Your Baby Week Fifteen

1
Thumb Sucking

Baby waking up
Image Source/Digital Vision/Getty Images

Parents often find that their babies enjoy sucking on their fingers, thumb, and sometimes even try to put their whole hand in their mouth at around three months.

Although thumb sucking has a bit of a negative stigma associated with it, typically because parents worry that their baby just won't stop, it is a normal and natural thing for babies to do.

Even the American Academy of Pediatric Dentistry states that sucking on fingers, thumbs, and pacifiers, "is completely normal for babies and young children" and that most children stop before any "harm is done to their teeth or jaws."

Why do so many babies begin to suck their thumb at around two or three months of age? It is at this age that they can more consistently find their fingers and thumb. They are also awake for longer periods of time, giving them more opportunities to suck their thumb, especially when they need to comfort or calm themselves.

So don't worry about your baby's thumb sucking habit. She will likely give it up by the time she is six or seven months old. If not, then she may stop later on, when she is two to four years old. Your child may have some dental problems and may need some help if she doesn't stop by that age though.

 

Source:

American Academy of Pediatric Dentistry. Parent Education Brochures. Thumb, Finger and Pacifier Habits.

2
Baby Potty Training

Most parents are familiar with the traditional advice that their child will likely be ready for potty training when they are some time between 18 months to 3 years old.

That is in line with the guidance of the American Academy of Pediatrics, which states that "between 18 and 24 months, children often start to show signs of being ready, but some children may not be ready until 30 months or older."

They may be surprised by the idea that you could try to potty train your baby when he is just 2, 3, or 4 months old. In fact, experts on infant potty training say that if you are considering this technique, you might be getting a late start if you don't begin by the time your baby is 6 months old.

Baby Potty Training

Also called 'elimination communication,' baby potty training is reportedly how children are potty trained in many non-Western cultures that do not rely on keeping their kids in diapers.

With baby potty training, you try to learn and anticipate when your baby will have to urinate or have a bowel movement and then have them go in a potty chair, the toilet, or outside. You also try to give your baby signals that he can associate with going on the potty.

Critics of baby potty training often say that it is not necessarily the baby that is being trained, but rather the parent, who learns her baby's signals and takes him to the potty. There is little to be critical of though, as long as you have patience and are willing to spend the time with your baby that it may take to complete infant potty training.

Books about Baby Potty Training:

If you are interested in baby potty training, one of these will likely be a good resource to help you learn what to do:

  • The Diaper-Free Baby
  • Diaper Free
  • Infant Potty Basics
  • Baby Bjorn Little Potty

 

Sources:

American Academy of Pediatrics. Toilet Training.

3
Hearing Tests

Can your baby hear you?

It is sometimes hard to tell, as babies are often pretty good at tuning out many noises.

By three months, your baby will likely begin turning towards some sounds though. And she should respond to at least some loud noises.

Newborn Hearing Tests

While parents often had to rely on their own observations to figure out if their baby could hear them, according to the American Academy of Pediatrics, all babies should now have their hearing tested before they even leave the hospital when they are born.

Did your baby have a hearing test when she was born?

Do you know if she passed?

In addition to universal hearing screening (testing all newborn babies), the AAP recommends that:

  • babies who fail their hearing screen in the hospital should be retested
  • by three months of age, "appropriate audiological and medical evaluations" be done for babies who continue to fail their hearing tests
  • early intervention services should be started as soon as possible and not later than six months of age for infants with a hearing loss

If your baby didn't have a hearing test when she was born or if you are unsure of the results, now would be a good time to discuss this with your pediatrician.

 

Source:

AAP Policy Statement. Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. Pediatrics 2007 120: 898-921.

4
Health Alert - Preventing Food Allergies

Although your baby won't be ready for peanuts for some time, that's because of the risk of choking.
Although your baby won't be ready for peanuts for some time, that's because of the risk of choking and not to try and prevent food allergies. Photo © Peter Finnie

In their baby's third month, many parents begin to look forward to the time when they can start feeding their baby cereal, fruits, vegetables, and other baby food.

Should you be in such a big rush?

