Our Baby News

Does Your Baby Need Vitamins?

The jury is still out on the question of whether or not vitamins are necessary to raise a healthy baby. In fact, the trial isn’t even over yet, the evidence is still being brought to light. It appears that a full-term, healthy breastfed baby receives all the nutrition she needs from Mom. For formula-fed babies, the question is partly answered for you: Most are supplemented with vitamin D and iron (low- or hi-grade).

Then there’s fluoride, an element that helps form healthy teeth. Supplementation is recommended by the AAP for exclusively breastfed babies (starting at two to four weeks of age) but not formula-fed babies* who get it from tap water in most jurisdictions.

Once solid food is begun, the game is still rigged: Certain baby foods are already vitamin fortified. If she’s eating an overall balanced diet, she’ll get all the vitamins she needs.

Excess vitamins, in fact, are excreted by the kidneys or are never absorbed.

So don’t sweat this one: A healthy baby can take them or leave them.

Herbal Remedy

There is so much more!

•Ginger:

An anti-nausea remedy. Only for the strong of stomach, since this can cause severe heartburn.

•Zinc:

Not an herb, but if s on the shelves right next to the echinacea.

Zinc, like echinacea and Vitamin C, is supposed to limit the severity and duration of cold symptoms.

The catch: You have to take one or two lozenges every two hours for two whole days, and you have to start at the onset of symptoms. If you can handle the stomach irritation, it may be worth it.

•Ginkgo:

An extract of the leaves of the Ginkgo biloba tree that, used as a dietary supplement, improves asthma.

This may be helpful for children who are dependent on steroids for severe asthma.

Herbal Remedy Compendium

Here are some qualities attributed to a few of the more popular herbal remedies. Just so you know, none are baby- or kid-tested for safety:

• Echinacea: reported to boost the immune system, to help fight flu and colds. In some reports it improves symptoms, other studies have demonstrated immune suppression with prolonged use.

• St John’s Wort: An antidepressant that shares pharmacological properties with a class of medication known as Mono-Amine Oxidase Inhibitors (MAOIs).

This class of antidepressant is largely unused because it can interact with other medications to cause hypertensive crises.

• Ephedra: A stimulant used to treat asthma, colds, and weight loss. Pseudoephedrine is chemically quite close and is available in many over-the-counter medications (i.e., Sudafed).

Herbal Remedy Advice

There are a huge number of herbal remedies available to you for everything from asthma to warts.

Many plants and natural extracts do have certain beneficial properties, and may provide relief for some conditions.

In general, however, the following advice is offered:

• Herbs are not appropriate for pregnant or nursing mothers.

• Let your doctor know you are taking an herbal preparation.

• If a condition for which you are taking an herbal remedy gets worse, see your doctor.

• Do not take an herbal remedy obtained from any plant to which you are allergic.

Wheezing

Wheezing is a symptom of a variety of problems; in infants, it almost always indicates a viral pneumonia or bronchitis (the correct term is actually bronchitis, which signifies involvement of a lower portion of the bronchial tree). Rarely, it is a sign of heart failure in children with congenital cardiac anomalies.

Babies with a first bout of cough, fever, congestion, and wheezing should be evaluated by a doctor—there are a variety of treatments (liquid and aerosolized medication) and the question of allergy versus infection should be looked into. With repeated bouts of wheezing, the prospect of asthma needs to be considered. (The term “Reactive Airway Disease” has become virtually interchangeable with asthma. It essentially means the same thing, without the negative connotations people—and insurance companies—associate with the term “asthma.”)

The first time your baby wheezes, or on repeated episodes when the usual medications no longer seem to be effective, consult with your doctor. The signs that you should go to an ER are: turning blue and expending excessive effort to breathe as shown by retracting ribs, stomach and neck muscles straining with each breath, and inability to eat because of the extreme breathing effort.

