it simple: a warm bath, jammies, a feeding, then lights-out. It's fine if feeding lulls your baby to sleep in the early months, Altmann says, but by 3 or 4 months you may want to try putting him down awake so he'll learn to fall asleep on his own.

Teach your baby the difference between night and day

Many babies mix up their days and nights at first, sleeping long stretches during the day only to perk up once the sun goes down. Helping your baby learn to tell day from night is a key first step to getting into a workable routine.

Amy Shelley, mom to 8-month-old Alex, offers these tips: "During the day, keep the house bright. Do the exact opposite at night: Keep the house dim and quiet. Don't talk to your baby much during night feedings. Let him learn that night is for sleeping and daytime is for socialization and playtime."

Learn to read your baby's cues

Websites, books, your baby's doctor, and other parents can all help as you figure out an appropriate schedule for your baby. But your child will be an important guide, and he'll tell you what he needs – if you learn to read his cues.

"When parents take the time to be with their baby, the information they receive gets sifted through their own experience. 'Instincts' come from learning about your baby's temperament and what works for him," says pediatrician Daniel Levy, president of the Maryland chapter of the American Academy of Pediatrics and clinical assistant professor of pediatrics at the University of Maryland.

Mom Liana Scott says paying close attention to 9-month-old Keaton has helped her anticipate his needs, which makes life easier and more fun for both of them.

"Now I'm able to feed him before he's really hungry and put him to bed before he's overtired and fussy," says Scott.

Learning what your baby needs when takes time and patience. But you'll see patterns emerge over time. And if you log your baby's naps, feedings, playtime, and so on in a notebook or on the computer, you can use this record to come up with a timetable for doing things.

When starting out, put your baby's schedule first

If you're encouraging your baby to follow a schedule or observing his patterns to figure out a routine that works, make this process a top priority for at least the first couple of weeks. Avoid deviating from the routine with vacations, meals on the go, outings that push naptime back, and so on.

Once you establish a pattern for your baby's sleeping, awake, and feeding times, changing things for an afternoon isn't likely to undo his habits. But it's best to keep your baby's schedule as consistent as possible while he's getting used to it.

Expect changes during growth spurts and milestones

Your child accomplishes so much in the first year. He'll nearly triple his weight and achieve some major feats like sitting up, crawling, even walking.

During periods of growth or when he's working to achieve a new milestone, don't be surprised if your baby diverges from his usual routine. He may be hungrier than usual, need more sleep, or return to waking up several times a night. Hang in there – your baby may be back on schedule shortly, or this may be a sign that you need to adjust your routine.

Adjust your baby's schedule to suit his age

It may feel like just when you've gotten into a predictable groove with your little one, it's time to change it again. As your baby gets older, he'll need fewer daytime naps and more playtime and stimulation. He'll also need to eat solid foods – first just once a day, but eventually several times a day.

As these developmental shifts happen, your child's schedule will shift as well. Reading up on these milestones and checking out our sample schedule for babies of all ages can help you know what to expect.

Don't expect perfection

Some parent-led schedules set the expectation that your baby's routine will always run like clockwork. And though babies do like consistency, you can expect changes from day to day and as your baby grows.

Sometimes, for whatever reason, your baby will want to skip a nap, have an extra snack, wake up before dawn, and so on. And life happens as well – vacations, older siblings, plans with friends and family, errands you need to take care of, and other factors will all come into play in your daily life with your baby. Variation is okay, as long as your baby is getting the sleep, play, food, care, and love he needs to thrive.