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Preserve Precious Breastmilk

December 4, 2017 by  
Filed under R.McAllister

by Rallie McAllister, MD, MPH

When my boys were babies, I was determined to breastfeed them. I knew that it would help boost their immunity and protect their teeth from cavities. To be honest, breastfeeding also saved me time and money.

I didn’t have lengthy maternity leaves, and when I went back to work, I wanted to continue to nurse my babies. This meant I had to pump and store my breastmilk.

Any woman who’s pumped will tell you, breastmilk is more precious than gold. It’s a time-consuming process. I was always careful to collect every single drop of that “liquid gold,” pour it into bags, and freeze it for safe keeping.

Then when I was ready to feed my babies, I warmed the breastmilk in bottles in a pan of water on the stove—the conventional method at the time. Little did I know I was overheating and damaging the milk.

Breastmilk is such a complex, amazing substance that it’s sometimes called “miracle milk.” It’s the perfect blend of proteins, essential fats, enzymes, and hormones. It offers nourishment, of course, and it also has antioxidant, antibacterial, prebiotic, probiotic, and immune-boosting properties.

When we feed our babies breast milk via the intended “delivery device”—Mom!—it’s perfectly fresh and at the ideal temperature. But like many other foods, breast milk isn’t shelf stable. If you let it sit out at room temperature, bacteria quickly multiply

Once breast milk is expressed, you should use it, refrigerate it, or freeze it within four hours. This slows the growth of bacteria, protecting and preserving the milk. It’s safe to store breastmilk in the fridge for a few days or in the back of a deep freezer for up to a year. Label each bag with the date so you know which one to use first.

Of course, now that you’ve refrigerated or frozen the milk, you need to warm it back up when you’re ready to feed it to your baby. Babies’ milk preferences are a lot like Goldilock’s choices: They don’t like it too cold or too hot. They like it just right: at body temperature, 98.6° degrees Fahrenheit. If the milk is too cold, it can disrupt your baby’s digestion and contribute to colic. If the milk is too hot, it can burn your baby’s mouth and degrade the nutrients in the milk.

When you warm breastmilk, it’s important to warm the milk evenly. A new breast milk bottle by nanobebe (link) has a concave shape bio-medically engineered to spread the milk into a thin layer, which warms at faster rates to protect nutrient damage while providing quick access to nutrition when baby is hungry.

Once the milk is warm, test the temperature by placing a few drops on the inside of your wrist. Then sit back, hold your baby in your arms, and enjoy one of the most beautiful, rewarding experiences that life has to offer—feeding your baby.

About the author: Rallie McAllister, MD, MPH, is a mom of three sons, a family physician, and coauthor of The Mommy MD Guide to Your Baby’s First Year, in Lexington, KY.

Unconfusing Nipple Confusion

December 4, 2017 by  
Filed under Uncategorized

by Michelle Davis-Dash, MD

Breastfeeding is not always beautiful, fun, and easy. To be honest, sometimes it can be downright ugly and hard. There’s one important thing to remember: You are not alone.

One of the frustrations that breastfeeding mothers encounter is method of feeding. In the beginning, there’s such a sense of accomplishment putting baby to breast and no longer feeling the pain and dread that was felt in the beginning. A new mom feels a sense of pride seeing her dear baby satiated by nursing at her breast and the sweet satisfied “milk coma” that comes after.

According to the Centers for Disease Control and Prevention’s breastfeeding report card (cdc.gov/brestfeedingreport), more than 80 percent of new moms try breastfeeding. Despite the many benefits of breastfeeding, most moms, for various professional and personal reasons, introduce a bottle at some point. Many babies resist this change. It’s a “no go.” The new moms panic, thinking, “My baby is going to starve. I’ll never be able to leave the house because I have to be here to feed my baby.”

Rest assured, there is hope. When a baby refuses to accept a bottle, it’s called “nipple confusion.” With some diligence, patience, time, and simple solutions, you can unconfuse your baby. Here are some ideas to try:

Before you try to give your baby a bottle, make sure she/he is hungry. Sometimes a baby wants to suckle for comfort, and that’s not the time to try to introduce the bottle. Instead, try switching to a bottle during a breastfeeding session. That way, if it doesn’t go well, you can put baby back on the breast and try switching to a bottle again later.

