Top stories this week

• 1.  What Happens to Your Body After Childbirth
• 2.  Baby Car Travel Tips
• 3.  Baby's Development in the First Trimester
• 4.  Third Trimester Infant Development
• 5.  Baby Development By Trimester

1. Expert: Joanne Saab, RD June 29th, 2009
   	When is my baby ready for finger foods?
   	You can usually start giving your baby finger foods around eight or nine months. Finger foods are not only a great way to introduce nutritious snacks, but they also keep babies busy and help them develop their fine motor skills. To prevent choking, always supervise your baby and start with small, soft foods, such as ripe fruit and soft, cooked vegetables, pasta and meats–all sliced into pieces no larger than 1/4- to 1/2-inch. Here are some great finger foods to try: •    grated cheese •    “O” shaped cereal or puffed rice cereal •    ripe fruit (bananas, pears, peaches, mango, apricots, plums, papaya) •    cooked veggies (green beans, carrots, peppers, sweet potato, broccoli, asparagus) •    avocado •    tofu •    soft pasta, brown rice, lentils Joanne Saab is a registered dietitian who practices in pediatrics at McMaster Children's Hospital in Hamilton, Ontario.  She is co-author of three books in conjunction with Toronto's Hospital for Sick Children entitled Better Food for Kids, Better Food for Pregnancy and the best-selling Better Baby Food.

   Permalinkwhen is my baby ready for finger foods, starting solids, textured foods, infant nutrition, finger foods

2. Expert: Dr. Lisa Kellett, M.D., F.R.C.P.(C), D.A.B.D. May 4th, 2009
   	My infant has baby acne – what should I do?
   	Baby acne is very common and is most likely due to hormones, says Dr. Lisa Kellett. It usually shows up as small whiteheads on an infant's cheeks, forehead or chin. "The best treatment for baby acne is to do absolutely nothing," says Dr. Kellett. "It will usually go away by itself in a couple of weeks, although it can take up to a month or two." She recommends using plain water or a mild cleanser at bath time and gently patting baby's skin dry. "Don't scrub, pick at the spots or apply acne medications as this will only irritate the skin further," she says. If your baby's acne hasn't cleared up within about three months, check with your doctor to rule out an infection or other health issue. Dermatologist Dr. Lisa Kellett is a Fellow of the Royal College of Physicians of Canada, a Diplomat of the American Board of Dermatology, a member of the Canadian Dermatology Association, the Canadian Laser Aesthetic Surgery Society, and the Toronto Dermatological Society. For more information and skincare advice from Dr. Kellett, check out www.dlkonavenue.com and www.skinlibrary.com

   Permalinkbaby acne, infant acne, baby pimples, whiteheads, baby skin

3. Expert: Lisa Weston, RM April 6th, 2009
   	What’s the best way to deal with baby’s gas pains?
   	Newborn gas pains are common, especially in the first few weeks. It's always best to have your midwife or doctor assess the baby to ensure there are no health concerns. You want to make sure the baby is healthy, gaining weight, sleeping and eliminating normally. A professional can also assess whether there are other symptoms and if the gas pain episodes are short and if your baby's discomfort is relived by passing gas. Once you are sure the gas pains are normal, you'll want to look at your baby's diet. A breastfed baby may be gassy while learning to cope with milk flow. If the baby is more than a few weeks old, there may be a fore- and hindmilk imbalance. The milk at the beginning of a feed is lower in fat and higher in sugar than the milk at the end. If baby is drinking mostly foremilk from one breast, then being switched to the other, she may experience: gas, greenish poops, less sleeping time, and less weight gain. If your baby drinks fully from one breast (switching to the other only if still hungry), she will get a balance of fore- and hindmilk. Baby will be less gassy, have normal yellow poops with little white seedy bits, often sleep better, and experience optimal weight gain. If baby is not breastfed, do a thorough review of formula: brand, how it is prepared, and how much she is taking. Simple adjustments may reveal a cause for excessive gassiness. Burping techniques should be reviewed for both breastfed and formula fed babies. Not all babies need to be burped, but if your baby is gassy, effective burping can help. Also, try using comfort holds and distraction, as well as massage, warm baths and leg bicycling to relieve gas. Lisa Weston, is the Vice President of the Association of Ontario Midwives, one of the founding members of the Sages-Femmes Rouge Valley Midwives practice, and served as the first Division Head of Midwifery.

