Your Baby Week Sixteen

Low Milk Supply

Breastfeeding babies sometimes get distracted, which can lead to a decreased breast milk supply.
Breastfeeding babies sometimes get distracted, which can lead to a decreased breast milk supply if they aren't feeding effectively or often enough. Photo © Vincent Iannelli, MD

Once they get through the first few two or three months of breastfeeding, many parents think that it will be smooth sailing without any problems.

Unfortunately, breastfeeding moms can still encounter problems, especially with their breast milk supply.

Sometimes breastfeeding mothers misinterpret some things as a sign of a slow down in milk production, when they are actually normal, including:

  • breasts that feel less full than they used to, or even empty, which may just mean that your body has gotten used to your baby's feeding schedule and your milk production
  • a baby who has begun having infrequent bowel movements, keeping in mind that some breastfed babies only have bowel movements once every week or two, and that can be normal if they are gaining weight and their bowel movements aren't hard when they finally do have them

Many factors can decrease a mother's breast milk supply though. One of the most common of these things is simply not breastfeeding or pumping often enough (about seven or eight times a day at this age) or giving too many formula supplements.

Mothers who notice a decrease in their breast milk supply and who have decreased the number of times that they nurse or pump, may have to increase the frequency again to boost their breast milk supply.

A mother's breast milk supply may also decrease if she is:

  • losing weight too quickly (more than one pound each week), which can happen if a mother is not following a healthy diet or is restricting her calories too much
  • exercising a lot and is not drinking enough fluids
  • taking a medication, such as birth control pills with estrogen
  • sick or overly stressed
  • allowing her baby to use his pacifier too often, which can sometimes satisfy a baby to the point that they nurse less often

Reporting Vaccine Reactions

While vaccines are helpful, unfortunately, they can sometimes cause side effects.

These side effects are usually minor, such as fever, redness or swelling where the shot was given, or fussiness.

More rarely, vaccines can cause more moderate or severe reactions. According to the Centers for Disease Control and Prevention (CDC), these might include symptoms of an allergic reaction or "a high fever, behavior changes, or flu-like symptoms that occur 1 to 30 days after vaccination."

Reporting Vaccine Reactions

If you think that your child has had a moderate or severe reaction to a vaccine, you should call your pediatrician.

Next, either you or your pediatrician can report the reaction to the Vaccine Adverse Event Reporting System (VAERS), a safety program jointly administered by the CDC and Food and Drug Administration (FDA).

Thanks to VAERS, experts quickly found that children were more at risk for intussusception after receiving RotaShield, a rotavirus vaccine. VAERS was also used to figure out that the swine flu vaccine in 1993 did not cause an increase risk of Guillain-Barre syndrome.

VAERS has also been helpful in evaluating:

  • the DTaP versus DTP vaccines (the older DTP vaccine caused more side effects than the newer DTaP vaccine)
  • the IPV versus OPV vaccine (the oral polio vaccine could rarely cause vaccine-associated paralytic poliomyelitis, while the inactivated polio vaccine, which is now used, does not)
  • the chicken pox vaccine
  • lot specific vaccine reactions
  • reports of intussusception with the RotaShield rotavirus vaccine

VAERS only works well if vaccine reactions are reported though. So be sure to ask your pediatrician to report any suspected vaccine reactions or do it yourself on the VAERS Web Submission.


CDC. Vaccines & Immunizations. Possible Side-effects from Vaccines.

MMWR: Surveillance for Safety Following Immunization: VAERS 1991-2001.

Crib Safety

Before putting your baby in her crib, be sure to take the blankets, pillows, and stuffed toys out.
Before putting your baby to sleep in her crib, be sure it is safe by taking the blankets, pillows, and stuffed toys out. Photo © Vincent Iannelli, MD

Before you move your baby to her crib, be sure it is safe.

That can often be a little more challenging that you would think, as parents often fill their baby's crib with all kinds of blankets and stuffed toys when they first set up their baby's nursery.

So obviously, the first crib safety tip is to get all of that stuff out of your baby's crib.

Other crib safety tips include:

  • using a firm mattress that fits tightly into the crib that is covered with a fitted sheet
  • making sure that you have assembled the crib properly and that no parts are loose or broken
  • ensuring that there is no more than 2 3/8 inches between the slats of the crib and that there are no missing or broken slats
  • that the crib doesn't have any cutouts in the headboard or footboard, in which the baby's head could get trapped, and doesn't have decorative knobs or cornerposts that are higher than 1/16 inch
  • not putting the crib near a window
  • checking for crib recalls (there have been several recalls in 2007 of cribs, crib mattresses, crib bumpers, and crib toys)
  • not letting a blanket cover your baby's face or head. A thin blanket tucked under one end of the mattress, with your baby's feet near that end, and letting the blanket only reach up to your baby's chest is safer. Even safer though is not using a blanket at all and just dressing him in a sleeper.

Bumper Pads

The use of crib bumper pads is a controversial topic. Since your baby's head can't fit through the slats of a crib that has been made with safety standards that were put in place in 1974, many experts question the need for the use of bumper pads. Their use is being especially discouraged by some because they have been thought to be a suffocation hazard and possible risk for SIDS.

If you do use bumper pads, make sure they fit all around the crib, are secured in place, are firm and not 'pillow-like,' and remove them once your baby can stand.

Unwanted Advice - Unwanted Parenting Advice

Be open minded when you get advice from other people.
Be open minded when you get advice from other people -- not all of it will seem as unnecessary as the advice on this sign. Photo © Tatiana Sayig

Even as new parents get some confidence in their abilities as their baby gets older, they sometimes have problems dealing with unwanted advice from family members, friends, and even strangers.