  • For infants from birth to two months old, a bottle may not be your best option to feed pumped breastmilk. Instead, you can use a plastic-tipped spoon, a medicine dropper, or a lipped cup.
  • A new breast milk bottle by nanobebe (link) is receiving some strong buzz (link to the bump article naming nanobebe the best bottle for breastfed babies). Unlike the uniform baby bottle shape, the nanobebe breastmilk bottle has a (breast like) ergonomic shape to which the baby is meant to instinctively connect. The concave shape was bio medically engineered to spreads the milk into a thin layer which warms at faster rates to protect nutrient damage while providing quick access to nutrition when baby is crying and hungry (a need fulfillment baby has grown accustomed to while breastfeeding).
  • Pump often. When you are first transitioning your baby to a bottle, you might have to do what is called “triple” feeding: a combination of nursing, bottle feeding, and pumping. You’ll have more than enough milk supply to experiment with different feeding techniques and know that you’re providing adequate nutrition.
  • If you’re concerned that your baby isn’t getting enough milk see your pediatrician immediately. Your baby’s doctor will monitor her developmental progress, tracking growth parameters and troubleshooting before things get serious, which, for an infant, can sometimes happen in a matter of hours to days. If your pediatrician is not well versed on breastfeeding, find one that is.
  • Last, but not least, relax. Don’t be so hard on yourself. Mothering is hard enough without piling more stress on yourself. You’re doing one of the most noble things imaginable—feeding your baby breast milk–and you are rocking it! Let yourself be proud of yourself!
About the author: Michelle Davis-Dash, MD is a mom of a son and a daughter, a board-certified pediatrician with more than 10 years of clinical experience, and a medical contributor to the Mommy MD Guides, in Baltimore, Maryland.

Breast or Formula? Do I really have to choose?

September 14, 2017 by  
Filed under R.McAllister

by Rallie McAllister, MD, MPH

Life is like a giant flow chart. Every minute of every day, you’re making decisions, whether you realize it or not – surprisingly it adds up to about 35,000 decisions a day!

Bath or shower?

Turn left or right?

Chicken or fish?

There are some things in life we feel so strongly about, we make a choice once and that’s it. For example, many decades ago you probably decided if you were a Republican or a Democrat, and you probably haven’t looked back.

Fortunately, other choices in life aren’t so definite. For example, no one minds if you bag your groceries in paper one day and use plastic the next.

In parenting, some moms feel tremendous pressure to choose between breastfeeding or formula feeding. My experience is a great example of how this doesn’t have to be a defining moment. It doesn’t have to be a limiting choice. It’s perfectly fine—better even—to choose both.

I got the best of both worlds by breastfeeding and formula feeding with all three of my sons, and I would not change that experience for the world! For all three of my kids, I started nursing. But early on, I supplemented with formula. I found this to be beneficial for two main reasons.

One, my husband could also feed our babies. This was incredibly valuable for me, and it was also a very positive experience for him and for our sons. And I’m not alone, in fact, 35 percent of moms chose to feed their baby with infant formula so they could share the feeding responsibilities for baby with their partner, per a survey conducted by Perrigo Nutritionals, the makers of store brand infant formula.

Two, adding formula helped me to transition back to work. Before my sons were born, I had bought a breast pump, and I worried a lot about how I was going to pump at work. Turns out I didn’t anticipate everything I could have. The first day I returned to work, I pumped—in the teeny supply closet they offered me. I put my pumped milk in a sealed container in the office refrigerator.

Imagine my surprise when the office administrator told me I had to move it to the biohazard refrigerator instead because milk was a body fluid. She wanted me to put my baby’s milk in with the throat cultures and stool samples!

I found that supplementing with formula meant that I no longer had to pump at work. That convenience factor helped simplify one aspect of my otherwise chaotic life. For many working moms, “convenience” is the number one factor for choosing to feed baby with infant formula. I nursed my sons at home before and after work, and then they drank formula during the day.

This flexibility helped me, and it also helped my babies as well. My sons thrived on the seamless combo of breastfeeding and formula feeding.