   Permalinkgas pains, newborn, burping, baby, milk flow, breastfeeding, formula, symptoms, common

4. Expert: Dr. Jeremy Friedman March 9th, 2009
   	My toddler recently had stitches. How can I promote healing and prevent scarring?
   	First of all, it's important to keep the area clean. Wash the area with soap and water once a day (a bath is fine). Healing occurs more rapidly in a moist environment so apply a lubricant, ideally Polysporin, three times a day until the wound has healed. After two or three weeks, you can switch to vitamin E instead. Light pressure and very gentle wound massage for a few minutes, three or four times a day, can also promote healing. Don't expect the scar to disappear right away. Scars can get thick and hard in the first few months and they may take as much as two years to soften and mature. To prevent long-term scarring, keep the area out of the sun for a full year after the wound has healed.    Dr. Jeremy Friedman is chief of Paediatric Medicine at the Hospital for Sick Children in Toronto. He is an associate professor in the department of Paediatrics at the University of Toronto, is the associate editor of the Canadian Paediatric Society's journal, Paediatrics and Child Health and has co-edited three bestselling books for parents, including the most recent The Toddler Book.

   Permalinkscar, stitches, scars, toddler, baby, heal, polysporin, vitamin e, promote healing, jeremy friedman, sick children, toronto

5. Expert: Steve and Andrew Hammond February 22nd, 2009
   	When can I start using a pillow and stuffed toys in my child’s crib?
   	Don't place anything in your infant's crib until you are completely satisfied your child has the ability to move with ease. Once baby has mastered rolling you can give her a stuffed toy as a transitional "comfort" object. As a general rule, it is much better for a baby to sleep on a flat surface for the first year. Pillows are typically safe around 14 to 16 months of age, but it depends on the child. Before placing a pillow in your baby's crib, you must be 100 percent confident she is able to roll over with ease and sit for a prolonged period without any difficulty. Steve and Andrew Hammond are co-owners of Baby First Aid–an Ontario-based company that specializes in baby and toddler emergencies.

   Permalinkpillow, crib, stuffed toys, safety, sleep, flat surface, first year, safe

6. Expert: Dr. Jennifer Shu January 26th, 2009
   	Is it better to give my one-year-old cow’s milk or toddler formula if she doesn’t eat many solids?
   	For babies growing and developing normally, it's perfectly fine to switch to whole cow's milk at 12 months of age, although toddler formulas are also acceptable. Toddler formulas (aimed at children nine to 24 months) have the same amount of calories, fat, vitamin D and calcium as cow's milk, but also contain iron and vitamins C and E, which may benefit children who are not eating much in the way of solids. Plus, formulas fortified with DHA and ARA (omega fatty acids) may help with brain and eye development. If you choose to use cow's milk at this point, your pediatrician may recommend a multi-vitamin supplement to make sure your baby gets all the nutrients she needs. Keep in mind that when babies are taking in more than about 24 ounces of any liquid, they may have little room left for solid foods. If you think this might be the case, here are a few things you can try: offer foods first and limit bottles or sippy cups to three or four times a day offer her smaller bottles or cups (four ounces for example) give her a small amount of milk or formula at mealtime to take the edge off her hunger, followed by as much solid food as she'll take. You could then finish off with a little milk or formula if she's still hungry. Finally, remember that a serving size for a 12-month-old is very small–about the size of her palm–so don't be surprised if she doesn't eat large amounts of solids. In rare cases babies who don't take well to solids may have a problem with their swallowing and may need an evaluation by a feeding specialist. Be sure to consult with your pediatrician for the best approach to your individual situation. Dr. Jennifer Shu is a board-certified pediatrician in Atlanta and editor-in-chief of the American Academy of Pediatrics' Baby & Child Health: The Essential Guide from Birth to 11 Years and co-author of the award-winning book Heading Home with Your Newborn and Food Fights, both published by the AAP. www.jennifershu.com

   Permalinktoddler formula, toddler doesn't eat enough solids, milk, one year old.

7. Expert: Dr. Marjorie Greenfield December 29th, 2008
   	What is an Apgar score and does it affect my baby's development?
   	An Apgar score is used to assess a newborn's wellbeing and is usually done twice–at one and five minutes after birth. The baby's heart rate, breathing, color, muscle tone and response to stimuli are assessed to determine whether she needs extra help, such as oxygen. Any score over seven (out of a possible 10) means a baby is doing just fine on her own, while lower scores may mean she'll need a little extra help at first. The one-minute score has no correlation with future development and most babies with a low score at five minutes also do really well–it's normal for newborns to need some assistance initially. If a baby still needs a lot of help at five minutes, a third Apgar score may be done at 10 minutes. Although some babies with low scores at 10 or 15 minutes may show signs of neurological problems later on, most babies are alert and breathing on their own by 10 minutes after birth. Dr. Marjorie Greenfield is a practicing board-certified obstetrician-gynecologist and fellow of the American College  of Obstetrics and Gynecology (ACOG). She is currently associate professor at Case Western Reserve University School of Medicine and author of the new book, The Working Woman's Pregnancy Book. www.marjoriegreenfield.com

   Permalinkapgar, apgar score, baby development, newborn health, dr. greenfield, low apgar