Experts once recommended delaying the introduction of solid foods until infants were at least six months old in hopes of preventing the high-risk baby from developing food allergies. They also recommended that infants and toddlers "avoid eggs until 2 years of age and avoid peanuts, tree nuts, and fish until 3 years of age."

That advice has changed now though.

Can you Prevent Food Allergies?

Previous recommendations to delay giving kids allergy foods ended up not being helpful and didn't actually prevent kids from developing allergies.

The American Academy of Pediatrics, in their latest recommendations, now state that infants can "begin consuming foods in addition to breast milk or formula after 4 months of age, preferably at 6 months of age."

Although there aren't any restrictions on what solids you can feed your baby any more, for babies who are at high risk for developing allergies, experts do still state that exclusively breastfeeding for at least 4 months can help decrease the risk of developing eczema or a cow's milk allergy though. If a baby isn't breastfeeding, then feeding a partially or extensively hydrolyzed baby formula may be helpful too.

How do you know if your baby is at high risk for developing food allergies?

Risk factors include:

  • having another allergic disorder, such as hay fever, asthma, or eczema
  • having other food or formula allergies
  • having a family member, such as a parent or sibling, with a food allergy or hay fever, asthma, or eczema

Preventing Food Allergies

Again, it is recommended that these children who are at high for allergies should:

  • breastfeed exclusively until they are 4 months old or if not breastfeeding, they should consider drinking a hypoallergenic formula, such as Nutramigen or Alimentum.
  • start solid foods after 4 to 6 months of age
  • delaying allergy foods which are most likely to trigger allergies is no longer recommended

Many experts do still recommend that a parent introduce allergy foods carefully though. Introduce them gradually, even giving your high-risk child his first taste at home where you have an antihistamine handy in case he has an allergic reaction. You can then gradually give more as you are convinced that he is tolerating the foods well, that way he won't have his first taste and first reaction at day care or school.

And while it was once recommended that breastfeeding mothers of a baby who is at risk for food allergies might consider eliminating certain allergy foods from her diet, including peanuts, tree nuts, eggs, cow's milk, and fish, that is also not considered to be helpful at preventing food allergies.

 

Sources:

Dee, Deborah. Sources of Supplemental Iron Among Breastfed Infants During the First Year of Life. Pediatrics October 2008; 122:Supplement 2 S98-S104

Greer, Frank MD. Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. Pediatrics 2008;121;183.

5
Infant Q&A - Sweating Too Much

Over-bundling your baby can lead to excessive sweating and can be a risk factor for SIDS.
Over-bundling your baby can lead to excessive sweating and can be a risk factor for SIDS. Photo © Artyom Yefimov

Q. My baby seems to sweat a lot. When he wakes up in the morning, his hair is wet and his back is often sweaty when I am breastfeeding him. He seems fine otherwise and doesn't seem hot. Is it normal to sweat so much?

Excessive sweating can be normal, but it can also be a sign of some serious medical conditions, so an evaluation by your pediatrician would be a good idea.

When caused by a medical problem, you would typically expect other symptoms though, such as trouble feeding, fast breathing, or poor weight gain. For example, sweating while feeding can be a symptom of congestive heart failure. These infants may get tired while feeding, and have a fast respiratory rate, a frequent cough, and poor weight gain. So if your baby had a heart problem, you would expect other symptoms besides sweating.

Having an overactive thyroid, or hyperthyroidism, can also cause excessive sweating, but again, you would expect some of those other symptoms.

Keep in mind that overbundling or overdressing your child and keeping your home too warm, could also cause excessive sweating. Since getting overheated is a risk factor for SIDS, you should make sure that your baby is not getting overheated by:

  • keeping your home at a temperature that is comfortable for an adult that is lightly clothed
  • not over-bundling your baby, but instead dressing him with one extra layer than you are wearing yourself

 

Sources:

AAP Policy Statement. The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk. PEDIATRICS Vol. 116 No. 5 November 2005, pp. 1245-1255.

6
Infant Care Tips - Cleaning Baby Teeth and Gums

It is never too soon for good oral hygiene, including cleaning your baby's gums or teeth.
Although it will be some time before your baby is able to brush his own teeth, it is never too soon for good oral hygiene, including cleaning your baby's gums or teeth. Photo © Olga Solovei

Parents often don't think about oral hygiene until their baby gets her first tooth.