If you decide to combo feed and you receive formula samples at the hospital, rest easy knowing that you can switch from the nationally advertised brand to a less expensive, nutritionally comparable store brand formula when you return home with baby.  In fact, a clinical study by University of Virginia researchers found that switching from one brand of formula to another is safe and well tolerated in infants.

In the study, babies who switched from a big-name milk-based formula to a store brand milk-based formula didn’t experience an increase in spit up, burping, gas, crying or irritability compared to babies who stayed with the advertised brand. No matter what you decide – breastfeeding, formula feeding, or supplementing with formula – please know that all three or a combination of these options will support your baby’s healthy growth and development.

 

About the author: Rallie McAllister, MD, MPH, is a family physician and mom of three sons in Lexington, KY. She’s the co-author of the Mommy MD Guides books, including The Mommy MD Guide to Your Baby’s First Year.

About the survey: Perrigo Nutritionals, the makers of store brand formula, conducted the survey in February of 2017, among 2,000 nationally representative Americans between the ages of 18 and 65 who currently have a child between the ages of one and three.  Margin of error is +/- 3 percent. To learn more about store brand formula or to discover special promotions or offers, visit storebrandformula.com.

My Top 5 Breastfeeding Essentials

August 30, 2017 by  
Filed under J.Reich

By Jennifer Bright Reich

When I was pregnant with my older son, I was determined to breastfeed. With the confidence one has before children, I didn’t give breastfeeding much thought.  I just figured I would do it, no problem.

Then my son was born.

Within hours of his birth, my fantasies of serenely nursing my baby went out the window. My baby cried a lot, he wanted to nurse all of the time, and it hurt.

It took all of the determination I had to continue, but I’m proud to say I did.  I asked my friends who had nursed their babies and my own mom for advice. I would have done just about anything they suggested to make nursing easier. If someone had told me it would help to nurse my baby while standing on my head, singing “I’m a Yankee Doodle Dandy,” I’d have done it. Willingly.

Fortunately, it didn’t come to that, because I found the following five essentials that made nursing so much easier.

#1: Boppy: A friend gave me a beautiful blue Boppy® nursing pillow with sweet little honeybees on it.  I loved it on sight, and it was the absolute nursing (and sanity) saver. I sat on my sofa or nursing chair, rested the Boppy® pillow on my lap, and then put my baby on the pillow. We were both so much more comfortable in that position. My boys are 12 and 10, and I still have this pillow! Visit www.boppy.com for more information.

#2: Glider rocker: Before my son was born, I bought a glider rocker with ottoman. I “test sat” quite a few chairs before buying this one. I chose it because it was extremely comfortable and quiet.

#3: Nursing bras: I’m not well endowed, so I was actually not going to buy nursing bras. I didn’t think I would need them.  That idea went out the same window as my nursing fantasies. When you’re nursing, exhausted, and half asleep, the convenience and comfort of a nursing bra are key! ThirdLove just came out with a nursing bra collection as well. Visit www.thirdlove.com for more information.

#4: Nursing pads: Mother’s milk doesn’t switch on—or off—like the light in the fridge. I leaked a lot, and I wore nursing pads in my bras to keep the milk from leaking through, and staining, my clothing.

#5: Palmer’s Cocoa Butter Nursing Cream: For the first few weeks, nursing was painful as both my son and I learned what we were doing. This cream eased the painful, cracked nipples and really saved my nursing hopes. Visit www.palmers.com for more information.

Breastfeeding is one of many things in parenting that seem like they should be easy, but aren’t. But also like so many things in parenting, sticking with breastfeeding—or finding a nursing/formula combo that works for you and your family—offers many rewards to your baby—and you!

About the author: Jennifer Bright Reich is a mom of two sons and co-author of The Mommy MD Guide to Your Baby’s First Year. She lives with her two sons and three cats in Hellertown, PA.

No, Formula Doesn’t Need Warming!