Taking Medicine

Giving a baby medicine does not have to mean that you will make your baby cry. There are many medicine-taking techniques. I have seen babies who gulp down the pink stuff as well as those who need a full, four-point restraint, plus a head hold. This latter type can’t be fooled by the old meds-in-the-applesauce routine. To optimize the experience, try these tricks:

• Refrigerate or chill it in the freezer to cut the taste.

• Avoid medication that you know has a bad taste. Some are notoriously bad-tasting, and most have some viable alternative.

• Avoid cold-and-cough medicines that don’t really work anyway. Why ask for trouble?

• Combine meds (if okayed by your pharmacist) if more than one are needed.

• Ask for medication that can be given once or twice a day instead of three or four times.

Projectile Vomiting

A term that gets thrown about quite often is “projectile” vomiting. Parents generally use it to mean forceful vomiting; pediatricians generally use it in reference to pyloric stenosis (or other far rarer blockages of the upper intestinal tract).

Pyloric stenosis is a condition where the muscle sphincter separating the stomach from the small intestine becomes too tight and actually blockades the stomach. The stomach’s normal peristaltic contractions get hurled into reverse, and the last feeding can end up, literally, across the room.

Forceful vomiting ends up only a quarter way across the room, or halfway across the room for overachievers or those living in small apartments. This generally occurs with reflux and is a completely separate problem.

Pyloric stenosis requires surgery, and since it runs in families, often Mom or Dad has a small, midline horizontal surgical scar, just under the middle of the ribcage. For some reason, only the firstborn is affected, and subsequent children are spared. So contemplate (just above) your navel. If you have one of these scars and your firstborn is vomiting all the way across the room, start dialing your doctor now.

 Snot and Coughing

Colds are caused by viruses, and viruses produce congestion and irritation of the moist (mucous membrane) nose and throat lining. The resultant cough probably bothers you more than it does your baby. Ditto for congestion: It might drive you to tears to see a runny nose, especially when it goes on for days and days, but your smiling, happy baby figures it’s normal to have wet 11s on his upper lip.

 So how do you treat it?

Not with antibiotics. Antibiotics eradicate bacteria, and you (or your doctor) ought to be sure a bacterial infection is present before using them. Instead, offer symptomatic relief.

Drop salt water (saline) into his nose, then use a squeeze bulb to aspirate hard mucous away. A cold-air humidifier serves the same purpose as nose drops and moistens up the dried snot. That’s what causes problems: Petrified boogers clog your baby’s airway making it hard to breathe and eat at the same time. Moistening them up again makes your baby feel better.

Jaundice

Babies start turning yellow at about the second day of life. This is called jaundice; it is normal, and it lasts for about five to seven days.

A baby’s red blood cells have a short life span; when they break down, the liver metabolizes them so they can be recycled into new blood cells. Jaundice occurs because the liver isn’t fully geared up to handle the load for a week or more.

A baby can become too jaundiced for a variety of reasons (blood-type incompatibility between mother and baby, infection, et cetera). If the jaundice level is too high, your doctor will recommend treatment, usually a short course of phototherapy: putting the baby under a special light for a day or two.

How can you tell if she’s too jaundiced? Press (lightly) on the nose. It will be pale yellow for a moment or two until the blood returns—that’s the jaundice. Pressing on the palms leaves a pale white color. When the jaundice extends past the elbows or knees, if s time to get the baby checked.

Breast milk Jaundice

For some reason, breastfed babies stay jaundiced longer than formula-fed babies.

This has nothing to do with the baby’s liver being more or less mature, and it has nothing to do with the breakdown of red blood cells. It just is.

There’s nothing unhealthy about this, either. Breast milk jaundice rarely rises to the level where photo therapy needs to be considered (after the first few days), even though it can stick around for a week or so longer.

The only real downside is this: All your pictures of baby in the first two or three weeks of life are going to look funny.

Small price to pay. Keep on nursing your baby, this is not a reason to quit.