That could be a little too late though.

Some experts recommend that even before your baby gets his first baby tooth, that you should wipe your baby's gums with a soft washcloth or soft infant toothbrush and water each day.

This is especially important if the baby has any risk factors for later developing cavities, such as having a mother with cavities, since the bacteria that cause cavities, Streptococcus mutans, is often passed from a mother to her infant sometime in the child's first two years of life.

In addition to early oral hygiene, you may be able to help decrease your baby's risk of later getting cavities if you:

  • don't share utensils, cups, or toothbrushes, since that might help spread the bacteria that can cause cavities from your mouth to your baby's mouth
  • avoiding giving your baby too much fruit juice, and no fruit juice before six months, or any fruit drinks
  • give your baby fluoridated water once she is six months old, keeping in mind that many brands of bottled water doesn't have fluoride added to them
  • don't let your baby fall asleep with a bottle of formula or frequently nursing at night once she has teeth

In addition to learning to care for their baby's gums and teeth, one of the easiest things that parents can do for their kids is take care of their own oral hygiene and regular visit their dentist to make sure their own teeth are healthy.

 

Sources:

American Academy of Pediatric Dentistry. Guideline on Infant Oral Health Care. Revised 2004.

AAP Policy Statement. Oral Health Risk Assessment Timing and Establishment of the Dental Home. Pediatrics 2003 111: 1113-1116.

7
Health Alert - Optional Vaccines and Alternative Immunization Schedules

Typical vaccines a child might get at their two and four-month old checkups.
If using a combination vaccine, such as Pediarix, then your baby will likely get three shots and RotaTeq, an oral vaccine, at her two- and four-month-old well child checkup. Photo © Vincent Iannelli, MD

Experts often describe vaccines as one of the top medical advances in all of history. In fact, the CDC reports that "vaccines have reduced or eliminated many infectious diseases that once routinely killed or harmed many infants, children, and adults."

Some parents do worry about the fact that young children have to receive so many vaccines by the time they are 4 to 6 years old though, including:

  • 3 doses of Hep B
  • 2 or 3 doses of Rotavirus vaccine (depending on the brand of vaccine used)
  • 5 doses of DTaP
  • 3 or 4 doses of Hib (depending on the brand of vaccine used)
  • 4 doses of Prevnar
  • 4 doses of IPV
  • 2 doses of MMR
  • 2 doses of the chicken pox vaccine
  • 2 doses of Hep A
  • a yearly flu vaccine

That can add up to about 36 vaccines by the time your child is 4 to 6 years old. Fortunately, the development of combination shots (Pediarix, Pentacel, Kinrix, ProQuad, and Comvax), oral (RotaTeq), and nasal vaccines (FluMist) now means that your child may not actually get that many shots. Now, your child might receive 36 vaccines, but just 22 shots.

Optional Vaccines and Alternative Schedules

None of these vaccines is optional though. According to the CDC, if more parents begin to adopt alternative vaccine schedules and not give their kids some or all of these vaccines, then many of these vaccine preventable illnesses, including measles and pertussis, "would increase to pre-vaccine levels."

Unvaccinated children and those who are not fully vaccinated also pose a risk to infants who haven't completed their first series of immunizations and children who have immune system disorders.

Vaccines are important. If you are worried about your child's vaccines or have become confused about any misconceptions about vaccines you have read about, be sure to talk to your pediatrician.

Using any type of non-standard, parent-selected, delayed protection vaccine schedules, like those that have been pushed by Dr. Bob Sears, Dr. Jay Gordon, and many other "vaccine-friendly" pediatricians is not the answer and will just leave your child unprotected. In fact, Sandra, G. Hassink, MD, FAAP, President of the AAP states that "advocacy of delayed or alternative immunization schedules increases the risks to all children."

 

Sources:

CDC. National Center for Immunization and Respiratory Diseases. What Would Happen If We Stopped Vaccinations?.

Paul A. Offit, MD - The Problem With Dr Bob's Alternative Vaccine Schedule. PEDIATRICS Vol. 123 No. 1 January 2009, pp. e164-e169

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