June 30, 2017 by  
Filed under J.Reich

Mother Feeding Her Baby ca. October 2000

And 5 other baby formula myths—debunked

By Rallie McAllister, MD, MPH

The MythBusters on TV’s Discovery channel tackled hundreds—if not thousands—of myths in their 19 seasons on the air. If they talked about infant feeding, I must have missed that episode. Yet baby feeding has many pervasive myths—especially about infant formula. Here are five of my favorites.

Myth 1: Breast is best.

Fact: Not for every mother and baby. Baby formulas are a completely acceptable, doctor-approved, and time-tested option when feeding baby. Breastfeeding is hard. It seems like it should be natural easy, but so often it isn’t. A recent study conducted by Perrigo Nutritionals found that more than half of moms experience issues when it comes to breastfeeding baby with low breast milk supply being the top concern. Additionally, while only 18 percent of new moms expect to introduce infant formula to baby during the first three days of life, in reality, 45 percent relied on infant formula during those first days. If you experience breastfeeding challenges, look to formula as an ally – it can be used as a supplement while breastfeeding to provide some relief or used exclusively depending on mom and baby’s needs. Also, know that you can find help and support. Consider talking with a friend who has nursed her babies, your pediatrician, a lactation consultant, or a local La Leche League.

Myth 2: You have to sterilize your baby’s bottles.

Fact: No. This is another time-saver for you! You should sterilize new bottles and nipples before you use them for the first time. Simply put them in boiling water for 5 minutes. After that first time, however, you probably don’t need to sterilize them again.

Instead, you can run bottles and nipples through the dishwasher. Or if you’re “old school,” wash them in hot, soapy water. Rinse them carefully to remove any soap residue.

Myth 3: Babies prefer warm formula.

Fact: Not necessarily. It’s perfectly fine to feed your baby formula at room temperature (as long as it’s freshly prepared), or even a little cool from the refrigerator. Your baby is most likely to prefer his or her formula at a consistent temperature. In other words, if you start warming it you’ll probably have to continue warming it.

Here’s an easy way to warm your baby’s bottle: Set the filled bottle in a container of warm water and let it stand for a few minutes. Check the temperature of the formula on the inside of your wrist before feeding it to your baby. It should feel lukewarm, not hot.

Myth 4: Measuring formula isn’t a big deal—just “eyeball it.”

Fact: The instructions for preparing your baby’s formula are important. Follow the directions on the label carefully. If you put too little water in your baby’s formula, it can give baby dehydration or diarrhea. If you put too much water in the formula, you’re watering it down and your baby isn’t getting enough nutrients. It’s critical to measure carefully each and every time.

Myth 5: Brand name formula is best.

Fact: Nationally advertised, brand-name formula and store brand formula are practically identical—but have different effects on your family budget! Did you know that all infant formulas sold in the United States must meet the same FDA standards and offer complete nutrition for baby? That means store brand formula is nutritionally comparable to nationally advertised brands. In fact, store brand formula is clinically proven to support baby’s growth and development and proven to be just as well tolerated by your baby as those other brands.

So, what’s the main difference? Store brand formula costs less because they don’t spend millions of dollars on marketing – think about all the ads you see on TV and all the samples that get handed out in doctors’ offices.  In the case of those big brands, those marketing costs are passed on to you in the form of a higher price tag on each container of formula.

Once you get into the groove of feeding your baby, it will all feel like second nature. And then it will almost be time to give up the bottle!

About the author: Rallie McAllister, MD, MPH, is a family physician and mom of three sons in Lexington, KY. She’s the co-author of the Mommy MD Guides books, including The Mommy MD Guide to Your Baby’s First Year.

About the survey: Perrigo Nutritionals, the makers of store brand formula, conducted the survey in February of 2017, among 2,000 nationally representative Americans between the ages of 18 and 65 who currently have a child between the ages of one and three.  Margin of error is +/- 3 percent. To learn more about store brand formula or to discover special promotions or offers, visit www.storebrandformula.com.

Total savings with Store Brand Infant Formula calculations based on a price per fl. oz. comparison of Store Brand Infant Formulas and their comparable national brands. Retail prices are from a May 2017 retail price survey of assorted stores. Actual prices and savings may vary by store and location.