From giving your baby water and when to start baby food to the observation that you may be overdressing or under-dressing your baby, you will likely get lots of unwanted advice from people.

How do you respond to this advice?

Remember that there is often more than one right way to do some things. That doesn't mean that you have to change how you do things. But rather keep in mind that that could be what is motivating the advice. The other person likely did something differently from how you are doing it, and the fact that it worked for them makes them think that you should do it the same way. They likely are considering that the way you are doing it is working for you though.

Some good ways to respond to unwanted advice include saying:

  • "Thanks, I might try that."
  • "That's a good idea, but this way is really working for us."
  • "Our pediatrician suggested that we do it this way."
  • "I might try that, but I want to see what my pediatrician thinks about it first."

Most importantly, if what you are doing is really working for you, then have the confidence to say so. While you should do some things in a certain way, like putting your baby to sleep on his back to reduce the risk of SIDS and placing her in the back seat of the car in a rear-facing car seat, you have more flexibility in the way you do other things. For example, you might figure out a way to hold, rock, or burp your baby that works better for you and your baby though it may be different than other people do it.

If you aren't sure about the best way to do something, ask your pediatrician.

Childhood Infections - Roseola

Roseola is caused by the human herpesvirus 6 virus and is a common childhood infection. Getting a child diagnosed with roseola, which is also called exanthem subitum or sixth disease, can be confusing for parents though.

After all, it is usually not until a child is getting better that the symptoms become clear and a diagnosis can be made.

Symptoms of Roseola

Children with roseola usually just have a high fever. About three to seven days later, once the fever breaks, kids with roseola get a red or pink raised rash all over their body. This rash usually lasts a few hours to a few days, begins on the trunk and then can spread to the child's arms, legs and face. Unlike many other rashes that kids get, roseola is not itchy.

Some children infected with the virus that causes roseola do have other typical viral symptoms such as a runny nose, cough, swollen glands, irritability, and diarrhea. Other symptoms might include febrile seizures or a bulging fontanel (soft spot).

Diagnosis and Treatments for Roseola

It is the pattern of symptoms, a rash which begins once a fever breaks, that typically makes a pediatrician suspect that a child has roseola. By then though, once the rash appears, the child is already better.

As with many other viral infections, there is no specific treatment for roseola and most kids recover without problems. Fever reducers, such as acetaminophen or ibuprofen, can be helpful while your child has a fever.

Health Alert - Foods to Avoid

Because of the risk of botulism, babies shouldn't eat honey before their first birthday.
Because of the risk of botulism, babies shouldn't eat honey before their first birthday. Photo © Roman Chmiel

As you get ready to start your baby on iron-fortified rice cereal -- her first baby food -- it is a good idea to know which foods you should avoid in her first year.

This foods include:


Experts advise that you should not feed honey to infants under 12 months of age. The spores of the Clostridium botulinum bacteria can sometimes be found in honey. When ingested by an infant, the spores can release a toxin that causes botulism.

Parents should also likely avoid other foods that contain honey in them, such as Honey Graham Crackers, Honey Nut Cheerios or Honey Wheat Bread. Although the honey in these foods may be processed, it may not be pasteurized, so they may still contain botulism spores.

Egg Whites

Because they are considered an allergy food, parents were once told to avoid giving their infants egg whites until they were twelve months old.

Experts no longer recommend that you delay giving any foods once you start solid foods at four to six months, even if your baby is at risk for food allergies, as it doesn't seem to help prevent food allergies.

Homemade Baby Food and Nitrates

This is only an issue for parents who make their own baby food from fresh vegetables, but they should avoid feeding their baby homemade food with beets, carrots, collard greens, spinach, and turnips. These vegetables can sometimes have high levels of nitrates, a chemical that can cause low blood counts (anemia).

Commercial baby food is usually screened for their nitrate levels. So, when considering these specific vegetables, it should be safer.


Experts usually recommend that breast milk or an iron-fortified infant formula are best for babies. Parents should avoiding substituting either of those with homemade baby formula, such as you might make with evaporated milk, cow's milk, soy milk (which is much different than an iron-fortified soy formula), or even goat's milk.

Safety Alert - Traveling with your Baby

Traveling these days can be frustrating - don't add to it by taking chances with your baby's safety.
Traveling these days can be frustrating enough - don't add to it by taking chances with your baby's safety and letting him get hurt. Photo © Elena Elisseeva

As your baby gets older, you may be taking her out in public more and may even consider traveling now.

Is that OK?

Probably. In your baby's third month, her immune system is getting stronger and she likely already got her first set of vaccines, and so has some protection against some germs.

You still want to be safe though. Taking a vacation doesn't mean that you should take a break from recommended safety practices.

In addition to continuing to use a car seat, putting your baby to sleep on her back in a crib, not leaving your baby where she could fall, keep these safety tips in mind when traveling with your baby:

  • consider bringing your own babyproofing equipment with you, including electrical outlet covers, doorknob covers or gates to make sure your hotel room or wherever you are staying is safe and childproofed
  • use your own travel crib or make sure that a crib or play yard provided to you meets all the latest crib safety standards
  • bring sunscreen, insect repellent, diaper rash cream, and other supplies that you may need
  • know where to find a doctor, including the local Children's Hospital, near where you are visiting, just in case your baby gets sick on your trip
  • try to travel during off-peak hours (early morning, middle of the week), when places may be less crowded

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