8. Expert: Dr. Jennifer Shu December 15th, 2008
   	I think my baby is constipated, what should I do?
   	Constipation is defined as a decrease in the frequency of stools, or having pain with bowel movements. It may occur when there is a change in the diet, such as when babies transition from breast milk to formula or cow's milk, or when they first begin solid foods. Children under one year typically have one to four bowel movements per day, although if a child usually goes a few days between normal bowel movements, it is not considered constipation unless there is a change in the pattern. There are many signs that an infant may be constipated, including:   She often skips days in between bowel movements. Her poops are hard and small and difficult to pass, or may be large and painful. She may have more fussiness than usual, stomach pains, a poor appetite, or small amounts of bleeding from the anus. Constipation may be treated by increasing fluids (such as water or 100 percent fruit juice) and fiber (from fruit, bran and other foods) in the diet. Talk to your baby's doctor about the best ways to change her diet. If changing her diet does not treat the condition, your pediatrician may recommend a suppository, stool softener, or laxative until the constipation improves. Babies with severe constipation may need to see a pediatric gastroenterologist, who specializes in intestinal problems in children. Dr. Jennifer Shu is a board-certified pediatrician in Atlanta. Her passion is educating parents on all topics relating to children. Dr. Shu is editor-in-chief of the American Academy of Pediatrics' Baby & Child Health: The Essential Guide from Birth to 11 Years and co-author of the award-winning book Heading Home with Your Newborn and Food Fights. web site: www.jennifershu.com blog: www.parentingsense.com

   Permalinkbaby constipation, baby constipated, constipation infants, constipation newborns, dr. jennifer shu, baby bowel movement, baby trouble pooing

9. Expert: Dr. Jeremy Friedman November 17th, 2008
   	When can I introduce milk to my baby?
   	You can begin introducing homogenized milk at around 10 to 12 months, which is when your baby's digestive system is mature enough to tolerate cows' milk protein. (This is also when an infant's nutritional needs are beginning to be met by solid foods, so he will likely be drinking less breast milk or formula.) The most common issue I see is when toddlers drink much more milk than they need. Because cows' milk is not a complete source of nutrition, your baby only needs 16 to 20 ounces (475 to 600 mL), which is about the equivalent of three bottles a day. More than that puts children at risk for iron deficiency and may also affect their intake of nutritious solid food because they fill up on milk instead, which is why it's a good idea to offer milk during or after mealtime as opposed to before. Another tip to help children cut their milk intake down is to switch from a bottle to a cup. Dr. Jeremy Friedman is chief of Paediatric Medicine at the Hospital for Sick Children in Toronto. He is an associate professor in the department of Paediatrics at the University of Toronto and is the associate editor of the Canadian Paediatric Society's journal, Paediatrics and Child Health. Dr. Friendman has co-edited three bestselling books for parents, including the most recent The Baby Care Book (Robert Rose 2007). The Toddler Book will be released in spring 2009. He lives in Toronto with his wife and two young children.

   Permalinkintroduce milk to baby, homegenized milk infant, baby digestive system, introducing milk, iron deficiency baby, infant nutrition

10. Expert: Dr. Jennifer Shu October 20th, 2008
    	What should I do if I suspect my child has an ear infection?
    	Most children will have at least one ear infection before they reach three years old. The only way to confirm an ear infection is for a doctor to look at it with an otoscope, but there are several signs that can also point to the diagnosis.  Ear infections often start out with cold symptoms, such as a runny nose. There may be a fever over 101 F. The child may be fussy or crying more than usual, especially when lying down. There may be signs of ear discomfort or pain, such as the child repeatedly rubbing or pulling at the ear. There may be discharge (such as pus or even blood) coming from the ear canal, which can signal a ruptured eardrum. This happens occasionally with ear infections and will usually heal on its own within a few weeks. If you suspect an ear infection, your doctor can check your child’s ears and make the diagnosis. Children under two years who have an ear infection are typically treated with antibiotics; those over two may be observed to see if they can fight off the infection without antibiotics. It may take a few days for the antibiotics to start working. In the meantime, giving a pain reliever such as acetaminophen (Tylenol), or ibuprofen (Advil or Motrin) if the child is older than six months, can help with the pain. Applying a warm compress to the infected ear may also be soothing. Your doctor may also prescribe numbing drops to put in the ear. Always check with your doctor before using ear drops because some can be harmful if used when the eardrum has burst. Dr. Jennifer Shu is a board-certified pediatrician in Atlanta. Her passion is educating parents on all topics relating to children. Dr. Shu is editor-in-chief of the American Academy of Pediatrics' Baby & Child Health: The Essential Guide from Birth to 11 Years and co-author of the award-winning book Heading Home with Your Newborn and Food Fights. web site: www.jennifershu.com blog: www.parentingsense.com

    Permalinkbaby ear infection, ear infection symptoms, dr. jennifer shu, baby expert