 

My Breastfeeding Turning Point

June 15, 2017 by  
Filed under J.Reich

My mom with my son Tyler

My mom with my son Tyler

I recently came across a blog on the Honest Company’s site about  Honest Moments. That got me thinking: What are MY parenting honest moments? I can honestly say I have had lots of them! Here’s one of my favorites…

My mom had a theory. She and I were always very close. My mom and I were dear friends who had the tremendous fortune to be mother and daughter. My mom attributed this to the fact that she nursed me.

Because of this, I was determined to nurse my son. Little did I know how hard that resolve would be tested!

My son started to cry the moment he was born. He cried—screamed really—the entire time we were in the hospital. At times, I wondered if the nurses might come take him away! I tried so hard to nurse, but it was challenging and painful.

I was determined to nurse, so I kept trying. And he kept crying—most of his waking hours. Nursing soothed him a bit, as did walking around carrying him in my arms. So I did both, for hours on end.

That ironically made nursing even harder! My nipples got sore and cracked, and I developed mastitis. In desperation, when my son was around a week old, I called my sister, whose children were older than mine.

“Keep trying,” she advised. “I promise, if you stick with it, in a week or two, he will become so comfortable nursing he’ll be hanging off of you like a little monkey.”

I found that extremely hard to believe, but the image amused me at least. The promise of that gave me the strength to stick with it.

My greatest fear was that my son was crying because he was starving. He was nursing often, but was he actually getting any milk? Nursing wasn’t working well for us, and I was almost ready to quit.

The hospital had given me the name and phone number for a local lactation consultant. I called and set up an appointment for her to come to my house.

When the lactation consultant arrived the next day, it was like a breath of fresh air. She was warm, comforting, confident. She talked to me for a few minutes and asked me some questions.

And then she did something completely unexpected.  She weighed my son. Then she had me nurse him. And then she weighed him again! Voila! He weighed more! That was the proof I needed that nursing was working, he was getting milk. I knew that I could do this.

Shortly after that aha moment, nursing clicked for us. I felt so much better, and my baby stopped crying quite so much. I nursed him for over a year—until I got pregnant with his brother.

He took to nursing right away. I nursed him for almost two years. I have the wonderful memory that the last time I ever nursed a baby was on vacation at Walt Disney World. Knowing I’d have that treasured memory made it easier to wean my youngest for good.

About the author: Jennifer Bright Reich is cofounder of Momosa Publishing LLC, publisher of the Mommy MD Guides books, featuring tips that doctors who are also mothers use for their own families—and more. She lives with her two sons in Allentown, PA. (please link to www.mommymdguides.com)

Feeding Baby the First Year: What Pediatricians Actually Do At Home

April 20, 2017 by  
Filed under R.McAllister

Mother Feeding BabyIt’s one of the great ironies of parenting: feeding your baby.  Something that should be so simple, so often isn’t. In fact, deciding how to feed your baby in the first year may appear, at first glance, to be one of the great divides of parenting. Many parents think that you  must choose between breastfeeding OR formula feeding, but that’s simply not true.

Think of it as a continuum with exclusively breastfeeding on one end and exclusively bottle-feeding with formula on the other with a wide range of combinations in between.  It may be surprising to learn that most babies fall within the latter, with parents choosing to do a combination of both.

Perrigo Nutritionals, the makers of store brand infant formula, recently conducted a nationwide survey of 2,000 moms with children between the ages of one and three to gain insight into mom’s thoughts on baby’s first year. Interestingly, the survey found that although three out of four moms said they used infant formula during baby’s first year, one out of 10 new moms weren’t completely honest about breastfeeding baby to avoid criticism from family and friends. As parents, we face many pressures each day.  We talked to some of our Mommy MD Guides—doctors who are also mothers— to share some of their own personal feeding experiences. What we learned? It’s a personal decision and there’s no right or wrong choice. Here’s what they had to say…

“I had really set out to breastfeed my son. But from the very beginning, breastfeeding was very challenging,” said Wendy Sue Swanson, MD, a pediatrician and mom of two, in Seattle. “It was extremely emotional for me; on some level it was even devastating. When my son was a few weeks old, I got such severe mastitis that I was hospitalized. After I went home, I continued to pump for several months. It was pure misery for me. The moment both my son and I started to thrive was when I finally stopped and switched to formula”

“Although I nursed both of my daughters for their first six or seven months, I found it helpful not to be rigid with only breast milk,” said Darlene Gaynor-Krupnick, DO, urologist and mom of two in northern Virginia. “Formula was heavier, and my daughters seemed to sleep better when they were ‘topped off’ with a bottle before bedtime.”

“I breastfed and gave my babies formula as a supplement early on and switched to formula all the way by 4 months,“ says Sigrid Payne DaVeiga, MD, a pediatric allergist and mom of three,  in Philadelphia, PA.

“I had planned to breastfeed for the first six months, but unfortunately I was only able to breastfeed for approximately four months,” said Kathleen Moline, DO, a family physician and mom of one in Winfield, IL. “Pumping at work was challenging, and eventually my daughter preferred bottles to breastfeeding. Part of the learning process was that what I had planned or expected wasn’t always the way it worked out, and that was okay.”

“I breastfed my son, but to give myself more flexibility time-wise, I pumped often,” said Leigh Andrea DeLair, MD, a family physician and mom of one in Danville, KY. “I also supplemented my son’s diet with formula. He thrived.”

At the end of the day, choosing how to feed your baby is a great microcosm for the parenting experience in general: You do the best that you can, you learn as you go, and flexibility is the key. You—and your baby—will be happier and healthier if every now and then you have a tincture of patience and a cup of calm, two of the best medicines.

About the author: Rallie McAllister, MD, MPH, is a family physician and mom of three sons in Lexington, KY. She’s the co-author of the Mommy MD Guides books, including The Mommy MD Guide to Your Baby’s First Year, from where these tips were excerpted.

About the survey: Perrigo Nutritionals, the makers of store brand formula, conducted the survey in February of 2017, among 2,000 nationally representative Americans between the ages of 18 and 65 who currently have a child between the ages of one and three.  Margin of error is +/- 3 percent. To learn more about store brand formula or to discover special promotions or offers, visit storebrandformula.com.

 

Infectious Diarrhea

August 12, 2013 by  
Filed under Uncategorized

by Mommy MD Guide Stacey Ann Weiland, MD

Infectious diarrhea is one of the most common childhood diseases worldwide, particularly in babies between the ages of 6 and 18 months. While it can be deadly in developing countries, even in the Western world, infectious diarrhea can sometimes be serious enough for parents to seek the advice of a physician, or even require hospitalization for their child.

About 70 percent of all cases of infectious diarrhea are caused by viruses. The most common of these is the rotavirus, which is responsible for 40 percent. Less common, but sometimes more serious, are the bacterial-induced cases, which account for 20 percent, while parasites cause fewer than 5 percent.

Although episodes of infectious diarrhea can occur throughout the year, rotavirus outbreaks show a seasonal pattern in temperate climates, with infections peaking during the winter months.

Generally, the most serious complication of infectious diarrhea is progressive dehydration. Infants may suffer major fluid losses from a combination of continuous watery stools, vomiting, and fever. Infants who develop mild to moderate dehydration may be more agitated or irritable, have diminished tear production, dry mucous membranes, decreased skin turgor, sunken eyes, and decreased urine output. More severe dehydration can lead to lethargy, fast heart rate, deep breathing, cold limbs, and a near absence of urination.

Early and adequate oral rehydration with a glucose-electrolyte solution is the best prevention for complications of infectious diarrhea and hospitalization. Over-the-counter oral rehydration solutions (ORS), such as Enfalyte or Pedialyte, are recommended over and above cola drinks, sports drinks, or homemade mixtures of juice, sugar, salt, and water. Colas contain an excessively high concentration of sugar and little sodium and potassium. Home remedies may lead to severe alterations in a child’s fluid and electrolyte status.

ORS is best given in multiple divided doses over 3 to 4 hours. For infants between 5 and 9 kilograms (11 to 20 pounds), 2 milliliters can be given every minute (120 milliliters /hour). For infants between 9 and 12 kilograms (20 to 26 pounds), 2.5 milliliters can be given every minute (150 milliliters /hour). For infants between 12 and 15 kilograms (26 to 33 pounds), 3.0 milliliters can be given every minute (180 milliliters /hour). If there is no associated vomiting, larger volumes can be given at longer intervals (10 to 15 milliliters every 5 minutes, or 20 to 30 milliliters every 10 minutes). Even for hospitalized children, oral rehydration has proven superior to intravenous therapy.

Breast feeding, formula, and solid food should not be withheld from a child with infectious diarrhea, and should be restarted within 4 to 6 hours after rehydration is started. Further, parents should not switch formulas, change to lactose free, or soy, etc., because this may lead to future food intolerance.

Toddlers should be reintroduced to foods appropriate for their age, starting with complex carbohydrates such as bread, noodles, potatoes, and rice. Juices with a high fructose content, such as apple and pear juice should be avoided.

Probiotics have shown some efficacy in reducing the duration of diarrhea, particularly compounds containing the Lactobacillus species. Antibiotics are generally unnecessary except in certain bacterial- or parasitic-induced cases of infectious diarrhea. Zinc supplementation has undergone intensive investigation in both the treatment and prevention of infectious diarrhea. While recommended by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) since 2004 for children living in developing countries, results in the Western world remain equivocal.

Perhaps the best treatment for your child’s infectious diarrhea is prevention. As with many other infections, breastfeeding has been shown to protect against acute infectious enteritis. Good hygiene also has major benefits. Parents should always wash their hands after diaper changes and before handling food. Consumption of incompletely cooked meats, raw eggs, and unpasteurized milk also increase the risk of infectious diarrhea.

The rotavirus vaccine became available in the United States in February of 2006. Its introduction has led to a dramatic reduction in hospitalizations and emergency treatment due to rotavirus infections. Two different vaccines are currently licensed for infants in the United States, RotaTeq® (RV5) and Rotarix® (RV1). Both varieties can be given in combination with other vaccines and are often paired with the DTaP, Hib, Hepatitis B, Polio, and Pneumoccus vaccinations. The rotavirus vaccine is not a shot, but is given orally at 2, 4, and sometimes 6 months (depending on which vaccine is used).

Want to read more blogs by Mommy MD Guide Stacey Weiland, MD? Here’s her recent blog about raising children to be healthy eaters.

Your Less-Than Fertile Forties

August 1, 2013 by  
Filed under J.Reich

by Mommy MD Guides blogger Jennifer Bright Reich

My thirties totally snuck up on me. I was busy transitioning from being a Lieutenant in the Army to civilian life back home, gearing up my job with a publishing company, and enjoying married life. It’s amazing how fast the time went.

Finally, at age 35, I was ready to start a family. Fortunately, my fertility cooperated, and I got pregnant easily. Sadly, I watched as many of my friends who were my age and older didn’t have the same experience.

It turns out that I had plenty of company with many women waiting like I did to try to get pregnant. Approximately 20 percent of women wait until age 35 to start trying to get pregnant.

Yet ironically, the time is ticking away much faster than our own biological clocks are. Fertility begins to decline as early as the late 20s. A healthy 30-year-old woman has a 20 percent chance per month to get pregnant. A healthy 40-year-old woman, on the other hand, has only a 5 percent chance of getting pregnant per month according to the American Society for Reproductive Medicine.

So it’s not surprising that Mother Nature needs some help now and then. More than 6.7 million women (almost 11 percent of US women), ages 15 to 44, have impaired fertility or ability to carry a baby to term, according to the Centers for Disease Control and Prevention (CDC). More than 7.4 million women in the United States have used infertility services, according to the CDC.

Fortunately, infertility specialists, such as the physicians at HRC Fertility’s Pacadena, California, Fertility Clinics, have treatments designed specifically for women in this age group. They understand the diminished fertility of women in their forties and also the additional pregnancy risks women in this age group face. Physicians such as HRC’s Bradford A. Kolb, MD, FACOGJeffrey R. Nelson, DO, FACOOG; and John Wilcox, MD, FACOG, offer help—and hope. HRC has a second office, HRC Fertility’s Rancho Cucamonga, California, Fertility Clinic, where physicians such as  John M. Norian, MD, FACOG, and Jeffrey R. Nelson, DO, FACOOG, work with patients.

Visit www.havingbabies.com for more information on getting pregnant, infertility treatments, and more.

 

About the author: Jennifer Bright Reich is coauthor of The Mommy MD Guide to Pregnancy and Birth, cofounder of MommyMDGuides.com, and a mom of two sons, in Allentown, PA. She was compensated by HRC for this blog but feels so passionately about the topic would have written about it for free.

Why Won’t My Baby Stop Crying?

May 13, 2013 by  
Filed under Uncategorized

by Mommy MD Guide Stacey Ann Weiland, MD

A crying baby can be very stressful to new and seasoned parents, alike. We worry about our baby’s health, and want to make sure we are not causing any harm.

We check to see if our baby is hungry, needs to be changed, is too cold, too hot, or otherwise uncomfortable. Once we are out of ideas, and our baby continues to cry, the most likely cause is a condition called colic.

Colic is the most common cause of unexplained crying in an otherwise healthy infant. It affects anywhere from 10 to 30 percent of infants worldwide, occurs equally in boys and girls, and is generally seen in children between the ages of 2 weeks and 4 months. Its incidence is similar in breastfed and bottle-fed infants.

Colic can be defined by the “Rule of Three”:

  1.  Paroxysms of excessive crying in an otherwise healthy baby lasting more than 3 hours per day.
  2. Crying occurring more than 3 days in any week
  3. Crying episodes span for a period of at least 3 weeks.

Crying generally begins around the same time every day. For my son, Andrew, this was generally around 7:00 pm (right when we were trying to get my older two children bathed and to bed!). Episodes usually begin suddenly and for no clear reason. Crying can be intense and high pitched. The baby’s face may flush, she may curl up her legs, clench her fists, and tense up her abdominal muscles.

While these episodes are unbelievably distressing to the baby and the parents, crying of this nature has been found to be attributable to “organic” causes in less than 5 percent of cases!

Warning signs that may indicate that your baby is suffering from something more than simple colic may include fever, breathing difficulties, poor weight gain, or abnormal findings on a neurologic exam.

Laboratory tests and x-rays are usually unnecessary if your child is gaining weight normally and has a normal physical exam.

Gastrointestinal symptoms such as frequent regurgitation of more than 28 g (1oz) may indicate reflux. Diarrhea or watery stools may indicate signs of lactose intolerance or a cow’s milk allergy.

Sometimes, physicians suggest medication treatments to parents in an effort to treat a colicky baby. One of the most popular, simethicone, is a safe, over-the-counter drug used for decreasing intestinal gas. While some parents swear by its benefit, randomized controlled studies with simethicone have actually demonstrated no benefit compared with placebo.

If a cow’s milk allergy is suspected, a protein hydolysate formula is indicated. Soy-based formulas are generally not recommended to infants allergic to cow’s milk, because these infants are at an increased risk of developing an intolerance to soy protein, as well. If the crying is related to a cow’s milk allergy, benefits should be observed within the first 2 to 7 days of making the switch.

In breastfed colicky infants, mothers are sometimes encouraged to systematically eliminate certain allergenic foods, including dairy, nuts, soy, and citrus. If an allergy exists, changes in the baby’s behavior should be seen within a week.

Other treatments that may prove beneficial in a colicky baby include probiotics, oral glucose and sterile water, and several herbal tea remedies.

The “5S” approach consists of a set of rhythmic calming techniques that have also been found to be effective in calming a colicky baby:

  1. Swaddling
  2. Side or stomach (the baby is held on its side or stomach) Note: A baby must always be placed on its back for sleep
  3. Shhh sound
  4. Swinging the baby with tiny 1-inch jiggly movements back and forth (care must be made to support the head and neck)
  5. Sucking (let the baby suckle on the breast or pacifier)

If all else fails, play soothing music, make eye contact, talk to and touch your baby, rock her, and walk. Be assured that colic is just a phase, that you are doing everything right, and that you are being a good parent.

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The information on MommyMDGuides.com is not intended to replace the diagnosis, treatment, and services of a physician. Always consult your physician or child care expert if you have any questions concerning your family's health. For severe or life-threatening conditions, seek immediate medical attention.